Objective: Recreational nitrous oxide use is an emerging public health concern in the United States, particularly among adolescents and young adults. Given its status as a legal marketable product and...

Objective: Historically, alcohol taxation has been one of the best strategies to reduce drinking and related harms in the general population, and prior analyses support that increased alcohol taxes are associated with fewer harms related to drinking during pregnancy. Here, we examine how alcohol taxes are related to preterm and low birthweight births. Method: Birth certificate data for 101,191,080 births conceived between January 1993 and March 2019 come from the U.S. National Vital Statistics System. Outcomes were preterm birth (<37 weeks) and low birthweight (<2,500 g). Time-varying state-level alcohol tax policies were beverage-specific volume-based, sales, and ad valorem taxes. Final regression models adjusted for individual and state covariates, state trends, and clustered standard errors by state. Results: Only sales taxes were consistently related to birth outcomes. Having a beer sales tax was significantly related to lower odds of preterm birth (odds ratio [OR] = 0.94, 95% CI [0.90, 0.98]) and lower odds of low birthweight (OR = 0.98, 95% CI [0.96, 0.99]). Similarly, having a wine sales tax was significantly related to lower odds of preterm birth (OR = 0.94, 95% CI [0.90, 0.98]) and lower odds of low birthweight (OR = 0.97, 95% CI [0.95, 0.99]). Finally, having a spirits sales tax was also significantly related to lower odds of preterm birth (OR = 0.95, 95% CI [0.91, 0.98]) and lower odds of low birthweight (OR = 0.97, 95% CI [0.95, 0.99]). Conclusions: State-level beverage-specific sales taxes are associated with fewer adverse birth outcomes. This study provides additional evidence that increased alcohol taxes may be relevant for reducing adverse effects related to pregnant people's alcohol consumption. Public health significance statement: Policies related to alcohol use during pregnancy in the United States are related to more harms than benefits. Broader alcohol policies that affect the general public—and not just pregnant people—might be better for reducing harms related to drinking during pregnancy. Increased alcohol taxes are linked to better birth outcomes and are one example of broader alcohol policies that may reduce harms from alcohol use during pregnancy.

Objective: This study examines how sulbang (drinking broadcast) content on Korean YouTube contributes to alcohol normalization by analyzing structural organization, thematic framing, and audience engagement patterns. Method: We analyzed 1,012 sulbang-related videos using computational methods including channel networks, keyword co-occurrence clustering via CONCOR analysis, and semantic network mapping of user comments. Data collection involved scraping YouTube videos with more than 50,000 views and algorithmically recommended content, and generating transcripts using automatic speech recognition. Results: Analysis revealed a highly centralized network, dominated by mainstream entertainment channels (tvN ENT, MBC, JTBC), that received algorithmic amplification. Keyword clustering identified six thematic domains that embed alcohol within everyday narratives of food, relationships, leisure, and emotional expression rather than prominently featuring it. Semantic analysis of viewer comments demonstrated parasocial engagement patterns, with audiences using relational language (“older sister,” “friend”) alongside alcohol-related terms. Conclusions: Sulbang normalizes alcohol consumption through subtle embedding within emotionally resonant, culturally familiar contexts amplified by platform algorithms rather than explicit promotion. These findings expose critical regulatory gaps in digital alcohol marketing and underscore the importance of comprehensive policy frameworks that address influencer-driven content on social media platforms. Public health significance statement: This study indicates how Korean YouTube drinking shows, known as sulbang, portray alcohol as a normal and enjoyable part of daily life. Because many young viewers watch these videos without realizing their influence, the findings of this study highlight the need for stronger regulations and public education to prevent risky drinking behaviors and protect youth from subtle forms of alcohol marketing.

Objective: Fetal alcohol spectrum disorder (FASD) results from prenatal alcohol exposure and is associated with long-term neurobehavioral deficits, including anxiety and depression. Ethanol-induced ox...

Objective: Youth who use electronic nicotine delivery system (ENDS) products have lower perceptions of the health harms of ENDS products compared with youth who do not use them. However, it remains un...

Objective: The multistage model of substance use proposes that reinforcement mechanisms and motives for use change as individuals develop substance use disorders, with positive reinforcement driving s...

