BackgroundThe integration of trauma-informed interventions for justice-involved women into SUD treatment is a key strategy for mitigating overdose risk. Coupling the unique overdose risk factors for women with their histories of violent victimization and related trauma, overdose intervention approaches for women must be engaging, targeted, and trauma-informed.MethodsThis study utilizes a type 1 hybrid effectiveness and implementation trial to examine an innovative trauma-inforned intervention for justice-involved women (N = 264) in corrections-based substance use treatment during the transition from jail to the community. By equipping women with relational, coping, and emotional regulation skills to manage trauma-related reactions, they are expected to gain the tools and strategies needed to reduce their risk of returning to substance use after release.DiscussionThe importance of knowledge gained through this study is grounded in the national public health crisis associated with overdose deaths, largely associated with the opioid epidemic, but also related to unique issues faced by women and the limited, targeted, trauma-informed overdose prevention interventions for this population. This study that has the potential to significantly reduce overdose risk among justice-involved women with a history of violent victimization and related trauma.Trial registrationThis study is registered in ClinicalTrials.gov under protocol identifier-NCT06651528 with an original submission date of October 16, 2024, and updated December 12, 2025 (clinicaltrials.gov/study/NCT06651528).

INTRODUCTION:Overdose deaths disproportionately increased among adolescents and young adults (AYA) between 2019 and 2022, despite declining substance use. We examined the prevalence of nonfatal overdose and characteristics associated with overdose history in AYA. METHODS:AYA enrolled between 2020 and 2023 in five opioid use disorder prevention studies in child welfare, healthcare, and legal settings from six states were included in this analysis. Nonfatal overdose history, demographic, and clinical characteristics were assessed at baseline. Across studies, overdose history was assessed with slight variations in wording, but most other measures were standardized. Odds ratios (OR) of lifetime overdose were calculated with logistic regression for each risk factor with demographic control variables (age, sex, race) included as covariates, and reported separately by sample. RESULTS:Sample sizes ranged from 137 to 929 (total N = 1856). Characteristics across samples ranged from M = 16.2-26.4 years for age, and 11.7-91.9 % for female sex. For race, samples ranged from 35 % to 89.4 % White and 17.3-89.4 % Black. History of nonfatal overdose ranged from 6.6 % to 41.4 %. Statistically significant characteristics associated with overdose history in all samples included history of opioid misuse (ORs ranging from 1.98 to 6.73) and family members with a substance use problem (ORs range from 1.27 to 2.05). Frequent and early onset alcohol and cannabis use was also associated with overdose history in several samples. CONCLUSIONS:Overdose prevention interventions for AYA should include a focus on AYA who misuse opioids and families with a history of substance use problems.

Physical distancing restrictions related to the COVID-19 pandemic accelerated the uptake of virtual options for prevention providers and clinical service provision in general. In this paper, we bring together experiences from the HEAL Prevention Cooperative, a unique cohort of research projects representing a continuum of care from community-level promotion to indicated prevention with older adolescents and young adults to increase access to services to prevent opioid misuse. We offer options that preventionists and other providers can implement or continue to use to expand access to youth and families who experience difficulty accessing opioid-related preventive services and supports. We also discuss challenges in implementing physical distancing adaptations that were required to operate during the pandemic. We discuss intervention adaptations along four pillars useful for providers and researchers: connecting with partners, recruitment, prevention service provision, and data collection and evaluation. We also provide recommendations for health professionals and practitioners and for future research.

Background: Youth in the legal system (YILS) have high rates of trauma exposure, which are associated with increased risk of behavioral health needs (e.g., substance-use problems) and recidivism. Research suggests that a trauma-focused therapeutic approach can improve outcomes for YILS, but few evidence-based interventions (EBIs) are designed with justice-involved youth in mind. Consequently, implementing trauma-informed EBIs within juvenile justice (JJ) systems is challenging. The current paper describes the systematic adaptation of Trust-based Relational Intervention (TBRI) as a substance use prevention intervention for YILS and their caregivers. Methods: The current study utilized a methodology based on the ADAPT-ITT framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention program. Phases of adaptation included (1) Assessment , (2) Decision, (3) Prototype Development , and (4) Testing and Integration . The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., YILS and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) in an iterative process with input from participants from the target population, key stakeholders, and content experts. Results: The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum , TBRI Youth & Young Adult Curriculum , and TBRI Nurture Groups . The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum . Conclusions: Utilizing an implementation science framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually-appropriate interventions. Accounting for contextual factors and population needs can improve the fit of EBIs in juvenile justice, facilitating uptake and ultimately improving outcomes for youth. Trial registration : ClinicalTrials.gov Identifier: NCT04678960

