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Ellis RA, Bailey AJ, Jordan C, Shapiro H, Greenfield SF, McHugh RK. Gender differences in illicit drug access, use and use disorder: Analysis of National Survey on Drug Use and Health data. J Psychiatr Res 2024; 175:118-122. [PMID: 38728914 DOI: 10.1016/j.jpsychires.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
Although gender differences in the prevalence of substance use disorders (SUD) have been well-characterized, little is known about when gender differences emerge along the continuum of substance use. Understanding the contribution of gender to risk at key transition points across this continuum is needed to identify potential mechanisms underlying gender differences and to inform improved gender-responsive interventions. To characterize gender differences in the progression of cannabis, cocaine, and heroin use, the current study used data from the United States-based 2015-2019 National Survey on Drug Use and Health to quantify gender differences in: (1) perceived access to drugs, (2) lifetime drug use among individuals with at least some access, and (3) past-year SUD among those who had ever used each drug. Logistic regressions were conducted for each drug to examine gender differences across all three stages, controlling for sociodemographic factors and survey year. Compared to women, men had higher odds of reporting access to and lifetime use of all three drug types. Men also had higher odds of past-year cannabis and cocaine use disorders compared to women. Results suggest gender differences emerge in the earliest stage of drug use (access) and may accumulate across the stages of use. The magnitude of gender differences varied across stages, with the largest differences observed for odds of drug initiation among those with perceived access to each drug. Longitudinal data will be needed to confirm these findings and to provide insight into potential contributors to gender-specific risk and intervention targets across the continuum of drug use severity.
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Affiliation(s)
- Robyn A Ellis
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Allen J Bailey
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Chloe Jordan
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Shelly F Greenfield
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - R Kathryn McHugh
- McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Gardner LA, Stockings E, Champion KE, Mather M, Newton NC. Alcohol initiation before age 15 predicts earlier hazardous drinking: A survival analysis of a 7-year prospective longitudinal cohort of Australian adolescents. Addiction 2024; 119:518-529. [PMID: 37926434 DOI: 10.1111/add.16376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND AIMS Early alcohol use may predict later alcohol problems, but the magnitude of this effect and impact of delayed onset remain uncertain. This study measured age-based differences in progression from first full alcoholic drink to hazardous drinking in one of the largest and most recent prospective cohorts of Australian adolescents. DESIGN, SETTINGS, PARTICIPANTS AND MEASUREMENT A 7-year (2012-19) prospective longitudinal cohort of 2082 Australian adolescents was established from the Climate and Preventure (cohort 1) and Climate Schools Combined (cohort 2) studies. Participants completed surveys annually from ages 13 to 20 years. Interval censored survival analyses were conducted with first episode of hazardous drinking [three or more on proxy Alcohol Use Disorders Identification Test (AUDIT-C)] as the survival end-point, controlling for age, sex and mental health symptomatology. Onset of hazardous drinking was expressed as hazard ratios (HRs), and median survival time (years) was used to model first onset of hazardous alcohol use in survival curves. FINDINGS Compared with those aged 15 or older, those who had their first full drink at 12 or younger had significantly elevated risk of hazardous drinking onset during the study period [log (HR): 9.3; 95% confidence interval (CI) = 7.0-12.0, P < 0.001]. Compared with those who had their first full drink at ages 13-14, those who delayed until 15 or older had significantly later onset of hazardous drinking; 1.63 years for males (95% CI = 1.31-1.92, P < 0.001) and 1.50 for females (95% CI = 1.15-1.81, P < 0.001), resulting in a median age of onset of hazardous drinking of > 19 for both sexes (male: 19.05 years, 95% CI = 18.74-19.38; female: 19.47 years, 95% CI = 19.19-19.75). First drink at ages 13-14 was associated with the earliest onset of hazardous drinking (males: 17.43 years; females: 17.98 years). CONCLUSIONS In Australia, alcohol initiation prior to age 15 appears to be associated with an earlier onset of hazardous drinking than initiation after age 15.
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Marius Mather
- Sydney Informatics Hub, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Shah K, Farwa UE, Vanaparti A, Patel S, Kanumuri M, Vashishth O, Hossain N, Dahiya R, Banala M, Enamorado FRP, Patel AS, Nadeem H, Kanani R, Desai HD, Sharma KH, Tripathi S. Global epidemiology of cannabis use disorders and its trend from 1990 to 2019: Benchmarking analysis of the global burden of disease study. J Family Med Prim Care 2024; 13:881-889. [PMID: 38736814 PMCID: PMC11086777 DOI: 10.4103/jfmpc.jfmpc_824_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/16/2023] [Accepted: 08/01/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Cannabis is one of the most widely used psychoactive substances globally, with an increasing trend in its legalization for both medical and recreational purposes in various countries. While cannabis offers potential therapeutic benefits, its regular use can lead to the development of Cannabis Use Disorders (CUDs). Understanding the epidemiology of CUDs is crucial in assessing the public health burden associated with cannabis use. Methods Epidemiological parameters of CUDs were assessed using the Global Burden of Disease (GBD) methodology across different age-groups, years, sexes, and locations worldwide from 1990-2019. Results Globally, for both sexes combined, prevalent cases of CUDs increased steadily from 17.1 million(95%UI=12.7-22.8million) in 1990 to 23.8-million(95%UI=17.8-30.9 million) in 2019. All age-adjusted highest number of incidence observed in High-Income-North-America(HINA)(121/100,000), followed by Australasia(100/100,000), Oceania(83.97/100,000), Tropical Latin America(69.59/100,000). Globally, age-standardized disability-adjusted life years rate(ASDR) observed higher in HINA, followed by Australasia, and Western-Europe. In male, all-age incidence counts increased from 1.7 million(95%UI=1.3-2.4million) in 1990 to 2.4 million(95%UI=1.8-3.2 million) in 2019. The highest annual percentage of change in age-standardized incidence rate(ASIR) was found in East-Asia (22%) followed by Middle-East and North-Africa(MENA)(15%). The age group of 15-24 years exhibited the highest burden of CUDs. Conclusion The widespread occurrence of CUDs on a global scale poses a substantial challenge to public health. Understanding the impact of CUDs and implementing evidence-based interventions is crucial in mitigating the associated individual, societal, and economic burdens. Continued research, collaboration, and knowledge dissemination are essential to inform policies, prevention efforts, and treatment strategies aimed at addressing CUDs on a global-scale.
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Affiliation(s)
- Kinjal Shah
- Department of Public Health Administration, Rutgers University, Edward J. Bloustein School of Planning and Public Policy, New Jersey, United States of America
| | - Umm E. Farwa
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ankitha Vanaparti
- Department of Internal Medicine, Kakatiya Medical College, Hyderabad, Telangana, India
| | - Savan Patel
- Department of Internal Medicine, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Manisha Kanumuri
- Department of Psychiatry, Mediciti Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Oshin Vashishth
- Department of Internal Medicine, St. Martinus University, Willemstad, Curaçao
| | - Nadia Hossain
- Department of Internal Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Roopali Dahiya
- Department of Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, Delhi, India
| | - Mallareddy Banala
- Department of Internal Medicine, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India
| | | | - Abhiraj S. Patel
- Department of Internal Medicine, Our Lady of Fatima University College of Medicine, Valenzuela, Philippines
| | - Huzaifa Nadeem
- Department of Psychiatry, CMH Lahore Medical College, Combined Military Hospital, Lahore, Pakistan
| | - Ravi Kanani
- Department of Research Wing, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India
| | - Hardik D. Desai
- Department of Research Wing, Gujarat Adani Institute of Medical Sciences, Affiliated to K.S.K.V University, Bhuj, Gujarat, India
| | - Kamal H. Sharma
- Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India
| | - Sharanya Tripathi
- Department of Internal Medicine, G.M.E.R.S Medical College, M.S. University, Gotri, Vadodara, Gujarat, India
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Farokhnia M, Harris JC, Speed SN, Leggio L, Johnson RM. Lifetime use of alcohol and cannabis among U.S. adolescents across age: Exploring differential patterns by sex and race/ethnicity using the 2019 NSDUH data. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 10:100214. [PMID: 38234369 PMCID: PMC10791568 DOI: 10.1016/j.dadr.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/09/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
Background Early use of alcohol and cannabis is associated with health and social problems. It is unclear how lifetime use changes for each additional year of age during adolescence, and whether this change varies by sex and race/ethnicity. This study characterized lifetime rates of alcohol and cannabis use by age among 12- to 17-year-old American youth and explored differential patterns by sex and race/ethnicity. Methods Data were obtained from the 2019 National Survey on Drug Use and Health. Analyses were restricted to 12-17-year-olds who were non-Hispanic White, non-Hispanic Black, or Hispanic/Latino (n = 11,830). We estimated the increase in lifetime use of alcohol and cannabis by age for the full sample and stratified by sex and race/ethnicity. Slopes of the regression lines were compared to assess differential patterns across groups. Results In these cross-sectional analyses, reported lifetime use increased substantially from age 12 to 17 for alcohol (6.4 % to 53.2 %) and cannabis (1.3 % to 35.9 %). The increase in lifetime alcohol use was slightly, but not significantly, steeper among girls than boys (F1,8 = 3.40, p = 0.09). White and Latino youth showed similar rates of increase in lifetime alcohol use, which was significantly flatter among Black youth (F2,12=21.26, p<0.0001). Latino youth had a slightly, but not significantly, steeper increase in lifetime cannabis use than White and Black youth (F2,12=3.17, p = 0.07). Conclusions Reports of lifetime alcohol and cannabis use substantially increase from age 12 to 17 and the rates are different according to sex and race/ethnicity, highlighting the need for early and tailored substance use prevention in adolescents.