Objective: Simultaneous alcohol and cannabis use is prevalent among young adults and linked with heavy use and related harms. Days with simultaneous use have been linked with poorer proximal outcomes than days involving only alcohol or cannabis, but findings are mixed. Importantly, days with simultaneous use vary greatly with respect to level and timing of use, and other substance use. Thus, all simultaneous use days may not carry the same risks, which partially explains the discrepancies. We aimed to characterize heterogeneity across simultaneous use days via an innovative statistical method applied to daily data--multilevel latent class analysis (MLCA)--and identify features of days most strongly linked to same-day harms and motives. Method: Participants were n = 255 young adult college students (48% male) who completed 54 or fewer days of surveys on substance use behavior, yielding 1,527 person-days with simultaneous use. Results: MLCA identified four day-level latent classes of simultaneous use occasions: Alcohol-Focused (43% of days), Cannabis-Focused (35%), Heavy Use (14%), and Early-Day Use (8%). Same-day harms were more likely on heavy use days than on other days, and day-level classes varied significantly across three same-day motivations for simultaneous use: to be social, because it was offered, and to have fun. Conclusions: Simultaneous alcohol and cannabis use days are highly varied. Heavy use days, characterized by the level of alcohol/cannabis use and engagement in other substance use, were most strongly linked with harms, but timing of use in a day also distinguished patterns of use. Studies investigating the role of additional substances are warranted. Public health significance statement: Simultaneous alcohol and cannabis use, or the use of both substances such that the effects overlap, is prevalent among young adults and highly varied with respect to level of substance use, ordering of substances used, and use of other substances beyond alcohol and cannabis. Motivations to be social, because a substance was offered, and to have fun were the strongest predictors for particularly higher-risk simultaneous use occasions. Findings represent an important step toward developing targeted, timely interventions for young adults who engage in simultaneous use.

Objective: Participation in 12-step groups, such as Alcoholics Anonymous, confers benefits among individuals with alcohol use disorder (AUD), and one candidate mechanism underlying these effects is re...

Objective: Early initiation of substance use during adolescence is linked to immediate and long-term risks, including impaired cognitive development; challenges in social, academic, and psychological ...

Objective: There is a substantial literature indicating that brief interventions (BIs) for alcohol use disorder (AUD) are as effective as more extensive treatments. The research assessment reactivity ...

Objective: Murphy et al. (2014) found that university students with a family history (FH) of alcohol problems exhibit a reduced sensitivity of alcohol demand to next-day academic responsibilities. Considering the ongoing replication crisis, the objective of this study was to replicate and extend this research in community adults, including a range of non-academic responsibilities. Method: We conducted a secondary analysis of 461 adults who reported past-year alcohol consumption (39% women; mean age = 38.42 years), recruited from Amazon Mechanical Turk. Participants were coded as FH+ (40%) or FH- (60%) based on reporting if any biological parents or grandparents had a history of alcohol problems. Participants completed alcohol purchase tasks (APT) involving a typical drinking situation or next-day responsibility (e.g., work, caregiving). FH status was examined as a moderator of reductions in observed indices of alcohol demand in separate analyses of covariance, controlling for participant sex and severity of alcohol misuse. Results: Alcohol demand did not significantly differ by FH status on the no-responsibility APT (ps >.56). Compared with FH- participants, FH+ participants showed a smaller magnitude reduction in the responsibility condition for breakpoint (p = .002, ηp2 = .036), Omax (p = .002, ηp2 = .041), and Pmax (p = .001, ηp2 = .040), and nonsignificant effects for intensity (p = .053, ηp2 = .015). Conclusions: These findings replicate and extend Murphy et al. (2014) by confirming that FH confers a greater risk of alcohol consumption despite upcoming responsibilities. People with a FH of problem drinking may require specific interventions that make the impact of drinking on next-day responsibilities more salient. Public health significance statement: This study replicates previous research showing that adults who drink alcohol and report a family history of alcohol problems report that they would continue to consume more alcohol when they have important responsibilities the next morning, compared to adults who drink alcohol and do not report a family history of alcohol problems. These results suggest that people with a family history may need targeted interventions to increase the importance of responsibilities and reduce their alcohol consumption to mitigate risks of adverse outcomes associated with drinking in these situations.

Objective: The blackout rage gallon (BORG) is an excessive drinking trend popular at some colleges in the United States and propelled by social media. Media reports depict harmful consequences of BORG use, but others view this trend as a strategy to reduce drink contamination, control alcohol intake, and minimize hangovers. This study provides the first detailed assessment of college students’ perceptions and use of BORGs, including consequences and motivations for use and nonuse. Method: Participants (ages 18–25 years) were past-year college students (N = 103) from both public and private U.S. institutions who reported weekly binge drinking and completed a survey assessing BORG use, motivations, and drinking-related outcomes. Results: Participants were 20.4 years old, 62% female sex at birth, and their mean Alcohol Use Disorders Identification Test score was 11.3 ± 5.2. We oversampled college students who reported past-year BORG use (BORG+; n = 63) relative to those who denied BORG use (BORG-; n = 40). BORG+ participants consumed 9–10 standard alcohol drinks during a typical BORG event. Most reported getting buzzed or drunk (98%), nearly one third (29%) experienced a blackout, 17% vomited, and 59% said/did something embarrassing. Regardless of these effects, two thirds endorsed intending to engage in future BORG drinking. BORG-participants cited refraining from BORG use because it was not part of their college culture and was not effective for limiting alcohol intake. Conclusions: The BORG trend presents another challenge for harm reduction efforts focused on curbing excessive drinking in college students. The high-intensity drinking of BORG use, paired with associated blackouts, vomiting, and behavioral disinhibition, renders this phenomenon as living up to its name. Public health significance statement: The blackout rage gallon (BORG) is a binge-drinking trend popular among some college students that facilitates high-intensity drinking and produces acute alcohol-related harm. The present study provides insight into the motivations and outcomes of BORG use, which may inform prevention and education efforts to mitigate its negative consequences.

