Missing Opportunities in the Screening of Alcohol Use and Problematic Use, and the Provision of Brief Advice and Treatment Information Among Individuals With Alcohol Use Disorder.

OBJECTIVES: The aim of this study was to identify sociodemographic and substance-related factors associated with being screened, receiving advice or treatment information from healthcare providers, among individuals who met the criteria for the past 12-month alcohol use disorder (AUD). METHODS: The 2015-2019 National Survey on Drug Use and Health data were analyzed to identify factors associated with being (1) asked about alcohol used among adults with AUD, who visited a healthcare provider within the past 12 months, and were not receiving AUD treatment (sample 1, n = 13,321); (2) asked about problematic use; (3) advised to reduce consumption; and (4) offered alcohol treatment information, among those in sample 1 who were asked about their use (n = 6,905). RESULTS: About half (52.9%) in sample 1 were asked about their alcohol use. Among them, 21.6% were asked about problematic use, 17.7% were advised to reduce alcohol consumption, and 7.6% were offered information. The odds of being asked about alcohol use among male participants were 0.72 times the odds of female participants; however once asked, male participants showed greater odds of being asked about problematic use (adjusted odds ratio [aOR] = 1.53, 95% confidence interval [CI] = 1.29-1.82), advised to reduce consumption (aOR = 1.64, 95% CI = 1.24-2.16), and offered treatment information (aOR = 1.77, 95% CI = 1.34-2.35). As compared with non-Hispanic White participants, other racial/ethnic groups were less likely to be asked about alcohol use; however, once asked, no differences were observed for other outcomes. CONCLUSIONS: Significant gaps in the screening and provision of advice or treatment information were identified, particularly for racial/ethnic and sex subgroups. Reducing barriers for effective screening could help address AUD-related disparities.

The independent and joint effect of socioeconomic status and Multiracial status on the prevalence and frequency of substance use and depression among U.S. adolescents.

AIM: While the United States is becoming increasingly Multiracial, much is still unknown about the behavioral health of these growing new generations of Multiracial Americans. To narrow this research gap, this study investigated the prevalence/frequency of substance use and major depressive episodes [MDE] among non-Hispanic Multiracial [NHM] adolescents compared to their non-Hispanic White [NHW] counterparts and whether racial differences vary by socioeconomic status. METHODS: We analyzed data from the 2015-2019 National Survey on Drug Use and Health (N = 3,645 NHM and 34,776 NHW adolescents aged 12-17). Average Marginal Effects derived from logistic regression and negative binomial regression were used to examine (1) differences in six outcomes (past-month use of alcohol, cannabis, or drugs other than cannabis [DOTC], past-year MDE, and the frequency of alcohol and cannabis use among past-month users) by Multiracial status; (2) the moderation effect of family income on these associations. RESULTS: Compared to high-income NHW adolescents, high-income NHM adolescents reported significantly higher prevalence of past-month cannabis and DOTC use, and past-year MDE. No racial differences were observed at other income levels. Furthermore, moderation analyses indicated that the effect of Multiracial status on MDE was larger in the highest income group compared to the lowest income group. CONCLUSION: Our findings suggested that NHM adolescents, particularly those from high income families, exhibit increased prevalence of drug use and depression than NHW adolescents. As the US becomes more diverse, there is a need to further examine the social and structural factors driving the identified racial differences.

Examining the Intersection of Ethnoracial Disparities and HIV Status in Substance Use Risks among U.S. Adults.

Black/African American and Hispanic Americans experience significant HIV-related disparities. Substance use might be a contributing factor to these disparities, but there is limited research on this topic. This study investigated various substance use risks by HIV status and race/ethnicity (Black, Hispanic, White) among U.S. adults. We used data from the 2005-2019 National Survey on Drug Use and Health (N = 541,921). In each racial/ethnic group, the prevalence rates of past-year and past-month tobacco, alcohol, cannabis, and cocaine use, and past-year alcohol and illicit drug use disorders were estimated by HIV status. A series of logistic regressions with the interaction term of HIV x race/ethnicity were performed to examine race/ethnicity's moderating effect on the HIV-substance use associations, while controlling for sociodemographic factors and survey year. Moderation analysis showed that HIV status's association with the risks of past-year tobacco use (AOR = 1.67, 95% CI = 1.01-2.75), past-year cocaine use (AOR = 3.80, 95% CI = 1.91-7.57), past-month cocaine use (AOR = 5.34, 95% CI = 2.10-13.60), and past-year alcohol use disorder (AOR = 2.52, 95% CI = 1.29-4.92) differed significantly between Black and White adults. Between the Hispanic and White groups, HIV status's association with the risks of past-year alcohol use (AOR = 2.00, 95% CI = 1.09-3.69), past-year cocaine use (AOR = 2.40, 95% CI = 1.06-5.39), and past-month cocaine use (AOR = 3.69, 95% CI = 1.36-10.02) also differed significantly. It is well-established that individuals with HIV face an elevated risk of substance use. Our study added valuable insights by highlighting that this phenomenon is particularly more significant among Black and Hispanic adults for several substances when compared to White adults. Implications for practice are discussed.