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Affiliation(s)
- Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julia C. Harris
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Shannon N. Speed
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
| | - Renee M. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Coscas S, Benyamina A. [Women and alcohol, the addictologist's point of view and treatment]. REVUE DE L'INFIRMIERE 2023; 72:22-25. [PMID: 38071011 DOI: 10.1016/j.revinf.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Women have difficulty seeking help for alcohol-related problems. Shame and guilt are often present, which is why the caregiver must succeed in establishing a climate of trust so that things can be said, in order to best assess the impact of consumption and find alternatives. Treatment is often multidisciplinary. The nurse's role is essential, not only to identify drug use, but also to provide a link between the various players involved.
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Affiliation(s)
- Sarah Coscas
- Hôpital universitaire Paul-Brousse, AP-HP, 12, avenue Paul-Vaillant-Couturier, 94800 Villejuif, France.
| | - Amine Benyamina
- Centre d'enseignement, de recherche et de traitement des addictions, Hôpital universitaire Paul-Brousse, Université Paris-Saclay, UR Psycomadd, 12, avenue Paul-Vaillant Couturier B.P 200, 94804 Villejuif, France
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6
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Gräfe EL, Reid HMO, Shkolnikov I, Conway K, Kit A, Acosta C, Christie BR. Women are Taking the Hit: Examining the Unique Consequences of Cannabis Use Across the Female Lifespan. Front Neuroendocrinol 2023; 70:101076. [PMID: 37217080 DOI: 10.1016/j.yfrne.2023.101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
Cannabis use has risen dramatically in recent years due to global decriminalization and a resurgence in the interest of potential therapeutic benefits. While emerging research is shaping our understanding of the benefits and harms of cannabis, there remains a paucity of data specifically focused on how cannabis affects the female population. The female experience of cannabis use is unique, both in the societal context and because of the biological ramifications. This is increasingly important given the rise in cannabis potency, as well as the implications this has for the prevalence of Cannabis Use Disorder (CUD). Therefore, this scoping review aims to discuss the prevalence of cannabis use and CUD in women throughout their lifespan and provide a balanced prospective on the positive and negative consequences of cannabis use. In doing so, this review will highlight the necessity for continued research that goes beyond sex differences.
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Affiliation(s)
- E L Gräfe
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - H M O Reid
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - I Shkolnikov
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - K Conway
- Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - A Kit
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - C Acosta
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - B R Christie
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada; Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada.
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Betz LT, Penzel N, Rosen M, Bhui K, Upthegrove R, Kambeitz J. Disentangling heterogeneity of psychosis expression in the general population: sex-specific moderation effects of environmental risk factors on symptom networks. Psychol Med 2023; 53:1860-1869. [PMID: 37310332 DOI: 10.1017/s0033291721003470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychosis expression in the general population may reflect a behavioral manifestation of the risk for psychotic disorder. It can be conceptualized as an interconnected system of psychotic and affective experiences; a so-called 'symptom network'. Differences in demographics, as well as exposure to adversities and risk factors, may produce substantial heterogeneity in symptom networks, highlighting potential etiological divergence in psychosis risk. METHODS To explore this idea in a data-driven way, we employed a novel recursive partitioning approach in the 2007 English National Survey of Psychiatric Morbidity (N = 7242). We sought to identify 'network phenotypes' by explaining heterogeneity in symptom networks through potential moderators, including age, sex, ethnicity, deprivation, childhood abuse, separation from parents, bullying, domestic violence, cannabis use, and alcohol. RESULTS Sex was the primary source of heterogeneity in symptom networks. Additional heterogeneity was explained by interpersonal trauma (childhood abuse and domestic violence) in women and domestic violence, cannabis use, ethnicity in men. Among women, especially those exposed to early interpersonal trauma, an affective loading within psychosis may have distinct relevance. Men, particularly those from minority ethnic groups, demonstrated a strong network connection between hallucinatory experiences and persecutory ideation. CONCLUSION Symptom networks of psychosis expression in the general population are highly heterogeneous. The structure of symptom networks seems to reflect distinct sex-related adversities, etiologies, and mechanisms of symptom-expression. Disentangling the complex interplay of sex, minority ethnic group status, and other risk factors may help optimize early intervention and prevention strategies in psychosis.
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Affiliation(s)
- Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kamaldeep Bhui
- Department of Psychiatry, University of Oxford, Oxford, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- Birmingham Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Rooney B, Sobiecka P, Rock K, Copeland C. From Bumps to Binges: Overview of Deaths Associated with Cocaine in England, Wales and Northern Ireland (2000-2019). J Anal Toxicol 2023; 47:207-215. [PMID: 36611264 PMCID: PMC10037635 DOI: 10.1093/jat/bkad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/24/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
The UK, as the "cocaine capital of Europe," currently accounts for ∼75% of all cocaine-related hospital admissions in Europe. This study aims to analyze the trends in cocaine-related deaths in England, Wales and Northern Ireland over 20 years (2000-2019). Cases reported to the National Programme on Substance Abuse Deaths (NPSAD) occurring between 2000 and 2019 where cocaine was detected at post-mortem (PM) were extracted for analysis. A total of 5,339 cases were retrieved, with an increase in the rate of reporting over time. Cocaine was deemed a cause of death and quantified in PM blood samples along with its major metabolite benzoylecgonine in 685 cases. Of these 685 cases, 25% (n = 170/685) occurred following acute use, 22% (n = 154/685) following chronic/binge use, 40% (n = 271/685) in combination with morphine, 4% (n = 29/685) in drug packer/swallower circumstances and 9% (n = 61/685) in a suicide context. Cardiac complications were evident in 22% of cases (n = 154/685). The average concentration of cocaine detected in cardiac cases (900 ng/mL) was considerably lower than that detected in cases where acute (19,100 ng/mL) or chronic/binge (6,200 ng/mL) dosing was evident. This is the first cocaine-related mortality study in these geographical areas. Deaths following cocaine use continue to rise despite its Class A drug listing in the UK. While underlying and external risk factors including polydrug use, cardiac complications and mental health can all contribute to the incidence of fatal drug toxicity following cocaine use, this study demonstrates that the risk of a cocaine overdose cannot be attributed to a specific blood concentration range.
