Search

Background and Objectives: Recent work highlights an increase in the overlap of autism spectrum disorder (ASD) and substance use disorder (SUD). Little is known about the presence of ASD symptoms in SUD‐treatment‐seeking populations. Methods: The informant‐rated Social Responsiveness Scale‐2 (SRS‐2) was completed at intake to an outpatient SUD clinic for youth aged 16–26 (N = 69). Comparisons were made between those with elevated SRS‐2 scores on demographic, psychiatric, and substance use variables. Results: Parents of sixty‐nine patients with SUD completed the SRS‐2. Fourteen (20%) (average age 18.7 ± 2.5) had elevated SRS‐2 Total T‐scores (≥66) and 55 (average age 18.1 ± 2.8) had non‐clinical SRS‐2 Total T‐scores. There were few differences between groups; however, those with elevated SRS‐2 Total T‐scores were more likely to have a stimulant use disorder (odds ratio [OR] = 7.59, 95% confidence interval [CI] = 0.77, 101.88; p = 0.05) or an opioid use disorder (OR = 5.02, 95% CI = 0.59, 43.27; p = 0.08) than patients with normal SRS‐2 Total T‐scores as well as alcohol use in the week prior to intake. Discussion and Conclusions: A significant proportion of treatment‐seeking SUD outpatients suffer from clinically elevated autistic traits. These findings highlight the importance of assessing for autistic traits in SUD treatment settings yet additional research is needed to determine if these findings are specific to the presence of ASD or secondary to sequelae of specific SUD presentations. Scientific Significance: This study is, to our knowledge, the first to have examined the prevalence, morbidity, or clinical characteristics, associated with ASD symptoms in a SUD‐specific population. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to investigate the social context of nonmedical use of prescription stimulants (NMUPS) among college students who endorsed NMUPS with co-occurring substance use disorders (SUD) compared with those without co-occurring SUDs.Methods: Presented here are new analyses based on data previously collected from college students aged 18 to 28 years derived from the Boston metropolitan area who endorsed NMUPS (N = 100) at least once in their lifetime. Differences between those with lifetime history of SUD (N = 46) and without a history of SUD (N = 54) on the Massachusetts General Hospital ADHD Medication Misuse and Diversion Assessment were analyzed using the Student t test, the Pearson χ2 test, and the Wilcoxon rank-sum test.Results: College students who endorsed NMUPS with co-occurring SUD were more likely than those without SUD to have bought or traded stimulants, bought or traded in their car, used at parties with drugs/alcohol, or used intranasally (all P < .05). Intranasal administration was common (38% of all students endorsing NMUPS) and was associated with misuse at a party and simultaneous use with cocaine (P = .04), marijuana (P < .001), and alcohol (P < .001), compared with only oral use.Discussion and Conclusions: Notable characteristics were identified among individuals who engaged in NMUPS in the type, amount, cost, and ascertainment of stimulants.Scientific Significance: The concurrence of SUD and/or intranasal administration appear to represent a more severe phenotype of NMUPS that should be considered in the implementation of future prevention and intervention protocols on college campuses. (Am J Addict 2020;29:476-484). [ABSTRACT FROM AUTHOR]

Background and Objectives: To identify substance and psychiatric predictors of overdose (OD) in young people with substance use disorders (SUDs) who received treatment.Methods: We conducted a retrospective review of consecutive medical records of young people who were evaluated in a SUD program between 2012 and 2013 and received treatment. An independent group of patients from the same program who received treatment and had a fatal OD were also included in the sample. OD was defined as substance use associated with a significant impairment in level of consciousness without intention of self-harm, or an ingestion of a substance that was reported as a suicide attempt. t Tests, Pearson's χ2 , and Fisher's exact tests were performed to identify predictors of OD after receiving treatment.Results: After initial evaluation, 127 out of 200 patients followed up for treatment and were included in the sample. Ten (8%) of these patients had a nonfatal OD. Nine patients who received treatment and had a fatal OD were also identified. The sample's mean age was 20.2 ± 2.8 years. Compared with those without OD, those with OD were more likely to have a history of intravenous drug use (odds ratio [OR]: 36.5, P < .001) and mood disorder not otherwise specified (OR: 4.51, P = .01).Discussion and Conclusions: Intravenous drug use and mood dysregulation increased risk for OD in young people who received SUD treatment.Scientific Significance: It is important to identify clinically relevant risk factors for OD specific to young people in SUD treatment due to the risk for death associated with OD. (Am J Addict 2019;28:382-389). [ABSTRACT FROM AUTHOR]

