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Tolan NV, Kang P, Chai PR, Erickson TB, Hayes BD, Uljon SN, Demetriou CA, Melanson SEF. Impact of COVID-19 on Drug Positivity Rates in the Emergency Departments in Boston and Surrounding Areas. J Appl Lab Med 2024:jfae076. [PMID: 39076019 DOI: 10.1093/jalm/jfae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/17/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND The COVID-19 pandemic reportedly had a significant impact on drug and alcohol use. In this article, we determine positivity rates for urine drugs of abuse and blood alcohol in 5 emergency departments (ED) in the greater Boston metropolitan area over a 4-year period (pre-, during, and post-COVID-19 pandemic). METHODS Positivity rates for the urine drug screening (UDS) panel and blood alcohol concentration (>80 mg/dL; over the legal limit in MA) were calculated in patients presenting to one of the 5 ED (2 academic hospitals in Boston, MA and 3 community hospitals outside Boston, MA) during each of the 4 different time periods: pre-COVID (January 1, 2019 to December 31, 2019), stay-at-home (March 24, 2020 to May 18, 2020), during COVID (May 19, 2020 to March 28, 2021), and post-COVID (May 12, 2023 to August 31, 2023). Trend analysis was performed. Additionally, positivity rates during and post-COVID were compared to pre-COVID to determine any significant changes in drug positivity. RESULTS Stimulant (amphetamines and cocaine), cannabinoid, and methadone positivity increased during the pandemic and cocaine, cannabinoid, and methadone positivity remains elevated. By contrast, benzodiazepine and opioid (opiates, fentanyl, oxycodone) positivity decreased and remains lower post-COVID compared to pre-COVID. Patients in the ED with blood alcohol over the legal limit decreased both during and post-COVID. CONCLUSION Our study showed that the COVID-19 pandemic significantly affected drug and alcohol positivity rates in patients presenting to the ED in greater Boston area. We encourage other institutions to perform similar analyses to help determine local drug use patterns and appropriate composition of UDS panels.
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Affiliation(s)
- Nicole V Tolan
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Phillip Kang
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, United States
| | - Peter R Chai
- Harvard Medical School, Boston, MA, United States
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Boston, MA, United States
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
- The Fenway Institute, Boston, MA, United States
| | - Timothy B Erickson
- Harvard Medical School, Boston, MA, United States
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Boston, MA, United States
- Harvard Humanitarian Initiative, Cambridge, MA, United States
| | - Bryan D Hayes
- Harvard Medical School, Boston, MA, United States
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, United States
| | - Sacha N Uljon
- Harvard Medical School, Boston, MA, United States
- Department of Pathology, Massachusetts General Hospital, Boston, MA, United States
| | - Christiana A Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Stacy E F Melanson
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Swahn MH, Martinez P, Balenger A, Luningham J, Seth G, Awan S, Aneja R. Demographic disparities in the limited awareness of alcohol use as a breast cancer risk factor: empirical findings from a cross-sectional study of U.S. women. BMC Public Health 2024; 24:1076. [PMID: 38637773 PMCID: PMC11025251 DOI: 10.1186/s12889-024-18565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/10/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Alcohol use is an established yet modifiable risk factor for breast cancer. However, recent research indicates that the vast majority of U.S. women are unaware that alcohol use is a risk factor for breast cancer. There is limited information about the sociodemographic characteristics and alcohol use correlates of awareness of the alcohol use and breast cancer link, and this is critically important for health promotion and intervention efforts. In this study, we assessed prevalence of the awareness of alcohol use as a risk factor for breast cancer among U.S. women and examined sociodemographic and alcohol use correlates of awareness of this link. METHODS We conducted a 20-minute online cross-sectional survey, called the ABLE (Alcohol and Breast Cancer Link Awareness) survey, among U.S. women aged 18 years and older (N = 5,027) in the fall of 2021. Survey questions assessed awareness that alcohol use increases breast cancer risk (yes, no, don't know/unsure); past-year alcohol use and harmful drinking via the Alcohol Use Disorders Identification Test (AUDIT); and family, health, and sociodemographic characteristics. We conducted multivariate multinomial regression analysis to identify correlates of awareness that alcohol use increases breast cancer risk. RESULTS Overall, 24.4% reported that alcohol use increased breast cancer risk, 40.2% reported they were unsure, and 35.4% reported that there was no link between alcohol use and breast cancer. In adjusted analysis, awareness of alcohol use as a breast cancer risk factor, compared to not being aware or unsure, was associated with being younger (18-25 years old), having a college degree, and having alcohol use disorder symptoms. Black women were less likely than white women to report awareness of the alcohol use and breast cancer link. CONCLUSIONS Overall, only a quarter of U.S. women were aware that alcohol use increases breast cancer risk, although 40% expressed uncertainty. Differences in awareness by age, level of education, race and ethnicity and level of alcohol use offer opportunities for tailored prevention interventions, while the overall low level of awareness calls for widespread efforts to increase awareness of the breast cancer risk from alcohol use among U.S. women.