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Affiliation(s)
- Brian Rooney
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, London KT1 2EE, UK
| | - Pola Sobiecka
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, London KT1 2EE, UK
| | - Kirsten Rock
- Institute of Pharmaceutical Sciences, King's College London, Stamford St., London SE1 9NQ, UK
- National Programme on Substance Abuse Deaths, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Caroline Copeland
- Institute of Pharmaceutical Sciences, King's College London, Stamford St., London SE1 9NQ, UK
- National Programme on Substance Abuse Deaths, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
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Towers EB, Williams IL, Qillawala EI, Rissman EF, Lynch WJ. Sex/Gender Differences in the Time-Course for the Development of Substance Use Disorder: A Focus on the Telescoping Effect. Pharmacol Rev 2023; 75:217-249. [PMID: 36781217 PMCID: PMC9969523 DOI: 10.1124/pharmrev.121.000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/05/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
Sex/gender effects have been demonstrated for multiple aspects of addiction, with one of the most commonly cited examples being the "telescoping effect" where women meet criteria and/or seek treatment of substance use disorder (SUD) after fewer years of drug use as compared with men. This phenomenon has been reported for multiple drug classes including opioids, psychostimulants, alcohol, and cannabis, as well as nonpharmacological addictions, such as gambling. However, there are some inconsistent reports that show either no difference between men and women or opposite effects and a faster course to addiction in men than women. Thus, the goals of this review are to evaluate evidence for and against the telescoping effect in women and to determine the conditions/populations for which the telescoping effect is most relevant. We also discuss evidence from preclinical studies, which strongly support the validity of the telescoping effect and show that female animals develop addiction-like features (e.g., compulsive drug use, an enhanced motivation for the drug, and enhanced drug-craving/vulnerability to relapse) more readily than male animals. We also discuss biologic factors that may contribute to the telescoping effect, such as ovarian hormones, and its neurobiological basis focusing on the mesolimbic dopamine reward pathway and the corticomesolimbic glutamatergic pathway considering the critical roles these pathways play in the rewarding/reinforcing effects of addictive drugs and SUD. We conclude with future research directions, including intervention strategies to prevent the development of SUD in women. SIGNIFICANCE STATEMENT: One of the most widely cited gender/sex differences in substance use disorder (SUD) is the "telescoping effect," which reflects an accelerated course in women versus men for the development and/or seeking treatment for SUD. This review evaluates evidence for and against a telescoping effect drawing upon data from both clinical and preclinical studies. We also discuss the contribution of biological factors and underlying neurobiological mechanisms and highlight potential targets to prevent the development of SUD in women.
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Affiliation(s)
- Eleanor Blair Towers
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Ivy L Williams
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Emaan I Qillawala
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Emilie F Rissman
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Wendy J Lynch
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
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10
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Struble CA, Borodovsky JT, Habib MI, Hasin DS, Shmulewitz D, Livne O, Walsh C, Aharonovich E, Budney AJ. Cannabis Practices Among a Gender-Diverse Sample of Young Adults. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100113. [PMID: 36741544 PMCID: PMC9894216 DOI: 10.1016/j.dadr.2022.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background Gender is an important factor in understanding cannabis patterns, yet few studies have explored cannabis patterns among gender minority (GM) individuals - particularly among high-risk age groups including young adults. The evolving cannabis market is reshaping typical patterns of cannabis use in the U.S. The combination of these factors warrants increased efforts to examine cannabis practices in gender-diverse samples. Methods Online survey participants between 18-34 years (N=2377) from the U.S. provided information on cannabis practices from May - July 2021. Gender differences across several cannabis outcomes (onset, methods of consumption, product potency, frequency, and quantity) were assessed. Bivariate tests and multiple regression models examined associations between gender (cisgender men: n=1020; cisgender women: n=1178; and GM: n=179) and cannabis outcomes adjusting for sociodemographic characteristics. Results In regression models adjusted for sociodemographic characteristics, GM identity was associated with later age of onset and lower likelihood of daily use compared to cisgender men and women. Identifying as GM or cisgender woman was associated with fewer lifetime methods of consumption and lower plant and concentrate potency usage. Conclusions Findings provide initial insights into potential gender differences in cannabis practices from a sample of heavy cannabis users. GM young adults report use patterns indicative of lower risk compared to cisgender men and women in our sample. Future investigations of gender differences in cannabis use that explore specific gender minority categories and that include alternative sampling strategies are needed to better understand differential risks associated with gender.
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Affiliation(s)
- Cara A. Struble
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Lebanon, NH, United States of America
- Corresponding author.
| | - Jacob T. Borodovsky
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Lebanon, NH, United States of America
| | - Mohammad I. Habib
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Lebanon, NH, United States of America
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
- New York State Psychiatric Institute, New York, NY, United States of America
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
- New York State Psychiatric Institute, New York, NY, United States of America
| | - Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY, United States of America
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
- New York State Psychiatric Institute, New York, NY, United States of America
| | - Alan J. Budney
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Lebanon, NH, United States of America
- Department of Psychiatry, Dartmouth Geisel School of Medicine, Lebanon, NH, United States of America
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11
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Wang L, Zheng H, Wang M, Chen S, Du X, Dong GH. Sex differences in neural substrates of risk taking: Implications for sex-specific vulnerabilities to internet gaming disorder. J Behav Addict 2022; 11:778-795. [PMID: 36053718 PMCID: PMC9872542 DOI: 10.1556/2006.2022.00057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/15/2022] [Accepted: 07/20/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Sex differences in internet gaming disorder (IGD) remain unknown. Investigating sex-specific neural features that underlie the core risk factor (i.e., risk-taking) of IGD would help in understanding sex-specific vulnerabilities to IGD and advance sex-specific treatments and prevention for IGD. METHODS 111 participants (28 IGD males, 27 IGD females, 26 recreational game user (RGU) males, 30 RGU females) completed a probability discounting task during fMRI scanning. RESULTS First, among RGUs, males showed a higher risk-taking tendency and greater neural activation associated with risk/value evaluation for reward (the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), left putamen) and smaller activation associated with cognitive control (the inferior frontal gyrus) than females during the contrast of risky-safe choices. Moreover, males showed a greater modulatory effect of risky choices on the connection from the vmPFC/ACC to the left putamen than females. Second, IGD males showed decreased activation in the vmPFC/ACC and left putamen compared to RGU males, whereas this decrease did not exist in IGD females. DISCUSSION Males show a higher risk-taking tendency than females. Altered neural substrates associated with risky decision-making exist in IGD males but not in IGD females. CONCLUSIONS The present findings fill the gap in information on the behavioral and neural substrates underlying IGD among females and demonstrate that a high risk-taking tendency is a risk factor and core symptom only in IGD males but not in IGD females. It is necessary to design and adopt distinct treatments and prevention strategies for IGD in males and females.
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Affiliation(s)
- Lingxiao Wang
- Centre for Cognition and Brain disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China,Corresponding author. E-mail:
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Min Wang
- Centre for Cognition and Brain disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Shuaiyu Chen
- Centre for Cognition and Brain disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Xiaoxia Du
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Guang-Heng Dong
- Centre for Cognition and Brain disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, China,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China,Corresponding author. E-mail:
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12
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Expression of stable and reliable preference and aversion phenotypes following place conditioning with psychostimulants. Psychopharmacology (Berl) 2022; 239:2593-2603. [PMID: 35482071 DOI: 10.1007/s00213-022-06130-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE AND OBJECTIVES Drug-seeking behavior occurs more readily in some individuals than others. This phenomenon is considered in studies of drug self-administration in which high drug-seeking/taking individuals can be identified. In contrast, studies of conditioned place preference (CPP) often involve a random sample of drug-naïve rodents that includes phenotypes not considered relevant to addiction. The main objective of the current studies was to determine if a priori identification of different conditioning phenotypes could improve the validity and sensitivity of CPP expression as a preclinical test for vulnerability to addiction. METHODS AND RESULTS Analysis of cocaine place conditioning data from 443 Swiss-Webster mice revealed a trimodal distribution with peaks corresponding to means of k = 3 clusters. The cluster means occurred at high, low, or negative preference scores, the latter suggesting a phenotype acquiring conditioned place aversion (CPA). The same clusters were identified in mice conditioned with methamphetamine, MDPV, or amphetamine, and these clusters remained stable and reliable during three additional expression tests spaced at 24 h. A meta-analysis of effect sizes obtained from CPP literature revealed a positively skewed distribution affected by sample size, consistent with the existence of a CPA phenotype within the populations tested. A dopamine receptor antagonist, flupentixol, blocked cocaine CPP expression in a group containing all phenotypes, but sensitivity improved markedly when CPA phenotypes were excluded from the dataset. CONCLUSIONS These studies suggest that taking phenotype into consideration when designing place conditioning studies will improve their application as a preclinical tool in addiction biology and drug discovery.
