Alcohol-related non-fatal motor vehicle crash injury in the US from 2019 to 2022.

Background: Information on recent alcohol-related non-fatal motor vehicle crash (MVC) injuries is limited.Objectives: To analyze alcohol-related non-fatal MVC injuries, 2019-2022, considering COVID-19 and Stay-at-Home policies.Methods: State-level counts of alcohol-related non-fatal MVC injuries (involving individuals age 15+) from Emergency Medical Services data in 18 US states, chosen for comprehensive coverage, were analyzed for the annual rate. The total non-fatal MVC injury count in each state served as the denominator. We used analysis of variance to evaluate annual rate changes from 2019 to 2022 and used robust Poisson regression to compare annual mean rates to the 2019 baseline, pre-pandemic, excluding Quarter 1 due to COVID-19's onset in Quarter 2. Additional Poisson models compared rate changes by 2020 Stay-at-Home policies.Results: Data from 18 states were utilized (N = 1,487,626, 49.5% male). When evaluating rate changes of alcohol-related non-fatal MVC injuries from period 1 (Q2-4 2019) through period 4 (Q2-4 2022), the rate significantly increased from period 1 (2019) to period 2 (2020) by 0.024 (p = .003), then decreased from period 2 to period 4 (2022) by 0.016 (p = .04). Compared to the baseline (period 1), the rate in period 2 was 1.27 times higher. States with a 2020 Stay-at-Home policy, compared to those without, had a 30% lower rate (p = .05) of alcohol-related non-fatal MVC injuries. States with partial and mandatory Stay-at-Home policies had a 5.2% (p = .01) and 10.5% (p < .001) annual rate decrease, respectively.Conclusion: Alcohol-related non-fatal MVC injury rates increased initially (2019-2020) but decreased thereafter (2020-2022). Stay-at-home policies effectively reduced these rates.

Willingness to provide a hair sample for drug testing: results from an anonymous multi-city intercept survey.

Background: Hair provision for drug testing can provide secondary measurement to complement self-reported drug use data, thereby providing a more accurate representation of an individual's drug use. Understanding factors associated with hair provision offers valuable insights into recruitment methods.Objective: To identify demographic and drug-related correlates of providing hair samples in a multi-site venue-intercept study.Methods: We utilized venue-intercept sampling for our Rapid Street Reporting study across 12 US cities between January and November 2022. Participants reported past 12-month drug use and were asked if they would provide a hair sample. We conducted multivariable (generalized linear model with logit link) analyses on demographics and drug use characteristics correlated to hair provision for drug testing.Results: Among 3,045 participants, 55.8% were male, 13.6% provided hair samples. Compared to males, those identifying as "other gender" had higher odds of hair collection (adjusted odds ratio = 2.24, 95% confidence interval: 1.28-3.80). Participants identifying as Black (aOR = 0.32, CI: 0.23-0.45) or "other race" (aOR = 0.50, 95% CI: 0.29-0.80) had lower odds of providing hair than those identifying as White. All levels of reported drug use - one drug (aOR=1.50, 95% CI: 1.15-1.96), two-three drugs (aOR=1.51, 95% CI: 1.11-2.05), four or more (aOR = 2.13, 95% CI: 1.50-3.01) - had higher odds of providing hair samples than those reporting no drug use. Similar associations applied to reporting cannabis use with or without another drug (aOR = 1.52-1.81, 95% CI: 1.15-2.38).Conclusion: Differential hair provision based on participant sex, race/ethnicity, and drug use may introduce biases in drug testing, limiting generalizability to individuals from minority backgrounds.

Electronic Nicotine Delivery Systems (ENDS) use Among Members of a Community Engagement Program.

Electronic nicotine delivery systems (ENDS) are relatively new and ENDS use data from community engagement programs may help us understand usage patterns and facilitate targeted longitudinal studies. Community members in Florida, USA, were asked about ENDS use, tobacco use, and health history/concerns by Community Health Workers. Among 7253 members recruited during 2014 to 2021 into our HealthStreet program, 1177 had ever used ENDS; the proportion increased from 12 to 27% from 2014 to 2021 (adjusted odds ratio (aOR) 2.5; 95% CI 1.7-3.5; Ever versus never used ENDS). Ever tobacco use was strongly associated with ENDS use; 69% of ever users were current tobacco users. Demographic determinants (sex, age, race) and food insecurity were strongest predictors of ENDS use. Most who had ever used ENDS were aged 18-25 (aOR 5.9; 95% CI 4.6-7.6; vs. aged 60 + years), White (aOR 3.7; 95% CI 3.2-4.3; vs. Black/African American), male (aOR 1.5; 95% CI 1.3-1.7; vs. female), and recently food insecure (aOR 1.8; 95% CI 1.5-2.0; vs. not recently food insecure). Those with respiratory issues were more likely to have used ENDS compared to those without (aOR 2.0; 95% CI 1.6-2.6; aOR 1.3; 95% CI 1.1-1.5). Members concerned about hypertension were less likely to have used ENDS (aOR 0.7; 95% CI 0.5-0.9). In this relatively rural, micropolitan sample, tobacco use, socio-economic determinants, and certain health history/concerns were strongly associated with ENDS use. Community outreach approaches are needed to further understand these factors and implement interventions.

