113 results on '"Volkow, Nora D"'
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2. Cardiac and mortality outcome differences between methadone, buprenorphine and naltrexone prescriptions in patients with an opioid use disorder.
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Wang, Lindsey, Volkow, Nora D., Berger, Nathan A., Davis, Pamela B., Kaelber, David C., and Xu, Rong
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OPIOID abuse , *COHORT analysis , *SUDDEN death , *BUPRENORPHINE , *NALTREXONE , *METHADONE hydrochloride , *LONG QT syndrome - Abstract
Importance: More than 109,000 Americans died of drug overdose in 2022, with 81,231 overdose deaths involving opioids. Methadone, buprenorphine and naltrexone are the most widely used medications for opioid use disorders (MOUD) and the most effective intervention for preventing overdose deaths. However, there is a concern that methadone results in long QT syndrome, which increases the risk for fatal cardiac arrythmias. Currently few studies have systematically evaluated both the short‐term and long‐term differences in cardiac and mortality outcomes between MOUD. Objectives: To compare the risks of cardiac arrythmias, long QT syndrome and overall mortality between patients with opioid use disorders (OUD) who were prescribed methadone, buprenorphine or naltrexone. Design, Setting, and Participants: Retrospective cohort study based on a multicenter and nationwide database of electronic health records (EHRs) in the United States. The study population was comprised of 144,141 patients who had medical encounters for OUD in 2016‐2022, were prescribed MOUD within 1 month following a medical encounter for OUD diagnosis and had no diagnosis of cardiac arrythmias or long QT syndrome before any MOUD prescription. The study population was divided into three cohorts: (1) Methadone cohort (n = 40,938)—who were only prescribed methadone. (2) Buprenorphine cohort (n = 80,055)—who were only prescribed buprenorphine. (3) Naltrexone cohort (n = 5,738)—who were only prescribed naltrexone. Exposures: methadone, buprenorphine, or naltrexone. Main Outcomes and Measures: Cardiac arrythmias, long QT syndrome, and death. Hazard ratio (HR) and 95% confidence interval (CI) of outcomes at six different follow‐up time frames (1‐month, 3‐month, 6‐month, 1‐year, 3‐year, and 5‐year) by comparing propensity‐score matched cohorts using Kaplan‐Meier survival analysis. Results: Patients with OUD who were prescribed methadone had significantly higher risks of cardiac arrhythmias, long QT syndrome and death compared with propensity‐score matched patients with OUD who were prescribed buprenorphine or naltrexone. For the 1‐month follow‐up, the overall risk for cardiac arrythmias was 1.03% in the Methadone cohort, higher than the 0.87% in the matched Buprenorphine cohort (HR: 1.20, 95% CI: 1.04−1.39); The overall risk for long QT syndrome was 0.35% in the Methadone cohort, higher than the 0.15% in the matched Buprenorphine cohort (HR: 2.40, 95% CI: 1.75−3.28); The overall mortality was 0.59% in the Methadone cohort, higher than the 0.41% in the matched Buprenorphine cohort (HR: 1.48, 95% CI: 1.21−1.81). The increased risk persisted for 5 years: cardiac arrhythmias (HR: 1.31, 95% CI: 1.23−1.38), long QT syndrome (HR: 3.14, 95% CI: 2.76−3.58), death (HR: 1.50, 95% CI: 1.41−1.59). Conclusions and Relevance: Methadone was associated with a significantly higher risk for cardiac and mortality outcomes than buprenorphine and naltrexone. These findings are relevant to the development of guidelines for medication selection when initiating MOUD treatment and inform future medication development for OUD that minimizes risks while maximizing benefits. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Hippocampal volume loss in individuals with a history of non‐fatal opioid overdose.
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Todaro, Dustin R., Li, Xinyi, Pereira‐Rufino, Laís S., Manza, Peter, Nasrallah, Ilya M., Das, Sandhitsu, Childress, Anna Rose, Kranzler, Henry R., Volkow, Nora D., Langleben, Daniel D., Shi, Zhenhao, and Wiers, Corinde E.
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DRUG overdose ,OPIOID abuse ,HIPPOCAMPUS (Brain) ,OPIOIDS ,VOXEL-based morphometry ,APOLIPOPROTEIN E4 - Abstract
Incidence of opioid‐related overdoses in the United States has increased dramatically over the past two decades. Despite public emphasis on overdose fatalities, most overdose cases are not fatal. Although there are case reports of amnestic syndromes and acute injury to the hippocampus following non‐fatal opioid overdose, the effects of such overdoses on brain structure are poorly understood. Here, we investigated the neuroanatomical correlates of non‐fatal opioid overdoses by comparing hippocampal volume in opioid use disorder (OUD) patients who had experienced an opioid overdose (OD; N = 17) with those who had not (NOD; N = 32). Voxel‐based morphometry showed lower hippocampal volume in the OD group than in the NOD group, which on post hoc analysis was evident in the left but not the right hippocampus. These findings strengthen the evidence that hippocampal injury is associated with non‐fatal opioid overdose, which is hypothesized to underlie overdose‐related amnestic syndrome. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Disparities in sleep duration among American children: effects of race and ethnicity, income, age, and sex.
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Giddens, Natasha T., Juneau, Paul, Manza, Peter, Wiers, Corinde E., and Volkow, Nora D.
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RACE ,POOR families ,AMERICANS ,INCOME ,POOR children - Abstract
Children in the United States sleep less than the recommended amount and sleep deficiencies may be worse among disadvantaged children. Prior studies that compared sleep time in children of different race/ethnic groups mostly relied on questionnaires or were limited to small sample sizes. Our study takes advantage of the Adolescent Brain Cognitive Development study to compare total sleep time using a week of actigraphy data among American children (n = 4,207, 9 to 13 y old) of different racial/ethnic and income groups. We also assessed the effects of neighborhood deprivation, experience of discrimination, parent’s age at child’s birth, body mass index (BMI), and time the child fell asleep on sleep times. Daily total sleep time for the sample was 7.45 h and race/ ethnicity, income, sex, age, BMI, were all significant predictors of total sleep time. Black children slept less than White children (∼34 min; Cohen’s d = 0.95), children from lower income families slept less than those from higher incomes (∼16 min; Cohen’s d = 0.44), boys slept less than girls (∼7 min; Cohen’s d = 0.18), and older children slept less than younger ones (∼32 min; Cohen’s d = 0.91); mostly due to later sleep times. Children with higher BMI also had shorter sleep times. Neither area deprivation index, experience of discrimination, or parent’s age at child’s birth significantly contributed to sleep time. Our findings indicate that children in the United States sleep significantly less than the recommended amount for healthy development and identifies significant racial and income disparities. Interventions to improve sleep hygiene in children will help improve health and ameliorate racial disparities in health outcomes. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Prenatal caffeine exposure: association with neurodevelopmental outcomes in 9‐ to 11‐year‐old children.
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Zhang, Rui, Manza, Peter, and Volkow, Nora D.
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MATERNAL exposure ,MOTHERS ,SUBSTANCE abuse ,DRINKING (Physiology) ,PRENATAL exposure delayed effects ,NEURAL development ,CAFFEINE ,BODY mass index - Abstract
Background: Despite the widespread use of caffeine including consumption during pregnancy, the effect of prenatal caffeine exposure on child brain development and behavior is unclear. Methods: To address this, we used data from the Adolescent Brain and Cognitive Development Study (n = 11,875 children aged 9–11 years from 22 sites across the United States). We explored the associations between prenatal caffeine exposure and various developmental outcomes including birth outcomes, physical health, behavior problems, cognition, substance use and brain structure in children, and evaluated dose effects. Results: Among 9,978 children (4,745 females) who had valid data for prenatal caffeine exposure and whose mothers did not use drugs of abuse after knowing of pregnancy, 4,170 (41.79%) had no prenatal caffeine exposure, 2,292 (22.97%) had daily, 1,933 (19.37%) had weekly, and 1,583 (15.86%) had less than weekly exposures. Prenatal caffeine exposure including the widely recommended 'safe' dose was associated with greater externalizing problems, whereas greater BMI and soda consumption were only observed in children with high dose exposures (3+ per day). Notably, the effect size for association of externalizing problems with prenatal caffeine exposure was comparable with that reported for prenatal alcohol (The American Journal of Psychiatry, 177, 2020 and 1060) and prenatal cannabis (JAMA Psychiatry, 78, 2020 and 64) exposures from previous ABCD publications. Additionally, prenatal caffeine exposure was associated with brain structural changes that included greater posterior and lower frontal cortical thickness and altered parietooccipital sulcal depth. Conclusions: The recommended 'safe' dose of caffeine during pregnancy should be carefully studied to assess whether the behavioral and brain correlates observed here are clinically relevant and determine whether it needs adjustment. Because of the high prevalence of caffeine use in the general population, studies on prenatal exposure to drugs of abuse should include prenatal caffeine use as a covariate. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States.