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13
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Masum M, Sparks J. Labor force status as a buffer against mortality risks associated with alcohol consumption: A study of adult U.S. women, 2001-2015. Prev Med 2022; 161:107139. [PMID: 35809823 PMCID: PMC9507174 DOI: 10.1016/j.ypmed.2022.107139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/05/2022] [Accepted: 07/02/2022] [Indexed: 11/25/2022]
Abstract
The association between women's labor force participation, their alcohol consumption patterns, and mortality risk is unclear. This study assessed all-cause mortality risk among women in the United States, considering their labor force status and alcohol drinking. This study used discrete-time hazard models to examine this association using 2001-2015 National Health Interview Survey-Linked Mortality Files (NHIS-LMF) data (n = 147,714) for women aged 25 to 65 with 5725 deaths in this sample. Complex survey-weighted adjustments and E-values calculations were used to limit quantitative and observational biases. Alcohol consumption and labor force status together lead to substantial mortality risks. There is a statistically significant mortality risk among unemployed women (HR 2.15, 95% CI 1.18-3.91) and women not in labor force (HR 2.38, 95% CI 1.87-3.01). In the stratified models, non-Hispanic blacks (HR 1.48, 95% CI 1.30-1.67) and Asians (HR 1.93, 95% CI 1.54-2.44) have heightened mortality risks borne out of employment. Women with higher psychological distress have a 26% higher risk of all-cause mortality when not in labor force. With the help of cross-sectional data, this study demonstrates that women not in labor force and unemployed women are more likely to be affected by their drinking habits, and their employment status is associated with lower mortality risk. Further research should be focused on cause-specific mortality, gender roles and norms, reasons for unemployment, and comorbidities using more recent data, causal modeling techniques, and an extended mortality follow-up period.
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Affiliation(s)
- Muntasir Masum
- Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States.
| | - Johnelle Sparks
- Department of Demography, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, United States
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14
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Streck JM, Regan S, Bearnot B, Gupta PS, Kalkhoran S, Kalagher KM, Wakeman S, Rigotti NA. Prevalence of Cannabis Use and Cannabis Route of Administration among Massachusetts Adults in Buprenorphine Treatment for Opioid Use Disorder. Subst Use Misuse 2022; 57:1104-1110. [PMID: 35410577 PMCID: PMC10091221 DOI: 10.1080/10826084.2022.2063899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Recent prevalence estimates of cannabis use among individuals receiving medication treatment for OUD (MOUD) are lacking, and no study has characterized cannabis route of administration (cROA) in this population. These knowledge gaps are relevant because cannabis' effects and health outcomes vary by cROA and the availability and perceptions of cROA (e.g., vaping devices) are changing. METHODS The Vaping In Buprenorphine-treated patients Evaluation (VIBE) cross-sectional survey assessed the prevalence and correlates of cannabis use and cROA among adults receiving buprenorphine MOUD from 02/20 to 07/20 at five community health centers in Massachusetts, a state with legal recreational and medical cannabis use. RESULTS Among the 92/222 (41%) respondents reporting past 30-day cannabis use, smoking was the most common cROA (75%), followed by vaping (38%), and eating (26%). Smoking was more often used as a single cROA vs. in combination others (p = 0.01), whereas vaping, eating, and dabbing were more often used in combination with another cROA (all p < 0.05). Of the 39% of participants reporting multiple cROA, smoking and vaping (61%), and smoking and eating (50%), were the most prevalent combinations. Nonwhite race (vs. white) and current cigarette smoking (vs. no nicotine use) were associated with past 30-day cannabis use in multiple logistic regression. CONCLUSIONS Prevalence of past 30-day cannabis use among individuals receiving buprenorphine MOUD in Massachusetts in 2020 was nearly double the prevalence of cannabis use in Massachusetts' adult general population in 2019 (21%). Our data are consistent with state and national data showing smoking as the most common cROA.
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Affiliation(s)
- Joanna M Streck
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Regan
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin Bearnot
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Priya S Gupta
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Sara Kalkhoran
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly M Kalagher
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah Wakeman
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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15
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Jackson KM, Marceau K, Colby SM, Barnett NP, Rogers ML, Hayes KL. Trajectories of early alcohol use milestones: Interrelations among initiation and progression. Alcohol Clin Exp Res 2021; 45:2294-2308. [PMID: 34585748 PMCID: PMC8642286 DOI: 10.1111/acer.14723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Alcohol use shows age-graded patterning, with normative use progressing through characteristic milestones of escalating use or severity. Despite some knowledge about the timing of milestone attainment and sequencing across milestones, there is a gap in our understanding of the earliest stages of use. This study characterizes the timing, sequencing, and speed of progression through milestones beginning with the first sip of alcohol. METHODS Sixth through eighth graders (N = 1023; 52% female; 76% White; M = 12.23 years old) completed web surveys through the end of high school. Participants reported on alcohol experiences including the first sip, full drink, consumption of 3+ drinks/occasion (heavy drinking), being drunk, and experiencing acute consequences, from which milestone age and speed of progression (duration) were calculated. Milestone prevalence, sequencing, and timing were characterized, and associations between age of attainment and speed of progression were examined. We also examined whether milestone timing and progression varied by sex and racial/ethnic group. RESULTS Overall, milestones followed the expected ordering with the exception of heavy drinking (3+ drinks/occasion) and being drunk, which appear to index similar experiences. An earlier age of attainment was associated with an increased likelihood of attaining each of the milestones. In contrast, once a milestone was achieved, there was reduced risk of initiation of subsequent adjacent milestones for individuals with an earlier first sip and full drink, and earlier initiation was associated with a longer duration to subsequent milestones. Girls were more likely to attain all milestones than boys, but there was no sex difference in the age of attainment. In contrast, Hispanic youth reported earlier ages of initiation than White non-Hispanic youth, but the likelihood of attainment did not vary by race/ethnicity. Rapid progression was observed in females but did not vary by race/ethnicity. DISCUSSION Risks associated with early drinking are complex, with little support for normative ordering of milestones beyond the first sip. Although early drinking is associated with an increased risk of subsequent drinking, it does not appear to place the drinker on an accelerated course to heavier use. A nuanced understanding of risks associated with milestone timing may inform intervention efforts.
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Affiliation(s)
- Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Kristine Marceau
- Human Development and Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Nancy P Barnett
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Michelle L Rogers
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA
| | - Kerri L Hayes
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
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16
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Requena-Ocaña N, Flores-Lopez M, Martín AS, García-Marchena N, Pedraz M, Ruiz JJ, Serrano A, Suarez J, Pavón FJ, de Fonseca FR, Araos P. Influence of gender and education on cocaine users in an outpatient cohort in Spain. Sci Rep 2021; 11:20928. [PMID: 34686732 PMCID: PMC8536710 DOI: 10.1038/s41598-021-00472-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/11/2021] [Indexed: 12/25/2022] Open
Abstract
Gender significantly influences sociodemographic, medical, psychiatric and addiction variables in cocaine outpatients. Educational level may be a protective factor showing less severe addictive disorders, longer abstinence periods, and better cognitive performance. The aim was to estimate gender-based differences and the influence of educational level on the clinical variables associated with cocaine use disorder (CUD). A total of 300 cocaine-consuming patients undergoing treatments were recruited and assessed using the Psychiatric Research Interview for Substance and Mental Diseases according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Women developed CUD later but exhibited more consumption of anxiolytics, prevalence of anxiety disorders, eating disorders, and major depressive disorders. Alcohol and cannabis use disorders were more frequent in men. A predictive model was created and identified three psychiatric variables with good prognosis for distinguishing between women and men. Principal component analysis helped to describe the different profile types of men and women who had sought treatment. Low educational levels seemed to be a risk factor for the onset, development, and duration of CUD in both genders. Women and men exhibited different clinical characteristics that should be taken into account when designing therapeutic policies. The educational level plays a protective/risk role in the onset, development and progression of CUD, thus prolonging the years of compulsory education and implementing cognitive rehabilitation programmes could be useful.
