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Objective: The current study examined the mediating role of distress tolerance on the association between pain-related disability and addiction to opioids, past-month opioid use, and risky opioid use among an ethno-racially diverse sample of young adults with current pain. Methods: Participants were 141 undergraduate college students (78.7% female, M age = 22.50, SD = 5.41) who reported experiencing current pain. Results: Results indicated that distress tolerance statistically significantly explained the relationship between pain-related disability and addiction to opioids, past-month opioid use, and risky opioid use after controlling for the variance accounted for by pain intensity, negative affectivity, gender, and other substance misuses. Conclusions: Clinical implications are discussed in terms of targeting distress tolerance in the context of pain-related disability among young adults with pain who are at risk for opioid misuse.

Objective: This study assessed undergraduate unhealthy substance use, levels of knowledge about opioid pharmacology, unhealthy use and safety, and students' perceptions about their level of knowledge. Participants: Participants were undergraduate students at a large, private university in the Northeast. Methods: This study employed a cross-sectional study design using an online survey. A convenience sample of undergraduate students (N = 317) described their actual and perceived levels of opioid knowledge and their self-reported substance use. Results: Objective answers to quiz-style questions about opioids showed knowledge deficits. Participants rated themselves as slightly less knowledgeable than the "average student." Ten percent of students surveyed had used opioids unhealthily at some point in their lifetime. Those reporting unhealthy opioid use had higher subjective and objective opioid knowledge scores. Conclusions: University students' subjective and objective knowledge of opioids warrants more effective and engaging substance use education on college campuses.

Drug addiction and misuse have long plagued communities throughout the country, with drug overdose claiming more than 750,000 lives over the past two decades. As the crisis is multifaceted, it requires and beckons all sectors to respond, including the public, private, and nonprofit sectors. This creates unique data sharing challenges. In response to those challenges and recognizing the need for more accurate and timely data, the Washington Baltimore HIDTA created the Overdose Detection Mapping Application Program (ODMAP). This platform provides near real-time suspected overdose surveillance data across jurisdictions to support public health and safety response efforts. This article discusses the utility and functionality of ODMAP, and shares perspectives and practices established from the ODMAP stakeholder community, providing insight about effective information sharing and partnership, the use of ODMAP, and putting data into action.

The purpose of Science Education Against Drug Abuse Partnership (SEADAP) is to use the planarian animal model to develop an inquiry-based program to teach the science of drug addiction and pharmacology of drugs being abused. Upon completion of a SEADAP teacher professional development, study data reveals a favorable increase in teacher awareness of careers related to biomedical research, knowledge of the hazards of using addictive substances, knowledge about the science of drug addiction and skills related to the use of animals in scientific research. Additionally, SEADAP supported professional development (PD) for teachers is of high quality, relevant to their needs, and meets their expectations in providing important resources for teaching and learning. SEADAP teacher participants gain relevant knowledge about drug addiction and abuse to incorporate it into instruction about the scientific process. Teacher SEADAP participants administered a pretest to middle school students prior to SEADAP-related instruction and a posttest was administered to student participants after SEADAP-related instruction had concluded. Student mean posttests scores on knowledge about drugs, biomedical careers and animal model research significantly increased from pretest scores. This indicates that the implemented lessons of the SEADAP teachers impact students.

Introduction: Opioid use disorder (OUD) is a critical health issue in the USA. Pennsylvania has the third highest number of drug overdose deaths per year, with the COVID-19 pandemic worsening these trends. Stigmatising beliefs towards OUD are associated with negative health outcomes, and there is a need for a larger evidence base on OUD stigma reduction strategies. This study reports on the creation and implementation of "Life Unites Us," a digital media campaign which uses a collective impact framework to address OUD stigma reduction across Pennsylvania. Method: "Life Unites Us" consists of various components, including a general public media campaign which uses education and contact-based strategies; engagement with stakeholders and advocates in community-based organisations across the state; and a data sharing website to inform the public of previously unavailable OUD stigma statistics. Each campaign component contributes to the overall collective impact framework. Results: Digital metrics showed 755 followers across the "Life Unites Us" social media pages, and 2,826 total website users with an average of 565 users per month. The campaign has partnered with 60 community based organisations, 921 individuals receive the monthly email and 11 influencers have posted 23 times and achieved over 13,000 engagements and a reach of 661,000. The campaign hosted 5 webinars with 520 attendees and an overall 64.1% attendance rate. Conclusion: This study fills a gap in the need for evidence-based digital interventions to address OUD-related stigma. The positive process metrics from the first 6 months suggest that this model may be an important addition to research on approaches to reduce OUD stigma.