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Affiliation(s)
- Monica H Swahn
- Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA.
| | | | | | - Justin Luningham
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Gaurav Seth
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sofia Awan
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ritu Aneja
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.
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Tomsone LE, Neilands R, Kokina K, Bartkevics V, Pugajeva I. Pharmaceutical and Recreational Drug Usage Patterns during and Post COVID-19 Determined by Wastewater-Based Epidemiology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:206. [PMID: 38397695 PMCID: PMC10888181 DOI: 10.3390/ijerph21020206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Wastewater-based epidemiology (WBE) was applied to evaluate the consumption trends of pharmaceuticals (i.e., antibiotics, non-steroidal anti-inflammatory drugs, antiepileptics, antihypertensives, and others), as well as recreational drugs (caffeine, alcohol, and nicotine), in Latvia from December 2020 to July 2023. The time period covers both the COVID-19 pandemic and the post-pandemic periods; therefore, the impact of the implemented restrictions and the consequences of the illness in terms of the usage of pharmaceuticals thereon were investigated. Additionally, the seasonality and impact of the seasonal flu and other acute upper respiratory infections were studied. The results revealed that the pandemic impacted the consumption of alcohol, nicotine, and caffeine, as well as several pharmaceuticals, such as antihypertensives, antidepressants, psychiatric drugs, and the painkiller ibuprofen. The findings suggest that the imposed restrictions during the pandemic may have had a negative effect on the population's health and mental well-being. Distinct seasonal trends were discovered in the consumption patterns of caffeine and alcohol, where lower use was observed during the summer. The seasonal consumption trends of pharmaceuticals were discovered in the case of antibiotics, the antiasthmatic drug salbutamol, and the decongestant xylometazoline, where higher consumption occurred during colder seasons.
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Affiliation(s)
- Laura Elina Tomsone
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Riga, Latvia; (L.E.T.)
| | - Romans Neilands
- Faculty of Natural Sciences and Technology, Riga Technical University, Kipsalas Street 6B, LV-1048 Riga, Latvia
| | - Kristina Kokina
- Faculty of Natural Sciences and Technology, Riga Technical University, Kipsalas Street 6B, LV-1048 Riga, Latvia
| | - Vadims Bartkevics
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Riga, Latvia; (L.E.T.)
| | - Iveta Pugajeva
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Riga, Latvia; (L.E.T.)
