Associations Between Early-Life Adversity, Ambient Air Pollution, and Telomere Length in Children.

OBJECTIVE: Examine the independent associations and interaction between early-life adversity and residential ambient air pollution exposure on relative buccal telomere length (rBTL). METHODS: Experiences of abuse, neglect, household challenges, and related life events were identified in a cross-sectional sample of children aged 1 to 11 years ( n = 197) using the 17-item Pediatric ACEs and Related Life Event Screener (PEARLS) tool. The PEARLS tool was analyzed both as a total score and across established domains (Maltreatment, Household Challenges, and Social Context). Ground-level fine particulate matter (PM 2.5 ) concentrations were matched to residential locations for the 1 and 12 months before biospecimen collection. We used multivariable linear regression models to examine for independent associations between continuous PM 2.5 exposure and PEARLS score/domains with rBTL. In addition, effect modification by PEARLS scores and domains on associations between PM 2.5 exposure and rBTL was examined. RESULTS: Study participants were 47% girls, with mean (standard deviation) age of 5.9 (3.4) years, median reported PEARLS score of 2 (interquartile range [IQR], 4), median 12-month prior PM 2.5 concentrations of 11.8 µg/m 3 (IQR, 2.7 µg/m 3 ), median 1-month prior PM 2.5 concentrations of 10.9 µg/m 3 (IQR, 5.8 µg/m 3 ), and rBTL of 0.1 (IQR, 0.03). Mean 12-month prior PM 2.5 exposure was inversely associated with rBTL ( ß = -0.02, 95% confidence interval = -0.04 to -0.01). Although reported PEARLS scores and domains were not independently associated with rBTL, we observed a greater decrement in rBTL with increment of average annual PM 2.5 as reported Social Context domain items increased ( p -interaction < .05). CONCLUSIONS: Our results suggest that adverse Social Context factors may accelerate the association between chronic PM 2.5 exposure on telomere shortening during childhood.

Botulinum toxin injections for the treatment of neurogenic thoracic outlet syndrome: A systematic review.

Botulinum toxin (BTX) injections into the musculature surrounding the brachial plexus have been examined as a potential treatment for neurogenic thoracic outlet syndrome (nTOS). This systematic review identified 15 publications, of which one was a randomized controlled trial. BTX injections performed with ultrasound or electromyographic guidance, and with the inclusion of the pectoralis minor muscle, in addition to the anterior and/or middle scalenes, tended to provide greater symptom improvement and may predict response to first rib resection. Importantly, most studies were of low quality; thus, the results should be interpreted with caution. Further high-quality studies are needed to confirm these findings.

Exploring Potential Bellwethers for Drug-Related Mortality in the General Population: A Case for Sentinel Surveillance of Trends in Drug Use among Nightclub/Festival Attendees.

Background: Drug-related deaths in the US continue to increase. Sentinel surveillance of high-risk populations can provide early warning for shifts in trends. Nightclub/festival attendees have high levels of drug use, so we explored whether use among this population can serve as a potential bellwether or indicator for use-related mortality in the general population.Methods: Trends in past-year cocaine and methamphetamine use were estimated from nightclub/festival attendees in New York City (NYC) and among NY residents, and trends were estimated for related death rates in NYC (2014/15-2019/20). Using national data from England and Wales (2010-2019), trends in past-year cocaine and ecstasy use (among the full population and among nightclub attendees) and related deaths were also estimated.Results: In NY/NYC, cocaine use remained stable in the general population, but use among nightclub/festival attendees and cocaine-related deaths doubled. Methamphetamine use among nightclub/festival attendees and death rates also more than doubled while use among the general population remained stable. In UK countries, increases in cocaine and ecstasy use were larger for infrequent/frequent nightclub attendees than in the general population, with 3.6- and 8-fold increases in related deaths, respectively. In UK countries, the association between nightclub attendance and death rates increased in a dose-response-like manner with larger associations detected when death rates were lagged by one year.Conclusions: Patterns of use among nightclub/festival attendees, more so than patterns in the general population, were similar to patterns of drug-related deaths. Use among this subpopulation could possibly serve as a bellwether for use-related outcomes. Continued surveillance is recommended.

