Alcohol use disorder has primarily been a male-dominated problem, but gaps in alcohol use and consumption are closing, with females increasingly engaging in heavy and binge drinking. However, there has been limited research that has examined how alcohol-related cues affect inhibitory control differently in males and females. The present study investigated sex differences in alcohol-cued inhibitory control across a spectrum of drinkers. Participants (N = 267) aged 21-60 were recruited via Prolific and categorized as nondrinkers, light, moderate, or heavy drinkers based on self-reported alcohol consumption and National Institute on Alcohol Abuse and Alcoholism classifications. Participants completed the Attentional Bias-Behavioral Activation task. Results revealed a significant Sex × Drinking Status × Go Condition interaction, F(3, 251) = 2.753, p = .043, η2 = 0.032. Specifically, within the alcohol go condition, heavy- and moderate-drinking females exhibited significantly greater inhibitory failures in the presence of alcohol cues compared to their male counterparts and to nondrinking and light-drinking females. By contrast, the same effects were not observed within the neutral go condition. These findings suggest that alcohol cues may disproportionately disrupt inhibitory control in female heavy drinkers. This study extends prior research by including all drinker types, distinguishing between moderate and heavy drinkers, and using a broad age range. These findings underscore the importance of considering sex-specific cognitive vulnerabilities in alcohol use and suggest that interventions targeting inhibitory control may be particularly beneficial for females. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Nicotine improves withdrawal-related executive dysfunction and enhances task performance in chronic users, regardless of the delivery method. Research on combustible cigarette users shows that nicotine boosts performance by increasing activity in prefrontal and parietal brain regions. It remains unclear whether e-cigarettes offer the same improvements and involve similar neurobiological mechanisms. Nicotine-abstinent (14 hr) regular e-cigarette users completed working memory tasks (i.e., Rapid Visual Information Processing, n-back) before and after a 10-min e-cigarette protocol, with the n-back completed while fMRI measurements were taken. Whole-brain voxel-wise analyses were used to assess BOLD activation during an n-back task before and after e-cigarette use, examining the association between activation and nicotine boost (serum nicotine changes) and craving. Participants were 55% female, 87% White, and had a mean age of 36 years (N = 18). There were increases in Rapid Visual Information Processing accuracy after (M = 17.79, SD = 7.78) compared to before e-cigarette use (M = 14.41, SD = 7.76; t[16] = -4.35, p < .001). Rapid Visual Information Processing reaction time increased after (M = 412.33, SD = 47.53) compared to before (M = 380.64, SD = 67.16; t[16] = -2.69, p = .02). During the n-back task, there was increased activation in task-positive executive and attention networks and decreased activation in task-negative networks (e.g., the default mode network) after e-cigarette use. Although e-cigarette use did not alter BOLD signal during the task, higher nicotine boost was linked to reduced task-negative activity, and reduced craving following e-cigarette use was tied to increased task-positive activity. This pilot study supports that e-cigarette use improves target detection and alters brain function for e-cigarette users through nicotine exposure, with craving reductions potentially contributing to these effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Co-use of tobacco and cannabis poses adverse health consequences. Few studies have incorporated spatial analysis into smartphone-based assessments of co-use. This study aims to detect patterns of tobacco and cannabis co-use to inform the delivery of tailored interventions. We analyzed data from 30 young adults aged 18-30 in Northern California who used both tobacco and cannabis. Substance use/nonuse events were collected on participants' smartphones via geographic ecological momentary assessment over 30 days. Substance use events were categorized as tobacco use, cannabis use, or co-use and analyzed using the Space-Time Permutation Scan Statistic to identify distinct spatiotemporal clusters. Cluster characteristics were summarized to further explore use patterns. Substance use events showed clear clustering patterns in space and time, with 76% of events captured within clusters (interquartile range = 69%-87%). The number of tobacco use clusters peaked in the afternoon and dropped in the evening, while cannabis and co-use clusters peaked in the evening. Home was consistently a prevalent location. Additionally, tobacco use was clustered at others' homes (42.9%) in the early morning and then shifted to work (34.5%). Cannabis use clustered at work (17.6%) in the morning. Co-use clustered at others' homes (18.2%) in the early morning and then shifted to work (18.2%). This study identified individual patterns of tobacco and cannabis use on an event-level basis. Findings can inform the development of smartphone-based interventions that use contextual data to align with established co-use routines and intervene at the most likely times and locations of use. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Human laboratory alcohol administration studies are crucial for advancing knowledge of cognitive processes and behaviors that precede alcohol consequences in a controlled environment, improving our understanding of etiology of alcohol problems and ability to develop and test safety and efficacy of interventions. However, conducting lab administration studies is challenging in part due to high participant burden, limiting generalizability of results to individuals who do not typically present for lab studies. Given the advantages of lab administration methods coupled with their challenges, remote alcohol administration was pursued as an alternative to enhance generalizability by removing barriers to participation and reducing participant burden. To establish feasibility and acceptability of this new remote method, we conducted qualitative interviews of 27 individuals (51.8% male; = 21.96) and found that an average of 80% of individuals were willing to potentially participate in remote administration. Several themes emerged concerning participants' willingness and ability to participate, including (1) study location, (2) ease of participation, and (3) wanting to participate with a friend. However, some participants also cited specific barriers to participation, such as (1) living situation not conducive to participation, (2) study safety concerns, and (3) not wanting to participate with a romantic partner. Understanding both facilitators and barriers to potential participation will enable researchers to better design remote studies and enroll individuals not commonly included in current lab administration studies which has important implications for improved generalizability of findings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Both laboratory model and real-world study data suggest that cocaine use is associated with impulsivity and risk-taking. Further, many people who use cocaine report polysubstance use; however, there is a lack of research investigating associations between and among impulsivity, risk-taking, and polysubstance use. Polysubstance use involving cannabis is especially relevant given its use by over half of Americans who use cocaine. No work to date has examined the potential relations between concurrent use of cannabis and cocaine and outcomes of impulsivity and risk-taking. The present study compared participants whose urine was positive for cocaine, positive for cocaine and cannabis, and negative for cocaine and cannabis during an initial pretreatment baseline visit for 122 participants prior to enrollment in a randomized clinical trial for cocaine use disorder. Data suggest participants who co-used cocaine and cannabis were likely to use more cocaine and other substances (e.g., alcohol, other drugs) and self-report risky sexual behavior. Participants who abstained from cocaine and cannabis prior to the baseline appointment gambled at greater rates in a gambling task. Groups did not differ with respect to self-reported impulsivity. Co-use of cocaine and cannabis among those with cocaine use disorder is associated with increased drug use but may have limited association with self-reported impulsivity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Impulsivity is the tendency to act hastily in reaction to internal and external cues without consideration of all potential outcomes. Limited research has used a person-centered approach to explore patterns of impulsivity and risky behavior involvement, but not how different dimensions of impulsivity relate to multiple risk behaviors within the same individuals. The present study aimed to identify latent groups based on five self-report impulsivity measures and to assess differences in latent profiles as related to alcohol use and problems, drug use, gambling, and polysubstance use. Participants were 1,608 college students (Mage = 20.52; 67% female) who completed an online survey assessing impulsivity and risky behavior engagement. Latent profile analysis indicated three profiles best represented the data: preference for reward/stimulation (39.2%), low sensitivity to punishment (39.1%), and behavioral activation (21.7%). Significant differences were found among profiles and risky behaviors, with Profile 1 "preference for reward/stimulation" exhibiting significantly higher levels of alcohol use and problems, drug use, gambling, and polysubstance use than other profiles. Results suggested that impulsivity, particularly marked by heightened responsiveness to rewards and elevated levels of rash impulsivity, may be associated with increased engagement in several risky behaviors, including polysubstance use and gambling. Findings offered more depth to the conceptualization of impulsivity and provided novel information on polysubstance use and behavioral addictions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Delay discounting tasks are increasingly used across psychology to examine self-regulation and value-based decision making. These tasks assess how individuals devalue rewards as delays to receipt increase, with responses expected to follow a decreasing pattern. When participants report higher valuation at longer delays-a violation of this expected trend-such responses are often flagged as nonsystematic and, in many cases, excluded from analysis. Although intended to optimize data quality, such exclusions may systematically bias samples and distort downstream inferences. Using data from the Adolescent Brain Cognitive Development study ( = 11,307), we examined whether nonsystematic responding covaried with demographic, cognitive/behavioral, and environmental characteristics. Nearly half of participants exhibited at least one nonsystematic responding violation, with greater likelihood among youth from low-income households, low-resource neighborhoods, and racially minoritized backgrounds. Nonsystematic responding was also associated with lower abstract reasoning and higher positive urgency. Violations disproportionately occurred at the earliest presented task delays, suggesting a possible learning effect. These findings raise concerns that data exclusion criteria may bias behavioral samples and alter conclusions in translational research domains such as addiction science, behavioral pharmacology, and public health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Despite awareness of polysubstance use-the co-use of multiple drugs-and its associated risks, there is a lack of research consensus on how to identify and classify individuals engaging in polysubstance use. Latent class analysis (LCA) and latent profile analysis (LPA) are data-driven approaches that may improve the identification and classification of polysubstance use. By clustering data using different indicators, LCA/LPA can extract subgroups of common drug use patterns within a sample. Variability in how LCA/LPA are conducted, however, can substantially impact how subgroups are extracted and have not been thoroughly reviewed. The present review was one of a two-part series preregistered on PROSPERO entitled, "A systematic review of studies using latent class analysis to examine patterns of polysubstance use in adults (Part 1) and adolescents (Part 2)" (CRD42022352293). The present review sourced relevant studies using LCA/LPA in the context of characterizing adult polysubstance use and identified factors influencing the number of latent classes extracted. Across several articles using LCA/LPA ( = 136), the current review found differences, for example, in the number of extracted classes based on study sample sizes (ρ = .275, < .001) and the number of indicators used ( = .244, = .004). The present review noted substantial heterogeneity in study methodologies, statistical analyses, and latent class solutions. For future research, the review suggests some methodological considerations including attention to sample sizes, study locations, and the number of indicators included in LCA/LPAs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

