This Week in Addiction Medicine from ASAM American Society of Addiction Medicine
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- Health & Fitness
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A podcast source for news briefings on the top stories in the field of addiction medicine.
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Lead: Disposable E-Cigarette Use and Subsequent Use Patterns in Adolescents and Young Adults
Disposable E-Cigarette Use and Subsequent Use Patterns in Adolescents and Young Adults
Pediatrics
Utilizing sequential surveys in adolescents and young adults, the study evaluated the association between disposable e-cigarette (E-cig) use versus non-disposable E-cig and subsequent E-cig use. Those reporting the use of disposable e-cigs at baseline reported greater number of use days in past 30-days. In the follow-up survey, while controlling for demographics and baseline e-cig use patterns, disposable e-cig use was associated with continued e-cig use (OR=1.92) and greater number of times used daily (IRR=1.29). The authors note that disposable E-cigs are generally inexpensive, relatively easy to hide, and sold in various flavors (not regulated compared to non-disposable forms) and thus recommend comprehensive policies to regulate all forms of nicotine products.
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Lead: Adolescent Δ8-THC and Marijuana Use in the US
Lead Story:
Adolescent Δ8-THC and Marijuana Use in the US 🔓
JAMA
D8-THC is synthesized from legal hemp plants (with low D9-THC) and has intoxicating effects similar to D9-THC. D8-THC is available in smoking, vaping, and edible products and is marketed as federally legal. To investigate the extent of D8-THC use by adolescents, data were extracted from the 2023 Monitoring the Future study in which a random selection of 12th grade students were asked about D8-THC use (n=2186). Prevalence of D8-THC use over the past 12 months was 11.4%, and for marijuana use was 30.4%. D8-THC use was lower in western states (5%) than southern states (14.4%), states where D8-THC was regulated (5.7% v. 14.4%), and states where marijuana was legal (8.0% v. 14.0%). The authors conclude that D8-THC use among adolescents is significant and deserves further attention.
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Lead: Association of Cannabis Use With Cardiovascular Outcomes Among US Adults
Lead Story:
Association of Cannabis Use With Cardiovascular Outcomes Among US Adults
Journal of the American Heart Association
Cannabis use has increased in the US and perceived harmfulness has decreased, but there is evidence to suggest that cannabis use may increase risk of cardiovascular disease. In this study, the authors utilized the Brief Risk Factor Surveillance System survey to assess association between cannabis use and cardiovascular disease. In a multivariate analysis, they found an association between daily cannabis use and myocardial infarction (MI) (aOR=1.25) and stroke (aOR=1.42). Among adults who had never smoked cigarettes, the association was even greater for MI (aOR=1.49) and stroke (aOR=2.16). While additional research is needed, these findings suggest cannabis may be a risk for cardiovascular disease, independent of cigarette use.
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Lead: Racial and Ethnic Disparities in Geographic Availability of Buprenorphine
Lead Story:
Racial and Ethnic Disparities in Geographic Availability of Buprenorphine
Journal of Addiction Medicine
To identify whether buprenorphine availability equitably meets the needs of diverse populations, this study examined the differential geographic availability of buprenorphine in areas with greater concentrations of racial and ethnic minority groups. There were 45% to 55% fewer prescribers in urban areas and 62% to 79% fewer prescribers in rural areas as minority composition increased. Differences in dispensed buprenorphine per capita were similar but larger in magnitude. Achieving more equitable buprenorphine access requires not only increasing the number of buprenorphine-prescribing clinicians; in urban areas with higher racial and ethnic minority group populations, it also requires efforts to promote greater buprenorphine prescribing among already prescribing clinicians.
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Lead: Smoking changes adaptive immunity with persistent effects
Lead Story
Smoking changes adaptive immunity with persistent effects
Nature
There is significant variability in immune response across the population, some of which is related to age, sex, and genetics, but this study examines other factors that may be related to immune response. Notably, the authors found that smoking affected both innate and adaptive immune response, and that the associations were consistent across number of years smoking and number of cigarettes. The effect on innate immune response was short-term, with immune response returning to levels comparable to non-smokers after quitting. The effect on adaptive immunity, however, was long-term and persisted even after quitting — the result of DNA methylation changes. These findings have clinical implications regarding risk of infection, cancer, and autoimmune disease in persons who smoke.
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Lead: Overdose mortality incidence and supervised consumption services
Lead Story:
Overdose mortality incidence and supervised consumption services in Toronto, Canada: an ecological study and spatial analysis
The Lancet Public Health
The objective of this study was to measure the effect of safe consumption sites (SCS) on overdose mortality. Between 2017 and 2019, nine SCS were implemented in Toronto, Canada. During this period there were 787 overdose deaths. In the 15 neighborhoods within 500 meters of an SCS, overdose deaths decreased by 67% (p=0.037) after SCS were implemented. There was no decrease in other neighborhoods. Researchers were surprised to observe some decrease in overdose deaths up to 5000m from SCS. They note that in addition to onsite overdose reversal, SCS also distribute naloxone and offer referrals to low-barrier MOUD. They speculate that these other services could explain the effects at greater distances. The authors conclude that SCS result in significant reductions in overdose deaths in surrounding neighborhoods.
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Customer Reviews
Be mindful in picking studies
I enjoy the podcast, but the lead article from the October 10th podcast, discussing association of increased temperatures with SUD hospitalizations and making the conclusion climate change is contributing to SUD hospitalizations, is disappointing. The study association is correlation at best. The authors making the leap of linking climate change to SUD hospitalizations is, frankly, terrible, but this podcast should not have highlighted the study. There is also correlation data to show warmer temperatures correlate with increased rape case, increased murders, likely others as well. Does this mean climate change is contributing to rape and murder? No, it is merely a correlation and cannot imply causation. Should the article been published with the author’s conclusions is a question for the journal, but, again, this podcast need not highlight it.