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Patients in opioid use disorder (OUD) treatment report high rates of childhood adversity, and women experience greater exposure to certain types of childhood adversity (e.g. , sexual abuse). Childhood adversity is associated with clinical severity, but the mechanisms explaining this association are not well understood. Participants (N = 171) in opioid agonist treatment completed measures of childhood adversity, emotion regulation, and clinical severity (i.e. , addictive behaviors, depression, and anxiety). Women endorsed greater childhood adversity and higher current psychopathology than men. The association between childhood adversity and clinical severity varied as a function of symptom type, although emotion regulation was a strong predictor in all models. Women reported higher levels of anxiety after controlling for covariates, childhood adversity, and emotion dysregulation. Future research should investigate treatment strategies to address emotion dysregulation among patients in OUD treatment, particularly women who may present with greater childhood adversity exposure and anxiety. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is associated with risk for committing future violence, but the relationship between subgroups and biological sex is unknown. The relationship between adverse childhood experiences (ACEs), violence, and sex was examined using a nationally representative sample. Results from a latent class analysis suggested a four-class model (low adversity; moderate maltreatment with high household dysfunction; severe maltreatment with moderate household dysfunction; severe multi-type adversities). When compared to low adversity, all typology groups were at significantly higher risk to engage in violence (odds ratio > 2.10, p s <.013). The data supported a linear trajectory, meaning increased childhood trauma was associated with increased risk for violence. Although men endorsed more violent behavior, the relationship between ACEs and violence was significantly stronger among women. Prior findings identify that women are more negatively impacted by ACEs and the current findings newly identify that this extends to violent crime. [ABSTRACT FROM AUTHOR]

Behavioral economic approaches to measuring cannabis demand represent a well-validated, low-cost method of assessing risk for hazardous cannabis use. One widely used measure of cannabis demand is the Marijuana Purchase Task (MPT), which has shown good psychometric properties across multiple samples. However, preliminary data suggest that changes could improve task ecological validity and acceptability. Using a predominantly White convenience sample, this study aimed to develop a revised MPT that uses a modern dispensary scenario to better reflect national trends in cannabis use (e.g., multiple forms of cannabis consumption). Participant inattentiveness due to increased task length and difficulty estimating purchases for the next month may have impacted demand measures. Lessons learned are discussed to inform future efforts to assess cannabis demand in a manner that is more reflective of naturalistic use: including minimizing participant burden, setting higher price ceilings to increase task utility, and considering person-level factors that may influence demand. [ABSTRACT FROM AUTHOR]

Background and Objectives: Drug‐related dreams are commonly reported by individuals in treatment for substance use disorders, which may be distressing. Existing evidence suggests that dream recollection may be influenced by clinically relevant phenomena, such as opioid use and withdrawal, general sleep disturbance, affective symptoms, and chronic pain. However, very few studies have explored drug‐related dreams among individuals who screened positive for opioid use disorder (OUD). Methods: Adults recruited from Amazon Mechanical Turk (MTurk) who screened positive for OUD (N = 154) completed a questionnaire about drug‐related dreams, as well as measures assessing sleep, opioid use history, stress, anxiety, and chronic pain. χ2 analyses, one‐way analysis of variance, and bivariate correlations, correcting for the false discovery rate, were used as appropriate to explore correlates of (1) recollecting a drug‐related dream, and (2) experiencing post‐dream craving and distress. Results: Individuals who recollected a past‐week drug‐related dream were more likely to report other recent sleep disturbances, including poorer sleep quality, greater insomnia symptoms, and a higher risk for sleep apnea. Post‐dream craving and distress were both associated with greater insomnia symptoms, poor sleep hygiene behaviors, and greater anxiety symptoms. Individuals who had ever experienced a drug‐related dream (recently, or in their lifetime) were more likely to report a history of severe withdrawal, overdose, and intravenous opioid use. Conclusion and Scientific Significance: Drug‐related dreams were common among individuals in the present sample and were related to other clinically relevant phenomena. Interventions that treat co‐occurring OUD, pain, sleep symptoms, and affective symptoms may improve overall well‐being in this population. [ABSTRACT FROM AUTHOR]

