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McLaurin KA, Ott RK, Mactutus CF, Booze RM. Adolescent oral oxycodone self-administration disrupts neurobehavioral and neurocognitive development. Neuropharmacology 2024; 258:110064. [PMID: 38981578 DOI: 10.1016/j.neuropharm.2024.110064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/05/2024] [Accepted: 07/05/2024] [Indexed: 07/11/2024]
Abstract
Nonmedical use of prescription opioids peaks during late adolescence, a developmental period associated with the maturation of higher-order cognitive processes. To date, however, how chronic adolescent oxycodone (OXY) self-administration alters neurobehavioral (i.e., locomotion, startle reactivity) and/or neurocognitive (i.e., preattentive processes, intrasession habituation, stimulus-reinforcement learning, sustained attention) function has not yet been systematically evaluated. Hence, the rationale was built for establishing the dose-dependency of adolescent OXY self-administration on the trajectory of neurobehavioral and neurocognitive development. From postnatal day (PD) 35 to PD 105, an age in rats that corresponds to the adolescent and young adult period in humans, male and female F344/N rats received access to either oral OXY (0, 2, 5, or 10 mg/kg) or water under a two-bottle choice experimental paradigm. Independent of biological sex or dose, rodents voluntarily escalated their OXY intake across ten weeks. A longitudinal experimental design revealed prominent OXY-induced impairments in neurobehavioral development, characterized by dose-dependent increases in locomotion and sex-dependent increases in startle reactivity. Systematic manipulation of the interstimulus interval in prepulse inhibition supports an OXY-induced impairment in preattentive processes. Despite the long-term cessation of OXY intake, rodents with a history of chronic adolescent oral OXY self-administration exhibited deficits in sustained attention; albeit no alterations in stimulus-reinforcement learning were observed. Taken together, adolescent oral OXY self-administration induces selective long-term alterations in neurobehavioral and neurocognitive development enjoining the implementation of safer prescribing guidelines for this population.
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Affiliation(s)
- Kristen A McLaurin
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 South Limestone Street, Lexington, KY, 40508, USA.
| | - Rachael K Ott
- Cognitive and Neural Science Program, Department of Psychology, Barnwell College, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Charles F Mactutus
- Cognitive and Neural Science Program, Department of Psychology, Barnwell College, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Rosemarie M Booze
- Cognitive and Neural Science Program, Department of Psychology, Barnwell College, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
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Adams ZW, Marriott BR, Karra S, Linhart-Musikant E, Raymond JL, Fischer LJ, Bixler KA, Bell TM, Bryan EA, Hulvershorn LA. User-Guided Enhancements to a Technology-Facilitated Resilience Program to Address Opioid Risks Following Traumatic Injury in Youth: Qualitative Interview Study. JMIR Form Res 2023; 7:e45128. [PMID: 38032728 PMCID: PMC10722375 DOI: 10.2196/45128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Youth with traumatic injury experience elevated risk for behavioral health disorders, yet posthospital monitoring of patients' behavioral health is rare. The Telehealth Resilience and Recovery Program (TRRP), a technology-facilitated and stepped access-to-care program initiated in hospitals and designed to be integrated seamlessly into trauma center operations, is a program that can potentially address this treatment gap. However, the TRRP was originally developed to address this gap for mental health recovery but not substance use. Given the high rates of substance and opioid use disorders among youth with traumatic injury, there is a need to monitor substance use and related symptoms alongside other mental health concerns. OBJECTIVE This study aimed to use an iterative, user-guided approach to inform substance use adaptations to TRRP content and procedures. METHODS We conducted individual semistructured interviews with adolescents (aged 12-17 years) and young adults (aged 18-25 years) who were recently discharged from trauma centers (n=20) and health care providers from two level 1 trauma centers (n=15). Interviews inquired about reactions to and recommendations for expanding TRRP content, features, and functionality; factors related to TRRP implementation and acceptability; and current strategies for monitoring patients' postinjury physical and emotional recovery and opioid and substance use. Interview responses were transcribed and analyzed using thematic analysis to guide new TRRP substance use content and procedures. RESULTS Themes identified in interviews included gaps in care, task automation, user personalization, privacy concerns, and in-person preferences. Based on these results, a multimedia, web-based mobile education app was developed that included 8 discrete interactive education modules and 6 videos on opioid use disorder, and TRRP procedures were adapted to target opioid and other substance use disorder risk. Substance use adaptations included the development of a set of SMS text messaging-delivered questions that monitor both mental health symptoms and substance use and related symptoms (eg, pain and sleep) and the identification of validated mental health and substance use screening tools to monitor patients' behavioral health in the months after discharge. CONCLUSIONS Patients and health care providers found the TRRP and its expansion to address substance use acceptable. This iterative, user-guided approach yielded novel content and procedures that will be evaluated in a future trial.
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Affiliation(s)
- Zachary W Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Brigid R Marriott
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Swathi Karra
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Jodi L Raymond
- Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
| | - Lydia J Fischer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kristina A Bixler
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Teresa M Bell
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Eric A Bryan
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Leslie A Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
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Adams RS, McKetta SC, Jager J, Stewart MT, Keyes KM. Cohort effects of women's mid-life binge drinking and alcohol use disorder symptoms in the United States: Impacts of changes in timing of parenthood. Addiction 2023; 118:1932-1941. [PMID: 37338343 PMCID: PMC10527386 DOI: 10.1111/add.16262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/02/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND AND AIMS Alcohol use is increasing among women in mid-life concurrently with societal changes in timing of parenthood and changing cultural norms, which may influence alcohol use. The aim of this study was to determine if age of first parenting was associated with excessive drinking [i.e. past 2-week binge drinking and past 5-year alcohol use disorder (AUD) symptoms] among women during mid-life in the United States and to determine if there were pronounced cohort effects influencing these relationships. DESIGN This was a retrospective cohort, longitudinal study. SETTING, PARTICIPANTS AND MEASUREMENTS Data were drawn from the Monitoring the Future survey, an annual ongoing survey of high school students' substance use behaviors in the United States. Participants were women who completed the age 35 survey between 1993 and 2019, corresponding to high school senior years 1976-2002 (n = 9988). Past 2-week binge drinking and past 5-year AUD symptoms were self-reported. Age of first parenting was self-reported. FINDINGS Binge drinking and AUD symptoms were higher among women in recent than in older cohorts. Women from the 2018-19 cohort had increased odds of binge drinking [odds ratio (OR) = 1.73, 95% confidence interval (CI) = 1.41-2.12] and AUD symptoms (OR = 1.51, CI = 1.27-1.80) relative to women from the 1993-97 cohort. Throughout cohorts, there was an inverse association between transition to parenthood and excessive drinking outcomes (e.g. range for ORs for binge drinking among those without children compared with those who had had children between the ages of 18 and 24: 1.22-1.55). Simultaneously, there was a population shift towards delaying parenting in recent cohorts (i.e. 54% of women in the 1993-97 cohort had children before age 30 compared with 39% in the two recent cohorts), increasing the size of the group at highest risk for excessive drinking. CONCLUSIONS In the United States, subgroups of women at highest risk of excessive drinking appear to be expanding, probably supported in part by a trend towards delayed parenting.