PISCATAWAY, NJ – A newly popular college drinking trend, the blackout rage gallon (BORG), fosters binge drinking and can lead to a host of alcohol-related harms, according to a new study in the Journal of Studies on Alcohol and Drugs, published at Rutgers University.

The U.S. Alcohol Policy Alliance (USAPA) is offering a limited number of registration scholarships for public health professionals who have lost federal or state government positions during the past t...

Background: Binge drinking during the transition from adolescence to emerging adulthood remains a significant public health concern. Mental health symptoms may be associated with increased risk for bi...

Objective. Although alcohol is largely consumed socially, experiments rarely test its effects on social language. Guided by the premise that language is a fundamental social behavior that shapes alcoh...

Objectives: Social media influencers significantly shape alcohol consumption norms, particularly in Low and Middle-Income Countries (LMICs) where regulatory frameworks lag behind digital marketing inn...

Objective: The 2018 Federal Farm Bill created a loophole allowing intoxicating hemp-derived tetrahydrocannabinol (THC) products to be manufactured and sold with limited regulations. Unless restricted ...

Background: Hispanic/Latino American college students report elevated rates of alcohol use and negative alcohol-related consequences compared to non-Hispanic/Latino white students. As cultural experie...

Objective Amid rising cannabis use, declining perceived harm, and policy liberalization over the past 15 years, we examined whether the association between cannabis use disorder (CUD) and past-year suicidal ideation among U.S. adults changed from 2014–2023 and varied by sex, age, and race/ethnicity. Method Using data from 415,861 adults in the 2014–2023 National Surveys on Drug Use and Health, we examined temporal association change between past-year suicidal ideation and CUD (≥2 of 9 harmonized DSM-5 criteria). Logistic regression models, adjusted for demographic, social, clinical, and geographic covariates, tested whether survey year moderated the CUD–suicidal ideation association overall and in strata by sex, age, and race/ethnicity. Results Adults with cannabis use disorder had 57% higher odds of past-year suicidal ideation than those without (OR, 1.57; 95% CI, 1.44–1.72) across years. Joint Wald tests showed no evidence that the association changed over time overall (p = 0.12) nor within strata defined by sex or age. Although the joint interaction test suggested some variation among Hispanic respondents (p = 0.01), no individual year-specific interaction terms remained statistically significant after Bonferroni correction. Conclusions Adults with CUD had higher odds of suicidal ideation but, contrary to expectations, the strength of this association remained stable from 2014–2023 and did not differ significantly across sex, age, or racial/ethnic groups despite widespread legalization, increased potency, and shifting norms.

Objective: Although Protective Behavioral Strategies (PBS) are effective in mitigating substance use and its associated consequences, research on the determinants of PBS use is limited. A previous stu...

Objective: This study cross-sequentially examined three measures of self-reported respiratory symptoms and nicotine e-cigarettes (EC) use adjusting for past 30-day use of cannabis/tobacco, COVID-19, a...

Objective: We examined associations between neighborhood socioeconomic context and substance use among U.S. adolescents using nationally representative samples. We further tested whether these associa...

Objective: Sexual minority (SM) people face a heightened risk for alcohol use relative to heterosexual people. SM people experience stressors related to their stigmatized identity that increase their ...

Objective: As the largest payer of addiction treatment in the United States, Medicaid plays an important role in the delivery and quality of AUD treatment. However, little is known about AUD in the Me...

