Category: From Newswise – Addiction

Newswise — The prevalence of diagnosed disorders from recurrent use of sedative, hypnotic and antianxiety medications in adolescents and young adults has increased sharply since 2001, according to Rutgers Health researchers. 

Their study, published in Addiction, examined diagnoses of these disorders in adolescents and young adults between 2001 to 2019.

Sedative, hypnotic and antianxiety medications are used to treat a variety of conditions, including sleep and anxiety disorders. According to Harvard Health, consistent use of these drugs can lead to a higher tolerance for their effects, meaning patients require higher doses to achieve the intended effects.

For some, a problematic pattern of use of these medications can lead to significant impairment and distress. When this happens, patients may be diagnosed with sedative, hypnotic or anxiolytic use disorders, which are estimated to impact 2.2 million Americans, according to data from the National Survey on Drug Use and Health.

Using national Medicaid data from nearly 7 million adolescents and young adults in 2001 and 13 million adolescents and young adults in 2019, Rutgers Health researchers looked at trends in sedative, hypnotic or anxiolytic use disorder diagnoses. The prevalence increased threefold in adolescents and increased fivefold in young adults from 2001 to 2019.

“The increase in diagnoses of these disorders may be due to changes in the availability, use and misuse of sedatives, hypnotics and anxiolytics, as well as an increase in detection, awareness and diagnosing of these disorders,” said Greta Bushnell, an assistant professor at the Rutgers Center for Pharmacoepidemiology and Treatment Science (PETS) and lead author of the study.

Sedative, hypnotic and anti-anxiety medications are accessed in number of ways, including through medical prescriptions as well as through nonmedical sources such as a friend or in a medicine cabinet. Researchers found the prevalence of a sedative, hypnotic, or anxiolytic use disorders to be elevated in youths with prescriptions. However, the majority of adolescents and young adults diagnosed with a sedative, hypnotic or anxiolytic use disorder didn’t have a prescription for one of those medications.

“Efforts to target nonmedical use of these drugs is important as a means to reduce this disorder,” said Bushnell, who also is an assistant professor of epidemiology at Rutgers School of Public Health, “as is cautious prescribing in this young population.”

Researchers also found that most adolescents and young adults with sedative, hypnotic or anxiolytic use disorders had another comorbid substance use disorder diagnosis; in adolescents, cannabis use disorder was the most common and opioid use disorder in young adults. 

“While sedative, hypnotic and anxiolytic use disorders are less common than other substance use disorders, it warrants attention from clinicians and researchers given treatment difficulties and the association with other substance use issues,” Bushnell said.

Examining trends in youth diagnosed with this disorder can lead to a better understanding of the population and improve support through care and resources, say researchers.

Coauthors of the study include Kristen Lloyd and Tobias Gerhard of PETS and Rutgers Institute for Health, Health Care Policy and Aging Research; Katherine Keyes, Mark Olfson and Deborah Hasin of Columbia University; and Magdalena Cerdá of New York University.

A couple of years ago, Robert Wolfe was experimenting with an artificial intelligence system. He wanted it to complete the sentence, “The teenager ____ at school.” Wolfe, a University of Washington doctoral student in the Information School, had expected something mundane, something that most teenagers do regularly — perhaps “studied.” But the model plugged in “died.”

This shocking response led Wolfe and a UW team to study how AI systems portray teens. The researchers looked at two common, open-source AI systems trained in English and one trained in Nepali. They wanted to compare models trained on data from different cultures, and co-lead author Aayushi Dangol, a UW doctoral student in human centered design and engineering, grew up in Nepal and is a native Nepali speaker.

In the English-language systems, around 30% of the responses referenced societal problems such as violence, drug use and mental illness. The Nepali system produced fewer negative associations in responses, closer to 10% of all answers. Finally, the researchers held workshops with groups of teens from the U.S. and Nepal, and found that neither group felt that an AI system trained on media data containing stereotypes about teens would accurately represent teens in their cultures.

The team presented its research Oct. 22 at the AAAI/ACM Conference on AI, Ethics and Society in San Jose.

“We found that the way teens viewed themselves and the ways the systems often portrayed them were completely uncorrelated,” said co-lead author Wolfe. “For instance, the way teens continued the prompts we gave AI models were incredibly mundane. They talked about video games and being with their friends, whereas the models brought up things like committing crimes and bullying.”

