But the preliminary clinical results exceeded researchers’ expectations: In the pilot trial with 12 veterans, 75% of participants were in remission one month after the study’s end. Their symptoms no longer met the criteria for post-traumatic stress disorder.

“For a population with severe treatment-resistant PTSD, these results are striking,” said Stacey Armstrong, first author of the new study, published today (July 30, 2026) in Communications Medicine.

“While treatments do work for some veterans with PTSD, they’re falling short for many, leaving veterans to continue to search for solutions, which can lead to treatment dropout, long-term disability and elevated suicide risk,” said Armstrong, senior researcher and associate director of the Center for Psychedelic Drug Research and Education (CPDRE) in The Ohio State University College of Social Work.

“It’s this unmet need that inspires us.”

The 11-week trial period combined eight hours of psychotherapy followed by two doses, 15 milligrams and 25 milligrams, of synthetic psilocybin, the active ingredient in magic mushrooms. Six to eight more hours of integrative therapy followed the drug treatment.

From baseline to one month after treatment was finished, there was an overall average drop of 27.5 points in clinician-rated PTSD symptoms among the group. Nine participants had a clinical response to treatment and were in remission. No severe adverse events occurred, with the most common side effect being a mild headache after taking psilocybin. Suicidal ideation scores did not significantly change from baseline to one month post-treatment.

Future papers from this study will assess the treatment’s effectiveness up to six months after the trial, as well as biological changes and effects on other PTSD-related problems like sleep disorders and substance use, said Alan Davis, senior author of the study, director of the CPDRE and associate professor of social work at Ohio State.

Anecdotal observations, and previous research showing that depression remission endured for five years after an earlier psilocybin trial that Davis co-led, suggest the combined therapies could have staying power for many people whose symptoms are not eased by traditional therapies.

“It’s been an incredible honor to work with veterans in this study, many of whom have been suffering with PTSD for decades or longer,” said Davis, who also holds faculty appointments in psychology and internal medicine at Ohio State.

“Some experiences we’ve seen in actual treatment sessions are extremely profound and meaningful. The ability for them to go back and to revisit really difficult events that happened to them and to find a new way of understanding them and a new way of moving forward in their life has really been exciting.”

One participant’s experience

To be eligible for the trial, veterans had to have severe PTSD that was considered treatment-resistant. The need for help in this population became quite evident as participant recruitment began: Over 3,600 applicants reached out to partake in online prescreening and 668 were assessed for eligibility. Though the initial goal was 15 participants, the final number was 12 – nine men and three women.

Zachariah Collett, a U.S. Army veteran from Washington Court House, Ohio, considers himself one of the lucky ones who was selected to participate.

Collett joined the Army in 2002 as an enlisted soldier and later became a military police corps paratrooper, serving a 28-month combat tour in Iraq. By age 25 he was medically retired. Among the diagnoses and service-connected disabilities that led to retirement was post-traumatic stress disorder.  

His symptoms included nightmares, a short temper, feeling constantly on guard and being angry virtually all the time – leading to behavior that had a negative effect on his family.

“I was just absolutely tortured by the internal struggle, the internal dialogue, the noise inside my head and the inability even to just be still,” Collett said. Years of trying counseling and medications didn’t help.

It was an intensive 41-day self-discovery experience combining a healthful diet with a series of integrative therapies that first put Collett on the path to healing. When he later learned about the psilocybin trial, he saw it as the perfect opportunity – and medicine – to take a “deeper dive.”

Now three years out from the treatment, he said the psilocybin-assisted therapy had a profound effect on him, his family and his marriage.

“For the first six months to a year, I felt like I had this fantastic set of training wheels while I’m relearning the way to act in situations,” he said. “That’s the great thing about this medicine. It’s gentle and it allowed me the space to rediscover, or discover, things I didn’t know I was capable of doing.

“It allowed me the opportunity to create peace, and stillness, and acceptance, and forgiveness and grace – all those things opposite of resentment and anger and hatred. It’s rather beautiful.”

Where the magic happens

A rigorous psychotherapy schedule is a key part of the process, with evidence from the trial suggesting that PTSD symptoms were lowered even before the drug was administered.

“There is this big question in the psychedelic therapy field right now about how much of this is a drug effect, how much of this is a therapy effect, and how much is a combination of the two,” Davis said.

This study, the first to try to answer the question, found a drop in PTSD symptoms from baseline to the end of preparation therapy, with a much larger reduction after the psilocybin doses.

“This treatment is more than just a drug,” Davis said. “The drug itself is a catalyst for the deep work that opens a window for people to perhaps access things they wouldn’t be able to access emotionally otherwise, and what that does is catalyze the therapeutic process after.

“That’s where the magic actually happens. It happens in the therapy, and in the changes that people start to make in their lives after the treatment’s concluded.”

The research team acknowledges that pilot studies with no control group tend to produce larger effect sizes than standard clinical trials. They hope to secure funding to follow up with a larger randomized, controlled clinical trial.

“Recognizing the tools that we have don’t work so well and recognizing the significant burden of PTSD in the United States carried by our servicemen and women and veterans, this seemed like the right direction to go,” Armstrong said. “Too many veterans right now are suffering despite the treatments that we have, and that’s why we feel that this research is important.”

Davis, who has been studying psychedelics as a component of mental health treatment for the past 16 years, said, “This is a very exciting time for psychedelic-assisted therapy research. These treatments are generally safe, well tolerated and showing a strong signal of efficacy.”

This research was supported by Ohio State’s College of Social Work, The Center for Psychedelic Drug Research and Education, the Clinical Research Center/Center for Clinical Research Management of The Ohio State University Wexner Medical Center and Ohio State’s College of Medicine.

Additional co-authors were Adam Levin, Nathan Sepeda, Hillary Shaub, Taweh Hunter, Angela Douglas and Rafaelle Lancelotta, all of Ohio State.

The study involved participants from a clinical trial published in 2021 that found psilocybin (the primary psychedelic substance in magic mushrooms) combined with psychotherapy in adults was effective at treating major depressive disorder.  

An average of five years after the clinical trial, a majority of participants reported lasting depression remission as well as improvement in a range of well-being measures. 

“We found that 67% were in remission at five years compared to 58% at one year. We also saw that across the board, anxiety, depression, global functioning, self-reported depression, all of these measures were showing the same signal of continued improvement up to five years later,” said lead author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education (CPDRE) in The Ohio State University College of Social Work.  

“Five years later, most people continued to view this treatment as safe, meaningful, important, and something that catalyzed an ongoing betterment of their life,” said Davis, who co-led the 2021 trial at Johns Hopkins University. “It’s important for us to understand the details of what comes after treatment. I think this is a sign that regardless of what the outcomes are, their lives were improved because they participated in something like this.” 

The follow-up results were published Sept. 4 in the Journal of Psychedelic Studies. 

In the original trial, two participant groups – one receiving treatment right away and another on a wait-list treatment condition – received two doses of psilocybin combined with about 13 hours of psychotherapy. Overall, the participants experienced a significant and large reduction in depression symptoms, with half reporting remission from depression up to one year after the trial. 

Of the 24 participants, 18 enrolled in the five-year follow-up, which consisted of a range of online questionnaires assessing depression, anxiety and functional impairment; a clinician-administered depression rating; and interviews to capture nuances of outcomes beyond the quantitative measures. 

In analyzing data at the five-year time point, researchers conservatively estimated that those who didn’t participate in the follow-up had experienced complete relapse and had returned to their pre-treatment levels of functioning. 

“Even controlling for those baseline estimates from the people who didn’t participate in the long-term follow-up, we still see a very large and significant reduction in depression symptoms,” said Davis, who also holds faculty positions in internal medicine and psychology at Ohio State. “That was really exciting for us because this showed that the number of participants still in complete remission from their depression had gone up slightly.” 

The depression remission cannot be attributed solely to the 2021 trial treatment, the findings suggest. Only three participants in the follow-up had reported no depression-related treatment since the trial. Others reported taking antidepressant medications, trying psychedelics or ketamine treatment, or undergoing psychotherapy. 

The follow-up interviews revealed context around those decisions to seek therapy, Davis said. Before the psilocybin-assisted therapy, these patients lived with debilitating depression that interfered with their capacity to engage in life. After the trial, many described perceiving depression as more situational and manageable. 

“They believed that overall, they had greater capacity for positive emotions and enthusiasm, regardless of whether their depression came back or not. A lot of folks reported that these shifts led to important changes in how they related to their experiences of depression,” Davis said. 

A few of the people who had tried psychedelics on their own in the intervening years reported that the experiences were not as helpful because of the lack of a clinical support framework. This notion supports findings from another study Davis and colleagues conducted with the clinical trial group – that when it comes to reducing depression with psychedelic-assisted therapy, what matters even more than the drug is a strong relationship between the therapist and study participant.  

At the five-year time point, 11 participants reported no adverse effects since the clinical trial. In looking back, three recalled they felt unprepared for the heightened emotional sensitivity that came with the psychedelic treatment, two said pre-trial weaning off medications and being on the waitlist was very difficult, and two believed integration therapy would have been helpful after the initial study. 

Acknowledging the study sample is small, Davis said there is still a lot to learn – but that this first look at the durability of the effects of psilocybin-assisted therapy offers a glimpse at the potential lasting positive effects of the treatment. 

“We believe that these data suggest that there is long-term efficacy with people who undergo these treatments,” they said. “Some of the most debilitating aspects of depression are people isolating and withdrawing from things that are important to them. Despite some of those symptoms coming back, they found they weren’t experiencing those same levels of impairment – that really speaks to the potential for some people that this treatment might catalyze future positive effects when they’re going through depression.” 

This study was supported by the CPDRE at Ohio State, and the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where Davis was an adjunct assistant professor at the time of the study. 

Co-authors included Meghan DellaCrosse, Nathan Sepeda, Adam Levin, Hillary Shaub, Peter Gooch, Shoval Gilead, Skylar Gaughan and Stacey Armstrong of Ohio State, and Mary Cosimano, Taylor Washington and Frederick Barrett of Johns Hopkins.

The risk for substance use among young employees was highest in the food preparation/service industry and in safety-sensitive occupations including construction – a sector linked in previous research with a high risk for drug overdose deaths. 

Based on their prior studies of workplace strategies related to employee substance use, the researchers say these new findings suggest comprehensive substance use policies and supportive interventions could improve safety and help reduce workers’ misuse of alcohol and drugs. 

“Especially for those working in blue-collar or heavy manual jobs, they often have limited access to support to address substance use,” said lead author Sehun Oh, associate professor of social work at The Ohio State University. “It’s easy to blame someone for using substances, but we want to pay attention to understanding their working conditions and barriers at the workplace.” 

Oh completed the study with Daejun “Aaron” Park, assistant professor of social work at Ohio University, and Sarah Al-Hashemi, a recent Ohio State College of Public Health graduate. 

The research was published recently in the American Journal of Industrial Medicine. 

Previous research has suggested that substance use is common among people who work long hours or evening shifts and earn low wages, or who experience life stressors such as low annual household income and limited education. But few studies have been able to report on substance use during work hours, and the occupations at highest risk for on-the-job alcohol and drug use, because the data is hard to come by. 

“There are many studies looking at specific occupations and their risks, and the prevalence of substance use outside work,” Oh said. “There is very limited evidence on workplace substance use, which is more concerning in terms of occupational safety, not just for the workers but also colleagues or others exposed to the workplaces. This is the only data we know of to inform this issue.” 

The study sample included 5,465 young employees who participated in the National Longitudinal Survey of Youth 1997, a nationally representative sample of men and women who were aged 12-17 in 1997 and were interviewed regularly until 2022. The NLSY surveys were conducted by Ohio State’s Center for Human Resource Research. Data for this study came from the 2015-16 survey, the most recent wave to collect information on substance use behaviors. 

Results were based on participants’ reports of substance use immediately before or during a work shift in the past month. Among respondents, 8.9% of workers reported any substance use in the workplace, including 5.6% drinking alcohol, 3.1% using marijuana and 0.8% taking cocaine or other hard drugs, a category that also included opioids. 

Statistical modeling showed a higher risk for all types of on-the-job substance use among food-industry workers, higher alcohol use among white-collar workers (linked in prior research to drinking while cultivating business relationships or celebrating accomplishments), and elevated alcohol and marijuana use in safety-sensitive occupations.

“We’re really concerned to see the findings for safety-sensitive occupations – not just in construction, but also installation, maintenance, repair, transportation and material movement,” Oh said. “In many federal-level transportation occupations, there are policies prohibiting operating under the influence. So we’re surprised to see that still 6% of material moving workers are working under the influence, and 2% of them are using marijuana – this was striking, because other than drug testing policies, it’s hard to implement interventions for workers moving from place to place.” 

Both Oh and Park said these new findings shed light on the impact that comprehensive employer substance use policies and supportive programs for workers could have.  

Variations in workplace substance-use policies may be one explanation for industry differences in risk for employee alcohol and drug use on the job, Park said. In a 2023 study he led, 20% of survey participants reported their workplaces had no substance use policy. The research showed that comprehensive workplace substance use policies – which included recovery-friendly initiatives – were linked to a significant decrease in employee drug and alcohol use across many employment sectors. 

“The work categories least likely to have substance use policies tend to be those managed individually by owners or workers,” he said. “Also the arts, food service, entertainment, recreation – those kinds of workplaces don’t tend to have polices in place.” 

And Oh found in a 2023 study that only half of workers in a national sample had access to support services for substance use problems, such as counseling, at their places of employment. Availability of workplace support services led to lower rates of marijuana and other illicit drug use among workers. 

“What I found was policy alone can’t be effective in reducing substance use problems – policies need to be accompanied by support services,” he said. “That’s one thing we propose in this paper – that combining alcohol and other drug policies with supportive services produces the greatest benefits, rather than relying on either alone.” 

The analysis also showed substance use in the workplace had strong associations with off-work substance misuse: Users of marijuana on the job were more likely to report daily cannabis use and were more than twice as likely to be heavy drinkers compared to those not using marijuana at work, and employees on cocaine or other hard drugs while working were more likely to drink heavily, use marijuana more frequently, and report frequent illicit drug use. 

“Our research shows that those under adverse working conditions with many barriers to economic and well-being resources tend to use substances as a coping mechanism, whether that relates to an emotional toll or physical demands of not just working conditions, but their life circumstances,” Oh said. “There is a need for more structural support to address these huge implications for the health of workers and others, and to reduce the stigma associated with substance use.” 

Researcher Adam Levin combined his experience in therapeutic psychedelics research and psychiatric training with a review of imaging, numerous studies and previous models to support his proposal, published in the Journal of Psychopharmacology. 

In this context, Levin emphasizes not what the two brain hemispheres do, but how they approach a topic or task – working in parallel, with left-brain dominance, during typical modes of consciousness. 

When we’re solving a problem, or, evolutionarily speaking, hunting for food, for example, the scope of attention differs: The left hemisphere focuses on manipulation of individual parts while the right hemisphere maintains a big-picture frame of reference. 

“In the psychedelic state, there’s a unique combination of the hemispheres coming together in a way that doesn’t usually happen in normal states of consciousness,” said Levin, a postdoctoral scholar and psychiatrist in the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work. “It’s almost a new encounter between the left and the right hemispheres’ way of thinking and perceiving the world.” 

He calls this model of psychedelic action HEALS: Hemispheric Annealing and Lateralization Under Psychedelics. In effect, he suggests, psychedelics reverse the hierarchical relationship between the two hemispheres of the brain, releasing the right hemisphere from inhibition by the left. 

Levin was initially inspired in part by the writings of Iain McGilchrist, author of “The Master and His Emissary: The Divided Brain and the Making of the Western World.” But his own clinical experience as a medical student and psychiatry resident gave Levin an up-close look at how disorders affecting one side of the brain or the other affected patients’ world view. 

“In people who lose the right hemisphere to stroke, the attentional window gets so narrow and they don’t even recognize a whole half of the world. Whereas people with an intact right hemisphere, who lose their left hemisphere, still have a broader general picture of things,” he said. “A lot of these people’s experiences seem, to me, to be similar to what I’m seeing in my psychedelic research.” 

Previous hypotheses about psychedelics’ effects on the brain have suggested “unrestrained cognition” occurs through the weakening of control exerted by frontal lobes and the top of the brain. 

While that is likely true, Levin said, patterns observed in people’s reports of their psychedelic experiences suggest there’s more going on: There are increases in psychological flexibility, creativity, and social and emotional intelligence; greater empathy, harmony and connection; a broader attentional window toward novelty and “aliveness”; and clarity and insight about one’s basic existence and, in some cases, need for healing. 

“Those general patterns are awfully similar to the pattern of the right hemisphere,” he said. “And I think psychedelics provide access to this whole picture, this whole view, that could have been operating in the background – and that’s this right hemisphere view. Restoration of this natural balance is an interesting way of explaining some of what’s happening.” 

Neuroimaging studies of lateral changes to brain blood flow and metabolism – brain regions’ use of glucose – that Levin analyzed showed signs of heavy activity in the frontal lobes in the right hemisphere as well as an overall rightward shift in metabolic activity under psychedelics, he said. 

The growing evidence that mindfulness meditation practice is linked to building new networks in the brain and increasing brain thickness in the right hemisphere is relevant to the HEALS theory, as well. 

“Psychedelics have been linked to improvements in mindfulness with just one or two uses. And sometimes these capacities are almost at levels consistent with practiced meditators,” Levin said. “That makes it likely, to me, that many core right-sided networks that are enhanced with practicing meditation might be enhanced briefly, or maybe longer, through psychedelics. 

“I think there’s an opportunity after the use of psychedelics to increase and sustain mindfulness capacities in these areas of the right hemisphere.” 

The field of psychedelic research is focused on therapeutic applications at Ohio State and elsewhere, but Levin expects that expansion of the field will stimulate pursuit of other research questions – including testing theories about how these substances act on the brain. 

He considers HEALS a complement to earlier theories about psychedelic action, and expects the growth in research to produce more hypotheses. 

“I think to explain something as complex as the brain, especially in the human being, you need a variety of theories to more closely approximate what’s actually happening,” he said. “If we get too fixated on one explanation or the other, we’re going to lose track of reality.”

Results showed that nearly two-thirds of schools in the Englewood neighborhood of Chicago had at least one gun incident within 400 meters (about one-quarter mile) of where children were walking home during the 2021-22 school year.