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Affiliation(s)
- Rachel Sayko Adams
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, CO, USA
| | - Sarah C McKetta
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Maureen T Stewart
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Hua Y, Shi G, Zheng X, Huang C, Xu Y, Huang G, Wang W, Lu C, Guo L. Sex differences in the associations of non-medical use of prescription drugs with depressive and anxiety symptoms among undergraduates in China. J Affect Disord 2023; 332:254-261. [PMID: 37031877 DOI: 10.1016/j.jad.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/06/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Non-medical use of prescription drugs (NMUPD) and their association with depression and anxiety are becoming global concerns. Biological sex may introduce differential exposure to NMUPD or depressive/anxiety symptoms. However, few studies have investigated the potential sex differences in the associations of NMUPD with depressive/anxiety symptoms. METHODS Data were drawn from the 2019 School-based Chinese College Students Health Survey. A total of 30,039 undergraduates (mean age: 19.8 [SD: 1.3] years) from sixty universities/colleges in China completed standard questionnaires and were included in the study (response rate: 97.7 %). RESULTS In the final adjusted model, non-medical use of opioids (experimenters: β = 1.10, [95 % CI, 0.62 to 1.57]) or sedatives (frequent users: β = 2.98, [95 % CI, 0.70 to 5.26]) was associated with depressive symptoms, while non-medical use of opioids (frequent users: β = 1.37, [95 % CI, 0.32 to 2.42]) or sedatives (frequent users: β = 1.19, [95 % CI, 0.35 to 2.03]) was also associated with anxiety symptoms. Sex-stratified analyses indicated that lifetime opioids misuse was associated with depressive symptoms in both sexes but with anxiety symptoms only in males (β = 0.39, [95 % CI, 0.09 to 0.70]). The association of lifetime sedative misuse with depressive symptoms was greater in males, while the significant association with anxiety symptoms remained only in female (β = 0.52, [95 % CI, 0.14 to 0.91]). LIMITATIONS Causal inference cannot be made due to the cross-sectional nature of the data. CONCLUSIONS Our study suggests NMUPD is associated with depressive and anxiety symptoms among Chinese undergraduates, and the associations may differ by sex.
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Affiliation(s)
- Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Guangduoji Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Xinyu Zheng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Cuihong Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Yan Xu
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
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Thach NN. Applying Monte Carlo Simulations to a Small Data Analysis of a Case of Economic Growth in COVID-19 Times. SAGE OPEN 2023; 13:21582440231181540. [PMID: 37362768 PMCID: PMC10285188 DOI: 10.1177/21582440231181540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Studies on the going-on COVID-19 pandemic face small sample issues. In this context, Bayesian estimation is considered a viable alternative to frequentist estimation. Demonstrating the Bayesian approach's advantage in dealing with this problem, our research conducted a case study concerning ASEAN economic growth during the COVID-19 pandemic. By using Monte Carlo standard errors and interval hypothesis testing to check parameter bias within a Bayesian MCMC simulation study, the author obtained significant conclusions as follows: first, in insufficient sample sizes, in contrast to frequentist estimation, the Bayesian framework can offer meaningful results, that is, expansionary monetary and contractionary fiscal policies are positively associated with economic growth; second, in the face of a small sample, by incorporating more information into prior distributions for the model parameters, Bayesian Monte Carlo simulations perform so far better than naïve Bayesian and frequentist estimation; third, in case of a correctly specified prior, the inferences are robust to different prior specifications. The author strongly recommends applying specific informative priors to Bayesian analyses, particularly in small sample investigations.
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Burdzovic Andreas J, Brunborg GS. Norwegian adolescents' use of energy drinks and painkillers and misuse of prescription drugs prior to and during the initial COVID-19 pandemic year: Evidence from the MyLife study. Scand J Public Health 2022:14034948221141516. [PMID: 36541574 PMCID: PMC9780563 DOI: 10.1177/14034948221141516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIMS This study aimed to examine and compare the use of energy drinks, over-the-counter (OTC) painkillers and misuse of prescription drugs in two cohorts of Norwegian adolescents entering high school (i.e. grade 11) immediately prior to and during the initial year of the COVID-19 pandemic. METHODS Accelerated longitudinal design and multi-cohort sampling enabled identification of the two socio-demographically comparable cohorts of grade 11 students: (a) COVID-19 cohort assessed in the autumn of 2020 (n=915) and (b) pre-COVID-19 cohort assessed in the autumn of 2018/19 (n=1621). Unadjusted and adjusted logistic and Poisson models were used to estimate the proportion of (mis)users and use frequencies among (mis)users in two cohorts. RESULTS Energy drinks use was both more common in the COVID-19 cohort (60.8% vs. 52.5%; adjusted odds ratio=1.40, 95% confidence interval (CI) 1.18-1.66, p<0.001) and more frequent among users from this cohort than among their pre-COVID-19 counterparts (9.58 vs. 7.79 days past month, adjusted incidence risk ratio (aIRR)=1.23, 95% CI 1.14-1.32, p<0.001). No cohort differences were observed in OTC painkillers use. Prescription drugs misuse was equally common in the two cohorts but was more frequent among misusers from the COVID-19 cohort than among their pre-COVID-19 counterparts (18.94 vs. 12.45 times past year, aIRR=1.52, 95% CI 1.10-2.10, p<0.001). CONCLUSIONS
Norwegian adolescents from the COVID-19 cohort were more likely to use energy drinks and, once engaged in these behaviours, to use energy drinks and misuse prescription drugs more frequently than their pre-COVID-19 counterparts.
