Examining risk and protective predictors of substance use among low-income Native Hawaiian and Pacific Islander adolescents.

The experiences and the everyday life stories of lesbian, gay, bisexual, and transgender (LGBT) youth who are also Asian American, Native Hawaiian, and Pacific Islander (AANHPI) are not well-known or documented in the literature about LGBT or AANHPI communities. To help address this lack of information and knowledge, this article highlights some of the issues that these youth face and offers recommendations regarding data collection, cultural competency, and utilization of an intersectional lens of race/ethnicity and sexual orientation to ensure changes will be considered to policies that affect these populations. The policy recommendations focus on issues such as bullying and sexual and reproductive health.

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Predictors of Chronic Opioid Use: A Population-level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djab082 ◽

2021 ◽

Author(s):

Devon K Check ◽

Christopher D Bagett ◽

KyungSu Kim ◽

Andrew W Roberts ◽

Megan C Roberts ◽

...

Keyword(s):

North Carolina ◽

Substance Use ◽

Cancer Survivors ◽

Low Income ◽

Opioid Therapy ◽

Adjusted Relative Risk ◽

Opioid Use ◽

Chronic Opioid Therapy ◽

Increased Risk ◽

Chronic Opioid Use

Abstract Background No population-based studies have examined chronic opioid use among cancer survivors who are diverse with respect to diagnosis, age group, and insurance status. Methods We conducted a retrospective cohort study using North Carolina (NC) cancer registry data linked with claims from public and private insurance (2006–2016). We included adults with non-metastatic cancer who had no prior chronic opioid use (N = 38,366). We used modified Poisson regression to assess the adjusted relative risk of chronic opioid use in survivorship (>90-day continuous supply of opioids in the 13–24 months following diagnosis) associated with patient characteristics. Results Only 3.0% of cancer survivors in our cohort used opioids chronically in survivorship. Predictors included younger age (adjusted risk ratio [aRR], 50–59 vs 60–69 = 1.23, 95% confidence interval [CI] = 1.05–1.43), baseline depression (aRR = 1.22, 95% CI = 1.06–1.41) or substance use (aRR = 1.43, 95% CI = 1.15–1.78) and Medicaid (aRR vs Private = 1.93, 95% CI = 1.56–2.40). Survivors who used opioids intermittently (vs not at all) before diagnosis were twice as likely to use opioids chronically in early survivorship (aRR = 2.62, 95% CI = 2.28–3.02). Those who used opioids chronically (vs intermittently or not at all) during active treatment had a nearly 17-fold increased likelihood of chronic use in survivorship (aRR = 16.65, 95 CI = 14.30–19.40). Conclusions Younger and low-income survivors, those with baseline depression or substance use, and those who require chronic opioid therapy during treatment are at increased risk for chronic opioid use in survivorship. Our findings point to opportunities improve assessment of psychosocial histories and to engage patients in shared decision-making around long-term pain management, when chronic opioid therapy is required during treatment.

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Associations Between Adverse Childhood Experiences and Prenatal Mental Health and Substance Use Among Urban, Low-Income Women

Community Mental Health Journal ◽

10.1007/s10597-021-00862-1 ◽

2021 ◽

Author(s):

Divya L. Jasthi ◽

Sarah Nagle-Yang ◽

Scott Frank ◽

Marie Masotya ◽

Alissa Huth-Bocks

Keyword(s):

Mental Health ◽

Substance Use ◽

Low Income ◽

Adverse Childhood Experiences ◽

Childhood Experiences ◽

Adverse Childhood ◽

Low Income Women ◽

Prenatal Mental Health

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