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Affiliation(s)
- Nerea Requena-Ocaña
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.,Departamento de Psicobiología, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas, 28223, Pozuelo de Alarcón, Madrid, Spain
| | - María Flores-Lopez
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Alicia San Martín
- Departamento de Psicobiología, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas, 28223, Pozuelo de Alarcón, Madrid, Spain
| | - Nuria García-Marchena
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.,Institut D, Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Unidad de Adicciones-Servicio de Medicina Interna, Campus Can Ruti, Carrer del Canyet s/n, 08916, Badalona, Spain
| | - María Pedraz
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Juan Jesús Ruiz
- Centro Provincial de Drogodependencias (CPD) de Málaga, Diputación de Málaga, C/Ana Solo de Zaldívar, no 3, 29010, Málaga, Spain
| | - Antonia Serrano
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Juan Suarez
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.,Department of Anatomy, Legal Medicine and History of Science, School of Medicine, University of Malaga, Boulevard Louis Pasteur 32, 29071, Málaga, Spain
| | - Francisco Javier Pavón
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria de Málaga, Planta 5ª-Sección Central, Malaga, Spain.,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain
| | - Fernando Rodríguez de Fonseca
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
| | - Pedro Araos
- Laboratorio de Medicina Regenerativa (LMR), Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain. .,Departamento de Psicobiología y Metdología de las CC del Comportamiento, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos s/n, 29071, Málaga, Spain.
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17
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Newman EL, Covington HE, Leonard MZ, Burk K, Miczek KA. Hypoactive Thalamic Crh+ Cells in a Female Mouse Model of Alcohol Drinking After Social Trauma. Biol Psychiatry 2021; 90:563-574. [PMID: 34281710 PMCID: PMC8463500 DOI: 10.1016/j.biopsych.2021.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 05/04/2021] [Accepted: 05/20/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Comorbid stress-induced mood and alcohol use disorders are increasingly prevalent among female patients. Stress exposure can disrupt salience processing and goal-directed decision making, contributing to persistent maladaptive behavioral patterns; these and other stress-sensitive cognitive and behavioral processes rely on dynamic and coordinated signaling by midline and intralaminar thalamic nuclei. Considering the role of social trauma in the trajectory of these debilitating psychopathologies, identifying vulnerable thalamic cells may provide guidance for targeting persistent stress-induced symptoms. METHODS A novel behavioral protocol traced the progression from social trauma to the development of social defensiveness and chronically escalated alcohol consumption in female mice. Recent cell activation-measured as cFos-was quantified in thalamic cells after safe social interactions, revealing stress-sensitive corticotropin-releasing hormone-expressing (Crh+) anterior central medial thalamic (aCMT) cells. These cells were optogenetically stimulated during stress-induced social defensiveness and abstinence-escalated binge drinking. RESULTS Crh+ aCMT neurons exhibited substantial activation after social interactions in stress-naïve but not in stressed female mice. Photoactivating Crh+ aCMT cells dampened stress-induced social deficits, whereas inhibiting these cells increased social defensiveness in stress-naïve mice. Optogenetically activating Crh+ aCMT cells diminished abstinence-escalated binge alcohol drinking in female mice, regardless of stress history. CONCLUSIONS This work uncovers a role for Crh+ aCMT neurons in maladaptive stress-induced social interactions and in binge drinking after forced abstinence in female mice. This molecularly defined thalamic cell population may serve as a critical stress-sensitive hub for social deficits caused by exposure to social trauma and for patterns of excessive alcohol drinking in female populations.
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Affiliation(s)
- Emily L Newman
- Department of Psychology, Tufts University, Medford, Massachusetts; Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | | | | | - Kelly Burk
- Department of Psychology, Tufts University, Medford, Massachusetts
| | - Klaus A Miczek
- Department of Psychology, Tufts University, Medford, Massachusetts; Department of Neuroscience, Tufts University, Boston, Massachusetts.
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18
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Kozak K, Smith PH, Lowe DJ, Weinberger AH, Cooper ZD, Rabin RA, George TP. A systematic review and meta-analysis of sex differences in cannabis use disorder amongst people with comorbid mental illness. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:535-547. [PMID: 34280058 PMCID: PMC9144491 DOI: 10.1080/00952990.2021.1946071] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND While males are more likely diagnosed with cannabis use disorder (CUD), females are more susceptible to developing and maintaining CUD. Yet, for both sexes, CUD is associated with high rates of comorbid mental illness (MI). OBJECTIVES To identify and compare sex differences in the prevalence of comorbid CUD amongst individuals with/without MIs. METHODS This systematic review generated pooled odds ratios (OR) and 95% confidence intervals (CI) from 37 studies (including clinical trials, cohort, and case-control studies) among individuals with and without MIs, quantifying sex differences in rates of comorbid CUD. A meta-analysis was also completed. RESULTS In the CUD-only group, males were twice as likely to have CUD than females (OR = 2.0, CI = 1.9-2.1). Among MIs, males were more likely than females to have CUD comorbid with schizophrenia (OR ~2.6, CI = 2.5-2.7) and other psychotic, mood, and substance use disorders (1> OR <2.2, CI = 0.7-2.6). The reverse association (females > males) was observed for anxiety disorders and antisocial personality disorder (OR = 0.8, CI = 0.7-1.0). Among females, MIs increased the likelihood of having CUD, except for psychotic disorders and depression. A meta-analysis was inconclusive due to high heterogeneity across studies. Thus, comparisons across MI groups were not possible. CONCLUSION While males are more likely to be diagnosed with CUD, there are important sex differences in the prevalence of CUD across MI diagnoses that should be taken into account when approaching CUD prevention and determining treatment efficacy.
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Affiliation(s)
- Karolina Kozak
- Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Philip H. Smith
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, USA
| | - Darby J.E Lowe
- Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Andrea H. Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University and the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ziva D Cooper
- Department of Psychiatry and Biobehavioral Science, University of California, Los Angeles (UCLA), Los Angeles, California, USA
- UCLA Cannabis Research Initiative, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Rachel A. Rabin
- Department of Psychiatry, McGill University and the Douglas Mental Health Institute, Montreal, Quebec, Canada
| | - Tony P. George
- Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
- Addictions Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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19
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Rhee TG, Rosenheck RA. Opioid analgesic use and its sequelae: Opioid and other substance use disorders. Early Interv Psychiatry 2021; 15:975-982. [PMID: 32930517 DOI: 10.1111/eip.13043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 07/02/2020] [Accepted: 08/30/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES While use of opioids is a well-established risk factor for opioid use disorder (OUD), its association with lifetime use of other addictive substances and the emergence of other lifetime substance use disorders (SUDs) has not been studied. METHODS We used data from 36 309 US adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III to identify those with lifetime opioid use (n = 4090; 11.3%). Of these individuals, we quantified use of other addictive substances; development of OUD and other SUDs; and whether use of opioids and development of OUD came before or after use of other substances and the emergence of other SUDs. RESULTS Of the 11.3% of adults who reported any opioid use, 98.2% of such users reported use of other addictive substances. Of these opioid users, 18.1% met criteria for lifetime OUD but only 3.5% had OUD alone; 47.6% had SUDs other than OUD and 14.6% had OUD plus another SUD. In most instances, opioid use followed use of other substances and OUD followed development of other SUDs. CONCLUSION Opioid use is typically linked to use of multiple substances and while less than 20% developed OUD, more than half developed either OUD or another SUD. Opioid use and OUD most often followed other substance use and the emergence of other SUDs. Early intervention in OUD should consider potential complications of other present or past SUDs, and both prevention and treatment development efforts should focus on the multi-morbid dimensions of the current opioid epidemic.