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Volkow, Nora D., Compton, Wilson M., Blanco, Carlos, Einstein, Emily B., and Han, Beth
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RISK of violence , *SUBSTANCE abuse , *RISK assessment , *CRIME , *VIOLENCE , *SEX distribution , *LOGISTIC regression analysis , *DESCRIPTIVE statistics , *DISEASE prevalence , *STATISTICS , *CANNABIS (Genus) , *CONFIDENCE intervals , *DISEASE complications , *ADULTS - Abstract
Most violent crimes (52 %) are committed by adults aged 18–34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use disorder (CUD). We examined whether and how associations of cannabis use, use frequency, and CUD with violent behavior (i.e., attacking someone with the intent to harm seriously) vary by sex in U.S. young adults. Data were from 113,454 participants aged 18–34 in the 2015–2019 US National Surveys on Drug Use and Health, providing nationally representative data on cannabis use, CUD (using DSM-IV criteria), and violent behavior. Descriptive analyses and bivariate and multivariable logistic regression analyses were conducted. Among U.S. adults aged 18–34, 28.9 % (95 % CI = 28.5–29.2 %) reported past-year cannabis use (with/without CUD), including 20.5 % (95 % CI = 20.2–20.8 %) with non-daily cannabis without CUD, 4.7 % (95 % CI = 4.5–4.8 %) with daily cannabis use without CUD, 2.1 % (95 % CI = 1.9–2.2 %) with non-daily cannabis use and CUD, and 1.7 % (95 % CI = 1.5–1.8 %) with daily cannabis use and CUD. Past-year adjusted prevalence of violent behavior was higher among males with daily cannabis use but without CUD (2.9 %, 95 % CI = 2.4–2.7 %; adjusted prevalence ratio (PR) = 1.7, 95 % CI = 1.3–2.2) and males with daily cannabis use and CUD (3.1 %, 95 % CI = 2.3–4.0 %; adjusted PR = 1.8, 95 % CI = 1.3–2.4) than males without past-year cannabis use (1.7 %, 95 % CI = 1.6–1.9 %). Adjusted prevalence of violent behavior was higher among females with cannabis use regardless of daily cannabis use/CUD status (adjusted prevalence = 1.6–2.4 %, 95 % CIs = 0.9–3.2 %; adjusted PRs = 1.6–2.4, 95 % CI = 1.3–3.2) than females without past-year cannabis use (1.0 %, 95 % CI = 0.9–1.1 %). Research is needed to ascertain the directionality of the associations between cannabis use and violent behavior and underlying sex-specific mechanism(s). Our results point to complex sex-specific relationships between cannabis use frequency, CUD, and violent behavior and highlight the importance of early screening for and treatment of CUD and of preventive interventions addressing cannabis misuse. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Naloxone's dose-dependent displacement of [11C]carfentanil and duration of receptor occupancy in the rat brain.
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Kang, Yeona, O'Conor, Kelly A., Kelleher, Andrew C., Ramsey, Joseph, Bakhoda, Abolghasem, Eisenberg, Seth M., Zhao, Wenjing, Stodden, Tyler, Pearson, Torben D., Guo, Min, Brown, Nina, Liow, Jeih-San, Fowler, Joanna S., Kim, Sung Won, and Volkow, Nora D.
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NALOXONE ,POSITRON emission tomography ,OPIOID receptors ,RATS ,DRUG overdose - Abstract
The continuous rise in opioid overdoses in the United States is predominantly driven by very potent synthetic opioids, mostly fentanyl and its derivatives (fentanyls). Although naloxone (NLX) has been shown to effectively reverse overdoses by conventional opioids, there may be a need for higher or repeated doses of NLX to revert overdoses from highly potent fentanyls. Here, we used positron emission tomography (PET) to assess NLX's dose-dependence on both its rate of displacement of [
11 C]carfentanil ([11 C]CFN) binding and its duration of mu opioid receptor (MOR) occupancy in the male rat brain. We showed that clinically relevant doses of intravenously (IV) administered NLX (0.035 mg/kg, Human Equivalent Dose (HED) 0.4 mg; 0.17 mg/kg, HED 2 mg) rapidly displaced the specific binding of [11 C]CFN in the thalamus in a dose-dependent manner. Brain MOR occupancy by IV NLX was greater than 90% at 5 min after NLX administration for both doses, but at 27.3 min after 0.035 mg/kg dose and at 85 min after 0.17 mg/kg NLX, only 50% occupancy remained. This indicates that the duration of NLX occupancy at MORs is short-lived. Overall, these results show that clinically relevant doses of IV NLX can promptly displace fentanyls at brain MORs, but repeated or higher NLX doses may be required to prevent re-narcotization following overdoses with long-acting fentanyls. [ABSTRACT FROM AUTHOR]- Published
- 2022
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8. Personality traits in substance use disorders and obesity when compared to healthy controls.
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Ramirez, Veronica, Wiers, Corinde E., Wang, Gene‐Jack, and Volkow, Nora D.
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ANALYSIS of variance ,MULTIVARIATE analysis ,OBESITY ,PERSONALITY ,QUESTIONNAIRES ,SELF-management (Psychology) ,SMOKING ,SUBSTANCE abuse ,SECONDARY analysis ,DESCRIPTIVE statistics - Abstract
Background and Aims: Although personality traits are implicated in substance use disorders (SUDs) and obesity, differences and similarities between them have not been assessed. Our main aim was to compare personality traits between people with different SUDs, obese people and healthy controls. Design This was a secondary analysis of personality scores obtained from participants in neuroimaging studies from Brookhaven National Laboratory and the Laboratory of Neuroimaging, National Institutes of Health. Setting: United States. Participants/Cases: Individuals with obesity (OB) n = 41, alcohol use disorder (AUD) n = 39, marijuana use disorder (MUD) n = 24, cocaine use disorder (CUD) n = 100, and healthy controls (HC) n = 117 (237 males and 84 females). Measurements The Multidimensional Personality Questionnaire, which characterizes positive emotionality (PEM), negative emotionality (NEM) and constraint (CON) traits. Adjusted covariates included cigarette smoking status, age, gender and body mass index (BMI). Findings Multivariate analysis of covariance showed a main group effect (i.e. OB, AUD, MUD, CUD and HC) only on NEM (P < 0.0001, η2 = 0.17) and CON (P = 0.005, η2 = 0.12). Specifically, NEM was higher in AUD (P < 0.0001, d = 10.4), CUD (P < 0.0001, d = 8.2) and MUD (P = 0.001, d = 9.2), but not in OB (P > 0.05, d = 2.8) relative to HC. CUD showed lower CON (P = 0.015, d = 5.4) and PEM (P = 0.018, d = 4.8) than HC; however, these differences were not significant in the other groups. NEM and CON were negatively correlated for groups combined (r = −0.26, P < 0.0001), and separately for OB (r = −0.49, P = 0.001) and CUD (r = −0.22, P = 0.03). Cigarette smoking status did not influence group differences in NEM, PEM or CON. Conclusions: Compared with healthy controls, people with substance use disorders appear to show higher negative emotionality, and people with cocaine use disorders appear to show lower positive emotionality and constraint traits. Similar findings were not found among people with obesity. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Ethical Imperatives to Overcome Stigma Against People With Substance Use Disorders.
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Adams, Jerome M. and Volkow, Nora D.