These findings suggest a need to redefine federal definitions of school gun violence to include indirect forms of violence that take place near schools, not only on school grounds, in order to more appropriately capture the burden on communities of color, said Gia Barboza-Salerno, lead author of the study and assistant professor of public health and social work at The Ohio State University.

“Not all the violence children are exposed to is direct violence or happens on school grounds,” Barboza-Salerno said.

“But that doesn’t mean it doesn’t have an impact. Hearing gunshots on the way to and from school is terrifying and will affect how kids perform in school.”

The study was published recently in the journal SSM-Population Health.

The findings are important because research shows that exposure to gun violence in schools is linked to poor outcomes for students, including diminished performance on standardized assessments in mathematics and English, elevated rates of absenteeism, decreased student enrollment, and lower graduation rates.

In this new study, the researchers found that 4.5 times more gunshots were detected using the acoustic sensors compared to what police recorded in investigative reports.

This sensor data shows how staggering the amount of indirect violence is for children in Englewood, and potentially other areas, said study co-author Sharefa Duhaney, a graduate student in public health at Ohio State.

“You can’t just put metal detectors in schools to deal with violence,” Duhaney said. “Children are exposed to violence on the way to and from school, and we need to recognize that.”

Englewood, a community on the south side of Chicago, is one of the most violent in the United States. In 2022, the Englewood area accounted for about 10% of all gun violence that occurred in Chicago. The community is 94% Black and one of the most socioeconomically vulnerable neighborhoods in the city.

The researchers used computational spatial network methods to analyze data on gunshots detected by acoustic sensors operated along Safe Passage Routes for each school in the Englewood School District. These routes are designated routes created to ensure safer travel for students walking to and from school.

The study analyzed gunshots detected during the morning (6-9 a.m.) and afternoon (3-6 p.m.) commutes of children during the 2021-22 school year.

Acoustic detectors showed 610 gunshots fired in Englewood on days when schools were in session during the school year.  Of, those 52% occurred during afternoon commutes and 12% during the morning commutes.

Results showed that 40% of Englewood schools had at least one gunshot fired within 400 meters of the routes to school during the morning commute, and 62% had at least one during the afternoon commute.

“Hearing gunshots during school has not typically been considered ‘school gun violence,’ but it should be,” Barboza-Salerno said. “Imagine what that is like for children to hear gunshots while walking to school and how scared they must be.”

Analysis of the data showed that shooting incidents cluster along city streets, including safe passage routes, near schools. The configurations of streets that support walking for students also attract other types of foot traffic, and increase the likelihood of violent incidents, Duhaney said.

“Youth in violence-prone areas are not safe along Safe Passage Program Routes,” she said.

One issue in Englewood is that almost half of residents live in households without access to vehicles, meaning that residents are heavily dependent on public transit and walking.  Other studies have shown that students feel safer going to school via car rather than walking, but that is not an option for many in the community.

The researchers noted that the U.S. Department of Education is directed to collect and report on data on school safety, including violence. But they said the definition of gun violence doesn’t currently include witnessing and hearing gun violence.

In addition, the focus on student safety should go beyond what happens on school grounds and beyond direct violence: Hardening schools and using metal detectors and police officers there won’t solve the problem, the researchers said. They emphasized the need for policymakers to focus on violence prevention in the communities at large.

“We are failing to address the underlying issues in the community that lead to violence,” Barboza-Salerno said. “We need to focus on the root causes.”

Hexin Yang, a graduate student in social work and public health at Ohio State, was also a co-author of the study.

The survey also indicated many of the veterans would be more likely to seek mental health care, or return to care, at the U.S. Department of Veterans Affairs (VA) if psychedelic-assisted therapy were offered. 

Findings from this comprehensive examination of veterans’ experiences with psychedelics can give clinicians a clearer understanding of the veteran community’s expectations and specific needs for mental health care, researchers say. 

“Because of all of the complexity that veterans are experiencing and the higher risk they’re at for experiencing not just one, but several mental health and physical health-related challenges, it makes sense that they would be searching for opportunities to address those challenges, especially when they feel like they’re not being met with the current system here in the U.S.,” said lead author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education at The Ohio State University College of Social Work.

The study was published recently in the Journal of Psychoactive Drugs. 

The VA estimates that more than 17 U.S. veterans die by suicide each day, according to 2021 data. And studies suggest between 44% and 72% of veterans are highly stressed during the transition from military to civilian life. 

The research team, which included veterans, consulted with other past military service members to design a survey examining patterns of psychedelic use, perspectives of those who did and did not report use, and what kinds of benefits and adverse outcomes were associated with veterans’ use of the drugs. Veterans were referred to the survey through online advertisements and communities, email invitations and word of mouth. 

“Understanding military veteran culture is crucial for civilian therapists working with this population,” said co-author Mark Bates, a retired U.S. Air Force pilot and clinical psychologist at Sunstone Therapies, a Maryland treatment center researching psychedelic-assisted therapies. 

“It’s about avoiding inadvertently undermining the therapeutic relationship and knowing how to use military culture as an effective frame of reference. This is also part of the reason of why we carefully consulted with a team of veteran advisers in the development and validation of the survey questions.” 

With veteran advocacy for access to psychedelic-assisted therapy increasing in recent years, Bates said, “There is a really pressing need to explore anything that’s promising for mental health treatment.” 

The survey sample consisted of 426 participants categorized into two groups – those who had (217) and had not (209) used psychedelics. Drugs used by veterans included psilocybin (magic mushrooms), LSD, ketamine, MDMA (ecstasy), ayahuasca, ibogaine, 5-MeO-DMT (toad) and peyote/mescaline. The most commonly reported reasons for use were healing or treatment (69%), spiritual exploration (47.5%) or recreation (38.7%). 

Compared to veterans who had not used psychedelics, the veterans who had taken the drugs were more likely to be older and had spent more time deployed during their service, and a larger proportion of them reported PTSD, depression and anxiety. 

While some participants were alone when they used psychedelics, many reported taking them in spiritual locations or outdoors, with friends, or in medical clinics or retreat centers – both in the United States and abroad. 

Overall, participants rated the psychedelic experiences as beneficial whether they considered the experience uniformly positive (88.6%) or endured one or more adverse outcomes (81.3%). The most common adverse outcomes were flashbacks and craving or trying to reduce use of psychedelics. Fewer participants reported being arrested or seeking medical treatment in relation to using the drugs. 

Statistical analysis identified a number of factors that lowered the likelihood of having negative outcomes: being older, using psilocybin, having depression or anxiety, obtaining psychedelics from a safe source, being prepared, comfortable and confident during the treatment, and being able to trust, let go and be open to the experience.

“This finding highlights the importance of people in the veteran community knowing that keeping these things in mind prior to use can help set them up for the best possible outcome,” Davis said. 

With most psychedelic substances classified as Schedule I drugs under the Controlled Substances Act, the only legal way for most people to access them in the United States currently is in a clinical trial setting. Davis is leading a current psilocybin-assisted therapy study at Ohio State for the treatment of PTSD among military veterans, and Bates and colleagues at Sunstone Therapies have treated many veterans to date. 

Finding that surveyed veterans would welcome a chance to access psychedelic-assisted therapy at the VA is an important highlight of the study, the researchers said. 

“What’s really exciting about this study and understanding veterans’ interest in psychedelic-assisted therapy is it’s potentially opening up an opportunity to address some of their core challenges head-on,” Davis said. “Veterans are dying by suicide and fleeing the country to find these opportunities in other places, so the message is clear. This needs to be available.” 

Additional co-authors were Nathan Sepeda, Adam Levin and Stacey Armstrong of Ohio State; independent researcher Erik Lund; Robert Koffman of Sunstone Therapies; Katinka Hooyer of the Medical College of Wisconsin; and Rachel Yehuda of the Icahn School of Medicine at Mount Sinai. 

This work was supported by private donors, the Cammack Family Gift Fund, the Center for Psychedelic Psychotherapy and Trauma Research at the Icahn Medical School, the Johns Hopkins Center for Psychedelic and Consciousness Research, and the CPDRE at Ohio State.

Pat Tillman, the NFL-star-turned-Army Ranger, walked away from a lucrative professional football career to join the elite unit following the 2001 terror attack. Sowers was a Columbus high school student at the time, felt the same call to service and enlisted at the earliest opportunity – he wanted to join the Army at 16.

“They told me to come back in another year. I came back when I was 17, signed up in the delayed entry program and once I completed high school in 2004, I left for the Army,” he said.

“When I went to the recruiter's office, he was like, ‘Well, what do you want to do?’ I just wanted to serve with Pat Tillman. That’s all I knew. I wanted to be an airborne ranger. Unfortunately, he was killed in action, so that never came to fruition.”

His delayed enlistment wouldn’t be the first time Sowers would be told no – but he pressed forward regardless. In the Army, Sowers was a member of the famed 82nd Airborne Division and spent four years in the service, including 15 months in Afghanistan.

When he left the Army and returned to Columbus, he admits he got into trouble right away.

“Everything that I do now for veterans really took off when I got out in 2008. … I spent the better part of the next decade getting a legal education on the wrong side of the law,” Sowers said.

Run-ins with the legal system included assault and drunk driving convictions. He said he became so familiar with the process that he committed to memory the steps it would take to bail himself out of jail.

The birth of his children inspired Sowers to take stock of his life.

“I was like, ‘Yeah, I need to fix this, to be the best version I could be for them.’”

He returned to school: Columbus State Community College and then Kent State’s online program. Sowers completed a paralegal degree to become a lawyer to help fellow veterans in the criminal justice system. He began working in Veteran Treatment Courts in Franklin and Delaware counties.

Through his work, Sowers met other veterans who had established careers in social work, and it shifted his focus. Ohio State was his dream school, and he applied for the Master of Social Work program – but he kept getting turned down.

After his application was turned down a third time, Sowers worked to get an in-person meeting with college admissions.

“I just wanted to know, what do I have to do to make Ohio State like me enough to let me be a student?” he said.

Once again in his life, Sowers’ persistence paid off. He explained how his experience as a veteran and his desire to understand and improve the systems supporting veterans would benefit the program and his career as a student. It worked and he was admitted into the program.

Now a PhD candidate in the College of Social Work, Sowers continues to live up to that commitment. He has helped develop and support federal legislation for veterans including the Veterans Justice Outreach Improvement Act and STRONG Veterans Act. He serves the university’s military-connected community as a Military Community Advocate and was president of the Student Veterans Association.

He is now one of the 60 U.S. service members, veterans and military spouses chosen as Tillman Scholars this year. The program, part of the Pat Tillman Foundation, supports active-duty service members, veterans and military spouses through education, lifelong leadership development, and a community of peers and mentors to help them impact their community and the world. 

John Provenzano, a lecturer in the College of Social Work, has known Sowers since 2018 when they met through the Save a Warrior program. They are currently working in the college on courses that would benefit both student veterans and non-veteran students to better understand the military and veteran issues they may face in the field. He believes Sowers honors Tillman’s legacy.

“Eric is one of the most dedicated individuals I have met when it comes to veterans’ issues. He has dedicated himself to serving veterans in the social work field and has put in the hours to raise awareness to issues that veterans, both student and non-student alike, face,” he said. “He has persevered through his time in the service and is using his experiences to help others. I think these are amazing qualities that a Tillman Scholar should embody.”

The Tillman Scholarship will help Sowers manage life as a student, father and community advocate. He hopes to finish his PhD program by 2026 and continue to improve veterans’ transition into civilian life, help them remain in good legal standing and advance their opportunities.

“I don’t hide behind anything that I’ve done because to me, it’s fuel,” he said. “It helps motivate me. It helps show others that your current situation doesn’t have to define you or your future.”

Launched in 2019, the HEALing (Helping to End Addiction Long-Term) Communities Study (HCS) is the largest addiction prevention and treatment implementation study ever conducted. Researchers from the four participating states report today (June 16, 2024) in the New England Journal of Medicine and at the College on Problems of Drug Dependence (CPDD) annual meeting that the intervention did not result in a statistically significant reduction in opioid-related overdose death rates during the evaluation period. 

The data-driven intervention deployed evidence-based practices in 67 communities across states hit hard by the opioid crisis: Kentucky, Massachusetts, New York and Ohio. Though the goal to significantly reduce opioid overdose deaths was not met, Ohio implemented 137 evidence-based practice strategies in nine counties in Ohio. These strategies, implemented in complicated settings – hospital emergency departments and jails, to name just two – was an accomplishment that will have enduring positive effects, researchers say. 

“Implementing all of those evidence-based practices is the success,” said Bridget Freisthler, professor of social work at The Ohio State University and Ohio’s principal investigator for the HEALing Communities Study. “The practices are really about changing clinical care. The fact that many of those services are in place and are still working gives us some confidence that, going forward, these communities are going to be better prepared to address overdoses and overdose deaths. And hopefully they’ll see reductions over time.” 

T. John Winhusen, the HCS co-principal investigator for Ohio and director of the University of Cincinnati Center for Addiction Research, led the national group of experts convened to develop the Opioid-Overdose Reduction Continuum of Care Approach (ORCCA), a compendium of evidence-based practice strategies that guided the selection of interventions to be implemented in HCS intervention communities. 

ORCCA includes three “menus” of evidence-based practices: one devoted to overdose education and naloxone distribution, one focused on increasing exposure to medication for opioid use disorder, and a third focused on safer opioid prescribing. 

“ORCCA was designed to be flexible enough to meet the needs of a given community while also ensuring that strategies known to reduce opioid-related overdose deaths would be selected for implementation,” said Winhusen, also the Donald C. Harrison Endowed Chair in Medicine and professor and vice chair for addiction sciences in the Department of Psychiatry and Behavioral Neurosciences at UC.   

The National Institutes of Health (NIH) launched the four-year, multisite HCS to test a set of interventions for reducing overdose deaths across health care, justice and behavioral health settings. Over 100,000 people die annually of a drug overdose – 75% of which involve an opioid, according to the Centers for Disease Control and Prevention. Numerous evidence-based practices have been proven to prevent or reverse opioid overdose, but are gravely underused due to numerous barriers, according to the National Institute on Drug Abuse (NIDA).  

Between January 2020 and June 2022, intervention communities successfully implemented 615 evidence-based practice strategies to address opioid-related overdose deaths – but only 235 were implemented before the study period comparing outcomes in intervention and control communities began. The authors of the NEJM article noted the COVID-19 pandemic, a short timeframe for implementing the interventions, and increased prevalence of fentanyl in the illicit drug market may have diminished the mortality impact of the intervention. 

The evidence-based practices compiled for the ORCCA covered a lot of ground and required a lot of coordination to launch. 

“Some of the strategies were major undertakings,” Winhusen said. “For example, working with a jail to start a buprenorphine treatment program is one strategy out of the 137 strategies implemented in Ohio. Another example was working with emergency departments to identify people with opioid use disorder, get them started on buprenorphine, and link them to ongoing buprenorphine treatment. 

“Due to both COVID-19 and time constraints, only 38% of the strategies were implemented before the start of the comparison period so you’re not going to see the full effects. It just wasn’t enough time.” 

Freisthler co-led the charge to engage community coalitions and help them consult data to select interventions best suited to the areas they served. The team also developed communications campaigns addressing a range of topics – the stigma linked to opioid misuse and to taking medications to combat opioid addiction, and the necessity of adopting evidence-based practices – that were among written materials that will help sustain Ohio’s participation in the initiative, all housed on an Ohio State HCS website. 

“Communities have been at the forefront of addressing opioid use and overdoses for years. A success of Ohio’s implementation is peer-to-peer learning and feedback about the evidence-based practice strategies. This effort moved the needle and what had been barriers to services in the past,” she said. “It takes a coordinated effort, and some might need help and expertise, but really, that piece showed that communities can be an agent of change in this process.” 

The Ohio consortium brought together experts from Ohio State, UC and four other universities – Case Western Reserve University, Ohio University, University of Toledo and Wright State University – as well as the community organizations and leaders from state agencies. 

Freisthler noted that ongoing engagement with the RecoveryOhio multi-agency initiative created by Gov. Mike DeWine was an enabling force behind many features of the HEALing Communities Study, including establishment of the State of Ohio Integrated Behavioral Health Dashboard of county statistics and trend data, as well as streamlined navigation of policy and communication challenges over the course of the study. 

Many U.S. states have access to national opioid settlement funds specifically designated to address the opioid epidemic. Winhusen said that several free products developed from the Opioid-Overdose Reduction Continuum of Care Approach, including a practice guide and a guide for policymakers, are “perfect for communities that are trying to decide how to wisely invest their opioid settlement dollars.” 

“Back in 2019, the four states convened top experts to discuss the scientific literature in order to develop this,” he said. “A great deal of time and effort went into reaching consensus on the strategies included in the ORCCA, and we would love to see communities use this resource to determine how best to invest their opioid settlement funds.” 

The HEALing Communities Study was supported and carried out in partnership between NIDA (see NIDA’s HCS press release on the NEJM article) and the Substance Abuse and Mental Health Services Administration through the NIH HEAL Initiative. 

A $65.9 million NIH award funding Ohio State’s leadership of the Ohio portion of the study was housed in the university’s College of Medicine. Additional sites funded to conduct implementation research within communities in their state were the University of Kentucky, Lexington; Boston Medical Center, Boston; and Columbia University, New York City. RTI International, based in North Carolina, received an award to serve as the study’s data coordinating center.

Researchers found that economic insecurity was linked to higher levels of depressive symptoms for parents, which was then associated with poorer relationship quality for the couples.  That was linked with more harsh parenting and then to increased internalizing behaviors for their children.

“Pandemic-induced economic hardship had this downstream spillover effect that was ultimately linked negatively with their children’s mental health,” said Joyce Lee, lead author of the study and assistant professor of social work at The Ohio State University.

“Our findings parallel with other descriptive research showing that children’s mental health plummeted during the pandemic.”

The study was published online last week in the journal Child & Family Social Work.

The study involved 259 parents raising one or more children ages 12 years or younger who said they experienced at least one pandemic-related economic hardship. The longitudinal survey, which included participants from across the country, focused on two different points during the early weeks of the pandemic.

One of the strengths of this research is that it didn’t just include middle-income families – in 31% of the families studied, the parents’ income was below $30,000.

Parents were asked about their depressive symptoms, relationship quality and harsh parenting practices. They were also asked about their children’s internalizing behaviors such as complaining of loneliness, crying a lot, and being fearful or anxious.

