The article, “Recovery Support and Capacity Assessment Using the Calculating an Adequate System Tool: Two Case Studies,” has been published in SAj.

In this commentary, the authors state that there are multiple, reliable, and authoritative federally managed data sources for understanding the incidence and prevalence of substance use disorder (SUD) and its sequela. However, there remains a gap in metrics representing the need and capacity for treatment and related supports within local communities. To address this challenge, Calculating an Adequate System Tool (CAST) was developed in 2016 by an interdisciplinary group of researchers at the Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality to assess the capacity of the SUD care system within a defined geographic area. It allows for risk assessment of local social and community determinants of substance abuse, as well as an assessment of local service needs across the continuum of SUD care.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“CAST is designed to assist with short- and long-term planning for improving the behavioral health of communities. Program saturation, estimated with CAST algorithms, should be interpreted as a guide for decision-making and not a rigid boundary for program activity levels. CAST is predicated on the assumption that resources are finite and decisions need to be made about how financial and human capital are allocated within a given community. It is important to note that CAST estimates are based upon data that were provided by community organizations and not all organizations that responded to the survey provided detailed program activity information. In both the Ohio and Montana projects presented in this research brief, the logic of CAST and the quantification of need were able to elucidate community-level needs and differences in a manner that allowed for meaningful action among the coalitions that commissioned the studies.”

“Throughout the projects identified in this research brief, it has become clear that there is a need for further expansion and refinement of quantitative methods for assessing the capacity of the substance use care systems. One of the distinctive elements of CAST, as highlighted in the Missoula County case study, is quantification of prevention programming. Future research and additional efforts should be made to offer mathematical models of demand and program saturation, leveraging the progress made with CAST to improve the ability of community needs assessments to inform resource allocation.”

The article, “Latent Class Groups of Concurrent Substance Use Among Adolescents in an Urban Community: Correlates With Mental Health, Access to Drugs and Alcohol, and Risk Perception,” has been published in SAj.

In this commentary, the authors state that concurrent substance use among adolescents has been associated with an increase in physical and mental health problems. These outcomes tend to be exacerbated among adolescents of color in underserved urban settings. The purpose of their study was to understand alcohol and concurrent drug use patterns among adolescents in an underserved urban community to provide targeted prevention and treatment recommendations.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“There is a need in the adolescent substance use literature to further understand Latent class (LC) group membership characteristics of concurrent substance use among adolescents living in under-served urban communities. Primary aims for this study were to: 1. Use LCA to identify and investigate patterns of concurrent substance use among adolescents from an under-served urban community in the northeastern United States. 2. Examine corollary clinical features of substance use with LCA patterns of concurrent substance use among adolescents of color.”

“Concurrent substance use during adolescence has innumerable unfavorable developmental outcomes. Our findings have important implications for both prevention and practice, and provide a step in understanding concurrent substance use and associations with mental health and other corollary clinical features. Recognizing patterns of alcohol and substance use in under-served communities can support interventions targeted to such groups without disregard for other environmental factors that promote the likelihood of access to substances.”

The article, “Cannabis Use Differences Among Sexual Minority Versus Heterosexual Females and Males in Oklahoma: The Roles of Mental Health, Cannabis Perceptions, and Cannabis Marketing Exposure,” has been published in SAj.

In this commentary, the authors state that despite the high cannabis use rates among sexual minority (SM) individuals, less research has examined factors related to cannabis use among SM (vs. heterosexual) individuals, especially in places with legal medical cannabis retail markets and high structural stigma, like Oklahoma.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Although elevated rates of cannabis use among SM individuals are evident, less is known about the range of factors that may be associated with cannabis use and use severity among SM, relative to heterosexual adults. Moreover, research on SM cannabis use is lacking in places with legal cannabis retail markets, high structural stigma, and pronounced SM substance use, like Oklahoma. This work is critical to inform public health efforts aimed at reducing cannabis use among this vulnerable population, particularly as further cannabis legalization across the United States is likely. To identify factors associated with differences in cannabis use among SM versus heterosexual individuals, the current study examined associations between sexual identity and potential cannabis-related factors (i.e., perceived harm to health, positive cannabis perceptions, cannabis marketing exposure, depressive symptoms, anxiety symptoms). We then examined associations of sexual identity and these cannabis-related factors with cannabis use and use severity (i.e., any past 30-day use, daily/near-daily use, CUD symptoms). Based on the aforementioned literature, we hypothesized that SM (vs. heterosexual) individuals would display greater odds for current cannabis use, daily/near-daily cannabis use, and CUD symptoms. Moreover, SM (vs. heterosexual) individuals were expected to report lower cannabis-related harm perceptions and greater positive attitudes toward cannabis; a greater proportion of SM individuals was expected to report cannabis marketing exposure, depressive symptoms, and anxiety symptoms. Lower harm perceptions, greater positive attitudes, marketing exposure, and depressive and anxiety symptoms were hypothesized to predict greater odds of each cannabis-related outcome.”

