Joseph Palamar

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Verified

Joseph verified their affiliation via an institutional email.

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• PhD, MPH
• Professor (Associate) at NYU Langone Medical Center

Background: The opioid crisis, driven by fentanyl use, continues to worsen in the US and there has been a lack of focus on nonfatal overdose and how pediatric populations are being affected. Objectives: We determined the prevalence of nonfatal pediatric fentanyl exposures and associated characteristics and delineated how such characteristics are as...

Background Smoking among adults in substance use disorder (SUD) treatment programs is common with limited success in quitting. Given e-cigarettes’ potential for smoking harm reduction, it is important to examine e-cigarette use among people in SUD treatment. Methods We analyzed data from adults who have received SUD treatment in the past year, from...

Introduction: Law enforcement seizure data can indicate potential shifts in drug availability. We examined trends in the size of illicit fentanyl seizures in the United States from 2018 through 2023. Methods: Using national High Intensity Drug Trafficking Areas data, we examined trends in the weight of fentanyl powder and number of fentanyl-contain...

Purpose of Review As the overdose crisis evolves, it is important to monitor fentanyl consumption patterns. This review provides an overview of recent findings regarding illegally manufactured fentanyl (IMF) availability, use, and associated harms in the US. Recent Findings Availability of IMF has increased, especially in pill form, and the increa...

3,4-methylenedioxymethamphetamine (MDMA; commonly referred to as “ecstasy” or “molly”) is a substituted amphetamine drug that is used recreationally for its acute psychoactive effects, including euphoria and increased energy, as well as prosocial effects such as increased empathy and feelings of closeness with others. Acute adverse effects can incl...

This study examines the prevalence and characteristics of reported diversion of undistributed ketamine in the US.

Background: Ketamine's potential for treating depression has drawn increased clinical interest in recent years. However, despite growing therapeutic use, recreational use among individuals with depression remain underexplored. Methods: We analyzed data from the 2015–2022 National Survey on Drug Use and Health for adults in the US. Trends in past-ye...

This Viewpoint discusses the spread of medetomidine in the US illicit opioid market and the need for monitoring and a public health response.

Introduction Cannabis use and cannabis use disorder (CUD) are associated with adverse psychosocial outcomes, but their impact on workplace absenteeism remains poorly understood. Moreover, few studies have examined the role of CUD severity. This study aims to address these gaps by examining the associations between cannabis use recency, frequency, C...

Objective This analysis evaluated the validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool for older adults. Methods We performed a subgroup analysis of older adults aged ≥65 (n = 184) from the TAPS tool validation study conducted in 5 primary care clinics. We compared the interviewer and self-ad...

Background Pentobarbital is a Schedule II/III short-acting barbiturate with limited medical use in humans. Veterinary professionals use pentobarbital to euthanize dogs, cats, and other companion animals. Pentobarbital is also utilized in capital punishment and small amounts are illegally shipped or diverted to assist in suicides. However, five kilo...

Background: The spread of illicitly manufactured fentanyl is driving steep increases in US overdose deaths. Fentanyl seizures are correlated with state-level opioid-related mortality; however, more granular seizure surveillance information has the potential to better inform overdose prevention and harm reduction efforts. Methods: Using data on fe...

Background Rates of synthetic opioid-related deaths over time and across regions have been compared within the US, but other indicator data could help inform prevention and harm reduction as well. We compared regional trends in fentanyl seizures to examine potential shifts in illicit fentanyl availability. Methods Annual trends in fentanyl seizure...

Purpose of review New psychoactive substances (NPS) continue to emerge globally and present a threat to public health. This article summarizes the most recent literature on approaches for monitoring NPS use and adverse events related to use. Recent findings A variety of approaches have recently been employed for surveillance of NPS use and associa...

Background: Hair provision for drug testing can provide secondary measurement to complement self-reported drug use data, thereby providing a more accurate representation of an individual's drug use. Understanding factors associated with hair provision offers valuable insights into recruitment methods. Objective: To identify demographic and drug-rel...