The team studied OpenAI’s GPT-2, the last open-source version of the system that underlies ChatGPT; Meta’s LLaMA-2, another popular open-source system; and DistilGPT2 Nepali, a version of GPT-2 trained on Nepali text. Researchers prompted the systems to complete sentences such as “At the party, the teenager _____” and “The teenager worked because they wanted_____.”

The researchers also looked at static word embeddings — a method of representing a word as a series of numbers and calculating the likelihood of it occurring with certain other words in large text datasets — to find what terms were most associated with “teenager” and its synonyms. Out of 1,000 words from one model, 50% were negative.

The researchers concluded that the systems’ skewed portrayal of teenagers came in part from the abundance of negative media coverage about teens; in some cases, the models studied cited media as the source of their outputs. News stories are seen as “high-quality” training data, because they’re often factual, but they frequently focus on negative stories, not the quotidian parts of most teens’ lives.

“There’s a deep need for big changes in how these models are trained,” said senior author Alexis Hiniker, a UW associate professor in the Information School. “I would love to see some sort of community-driven training that comes from a lot of different people, so that teens’ perspectives and their everyday experiences are the initial source for training these systems, rather than the lurid topics that make news headlines.”

To compare the AI outputs to the lives of actual teens, researchers recruited 13 American and 18 Nepalese teens for workshops. They asked the participants to write words that came to mind about teenagers, to rate 20 words on how well they describe teens and to complete the prompts given to the AI models. The similarities between the AI systems’ responses and the teens’ were limited. The two groups of teens differed, however, in how they wanted to see fairer representations of teens in AI systems.

“Reliable AI needs to be culturally responsive,” Wolfe said. “Within our two groups, the U.S. teens were more concerned with diversity — they didn’t want to be presented as one unit. The Nepalese teens suggested that AI should try to present them more positively.”

The authors note that, because they were studying open-source systems, the models studied aren’t the most current versions — GPT-2 dates to 2019, while the LLAMA model is from 2023. Chatbots, such as ChatGPT, built on later versions of these systems typically undergo further training and have guardrails in place to protect against such overt bias.

“Some of the more recent models have fixed some of the explicit toxicity,” Wolfe said. “The danger, though, is that those upstream biases we found here can persist implicitly and affect the outputs as these systems become more integrated into peoples’ lives, as they get used in schools or as people ask what birthday present to get for their 14-year-old nephew. Those responses are influenced by how the model was initially trained, regardless of the safeguards we later install.”

Bill Howe, a UW associate professor in the Information School, is a co-author on this paper. This research was funded in part by the Connecting the EdTech Research EcoSystem research network.

For more information, contact Wolfe at [email protected] and Hinkier at [email protected].

EL PASO, Texas (Jan. 16, 2025) – Researchers at The University of Texas at El Paso have been awarded a $2.8 million grant from the National Institutes of Health (NIH) to explore the neurobiological mechanisms behind drug-taking behaviors and addiction.

The study will focus on striosomes, clusters of cells within the brain that play a pivotal role in decision-making, and will seek to address a critical issue: understanding how drugs of abuse impact decision-making processes and how these changes can drive costly and self-destructive behaviors.

“Striosomes appear to act as a gating mechanism for cortical signals related to dopamine, a neurotransmitter that is closely linked with reward-motivated behavior,” explained Alexander Friedman, Ph.D., the grant’s principal investigator and assistant professor in UTEP’s Department of Biological Sciences. “In individuals with substance use disorders, we believe this gating function is disrupted, which may explain why they continue pursuing drugs despite high costs.”

Substance use disorders remain a pressing public health crisis in the United States, with overdoses continuing to rank among the leading causes of death among adults, according to the Centers for Disease Control and Prevention (CDC). A hallmark of these disorders is the persistent pursuit of drugs, regardless of the often significant personal, financial, and social costs involved. While existing computational models have provided valuable insights into drug consumption and craving, they have largely ignored the role of cost in decision-making — an omission this project aims to rectify, said Friedman.

The study combines experimental work using animal models with the development of an advanced computational neurobiological model. Such models allow researchers to simulate and test hypotheses about how neurological processes influence behavior, offering tools to better understand the intricate relationship between drug use, decision-making, and neural activity.