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Affiliation(s)
- Jasmina Burdzovic Andreas
- Norwegian Institute of Public Health, Norway,Department of Psychology, University of Oslo, Norway,Jasmina Burdzovic Andreas, Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway. E-mail:
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Si Y, West BT, Veliz P, Patrick ME, Schulenberg JE, Kloska DD, Terry‐McElrath YM, McCabe SE. An empirical evaluation of alternative approaches to adjusting for attrition when analyzing longitudinal survey data on young adults' substance use trajectories. Int J Methods Psychiatr Res 2022; 31:e1916. [PMID: 35582963 PMCID: PMC9464329 DOI: 10.1002/mpr.1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Longitudinal survey data allow for the estimation of developmental trajectories of substance use from adolescence to young adulthood, but these estimates may be subject to attrition bias. Moreover, there is a lack of consensus regarding the most effective statistical methodology to adjust for sample selection and attrition bias when estimating these trajectories. Our objective is to develop specific recommendations regarding adjustment approaches for attrition in longitudinal surveys in practice. METHODS Analyzing data from the national U.S. Monitoring the Future panel study following four cohorts of individuals from modal ages 18 to 29/30, we systematically compare alternative approaches to analyzing longitudinal data with a wide range of substance use outcomes, and examine the sensitivity of inferences regarding substance use prevalence and trajectories as a function of college attendance to the approach used. RESULTS Our results show that analyzing all available observations in each wave, while simultaneously accounting for the correlations among repeated observations, sample selection, and attrition, is the most effective approach. The adjustment effects are pronounced in wave-specific descriptive estimates but generally modest in covariate-adjusted trajectory modeling. CONCLUSIONS The adjustments can refine the precision, and, to some extent, the implications of our findings regarding young adult substance use trajectories.
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Affiliation(s)
- Yajuan Si
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Brady T. West
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Philip Veliz
- Department of Systems, Populations and LeadershipSchool of NursingUniversity of MichiganAnn ArborMichiganUSA
| | - Megan E. Patrick
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - John E. Schulenberg
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Deborah D. Kloska
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | | | - Sean E. McCabe
- Center for the Study of Drugs, Alcohol, Smoking and HealthDepartment of Health Behavior and Biological SciencesSchool of NursingUniversity of MichiganAnn ArborMichiganUSA
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Harder VS, Varni SE, Murray KA, Plante TB, Villanti AC, Wolfson DL, Maruti S, Fairfield KM. Prescription opioid policies and associations with opioid overdose and related adverse effects. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 97:103306. [PMID: 34107447 PMCID: PMC8585674 DOI: 10.1016/j.drugpo.2021.103306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 05/01/2021] [Accepted: 05/13/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND United States (US) policies to mitigate the opioid epidemic focus on reducing access to prescription opioids to prevent overdoses. We examined the impact of state policies in Vermont (July 2017) and Maine (July 2016) on opioid overdoses and opioid-related adverse effects. METHODS Study population included patients 15 years and older in all-payer claims of Vermont (N = 597,683; Jan.2016-Dec.2018) and Maine (N = 1,370,960; Oct.2015-Dec.2017). We used interrupted time series analyses to assess the impact of opioid prescribing policies on monthly opioid overdose rate and opioid-related adverse effects rate. We used the International Classification of Disease-10-CM to identify overdoses (T40.0 × 1-T40.4 × 4, T40.601-T40.604, T40.691-T40.694) and adverse effects (T40.0 × 5, T40.2 × 5-T40.4 × 5, T40.605, T40.695). RESULTS Immediately after the policy, the level of Vermont's opioid overdose rate increased by 34% (95% confidence interval, CI: 1.09, 1.65) while the level of opioid-related adverse effects rate decreased by 29% (95% CI: 0.58, 0.87). In Maine, there was no level change in opioid overdose rate, but the slope of the adverse effects rate after the policy decreased by 3.5% (95% CI: 0.94, 0.99). These results varied within age and rurality subgroups in both states. CONCLUSION While the decrease in rate of adverse effects following the policy changes is promising, the increase in Vermont's opioid overdose rate may suggest there is an association between policy implementation and short-term risk to public health.
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Affiliation(s)
- Valerie S Harder
- University of Vermont, Larner College of Medicine, Department of Pediatrics, 1 South Prospect Street, Burlington VT, 05401, USA; University of Vermont, Larner College of Medicine, Department of Surgery, 111 Colchester Avenue, Burlington, VT 05401, USA.
| | - Susan E Varni
- University of Vermont, Larner College of Medicine, Department of Pediatrics, 1 South Prospect Street, Burlington VT, 05401, USA
| | - Kimberly A Murray
- Maine Medical Center Research Institute, Center for Outcomes Research and Evaluation, 509 Forest Avenue, Suite 200, Portland, Maine 04101, USA
| | - Timothy B Plante
- University of Vermont, Larner College of Medicine, Department of Medicine, 89 Beaumont Ave, Burlington, VT 05405, USA
| | - Andrea C Villanti
- University of Vermont, Larner College of Medicine, Department of Psychiatry, 1 South Prospect Street, Burlington VT, 05401, USA
| | - Daniel L Wolfson
- University of Vermont, Larner College of Medicine, Department of Surgery, 111 Colchester Avenue, Burlington, VT 05401, USA
| | - Sanchit Maruti
- University of Vermont, Larner College of Medicine, Department of Psychiatry, 1 South Prospect Street, Burlington VT, 05401, USA
| | - Kathleen M Fairfield
- Maine Medical Center, Department of Medicine, 22 Bramhall Street, Portland, Maine 04102, USA
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Jager J, Keyes KM, Son D, Kloska D, Patrick ME, Schulenberg JE. Cohort and age trends in age 35-45 prevalence of alcohol use disorder symptomology, by severity, sex, race, and education. Drug Alcohol Depend 2021; 226:108820. [PMID: 34245999 PMCID: PMC8355144 DOI: 10.1016/j.drugalcdep.2021.108820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/25/2022]
Abstract
AIMS To present national trends by age and cohort among middle-aged adults in the prevalence of AUD symptomology, by severity, sex, race, and education. DESIGN National, multi-cohort longitudinal probability samples of US adults, with data collected at ages 35, 40, and 45 among 14 cohorts who reached age 45 between 2003 and 2016. SETTING Data were collected via self-administered questionnaires to adults in the United States. PARTICIPANTS The sample consisted of 20,634 individuals. MEASUREMENTS 5-year prevalence of symptoms consistent with a DSM-5 AUD. FINDINGS Between ages 35-45 prevalence of any AUD symptoms decreased 19 %; decreases were most evident between ages 35-40. From 2003 to 2016, AUD symptoms were steady across cohort. However, because the pace of decrease across ages 35-45 slowed across cohort, cohort differences emerged at specific ages: age 35 prevalence decreased 18 % across cohort, but age 45 prevalence was equivalent across cohort. Age and cohort effects, and their interaction, did not vary by AUD severity level. Declines in AUD symptoms across age were 17 % slower for women, and declines in AUD symptoms across age and cohort were 11 % and 29 % slower, respectively, for those with a college degree. The protection afforded by a college degree was reversed among mild AUD and most pronounced for severe AUD. CONCLUSIONS AUDs may be more plastic and responsive to intervention during early mid-life than later. Despite progress in reducing the burden of AUD in the US population among younger middle-aged adults, an increased focus remains necessary as they continue to age.
