Tobacco industry contributions to the development of ultraprocessed food in the United States, 1985–2007: A case study of Lunchables

American Journal of Public Health

Tobacco firms began acquiring US food companies in the 1960s-1990s to increase revenues and leverage research and development across holdings in tobacco, alcohol, and ultraprocessed foods (UPF) subsidiaries. In this case study, the authors examine the development of Lunchables® following the Philip Morris (PMC) acquisition of Kraft and General Foods (KGF). PMC applied a "consumer-driven product development" strategy, previously used for tobacco, in the development process to maximize consumer appeal. PMC also used technologies from KGF to make lower-nicotine cigarettes and then low-fat versions of Lunchables®, in a "better-for-you" strategy to preserve market share in the face of health concerns about both products. The authors suggest public health strategies and policies used to address tobacco could be expanded to UPFs to reduce harm to children.

Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement 🔓

Addiction

This population-based study of national death records aims to characterize decreases in overdose death rates in the United States between 2023 and 2024 by race/ethnicity and substance involvement. Researchers found that all four previously defined waves of the US overdose crisis appear to be in decline, as deaths involving illicit fentanyl, with and without stimulants, dropped sharply between 2023 and 2024. Concurrently, the fraction of overdose deaths involving stimulants without fentanyl and those involving xylazine continued to increase. While racial disparities in drug overdose death rates narrowed slightly during this period, large gaps remain, with the highest overdose death rates among American Indian, Alaska Native, and Black individuals.

Associations between modes of cannabis use and cannabis use disorder: Evidence from the 2022 to 2023 United States National Survey on Drug Use and Health

Addiction

This cross-sectional study analyzed data from the 2022-2023 National Survey on Drug Use and Health (NSDUH) to estimate the association between modes of cannabis use and past-year cannabis use disorder (CUD). Of all respondents who reported past-year cannabis use, 53.9% reported multi-modal cannabis use (at least two modes of use). The overall prevalence of CUD was 30.3%; however, this varied by mode of use. Respondents who reported oral/mucosal-only cannabis use had a CUD rate of 4.4% compared to 40.5% with multi-modal use, 24.3% with smoke-only use, and 28.9% with dab-only use. The highest CUD odds were among those using smoke + vape + oral/mucosal + dab, compared to oral/mucosal + topical use (AOR = 19.74, 95% CI: 9.11-42.75).

Expanding methadone access through community pharmacies: A qualitative study exploring opioid treatment program staff perceptions of pharmacy-based medication units 🔓

Substance Use & Addiction Journal

Methadone for opioid use disorder (OUD) is limited to opioid treatment programs (OTP), which can in turn limit access in much of the country. Proposals to expand access have included a federal law allowing prescribing by addiction specialists, but these proposals have not advanced. State regulations in North Carolina would allow pharmacies to act as medication units functioning as satellite sites for OTPs. The authors conducted qualitative research among OTP staff to ascertain perceptions about an OTP-pharmacy collaboration. While OTP staff identified increased access as a benefit and were generally supportive, they also raised concerns about potential stigma in pharmacies and loss of access to counseling and other services offered in OTPs. The staff also noted potential facilitators for implementation include telehealth, reimbursement changes, and communication between OTPs and pharmacies.

Naloxone and clinical outcomes in suspected opioid-associated out-of-hospital cardiac arrests 🔓

JAMA Network Open

Recent studies estimate 17% of out-of-hospital cardiac arrests (OHCA) involve drug overdose. Data were obtained from a California EMS database for 2021-2022. Standard criteria indicating opioid-associated OHCA were found in 3,811 patients, and 33% of these received naloxone. Patients who received naloxone, compared to those who did not, had higher probability of survival to hospital discharge (8.1% vs 4.4%), favorable neurologic outcome at discharge (7.4% vs 3.3%), and return of spontaneous circulation (14.1% vs 9.6%). Similar favorable results were found in the group who received naloxone because EMS suspected opioid involvement. Naloxone even improved outcomes in the entire group of OHCA. However, in OHCA where epinephrine was administered naloxone provided no benefit. The authors suggest a randomized trial of naloxone in opioid-suspected OHCA.

Using deep learning to identify brain networks mediating cognitive and motor impairments in alcohol use disorder 🔓

Translational Psychiatry

Alcohol use disorder (AUD), which affects 29.1% of individuals over a lifetime in the US, is linked to impairments in visuospatial working memory, executive function, and motor control. This study used a data-driven deep learning approach to distinguish individuals with AUD from controls by integrating resting-state functional MRI connectivity data with cognitive and motor performance measures. The model identified 16 brain networks mapped to neuropsychological functions and grouped them into 14 functional units. The Temporal Attention Network (TAN) fully mediated the impact of AUD on spatial working memory, attention, set-shifting, and motor performance, while the Sensorimotor Network (SMN) additionally mediated motor-related deficits. These findings demonstrate distinct brain-behavior relationships underlying AUD-related impairments and were replicated in an independent cohort, supporting their robustness.

The comparative effects of prenatal exposure to methadone versus buprenorphine for opioid use disorder on neonatal outcomes: a systematic review and meta-analysis 🔓

BMC Pregnancy and Childbirth

This systematic review and meta-analysis evaluated the impacts of methadone and buprenorphine on neonatal health outcomes, particularly preterm birth, low birthweight, small for gestational age, stillbirth, neonatal opioid withdrawal syndrome (NOWS) diagnosis, and NOWS treatment. A total of 27 studies were included, with 22 observational studies, 4 randomized clinical trials (RCTs), and 1 RCT/observational study. Within these studies, there were a total of 14,978 individuals exposed to buprenorphine and 8,358 exposed to methadone. Buprenorphine was associated with lower risk of preterm birth, low birthweight, small for gestational age, and NOWS treatment. There were no differences in NOWS diagnosis or stillbirth between groups. The study was limited due to lack of adjustment for potential confounding or timing, duration, and dosage of exposure to each regimen in the majority of the included studies.