“The current study examined differences in a range of potential cannabis-related factors and behaviors among SM and heterosexual adults in Oklahoma. SM (vs. heterosexual) females reported higher rates of cannabis use, whereas SM (vs. heterosexual) females and males reported higher rates of daily/near-daily cannabis use. Among females, findings may be related to cannabis marketing exposure (for past 30-day and daily/near-daily use) and harm perceptions (past 30-day use), whereas past 30-day cannabis use among males may be related to depressive symptoms. With future replication, findings highlight important potential targets for reducing cannabis-related disparities among SM, relative to heterosexual females and males, respectively, living in places with legal medical cannabis retail markets, high structural stigma, and pronounced substance use. Public health campaigns aimed at correcting misinterpretations of harm that could emanate from marketing efforts by the cannabis industry may help reduce cannabis use among SM females, whereas SM males may be better reached by intervention efforts targeting mental health symptoms, as well as large-scale interventions that attend to the unjust social conditions that perpetuate stigma and discrimination related to sexual identity.”

The article, “Perceptions and Attitudes Related to Driving after Cannabis Use in Canadian and US Adults,” has been published in SAj.

In this commentary, the authors state that people in Canada and the United States (US) have seen expanding access to cannabis following the legalization of both medicinal and recreational use. Canadians have been able to access cannabis for medical purposes since 2001, but the Cannabis Act legalized recreational use at the federal level as of October 2018. As of May 2023, recreational use is legal in 23 US states and the District of Columbia, and medicinal use is legal in 38 states and the District of Columbia. With expanded access, there is increasing emphasis on understanding potential harms to individuals and public health, including driving after cannabis use (DACU).

Their study examined the risk perceptions related to driving after cannabis use (DACU) among Canadian and US adults who used cannabis in the past six months.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Relative to studies of people who DACU and driving-related cognitions in the US, data on these same measures in people from Canada are notably lacking. In the study by Goodman et. al. Canadian younger adults who rated DACU as less risky reported higher frequency of engagement in DACU. Despite these initial findings, understanding the risk perceptions of Canadians who DACU remains a priority area for research, and no studies have directly compared US and Canadian samples. Comparing US and Canadian samples is scientifically important, given the rapidly shifting legal landscape concerning cannabis use in both countries. Differences in legalization also result in variability in public messaging, psychoeducation, and other prevention campaigns concerning cannabis risks and harms, including DACU. To further expand the US literature on DACU among community adults and add new data from Canadian community adults, the current study examined perceptions, driving behavior, and cannabis use among Canadian and US adults who reported recent cannabis use in the past six months”

“The findings of the present study affirm previous research that suggests that when people endorse favorable perceptions of DACU, they are more likely to engage in DACU. While this association has been studied in the US, this study expands on this subject by providing novel insights into DACU cognitions and behaviors of Canadians, although updated research with contemporary samples is needed to determine if these perceptions and attitudes have changed with expanded access to cannabis following federal legalization. Informed by an understanding of the perceptions and attitudes of people who DACU, tailored prevention and treatment efforts aimed at the people most likely to engage in this behavior can be made to promote safe decision-making concerning driving.”

The article, “High Seroprevalence of Hepatitis C Virus Among Cisgender Women Who Exchange Sex in the Seattle, Washington Area,” has been published in SAj.

The authors state that injection drug use (IDU) is a risk factor for hepatitis C virus (HCV) acquisition and occurs disproportionately among women who exchange sex (WES). However, little is known about HCV epidemiology in this population. We estimated HCV seroprevalence, identified correlates of HCV seropositivity, and characterized social networks by HCV serostatus and IDU history among WES in the Seattle, Washington, area.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Previous studies among PWID have found peer referral to be an effective means of linking PWID with HCV care, but most of this research has been conducted outside of the United States, and to our knowledge, none has focused on WES.

To address these knowledge gaps, we used data from a cross-sectional survey of WES in the Seattle, Washington area to (1) estimate the prevalence of HCV seropositivity, (2) identify correlates of HCV seropositivity, and (3) characterize social networks among WES by analyzing participant recruitment trees and measuring whether and to what extent individuals were likely to recruit others with the same HCV serostatus or IDU history.”

“The high prevalence of lifetime IDU in our sample of WES highlights the need for targeted HCV services and interventions for this population. WES—as well as other women who have HCV—are likely to encounter barriers and stigma when accessing health care. One strategy for reaching stigmatized communities is through peer referral. For example, a team from the University of British Columbia found that peer referrals to drug treatment were effective for WES. Based on this and other work among populations with a high HCV burden, we hypothesized that HCV treatment interventions involving peer referral of networks may be beneficial to WES.”