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Affiliation(s)
- Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701, Tempe, AZ 85287-3701, United States.
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Daye Son
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701, Tempe, AZ 85287-3701
| | - Deb Kloska
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - John E. Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, MI,Department of Psychology, University of Michigan, Ann Arbor, MI
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Young HN, Pathan F, Reeves JH, Knight KN, Chen F, Cox ED, Moreno MA. Using a theoretical approach to predict college students' non-medical use of prescription drugs - a survival analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:470-477. [PMID: 31662045 PMCID: PMC7188581 DOI: 10.1080/07448481.2019.1680556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/25/2019] [Accepted: 10/06/2019] [Indexed: 06/10/2023]
Abstract
This study assesses students' non-medical use of prescription drugs (NMUPD) from college entrance to graduation, and examines factors that predict NMUPD. Participants: The study was conducted between May 2011 and September 2015 with 338 students. Methods: Longitudinal cohort study design was used to examine NMUPD across time, and NMUPD-related attitudes and subjective norms. Five yearly interviews were conducted to collect data. Cox proportional hazards regression analysis was used to examine time to NMUPD. Results: Thirty-five percent of study participants reported NMUPD; the majority of those initiated non-medical use before their third year in college. Analyses indicated that more positive attitudes towards NMUPD (HR = 1.73, p < 0.001), increased subjective norms regarding NMUPD (HR = 1.01, p < 0.01), and gender (male) (HR= 1.89, p < 0.001) were significantly associated with sooner NMUPD. Conclusions: Findings suggest that NMUPD prevention efforts that target mutable factors such as attitudes and subjective norms should be implemented early during students' college careers.
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Affiliation(s)
- Henry N. Young
- Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA, USA
| | - Farah Pathan
- Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, GA, USA
| | - Jaxk H. Reeves
- Statistics Department, University Of Georgia, Athens, GA, USA
| | | | - FuNing Chen
- Statistics Department, University Of Georgia, Athens, GA, USA
| | - Elizabeth D. Cox
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Megan A. Moreno
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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D'Amico EJ, Davis JP, Tucker JS, Seelam R, Stein BD. Opioid misuse during late adolescence and its effects on risk behaviors, social functioning, health, and emerging adult roles. Addict Behav 2021; 113:106696. [PMID: 33264695 DOI: 10.1016/j.addbeh.2020.106696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/04/2020] [Accepted: 10/02/2020] [Indexed: 12/22/2022]
Abstract
Opioid misuse has emerged in recent years as a major public health concern in the United States, particularly for adolescents and emerging young adults. We examined the association of opioid misuse from ages 18 to 20 with four domains at age 21-22: risk behaviors and consequences; health; social functioning; and emerging adult roles. Participants were surveyed annually from 2008 through 2019. The sample includes N = 2880 youth from waves 8-11. The sample was approximately 18 years old at wave 8; 54% female, 46% Hispanic, 20% white, 20% Asian, 2% Black, and 11% multiracial. Opioid misuse was low in this general sample of young adults, with about 4% reporting misuse from age 18-20. We used latent growth curve modeling to examine how misuse from ages 18-20 was associated with functioning at age 21-22. Adolescents who reported opioid misuse at age 18 also reported more negative consequences from alcohol and cannabis use and greater odds of other prescription drug misuse at age 21-22 than those with no misuse. Those reporting opioid misuse at age 18 were also more likely to engage in sexual risk behaviors, report delinquent behavior, and have a higher likelihood of experiencing sexual victimization and engaging in sexual perpetration at age 21-22 than those with no misuse. Neither the intercept nor slope of opioid misuse was associated with depression, anxiety, physical health or ailments, satisfaction with friends, romantic relationship functioning, or emerging adult roles at wave 11. Findings highlight the importance of screening and brief intervention for adolescents reporting opioid misuse.
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Affiliation(s)
- Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, USA.
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, 669 W 34th St, Los Angeles, CA 90089, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, USA
| | - Bradley D Stein
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
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12
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Kogan SM, Bae D, Sigfusdottir ID, Kristjansson AL. Mental Health, Academic Engagement, and Youths' Nonmedical Use of Stimulants: A Latent Profile Analysis. Subst Use Misuse 2021; 56:479-483. [PMID: 33605832 DOI: 10.1080/10826084.2021.1879147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND: Nonmedical prescription stimulant (NPS) use is a growing problem in Europe. Poor mental health and lack of academic engagement are potent sources of risk for substance use. Studies suggest that considerable heterogeneity may characterize the risk profiles of NPS users. To understand better the potential profiles of risk that characterize NPS users, we conducted a latent profile analysis (LPA) to document subgroups of users based on their mental health and academic engagement. METHODS: A nationally representative, cross sectional survey of Icelandic youth was analyzed. The sample included 584 (5% of the sample) older adolescent students participating in a national study in Iceland who reported lifetime NPS use. RESULTS: Three subgroups of NPS users emerged from our analyses. The largest subgroup (43.1%) we labeled mentally healthy achievers; youth who appear to be academically motivated and have few if any mental health concerns. The second largest group (40.4%), low achievers, resembled a typical profile for drug users in that they reported low or modest academic engagement and moderate levels of mental health concerns. The third group, anxious achievers (16.5%) appears to represent youth who felt academics were very important, had moderate study motivation, and also reported elevated mental health concerns, especially anxiety. CONCLUSIONS: LPA revealed considerable heterogeneity among these users. Group membership suggests distinct approaches to prevention to address heterogeneity in motivations for NPS use.