Objective: The global cannabis policy landscape has changed dramatically in recent decades. In the United States, there is significant variation in cannabis tax structures, and there is limited consensus on how to implement cannabis tax policy to mitigate related harms. Therefore, the objective of this rapid review was to synthesize current evidence on the impact of cannabis taxation on purchasing behavior, use, and risk perceptions among U.S. adults. Method: We systematically searched for peer-reviewed studies published in English (2014–present) in PubMed, SCOPUS, and Google Scholar. Two reviewers independently screened all relevant articles for eligibility using Covidence software. Out of the 1,342 references identified, 1,337 were not eligible for inclusion. Results: The five included studies examined excise taxes on cannabis. Outcomes measured across the studies included cannabis use, cannabis demand, purchasing patterns, and perceptions. The data sources ranged from participant-level to state-level to nationally representative. One study found a negative association between taxes and past-30-day cannabis use, although it was statistically insignificant. A higher cannabis tax was linked to a decrease in cannabis demand. Another study demonstrated evidence of consumer stockpiling and increased crossborder substitution in response to higher cannabis tax rates. In terms of perceptions, policymakers rated taxes as a highly efficacious public health tool, and cannabis users viewed taxation as an important factor in their purchase decisions. Conclusions: The limited number of articles identified in this rapid review highlights the need for future studies to better understand consumer behavior and inform policy. Public health significance statement: In this review, we found a paucity of evidence on the impact of cannabis taxation on cannabis risk perceptions, purchasing, and use, which hinders policymakers’ decisions to enact evidence-informed cannabis tax policies. As state cannabis legalization continues in the United States, future studies must evaluate the impact different tax policies have on health outcomes.

Objective: Parental behaviors have been suggested to affect substance use in their offspring. The present meta-analysis examines associations between five types of substance-specific parental behavior...

Journal of Studies on Alcohol and Drugs

Objective: Prolonged alcohol consumption is associated with immune system alterations, high blood pressure, and neurotoxicity. Alcohol use disorder (AUD) is a devastating disease worldwide that leads to several changes in the neurochemical balance within the brain. Moreover, the high incidence of certain cancers and the prevalence of infectious diseases among individuals with AUD demonstrate how alcohol impairs the immune system. Our research offers a new perspective on the important pathways and genes involved in the dynamic alterations of AUD progression. Method: The methods used in this research include microarray data collection from the Gene Expression Omnibus (GEO) database, functional enrichment analysis of gene sets, weighted gene co-expression network analysis to find regulated modules, and analysis of modules and identification of hub genes. Results: The findings showed that alcohol affects the expression of a wide range of genes, leading to significant changes in the regulation of biological processes and signaling pathways related to the cell cycle and cellular senescence. Some of the pathways significantly affected are polyubiquitination, NF-κB, FOXO, mTOR, P53, calcium, and PPAR signaling. Conclusions: The expression of genes associated with cellular senescence is likely altered by alcohol and its related disorders. Public health significance statement: Alcohol use disorder disrupts genes and pathways that govern immune function and brain signaling. This study identifies key gene networks altered by alcohol, pointing to potential targets for prevention and therapies. In practical terms, these findings could inform the monitoring of molecular changes to guide personalized interventions and public health strategies.

Objective: The purpose of this study was to identify latent classes of substance use behaviors (i.e., alcohol and illicit drug use) and their correlates among transgender women and transfeminine nonbinary adults. Method: Baseline data (March 2018 to August 2020; n = 1,614) from The LITE Study were used to identify latent substance use classes and report latent class membership probabilities (γ) and item-response probabilities (ρ). We assigned participants to the class with their highest probability of class membership and assessed associations with socioeconomic conditions. We reported adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for each correlate. Results: Mean age was 33.0 years (SD = 12.1), and 45.3% were non-Latina/e, White. We identified four classes: no illicit drug use (γ = .63), alcohol misuse and cannabis use (γ = .26), polysubstance use (γ = .062), and opioid and cannabis use (γ = .046). Compared with the “no illicit drug use” class, the need for medical gender affirmation was associated with lower odds of being in the polysubstance use and opioid and cannabis use classes, and housing security and lack of arrest were associated with lower odds of being in the alcohol misuse and cannabis use, polysubstance use, and opioid and cannabis use classes. For example, compared with those who were food insecure most or all of the time, those who were never food insecure had lower odds of being in the polysubstance use class (aOR = 0.22, 95% CI [0.09, 0.52]) versus the no illicit drug use class. Living with HIV was associated with greater odds of polysubstance use. Conclusions: For transfeminine adults, having met need for medical gender affirmation and better socioeconomic conditions may be protective for alcohol misuse and/or polysubstance use. Interventions aimed at improving socioeconomic conditions among transgender women and transfeminine nonbinary adults may improve substance use outcomes. Public health significance statement: Our findings suggest that transgender women and transfeminine nonbinary adults may experience increased risk of substance use, including polysubstance use, in part due to a lack of access to gender affirmation and social determinants of health. Polysubstance use was also more common among people living with HIV. Intervention work for transgender women and transfeminine nonbinary adults may benefit from addressing access to gender affirmation and social determinants of health.