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PUBLIC health , *SOCIAL stigma , *SUBSTANCE abuse , *SUBSTANCE abuse treatment , *HARM reduction - Abstract
Responding to the public health crisis in the United States resulting from untreated opioid use disorder (OUD) requires expanding delivery of effective treatments, including medications, and eliminating stigma against people with OUD and people seeking OUD treatment. Stigma discourages people with substance use disorders from seeking care and compromises the care they receive when they do seek it. Stigma against both medication treatments for OUD and harm-reduction approaches like syringe services programs has created additional barriers to these strategies' acceptance and use. It is ethically incumbent upon everyone in medicine and health care to recognize addiction not as a moral failing but as a treatable disease. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Reported Heroin Use, Use Disorder, and Injection Among Adults in the United States, 2002-2018.
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Han, Beth, Volkow, Nora D., Compton, Wilson M., and McCance-Katz, Elinore F.
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HEROIN abuse , *DRUG abuse , *PEOPLE with heroin addiction , *INTRAVENOUS drug abusers , *DRUG abusers , *SUBSTANCE abuse , *INTRAVENOUS drug abuse , *DISEASE prevalence - Abstract
This study uses National Surveys on Drug Use and Health data to characterize trends in heroin use, heroin use disorder, and heroin injection overall and by age, race, and geographic region. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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11. Molecular Imaging of Opioid and Dopamine Systems: Insights Into the Pharmacogenetics of Opioid Use Disorders.
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Burns, Jamie A., Kroll, Danielle S., Feldman, Dana E., Kure Liu, Christopher, Manza, Peter, Wiers, Corinde E., Volkow, Nora D., and Wang, Gene-Jack
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OPIOID abuse ,PHARMACOGENOMICS ,SUBSTANCE-induced disorders ,DOPAMINE ,OPIOIDS - Abstract
Opioid use in the United States has steadily risen since the 1990s, along with staggering increases in addiction and overdose fatalities. With this surge in prescription and illicit opioid abuse, it is paramount to understand the genetic risk factors and neuropsychological effects of opioid use disorder (OUD). Polymorphisms disrupting the opioid and dopamine systems have been associated with increased risk for developing substance use disorders. Molecular imaging studies have revealed how these polymorphisms impact the brain and contribute to cognitive and behavioral differences across individuals. Here, we review the current molecular imaging literature to assess how genetic variations in the opioid and dopamine systems affect function in the brain's reward, cognition, and stress pathways, potentially resulting in vulnerabilities to OUD. Continued research of the functional consequences of genetic variants and corresponding alterations in neural mechanisms will inform prevention and treatment of OUD. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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12. Management of opioid use disorder in the USA: present status and future directions.
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Blanco, Carlos and Volkow, Nora D
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SUBSTANCE-induced disorders , *MENTAL illness , *THERAPEUTICS , *DRUG utilization , *DISEASES , *THERAPEUTIC use of narcotics , *ANALGESICS , *DRUG withdrawal symptoms , *DRUG overdose , *FORECASTING , *MEDICAL care , *NARCOTICS , *SUBSTANCE abuse , *SUBSTANCE abuse treatment , *DISEASE prevalence , *EARLY diagnosis , *PATIENTS' attitudes - Abstract
Opioid use disorder is characterised by the persistent use of opioids despite the adverse consequences of its use. The disorder is associated with a range of mental and general medical comorbid disorders, and with increased mortality. Although genetics are important in opioid use disorder, younger age, male sex, and lower educational attainment level and income, increase the risk of opioid use disorder, as do certain psychiatric disorders (eg, other substance use disorders and mood disorders). The medications for opioid use disorder, which include methadone, buprenorphine, and extended-release naltrexone, significantly improve opioid use disorder outcomes. However, the effectiveness of medications for opioid use disorder is limited by problems at all levels of the care cascade, including diagnosis, entry into treatment, and retention in treatment. There is an urgent need for expanding the use of medications for opioid use disorder, including training of health-care professionals in the treatment and prevention of opioid use disorder, and for development of alternative medications and new models of care to expand capabilities for personalised interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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13. Self-reported Medical and Nonmedical Cannabis Use Among Pregnant Women in the United States.
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Volkow, Nora D., Han, Beth, Compton, Wilson M., and McCance-Katz, Elinore F.
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SUBSTANCE abuse , *PREGNANT women , *CANNABIS (Genus) , *MARIJUANA , *PREGNANCY complications , *DRUG utilization , *REGRESSION analysis , *SELF-evaluation , *SURVEYS , *MEDICAL marijuana , *THERAPEUTICS - Abstract
This study uses National Survey on Drug Use and Health data to examine prevalence and frequency of medical and nonmedical cannabis use among pregnant and nonpregnant women between 2013 and 2017. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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14. The role of the oral health community in addressing the opioid overdose epidemic.
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Somerman, Martha J. and Volkow, Nora D.
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SUBSTANCE abuse prevention , *THERAPEUTIC use of narcotics , *DENTISTS , *DRUGS , *DRUG overdose , *EPIDEMICS , *HOSPITAL emergency services , *DENTAL implants , *ORAL hygiene , *NARCOTICS , *PHYSICIANS , *RURAL population , *TOOTHACHE , *DECISION making in clinical medicine , *EVIDENCE-based dentistry , *COMMUNITY support , *OCCUPATIONAL roles - Abstract
The article presents information on the impact of oral health community on the incidents of opioid overdose epidemic, highlighting the prescribed opioids, and use of opioids in emergency departments (ED). Topics include the role of dentists in the opioid treatment, patients with the dental issue to be prescribed with opioids.
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- 2018
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15. Fast uptake and long-lasting binding of methamphetamine in the human brain: Comparison with cocaine
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Fowler, Joanna S., Volkow, Nora D., Logan, Jean, Alexoff, David, Telang, Frank, Wang, Gene-Jack, Wong, Christopher, Ma, Yeming, Kriplani, Aarti, Pradhan, Kith, Schlyer, David, Jayne, Millard, Hubbard, Barbara, Carter, Pauline, Warner, Donald, King, Payton, Shea, Colleen, Xu, Youwen, Muench, Lisa, and Apelskog, Karen
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METHAMPHETAMINE abuse , *NEUROTOXIC agents , *DOPAMINE , *PHARMACOKINETICS , *COCAINE , *DISEASE prevalence - Abstract
Abstract: Methamphetamine is one of the most addictive and neurotoxic drugs of abuse. It produces large elevations in extracellular dopamine in the striatum through vesicular release and inhibition of the dopamine transporter. In the U.S. abuse prevalence varies by ethnicity with very low abuse among African Americans relative to Caucasians, differentiating it from cocaine where abuse rates are similar for the two groups. Here we report the first comparison of methamphetamine and cocaine pharmacokinetics in brain between Caucasians and African Americans along with the measurement of dopamine transporter availability in striatum. Methamphetamine''s uptake in brain was fast (peak uptake at 9 min) with accumulation in cortical and subcortical brain regions and in white matter. Its clearance from brain was slow (except for white matter which did not clear over the 90 min) and there was no difference in pharmacokinetics between Caucasians and African Americans. In contrast cocaine''s brain uptake and clearance were both fast, distribution was predominantly in striatum and uptake was higher in African Americans. Among individuals, those with the highest striatal (but not cerebellar) methamphetamine accumulation also had the highest dopamine transporter availability suggesting a relationship between METH exposure and DAT availability. Methamphetamine''s fast brain uptake is consistent with its highly reinforcing effects, its slow clearance with its long-lasting behavioral effects and its widespread distribution with its neurotoxic effects that affect not only striatal but also cortical and white matter regions. The absence of significant differences between Caucasians and African Americans suggests that variables other than methamphetamine pharmacokinetics and bioavailability account for the lower abuse prevalence in African Americans. [Copyright &y& Elsevier]
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- 2008
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16. SCHOLASTIC ACTION Vol. 32 No. 8 JANUARY 12, 2009.
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Caroled, Christy Damio and Volkow, Nora D.
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SYNONYMS ,INAUGURATION of United States presidents ,DRUG abuse ,TEENAGERS - Abstract
The article presents a teacher's guide to issues and topics discussed in the January 12, 2009 issue of "Scholastic Action (Teacher's Edition)." Among the topics explored in the issue include synonyms, facts about the inauguration of U.S. President Barack Obama on January 20, 2009 as the country's 44th president and trends in drug use among teenagers from 1996 to 2007.
