Factors associated with methamphetamine withdrawal symptoms among people who inject drugs.

BACKGROUND: Regular methamphetamine (MA) use can result in withdrawal syndrome characterized by fatigue, agitation, depression, and anxiety. No studies that we are aware of have examined the prevalence and predictors of MA withdrawal symptoms among people who inject drugs (PWID). METHODS: PWID were recruited using targeted sampling methods in Los Angeles and San Francisco, California from 2016 to 2017. Survey questions included demographics, drug use, and MA withdrawal symptoms, frequency, and symptom severity. Participants who reported regular MA use (> 12 times in the last 30 days) were included in this analysis (N = 595). Multivariable regression models were developed to examine factors associated with any MA withdrawal, withdrawal frequency, symptom severity, and receptive syringe sharing. RESULTS: MA withdrawal symptoms in the past 6 months were reported by 53 % of PWID, with 25 % reporting weekly withdrawal symptoms, and 20 % reporting very or extremely painful symptoms. In multivariable logistic regression, presence of any MA withdrawal symptoms was positively associated with more frequent MA use and non-injection tranquilizer use and inversely associated with crack cocaine use. Among those reporting any withdrawal, female sex was associated with more frequent withdrawal symptoms. Very or extremely painful withdrawal symptoms were associated with being in residential treatment. Receptive syringe sharing was associated with any MA withdrawal symptoms and weekly frequency of symptoms. CONCLUSION: MA withdrawal symptoms are common among PWID and are associated with receptive syringe sharing. Strategies for implementing MA use treatment, safe supply programs, and syringe services programs targeting people who inject MA are indicated.

Electronic Cigarette Product Placement and Imagery in Popular Music Videos.

INTRODUCTION: Given the increasing use of electronic cigarettes (e-cigarettes) among young adults, it is crucial to identify possible sources of e-cigarette marketing exposure in media popular among young adults. However few studies document e-cigarette product placement (eg, visible logo, branded merchandise or gear such as a branded hat or shirt) in music videos. The objective of this study was to determine the extent of e-cigarette product placement and imagery in popular music videos. METHODS: Songs on the Billboard Hot 100 list during the weeks of June 16 through September 22, 2018 with official music videos were identified (n = 180) and coded for e-cigarette product placement and imagery (including aerosol clouds), visible brand names, number of views (as of October 25, 2018), music genre, video themes, and combustible tobacco content. RESULTS: E-cigarette product placement and imagery appeared in 7 (3.8%) music videos which were viewed over a billion times, providing billions of e-cigarette impressions. Among music videos with e-cigarette product placement and imagery, the most prevalent theme was Image/Lifestyle/Sociability (eg, ostentatious lifestyle, partying) and the most prevalent genre was Hip Hop. The e-cigarette companies KandyPens and Mig Vapor were identified. CONCLUSION: While e-cigarette product placement or imagery appeared in a relatively low number of music videos in this study, these videos received views in the billions. Music videos should be considered when assessing e-cigarette marketing exposure among priority populations. Future research should examine how viewing e-cigarette product placement and imagery in music videos influences susceptibility to use such products among young adults. IMPLICATIONS: While e-cigarette product placement (eg, scenes with visible branding, a visible logo, branded merchandise or gear such as a branded hat or shirt) or imagery appeared in a relatively low number of popular music videos in this study, these videos received views in the billions on YouTube. KandyPens and Mig Vapor were the companies responsible for the majority of the product placement identified in this study. The predominant music genre of videos featuring any e-cigarette product placement or imagery was Hip Hop, while the predominant theme of videos was Image/Lifestyle/Sociability. Music videos appear to be a potential source of exposure to e-cigarette products. Future research should examine how viewing e-cigarette product placement and imagery in music videos influences susceptibility to use such products among priority populations.