The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already exist—like evidence-based medications—are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

Medications for Opioid Use Disorder Save Lives

Summary Mental health encompasses a range of mental, emotional, social, and behavioral functioning and occurs along a continuum from good to poor. Previous research has documented that mental health among children and adolescents is associated with immediate and long-term physical health and chronic disease, health risk behaviors, social relationships, education, and employment. Public health surveillance of children’s mental health can be used to monitor trends in prevalence across populations, increase knowledge about demographic and geographic differences, and support decision-making about prevention and intervention. Numerous federal data systems collect data on various indicators of children’s mental health, particularly mental disorders. The 2013–2019 data from these data systems show that mental disorders begin in early childhood and affect children with a range of sociodemographic characteristics. During this period, the most prevalent disorders diagnosed among U.S. children and adolescents aged 3–17 years were attention-deficit/hyperactivity disorder and anxiety, each affecting approximately one in 11 (9.4%–9.8%) children. Among children and adolescents aged 12–17 years, one fifth (20.9%) had ever experienced a major depressive episode. Among high school students in 2019, 36.7% reported persistently feeling sad or hopeless in the past year, and 18.8% had seriously considered attempting suicide. Approximately seven in 100,000 persons aged 10–19 years died by suicide in 2018 and 2019. Among children and adolescents aged 3–17 years, 9.6%–10.1% had received mental health services, and 7.8% of all children and adolescents aged 3–17 years had taken medication for mental health problems during the past year, based on parent report. Approximately one in four children and adolescents aged 12–17 years reported having received mental health services during the past year. In federal data systems, data on positive indicators of mental health (e.g., resilience) are limited. Although no comprehensive surveillance system for children’s mental health exists and no single indicator can be used to define the mental health of children or to identify the overall number of children with mental disorders, these data confirm that mental disorders among children continue to be a substantial public health concern. These findings can be used by public health professionals, health care providers, state health officials, policymakers, and educators to understand the prevalence of specific mental disorders and other indicators of mental health and the challenges related to mental health surveillance.

/pdf/mental-health-surveillance-among-children-united-states-2013-1f3h1jha.pdf

Mental Health Surveillance Among Children — United States, 2013–2019

Human Endogenous Retroviruses in Neurological Diseases

Background
Adolescence is a critical biological, psychological, and social developmental stage involving heightened risk for substance use and associated adverse consequences. This review, synthesizing emerging findings on this complex topic, is intended to inform research and clinical care focused on adolescents.

Methods
Literature searches were conducted using PubMed, yielding a cross-section of observational and interventional studies focused on adolescent substance use. Findings were organized and categorized to cover key areas of epidemiology, neurobiology, prevention, and treatment.

Findings
Adolescent substance-related attitudes and use patterns have evolved over time, informed by adult and peer behaviors, public policy, media messaging, substance availability, and other variables. A number of risk and resiliency factors contribute to individual differences in substance use and related consequences. Advances in observational techniques have provided enhanced understanding of adolescent brain development and its implications for substance use. Prevention efforts have yielded mixed results, and while a number of adolescent-targeted evidence-based treatments for substance use disorders have been developed, effect sizes are generally modest, indicating the need for further research to enhance prevention and treatment outcomes.

Conclusions
Substance use in adolescence is heterogeneous, ranging from normative to pathological, and can lead to significant acute and long-term morbidity and mortality. Understanding risk and resiliency factors, underlying neurobiology, and optimal developmentally sensitive interventions is critical in addressing substance-associated problems in adolescence.

Research Review: What have we learned about adolescent substance use?

https://digitalcommons.fiu.edu/cgi/viewcontent.cgi?article=1005&context=ccf_fac

The structure of cognition in 9 and 10 year-old children and associations with problem behaviors: Findings from the ABCD study’s baseline neurocognitive battery

Data from the National Institute on Drug Abuse (NIDA) and the Centers for Disease Control and Prevention (CDC) reveal high numbers of adolescent substance use in the United States. Substance use among adolescents can lead to increased risk of transmission of sexually transmitted infections, vehicular fatalities, juvenile delinquency, and other problems associated with physical and mental health. Adolescents are particularly susceptible to involvement in substance use due to the underdeveloped state of the adolescent brain, which can lead to reduced decision-making ability and increased long-term effects of drugs and alcohol. Understanding the causes of adolescent substance use is vital for successful prevention and intervention programs.

/pdf/familial-social-and-individual-factors-contributing-to-risk-52bwt9i4tn.pdf

Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use

Retroviruses, a form of mobile genetic elements, have important roles in disease and primate evolution. Exogenous retroviruses, such as human immunodeficiency virus (HIV), have significant pathological implications that have created a massive public health challenge in recent years. Endogenous retroviruses (ERVs), which are the primary focus of this review, can also be pathogenic, as well as being beneficial to a host in some cases. Furthermore, retroviruses may have played a key role in primate evolution that resulted in the incorporation of these elements into the human genome. Retroviruses are mobile genetic elements that have important roles in disease and primate evolution. We will further discuss the pathogenic potential of retroviruses, including their role in cancer biology, and will briefly summarize their evolutionary implications.

https://www.mdpi.com/2073-4425/4/4/573/pdf

Pathological and Evolutionary Implications of Retroviruses as Mobile Genetic Elements

Breast cancer is a leading cause of cancer death in the world. The triple-negative breast cancer subtype is associated with poorer prognosis than hormone receptor-positive subtypes and is more prevalent among African Americans than white, European Americans. The goal of this study has been to elucidate environmental, hormonal, and cultural factors that may be contributing to this disparity in an effort to identify modifiable risk factors and improve triple-negative breast cancer outcomes. Factors that may impact risk include vitamin D defiency, hormonal factors, environmental and dietary exposure, radiation exposure, and obesity. These factors may disproportionately affect African American women as a result of socioeconomic status, lifestyle, and cultural norms. Furthermore, disparities in prognosis may be compounded by barriers such as access to healthcare, prevention education, and perceptions of healthcare. Both biological and sociocultural factors impacting risk must be addressed in order for future prevention and treatment efforts to succeed.

/pdf/cultural-and-environmental-factors-of-triple-negative-breast-eytd0j4vy9.pdf

Mackenzie Whitesell

Papers

Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use

Pathological and Evolutionary Implications of Retroviruses as Mobile Genetic Elements

Cultural and Environmental Factors of Triple-Negative Breast Carcinomas