Silvia Saboia Martins

Silvia Saboia Martins
Columbia University | CU · Department of Epidemiology

MD, PhD

About

377
Publications
35,129
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10,369
Citations
Citations since 2017
189 Research Items
7987 Citations
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Publications

Publications (377)
Article
Full-text available
Objective The Department of Veterans Affairs’ (VA) electronic health records (EHR) offer a rich source of big data to study medical and health care questions, but patient eligibility and preferences may limit generalizability of findings. We therefore examined the representativeness of VA veterans by comparing veterans using VA healthcare services...
Article
This study evaluates changes in overall and drug-specific overdose mortality among pregnant and postpartum persons before and during the COVID-19 pandemic.
Article
Objective: While peer influence is a well-documented risk factor for adolescent substance use, it remains unclear whether peer or parental attitudes have greater impact, and if this relationship is moderated by having a confidant and the relationship between adolescents and their confidant. Method: Pooled (2015-2018) National Survey on Drug Use and...
Article
Background While housing is a critical social determinant of nonprescription opioid overdose, little is known about how place impacts fatal overdose for people experiencing homelessness (PEH) who use drugs beyond the public versus private domains. This study investigated patterns of neighborhood environment features at locations of fatal overdoses...
Article
Background: Simultaneous cannabis/alcohol use, using both substances within a short time interval so that their effects overlap, has a greater risk of potential negative consequences than single-substance use and is more common in younger age. Relationships between recreational cannabis laws (RCLs) and changes in simultaneous cannabis/alcohol use...
Article
Purpose Adolescent internalizing symptoms are increasing in the United States. Changes in parenting practices, including monitoring and communication, have been hypothesized to contribute to these increases. We aimed to estimate trends in parenting practices and understand whether shifts in such practices explain increases in internalizing symptoms...
Article
Aims: Asian Americans are the fastest growing racial and ethnic subgroup in the USA but are underrepresented in the alcohol literature, partially due to misconceptions and racial stereotypes. We estimated any alcohol screening/discussions with providers among Asian Americans and other racial and ethnic subgroups and tested associations with alcoho...
Article
Background States have enacted multiple types of laws, with a variety of constituent provisions, in response to the opioid epidemic, often simultaneously. This temporal proximity and variation in state-to-state operationalization has resulted in significant challenges for empirical research on their effects. Thus, expert consensus can be helpful to...
Article
Background In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed cannabis/cocaine-related dependence and treatment in Argentina, Chile, and Uruguay. Methods Nationally representative cross-sectional household surveys of people ages 15-64 in Argentina (4 sur...
Article
Background: Simultaneous use of alcohol and cannabis to enhance each other's effect can cause potential harm. Time trends are diverging in adolescent use of alcohol, which is declining, and cannabis, which is increasing among certain subgroups. However, little is known about trends in their simultaneous and non-simultaneous use. Racial and socioec...
Article
Background: Understanding time trends in risk factors for substance use may contextualize and explain differing time trends in substance use. Methods: We examined data (N = 536,291; grades 8/10/12) from Monitoring the Future, years 1991-2019. Using Latent Profile Analyses, we identified six time use patterns: one for those working at a paid job and...
Article
Full-text available
Introduction Adolescent time use in recent cohorts is distinguished by large-scale changes, including shifts in parental monitoring, supervision, and adolescent activity patterns, that together may provide a more complete perspective on changing patterns of mental health than can be captured by single risk factors. Methods To determine whether pat...
Article
Objective: In the United States, adult cannabis use has increased over time, but less information is available on time trends in cannabis use disorder. The authors used Veterans Health Administration (VHA) data to examine change over time in cannabis use disorder diagnoses among veterans, an important population subgroup, and whether such trends d...
Article
Full-text available
Social influence can shape early childhood at different levels. We explored the association between social vulnerability and lifetime caregiver alcohol use with children’s psychiatric symptoms. Multivariable logistic regression assessed the association between child psychiatric symptoms and social vulnerability among 1275 preschool child-caregiver...
Article
Background Substance use disorders (SUD) elevate the risk for COVID-19 hospitalization, but studies are inconsistent on the relationship of SUD to COVID-19 mortality. Methods Veterans Health Administration (VHA) patients treated in 2019 and evaluated in 2020 for COVID-19 (n=5,556,315), of whom 62,303 (1.1%) tested positive for COVID-19 (COVID-19+)...