The researchers found a clear connection between these issues, Lee said.

It started with the pandemic-induced economic insecurity.  Those parents who reported higher levels of economic insecurity at the time of the first survey also had higher levels of depressive symptoms at the same time.  And that was linked to a more negative relationship with their partner at the time of the second survey.

“They were reporting more disagreements and arguments and fights among themselves during the pandemic,” Lee said.

That in turn was linked to reports of using more harsh parenting with their children.  This included yelling, screaming and shouting at their child; and physical punishment such as spanking.

And finally, harsh parenting was linked to children who had internalizing behaviors such as frequent crying and loneliness. (Data from the study did not include externalizing behaviors, such as physical aggression and tantrums.)

“There are these cascading effects that begin with pandemic-initiated economic difficulties that all trickle down to children’s mental health,” Lee said.

While other studies have found that depressive symptoms in parents can be related to harsh parenting, one strength of this study is that it also included partner relationship quality, she said.

“Relationship quality is an important part of this.  If you’re not doing well with your partner, that speaks to a wider family dynamic that can spill over to how you deal with your children,” Lee explained.

Findings also showed that there was not a significant gender difference in how mothers and fathers reacted when faced with economic problems during the pandemic. That was somewhat of a surprise since some reports said mothers took a larger hit to their careers because of COVID-19 and were more likely to take care of children at home when schools closed. That suggested mothers might do worse than fathers, but it wasn’t found in this study.

Lee noted that this was a relatively small sample, so more research is needed to confirm gender differences in reactions to the pandemic.

While this study was done during the early weeks of the COVID-19 pandemic, Lee said that the findings could be relevant to other disasters or issues that lead to economic downturns.

One implication is the need for interventions that could help mothers and fathers who are struggling economically to stop the cascade of problems leading to child mental health issues, she said.

But it goes beyond that.

“We need a better social safety net to catch these parents early on before the economic pressures lead to these negative consequences,” she said.

Co-authors on the study were Sehun Oh, Amy Xu and Angelise Radney of Ohio State; Shawna J. Lee of the University of Michigan; and Christina M. Rodriguez of Old Dominion University.

Researchers analyzed data on employment, demographics, drug seizures and causes of death for over 200 counties in the United States between 2010 and 2021. 

They found that overall, one more job per 100 Black workers in a county was associated with .29 fewer overdose deaths per 100,000 Black Americans – a substantial difference when considering that the latest drug mortality rate stands at 44.2 deaths per 100,000 Black Americans, researchers said. 

“We thought that to be very significant. Personally, I wasn’t surprised,” said Sehun Oh, lead author of the study and assistant professor of social work at The Ohio State University. “Others may be more focused on supply factors, but I believe economic context is critical to understanding the demand side of the story. 

“The basic underlying framework I’m using to approach this issue is seeing the drug epidemic as a disease of despair, and examining how local labor market situations might have affected this at-risk population. By doing so, we could better understand what’s driving the growth that resulted in now one of the highest drug overdose death rates.” 

Oh completed the work with Manuel Cano, assistant professor of social work at Arizona State University. The study is published today (April 25, 2024) in the American Journal of Public Health. 

After a decade of rapid growth in drug mortality among Black Americans, the death rate among Black Americans surpassed that of white Americans for the first time in 2020. The drug epidemic now is primarily driven by synthetic opioids – especially illicitly manufactured fentanyl. 

“There have been many descriptive studies that show this prevalence and the high risk among Black Americans, but there isn’t much research that explains why this might be the case,” Oh said. 

He and Cano focused the analysis on 214 U.S. counties in which at least 10 Black residents died as a result of drug use during two four-year periods, 2010-2013 and 2018-2021, by combining data from the National Center for Health Statistics and International Classification of Disease codes. Death data were then linked with statistics on county-level job counts and drug supply, including state-level fentanyl seizures, as well as U.S. Census sociodemographic data and opioid prescribing rate maps. 

Results showed drug deaths among Black Americans in the study time frame increased, on average, by 27.5 deaths per 100,000 population. Counties in the top third of mortality rates were primarily Midwest and Northeast communities with lower median household incomes, where the average increase was 48.7 deaths per 100,000 – a 327% increase over the course of the 2010s. 

In areas with higher fentanyl seizure rates – suggesting greater availability of the drug – growth in jobs available to Black workers had a stronger protective effect against increases in overdose deaths. In municipalities with more seized drugs, 50 fewer jobs per Black worker in 2018-2021 than in 2010-2013 was associated with an increase of 98.6 deaths per 100,000 – compared to an increase of only 4.9 deaths per 100,000 in municipalities with 50 additional jobs per Black worker. 

Oh said these findings speak to the lack of uniformity in economic recovery after the recession, and how the emotional distress that comes with job loss and poverty can lead people to seek refuge in illicit drugs – with far-reaching public health consequences. 

Improving employment opportunities for the Black workforce could be one way to address drug mortality, the authors said, especially in Midwest and Northwest counties with lower incomes and in regions with higher fentanyl seizure rates. 

“In addition to efforts involving harm reduction and other public health interventions, there is a pressing need for greater socioeconomic support and equitable development nationwide to confront the fundamental issues driving this public health crisis,” Oh said. “There are many micro-level interventions to tackle the drug epidemic, but we can’t ignore the economic side that drives demand.” 

This work was supported by the National Institute on Drug Abuse.

Researchers analyzed data from a 2021 clinical trial that found psilocybin (magic mushrooms) combined with psychotherapy in adults was effective at treating major depressive disorder. 

Data included depression outcomes and participant reports about their experiences with the drugs and their connection with therapists. Results showed that the stronger the relationship between a participant and clinician – called a therapeutic alliance – the lower the depression scores were one year later. 

“What persisted the most was the connection between the therapeutic alliance and long-term outcomes, which indicates the importance of a strong relationship,” said lead author Adam Levin, a psychiatry and behavioral health resident in The Ohio State University College of Medicine. 

Past research has consistently found that as mental health treatments changed, a trusting relationship between clients and clinicians has remained key to better outcomes, said senior author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work. 

“This concept is not novel. What is novel is that very few people have explored this concept as part of psychedelic-assisted therapy,” Davis said. “This data suggests that psychedelic-assisted therapy relies heavily on the therapeutic alliance, just like any other treatment.” 

The study was published recently in the journal PLOS ONE. 

Twenty-four adults who participated in the trial received two doses of psilocybin and 11 hours of psychotherapy. Participants completed the therapeutic alliance questionnaire, assessing the strength of the therapist-participant relationship, three times: after eight hours of preparation therapy and one week after each psilocybin treatment. 

Participants also completed questionnaires about any mystical and psychologically insightful experiences they had during the drug treatment sessions. Their depression symptoms were assessed one week, four weeks, and up to one year after the trial’s end. 

The analysis showed that the overall alliance score increased over time and revealed a correlation between a higher alliance score and more acute mystical and/or psychologically insightful experiences from the drug treatment. Acute effects were linked to lower depression at the four-week point after treatment, but were not associated with better depression outcomes a year after the trial. 

“The mystical experience, which is something that is most often reported as related to outcome, was not related to the depression scores at 12 months,” Davis said. “We’re not saying this means acute effects aren’t important – psychological insight was still predictive of improvement in the long term. But this does start to situate the importance and meaning of the therapeutic alliance alongside these more well-established effects that people talk about.” 

That said, the analysis showed that a stronger relationship during the final therapy preparation session predicted a more mystical and psychologically insightful experience – which in turn was linked to further strengthening the therapeutic alliance. 

“That’s why I think the relationship has been shown to be impactful in this analysis – because, really, the whole intervention is designed for us to establish the trust and rapport that’s needed for someone to go into an alternative consciousness safely,” Davis said. 

Considering that psychedelics carry a stigma as Schedule I drugs under the Controlled Substances Act, efforts to minimize negative experiences in future studies of their therapeutic potential should be paramount – and therapy is critical to creating a supportive environment for patients, the authors said. 

This study ideally will help clearly position psychedelics treatment as a psychotherapeutic intervention moving forward – rather than its primary purpose being administration of a drug, Levin said. 

“This isn’t a case where we should try to fit psychedelics into the existing psychiatric paradigm – I think the paradigm should expand to include what we’re learning from psychedelics,” Levin said. “Our concern is that any effort to minimize therapeutic support could lead to safety concerns or adverse events. And what we showed in this study is evidence for the importance of the alliance in not just preventing those types of events, but also in optimizing therapeutic outcomes.” 

This work was supported by the Center for Psychedelic and Consciousness Research, funded by the Steven & Alexandra Cohen Foundation, the RiverStyx Foundation and private donors. It was also supported by the Center for Psychedelic Drug Research and Education (CPDRE), funded by anonymous donors. 

Additional co-authors are Rafaelle Lancelotta, Nathan Sepeda and Theodore Wagener of Ohio State, and Natalie Gukasyan, Sandeep Nayak, Frederick Barrett and Roland Griffiths of the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where Davis is an affiliate.

That is concerning because research shows older adults are at greater risk of harm during disasters such as extreme weather events, said Smitha Rao, lead author of the study and assistant professor of social work at The Ohio State University.

And Ohio is not immune from weather catastrophes.

“Ohio and the Midwest are often considered a safe haven from extreme weather, but that is not true anymore with climate change,” Rao said.

“Climate projections suggest that Ohio will experience intensifying weather patterns with a higher risk of heavy rainfalls, extreme heat and air pollution days. We need to protect our most vulnerable citizens, which include older adults.”

The study was published recently in the International Journal of Disaster Risk Science.

Researchers used data from the 2021 Central Ohio Regional Assessment on Aging (CORAA) Survey.  It involved 1,417 adults over age 65 in eight central Ohio counties, including Franklin County, which contains Columbus, the state capital. They also included information on county-level data from administrative sources.

Overall, 78% of respondents were prepared for emergencies, 13% were not and 9% didn’t know. Those who were prepared indicated they had at least a three-day supply of necessities to sustain life during emergencies, including food, water, clothing, flashlights and medicine.

In counties where greater proportions of older adults faced cumulative disadvantages such as lower income, living in subsidized housing, and having a disability, higher percentages of respondents also reported not being prepared.

There was a wide range of preparedness by county, from only 68% being ready for emergencies in Fayette County to 94% being prepared in Union County, Rao said.

“Fayette County scored high on vulnerability in terms of socioeconomic status and household characteristics,” Rao said.

For example, the median income in Fayette County was under $40,000 – the lowest of the eight counties in the study.  In addition, 37% of county residents in subsidized housing were over 62 years old and 41% of older adults in the county lived with some form of disability.

Especially for the most vulnerable older adults, the effects of extreme weather aren’t just something to worry about in the future – they have already arrived.

That was evident in Fayette County, where, compared to other counties, older residents were more likely to report weather-related disruptions to their lives.

Nearly one-fifth of its older residents reported missing health appointments or not being able to get medicine, reach their work or place of volunteering, or get to family and friends because of severe weather conditions.

The survey didn’t ask about the specific extreme weather events that caused these issues, but it could have been events like flooding that blocked off local roads, or power outages, Rao said.

“We tend to think of the worst outcomes that can occur from extreme weather, but there are much more common disruptions that are affecting older residents on a more regular basis,” she said.

“Many of the most vulnerable residents in places like Fayette County don’t have the social and economic resources or service landscapes to fall back on when those disruptions occur,” said study co-investigator Holly Dabelko-Schoeny, professor of social work and the director of the Age-Friendly Innovation Center at Ohio State.

The results provide key information for policymakers, service professionals and other officials who need to know which older adults will need help in case of extreme weather events,” Rao said.

“We do this work to identify communities who are not prepared so that important resources can be directed towards them,” she said.

Some of the interventions are easy to identify. Rao noted that Fayette, unlike other counties, did not have an existing tax levy for senior services.

“Levies help get resources to older adults that need them, so that could help more older adults be prepared for emergencies,” she said.

Another issue is that many older adults, especially in places like Ohio that are far from rising oceans and tropical heat waves, don’t understand the risks they face from a changing climate.

“We’ve found in other studies that emergency preparedness is not a top priority, especially for vulnerable adults who already have plenty to worry about in their everyday lives,” Rao said.

That’s one reason why the researchers plan to share their results with community partners and county leaders so they can take the appropriate actions to identify and help older adults who most need it, she said.

In addition, the researchers have started a project to talk directly to older adults with the goal of learning from their experiences to develop tools that can help them become better prepared for emergencies.

This project reflects commitment by the Central Ohio Area Agency on Aging and the Franklin County Office on Aging, collaborative partners on the CORAA survey to understand how best to support their clients with the changing weather patterns in Ohio, an area of commitment of the Age-Friendly Innovation Center with the college.

Other co-authors on the study, all from Ohio State, are Fiona Doherty, Anthony Traver, Marisa Sheldon and Emma Sakulich.

By Bridget Freisthler, Professor of Social Work, The Ohio State University 

How much alcohol do you typically drink in a week? A month? A year? Did your answer take into account how much you drink on New Year’s Eve? On Christmas? During the Super Bowl or World Cup?

When researchers compare how much alcohol is sold to how much people say they drink, alcohol consumption is underestimated by anywhere from 30% in the U.S. to 80% in Australia.

Special occasions such as holidays, weddings or major sporting events make up much of that difference. How much a person drinks at a special event can vary quite a bit, adding an extra four drinks per week for men and three drinks per week for women, and people usually don’t include these splurges in their tallies.

My research team studies alcohol use and its effects on parenting, with an ultimate goal to identify strategies that support positive parenting. Particularly in the festive holiday season – filled with gatherings where drinking is commonplace – understanding how special-occasion drinking affects how parents treat their children could help people change their routines in ways that make these occasions more enjoyable for everyone.

Alcohol’s effects on social problems

It’s not news that alcohol is related to many social problems: violence, traffic crashes, child abuse and neglect. Alcohol can enable bad behavior during special occasions. Incidents of drunken driving are highest after New Year’s Eve, for instance.

Alcohol use by men on days of major sporting events is related to more violence toward their families. However, because this relationship has been primarily studied among men, we don’t know if it is the same for women. Women’s drinking has increased over the past several decades, making this an important topic to understand.

Drinking while parenting can cause lax supervision of children or more harsh parenting practices. In our recent study, my colleagues and I wanted to see if a parent’s alcohol use on two special occasions was related to the use of aggressive discipline – whether physical punishment like spanking, or psychological aggression like yelling and name-calling.

As part of a larger study, we focused on two special occasions where drinking might differ from a typical day: Super Bowl Sunday and Valentine’s Day. What we found surprised us.

Drinking more on special days

In February 2021, we asked 307 parents to take three brief daily surveys for 14 days. We pushed a text message to parents’ phones at 10 a.m., 3 p.m. and 9 p.m. that asked questions about whether they had used specific discipline strategies since the last survey.

On the seventh and 14th day, the survey included questions about whether parents drank alcohol during the past week. If they did, we asked them to tell us on which days, and during what time frames. We matched the days and times they drank with parenting behaviors they’d previously reported. Importantly, 93% of parents in our study were mothers.

A higher percentage of parents drank at some point on Valentine’s Day (23.7%) and Super Bowl Sunday (16.9%) than on non-special occasion days during the study (14.7%).

Drinking alcohol during the Super Bowl was related to a 2.5 times higher odds of using aggressive discipline. However, drinking on Valentine’s Day was related to lower odds of using aggressive discipline.

So special-event drinking did affect parenting behavior – but in different ways depending on the event.

When drinking while watching a fairly violent sport, such as football, parents could be “copycatting” aggressive behavior they see on the screen. Researchers have suggested this link for men’s behavior toward their families. With women now making up 46% of the Super Bowl audience, my colleagues and I suggest there might be a similar relationship for them. When children appear disruptive or are playing in the same room, dads and moms may be quicker to yell instead of redirecting the behavior without resorting to aggression.

Valentine’s Day is different. Although more parents reported drinking on Valentine’s Day than on Super Bowl Sunday, we didn’t see the same increase in aggressive parenting. Valentine’s Day celebrates romance and love. Its norms are markedly different from the Super Bowl, leading to a more relaxed parenting style. Drinking may be more likely to occur at a restaurant with a nice dinner that may or may not include children. For couples who leave their children at home, the holiday provides respite from parenting and focuses attention on other activities.

Celebrating while still parenting with care

Our results suggest parents may want to remember that drinking at special events like holiday parties or family gatherings may not only be different than their regular pattern of alcohol consumption, but also may influence how they interact with their children both during the event and even the next day.

What can moms and dads do to reduce harsh parenting during special occasions when they choose to drink?

• Parents can plan ahead and choose a “designated parent” who does not drink and takes the lead on supervising the children. This could be one or multiple people.
• Drinking nonalcoholic mocktails or light beers to reduce the alcohol content can bring drinking more in line with a regular day.
• Hiring a babysitter during the event, planning a playdate or bringing alternative activities to keep children engaged might lessen everyone’s stress.
• For an event like the Super Bowl, having activities supervised in another room, such as watching a child-friendly movie, might reduce problems.

Even special occasions as simple as a summer barbecue with friends or family could change how you parent, especially for those who drink infrequently. With so many adults around, it’s easy to assume another adult is watching the kids when no one actually is. Putting a plan in place around special events where parents will be drinking may reduce possible harm to your children.

Bridget Freisthler, Professor of Social Work, The Ohio State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Results showed that, in one of the neighborhoods where the program was put into place, total entries into foster care were reduced by 11.8% and alcohol-related foster care entries were reduced by 11.2% a full seven years after implementation.

These new results were not as strong as those found right after the project was implemented, and there are other caveats to the success of the program. But the results are still very encouraging, said Bridget Freisthler, lead author of the study and professor of social work at The Ohio State University.

“We knew that this project had short-term success, but it is rare to have the opportunity to see if an intervention like this continues to be effective years afterwards,” Freisthler said.

“Now we have evidence that it actually does have a positive long-term effect.”

The study was published today (Jan. 30, 2024) in the journal Drug and Alcohol Review.

In this study, the researchers examined the effect of the Sacramento Neighborhood Alcohol Prevention Project (SNAPP), an intervention implemented from 1999-2003 aimed at reducing alcohol-related problems in two neighborhoods in the city. The project wasn’t designed specifically to reduce child abuse and neglect, but the researchers believed it would have that positive effect, based on previous studies.

