Linda B Cottler

University of Florida | UF · Department of Epidemiology

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: 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...

Background This study describes attitudes towards diversity, equity, and inclusion (DEI) among members of the Clinical and Translational Science Awards (CTSA) Program. It also explores associations between program members’ roles and their perceived importance of and commitment to improving DEI and assesses the link between perceived importance of a...

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...

Introduction: Pharmacogenetic testing may hold promise in addressing health disparities, as medically underserved patients appear to be prescribed medications with pharmacogenetic guidelines at higher rates. While routine clinical implementation of testing in medically underserved populations has not yet been achieved, using patient perspectives to...

Researchers often conduct randomized controlled trials among patient populations that may not reflect the community in which findings will be translated. The University of Florida’s community engagement program HealthStreet provides a diverse sample in which to consider differences between people 65 years of age and older who have seen a physician...

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...

Electronic nicotine delivery systems (ENDS) are relatively new and ENDS use data from community engagement programs may help us understand usage patterns and facilitate targeted longitudinal studies. Community members in Florida, USA, were asked about ENDS use, tobacco use, and health history/concerns by Community Health Workers. Among 7253 members...

Background There is a higher prevalence of substance use disorder (SUD) among justice-involved children (JIC). It is critical to ensure that JIC who report current use are referred for SUD assessment and potentially life-saving treatment services. Prior research suggests that certain minoritized groups may be less likely to have ever been referred...

Introduction: Community Health Workers and Promotoras (CHW/Ps) are valued for their role in helping to engage community members in research. CHW/Ps have traditionally received variable training in research fundamentals, including importance and promotion of research rigor to establish consistency in the methods used over time. Research best practic...

Purpose of review The coronavirus disease 2019 pandemic resulted in cataclysmic changes to the research enterprise, causing a forced shutdown or rapid pivot to virtual methods. Adapting studies to the virtual environment also impacted recruitment and retention strategies. This review elucidated challenges and offered pragmatic recommendations, draw...

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...

Objective While polysubstance use is highly prevalent among people who use drugs, the field lacks a reliable assessment that can detect detailed temporal patterns of polysubstance use. This study assessed the test‐retest reliability of the newly developed Polysubstance Use–Temporal Patterns Section (PSU‐TPS). Methods Participants who used cocaine...

Objective: This study investigated the relationship between the students' combined belonging and binge drinking. Combined belonging was defined as a combination of both subjective (perceived belonging) and objective (participation in school activities) measures of belonging. Participants: The sample included 33,360 college students enrolled in U.S....

The Adolescent Brain Cognitive Development (ABCD)SM study aims to retain a demographically diverse sample of youth and one parent across 21 sites throughout its 10-year protocol while minimizing selective (systematic) attrition. To evaluate the effectiveness of these efforts, the ABCD Retention Workgroup (RW) has employed a data-driven approach to...

OBJECTIVES/GOALS: COVID-19 has taken a big toll on health, mental health and community well-being. COVID-19 has also presented unique opportunities for community engagement programs to sustain their work within communities. Low-tech methods of engagement might provide opportunities for success. METHODS/STUDY POPULATION: When we could not be in the...

OBJECTIVES/GOALS: Alachua TranQuility was formed in early 2016 to address needs of transgender people in Alachua County, Florida and surrounding areas. Increasing awareness of gender identity issues created a growing population in need of additional health and social services to counter the negative health outcomes traditionally experienced by tran...

OBJECTIVES/GOALS: Researchers include community health workers and promotoras (CHW/Ps) on research teams to increase community engagement; however, no formal training on research best practices exists for this group. Study objectives were to examine perceived relevance of a new culturally and linguistically appropriate CHW/P training and optimal de...

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...

Background: Pain is the most commonly treated symptom in the emergency department, and opioids are often prescribed from the emergency department to treat pain. The American College of Emergency Physicians recommends that providers assess the patient's risk of abusing opioids prior to prescribing opioids. In this study, we use a validated risk ass...

The socioecological model (SEM) was used as a conceptual framework to examine the effect of generational cohorts on study navigation and enrollment in health research. The study population was 7,370 community-dwelling Gen Xers and Baby Boomers in North Central Florida. Analyses found that Leading-edge Boomers (individuals born between 1946 and 1955...

Introduction Increases in opioid prescribing contributed to the opioid epidemic in the U.S. Subsequent efforts to promote safer use of opioids for treating pain included augmenting prescription drug monitoring programs and prescribing guidelines. The purpose of this study is to characterize the distribution of opioids dispensed in the U.S. by speci...