E-cigarettes have been proposed as a harm-reduction strategy to reduce combustible cigarette use. Comparing the cardiopulmonary effects of vaping to smoking is necessary before recommending their use, especially for people at high risk from continued smoking, like those with chronic obstructive pulmonary disease (COPD). Differences in the cardiopulmonary effects of combustible cigarettes and e-cigarettes for people with COPD who smoke were examined. Twenty-one individuals ≥40 years old diagnosed with COPD who smoked (≥5 cigarettes/day for ≥1 year) underwent two consecutive randomly ordered 2-week phases: a cigarette phase (usual-brand cigarettes) and a nicotine-containing e-cigarette phase (combustible cigarette abstinence with 3% and/or 5% nicotine tobacco-flavored JUUL available). Participants earned monetary incentives during the e-cigarette phase for cigarette abstinence, which was biochemically verified with daily carbon monoxide breath testing conducted remotely via phone (readings ≤6 parts per million). Pulmonary (spirometry, oscillometry, COPD Assessment Test, Saint George's Respiratory Questionnaire for COPD) and cardiac (heart rate, blood pressure) measures were completed at baseline, daily (remotely) throughout phases (spirometry, heart rate, and blood pressure only), and after each phase. Changes across assessments were analyzed using mixed-model repeated measures analyses of variance. Diastolic blood pressure and airway resistance at 19 Hz significantly improved during the e-cigarette phase, with the latter restricted to those who substantially abstained from combustible cigarettes (≥10 negative breath carbon monoxide samples) during this phase. The lack of significant adverse cardiopulmonary outcomes following e-cigarette use is promising. However, evaluating longer durations of e-cigarette substitution is warranted to determine their safety as a replacement for combustible cigarettes in patients with COPD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The U.S. Food and Drug Administration has proposed a nicotine-limiting standard, which would increase the unit price of nicotine in cigarettes and could cause people who smoke and are unable/unwilling to quit nicotine to switch to other products. This study examined the substitutability of little cigars/cigarillos (LCCs), e-cigarettes, and other nicotine products for cigarettes using the Experimental Tobacco Marketplace. Participants ( = 145) recruited through Amazon Mechanical Turk completed hypothetical purchases for 7 days' worth of nicotine/tobacco products in the Experimental Tobacco Marketplace. Purchases required participants to allocate their usual weekly expenditure across products at five escalating cigarette prices while alternative product prices remained fixed. Purchases were made in three marketplaces: (a) with a range of products, including e-cigarettes and LCCs, (b) without e-cigarettes, and (c) without LCCs. Participants were 45.7 (mean; = 10.3) years old and primarily female (70.3%) and White (82.1%) and smoked 17.6 (mean; SD = 8.9) cigarettes/day. Cigarette purchasing decreased as price increased ( < .001). When all products were available, the most appealing substitutes were e-cigarettes, followed by nicotine replacement therapy, LCCs, and chew ( < .05). Findings were similar for products other than e-cigarettes and LCCs in marketplaces without e-cigarettes and LCCs, respectively. Findings demonstrate the potential for noncombusted and combusted products to substitute for cigarettes, with experimental evidence that LCCs substitute for cigarettes, although less effectively than other products. Results underscore the importance of regulation that limits the potential for LCC substitution for cigarettes and maintains noncombusted alternatives in the marketplace to promote harm reduction among those unable to quit nicotine. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

A national nicotine-reduction policy could reduce cigarette smoking in the United States. The present study evaluated effects of cigarettes varying in nicotine content and provision of e-cigarettes on affective symptoms in populations with vulnerabilities to smoking. The overarching aim was to examine whether a nicotine-reduction policy could have unintended negative consequences, including exacerbation of psychiatric symptoms. This is a secondary analysis of three parallel 16-week randomized clinical trials examining four experimental conditions: normal nicotine content cigarettes, very-low-nicotine-content (VLNC) cigarettes, VLNC cigarettes plus e-cigarettes restricted to tobacco flavor (VLNC + TF), or VLNC cigarettes plus e-cigarettes in preferred flavors (VLNC + PF). Participants were adults who smoked daily from three vulnerable populations: socioeconomically disadvantaged reproductive-aged women ( = 80) and individuals with opioid use disorder ( = 74) or affective disorders ( = 172). Beck Depression Inventory and Overall Anxiety Severity and Impairment Scale scores were assessed weekly. There was a significant effect of experimental condition on Beck Depression Inventory, (3, 315) = 4.26, = .006, and Overall Anxiety Severity and Impairment Scale, (3, 315) = 4.26, = .006, scores, with scores in the VLNC only (least square means and standard error of the means: 12.68 [± 0.53] and 5.58 [± 0.27]), but not VLNC + TF or VLNC + PF conditions exceeding those in the normal nicotine content condition (least square means standard error of the means: 10.66 [± 0.53], = .006 and 4.69 [± 0.27], = .004). There was also a significant main effect of time, Beck Depression Inventory: (15, 4050) = 3.74, < .001; Overall Anxiety Severity and Impairment Scale: (15, 4050) = 2.24, = .004, with scores decreasing over the experimental period across experimental conditions. In conclusion, providing VLNC cigarettes in combination with e-cigarettes appeared to ameliorate modest increases in affective symptoms observed when VLNC cigarettes were provided alone. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Point-Scoring Reaction-Time Task (PSRTT) is designed to measure sensitivity to reward and punishment; the task has empirically demonstrated associations with substance use and related variables. However, like most performance-based paradigms, applications of the PSRTT have not usually applied falsifiable tests of reliability of measurement in the samples used to make inferences. Participants were (n = 150) 18- to 20-year-olds, recruited via social media advertisements and required to report drinking on average on 2+ occasions per month. We apply psychometric tests of reliability of measurement (e.g., confirmatory factor analysis) to the PSRTT and evaluate links with alcohol consumption (past 6-month average frequency, quantity, and maximum drinking) and problem alcohol use via the Brief Young Adult Alcohol Consequences Questionnaire. The task yields an internally consistent sensitivity to reward factor. However, there was no evidence for reliable measurement of sensitivity to punishment. Sensitivity to reward was associated with frequency of drinking (β = .24, < .01) and quantity of drinking (β = .21, < .05), but not maximum number of drinks consumed (β = .09, > .05). Sensitivity to reward was significantly associated with alcohol-related problems (β = .21, < .05). Integrating modern measurement theories with performance-based methodologies has the potential to improve the precision of science by providing falsifiable estimates of the quality of measurement. The PSRTT provides reliable scores to index individual differences in reward sensitivity but may not be a reliable measure of punishment sensitivity. Sensitivity to reward may be involved in the etiology of alcohol use and problem use during young adulthood. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Financial scarcity is associated with greater delay discounting and cigarette smoking. In experimental research, narrative simulation of scarcity increases delay discounting, but the effects of simulated scarcity on smoking behaviors have not yet been examined. In an online survey study, we examined the effects of scarcity narratives on delay discounting, cigarette craving, and behavioral economic demand for cigarettes. Adults who smoke cigarettes were randomized to read brief narratives describing either scarcity (n = 102) or neutral (control; n = 105) income conditions and imagine they were experiencing the conditions described. Participants then completed assessments of delay discounting (adjusting-delay task), cigarette craving (Questionnaire on Smoking Urges-Brief), cigarette demand (purchase task), and affect (Positive and Negative Affect Schedule-Short Form). Adjusting for affect, the scarcity group showed higher delay discounting (p < .001) and higher overall craving (p < .001). Moreover, delay discounting partially mediated the observed effect scarcity on craving (p < .001). No statistically significant group differences in cigarette demand were observed (all p values > .05). Exploratory analyses examining the two-factor latent structure of the Questionnaire on Smoking Urges showed that delay discounting partially mediated the effects of narrative group on craving Factor 1 (anticipated positive reinforcement) and fully mediated the effects of group on craving Factor 2 (anticipated relief from negative affect). Together, these findings show that narrative simulation of financial scarcity increases cigarette craving and identifies delay discounting as a mechanism of action in this effect. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Sign-tracking, the behavior of approaching and interacting with cues for appetitive outcomes in classical conditioning, has been implicated in relapse to drug addiction. In this experimental study, we examined the serotonin/norepinephrine reuptake inhibitor venlafaxine to determine whether it was effective in reducing sign-tracking in an animal model (Sprague-Dawley male rats, = 35) of sign-tracking using a retractable lever as a conditioned stimulus and sucrose pellets as an unconditioned stimulus. After training, male rats were administered venlafaxine (0, 30, or 60 mg/kg) intraperitoneally and tested for sign-tracking and goal-tracking (approach of the site of unconditioned stimulus delivery) behaviors. Venlafaxine was significantly effective in reducing sign-tracking in animals previously identified as primarily sign-trackers and intermediates, and it also reduced goal-tracking in animals who primarily goal-tracked. Venlafaxine may be effective in reducing cue-driven approach and interaction behavior that may contribute to relapse in patients rehabilitating from drug use. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Prescription stimulant diversion (PSD) and misuse (PSM) are prevalent among young adults with stimulant prescriptions and have been associated with conduct problems and poorer attention-deficit/hyperactivity disorder symptom management, functional impairment, and other substance use and misuse. Few evidence-based interventions address PSD and PSM; to date, no research has examined for whom these interventions are most/least effective and potential downstream benefits on psychosocial functioning. In the present study, we examined whether conduct problems in childhood moderated response to an interactive web-based intervention focused on preventing PSD and PSM and whether immediate release prescriptions were associated with more PSD and PSM. We also evaluated the impact of the intervention on functional impairment, binge drinking, other substance use, and accidental injuries. We randomized students from three U.S. universities with current stimulant prescriptions ( = 20.42 years, 74% female, 86% White) to the intervention ( = 128) or attention-matched placebo ( = 121) in a single-blind design, with 3- and 6-month follow-ups. Conduct problems and being prescribed an immediate release medication were associated with a greater likelihood of PSD, but not PSM; however, conduct problems were not associated with a differential response to the intervention (any PSD/PSM). Compared to the placebo, the intervention group reported lower attention-deficit/hyperactivity disorder impairment and substance use at the 6-month follow-up; rates of accidental injuries did not differ between the two groups. Findings suggest the intervention had significant but modest effects on psychosocial outcomes. Future targeted interventions for PSD may focus on students with conduct problem histories and/or immediate release prescriptions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Ecological momentary assessment (EMA) is increasingly used to examine risk and protective factors associated with alcohol-involved sexual assault (SA). Whereas extant literature