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Palamar JJ, Rutherford C, Le A, Keyes KM. Seasonal Variation of Use of Common Psychedelics and Party Drugs Among Nightclub/Festival Attendees in New York City. J Psychoactive Drugs 2023:1-8. [PMID: 37605471 PMCID: PMC10879452 DOI: 10.1080/02791072.2023.2240322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/29/2023] [Indexed: 08/23/2023]
Abstract
Few epidemiological studies have focused on seasonal variation in the use of common psychedelics and party drugs among nightclub and festival attendees, typically those who attend electronic dance music (EDM) events. We sought to determine whether the use of different drug types varies seasonally within this population. Across 15 seasons from summer 2017 through fall 2022, we surveyed 3,935 adults entering randomly selected nightclubs and festivals in New York City regarding their past-month use of cocaine, MDMA (3,4-methylenedioxymethamphetamine, commonly known as ecstasy), lysergic acid diethylamide (LSD), psilocybin (shrooms), and ketamine. Multivariable models were used to compare adjusted odds ratios for drug use within each season with the grand mean of combined seasons. Summer was associated with higher odds for use of LSD (aOR 2.72; 95% CI, 1.88-3.93) and psilocybin (aOR 1.65; CI, 1.12-2.43), independent of increases in psilocybin use over time (p < .001). A significant increase in use of ketamine (p = .014) and significant decreases in use of cocaine (p = .002) and ecstasy (p = .002) were found across time, but multivariable models did not detect seasonal variations. Summer is a risk factor for use of common psychedelics among people who attend EDM events. Therefore, the summer months may be the best time to disseminate information about harm reduction for psychedelic drug users.
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Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY
| | - Caroline Rutherford
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY
| | - Austin Le
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY
- New York University College of Dentistry, New York, NY
| | - Katherine M. Keyes
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY
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Wang C, He J, Yan X, Zhang C, Chen Y, Ye Y. Temporal-spatial evolution analysis of severe traffic violations using three functional forms of models considering the diurnal variation of meteorology. ACCIDENT; ANALYSIS AND PREVENTION 2022; 174:106731. [PMID: 35696853 DOI: 10.1016/j.aap.2022.106731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/05/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Traffic violations and crashes are inherently associated. Analysis of traffic violation frequency is a prerequisite for improvements in crash prevention and corresponding countermeasures. One of the essential works in the field of traffic violations relates to the exploration of the correlations between a certain violation type (e.g., speeding or safety belt use) and its causal factors (e.g., demographics and road types). Till now, the effects of spatiotemporal and meteorological factors on severe traffic violations, a general term for dangerous driving behaviors, have not been fully considered. Using the dataset consisting of daily severe traffic violations and meteorological conditions during 12 months in Jiangsu Province, China, violation performance functions were developed for three violation types (total violations, driving under the influence, and speeding) based on three models (Poisson regression, zero-inflated Poisson regression, and negative binomial model). The findings indicate that the negative binomial model has a better performance for traffic violation frequency estimation. Additionally, elastic analysis for three violation types relying on the negative binomial model was conducted to present the relationships between the explanatory variables and the expected violation frequency. The effects of spatiotemporal factors have revealed that the violation situations are significantly different in varying cities and the frequency of drunk driving shows a significant time instability. It is also found that rainy days will generate a decrease in the possibility of violation occurrence. With regard to temperature, a significant negative effect is found and the decrease in temperature will bring about an increase in violation frequency. Besides, traffic violation frequency is significantly increased during holidays with comfortable weather conditions. The conclusion of this study can provide insightful suggestions for the department of traffic enforcement to adjust the patrol plans according to the specified periods (weeks, months, or holidays) and weather conditions. Special rectification actions and targeted educational activities are also advised to be put forward simultaneously.
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Affiliation(s)
- Chenwei Wang
- School of Transportation, Southeast University, 2 Si pai lou, Nanjing 210096, PR China.
| | - Jie He
- School of Transportation, Southeast University, 2 Si pai lou, Nanjing 210096, PR China.
| | - Xintong Yan
- School of Transportation, Southeast University, 2 Si pai lou, Nanjing 210096, PR China.
| | - Changjian Zhang
- School of Transportation, Southeast University, 2 Si pai lou, Nanjing 210096, PR China.
| | - Yikai Chen
- School of Automotive and Transportation Engineering, Hefei University of Technology, 193 # Tunxi Road, 230009 Hefei, PR China.
| | - Yuntao Ye
- School of Transportation, Southeast University, 2 Si pai lou, Nanjing 210096, PR China.
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