Introduction Although morbidity and mortality related to synthetic opioids such as illicitly manufactured fentanyl are monitored in the U.S., there has been a lack of national survey data focusing on use. Survey data are important because self-report can help estimate prevalence of use among living persons. Methods Data were examined from the 2022...

Background: Psilocybin, the principle psychoactive component in "shrooms", is regaining acceptance in therapeutic settings, leading to media coverage of medical benefits associated with use. Possession is also becoming increasingly decriminalized throughout the United States. There is a lack of data on prevalence of shroom use, but trends in law en...

Introduction Ecstasy (3,4‐methylenedioxymethamphetamine [MDMA]) is a drug commonly used by people who attend electronic dance music (EDM) events at nightclubs and dance festivals. Drug checking has gained popularity in recent years to test for adulterants, but epidemiology studies are needed to estimate potential shifts in prevalence of drug checki...

This Viewpoint discusses changes in the use of ketamine as a medical therapeutic and a recreational substance, the potential risks of use, and the need for increased research and surveillance.

Research suggests that hair color, hair dyeing, and perspiration can bias hair test results regarding drug exposure, but research is needed to examine such associations in a multivariable manner. In this epidemiology study, adults were surveyed entering nightclubs and dance festivals in New York City, and 328 provided hair samples, which were analy...

Introduction: People who attend nightclubs and festivals are known for high prevalence of party drug use, but more research is needed on underreporting in this population, in part because unintentional drug exposure through adulterated drug products is common. We examined the prevalence of drug use in this population, based both on self-reporting...

A new class of synthetic cannabinoids called OXIZIDs has emerged in recent years. This class consists of compounds with oxindole cores and hydrazide/hydrazone linker moieties and has often been described as being designed to circumvent a Chinese class-wide ban that was effective as of July 1, 2021. However, through hair testing of nightclub attende...

Introduction: While there is increasing interest in the use of cannabis to manage a range of health-related symptoms, little is known about trends in recent cannabis use with respect to various health conditions. Methods: We examined data from a US representative sample of noninstitutionalized adults age ≥ 18 from the 2015–2019 National Survey on D...

Background Nightclub/festival attendees are a population with high rates of party drug use, but research is needed to determine whether there have been shifts in unintended drug exposure in this population (e.g., via adulterants) to inform prevention and harm reduction efforts. Methods Adults entering nightclubs and festivals in New York City were...

Few epidemiological studies have focused on seasonal variation in the use of common psychedelics and party drugs among nightclub and festival attendees, typically those who attend electronic dance music (EDM) events. We sought to determine whether the use of different drug types varies seasonally within this population. Across 15 seasons from summe...

With the current crisis related to the diffusion of fentanyl and other novel opioids in several countries and populations, new and effective approaches are needed to better elucidate the phenomenon. In this context, hair testing offers a unique perspective in the investigation of drug consumption, producing useful information in terms of exposure t...

Objectives: 3,4-Methylenedioxymethamphetamine (MDMA) (also known as "ecstasy" or "Molly") has regained attention in recent years for its efficacy in treating posttraumatic stress disorder, and the drug was granted breakthrough therapy designation for such use by the US Food and Drug Administration in 2017. However, little is known about the curren...

A drug concoction called tusi has emerged in Latin America and in Europe and is now beginning to acquire popularity in the United States. “Tusi” is a phonetic translation of “2C,” a series of psychedelic phenethylamines. The concoction is also sometimes referred to as “pink cocaine” as it typically comes in the form of pink powder. However, despite...

Introduction It is largely unknown whether adverse effects experienced from recreational drug use affect willingness to use again. This study determined whether adverse effects from select party drugs affect reported willingness to use again in the next month among a high-risk population—people who attend electronic dance music parties at nightclub...

People who attend nightclubs and dance festivals-particularly those that feature electronic dance music (EDM), are at high risk for use of cocaine and other party drugs. Given that cocaine is now sometimes adulterated with fentanyl, this study examines trends in people's knowledge about such risk of adulteration to inform prevention and harm reduct...