There is no "magic potion" or vaccine to prevent youth from using alcohol or other drugs. Adolescent substance abuse prevention programs have been largely ineffective because the messaging is taken for granted. Efforts based on theories of growth and development patterns, and are inclusive of strategies beyond the classroom and home, have demonstrated encouraging findings particularly when members of the community are involved. This paper will explore factors behind illicit substance use among youth in Staten Island, New York and how Wagner College is playing an important part of a collective impact initiative that is starting to make a difference.

This article offers a longitudinal computational-rhetorical analysis of biomedical writing on opioids. Using a corpus of 1,467 articles and essays published in the "New England Journal of Medicine" and the "Journal of the American Medical Association" between 1959 and May 2019, this study evaluates diachronic shifts in (a) the framing of opioid pharmacology, (b) the relative attention paid to pain management versus opioid dependence risks, and (c) the distribution of statements related to physicians' primary ethical obligations. The results of these analyses largely disconfirm different current accounts of shifting physician rhetoric around opioids and pain management leading up to the recognition opioid epidemic. Most notably, the results also suggest that biomedical debates surrounding opioids are serving as proxy arguments for shifting primary bioethical obligations from individual patients to public health.

The urgency of this study has become vivid in the light of the growing problem of prevalence and use of new synthetic drug types. Lately there has been a tendency of expanding the range of psychologically active substances (PAS) used by addicts with the purpose of their illegal taking. The aim of this research is an attempt of systematizing and classifying "design" drugs according to their chemical structure, neurochemical mechanisms of action and clinical manifestations. As a result, we have found that they can be divided into ten big groups. This classification will allow to better arrange new clinical phenomenology in modern addictology. This paper would be useful for psychiatrists, experts in narcology, as well as for personnel of institutions and agencies engaged in anti-drug activity.

Drug Outreach, Promoting Awareness (DOPA) is an undergraduate outreach program for local high school students designed to convey the neurobiological basis, risks, and addictive potential of commonly abused drugs. Here we describe DOPA and evaluate the program, including its impact on high school student attitudes about drug harm risk and addiction. Undergraduate neuroscience students versed in the neurobiology, physiology, and policy of drugs are trained in active learning methods, enabling them to create engaging and interactive classroom-based educational materials. Survey results showed that participation in DOPA increased high school student perceptions of the addictive potential and harm risk of drugs, which studies have shown to be inversely correlated with drug-taking. High school students also responded positively to the interactive nature of the program. These findings demonstrate how extensively trained undergraduates who are close peers to high school students can effectively lead science outreach initiatives and shift adolescent attitudes about drugs.

Approximately 70% of 67,367 drug overdose deaths involved opioids with rates 4 times higher than in 1999. The purpose of this systematic review is to assess the effectiveness of psychosocial interventions in opioid cessation. The search criteria for this review were: (a) published in English language between 2014 and 2019; (b) indexed in MEDLINE/PubMed, CINAHL, AltHealthWatch, and SCOPUS. Articles were selected based on predetermined criteria. 11 interventions with a combined total of 916 individual and 52 dyad participants met the eligibility criteria. The present evidence indicates that psychosocial interventions may lead to opioid cessation and improved quality of life. More large scale, rigorous randomized control trials using behavioral health theories are needed.

Illicit drug use is a persistent health problem among Nigerian youths. Social media platforms currently facilitate online illicit drug markets in the sub-Saharan Africa state. The current qualitative study investigates the influence of social media platforms on the sale and use of illicit drugs among undergraduates in selected tertiary institutions in Lagos State, Nigeria. Thirty undergraduate students completed semi-structured interviews sharing their experiences with purchasing illicit drugs through social media platforms. Researchers analysed data using thematic content analysis. Participants mean age was 26.33 years (SD=5.13). Findings show that online drug accessibility is technical but easy with links from friends. The process is organized with the aid of online commerce. The commonly used social media networks were Facebook, Twitter, Instagram, and WhatsApp, while delivery is done with motorcycles, bicycles, and walking across the street without law enforcement agents being able to track them. However, there exist the possibility of victimisation both from vendors and platform administrators, because of the illegality. How social media owners and youth stakeholders will control these channels to impede criminal activities remains a challenge.

