Objective Cannabis use is a globally prevalent, though potentially harmful, behavior whereby varying patterns of use manifest from a range of motivating factors. Individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) are often overrepresented in cannabis use statistics, with some users anecdotally reporting that cannabis improves ADHD symptoms. Current motive scales do not fully capture the breadth of cognitions, specifically perceived improvement in attention, necessary to capture the range of cannabis use motivations within this population. This study developed the Cannabis Attention and Affect Motives Scale (CAAMS) to assess cannabis use in response to various situations and affective states. Method Adult cannabis users (n = 417, 61.9% male, predominantly NZ/Other European) completed an online survey detailing their motives and expectancies of cannabis use as well as an ADHD risk screener. Results While the hypothesized 46-item, 3-factor model was not an appropriate fit, a split-half sample EFA and CFA yielded a refined, theoretically and psychometrically sound, 28-item, 5-factor model. Post-hoc between-groups comparisons on those having low, medium, or high risk of ADHD showed significant differences for CAAMS factors: Negative Affect Reduction, Attention Enhancement, Attention and Behavior Motivation, and Social Anxiety Reduction, but not for Recreation and Relaxation Enhancement. Conclusions The CAAMS is psychometrically valid, measuring five separate motives of cannabis use pertaining to cognitive enhancement. An initial analysis of these motives as a function of ADHD risk highlights the potential of this scale to understand the cognitive pathways leading to cannabis use in individuals with attentional difficulties.

Background: A strong association between alcohol use and adverse sexual experiences (e.g., sexual assault, risky sex, and regretted sexual experiences) exists on college campuses in the United States. The Sexual and Negative Dating Inventory (SANDI) is a recently developed measure of dating and sexual protective behavioral strategies (PBS). Objectives: As part of the original development study, a subsample of participants (n = 15) was invited to participate in qualitative follow-up interviews examining contexts and environments in which they implement PBS. College students (93% female, M age = 19.2, SDage = 1.01, 66% heterosexual) all endorsed regular alcohol use and engagement in dating behaviors. Results: Qualitative thematic analysis of double-coded transcripts was conducted with the overarching three aims in mind: 1) to identify barriers of using dating and sexual protective behaviors, 2) to identify facilitators of using dating and sexual protective behaviors, and 3) to identify contexts in which dating and sexual protective behaviors are utilized. The following themes were identified across the three questions: 1a) trusting the other person/location, 1b) awareness of and anticipation for high-risk situations, 2a) decreased reactivity and responsivity in high-risk situation, 2b) not knowing the other person/location well, 3a) being in public, 3b) being in private, and 3c) depending on safety/comfort. Conclusions: Findings provide nuanced information on targeting problematic alcohol use and adverse sexual experiences among college students. Addressing barriers, facilitators, and contextual factors that influence PBS use is crucial for preventing and reducing adverse sexual experiences.

Background : Prior work suggests psychological need satisfaction (PNS) may protect against single-substance alcohol and marijuana use, yet little is known about its association with simultaneous alcohol and marijuana (SAM) use. This study aims to address this gap by examining the link between PNS and SAM use in college students. Further, to better explain the conditions under which PNS associates with SAM use, we also explore SAM use motives as a potential mechanism through which PNS associates with SAM use, and investigate whether this relationship is moderated by positive expectancies about SAM use (i.e., first-stage moderated mediation). Methods : Participants were 822 college students from six universities who reported past-month SAM use. The sample was predominantly White, non-Hispanic (62.9%), female (70.2%), with a mean age of 19.44 (SD = 1.98) years. Results : Calm/coping and social motives mediated the association between PNS and SAM use, such that students with lower PNS reported higher levels of these motives, which were in turn associated with greater SAM use. The indirect effect of PNS on SAM use through calm/coping motives, but not social motives, was stronger among students with higher levels of positive expectancies for SAM use, compared to those with lower or average positive expectancies. Consclusion : These findings suggest that students with lower PNS and higher positive SAM expectancies may be at greater risk of engaging in SAM use, especially for relaxation or coping reasons. Overall, the results highlight the importance of addressing unmet psychological needs and positive expectancies in efforts to reduce SAM use among college students.