Opioid Misuse and Associated Health Risks among Adults on Probation and Parole: Prevalence and Correlates 2015-2020.

BACKGROUND: As state legislatures work to reduce prison populations and increase the use of community-based alternatives, limited knowledge exists about the service needs of those under criminal justice supervision in the community. Preliminary research indicates unusually high rates of disease, disability, and death. Health risks for this population include opioid misuse, a form of substance misuse that has reached epidemic proportions in the U.S. Evidence indicates this may be one of multiple epidemics this population experiences, complicating intervention. METHODS: Our study included 5154 individuals on probation or parole. Using 2015-2020 data from the National Survey of Drug Use and Health (NSDUH), we conducted a series of logistic regressions examining associations between opioid misuse and a range of health risks, controlling for sociodemographic variables and survey year. RESULTS: Approximately 17% of those on probation or parole indicated past-year opioid misuse, a rate 4 times higher than in the general population. Compared to those on probation and parole who did not misuse opioids, it was associated with higher odds of other health risk behaviors and mental health problems. For example, the odds of marijuana and cocaine use were 4-6 times higher and the odds of substance use disorder were 10 times higher. Similarly, the odds of experiencing major depressive episodes and serious psychological distress were 2-3 times higher. CONCLUSIONS: Our findings reveal a markedly high risk for opioid misuse within this population along with associated risks for behavioral and mental health problems. The complex treatment needs of this population require greater policy attention and further research.

Driving under the influence of cannabis and alcohol: Evidence from a national sample of young drivers.

OBJECTIVE: Driving under the influence (DUI) of psychoactive substances is an important public health and criminal justice issue, impacting the lives of millions of Americans. Although recent research provides up-to-date information regarding DUI among adults, there is a pressing need for research that focuses specifically on younger/underage drivers. We draw from a large, nationally-representative sample to provide up-to-date evidence as to the prevalence and key criminal justice, substance use, and behavioral health correlates of DUI of cannabis and alcohol among drivers ages 16 to 20 in the United States. METHODS: We used data from the 2020 and 2021 National Survey on Drug Use and Health (young drivers ages 16-20; N=12,863). All analyses-survey adjusted prevalence estimates, logistic regression-were conducted using Stata SE 17.0 and weighted to account for the study's stratified cluster sampling design. RESULTS: The prevalence of DUI-cannabis for the full sample-including those not endorsing past-year use-was 6.3%. Among youth endorsing past-year cannabis use, 24.5% reported DUI of cannabis. In the full sample and among cannabis users, DUI-cannabis risk was elevated among older and male youth. The prevalence of DUI-alcohol was 2.6% among all youth and 6.1% among youth reporting past-year alcohol consumption. CONCLUSIONS: Estimates indicate that more than one million young drivers each year are placing their lives and those of others at risk by operating motor vehicles after consuming cannabis and/or alcohol. Findings underscore the importance of prevention efforts targeting underaged cannabis and alcohol-impaired driving.

Culturally adapted motivational interviewing's effects on drinking in response to immigration and acculturation stressors among Latinx adults with heavy drinking problems.