The number of deaths caused by the use of heroin or prescription pain killers nationwide has increased annually over the past decade with some of the most rapid growth occurring in the nation's most rural areas. This qualitative study examines the responses of districts and superintendents to this growing health crisis in twelve rural school districts in western Pennsylvania, an area heavily affected by the recent opioid epidemic. I analyze how superintendents in these districts worked with their local school boards and communities to develop district programming to address local opioid misuse and addiction. I find that the capacity of superintendents to respond to the opioid crisis in their districts was at times limited by local perspectives of place and drug addiction, which justified limited support for district efforts to target this crisis. This research, however, also finds that the capacity of educational leaders to respond to this crisis expanded when community perspectives changed, typically after a community incident that stirred public support for responses to this crisis. However, despite these constraints or supports for leadership action, district responses to this crisis largely predicated on the ability of superintendents to successfully act on and within their unique zone of tolerance.

The PReventing Opioid Misuse In the SouthEast (PROMISE) Initiative team conducted a needs assessment to explore Mississippians' perceptions of the emerging issue of opioid misuse and to identify ways Extension professionals can assist in opioid misuse prevention. In this article, we describe the assessment process that included a series of community forums and a statewide electronic survey. Additionally, we explain how we used the assessment findings to define participants' involvement in opioid misuse prevention and to develop messages to be disseminated by Extension professionals. Information presented here may be of use to Extension personnel in other states interested in engaging in opioid misuse prevention.

Rehabilitation for persons who use drugs in the Philippines is premised on a multidisciplinary team approach to treatment, where delivery of services is collaboratively undertaken by physicians and rehabilitation practitioners. In 2013, a government-academe-civil society collaborative developed a customized training program for nurses, psychologists, social workers and other personnel involved in rehabilitation work. This 10-day accreditation course covered modules on understanding drug dependence, assessment, management of drug abuse and dependence, and drug rehabilitation work. Participants also had the opportunity to handle cases through a practicum. Between 2013 and 2016, eight training sessions were implemented for 252 rehabilitation practitioners from almost all of the Philippines' administrative regions. A paired-samples t-test showed that there was a significant difference in the pre-test (24.58 ± 4.08) and post-test scores (30.37 ± 4.66) of participants to the training, t(152) = 16.5949, p = <0.0001.

Opioid use in pregnancy and the postpartum period increases the vulnerability of the newborn in many ways. No single system can appropriately meet all the needs of this population. Due to the variety of systems that are involved, there are multiple opportunities for gaps in care. Thus, the systems of care must collaborate, communicate, and share information in an effective manner in order to provide optimal care. This article uses the metaphor of driving on a long journey with many twists and turns to illustrate the various aspects of opioid use in pregnancy, the challenges to intervention, and how to effectively support children and families in recovery.

We compared two strategies of prize-based contingency management (CM) in methadone-maintained outpatients. Urine was tested thrice weekly for 5 weeks pre-CM, 12 weeks CM, and 8 weeks post-CM. Participants were randomly assigned to a cocaine contingency (four prize draws for each cocaine-negative urine, N = 29) or an opiate-cocaine contingency (one draw for each urine negative for opiates or cocaine, four draws if negative for both, N = 38). There were no group differences in cocaine abstinence during CM or post-CM and no differences in opiate abstinence during CM. Opiate abstinence was greater in the opiate-cocaine group post-CM, and heroin craving was reduced in this group during and post-CM. Draws earned per cocaine-negative urine (four vs. one) did not affect cocaine use. (Contains 1 table and 3 figures.)

High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hours every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = 0.004; OR = 5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence. (Contains 4 tables and 5 figures.)

Introduction: There is scarcity of Indian data on substance dependence in children and adolescents. Methods: Case records of 85 adolescents with the final diagnosis of substance dependence were analyzed (out of 115 registrations during 1978-2003). Results: Time trends showed an increase in individuals with good social support and higher family income, a decrease in individuals with psychiatric comorbidity. Intravenous drug use was prominent during 1988-1997. Conclusions: Clinic attendance may reflect secular trends in the community. (Contains 1 table.)