As cannabis policy is rapidly evolving and support for marijuana legalization is increasing, understanding of the public's perception of cannabis and its associated risks is important for prevention efforts. Adults in Michigan (n = 2,189) were recruited to complete a web-based survey focused on attitudes toward marijuana (August–September 2016). Participants were recruited through online and email advertisements from community-based agencies and a statewide advocacy coalition. Measures were adapted from previous public opinion research with input from advocacy coalition members. Logistic regression analyses were used to assess public perceptions of cannabis potency and the perceived impact of marijuana legalization on road safety, employee safety, and emergency department (ED) visits. Independent variables included demographics, political orientation, and marijuana-related variables (marijuana use, attitude toward marijuana legalization). Respondents ranged in age from 18 to 88 years (mean = 45.5 years) and were 72% female. Most adults (79.7%) were aware that marijuana is more potent today compared to the past. Over half of adults felt marijuana legalization would negatively affect road safety (55.5%), employee safety (58.8%), and lead to an increase in ED visits (62.8%). Differences in attitudes were found based on demographics (age, gender, race, and education), marijuana use, and attitudes toward legalization. Although most adults recognize potential public health risks associated with cannabis legalization, a sizable minority of adults do not feel marijuana legalization will have negative public health consequences. As more states legalize, prevention efforts may be needed to reduce negative public health consequences associated with cannabis use. [ABSTRACT FROM AUTHOR]

Online platforms represent a cost-effective option for data collection; however, it is unclear whether online administration of certain kinds of tasks (e.g., behavioral measures of aggression) poses validity threats. The present study provided a preliminary examination of effort (as indexed by total number of presses), differential drop-out, and believability of an online version of the single-session point subtraction aggression paradigm (PSAP). Two subsamples of participants were recruited; a sample recruited through Amazon's Mechanical Turk (n = 758) and an in-person undergraduate sample (n = 88). All participants completed the PSAP, along with measures of trait hostility and state anger. The online sample did not differ from the in-person sample on effort (i.e., total number of presses), and did not find the task less believable. Higher scores on state anger were associated with lower likelihood of beginning the online PSAP, but were not associated with prematurely closing the task. State anger was related to aggressive responding on the PSAP. Limitations of the online PSAP and considerations for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Opioid-related deaths have risen dramatically in rural communities. Prior studies highlight few medication treatment providers for opioid use disorder in rural communities, though literature has yet to examine rural-specific treatment barriers.Objectives: We conducted a systematic review to highlight the state of knowledge around rural medication treatment for opioid use disorder, identify consumer- and provider-focused treatment barriers, and discuss rural-specific implications.Methods: We systematically reviewed the literature using PsycINFO, Web of Science, and PubMed databases (January 2018). Articles meeting inclusion criteria involved rural samples or urban/rural comparisons targeting outpatient medication treatment for opioid use disorder, and were conducted in the U.S. to minimize healthcare differences. Our analysis categorized consumer- and/or provider-focused barriers, and coded barriers as related to treatment availability, accessibility, and/or acceptability.Results: Eighteen articles met inclusion, 15 which addressed consumer-focused barriers, while seven articles reported provider-focused barriers. Availability barriers were most commonly reported across consumer (n = 10) and provider (n = 5) studies, and included the lack of clinics/providers, backup, and resources. Acceptability barriers, described in three consumer and five provider studies, identified negative provider attitudes about addiction treatment, and providers' perceptions of treatment as unsatisfactory for rural patients. Finally, accessibility barriers related to travel and cost were detailed in four consumer-focused studies whereas two provider-focused studies identified time constraints.Conclusions: Our findings consistently identified a lack of medication providers and rural-specific implementation challenges. This review highlights a lack of rural-focused studies involving consumer participants, treatment outcomes, or barriers impacting underserved populations. There is a need for innovative treatment delivery for opioid use disorder in rural communities and interventions targeting provider attitudes. [ABSTRACT FROM AUTHOR]

Objctive: To assess the long-term outcome of blunt trauma patients with suspected thoracic aortic or great vessel injury that was evaluated with contrast-enhanced chest computed tomography (CT). Methods: We studied the outcome of 278 consecutive patients who received contrast-enhanced CT for blunt chest trauma with computerized searches of the regional trauma database, hospital medical records, universal government medical coverage plan billing records, and regional vital statistics databases. Data retrieved included patient demographics, mechanism of injury, status of the aorta and proximal great vessels at contrast-enhanced CT, hospital discharge diagnoses, and outpatient procedural billings with specific attention to aortic or great vessel injury. Median follow-up was 615 days following the traumatic event. Results: Six subjects demonstrated direct signs of aortic or proximal great vessel injury on contrast-enhanced chest CT, as follows: aortic pseudoaneurysm and intimal flap (n = 4), carotid artery dissection (n = 1), and aortic dissection (n = 1). All were surgically treated, except the patient with aortic dissection, who was treated medically. In the other subjects, contrast-enhanced CT was negative (n = 230) or showed isolated mediastinal hematoma (n = 42). The computerized searches of the medical databases showed that none of these 272 subjects had procedures for, or died from, aortic or great vessel injury during the follow-up period. Conclusion: Computerized searches of medical databases found no evidence of missed thoracic aortic or proximal great vessel injury in blunt trauma patients who were evaluated with contrast-enhanced chest CT. [ABSTRACT FROM AUTHOR]