INTRODUCTION: Culturally adapted motivational interviewing (CAMI) is a form of motivational interviewing that was adapted to address immigration- and acculturation-related stressors among Latinx adults who met criteria for hazardous drinking. This study hypothesized that (1) receiving CAMI was associated with reduced immigration/acculturation stress and related drinking and that (2) these associations differed by participants' acculturation and perceived discrimination levels. METHODS: This study employed a single group pre-post study design using data from a randomized controlled trial. Participants were Latinx adults who received CAMI (N = 149). The study assessed immigration/acculturation stress with the Measure of Immigration and Acculturation Stressors (MIAS) and measured related drinking with the Measure of Drinking Related to Immigration and Acculturation Stressors (MDRIAS). The study team conducted linear mixed modeling for repeated measures to examine outcome changes between the baseline and the 6-month and 12-month follow-ups and moderation effects. RESULTS: Compared to baseline, the study found significant decreases in the total MIAS and MDRIAS scores and subscale scores at 6- and 12-month follow-ups. Moderation analysis results showed that lower acculturation levels and higher levels of perceived discrimination were significantly associated with larger decreases at follow-up in total MIAS and MDRIAS scores and several subscale scores. CONCLUSIONS: Findings provide preliminary support for CAMI's efficacy in reducing immigration and acculturation stress and related drinking among Latinx adults with heavy drinking problems. The study observed more improvements among the less acculturated and more discriminated participants. Larger studies with more rigorous designs are needed.

Mutual Help Group Participation for Alcohol and Drug Problems: Uncovering Latent Subgroups.

Objective: This report aims to identify US mutual help group (MHG) participants' psycho-socio-behavioral profiles. Method: We used data from the 2015-2018 National Survey on Drug Use and Health and the sample included 1022 adults with past-year substance use disorders (SUD). We conducted a latent class analysis to identify subgroups of MHG participants and estimated multinomial logistic regression models to examine the associations between sociodemographic/intrapersonal characteristics and class membership. Results: Analyses identified three latent classes. Class 1 (Low-Risk group, 54%) reported low risks in all correlates except for serious psychological distress (SPD, 33%). Class 2 (Psychological Distress group, 30%) demonstrated high risks of major depressive episodes (86%) and SPD (93%). Class 3 (Criminal Justice System Involvement group, 16%) showed high involvement in arrests (100%) and drug-related arrests (67%) and moderate risks for SPD (54%) and behavioral problems, e.g., drug selling (46%) and theft (35%). Compared to Class 1, Class 2 was more likely to be female, out of the labor force, and to show high risk propensity, and Class 3 was more likely to have lower education and drug use disorders. Class 3 was also less likely to be older, belong to the "other" racial/ethnic category, have lower English proficiency, and report alcohol use disorder. Conclusions: The three subgroups of the US MHG participant population illustrate the complex and heterogeneous psycho-social-behavioral profiles of MHG participants with SUD. MHG referral's effectiveness may be augmented by tailoring it to the patient/client's specific psycho-socio-behavioral profile.

Simultaneous alcohol and marijuana use among college students in the United States, 2006-2019.

Objective: Simultaneous alcohol and marijuana (SAM) use exposes college students to a myriad of adverse consequences. However, there is no recent nationally representative study on SAM use among college students in the United States (US). To provide an update to the literature, the present study aimed to examine the trends, prevalence, and correlates of SAM use among US college students between 2006 and 2019, using nationally representative data. Method: We used data from the 2006-2019 National Survey on Drug Use and Health (NSDUH) and the analytic sample was limited to the 55,669 full-time college student respondents (ages 18-22). Using logistic regression analysis, we assessed trends in SAM use prevalence and examined sociodemographic and psycho-social-behavioral correlates of SAM use. Results: The proportion of US college students who reported SAM use increased significantly from 8.13% (2006-2010) to 8.44% (2015-2019). However, examination by race/ethnicity revealed that the increasing trend was largely driven by Black college students, whose SAM use prevalence increased significantly from 5.50% (2006-2010) to 9.30% (2015-2019), reflecting a 69.09% increase. SAM use rates did not change significantly among other racial/ethnic groups. Conclusions: This study uncovered an upward trend and prevalence of SAM use among US college students, calling for more research and public health interventions in this area. At-risk subgroups that warrant more attention include college students who are Black, female, above the legal drinking age, have a lower than $20,000 household income, and reside in small metropolitan areas.

Who benefits from Two Way Prayer Meditation? Treatment effect moderators in a pilot randomized controlled trial of a spiritual intervention for people with substance use disorders.