Article
Introduction: Alcohol and cannabis are commonly involved in motor vehicle crashes and fatalities. This study examines whether simultaneous use of alcohol/cannabis is associated with higher odds of reporting driving under the influence of alcohol and cannabis in the U.S. Methods: Drivers aged ≥16 years with any past-year alcohol and cannabis use...
Article
Full-text available
Differences in cannabis use patterns among racial, ethnic and sexual minoritized identity subgroups have been attributed to marginalized identity stressors. However, associations at the intersection of these minoritized identities remain underexplored in a changing medical cannabis law (MCL) context. We estimated medical cannabis and daily cannabis...
Article
Aim: To quantify the trends in frequent and occasional cannabis vaping, demographic differences and concurrent nicotine and alcohol use. Design: Observational study. Survey-weighted multinomial logistic regression models assessed trends and disparities in past 30-day cannabis use. Trends were assessed overall and by sex, race/ethnicity, parental...
Article
Introduction: Nonopioid-based strategies for managing chronic noncancer pain are needed to help reduce overdose deaths. Although lab studies and population-level data suggest that cannabinoids could provide opioid-sparing effects, among medical cannabis participants they may also impact overdose risk by modifying other controlled substance use such...
Article
Full-text available
We explored the association between household alcohol use and behavior problems among South-African children, using data from the Asenze study, a population-based cohort of South African children and their caregivers. Household alcohol use and child behavior were assessed when children were 6–8 years old. To examine the association, we performed li...
Article
Objective Suicidal behavior and bullying victimization are important indicators of adolescent psychological distress, and are patterned by sex, race/ethnicity and sexual identity. This study aimed to estimate trends and disparities in these factors along key demographics. Method Youth Risk Behavior Survey data (2015-2019, N=44,066) were collected...
Article
Full-text available
Objective: We examined the prevalence of risky alcohol and cannabis use among Brazilian varsity college athletes and whether this group had a greater likelihood of risky use than non-athletes. Methods: In 2009, Brazilian college students (n=12,711) were recruited for a national stratified random survey. Their sociodemographic characteristics, me...
Article
In the United States, combined stimulant/opioid overdose mortality has risen dramatically over the last decade. These increases may particularly affect non-Hispanic Black and Hispanic populations. We used death certificate data from the US National Center for Health Statistics (2007–2019) to compare state-level trends in overdose mortality due to o...
Article
Full-text available
Over the past decade, US adolescents’ depressive symptoms have increased, and changing religious beliefs and service attendance may be contributing factors. We examined the contribution of religious factors to depressive symptoms among 417,540 US adolescents (grades: 8, 10, 12), years:1991–2019, in survey-weighted logistic regressions. Among adoles...
Article
As opioid prescribing has declined, it is unclear how the landscape of prescription pain treatment across the U.S. has changed. We used nationally-representative data from the Medical Expenditure Health Survey, 2014 to 2018 to examine trends in prescriptions for opioid and non-opioid pain medications, including acetaminophen, non-steroidal anti-inf...
Article
Full-text available
This study examined how different domains of social capital and of social support among caregivers are associated with social-emotional development in children ages 4–6 and how caregiver depressive symptoms modify these associations. Using a stratified random sample of preschools, data included a cross-sectional study of 1147 child-caregiver pairs...
Article
Full-text available
Background In response to COVID-19, the city of Chicago issued stay-at-home orders, which began on March 20, 2020, and restrictions meant to “flatten the curve” remained in effect until June 2, 2020. On June 3, 2020, Chicago entered the reopening phase. This study compares rates of polysubstance use by COVID-19 lockdown phase and across sociodemogr...
Article
Background: Being bullied online is associated with being bullied in school. However, links between online bullying and violence-related experiences are minimally understood. We evaluated potential disparities in these associations to illuminate opportunities to reduce school-based violence. Methods: We used five cohorts of Youth Risk Behavior S...
Article
Background There is sparse knowledge on overdose deaths resulting from non-benzodiazepines and gabapentinoids usage. We examined overdose death rate across demographics categories and the overdose death trends over time. Methods Using data from the National Center for Health Statistics (USA), we identified 21,167 persons that died with an overdose...
Article
Adolescent internalizing symptoms have increased since 2010, while adequate sleep has declined for several decades. It remains unclear how self-reported sleep attainment has impacted internalizing symptoms trends. Using 1991-2019 MTF data (N~390,000), we estimate age-period-cohort effects in adolescent internalizing symptoms (loneliness, self-estee...
Article
Full-text available
Background Consensus guidelines recommend multimodal chronic pain treatment with increased use of non-pharmacological treatment modalities (NPM), including as first-line therapies. However, with many barriers to NPM uptake in US healthcare systems, NPM use may vary across medical care settings. Military veterans are disproportionately affected by c...