Objective: There is no externally validated instrument for predicting which children will show frequent substance use in young adulthood. This study evaluated whether an instrument previously shown to predict substance use outcomes in mid-adolescence could also predict substance use outcomes in young adulthood, comparing performance across ages and demographics. Method: The Loeber Risk Score (LRS) is a five-item, parent-completed screener indexing risk of future substance use in children. We evaluated the predictive performance of the LRS in a nationally representative longitudinal birth cohort (N = 4,898, 48% female). Parents completed the LRS when the child was about 5 and about 9 years old. Subsequently, the youth reported their substance use at about 22 years old. Results: The LRS at age 9 predicted several outcomes at age 22 better than chance (ps < .05): daily cigarette use (area under the receiver operating characteristic curve [AUROC] = 0.71–0.75), cannabis use ≥3 days per week (AUROC = 0.59), vaping ≥3 days per week (AUROC = 0.55), and receipt of treatment for an alcohol/drug problem (AUROC = 0.60). Performance was no better than chance for alcohol outcomes (AUROCs = 0.47–0.50). Children with LRS scores ≥2 were 1.3–2.0 times more likely to display frequent substance use outcomes. There were no consistent performance differences when the LRS was measured at age 5 versus age 9 or by the child’s sex, race, or ethnicity. Conclusions: The LRS would be an improvement over random or ad hoc selection, but screening accuracy is generally low. Much more accurate screeners are needed. Public health significance statement: This study showed that a five-item survey instrument administered in childhood can predict some substance use outcomes in young adulthood significantly better than chance. However, accuracy was generally low, and the instrument did not work for alcohol use outcomes in particular. The field needs better risk prediction algorithms to support targeted prevention.

Objective: Understanding the relationship between people’s lifetime alcohol use and their awareness of the risk of common chronic diseases from alcohol use is important for informing health messaging efforts. This article aimed to (a) assess the level of awareness that alcohol use increases the risk of cancer, diabetes, and hypertension, and (b) examine the association between lifetime drinking patterns and levels of awareness. Method: We used data from the 2019–2020 National Alcohol Survey that included awareness that cancer, hypertension, and diabetes could result from drinking too much alcohol (yes/no/ unsure), past-year alcohol use, and lifetime alcohol use operationalized as peak lifetime drinking pattern and ever having two or more symptoms of alcohol use disorder. We conducted multinomial regressions to examine associations between lifetime alcohol use and awareness of alcohol as a risk factor for each health outcome, controlling for past-year use. Results: Overall, 42.1% acknowledged the link between alcohol use and cancer, 52.2% between alcohol use and diabetes, and 61.3% between alcohol use and hypertension. Nearly all peak lifetime drinking pattern levels were associated with a lower likelihood of awareness of the alcohol–cancer link. Conversely, nearly all levels were associated with a higher likelihood of awareness of the link between alcohol use and hypertension, and only one level was associated with awareness of the alcohol–diabetes link. Conclusions: Awareness of alcohol’s effects on chronic diseases varies by type of disease. Lifetime alcohol use is a relevant factor for understanding levels of awareness of alcohol’s health effects. Public health significance statement: This study reveals important gaps in public awareness of alcohol’s chronic disease risks, with substantial variation in recognition across different health conditions. The contrasting findings that a range of light to heavy lifetime drinking patterns are associated with lower awareness of alcohol’s cancer risk, while associated with greater awareness of its hypertension risk, show the value of lifetime alcohol use assessments beyond measures of current use and suggest that disease-specific factors influence how drinking experience shapes risk perception. Future research should explore why people who use alcohol and know about the health risks continue to use alcohol and the effects of increasing awareness of alcohol’s health harms on subsequent alcohol consumption.

Objective: Alcohol misuse and sexual assault are prevalent in the U.S. military, including in military service academies. As these behaviors frequently co-occur, there is an urgent need to develop and test prevention programs that address risk factors for both and that are also appropriately tailored for military cadets. The purpose of this study was to compare the efficacy of a combined alcohol misuse and sexual assault prevention program to that of an alcohol misuse prevention program plus a healthy skills program, a standalone sexual assault prevention program, and a standalone healthy skills program. Method: A four-arm quasi-experimental study was conducted at the U.S. Air Force Academy with two incoming classes of cadets (N = 1,985). Participants completed pre- and posttest surveys to assess alcohol misuse–and sexual assault–related knowledge and attitudes. Mixed-effects multilevel models tested changes over time by condition; interactions were examined to determine whether program effects were moderated by sex or prior alcohol use. Results: Several significant differences in pre-to posttest changes were observed, with most indicating greater improvement in the combined condition than in other conditions. Alcohol readiness to change improved in the combined program compared with the alcohol misuse prevention and healthy skills program (p < .05); knowledge regarding sexual assault and self-efficacy to resist unwanted sexual advances increased significantly more in the combined program than in all others (p < .05). Conclusions: This study provides initial evidence to support combined, tailored alcohol misuse and sexual assault training in military academy settings. Public health significance statement: Sexual assault and alcohol misuse among young adults, including military cadets, are important public health issues. This study presents the results of a multi-arm intervention trial that evaluated the impacts of a combined, tailored, alcohol misuse and sexual assault prevention program on alcohol- and sexual assault–related knowledge and beliefs, relative to the impacts of separate programs or a standard classroom training, among military cadets. The results indicate that tailored interventions can reduce risk for these adverse public health issues.