Background: Two Way Prayer Meditation (TWPM) is a spiritual intervention that holds promise for improving the psychospiritual well-being of individuals in recovery from substance use disorders (SUD). This study aimed to identify moderators of TWPM's treatment effects. Moderators tested included gender, race/ethnicity, age, education, religious/spiritual affiliation, and most often used substance. Methods: This study employed a randomized controlled trial design with pretest and posttest. In total, 134 adults in four residential recovery programs participated in the study and were randomly assigned to the TWPM group or the treatment as usual control group. Linear mixed modeling was used to assess the moderating effect of each hypothesized moderator in the form of interaction tests. Sensitivity analyses were conducted by excluding cases with more than a minimum number of missing items. Results: There were no significant moderators for psychological distress, self-esteem, and most of the spiritual well-being outcomes. Both the primary and sensitivity analyses showed education significantly moderated TWPM's effect on overall spirituality self-ranking. Specifically, TWPM's positive effect on overall spirituality self-ranking was greater in the master's degree subgroup than in the less than high school subgroup. Conclusion: TWPM's treatment effects on most outcomes were not found to vary by the tested participant characteristics. The only statistically significant finding suggests clinicians may need to adjust TWPM workshop/teaching content, delivery style, or language used to reach clients with lower levels of education. Future better-powered studies are recommended to continue exploring the potential moderating effects of race/ethnicity, education, spiritual/religious affiliation, and most often used substance.

Mutual-help group participation for substance use problems in the US: Correlates and trends from 2002 to 2018.

BACKGROUND: Mutual-help groups (MHGs) are an integral component of the substance use disorder (SUD) treatment system in the U.S., and growing evidence suggests that they are effective and cost-effective for SUD-related problems. However, not much is known about the MHG participation patterns in the U.S. METHODS: Using the 2002-2018 National Survey on Drug Use and Health data, we estimated the annual participation rates and examined the psycho-social-behavioral correlates of MHG participation using logistic regression. RESULTS: There was no significant linear trend of MHG participation in the total US adult population between 2002 and 2018 (AOR = 0.999, 95% CI = 0.991-1.007). Among adults with past-year SUD, 4.8-7.4% of men and 4.4-6.7% of women participated in MHGs. MHG participants were more likely to be middle-aged (vs. young adults), lower education (less than high school, high school, some college vs. college or higher), lower income (annual household income <$20,000, $20,000-39,999 vs. $75,000 + ), be unemployed or not in the labor force (vs. employed), and were less likely to be Black/African American (vs. White American) and have lower English proficiency (speak English not well/not at all vs. very well/well),. CONCLUSION: MHG participation rates have remained relatively stable over the past two decades. MHGs were utilized more by individuals with lower socioeconomic status indicators and more criminal/legal involvement, possibly due to MHGs' free accessibility. However, research is needed to understand why young adults, Black, and individuals with lower English proficiency are somewhat less likely to attend MHGs.

Binge drinking in early adulthood: A machine learning approach.

Binge drinking among young adults (18-25) has been recognized as a public health concern. Considerable variation among drinking behaviors have been found among this group. Several statistical methods are available to identify theoretically and empirically meaningful correlates of binge drinking. The present study evaluated three methods for identifying correlates of binge drinking, comparing logistic regression to two machine learning methods-classification tress and random forests. While each model identified similar correlates of binge drinking-such as propensity for engaging in risky behaviors, marijuana dependence, cocaine dependence, identifying as non-Hispanic white, and higher education-the AUC analysis showed that the random forest analysis more accurately classified positive cases of binge drinking. Random forests modelling of psychosocial data is a feasible approach for identifying correlates of binge drinking behaviors among young adults. Clinical implications are discussed related to screening for binge drinking in behavioral health organizations.

Alcohol abstinence and binge drinking: the intersections of language and gender among Hispanic adults in a national sample, 2002-2018.

