{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:30:15Z","timestamp":1769603415056,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>International consensus statements on depression and anxiety in adolescents and adults with cystic fibrosis\u00a0(awCF) recommend assessment for comorbid substance misuse. However, at CF centers, the frequency and impact of substance misuse have not been well characterized, and best practices for prevention, identification, and evidence\u2010based treatment have not been routinely implemented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of 148 awCF over 3 years were reviewed to determine the prevalence of substance misuse (alcohol or opiates) and its relationship with clinical variables and healthcare utilization. Independent sample <jats:italic>t<\/jats:italic>\u00a0test for continuous outcomes and <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> test for binary outcomes were used to compare groups with and without substance misuse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Substance misuse was documented in 28 (19%) awCF, equally distributed between alcohol (<jats:italic>n<\/jats:italic>\u2009=\u200913) and opiates (<jats:italic>n<\/jats:italic>\u2009=\u200915). Adults with substance misuse were more likely to be male. The prevalence of diagnosed anxiety and depression did not differ significantly between groups, but those with substance misuse had more severe anxiety (Generalized Anxiety Disorder\u20107 Item [GAD\u20107]: 10.0\u2009\u00b1\u20096.1 vs. 3.3\u2009\u00b1\u20094.4; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and depressive symptoms (Patient Health Questionnaire\u20109: 10.4\u2009\u00b1\u20096.5 vs. 4.0\u2009\u00b1\u20094.8; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Adults with substance misuse had higher annual rates of missed outpatient CF visits, more frequent \u201csick\u201d visits, more frequent and longer hospitalizations, and a higher mortality rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In awCF, substance misuse is common and associated with adverse indicators of emotional and physical health, including via proxy of service utilization, suggesting that systematic approaches to addressing substance misuse in CF clinics should be considered. Prospective, longitudinal study is warranted to elucidate the complex relationships between depression, anxiety, substance misuse, and health outcomes in individuals with CF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26541","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T13:23:06Z","timestamp":1686316986000},"page":"2535-2542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Alcohol and opiate misuse in adults with cystic fibrosis"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1182-0613","authenticated-orcid":false,"given":"Christopher J.","family":"Richards","sequence":"first","affiliation":[{"name":"Pulmonary and Critical Care Medicine Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6833-5216","authenticated-orcid":false,"given":"Deborah","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Pinsky","sequence":"additional","affiliation":[{"name":"Pediatric Cystic Fibrosis Center Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Gootkind","sequence":"additional","affiliation":[{"name":"Pediatric Cystic Fibrosis Center Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Lee","sequence":"additional","affiliation":[{"name":"MGH Center for Biostatistics Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1711-8227","authenticated-orcid":false,"given":"Lael","family":"Yonker","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonary, Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0924-4031","authenticated-orcid":false,"given":"Anna M.","family":"Georgiopoulos","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2014.05.017"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-205983"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01328"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.101.2.250"},{"issue":"2","key":"e_1_2_9_6_1","first-page":"S148","article-title":"Impact of depression on subsequent pulmonary exacerbations and lung function decline","volume":"53","author":"Schechter MOJ","year":"2018","journal-title":"Pediatr Pulmonol"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2020.07.020"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2022.06.014"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207488"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25563"},{"key":"e_1_2_9_11_1","unstructured":"Substance Abuse and Mental Health Services Administration.\u00a02019.Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19\u20105068 NSDUH Series H\u201054). 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