Illicit and Prescription Drug Misuse among Sexual Minority Women in the United States: A Protocol for a Scoping Review

  Background: The United States Institute of Medicine (IOM) published reports in 1999 and 2011 identifying drug use as a priority area for sexual minority health research, specifically focused on mechanisms contributing to drug use disparities and the development of tailored interventions. Limited research has prioritized sexual minority women (SMW) with the majority of substance use research among sexual minorities focused on adolescents and men who have sex with men. This scoping review will characterize the research literature related to illicit drug use and prescription drug misuse among SMW and sub-groups within the SMW population. Through this, we will identify: (1) specific substances used; (2) patterns of substance use; (3) risk and protective factors; (4) prevention interventions; and (5) drug treatment programs specific to SMW. Methods/Design: This review will include studies with empirical data of illicit or prescription drug misuse among sexual minority women. Peer-reviewed quantitative research conducted in the United States and published in English from 2011-Present will be included. We will search Medline, PsycINFO, and Web of Science databases for relevant articles. Two independent reviewers will screen abstracts and relevant full-text studies for eligibility. Data will be extracted from eligible articles and results will be presented in narrative and tabular form as appropriate. Discussion: This work will identify gaps of knowledge in the research pertaining to illicit or prescription drug misuse among sexual minority women since the 2011 US IOM report. As a result of this work, we will propose directions for future research to address identified gaps

Social Ecological Contexts of Hospital Admissions in the First Year Postpartum among Persons with Opioid Use Disorder

Opioid overdose is a leading cause of death during pregnancy and within a year of delivery. While the postpartum period is marked by profound life changes for all, individuals with opioid use disorder (OUD) may face additional challenges that heighten their vulnerability to drug and health concerns within the first year postpartum. The goal of this dissertation is to further our understanding of the individual factors and social ecological contexts that contribute to OUD in pregnancy and hospitalization in the first year postpartum among persons with OUD. Utilizing statewide, inpatient hospital discharge data from the Pennsylvania Health Care Cost Containment Council (PHC4), this dissertation aims to: 1) assess the spatial patterns and ZIP code-level factors associated with delivery hospitalizations with OUD across the state; 2) identify subgroups of persons with OUD at delivery by comorbid conditions who are at increased risk of hospitalization in the first year postpartum; and 3) examine the associations of county-level contextual factors with hospitalization within a year of delivery within the same cohort. The first analyses found that ZIP code-level urbanicity, worse economic conditions, overall hospitalization rate, and the presence of an OUD treatment facility were associated with increased OUD delivery hospitalizations in the general population across Pennsylvania. In the second analysis, three distinct subgroups were identified among a cohort of individuals with OUD at delivery by comorbid substance use disorders (SUDs), mental health conditions, and infections. Compared to the Low Comorbidities class (low prevalence of most comorbidities), both the moderate polysubstance use/depression class (all persons had depression and some had co-occurring SUDs) and the high polysubstance use/bipolar disorder class (highest prevalence of SUDs and bipolar disorder across classes) had increased risk of all-cause and mental health-related hospitalizations from 0-42 days postpartum and SUD- and mental health-related hospitalizations from 43-365 days postpartum. The third analysis found that an increased rate of OUD treatment facilities per population in a county was associated with a reduction in OUD-related hospitalizations from 0-42 days postpartum. These findings provide important information needed to develop and implement multilevel interventions to address maternal opioid morbidity and mortality

Young Men's State Christian Association welcome meeting program

Dated 1872, this is a program for the welcome meeting for the Young Men's State Christian Association (YMCA) at the First Congregational Church on Friday, November 15, 1872. The first page lists the agenda for the event and provides general event information. Pages two, three and four list excerpts from various hymns. The Young Men's Christian Association (YMCA) was founded in 1844 in London by a George Williams, a draper who was concerned large cities didn't provide good recreational activities for young men other than taverns. By 1851, YMCA chapters extended to other countries, including the United States