PURPOSE: Prior research examining alcohol use using national data has often overlooked vital heterogeneity among Hispanics, especially that related to language dominance and gender. We examine the prevalence of alcohol abstinence and-given prior research suggesting that many Spanish dominant Hispanics do not drink-examine rates of binge drinking among past-year alcohol users with a focus on the intersections of language and gender among Hispanics, while drawing comparisons with non-Hispanic (NH) White and NH Black adults. METHODS: Drawing from the National Survey on Drug Use and Health-a nationally representative survey between 2002 and 2018-we examine the year-by-year prevalence of alcohol abstinence and binge drinking among adults ages 18 and older in the United States. RESULTS: A disproportionate number of Spanish-dominant Hispanics abstain from alcohol use (54%), with particularly high levels of alcohol abstinence observed among Spanish dominant women (men: 39%, women: 67%). The prevalence of alcohol abstinence among English-dominant Hispanic men (24%) and women (32%) is far lower, approximating that of NH Whites (men: 23%, women: 32%). Importantly, however, among Spanish-dominant drinkers, the prevalence of binge drinking (men: 52%, women: 33%) is comparable to or greater than NH Whites (men: 42%, women: 32%). Binge drinking levels among English-dominant Hispanic men (50%) and women (37%) are greater than among their NH White counterparts. CONCLUSION: Findings paint a complex picture; consistent with prior research, we see that many Hispanics abstain from alcohol, but we also see new evidence underscoring that-among Hispanic drinkers-the prevalence of binge drinking is disconcertingly elevated.

Toward a typology of hallucinogen users in the United States.

BACKGROUND: Roughly one in ten American adults have used hallucinogens, and emerging evidence suggests that the prevalence of use is increasing. However, our understanding of the degree to which individuals "specialize" in the use of a particular hallucinogen or are poly-hallucinogen users remains incomplete. METHODS: This study examined data from 6381 individuals reporting past-year hallucinogen use in the 2016-2018 National Survey on Drug Use and Health. Logistic regression examined the association between the number of distinct hallucinogens used and psychosocial/behavioral risks, and latent class analysis (LCA) characterized subgroups of hallucinogen users. RESULTS: The vast majority of hallucinogen users, roughly 70%, are not "specialists" who use only one hallucinogen type; rather, lifetime poly-hallucinogen use is the norm. Critically, however, we also see that important differences exist within the population of hallucinogen users-half (51%) could be classified as LSD-Mushroom-Ecstasy users only (this group was disproportionally comprised of youth), nearly one third (30%) were Poly-Hallucinogen users (this group was disproportionately male and non-Hispanic White), and smaller proportions were limited primarily to use of LSD-Mushrooms (6%; these individuals were almost exclusively ages 35 and older) or Ecstasy Only (12%; these individuals were mostly younger adults ages 18-34). CONCLUSIONS: Findings provide a fresh contribution to our understanding of poly-hallucinogen use in a time in which local and state governmental leaders, and people across the country, weigh the benefits and drawbacks of legalizing specific hallucinogenic drugs.

Debunking the myth of low behavioral risk among Asian Americans: The case of alcohol use.

BACKGROUND AND PURPOSE: Asian Americans (AAs) are the fastest-growing ethnic group in the United States. There is a paucity of research on alcohol-related problems among AAs. However, alcohol use and misuse are a growing concern within this population and are associated with adverse health and mental health consequences. METHODS: Using data from the 2015-2018 National Survey on Drug Use and Health (NSDUH), we examined the prevalence, psycho-social-behavioral correlates, and gender differences in drinking, binge drinking, and alcohol use disorder (AUD) among AA adolescents and adults. We also estimated the prevalence of binge drinking and AUD by country of origin and nativity. RESULTS: Older adolescents (15-17) had the highest prevalence of past-month drinking (8.00%), binge drinking (4.3%), and AUD (1.8%). Among AA adults, the highest rates of binge drinking (23.0%) and AUD (7.2%) were observed among young adults ages 18-25. The highest rates of binge drinking and AUD were observed among US-born Korean Americans (binge drinking: 26.9%, AUD: 13.1%) and US-born Filipino Americans (binge drinking: 25.9%, AUD: 6.2%). CONCLUSIONS: Contrary to the common perception that AA is a low-risk group for alcohol problems, we found that AA young adults, US-born Korean, Filipino, and Indian Americans have a high risk for drinking, binge drinking, and/or AUD. We also identified risk and protective factors against alcohol use/misuse among AAs. Preventions and interventions that incorporate the important risk/protective factors for AAs using a culturally sensitive approach are needed.

Driving while under the influence of hallucinogens: Prevalence, correlates, and risk profiles.