Purpose This report describes a cancer survivor cohort from a community engagement program and compares characteristics and willingness to participate in health research between the cancer survivors and non-cancer community members. Methods Among 11,857 members enrolled in HealthStreet at the University of Florida (10/2011–03/2020), 991 cancer sur...

Objective: Among the general population, co-use of opioids and sedatives is associated with greater risk of overdose compared with opioid use alone. National Football League (NFL) retirees experience higher rates of opioid use than the general population, although little is known about their co-use with sedatives. The aim of this study was to exam...

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...

Objective: While polysubstance use is highly prevalent among people who use drugs, the field lacks a reliable assessment that can detect detailed patterns of polysubstance use. This study assessed the test-retest reliability of the newly developed Polysubstance Use–SAM (PSU-SAM).Methods: Participants who used cocaine plus either alcohol, marijuana...

Background: Justice-involved children (JIC) have a high risk for illicit substance use (SU) and substance use disorders (SUD). Females are particularly vulnerable. It is critical that JIC who report current SU are referred for SUD screening to be provided with potentially life-saving treatment services. Florida law and Florida Department of Juvenil...

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...

The human toll of disasters extends beyond death, injury and loss. Post-traumatic stress (PTS) can be common among directly exposed individuals, and children are particularly vulnerable. Even children far removed from harm’s way report PTS, and media-based exposure may partially account for this phenomenon. In this study, we examine this issue usin...

Background Kratom (Mitragyna speciosa) is an opioid-like psychoactive substance not approved by the U.S. Food and Drug Administration that could be used due to its euphoric, stimulant, and analgesic effects. Kratom is gaining popularity in the U.S. and becoming a reason of concern among pediatricians. Methods Data from the 2019 National Survey on...

Over 80% of National Football League (NFL) retirees experience daily pain. Pain acceptance is an important psychological construct implicated in the intensity of chronic pain, though these findings have not been extended to NFL retirees. Therefore, the current study examined the association between pain acceptance and pain intensity among former NF...

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...

As the population ages, the prevalence of dementia will increase. More research is needed; however, low rates of research participation, especially by older adults, hinder progress. Data came from HealthStreet, a University of Florida community engagement program in which community health workers assess community members for their health conditions...

Objective The majority of prescription drugs, including prescription stimulants, are marketed using multiple brand names, doses, and formulations. There is limited research on the extent to which individuals correctly identify medication by brand name or packaging, but such identification is important for epidemiological studies especially among yo...

Background The Adolescent Brain Cognitive Development ™ Study (ABCD StudyⓇ) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation t...

Introduction Clinical and Translational Science Award Program (CTSA)-funded institutions were charged with developing clinical and translational science programs and transforming clinical research at their institutions. Community engagement (CE) was recognized as a key component and catalyst of that transformation. CE hub capacities for working wit...

A full list of affiliations appears at the end of the paper. T he ABCD Study ® aims to characterize adolescent development and evaluate many influences that might shape developmental trajectories. While numerous factors are plausibly associated with neurodevelopment (for example, nutrition, sleep, exercise, head injuries and substance use), we have...

Background: Women bear a heavier burden of the consequences related to prescription opioid use compared to their male counterparts; however, there has been little attention in the literature regarding prescription opioid use among women. We aimed to examine risk factors for prescription opioid use among women. Methods: Demographics, health status,...

Suicide for rural-to-urban migrants in China presents a challenge. Social capital as a modifiable factor is associated with suicidal behaviors at different levels for different populations. This study focuses on the social capital–suicidal behavior relationship among rural migrants with detailed social capital measures and their interaction with mi...

ABSTRACT IMPACT: For community engagement to be impactful and reduce health inequity, it needs to address timely needs in the community, including COVID-19 impacts. Here, we describe how pre- and post-COVID-19 food insecurity worsened mental health among community members served by HealthStreet University of Florida community engagement program. OB...

Importance Incidental findings (IFs) are unexpected abnormalities discovered during imaging and can range from normal anatomic variants to findings requiring urgent medical intervention. In the case of brain magnetic resonance imaging (MRI), reliable data about the prevalence and significance of IFs in the general population are limited, making it...

Use of New Psychoactive Substances (NPS) has posed a global threat to public health and the security of the population. As of December 2019, the NPS items identified in total have outnumbered by three to one the controlled substances listed in the 1961 and 1971 UN Drug Conventions. However, most of these NPS have not been scheduled by the United Na...