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Affiliation(s)
- Taeho Greg Rhee
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, Connecticut, USA.,Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA.,Mental Illness, Research, Education and Clinical Center of New England, US Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Robert A Rosenheck
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA.,Mental Illness, Research, Education and Clinical Center of New England, US Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
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Keethakumar A, Mehra VM, Khanlou N, Tamim H. Cannabis use and patterns among middle and older aged Canadians prior to legalization: a sex-specific analysis of the Canadian Tobacco, Alcohol and Drugs Survey. BMC Public Health 2021; 21:26. [PMID: 33407292 PMCID: PMC7786462 DOI: 10.1186/s12889-020-10074-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The recreational use of cannabis was legalized across Canada in October 2018. While many people use cannabis without harm, adverse outcomes have been noted in a few populations, including middle-aged and older adults. Given that the current literature has neglected to study cannabis use among this population and between sexes, the objective of our study was to identify the prevalence, characteristics, and patterns of cannabis use among middle and older aged males and females prior to legalization in Canada. METHODS Secondary analysis was conducted on the Canadian Tobacco, Alcohol and Drugs Survey 2017, with the sample restricted to adults ages 40 and above. The main outcome was defined as past-year cannabis use and statistical analysis was conducted separately for males and females. Bivariate and multivariable logistic regression was performed to identify associations between the main outcome and various sociodemographic, health, and substance use variables. Explanatory supplementary variables were also explored. RESULTS In 2017, 5.9% of females and 9.0% of males over the age of 40 reported past-year cannabis use. Almost 62% of males who used cannabis in the past-year reported a failed attempt at reducing or stopping their cannabis use. Over half (56%) of older females, self-reported using cannabis for medical purposes. Additionally, over one in five older adults reported using a vaporizer or e-cigarette as a delivery method for cannabis. Significant characteristics of male cannabis use included having no marital partner, cigarette smoking, and illegal drug use. Furthermore, significant predictors of past-year cannabis use in females included residing in an urban community, Eastern- Atlantic provinces or British Columbia, having fair/poor mental health, smoking cigarettes, use of other tobacco products, and illegal drugs. CONCLUSION To our such knowledge, this is the first nationally representative study to outline the prevalence, characteristics, and patterns of past-year cannabis use prior to Canadian legalization, among middle and older aged Canadians. Results from this study are expected to be used to reliably to track changes in usage, behaviours, and related disorders in the years to come.
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Affiliation(s)
- Asvini Keethakumar
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada.
| | - Vrati M Mehra
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
| | - Nazilla Khanlou
- School of Nursing, Faculty of Health, York University, Toronto, Canada
| | - Hala Tamim
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
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21
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Sherman BJ, Baker NL, Schmarder K, McRae-Clark AL, Gray KM. Latency to cannabis dependence mediates the relationship between age at cannabis use initiation and cannabis use outcomes during treatment in men but not women. Drug Alcohol Depend 2021; 218:108383. [PMID: 33183908 PMCID: PMC7750256 DOI: 10.1016/j.drugalcdep.2020.108383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Time from first cannabis use to cannabis dependence (latency) may be an important prognostic indicator of cannabis-related problems and treatment outcomes. Gender differences in latency have been found; however, research in this general area is limited. As cannabis use increases and perceived risk declines, a better understanding of how these factors interact in predicting treatment outcomes is critical. METHODS A secondary data analysis of a randomized, double-blind, placebo-controlled pharmacotherapy trial for cannabis dependence (N = 302) examined the associations between age of cannabis use onset, time to cannabis dependence (latency), and gender on cannabis use during the trial. Mediation analysis tested whether the association between age of onset and cannabis use during the trial was mediated by latency to cannabis dependence differentially for men and women. RESULTS Age of use initiation was inversely correlated with latency to dependence prior to treatment [HR(95% CI) = 1.18 (1.06, 1.30); p = .002] and cannabis use during treatment (β=-1.27; SE = 0.37; p < .001). There was a significant mediation effect between age of onset, latency, and cannabis use that varied by gender. Earlier age of onset predicted longer latency, and subsequently, greater cannabis use during the trial in men (21.4% mediated; p < .05), but not women. Other substance use, race, and past psychiatric diagnosis did not predict latency either independently or in interaction models. CONCLUSION Findings support existing evidence that early cannabis use onset is associated with worse outcomes and add new knowledge on the differential associations between age of onset, latency to cannabis dependence, and treatment outcomes for men and women.
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Affiliation(s)
- Brian J. Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Katherine Schmarder
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Aimee L. McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
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22
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Hasin D, Walsh C. Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review. J Clin Med 2020; 10:E15. [PMID: 33374666 PMCID: PMC7793504 DOI: 10.3390/jcm10010015] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/10/2020] [Accepted: 12/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. METHODS A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. RESULTS A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. CONCLUSIONS Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.
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Affiliation(s)
- Deborah Hasin
- New York State Psychiatric Institute, New York, NY 10032, USA;
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY 10032, USA;
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23
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Gullo MJ, Saunders JB. The essential role of theory in minimizing harm from emerging technologies. Lost in committee? •. J Behav Addict 2020; 9:879-885. [PMID: 33325839 PMCID: PMC8969739 DOI: 10.1556/2006.2020.00087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/13/2020] [Accepted: 10/25/2020] [Indexed: 12/03/2022] Open
Abstract
A coherent framework for addressing risk arising from new technologies is needed. In proposing a framework of broad application and future focus, where empirical evidence is scarce, reliance on strong theory becomes all the more important. Some technologies are more prone to excessive engagement than others (i.e. more addictive). Some users are also more susceptible to excessive engagement than others. Impulsivity theory emphasises the importance of reinforcement magnitude in determining the risk associated with a new technology, and that an individual's sensitivity to reinforcement (reward drive) and capacity to inhibit previously reinforced behaviour (rash impulsiveness) determines their susceptibility to problematic engagement. Online gaming provides a good example of how such theory can be applied to facilitate intervention efforts and develop policy.
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Affiliation(s)
| | - John B. Saunders
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD 4072, Australia
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24
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Lecca D, Scifo A, Pisanu A, Valentini V, Piras G, Sil A, Cadoni C, Di Chiara G. Adolescent cannabis exposure increases heroin reinforcement in rats genetically vulnerable to addiction. Neuropharmacology 2020; 166:107974. [DOI: 10.1016/j.neuropharm.2020.107974] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/12/2019] [Accepted: 01/20/2020] [Indexed: 01/30/2023]
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25
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Santos JAT, Perruci LG, Pegoraro NPJ, Scherer ZAP, Souza JD, Santos MAD, Pillon SC. Use of psychoactive substances in women in outpatient treatment. Rev Bras Enferm 2019; 72:178-183. [PMID: 31851251 DOI: 10.1590/0034-7167-2018-0399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/18/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to characterize the sociodemographic and psychiatric profile of women users of psychoactive substances in treatment for drug addiction. METHOD descriptive study of quantitative approach performed with women attended at a Psychosocial Care Center for Users of Alcohol and Other Drugs (CAPS ad) from the interior of São Paulo State. RESULTS the sample consisted of 349 adult women, single, low educational level and unemployed, users of alcohol, cocaine, crack and tranquillizers. Among the consequences of use include withdrawal syndrome, overdose, depressive and suicidal symptoms. Most were referred for treatment by the family or health services. Almost 20% of these women had previously started treatments. CONCLUSION The results suggest marked morbidity and high levels of psychosocial vulnerability, which require thorough investigation at the patient's admission, as well as damage associated with use, withdrawal symptoms and depressive symptoms.