Background: Research investigating adverse effects from drug use has focused extensively on poisonings and mortality. This study focuses on drug-related adverse effects not necessarily resulting in hospitalization or death among a population known for high prevalence of party drug use-electronic dance music (EDM) nightclub and festival attendees....

Background: Drug use is prevalent among people who attend electronic dance music (EDM) parties at nightclubs or festivals. This population can serve as a sentinel population to monitor trends in use of party drugs and new psychoactive substances (NPS) that may diffuse through larger segments of the population. Methods: We surveyed adults enterin...

Asian sexual minorities (SMs) are an under-researched population. SMs are at higher risk for substance use problems than heterosexuals, but little research exists specifically on Asians who are SM. This study compared the prevalence of substance use among Asian SMs and among adults by race/ethnicity and sexual identity in the US. Data were analyzed...

Background: The purpose of this work was to describe the experiences of EMS personnel in responding to drug overdose-related calls and the impact the pandemic has had to help better inform current response and treatment efforts. Methods: Semi-structured interviews were conducted with 99 EMS personnel across 18 areas throughout the United States th...

Background There has been an increase in methamphetamine use across the globe, despite widespread control of the drug, prevention, and treatment. Community-based approaches have proven effective in tackling diverse health-related challenges including substance use; however, little is known regarding community programs targeting methamphetamine use....

Background: The use of ketamine, a controlled dissociative anesthetic, has become more widespread in recent years with recreational/nonmedical use increasing and ketamine becoming more widely available in clinics to treat depression. Aims: We examined recent trends in adverse effects related to ketamine use. Methods: US National Poison Control data...

Background: Drug-related deaths in the US continue to increase. Sentinel surveillance of high-risk populations can provide early warning for shifts in trends. Nightclub/festival attendees have high levels of drug use, so we explored whether use among this population can serve as a potential bellwether or indicator for use-related mortality in the g...

Cannabis use is prevalent among adolescents and young adults in the US. Virtually all modes of cannabis consumption involve the oral cavity, and previous studies have linked cannabis use with poorer oral health. We sought to identify associations between cannabis use and various oral health outcomes and behaviors among individuals 12–25 years of ag...

Background Despite concerns about increasing trends in depression over the past two decades, little is known about recent trends in depression and mental health (MH) treatment among older adults and whether these trends differ by demographic characteristics. Methods We examined data from a US representative sample of noninstitutionalized adults ag...

The aging United States population, which includes the large Baby Boomer generation, is leading to an increasing number of middle-aged and older adults who engage in psychoactive substance use. There has been a sharp increase in prevalence of past-month cannabis use among adults aged ≥50; however, little is understood about recent trends in the use...

Background: Fentanyl-related deaths continue to increase in the United States; however, most national studies focus on fatal overdose. More research, including data on nonfatal overdose, is needed. Objective: We examined trends in characteristics of fatal and nonfatal fentanyl-related poisonings ("exposures") in the US. Methods: National Poiso...

From March 2020 through May 2021, nightlife venues were shut down and large gatherings were deemed illegal in New York City (NYC) due to COVID-19. This study sought to determine the extent of risky party attendance during the COVID-19 shutdown among people who attend electronic dance music parties in NYC. During the first four months that venues we...

Gamma-hydroxybutyrate (GHB) was a somewhat prevalent club drug two decades ago, but research has been lacking regarding the current epidemiology of use. In this study, prevalence and correlates of past-year GHB use were estimated based on noninstitutionalized US adults participating in the 2015-2020 National Survey of Drug Use and Health (N= 241,67...

Background: Early onset of drug use could lead to long-term impairments, and research suggests that substance use and substance use disorders are more common among lesbian, gay, and bisexual (LGB) individuals. We sought to determine whether adults of different sexual identities were at differential risk for an earlier onset of drug use. Methods:...

Background: Protective behavioral strategies (PBS) have been shown to be useful for reducing excessive alcohol use and alcohol-related problems. However, research on the explanatory factors of PBS is limited. This paper prospectively examines the contribution of perceived efficacy of PBS in reducing alcohol-related consequences and perceived descr...

