Faculty Bibliography

Background: Research has shown that lesbian, gay, and bisexual (LGB) young adults have substantially higher rates of tobacco, alcohol, and drug use compared to heterosexuals. Many have attributed these higher rates to minority stressors including discrimination and stigma. Substance use behaviors often continue through later life and can interact with chronic medical disease to increase the risk for adverse events. However, little research focuses on the prevalence of unhealthy substance use among older LGB adults. This study estimates the national prevalence of substance use among LGB middle-aged and older adults and odds of use relative to heterosexuals.
Method(s): We examined aggregated data from 25,880 adults age >=50 from the 2015 to 2017 National Survey on Drug Use and Health, an annual cross-sectional survey of a nationally representative sample of non-institutionalized individuals in the United States. We estimated the prevalence for past-month binge drinking and past-year non-medical cannabis use, alcohol use disorder, nicotine dependence, cocaine, methamphetamine, and prescription opioid, sedative, stimulant, and tranquilizer misuse and their odds of use relative to heterosexual adults age >=50 adjusting for age, gender, race, income, and marital status.
Result(s): In adjusted analyses, we found that LGB adults age >=50 were at 2.3 times higher odds (95% confidence interval [CI]=1.6, 3.2) of reporting past-year non-medical cannabis use; they were at 1.7 times higher odds (95% CI 1.1, 2.5) of reporting prescription opioid misuse, and 2.4 times higher odds (95% CI 1.3, 4.3) of reporting prescription tranquilizer misuse compared to heterosexuals. We did not find significant differences in use of other substances.
Conclusion(s): Consistent with other studies of younger LGB, this study shows some substance use is higher in older LGB adults compared to their heterosexual counterparts. LGB middle-aged and older adults are at higher risk for cannabis use, prescription misuse of opioids and tranquilizers. Prevention and interventions for unhealthy substance use should focus on older LGB populations to reduce harms.

Background: Little is known about how COVID-19-related social distancing has affected illegal drug use. We surveyed electronic dance music (EDM) partygoers-a population known for high levels of drug use-to determine whether their drug use patterns had changed during state-mandated social distancing in New York. Methods: Individuals were recruited online and screened for eligibility throughout April and May 2020. We surveyed 128 eligible adults and queried, retrospectively, whether their drug use behavior had changed during COVID-19-related social distancing. Results: Most participants reporting past-three-month use reported decreased frequency of use during COVID-19-related social distancing. Specifically, 78.6% reduced frequency of use of cocaine, 71.1% reduced frequency of use of ecstasy/MDMA/Molly, and 68.0% reduced frequency of use of LSD. Although some participants reported increased frequency of use of cocaine (7.1%), ecstasy (7.9%), or LSD (12.0%), 35.0% reported increased frequency of cannabis use. Most (66.7%) of those reporting cocaine use reduced the amount used. The majority of those reporting use of cannabis, ecstasy, cocaine, and/or LSD reported that drug cost (80.0-84.0%) and drug quality (84.2-92.0%) did not change during social distancing. Having a college degree was associated with higher odds for decreasing frequency of cannabis use. Older participants (ages ≥23) were at lower odds for decreasing frequency of cocaine use, as were those earning >$500 per week, and participants who attended EDM events biweekly or more often were at higher odds for decreasing frequency of LSD use. Conclusions: Participants in this sample tended to reduce party drug use during COVID-19-related social distancing.

BACKGROUND:A variety of substance use-related topics are discussed in the public discourse; however, it is unknown how public discussion of published substance-related findings relates to manuscript downloads and citations. This manuscript examines how traditional and social media coverage of published findings about substance use affects downloads and scientific citations. METHODS:percentile of downloads and citations. RESULTS:73.3 % of articles were shared on Twitter, 23.6 % were shared on Facebook, and 13.9 % were covered in news sources (with 4.0 % receiving major media coverage). Epidemiology papers were among the most covered in the news, and e-cigarette review papers were among the most downloaded. News and social media coverage were positively associated with number of downloads and citations in bivariable models and with achieving the top 10 % of downloads and citations in multivariable models (ps < .001). Publishing a press release was associated with higher likelihood of receiving additional news coverage (aPR = 7.85, 95 % CI: 5.15-11.97). CONCLUSIONS:Traditional and social media coverage of manuscripts focusing on substance use are associated with more downloads and citations. Researchers should consider sharing findings not only to increase downloads and citations but also to educate the general public.