Oxytocin is increasingly being studied for treating symptoms of alcohol use disorders and heavy drinking behavior. The neuropeptide oxytocin facilitates social relationships and modulates the body's stress response by strengthening coping mechanisms and reducing anxiety. Relatedly, oxytocin is also thought to play a role in processes associated with craving and withdrawal from alcohol. This review aims to primarily provide an overview of preclinical and clinical literature on the applications of oxytocin in alcohol use, and additionally discuss a framework for types of trials and the variety of parameters that affect different study designs. A review of the existing literature in this area suggests that while low dosages of oxytocin do not affect drinking behavior and tolerance, higher dosages taken prior to alcohol exposure have varying behavioral and physiological results. Depending on quantity and timing, oxytocin treatments resulted in declines in withdrawal symptoms and alcohol self-administration in preclinical studies and may decrease neural cue reactivity and withdrawal symptoms in clinical studies. Current ongoing trials are expanding on this work to thoroughly explore clinical applications of oxytocin. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract ., Introduction: Sleep disturbances and elevated stress levels are commonly reported among individuals seeking treatment for substance use disorders (SUDs). However, it remains unclear whether the relationship between sleep and stress differs based on the primary substance of use or if there are commonalities across different substances. This study aimed to investigate the association between sleep disturbances and perceived stress among individuals in SUD treatment and examine whether primary substance influences this relationship., Method: A sample of 4,201 individuals from 59 SUD treatment programs completed assessments including the Insomnia Severity Index and Perceived Stress Scale in 2021. Cross-sectional and longitudinal analyses were conducted to evaluate the relationship between sleep and stress across different primary substances during treatment., Results: The results demonstrated that higher stress was associated with more severe insomnia, and vice versa, both at treatment intake and over the course of treatment, regardless of primary substance. Persons using heroin/ fentanyl evidenced a stronger association of sleep on stress, and persons using cocaine evidenced a stronger relationship of stress on sleep., Discussion: The findings suggest that sleep/stress associations are ubiquitous across different classes of drugs, although sleep might have more influence on stress in persons primarily using heroin/ fentanyl, and stress might have more influence on sleep in persons primarily using cocaine, relative to other substances. Interventions targeting either sleep or stress could have positive effects on SUD outcomes, but further research is needed to investigate the underlying neurobiological mechanisms and inform the development of effective interventions for sleep and stress in SUD populations., (© Copyright 2024 Physicians Postgraduate Press, Inc.)

Background: Opioid-overdose deaths and opioid prescriptions have increased substantially within the past decade, leading to examinations of urban-rural differences for these opioid-related outcomes, and whether annual trends differ by urban-rural status. Most investigations have examined differences using national data, whereas few studies have identified patterns in hard-hit regions. Therefore, we examined urban-rural differences for opioid-related outcomes in Michigan, a state with overdose death and prescribing rates above the national average., Methods: This study used county-level public data on opioid prescribing and opioid-overdose death rates in Michigan. Bivariate and joinpoint regression analyses tested for annual differences and annual changes in opioid-related outcomes across 2013-2017. Rural Urban Continuum Codes classified urban-rural county status., Results: Bivariate analyses demonstrated that urban counties had consistently higher opioid-overdose death rates than rural, whereas rural counties had consistently higher opioid prescribing rates than urban. Joinpoint regression (2013-2017) revealed opioid-overdose death rates increased in urban (Annual Percent Change = 25.0%, p  = .001) and rural counties (Annual Percent Change = 21.7%, p  = .002), though no changes for opioid prescribing rates were observed among urban or rural counties., Conclusions: Our study highlights nuanced urban-rural patterns in Michigan, a hard-hit state, compared to trends in national data. Both urban and rural counties experienced rising rates of opioid-overdose deaths, and rural counties experienced higher opioid prescribing rates than urban. Though urban counties experienced higher opioid-overdose death rates than rural, the rise in both county types was similar. Future research directions, implications for public health, and healthcare policy recommendations are discussed., Competing Interests: The first and second author received funding from the State Targeted Response to the Opioid Crisis and State Opioid Response Grants from the State of Michigan (spend-through funding to the 10.13039/100009931Michigan Department of Health and Human Services from the 10.13039/100000058Substance Abuse and Mental Health Services Administration). Both authors declare no conflict of interest., (© 2019 The Authors.)