Article
Background Maintained abstinence during the first 24 hours of a quit attempt is a critical predictor of long-term smoking cessation. Little is known about sex differences in the very early abstinence period, particularly in the context of low- and middle-income countries (LMICs) with varying anti-smoking policies and female smoking prevalences. We...
Conference Paper
Introduction: The United States is responsible for the highest rate of incarceration globally. The impacts of incarceration extend beyond those incarcerated and can result in adverse outcomes for chosen romantic or life partners and the family unit. This study aimed to explore the impact of partner incarceration on maternal substance use and whethe...
Conference Paper
Introduction: Cannabis use combined with other substances, such as tobacco and/or alcohol, is related to heavy patterns of substance use and adverse social outcomes. We aimed to examine whether early age of cannabis initiation was associated with dual simultaneous substance (tobacco + cannabis / alcohol + cannabis) use and tri-use (tobacco + alcoho...
Conference Paper
Introduction and Aims: Cannabis use and cannabis use disorders (CUD) have been increasing in the US. Recent studies have aimed to assess the rates of transition from cannabis use to CUD over time across several sociodemographic corelates (e.g., age and sex). Depressive disorders are a strong clinical correlate of cannabis use, and carry a substanti...
Article
Full-text available
BACKGROUND AND AIMS To prevent COVID-19 transmission, some U.S. federal regulations on substance use disorder (SUD) treatment were suspended in March 2020. This study aimed to quantify the extent of state-level policy uptake and the potential number of people with SUD affected by these policy changes across the U.S., as well as to assess if policy...
Article
Background We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates. Methods A scoping review, compiling both peer-reviewed and grey lite...
Article
Background Prenatal exposure to opioids (PEO) is a worldwide public health issue. Opioids cross the placental barrier and may affect the developing foetus and the birth outcomes. Objectives This review aimed to explore newborns’ weight, length and head circumference, preterm birth, and perinatal death as primary outcomes in relation to PEO. The se...
Article
Full-text available
At the structural level, medical cannabis laws (MCLs) have been negatively associated with opioid prescribing practices, and sexual minority adults report disproportionately high non-medical prescription opioid use. We examined medical/non-medical prescription opioid use by intersecting sexual identity and gender and explored associations with MCLs...
Article
Objective To test whether a policy approach aimed at reducing prescription drug misuse, specifically, state monitoring of controlled substance prescriptions—Prescription Drug Monitoring Programs (PDMPs)—were associated with changes in Child Protective Services-reported maltreatment prevalence. Study design Using a difference-in-differences design...
Article
Objective: To understand the prevalence of child maltreatment-related emergency department (ED) visits in the United States, we examined data from the 2007 to 2014 Nationwide Emergency Department Sample. Methods: Based on existing literature, International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9 CM) ED discharge c...
Article
Importance Little is known about changes in cannabis use outcomes by race and ethnicity following the enactment of recreational cannabis laws (RCLs). Objectives To examine the association between enactment of state RCLs and changes in cannabis outcomes by race and ethnicity overall and by age groups in the US. Design, Setting, and Participants Th...
Article
Aims: Most information on the relationship between medical cannabis laws (MCL) and the risk for opioid overdose fatality has been based on studies with ecological designs. To contribute additional information, we used a novel case-control design and individual-level data from national surveys to assess whether state medical cannabis laws were asso...
Article
Background Alcohol outlets have been associated with various forms of injury and may contribute to neighborhood disparities in drug overdose. Few studies have examined the associations between alcohol outlets and drug overdose. This study investigated whether alcohol outlets were associated with the neighborhood drug overdose rate and whether the s...
Article
Full-text available
Introduction Traditional treatment programs for substance use disorder (SUD) tend to be male-dominated environments, which can negatively affect women's access to treatment and related outcomes. Women's specific treatment needs have led some providers to develop women-only SUD treatment programs in several countries. In Chile, women-only programs w...
Article
Full-text available
Objective: The authors sought to estimate the prevalence of past-12-month and lifetime cannabis use and cannabis use disorder among U.S. veterans; to describe demographic, substance use disorder, and psychiatric disorder correlates of nonmedical cannabis use and cannabis use disorder; and to explore differences in cannabis use and cannabis use dis...
Article
Objective: Suicidal ideation and plans are increasing among US adolescents. Changing prevalence of online victimization is frequently hypothesized as an explanation for this increase. We tested trends in online and offline victimization and whether they contribute to recent trends in adolescent suicidal outcomes. Methods: Youth Risk Behavior Sur...