For example, one study led by Freisthler showed that the number of stores selling alcohol in a neighborhood is linked to cases of child abuse and neglect in the same area. Another study found that a 1% increase in the volume of alcohol consumption per capita in Sacramento was related to 3.2% more alcohol-related foster care entries.

The two low-income, racially diverse neighborhoods in the study – dubbed the North area and South area – were selected because they had high rates of crime and alcohol-related problems.

SNAPP was a community-based intervention focused on reducing alcohol supply, namely to underage youth and already intoxicated people. The project included mobilization of local leaders, community awareness activities for neighborhood residents, responsible beverage service training for managers and staff at alcohol outlets, and increased enforcement of alcohol-related laws.

An earlier study showed that, shortly after SNAPP was implemented, alcohol-related foster care entries were reduced by 24% in the North area, but actually increased in the South area.

There may be several reasons for that finding in the South area, Freisthler said.  One is that there was a cluster of serious child abuse and neglect cases in the South area during the intervention period, so case workers may have been more likely to place children into foster care when a parent was misusing alcohol during this time period.

In addition, the study implementation for the South area (but not the North) began right before the Sept. 11, 2001, terrorist attacks. Research has shown that alcohol use across the country rose right after the attacks, which may have led to more child abuse cases.

But in this new study, there was no longer any increase in foster care entries in the South area after seven years.

“The increases in child abuse and neglect that we saw in the South area are gone seven years later, but the decreases in the North area are continuing. That’s great news,” Freisthler said.

The researchers don’t know how many parts of SNAPP were still being implemented seven years later. It is possible that some parts were dropped, and others were no longer a priority, Freisthler said.  

So the fact that this intervention program was still having a significant positive impact should encourage similar efforts, according to the researchers.

Freisthler noted that most interventions to stop alcohol misuse and its effects on child abuse happen at the individual and family level.

The power of SNAPP is that it is a community-level intervention that is designed to change the neighborhood environment, reducing the easy access to alcohol throughout the entire community.

“Changing the environment surrounding alcohol is more effective and less costly than working just with individuals and families,” Freisthler said.

“This study provides evidence that effects of environmental prevention efforts can be maintained for a significant period of time after they are implemented.”

And an environmental intervention like SNAPP has a lot of positive effects on the neighborhood.

“It reduces traffic crashes, it reduces assaults, it reduces child abuse and neglect,” Freisthler said. “One project like this does a lot to improve public health.”

Freisthler conducted the study with Jennifer Price Wolf, associate professor of social work at San Jose State University.

The research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism.

Most of the parents in the study – more than 90% - were mothers, which is significant, said Bridget Freisthler, lead author of the study and professor of social work at The Ohio State University.

“The links between alcohol use, aggression and watching violent sports have been studied almost exclusively among men,” Freisthler said.

“This is the first study we’re aware of that shows women may also be affected to act more aggressively by the combination of alcohol and watching violent sports like pro football.”

The study also looked at use of alcohol among parents during another special occasion – Valentine’s Day. Results showed that parents who drank on Valentine’s Day were actually less likely to use aggressive discipline on their children that day than were parents who didn’t drink.

The study was published today in the journal Alcohol: Clinical and Experimental Research.

Most studies that examine alcohol use tend to focus on people’s typical drinking habits. But special occasions like holidays, weddings and big sporting events may be anything but typical, Freisthler said.

“When you ask about typical drinking behavior, people may say they usually only have one beer a day,” she said.  “But on the Fourth of July they may say they have four beers.  That could be a big difference.”

This study was part of a larger project that asked parents in central Ohio to report on their alcohol use and parenting techniques three times a day for 14 days. For this study, the researchers included parents who participated during the Super Bowl in February 2021 (255 participants) and one week later on Valentine’s Day (184 participants).

All the parents in the study had a child who was 2 to 12 years old at the time.

During the three times on Super Bowl Sunday and Valentine’s Day (and on the rest of the 14 days in the study) parents were asked whether they were drinking alcohol and whether they were using punitive or aggressive discipline with their child.

That could include discipline such as spanking or shaking the child, or shouting or yelling at them – not just to stop a behavior but to call them a name or shame them. This includes behaviors that are less severe than official child abuse or neglect, yet more frequent.

The study didn’t find any relationship between alcohol use and aggressive discipline on most days studied – but the results of the Super Bowl and Valentine’s Day stood out, according to Freisthler.

“That’s why we think drinking on special occasions deserves more attention,” she said.

There are many reasons why the use of alcohol during the Super Bowl may make parents – particularly mothers – more likely to use aggressive discipline, Freisthler said.

“When you add stress and alcohol, that is not a good combination. There’s the stress of the game, particularly if you’re invested in one of the teams. If mothers are hosting a Super Bowl party, that’s another level of stress,” she said.

“And for mothers, if their husbands are invested in the game, they may feel it is their job to keep the kids quiet and out of the way of the TV.”

The reason that Valentine’s Day resulted in less use of aggressive discipline, despite the alcohol use, may be because of the different nature of that holiday compared to the Super Bowl, according to Freisthler.

On Valentine’s Day, the parents may be more likely to be drinking at a restaurant, away from their children. They may feel less stress than normal because of the nature of the romantic holiday, and alcohol use could enhance the good feelings – all of which could lead to less harsh discipline.

But Freisthler noted that there are probably more special occasions throughout the year that resemble the Super Bowl than Valentine’s Day.  Holidays like Christmas and the Fourth of July often involve events at home with large groups of people and children around, and also involve more alcohol use than usual.

“We need to understand how much parents are drinking on special occasions, how that differs from their normal drinking behaviors, and how is that related to their parenting,” she said. “That’s what we are trying to get at in this study.”

Knowing that drinking on special occasions affects levels of drinking – and parenting – means that parents can take steps beforehand to minimize negative impacts, she said.

For example, during events like the Super Bowl, parents could hire babysitters if they are able. They could have a special room set up for the kids with fun activities. Or maybe some people who are not interested in the game, like possibly grandparents, could entertain the children during the game.

“Parents need to create environments that are most conducive to positive parenting and reduce the risk of harsh parenting,” she said.

Freisthler conducted the study with Joselyn Sarabia, a doctoral student in social work at Ohio State, and Jennifer Price Wolf, associate professor of social work at San Jose State University.

And those supportive relationships were linked to their children showing more empathy, less emotional insecurity and fewer behavior problems.

Parents who are good co-parents work together as a team, provide support to each other and back up each other’s parenting decisions, said Susan Yoon, lead author of the study and associate professor of social work at The Ohio State University.

Those types of relationships may be particularly hard for the parents in this study, who may be more likely than others to be stressed by finances, racism, and lack of support.

“Our study specifically focused on racially and ethnically diverse unmarried couples with low incomes who are more likely to face a lot of parenting challenges,” Yoon said.

“But we found that 56% of these families had good co-parenting relationships which was linked to positive outcomes for their children.  Our findings really highlight the strengths these families exhibit.”

The study was published online recently in the Journal of Marriage and Family.

Participants in the study were 4,266 unmarried couples and their preschool-aged children from eight cities across the country who participated in the Building Strong Families study.

Parents in the study completed measures of how much they worked with their partner as a team to raise their child, and their perception of the other parent as a supportive co-parent.

Children’s socioemotional development was measured by asking mothers a variety of questions about their child’s empathy toward other children, their emotional insecurity and their internalizing problems (such as how fearful they were) and externalizing problems (such as being overly active).

The results of the study showed couples fell into four categories based on the quality of co-parenting and how each member of the couple thought the other did as a co-parent.

The largest category, Profile 4 – 56% of the sample - included couples with high-quality co-parenting in which both the mothers and fathers thought the other parent was supportive.

“This is the category where the children had the best outcomes, and it is encouraging that this was the largest group in our study,” Yoon said.

Parents in the other categories showed that it wasn’t just the quality of co-parenting that was related to how well the children fared – it also mattered quite a bit how much parents agreed that their partner was supportive, according to Yoon.

Children fared the worst in Profile 2 - (25% of the sample) – in which co-parenting was of moderate-high quality, but fathers had more negative views of how the mother co-parented.

“These findings suggest that fathers’ dissatisfaction might be an important warning sign for children’s poor functioning, even though co-parenting seemed relatively good,” Yoon said.

Children didn’t do much better in Profile 3 (12%), where co-parenting was rated moderate, but mothers were much less happy than fathers were with the co-parenting relationship.

Parents in Profile 1 (7%) had low-quality co-parenting and mothers had more negative perceptions of the co-parenting relationship.  Here children also did not fare well.

“Overall, we found that it isn’t just the quality of co-parenting that matters for children, it is also important to look at whether both the mother and father are satisfied with how things are going,” Yoon said.

“It is not good if there is a discrepancy between how mothers and fathers feel about the co-parenting relationship.”

These results show how important it is to include fathers in studies like this, given how their agreement or disagreement with mothers on co-parenting played a key role in child development.

Results also showed that when both parents had higher income and education, they were more likely to demonstrate high levels of supportive co-parenting.

“In order to strengthen families, we need to ensure that these low-income, unmarried parents have access to financial and material resources,” Yoon said.  “That can help support the development of mutually satisfying, high-quality co-parenting relationships.”

Other co-authors, all from Ohio State, were Joyce Y. Lee, Junyeong Yang, Jingyi Wang, Yiran Zhang, Minjung Kim and Sarah Schoppe-Sullivan.

The study was funded by the Department of Health and Human Services Administration for Children and Families and the National Institute on Drug Abuse.

Researchers surveyed and interviewed a group of mostly first-generation organic farmers, half of whom were women, and some of whom were racial and sexual minorities.

Results showed that 58% of survey respondents reported mild to severe symptoms of anxiety or depression, said Fiona Doherty, lead author of the study and a doctoral candidate in social work at The Ohio State University.

“They have all the stressors that other farmers have, but many face additional obstacles because they are women or racial and sexual minorities,” Doherty said.

The study was published in the Journal of Agriculture, Food Systems and Community Development.

Ohio State researchers worked with the Ohio Ecological Food and Farm Association (OEFFA) on the study, with OEFFA identifying farmers to participate in the study.

“This is not a representative sample of farmers. We worked with OEFFA to capture the experience of new organic farmers on small to medium-sized farms,” Doherty said.

Data for the study came from a survey of 62 farmers and in-depth interviews with an additional 20. All were from the Midwest and most were from Ohio and Michigan. Most were certified organic (16%) or were using organic practices but not certified (65%).

The researchers also sought out farmers who were not traditional white males from multigenerational family farms. About half of the farmers interviewed were female, and 20% were nonbinary or transgender. One-fourth of those interviewed were not white, and 90% were first-generation farmers.

Many of those surveyed got into farming because they wanted to sell what they produced directly to their communities, said Michelle Kaiser, co-author of the study and associate professor of social work at Ohio State.

“They tended to gravitate toward this work because they wanted to feed and interact with their communities in the most equitable, healthy way possible,” Kaiser said.

Many of the issues they faced were the same as all farmers. “Too much to do and too little time” was the top stressor of survey respondents, mentioned by 89%.  And 79% of survey respondents listed “not having enough person power” as a stressor, making it the third most prominent source of stress.

The survey was done in 2020 during the height of the COVID-19 pandemic, so, not surprisingly, COVID-19 was the second most prominent stressor.

Women, racial and ethnic minorities and LGBTQ farmers faced additional stressors that majority farmers don’t face.

“Some of the farmers we interviewed have identities that are likely different than most other farmers and others in their communities,” Doherty said.

“They face challenges of feeling invisible, not being trusted or taken seriously as a farmer due to their identity.”

Some talked about going to farmers markets and seeing customers pass them by to go to stands run by “what they think looks like a ‘real’ farmer, like a white male,” she said.

Some study participants also identified climate change as a source of stress.  Most of those interviewed identified unpredictable weather as a source of stress, but did not identify climate change specifically, the study found.

Some said they didn’t bother worrying about climate change because it was beyond their control.

For many of those interviewed, both the good and the bad were intertwined in their lives as farmers. One of the themes in many interviews was the farm as “both the cause and the cure,” Kaiser said.

“The farm was a cause of a great deal of stress in their lives. But they also talked about the therapeutic nature of working in the outdoors, being in the soil and spending time with animals,” she said.

“It provided a sense of purpose, and it was rewarding playing this important role in their community.”

Doherty said that many farmers interviewed in this study wanted to feel they were supported by their community.

“One of the things that could help them deal with the stress is just hearing from folks that they are valued, and their work providing food is valuable,” she said.

“Greater appreciation and respect and support for local farmers would go a long way.”

This includes structural support such as policies that improve equity, accessibility, and representation for beginning, women, racial and ethnic minorities and LGBTQ+ farmers, Doherty said.

Other co-authors of the study were Smitha Rao, assistant professor of social work at Ohio State, and Rachel Tayse of Harmonious Homestead LLC.

The research was supported by funding from the North Central Sustainable Agriculture and Education Graduate Student Grant and Ohio State’s Outreach and Engagement office.

And the good news is that this shared parental responsiveness was found in many families studied, said study co-author Joyce Y. Lee, assistant professor of social work at The Ohio State University.

“It is a very encouraging finding,” Lee said.

“You can imagine that living in poverty, facing material hardship and other disadvantages could put stress on a relationship that could be negative for children. But that’s not what we found.”

Results showed that both mothers and fathers showed moderate levels of responsiveness to their children and that this shared responsiveness was linked to higher levels of prosocial behaviors in children and increases in receptive language.

The study was published in the journal Family Relations.

Data from the study came from the Building Strong Families project and included a racially diverse sample of 1,173 families from low-income contexts. Data were collected in eight cities across the United States between 2005 and 2011.

Trained researchers observed mothers and fathers in each family separately as they interacted with one of their children, whose average age was between 3 and 4.  They measured parental responsiveness on several dimensions, including the ability to respond appropriately to the child’s behavior, demonstration of positive feelings toward the child, and quality of the parent-child relationship.

The researchers found that the more that both parents showed higher levels of responsiveness, the better that the children were rated by their mothers for pro-social behavior, such as showing affection to other children.

Children in the study were also given a test for receptive language – the ability to recognize words. This test has been shown to relate to early school readiness.

Findings showed that shared parental responsiveness was related to higher scores on this test, Lee said.

“It was very exciting for us to see that when low-income parents engage in this mutually agreed upon way of positively parenting, there are clear benefits to their children,” she said.

Another positive finding was that it didn’t matter if the father lived with the mother and child – as long as both parents showed responsiveness, the child reaped the benefits.

“There is often this belief that if the father is not in the home, he must be absent and that’s terrible for the child,” Lee said.

“That’s not what we found. Parents can still coordinate how they respond to their children and work together for the good of the child.”

The results suggest ways to support low-income families to help them raise their children – even if the father is not living with them.

“Parenting programs could prioritize specific strategies for promoting shared parental responsiveness among mothers and fathers who are no longer romantically involved,” Lee said.

“That can help foster the well-being of their children.”

Co-authors on the study were Shawna J. Lee and Olivia D. Chang of the School of Social Work at the University of Michigan; Kaitlin P. Ward, who did this work while at the School of Social Welfare at the University of California-Berkeley; and Garrett T. Pace of the School of Social Work at the University of Nevada-Las Vegas.

Support for the study came from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The treatment included a combination of ibogaine hydrochloride, derived from the West African shrub iboga, and 5-MeO-DMT, a psychedelic substance secreted by the Colorado River toad. Both are designated as Schedule I drugs under the U.S. Controlled Substances Act.

In addition to relieving symptoms of post-traumatic stress disorder (PTSD), the combined treatment also alleviated cognitive impairment linked to traumatic brain injury – which stood out to researchers from The Ohio State University who led the chart-review analysis. Many special operations forces veterans seeking treatment for complex psychiatric symptoms do not respond to more traditional therapies. 

“What sets this group apart from some other veterans and civilians is that often, they are exposed to repeated traumatic events as a routine part of their jobs. This build-up of exposure to these difficulties seems to produce a cluster of challenges that include traumatic brain injury, which we know in and of itself predisposes people to mental health problems,” said lead author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education (CPDRE) in Ohio State’s College of Social Work. 

“So the fact that we saw that there were improvements in cognitive functioning linked to brain injury were probably the most striking results, because that’s something we didn’t predict and it’s very new and novel in terms of how psychedelics might help in so many different domains.” 

The study is published in the American Journal of Drug and Alcohol Abuse. 

Most of the veterans attending the clinic retreat program had been on active duty after 9/11 and reported seeking care for memory problems, brain injury, depression, anxiety, PTSD, sleep problems, anger and fatigue. Head injuries were reported by 86% of attendees, most of whom attributed memory problems, irritability, disordered sleep and ringing in the ears to those long-ago head traumas. 

Eighty-six veterans completed pre-treatment questionnaires assessing a range of mental health symptoms as well as satisfaction with life, anger levels and suicidality. Each attendee received a single oral ibogaine hydrochloride dose and, on a separate day, at least three incremental inhalation doses adding up to 50 milligrams of 5-MeO-DMT, also commonly called Five or Bufo. Preparation and reflection sessions preceded and followed each treatment. 

Overall, participants reported large improvements in self-reported PTSD symptoms, depression, anxiety, insomnia severity and anger, as well as a significant increase in satisfaction with life, from pre-treatment to the one-month follow-up, and sustained benefits at the three- and six-month follow-ups. Additional reported improvements that continued for six months included reductions in disability and post-concussive symptoms, and very large increases in psychological flexibility and cognitive functioning. 

Davis said the improved cognitive functioning warrants more research into whether better thinking results from lowered mental health symptoms or biological changes to signaling in the brain, or a mixture of both types of effects. And they noted that changes to psychological flexibility – one’s capacity to act in ways that are consistent with their values regardless of whatever internal or external experience they might have – have been found in previous research to be connected to insightful and mystical psychedelic experiences. 

“I think we’re seeing a similar picture emerging here where the more one is psychologically flexible, the more likely it is that one’s mental health symptoms will be reduced or ameliorated,” Davis said. 

Most attendees also reported moderate to strong desirable changes across a range of attitudes, behaviors and relationships. One month after treatment, almost half reported the psychedelic experience was the most spiritually significant (48.6%) or psychologically insightful (42.9%) of their lives, and 17.1% called it the most difficult or challenging experience in their life. 