Objective: Experimentation with alcohol and other substances during the early adolescent period is associated with myriad potentially deleterious health outcomes. The present analysis used data from the Adolescent Brain and Cognitive Development Study (ABCD Study) to examine the relationships among risk perception, susceptibility to peer influence, and substance use in early adolescence. Method: Participants completed a Social Influence Task (SIT) in which they were asked to rate the riskiness of various hypothetical scenarios. They were then presented with a risk rating purportedly provided by their peers and asked to rate each scenario again. Mixed-effects logistic regression models were used to evaluate the relationships among risk perception (initial risk rating), susceptibility to peer influence (risk rating change), and future substance use. Results: Higher initial risk perception was associated with lower odds of future substance use. Greater susceptibility to peer influence in the positive direction (i.e., being more swayed by peers to rate a scenario as more risky than the participant had originally decided) was also associated with lower odds of future substance use. Conclusions: These findings highlight the potential importance of leveraging positive peer influence to affect substance use outcomes. Public health significance statement: Adolescents’ perceptions of risk and sensitivity to peer influence play an important role in the early stages of substance use. This study found that youth who viewed risky behaviors as more dangerous and those more strongly influenced by peers promoting safe choices were less likely to engage in substance use in the future. These findings suggest that prevention programs leveraging positive peer influence may help reduce early substance use.

Objective: We assessed alcohol product availability, sales, and prices among privatized off-premises alcohol sales in 42 U.S. states and quantified sales among lower-priced products. Method: We used N...

Objective: Suicidal thoughts and behaviors (STB) are elevated among individuals with alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD). The highest STB prevalences occur among those with comorbid AUD-PTSD. STB interferes with AUD and PTSD recovery outcomes. However, no research has examined the impact of STB on recovery trajectories among those with dual AUD-PTSD, a comorbidity with a chronic and difficult-to-treat clinical profile. Method: Data from a randomized controlled trial with 141 (84.4% male) treatment-seeking Veterans with comorbid AUD-PTSD were used to compare the 12-week recovery trajectories for alcohol consumption (percent drinking days; percent heavy drinking days) and PTSD symptoms between the following groups: (a) Veterans with (n = 90) versus without (n = 51) lifetime STB and (b) Veterans with (n = 46) versus without (n = 95) current STB. Results: Compared to respective groups without STB, Veterans with lifetime and current STB had similar severity of drinking consumption over 12 weeks and similar reductions in drinking consumption and PTSD symptoms over the study period. Veterans with (vs. without) current STB reported significantly higher PTSD symptom levels throughout the 12 weeks. Conclusions: Results suggest that the presence of lifetime and current STB does increase the severity of PTSD but does not appear to impact the rates of symptom recovery across a 12-week period. Results provide important context for cross-sectional research, underscoring the greater severity of AUD-PTSD. Our longitudinal analyses indicate that Veterans can achieve symptom improvements in AUD and PTSD, even in the context of co-occurring STB. Public health significance statement: Veterans with (vs. without) current suicidal thoughts and behaviors (STB) had more severe posttraumatic stress disorder (PTSD) symptoms during the 12 weeks of a clinical trial testing a medication for alcohol use disorder (AUD) and PTSD. However, lifetime STB and current STB did not impact the rates of AUD or PTSD symptom recovery during the 12 weeks. All groups experienced improvement over time. Veterans may experience AUD and PTSD symptom reductions even with current or past STB. Results imply that Veterans with current or lifetime STB may be safely enrolled in clinical treatment trials for AUD and PTSD.