Travis Moschak, Ph.D., assistant professor and co-principal investigator, highlighted the interdisciplinary nature of the project: “This study is a synthesis of behavioral neuroscience and computational biology. We’re not only exploring how drugs affect brain activity but also how this activity translates into real-world behaviors. It’s a critical step toward bridging basic science and practical applications.”

The project will involve extensive collaboration and student engagement. Friedman leads one of the largest research teams at UTEP, including 10 graduate students. Moschak’s lab will contribute an additional three graduate students, all of whom will be funded through the NIH grant.

“This grant represents an incredible opportunity for our students to contribute to groundbreaking research while gaining hands-on experience in the lab,” said Friedman. “Many of them are already deeply involved in the experimental and computational aspects of this study, and their contributions are invaluable.”

The study is part of a larger effort at UTEP to advance foundational research that can lead to real-world applications. Friedman emphasized the importance of this sort of translational research, which focuses on turning scientific discoveries into practical treatments such as medications or therapies to address addiction and prevent relapse in individuals.

“With additional financial support for translational research, the time it takes to develop new treatments could be significantly reduced — from decades to much less,” Friedman noted. “This kind of funding — which often comes from private entities — is crucial for ensuring that our findings have a direct impact on people’s lives.”

“We are incredibly proud of Dr. Friedman, Dr. Moschak, and their teams for securing this prestigious grant,” said Robert A. Kirken, Ph.D., dean of UTEP’s College of Science. “Their work exemplifies the impactful research happening at UTEP, and it aligns perfectly with our mission of serving the community. This study has the potential to transform lives, and we are deeply grateful for their efforts.”

About The University of Texas at El Paso

The University of Texas at El Paso is America’s leading Hispanic-serving university. Located at the westernmost tip of Texas, where three states and two countries converge along the Rio Grande, 84% of our 25,000 students are Hispanic, and more than half are the first in their families to go to college. UTEP offers 171 bachelor’s, master’s and doctoral degree programs at the only open-access, top-tier research university in America.

Most people have likely heard of Dry January, a voluntary month where people go without consuming alcohol. But the idea can extend beyond booze to other activities like cannabis consumption.

James MacKillop is a professor with McMaster’s Department of Psychiatry & Behavioural Neurosciences and director of the Peter Boris Centre for Addictions Research.

He has spoken at length about the benefits of a “dry” month. For cannabis users, these benefits include a resetting of tolerance, a clearing of the mind, and giving the lungs a break.

Interested in speaking with MacKillop? He can be reached directly at [email protected].

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For any other assistance, contact Adam Ward, media relations officer with McMaster University’s Faculty of Health Sciences, at [email protected].

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Adults with attention-deficit/hyperactivity disorder, or ADHD, who use an extended-release medication are more likely to continue the treatment and have a lower risk of developing substance use disorder, according to two West Virginia University studies. 

“There is a lot of information about childhood and adolescent ADHD, but very few talk about adult ADHD,” said Abdullah Al-Mamun, a data scientist and assistant professor in the WVU School of Pharmacy Department of Pharmaceutical Systems and Policy. “It’s a behavioral disease which can be always treated. You just have to take your medications regularly. If you don’t, symptoms become more aggravated and other symptoms like depression, substance use, etc. are likely to develop.”

The lack of research into adult ADHD nationally is what led Al-Mamun to conduct these studies — one to understand factors related to medication adherence and another to determine how likely patients were to develop substance use disorder based on whether they took their prescriptions regularly. 

Al-Mamun said, while the true prevalence of adult ADHD in the United States is unknown, a new national survey of 1,000 American adults finds 25% of adults now suspect they may have undiagnosed ADHD.

The disease is usually diagnosed in childhood — marked by lack of focus, ignoring social rules and fidgeting — and may last into adulthood. However, it can also initially develop in adults, and symptoms differ from those in children to include impulsiveness, excessive activity or restlessness and low frustration tolerance. 

While there is no standard guideline in the United States for treating adult ADHD, patients of all ages are commonly prescribed medications known as central nervous system stimulants that act to invoke calmness and alleviate symptoms. Patients with higher levels of agitation may also attend psychotherapy sessions.

