A decision analytic dynamic Markov model on the US population aged 12 years or older was used to project the number of fatal overdoses caused by any opioid between 2020 – 2029 and project the number of deaths that can be averted by prescribing restrictions, naloxone distribution, and expansion of MAT interventions. Based on data taken from 2010-2018 National Survey on Drug Use and Health, Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey, the US Census, and the National Epidemiologic Survey on Alcohol and Related Conditions- III, the status quo, the model projects 484,429 fatal opioid overdoses to occur between 2020 and 2029, with 155,628 attributed to prescription opioid use (both medical and non-medical use), 199,751 attributed to heroin and previous prescription opioid use, and 129,050 attributed to heroin without previous prescription opioid use. Implementing interventions such as reducing opioid prescribing, enhanced naloxone distribution, and expanding MAT can avert 37% or 179,151 of the projected fatal opioid overdoses, with each of the preceding interventions averting 0.3%, 15.4%, and 25.3% of these projected fatal opioid overdoses, respectively. This model also projected that the combined interventions would decrease the prevalence of people with opioid use disorder by 27.5%, reducing from 2.47 million with opioid use disorder in 2019 to 1.79 million with opioid use disorder in 2029.

Ballreich J, Mansour O, Hu E, et al. Modeling Mitigation Strategies to Reduce Opioid-Related Morbidity and Mortality in the US. JAMA Netw Open. 2020;3(11):e2023677. doi:10.1001/jamanetworkopen.2020.23677

One area of substance misuse among adolescents that is currently a problem, and has not been fully understood in the Nigerian context is the attitudes of adolescents towards cough syrup abuse. Thus, to inform policy actions for reducing cough syrup abuse among Nigerian adolescents, this study explored the attitudes of adolescents towards cough syrup abuse in two Southwest states of Nigeria, where substance abuse is rampant.

By a stratified sampling method, 302 adolescents (152 males, 150 females; mean age = 13.61 years, SD = 2.09) were selected from secondary schools in Lagos and Oyo states, Nigeria, and data were collected using existing questionnaires with strong psychometric properties, and the response rate was 97.42%. Four (4) hypotheses were stated and tested using independent sample t-test and correlation statistics at p<0.05.

The findings from the study concluded that, adolescents’ age and family marital structure were the variables found that significantly accounted for their attitudes towards cough syrup abuse, thus it is imperative enough that as adolescents are growing older, they are rightly guided against giving into substance abuse. Also, parents/caregivers of adolescents need to be actively involved in educating adolescents on the hazards associated with substance abuse.

Abstract

Importance: Nonmedical prescription opioid use is a pressing public health issue in the United States. Transgender youth, including adolescent girls and young women who were assigned male at birth and currently identify as women, female, transgender women, or another diverse gender identity along the transfeminine gender spectrum, are more likely than their cisgender peers to report illicit substance use and meet diagnostic criteria for substance use disorders. However, relatively little is known about the experiences of these populations in the current era of opioid addiction and misuse.

Objective: To report the prevalence of and risk factors associated with lifetime nonmedical prescription opioid use in a high-risk community sample of transgender adolescent girls and young women who are sexually active.

Design, Setting, and Participants: This cross-sectional study used 2012 to 2015 baseline data from Project LifeSkills, a randomized clinical trial of a behavioral intervention to reduce the risk of HIV acquisition and transmission among a diverse sample of transgender adolescent girls and young women recruited from Boston, Massachusetts, and Chicago, Illinois. A total of 297 transgender girls and women aged 16 to 29 years who were sexually active were included in this analysis. Data were analyzed from June 2019 to August 2019.

Exposures: Transgender woman identification.

Main Outcomes and Measures: Self-reported lifetime nonmedical prescription opioid use.

Results: Among 297 transgender adolescent girls and young women (mean [SD] age, 23.4 [3.5] years), 145 (48.8%) identified as non-Hispanic/Latinx black, 76 (25.6%) identified as non-Hispanic/Latinx white, 37 (12.5%) identified as Hispanic/Latinx, 7 (2.4%) identified as non-Hispanic/Latinx Asian, and 32 (10.8%) identified as multiracial or other race/ethnicity. Thirty-five participants (11.8%) reported lifetime nonmedical prescription opioid use. Young transgender women who smoked cigarettes monthly or less (adjusted odds ratio, 3.92; 95% CI, 1.10-13.89) and who smoked daily (adjusted odds ratio, 5.69; 95% CI, 1.87-17.33) had greater odds of nonmedical prescription opioid use compared with those who did not smoke. Additionally, participants who identified as a sexual orientation other than heterosexual, gay, lesbian, or bisexual had significantly greater odds of lifetime nonmedical prescription opioid use compared with those who identified as heterosexual (adjusted odds ratio, 3.69; 95% CI, 1.07-12.72).

Conclusions and Relevance: These findings suggest that transgender adolescent girls and young women have similar prevalence of lifetime nonmedical prescription opioid use compared with the US general population prevalence of 12.5%. These findings may serve as a call-to-action for public health surveillance studies and evidence-based interventions to be comprehensively tailored to examine and respond to specific trends of substance use, particularly opioid use disorder, among transgender populations.