Objective: International mobility and collaborations are a cornerstone of the academic career trajectory, as well as a pathway to better science. This article aims to advocate for strengthening global connections among early-career investigators to advance science and accelerate discovery in addiction research. Drawing on the authors’ experiences, we offer specific recommendations to help addiction researchers design international exchange programs for early-career investigators. Method: The program consisted of four key components: (a) pre-exchange participant matching of early-career investigators at each institution, (b) individualized goal setting for participants, (c) a structured orientation program on the first day of the in-person exchange, and (d) 2 weeks of research-focused, in-person collaborations and networking activities. Quantitative and qualitative data are presented, including 2-year outcomes from the program (N = 8). Results: The exchange program had both immediate and sustained impacts on professional development and research productivity. Participants reported increased confidence in international collaboration, a broader global perspective, and enhanced scholarly output, and all emphasized the importance of in-person interaction. Two years after exchange, participants reported a more than threefold increase in internationally co-authored publications, a newly awarded international grant, and the establishment of four new formal mentorship relationships. All participants reported changes in their research focus, scientific approach, or lab management practices as a result of the exchange program. Unexpected benefits included strengthened collaboration within home research teams and the emergence of broader institutional partnerships in both the United States and Australia. Conclusions: Understanding and addressing addiction requires a global perspective, and engaging early-career researchers in international exchange programs can foster lasting collaborations and encourage globally focused research. Even short-term exchanges can be cost-effective in promoting long-term productivity in international addiction research. Public health significance statement: This work highlights how short-term international exchange programs for early-career researchers can strengthen global collaboration and lead to more effective addiction research. By building international networks early in their careers, researchers are better equipped to tackle the complex, worldwide challenges of substance use and addiction, ultimately leading to better-informed public health solutions across countries.

Objective: The opioid crisis remains an important public health concern, with nonmedical use of prescription opioids (NMUPO) playing a significant role. However, limited evidence exists on how adults ...

Objective: The public health impact of substance use is substantial, with tobacco use and excessive drinking leading as causes of death in the United States. To address this growing epidemic, governments have implemented a range of substance use–related policies. The National Institutes of Health’s Clinical and Translational Science Awards (CTSA) program, which aims to accelerate the translation of research findings into health impact, may advance translation by shaping the policy literature that informs policymakers, health professionals, and the public. Using innovative bibliometric tools, this study evaluates how CTSA-supported research published from 2006 to 2023 has influenced substance use–related policy literature. Method: The authors identified 135,000 publications that acknowledged CTSA support. Those publications were queried in the Overton Policy Database, which indexes references to research publications in global policy literature. Results: Thus far, CTSA-supported publications have been cited in 3,451 policy documents identified as substance use–related according to Overton’s Topics field. Substance use–related Topics were classified into the top categories of Tobacco, Opioids, Cannabis, Alcohol, and General/Other substance use. Policy documents came from 321 organizations across 49 countries—often governments, health agencies, or political think tanks, including the World Health Organization, Guidelines in PubMed Central, and the RAND Corporation. The authors present case illustrations of individual research publications that have had a notable influence on substance use policy. Conclusions: By elucidating how supported publications are applied beyond academia, bibliometrics offer a useful avenue for evaluating the translational impact of programs in specific policy areas. Our findings showcase the impact of CTSA research on the substance use–related policy literature, an important area of health policy. Public health significance statement: This study examined how clinical and translational research publications are used in substance use–related policy literature worldwide. This body of literature plays an important role in informing and influencing stakeholders in a policy area of critical importance to social, economic, legal, and health concerns. Public health concerns like substance use/substance use disorder can be better addressed with an understanding of the role of research in the process of evidence-based policymaking.

Objective: Reduction in alcohol craving has often been specified as an outcome for alcohol use disorder (AUD) interventions. This study evaluated changes in multiple craving measures from a double-blind randomized clinical trial (RCT) evaluating the efficacy of intermittent theta burst stimulation (iTBS) to the left dorsolateral prefrontal cortex for the treatment of AUD. We predicted that veterans in AUD residential treatment, who received active iTBS (Active; n = 22), would show greater reductions than those who received sham iTBS (Sham; n = 22). Method: Twenty iTBS sessions (1,200 pulses/session) were delivered over 2 weeks. Craving measures were administered before iTBS sessions (Baseline) and following completion of sessions (Post-Assessment). Craving measures administered were the Alcohol Craving Questionnaire Short Form–Revised Total Score, Abstinence Self-Efficacy Scale (AASE) Tempted Cravings and Urges subscale, and Obsessive Compulsive Drinking Scale (OCDS). Results: All craving measures showed reductions in scores (time main effect), collapsed across Active and Sham groups; however, the absence of significant Group × Time interactions indicated that active iTBS did not produce statistically greater reductions than sham. Exploratory post hoc simple effects analyses were conducted to further examine the significant main effect of time. Active participants showed reductions on the AASE Tempted Cravings and Urges and all OCDS measures, whereas the Sham group showed no significant changes on any measure. Conclusions: Active iTBS did not produce a statistically greater reduction in craving symptomatology than sham, as indicated by the absence of significant Group × Time interactions. However, the exploratory post hoc results can guide future larger-scale transcranial magnetic stimulation RCTs for AUD on the utility of the acquired craving measures. Public health significance statement: This study assessed the effects of left dorsolateral prefrontal cortex intermittent theta burst, a type of transcranial magnetic stimulation, on measures of alcohol craving. Evaluation for changes in alcohol craving is important because higher levels of craving during and after treatment are linked to a return to heavy alcohol drinking. Twenty-two (22) participants received Active (real) and 22 received Sham (placebo) stimulation. Primary analyses indicated comparable decreases in the Active and Sham groups across craving measures; however, exploratory analyses indicated that only the Active group showed a significantly greater reduction on four of five measures after the treatment sessions.