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...

Aim To examine individual variability between perceived physical features and hormones of pubertal maturation in 9–10-year-old children as a function of sociodemographic characteristics. Methods Cross-sectional metrics of puberty were utilized from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study—a multi-site samp...

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...

Efforts to move community engagement in research from marginalized to mainstream include the NIH requiring community engagement programs in all Clinical and Translational Science Awards (CTSAs). However, the COVID-19 pandemic has exposed how little these efforts have changed the dominant culture of clinical research. When faced with the urgent need...

This study examined the association between sex, study risks and willingness to participate in research among a community sample of African Americans. We hypothesized that African American males would be more willing to participate in studies involving both minimal and greater-than-minimal risk. The study sample was recruited through a community en...

The novel coronavirus pandemic that emerged in late 2019 (COVID-19) has created challenges not previously experienced in human research. This paper discusses two large-scale NIH-funded multi-site longitudinal studies of adolescents and young adults – the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) and the Adolescent...

People from all over the globe told their stories of living with mental health challenges. These twelve people had numerous commonalities and reflected on a number of salient themes and lessons for those of us in the mental health field as well as those with lived experience. These lessons are especially important since we have been experiencing a...

Objectives Cocaine use is on the rise and it is comorbid with marijuana use. We examined the association between lifetime cocaine + marijuana polysubstance use (CM PSU) versus cocaine only and lifetime cocaine use disorder (CocUD) and examined the potential mediation by cocaine use patterns. Methods A total of 2,968 lifetime cocaine users were ide...

Background While accumulated evidence has shown that the prevalence of cannabis use among pregnant women in the US has increased in recent years, little is known about the specific subpopulations affected. The aim of this study was to estimate the prevalence and correlates of the perceived risk of weekly cannabis use, past 30-day cannabis use, and...

Objectives: We identified the patterns of cocaine use during individuals' heaviest use period by considering quantity, frequency, and duration simultaneously and examined the correlates and risk profile for these patterns. Methods: Latent profile analysis was conducted among the 3117 individuals who reported lifetime use of cocaine in the Nation...

Aims: This analysis identifies the correlates of 60- and 120-day telephone-based study follow-ups among community-dwelling adults in North Central Florida. Methods: Six thousand three hundred and forty participants were recruited by Community Health Workers from the University of Florida's community engagement program with a face-to-face baselin...

As natural disasters increase in frequency and severity (1,2), mounting evidence reveals that their human toll extends beyond death, injury, and loss. Posttraumatic stress (PTS) can be common among exposed individuals, and children are particularly vulnerable (3,4). Curiously, PTS can even be found among youth far removed from harm's way, and media...

IntroductionOlder adults, including racial and ethnic minorities, are underrepresented in research. As the US population ages, the number of older racial and ethnic minority individuals will increase. Including these individuals in research is an important step towards reducing health disparities.Methods We used data from HealthStreet, a University...

Background Many retired National Football League (NFL) athletes manage pain with opioids during their playing careers and in retirement, though the longitudinal association between opioid use and health outcomes pertinent to an NFL career are not yet known. This study aimed to assess the relationship between opioid use in 2010 and current use, depr...

Non-medical use, especially non-oral use, of prescription stimulants is a public health concern. This study analyzed data from the National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS). Users (n = 723) were categorized as oral medical only users (n = 330, 45.6%), any oral non-medical users (n = 270, 37.3%), and any non-oral user...

Background: Research based on emergency departments (EDs) primarily focuses on medical conditions. There is limited research that investigates patients who willingly participate in research. This current study explored ED super-utilizers' (SUs') and nonsuper-utilizers' (NSUs') attitudes toward research. Objective: The study assesses the willingn...

Background Quantity (Q), frequency (F), and duration (D) of cocaine use during a person’s heaviest use period are important aspects of cocaine use patterns that associated with cocaine use disorder (CocUD). Methods A total 2,988 lifetime cocaine users who met CocUD after the onset of cocaine heaviest use were identified from the National Epidemiol...

OBJECTIVES/GOALS: To explore the patterns, sequence, quantity, frequency and duration of poly substance use among adults for back translation of information to rodent models. METHODS/STUDY POPULATION: From May –December 2019, we conducted 13 focus group discussions with adults 19 to 63 years of age who reported concurrent use of cocaine with alcoho...