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Affiliation(s)
- Steve M Kogan
- Human Development and Family Science, University of Georgia, Athens, USA
| | - Dayoung Bae
- Department of Home Economics Education, Korea University, Seongbuk-gu, Republic of Korea
| | - Inga Dora Sigfusdottir
- Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavik, Iceland
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13
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Fedorova EV, Schrager SM, Robinson LF, Roth AM, Wong CF, Iverson E, Lankenau SE. Developmental trajectories of illicit drug use, prescription drug misuse and cannabis practices among young adult cannabis users in Los Angeles. Drug Alcohol Rev 2020; 39:743-752. [PMID: 32390280 PMCID: PMC7652718 DOI: 10.1111/dar.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/27/2020] [Accepted: 04/05/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Young adults have the highest rates of drug use and contribute significantly to the growing population of medical cannabis patients (MCP). This study examined relationships between longitudinal patterns of illicit/prescription drug use/misuse and cannabis practices among young adult cannabis users. DESIGN AND METHODS In 2014-2015, 210 young adult MCP and 156 nonpatient users were recruited in Los Angeles and surveyed annually over four waves. The analytical sample was limited to completers of all four waves (n = 301). Distinct developmental trajectories of illicit drug use and prescription drug misuse were identified. Fixed effects regression analysis evaluated changes in cannabis practices by trajectory groups. RESULTS Results supported two-trajectory solutions (high/low) for illicit drug use and prescription drug misuse. Decreases in use within all four trajectories occurred by wave 4. Low illicit drug use trajectory members were more likely to self-report medical cannabis use. Membership in both types of high-use trajectories was associated with use of concentrates and edibles. The prevalence of MCP, edibles use and cannabis days decreased significantly by wave 4. DISCUSSION AND CONCLUSIONS While alternative cannabis forms use was associated with membership in high drug use trajectories, self-reported medical cannabis use (not MCP) was negatively associated with high illicit drug use trajectory membership. Reductions in the prevalence of MCP, cannabis days, edibles use and other drug use by wave 4 alongside stable levels of self-reported medical cannabis use might reflect the changing legal status of cannabis in California, maturing out phenomenon and safer patterns of cannabis use.
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Affiliation(s)
- Ekaterina V Fedorova
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Sheree M Schrager
- Department of Research and Sponsored Programs, California State University Northridge, Los Angeles, USA
| | - Lucy F Robinson
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Alexis M Roth
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Carolyn F Wong
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA
- Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, USA
- Division of Research on Children, Youth, and Families, Children's Hospital Los Angeles, Los Angeles, USA
| | - Ellen Iverson
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA
- Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, USA
| | - Stephen E Lankenau
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, USA
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14
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Arterberry BJ, Boyd CJ, West BT, Schepis TS, McCabe SE. DSM-5 substance use disorders among college-age young adults in the United States: Prevalence, remission and treatment. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:650-657. [PMID: 30946626 PMCID: PMC6776717 DOI: 10.1080/07448481.2019.1590368] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 12/20/2018] [Accepted: 02/24/2019] [Indexed: 05/26/2023]
Abstract
Objective: To determine the prevalence, remission, and treatment associated with DSM-5 substance use disorders (SUDs) among young adults based on college attendance. Participants: The population-based sample included 2,057 young adults aged 19-23 in college/school and 1,213 not currently attending college/school who participated from April 2012 through June 2013. Methods: Face-to-face interviews were conducted as part of a cross-sectional national survey. Results: The prevalence of any past-year DSM-5 SUD was 39.6% among young adults in college and 44.5% among those not attending college. Past-year tobacco use disorder and multiple DSM-5 SUDs were more prevalent among those not attending college. Among those with prior-to-past-year SUDs, abstinent remission was low among college (1.0%) and noncollege (1.9%) young adults. Conclusions: Approximately two in five U.S. college students had at least one past-year DSM-5 SUD. Sustained abstinent remission from SUDs is extremely rare (1-2%) and the majority of those with SUDs do not receive treatment.
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Affiliation(s)
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Brady T West
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
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15
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Drazdowski TK, Kelly LM, Kliewer WL. Motivations for the nonmedical use of prescription drugs in a longitudinal national sample of young adults. J Subst Abuse Treat 2020; 114:108013. [PMID: 32527515 DOI: 10.1016/j.jsat.2020.108013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/09/2020] [Accepted: 04/21/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION People's motivations for nonmedical use of prescription drugs (NMUPD) are not well studied, particularly in longitudinal representative samples. However, understanding which motivations are most popular and how these change over time for specific groups is important to inform interventions for NMUPD. METHODS The current study examined how young adults' motives for NMUPD changed over young adulthood, using a nationally representative sample of 12,223 young adults in 36 cohorts (1976-2012) as part of the Monitoring the Future study across three biennial waves (waves 1, 2, 3: modal ages 19/20, 21/22, and 23/24 years). We investigated these young adults' motivations for using stimulants, central nervous system depressants, and opioids when controlling for possible cohort effects. We included sex and college attendance as potential moderators. RESULTS Participants commonly reported recreational and self-treatment motivations over time and across drug classes, reporting four to five popular motivations in each drug class. Generalized estimating equations repeated measure analyses revealed relatively stable NMUPD motivations across young adulthood. Participants reported some reductions in experimentation and boredom as motivations for NMUPD and increases in certain self-treatment motivations, depending on prescription drug class. Overall, men were more likely to endorse recreational motivations, whereas women were more likely to endorse self-treatment motivations, though this varied somewhat by prescription drug class. Young adults not enrolled in college courses were more likely to endorse using stimulants nonmedically for different reasons than their peers who were enrolled. CONCLUSIONS NMUPD prevention and treatment efforts tailored to the young adult population should include methods to reduce both self-treatment and recreational use and need to consider prescription drug class, sex, and college attendance.