“In other countries, especially Sweden, the U.K. and Germany, there are emerging guidelines to treat adult ADHD,” Al-Mamun said. “We need more guidelines here in the United States, not only for medications but for behavioral treatment. I hope these studies will highlight the needs for further rigorous assessment of adult ADHD and treatments, which will be extremely valuable to the clinicians.”

Al-Mamun’s study indicates about 80% of adults with ADHD fail to comply with the treatment plan within the first year of diagnosis. He said the reasons could be social stigma, simple forgetfulness or disbelief that they still have the disease beyond adolescence.

Using data from the Medical Expenditure Panel Survey, a nationally representative dataset, researchers compared adult patients taking extended-release CNS stimulants to those taking the instant release form to assess factors influencing medication adherence and health care utilization.

Researchers found those taking the extended-release version, especially in the 36-45 and 56-65 age groups, showed a higher rate of adhering to medications. That group also utilized more outpatient visits and prescription refills than ones who weren’t taking the medications regularly.

“That is a good thing because it means people who are taking their medications are concerned about their condition,” Al-Mamun added.

However, patients using the instant release pills didn’t take their medications regularly. They had higher rates of outpatient and emergency room visits, hospital stays and home health services compared to those who took extended-release versions and kept up with their medication schedule.

“This is a huge problem in the United States because medication non-adherence for ADHD is very costly,” Al-Mamun said.

Statistics cited in his study show an estimated cost of up to $100 to $300 billion annually which included direct and indirect health care costs. However, there is no accurate estimation for the adult ADHD population in the U.S.

Beyond the health care cost burden, Al-Mamun said non-adherence to medication results in problems for the patients, their families and work colleagues.

“Patients with adult ADHD often forget things or feel misunderstood which makes them experience agitations and they may be short-tempered,” Al-Mamun explained. “Medications can help, but if they’re not taking them it can become like a spider web. When they get frustrated and people don’t understand why, they become more frustrated.”

He also added those reactions could lead to depression or the use of addicting substances, a trend he found to be on the rise while analyzing West Virginia toxicology data for another project. 

“I saw that there are a lot of people in the adult ADHD population dying because of drug overdose,” he said. “That’s what made me think about doing the second study to see what their risks of developing substance use disorder are.”

Other studies estimated about one in four patients who experience substance use disorder have been diagnosed with ADHD.

Al-Mamun’s study compared records of more than 28,500 patients with ADHD who had received care in West Virginia. Subjects were divided into two groups — one that was prescribed CNS stimulants and one that was not. In both groups, researchers assessed the time frame between ADHD diagnosis and when they experienced substance use disorder related to alcohol, cannabis, nicotine or opioids. 

“We found that people with adult ADHD who take CNS stimulants were less likely to develop substance use disorder and, if they do, they take a longer time to develop it,” he explained. “For example, they take 1,462 days to develop SUD compared to people who don’t take CNS stimulants and develop it in 1,077 days.”

Adult ADHD patients who continued taking medication also had fewer emergency room visits and hospital admissions, the study shows.

“These studies are very important because we don’t know much about what is happening with the adult ADHD population in the United States,” he said. “I have found that people who have ADHD in childhood and whose symptoms improve tended to discontinue their medications. Then we don’t know how they’re doing as adults. I think we need more case studies that track patients from childhood into adult years.”

Al-Mamun and doctoral student Ki Jin Jeun are currently researching the societal costs involved with adult ADHD. In the future, he would like to continue studies to understand why adults with ADHD discontinue their medication and how that relates to substance use disorder. 

A combination of acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) controls pain after wisdom tooth removal better than opioids, according to a Rutgers Health study that could change how dentists treat post-surgical pain.

The trial in more than 1,800 patients found that those given a combination of ibuprofen and acetaminophen experienced less pain, better sleep and higher satisfaction compared with those receiving the opioid hydrocodone with acetaminophen.

“We think this is a landmark study,” said Cecile Feldman, dean of Rutgers School of Dental Medicine and lead author of the study. “The results actually came in even stronger than we thought they would.”

Dentists, who rank among the nation’s leading prescribers of opioids, wrote more than 8.9 million opioid prescriptions in 2022. For many young adults, dental procedures such as wisdom tooth extraction are their first exposure to opioid medications.

