Joseph Palamar

Joseph Palamar
NYU Langone Medical Center | NYUMC · Department of Population Health

PhD, MPH

About

194
Publications
24,168
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
4,289
Citations
Introduction
Skills and Expertise
Additional affiliations
April 2017 - March 2020
NYU Langone Medical Center
Position
  • Professor (Associate)
September 2013 - July 2021
NYU Langone Medical Center
Position
  • Professor (Associate)
Education
September 2006 - May 2010
New York University
Field of study
  • Public Health

Publications

Publications (194)
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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:...
Article
Full-text available
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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....
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
Background The popularity of virtual raves and happy hours has increased during the COVID-19 pandemic. While nightlife settings are often associated with drug use, it is unknown whether virtual events are associated with use. Methods Electronic dance music (EDM) partygoers who live in New York and reported recent drug use were recruited online and...
Article
Full-text available
Background: Older lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity....
Article
Background Ecstasy (MDMA, Molly) is among the most prevalent drugs used by people who attend electronic dance music (EDM) events; however, little recent research has examined diffusion of ecstasy in this high-risk population. Methods: 1,020 EDM event-attending adults (aged 18–40) were surveyed in NYC in 2018 using time-spacing sampling. Participant...
Article
Background and Objectives Electronic dance music (EDM) party attendees who use ecstasy (3,4‐methylenedioxymethamphetamine [MDMA], Molly) are at high risk for ingesting adulterant drugs, but little is known regarding trends in exposure. We sought to determine whether adulteration has shifted in recent years. Methods Adults entering EDM events at ni...
Article
Most human subjects research involving contact with participants has been halted in the US due to the COVID-19 crisis. We have been testing an online method to recruit and survey participants as a temporary replacement for our street-intercept survey method. Online surveys already generate less generalizable findings than other surveys, but offerin...
Article
We sought to estimate the prevalence as well as demographic and drug use-related correlates of poppers use among adults in the United States. Data were analyzed from adult participants (ages 18-64) in the 2015-2017 National Survey on Drug Use and Health (N = 115,744), a nationally representative survey of non-institutionalized adults in the US. An...
Article
Background and Objectives Electronic dance music (EDM) party attendees are at high risk for drug use. However, little is known regarding the extent of underreporting of drug use in this population, in part, because use of synthetic drugs is often associated with unknown exposure to adulterant drugs. We estimated the extent of underreported drug use...
Article
Background Prevalence of self-reported methamphetamine use has remained relatively stable over the past decade; however, deaths and seizures involving methamphetamine have been increasing. Research is needed to determine if select subgroups in the US are at increased risk for use. Methods We examined data from individuals ages ≥12 from the 2015–20...
Article
Intention and willingness to use drugs are proximal predictors of drug use; however, willingness to use requires more research to inform prevention efforts. This study examines willingness to use drugs among electronic dance music (EDM) party attendees, a population at high risk for drug use. Data were examined from a repeated cross-sectional study...
Article
Background: Electronic dance music (EDM) party attendees are at high risk for use of various illegal drugs; however, little is known about their tobacco use. Understanding tobacco use patterns in this population at high risk for illegal drug use can inform multi-product interventions. Objectives: 954 EDM party attendees (ages 18-40) were surveyed i...
Article
Background: Due to underreporting, a major challenge associated with drug use surveys is obtaining precise estimates of drug use. Objective: This study examined reliability of self-reported lifetime marijuana use among electronic dance music (EDM) party attendees – a high-risk population for drug use. Methods: 794 adults (35.1% female) entering EDM...
Article
Full-text available
Non-consensual sexual contact in bars is common, but few studies have focused on the extent of this problem at electronic dance music (EDM) parties, which are growing in popularity. We aimed to estimate prevalence and correlates of non-consensual sexual contact among individuals who attend EDM parties in New York City (NYC). Adults (ages 18-40 year...