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Affiliation(s)
| | - Lourah M Kelly
- University of Connecticut School of Medicine, United States of America
| | - Wendy L Kliewer
- Virginia Commonwealth University, Department of Psychology, United States of America
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16
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Schepis TS, Klare DL, Ford JA, McCabe SE. Prescription Drug Misuse: Taking a Lifespan Perspective. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820909352. [PMID: 32214819 PMCID: PMC7065295 DOI: 10.1177/1178221820909352] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 01/30/2020] [Indexed: 11/16/2022]
Abstract
Prescription drug misuse (PDM), or medication use without a prescription or in ways not intended by the prescriber, is a notable public health concern, especially in the United States. Accumulating research has characterized PDM prevalence and processes, but age-based or lifespan changes in PDM are understudied. Given age-based differences in the medical or developmental concerns that often underlie PDM, it is likely that PDM varies by age. This review summarizes the literature on PDM across the lifespan, examining lifespan changes in prevalence, sources, motives and correlates for opioid, stimulant, and tranquilizer/sedative (or benzodiazepine) PDM. In all, prevalence rates, sources and motives vary considerably by age group, with fewer age-based differences in correlates or risk factors. PDM prevalence rates tend to decline with aging, with greater use of physician sources and greater endorsement of self-treatment motives in older groups. Recreational motives (such as to get high) tend to peak in young adulthood, with greater use of peer sources or purchases to obtain medication for PDM in younger groups. PDM co-occurs with other substance use and psychopathology, including suicidality, across age groups. The evidence for lifespan variation in PDM is strongest for opioid PDM, with a need for more research on tranquilizer/sedative and stimulant PDM. The current literature is limited by the few studies of lifespan changes in PDM within a single sample, a lack of longitudinal research, little research addressing PDM in the context of polysubstance use, and little research on minority groups, such as sexual and gender minorities.
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Affiliation(s)
- Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Dalton L Klare
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Jason A Ford
- Department of Sociology, University of Central Florida, Orlando, FL, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of MI, Ann Arbor, Michigan, USA.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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17
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18
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Schepis TS, Wilens TE, McCabe SE. Prescription Drug Misuse: Sources of Controlled Medications in Adolescents. J Am Acad Child Adolesc Psychiatry 2019; 58:670-680.e4. [PMID: 30768405 PMCID: PMC6491250 DOI: 10.1016/j.jaac.2018.09.438] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/12/2018] [Accepted: 10/24/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Adolescent controlled prescription drug misuse (PDM) co-occurs with significant consequences, including lower educational achievement, substance use disorder (SUD) symptoms, and psychopathology. Nonetheless, adolescent PDM sources and the prevalence of other substance use, SUD, and mental health outcomes associated with sources remain poorly understood. METHOD Data were from the 2009 to 2014 National Survey on Drug Use and Health, including 103,920 adolescents (12-17 years of age). Six mutually exclusive sources were used: physician source only, theft/fake prescription only, friend/relative for free only, purchases only, other source only, or multiple sources. Analyses occurred separately for prescription opioids, stimulants, and tranquilizer/sedatives. PDM source prevalence across adolescents and by sex and school enrollment/engagement were estimated. Adjusted odds of past-year DSM-IV substance-specific SUD, marijuana use, any SUD, major depressive disorder (MDD), anxiety diagnosis, mental health treatment, and past-month binge drinking were estimated by source. RESULTS Friends/relatives, for free, was the most common source (29.0%-33.2%), followed by physician sources for opioids (23.9%), purchases for stimulants (23.5%), and tranquilizer/sedatives (22.7%). Few school enrollment/engagement differences existed, but female adolescents were more likely to use multiple sources. Over 70% of adolescents using multiple sources had a past-year SUD. Multiple sources, purchases, and theft/fake prescription were more strongly associated with other substance use than physician source use, and multiple source use was linked with MDD. CONCLUSION Adolescents using multiple sources, purchases and theft/fake prescriptions have elevated rates of other substance use, SUD and MDD and particularly warrant intervention. Also, adolescents with other SUD and MDD should be screened for PDM and misuse sources.
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Affiliation(s)
| | - Timothy E. Wilens
- Massachusetts General Hospital, Boston, and Harvard Medical School, Cambridge, MA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, and the Institute for Research on Women and Gender, University of Michigan, Ann Arbor
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19
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Barman-Adhikari A, Hsu HT, Brydon D, Petering R, Santa Maria D, Narendorf S, Shelton J, Bender K, Ferguson K. Prevalence and correlates of nonmedical use of prescription drugs (NMUPD) among Young adults experiencing homelessness in seven cities across the United States. Drug Alcohol Depend 2019; 200:153-160. [PMID: 31132682 DOI: 10.1016/j.drugalcdep.2019.03.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/25/2019] [Accepted: 03/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Nonmedical use of prescription drugs (NMUPD) is an urgent public health concern facing the United States. Young adults experiencing homelessness (YEH) are at increased risk of NMUPD; however, community estimates of NMUPD among YEH are sparse. This current study sought to understand patterns and correlates of NMUPD in a geographically heterogeneous sample of YEH recruited from seven cities across the United States. METHODS From June 2016 to July 2017, 1,426 YEH (aged 18-26) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information on substance use, mental health, trauma, and sexual-risk behaviors. Multivariable logistic regression was utilized to assess demographic, psychological, and behavioral correlates of self-reported past-month NMUPD and NMUPD types (i.e., prescription stimulant, sedative, and opioids). RESULTS Approximately 20% of participants reported past-month NMUPD. Almost 9% reported misusing prescription opioids, 8.7% misused prescription sedatives, and 6% misused prescription stimulants. Multivariable logistic regressions revealed unmet mental health needs were associated with sedative and stimulant misuse but not opioid misuse. Having suicidal thoughts was associated with opioid misuse but not sedative or stimulant misuse. Although no geographical differences emerged for stimulant and sedative misuse, youth from Denver, Phoenix, and San Jose were more likely to engage in opioid misuse relative to youth in Los Angeles. CONCLUSIONS These findings indicate that interventions designed to address NMUPD need to be multifaceted, designed to address other risk behaviors correlated with NMUPD, and target unmet mental health needs.
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Affiliation(s)
- Anamika Barman-Adhikari
- Graduate School of Social Work, University of Denver, 2148 S. High St. Denver, CO, 80208, USA.
| | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, 729 Clark Hall, Columbia, MO, 65211, USA.
| | - Daphne Brydon
- Graduate School of Social Work, University of Denver, 2148 S. High St. Denver, CO, 80208, USA.
| | - Robin Petering
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1150 South Olive St. 1503-1, Los Angeles, CA, 90015, USA.
| | - Diane Santa Maria
- Department of Nursing Systems, Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave. Ste. 591, Houston, TX 77030, USA.
| | - Sarah Narendorf
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd. #110HA, Houston, TX, 77204-4013, USA.
| | - Jama Shelton
- Silberman School of Social Work at Hunter College, 2180 Third Ave. New York, NY, 10035, USA.
| | - Kimberly Bender
- Graduate School of Social Work, University of Denver, 2148 S. High St. Denver, CO, 80208, USA.
| | - Kristin Ferguson
- School of Social Work, Arizona State University, 411 N. Central Ave. #865, Phoenix, AZ 85004-0689, USA.