BACKGROUND: Hallucinogen use is rising in the US, yet little is known regarding the prevalence and psychosocial/behavioral correlates of driving under the influence of these drugs. METHODS: This study examined data from 4447 individuals ages 16-64 who reported past-year hallucinogen use in the 2016-2018 National Survey on Drug Use and Health. Prevalence estimates (with 95% confidence intervals [CIs]) were calculated for driving under the influence of hallucinogens (DUIH). Logistic regression examined psychosocial/behavioral correlates of DUIH, and latent class analysis (LCA) characterized subgroups of individuals reporting DUIH. RESULTS: The prevalence of past-year hallucinogen use was 2.42% (CI = 2.30-2.54) and, in the general population, the prevalence of DUIH was 0.21%. Among past-year hallucinogen users, 8.94% (CI = 7.74-10.31) reported DUIH on at least one occasion over the previous 12 months. The probability of DUIH increased significantly with more frequent use. Compared to individuals who used hallucinogens and did not report DUIH, individuals reporting DUIH were significantly more likely to report mental health problems; use of other illicit drugs; selling drugs; a past-year arrest; or driving under the influence of alcohol, cannabis, or other illicit drugs. LCA identified three classes of individuals reporting DUIH, characterized by: use of and driving under the influence of cannabis; use of and driving under the influence of cannabis and other illicit drugs; and mental health concerns. CONCLUSIONS: Nearly one in ten individuals who report using hallucinogens also report driving under the influence of hallucinogens-drugs that affect perception and risk-taking, with alarming implications for driving safety.

Culturally adapted evidence-based treatments for adults with substance use problems: A systematic review and meta-analysis.

BACKGROUND: This systematic review/meta-analysis aimed to synthesize empirical evidence from randomized controlled trials on the efficacy of culturally adapted interventions (CAIs) for substance use and related consequences for adults of color. METHODS: Six electronic databases were searched to identify eligible studies. Two reviewers independently screened studies, extracted data, and assessed risks of bias. We used robust variance estimation in meta-regression to synthesize effect size estimates and conduct moderator analyses. RESULTS: Twenty-two studies met the inclusion criteria and were included in the review. The overall effect size was 0.23 (95 % Confidence Interval [CI] = 0.12, 0.35). The subgroup effect sizes for comparing CAIs with inactive controls and with active controls were 0.31 (CI = 0.14, 0.48) and 0.14 (CI=-0.02, 0.29), respectively. The effect sizes for alcohol use, illicit drug use, unspecified substance use outcomes, and substance use related consequences were 0.25 (CI = 0.08, 0.43), 0.35 (CI =-0.30, 1.00), 0.22 (CI=-0.17, 0.62), and 0.02 (CI=-0.11, 0.16), respectively. Moderator analysis showed that CAIs' effects might not vary significantly by treatment model, dose, country, follow-up assessment timing, participant age, or gender/sex. CONCLUSIONS: Research on substance use interventions that are culturally adapted for people of color is growing, and more high-quality studies are needed to draw definitive conclusions about CAIs' treatment effects. Our study found CAIs to be a promising approach for reducing substance use and related consequences. We call for more efficacy/effectiveness and implementation research to further advance the development and testing of evidence-based CAIs that meet the unique needs and sociocultural preferences of diverse populations.

Risk of bias assessments in systematic reviews and meta-analyses of behavioral interventions for substance use outcomes.

OBJECTIVE: This study aims to explore the current practice of risk of bias assessment in systematic reviews of behavioral clinical trials published in substance use journals and how assessment results were incorporated into meta-analysis. STUDY DESIGN AND SETTING: The authors searched for systematic reviews and meta-analyses of behavioral interventions published from 2016 to 2020 in 40 substance use journals. Two authors independently screened and extracted relevant information from each review. Different tools for risk of bias assessment and approaches of incorporating the risk of bias assessment results into meta-analysis were summarized. RESULTS: The study identified 35 systematic reviews and meta-analyses of behavioral clinical trials. Among the 35 reviews, 31 (89%) assessed the risk of bias of their included studies. Twelve (39%) of the 31 reviews incorporated these assessment findings into their meta-analysis of intervention effects (e.g., conducted meta-regression or subgroup analysis, sensitivity analysis, limited the synthesis only to the "high quality" studies). CONCLUSION: Performing and reporting risk of bias assessment remain inconsistent in published systematic reviews. Future systematic reviews and meta-analyses are encouraged to connect their risk of bias assessment findings with meta-analysis and follow the most updated PRISMA guidelines in reporting the methods and results of risk of bias assessment.