Background and Objectives: Relatively little is known about the neuropsychological profiles of college students who misuse prescription stimulant medications.Methods: Data presented are from college students aged 18-28 years who misused prescription stimulants prescribed for attention-deficit/hyperactivity disorder and controls (no prescription stimulant misuse). Students were assessed neuropsychologically using the self-report Behavioral Rating Inventory of Executive Functioning (BRIEF-A), the Cambridge Automated Neuropsychological Test and Battery (CANTAB), and other tests of cognitive functioning. The analyses included 198 controls (age 20.7 ± 2.6 years) and 100 prescription stimulant misusers (age 20.7 ± 1.7 years).Results: On the BRIEF-A, misusers were more likely than controls to endorse greater dysfunction on 8 of 12 measures including Inhibition, Self Monitor, Initiation, Working Memory, and Plan/Organize, when adjusting for race and sex (all p's < .05). Similarly, when dichotomizing the BRIEF-A as abnormal (T score ≥ 65), misusers had more abnormalities on five of nine subscales, as well as all major indices (p's < .05). Misusers also performed worse on several subtests of the CANTAB and standardized cognitive battery (p's < .05). A proxy of prescription stimulant misuse frequency was positively correlated with greater executive dysfunction on the BRIEF-A.Discussion and Conclusions: These data demonstrate elevated risk for neuropsychological dysfunction among students who misuse prescription stimulants compared to non-misusing peers. The presence of ADHD contributed significantly to these cognitive findings. Students who misuse prescription stimulants should be screened for neuropsychological dysfunction.Scientific Significance: These data may better elucidate the neuropsychological profile of college-aged prescription stimulant misusers. (Am J Addict 2017;26:379-387). [ABSTRACT FROM AUTHOR]

Background and Objectives Adolescents with bipolar disorder (BPD) have been previously shown to be at very high risk for substance use disorders (SUD). We now examine the influence of a parental history of substance use disorders on SUD risk in offspring with and without BPD. Methods We studied 190 parents ascertained through 104 adolescent BPD probands and 189 parents ascertained through 98 control probands using structured interviews. We compared the prevalence of SUD using logistic regression. Results While adjusting for BPD in our combined sample, probands with a parental history of SUD were more likely to have an alcohol use disorder compared to probands without a parental history. Probands with a parental history of SUD were not more likely to have a drug use disorder or overall SUD compared to probands without a parental history. BPD in the offspring did not pose any additional risk between parental history of SUD and offspring SUD. Conclusion Alcohol use disorders were more common in the offspring of parents with a SUD history compared to parents without SUD and the risk was not influenced by offspring BPD. Scientific Significance Clarifying the mechanisms linking parental SUD to offspring SUD, particularly in children and adolescents with BPD, would help clinicians to educate and monitor high-risk families, which would facilitate strategies to mitigate risks associated with parental substance abuse. (Am J Addict 2014;23:440-446) [ABSTRACT FROM AUTHOR]

Background This study examined the impact of exposure to parental substance use disorders (SUD) (alcohol or drug abuse or dependence) on the development of SUD in offspring. Methods The original sample was derived from pediatric and psychiatric ascertained females 6-17 years old with ( N = 140) and without Attention Deficit Hyperactivity Disorder (ADHD; N = 122). At baseline, these groups had 143 and 131 biological siblings and 274 and 238 parents, respectively. All subjects and their family members were comprehensively and blindly assessed by structured psychiatric interviews for psychopathology and substance use. The female probands and their siblings were reassessed after a follow-up period of 5 years. Results At follow-up the mean age of offspring was 17.9 ± 4.20 years. Independently of ADHD, familial risk, and socioeconomic status, exposure to maternal drug use disorders, but not paternal drug use disorders, was significantly associated with the development of a drug use disorder in offspring (OR: 7.04; p = 0.03). There was a significant association between exposure to parental SUD during adolescence (relative to preschool or latency years) and SUD in offspring (OR: 3.61; p = 0.03). Conclusions Exposure to maternal drug use disorders during adolescent years increased the risk for the development of a drug use disorder in a sample of females with and without ADHD and their siblings. Exposure to parental SUD during adolescence specifically increases the risk of SUD development in offspring. (Am J Addict 2013;22:460-465) [ABSTRACT FROM AUTHOR]