Article
Cannabis use and binge drinking are increasingly common in the United States, yet little is known about cannabis use patterns among people who engage in binge drinking. This study explored the relationship between several cannabis use outcomes and past-month binge drinking status. Pooled 2015-2018 National Surveys on Drug Use and Health data (N = 2...
Article
Background: Hundreds of laws aimed at reducing inappropriate prescription opioid dispensing have been implemented in the United States, yet heterogeneity in provisions and their simultaneous implementation have complicated evaluation of impacts. We apply a hypothesis-generating, multi-stage, machine learning approach to identify salient law provis...
Article
Pain management clinic (PMC) laws were enacted by 12 states to promote appropriate opioid prescribing, but their impact is inadequately understood. We analyzed county-level opioid overdose deaths (National Vital Statistics System) and patients filling long-duration (≥30 day) or high-dose (≥90 morphine milligram equivalents) opioid prescriptions (IQ...
Article
There are some concerns regarding alcohol use behaviors during the COVID-19 pandemic. The mixed findings of the first alcohol use studies during this pandemic may reflect the lack of differentiation between on-premise and home consumption. Most of the countries adopted severe restrictions on drinking place functioning. Alcohol retail store sales te...
Article
Background Prior work suggests that perceived risk and perceived availability of cannabis independently affect cannabis use. However, perceived risk likely modifies the effect of perceived availability, and vice versa. This study explored trends in joint perceived risk and availability of cannabis from 2002 to 2018 and the relationship between comb...
Article
Full-text available
A Corrigendum on "Substance Use in Mild-COVID-19 Patients: A Retrospective Study" by Ismael, F., Zaramella, B., Battagin, T., Bizario, J. C. S., Gallego, J., Villela, V., et al. (2021). Front. Public Health 9:634396. doi: 10.3389/fpubh.2021.634396. In the original article, we neglected to include the funder “NIDA”, “T32DA031099 (Hasin)” to “Priscil...
Article
Chronic pain is associated with mental and physical health difficulties and is prevalent among veterans. Cannabis has been put forth as a treatment for chronic pain, and changes in laws, attitudes, and use patterns have occurred over the last two decades. Differences in prevalence of non-medical cannabis use and cannabis use disorder (CUD) were exa...
Article
Background: It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of...
Article
Human Immunodeficiency Virus (HIV) infection remains prevalent among the marginalized and drug using population in the United States. Testing for HIV is an important and cost-effective way to reduce HIV prevalence. Our objective was to determine if there is a difference in the number of HIV testing by injection status among users of illicit drugs a...
Article
Objective: This study aims to characterize the association between maternal pregnancy intention and socioemotional developmental outcomes in a Brazilian sample of preschool-aged children. Methods: Data from children aged 4 to 5 years and their primary caregivers in Embu das Artes, a Brazilian municipality in the state of São Paulo, were collecte...
Article
Objectives Inhalants are substances with underestimated abuse potential associated with cardiac problems, dizziness, seizures, and decreased level of consciousness. Inhalants are commonly used by the LGB population, who are vulnerable to their harms. US epidemiologic inhalants data are scarce. The aims of this study are to: i) investigate associati...
Article
Full-text available
Background: There is a need for prospective studies investigating substance use variations in mild COVID-19 patients. These individuals represent the majority of patients affected by the disease and are routinely treated at home, facing periods of quarantine. Methods: This was a retrospective cohort study. All people who tested positive for COVID-1...
Article
Full-text available
Background COVID-19 physical distancing measures can potentially increase the likelihood of mental disorders. It is unknown whether these measures are associated with depression and anxiety. Objectives To investigate meta-analytic global levels of depression and anxiety during the COVID-19 pandemic and how the implementation of mitigation strategi...
Article
Full-text available
Background The COVID-19 pandemic is creating severe issues for healthcare and broad social structures, exposing societal vulnerabilities. Among the populations affected by COVID-19 are people engaged in substance use, such as people who smoke; vape (e-cigarette use); use opioids, cannabis, alcohol, or psychoactive prescription drugs; or have a subs...
Article
Background Benzodiazepine (BZD)-related overdose deaths have risen in the past decade and BZD misuse contributes to thousands of emergency department (ED) visits annually, with the highest rates in adolescents and young adults. Because there are gaps in understanding BZD poisoning in youth and whether differences occur by sex, we aimed to character...