Solution-Focused Brief Therapy for Substance Use: A Review of the Literature.

Substance use is a prevalent public health issue. Most social workers may encounter substance use in their work with clients and need effective therapeutic strategies for this issue. Since the 1980s, solution-focused brief therapy (SFBT) has been practiced with clients who have substance use problems, and clinical training materials have been developed to help practitioners learn and use SFBT in substance use treatment. Despite the longevity of the use of SFBT in practice, there are no published reviews of outcome studies to guide practitioners using SFBT. This article fills a gap in current literature on SFBT and substance use treatment by reviewing the published studies on SFBT where the focus was on substance use treatment. Five databases were searched to identify eligible studies. Experts and reference lists of relevant studies were also consulted. Nine studies were identified and included in the review. All studies reviewed found promising evidence on SFBT's effectiveness in improving substance use behaviors and related psychosocial problems. Five of the nine studies reviewed showed that SFBT can change substance use and comorbid mental health and psychosocial problems such as depression, trauma, and school- and work-related behavior problems. The article concludes with a discussion of the study results' implications for clinical practice and future research.

LSD use in the United States: Trends, correlates, and a typology of us.

BACKGROUND: Recent years have witnessed an increased interest in LSD. This study investigates current information on the trends and correlates of LSD use from years 2002-2018 and seeks to develop an initial typology of use and misuse. METHODS: Data is taken from the NSDUH (National Survey on Drug Use and Health) collected between 2002 and 2018 and trends and correlates of LSD use were analyzed with a survey adjusted logistic regression. RESULTS: Our findings indicate that LSD use has increased 200 % over the study period (.23 % 2002-2005 to .72 % 2015-2018, AOR = 1.10, 95 % CI = 1.08, 1.12). Our findings also indicate several correlates of LSD use including higher levels of education (college degrees: AOR = 1.62, 95 % CI = 1.23, 2.13), not being married (divorced or separated, AOR = 2.31, 95 % CI = 1.44, 3.73, and have never been married, AOR = 5.67, f 95 % CI = 4.09, 7.86), as well as higher levels of antisocial behavior (having been arrested AOR = 3.20, 95 % CI = 2.50, 4.09) and comorbid mental health and substance abuse disorders (serious psychological distress, AOR = 2.39, 95 % CI = 2.05, 2.80). Further, four distinct subclasses were also discovered within LSD users and two of these subtypes of LSD users contained comorbid mental health disturbances and heavy involvement in the criminal justice system. CONCLUSION: LSD use has been on the rise within the last decades, particularly among those who are well educated. Two subclasses of LSD use (those with severe comorbid mental health disorders and those with criminal justice involvement) may require further interventions.

Prevalence and Correlates of Driving Under the Influence of Cannabis in the U.S.

INTRODUCTION: As cannabis use rises among adults in the U.S., driving under the influence of cannabis represents a public health concern. METHODS: In 2020, public-use data from the National Survey on Drug Use and Health were examined, using an analytic sample of 128,205 adults interviewed between 2016 and 2018. The annual prevalence of driving under the influence of cannabis was computed overall, by state, by demographic group, and among cannabis users. Demographic, psychosocial, and behavioral correlates of driving under the influence were tested by multivariate logistic regression. RESULTS: The self-reported annual prevalence of driving under the influence of cannabis was 4.5% (95% CI=4.3, 4.6) among U.S. adults, ranging from 3.0% (Texas) to 8.4% (Oregon) in individual U.S. states. Among cannabis users, 29.5% (95% CI=28.6, 30.3) reported driving under the influence of cannabis; the predicted probabilities of driving under the influence of cannabis were highest for those with more frequent use, with daily cannabis users evidencing a 57% predicted probability. Among individuals with symptoms suggestive of a cannabis use disorder, the prevalence of driving under the influence of cannabis was 63.8% (95% CI=60.8, 66.6). Among cannabis users, those reporting driving under the influence of cannabis had higher odds of driving under the influence of other illicit substances, using other illicit drugs, taking part in illegal behavior, and suffering from mental distress, after adjusting for demographic characteristics and psychosocial/behavioral correlates. CONCLUSIONS: Findings suggest that prevention efforts should focus on frequent and problem cannabis users and should include content related to other illicit drug use and other drug-impaired driving.