The current study examined the state- and trait-level associations of psychological and physical aggression to somatic symptoms, and alcohol and drug use and tested the influence of distress tolerance on these associations, while controlling for stress, sex, and minority status. A naturalistic observation was used to collect data with a sample of 245 college students at three time points with 2 weeks apart. Random-intercept cross-lagged panel models were used to disaggregate within-person effects (autoregressive and cross-lagged effects) from the between-person (latent trait-level) associations. The findings revealed that there were autoregressive effects of psychological aggression between Time 1 (T1) and Time 2 (T2) and of physical aggression between T1 and T2. There was a bidirectional association between psychological aggression and somatic symptoms at T2 and Time 3 (T3), in which T2 psychological aggression predicted T3 somatic symptoms and verse vera. T1 drug use predicted T2 physical aggression, which in turn predicted T3 somatic symptoms, indicating physical aggression being a mediator between earlier drug use and later somatic symptoms. Distress tolerance was negatively associated with psychological aggression and somatic symptoms, respectively, and such an influence did not differ across time occasions. The findings indicated the importance of incorporating physical health in the prevention and intervention of psychological aggression. Clinicians may also consider including psychological aggression in the screening of somatic symptoms or physical health. Empirical-supported therapy components for enhancing distress tolerance may help mitigate psychological aggression and somatic symptoms.

The current study adopted a daily diary design to examine the impact of exposure to daily stressors, daily resilience, and trait aggression on somatic symptoms, and the moderation of aggression on the associations of exposure to daily stressors and resilience on somatic symptoms. College students completed baseline and seven-day daily assessments. The results indicated that a greater exposure to daily stressors and high levels of trait aggression predicted more daily somatic symptoms. Trait aggression moderated the influence of daily resilience on somatic symptoms, in which higher levels of resilience was associated with fewer somatic symptoms only for those with high levels of aggression but not for those with medium or low levels of aggression. The findings suggest the importance of considering daily stressor and trait aggression in screening for clinic visits for somatic symptoms. The findings also underscore the importance of aggression being a marker in prevention programs and enhancing resilience, particularly for aggressive individuals in preventing somatic symptoms.

The continued need for advancement in evidence-based SUD treatment, as well as increases in treatment expense and decline in support from insurance providers, suggest that brief, innovative, and affordable treatments are needed. Meditation, spirituality, and adherence to medication-assisted treatments have all been shown to support abstinence. The current trial assessed effects of spiritually-based meditation, versus relaxation or standard treatment, on substance abstinence and psychological distress and dysfunction in a partially buprenorphine-supported (41.5%) treatment sample. Participants (N = 40) were recruited from an intensive outpatient treatment program, in which three treatment locations acted as separate experimental conditions. Abstinence was measured through urinalyses at baseline and weekly thereafter for the duration of the intervention. Psychological distress and dysfunction were assessed with a Likert-scaled questionnaire measuring symptoms typically associated with SUD. Co-varying for buprenorphine use, participants in the Meditation condition had better odds of remaining abstinent than participants in the Treatment-as-Usual (TAU) and Relaxation conditions. There were no significant differences in substance abstinence between the Relaxation and TAU conditions. Further, co-varying out baseline there were no significant differences at post-course in psychological distress and dysfunction between the three conditions. Results from this pilot trial suggest that this spiritually-informed approach may offer additive support to individuals in SUD treatment, as an aid to the meditative aspect of the 12 steps, or a non-12-step alternative spiritual supplement to standard SUD treatment.

Materials and methods The sample included 90 male participants (64 of which completed follow-up) and seven counselor participants (i.e., four females and three males) from communitybased treatment in a Midwestern metropolitan area. Hierarchical linear modeling was conducted to examine the influence of victimization and violence history, psychiatric disorders (i.e., anxiety, depression), social functioning (i.e., social support, self-esteem), drug use severity, and treatment motivation on treatment satisfaction and progress after controlling for counselor-level variances. Hierarchical linear modeling also was employed to test the mediation of treatment satisfaction on the relationship between client-level factors and treatment progress.