Study Navigation and Enrollment in a Community Sample: Does Generational Cohort Matter?

The socioecological model (SEM) was used as a conceptual framework to examine the effect of generational cohorts on study navigation and enrollment in health research. The study population was 7,370 community-dwelling Gen Xers and Baby Boomers in North Central Florida. Analyses found that Leading-edge Boomers (individuals born between 1946 and 1955) [vs Gen Xers (individuals born between 1965 and 1955)] and individuals with higher trust (vs lower trust) were 41% and 25% respectively more likely to be enrolled in health research compared to their counterparts, controlling for factors at the individual, relationship, and community levels of the SEM. We conclude the study with a summary of the findings and the recruitment implications for study enrollment.

Co-Use of Opioids and Sedatives Among Retired National Football League Athletes.

OBJECTIVE: Among the general population, co-use of opioids and sedatives is associated with greater risk of overdose compared with opioid use alone. National Football League (NFL) retirees experience higher rates of opioid use than the general population, although little is known about their co-use with sedatives. The aim of this study was to examine the prevalence and risk factors of opioid and sedative co-use among NFL retirees. DESIGN: Retrospective cohort study. SETTING: Professional American football. PARTICIPANTS: NFL retirees (N = 644). INDEPENDENT VARIABLES: Self-reported concussions, pain intensity, heavy alcohol use, physical and mental health impairment, disability status. MAIN OUTCOME MEASURE: Any past 30-day co-use of opioids and sedatives. RESULTS: Approximately 4.9% of the sample reported past 30-day co-use of opioids and sedatives, although nearly 30% of retirees using opioids also used sedatives. Greater pain was associated with co-use of opioids and sedatives (adjusted odds ratios [aOR] = 1.58; 95% confidence interval [CI] = 1.23-1.98), although retirees with moderate/severe mental health impairment (vs none/mild; aOR = 2.47; 95% CI = 1.04-5.91) and disability (vs no disability; aOR = 1.35; 95% CI = 1.05-1.73) demonstrated greater odds of co-use compared with retirees not using either substance. CONCLUSIONS: Given the high rate of sedative use among participants also using opioids, NFL retirees may be susceptible to the negative health consequences associated with co-use. Interventions focused on improving pain and mental health may be especially effective for reducing co-use of these substances among NFL retirees.

Trends in characteristics of fentanyl-related poisonings in the United States, 2015-2021.

Background: Fentanyl-related deaths continue to increase in the United States; however, most national studies focus on fatal overdose. More research, including data on nonfatal overdose, is needed.Objective: We examined trends in characteristics of fatal and nonfatal fentanyl-related poisonings ("exposures") in the US.Methods: National Poison Control data were examined to estimate trends in characteristics of reported exposures between 2015 and 2021 (N = 15,391; 38.7% female). We also delineated correlates of experiencing a major adverse effect or death.Results: The proportion of exposures increased among all age groups between ages 13 and 39 (ps < .05) with the largest increase among those age 13-19 (a 127.8% increase). With respect to reasons for use, the proportion of cases involving fentanyl "abuse" increased by 63.8% (p < .001). The proportion involving fentanyl inhalation increased 427.6% from 5.7% to 29.9% and injection increased from 6.7% to 9.6%, a 42.3% increase (ps < .01). The proportion also increased for co-use of methamphetamine (by 669.0%), cocaine (by 374.0%), and heroin (by 159.5%). The proportion of major adverse effects increased from 15.5% to 39.6% (p < .001). In the multivariable model, "abuse", suspected suicide attempts, and use via inhalation were risk factors for experiencing a major effect or death, and misuse, ingestion, dermal use, and co-use of methamphetamine were associated with lower risk.Conclusion: Poison Control data suggest that characteristics of individuals exposed to fentanyl continue to shift, with use via inhalation increasing and medical outcomes of nonfatal poisonings becoming more severe. These results complement mortality data and inform prevention and harm reduction efforts.

Defining Belonging and Its Association to Binge Drinking among College Students.

Objective: This study investigated the relationship between the students' combined belonging and binge drinking. Combined belonging was defined as a combination of both subjective (perceived belonging) and objective (participation in school activities) measures of belonging. Participants: The sample included 33,360 college students enrolled in U.S. States collegiate institutions. Methods: Data were obtained from an online survey through the Healthy Minds Study from 2018 to 2019. Logistic regression models estimated odds ratios and corresponding 95% confidence intervals. Results: Overall, 39.3% of students met criteria for binge drinking. Combined belonging had the highest odds of binge drinking compared to their counterparts. Being 21 and 22 years of age was the strongest risk factor for binge drinking. Conclusions: Interventions should be tailored to include objective and subjective measures of belonging to effectively reduce college binge drinking.

Building global capacity for brain and nervous system disorders research.

The global burden of neurological, neuropsychiatric, substance-use and neurodevelopmental disorders in low- and middle-income countries is worsened, not only by the lack of targeted research funding, but also by the lack of relevant in-country research capacity. Such capacity, from the individual to the national level, is necessary to address the problems within a local context. As for many health issues in these countries, the ability to address this burden requires development of research infrastructure and a trained cadre of clinicians and scientists who can ask the right questions, and conduct, manage, apply and disseminate research for practice and policy. This Review describes some of the evolving issues, knowledge and programmes focused on building research capacity in low- and middle-income countries in general and for brain and nervous system disorders in particular.

Cocaine and Marijuana Polysubstance Use and Cocaine Use Disorder: Investigating Mediated Effects through Patterns of Cocaine Use.

OBJECTIVES: Cocaine use is on the rise and it is comorbid with marijuana use. We examined the association between lifetime cocaine + marijuana polysubstance use (CM PSU) versus cocaine only and lifetime cocaine use disorder (CocUD) and examined the potential mediation by cocaine use patterns. Methods: A total of 2,968 lifetime cocaine users were identified from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Mediation analysis was utilized to examine cocaine use quantity, frequency, and duration as potential mediators in the association between CM PSU and CocUD. A parallel multiple mediator model and a structural equation model were used, respectively, to examine: (1) the individual contribution of cocaine use quantity, frequency, and duration, and (2) combined contribution as a set specified by a latent variable. Results: Cocaine users were divided into 2,782 (93.7%) CM polysubstance users and 186 (6.3%) cocaine only users. CM PSU was associated with decreased risk of CocUD, but after including the mediators, the association was no longer significant. Examined separately, only quantity was found to be a significant mediator over and above frequency and duration, while the latent variable with three cocaine use pattern indicators explained 56.6% of the total association between CM PSU and CocUD. Conclusions: Compared to cocaine only users, CM polysubstance users were less likely to use cocaine heavily; this lower intensity of cocaine use was in turn associated with decreased risk of CocUD. Future research is warranted to determine the nature of the association between CM PSU and reduced CocUD.

Reasons for Prescription Opioid Use While Playing in the National Football League as Risk Factors for Current Use and Misuse Among Former Players.

OBJECTIVE: Prescription opioid misuse has become a significant public health issue. Previous research has examined predictors of prescription opioid use and misuse among former National Football League (NFL) players. The present study aimed to describe how reasons for prescription opioid use while in the NFL corresponds to use and misuse in retirement. DESIGN: Former NFL players reporting prescription opioid use during their playing careers (N = 336) were included in this secondary data analysis. Participants reported reasons for prescription opioid use, including pain management, use "to function," to improve mood, to reduce stress, and to aid sleep. RESULTS: Among retired NFL players with exposure to prescribed pain medication during their playing career, 26.2% reported recent use of prescription opioids (past 30 days) and 73.8% reported no use. Specifically, 14.3% of retired players reported opioid use only as prescribed, whereas 11.9% reported misuse (not prescribed or use other than as prescribed). Using prescription opioids to function while in the NFL was associated with any opioid use in the past 30 days [odds ratios (OR) = 1.30, 95% CI: 1.12-1.50, P < 0.001]. Further, opioid use in the NFL to reduce stress and anxiety was associated with increased odds of past 30-day misuse of prescription opioids (OR = 1.45, 95% CI: 1.01-2.11; P = 0.048). CONCLUSIONS: The present study adds to the literature on elite athletes at high risk for pain and prescription opioid use and misuse. The findings may help to identify and provide early intervention for professional athletes most at risk for misuse of prescription opioids.

Gender differences in diversion among non-medical users of prescription opioids and sedatives.

BACKGROUND: Non-medical use of prescription drugs is a major public health concern in the United States. Prescription opioids and sedatives are among the most widely abused drugs and their combined use can be lethal. Increasingly rigid prescribing guidelines may contribute to the changing context of opioid use and increase drug diversion. OBJECTIVE: To examine gender differences in diversion of prescription opioids and sedatives among non-medical prescription opioid and sedative polysubstance users. We hypothesize that men will be more likely than women to engage in incoming diversion. METHODS: Data from the Prescription Drug Abuse, Misuse, and Dependence Study, a cross-sectional study focused on prescription drug users, were analyzed. Non-medical use was defined as use of a drug that was not prescribed or use in a way other than prescribed. Individuals who reported past 12-month non-medical opioid and sedative use were included; diversion was defined as incoming (obtaining drugs from a source other than a health professional) and outgoing (giving away/selling/trading prescription drugs). RESULTS: Among the 198 polysubstance users, 41.4% were female. Men were 2.85 times as likely as women to report incoming diversion (95% CI: 1.21-6.72). Women were more likely to obtain opioids from a healthcare professional; men were more likely to obtain sedatives from a roommate, coworker, or friend. Over half of men and women reported outgoing diversion opioids or sedatives. CONCLUSION: Drug diversion highlights an important point of intervention. Current prevention efforts that target prescribers should be expanded to include users and diversion activities; these interventions should be gender-specific.

Sex differences in peer and parental risk factors for non-medical use of prescription opioids in youth.

Background: Prescription opioid non-medical use (NMU) and its associated consequences have been of concern in the US in recent years.Objective: We examined peer influence and parental guidance, in addition to peer and parental sources of alcohol, on patterns of prescription opioid use, including NMU, among males and females separately. We hypothesized that peer influence and parental guidance would have a differential influence for males and females.Methods: The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) recruited youth 10-18 years from 10 US cities between 2008 and 2011 (n = 11,048). The cross-sectional survey included questions on past 30-day prescription opioid use (10,965 provided responses), with NMU defined as non-oral use and/or use of someone else's opioids. Multinomial logistic regression was conducted, examining medical use only and NMU in the past 30 days.Results: Among the 10,965 youth, 3.1% (n = 345) reported past 30-day NMU. Obtaining alcohol from parents was associated with increased odds of past 30-day NMU among males (OR = 2.49, 95%CI: 1.54,4.03) only. For each additional close friend who used other substances, odds of past 30-day NMU increased among males (OR = 1.23, 95%CI: 1.11,1.37) and females (OR = 1.15, 95%CI: 1.04,1.27). Increased number of close friends was associated with decreased odds of past 30-day NMU among males (OR = 0.87, 95%CI: 0.78,0.97) and females (OR = 0.86, 95%CI: 0.77,0.96).Conclusions: Peer and parental risk factors for prescription opioid NMU were identified among youth, although not all differed by sex. An increased number of close friends was a protective factor against prescription opioid NMU for both males and females.

Age of First Use of Prescription Opioids and Prescription Opioid Non-Medical Use among Older Adolescents.

BACKGROUND: Non-medical use (NMU) of prescription opioids is of concern due to the opioid epidemic in the United States. Objective: We examined sex differences in the effect of age of first use of prescription opioids on prescription opioid NMU among 17- and 18-year olds. Methods: The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) recruited youth 10-18 years from 10 United States cities between 2008 and 2011 (n = 11,048). The cross-sectional survey included questions on past 30 day prescription opioid use (10,965 provided responses; 278 age 17 to 18 years who used opioids in past 30 days), with NMU defined as non-oral use and/or use of someone else's opioids. Nonparametric survival analysis with lifetable estimates was used to examine age at first use. Binomial logistic regression was conducted predicting any NMU, adjusted for covariates. Results: Among 278 youth 17 to 18 years, a significant difference in age of first use between those with MU only and any NMU (p < .0001) was observed. Each one year increase in age resulted in a 33% decrease in the odds of any prescription opioid NMU compared to MU only, after controlling for covariates (Odds Ratio = 0.67, 95% Confidence Interval: 0.47,0.96). Sex differences in age at first use were not observed. Conclusions: Risk of past 30 day prescription opioid NMU decreased by a third for each one year increase in age of first use, after adjustment for other covariates. Use of prescription opioids in young adolescents may need to be limited where possible and researched further.

Exposure to Medicines in the Family Medicine Cabinet: Is It a Harbinger of Later Opioid Dependence?

Background: Despite research on prescription opioids and dependence being a national priority, little is known about the association between several potential adolescent risk factors and later opioid dependence among those who use opioids non-medically. Objectives: To investigate the association between lifetime opioid dependence and adolescent self-perceived health, health beliefs (thinking there was a pill for everything), health behaviors (onset of alcohol use before 15, onset of prescription opioid use before 15) and parental health practices (having opioids in the family medicine cabinet at age 14, parental suggestions to take pills when sick). Methods: A sample of 343 community members who non-medically used prescription opioids in the past 12 months were recruited for the Prescription Drug Misuse, Abuse, and Dependence Study and retrospectively assessed for adolescent risk factors of lifetime opioid dependence (DSM-IV). Results: Logistic regression revealed the strongest predictor of lifetime opioid dependence was having a prescription opioid in the family medicine cabinet at age 14. Those who grew up believing there was a pill for everything and those who initiated alcohol use before 15 were 1.83 and 1.78 times as likely, respectively, to meet dependence criteria than their counterparts. Demographics and other adolescent predictors were not associated with opioid dependence. Conclusions: Findings suggest several adolescent exposures can be targeted to reduce opioid dependence. Through their behavior, parents can reduce their teens' risk for opioid dependence.

Correlates related to follow-up in a community engagement program in North Central Florida.

AIMS: This analysis identifies the correlates of 60- and 120-day telephone-based study follow-ups among community-dwelling adults in North Central Florida. METHODS: Six thousand three hundred and forty participants were recruited by Community Health Workers from the University of Florida's community engagement program with a face-to-face baseline and two phone follow-ups assessing indicators of health. RESULTS: Physical disability versus none (adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.2─1.9), high trust in research versus none (aOR, 1.5; 95% CI, 1.1─2.1), history of research participation versus none (aOR, 1.6; 95% CI, 1.3─2.0), having health insurance versus none (aOR, 1.4; 95% CI, 1.1─1.7), interest in research participation versus none (aOR, 1.8; 95% CI, 1.3─2.7), and no drug use versus drug use (aOR, 0.5; 95% CI, 0.3─0.9) significantly predicted completion of follow-up. CONCLUSIONS: Health and social factors such as disability, insurance, history of and interest in research, trust and no drug use significantly predicted completing two follow-ups. These findings can facilitate efforts to minimize attrition in the research enterprise.

Factors influencing attrition in 35 Alzheimer's Disease Centers across the USA: a longitudinal examination of the National Alzheimer's Coordinating Center's Uniform Data Set.

OBJECTIVE: A lack of understanding of the causes of attrition in longitudinal studies of older adults may lead to higher attrition rates and bias longitudinal study results. In longitudinal epidemiological studies of Alzheimer's disease and related dementias, high rates of attrition may cause a systematic underestimation of dementia prevalence and skew the characterization of the disease. This can compromise the generalizability of the study results and any inferences based on the surviving sample may grossly misrepresent the importance of the risk factors for dementia. The National Institute on Aging outlined a National Strategy for Recruitment and Participation in Alzheimer's Disease Clinical Research to address this problem, providing evidence of the magnitude of this problem. METHOD: To explore predictors of attrition, this study examined the National Alzheimer's Coordinating Center (NACC) Uniform Data Set, a repository of observations of older adults spanning 11 years, using survival analysis. Four samples were examined: the full sample (n = 30,433), the alive subsample excluding those who died (n = 24,231), the MRI sample [participants with complete MRI data (n = 1104)], and the alive MRI subsample [participants with MRI data excluding those who died (n = 947)]. RESULTS: Worsening cognitive impairment, neuropsychiatric symptoms, and difficulty with functional activities predicted attrition, as did lower hippocampal volume in the MRI subsample. Questionable co-participant reliability and an informant other than a spouse also increased risk of attrition. DISCUSSION: Special considerations exist in recruiting and retaining older adults in longitudinal studies, and results of baseline psychological, functional, and cognitive functioning should be used to identify targeted retention strategies.

Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members.