Risky Party and Nightclub Attendance during the COVID-19 Nightlife Shutdown in New York City.

From March 2020 through May 2021, nightlife venues were shut down and large gatherings were deemed illegal in New York City (NYC) due to COVID-19. This study sought to determine the extent of risky party attendance during the COVID-19 shutdown among people who attend electronic dance music parties in NYC. During the first four months that venues were permitted to reopen (June through September 2021), time-space sampling was used to survey adults (n = 278) about their party attendance during the first year of the shutdown (March 2020-March 2021). We examined prevalence and correlates of attendance and mask-wearing at such parties. A total of 43.9% attended private parties with more than 10 people, 27.3% attended nightclubs, and 20.5% attended other parties such as raves. Among those who attended any, 32.3% never wore a mask and 19.3% reported attending parties in which no one wore a mask. Past-year ecstasy use was associated with increased risk for attending private (aPR = 1.51, 95% CI: 1.00-2.28) or other parties (aPR = 2.75, 95% CI: 1.48-5.13), and use of 2C series drugs was associated with increased risk for attending nightclubs (aPR = 2.67, 95% CI: 1.24-5.77) or other parties (aPR = 2.50, 95% CI: 1.06-5.87). Attending >10 parties was associated with increased risk for never wearing a mask (aPR = 2.74, 95% CI: 1.11-6.75) and for no other attendees wearing masks (aPR = 4.22, 95% CI: 1.26-14.07). Illegal dance parties continued in NYC during the COVID-19 shutdown. Prevention and harm reduction efforts to mitigate risk of COVID-19 transmission during such shutdowns are sorely needed.

Discordant report of vaping of cannabis among high school seniors in the United States.

Introduction: Reliable responses on surveys are important to ensure accurate estimates of drug use. This study compared prevalence of self-reported vaping of cannabis based on two separate questions on the same survey.Methods: We examined combined data from the 2017-2019 Monitoring the Future nationally representative survey of high school seniors in the US (N = 6,982). Students were first asked whether they had used cannabis in the past year via vaporizer in a section about cannabis use. Later on, students were asked about vaping behaviors, including cannabis vaping. Prevalence of self-reported vaping of cannabis was compared and a multivariable model delineated correlates of providing a discordant response - defined as reporting vaporizer use but not reporting vaping.Results: Estimated prevalence of use based on the question in the cannabis section was 11.9% (95% CI: 11.0-12.9) and prevalence based on the question in the vaping section was 13.2% (95% CI: 12.3-14.2). Among those reporting vaping of cannabis, 17.3% provided a discordant response. The corrected prevalence was 16.5% (95% CI: 15.5-17.6). Black students were more likely to provide a discordant report (aPR = 1.82, 95% CI: 1.23-2.69) and those reporting past-year vaping of nicotine (aPR = 0.27, 95% CI: 0.19-0.38) and/or nonmedical use of prescription stimulants (aPR = 0.44, 95% CI: 0.21-0.91) were less likely to provide a discordant report.Conclusions: Self-report of vaping of cannabis varies depending on whether it is asked in a section about vaping practices or about overall cannabis use (use via vaporizer). Survey researchers need to consider how to best query cannabis vaping practices on surveys.

Underreporting of past-year cannabis use on a national survey by people who smoke blunts.