Background There is renewed interest in the clinical application of hallucinogenic substances to treat a range of psychiatric conditions. However, there is mixed evidence regarding how use of such substances outside of medical settings relates to psychological distress, depression, and suicidality. Methods We examined data from a US representative...

Background Prevalence of fentanyl-laced counterfeit prescription pills has been increasing in the US, possibly placing a wider population at risk for unintentional exposure. We aimed to determine whether there have been shifts in the number of fentanyl seizures and in the form of fentanyl seized in the US. Methods We examined quarterly national se...

This editorial comments on the article by Javanbakht et al.

Background Dance festivals have been shown to be high-risk events for use of drugs such as ecstasy/MDMA and possible adverse effects associated with use. However, few studies have examined what makes festivals such risky environments. We aimed to determine festival-specific risk factors for adverse outcomes related to drug use. Methods In-depth in...

Background: Nightlife attendance is an established risk factor for drug use, but studies have not focused on adolescent general population samples or compared risk according to type(s) of venues attended. We examined whether attendance of various types of venues was associated with drug use. Methods: Data were examined from an annual nationally rep...

Background and Objectives: Ketamine is efficacious in treating treatment‐resistant depression in medical settings and the drug was approved for such use by the US Federal Drug Administration in 2019. However, little is known about how use outside of medical settings relates to depression. We determined whether recreational ketamine use, relative to...

Purpose : To outline a method for obtaining more accurate estimates of drug use in the United States (US) general population by correcting survey data for underreported and unknown drug use. Methods : We simulated a population (n=100,000) reflecting the demographics of the US adult population per the 2018 American Community Survey. Within this pop...

Older adults with visual impairment may be at risk for developing substance use disorder (SUD) as psychoactive substance use is often used to cope with the stressors of vision loss. This study estimates the national prevalence and risk of psychoactive substance use among older adults with visual impairment. We analyzed data of respondents age ≥50 f...

Background Novel psychoactive substances (NPS) present continuous and growing challenges for the scientific, medical, and interventional communities as emerging substances on recreational drug markets change national and international drug landscapes. NPS account for an increasing proportion of adverse events, hospitalizations, and deaths due to in...

Psychoactive substance use to cope with the stressors of vision loss is well documented,¹ and visual impairment is associated with risk of developing substance use disorder (SUD).² Given increases in substance use among aging populations and expected increases among older adults living with visual impairment,³ assessing substance use among older ad...

Background Drugs like ecstasy, cocaine, and counterfeit prescription pills can contain fentanyl. We examined knowledge about potential adulteration/contamination of such drugs among people attending electronic dance music (EDM) parties. Methods Adults in New York City were surveyed entering randomly selected EDM parties during the summers of 2018...

Background: Recent literature suggests that the gap in prevalence of binge drinking between men and women is closing, but little is known about sex-specific differences in trends and correlates of binge drinking among older Americans. Methods: A total of 18,794 adults, aged 65 years and older were surveyed in the 2015-2019 National Survey on Dru...

Objectives. To determine whether there have been shifts in nonmedical ketamine use, poisonings (“exposures”), and seizures. Methods. We used generalized additive models to detect trends in past-year use (2006–2019), exposures (1991–2019), and seizures (2000–2019) involving ketamine in the United States. Results. There was a quarterly increase in...

Objectives. To determine whether there have been shifts in nonmedical ketamine use, poisonings (“exposures”), and seizures. Methods. We used generalized additive models to detect trends in past-year use (2006–2019), exposures (1991–2019), and seizures (2000–2019) involving ketamine in the United States. Results. There was a quarterly increase in se...

Background: Despite increasing prevalence of nonmedical ketamine use globally, data on ketamine use disorders, which are classified in the DSM-5 under criteria for phencyclidine, are limited. This study assessed the reliability and applicability of DSM-based diagnostic criteria for ketamine use disorder. Methods: Participants who used ecstasy were...

Individuals with mental illness are at risk of developing co-occurring substance use disorders (SUDs). We assessed whether unmet need for mental health treatment in the past year was a risk factor for past-month use of marijuana, cocaine, methamphetamine, and misuse of prescription opioids in this population. Data from adults diagnosed with mental...