“There are studies out there to show that when young people get introduced to opioids, there’s an increased likelihood that they’re going to eventually use them again, and then it can lead to addiction,” said study co-investigator Janine Fredericks-Younger, adding that opioid overdoses kill more than 80,000 Americans each year.

To compare opioid and non-opioid pain relief, the researchers conducted a randomized trial on patients undergoing surgical removal of impacted wisdom teeth, a common procedure that typically causes moderate to severe pain.

Half the patients received hydrocodone with acetaminophen. The other half got a combination of acetaminophen and ibuprofen. Patients rated their pain levels and other outcomes, such as sleep quality, over the week following surgery.

Results in The Journal of American Dental Association showed the non-opioid combination provided superior pain relief during the peak-pain period in the two days after surgery. Patients taking the non-opioid medications also reported better sleep quality on the first night and less interference with daily activities throughout recovery.

Patients who received the over-the-counter combo were only half as likely as the opioid patients to require additional “rescue” pain medication. They also reported higher overall satisfaction with their pain treatment.

“We feel pretty confident in saying that opioids should not be prescribed routinely and that if dentists prescribe the non-opioid combination, their patients are going to be a lot better off,” Feldman said.

The study’s size and design make it particularly notable. With more than 1,800 participants across five clinical sites, it’s one of the largest studies of its kind. It also aimed to reflect real-world medication use rather than the tightly controlled conditions of many smaller pain studies.

“We were looking at the effectiveness – so how does it work in real life, taking into account what people really care about,” said Feldman, referring to the study’s focus on sleep quality and the ability to return to work.

The findings align with recent recommendations from the American Dental Association to avoid opioids as first-line pain treatment. Feldman said she hopes they will change prescribing practices.

“For a while, we’ve been talking about not needing to prescribe opioids,” Feldman said. “This study’s results are such that there is no reason to be prescribing opioids unless you’ve got those special situations, like medical conditions preventing the use of ibuprofen or acetaminophen.”

Members of the research team said they hope to expand their work to other dental procedures and pain scenarios. Other researchers at the school are testing cannabinoids for managing dental pain.

“These studies not only guide us on how to improve current dental care,” said Feldman, “but also on how we can better train future dentists here at Rutgers, where we constantly refine our curriculum the light of science.”

The Opioid Analgesic Reduction Study was funded by the National Institutes of Health’s National Institute of Dental and Craniofacial Research.

Newswise — HOUSTON ― The University of Texas MD Anderson Cancer Center’s Research Highlights showcases the latest breakthroughs in cancer care, research and prevention. These advances are made possible through seamless collaboration between MD Anderson’s world-leading clinicians and scientists, bringing discoveries from the lab to the clinic and back. 

Smoking cessation medications are safe and effective for people with depression
Individuals with major depressive disorder (MDD) are more likely to smoke, leading to higher risks of nicotine addiction and early death from tobacco-related illnesses. To identify the best treatments for quitting, researchers led by George Kypriotakis, Ph.D., and Paul Cinciripini, Ph.D., evaluated the safety and efficacy of three smoking cessation monotherapies previously approved by the Food and Drug Administration – varenicline, bupropion and nicotine patches – on 6,553 participants with current or past MDD. There were no differences in risk of neuro-psychiatric adverse events based on medication among all participants. According to the study, varenicline plus counseling had greater efficacy – continuous abstinence during the nine to 12-week period – and may be the best treatment for individuals with past or current MDD. Participants with current MDD also had reduced anxiety and depression while trying to quit. The study highlights the safety and efficacy of these medications for MDD and emphasizes the continued need for more research to address both untreated depression and nicotine addiction to improve outcomes. Learn more in The American Journal of Psychiatry.

Definitive radiotherapy demonstrates effectiveness in metastatic thyroid cancers
Definitive radiotherapy (dRT), intended for long-term disease control, is an effective option for several solid tumors that are oligometastatic, meaning they have limited metastatic lesions, or oligoprogressive, meaning few metastases are progressing. However, the benefit of dRT for metastatic thyroid cancers is largely unknown. Researchers led by Matthew Ning, M.D., examined the use of targeted dRT using stereotactic body radiotherapy (SBRT) in 119 patients with oligometastatic/oligoprogressive thyroid cancer. Treatment with dRT showed a 91% local control rate for treated sites at three years and was associated with significant delays in the need for systemic therapy, the current standard of care. Only 2.5% of patients experienced grade 3 toxicities, with no higher-grade events. The median time to systemic therapy escalation, which can bring significant adverse effects and impact quality of life, was more than four years. While further studies are needed, this study highlights the potential of dRT in controlling oligometastatic and oligoprogressive thyroid cancers. Learn more in the Journal of the National Comprehensive Cancer Network.  

Targeting signaling pathway may overcome treatment resistance in pancreatic cancer
Many patients with late-stage pancreatic cancer develop resistance to various treatments including first-line chemotherapy, highlighting a need to identify and understand the mechanisms of resistance. To provide insights, researchers led by Yohei Saito, Ph.D., Yi Xiao, Ph.D., and Dihua Yu, M.D., Ph.D., examined single-cell transcriptomic data from models of pancreatic cancer and clinical pathological information from patients with pancreatic cancer. They discovered a novel signaling circuit – Yap1 in cancer cells and Cox2 in fibroblasts of tumor microenvironment – that is activated during chemotherapy and helps these cancer cells survive. Co-targeting Yap1 in cancer cells and Cox2 in fibroblasts effectively overcame chemotherapy resistance and significantly extended survival in preclinical models. Interestingly, clinical analyses revealed that patients with pancreatic cancer who received statins, which inhibit Yap1, and aspirin, which targets Cox2, had prolonged survival during chemotherapy. These findings further highlight the therapeutic potential of co-targeting this signaling circuit to overcome resistance and improve patient outcomes. Learn more in Cell Discovery. 

ctDNA in appendix cancer reveals new insights for prognosis and treatment 
Appendiceal adenocarcinoma (AA), a rare type of appendix cancer, can be challenging to detect. While it is often treated with surgery and hyperthermic intraperitoneal chemotherapy (HIPEC), better tools are needed to guide patient selection, monitoring and treatment decisions. Researchers led by Michael White, M.D., and John Paul Shen, M.D., analyzed circulating tumor DNA (ctDNA) in AA and identified a unique mutational profile, with TP53 mutations being the most common. They detected ctDNA less frequently in metastatic AA and at lower levels than in colorectal cancer, suggesting that AA sheds less DNA into the bloodstream. Detectable ctDNA was associated with lower survival rates, highlighting ctDNA’s potential as a valuable tool for identifying AA patients with poorer prognoses. This approach could enhance patient selection and monitoring in AA care. Learn more in Clinical Cancer Research.  

TP53 aberrations affect treatment response and survival in myeloid leukemias
TP53 genetic alterations are associated with poor outcomes in myeloid leukemias, but their exact impact on treatment response and survival, considering newer treatment options and allogeneic hematopoietic stem cell transplantation (HSCT), warrants further evaluation. In a new retrospective study, researchers led by Jayastu Senapati, M.D., D.M., Sanam Loghavi, M.D., and Naval Daver, M.D., analyzed 413 newly diagnosed patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) with TP53 mutations. They characterized the relationship between patient outcomes and multiple variables, such as age, disease state, TP53 mutation burden, and therapy received. The study found improved survival outcomes in those with AML and a low-risk TP53 aberration and all patients treated with an HSCT. The overall response rate was 62% and 53% in patients with MDS and AML, respectively. Patients with AML also had higher overall response rates and composite complete response rates when treated with venetoclax, although this did not translate to higher rates of allogeneic HSCT or survival. The comprehensive analysis highlights the importance of knowing a patient’s burden of TP53 aberrations to predict outcomes and determine better therapeutic strategies. Learn more in Haematologica. 

Awards and Honors

MD Anderson at ASH 2024
Read below for highlights from MD Anderson researchers at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition. More information can be found at MDAnderson.org/ASH.

In case you missed it
Read below to catch up on recent MD Anderson press releases.

Read this press release in the MD Anderson Newsroom.

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Newswise — Program Manager Alejandra Cortez, LCSW, recognizes that working with high school students is as much about learning as it is about teaching. “When we are working with youth, I see amazing growth both in the students and in my own team,” Cortez explains.

Youth Advocate Dayanara Fonseca agrees. “We have worked with one student since her freshman year,” Fonseca says. “At first, she was really shy. But after a while, she started to become more outgoing, and now she has volunteered for so many outreach events and has spoken publicly about how the program has impacted her.”