Davis and colleagues took a conservative approach to analyzing outcome data, building in an assumption that attendees who didn’t complete all of the follow-up surveys may not have gotten the relief they had hoped for from the treatment. But they said finding that a population of veterans with complicated trauma histories can benefit from psychedelic therapy supports the importance of continuing to test psychedelic-assisted therapies in U.S. clinical trials. 

Psilocybin-assisted therapy is currently being studied at Ohio State for the treatment of PTSD among military veterans. 

This work was funded by Veterans Exploring Treatment Solutions. The authors are also supported by the Center for Psychedelic and Consciousness Research at Johns Hopkins University, the CPDRE, the U.S. Department of Veterans Affairs and the American Foundation for Suicide Prevention. 

Co-authors of the study include Yitong Xin and Nathan Sepeda of Ohio State and Lynnette Averill of Baylor College of Medicine and the U.S. Department of Veterans Affairs.

Researchers at The Ohio State University conducted a systematic review of 20 studies connecting droughts, floods and other extreme weather events to increases in child, early and forced marriages in low- and middle-income countries.

Overall, the studies provide compelling evidence of the problem, said Fiona Doherty, lead author of the study and a doctoral candidate in social work at Ohio State.

It’s not that extreme weather has a direct effect on child marriages, Doherty said.

“What these disasters do is exacerbate existing problems of gender inequality and poverty that lead families to child marriage as a coping mechanism,” she said.

The study was published recently in the journal International Social Work.

Globally, one in five girls is married before the age of 18, and in lower- and middle-income countries that number rises to 40%.

Those numbers may grow as climate change increases the frequency of extreme weather events around the world, said study co-author Smitha Rao, assistant professor of social work at Ohio State.

“The complexities surrounding child marriage and extreme weather will worsen amid climate change,” Rao said.

The researchers examined 20 studies published between 1990 and 2022 that examined how extreme weather was related to marriages involving children, mostly girls, who were below the age of 18.  Most of the studies were done in low- and middle-income countries in Asia and Africa, including Bangladesh, India, Pakistan, Kenya, Nepal and Vietnam.

Droughts and floods were the most common disasters, but other studies looked at the impact of cyclones and high temperature shocks, among other weather events.

The studies revealed the impacts of disasters on child marriage in a variety of contexts, Doherty said.

One study in Bangladesh found that in years with heat waves lasting more than 30 days, 11- to 14-year-old girls were 50% more likely to marry and girls aged 15-17 were 30% more likely.

A major reason is simply economics.

“Child marriage is often seen as a coping strategy to reduce economic vulnerability and food insecurity that a family is facing because of a disaster,” Doherty said.

For example, one study found that daughters were married early in Bangladesh after Cyclone Aila to curtail the economic and food burden on households.

Early marriage was also sometimes encouraged to provide needed workers for families.

When a drought threatened water sources and livestock in Kenya, one study found that young brides were sought to help with increased labor demands, such as walking long distances to find food and water.

Regional customs such as bride price and dowry were found to be key factors in the link between child marriage and extreme weather.

In areas such as sub-Saharan Africa and Vietnam that practice bride price – the groom’s family pays the bride’s family – girls had an increased probability of being forced to marry during droughts and periods of heavy rainfall, studies showed.

In contrast, research found that in regions like India where dowry is common – the bride’s family pay the groom’s family – girls were less likely to get married during a drought year, likely because the bride’s family could not afford dowry payment.

Beyond economics, studies showed a variety of ripple effects from weather disasters that led to more child marriages, Rao said.

Communities that were displaced by floods, cyclones and other disasters often ended up in camps where young girls were targeted for sexual harassment and violence.

“Families sometimes made the choice to get their young daughters married off in these situations to protect them from harassment and sexual violence,” Rao said.

But there was one key factor that helped protect children from being forced to get married.

“We found that education played a significant role in protecting girls,” Doherty said.

Girls who were educated were less likely to be married off early, research found. In addition, studies showed that as parental education increased, they were less likely to marry off their daughters.

While education is one way to help protect against child marriage, Doherty and Rao said more needs to be done. One obvious choice would be laws against child marriage.  Another factor is helping families with the economic difficulties that often lead to them marrying off daughters.

“But we found the main driver of child marriage is gender inequality,” Doherty said.  “We need to find ways to empower women and girls with education and financial control that will allow them to make their own decisions.”

The researchers noted that all of the studies they analyzed were done in low- and middle-income countries – only because they could not find any studies done in high-income countries.

But weather disasters could also be increasing child marriage in high-income countries, including the United States, they said.

“We need more research to understand the differences and additional factors that may be affecting the link between extreme weather events and child marriage in other parts of the world, including high-income countries,” Rao said.

Angelise Radney, a doctoral student in social work at Ohio State, was also a co-author on the study.

By Smitha Rao
Assistant Professor of Social Work, The Ohio State University

Residents walk out of a flooded neighborhood in Fort Lauderdale on April 13, 2023. Joe Raedle/Getty Images

When a powerful storm flooded neighborhoods in Fort Lauderdale, Florida, in April with what preliminary reports show was 25 inches of rain in 24 hours, few people were prepared. Even hurricanes rarely drop that much rain in one area that fast. Residents could do little to stop the floodwater as it spread over their yards and into their homes.

Studies show that as global temperatures rise, more people will be at risk from such destructive flooding – including in areas far from the coasts that rarely faced extreme flooding in the past.

In many of these communities, the people at greatest risk of harm from flash flooding are low-wage workers, older adults and other vulnerable residents who live in low-lying areas and who have few resources to protect their properties and themselves.

I study the impact of extreme weather on vulnerable communities as an assistant professor of social work. To limit the damage, communities need to know who is at risk and how they can be better prepared.

More extreme downpours in a warming world

The Fort Lauderdale storm on April 12-13, 2023, offered a view into the risks ahead as temperatures rise.

A warmer atmosphere can hold more moisture, leading to stronger downpours. The resulting deluges can be devastating. These events are expected to increase in frequency and intensity in many regions as greenhouse gas emissions from human activities continue to heat up the planet.

Recent disasters, including several in 2022 and in 2023 already, show how the risk of flash flooding is expanding beyond areas traditionally considered at risk.

Knowing who is most at risk

To plan for extreme weather, it’s crucial for community leaders and residents to know where the risks are highest and who might not be prepared.

Low-lying areas with poorly planned development, lack of investment in protective infrastructure and the lingering effects of historic disinvestment and discrimination are often at higher risk. So are low-income communities with tight budgets that can’t afford protective measures like upgraded levees or stormwater systems and can’t recover from damage quickly.

When older adults live in these flood-prone areas, they are at even higher risk. Older adults have a higher likelihood of having health needs or some form of disability that could affect their ability to leave quickly during a disaster. They are also more likely to be socially isolated, which may mean they don’t hear timely information or have help to evacuate or quick access to resources for recovering.

Renters and the impact of housing insecurity

In a recent study, my colleagues and I looked at how prepared people were for disasters of any kind across the U.S. – flooding, tornadoes, hurricanes and others – and how housing security played a role. The numbers were sobering.

Overall, we found 57% of the population, among 29,070 housing units surveyed nationwide, reported they were not prepared with food, water, emergency funds and transportation in case disaster struck. We found that households facing housing insecurity – those behind on their payments for rent, mortgage or utilities – were less prepared for disasters than others, even when the occupants had similar incomes and educations.

People who are struggling to meet day-to-day needs often don’t have the ability and resources to plan for everyday events, let alone for disasters. Our research has shown that households with children, households led by women, and low-income households were less prepared than others for disasters.

Renting adds additional challenges. In the U.S., lower-income families often depend on the rental market. They tend to move more frequently, and since they don’t own the property, they often can’t make upgrades for safety. And landlords might not prioritize those risks that seem rare but carry costs.

How to help communities stay safe

The most effective way to address these challenges is through solutions that are tailored to the community.

That can involve investing in infrastructure, including state-funded priorities like drainage systems and large-scale flood prevention measures, as well as ensuring that people have access to safe and affordable housing. Some communities and federal agencies have bought out properties that frequently flood and changed zoning rules to prevent more people from moving into harm’s way.

Raising community awareness about climate change and extreme weather risks is also crucial, especially among those most at risk, such as older adults. If people understand the risks, know how to prepare their homes, know how to plan for emergencies and know where to find assistance, they’re more likely to be prepared when disasters strikes.

I believe the most successful efforts are those that bring at-risk communities into planning discussions.

For example, in Columbus, Ohio, the city is working with the Central Ohio Area Agency on Aging, Age Friendly Innovation Center and my team to improve disaster preparedness among older residents. We hope to learn from older adults in affordable housing communities who have experienced extreme weather in recent years to help design action plans for communities with special needs. The goal is to ensure residents are better prepared for climate- and weather-related emergencies in the future.

Smitha Rao, Assistant Professor of Social Work, The Ohio State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A new study that aimed to shine a light on risk factors for mistreatment coming from both parents found some surprising results.

For example, mothers and fathers who were substance users had lower odds of both being involved in physical or sexual abuse. Couples in which at least one of the parents was a prior abuse perpetrator also had lower odds of physical abuse.

These and other results suggest that the factors that predict when both parents will be involved in specific types of maltreatment are not always obvious, said Joyce Lee, lead author of the study and assistant professor of social work at The Ohio State University.

“We need more nuanced ways of understanding and addressing multiple risk factors within the family to prevent child maltreatment involving both mothers and fathers,” Lee said.

The issue is important because previous research suggests that child maltreatment perpetrated by mothers and fathers is more severe than maltreatment committed by one parent alone.

“That’s alarming, but also not surprising. Two parents can have more of a harmful impact on a child if they are both involved with maltreatment,” Lee said.

The research was published online recently in the journal Children.

The study involved data from the National Child Abuse and Neglect Data System, which is a federally sponsored project of the Children’s Bureau at the U.S. Department of Health and Human Services.

The final sample included 6,996 families from 11 states in which biological mother-father pairs were identified as co-perpetrating maltreatment against a child that led to involvement in the foster care system.

Results showed that about 93% of the maltreatment cases involved neglect, followed by 14% physical abuse, 2% sexual abuse and 1% emotional abuse.

The findings related to physical abuse contradict the results of previous research that suggested parental substance use and housing insecurity were risk factors for child physical abuse.

“Parents who are intoxicated from alcohol or drugs, as well as those struggling to find adequate housing, may not have the bandwidth for any type of parenting – even harsh parenting linked to physical abuse,” Lee said.

But those same risk factors were linked to higher odds of both parents participating in neglect, she said.

“There seems to be differences in how family characteristics are linked to acts of omission, such as neglect, versus acts of commission, such as physical abuse,” Lee said.

The fact that having a parent who was a prior perpetrator was linked to lower odds of both parents being involved in physical abuse suggests that additional services provided to parents and increased monitoring of these families may mitigate the risk of maltreatment recurrence, she said.

Results also showed that intimate partner violence in a couple relationship was linked to higher odds of both parents participating in child neglect.

In cases of sexual abuse, disability and medical conditions among parents were linked with higher odds of mothers and fathers being co-involved, while parental substance use was linked with lower odds of sexual abuse.

Intimate partner violence was the only factor in the study linked to the emotional abuse of children.

The study also found, somewhat surprisingly, that economic insecurity and parental mental health problems were not risk factors for any type of maltreatment. That is inconsistent with other research, and Lee said more research is needed to determine if those factors truly aren’t linked to both parents being involved in maltreatment.

Lee said the results suggest a critical need for programs and policies to address the presence of a prior perpetrator in the family, parental substance use, disability and medical conditions, inadequate housing, and intimate partner violence in families.

But the results suggest a nuanced approach, because efforts to reduce maltreatment may not have an equal impact on all the various types.

“For example, interventions that aim to prevent intimate partner violence may help prevent emotional abuse and neglect, but not help prevent physical or sexual abuse,” she said.

“We really need to have a comprehensive assessment and treatment of risk factors so that we can stop all types of child maltreatment by both parents.”

Co-authors of the study were Susan Yoon and Angelise Radney of Ohio State, Keunhye Park of Michigan State University, Stacey Shipe of Binghamton University, and Garrett Pace of the University of Nevada Las Vegas.

But a new national study found that housing is also important before disasters happen: People with homes not meeting federal quality classifications and those who are housing insecure tend to be less prepared to face natural calamities.

“Housing security and quality are vital for people to be better prepared for disasters,” said Smitha Rao, lead author of the study and assistant professor of social work at The Ohio State University.

Results showed that households facing housing insecurity – those behind on their payments for rent, mortgage or utilities – scored lower on a scale of disaster preparedness than those that were housing secure – even if the occupants had similar income and education.

“Clearly, a precarious housing situation can make it harder for families to be ready when disaster strikes,” Rao said.

The study was published recently in the journal Global Environmental Change.

The importance of preparedness has never been greater in the United States. Between 2011 and 2019, the United States experienced 119 weather and climate disasters with damages exceeding $1 billion.

While concerns around disasters and extreme weather events have risen, fewer than 40% of Americans have an emergency plan in place, research shows.

This study was designed to examine how a variety of social and structural vulnerabilities – from socioeconomic and minority status, and household composition to housing quality and housing insecurity – were related to disaster preparedness, Rao said.

Further, these vulnerabilities do not occur in isolation and some of these, when taken together, often have compounding consequences, she said.

Data for the study came from the 2017 American Housing Survey, conducted by the U.S. Census Bureau and the Department of Housing and Urban Development. The 29,070 representative households in this study were located across the country.

Disaster preparedness was measured by asking participants if they had nine essential safety elements available, including nonperishable food, an evacuation plan, emergency kit, reliable transportation and financial resources.

Overall, 57% of the population was not prepared with food, water, emergency funds and transportation. About 18% were classified as housing insecure because of an inability to pay rent, mortgage or utilities.

Results showed that those who were housing insecure were less likely to be prepared for disasters. And housing-insecure households relied more on household income for disaster preparedness than did housing-secure households.

That’s a big issue because housing-insecure families tend to have lower incomes, so this is an added burden, Rao noted. Defaulting on these payments is a crucial factor, and one job loss can quickly lead to a household becoming housing insecure. Supporting families at risk of defaulting is a key policy imperative.

Lower-income families in the United States depend on the rental market, and studies suggest that renters have fewer means of being prepared than homeowners, in part because of their more frequent moves.

“Housing stress compounds other stressors such as poverty,” she said. “Safe and affordable housing is a basic right and can help families be more resilient as we see more frequent and intense disasters with the global climate crisis.”

Housing security also interacted with other factors associated with preparedness, such as minority status.

For example, Black-headed households that were housing secure had a 40% predicted probability of being prepared for a disaster, compared to 30% of those who were housing insecure.  For white-headed households, being housing insecure dropped the predicted probability of being prepared from about 43% to 40%.

“Overall, being housing insecure exacerbated the effects of many other sources of vulnerability – such as minority status and income – on preparedness,” Rao said.

The research also found that households with older adults were able to maintain their preparedness even when they were housing insecure, as opposed to those who did not have older adults at home, pointing to the need to focus on this oft-forgotten demographic, Rao said.

“Maybe it points to their prior experience or embeddedness in the community,” she said. “In any case we need to focus on older adults as a vulnerable yet significant group that can be an important piece of the puzzle.”

The study also found that where people got their disaster-related information was a factor in whether they were at least minimally prepared.  Results showed lower readiness among those who received information from the internet rather than from social networks of friends and family.

People with secure housing may find it easier to build the social cohesion and networks associated with being better prepared, Rao said.

She said the results suggest that, in order to protect more Americans from disasters, housing clearly needs to be a priority.

“We found that safe and affordable housing is extremely important in terms of disaster preparedness,” she said. “That is concerning given the current affordable housing crisis in the U.S.”

Co-authors on the study were Fiona Doherty of Ohio State; Samantha Teixeira and Shanta Pandey of Boston College; and David Takeuchi of the University of Washington.

Researchers conducted a machine learning analysis of data from nearly 1,000 respondents to a survey about their previous non-clinical experiences with psychedelic drugs. The analysis suggests that individuals who scored the highest on questionnaires assessing the mystical and insightful nature of their experiences consistently reported improvements in their anxiety and depression symptoms.

The analysis also suggests that a challenging experience while on these substances, one that feels frightening or destabilizing, can have beneficial results, especially in the context of mystical and insightful experiences. This could be helpful for practitioners to know as they guide patients through clinical trials testing psychedelics’ therapeutic potential.

“Sometimes the challenge arises because it’s an intensely mystical and insightful experience that can, in and of itself, be challenging,” said senior author Alan Davis, assistant professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work. 

“In the clinical research setting, folks are doing everything they can to create a safe and supportive environment. But when challenges do come up, it’s important to better understand that challenging experiences can actually be related to positive outcomes.”

The research was published online recently in the Journal of Affective Disorders.

The study is the first to characterize subtypes of the subjective psychedelic experience and link them to mental health outcomes. The data came from previous work Davis led consisting of an anonymous internet-based survey of people who reported having a moderate to strong psychedelic experience in the past and resulting changes to their symptoms of anxiety and depression – regardless of the level of those symptoms before the psychedelic experience. 

The 985 participants whose responses were analyzed in this study described substances they had used and completed questionnaires evaluating the extent to which their psychedelic experience was mystical (evoking a sense of pure awareness, positive mood and/or transcendence of time and space that is difficult to describe in words), psychologically insightful (eliciting acute insight into memories, emotions, relationships, behaviors or beliefs), or challenging. Outcomes assessed in the survey included depression and anxiety symptom levels and ratings of satisfaction with life and psychological flexibility – one’s capacity to act in ways that are consistent with their values regardless of whatever internal or external experience they might have – before and after using the psychedelic. 

The sample included users of psilocybin (magic mushrooms), LSD, Ayahuasca, mescaline, peyote cactus and 5-MeO-DMT, the natural psychedelic substance in the venom of the Colorado River toad, with the estimated dose level of the single drug use they recalled. 

The data analysis yielded three distinct subtypes of psychedelic experiences:

• High scoring, combining high scores on the mystical and insightful assessments with moderate scores on the challenging assessment.
• Low scoring, with low to moderate scores on mystical and insightful experiences and low scores on the challenging scale.
• Positive scoring, with high scores for mystical and insightful experiences and low scores on the challenging assessment.