Introduction The COVID-19 pandemic had a devastating impact on people who use drugs (PWUD). Reductions in access to harm reduction tools and treatment services elevated rates of fatal overdose for many. We explore the mechanism through which these factors influenced the rise in overdose mortality during COVID-19 from the perspective of people with overdose encounters. Methods We conducted in-depth, semi-structured, 60-minute telephone-based interviews with 43 overdose survivors and witnesses between January and May 2022. Participants were from nine states (ME, MI, MD, NJ, NY, NM, PA, TN, WV) and Washington, DC. Data were analyzed thematically following the Continuum of Overdose Risk. Results Most reported worsening mental health and increasing substance use during COVID-19. Isolation due to quarantining measures, coping behaviors, despair, and traumatic grief contributed to resumptions in drug use and risky behaviors. Some discussed how these stressors, combined with the rapid availability of financial resources led to increased use. Participants also attributed increased overdose risk to the increasingly toxic drug supply and stifled harm reduction access. Accounts of methadone treatment varied, however several expressed inconsistent access to take-home methadone, potentially contributing to resumed use. Conclusions Numerous micro- and macro-social factors, as well as the drug supply and treatment disruptions contributed to the acceleration in overdose risk. Increased funding and policy reform are needed to reduce overdose mortality in future public health emergencies, including improving harm reduction and treatment service adaptations to fit the needs of clients, as well as upholding and expanding novel methadone treatment delivery models.

Background Medicinal cannabis has been legally available in Australia since 2016. The current study examined the motivations for seeking medicinal cannabis and the pathways through which Australians accessed it. Methods Brief semi-structured interviews were conducted with 15 adults who self-reported medicinal cannabis use within the past 12 months. Informants were recruited at two cannabis-related events in Queensland and New South Wales. Interviews explored motivations, pathways to access, and experiences with medicinal cannabis. Thematic analysis was conducted using Braun and Clarke’s six-step framework which identified two key themes: “The Diverse Drivers of Medicinal Cannabis Use” and “Tales of Access: Journeys to Medicinal Cannabis.” Results Informants reported varied motivations for medicinal cannabis use, including managing treatment-resistant medical conditions and avoiding the legal consequences of illicit cannabis use. Some described transitioning from recreational to medicinal use, with dual-use (i.e., both recreational and medicinal) motives described in the sample. Accessibility was reported as straightforward, through telehealth consultations and single-purpose dispensaries facilitating prescriptions. Informants reported financial barriers to accessing medicinal cannabis products and frustrations with initial prescriptions of cannabis oil rather than cannabis flower. Informants reported limited knowledge of product constituents and dosages. Conclusions The study highlights the nuanced motivations and pathways to medicinal cannabis in Australia, including legal and medical drivers. Accessibility was described as simple through telehealth, single-purpose dispensaries but cost remained a barrier. Dual usage raises concerns about the risks associated with medicinal cannabis use. More qualitative research is needed to better understand the behaviour and risks facing medicinal cannabis consumers.

Introduction Delta-8 Tetrahydrocannabinol (THC) has become increasingly popular in the United States. Many online stores sell Delta-8 THC products, yet little is known about how they are marketed to consumers. Methods We selected a sample of popular Delta-8 online stores, captured them on one day, and coded their main pages for marketing and advertising strategies. The primary marketing strategies coded for were grouped into four main themes: 1) product claims; 2) engagement strategies; 3) user testimonials and other information; and 4) regulations and warnings. Descriptive statistics were calculated to estimate percentages of each strategy used. Results A total of 134 online stores were identified and coded. With respect to claims, over one-third stated that a product was natural or organic (35.1%), changed energy levels (37.3%) or mood (36.5%). Engagement strategies were used by most stores, with the most common feature being a link to their social media page (79.9%) and sales and discounts on products (over 50%). Over half of websites included product reviews (60.5%) or blogs (53.7%). Nearly three-quarters (72.4%) stated that the products were not regulated by the FDA and over half (59%) required an age verification. Discussion Surveillance is an essential public health service. For Delta-8, it is important to understand the marketing practices that retailers are using online because this setting caters to a large consumer base. Moreover, online stores can evade state regulations. A deeper investigation into Delta-8 marketing strategies could yield regulatory policies to protect public health.