Background: Despite research on prescription opioids and dependence being a national priority, little is known about the association between several potential adolescent risk factors and later opioid dependence among those who use opioids non-medically. Objectives: To investigate the association between lifetime opioid dependence and adolescent sel...

Background Research participation by members of racial or ethnic minority groups continues to be less than optimum resulting in difficulties to generalization of research findings. Community-engaged research that relies on a community health worker (CHW) model has been found effective in building trust in the community, thereby motivating people to...

Purpose This study examined how youth would mitigate non-medical use of prescription medication among their peers. Design/methodology/approach The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) was conducted as an interview comprising 11,048 youth of 10–18 years of age between 2008 and 2011 from entertainment venues of 1...

Objective: This study examined the association between pain catastrophizing with pain interference, depressive symptoms, and health-related quality of life (HRQoL) among National Football League (NFL) retirees. Method: Former NFL athletes from the Retired NFL Players Association (N = 90) were recruited from 2018 to 2019 via telephone and were ad...

Stakeholder engagement is acknowledged as central to dissemination and implementation (D&I) of research that generates and answers new clinical and health service research questions. There is both benefit and risk in conducting stakeholder engagement. Done wrong, it can damage trust and adversely impact study results, outcomes, and reputations. Don...

Background: Non-medical use of prescription drugs is a major public health concern in the United States. Prescription opioids and sedatives are among the most widely abused drugs and their combined use can be lethal. Increasingly rigid prescribing guidelines may contribute to the changing context of opioid use and increase drug diversion. Objective...

Aim: Adolescents in the criminal justice system, called justice-involved children (JIC), are particularly vulnerable in the modern opioid misuse (OM) epidemic. After release, relapse and overdose occur at higher rates than the general population. The current study assesses optimism and likelihood of P30D consumption of non-prescription or illicit...

The opioid crisis in the USA requires immediate action through clinical and translational research. Already built network infrastructure through funding by the National Institute on Drug Abuse (NIDA) and National Center for Advancing Translational Sciences (NCATS) provides a major advantage to implement opioid-focused research which together could...

Background: Prescription opioid non-medical use (NMU) and its associated consequences have been of concern in the US in recent years. Objective: We examined peer influence and parental guidance, in addition to peer and parental sources of alcohol, on patterns of prescription opioid use, including NMU, among males and females separately. We hypothes...

Objective: Marijuana and nonprescription opioids remain the two most commonly used illicit substances in the United States. They have commonalities, yet the use of both at the same time may have a greater impact on psychological and health outcomes. Research is needed to determine whether dual-use is associated with more negative outcomes than ind...

Purpose of review: Personality disorders, mental disorders marked by long-term deviations from societal expectations that cause distress, and substance use and related disorders (SUDs), mental disorders marked by engaging with substances or behaviors that activate the brain's reward system to the point that normal activities are neglected, are com...

Objective A lack of understanding of the causes of attrition in longitudinal studies of older adults may lead to higher attrition rates and bias longitudinal study results. In longitudinal epidemiological studies of Alzheimer’s disease and related dementias, high rates of attrition may cause a systematic underestimation of dementia prevalence and s...

Background: Morbidity and mortality attributed to prescription opioids are a crisis in the US and spreading globally. Sex differences related to these conditions have not been adequately assessed. Methods: Through our community engagement program, data on demographics, health status, and substance use, including prescription opioids (e.g., Vicod...

The Adolescent Brain Cognitive Development (ABCD) Study is an ongoing, nationwide study of the effects of environmental influences on behavioral and brain development in adolescents. The main objective of the study is to recruit and assess over eleven thousand 9-10-year-olds and follow them over the course of 10 years to characterize normative brai...

Background Asian Americans constitute 5% of the U.S. population. Their willingness to participate in research is important to examine because it influences participation rates and the representativeness of study results. Methods A total of 17,339 community members participated from six diverse Clinical and Translational Award (CTSA) sites. Communi...

Background: Understanding motivations behind non-medical use of prescription stimulants (NMUPS) is important to prevent such use. Methods: Adult participants from St. Louis, MO, who endorsed NMUPS on 5 or more days in the past 12 months (n = 60) were asked about their motivations for use. Associations between motives for use and patterns of non-med...

Health research participation of racial and ethnic minorities is significantly lower than their counterparts, impeding the testing and development of evidence based clinical and public health interventions for these populations. The purpose of this study was to determine African-Americans’ (AAs) perceptions about health research, past participation...