demonstrates limited reactivity (i.e., systematic behavior change) to repeated assessment of risk behaviors (e.g., drinking), we know little about the impact of EMA on protective behaviors (i.e., harm reduction strategies). The present study examined between- and within-person reactivity to EMA participation using data from a larger study of alcohol and SA protective behavioral strategy (PBS) use. First-year college women ( = 138) were randomized to a 14-day EMA or a reactivity control condition. Both conditions completed baseline/follow-up measures of drinking behavior, alcohol PBS, and SA PBS. The EMA condition reported alcohol and SA PBS use each morning after drinking. We used 2 × 2 analyses of variance to examine differences in PBS use by condition (EMA vs. control) over time (baseline vs. follow-up); within-person changes in PBS use were probed with multilevel models. We found Significant Condition × Time interactions for both alcohol PBS and SA PBS; the EMA condition increased PBS use relative to the control condition across the first semester of college. Across the 14-day EMA protocol, women marginally increased alcohol PBS use and significantly increased SA PBS use. Participation in a 14-day EMA protocol may lead to changes in PBS use among first-semester college women. Results encourage examination of and controlling for potential reactivity in etiology and intervention studies of PBS use and highlight the potential of momentary interventions to increase PBS use over time. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

E-cigarette use is prevalent among young adults, with "ice" e-cigarettes/liquids that combine sweet and cooling flavors becoming increasingly popular. This study examines if an "ice" component (e.g., menthol) alters liking, sensory experiences, and reward of sweet-flavored nicotine e-liquids among young adults. A double-blinded laboratory session was conducted with past-month e-cigarette users aged 18-20 (N = 40). Participants were exposed in random order to a sweet-flavored (watermelon) e-liquid with and without menthol in two 10-puff bouts. Both e-liquids contained 36 mg/ml nicotine salt and 50:50 propylene glycol/vegetable glycerin. Participants rated flavor liking and overall vaping experience using the Labeled Hedonic Scale, sensory effects using generalized Labeled Magnitude Scales, and reward effects using the Drug Effects Questionnaire. Linear mixed models analyzed outcomes with flavor condition, sex, and their interaction as fixed effects, adjusting for flavor order. Participants (average age = 19.1 years, = 0.8; 52.5% female and 67.5% White) used e-cigarettes on average 6.2 ( = 1.5) days/week. Participants reported marginally less liking of the overall vaping experience for the watermelon flavor with menthol ( = -3.92 [ = 3.16]) compared to the watermelon flavor without menthol ( = 1.27 [SE = 3.16], = .05). No main effects of flavor, sex, or their interactions were observed in sensory and reward effects (s > .05). Among our sample of young adult e-cigarette users, adding a cooling component to a sweet-flavored e-liquid did not result in altered liking, sensory, or reward effects compared to sweet-flavored e-liquid without cooling. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

A number of studies have been conducted to assess the efficacy of exercise-based interventions for substance-use disorders. Nicotine use has been overrepresented in prior meta-analytic and systematic reviews, potentially obscuring the effects of exercise on outcomes related to other drugs. The aim of this meta-analysis and systematic review was to offer an updated account of the impact of exercise on substance-use outcomes for drugs other than nicotine. Eligible studies included peer reviewed articles published before August 2023 describing randomized controlled trials or clinical trials involving adults in which exercise served as the primary treatment intervention and substance use and/or craving outcomes were assessed for drugs other than nicotine. In addition to omnibus effects, meta-regression models were conducted to assess study design (within vs. between), data collection (acute vs. long-term), and outcome measure (drug craving vs. drug use) as potential moderating variables. A total of 19 articles describing 17 unique studies were selected for analysis, including data from 1,363 individual participants. An omnibus robust variance estimation meta-analysis indicated a significant reduction in substance-use outcomes following exercise intervention. The moderator analysis additionally indicated a significant effect of design type such that between-subject designs displayed smaller magnitude reductions than within-subject designs. Other potential moderators were not significant. These findings indicate that a variety of exercise-based interventions produce moderate improvements in substance use and craving for people using nonmedical drugs and corroborate prior reports that exercise is effective as an adjunctive or standalone treatment for substance-use disorder. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Alcohol-related consequences remain a major public health issue, especially for emerging adults. Additionally, experiences of discrimination can have a deleterious impact on an individuals' drinking habits and mental health, especially when an individual is discriminated against for multiple, intersecting aspects of their identity. For example, experiencing multiple forms of discrimination has been linked to anxiety, depression, and alcohol-related consequences. The purpose of this study was to investigate if experiences of multiple discrimination are associated with alcohol-related consequences and if a pathway exists between multiple discrimination, anxiety and depression coping motives, and alcohol-related consequences. Participants (N = 399; 54.9% female, 48.1% White) were emerging adults who completed a survey on Prolific Academic, including questionnaires on number of drinks per week, alcohol-related consequences, experiences of perceived discrimination, depression and anxiety, and substance use coping motives. Results supported a significant association between multiple forms of discrimination and alcohol consequences. Serial mediation analyses supported an indirect effect of multiple forms of discrimination on alcohol-related consequences through both depression and depression coping motives, and anxiety and anxiety coping motives. Overall, the results of this study build upon previous research on the association between coping motives and alcohol consequences, demonstrate the depth of the impact of experiencing discrimination, and highlight the need for research to consider discrimination from an intersectional lens. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