“The group that had the highest insightful and mystical experiences and low challenging experiences showed the most benefit in terms of remission of anxiety and depression symptoms and other longer lasting benefits to their life,” said first author Aki Nikolaidis, an affiliate of Ohio State’s Center for Psychedelic Drug Research and Education (CPDRE) and a research scientist in the Center for the Developing Brain at the Child Mind Institute. 

When the researchers analyzed only data from participants who had used psilocybin and LSD, the same patterns emerged: Three distinct subtypes that were associated with the same outcomes, including benefits to mental health even after a challenging experience. That replication speaks to the importance of the subjective experience for psychedelics users, Nikolaidis said.

“Identifying subtypes that exist regardless of which psychedelic you take answers an interesting question,” he said. “But the fact that we found that they’re associated with specific outcomes, and replicated that finding, really shows why it’s important to understand the powerful nature of what is happening subjectively and its potential to yield a beneficial outcome.”

A few trends also stood out: The positive scoring group whose experience could be considered optimal – high scores on mysticism and insight and low scores on challenges – tended to be younger than participants in the other groups. Among individuals who scored highest on challenging experiences, there was a higher proportion of people who had taken large doses of the psychedelic drugs. And the low scoring subtype had lower psychological flexibility, anxiety and depression scores before the psychedelic experience, and lower improvements in those symptoms and satisfaction with life than the other two subtypes.

Davis said he will be watching to see if these subtypes of experiences apply in the clinical setting, where psilocybin-assisted therapy is being studied at Ohio State for the treatment of post-traumatic stress disorder among military veterans.

“Finding the variety of other outcomes that these subtypes might be related to is an interesting next step,” he said. “These could include adaptive or functional outcomes in people’s quality of life or well-being, or a better understanding of their life’s purpose or relationships.” 

This work was supported by the Brain and Behavior Research Foundation, the National Institute of Mental Health, the CPDRE, the Steven & Alexandra Cohen Foundation, and private donors.

Additional co-authors include Rafaelle Lancelotta of Ohio State, and Natalie Gukasyan, Roland Griffiths and Frederick Barrett of the Center for Psychedelic & Consciousness Research at Johns Hopkins School of Medicine, where Davis is also an affiliate.

About 29,000 fewer children may have entered foster care during the 12 years of the study if states had made it easier for low-income families to receive cash assistance through the Temporary Assistance for Needy Families (TANF) program, the findings suggest.

“The relatively small amount of income provided through TANF may be enough to help prevent some child maltreatment and result in fewer kids being placed into foster care,” said Michelle Johnson-Motoyama, co-author of the study and professor of social work at The Ohio State University.

Johnson-Motoyama conducted the study with Donna Ginther of the University of Kansas. Their results were published today (Dec. 5, 2022) in the journal Health Affairs.

The study is thought to be the first to analyze how state TANF policies are associated with child maltreatment and foster care placement on a national level since the 2005 Deficit Reduction Act was passed. The study is also one of the first to examine how changes in state TANF policies over time affected child protective services involvement and foster care placement.

The TANF program, established in 1996, was a major reform of the U.S. welfare system.  It is a block grant program that gives states up to $16.5 billion a year to provide assistance for needy families.

“States have a lot of discretion in how they use the block grants for TANF and that allowed us to see how differences between states – and changes in states over time – were linked to child protective services involvement and foster care,” Johnson-Motoyama said.

TANF benefits vary wildly because of the discretion states are given. Monthly cash payments for a family of three ranged from $170 in Mississippi to $923 in Alaska in 2016.

The researchers examined the link between TANF policies and child protective services involvement and foster care placements over time and among all 50 states (and Washington, D.C.) from 2004 to 2016.

They looked specifically at how six different restrictions on TANF benefits implemented by various states affected how many low-income people participated in TANF in those states and links between changes in participation and child welfare system outcomes.

Some of the restrictions included work requirements for mothers of children less than a year old, and cutting off benefits before the five years allowed by the federal government.

Results showed that each additional TANF policy that restricted access to benefits was linked to 13% fewer families participating in the TANF program.

And fewer participating families had a big impact, the study found.  One analysis in the study showed that restrictions on TANF access were associated with 44 additional neglect victims per 100,000 child population and 22 additional children per 100,000 placed in foster care.

And these results were found after the researchers took into account a variety of other factors that could be related to child protective services involvement and foster care placement. In addition, the researchers did checks to see if social safety-net caseloads, the U.S opioid epidemic or the number of women in prisons changed the overall results of their study – and they did not.

This study can’t answer why less restrictive TANF benefits were linked to fewer cases of child maltreatment, Johnson-Motoyama said.  But previous research provides possible explanations.

“Other studies have demonstrated how economic instability and simply not having enough resources can cascade into a number of different problems for families that affect their health, housing stability, relationships, and general well-being,” she said.

“We know that when families have reliable income, some security, they have less stress, better mental health, and they make different choices for themselves and for their families.  That may help prevent involvement in the child protection system and make it less likely for children to be placed in foster care.”

In the end, helping more families access TANF benefits may actually save states money, Johnson-Motoyama explained.  As of 2016, monthly foster care payments ranged from a low of $250 in some states to more than $1,000.  And these payments represent only a portion of the cost of placing children in out-of-home care.

“Foster care is extremely expensive, and it is a much better value for states to prevent these placements when it is possible. That’s how TANF can help,” she said.

Johnson-Motoyama noted the study’s finding that about 29,000 fewer children would have ended up in foster care if states were less restrictive in offering TANF benefits.

“That’s about 29,000 children who might have a different life trajectory if their family had more resources.  I think we have a pretty strong case for why we should invest in families and support them to do their best at parenting,” she said.

The study was supported by grants from the Centers for Disease Control and Prevention and by the Robert Wood Johnson Foundation.

For example, the anxiety medication Xanax is a Schedule IV drug under the Controlled Substances Act, meaning it is judged to have low potential for misuse and dependence and strong therapeutic value. But the surveyed psychiatrists rated the drug, known generically as alprazolam, as having the highest misuse potential among all of the drugs they were asked about – equivalent to ratings of misuse potential of methamphetamine and alcohol.

The group also rated the psychedelic compound psilocybin as having the lowest misuse potential and the second-highest therapeutic potential behind ketamine. And yet, as a Schedule I drug, psilocybin has no currently accepted medical use and is deemed to pose a high risk for abuse.  

“The problem is that our drug schedules don’t match the scientific evidence of their actual harm and their actual therapeutic and abuse potential,” said senior author Alan Davis, assistant professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work. 

The authors noted how the evidence has changed since substances were scheduled under the Controlled Substances Act (CSA) in 1970: Studies have suggested psilocybin, MDMA (ecstasy) and cannabis, all Schedule I drugs, have therapeutic potential and relatively low risk for misuse or physical harm. Meanwhile, benzodiazepines, the family of drugs to which Xanax belongs, are the third most commonly misused substances – among both outlawed and prescription drugs – in the United States. 

“The question became, are these schedules actually in alignment with the current state of evidence as measured through experts in the field of psychiatry?” Davis said. “That really was the whole point of this study.” 

The research was recently published online in the International Journal of Drug Policy.

The research team recruited 181 psychiatrists from across the U.S. for the survey. Participants’ average age was 49 years, and they had been in practice for an average of 16 years.

The participants were presented with one of four scenarios depicting a patient who had found relief from severe depressive symptoms with a non-prescribed drug and is now asking to incorporate it into treatment: either psilocybin, methamphetamine (a Schedule II drug), ketamine (Schedule III) or Xanax. The researchers asked participants to rate their level of agreement with hypothetical clinical decisions and future outcomes for each vignette. All participants also responded to questions about the safety, therapeutic potential and abuse potential of the four drugs from the vignettes plus alcohol.

“We wanted to choose two drugs for the vignettes that we felt were appropriately scheduled based on the scientific evidence, and then we chose two that we felt were not necessarily reflecting current evidence,” said first author Adam Levin, a third-year psychiatry and behavioral health resident in Ohio State’s College of Medicine. “Psilocybin may not be appropriately scheduled, and we felt risk might be underestimated for Xanax. Methamphetamine and ketamine, based on a review of the literature, are fairly consistent with their schedules. And then we wanted to see whether psychiatrists perceived any incongruities.”

Statistical analyses showed that the surveyed psychiatrists’ perceptions of the acceptability, safety, and abuse and therapeutical potentials of the drugs generally conflicted with those defined by their current Controlled Substances Act schedule.

The psychiatrists tended to rate psilocybin and ketamine as safer, less likely to be abused and more potentially therapeutic than alprazolam, methamphetamine and alcohol – a substance that isn’t scheduled under the CSA.

“Methamphetamine, alcohol and Xanax were rated statistically equivalent in terms of their abuse potential,” said Davis, who also holds a faculty appointment in psychiatry and behavioral health. “And we showed a similar finding where methamphetamine, alcohol and Xanax were all found to be equivalent in terms of lower on the safety scale – more unsafe compared to psilocybin and ketamine.”

The authors noted that restrictions associated with Schedule I drugs in particular limit scientists’ ability to study these compounds – for their beneficial and harmful qualities, all of which need to be determined – and carry criminal consequences for users who may not find symptom relief from any legally available medications.

“You might ask, why does it matter that the drug schedule doesn’t reflect the evidence? Well, it matters,” Levin said. “We want our policies to be congruent with scientific evidence.

“Another interesting finding was that psychiatrists’ views about these drugs were largely in agreement with other mental health professionals, drug addiction experts, including in other countries, and with drug users themselves. They’re just not in agreement with the current drug schedule,” he said. “It’s important to call attention to this – we should have a flexible policy that can incorporate expert consensus.” 

Co-author Paul Nagib, a third-year medical student at Ohio State, said the findings may influence other physicians to rethink their own attitudes about substances that have been historically stigmatized.

“Whatever the evidence brings forward – that’s what we want to follow, rather than outdated policies,” he said. “Let’s look to where the evidence guides us, even if it challenges what we’ve assumed to be true.”

This work was supported by the Drug Enforcement and Policy Center in Ohio State’s Moritz College of Law, the Steven & Alexandra Cohen Foundation, the Center for Psychedelic Drug Research and Education (CPDRE), and private donors.

Davis is an affiliate of Johns Hopkins University’s Center for Psychedelic & Consciousness Research. Levin and Nagib are affiliates of the CPDRE. Additional co-authors included Selina Deiparine, Thomas Gao and Justin Mitchell, all of Ohio State.

The Center for Psychedelic Drug Research and Education (CPDRE) was approved by the Ohio State College of Social Work faculty in January, and its director, Assistant Professor of Social Work Alan Davis, officially took the helm in March.

The new center is designed to formalize a network of experts across the university based in a range of academic departments as well as existing centers focused on drug policy and substance misuse prevention and recovery. Center designation also enables the hiring of research and administrative staff, postdoctoral fellows and graduate students who will help propel the work. 

“Creating this infrastructure helps establish a system of values that shapes our goals and focuses our mission in strategic ways – all important steps given that the topic is so new,” Davis said. 

“All of this allows us to demonstrate the ways we are capable as a group of investigators and instructors to best utilize resources for future work, which sets us up to be competitive for future funding.” 

Davis came to Ohio State in 2019 with a research background in psychedelics after completing a postdoctoral research fellowship in Johns Hopkins University’s Center for Psychedelic & Consciousness Research. He is still affiliated with the Hopkins center, and holds an additional Ohio State faculty appointment in the Department of Psychiatry and Behavioral Health. 

Jason Slot, an associate professor of fungal evolutionary genomics in the Department of Plant Pathology, is the director of educational initiatives for the CPDRE. Slot studies the evolution and ecology of the roughly 300 species of mushrooms that contain the hallucinogenic compound psilocybin.

“Although more mental health services are provided by social workers than all other disciplines combined, no other social work program in the country is engaged in this type of work that Dr. Davis and his colleagues are undertaking,” said College of Social Work Dean Tom Gregoire. “This line of inquiry has great promise in helping individuals and families with what can be intractable challenges. 

“Our purpose as scholars and educators is to advance innovation in practice and widely disseminate it so that it touches many lives. Our capacity to reach so many makes this commitment essential.” 

In the United States, there are two leading drug-assisted therapies in phase 3 clinical trials testing MDMA (ecstasy) as a treatment for post-traumatic stress disorder and psilocybin for depression. Davis and Slot predicted that as things stand, these therapies could be federally approved in three to five years.

“If psychedelics are made available at the national level for medical purposes, then there will be a rapid shift in our cultural perspective, one that will need to integrate psychedelics and psychedelic-assisted therapy into our communities, families and mental health system,” Davis said. 

“Making sure we can educate people and help them understand what psychedelic experiences are, how people talk about these experiences, the history of psychedelics and their cultural context, how they act in the brain – are all critical endeavors which the CPDRE will undertake.”

Initial goals of the center are focused on research and educational initiatives. On the research side, several new clinical studies are under development at the center, subject to regulatory approval at the federal, state and university levels. Educational initiatives include hosting the “Psychedemia” conference on Interdisciplinary Psychedelic Scholarship in August 2022 and development of psychedelic studies curricula for an online continuing education certificate program and an interdisciplinary undergraduate minor. An existing course in the Department of Plant Pathology titled Psychedelic Studies: Neurochemistry, Plants, Fungi and Society will be a core component of the new programs. 

“The interdisciplinary minor would be aimed at really bringing pieces together from drug discovery to historical and ethical aspects through the clinical realm,” Slot said. “One big outcome will be that we can give a holistic education and perspective to our students both at the graduate and undergraduate level to be able to understand the history of what they’re working on, the pitfalls and the ethics. 

“This being an explosive time in psychedelic science, it’s important to bring together different perspectives in an emerging field and create a place where people can focus together on psychedelics.”

The center’s initial $1.5 million in financial support comes from the Fund for Psychedelic Drug Research and Education financed by two anonymous donors, one of which dedicated their donation in the name of Peter and Barbara.

Additional Ohio State CPDRE fellows, graduate students and staff include Stacey Armstrong, Diana Quinn, Nate Sepeda, Yitong Xin, Rafael Lancelotta and Grace Adams of the College of Social Work; Adam Levin of the Department of Psychiatry and Behavioral Health; Paul Nagib of the College of Medicine; and Nese Devenot and Brian Pace of the Department of Plant Pathology.

Ohio State University Executive Vice President and Provost Melissa L. Gilliam announced David A. Jenkins has accepted an offer to serve as dean of the College of Social Work. The hire is subject to approval by the Board of Trustees.

Jenkins’ appointment is effective July 1.

Jenkins joins Ohio State from the University of Louisville, where he has served as professor and dean of the Raymond A. Kent School of Social Work and Family Science since 2016. As dean, he advanced support for faculty research and teaching while strengthening efforts in diversity, equity, and inclusion within the Kent School and across the broader campus and communities. Before arriving at the University of Louisville, he served on the social work faculty of Texas Christian University for 25 years, including nine years as department chair.

“Please join me in extending a warm Ohio State welcome to our new colleague, David,” Gilliam said in a message to the university community.

His scholarship focuses on health disparities faced by marginalized individuals and families, seeking to better understand lived experiences of those underrepresented in academic and professional literature, Gilliam said. Most frequently, his research examines the lives and issues facing sexual minorities as individuals, couples, and families.

Jenkins earned a bachelor’s degree in business administration and MSW from Louisiana State University in addition to a PhD in social work from Florida State University. He also is certified as a licensed clinical social worker.

 “Through scholarship, teaching and service, the college is dedicated to enhancing individual and community well-being, celebrating difference, and promoting social and economic justice for vulnerable populations,” Gilliam said. “Under David’s leadership, the college will build on its longstanding work, envisioning new ways to address complex individual and social problems through innovation and compassion in service to local communities, the state, the nation, and the world.”

Gilliam thanked the search committee chaired by Dean Trevor Brown of the John Glenn College of Public Affairs. Gilliam thanked current dean Tom Gregoire for his 13 years of service. She said leadership will continue to be “an asset for the university as we engage the communities of which we are a part.”

But a new study, focusing on parents of young children, suggests it isn’t just where people live that’s important – it also matters where they spend their time.

Findings showed alcohol use was related to how many bars and restaurants were near where parents shopped, where they worked and where their children went to school.

“What we found suggests that parents may choose where they shop based on opportunities to engage in other activities, including drinking.  They may also be cued to drink when they go out shopping or when they finish work by the convenience of nearby bars and restaurants,” said Bridget Freisthler, co-author of the study and professor of social work at The Ohio State University.

“If you have a tough day at work, you may stop at the nearby bar for a drink before going home. If you’re out shopping with your kids, you might stop for dinner at the chain restaurant next door that serves alcohol.”

Freisthler conducted the study with Uwe Wernekinck, a doctoral student in social work at Ohio State. Their results were published online recently in the journal Drug and Alcohol Dependence.

The study involved 1,599 people in 30 cities in California, who participated in a telephone or web-based survey.  All participants were parents or guardians with at least one child aged 10 years or younger who lived with them at least half the time.

Participants answered questions that allowed researchers to calculate how frequently they drank alcohol (number of days over a year) and the total volume of alcohol they drank over a year. Data was collected before COVID-19, in 2015.

All participants listed where they lived, grocery stores where they most often shopped, another store where they often shopped (such as a big box or drug store), the child’s school or preschool and the parent’s place of employment.

The researchers then calculated the density of alcohol outlets – bars and restaurants where alcohol was consumed on site – near these sites where people spent time. (The researchers called these sites “destination nodes.”)

The findings confirmed other studies that suggested parents living in neighborhoods with higher bar and restaurant densities drank on more days and drank more alcohol during the past year than those living in areas with fewer such outlets.

Parents who visited destination nodes with higher densities of bars and restaurants that served alcohol did not drink more frequently than others, but they did report drinking more total alcohol over the course of a year than did others.

“We can’t tell how they spread out their drinking over the course of the year, but it is concerning that parents who frequent these areas with bars and restaurants are indeed consuming more alcohol,” Freisthler said.

Freisthler said the data doesn’t show if parents had children with them when they drank alcohol.

“But that’s something to pay attention to,” she said.

“Based on where parents reported going, these were places where they could bundle a lot of errands together at one time and could likely have their kids with them. They could go shopping and then go to a chain restaurant that serves alcohol, but is still appropriate to bring children, unlike a bar or pub. It gives parents opportunities to drink.”

The issue is not that parents may have an occasional beer or wine at a restaurant with their children present, Freisthler said. But studies, including this one, show that people drink more alcohol when there are more places that serve alcohol nearby.

