Research News Roundup: February 27, 2025

Effectiveness of Educational Interventions in United States Schools to Prevent Opioid-Related Harms: A Systematic Review

Journal: Addictive Behaviors, 2025, doi: 10.1016/j.addbeh.2025.108268

Authors: Christina Hua-Nguyen, Ashley Harris, Micah E. Herrera, Jamison Falk, Me-Linh Le, & Shweta Mital

Abstract:

Issues: The opioid crisis in North America has increased concerns about adolescent problematic opioid use. Schools are crucial in prevention efforts, but the effectiveness of school-based educational programs is debated. This review evaluates the effectiveness of school-based opioid education programs in preventing opioid-related harms, and improving knowledge, attitudes, and beliefs about opioids among youth.

Approach: Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, ERIC, and Web of Science databases were searched in January 2025. Included studies met the following criteria: (1) were published in English; (2) conducted in a middle or high school setting; (3) the intervention related to opioid education; (4) randomized trials or observational studies; and (5) published between January 2000 and January 2025.

Key findings: Among 1405 studies screened, eight met the inclusion criteria and evaluated seven school-based opioid education programs with participants aged between 11 and 18 years. Most studies used quasi-experimental designs, and only one was a randomized controlled trial. One study showed that combining classroom-based interventions in grade 7 with sessions that involved parents participating alongside students significantly reduced prescription opioid misuse, with effects lasting until grade 12. Four studies showed improved knowledge and attitudes towards opioid use and two showed increased understanding of opioid withdrawal and overdose management.

Implications and conclusion: This review is the first to evaluate school-based opioid education programs for adolescents. Findings indicate that these programs effectively increase opioid knowledge and reduce problematic opioid use, though further randomized trials among diverse participant samples are needed to confirm efficacy and generalizability of findings.

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Journal: Addiction, 2025, doi: 10.1111/add.16773

Authors: Rachna Begh, Monserrat Conde, Thomas R. Fanshawe, Dylan Kneale, Lion Shahab, Sufen Zh, … Jamie Hartmann-Boyce

Abstract:

Aims: To assess the evidence for a relationship between the use of e-cigarettes and subsequent smoking in young people (≤29 years), and whether this differs by demographic characteristics.

Methods: Systematic review with association direction plots (searches to April 2023). Screening, data extraction and critical appraisal followed Cochrane methods. Our primary outcome was the association between e-cigarette use, availability or both, and change in population rate of smoking in young people. The secondary outcomes were initiation, progression and cessation of smoking at individual level. We assessed certainty using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

Results: We included 126 studies. For our primary outcome, there was very low certainty evidence (limited by risk of bias and inconsistency) suggesting that e-cigarette use and availability were inversely associated with smoking in young people (i.e. as e-cigarettes became more available and/or used more widely, youth smoking rates went down or, conversely, as e-cigarettes were restricted, youth smoking rates went up). All secondary outcomes were judged to be very low certainty due to very serious risk of bias. Data consistently showed direct associations between vaping at baseline and smoking initiation (28 studies) and smoking progression (5 studies). The four studies contributing data on smoking cessation had mixed results, precluding drawing any conclusion on the direction of association. There was limited information to determine whether relationships varied by sociodemographic characteristics.

Conclusion: At an individual level, people who vape appear to be more likely to go on to smoke than people who do not vape; however, it is unclear if these behaviours are causally linked. Very low certainty evidence suggests that youth vaping and smoking could be inversely related.

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Journal: JMIR Formative Research, 2025, doi: 10.2196/49557

Authors: Christine Hahn; Emily Tilstra-Ferrell, Selime Salim, Nada Goodrum, Alyssa Rheingold, Amanda K Gilmore, … Angela Moreland

Abstract:

Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal violence are prevalent and associated with greater substance misuse; however, more research is needed to refine the delivery of PTSD-substance use content within the SBIRT model. This study examined clinical data collected as part of a web-based SBIRT developed for co-occurring substance misuse and PTSD symptoms after interpersonal violence to characterize the clinical symptoms and responses of adults presenting to agencies serving intimate partner and sexual violence survivors. The respondents (N = 52) completed self-report measures during the SBIRT tool to personalize the recommendations, as well as motivational enhancement exercises. Descriptive statistics were conducted. The results underscored high rates of probable PTSD, substance use, and trauma-related motives for substance use. The respondents were ready to change their substance use on average after receiving personalized feedback. Many expressed values related to trauma recovery and self-empowerment, perceived these values as useful for substance use reduction, and set goals to seek mental health services or reduce their drinking quantity. The findings point to several clinical targets for integrated PTSD-substance misuse interventions for interpersonal violence survivors.

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Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen.2024.57976

Authors: Rui Zhang, Peter Manza, Sukru Baris Demiral, Dardo Tomasi, Michele-Vera Yonga, Weizheng Yan, … Nora D. Volkow

Abstract:

Importance: Sleep and circadian disruptions are highly prevalent in opioid use disorder (OUD) and are a barrier to successful treatment and recovery; yet few objective data are available, especially for individuals in OUD treatment with opioid agonist therapy. If disruptions remain present despite OUD treatment, this information would yield potential new targets for adjunctive therapy.

Objective: To systematically investigate different aspects of rest-activity rhythms (RAR), including sleep, physical activity, circadian rhythmicity, and brain functional correlates in individuals with OUD.

Design, setting, and participants: This cross-sectional study conducted from October 12, 2017, through January 11, 2024, recruited participants with OUD from treatment programs or the community in the District of Columbia, Maryland, and Virginia area. Participants included individuals with OUD treated with methadone or buprenorphine, individuals with OUD who remained abstinent without medications, and healthy controls (HCs). Healthy participants were recruited from advertisements. Statistical analyses were conducted between March 1 and May 31, 2024.

Main outcomes and measures: In total, 21 RAR features were derived from 1-week actigraphy data, and principal components were used to extract independent RAR components. Modulators and brain and clinical correlates of RAR were also examined.

Results: This study included 73 participants (46 [63%] male; mean [SD] age, 43.5 [11.3] years). Among 42 patients with OUD (16 [38%] female; mean [SD] age, 42.7 [11.4] years), 33 receiving medications for opioid use disorder (MOUD) exhibited greater sleep-wake irregularity than 9 patients without MOUD (mean difference, 0.85 [95% CI, 0.00-1.69]) or 31 age- and sex-matched HCs (11 [36%] female; mean [SD] age, 44.5 [11.3] years; mean difference, 0.75 [95% CI, 0.19-1.31). Among participants receiving MOUD, greater sleep irregularity was associated with longer heroin use history (r26 = 0.45; P = .02) and lower daytime light exposure (r33 = -0.57; P < .001). Compared with HCs, participants with OUD exhibited lower fractional occupancy (percentage of occurrence) in a default mode network-dominated brain state, with individuals experiencing more pronounced sleep-wake irregularities displaying exacerbated impairments (r23 = -0.55; P = .007). Conclusions and relevance: Findings of this cross-sectional study showed that sleep irregularity in participants with OUD receiving opioid agonist medications correlated with years of opioid misuse and shorter daylight exposures and was associated with impaired brain state dynamics. These findings suggest that interventions increasing light exposure may improve sleep-wake irregularity and brain functional network dynamics in individuals with OUD receiving opioid agonist medications.

To read the full text of the article, please visit the publisher’s website.