Background: Accurate prevalence estimates are critical to epidemiological research but discordant responses on self-report surveys can lead to over- or underestimation of drug use. We sought to examine the extent and nature of underreported cannabis use (among those later reporting blunt use) from a national drug survey in the US. Methods: We used data from the 2015-2019 National Survey on Drug Use and Health (N = 281,650), a nationally representative probability sample of non-institutionalized populations in the US. We compared self-reported prevalence of past-year cannabis use and blunt use and delineated correlates of underreporting cannabis use, defined as reporting blunt use but not overall cannabis use. Results: An estimated 4.8% (95% CI: 4.4-5.2) of people reported blunt use but not cannabis use. Although corrected prevalence, cannabis use recoded as use only increased from 15.2% (95% CI: 15.0-15.4) to 15.5% (95% CI: 15.3-15.7), individuals who are aged ≥50 (aOR = 1.81, 95% CI: 1.06-3.08), female (aOR = 1.35, 95% CI: 1.12-1.62), Non-Hispanic Black (aOR = 1.43, 95% CI: 1.16-1.76), or report lower English proficiency (aOR = 3.32, 95% CI: 1.40-7.83) are at increased odds for providing such a discordant response. Individuals with a college degree (aOR = 0.57, 95% CI: 0.39-0.84) and those reporting past-year use of tobacco (aOR = 0.75, 95% CI: 0.62-0.91), alcohol (aOR = 0.42, 95% CI: 0.33-0.54), cocaine (aOR = 0.50, 95% CI: 0.34-0.73), or LSD (aOR = 0.52, 95% CI: 0.31-0.87) were at lower odds of providing a discordant response. Conclusion: Although changes in prevalence are small when correcting for discordant responses, results provide insight into subgroups that may be more likely to underreport use on surveys.

Media coverage about medical benefits of MDMA and ketamine affects perceived likelihood of engaging in recreational use.

Background: Research on the efficacy of ketamine in treating depression and 3,4-methylenedioxymethamphetamine (MDMA) in treating post-traumatic stress disorder have been widely covered by the media. Given recent widespread coverage of the efficacy of these drugs, it is important to determine whether such coverage influences prevalence of recreational use. While longitudinal studies would be most ideal for assessing this, to acquire preliminary data, we tested survey items assessing this potential phenomenon in a population known for high prevalence of use of these drugs. Method: Adults entering randomly selected nightclubs in New York City (n = 209) were surveyed about drug use. Questions were included to assess their perceived likelihood of recent media coverage about medical benefits associated with use of ketamine and MDMA affecting their own use. Results: Two-thirds (66.8%) of participants had ever used ecstasy/MDMA and 22.6% had ever used ketamine. The plurality of participants reported that media coverage about ketamine (46.1%) and MDMA (39.9%) did not affect their likelihood of using. 10.1% and 21.0% of participants reported increased likelihood of using ketamine and MDMA, respectively. 52.3% of those reporting past-month ketamine use and 6.1% of those reporting no lifetime use reported being more likely to use in response to media coverage about ketamine. 28.6% of those reporting past-month ecstasy use and 5.5% of those reporting no lifetime use reported being more likely to use in response to media coverage about MDMA. Discussion: Media coverage about the medical benefits of ketamine and MDMA might influence specific subsets of people to use.

Shifts in Drug Use Behavior Among Electronic Dance Music Partygoers in New York During COVID-19 Social Distancing.

Background: Little is known about how COVID-19-related social distancing has affected illegal drug use. We surveyed electronic dance music (EDM) partygoers-a population known for high levels of drug use-to determine whether their drug use patterns had changed during state-mandated social distancing in New York. Methods: Individuals were recruited online and screened for eligibility throughout April and May 2020. We surveyed 128 eligible adults and queried, retrospectively, whether their drug use behavior had changed during COVID-19-related social distancing. Results: Most participants reporting past-three-month use reported decreased frequency of use during COVID-19-related social distancing. Specifically, 78.6% reduced frequency of use of cocaine, 71.1% reduced frequency of use of ecstasy/MDMA/Molly, and 68.0% reduced frequency of use of LSD. Although some participants reported increased frequency of use of cocaine (7.1%), ecstasy (7.9%), or LSD (12.0%), 35.0% reported increased frequency of cannabis use. Most (66.7%) of those reporting cocaine use reduced the amount used. The majority of those reporting use of cannabis, ecstasy, cocaine, and/or LSD reported that drug cost (80.0-84.0%) and drug quality (84.2-92.0%) did not change during social distancing. Having a college degree was associated with higher odds for decreasing frequency of cannabis use. Older participants (ages ≥23) were at lower odds for decreasing frequency of cocaine use, as were those earning >$500 per week, and participants who attended EDM events biweekly or more often were at higher odds for decreasing frequency of LSD use. Conclusions: Participants in this sample tended to reduce party drug use during COVID-19-related social distancing.