Objectives/UNASSIGNED:Skip-logic is commonly used on electronic surveys in which programs provide follow-up questions to affirmative responses and skip to the next topic in response to non-affirmative responses. While skip-logic helps produce data without contradictory responses, erroneous non-affirmative reports can lead to loss of accurate information. We examined the extent to which type-in drug use responses contradict unreported use in a survey of a high-risk population-electronic dance music (EDM) party attendees. Design/UNASSIGNED:We surveyed 1029 EDM party-attending adults (ages 18-40) using time-spacing sampling in 2018. We examined the extent to which reporting of recent drug use via type-in responses occurred after past-year use of the same drugs were unreported earlier on the same survey. Changes in prevalence of use and predictors of providing discordant responses were examined. Results/UNASSIGNED:< .001) were at higher odds of providing a discordant response. Conclusions/UNASSIGNED:Electronic surveys that query drug use can benefit from follow-up (e.g. open-ended) questions not dependent on previous responses, as they may elicit affirmative responses underreported earlier in the survey.

Background/UNASSIGNED:Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]), commonly referred to as Molly in the US, is commonly adulterated with drugs potentially more dangerous than MDMA. Synthetic cathinones ("bath salts") are common adulterants, and use of these compounds tends to be stigmatized. We investigated whether presenting information on the extent of ecstasy being adulterated with "bath salts" affects intentions to use. Methods/UNASSIGNED:A total of 1,025 adults entering electronic dance music parties were surveyed in 2018. Using an experimental posttest-only design with random assignment, half were randomly assigned to view a published Vice headline about ecstasy/Molly commonly being adulterated with "bath salts." Results/UNASSIGNED:= .030) of past-year ecstasy users' intention to test their ecstasy for adulterants. Conclusions/UNASSIGNED:Knowledge that ecstasy is commonly adulterated may help reduce the risk for future use among non-recent users and increase the willingness of users to test their ecstasy. This information can be used to target those at risk for ecstasy/Molly use.

BACKGROUND:The popularity of virtual raves and happy hours has increased during the COVID-19 pandemic. While nightlife settings are often associated with drug use, it is unknown whether virtual events are associated with use. METHODS:Electronic dance music (EDM) partygoers who live in New York and reported recent drug use were recruited online and screened for eligibility throughout April and May 2020. Eligible adults (n = 128) were asked about virtual rave and happy hour attendance during the COVID-19 crisis. We examined prevalence and correlates of drug use during such events. RESULTS:55.5% of participants attended virtual raves and 69.5% attended virtual happy hours. 40.9% used illegal drugs during virtual raves and the most frequently used drugs were cannabis (29.6%), ecstasy/MDMA/Molly (8.5%), LSD (7.0%), and cocaine (4.2%). 33.7% used illegal drugs during virtual happy hours and the most frequently used drugs were cannabis (29.2%), cocaine (3.4%), and ketamine (3.4%). Older participants were more likely to use illegal drugs during virtual raves, and those reporting past-year use of more drugs were more likely to use drugs during virtual raves and/or happy hours (ps<0.05). CONCLUSIONS:EDM partygoers are at risk for using drugs during virtual events. Results can inform prevention and harm reduction efforts.

BACKGROUND:Results provide insight regarding diffusion and initiation of ecstasy in the EDM scene. Findings can inform prevention and harm reduction efforts.

BACKGROUND:Older lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity. Understanding multimorbidity among older LGB adults may help inform interventions to reduce disparities in health outcomes. METHODS:Data come from the 2015 to 2017 National Surveys on Drug Use and Health (n = 25,880). We first determined whether sexual orientation was associated with reporting: past-year drug use, mental illness, and/or 2 or more chronic medical diseases. We then determined whether sexual orientation was associated with reporting co-occurrence of these conditions. This was done using multivariable logistic regression. Analyses were stratified by gender. RESULTS:Compared to heterosexual men, gay men were at increased odds for reporting 2 or more chronic medical diseases (adjusted odds ratio [aOR] = 2.18, 95% confidence interval [CI] = 1.48, 3.21), and gay (aOR = 1.79, 95% CI = 1.09, 2.93) and bisexual men (aOR = 3.53, 95% CI = 2.03, 6.14) were at increased odds for reporting mental illness. Gay men (aOR = 2.95, 95CI = 1.60, 5.49) and bisexual men (aOR = 2.84, 95% CI = 1.58, 5.08) were at increased odds of reporting co-occurring conditions. Compared to heterosexual women, bisexual women were at increased odds for past-year drug use (aOR = 4.20, 95% CI = 2.55, 6.93), reporting mental illness (aOR = 1.94, 95% CI = 1.03, 3.67), and reporting co-occurring conditions (aOR = 3.25, 95% = 1.60, 6.62). CONCLUSIONS:Middle-aged and older LGB adults in the United States are at high risk for experiencing co-occurring drug use, mental illness, and/or medical multimorbidity. Interventions for older sexual minority populations are needed to reduce disparities.