“Are there additional risks in terms of how people parent their kids, such as drinking and driving? That’s what we should be worried about,” she said.

The project was supported by the National Institute on Alcohol Abuse and Alcoholism.

While other research has found this link at the county level, this study is one of the few to look at the crisis at the neighborhood level, said Bridget Freisthler, lead author of the study and professor of social work at The Ohio State University.

“When you look at the county level, it makes it very difficult for child welfare agencies and other groups to figure out where they need to devote resources and target interventions,” Freisthler said.

“If we can identify particular neighborhoods as potential hotspots of opioid-related child maltreatment, we can prepare community-based interventions.”

Freisthler conducted the research with Nichole Michaels of Nationwide Children’s Hospital in Columbus and Jennifer Price Wolf of the Pacific Institute for Research and Evaluation in Berkeley, California.

The study was published in the January 2022 issue of the Journal of Studies on Alcohol and Drugs.

The researchers studied 9,231 Census block groups in Ohio, which were used as a stand-in for neighborhoods. Those Census block groups covered nearly the entire state.

For each Census block group, the team collected 2015 data on the number of children referred for investigations of child abuse and neglect, as well as the number of substantiated cases of child maltreatment.

They also examined rates of naloxone administration for each Census block that same year. Naloxone is a prescription drug that emergency personnel use to treat people experiencing an opioid overdose.

Findings showed that higher rates of naloxone administration were related to a higher number of both referrals for child welfare investigations and confirmed cases of child maltreatment.

“There’s been an increase in child maltreatment in recent years after decades of decline and that trend is likely related, at least in part, to the opioid crisis,” Freisthler said.

The link between naloxone use and child maltreatment was particularly strong in rural Appalachian counties, which may be because of their high rates of poverty, she said.

The study found that neighborhoods with concentrated disadvantage – measured by levels of extreme poverty, among other problems – had particularly severe issues with child maltreatment.

“Appalachian counties already have depressed economies, which is a risk factor for child abuse and neglect by itself,” Freisthler said.

“If you add opiate use on top of that disadvantage, it only compounds those risks.”

The results suggest ways to help mitigate the crisis, she said.

Rapid response teams consisting of public health, social work, medicine, emergency medical services and nursing professionals could be deployed to neighborhoods experiencing high rates of overdoses in an effort to prevent additional social problems.

The main message is that the child welfare system needs to work with professionals involved in dealing with the opioid crisis to address these interconnected social problems, according to Freisthler.

“The opioid crisis is still with us, even though it may not be in the headlines as much,” she said.

“As long as we have that crisis, we’re going to have to deal with more potential cases of child maltreatment.”

The research was supported by grants from the federal Children’s Bureau, the Centers for Disease Control and Prevention, the Ohio Department of Job and Family Services and the Victims of Crime Act Fund.

Beginning this summer, a social worker from Southeast Healthcare will work in the off-campus area, with a special emphasis on North High Street, to provide outreach and offer resources and support to people who are homeless, housing insecure, or in need of other assistance. Southeast Healthcare, based in Ohio, has a long history of helping the state’s most vulnerable populations.

While the social worker’s coverage area includes campus itself, the person will focus on the adjacent University District area.

Offering proactive social service outreach in the University District is one of the recommendations made in Ohio State’s Task Force on Community Safety and Well-Being. Since its inception in fall 2020, the task force has put forth 15 recommendations that include a variety of strategies, acknowledging that “safety” means different things to different people.

As a highly trained Licensed Independent Social Worker, the person will also supervise College of Social Work undergraduate and graduate students who are acquiring experience as part of their in-the-field training. These students will gain valuable knowledge and build connections to the community, while extending the reach and impact of the new University District social worker.

“There’s a strong need for a dedicated professional to operate in the University District, and I’m thrilled that we can help meet it,” said College of Social Work Dean Tom Gregoire. “Our students will benefit greatly from this initiative and get a personal view of the issues that can lead to housing vulnerability.”

Once established, the social worker will work with community and university partners, including local businesses, law enforcement and students, staff and faculty, to get individuals help and assist with obtaining shelter and permanent supportive housing, counseling and treatment services. The social worker will make public their contact information to more easily connect with community members who may see someone who could use their services.

Ohio State continues to work to build a more empathetic community in the University District. Since February, for example, the Office of Student Life, through a grant from the Center for HumanKindness at the Columbus Foundation, has partnered with the College of Social Work and University District Organization to engage with people who are homeless or housing challenged in the North High Street area. Together, they’ve distributed 1,000 pairs of socks, hundreds of care bags and offered the services of a mobile health clinic operated by Southeast Healthcare. Ohio State has also partnered with the Reeb Avenue Center to distribute food vouchers and bus passes to those who need them.

The university has worked closely with the University District Organization on the new partnership. The nonprofit has helped to identify the needs of the off-campus community.

“Our partners in the University District have often asked how to best help the most vulnerable in the area,” said Matt Hansen, executive director of the University District Organization. “Dedicating a social worker to work full-time with this population is a great step toward providing people services and assistance they may need.”

The study showed 11% of Black teens and young adults living in a mid-Atlantic public housing development reported that in the previous 12 months, they had made a plan to die by suicide.

The finding fits with what previous research has shown: that African American youths are the fastest-growing group engaging in suicidal behavior and dying by suicide, and have the highest suicide death rate increase among any other racial or ethnic minority group, from 2.55 per 100,000 in 2007 to 4.82 per 100,000 in 2017.

Males were more likely than females to have come up with a suicide plan, and certain family dynamics increased the chances a youth would engage in suicidal behavior: mothers who were currently incarcerated or fathers with a history of alcohol abuse.

Researchers suggest the findings warrant expansion of the types of locations that national suicide prevention experts have targeted as the best places to deliver prevention programs. Rather than basing interventions at community hospitals or schools, the researchers argue, culturally tailored suicide-prevention interventions should be offered within public housing communities themselves as well as these other locations.

Though public housing was originally envisioned as a temporary residence for transitory families, societal changes – the collapse of manufacturing jobs, crack cocaine epidemic and welfare-to-work mandates among others – combined to leave most families in these developments without the means to move out.

“I call it a ‘constellation of correlations.’ There was no more transition and these communities were devastated, and as a result, you see a ‘Lord of the Flies’ type of narrative where children were unintentionally left to their own devices,” said Camille R. Quinn, lead author of the study and assistant professor of social work at The Ohio State University. 

“Today, even though there is not as much drug trafficking, it is still part of the tapestry in these communities and that has definitely left an imprint. And parents and their children are likely living with the aftermath,” Quinn said. “If either parent is in or out of the prison system, or has charges or offenses on their record, that makes it harder for them to find employment, and that makes it difficult for them to do the best they can for their children.”

The study is published online in the Journal of Racial and Ethnic Health Disparities.

This study used select data from a larger research project examining the association for residents in public housing between neighborhood factors and health risk behaviors. The sample of a subset of the participants in the initial study included 190 African American youths and young adults between ages 15 and 24.

Quinn and colleagues analyzed results from survey questions asking the youths if they had made a plan to attempt suicide in the past 12 months, if either parent were currently or had previously been in jail, and if either parent had ever had problems with illegal substances or consuming too much alcohol.

Almost 34% of fathers and 8.4% of mothers were incarcerated at the time the survey data were collected, and more dads than moms had had drug and alcohol problems. Statistical analysis showed that a father’s past alcohol problem or a mother’s current incarceration had the strongest association with a youth’s plan to die by suicide. Males were significantly more likely than females to have planned a suicide.

“It’s significant that so many males reported a plan to die by suicide, which is really stark,” said Quinn, adding that this finding matches patterns seen in previous research: Girls and women as a whole are much more likely to think about, plan and attempt suicide but survive, while young men who have decided they are going to die are more likely to follow through.

The researchers cite U.S. Census data showing that public housing constitutes almost a quarter of households in the most highly segregated and lowest-opportunity neighborhoods in the United States, and African American households represent 51% of the families living in public housing in these neighborhoods. Of those families, 29% have been contacted by child protective services – suggesting these housing communities are marked by violence and social problems, including parental substance misuse and jail time, which have been linked in previous research with youths’ suicidal behavior.

The study findings imply that African American families living in public housing should be targeted for family-centered, evidence-based interventions delivered in their residential communities, the researchers say, which could lead to development of the most effective suicide prevention practices for this specific population.

The National Action Alliance for Suicide Prevention Research Prioritization Task Force published a plan in 2014 to reduce suicide attempts and deaths by 40% or more by 2024. The plan recommended reaching “boundaried” populations by delivering interventions in hospital emergency rooms, schools, correctional facilities, and mental health and substance abuse centers – systems from which families living in public housing may be isolated and therefore missed by suicide prevention outreach.

In the meantime, Quinn is investigating potential factors beyond the family that could influence – positively or negatively – suicidal behavior in African American teens and young adults living in public housing.

“What impact might school have, or peers?” she said. “In this paper, we don’t even know whether or not the young people in this sample have any involvement with any system – child welfare, special education or juvenile justice. We would guess that if they were, that would have implications for what kind of considerations might be made for treatment.”

Co-authors include Oliver Beer and Donte Boyd of Ohio State, Taqi Tirmazi of Morgan State University, and Von Nebbitt and Sean Joe of Washington University in St. Louis.

New research identifies personality traits that have been associated with positive and negative experiences on psychedelics in previous studies, information that could help predict how future clinical trial participants will respond to the drugs.

The findings suggest that people more open to new experiences and willing to surrender to the unknown may be best positioned to have a positive experience on psychedelics, and individuals who tend to be preoccupied or apprehensive could be more likely to have a negative, or challenging, experience.

These predictions could be used by scientists to help hesitant clinical trial patients feel more open to the potential therapy, possibly by offering lower doses as a starting point, researchers say – though such a concept remains speculative.

“The findings point to interesting testable things we can look at in future research,” said Alan Davis, assistant professor of social work at The Ohio State University and senior author of the review. “It might be plausible to use threshold doses that are smaller than those used in a trial as a first exposure so people have less anxiety, experience the benefit and, from that, go into a higher dose later.”

The study is published online in the journal ACS Pharmacology & Translational Science.

To arrive at these predictions, the researchers reviewed 14 published clinical trials and other types of studies conducted in recent years that documented participants’ personality traits or states of mind and their associations with a positive or negative experience on psychedelics.

“It’s been an open question so far in psychedelic science: How can we predict how people will react? We thought this review would be a good opportunity to develop a narrative of what the consensus is so far,” said study first author Jacob Aday, a PhD candidate in psychology at Central Michigan University who collaborates with Davis.

Preliminary evidence has suggested that psychedelics may be effective in treating mood, anxiety, trauma-based and substance use disorders.

“Psychedelics might broadly apply to a whole range of different psychiatric problems, and in part that might be because they’re directly affecting neurotransmission and the brain’s ability to communicate in new ways that involve different parts of the brain,” Davis said. “But there is still a lot to unpack about exactly how this all works and why it may be effective.”

Of the studies reviewed, 10 tested psilocybin (commonly known as magic mushrooms) as a therapy, two involved LSD, one used a hallucinogenic brew called ayahuasca and one examined psychedelic use in general.

Experiences on psychedelics vary in intensity and tend to comprise three categories: a mystical, insightful or challenging experience. A mystical experience can feel like a spiritual connection to the divine, an insightful experience increases people’s awareness and understanding about themselves, and a challenging experience relates to emotional and physical reactions such as anxiety or increased arousal.

The review suggests that people who are high in the traits of openness, acceptance and absorption – the tendency to immerse oneself into imaginative experiences – and in a psychological state of surrendering to whatever may transpire are more likely to have positive psychedelic experiences.

A state of surrender, in particular, stood out for its association with a lower chance for acute dread and a higher likelihood of a mystical experience and what is known as “ego dissolution,” when one’s sense of self gives way to a closer connection to other people and the broader world.

In contrast, people who are low in those traits or who are in preoccupied, apprehensive or confused states are considered more likely to experience adverse reactions.

“There was also tentative evidence that increased experience with psychedelics and increased age were associated with slightly less intense effects with the drugs,” Aday said. “And there weren’t any differences according to sex. Men and women responded similarly.”

Three studies had identified potential neurological markers that could help predict research participant reactions to psychedelics, but the cost of collecting brain scans to screen trial candidates made them less practical predictors than psychological traits, Aday said.

Davis has already considered potential reactions to psychedelics for a psilocybin trial he is planning for veterans who have post-traumatic stress disorder.

“People who have experienced trauma are not very high in surrender, because they are anxious all the time about their past traumatic experiences,” he said. “A possibility to explore is starting with a low or moderate dose prior to giving the full therapeutic dose, which might help them increase in surrender. We’ve designed the study this way, thinking that might be helpful.”

Study co-authors include Cayla Mitzkovitz, Emily Bloesch and Christopher Davoli of Central Michigan University.

Though parental attentiveness would generally be considered beneficial to troubled youths, the finding hints at the possibility that a history of trauma in a household’s adults may filter down to younger generations, researchers say.

The study, examining how family and peer social support influenced post-traumatic stress disorder (PTSD) symptoms in Black girls who were in detention, found that lower self-esteem, less optimism about the future and higher negative behaviors by peers were associated with greater PTSD symptoms in these girls. But one more factor also correlated with those symptoms: a higher level of caregiver support.

“This finding really pushed me to focus on parents and the girls, because initially it was just the girls,” said Camille R. Quinn, lead author of the study and assistant professor of social work at The Ohio State University. “So I started digging. And research I found explained how this could be an intersection between moms and girls. If mom had a history of violence, how she coped or didn’t cope with that trauma influenced the girls.

“More and more, I saw that this described parents with experiences of not just present-day, but historical, trauma. And if they had a limited ability to resolve or heal, that would dictate their perception of their child’s suffering. So they might say, ‘Get over it.’ And the girl might say, ‘OK, fine.’ But she’s still struggling.”

Quinn has applied for a grant from the National Institute on Minority Health and Health Disparities to follow up by working with Black girls and their parents and caregivers on proposed interventions that would equip these girls with faith in their own power to heal while also acknowledging the historic victimization of Black girls and Black women.

The study is published in a recent issue of the journal Criminal Justice and Behavior.

Quinn will discuss the paper and its implications for social work practitioners in a plenary talk at 11:30 a.m. (Eastern) Sunday, March 7, at the annual conference of the New Jersey chapter of the National Association of Social Workers. The talk is titled “The Strength of Justice-involved Black Girls and Women in Spite of Adversity: Identifying Assets to Enhance Well-being.”

Girls are the fastest-growing group in the U.S. juvenile justice system, and Black girls are overrepresented in that detained population. Their higher likelihood to have a history of abuse also predisposes them to PTSD symptoms, such as hypervigilance, reliving trauma in nightmares, and seeing a threat at every turn. In most cases, however, chances are that they are not diagnosed, and therefore receive no help in learning how to get through the day, Quinn said. They might abuse drugs, steal food or hit someone and end up in trouble, when they are really trying to survive – what is called survival coping.

With an eye toward improving interventions for youths who engage in law-breaking behavior, Quinn conducted a secondary analysis of data that had been collected from 188 Black girls for an earlier study. The girls were age 12 to 17 and living in a detention center before their criminal cases were heard.

Using a variety of established research measures, the survey collected data on the girls’ PTSD symptoms, history of abuse, caregiver support, negative peer norms such as friends who skip school or steal, self-esteem and future orientation – how optimistic they were about, for example, graduating from high school or being respected in their communities.

More than half of the girls, 56%, reported being subjected to emotional abuse, 43% experienced physical abuse and 24% reported sexual abuse. As a group, their symptoms for PTSD were considered clinically relevant. The analysis looked at how factors individually and in combination were associated with PTSD symptoms, with higher rates of caregiver support, higher negative peer norms, lower self-esteem rates and lower future orientation rates correlated with greater PTSD symptoms.

In the paper, Quinn suggested that comprehensive treatment programs for delinquent Black girls should include caregivers and peers, and emphasize healing to bolster self-esteem and hopefulness. In her talk, Quinn will note the need for practitioners to recognize the historical context of trauma and violence in the lives of Black women and girls, and give thought to societal barriers these clients may have encountered on the way to seeking help.

“The population we’re talking about are the least likely to receive any kind of services, the least likely to be referred, because they can be seen as scary,” said Quinn, a longtime practitioner before becoming a professor. “They’re perceived as aggressive. But if you think about it historically, they’re also some of the individuals who have been the most victimized and the most dehumanized. And that is how they then become criminalized. I want my work to humanize them and help them heal.”

The participants in the retrospective study reported that their trauma-related symptoms linked to racist acts were lowered in the 30 days after an experience with either psilocybin (Magic Mushrooms), LSD or MDMA (Ecstasy).

“Their experience with psychedelic drugs was so powerful that they could recall and report on changes in symptoms from racial trauma that they had experienced in their lives, and they remembered it having a significant reduction in their mental health problems afterward,” said Alan Davis, co-lead author of the study and an assistant professor of social work at The Ohio State University.

Overall, the study also showed that the more intensely spiritual and insightful the psychedelic experience was, the more significant the recalled decreases in trauma-related symptoms were.

A growing body of research has suggested psychedelics have a place in therapy, especially when administered in a controlled setting. What previous mental health research has generally lacked, Davis noted, is a focus on people of color and on treatment that could specifically address the trauma of chronic exposure to racism.

Davis partnered with co-lead author Monnica Williams, Canada Research Chair in Mental Health Disparities at the University of Ottawa, to conduct the research.

“Currently, there are no empirically supported treatments specifically for racial trauma. This study shows that psychedelics can be an important avenue for healing,” Williams said.

The study is published online in the journal Drugs: Education, Prevention and Policy.

The researchers recruited participants in the United States and Canada using Qualtrics survey research panels, assembling a sample of 313 people who reported they had taken a dose of a psychedelic drug in the past that they believed contributed to “relief from the challenging effects of racial discrimination.” The sample comprised adults who identified as Black, Asian, Hispanic, Native American/Indigenous Canadian, Native Hawaiian and Pacific Islander.

Once enrolled, participants completed questionnaires collecting information on their past experiences with racial trauma, psychedelic use and mental health symptoms, and were asked to recall a memorable psychedelic experience and its short-term and enduring effects. Those experiences had occurred as recently as a few months before the study and as long ago as at least 10 years earlier.