Self-Correction of Unreported Marijuana Use by Participants Taking a Street Intercept Survey.

Background: Due to underreporting, a major challenge associated with drug use surveys is obtaining precise estimates of drug use. Objective: This study examined reliability of self-reported lifetime marijuana use among electronic dance music (EDM) party attendees - a high-risk population for drug use. Methods: 794 adults (35.1% female) entering EDM parties were intercept-surveyed. Participants were asked about lifetime marijuana use early in the survey. Those not reporting use were asked 5-10 min later if their earlier response was correct. Participants reporting their original response was not correct were asked to check off a reason why they did not originally report use. Participants were also asked at the end of the survey how honestly they responded throughout the survey. Prevalence of lifetime marijuana use with and without corrected responses was compared and risk factors for underreporting were examined using a Poisson generalized linear model. Results: Among those not reporting marijuana use, 31.2% subsequently reported use when asked again. Prevalence of use increased from 73.7% to 81.9% after correcting responses, an 8.2% absolute increase and a 10.0% relative increase. Reporting lifetime use of ecstasy and/or LSD was associated with lower risk for underreporting marijuana use. Compared to those reporting that they answered all questions honestly, those who reportedly answered most or no questions honestly were at higher risk for underreporting. Conclusion: Asking participants to confirm previous responses can help detect underreporting of drug use on intercept surveys. Results can inform survey methods when participants are believed to be at risk for underreporting.

Posting, texting, and related social risk behavior while high.

Background: Posting on social media can have lasting consequences in one's social life and career. Research has not yet focused on social media or more modern forms of communication as social risk factors for individuals high on drugs. This study aims to examine prevalence and correlates of engaging in social media posting and related behavior while high. Methods: We examined data from 872 adults (39.8% female) who were surveyed entering electronic dance music (EDM) parties in New York City and reported lifetime illegal drug use. Participants were asked whether they were ever high on a drug while (1) posting on social media, (2) calling or texting someone, and (3) being in a photo. Those answering affirmatively were also asked whether they later regretted the behavior. We examined demographic and drug-related correlates of these behaviors. Results: Of the participants, 34.3% posted on social media while high (with 21.4% regretting it), 55.9% had texted or called someone while high (with 30.5% regretting it), and 47.6% had been in a photo while high (with 32.7% regretting it). Females and young adults (ages 18-24) were at high risk for posting on social media while high and at higher risk for engaging in more of these behaviors. Past-month marijuana users in particular were at increased risk for engaging in each of these behaviors. Conclusion: Engaging in these behaviors while high on drugs appears to be prevalent, and prevention and harm reduction efforts should seek to prevent or reduce likelihood of social harm that can result from such situations.

Underreporting of drug use on a survey of electronic dance music party attendees.