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26
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Butelman ER, Chen CY, Brown KG, Kreek MJ. Escalation of drug use in persons dually diagnosed with opioid and cocaine dependence: Gender comparison and dimensional predictors. Drug Alcohol Depend 2019; 205:107657. [PMID: 31698322 PMCID: PMC6893149 DOI: 10.1016/j.drugalcdep.2019.107657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/10/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Persons dually diagnosed with opioid and cocaine dependence (OD + CD) present a clinical challenge and are at risk of morbidity and mortality. The time of escalation of heroin and cocaine exposure in persons with OD + CD remain understudied, and the influence of gender and other variables have not been examined. This observational study focused on the time of escalation of heroin and cocaine in volunteers with OD + CD, examining gender and exposure to other drugs (e.g., cannabis or alcohol) as predictors. Ages of first use and of onset of heaviest use of each drug were collected (in whole years). Time of escalation was defined as the interval between age of first use and onset of heaviest use. VOLUNTEERS sequentially ascertained adult volunteers recruited from the New York Metropolitan area, of which n = 297 were diagnosed with OD + CD. METHODS Instruments administered were the SCID-I diagnostic interview (DSM-IV criteria), BIS-11 impulsiveness scale, and KMSK scales, dimensional measures of maximal exposure to specific drugs. RESULTS In volunteers with OD + CD, ages of onset of heaviest use of cannabis (median age = 15) and alcohol (median age = 19) were in adolescence or emerging adulthood and preceded those for heroin and cocaine (median ages = 26 and 25, respectively). Maximal levels of cannabis and alcohol exposure were high, in volunteers with OD + CD. In adjusted Cox regressions, gender was not a significant predictor of time of heroin or cocaine escalation. However, more rapid time of alcohol escalation was a predictor of more rapid time of escalation of both heroin and cocaine, in volunteers with OD + CD.
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Affiliation(s)
- Eduardo R Butelman
- Laboratory of the Biology of Addictive Diseases, the Rockefeller University, New York NY, United States.
| | - Carina Y Chen
- Laboratory of the Biology of Addictive Diseases, the Rockefeller University, New York NY, United States
| | - Kate G Brown
- Laboratory of the Biology of Addictive Diseases, the Rockefeller University, New York NY, United States
| | - Mary Jeanne Kreek
- Laboratory of the Biology of Addictive Diseases, the Rockefeller University, New York NY, United States
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Kettner H, Mason NL, Kuypers KPC. Motives for Classical and Novel Psychoactive Substances Use in Psychedelic Polydrug Users. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/0091450919863899] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Novel psychoactive substances (NPS) are compounds designed to mimic the effects of existing recreational drugs (classical psychoactive substances [CPS]), while eluding established legal frameworks. Little is known about their effects and potential harms, rendering the increasing number of NPS a challenge to policy makers and researchers alike. Quantitative studies on the motives underlying NPS use are limited, though understanding them is crucial for the design of effective harm prevention strategies. The present study therefore aimed to compare motivational patterns for NPS, CPS, and legal psychoactive substance (LPS) use. An online survey including questions about lifetime drug use, demographics, and motives for use was completed by 2,319 participants of which 1,967 consented and were 18 years or older. Data on lifetime use and endorsed motives are presented for 12 psychoactive substances classified into LPS (alcohol, nicotine), CPS (cannabis, MDMA/ecstasy, amphetamines, cocaine, psilocybin, LSD, ayahuasca), and NPS (synthetic cannabinoids, stimulant, and hallucinogenic) and compared between classes. Across substances, the most frequently endorsed motives were to feel euphoric (58.0%), enhance an activity (52.3%), and broaden consciousness (48.1%). Motives for use were found to differ by substance and gender, with coping-related reasons being more frequent among female participants compared to males who indicated to use for a broad range of reasons. Motivational patterns of CPS and NPS use were largely similar to their classical analogues, this was not the case for synthetic cannabinoids, which had as main endorsed motive getting intoxicated, indiscriminate of specific qualities. This information can feed into tailoring of educational campaigns and prevention strategies.
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Affiliation(s)
- Hannes Kettner
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Natasha L. Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Kim P. C. Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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28
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Andersen SL. Stress, sensitive periods, and substance abuse. Neurobiol Stress 2019; 10:100140. [PMID: 30569003 PMCID: PMC6288983 DOI: 10.1016/j.ynstr.2018.100140] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/18/2018] [Accepted: 11/26/2018] [Indexed: 12/14/2022] Open
Abstract
Research on the inter-relationship between drug abuse and social stress has primarily focused on the role of stress exposure during adulthood and more recently, adolescence. Adolescence is a time of heightened reward sensitivity, but it is also a time when earlier life experiences are expressed. Exposure to stress early in postnatal life is associated with an accelerated age of onset for drug use. Lifelong addiction is significantly greater if drug use is initiated during early adolescence. Understanding how developmental changes following stress exposure interact with sensitive periods to unfold over the course of maturation is integral to reducing their later impact on substance use. Arousal levels, gender/sex, inflammation, and the timing of stress exposure play a role in the vulnerability of these circuits. The current review focuses on how early postnatal stress impacts brain development during a sensitive period to increase externalizing and internalizing behaviors in adolescence that include social interactions (aggression; sexual activity), working memory impairment, and depression. How stress effects the developmental trajectories of brain circuits that are associated with addiction are discussed for both clinical and preclinical studies.
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Marel C, Sunderland M, Mills KL, Slade T, Teesson M, Chapman C. Conditional probabilities of substance use disorders and associated risk factors: Progression from first use to use disorder on alcohol, cannabis, stimulants, sedatives and opioids. Drug Alcohol Depend 2019; 194:136-142. [PMID: 30439610 DOI: 10.1016/j.drugalcdep.2018.10.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/09/2018] [Accepted: 10/29/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Relatively little is known about factors that may lead to the development of a substance use disorder (SUD), across a range of drug classes. This study aimed to identify factors that predict the likelihood of transition from use to SUD and the speed with which this may occur at the population level, with a focus on the impact of pre-existing mental disorders. METHODS Data were collected as part of the 2007 Australian National Survey of Mental Health and Wellbeing, a nationally representative survey of 8841 Australian adults. A series of discrete time survival analyses were undertaken on data pertaining to the age of onset of use and symptoms of use disorder, for alcohol, cannabis, sedatives, stimulants, and opioids, as well as the impact of pre-existing mood and anxiety disorders on the likelihood of developing a SUD. RESULTS Lifetime cumulative probability estimates indicated that 50.4% of stimulant, 46.6% of opioid, 39% of sedative, 37.5% of alcohol, and 34.1% of cannabis users would develop a SUD on those substances, within an estimated 14, 12, 8, 30, and 23 years after onset respectively. Pre-existing mental disorders were significantly associated with increased risk of developing a SUD for alcohol, cannabis and stimulant use disorder. CONCLUSION The relative speed associated with the transition from use to SUD emphasizes the narrow window of time available to intervene, underscoring the urgency of early identification of mental health conditions and the timely provision of appropriate evidence-based interventions, which could potentially prevent the development of secondary SUDs.
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Affiliation(s)
- Christina Marel
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia.
| | - Matthew Sunderland
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia
| | - Katherine L Mills
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia
| | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia
| | - Maree Teesson
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia
| | - Cath Chapman
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, NSW 2052, Sydney, Australia
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Becker JB, Chartoff E. Sex differences in neural mechanisms mediating reward and addiction. Neuropsychopharmacology 2019; 44:166-183. [PMID: 29946108 PMCID: PMC6235836 DOI: 10.1038/s41386-018-0125-6] [Citation(s) in RCA: 247] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/27/2018] [Accepted: 06/11/2018] [Indexed: 12/18/2022]
Abstract
There is increasing evidence in humans and laboratory animals for biologically based sex differences in every phase of drug addiction: acute reinforcing effects, transition from occasional to compulsive use, withdrawal-associated negative affective states, craving, and relapse. There is also evidence that many qualitative aspects of the addiction phases do not differ significantly between males and females, but one sex may be more likely to exhibit a trait than the other, resulting in population differences. The conceptual framework of this review is to focus on hormonal, chromosomal, and epigenetic organizational and contingent, sex-dependent mechanisms of four neural systems that are known-primarily in males-to be key players in addiction: dopamine, mu-opioid receptors (MOR), kappa opioid receptors (KOR), and brain-derived neurotrophic factor (BDNF). We highlight data demonstrating sex differences in development, expression, and function of these neural systems as they relate-directly or indirectly-to processes of reward and addictive behavior, with a focus on psychostimulants and opioids. We identify gaps in knowledge about how these neural systems interact with sex to influence addictive behavior, emphasizing throughout that the impact of sex can be highly nuanced and male/female data should be reported regardless of the outcome.