Research on Drugs and Social Characteristics

Drug use and related disorders are highly associated with race/ethnicity, with rates varying by drug type and race/ethnic group. Substance use is widespread among adolescents of whites, American Indians/Alaska Natives, African Americans, and Hispanics. Data show that drug‐related deaths vary by race/ethnicity and gender. Men are twice as likely to die of a drug overdose as women, while non‐Hispanic whites account for 82% of all drug‐induced deaths. However, currently American Indians/Alaska Natives have the highest rates of drug‐related mortality at 17.1 per 100,000 population compared to 16.6 among non‐Hispanic whites. This reflects a change from the 1980s and 1990s when non‐Hispanic blacks and whites had higher drug‐related mortality rates. Research has documented that sexual minority students have a higher prevalence of drug use than their heterosexual counterparts. Research should continue to unpack the contexts that give rise to higher drug use among sexual minorities

The opioid epidemic among the Latino population in California

•In California, opioid mortality rates among Latinos remained stable from 2006–2016.•Starting in 2017, opioid-related death rates increased dramatically among Latinos.•Rates of opioid-related ED visits steadily increased in this population since 2006.•High-risk counties for opioid-related deaths and ED visits are identified. The opioid epidemic in the United States has manifested differently across geographic regions and populations, with recent increases among racial/ethnic minorities and in the Western region of the U.S. This study provides an overview of the opioid overdose epidemic among Latinos in California and highlights high-risk areas in the state. Using publicly available data from California, we examined trends in opioid-related deaths (e.g., overdose) and opioid-related emergency department (ED) visits among Latinos at the county-level, as well as changes in opioid outcomes overtime. Opioid-related death rates among Latinos (mostly Mexican-origin) in California remained relatively stable from 2006–2016, but started to increase in 2017 peaking at an age-adjusted opioid mortality rate of 5.4 deaths per 100,000 Latino residents in 2019. Prescription opioid-related deaths, compared to heroin and fentanyl, have remained the highest over time. However, fentanyl-related deaths began to increase dramatically in 2015. Lassen, Lake, and San Francisco counties had the highest 2019 opioid-related death rates among Latinos. Opioid-related ED visits among Latinos have steadily increased since 2006 with a sharp increase in rates in 2019. San Francisco, Amador, and Imperial counties had the highest 2019 rates of ED visits. Latinos are facing detrimental consequences associated with recent increasing trends in opioid overdoses. The identified high-risk counties may have vulnerable sub-populations of Latinos, such as those in northern rural regions, that have gone underrepresented in conventional surveillance health databases. Time sensitive policies and interventions are needed to curtail health consequences especially among “hidden” Latino populations

Trajectories of heroin use: A 15-year retrospective study of Mexican-American men who were affiliated with gangs during adolescence

•Five discrete heroin trajectories groups were identified over the life course.•Trajectories varied despite baseline levels of use in adolescence.•Lower use groups generally reported better social and health outcomes in adulthood.•All groups continue to be socially embedded into family and community social networks. Heroin use is a public health concern in the United States. Despite the unique etiology and patterns of heroin use among U.S. Latinos, long-term heroin trajectories and health consequences among Latinos are not well understood. This study aims to document the distinct heroin use trajectories for a group of street-recruited (non-treatment), young adult Mexican American men living in a disadvantaged community who were affiliated with gangs during their youth. One-time interviews conducted between 2009–2012 in San Antonio, TX collected retrospective data from a sample of 212 Mexican American young adult men who reported using heroin at least once. Group-based trajectory modeling was applied to determine discrete developmental trajectories of heroin use. ANOVA, Chi square tests, and multinomial logistic regression examined current (past year) social and health indicators among each trajectory group. Five discrete heroin trajectories groups were identified: low use (n = 65); late accelerating (n = 31); early decelerating (n = 26); late decelerating (n = 38); and stably high (n = 52). Varying social and health consequences were found among the trajectory groups. This study describes the unique heroin use trajectories and social and health outcomes among a high-risk subgroup of Mexican American men. The findings suggest that early intervention and intervention available in easy to access non-treatment spaces may be especially useful for groups of people who use relatively less heroin