OBJECTIVES: Skip-logic is commonly used on electronic surveys in which programs provide follow-up questions to affirmative responses and skip to the next topic in response to non-affirmative responses. While skip-logic helps produce data without contradictory responses, erroneous non-affirmative reports can lead to loss of accurate information. We examined the extent to which type-in drug use responses contradict unreported use in a survey of a high-risk population-electronic dance music (EDM) party attendees. DESIGN: We surveyed 1029 EDM party-attending adults (ages 18-40) using time-spacing sampling in 2018. We examined the extent to which reporting of recent drug use via type-in responses occurred after past-year use of the same drugs were unreported earlier on the same survey. Changes in prevalence of use and predictors of providing discordant responses were examined. RESULTS: 3.6% of participants typed in names of drugs they had used that they did not report using earlier on the survey. Changes in prevalence were not significant when correcting contradictory responses, but prevalence of past-year cocaine use increased from 23.3% to 24.3%. Those with a college degree were at lower odds for providing a discordant response (aOR = 0.13, p = .019). Females (aOR = 2.82, p = .022), those earning ≥$1000 per week (aOR = 11.03, p = .011), and those identifying as gay/lesbian (aOR = 5.20, p = .032) or bisexual or other sexuality (aOR = 15.12, p < .001) were at higher odds of providing a discordant response. CONCLUSIONS: Electronic surveys that query drug use can benefit from follow-up (e.g. open-ended) questions not dependent on previous responses, as they may elicit affirmative responses underreported earlier in the survey.

Use of new and uncommon synthetic psychoactive drugs among a nationally representative sample in the United States, 2005-2017.

OBJECTIVES: This study aims to examine patterns and first mentions of reported use of new or uncommon drugs across 13 years, among nationally representative samples in the United States. METHODS: Participants (ages ≥12) in the National Surveys on Drug Use and Health (2005-2017, N = 730,418) were provided opportunities to type in names of new or uncommon drugs they had ever used that were not specifically queried. We examined self-reported use across survey years and determined years of first mentions. RESULTS: From 2005 to 2017, there were 2,343 type-in responses for use of 79 new or uncommon synthetic drugs, and 54 were first-ever mentions of these drugs. The majority (65.8%) of mentions were phenethylamines (e.g., 2C-x, NBOMe), which were also the plurality of new drug mentions (n = 22; 40.7%). Mentions of 2C-x drugs in particular increased from 30 mentions in 2005 to 147 mentions in 2013. We estimate an upward trend in use of new or uncommon drugs between 2005 and 2017 (p < 0.001). CONCLUSION: Although type-in responses on surveys are limited and underestimate prevalence of use, such responses can help inform researchers when new compounds are used. Continued surveillance of use of new and uncommon drugs is needed to inform adequate public health response.

Oral health implications of increased cannabis use among older adults: Another public health concern?

Prevalence of cannabis use among older Americans (aged ≥ 65) appears to be rising, and emerging evidence associates cannabis use with several oral diseases. The burden of oral diseases among older Americans is great, but literature discussing potential implications of increasing rates of cannabis use and the oral health of older persons is lacking. This paper explores the latest trends in prevalence of cannabis use among older Americans and summarizes the literature on the oral health status of older adults and oral effects of cannabis use, and considers broad implications for oral health and public health policy and future research. Further studies on the effects cannabis use on the oral health of older adults are needed. Future research should investigate older subjects' susceptibility to cannabis-related oral diseases, as well as the proportions that develop disease. Policymakers may wish to tackle barriers to access of dental services for the older population, or target subsets of the population that suffer from comparably higher rates of oral diseases, while dental professionals may require training on managing underlying substance use behaviors in addition to clinical oral manifestations.

Trends in DMT and other tryptamine use among young adults in the United States.