- Published
- 2009
17. SCHOLASTIC ACTION TEACHER'S EDITION Vol. 31 No. 5&6, NOVEMBER 12-26, 2007.
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Caroleo, Christy Damio and Volkow, Nora D.
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TEACHING ,ENGLISH teachers ,COMPOSITION (Language arts) ,HIGH school students ,SUFFIXES & prefixes (Grammar) - Abstract
This publication offers a guide to English teachers in the U.S. on teaching and reinforcing essential reading and writing skills for middle and high school students. It presents classroom lessons for teaching students about proper nouns, new vocabulary, vowel rules, the "u" sound, common suffixes and using vocabulary words in context.
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- 2007
18. SCHOLASTIC TEACHER EDITION.
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Volkow, Nora D. and McCabe, Suzanne
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LESSON planning ,TEACHING ,DRUG addiction ,DRUG abuse ,PETROLEUM reserves ,CULTURE - Abstract
The article presents lesson plans for addiction, oil reserves in the world and global connections. Give students time for discussion on their own perspectives of addiction and discuss with them the effects of drug abuse and the risk factors that lead to drug abuse and addiction. The students should recognize how and why the U.S. uses the largest share of world oil reserves. The culture of Great Britain has influenced the lives of people in Asia, Africa and the Caribbean.
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- 2006
19. Prescription Drug Abuse: Teens in Danger Teacher's Edition Vol. 62 No. 11, March 6, 2006.
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Volkow, Nora D.
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ACTIVITY programs in education ,DRUG abuse ,LESSON planning ,QUESTIONS & answers ,PHARMACEUTICAL research - Abstract
The article presents activities that teachers can use to educate students about prescription drug abuse. It offers lesson plans for student activities. It provides a quiz concerning prescription drug abuse. It highlights a study of drug abuse conducted by the U.S. National Institute on Drug Abuse.
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- 2006
20. The New York Times upfront, Vol. 138 No. 10, February 20, 2006.
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Broder, John M., Smith, Patricia, Roberts, Sam, Bilyeu, Suzanne, LaFraniere, Sharon, Barboza, David, Volkow, Nora D., Rebhun, Elliott, Bennet, James, Berger, Joseph, Erlanger, Steven, Hauser, Christine, Myre, Greg, O'Neil, John, Smith, Craig S., Lichtblau, Eric, Schwartz, John, Johnston, David, Lewis, Neil A., and Shane, Scott
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PERIODICALS ,TERRORISM ,PRESIDENTS of the United States ,ESPIONAGE ,SKI resorts - Abstract
Presents the February 20, 2006 issue of "The New York Times Upfront." Explanation that the constitutionality of U.S. President George W. Bush's expanded domestic spying after the September 11, 2001 terrorist attacks is the cover article for this issue; Information on the Ski Dubai, an artificial ski resort in Dubai, United Arab Emirates; Number of U.S. students who are learning Mandarin, a Chinese dialect; Funniest justices of the U.S. Supreme Court.
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- 2006
21. SCHOLASTIC ACTION TEACHER'S EDITION Volume 29 Number 7, December 12, 2005.
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Damio-Caroleo, Christy and Volkow, Nora D.
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CLASSROOM activities ,READING (Middle school) ,STUDENTS ,COMPOSITION (Language arts) ,VOCABULARY - Abstract
The article presents several classroom activities suggested for teaching and reinforcing essential reading and writing skills for middle and high school students in the U.S. In the column vocabulary in action, students will understand the relationship between words in the same word families. In the writing and grammar in action column, on the other hand, students will understand the purpose of point of view in writing.
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- 2005
22. SCHOLASTIC CHOICES Teacher's Edition, Vol. 21 No. 2 October 01, 2005.
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Hugel, Bob and Volkow, Nora D.
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ACTIVITY programs in education ,LIFE skills ,INTERPERSONAL relations ,TEENAGERS ,NUTRITION - Abstract
This journal presents curricular ideas for teaching family and consumer science, health and life skills. Teenagers who have a parent serving in Iraq for the U.S. military are profiled. The activity involving the evaluation of teenagers' diets will help students internalize the food pyramid created by the U.S. Department of Agriculture and understand how to choose more nutritious lunches. A research activity is presented which will aid students to build investigative skills and empathy for the homeless.
- Published
- 2005
23. Junior Scholastic TEACHER'S EDITION Volume 107 Number 18, April 11, 2005.
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McCabe, Suzanne and Volkow, Nora D.
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PERIODICALS ,NATIONAL parks & reserves ,CONSERVATION of natural resources ,SOCIAL security ,DRUG abuse - Abstract
Presents information on the topics discussed in the April 2005 teacher's edition of "Junior Scholastic." Efforts to save the Everglades National Park in Florida; Benefits of Social Security; Trends in drug use among teenagers in the U.S.
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- 2005
24. The New York Times upfront TEACHER'S EDITION Vol. 137 No. 11, March 7, 2005.
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Nebhun, Elliot and Volkow, Nora D.
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TEACHING ,JUDGES ,AIDS in women ,PERIODICALS - Abstract
Presents guides to teaching about various topics, including tenure of justices of the U.S. Supreme Court and the prevalence of AIDS in women, featured in the Vol. 137, No. 11, March 7, 2005 issue of the journal "The New York Times Upfront."
- Published
- 2005
25. Issues for DSM-V: Should Obesity Be Included as a Brain Disorder?
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Volkow, Nora D. and O'Brien, Charles P.
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OBESITY , *MENTAL illness , *MEDICAL care costs - Abstract
The article focuses on the suggestion that some forms of obesity are driven by an excessive motivational drive for food and should be included as a mental disorder in DSM-V. Obesity increases risk for other diseases resulting in annual health care costs estimated for the U.S. at $70 to $100 billion a year. According to the author, consideration of the mental component of obesity should be a key target in the treatment to facilitate compliance and minimize relapse.
- Published
- 2007
- Full Text
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26. Helping to End Addiction Over the Long-term: The Research Plan for the NIH HEAL Initiative.
- Author
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Collins, Francis S, Koroshetz, Walter J, and Volkow, Nora D
- Subjects
SUBSTANCE abuse prevention ,NEONATAL abstinence syndrome ,CHRONIC pain ,CLINICAL trials ,EXPERIMENTAL design ,HEALTH promotion ,MEDICAL research ,SUBSTANCE abuse ,THERAPEUTICS - Published
- 2018
- Full Text
- View/download PDF
27. Taking a science-informed approach to medical marijuana.
- Author
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Volkow, Nora D.
- Subjects
- *
PUBLIC health , *SAFETY , *SCIENCE , *ADOLESCENT health , *MEDICAL marijuana - Abstract
The author conveys her thoughts about the use of medical marijuana in the U.S. as of April 27, 2015. Topics mentioned include the effectiveness of tetrahydrocannabinol or THC at controlling nausea and boosting appetite, an increase in accidental ingestion of marijuana edibles by children in Colorado since 2009, and approval of medications dronabinol and nabilone by the U.S. Food and Drug Administration to treat nausea caused by chemotherapy.
- Published
- 2015
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- View/download PDF
28. Physician Education in Addiction Medicine.
- Author
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Wood, Evan, Samet, Jeffrey H., and Volkow, Nora D.
- Subjects
CONTINUING medical education ,EDUCATION of physicians ,ADDICTIONS ,SUBSTANCE-induced disorders ,DIAGNOSIS ,MEDICAL education ,THERAPEUTICS - Abstract
The authors offer insights on physician education in addiction medicine in the U.S. According to them, failure to diagnose and treat substance use disorders still emerge in the medical community partly due to the failure to educate physicians about addiction medicine. They argue that improvement in knowledge of the neurobiology underlying addictive behaviors has contributed to the development of substance use disorder medications.
- Published
- 2013
- Full Text
- View/download PDF
29. Expanded Access to Opioid Overdose Intervention: Research, Practice, and Policy Needs.
- Author
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Compton, Wilson M., Volkow, Nora D., Throckmorton, Douglas C., and Lurie, Peter
- Subjects
- *
DRUG overdose , *OPIOIDS , *MEDICATION abuse , *NALOXONE , *THERAPEUTICS , *PREVENTION - Abstract
The author reflects on prescription opioids overdoses which are causing deaths in the U.S. He states that naloxone can be used in place of opioid since it is safer and effective. An overview of the efforts of the Office of National Drug Control Policy for addressing the issue is offered. The author suggests that pharmacokinetic studies of intranasal and injectable naloxone must be conducted by U.S. Food and Drug Administration (FDA) and the National Institute on Drug Abuse (NIDA).