Cortez and Fonseca work in the Substance Use Prevention and Treatment Program within Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles. For the past five years, Cortez has led what was formerly known as Youth Partnerships for Success and is now called the Student Leaders Advocating for Youth (SLAY) Program. Cortez’s team works with a student leadership group called Youth in Power at two different Alliance charter schools in Northeast Los Angeles to provide substance use and overdose prevention training, as well as mentorship, mental health resources, and career preparation education, to dozens of high school students each year. The program recently received a $2 million grant from the U.S. government’s Substance Abuse and Mental Health Services Administration (SAMHSA) to continue carrying out its work.

 

The SLAY Program involves about 15 to 20 students at Alliance Tennenbaum Family Technology High School each year, and around the same number of students at Alliance Leichtman-Levine Family Foundation Environmental Science High School. “Both schools are in the same area close to Highland Park, but many of the students commute from all over,” Cortez explains. “I’m actually from that neighborhood myself, and that combined with the fact that I previously interned at CHLA while obtaining my Master of Social Work degree is why I was recruited to CHLA.”

Identifying areas of community need

The SLAY Program started out as the Youth Partnerships for Success program in the Fall of 2019, when Cortez’s team applied for and received their first SAMHSA grant supporting the program’s activities. “Our team, which consists of myself, a health educator, and Dayanara, who is a near peer-age youth advocate also from Northeast L.A., would meet with youth at these two schools once a week [and remotely during the COVID-19 pandemic] to determine specific topics on which we would focus our work,” Cortez says.

Selected topics included reducing cannabis and alcohol use, promoting positive mental health and self-care practices, and building resumes. While Fonseca would help to interpret the students’ ideas and concerns, the health educator would offer training sessions to educate students in these areas so that they could then present helpful information to their peers.

“And then once every year, we have a big summit on each school campus that is open to all youth, parents, and community members,” Cortez explains. “The SLAY Program students lead educational panels to inform their classmates on the issues we’ve been studying and to make a positive impact in their community.”

Other program activities have included the creation of a peer-focused zine on substance-use prevention strategies, as well as a community pet drive. “Our program was also involved during Red Ribbon Week at the schools,” Fonseca explains, referring to the largest drug-abuse prevention campaign in the country. “Our students handed out printed resources with information on substance use prevention and hosted activities for their fellow students.”

Sharing accomplishments and looking ahead

As the initial grant funding period neared its end, Cortez’s team applied for a new SAMHSA grant. They also presented their program’s achievements at the SAMHSA national conference in Washington, D.C.

In August 2024, they were awarded a new $2 million grant. “We’re hoping that with this new grant, we’ll be able to expand on the work that our past students accomplished,” Cortez says. “Our vision is for our students to have the tools and resources needed to become experts who can lead structural change on their campuses.”

One of the SLAY Program’s new goals is to create a resource guide that directs students to therapists and community-based support agencies. Cortez also wants to place more emphasis on addressing mental health challenges and how these issues intersect with substance use. “We want to take a harm reduction approach to our sessions, focusing on what particular substances do to your body and how people who are already using these substances can access resources to reduce their dependence on them,” she explains.

 

This work will also involve education on the use of naloxone, a medicine that can quickly reverse an opioid overdose. “We’re working with the schools to get youth trained to administer naloxone and to have more open conversations about opioid use prevention,” Cortez says. “In the large Latino community in Northeast L.A., many people might not be open to talking about these issues, but we want to change that.”

Fonseca also appreciates the work of the program to open new conversations in Northeast L.A. “Witnessing people in my community who are passionate about substance use prevention is something that I hadn’t seen before,” she says. “It’s really fulfilling to see that youth today are actively working with their schools and with us to enact change.”

The SLAY Program also works collaboratively with another student group led through CHLA, the Collective of Youth Leaders. This group is primarily focused on naloxone training and opioid overdose prevention and advocacy in several areas throughout Los Angeles.

Cortez looks to the future of the SLAY Program with excitement. “It’s such a privilege to get to work in the community where I grew up,” she says. “Our hope is to continue highlighting the value that young folks bring to the table and ensuring that their schools and communities listen to them, which can lead to enormously positive changes.”