Article
Full-text available
Purpose of review Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose and/or presence of adulterants. Drug checking appears to be more common in recent years in response to increases in fentanyl-related deaths and the proliferation...
Article
With the legalization of cannabis in many states for medical and/or recreational purposes, there is increasing interest in using cannabis to treat a variety of long-term health conditions and symptoms common among older adults. The use of cannabis in the past year by adults 65 years and older in the United States increased sharply from 0.4% in 2006...
Article
Objective: Electronic dance music (EDM) party attendees are a high-risk population for drug use and associated adverse effects. We examined trends in past-year drug use within this population to better inform prevention and harm reduction efforts. Methods: Each summer from 2016 through 2019, we used time-space sampling to survey a cross-section of...
Article
Objective: The number of novel psychedelic phenethylamines and tryptamines has continued to increase, but little academic research has focused on the effects of these substances. We sought to determine and compare the subjective effects of various substances. Methods: We conducted in-depth interviews with 39 adults (75.4% male and 87.2% White) w...
Article
The detection of NPS in hair has become extensively researched in recent years. Although most NPS fall into the classes of synthetic cannabinoids and designer cathinones, novel synthetic opioids (NSO) have appeared with increasing frequency in the illicit drug supply. While the detection of NSO in hair is now well-documented, interpretation of resu...
Article
Objective: To estimate prevalence of past-month marijuana, cocaine, and nonmedical prescription opioid (NPO) use and determine employment-related correlates of drug use among construction trade/extraction workers (CTEW). Methods: We analyzed ten years of data (2005-2014) from 293,492 adults (age≥18) in the National Survey on Drug Use and Health, c...
Article
Background: Drug use among electronic dance music (EDM) party attendees is common; however, studies are needed to examine associations between drug use and sexual orientation as this can inform prevention and harm reduction efforts in the lesbian, gay, and bisexual (LGB) community. Methods: Data were examined from a repeated cross-sectional study o...
Article
Introduction and aims: Longitudinal studies have found that recanting of drug use is common. We investigate the extent to which individuals in a high-risk population-electronic dance music (EDM) party attendees-provide inconsistent reports of drug use. Design and methods: Nine hundred and thirty-three EDM party attendees were intercept-surveyed...
Article
Background: Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]), commonly referred to as Molly in the US, is commonly adulterated with drugs potentially more dangerous than MDMA. Synthetic cathinones (“bath salts”) are common adulterants, and use of these compounds tends to be stigmatized. We investigated whether presenting information on the extent...
Article
Objectives: Skip-logic is commonly used on electronic surveys in which programs provide follow-up questions to affirmative responses and skip to the next topic in response to non-affirmative responses. While skip-logic helps produce data without contradictory responses, erroneous non-affirmative reports can lead to loss of accurate information. We...
Article
Background: Posting on social media can have lasting consequences in one's social life and career. Research has not yet focused on social media or more modern forms of communication as social risk factors for individuals high on drugs. This study aims to examine prevalence and correlates of engaging in social media posting and related behavior whil...
Article
Objectives: Binge drinking is a risk factor for a range of harms. This study estimates the national prevalence of binge drinking and adds to our understanding of correlates of binge drinking among older adults in the United States. Design: Cross-sectional analysis. Setting/participants: A total of 10 927 adults, aged 65 years or older, from th...
Article
Background: Drug use is prevalent among electronic dance music (EDM) party attendees, but research is needed to determine the extent of adverse drug-related outcomes in this population in order to better inform prevention and harm reduction efforts. Method: 1029 adults were surveyed entering EDM parties in New York City in 2018. Those reporting...
Article
Better screening instruments to detect drug use during pregnancy are needed, but under reporting of use in this population will probably continue as long as many pregnant women who use drugs fear social and/or legal repercussions.
Article