- Published
- 2013
- Full Text
- View/download PDF
30. Marijuana Use by Youth Can Have Long-Term Consequences.
- Author
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Volkow, Nora D.
- Subjects
MARIJUANA abuse ,MARIJUANA legalization ,DRUG legalization ,YOUTH ,CONTROLLED drugs - Abstract
The article focuses on an evidence-based research for police chiefs about marijuana use among teenagers in the U.S. It highlights the long-term impact of the public attitudes about marijuana shift as well as the move of several states to legalize marijuana for medicinal or recreational use on public safety and health. Information about marijuana's harmful effects on youth is presented.
- Published
- 2015
31. LETTER FROM THE NIDA.
- Author
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Volkow, Nora D.
- Subjects
DRUGS of abuse ,SYNTHETIC drugs ,AMPHETAMINES ,DRUG abuse ,HOSPITAL emergency services - Abstract
The article focuses on "bath salts," a drug of abuse in synthetic powder form which is being sold legally online and drug paraphernalia stores in the U.S. It says that the "bath salts" contain different amphetamine-like chemicals such as mephedrone, pyrovalerone, and methylenedioxypyrovalerone (MPDV). It also mentions the product is being administered by injection, inhalation, or orally. Moreover, the abuse of "bath salts" is being linked to the high number of emergency room (ER) visits in the country.
- Published
- 2012
32. Abuse of prescription drugs and the risk of addiction
- Author
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Compton, Wilson M. and Volkow, Nora D.
- Subjects
- *
MEDICATION abuse , *DRUG overdose , *CLINICAL medicine - Abstract
Abstract: Abuse of several categories of prescription drugs has increased markedly in the United States in the past decade and is now at alarming levels for certain agents, especially opioid analgesics and stimulants. Prescription drugs of abuse fit into the same pharmacological classes as their non-prescription counterparts. Thus, the potential factors associated with abuse or addiction versus safe therapeutic use of these agents relates to the expected variables: dose, route of administration, co-administration with other drugs, context of use, and expectations. Future scientific work on prescription drug abuse will include identification of clinical practices that minimize the risks of addiction, the development of guidelines for early detection and management of addiction, and the development of clinically effective agents that minimize the risks for abuse. With the high rates of prescription drug abuse among teenagers in the United States, a particularly urgent priority is the investigation of best practices for effective prevention and treatment for adolescents, as well as the development of strategies to reduce diversion and abuse of medications intended for medical use. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
- View/download PDF
33. A Note From NIDA's Director.
- Author
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Volkow, Nora D.
- Subjects
SUBSTANCE abuse treatment ,DRUG abusers ,DRUG abuse prevention ,DRUGS & crime ,PUBLIC safety - Abstract
The article presents the message from the Director of the U.S. National Institute on Drug Abuse (NIDA) regarding the development of treatments programs for drug abusers in the country as of 2009. She stresses that improving treatment for substance-abusing criminal offenders could be a key to raising the overall success in the country's drug abuse treatment system. She likewise announces the launch of NIDA's Criminal Justice: Drug Abuse Treatment Studies project in 2002.
- Published
- 2009
34. Prescription Drug Abuse: Teens in Danger.
- Author
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Volkow, Nora D.
- Subjects
MEDICATION abuse ,DRUG abuse ,DRUGS of abuse ,SUBSTANCE abuse ,TEACHING - Abstract
Introduces an article on science-based information about prescription drug abuse in the U.S. Threat of prescription drug abuse among young people; Instruction for teachers regarding the discussion of the article to students.
- Published
- 2006
35. Sex differences in weight gain during medication-based treatment for opioid use disorder: A meta-analysis and retrospective analysis of clinical trial data.
- Author
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Manza, Peter, Kroll, Danielle, McPherson, Katherine L., Johnson, Allison, Dennis, Evan, Hu, Lianne, Tai, Betty, and Volkow, Nora D.
- Subjects
- *
OPIOID abuse , *WEIGHT gain , *CLINICAL trials , *BODY mass index , *RETROSPECTIVE studies , *METHADONE treatment programs , *HUMAN reproduction , *RESEARCH , *SUBSTANCE abuse , *META-analysis , *BUPRENORPHINE , *RESEARCH methodology , *SYSTEMATIC reviews , *EVALUATION research , *COMPARATIVE studies , *RESEARCH funding , *OPIOID analgesics - Abstract
Background: Side effects of medications for opioid use disorder (MOUD) such as weight gain contribute to their stigma. Substantial evidence suggests that women have a more severe side effect profile to MOUD than men, and concerns about weight gain during treatment are prevalent. However, the few studies reporting sex differences in weight gain during treatment show conflicting results and are restricted to methadone. In addition, little is known about possible sex differences in weight gain to buprenorphine, which is the most commonly prescribed MOUD in the United States.Methods: To address these issues, we performed a systematic review and meta-analysis on the few studies reporting longitudinal data on sex differences in body mass index (BMI) gain during methadone treatment (Study 1). In a separate study, we also re-analyzed data from trial CTN-0030 of the National Institute on Drug Abuse Clinical Trial Network (NIDA CTN), which involved a 12-week buprenorphine treatment regimen (Study 2; n = 360; 209 Male, 151 Female).Results: For Study 1, across all papers reporting longitudinal data (k = 4, n = 362 OUD patients), there were BMI increases that ranged from 2.2 to 5.4 BMI after at least one year of methadone treatment, but there were no significant sex differences in BMI increases (Standardized Mean Difference, Female > Male = 0.352, SE =0.270; 95 % CI = [-0.18 0.88]; p = .193). Study 2 showed no significant differences in weight before and after 12 weeks of buprenorphine treatment nor did it show sex differences in weight change with treatment (β = 2.34, p = .511).Conclusion: These analyses corroborate evidence of weight gain with methadone treatment but did not observe a sex-based disparity in weight gain with methadone or buprenorphine treatment for OUD. [ABSTRACT FROM AUTHOR]- Published
- 2022
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- View/download PDF
36. Charting a course for health services research at the National Institute on Drug Abuse
- Author
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Compton, Wilson M., Stein, Jack B., Robertson, Elizabeth B., Pintello, Denise, Pringle, Beverly, and Volkow, Nora D.
- Subjects
- *
DRUG abuse treatment , *SUBSTANCE abuse , *SUBSTANCE abuse treatment , *HEALTH services administration , *SUBSTANCE abuse prevention , *EXPERIMENTAL design , *HEALTH planning , *MEDICAL care research - Abstract
Abstract: Through research, we continue to develop and refine an array of safe and efficacious interventions to prevent and treat drug abuse; however, these interventions have not led to widespread improvements in prevention and treatment services in nonresearch settings. In addition, investigator-initiated research rarely examine or refine interventions that practitioners have found relevant and that are widely practiced. To address these problems, the National Institute on Drug Abuse convened a blue ribbon task force to examine its health services research program. The report served as a catalyst for the institute to promote a vigorous program of research that seeks to examine prevention and treatment intervention delivery systems and policies that facilitate provision of effective care in a range of real world settings. Findings from this research should help address the translational bottleneck of bringing evidence-based interventions into the community. [Copyright &y& Elsevier]
- Published
- 2005
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- View/download PDF
37. Treatments for nicotine addiction should be a top priority.
- Author
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Pollock, Jonathan D., Koustova, Elena, Hoffman, Allison, Shurtleff, David, and Volkow, Nora D.
- Subjects
- *
NICOTINE addiction treatment , *SMOKING cessation , *CIGARETTE smokers , *PHYSIOLOGICAL effects of tobacco , *SMOKING , *LUNG cancer - Abstract
The authors emphasize that treatments for nicotine addiction should be considered a priority in the U.S. They described the prevalence of cigarette smoking in the country, along with the epidemiology of medical conditions associated with smoking. They argued that several smokers will try to quit smoking if effective and inexpensive treatment approaches are available. The authors added that despite efforts to search for lung cancer treatment, five-year survival rate only increased to 14 percent and mortality increased by only 2.5-fold.
