A Call for Better Guidance and Treatments for Comorbid Postpartum Depression and Substance Use Disorders.

Postpartum depression is a serious, but treatable condition experienced after childbirth. While most cases do not involve excess substance use, alcohol and other substance use have been strongly associated with this condition. While serotonergic antidepressants have been a mainstay of pharmacologic therapy for postpartum depression, studies of antidepressant use in postpartum depression have largely excluded those with substance use disorder, and meta-analyses suggest antidepressants offer limited benefit in those with depression and co-occurring substance use disorder.

Perinatal Substance Use-Related Content at Major Addiction Scientific Conferences: An Analysis of Oral Presentation Sessions.

Background: Substance use is a leading cause of pregnancy-associated death in the US. It is not known if the amount of perinatal content at national addiction science conferences reflects the research and education being done in this area nationally.

Methods: We analyzed oral presentation sessions at five major addiction scientific conferences from 2021 to 2023 (American Academy of Addiction Psychiatry [AAAP], American Society of Addiction Medicine [ASAM], Association for Multidisciplinary Education and Research in Substance use and Addiction [AMERSA], College on Problems of Drug Dependence [CPDD], Research Society on Alcohol [RSA]) closely affiliated with organizations involved with substance use-related research and funding.

Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis.

Background: The postpartum period provides an opportunity for birthing people with opioid use disorder (OUD) to consider their future reproductive health goals. However, the relationship between the use of medication for opioid use disorder (MOUD) and contraception utilization is not well understood. We used multistate administrative claims data to compare contraception utilization rates among postpartum people with OUD initiating buprenorphine (BUP) versus no medication (psychosocial services receipt without MOUD (PSY)) in the United States (US).

Prescription psychostimulant use, admissions and treatment initiation and retention in pregnant people with opioid use disorder.

While attention deficit hyperactivity disorder is common among people with addiction, the risks and benefits of attention deficit hyperactivity disorder medication in pregnant people with opioid use disorder are poorly understood. Here, using US multistate administrative data, we examined 3,247 pregnant people initiating opioid use disorder treatment, of whom 5% received psychostimulants. Compared to peers not receiving psychostimulants, the psychostimulant cohort had greater buprenorphine (adjusted relative risk 1.

Energy Drinks: A Clinical Primer and National Data Update.

This article describes estimates of energy drink uptake using national-level data in the US and provides clinical strategies for evaluating patients with unhealthy energy drink consumption. Our approach is grounded in the paradigm of harm reduction, which supports incremental change while recognizing people's dignity, autonomy, individualism, and accountability.1 Rather than urge complete abstinence, we emphasize the importance of helping people understand energy drinks' potential harmful effects independently of whether individuals are ready to abstain from energy drinks.

Cannabidiol prescribing in the United States: An analysis of real-world data.

Background: Off-label prescribing of Epidiolex® (pharmaceutical cannabidiol) comes with both potential benefits and risks for patients. The aims of this study were to: (1) identify the percentage of people prescribed Epidiolex® who do not have diagnostic indications for Epidiolex® (Lennox Gastaut Syndrome [LGS], Dravet Syndrome [DS], and Tuberous Sclerosis Complex [TSC]) and (2) examine potential co-prescribing of medications that may interact with Epidiolex®.

Method: Using TriNetX analytics, a web-based database of de-identified electronic health records spanning >110 million people in the United States, we analyzed 4214 people receiving Epidiolex® in 2022.

The Reporting of Race and Ethnicity in the Conduct Disorder Literature: A Time-Sensitive Review.

Background: Among presenting conditions in pediatric acute care settings, conduct disorder (CD) is a potentially stigmatizing yet common diagnosis in the setting of behavioral dysregulation requiring psychiatric admission. Concerns exist about over-diagnosis of CD in non-Hispanic Black children relative to White peers and the potential for the CD diagnosis to obfuscate manifestations of co-occurring psychiatric conditions.

Methods: We evaluated the number of manuscripts on CD diagnoses that report race and ethnicity and co-occurring mental health characteristics (i.

Antiseizure medication prescribing in people with Dravet syndrome: An analysis of real-time administrative data.

Since 2018, three new antiseizure medications (ASMs) received FDA approval for Dravet syndrome (DS) in the U.S: cannabidiol, stiripentol, and fenfluramine. Yet, the uptake of these ASMs in routine clinical practice is unknown.