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20
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Sasao A, Takaki M, Jeong HJ, Yonemitsu K, Ohtsu Y, Tsutsumi H, Furukawa S, Morioka H, Ueda H, Nishitani Y. Development of a fluvoxamine detection system using a Quenchbody, a novel fluorescent biosensor. Drug Test Anal 2018; 11:601-609. [PMID: 30328685 DOI: 10.1002/dta.2520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 11/05/2022]
Abstract
The misuse of psychotropic drugs intended for medical treatment represents a recent worldwide public health concern. Quenchbody (Q-body) is a novel fluoroimmunosensor that can detect an antigen immediately without additional reagents or washing steps. Here, we describe creating Q-bodies for the detection of the antidepressant fluvoxamine (FLV) and determining optimal conditions to achieve the highest fluorescence intensity (FI). We prepared five Q-bodies with the fluorophore labeled at either the N- or C- terminus and with different linker lengths. Fluorescence was measurable within minutes, indicating the interaction of Q-bodies with FLV. The normalized FI (FI ratio) of the N-terminus labeled Q-body increased approximately 1.5-fold upon FLV addition; Q-bodies labeled at the C-terminus did not significantly increase FI. Among the fluorescence dyes used in this study, Rhodamine 6G labeled Q-body showed the best FI ratio. EC50 values of the N-terminus labeled Q-bodies were similar (23.2-224nM) regardless of linker length or labeling dye. We examined whether the Q-body could be applicable to serum matrix instead of phosphate-buffered saline. The intact serum interfered strongly with the Q-body fluorescence. However, the FI ratios of the Q-body for FLV-spiked serum filtrate, for which proteins were removed by filtration, showed a dose-dependency for detecting FLV levels. Deproteinization, which does not interfere with Q-body fluorescence measurements, is likely necessary to detect serum FLV with high sensitivity. This study demonstrates the potential of Q-body probes as a tool towards developing creative immunoassay applications.
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Affiliation(s)
- Ako Sasao
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Michiyo Takaki
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hee-Jin Jeong
- Department of Biological and Chemical Engineering, Hongik University, Sejong-si, South Korea
| | - Kosei Yonemitsu
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuki Ohtsu
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Tsutsumi
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shota Furukawa
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Morioka
- Department of Analytical and Biophysical Chemistry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Ueda
- Laboratory for Chemistry and Life Science, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan
| | - Yoko Nishitani
- Department of Forensic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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21
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Barry DT, Marshall BD, Becker WC, Gordon AJ, Crystal S, Kerns RD, Gaither JR, Gordon KS, Justice AC, Fiellin DA, Edelman EJ. Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care. Drug Alcohol Depend 2018; 191:348-354. [PMID: 30176548 PMCID: PMC6596307 DOI: 10.1016/j.drugalcdep.2018.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND/AIMS Although nonmedical use of prescription opioids (NMUPO) is a public health problem, few studies have examined the new-onset NMUPO in clinical populations. We estimated NMUPO incidence among veterans in medical care who had received prescription opioid medication and examined correlates of new-onset NMUPO. DESIGN Prospective cohort study. SETTING Veterans Health Administration primary care and infectious disease clinics in Atlanta, Baltimore, Bronx, Houston, Los Angeles, Manhattan, Pittsburgh, and Washington, DC. PARTICIPANTS Patients enrolled in the Veterans Aging Cohort Study wave 3 (2005-2007) who received prescription opioids in the previous year and without lifetime NMUPO were followed at waves 4 and 5 (2008-2011). MEASUREMENTS Cox proportional hazards regression was used to examine the relationship between duration of prescription opioid receipt and incident NMUPO, adjusting for demographics, alcohol and tobacco use, substance use disorders, psychiatric and medical diagnoses, and medication-related characteristics. FINDINGS Among eligible participants (n = 815), the median age was 52 (IQR = 47-58) and 498 (59.8%) were Black; 122 (15.0%) reported new-onset NMUPO, for an incidence rate of 5.0 per 100 person-years. In a multivariable Cox model, compared to <30 days, receipt of prescription opioids for 30-180 days (adjusted hazard ratio [AHR] = 1.65 95% CI: 1.06, 2.58) or >180 days (AHR = 1.99, 95% CI: 1.21, 3.29) was associated with incident NMUPO. CONCLUSIONS Duration of prescription opioid receipt is a risk factor for incident NMUPO among veterans receiving medical care. Providers who prescribe opioids should monitor for NMUPO, especially among those with a longer duration of opioid therapy.
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Affiliation(s)
- Declan T. Barry
- Yale School of Medicine, New Haven, CT, 06510, USA,APT Foundation Pain Treatment Services, New Haven, CT, 06519, USA,Corresponding author at: APT Pain Treatment Services, Yale School of Medicine, 495, Congress Ave, 2nd Floor, New Haven, CT 06519, USA., (D.T. Barry)
| | | | - William C. Becker
- Yale School of Medicine, New Haven, CT, 06510, USA,VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Adam J. Gordon
- University of Utah School of Medicine, Salt Lake City, UT, 84148, USA
| | - Stephen Crystal
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, 08901, USA
| | - Robert D. Kerns
- Yale School of Medicine, New Haven, CT, 06510, USA,VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | | | - Kirsha S. Gordon
- Yale School of Medicine, New Haven, CT, 06510, USA,VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Amy C. Justice
- Yale School of Medicine, New Haven, CT, 06510, USA,VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - David A. Fiellin
- Yale School of Medicine, New Haven, CT, 06510, USA,Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, 06510, USA
| | - E. Jennifer Edelman
- Yale School of Medicine, New Haven, CT, 06510, USA,Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, 06510, USA
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Wilens TE, Isenberg BM, Kaminski TA, Lyons RM, Quintero J. Attention-Deficit/Hyperactivity Disorder and Transitional Aged Youth. Curr Psychiatry Rep 2018; 20:100. [PMID: 30221318 DOI: 10.1007/s11920-018-0968-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Extensive research has been conducted on attention-deficit/hyperactivity disorder (ADHD) in children and adults; however, less is known about ADHD during the transition from childhood to adulthood. Transitional aged youth (TAY) with ADHD represents a particularly vulnerable population as their newfound independence and responsibility often coincides with the development of comorbid disorders. The purpose of this review is to provide an update on the evaluation, diagnosis, and treatment of TAY-ADHD. RECENT FINDINGS Recent studies discovering ADHD symptoms emerging in TAY call the classification of ADHD as a disorder necessarily developing in childhood into question. TAY-ADHD are also shown to be vulnerable to academic and social impairments, increased risky behavior, and comorbid psychiatric disorders. Due to the risk of stimulant diversion in TAY, providers are advised to take precaution when prescribing medication to this population. Recent studies demonstrating the efficacy of psychotherapy in conjunction with non-stimulant or extended release stimulant medication provide a feasible alternative. This review highlights research on the course and evaluation of ADHD, impairments and comorbidities specific to TAY, and treatments tailored to address the unique challenges associated with TAY-ADHD.