- Published
- 2009
- Full Text
- View/download PDF
38. The HEALthy Brain and Child Development Study (HBCD): NIH collaboration to understand the impacts of prenatal and early life experiences on brain development.
- Author
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Volkow ND, Gordon JA, Bianchi DW, Chiang MF, Clayton JA, Klein WM, Koob GF, Koroshetz WJ, Pérez-Stable EJ, Simoni JM, Tromberg BJ, Woychik RP, Hommer R, Spotts EL, Xu B, Zehr JL, Cole KM, Dowling GJ, Freund MP, Howlett KD, Jordan CJ, Murray TM, Pariyadath V, Prabhakar J, Rankin ML, Sarampote CS, and Weiss SRB
- Subjects
- Humans, Female, United States, Pregnancy, Child, Longitudinal Studies, Child, Preschool, Prospective Studies, Adolescent, Infant, Child Development physiology, Brain growth & development, National Institutes of Health (U.S.), Prenatal Exposure Delayed Effects
- Abstract
The human brain undergoes rapid development during the first years of life. Beginning in utero, a wide array of biological, social, and environmental factors can have lasting impacts on brain structure and function. To understand how prenatal and early life experiences alter neurodevelopmental trajectories and shape health outcomes, several NIH Institutes, Centers, and Offices collaborated to support and launch the HEALthy Brain and Child Development (HBCD) Study. The HBCD Study is a multi-site prospective longitudinal cohort study, that will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. Influenced by the success of the ongoing Adolescent Brain Cognitive Development
SM Study (ABCD Study®) and in partnership with the NIH Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, the HBCD Study aims to establish a diverse cohort of over 7000 pregnant participants to understand how early life experiences, including prenatal exposure to addictive substances and adverse social environments as well as their interactions with an individual's genes, can affect neurodevelopmental trajectories and outcomes. Knowledge gained from the HBCD Study will help identify targets for early interventions and inform policies that promote resilience and mitigate the neurodevelopmental effects of adverse childhood experiences and environments., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Julia L. Zehr reports a relationship with Jazz Pharmaceuticals Inc that includes: equity or stocks. Co-author’s spouse is employed by Jazz Pharmaceuticals, Inc - JLZ If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024. Published by Elsevier Ltd.)- Published
- 2024
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- View/download PDF
39. Major Gaps in the Cascade of Care for Opioid Use Disorder: Implications for Clinical Practice.
- Author
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Arwady MA, Delphin-Rittmon M, and Volkow ND
- Subjects
- Humans, Buprenorphine therapeutic use, United States epidemiology, Young Adult, Adult, Middle Aged, Harm Reduction, Practice Patterns, Physicians', Drug Prescriptions, Narcotic Antagonists therapeutic use, Opiate Substitution Treatment, Opioid-Related Disorders epidemiology, Opioid-Related Disorders therapy, Professional Practice Gaps
- Published
- 2024
- Full Text
- View/download PDF
40. Association of semaglutide with reduced incidence and relapse of cannabis use disorder in real-world populations: a retrospective cohort study.
- Author
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Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, and Xu R
- Subjects
- Humans, Female, Retrospective Studies, Male, Middle Aged, Adult, Incidence, Hypoglycemic Agents therapeutic use, Aged, Glucagon-Like Peptide-1 Receptor agonists, United States epidemiology, Cohort Studies, Glucagon-Like Peptides therapeutic use, Glucagon-Like Peptides pharmacology, Diabetes Mellitus, Type 2 drug therapy, Marijuana Abuse epidemiology, Marijuana Abuse drug therapy, Recurrence
- Abstract
Cannabis is the most frequently used illicit drug in the United States with more than 45 million users of whom one-third suffer from a cannabis use disorder (CUD). Despite its high prevalence, there are currently no FDA-approved medications for CUD. Patients treated with semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA) approved for treating type 2 diabetes (T2D) and for weight management have reported reduced desire to drink and smoke. Preclinical studies have shown that semaglutide decreased nicotine and alcohol consumption. Preclinical and preliminary clinical evidence of semaglutide's potential beneficial effects on various substance use disorders led us to evaluate if it pertained to CUD. In this retrospective cohort study of electronic health records (EHRs) from the TriNetX Analytics Network, a global federated health research network of approximately 105.3 million patients from 61 large healthcare organizations in the US, we aimed to assess the associations of semaglutide with both incident and recurrent CUD diagnosis compared to non-GLP-1RA anti-obesity or anti-diabetes medications. Hazard ratio (HR) and 95% confidence intervals (CI) of incident and recurrent CUD were calculated for 12-month follow-up by comparing propensity-score matched patient cohorts. The study population included 85,223 patients with obesity who were prescribed semaglutide or non-GLP-1RA anti-obesity medications, with the findings replicated in 596,045 patients with T2D. In patients with obesity (mean age 51.3 years, 65.6% women), semaglutide compared with non-GLP-1RA anti-obesity medications was associated with lower risk for incident CUD in patients with no prior history CUD (HR: 0.56, 95% CI: 0.42-0.75), and recurrent CUD diagnosis in patients with a prior history CUD (HR: 0.62, 95% CI: 0.46-0.84). Consistent reductions were seen for patients stratified by gender, age group, race and in patients with and without T2D. Similar findings were replicated in the study population with T2D when comparing semaglutide with non-GLP-1RA anti-diabetes medications for incident CUD (HR: 0.40, 95% CI: 0.29-0.56) and recurrent CUD (HR: 0.66, 95% CI: 0.42-1.03). While these findings provide preliminary evidence of the potential benefit of semaglutide in CUD in real-world populations, further preclinical studies are warranted to understand the underlying mechanism and randomized clinical trials are needed to support its use clinically for CUD., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
41. Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes : Target Trial Emulation Using Real-World Data.
- Author
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Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, and Xu R
- Subjects
- Humans, Female, Male, Middle Aged, Aged, United States epidemiology, Smoking Cessation, Obesity complications, Obesity drug therapy, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 complications, Glucagon-Like Peptides therapeutic use, Glucagon-Like Peptides adverse effects, Hypoglycemic Agents therapeutic use, Tobacco Use Disorder drug therapy, Tobacco Use Disorder complications
- Abstract
Background: Reports of reduced desire to smoke in patients treated with semaglutide, a glucagon-like peptide receptor agonist (GLP-1RA) medication for type 2 diabetes mellitus (T2DM) and obesity, have raised interest about its potential benefit for tobacco use disorders (TUDs)., Objective: To examine the association of semaglutide with TUD-related health care measures in patients with comorbid T2DM and TUD., Design: Emulation target trial based on a nationwide population-based database of patient electronic health records., Setting: United States, 1 December 2017 to 31 March 2023., Participants: Seven target trials were emulated among eligible patients with comorbid T2DM and TUD by comparing the new use of semaglutide versus 7 other antidiabetes medications (insulins, metformin, dipeptidyl-peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, sulfonylureas, thiazolidinediones, and other GLP-1RAs)., Measurements: The TUD-related health care measures (medical encounter for diagnosis of TUD, smoking cessation medication prescriptions, and smoking cessation counseling) that occurred within a 12-month follow-up were examined using Cox proportional hazards and Kaplan-Meier survival analyses., Results: The study compared 222 942 new users of antidiabetes medications including 5967 of semaglutide. Semaglutide was associated with a significantly lower risk for medical encounters for TUD diagnosis compared with other antidiabetes medications, and was strongest compared with insulins (hazard ratio [HR], 0.68 [95% CI, 0.63 to 0.74]) and weakest but statistically significant compared with other GLP-1RAs (HR, 0.88 [CI, 0.81 to 0.96]). Semaglutide was associated with reduced smoking cessation medication prescriptions and counseling. Similar findings were observed in patients with and without a diagnosis of obesity. For most of the group comparisons, the differences occurred within 30 days of prescription initiation., Limitation: Documentation bias, residual confounding, missing data on current smoking behavior, body mass index, and medication adherence., Conclusion: Semaglutide was associated with lower risks for TUD-related health care measures in patients with comorbid T2DM and TUD compared with other antidiabetes medications including other GLP-1Ras, primarily within 30 days of prescription. These findings suggest the need for clinical trials to evaluate semaglutide's potential for TUD treatment., Primary Funding Source: National Institutes of Health., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-2718.