Co-occurring autism, ADHD, and gender dysphoria in children, adolescents, and young adults with eating disorders: an examination of pre- vs. post-COVID pandemic outbreak trends with real-time electronic health record data.

Background: Incidence rates of autism, attention-deficit/hyperactivity disorder (ADHD), and gender dysphoria (GD) are rising not only in the general population, but particularly among children, adolescents, and young adults with eating disorders (EDs). While ED rates have risen during the COVID pandemic, trends in co-occurring autism, ADHD, and GD have yet to be investigated in detail or at scale by way of large electronic medical record data.

Objectives: To investigate trends in rates of co-occurring autism, ADHD, and GD among children, adolescents, and young adults with EDs in years prior to and during the COVID-19 pandemic.

Contraceptive uptake in postpartum people with and without opioid use disorder and opioid use with co-occurring substance use.

Background: Using contraception to delay pregnancy allows people with opioid use disorder (OUD) to choose when they are ready to continue their families. Yet, postpartum contraceptive uptake among people with OUD has not been well characterized.

Methods: Analyses used 73,811 pregnancy episodes among 61,221 people (2016-2021) from the St.

Co-occurring psychiatric disorders in young people with eating disorders: An multi-state and real-time analysis of real-world administrative data.

Objective: We aimed to use real-world data to characterize the burden of psychiatric comorbidities in young people with eating disorders (EDs) relative to peers without EDs.

Method: This retrospective cohort study used a large federated multi-national network of real-time electronic health records. Our cohort consisted of 124,575 people (14,524 people receiving their index, first-ever, ED diagnosis, compared to 110,051 peers without EDs initiating antidepressants).

Brain-Hazardous Medications and Potential Subadequate Antidepressant Dosing in Older Surgical Patients Receiving Home Antidepressants: An Observational Study of a Large US Health System.

Background: Older surgical patients with depression often experience poor postoperative outcomes. Poor outcomes may stem from brain-hazardous medications and subadequate antidepressant dosing.

Methods: This was a retrospective, observational cohort study covering the period between January 1, 2021 and December 31, 2021.

Treatment setting and buprenorphine discontinuation: an analysis of multi-state insurance claims.

Background: Potential differences in buprenorphine treatment outcomes across various treatment settings are poorly characterized in multi-state administrative data. We thus evaluated the association of opioid use disorder (OUD) treatment setting and insurance type with risk of buprenorphine discontinuation among commercial insurance and Medicaid enrollees initiated on buprenorphine.

Methods: In this observational, retrospective cohort study using the Merative MarketScan databases (2006-2016), we analyzed buprenorphine retention in 58,200 US adults with OUD.

Pregnancy Rates Among Women Treated with Medication for Opioid Use Disorder.

Background: Treatment-seeking people with opioid use disorder (OUD) who are capable of pregnancy need accurate information about the potential impact of medication to treat OUD (MOUD) on fertility to make informed choices about treatment that are consistent with their reproductive wishes. There is a dearth of research on fertility associated with MOUD receipt in birthing people with OUD.

Objective: To estimate the association between treatment with MOUD and odds of conception among birthing people using national administrative claims.

County-level neonatal opioid withdrawal syndrome rates and real-world access to buprenorphine during pregnancy: An audit ("secret shopper") study in Missouri.

Background: Amid rising rates of neonatal opioid withdrawal syndrome (NOWS) worldwide and in many regions of the USA, we conducted an audit study ("secret shopper study") to evaluate the influence of county-level buprenorphine capacity and rurality on county-level NOWS rates.

Methods: In 2019, up to three phone calls were made to buprenorphine prescribers in the state of Missouri (USA). County-level buprenorphine capacity was defined as the number of clinicians (across all specialties) accepting pregnant people divided by the number of births.

Screen Use and Social Media "Addiction" in the Era of TikTok: What Generalists Should Know.

While the term "screen addiction" or "social media addiction" is gaining steam in the popular media, preclinical, clinical, and population health research have not caught up with regards to the diagnosis and treatment of unhealthy screen use. The overarching goal of this article is to provide broad clinical tips to generalists, working outside the mental health specialty, on the evaluation and treatment of unhealthy screen exposure in children and young adults. We will clarify the difference between addiction and overuse, and why this distinction matters.