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Affiliation(s)
- Timothy E Wilens
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.
| | - Benjamin M Isenberg
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Tamar A Kaminski
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Rachael M Lyons
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA
| | - Javier Quintero
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Medical School, Complutense University of Madrid, Madrid, Spain
- PSIKIDS, Madrid, Spain
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Grigsby TJ, McLawhorn J. Missing Data Techniques and the Statistical Conclusion Validity of Survey-Based Alcohol and Drug Use Research Studies: A Review and Comment on Reproducibility. JOURNAL OF DRUG ISSUES 2018. [DOI: 10.1177/0022042618795878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The goal of the present review was to examine whether or not the use of modern missing data techniques impacts the statistical conclusion validity of research on alcohol and drug use outcomes in survey-based research studies. We identified 28 papers and received complete case data from the authors of 12 studies. Seven studies (25%) reported the missing data pattern (missing not at random [MNAR], missing at random [MAR], missing completely at random [MCAR]), 15 studies (53.6%) indicated the amount of missing observations in the data set, and a significant proportion of studies ( n = 13, 46.4%) did not report any of the conditions or assumptions under which the missing data analysis was performed or implemented. Six of the 12 (50%) studies analyzed reported a different number of statistically significant associations between the complete case and full sample analyses. Efforts should be made to make missing data analysis more accessible, easy to implement and report to improve transparency and reproducibility of findings.
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Co-administration of amphetamine with alcohol results in decreased alcohol withdrawal severity in adolescent rats. Behav Pharmacol 2018; 29:547-550. [PMID: 29595541 DOI: 10.1097/fbp.0000000000000405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Simultaneous use of stimulants and alcohol is a growing problem, particularly among older adolescents already prone to binge alcohol consumption. Adolescent rats consume high levels of alcohol when administered in a liquid diet and develop a strong alcohol withdrawal syndrome. We exploited this system to administer amphetamine in combination with alcohol and to test the effect of co-administration of amphetamine on alcohol withdrawal-induced hypoactivity and overall withdrawal severity. The presence of dietary amphetamine (≤40 mg/l) had no effect on consumption of control or alcohol-containing diets. Measured in an activity chamber, alcohol withdrawal hypoactivity was reduced significantly by co-administration of amphetamine with alcohol. Overall withdrawal severity was also reduced significantly when rats consumed amphetamine with alcohol. The results suggest that amphetamine co-use may mask physical signs of alcohol dependency and add to the importance of educational strategies pointing out the potential problems associated with co-use of stimulants and alcohol.
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Rougemont-Bücking A, Grazioli VS, Marmet S, Daeppen JB, Lemoine M, Gmel G, Studer J. Non-medical use of prescription drugs by young men: impact of potentially traumatic events and of social-environmental stressors. Eur J Psychotraumatol 2018; 9:1468706. [PMID: 29760868 PMCID: PMC5944370 DOI: 10.1080/20008198.2018.1468706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 04/03/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Non-medical use of prescription drugs (NMUPD) is an increasing phenomenon associated with physical and psychological consequences. This study investigated the effects of distinct forms of stress on NMUPD. Methods: Data from 5308 young adult men from the Swiss cohort study on substance use risk factors (C-SURF) were analysed regarding NMUPD of sleeping pills, tranquilizers, opioid analgesics, psychostimulants, and antidepressants. Various forms of stress (discrete, potentially traumatic events, recent and long-lasting social-environmental stressors) during the period preceding the NMUPD assessment were measured. Backward log-binomial regression was performed and risk ratios (RR) were calculated. Results: NMUPD was significantly associated with the cumulative number of potentially traumatic events (e.g. for opioid analgesics, RR = 1.92, p < .001), with problems within the family (e.g. for sleeping pills, RR = 2.45, p < .001), and the peer group (e.g. for tranquilizer use, RR = 2.34, p < .01). Factors describing family functioning in childhood showed very few significant associations. Sexual assault by acquaintances was associated only with use of sleeping pills (RR = 2.91, p p <.01); physical assault by acquaintances was not associated with NMUPD. Physical (e.g. for psychostimulants, RR = 2.01, p < .001) or sexual assaults (e.g. for antidepressants, RR = 4.64, p < .001) perpetrated outside the family context did show associations with several drug categories. Conclusion: NMUPD appears to be more consistently associated with discrete and potentially traumatic events and with recent social-environmental stressors than with long-lasting stressors due to family functioning during childhood and youth. Physical and sexual assaults perpetrated by strangers showed more associations with NMUPD than those perpetrated by a family member.
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Affiliation(s)
- Ansgar Rougemont-Bücking
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland.,Chair of Psychiatry and Psychotherapy, University of Fribourg, Department of Neurosciences and Movement Science (NMS), Psychiatry and Psychotherapy, Fribourg, Switzerland
| | - Véronique S Grazioli
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Simon Marmet
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Mélissa Lemoine
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Gerhard Gmel
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland.,Addiction Suisse, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Toronto, Canada.,Frenchay Campus, University of the West of England, Bristol, UK
| | - Joseph Studer
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
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Zondervan-Zwijnenburg M, Peeters M, Depaoli S, Van de Schoot R. Where Do Priors Come From? Applying Guidelines to Construct Informative Priors in Small Sample Research. RESEARCH IN HUMAN DEVELOPMENT 2017. [DOI: 10.1080/15427609.2017.1370966] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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