Background The Centers for Disease Control and Prevention offered a multicomponent intervention called Local Opioid Overdose Prevention and Response (LOOPR). Five sites (Bell, KY, Boone, WV, Manchester, NH, St. Francois, MO, and Ware, GA) were selected to implement academic detailing (AD). AD is a strategy for communicating safer opioid prescribing practices to clinicians. This is the first study to assess changes in county-level opioid prescribing behaviors after implementing a multicomponent prevention program emphasizing AD. Objectives We examined three opioid prescribing behaviors (percentage of opioid prescribers in the top centile nationally, opioid prescribing rate, and average number of opioid prescriptions per prescriber) before and after program implementation in each site and a paired control. We used paired interrupted time series to examine the effect of LOOPR on each outcome for each site and control. Results Five jurisdictions incorporated AD as part of LOOPR. In addition, Bell County, KY implemented three other interventions (coalition establishment, communication campaign, and community-based overdose prevention program). Manchester City, NH (community-based overdose prevention program and public health/public safety partnership) and St. Francois, MO (communication campaign and public health/public safety partnership) implemented two additional interventions. Boone County, WV and Ware County, GA only incorporated AD. Though not always statistically significant, all sites showed decreasing or stabilizing trends after implementation of LOOPR for most outcomes. Conclusions/Importance This study shows AD is a versatile strategy and customizable activity that can be implemented in many settings as a separate activity or integrated with various prevention programs, making it particularly suitable for community-level interventions.

Objective: E-cigarette use is prevalent amongst young Australians, and recent studies confirm e-cigarette use has detrimental short and long-term effects on health. This study evaluated the extent to which e-cigarette outcome expectancies and refusal self-efficacy predict lifetime e-cigarette use in young Australians. Methods: Participants were 263 young Australians (M age = 20.4; 82.1% female). Participants completed an online survey assessing e-cigarette use, e-cigarette outcome expectancies, and e-cigarette refusal self-efficacy. Lifetime e-cigarette use was regressed on e-cigarette use outcome expectancies and e-cigarette refusal self-efficacy, with age, gender, and education as controls. Results: E-cigarette use outcome expectancies and e-cigarette refusal self-efficacy significantly predicted lifetime e-cigarette use, while controlling for demographic variables. Stronger e-cigarette dependency expectancies were associated with a lower likelihood of lifetime e-cigarette use. Stronger external refusal self-efficacy was associated with a lower likelihood of lifetime e-cigarette use. Conclusions: E-cigarette use intervention and prevention programs may benefit from strengthening awareness of dependency on e-cigarettes, particularly in the Australian context where the presence of nicotine in e-cigarette liquids is likely to be far more widespread than initially believed.

Background In the UK, the highest proportion of current smokers is in the 25–34 age group. Whilst there are effective smoking cessation interventions, they are not always accessed by young adults. An up-to-date review of smoking cessation strategies for young people has been conducted to understand the current state of the literature with a view to the implications for people with severe mental ill health (SMI). Methods A scoping review was conducted to explore individual-level interventions aimed at helping young adults to stop smoking. The protocol was registered on Open Science Framework (https://osf.io/8u24h/). We searched MEDLINE, CINAHL, PsycINFO, ASSIA and Web of Science databases. Randomized controlled trials published in English, conducted in any country in any setting with an aim of smoking cessation or reduction at an individual level, were included. We extracted data on study design, participant characteristics, intervention and control conditions, and key findings. A descriptive analytical approach was used, and the results are presented in tables. Results Thirty-one unique studies were identified for inclusion. Twenty were non-pharmacological, two were pharmacological, and nine contained both non-pharmacological and pharmacological elements. Fifteen of the studies included a digitally delivered component. Conclusions There is a growing body of research on individual-level smoking cessation interventions for young people. An increasing number of interventions are being delivered digitally. Further research should focus on ensuring that RCTs of digitally delivered interventions include diverse populations of young adults to ensure that existing inequalities are not exacerbated.