- Published
- 2024
- Full Text
- View/download PDF
42. Estimated Number of Children Who Lost a Parent to Drug Overdose in the US From 2011 to 2021.
- Author
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Jones CM, Zhang K, Han B, Guy GP, Losby J, Einstein EB, Delphin-Rittmon M, Volkow ND, and Compton WM
- Subjects
- Adolescent, Adult, Child, Female, Humans, Male, Middle Aged, Young Adult, Cross-Sectional Studies, Ethnicity, Parents, United States epidemiology, Racial Groups, Drug Overdose ethnology, Drug Overdose mortality
- Abstract
Importance: Parents' overdose death can have a profound short- and long-term impact on their children, yet little is known about the number of children who have lost a parent to drug overdose in the US., Objective: To estimate the number and rate of children who have lost a parent to drug overdose from 2011 to 2021 overall and by parental age, sex, and race and ethnicity., Design, Setting, and Participants: This was a cross-sectional study of US community-dwelling persons using data from the National Survey on Drug Use and Health (2010-2014 and 2015-2019) and the National Vital Statistics System (2011-2021). Data were analyzed from January to June 2023., Exposure: Parental drug overdose death, stratified by age group, sex, and race and ethnicity., Main Outcomes and Measures: Numbers, rates, and average annual percentage change (AAPC) in rates of children losing a parent aged 18 to 64 years to drug overdose, overall and by age, sex, and race and ethnicity., Results: From 2011 to 2021, 649 599 adults aged 18 to 64 years died from a drug overdose (mean [SD] age, 41.7 [12.0] years; 430 050 [66.2%] male and 219 549 [33.8%] female; 62 606 [9.6%] Hispanic, 6899 [1.1%] non-Hispanic American Indian or Alaska Native, 6133 [0.9%] non-Hispanic Asian or Pacific Islander, 82 313 [12.7%] non-Hispanic Black, 485 623 [74.8%] non-Hispanic White, and 6025 [0.9%] non-Hispanic with more than 1 race). Among these decedents, from 2011 to 2021, an estimated 321 566 (95% CI, 276 592-366 662) community-dwelling children lost a parent aged 18 to 64 years to drug overdose. The rate of community-dwelling children who lost a parent to drug overdose per 100 000 children increased from 27.0 per 100 000 in 2011 to 63.1 per 100 000 in 2021. The highest rates were found among children of non-Hispanic American Indian or Alaska Native individuals, who had a rate of 187.1 per 100 000 in 2021, more than double the rate among children of non-Hispanic White individuals (76.5 per 100 000) and non-Hispanic Black individuals (73.2 per 100 000). While rates increased consistently each year for all parental age, sex, and race and ethnicity groups, non-Hispanic Black parents aged 18 to 25 years had the largest AAPC (23.8%; 95% CI, 16.5-31.6). Rates increased for both fathers and mothers; however, more children overall lost fathers (estimated 192 459; 95% CI, 164 081-220 838) than mothers (estimated 129 107; 95% CI, 112 510-145 824)., Conclusions and Relevance: An estimated 321 566 children lost a parent to drug overdose in the US from 2011 to 2021, with significant disparities evident across racial and ethnic groups. Given the potential short- and long-term negative impact of parental loss, program and policy planning should ensure that responses to the overdose crisis account for the full burden of drug overdose on families and children, including addressing the economic, social, educational, and health care needs of children who have lost parents to overdose.
- Published
- 2024
- Full Text
- View/download PDF
43. Childhood obesity's effect on cognition and brain connectivity worsens with low family income.
- Author
-
Tomasi D and Volkow ND
- Subjects
- Humans, Male, Female, Adolescent, Child, Magnetic Resonance Imaging, United States epidemiology, Pediatric Obesity physiopathology, Cognition physiology, Body Mass Index, Poverty, Brain diagnostic imaging
- Abstract
Childhood obesity and its adverse health consequences have risen worldwide, with low socioeconomic status increasing the risk in high-income countries like the United States. Understanding the interplay between childhood obesity, cognition, socioeconomic factors, and the brain is crucial for prevention and treatment. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we investigated how body mass index (BMI) relates to brain structural and functional connectivity metrics. Children with obesity or who are overweight (n = 2,356) were more likely to live in poverty and exhibited lower cognitive performance compared with children with a healthy weight (n = 4,754). Higher BMI was associated with multiple brain measures that were strongest for lower longitudinal diffusivity in corpus callosum; increased activity in cerebellum, insula, and somatomotor cortex; and decreased functional connectivity in multimodal brain areas, with effects more pronounced among children from low-income families. Notably, nearly 80% of the association of low income and 70% of the association of impaired cognition on BMI were mediated by higher brain activity in somatomotor areas. Increased resting activity in somatomotor areas and decreased structural and functional connectivity likely contribute to the higher risk of being overweight or having obesity among children from low-income families. Supporting low-income families and implementing educational interventions to improve cognition may promote healthy brain function and reduce the risk of obesity.
- Published
- 2024
- Full Text
- View/download PDF
44. Treatment for Opioid Use Disorder: Population Estimates - United States, 2022.
- Author
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Dowell D, Brown S, Gyawali S, Hoenig J, Ko J, Mikosz C, Ussery E, Baldwin G, Jones CM, Olsen Y, Tomoyasu N, Han B, Compton WM, and Volkow ND
- Subjects
- Humans, United States epidemiology, Adult, Middle Aged, Male, Female, Young Adult, Adolescent, Buprenorphine therapeutic use, Aged, Opiate Substitution Treatment statistics & numerical data, Methadone therapeutic use, Opioid-Related Disorders epidemiology, Opioid-Related Disorders drug therapy
- Abstract
In 2022, 81,806 opioid-involved overdose deaths were reported in the United States, more than in any previous year. Medications for opioid use disorder (OUD), particularly buprenorphine and methadone, substantially reduce overdose-related and overall mortality. However, only a small proportion of persons with OUD receive these medications. Data from the 2022 National Survey on Drug Use and Health were applied to a cascade of care framework to estimate and characterize U.S. adult populations who need OUD treatment, receive any OUD treatment, and receive medications for OUD. In 2022, 3.7% of U.S. adults aged ≥18 years needed OUD treatment. Among these, only 25.1% received medications for OUD. Most adults who needed OUD treatment either did not perceive that they needed it (42.7%) or received OUD treatment without medications for OUD (30.0%). Compared with non-Hispanic Black or African American and Hispanic or Latino adults, higher percentages of non-Hispanic White adults received any OUD treatment. Higher percentages of men and adults aged 35-49 years received medications for OUD than did women and younger or older adults. Expanded communication about the effectiveness of medications for OUD is needed. Increased efforts to engage persons with OUD in treatment that includes medications are essential. Clinicians and other treatment providers should offer or arrange evidence-based treatment, including medications, for patients with OUD. Pharmacists and payors can work to make these medications available without delays., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Wilson M. Compton reports ownership of stock in General Electric Company (sold September 2022), 3M companies, and Pfizer, Inc. Yngvild Olsen reports providing medical care to patients with opioid use disorder as an approved, part-time (4 hours per week) external activity to her work at the Substance Abuse and Mental Health Services Administration. No other potential conflicts of interest were reported.
- Published
- 2024
- Full Text
- View/download PDF
45. Drugs and Addiction Science: NIDA Celebrates 50 Years of Research and Looks to the Future.
- Author
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Volkow ND
- Subjects
- Humans, United States, History, 20th Century, History, 21st Century, Biomedical Research history, Behavior, Addictive history, Substance-Related Disorders history, National Institute on Drug Abuse (U.S.) history
- Published
- 2024
- Full Text
- View/download PDF
46. Overdose mortality rates for opioids and stimulant drugs are substantially higher in men than in women: state-level analysis.