We assessed heart rate variability (HRV) as a measure of autonomic nervous system function during an ongoing double blind, placebo-controlled, trial of adjunct gabapentin during a buprenorphine-assisted taper and transition to injection naltrexone to explore how adjunctive pharmacotherapy and time influence autonomic nervous system activity and whether HRV metrics are predictive of treatment outcomes. Individuals with opioid use disorder who began their participation in an ongoing trial of adjunct gabapentin during an outpatient 10-day buprenorphine-assisted transition to injection naltrexone underwent experimental sessions at Weeks 1, 2, and 3 of the parent trial. HRV metrics were assessed for 2 min each while standing, sitting, and sitting while performing paced breathing (PB) using the ProComp2 System with sensor belt and analysis suite. Multiple imputation was used to analyze the HRV metrics due to some participants lacking data at all three weekly timepoints. Among 28 participants, logistic regression analyses indicated significant effects for frequency distributions and heart rate during PB exercises. Trends in frequency distribution during PB suggested potential influences of gabapentin on autonomic balance, resulting in lower HRV. Predictor variables for outcomes indicated a significant effect with higher low frequency/high frequency ratio during PB decreasing the odds of completing supervised withdrawal. Higher respiration rate and low frequency values while sitting showed trends and significant effects, respectively, for decreasing the odds of receiving Week 4 injection naltrexone. Selected HRV metrics change during supervised opioid withdrawal and are associated with treatment outcomes during supervised opioid withdrawal procedures. The significance of HRV metrics during PB exercises underscores the impact of specific activities on autonomic function, highlighting the importance of considering such effects when recording HRV metrics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The operant demand cigarette purchase task conventionally prompts participants to report imagined purchases in units of single cigarettes. Although this purchasing modality diverges from the units deployed in real purchasing scenarios (i.e., packs of 20), no research has examined how simulated purchasing of the more ecologically valid unit of cigarette packs maps onto single cigarette purchasing metrics. A sample of 212 participants in this study reported hypothetical cigarette purchases across three iterations of the cigarette purchase task. Two of these collected responses in a binary format-would or would not purchase-at yoked unit prices, where tasks were distinguished as purchases of single cigarettes or packs of cigarettes. This binary framework permitted a simplified probabilistic description of purchasing that maintained a consistent timeframe. Participants also completed the standard cigarette purchase task, reporting the quantity of single cigarettes they would purchase and consume at each unit price. Purchasing breakpoint, or the highest price at which participants reported purchasing cigarettes, was broadly consistent across these tasks, weakly so when comparing purchases made on the binary tasks ( = .183). Tests of equivalence suggested that there were meaningful differences between breakpoint values reported on the single cigarette binary task and the per pack binary task, (211) = -5.85, < .001, and between breakpoint values reported on the standard purchase task and the per pack binary task, (211) = 11.49, < .001. Results suggest more research is needed to determine what environmental factors or imposed constraints are practically influencing reported cigarette valuation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Subjective responses to alcohol, which encompass the subjective feelings and experiences elicited by alcohol consumption, are important factors implicated in the etiology of alcohol use disorder. Previous human laboratory studies have investigated how subjective responses to priming doses of alcohol influence alcohol self-administration (SA) but have not accounted for responses throughout the task. The present study investigated how subjective responses to alcohol, measured at multiple time points during a progressive ratio SA task, impacted subsequent motivation to self-administer alcohol. Participants ( = 67; 36 male/31 female) who drank heavily completed a 120-min progressive ratio alcohol intravenous SA paradigm. Every 15 min, participants were breathalyzed and completed self-report questionnaires to measure alcohol-induced stimulation, sedation, alcohol wanting, alcohol liking, negative mood, and positive mood. Alcohol SA was indicated by an increase in breath alcohol concentration. Time-lagged subjective response outcomes were examined as predictors of subsequent SA using multilevel modeling. Sex and family history of alcohol-related problems were investigated as potential moderators of the impact of subjective response measures on SA. Higher levels of alcohol-induced stimulation, as well as wanting and liking alcohol, predicted increased SA of alcohol. An increase in time, as a proxy for task demand, predicted a decreased likelihood of subsequent SA and moderated the effect of liking on SA. Family history of alcohol-related problems moderated the impact of alcohol-induced wanting and negative mood on motivation to consume alcohol. Overall, these findings emphasize the significant role of subjective responses to alcohol, as well as their interactions with task demand and family history, in influencing alcohol consumption behaviors. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Self-report is the most common way to measure substance use expectancies. Using such measures has led to insights regarding how, why, and for whom expectancies relate to use behavior. In fact, such insights have translated into interventions, such as expectancy challenges seeking to change one's expectancies. However, expectancy measures may be tricky for cannabis use, which has several product types and modalities that may impact the introspection of self-reported cannabis experiences. This study assessed whether a modern expectancies measure was invariant across cannabis use type/modality self-reported upon and whether cannabis type/modality moderated the influence of expectancies on use behavior. Young adults who recreationally used cannabis ( = 387) reported their cannabis use frequency and expectancies via the Anticipated Effects of Cannabis Scale. Participants also reported cannabis modality/type through which expectancies were self-reported upon. Each expectancy domain (high arousal negative, low arousal negative, positive) was invariant across cannabis type/modality. High arousal negative expectancies were higher when reporting vaping versus smoking, and positive expectancies were higher when reporting smoking versus vaping, but no other differences emerged. However, positive expectancies were associated with more frequent cannabis use when reporting on smoked (vs. vaporized) cannabis, and high arousal negative expectancies were associated with less frequent cannabis use when reporting on hash oil (vs. marijuana) and when reporting on vaporized (vs. smoked) cannabis. Cannabis type and modality may be important qualifiers in self-report research on cannabis expectancies. Future research should consider assessing modality- and type-specific cannabis constructs that are susceptible to such influences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Cannabis is increasingly used for managing chronic pain, despite the low quality and inconsistency of most evidence from randomized controlled trials and the divergent expert opinions and guidelines issued by academic societies. In this perspective piece, we suggest a way forward. The clinical trials have focused on traditional chronic pain outcomes (such as pain severity and interference, as well as physical and emotional functioning). However, qualitative studies suggest that many individuals perceive cannabis as beneficial not because it directly reduces pain but because it alters their psychological responses to it and improves other important outcomes, such as role and social functioning, sleep quality, and opioid substitution, which are largely overlooked in clinical trials of cannabis for chronic pain. We contend that the true clinical potential and limitations of cannabis for pain management may be fundamentally misunderstood if research continues to prioritize conventional chronic pain outcomes alone. We call for the integration of perspectives from people with lived experience in identifying meaningful clinical outcomes for future clinical trials on cannabis and chronic pain. Such a shift would clarify cannabis's true benefits and limitations, ultimately guiding more nuanced, evidence-based, and personalized treatment approaches for chronic pain. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Ketamine is increasingly used in community clinics as a long-term treatment for different psychiatric and pain conditions, including substance use disorders. Data are lacking, however, regarding the potential influence of ketamine on other substance use. In this secondary analysis, we aimed to explore the relationship between medical ketamine and other substance use among real-world patients by combining quantitative and qualitative data. In an online anonymous pilot survey ( = 201), patients rated change in other substance use since medical ketamine initiation and elaborated on their subjective experiences. Most patients self-reported positive/desirable change (54.7%) or no change in substance use (44.3%). Participants reporting past problematic substance use had significantly greater positive change compared with the groups of participants reporting present or no history of problematic substance use (s < .020). Participants reported positive outcomes such as reduced substance use due to reduced need to self-medicate for coping, reduced craving, or enhanced motivation to quit use. Among participants with minimal or no substance use, ketamine did not appear to induce or increase drug-using behaviors. However, there were some reports of risky behaviors such as openness to using other psychedelics or ketamine used recreationally as a substitute for alcohol. Several implications for providers are discussed. More targeted quantitative and qualitative research is needed to fully characterize all patients but especially those at risk for potentially harmful nonmedical substance use. Such research could inform regulation efforts on safety, screening, monitoring, and patient and provider education, to maximize benefits and minimize risks related to medical ketamine. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Nicotine pouches (NPs) contain no tobacco leaf but instead are filled with nicotine powder, flavorants, and pH adjusters. There are very few independent (i.e., non-industry-funded/affiliated) studies regarding the effects of NPs. The purpose of this industry-independent study is to examine NP effects in people who use smokeless tobacco (SLT). Twenty-four participants completed four sessions that included three NP conditions (2, 4, and 8 mg labeled total nicotine content; "on!" brand, Altria, Richmond, Virginia) and participants' own brand (OB) SLT. Participants completed two 30-min administration periods per session, and outcomes included plasma nicotine concentration as well as subjective and behavioral economic measures. Results indicate that the 8 mg NP did not differ significantly from OB across physiological and subjective measures; the 4 mg NP differed from OB and 8 mg on some measures, and the 2 mg NP reliably delivered less nicotine and reduced abstinence symptoms less effectively when compared to OB and the 8 mg NP. Study results offer preliminary support for the notion that higher nicotine content NPs may substitute for SLT in people who use SLT regularly, while lower nicotine content NPs may not. Overall, labeled nicotine content influences the nicotine delivery and abstinence symptom suppression of "on!" brand NP, and nicotine content and delivery should be considered when assessing the individual and public health impact of NP regulations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Kratom () is a psychoactive botanical native to Southeast Asia increasingly used in the United States for various self-reported benefits, including sleep improvement. However, empirical evidence concerning kratom's effects on sleep is limited. Here, we examined the association between bedtime kratom use and self-reported sleep outcomes in naturalistic settings across consecutive days, while also exploring sex and chronic pain status as potential moderators. A secondary analysis was conducted using the data