Objective: Driving while intoxicated (DWI) remains a preventable source of morbidity and mortality in the United States. Ignition interlock devices (IIDs) are used to prevent DWI offenders from driving while intoxicated during a mandated installation period and are effective during that time. Once IIDs are removed, DWI rates are similar to levels for offenders who had no IID. This study tested the efficacy of a smartphone app (B-SMART) for DWI offenders with an IID and concerned family members (CFMs), with the goal of reducing IID lockout events and alcohol consumption. Method: Four B-SMART app modules were developed: (a) Life with Interlock, (b) Supporting Changes in Drinking, (c) Doing Things Together, and (d) Effective Communication. Participants (pairs of DWI offenders and CFMs) were randomly assigned to receive the B-SMART app (n = 58) or referral to a state IID information page (usual and customary [UC] condition, n = 65) and followed for 9 months after randomization. IID data (failed tests and lockout events) were obtained from IID providers as the primary outcome variables. Offender and CFM reports of alcohol consumption in the last 30 days before assessment were secondary measures. Results: IID data were collected on 62% (N = 76) of participants. B-SMART participants had significantly fewer lockout events than UC participants. B-SMART offenders and their CFMs reported significantly less likelihood of DWI offender drinking at 9 months. Conclusions: Results suggest that the B-SMART app reduced IID lockout events and DWI offender alcohol consumption. These outcomes are important because fewer IID lockout events predict lower DWI recidivism. Public health significance statement: Use of the B-SMART app reduced IID lockout events and resulted in lower levels of alcohol consumption. These outcomes may predict reduced DWI recidivism, an important public health outcome. Future research should assess whether the use of the B-SMART app reduces DWI recidivism. The app could be used by courts and DWI monitoring programs in the United States.

A new study reveals that the health risks of alcohol begin with just one drink a day.

Objective: Cannabis use has increased among older adults, yet the neurocognitive effects in this demographic remain unclear. Prior work has suggested that cannabis may increase brain volume in areas r...

Objective: Parents play a role in shaping their children’s beliefs and behaviors around substance use. When faced with unfamiliar or challenging situations, many parents turn to peers for advice. This...

Objective: Vaping among adolescents has surged in recent years, underscoring the need to identify intentions and motivating factors behind vaping. Although weight management behaviors have been associated with vaping, the largely cross-sectional evidence precludes understanding of how these behaviors may relate to and reinforce each other over time. This study explored the bidirectional associations between vaping and changed eating to manage weight and shape over 3 years of adolescence. Method: Adolescents from the Cannabis, Obesity, Mental Health, Physical Activity, Alcohol, Smoking, and Sedentary Behaviour (COMPASS) Study (N = 8,960, M age = 13.8 [SD = 1.1], 55.5% cisgender girls) completed self-report surveys annually for 3 years (Time 1 [T1] = 2020/2021, T2 = 2021/2022, T3 = 2022/2023). Data were analyzed using random-intercept cross-lagged panel models with full information maximum likelihood. Results: Increases in vaping were observed over time (20.9% at T1, 40.0% at T3), and 30% of adolescents changed their eating habits to manage their weight/shape each year. Weak but significant associations were generally observed, such that cisgender girls who changed their eating to manage weight/shape engaged in more vaping the following year (betaT1–T2 = .05; betaT2–T3 = .05). Conversely, cisgender girls and boys with a higher vaping frequency reported more days of changing eating to manage weight/shape 1 year later (betaT1–T2 = .02 and .04, betaT2–T3 = .05 and .06). Conclusions: The bidirectional relationship between vaping and weight-related eating behaviors underscores the value of addressing these habits as interconnected behaviors, informing the development of targeted public health policies, preventative measures, and intervention strategies to support health and reduce the adoption of vaping among adolescents. Public health significance statement: Adolescents who vape more often are altering their food intake to control their weight over time. Girls who alter their food intake to control weight also report higher vaping 1 year later. Discerning the connections between these behaviors is important to understand why adolescents vape and potentially to prevent unhealthy weight control strategies within this high-risk group.