Concurrent use of prescription medications and alcohol is prevalent among older adults and impacts women more than men, however little is known about characteristics of older women who use both. The current analysis aims to evaluate those characteristics. Participants were recruited through HealthStreet, an outreach program. Community health workers (CHWs) assess health needs and concerns among community members. CHWs collect demographic, substance use, and other health data from participants. Female participants (≥ 50 years) interviewed November 2011-November 2017 were included and stratified into four groups: neither prescription opioid nor hazardous alcohol use (three or more drinks in a single day), hazardous alcohol use only, prescription opioid use only, and both prescription opioid and hazardous alcohol use. Chi square and ANOVA tests were used to compare these groups. Among the 2370 women (53% black; mean age 61 years), 70% reported neither prescription opioid nor hazardous alcohol use, 12% reported hazardous alcohol use only, 15% reported prescription opioid use only, and 3% reported use of both in the past 30 days. Concurrent prescription opioid and hazardous alcohol use were significantly associated with comorbid depression and anxiety (p < 0.0001); women who endorsed prescription opioid use only were significantly more likely to report a history of back pain, cancer, or diabetes compared to their counterparts (p < 0.0001). Nearly a third of women reported prescription opioid and/or hazardous alcohol use in the past 30 days. Because the risk and consequences of concomitant alcohol and opioid use increase with age, interventions tailored to women are needed.

Power of the Peer and Parent: Gender Differences, Norms, and Nonmedical Prescription Opioid Use Among Adolescents in South Central Kentucky.

This study examined risk factors of nonmedical prescription opioid use (NMPOU) among adolescents and how risk factors differ by gender. In the fall of 2017, adolescents attending 6th through 12th grades across 44 schools in 10 south central Kentucky counties were invited to participate in an anonymous, school-based survey. A total of 11,761 adolescents completed the survey. Logistic regression was conducted to examine the association between NMPOU and constructs of the Theory of Reasoned Action (i.e., attitudes and subjective norms), descriptive norms (i.e., peer use), and parental control of prescription medications in the home. There were 297 (2.7%) adolescents who reported NMPOU in the past 12 months. In the adjusted multivariate logistic regression model, for both males and females, the adolescents who perceived that more of their peers engaged in NMPOU were significantly more likely to endorse NMPOU, whereas male and female adolescents who perceived their peers disapproved of use were significantly less likely to report NMPOU. Parent disapproval was significantly associated with decreased NMPOU for females only. Moderated regression analyses revealed that gender moderated the relationship between parental disapproval and NMPOU. We found that during adolescence, NMPOU is influenced by peer norms for both genders and parental norms for females. These results indicate that prevention efforts should focus on changing adolescents' peer and parental norms related to NMPOU.

Community perceptions related to brain donation: Evidence for intervention.

INTRODUCTION: Research progress on neurocognitive disorders requires donation of both healthy and diseased brains. Here, we describe attitudes toward brain donation among a large community sample in Florida. METHODS: HealthStreet, a community engagement program at the University of Florida, used community health workers to assess community attitudes toward research participation, including brain donation. RESULTS: Over 60% of people, primarily Caucasian and employed, indicated that they would be likely or somewhat likely to donate their brain for research. Those who would be willing to donate were also more likely to be willing to participate in other research studies and to have participated in research. DISCUSSION: Brain donation will add to the science of disorders of aging, including accurate diagnoses and validation of in vivo biomarkers. Increasing willingness to donate is a first step toward donation. Community populations are willing; community health workers can educate others about the need for this initiative in communities.

Motives for prescription stimulant use by patterns of non-medical use.

BACKGROUND: Understanding motivations behind non-medical use of prescription stimulants (NMUPS) is important to prevent such use. METHODS: Adult participants from St. Louis, MO, who endorsed NMUPS on 5 or more days in the past 12 months (n=60) were asked about their motivations for use. Associations between motives for use and patterns of non-medical use in the past 12 months were assessed using multivariable logistic regression, controlling for demographic factors and non-medical use of other prescription drugs. RESULTS: On average, 5.5 different motives for stimulant use were endorsed. Compared to those who only used someone else's stimulants, adults who only used stimulants other than prescribed were less likely to endorse use "to get high" (aOR=0.48, 95%CI 0.26-0.90) and more likely to endorse use "to function" (aOR=1.97, 95%CI 1.04-3.75); adults who were engaged in both patterns of NMUPS were more likely to endorse use "to function" (aOR=4.12, 95%CI 1.56-10.88) and "to modify the effects of other drugs" (aOR=2.29, 95%CI 1.13-4.61). CONCLUSION: Although using stimulants for performance enhancement is common, most people who used diverted stimulants reported using stimulants to get high. Prevention and harm reduction strategies should consider these differences.