BACKGROUND AND OBJECTIVES: The popularity of tryptamines such as N,N-dimethyltryptamine (DMT) appears to be increasing in the United States (US), but epidemiologic literature on prevalence of use is scant. This paper aims to determine trends in prevalence and correlates of past-year tryptamine use among a nationally representative sample of young adults in the US. METHODS: Participants in the National Survey on Drug Use and Health survey were queried about past-year use of tryptamines-specifically DMT, α-methyltryptamine (AMT), and 5-MeO-DIPT ("Foxy"). Data were examined from young adults (ages 18-25), years 2007-2014 (N = 144,787). Linear trends in prevalence of past-year tryptamine use were examined in the full sample and stratified by specific demographic and drug use characteristics. RESULTS: Tryptamine use is rare, but increased from .2% in 2007/08 to .7% in 2013/14, a 273% relative increase (p < .001). While prevalence increased among all demographic groups, prevalence was substantially higher among individuals who use other drugs. In particular, between 2007/08 and 2013/14, prevalence of tryptamine use increased among past-year ecstasy users (from 2.1% to 10.0%) and LSD users (from 7.0% to 15.5%) (ps < .01). Prevalence of tryptamine use tended to be higher among lifetime and past-year users of psychedelic drugs compared to users of non-psychedelic drugs. CONCLUSION: While tryptamine use is not prevalent in the general young adult population, prevalence is increasing. Users of various other drugs-particularly drugs with psychedelic effects-report higher prevalence of tryptamine use. SCIENTIFIC SIGNIFICANCE: Users of other drugs can be targeted when disseminating information about tryptamines to ensure user safety. (Am J Addict 2018;27:578-585).

Social Determinants of Health and Allergic Disease Prevalence Among Asian American Children.

BACKGROUND: Although racial and ethnic disparities in allergic diseases have previously been observed, the relationship between social determinants of health (SDoH) and allergic disease prevalence among disaggregated Asian American (AsA) subgroups is poorly understood. OBJECTIVE: To examine the association of SDoH with allergic disease prevalence among disaggregated AsA subgroups. METHODS: Using the 2011-2018 National Health Interview Survey, we examined caregiver-reported race and ethnicity, SDoH, and allergic diseases. We compared survey-weighted allergic disease prevalence by AsA subgroup. Subgroup-stratified multivariable logistic regression accounting for age, sex, child/parent nativity, and survey year modeled the association between SDoH and allergic disease prevalence. We provide predicted probabilities of having each allergic disease based on exposure to each SDoH. RESULTS: We examined data from 5042 non-Hispanic AsA children representing 3,264,768 AsA children. Approximately 25% of all AsA children reported at least one allergic disease, ranging from 20% of Asian Indian children to 30% of Filipino/a children. The number of unfavorable SDoH was lowest among Asian Indian and Chinese children (mean 0.7) and highest among "other Asian" children (mean 1.2). In stratified analyses, financial instability and inaccessible healthcare were associated with greater probability of allergic diseases among some, but not all AsA subgroups. Lower parent education level, food insecurity, and rent/other housing arrangement were associated with lower probability of allergic disease among some AsA children. CONCLUSION: There was heterogeneity in the association of SDoH and allergic disease prevalence among AsA children. Further study of SDoH may inform modifiable environmental factors for allergic disease among AsA children.

Social Determinants of Cardiovascular Risk Factors Among Asian American Subgroups.

BACKGROUND: Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups. METHODS AND RESULTS: We utilized the National Health Interview Survey, a nationally representative survey of US adults, years 2013 to 2018. SDOH variables were categorized into economic stability, neighborhood and social cohesion, food security, education, and health care utilization. SDOH score was created by categorizing 27 SDOH variables as 0 (favorable) or 1 (unfavorable). Self-reported cardiovascular risk factors included diabetes, high cholesterol, high blood pressure, obesity, insufficient physical activity, suboptimal sleep, and nicotine exposure. Among 6395 Asian adults aged ≥18 years, 22.1% self-identified as Filipino, 21.6% as Asian Indian, 21.0% as Chinese, and 35.3% as other Asian. From multivariable-adjusted logistic regression models, each SD increment of SDOH score was associated with higher odds of diabetes among Chinese (odds ratio [OR], 1.45; 95% CI, 1.04-2.03) and Filipino (OR, 1.24; 95% CI, 1.02-1.51) adults; high blood pressure among Filipino adults (OR, 1.28; 95% CI, 1.03-1.60); insufficient physical activity among Asian Indian (OR, 1.42; 95% CI, 1.22-1.65), Chinese (OR, 1.58; 95% CI, 1.33-1.88), and Filipino (OR, 1.24; 95% CI, 1.06-1.46) adults; suboptimal sleep among Asian Indian adults (OR, 1.20; 95% CI, 1.01-1.42); and nicotine exposure among Chinese (OR, 1.56; 95% CI, 1.15-2.11) and Filipino (OR, 1.50; 95% CI, 1.14-1.97) adults. CONCLUSIONS: Unfavorable SDOH are associated with higher odds of cardiovascular risk factors in Asian American subgroups. Culturally specific interventions addressing SDOH may help improve cardiovascular health among Asian Americans.