Low perception of risk is a risk factor for heroin use. Research is needed to determine whether this risk factor for heroin use is affected by the use of other drugs. Data were analyzed from participants in the 2015/2016 National Surveys on Drug Use and Health who denied lifetime heroin use (N= 110,102). We examined how recency of use of various dr...
Article
Background: Biological testing can used to validate or detect underreported drug use. Since hair testing is increasingly used in survey research, we examined how the utility of hair testing compares to a more common method—urine testing. Methods: 532 adults (ages 18-29) reporting past-month heroin use and/or nonmedical prescription opioid use were...
Article
Background/Objectives Lean (a.k.a.: Sizzurp, Purple Drank) is a recreational beverage that commonly contains codeine cough syrup. Despite its popularization in the hip‐hop music scene, few epidemiologic studies have examined use. This study examined prevalence and correlates of use among a population at high‐risk for drug use—electronic dance music...
Article
Objectives This study aims to examine patterns and first mentions of reported use of new or uncommon drugs across 13 years, among nationally representative samples in the United States. Methods Participants (ages ≥12) in the National Surveys on Drug Use and Health (2005–2017, N = 730,418) were provided opportunities to type in names of new or unco...
Article
Full-text available
Rationale: Current prevalence estimates of synthetic cathinone (“bath salt”) use may be underestimates given that traditional metrics (e.g., surveys, urinalysis) often fail to capture the emergent issue of synthetic cathinone adulteration of more common illegal drugs, such as ecstasy (3,4-methylenedioxymethamphetamine). Objectives: This review exam...
Article
Background: Electronic dance music (EDM) parties at nightclubs and festivals are high-risk scenes for drug use. Although intention to use drugs (such as ecstasy) has been shown to be the most proximal determinant of use, little is known regarding the extent to which drug use is unplanned in this high-risk scene. Methods: We surveyed 954 adults e...
Article
Adults ≥50 years of age have high rates of prescription opioid use. The purpose of this study is to estimate the prevalence and correlates of prescription opioid misuse among middle-aged and older adults in the United States who use prescription opioids. Data from adults age ≥ 50 from the two most recent cohorts (2015 and 2016) of the National Surv...
Article
Background: Use of synthetic cathinones, commonly referred to as "bath salts", has been associated with tens of thousands of emergency department visits in the US; however, few national studies have estimated prevalence of use and we know very little about use among adolescents. In this study we estimate prevalence and correlates of use of "Flakka...
Article
Background: Deaths from fentanyl exposure continue to increase in the US. Fentanyl test strips are now available to test urine for presence of fentanyl, but additional testing methods are needed to determine past exposure and to determine exposure to specific analogs. Objectives: To investigate exposure to such analogs through hair testing. Methods...
Article
Full-text available
Introduction and Aims Ecstasy users in the electronic dance music scene are at high risk for using ecstasy adulterated with new psychoactive substances and/or methamphetamine. We examined self‐reported testing of ecstasy among users in this scene. Design and Methods We surveyed individuals (aged 18–40 years) entering electronic dance music parties...
Article
Background: Benzodiazepine overdose rates have increased in the US, largely from concomitant use of other drugs such as opioids. Studies are needed to examine trends in prescription tranquilizer (e.g., benzodiazepine) use-with a particular focus on use of other drugs such as opioids-to continue to inform prevention efforts. Methods: We conducted...
Article
Novel synthetic opioids include various analogs of fentanyl and emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45 and U-47700. In recent years, these drugs have rapidly emerged on the drug market, and their abuse has been increasing worldwide. The motivations for use of these new compounds include their lega...
Article
Introduction: The opioid epidemic in the U.S. continues to increase in severity, and misuse of prescription opioids is of particular concern since it commonly precedes heroin use. This study examined whether sexual orientation (i.e., sexual identity and sexual attraction) is a risk factor for prescription opioid misuse and use disorder among a nat...
Article
Introduction and Aims Polysubstance users are a high‐risk population for negative health‐related consequences. Although some studies have described harm reduction strategies adopted by polysubstance users, studies have not examined their effectiveness in minimising health‐related consequences. We aimed to identify dosing‐related harm reduction stra...