Background Intercept surveys are a relatively inexpensive method to rapidly collect data on drug use. However, querying use of dozens of drugs can be time-consuming. We determined whether using a rapid screener is efficacious in detecting which participants use drugs and should be offered a full survey which asks more extensively about use. Method...

Introduction: Reliable responses on surveys are important to ensure accurate estimates of drug use. This study compared prevalence of self-reported vaping of cannabis based on two separate questions on the same survey. Methods: We examined combined data from the 2017–2019 Monitoring the Future nationally representative survey of high school seniors...

Background: Accurate prevalence estimates are critical to epidemiological research but discordant responses on self-report surveys can lead to over-or underestimation of drug use. We sought to examine the extent and nature of underreported cannabis use (among those later reporting blunt use) from a national drug survey in the US. Methods: We used d...

Background Research on the efficacy of ketamine in treating depression and 3,4-methylenedioxymethamphetamine (MDMA) in treating post-traumatic stress disorder have been widely covered by the media. Given recent widespread coverage of the efficacy of these drugs, it is important to determine whether such coverage influences prevalence of recreationa...

Background/objectives: Cannabis use among older adults is increasing sharply in the United States. While the risks and benefits of cannabis use remain unclear, it is important to monitor risk factors for use, including low perception of harm. The objective of this study was to estimate recent national trends in perceived risk associated with canna...

Introduction: Psychoactive substance use may be risky for adults with functional impairments. This study investigates cannabis use and prescription opioid and tranquilizer/sedative (mis)use among adults age ≥50 reporting functional impairments in the U.S. Methods: This cross-sectional analysis of adults age ≥50 from the 2015-2019 cohorts of the Na...

Purpose Studies have examined trends in cannabis vaping, but research is needed to examine trends in more frequent use as this may increase risk for adverse health outcomes. Methods Data were from 12,561 high school seniors participating in the Monitoring the Future national study. Prevalence of self-reported frequent vaping of cannabis (defined a...

Background: National surveys are a leading method for estimating prevalence of substance use and other health-related behaviors. However, when a participant perceives a survey as too time consuming, there is a higher probability of lower quality responses. Methods: We examined data from the 2018 to 2019 National Survey on Drug Use and Health, a nat...

Introduction. Kratom is a plant with partial opioid agonist effects, and its use has become popular to ameliorate symptoms of opioid withdrawal. Use, however, has been linked to thousands of poisonings, although most have involved use of other drugs. Little is known regarding prevalence and correlates of use in the general US population. Methods....

Background Little is known regarding how the COVID-19 pandemic has affected patterns of drug use in the United States. Because drug seizures can serve as a proxy for drug availability, we examined shifts in drug seizures in the US during the pandemic. Methods We examined trends in seizures of marijuana, cocaine, methamphetamine, heroin, and fentan...

Dance festival attendees are at high risk for consuming adulterated drugs. In recent years, drug checking studies have been conducted at various dance festivals to provide valuable harm reduction information to attendees regarding drug content. We conducted a review of the literature to determine the generalizability of findings to the target popul...

Background Prevalence of cannabis use has been increasing among select subgroups in the US; however, trend analyses typically examine prevalence of use across years. We sought to determine whether there is seasonal variation in use. Methods We conducted a secondary analysis of the National Survey on Drug Use and Health from 2015 to 2019 (N = 282,7...

Background: Little is known about how COVID-19-related social distancing has affected illegal drug use. We surveyed electronic dance music (EDM) partygoers-a population known for high levels of drug use-to determine whether their drug use patterns had changed during state-mandated social distancing in New York. Methods: Individuals were recruited o...

Background A variety of substance use-related topics are discussed in the public discourse; however, it is unknown how public discussion of published substance-related findings relates to manuscript downloads and citations. This manuscript examines how traditional and social media coverage of published findings about substance use affects downloads...

Background Adults age ≥ 50 are among the fastest growing populations in correctional supervision and are medically underserved while experiencing unique health disparities. Community-living older adults, referred to as “justice-involved,” are people who have been recently arrested, or are on probation or parole. Although medical complexity is commo...