from a 15-day ecological momentary assessment study of 357 U.S. adults who reported regularly using kratom. Participants made daily reports of their bedtime kratom use and rated their sleep duration and quality. Linear mixed-effects models assessed associations between bedtime kratom use and sleep outcomes, with sex and chronic pain status as moderators, controlling for age. Bedtime kratom use occurred on 23.4% of days and was associated with modest increases in sleep duration (13 min) and perceived quality (5.93-point increase on a 0-100 scale). Female respondents reported greater improvements in sleep quality (but not duration) than male respondents. Participants with chronic pain reported greater improvements in sleep duration and quality compared to those without chronic pain. Bedtime kratom use is associated with modest sleep duration and quality improvements, particularly in adults with chronic pain, and better sleep quality in female respondents. These findings among experienced kratom consumers suggest the need for human laboratory studies in kratom-naïve participants to determine causality and underlying mechanisms, which could help inform clinical guidance and policy as kratom use continues to rise. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Nearly 2 million people had a diagnosis of methamphetamine use disorder (MUD) in 2023 and overdose deaths involving psychostimulants are increasing. Given that there are no currently approved U.S. Food and Drug Administration medications for MUD, novel treatments are needed to complement standard of care behavioral treatments. Neuromodulation using transcranial focused ultrasound (FUS) has the capacity to noninvasively and precisely target subcortical structures, such as the nucleus accumbens, a structure integral to the reward neurocircuitry. Previous findings in individuals with opioid use disorder have demonstrated the potential of FUS in reducing substance craving and use; however, to date, no study has examined the effects of FUS for primary MUD. The objective of the current case study was to evaluate the safety and impact of nucleus accumbens FUS on methamphetamine craving (via a cue-induced craving paradigm) and use (via urine toxicology and self-report) in a man in his mid-20s with primary MUD. The participant received a 20-min session of low-intensity FUS (220 kHz) neuromodulation and completed follow-up visits 1-, 7-, 30-, 60-, and 90-days postprocedure. Results demonstrated that the FUS procedure was safe and well-tolerated. Cue induced craving acutely reduced during the procedure with sustained complete suppression throughout the 90-day follow-up (baseline craving rating was nine out of 10 [where 10 represents maximum craving]; craving at follow-up visits were consistently zero out of 10). Methamphetamine negative urine toxicology was observed during all follow-up visits, contrasting his pre-FUS use patterns of multiple episodes of use per week. While promising, larger, sham-controlled, randomized studies are warranted to determine the potential of FUS for MUD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Wearable alcohol biosensors offer an innovative solution for real-time alcohol monitoring, yet concerns about comfort, privacy, and social acceptability have limited their adoption. This study presents the largest real-world evaluation to date of a new-generation wrist-worn alcohol biosensor. In this study, 150 healthy adults (ages 21-54) wore the BACtrack Skyn sensor continuously for 14 days. Using a mixed methods design, we assessed pre- and poststudy feasibility and acceptability through structured surveys and open-ended responses, applying innovative machine learning techniques, including Term Frequency-Inverse Document Frequency and sentiment analysis, to capture nuanced user experiences at scale. Participants showed high compliance (median wear time: 94.66%), and 77% expressed willingness to extend device use. The device's discreet, smartwatchlike appearance supported high social acceptability, with most users reporting easy integration into daily life even if no significant changes in alcohol consumption were observed. While some discomfort-particularly itching and sleep interference-was reported, overall comfort and usability ratings were favorable. Findings indicate that the new-generation wrist-worn alcohol biosensor is a feasible and well-accepted tool for alcohol monitoring. High compliance and positive user reception highlight its potential for real-world applications. While sensor comfort was generally positively rated, refining the device's fit and materials could enhance wearability over extended periods. These insights contribute to the ongoing development of wearable alcohol biosensors that balance usability, functionality, and user experience. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Naloxone administration can precipitate opioid withdrawal, concerns about which may result in hesitancy to use this life-saving intervention. Preclinical and clinical research suggests that cannabinoids may reduce the symptoms associated with opioid withdrawal. This proof-of-concept study sought to test the effects of vaporized cannabis pretreatment (T15 min) on naloxone-precipitated (T0-T50) withdrawal using the Clinical Opiate Withdrawal Scale (COWS, range = 0-48) as the primary dependent measure. Evaluating the safety of this drug combination was the secondary aim, assessed using vital signs. Before a major methodological redesign, a single participant (male, 52) with opioid use disorder completed testing. The ∼4-week inpatient study began with stabilization on oral morphine (120 mg/day). During testing, the following dose combinations of vaped cannabis (V-CB) and intranasal naloxone (IN-NLX) were tested: (a) IN-NLX 0.0 mg + V-CB 25.0 mg, (b) IN-NLX 4.0 mg + V-CB 0.0 mg, (c) IN-NLX 0.0 mg + V-CB 12.5 mg, (d) IN-NLX 4.0 mg + V-CB 12.5 mg, (e) IN-NLX 0.0 mg + V-CB 0.0 mg, and (f) IN-NLX 4.0 mg + V-CB 25.0 mg. Naloxone alone resulted in a COWS score of 22 at T+30. CB pretreatment (12.5 mg and 25.0 mg) reduced COWS scores at T+30 to 17 and 14, respectively. Active NLX and V-CB administered in combination resulted in elevated heart rate and blood pressure, though not to a greater extent than NLX alone. This study found that the addition of a cannabinoid reduced the severity of NLX-precipitated withdrawal and supported the continued investigation into combined NLX + cannabinoid formulations as overdose reversal agents. (PsycInfo Database Record (c) 2025 APA, all rights reserved).