Introduction Adverse childhood experiences are associated with the development of substance use disorders. With opioid use disorder, a growing concern in the United States, we were interested in examining the relationship between adverse experiences and three landmarks of opioid use: age of opioid initiation, injection drug use, and lifetime overdose. Methods Between May and December 2015, we interviewed consecutive persons seeking inpatient opioid detoxification. Participants were asked about age of opioid initiation, last month injection drug use, and lifetime history of overdose, and completed the ten-item Adverse Childhood Experience (ACE) questionnaire. Results Participants (n=457) averaged 32.2 (± 8.64) years of age, 71.3% were male, and 82.5% were non-Hispanic White. The mean score on the ACE scale was 3.64 (± 2.75). Mean age at time of initiating opioid use was 21.7 (± 7.1) years, 68.7% had injected drugs within the past month, and 39.0% had overdosed. After adjusting for age, gender, and ethnicity, the ACE score was inversely associated with age of initiating opioid use (b = −0.50, 95% CI −0.70; −0.29, p < .001), and positively associated with recent injection drug use (OR = 1.11, 95% CI 1.02; 1.20, p = .014) and the likelihood of experiencing an overdose (OR = 1.10, 95% CI 1.02; 1.20, p = .015) in a graded dose response manner. Conclusion Greater adverse childhood experiences are associated with three landmarks of opioid use risk. ACE screening may be useful in identifying high-risk subsets of opioid-using populations.

In this randomized trial, 121 mandated college students (33% female, 74% Caucasian, M age ϭ 19.42 years) received either a Brief Motivational Intervention (BMI) with personalized normative feedback (PNF) or the Expectancy Challenge Alcohol Literacy Curriculum (ECALC) to compare effectiveness in reducing alcohol use and associated harms. All participants received either BMI content (n ϭ 63) or ECALC (n ϭ 58). ECALC was delivered as a web-based program with clinician assistance. Measures of alcohol use and harms were completed at baseline and 4 weeks postintervention. ECALC produced significant reductions on all 4 positive expectancy subscales of the Comprehensive Effects of Alcohol Scale (CEOA). Both programs were associated with significant reductions on all alcohol use variables and harms, and expectancies significantly mediated the intervention to outcome relationship in the ECALC condition. There were no significant gender differences. Two one-sided equivalence test indicated superior effects for ECALC compared to BMI on four alcohol use variables (mean blood alcohol concentration, peak blood alcohol concentration, peak drinks per sitting, and drinking days per month), and noninferior to BMI in reducing others (mean drinks per sitting, mean drinks per week, & binge drinking). Superior effects of ECALC versus BMI are based on a short-term follow-up, and longevity of ECALC effects have yet to be established. ECALC has previously been found to be effective as a group-delivered program for male fraternity members, and these findings provide preliminary support for effectiveness for both males and females when delivered individually using a web-based clinician-assisted format.

Serolo,Eical screening of swine herds in 1984indicated that porcine respiratory coronavirus (PRCV) had been introduced into Denmark. To determine risk factors associated with the introduction of PRCV, a cross-sectional study of 408 Danish swine herds was carried out between May 1985 and June 1986. The association between herd-PRCV serological status and possible risk factors, obtained from a field questionnaire, was assessed by unconditional maximum likelihood logistic regression. An increasing herd size, location in the Jutland peninsula (compared with location on the island of Funen) (OR = 7.9 in a multivariable logistic regression model not including interaction terms), the presence of a slurry system (i.e. pigs living on a slatted floor) (OR=4.6) and purchase of pigs (OR= 1.7) were significantly (P < 0.05) associated with seropositivity. Two significant interactions, both involving herd s#ize, were subsequently identified.The PF!CV serological status of neighbouring herds was found to be related, and closeness of a seropositive herd was associated with an increased risk of a herd being serologically positive.The re.sults of this study indicate that herd size may be an important determinant of airborne transmission of PRCV infection, and that herd size may modify the effect of other risk factors.*Corresponding author. 0167-5877/95/$09.50 0 1995 Elsevier Science B.V. All rights reserved SSDI016?-5877(95)00498-X s2 J. Flori et al. /Preventive Veterinnry Medicine 25 (1995) 5142

Background: Without aftercare treatment, persons discharged from short-term inpatient detoxification for opioid use disorder are at high risk of relapse. In previous work, those who were recently homeless or had pending legal problems were more likely to prefer residential treatment for aftercare. Here, based on clinical experience, we hypothesize that a particular clinical factor, surviving an opioid overdose, will be associated with aftercare preference. Methods: Between May and December 2015, we surveyed consecutive persons seeking inpatient opioid detoxification. To assess aftercare treatment preference, participants were asked, “If you had unlimited treatment options and all were free, which one would work best for you when you leave here?” To assess overdose history, participants were asked about overdose “since your first drug use,” and “in the last year.” Results: Participants’ (n=440) mean age was 32.3 (± 8.7) years; 70.7% were male. More than half (51.1%) of participants expressed an aftercare preference for medication-assisted treatment (MAT), 12.7% for outpatient counseling only, 10.7% for residential treatment,18.6% for no formal treatment (NA/AA only or a halfway house), and 6.8% did not want any post-detoxification treatment. About 38.9% reported a history of overdose and 24.8% reported past year overdose. In the multivariate model, treatment preference was associated with sex (p < .001), homelessness (p = .01), and history of drug overdose (p = .02). Conclusions: Although MAT was preferred by the majority of participants, the experience of a non-fatal overdose was associated with the choice of residential treatment as post-detoxification treatment.