The discrimination they had encountered included unfair treatment by neighbors, teachers and bosses, false accusations of unethical behavior and physical violence. The most commonly reported issues involved feelings of severe anger about being subjected to a racist act and wanting to “tell someone off” for racist behavior, but saying nothing instead.

Researchers asked participants to recall the severity of symptoms of anxiety, depression and stress linked to exposure to racial injustice in the 30 days before and 30 days after the experience with psychedelic drugs. Considering the probability that being subjected to racism is a lifelong problem rather than a single event, the researchers also assessed symptoms characteristic of people suffering from discrimination-related post-traumatic stress disorder (PTSD).

“Not everybody experiences every form of racial trauma, but certainly people of color are experiencing a lot of these different types of discrimination on a regular basis,” said Davis, who also is an adjunct faculty member in the Johns Hopkins University Center for Psychedelic and Consciousness Research. “So in addition to depression and anxiety, we were asking whether participants had symptoms of race-based PTSD.”

Participants were also asked to report on the intensity of three common kinds of experiences people have while under the influence of psychedelic drugs: a mystical, insightful or challenging experience. A mystical experience can feel like a spiritual connection to the divine, an insightful experience increases people’s awareness and understanding about themselves, and a challenging experience relates to emotional and physical reactions such as anxiety or difficulty breathing.

All participants recalled their anxiety, depression and stress symptoms after the memorable psychedelic experience were lower than they had been before the drug use. The magnitude of the positive effects of the psychedelics influenced their reduction in symptoms.

“What this analysis showed is that a more intense mystical experience and insightful experience, and a less intense challenging experience, is what was related to mental health benefits,” Davis said.

The researchers noted in the paper that the study had limitations because the findings were based on participant recall and the entire sample of recruited research volunteers had reported benefits they associated with their psychedelic experience – meaning it cannot be assumed that psychedelics will help all people of color with racial trauma. Davis and Williams are working on proposals for clinical trials to further investigate the effects of psychedelics on mental health symptoms in specific populations, including Black, Indigenous and people of color.

“This was really the first step in exploring whether people of color are experiencing benefits of psychedelics and, in particular, looking at a relevant feature of their mental health, which is their experience of racial trauma,” Davis said. “This study helps to start that conversation with this emerging treatment paradigm.”

This work was funded by the University of Ottawa, the Canada Research Chairs Program and the National Institutes of Health. Additional co-authors included Yitong Xin of Ohio State’s College of Social Work; Nathan Sepeda of Johns Hopkins; Pamela Grigas and Sinead Sinnott of the University of Connecticut; and Angela Haeny of Yale School of Medicine.

These positive effects on drug use were seen in those who received job-specific skills training, but not in youth who received only basic job services, such as help with job search or a General Education Development (GED) program.

Results showed that the use of illicit drugs such as cocaine and heroin (not including marijuana) declined for youth who received job-skills training, down to 2.8 percent after 16 years. However, illicit drug use increased for those who received only basic services, up to 5.2 percent in the same time.

“We have to look at what kind of job services we provide low-income youth, because they don’t all provide the same level of benefits,” said Sehun Oh, lead author of the study and assistant professor of social work at The Ohio State University.

“There were positive spillover effects from job training on drug misuse, which we did not see in youth who were provided only more basic services.”

The study appears in the June 2020 issue of the American Journal of Public Health.

The results are important because the federal and state governments emphasize a “job-first” approach that focuses on helping adults in the Temporary Assistance for Needy Families (TANF) program obtain immediate employment, Oh said.

Under a “job first” approach, people usually receive only basic services, which alone were not found to be helpful in preventing drug misuse in this study.

The study uses data about young people from around the country who participated in the National Longitudinal Survey of Youth 1997. The NLSY97 interviewed people who were between the ages of 13 and 17 in 1997 and then interviewed the same people 17 times until 2016. The NLSY is conducted by Ohio State’s Center for Human Resource Research for the U.S. Bureau of Labor Statistics.

The researchers identified 581 people from NLSY97 who participated in government-sponsored employment programs for low-income youth and adults.

About half reported receiving job skills training services, such as vocational training, on-the-job training, work experience, and other classroom training for a specific job. The other half received only basic services, such as a GED program or job-search assistance.

Results showed that binge drinking decreased significantly among both the basic services and job skills training groups, with no group differences found in the trends.

Slightly more than 40 percent of both groups said they engaged in binge drinking (5 or more drinks on one occasion in the past month) at the start of the study, which declined to 30 percent in year 16.

Marijuana use was relatively steady for both groups over the entire period of the study, with 11 to 16 percent of the groups reporting they had used the drug in the past year.

The reduction seen in the use of illicit drugs like cocaine and heroin is an advantage of job skills training programs that has not been studied before, Oh said.

“Substance misuse is a significant public health problem in the United States,” he said.

“Giving people the skills needed to get good jobs is one way to help fight that crisis, and one that doesn’t come from a ‘jobs-first’ approach.”

The research was supported by the Society for Social Work and Research.

Co-authors on the study were Diana DiNitto, professor of social work, and Daniel Powers, professor of sociology, both at the University of Texas at Austin.

However, daily marijuana users with severe pain also reported their health had become worse in the past year.

The results don’t necessarily mean that marijuana is not effective in treating at least some kinds of pain, according to the researchers. But it suggests more research is needed before marijuana is accepted as an effective treatment for severe pain.

“It’s not clear if marijuana is helping or not,” said Bridget Freisthler, co-author of the study and professor of social work at The Ohio State University.

“The benefits aren’t as clear-cut as some people assume.”

The study was published recently in the International Journal of Drug Policy.

One issue is the complex relationship between pain, marijuana use and self-reported health, said Alexis Cooke, lead author of the study and postdoctoral scholar in psychiatry at the University of California, San Francisco.

“Having high chronic pain is related to poorer health, so it may be that people who are using marijuana more often already had worse health to begin with,” Cooke said.

“There are still a lot of questions to answer.”

The study involved a survey of 295 medical marijuana dispensary patients in Los Angeles. The surveys were conducted in 2013, when California allowed marijuana use only for medical purposes.

All participants were asked how often they used marijuana; rated how their current health compared to one year ago (on a five-point scale from “much better” to “much worse”); and were asked two questions about their pain levels. Based on their answers, the researchers rated participants’ pain as low, moderate or high.

Among those surveyed, 31 percent reported high pain, 24 percent moderate pain, and 44 percent were in the low-pain category.

Daily marijuana use was reported by 45 percent of the sample, and 48 percent said they used three or more times per day.

The percentage of participants who used marijuana every day did not differ by pain categories. But about 60 percent of those who reported high pain used the drug three or more times a day, compared to 51 percent of those with moderate pain and 39 percent of those in the low-pain group.

Findings showed no association between daily marijuana use and change in health status among those with low levels of pain. But daily marijuana use was linked to worsening health status among those reporting high levels of pain.

However, strangely, there was no association between how often participants used marijuana per day and changes in health status. There’s no easy explanation for this, Freisthler said.

“It shows how little we know about marijuana as medicine, how people are using it, the dosages they are receiving and its long-term effects,” she said.

People use marijuana for a variety of different types of pain, including cancer, joint pain, HIV and nerve pain. Researchers don’t know if marijuana has different effects on different causes of pain, Cooke said.

“Chronic pain is also associated with depression and anxiety. Marijuana may help with these problems for some people, even if it doesn’t help with the pain,” she said.

In addition, marijuana use seems to help people who have lost their appetite due to pain or nausea caused by cancer drugs.

“It may not be the pain that patients are trying to address,” Cooke said.

The results do suggest we need to know more about the link between marijuana and pain relief, Freisthler said.

“Particularly since the opioid crisis, some people have been touting marijuana as a good substitute for opioids for people in pain,” she said.

“But our study suggests we don’t know that marijuana is helping to address pain needs.”

The study was supported by the National Institute on Drug Abuse.

Laura Chavez of Nationwide Children’s Hospital in Columbus was also a co-author.

A new study shows that physical abuse of children in high-risk homes, especially when they’re toddlers or teens, dramatically increases the odds that their adolescent experimentation with cigarettes will lead to a heavy smoking habit.

Neglect of very young children in the same high-risk population was linked to a gradual increase in cigarette use among teens who smoked.

The study examined data on children who were at high risk for abuse and neglect – either because they had been referred to a child protective service or lived in conditions associated with the likelihood of maltreatment, or both.

“I wanted to look at different types of maltreatment and whether they have an impact on cigarette smoking,” said lead author Susan Yoon, assistant professor of social work at The Ohio State University. “There’s also the impact of timing – it’s not just maltreatment, yes or no. When did it happen, and does that matter with regard to outcomes?”

The study is published online in the journal Substance Use and Misuse.

Yoon noted that substance abuse research doesn’t often take cigarette smoking into consideration despite its significant damaging effects on health.

“Adolescent cigarette smoking is a really serious social problem and public health concern. Brain development is not complete until late adolescence or during young adulthood, and cigarette smoking is associated with damage in brain development,” Yoon said. “We also know that those who start smoking cigarettes during adolescence are more likely to continue smoking into adulthood.”

Yoon and colleagues used data from the Longitudinal Studies of Child Abuse and Neglect, a consortium of studies across different regions of the United States targeting children who were identified as maltreated or at risk for maltreatment. This study used data on 903 adolescents who were assessed at age 12, 16 and 18.

A breakdown of different types of abuse and neglect experienced by the sample population during three different time periods (early childhood, school age and adolescence) confirmed how vulnerable these kids were. Almost a quarter had been neglected during early childhood and their school-age years, and 19 percent reported school-age physical abuse. Almost half lived in poverty and 58 percent lived in households in which family members smoked cigarettes.

Yoon used their responses about smoking between the ages of 12 and 18 to identify three patterns of cigarette use: stable low/no use (61 percent of respondents), gradually increasing use (30 percent) and sharply increasing cigarette use (9 percent).

“It was almost shocking how the pattern of cigarette use over time went up so drastically in the sharply increasing use class,” Yoon said. “They were pretty similar to the others at age 12 – almost 80 percent didn’t smoke. At age 16, we saw that almost 60 percent had used cigarettes more than 20 days in the past year and by 18, every single kid in this group reported heavy use of cigarettes.”

A statistical analysis showed that adolescents who experienced early childhood physical abuse were 2.3 times more likely to be in the sharply increasing cigarette use group compared with the stable no/low group. Physical abuse during adolescence had an even stronger effect – this type of mistreatment at that point in life was linked to 3.7 times higher odds for sharply increased cigarette use.

Adolescents who had been neglected during early childhood were 1.89 times more likely to be in the gradually increasing cigarette use group than in the stable no/low use group. Neglect can include a lack of appropriate supervision and failure to meet kids’ needs – ranging from food and clothing to medical needs and education.

About 40 percent of these smokers had reported using cigarettes at age 16, and by age 18, more than 80 percent were smokers, and about 40 percent had smoked on more than 20 days in the previous year.

The analysis also measured the potential effects of sexual abuse and emotional abuse on cigarette use, but neither was a predictor of an increase in smoking.

“The different types of maltreatment predicted different patterns of cigarette use, but the timing mattered as well. It was early childhood and adolescence that appear to be really sensitive periods in which maltreatment influences these outcomes,” Yoon said.

The results suggest efforts to prevent smoking by teens at risk of maltreatment – and especially children experiencing physical abuse and neglect – should start before age 12, she said.

“If we intervene too late, it’s likely they’ve already started using cigarettes and are in the process of using more cigarettes,” Yoon said. “We know from our studies that these kids experiencing physical abuse and neglect are at much higher risk of showing this poor pattern of cigarette use over time. We should be targeting this high-risk group for cigarette use prevention and intervention.”

This work was funded by The Ohio State University Institute for Population Research through a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Ohio State co-authors include Rebecca Dillard, Julianna Nemeth and Sarah Schoppe-Sullivan.

The study, which appears online today (Sept. 6, 2019) in the journal JAMA Network Open, also highlights a cluster of factors, including lack of insurance and the prevalence of gun shops, that are associated with high suicide rates.

Researchers at The Ohio State University evaluated national suicide data from 1999 to 2016, and provided a county-by-county national picture of the suicide toll among adults. Suicide rates jumped 41 percent, from a median of 15 per 100,000 county residents in the first part of the study to 21.2 per 100,000 in the last three years of the analysis. Suicide rates were highest in less-populous counties and in areas where people have lower incomes and fewer resources. From 2014 through 2016, suicide rates were 17.6 per 100,000 in large metropolitan counties compared with 22 per 100,000 in rural counties.

In urban areas, counties with more gun shops tended to have higher suicide rates. Counties with the highest suicide rates were mostly in Western states, including Colorado, New Mexico, Utah and Wyoming; in Appalachian states including Kentucky, Virginia and West Virginia; and in the Ozarks, including Arkansas and Missouri.

“While our findings are disheartening, we’re hopeful that they will help guide efforts to support Americans who are struggling, especially in rural areas where suicide has increased the most and the fastest,” said lead researcher Danielle Steelesmith, a postdoctoral fellow at Ohio State’s Wexner Medical Center.

“Suicide is so complex, and many factors contribute, but this research helps us understand the toll and some of the potential contributing influences based on geography, and that could drive better efforts to prevent these deaths.”

Suicide rates are trending higher despite a national prevention effort that kicked off in 2015 with the goal of reducing suicide rates 20 percent by 2025. Another recent analysis found that suicide rates in almost 90 percent of U.S. counties increased more than 20 percent from 2005 to 2015.

The new study included 453,577 suicides by adults 25 to 64 years old from 1996 to 2016. Suicides were most common among men and those 45 to 54 years old.

Suicide prevention can be bolstered with this new information about trends and patterns of suicide, said Cynthia Fontanella, a study co-author and associate professor of psychiatry and behavioral health at Ohio State.

“For example, all communities might benefit from strategies that enhance coping and problem-solving skills, strengthen economic support and identify and support those who are at risk for suicide,” Fontanella said.

“The data showing that suicides were higher in counties with more gun shops – specifically in urban areas – highlights the potential to reduce access to methods of suicide that can increase the chances an at-risk person will die.”

Another factor related to increased suicide rates, particularly in rural areas, was “deprivation,” a cluster of factors including underemployment, poverty and low educational attainment.

Long-term and persistent poverty may be more entrenched and the economic opportunities for individuals more limited in rural areas, Steelesmith said, adding that many rural Americans rely on jobs in agriculture and industries including coal mining.

“In cities, you have a core of services that are much easier to get to in many cases. You may have better access to job assistance, food banks and nonprofits that might all contribute to less desperation among residents,” Steelesmith said.

High social fragmentation – which factors in levels of single-person households, unmarried residents and the impermanence of residents – was associated with higher suicide rates, as was low social capital, a measure of the interconnectedness of people in an area. Both of these were particularly pronounced in rural America.

Other factors associated with higher suicide rates included high percentages of veterans in a county and lower rates of insurance coverage.

Fontanella said that people who live in rural America might particularly benefit from strategies to promote social connections through community engagement activities that offer opportunities for residents to interact and to become familiar with supportive resources in their area.

Steelesmith said it’s important to note that county-by-county geographical information on suicide doesn’t tell the whole story. Some states, particularly in the West, have large counties with great variability in terms of resident life experiences, for instance. This work also excludes data on suicides by young and elderly Americans.

Ohio State researchers John Campo (now of West Virginia University), Keith Warren and Elisabeth Root also worked on the study. Jeffrey Bridge of Nationwide Children’s Hospital also was a collaborator.

For help, contact the National Suicide Prevention Lifeline at 1-800-273-8255/TALK (or 1-888-628-9454 for Spanish speakers). To reach someone at Ohio’s 24/7 Crisis Text Line, send 4HOPE to 741741.

A study of California parents found that current marijuana users administered more discipline techniques of all kinds to their children on average than did non-users. That includes everything from timeouts to, in some cases, physical abuse.

“The acceptability of marijuana is growing in the United States and with that, more parents feel free to use the drug, sometimes even in front of their children,” said Bridget Freisthler, co-author of the study and professor of social work at The Ohio State University.

“Some parents claim it makes them a better, more relaxed parent, but that may not be the case.”

The effect of marijuana use on parenting is a relevant concern: A 2017 survey from Yahoo News and Marist College found that 54 percent of adults who use marijuana in the United States are parents. A majority of those parents have children under the age of 18. Some groups of “marijuana moms” claim that use makes them better parents.

The results of this new study suggest that marijuana users – who are nearly always (92 percent of the time) also alcohol users – are trying to control their kids more than non-users, Freisthler said.

“It appears that users may be quicker than other parents to react to minor misbehavior,” she said.

“We can’t tell from this study, but it may be that parents who use marijuana or alcohol don’t want their children to spoil the buzz they have, or bother them when they have a hangover.”

Freisthler conducted the study with Nancy Jo Kepple of the University of Kansas. Their results were published online this week in the Journal of Social Work Practice in the Addictions.

The researchers interviewed 3,023 randomly selected California parents of children 12 years old or younger by telephone in 2009. They asked participants about their recent use (in the past year) and past use (a year or more ago) of alcohol, marijuana, methamphetamine and other drugs.

They also asked how often the parents used non-violent discipline (such as timeouts or taking away privileges), corporal punishment (such as spanking) and physical abuse (such as hitting a child with a fist).

This is one of the first studies to look at how use of specific types of substances are related to a variety of parental discipline practices in the general population, Freisthler said.

The findings revealed that parents who used marijuana in the past year tended to use more of all types of discipline compared to non-users, even after taking into account a variety of other factors that could impact use of discipline, such as parental stress and depression and child and parent demographics. The same was true of alcohol users.

Parents who had used alcohol or marijuana in the past, but were not at the time of the research interview, also applied most types of discipline more often than did non-users.

And the more substances that parents used, the more often they disciplined their children in all types of ways, according to the study. For example, parents who reported using the most substances practiced physical abuse at a rate about 1.45 times greater than those who used only one substance.

Results showed that the annual frequency of physical abuse was 0.5 times higher among parents who used both alcohol and marijuana in the past year, compared to those who consumed only alcohol.

“The use of several different kinds of substances certainly is a warning sign that parents may be relying more heavily on discipline to control their children,” she said.

Freisthler said this study shows that while marijuana use has become more mainstream and is legal in more states, there is still need for caution.

“Marijuana use is not risk-free. It affects a lot of behaviors, including parenting.”

The study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism.