STAT+: Trump pivots on kratom derivative 7-OH, floating approval for some forms

President Trump on Monday suggested the federal government could move to approve some forms of 7-OH, an opioid derived from the naturally occurring kratom plant.  

“We’re looking very seriously at natural 7-OH and getting that approved,” Trump said. 

It was not clear what Trump meant by “natural 7-OH.” Small amounts of the compound, shorthand for 7-hydroxymitragynine, occur naturally in kratom, which is increasingly used as a recreational drug and an unapproved pain treatment. While kratom is significantly less dangerous than potent synthetic opioids like fentanyl or prescription pain pills, it can still cause addiction and overdose. 

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Digital Therapeutic Content for Substance Use Disorder Treatment: Development and Evaluation Study

Background: Substance use disorders (SUDs) are a major public health concern, contributing to significant individual and societal costs. Despite this, the uptake of evidence-based pharmacologic and behavioral interventions remains limited. The digital delivery of SUD treatment has emerged as a potentially scalable way to reduce access barriers and increase treatment use. Existing digital therapeutic interventions are often created without clinician involvement, evidence-based materials, interdisciplinary input, or content review. The implementation of a structured and methodologically rigorous development process is needed across digital health interventions to help ensure patient-facing materials are validated, understandable, and actionable for the end user. Objective: This early report seeks to describe and evaluate an iterative, interdisciplinary, platform-agnostic process for adapting and refining existing print materials for digital therapeutic modules in SUD treatment. The a priori goal was to evaluate if a structured, human-centered approach would generate digital modules that were rated as understandable and actionable based on a validated assessment for written materials. Methods: Fourteen therapeutic modules were adapted from existing Mayo Clinic–written, patient-facing education materials originally developed by a board-certified addiction psychiatrist and a doctoral-level education specialist for clinical use. A team of 4 purposively recruited licensed alcohol and drug counselors with lived experience with a SUD, all in recovery, and a doctoral-level therapeutic specialist met weekly for one hour over a 6-month period to iteratively adapt this existing content for smartphone delivery (2‐3 hours per module). The process flow included selecting source material, restructuring content for viewing on a phone screen, simplifying language, improving organization and flow to promote understanding, and including specific actions users could take based on the content. The counselors then independently evaluated the modules using the Patient Education Materials Assessment Tool for printable materials (PEMAT-P). PEMAT-P scores for understandability and actionability were calculated as percentages, and descriptive statistics were used to summarize scores in aggregate and across modules. A target of >70% was set for each PEMAT-P domain, consistent with accepted benchmarking standards. Results: Mean understandability and actionability for all modules were 87.2% (SD 4.8%; range 81.4%‐96.9%) and 75.1% (SD 12.3%; range 57.1%‐95.0%), respectively, exceeding the recommended threshold. While all modules were adequately understandable, 35.7% (5/14) scored below the actionability threshold. Conclusions: This early report highlights the value of a human-centered, iterative process for adapting therapeutic materials for digital delivery in SUD treatment. Although the modules performed well overall on PEMAT-P benchmarks, actionability was less consistent than understandability, and aggregate scores masked weaknesses in several individual modules. This indicates that a standardized process does not guarantee actionable material across all content types. Involving current patients in this process may improve the end product by incorporating a perspective that was previously missed.

Trends of incident stimulant use disorder diagnoses before and after the COVID-19 pandemic in British Columbia (2013-2024): a population-based study

BackgroundThere is rising detection of unregulated stimulants (e.g. cocaine and methamphetamine) in toxicology results among people who died of unregulated drug poisoning. Nevertheless, little research describes the population-level trends of incident (new) stimulant use disorder (StUD) diagnoses. This study reports on trends of incident StUD diagnoses pre- and post-Covid-19 public health emergency in British Columbia (BC), Canada.MethodsInterrupted time series analyses were conducted with BC’s COVID-19 public health emergency declaration on March 16, 2020 as the interruption point. Descriptive statistics on demographic and health service contact were conducted for the population diagnosed before (January 1, 2013 – March 16, 2020) and after (March 17, 2020 – December 31, 2024) the COVID-19 pandemic emergency declaration. Seasonal autoregressive integrated moving average (sARIMA) models were used to .estimate changes to incident StuD diagnoses rates before and after the COVID-19 pandemic declaration.Results38, 217 people were identified with incident StUD diagnoses between January 1, 2013 and March 31, 2024. The average diagnosis rate of incident StUD was 5.18 per 100, 000 in the pre-pandemic period and increased by 19.9% to 6.21 per 100, 000 in the post-pandemic period. The estimated increase in slope (ramp) of incident StUD was 0.0315 cases per 100, 000 population per month (95% CI: -0.00182, 0.06482).ConclusionsWe identified a rate of increase in incident StUD diagnoses since the COVID-19 pandemic declaration in BC that was not statistically significant. Our study highlights the need for more comprehensive linked data -including, administrative health data, surveys, and other services/program data (e.g., community services, private sector) to better disentangle StUD incidence and prevalence to inform services to meet the needs of people with StUD. Stimulant use, Stimulant use disorder, pandemic, Covid-19, methamphetamines, cocaine, interrupted time series.

Trump administration’s drug strategy is at odds with recent actions on funding, policy

The White House’s new strategy for addressing the nation’s drug crisis calls for a number of consensus public health measures: the overdose-reversal medication naloxone, medication-assisted treatment, and test strips used to detect fentanyl or other drug supply adulterants. 

But the May 4 document appears to run counter to many of the Trump administration’s latest drug policy actions. In particular, it comes just days after the administration issued new restrictions on using federal dollars to distribute test strips and warned against the use of medication-assisted treatment unless accompanied by other services, like counseling. 

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“Failure to Launch” Syndrome: How to Stop Enabling Your Grown Child

When Zeke was in high school, he struggled with anxiety and substance use problems, and he left college after the first semester. Now 25, he is living at home, and his mom Carol is frustrated. While she’s pushed him to go back to school or work, he has only held one part-time job at a local smoothie shop and quit after a few months, embarrassed that high school classmates would see him working there. Another attempt at trade school to become an electrician also didn’t take — it didn’t feel like the right fit. Now he rarely leaves the house, stays up all night playing video games or scrolling online, and sleeps most of the day.

Failure to launch syndrome, highly dependent adult children, boomerang kids — there’s no standard term or definition, but if you’re a parent in this situation you recognize it. You are worried and frustrated about your adult child’s difficulty in leaving the nest, and you don’t know what to do because everything you’ve tried so far hasn’t worked. 

“These aren’t kids who come back home because they finished school, and the first job they get doesn’t pay enough for them to afford rent on an apartment,” says Theresa Welles, the Shapiro Family Director of the Bubrick Center for Pediatric OCD at the Child Mind Institute. “We’re talking about young adults who functionally have hit a wall, so to speak. They’re caught in a loop of dependency.”

What is failure to launch syndrome?

It’s not uncommon for adult children to live with their parents: According to Pew Research Center, 18 percent of adults ages 25 to 34 lived in their parents’ home in 2023, with young men more likely than young women to do so (20 percent vs. 15 percent). Young adults might leave home for a period of time and then move back in with their parents because they can’t find a job. Or for religious or cultural reasons, some adult children expect to live in the family home until they get married. Living at home is not the main criterion for determining a “failure to launch.”

While there is no official clinical definition, researchers who study this group of young adults generally categorize someone as a highly dependent adult child if they are:

  • Not in school, working, or actively looking for work (though physically capable of doing so)
  • Financially dependent on their parents for housing and other necessities
  • Emotionally reliant on parents (i.e., needing constant reassurance that they are okay)  

They usually have very limited social interactions other than online. Often, they have mental health challenges such as anxiety, depression, or OCD, which is a contributing factor, Dr. Welles says.

“They’re at the developmental stage of early adulthood, they’re figuring out who they are,” Dr. Welles says. “The fancy term in psychology is ‘individuation,’ but it’s essentially who you are, both as part of your family and separate from your family.” Highly dependent adult children haven’t made much progress in this stage for several years. Many of them want to change their life path and become more independent, but they struggle with anxiety or fear of failure and don’t follow through on the necessary steps. “Reliance on parents reduces opportunities to build autonomy, which in turn maintains that reliance,” she says. So, they remain stuck.  

Dependent behaviors and parental accommodations

Young adults who are highly dependent often fall into certain patterns of behavior. They don’t do their own laundry, cook, clean, or help out around the house. They rarely leave the home and often shut themselves in their bedroom or live in the basement, avoiding talking to others in person. As a result, they rely on their parents to act as an intermediary with the outside world, such as making doctor’s appointments. They might blame their parents for their difficulties in life.

While parents may not like the situation, they struggle to get their adult child to change. So instead, they accommodate them — especially when they are concerned about their child’s mental health challenges.

“In the world of neurodiversity, accommodations are a good thing — we want accommodations for testing and sensory environments,” says Natalia Aíza, LPC, the author of the forthcoming Anxious to Launch: Parenting Strategies to Help Your Adult Child Move On. “But in the anxious-to-launch world, accommodations are actually interfering with your child becoming independent.”

Aíza gives some examples of unhelpful family accommodations: You make sure there’s food in the fridge, don’t ask them to contribute to paying bills, and may give them spending money. When they get angry or upset, you accept the behavior and feel guilty, thinking you are to blame for the situation. If they are anxious when you aren’t nearby, you don’t travel because it causes them stress. Instead of expecting them to take steps to find a therapist, you do the legwork.

“The number one behavior of the highly dependent adult child is avoidance. I cannot emphasize this enough,” Aíza says. “If your child has a full-on virtual life, that’s their social outlet. They are avoiding real-life challenges. They are avoiding working at jobs that are unpleasant. They are probably avoiding adulting tasks that should fall on them at this point. So, we swoop in and take care of those tasks for them.”

A modern version of an old problem

While adult children have lived with their parents in past generations, researchers argue that phenomenon of highly dependent adult children is on the rise, and young people today seem particularly susceptible. Adolescence is more prolonged now in many cultures, and there’s an emphasis on finding a fulfilling career, not just a job that pays the bills.

Technology contributes to the problem. Playing video games, watching videos, scrolling through social media — “these activities don’t help matters because they can do things that feel like they’re accomplishing something,” Dr. Welles says.  

How to stop enabling your grown child

In Dr. Welles’s practice, she has worked with families where she initially treated the teen for anxiety or OCD, then involved the parents more deeply when the young adult had trouble launching. In one case, the son was in the habit of playing video games late at night and would sleep through class the next day. He had anxiety and depression, and his parents didn’t want to take away video games because it was the one thing he enjoyed doing. But they started turning off the Wi-Fi in the house at a certain time at night.

“It sounds so extreme, like he’s being punished,” Dr. Welles says. “But it’s about saying to him, ‘We’re going to pull back on ways we’ve accommodated that may have unintentionally made your anxiety worse.’” It was important that the parents validated his feelings, saying things like, “You feel like you’re in danger, as if you’re standing in front of a bear, and that’s really hard. But that’s the anxiety lying to you, and it won’t go away if we keep accommodating things that allow you to avoid what you need to do in order to overcome this anxiety.”

And tactics like these made a difference over time. The son is now attending college part-time and working as a server at restaurant. He has a girlfriend and has plans to save enough to move into an apartment with a friend.

Setting boundaries with your adult child

If the adult child doesn’t seem motivated to find a job, Aíza has recommended that parents take them off the family cellphone plan, giving them warning that this will happen by the next month’s bill. “This is not necessarily the most strategic financial choice” because it’s often much cheaper per person on a family plan, she acknowledges. “But it is a perfect first accommodation to remove because it is telling your adult child, ‘This is something you can handle. You can be responsible for it financially and logistically. It is something that I control, and I want to stop controlling parts of your life.’” And it’s often the motivation they need to find a job — something that can earn them $100 for the monthly cell phone bill is small enough that it feels doable.

When families take steps like these, the adult child will likely get angry or upset. “That’s hard. But think about when your kids were toddlers, and they wanted to touch a hot stove,” Dr. Welles says. “They were mad when you said, ‘No, you can’t touch that stove,’ but that didn’t mean you let them do it.”

“The good news is, generally speaking, even if there’s unhappiness in the beginning,” she continues, “pretty quickly, once they start to feel better and are doing the things that they actually care about, it can really help.”

Supporting without enabling adult children

Highly dependent adult children might accuse parents of not being supportive when they pull back on accommodations. Dr. Welles suggests communicating that you hear them and validate their feelings: “You can say things like, ‘Hey, I know this is tough or ‘I know that this makes you really nervous.’ But you combine it with the confidence that they can do it, like ‘I also know you can do it, as hard as it is.’”

Sometimes, you might think you are being supportive when you are actually enabling — like filling out a job application on behalf of the child. “Even if it works and they get an interview, you’re accommodating their anxiety,” Dr. Welles says. “But also, there’s going to be a point when you can’t do something for the child — the interview or the job itself — so the earlier that you can pull back the better.”

If your adult child has both ADHD and anxiety, you can support their executive functioning skills without accommodating the anxiety. “Maybe you sit down with them on Mondays and look at their schedule to help them determine if there’s a way you can help them organize, as opposed to you stepping in and letting them avoid things they need to do because they’re anxious about it,” Dr. Welles says.

Aíza encourages giving the adult child the minimum amount of help needed, to avoid creating another form of dependency. “It’s about noticing, ‘Am I working harder at this than they are?’” she says. “A lot of times the answer is ‘yes,’ and that’s a signal to back off and put more expectations on the child.”

Treatment for highly dependent adult children

While there is no standard treatment for highly dependent adult children, early evidence has shown a form of therapy called SPACE-FTL (Supportive Parenting for Anxious Childhood Emotions – Failure to Launch) to be promising. A variation on an effective treatment for anxiety and OCD, SPACE-FTL involves only the parents, since the adult child is often resistant to seeking help. The program helps parents reduce accommodations step by step and engage extended family and friends to help de-escalate conflict. 

One tactic is to make a plan to deliver a change in accommodation in writing — for instance, explaining that you will stop paying the cellphone bill at the end of the month and why. Doing it in writing (on paper or in a text) makes the message clear and helps you remain calm and non-reactive. If you are expecting an angry or violent response, they can ask a grandparent, uncle, or family friend be in the house when you deliver the letter, since that might make the response less extreme. The relative or friend may even spend the night if the adult child is more likely to cool off when others are present.

Asking for others’ help also helps you stop blaming yourself for the situation. “A lot of parents of highly dependent adults feel shame, but this is not something happening to only one family,” Aíza says. “We need to build on our social supports and get other people on our team so that we don’t feel so isolated in this process. Your adult child may be resisting change, but you don’t have to. It might sound cruel, but our central mandate as parents is making sure our child is okay after we’re gone. We brought them on earth to survive us — that is the design.”

Frequently Asked Questions

What is “failure to launch syndrome”?

“Failure to launch” isn’t a formal diagnosis but describes young adults who are stuck in a pattern of dependence. They’re typically not working or in school, rely on parents financially and emotionally, and struggle to move forward with adult responsibilities.

How can I motivate my adult child to become independent?

Change often starts with parents gradually pulling back on accommodations while staying supportive and calm. Set clear expectations, validate their feelings, and shift responsibility back to them in manageable steps so they can build confidence and autonomy.

The post “Failure to Launch” Syndrome: How to Stop Enabling Your Grown Child appeared first on Child Mind Institute.

Anxiety and Depression Associated With the Dependent Use of Generative AI in Medical Students: Cross-Sectional Study

Background: The growing integration of artificial intelligence (AI) in higher education has transformed learning processes but also raised concerns about potential mental health risks. Medical students represent a particularly vulnerable group due to high academic stress and increasing reliance on generative AI tools for study and decision-making tasks. Despite this, the relationship between AI dependence and psychological distress remains underexplored in Latin American contexts. Objective: This study aimed to evaluate the association between generative AI dependence and levels of stress, anxiety, and depression among medical students. Methods: A cross-sectional study was conducted with 187 human medicine students from a Peruvian university during the first academic semester of 2025. The Dependence on Artificial Intelligence Scale and the Depression, Anxiety, and Stress Scale–21 were applied. Negative binomial regression models, both crude and adjusted for sex, age, income, and year of study, were used to assess associations, reporting rate ratios (RRs) and 95% CIs. Results: Participants had a median age of 22 (IQR 19‐24) years, and 58.8% (110/187) were female. The median Dependence on Artificial Intelligence Scale score was 10 (IQR 7‐14). Generative AI dependence showed significant correlations with anxiety (ρ=0.336, 95% CI 0.22‐0.44) and depression (ρ=0.316, 95% CI 0.20‐0.43) and a smaller correlation with stress (ρ=0.277, 95% CI 0.16‐0.39). In the adjusted regression models, each 1-point increase in generative AI dependence was associated with a 5% higher expected anxiety score (RR 1.05, 95% CI 1.01‐1.09; =.01) and a 4% higher depression score (RR 1.04, 95% CI 1.01‐1.08; =.03), whereas the association with stress was positive but nonsignificant (RR 1.03, 95% CI 1.00‐1.07; =.08). Fifth-year students had significantly greater anxiety levels than their sixth-year peers (RR 1.82, 95% CI 1.09‐3.01; =.02). No significant effects were observed for sex, age, or income. Conclusions: This study empirically examined generative AI dependence as a distinct behavioral construct and its association with mental health symptoms in medical students. Unlike prior research, this study evaluated psychological dependence on generative AI and modeled its relationship with anxiety and depression using appropriate count-based regression techniques. By providing early evidence from a Latin American context, it contributes to the emerging field of digital mental health and medical education research. These findings underscore the need for universities to promote balanced and responsible AI use, integrate digital literacy with mental health support strategies, and develop preventive policies that mitigate potential maladaptive reliance on generative AI tools.
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Excessive Internet use and depressive symptom levels in adolescents with depressive disorders: chain mediation of social anxiety and sleep quality

BackgroundAdolescents with depressive disorders are at elevated risk for adverse mental health outcomes, and excessive Internet use has been increasingly linked to greater symptom severity. Therefore, this study aimed to examine the chain mediating roles of social anxiety and sleep quality in the association between excessive Internet use and depressive symptoms among adolescents with depressive disorders.MethodsA cross-sectional design was used. A total of 266 Chinese adolescents with clinically diagnosed depressive disorders (M = 15.79 years, SD = 1.85; 71.4% female) were assessed using the Internet Addiction Test, Zung Self-Rating Depression Scale, Social Anxiety Scale for Children, and Pittsburgh Sleep Quality Index. Correlation analyses and bootstrapping methods were conducted using SPSS and the PROCESS macro to examine the chain mediating effects of social anxiety and sleep quality.ResultsThe total indirect effect of excessive Internet use on depressive symptoms accounted for 65.66% of the total effect. Specifically, the indirect effects via social anxiety and sleep quality accounted for 24.10% and 26.51% of the total effect, respectively. In addition, the chain mediating effect of social anxiety and sleep quality was significant, accounting for 14.76% of the total effect.ConclusionExcessive Internet use was positively associated with more severe depressive symptoms among adolescents with depressive disorders, both directly and indirectly through the chain mediating effects of social anxiety and sleep quality. These findings highlight potential targets for preventing and intervening in excessive Internet use among this population.