Fentanyl-Related Substance Use Patterns, Morbidity, and Mortality Among Adolescents and Young Adults: Implications for Behavioral Health Services Research.

This commentary discusses best practices for responding to fentanyl-related overdose deaths in adolescents and young adults, and it outlines the current state of knowledge about them. Various types of approaches to fentanyl-related overdoses in this age group may need to be developed based on the different risk factors that are emerging from the existing data. We describe the National Institute on Drug Abuse (NIDA) behavioral health services research priorities connected with fentanyl-related overdoses in youth. We highlight a key target for intervention and discuss research opportunities related to early intervention with youth with identifiable risk factors. NIDA's research agenda is a means of assisting communities that experience fentanyl-related overdoses by providing scientific information that can be translated into clear recommendations for public action.

Operational Definitions of Poly-Victimization: A Scoping Review.

Throughout the last two decades, research on poly-victimization (PV) has evolved from examinations of a core set of past-year victimization types in youth samples to investigations of a broad range of victimization types experienced during variable time intervals in diverse samples of varying ages. As the concept of PV expands, greater clarity regarding the definition and measurement of PV is needed to advance understanding of its risk and protective factors as well as its associated outcomes. This scoping review aimed to (a) identify approaches used to operationally define and measure PV across studies and (b) synthesize empirical findings concerning risk factors and outcomes associated with PV. A systematic search of peer-reviewed research published before 2022 across 12 databases yielded 98 studies that met inclusion criteria. Study characteristics including the research design, sample type, victimization timeframe, operational definition(s) of PV, measurement of PV, analytic methods, and key findings were synthesized across studies. Findings indicated that the majority of reviewed studies were cross-sectional investigations that utilized categorical measures of lifetime PV in samples of youth. Results also demonstrated that PV is robustly associated with a broad range of predictors, including mental health symptoms and diagnoses as well as family- and community-level factors. PV is also associated with numerous adverse outcomes including depression, anxiety, suicidality, substance use, and delinquency across diverse study types and populations. Future research that examines the conditional effects of PV is needed to identify subgroups of individuals at higher risk of adverse outcomes following PV and modifiable targets for interventions.

Engaging the justice system to address the opioid crisis: The Justice Community Opioid Innovation Network (JCOIN).

Many individuals with opioid use disorder come into contact with the justice system each year, making the nexus between the criminal justice system and the health care system a critical juncture for responding to the opioid crisis and simultaneously promoting public health and public safety. Collaborations across these sectors are essential to providing effective screening, treatment, and discharge planning; connecting individuals to services following release; promoting long-term recovery while reducing recidivism; and ultimately bringing the opioid crisis under control. In 2019, with the support of the NIH Helping to End Addiction Long-term (HEAL) Initiative, the National Institute on Drug Abuse launched the Justice Community Opioid Innovation Network (JCOIN). JCOIN is a >$150M multisite cooperative designed to facilitate transdisciplinary collaborations that can create actionable, translatable insights for the justice system and community-based organizations to address the opioid epidemic in justice-involved populations. JCOIN brings together 11 Research Hubs, a coordination and translation center (CTC), and a methodology and advanced analytics resource center (MAARC), with the goal of generating evidence that is greater than the sum of the parts. Collectively, the network will field at least 12 large-scale multisite clinical trials, which are described in this special issue. This article provides a brief overview of the scientific underpinnings for these trials; describes the broad themes connecting them; and discusses the intersections of the JCOIN initiative with the COVID-19 pandemic.

Reappraising and Redirecting Research on the Victim-Offender Overlap.

The strong positive association between offending and victimization, or the victim-offender overlap, has received considerable amount of research attention in recent years. Empirical research has made important strides in unpacking the sources of the phenomenon, but important questions remain unanswered. Ambiguity surrounds the utility of certain theoretical explanations for the overlap, the nature of the phenomenon, and the methodological tools used to examine its etiology. Owing to these knowledge gaps, the scientific meaning of the victim-offender overlap is unclear. Moreover, a number of potentially important theoretical arguments are rarely subject to empirical testing in this line of research. The purpose of this article is to use a narrative review methodology to provide a critical reappraisal of the theoretical, empirical, and methodological research on the victim-offender overlap and offer directions for ways forward to develop a more comprehensive understanding of the phenomenon. This review includes critical analysis of 78 academic publications, along with a table that summarizes the key findings and conclusions from 18 critical empirical studies that have contributed to our understanding of the victim-offender overlap. We offer recommendations for the continued development of theoretical and methodological tools to better understand this complex phenomenon.

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool.

Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71-100%) and 90% (95% CI 85-93%), respectively. These results inform a proposed screening tool for multisite validation testing.

Victim Offender Overlap: Dual Trajectory Examination of Victimization and Offending among Young Felony Offenders over Seven Years.

The relationship between victimization and offending has been shown consistently across different samples, settings, and crime types. This study uses data from the Pathways to Desistance Study to examine dual trajectories of offending between the ages of 15 and 24 in a sample of male felony offenders. The dual trajectory models demonstrate substantial convergence in victimization and offending. And while there are sizable numbers of youth who continue to be victimized, but desist or decrease in their offending behaviors, very few youth continue to offend in the absence of continued victimization. This study also proposes and tests three criminological theories that have been employed as explanations for the victim-offender overlap - low self-control, lifestyles/routine activities, and street-code attitudes. The logistic regression results indicate that involvement in risky and/or unstructured, unsupervised activities is a key correlate of the victim-offender overlap. The strength of the relationship between routine activity variables and the victim-offender overlap supports the provision of structured, supervised activities for youth and young adults as a way of preventing future victimization and offending, particularly among youth who have high exposure to violence.

Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey.

This study examines the prevalence and correlates of psychological abuse and physical abuse against women and men aged 70 or older. Self-report data from 2,185 respondents in the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were used to create weighted estimates for past-year experiences of abuse. Correlates were then examined using survey logistic regression models. More than 1 in 10 adults who are 70 years of age or older (14.0%) have experienced some form of abuse in the past year, with 12.1% experiencing psychological abuse and 1.7% experiencing physical abuse. One in five victims (20.8%) were abused by both intimate and nonintimate partners. Health care insecurity was the strongest correlate of past-year abuse. The odds of experiencing abuse were 4.53 times greater for those who experienced health care insecurity than for those who did not. This presents a significant challenge for identifying and helping victims of abuse.

Teen dating violence: building a research program through collaborative insights.

The National Institute of Justice (NIJ) has an emerging portfolio of research in the area of teen dating violence (also known as adolescent relationship abuse). This article begins with a discussion of the developments that prompted NIJ to focus on teen dating violence. Next, the article highlights specific accomplishments and contributions that NIJ has made to helping develop knowledge and scientific understanding of adolescent relationship abuse, particularly around the prevention of teen dating violence perpetration and victimization. This is followed by a presentation of some of the key findings from NIJ-funded research. We then move to a discussion of some of the complex issues around definition, measurement and research methods and how NIJ has been involved in addressing those issues. The article concludes with some thoughts about the intersection of teen dating violence research, policy, and practice and highlights several research gaps that are in need of additional attention.