Article
Fatal drug overdoses increased in US cities from 1999 through 2017.¹ Low-resource urban areas—popularly characterized as places where overdoses and drug trade thrive—are often considered self-contained, with residents considered the primary consumers of local drug markets.² There has been less discussion regarding inbound travel to such drug market...
Article
Background Medical marijuana laws (MMLs) can impact marijuana and opioid use, but the relationship between MMLs and other drugs, such as prescription stimulants, remains unexamined. Because lesbian, gay and bisexual (LGB) individuals report higher levels of prescription stimulant use than heterosexuals, we explored the relationship between MMLs and...
Article
Introduction: Major knowledge gaps regarding medical and nonmedical prescription stimulant use and illegal stimulant use (i.e., cocaine/crack/methamphetamine) by sexual identity and gender have implications for individuals' health and well-being. This study improves stimulant use measurement by differentiating the type of stimulant use and focusin...
Research Proposal
Abstract Background: The COVID-19 pandemic is creating severe issues for healthcare and broad social structures, exposing societal vulnerabilities. Among the marginalized populations affected by COVID-19 are those engaged in substance use, such as those who smoke, vape (e-cigarette use), use opioids, cannabis, alcohol, psychoactive prescription dru...
Preprint
Full-text available
Background: COVID-19 physical distancing measures can potentially increase the likelihood of mental disorders. It is unknown whether these measures are associated with depression and anxiety. Objectives: To investigate meta-analytic global levels of depression and anxiety during the COVID-19 pandemic and how implementation of mitigation strategies...
Preprint
Full-text available
Background: The COVID-19 pandemic is creating severe issues for healthcare and broad social structures, exposing societal vulnerabilities. Among the populations affected by COVID-19 are people engaged in substance use, such as people who smoke, vape (e-cigarette use), use opioids, cannabis, alcohol, psychoactive prescription drugs, or have a substa...
Preprint
Full-text available
Background: The COVID-19 pandemic is creating severe issues for healthcare and broad social structures, exposing societal vulnerabilities. Among the populations affected by COVID-19 are people engaged in substance use, such as people who smoke, vape (e-cigarette use), use opioids, cannabis, alcohol, psychoactive prescription drugs or have a substan...
Article
Background The nonmedical use of opioids during pregnancy, either those prescribed or obtained illegally, is a worldwide public health issue. Opioids pass through the placental barrier, which can expose the fetus to maternal opioid use; opioid-exposed babies may experience Neonatal Abstinence Syndrome (or Neonatal Opioid Withdrawal). We conducted a...
Preprint
Full-text available
Background: It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of t...
Article
Full-text available
Objective: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and soc...
Article
Child maltreatment and elevated sensation seeking are associated with a wide range of negative outcomes. Longitudinal data from a study of Puerto Ricans living in two sociocultural contexts were used to determine whether child maltreatment subtypes, sex, or sociocultural context relate to trajectories of sensation seeking. Participants were 2,489 i...
Article
Background Z-drugs are hypnotic drugs used for insomnia with considerable potential of abuse. We investigated the relationship of past-year medical and non-medical use of z-drugs with past-year: i) psychological distress; ii) medical use, non-medical use, and DSM-IV use disorder of Benzodiazepine (BZD) tranquilizers; iii) use and DSM-IV alcohol and...
Article
Background Since 1999, the rate of fatal prescription opioid overdoses and of suicides has dramatically increased in the USA. These increases, which have occurred among similar demographic groups, have led to the hypothesis that the opioid epidemic contributed to increases in suicidal behavior, though the underlying association remains poorly defin...
Article
Background: Drug treatment utilization is low despite a high public health burden of drug use disorders (DUDs). Engaging people at risk for DUDs across a broader range of health care settings may improve uptake of drug treatment. Objectives: To estimate the prevalence of drug use screening/discussions between health care providers and individual...
Article
Background In 2013, Uruguay became the first country in the world to legalize recreational cannabis, instituting a non-commercial state regulatory model of production and supply. This study provides the first empirical evidence on its impacts on adolescent use of cannabis and related risks. Methods We use a generalization of the synthetic control...
Article
Background Barriers to early childhood development (ECD) are a global concern. Limited research exists on prenatal smoking and ECD in vulnerable populations, especially as it relates to school readiness (SR). Aims To examine how maternal cigarette use during pregnancy is associated with SR in a sample of Brazilian preschool-age children. Study de...
Article
Excessive screen media use exposure is a robust childhood predictor of sedentary behavior. The association between excessive exposure to sedentary behaviors (e.g., screen media use) and motor skills and how this association differs across sociodemographic strata is an important knowledge gap that needs to be addressed. The study aims to investigate...