- Author
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Butelman ER, Huang Y, Epstein DH, Shaham Y, Goldstein RZ, Volkow ND, and Alia-Klein N
- Subjects
- Humans, Female, Male, United States epidemiology, Adolescent, Young Adult, Adult, Middle Aged, Aged, Analgesics, Opioid, Heroin, Drug Overdose, Central Nervous System Stimulants, Cocaine
- Abstract
Drug overdoses from opioids and stimulants are a major cause of mortality in the United States. It is unclear if there are stable sex differences in overdose mortality for these drugs across states, whether these differ across the lifespan, and if so, whether they can be accounted for by different levels of drug misuse. This was a state-level analysis of epidemiological data on overdose mortality, across 10-year age bins (age range: 15-74), using the CDC WONDER platform for decedents in the United States in 2020-1. The outcome measure was rate of overdose death (per 100,000) for: synthetic opioids (e.g., fentanyl), heroin, psychostimulants with potential for misuse (e.g., methamphetamine), and cocaine. Multiple linear regressions controlled for ethnic-cultural background, household net worth, and sex-specific rate of misuse (from NSDUH, 2018-9). For all these drug categories, males had greater overall overdose mortality than females, after controlling for rates of drug misuse. The mean male/female sex ratio of mortality rate was relatively stable across jurisdictions: synthetic opioids (2.5 [95% CI, 2.4-7]), heroin, (2.9 [95% CI, 2.7-3.1], psychostimulants (2.4 [95% CI, 2.3-5]), and cocaine (2.8 [95% CI, 2.6-9]). With data stratified in 10-year age bins, the sex difference generally survived adjustment (especially in the 25-64 age range). Results indicate that males are significantly more vulnerable than females to overdose deaths caused by opioid and stimulant drugs, taking into account differing state-level environmental conditions and drug misuse levels. These results call for research into diverse biological, behavioral, and social factors that underlie sex differences in human vulnerability to drug overdose., (© 2023. The Author(s), under exclusive licence to American College of Neuropsychopharmacology.)
- Published
- 2023
- Full Text
- View/download PDF
47. Comparison of mRNA-1273 and BNT162b2 Vaccines on Breakthrough SARS-CoV-2 Infections, Hospitalizations, and Death During the Delta-Predominant Period.
- Author
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Wang L, Davis PB, Kaelber DC, Volkow ND, and Xu R
- Subjects
- Adult, Aged, COVID-19 mortality, COVID-19 prevention & control, COVID-19 virology, COVID-19 Vaccines, Female, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Survival Analysis, United States epidemiology, 2019-nCoV Vaccine mRNA-1273, BNT162 Vaccine, COVID-19 epidemiology, SARS-CoV-2
- Published
- 2022
- Full Text
- View/download PDF
48. Intentional Drug Overdose Deaths in the United States.
- Author
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Han B, Compton WM, Einstein EB, Cotto J, Hobin JA, Stein JB, and Volkow ND
- Subjects
- Humans, United States epidemiology, Drug Overdose, Self-Injurious Behavior, Suicide
- Published
- 2022
- Full Text
- View/download PDF
49. How Academic Medicine Can Help Confront the Opioid Crisis.
- Author
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Volkow ND, McLellan T, and Blanco C
- Subjects
- United States, Drug Overdose prevention & control, Internship and Residency organization & administration, Medicine organization & administration, Opioid Epidemic prevention & control, Opioid-Related Disorders prevention & control
- Abstract
The United States is in the midst of a devastating overdose and addiction crisis involving opioids as well as other drugs. Yet, despite the existence of effective treatments for opioid use disorder, only a minority of people who need treatment for this or other substance use disorders receive it. Besides the terrible human and economic costs of overdose deaths and the other health consequences of addiction, untreated substance use has wide-ranging impacts across health care. Academic medicine can help address this crisis by increasing the preparedness of the current and future clinical workforce to detect and treat substance misuse and addiction through increased attention to these topics in medical and nursing schools and in residency programs. In this commentary, the authors explore the barriers to treatment for substance misuse and addiction and the role of academic medicine in improving treatment outcomes through training, clinical care, health service delivery, and research.
- Published
- 2022
- Full Text
- View/download PDF
50. Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults.
- Author
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Han B, Compton WM, Jones CM, Einstein EB, and Volkow ND
- Subjects
- Adolescent, Adult, Amphetamine-Related Disorders mortality, Comorbidity, Cross-Sectional Studies, Drug Overdose mortality, Female, Health Surveys, Humans, Male, Middle Aged, Risk Factors, Substance Abuse, Intravenous mortality, United States epidemiology, Young Adult, Amphetamine-Related Disorders epidemiology, Cause of Death, Central Nervous System Stimulants administration & dosage, Drug Overdose epidemiology, Methamphetamine administration & dosage, Socioeconomic Factors, Substance Abuse, Intravenous epidemiology
- Abstract
Importance: Mortality associated with methamphetamine use has increased markedly in the US. Understanding patterns of methamphetamine use may help inform related prevention and treatment., Objective: To assess the national trends in and correlates of past-year methamphetamine use, methamphetamine use disorder (MUD), injection, frequent use, and associated overdose mortality from 2015 to 2019., Design, Setting, and Participants: This cross-sectional study analyzed methamphetamine use, MUD, injection, and frequent use data from participants in the 2015 to 2019 National Surveys on Drug Use and Health (NSDUH). Mortality data were obtained from the 2015 to 2019 National Vital Statistics System Multiple Cause of Death files., Exposures: Methamphetamine use., Main Outcomes and Measures: Methamphetamine use, MUD, injection, frequent use, and overdose deaths., Results: Of 195 711 NSDUH respondents aged 18 to 64 years, 104 408 were women (weighted percentage, 50.9%), 35 686 were Hispanic individuals (weighted percentage, 18.0%), 25 389 were non-Hispanic Black (hereafter, Black) individuals (weighted percentage, 12.6%), and 114 248 were non-Hispanic White (hereafter, White) individuals (weighted percentage, 60.6%). From 2015 to 2019, overdose deaths involving psychostimulants other than cocaine (largely methamphetamine) increased 180% (from 5526 to 15 489; P for trend <.001); methamphetamine use increased 43% (from 1.4 million [95% CI, 1.2-1.6 million] to 2.0 million [95% CI, 1.7-2.3 million]; P for trend = .002); frequent methamphetamine use increased 66% (from 615 000 [95% CI, 512 000-717 000] to 1 021 000 [95% CI, 860 000-1 183 000]; P for trend = .002); methamphetamine and cocaine use increased 60% (from 402 000 [95% CI, 306 000-499 000] to 645 000 [95% CI, 477 000-813 000]; P for trend = .001); and MUD without injection increased 105% (from 397 000 [95% CI, 299 000-496 000] to 815 000 [95% CI, 598 000-1 033 000]; P for trend = .006). The prevalence of MUD or injection surpassed the prevalence of methamphetamine use without MUD or injection in each year from 2017 to 2019 (60% to 67% vs 37% to 40%; P for trend ≤.001). Adults with MUD or using injection were more likely to use methamphetamine frequently (52.68%-53.84% vs 32.59%; adjusted risk ratio, 1.62-1.65; 95% CI, 1.35-1.94). From 2015 to 2019, the adjusted prevalence of MUD without injection more than tripled among heterosexual women (from 0.24% to 0.74%; P < .001) and lesbian or bisexual women (from 0.21% to 0.71%; P < .001) and more than doubled among heterosexual men (from 0.29% to 0.79%; P < .001) and homosexual or bisexual men (from 0.29% to 0.80%; P = .007). It increased over 10-fold among Black individuals (from 0.06% to 0.64%; P < .001), nearly tripled among White individuals (from 0.28% to 0.78%; P < .001), and more than doubled among Hispanic individuals (from 0.39% to 0.82%; P < .001). Risk factors for methamphetamine use, MUD, injection, and frequent use included lower educational attainment, lower annual household income, lack of insurance, housing instability, criminal justice involvement, comorbidities (eg, HIV/AIDS, hepatitis B or C virus, depression), suicidal ideation, and polysubstance use., Conclusions and Relevance: This cross-sectional study found consistent upward trends in overdose mortality, greater risk patterns of methamphetamine use, and populations at higher risk for MUD diversifying rapidly, particularly those with socioeconomic risk factors and comorbidities. Evidence-based prevention and treatment interventions are needed to address surges in methamphetamine use and MUD.
- Published
- 2021
- Full Text
- View/download PDF
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