Prevalence of self-reported adverse effects associated with drug use among nightclub and festival attendees, 2019-2022.

Background: Research investigating adverse effects from drug use has focused extensively on poisonings and mortality. This study focuses on drug-related adverse effects not necessarily resulting in hospitalization or death among a population known for high prevalence of party drug use-electronic dance music (EDM) nightclub and festival attendees. Methods: Adults entering EDM venues were surveyed in 2019-2022 (n = 1952). Those reporting past-month use of a drug were asked whether they had experienced a harmful or very unpleasant effect after use. We examined 20 drugs and drug classes with a particular focus on alcohol, cannabis, cocaine, and ecstasy. Prevalence and correlates of adverse effects were estimated. Results: Almost half (47.6%) of adverse effects involved alcohol and 19.0% involved cannabis. 27.6% of those using alcohol reported an adverse effect, while 19.5%, 15.0%, and 14.9% of participants reported an effect from use of cocaine, ecstasy, and cannabis, respectively. Use of less prevalent drugs, such as NBOMe, methamphetamine, fentanyls, and synthetic cathinones, tended to be associated with higher prevalence of adverse effects. The most consistent risk factor was younger age, while past-month use of a greater number of drugs was often a protective factor against adverse effects. For most drugs, taking too much was the most common perceived reason for the adverse effect, and visiting a hospital after use was most prevalent among those experiencing an adverse effect from cocaine (11.0%). Conclusions: Adverse drug effects are common in this population and results can inform prevention and harm reduction in this population and the general population.

Learning Games: A New Tool for Orthodontic Education.

Learning games that are based on current scientific concepts are underutilized in dental education. This paper explores the relevant science of learning and discusses several principles that are conducive to learning and teaching in an educational setting, namely retrieval practice, feedback, motivation, and engagement. A discussion of learning games in health professional education ensues, followed by a description of relevant best practices in game design for learning. This paper concludes by presenting Dealodontics©, a card game developed at New York University College of Dentistry with the goal of helping second-year dental students review, practice, and apply basic skills relevant to their orthodontics competency requirements.

Seasonal Variation of Use of Common Psychedelics and Party Drugs Among Nightclub/Festival Attendees in New York City.

Few epidemiological studies have focused on seasonal variation in the use of common psychedelics and party drugs among nightclub and festival attendees, typically those who attend electronic dance music (EDM) events. We sought to determine whether the use of different drug types varies seasonally within this population. Across 15 seasons from summer 2017 through fall 2022, we surveyed 3,935 adults entering randomly selected nightclubs and festivals in New York City regarding their past-month use of cocaine, MDMA (3,4-methylenedioxymethamphetamine, commonly known as ecstasy), lysergic acid diethylamide (LSD), psilocybin (shrooms), and ketamine. Multivariable models were used to compare adjusted odds ratios for drug use within each season with the grand mean of combined seasons. Summer was associated with higher odds for use of LSD (aOR 2.72; 95% CI, 1.88-3.93) and psilocybin (aOR 1.65; CI, 1.12-2.43), independent of increases in psilocybin use over time (p < .001). A significant increase in use of ketamine (p = .014) and significant decreases in use of cocaine (p = .002) and ecstasy (p = .002) were found across time, but multivariable models did not detect seasonal variations. Summer is a risk factor for use of common psychedelics among people who attend EDM events. Therefore, the summer months may be the best time to disseminate information about harm reduction for psychedelic drug users.