Orion Mowbray

Emerging adults aged 18 to 29 with opioid use disorder (OUD) have the lowest rates of treatment engagement and retention compared to other age groups. Understanding factors that influence retention and completion in this population is critical. Given the unique developmental stage of emerging adulthood, more research is needed on the role of medications for opioid use disorders (MOUD) in improving outcomes. Using data from the 2022 Treatment Episode Data Set: Discharges (TEDS-D), this study examined factors associated with treatment retention and completion among emerging adults with OUD in outpatient settings (N = 4,126). We also explored how age and sex moderate the association between MOUD and treatment outcomes. Negative binomial regression showed that emerging adults of older age, female sex, White non-Hispanic race/ethnicity, higher educational attainment, and those who received the MOUD plan, without past month opioid use, and referred from institutional sources (compared to self-referral) showed longer treatment retention. Logistic regression indicated that emerging adults of male clients, individuals with higher education, those with no recent opioid use, and those referred from healthcare providers or institutional sources showed a greater likelihood of treatment completion. Moderation analyses revealed that age and sex influenced the relationship between MOUD and treatment completion: Younger emerging adults, compared to older emerging adults, and male emerging adults, compared to female emerging adults, had a lower likelihood of treatment completion when taking MOUD. In conjunction with their shorter treatment duration, this finding implies that younger emerging adults receiving MOUD may be more likely to encounter barriers to treatment completion than older adults. These findings underscore the importance of considering within-group differences among emerging adults and highlight the complex role of MOUD in treatment outcomes. Treatment strategies should be tailored to the developmental stage and demographic characteristics to improve engagement and success in OUD treatment.

Although adverse childhood experiences (ACEs) are commonly associated with depressive symptoms in adulthood, studies frequently collapse ACEs into a single unitary index, making it difficult to identify specific targets for intervention and prevention. Furthermore, studies rarely explore sex differences in this area despite males and females often differing in the experiences of ACEs, depressive symptoms, and inflammatory activity. To address these issues, we used data from the National Longitudinal Study of Adolescent to Adult Health to model the effects of 10 different ACEs on C-reactive protein (CRP) and depressive symptoms in adulthood. Path modeling was used to measure the effects of ACEs on CRP and depressive symptoms conjointly while also assigning covariances among ACEs to assess their interrelations. Sex-by-ACE interaction terms and sex-disaggregated models were used to test for potential differences. Emotional abuse and parental incarceration were consistently related to both CRP and depressive symptoms for males and females. Childhood maltreatment was associated with depressive symptoms for females, whereas sexual abuse was associated with inflammation for males. Several covariances among ACEs were identified, indicating potential networks through which ACEs are indirectly associated with CRP and depressive symptoms. These data demonstrate that ACEs have differing direct effects on CRP and depressive symptoms – and that they differ with respect to how they cluster – for males versus females. These differences should be considered in theory and clinical workflows aiming to understand, treat, and prevent the long-term impacts of ACEs on depressive symptoms and inflammation-related health conditions in adulthood.

Substance use among criminal justice-involved adults is a significant concern for the rehabilitation and reintegration into their communities. Few have examined broader associations with substance use among those in probation or parole (community supervision) using an assessment of risks and needs with a representative sample. Using an assessment based on risk-need-responsivity principles, this research applies negative binomial analyses to examine sociodemographic, criminal, and other problem-area correlates of substance use risks and needs among a statewide dataset of adults in community supervision. Results indicated that mental health risk/need was the strongest predictor of substance use risk/need. Other risk areas, including criminal thinking, employment/education, and the presence of delinquent associates (peers/family) were associated with substance use. Implications highlight the ongoing call to develop integrated models of care that treat co-occurring disorders among adults in supervision. Additionally, diversion-oriented efforts that prevent adults with complex treatment needs from reentering the justice system are discussed.

Adults in community supervision (i.e., probation or parole) face disproportionately higher rates of substance use disorders (SUDs) compared to the general population, with older adults facing heightened risks. Further, SUDs often co-occur with mental illness, yet few studies have examined co-occurring SUDs and mental illness (CODs) among adults in community supervision and how these experiences vary across the life course. This study utilized a statewide sample of all adults in community supervision between 2018 and 2019 (N = 33,079) to assess the effects of mental health on substance use risks and needs, and whether age moderates this relationship. Multilevel modeling was used to examine associations while controlling for variation across judicial circuits. Findings revealed that substance use risk and need varies across circuits, effects of mental health on substance use vary regionally, and older persons in community supervision exhibit the highest rates of COD treatment needs. Social workers may benefit from these findings, which suggest a need for increased awareness of potential co-occurring needs among older adults in supervision, and available community-based interventions to meet these needs. Research evaluating training and available resources in the delivery of care for those with CODs in supervision remains a serious need.

Despite model minority stereotypes, low-income U.S. Asians experience difficulties derived from poverty and their racial positionality. We conducted scoping review to systematically understand and synthesize the current literature on young low-income U.S. Asians. From 22 studies, five categories of challenges emerged including perceived discrimination. Factors associated with current challenges and strengths of young low-income U.S. Asians, and implications for social work are also examined. This work disputes model minority stereotypes and highlights the heterogeneity of the group. Fragmented scholarly understanding on U.S. Asians is also discussed.

Day reporting centers (DRCs) vary considerably in how participant eligibility is determined and to date, there is little to no knowledge whether criteria for DRC eligibly are appropriately applied in program entrance. This study examines a statewide sample of individuals in community supervision settings and compares DRC eligibility criteria between DRC and non-DRC participants to examine differences between DRC participants and non-participants. Using a propensity score matched sample of 1,554 participants, study findings suggest that DRC participants show higher risk, need, and responsivity factors, consistent with the DRC programing model. These results suggest many individuals appear to be appropriately matched to DRCs, which may in turn, may influence their likelihood of program success, among other factors.

Due to multiple minority stressors, persons who are Hispanic and lesbian, gay or bisexual (LGB) can experience an increased risk of injury and death, including suicide. We examined trends and correlates of deaths by suicide among LGB Hispanic individuals using data from the National Violent Death Reporting System from 2012 to 2016 (N = 1,132). A multilevel mixed-effects logistic regression model examined time-series trends associated with suicide between LGB and heterosexual individuals, controlling for sociodemographic and clinical characteristics. Over time, increases in suicide were larger among LGB Hispanic individuals. Increased odds associated with suicide were also attributed to women, individuals with a higher education level, those who experienced mental health problems, those with alcohol-related problems, and individuals with a history of mental illness. LGB Hispanic individuals continue to see an increased risk for suicidality. Health intervention and policy efforts should focus on the multiple minority stressors experienced by this population.