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Affiliation(s)
- Jill B Becker
- Department of Psychology and the Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Elena Chartoff
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA.
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Transnational trends in prescription drug misuse among women: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 63:56-73. [DOI: 10.1016/j.drugpo.2018.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/21/2022]
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Newman EL, Leonard MZ, Arena DT, de Almeida RMM, Miczek KA. Social defeat stress and escalation of cocaine and alcohol consumption: Focus on CRF. Neurobiol Stress 2018; 9:151-165. [PMID: 30450381 PMCID: PMC6236516 DOI: 10.1016/j.ynstr.2018.09.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 12/15/2022] Open
Abstract
Both the ostensibly aversive effects of unpredictable episodes of social stress and the intensely rewarding effects of drugs of abuse activate the mesocorticolimbic dopamine systems. Significant neuroadaptations in interacting stress and reward neurocircuitry may underlie the striking connection between stress and substance use disorders. In rodent models, recurring intermittent exposure to social defeat stress appears to produce a distinct profile of neuroadaptations that translates most readily to the repercussions of social stress in humans. In the present review, preclinical rodent models of social defeat stress and subsequent alcohol, cocaine or opioid consumption are discussed with regard to: (1) the temporal pattern of social defeat stress, (2) male and female protocols of social stress-escalated drug consumption, and (3) the neuroplastic effects of social stress, which may contribute to escalated drug-taking. Neuroadaptations in corticotropin-releasing factor (CRF) and CRF modulation of monoamines in the ventral tegmental area and the bed nucleus of the stria terminalis are highlighted as potential mechanisms underlying stress-escalated drug consumption. However, the specific mechanisms that drive CRF-mediated increases in dopamine require additional investigation as do the stress-induced neuroadaptations that may contribute to the development of compulsive patterns of drug-taking.
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Affiliation(s)
- Emily L Newman
- Psychology Dept., Tufts University, Medford, MA, 02155, USA
| | | | | | - Rosa M M de Almeida
- Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Klaus A Miczek
- Psychology Dept., Tufts University, Medford, MA, 02155, USA.,Dept. of Neuroscience, Sackler School of Graduate Biomedical Sciences, Boston, MA, 02111, USA
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Perez PD, Hall G, Zubcevic J, Febo M. Cocaine differentially affects synaptic activity in memory and midbrain areas of female and male rats: an in vivo MEMRI study. Brain Imaging Behav 2018; 12:201-216. [PMID: 28236167 DOI: 10.1007/s11682-017-9691-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Manganese enhanced magnetic resonance imaging (MEMRI) has been previously used to determine the effect of acute cocaine on calcium-dependent synaptic activity in male rats. However, there have been no MEMRI studies examining sex differences in the functional neural circuits affected by repeated cocaine. In the present study, we used MEMRI to investigate the effects of repeated cocaine on brain activation in female and male rats. Adult female and male rats were scanned at 4.7 Tesla three days after final treatment with saline, a single cocaine injection (15 mg kg-1, i.p. × 1 day) or repeated cocaine injections (15 mg kg-1, i.p. × 10 days). A day before imaging rats were provided with an i.p. injection of manganese chloride (70 mg kg-1). Cocaine produced effects on MEMRI activity that were dependent on sex. In females, we observed that a single cocaine injection reduced MEMRI activity in hippocampal CA3, ventral tegmental area (VTA), and median Raphé, whereas repeated cocaine increased MEMRI activity in dentate gyrus and interpeduncular nucleus. In males, repeated cocaine reduced MEMRI activity in VTA. Overall, it appeared that female rats showed a general trend towards increase MEMRI activity with single cocaine and reduced activity with repeated exposure, while male rats showed a trend towards opposite effects. Our results provide evidence for sex differences in the in vivo neural response to cocaine, which involves primarily hippocampal, amygdala and midbrain areas.
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Affiliation(s)
- Pablo D Perez
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Gabrielle Hall
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Jasenka Zubcevic
- Department of Physiological Sciences, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Marcelo Febo
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, 32610, USA.
- Center for Addiction Research and Education (CARE), University of Florida, Gainesville, FL, USA.
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Khurana A, Romer D, Betancourt LM, Hurt H. Modeling Trajectories of Sensation Seeking and Impulsivity Dimensions from Early to Late Adolescence: Universal Trends or Distinct Sub-groups? J Youth Adolesc 2018; 47:1992-2005. [PMID: 29980957 DOI: 10.1007/s10964-018-0891-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
Developmental imbalance models attribute the rise in risk-taking during adolescence to a universal imbalance between rising reward sensitivity and lagging cognitive control. This study tested predictions of an alternate Lifespan Wisdom Model that distinguishes between exploratory/adaptive (e.g., sensation seeking) and maladaptive (e.g., acting-without-thinking, delay discounting) risk-taking propensities and attributes the latter to a sub-set of youth with weak cognitive control. Latent trajectory modeling of six waves of data from 387 adolescents (52% females; spanning average ages of 11-18 years) revealed distinct sub-groups with heterogeneous trajectory patterns for acting-without-thinking and delay-discounting. Only those trajectory groups with weak cognitive control, characterized as "high-increasing" acting-without thinking and "high-stable" delay discounting were predictive of a maladaptive risk-taking outcome, namely substance use disorder. Sensation seeking demonstrated a universal peak, but high levels of sensation seeking were not associated with weakness in cognitive control and were unrelated to substance use disorder, controlling for impulsivity. The findings suggest that maladaptive risk-taking characterized by weak cognitive control over reward-driven impulses is a phenomenon limited to only a sub-set of youth.
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Affiliation(s)
- Atika Khurana
- College of Education, University of Oregon, Eugene, OR, 97403, USA.
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Laura M Betancourt
- Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Hallam Hurt
- Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
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Christiansen SG, Bretteville-Jensen AL. Who seeks treatment for cannabis use? Registered characteristics and physical, psychological and psychosocial problem indicators among cannabis patients and matched controls. BMC Public Health 2018; 18:780. [PMID: 29929507 PMCID: PMC6013908 DOI: 10.1186/s12889-018-5625-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/29/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND There has been an absolute and relative increase in the number of patients with cannabis-related disorders as the principal diagnosis in many countries in recent years. Cannabis is now the most frequently mentioned problem drug reported by new patients in Europe, and cannabis patients constituted one third of all drug treatment patients in 2015. There is limited knowledge with regard to patient characteristics, the extent and types of health and psychosocial problems, as well as their association with long-term outcomes. METHODS We analysed indicators of physical, psychological and psychosocial problems of all patients admitted to treatment for cannabis use in Norway in 2009 and 2010 using register data and observed them to the end of 2013. Patient characteristics and outcomes were compared to a randomly drawn control group with corresponding age and gender distribution. Using logistic regression of prospective data, we studied associations between baseline characteristics and work and study status in 2013. RESULTS Cannabis patients tended to be relatively young and the large majority were male. They had parents who were less highly educated compared to controls, while there was no difference in migration background. In addition to an increased risk of premature death, nearly half of the patients received a secondary psychological diagnosis and a similar proportion received an additional substance use diagnosis during the 4-5 years of study follow-up. The cannabis patients were less educated than the control group and also less likely to be studying or working at the end of the study period. Entering treatment at a young age, having completed more than secondary education, having a highly-educated mother and not having a secondary diagnosis were factors that were positively associated with being in education or employment at the end of follow-up. CONCLUSIONS Data covering the entire Norwegian population of patients admitted primarily for cannabis-related problems showed comprehensive and complex patterns of physical, psychological and psychosocial problems. The prevalence and extent of these problems varied markedly from those of the general population. Work and study outcomes following treatment depended on the seriousness of the condition including co-morbidity as well as social capital.
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Louw KA. Substance use in pregnancy: The medical challenge. Obstet Med 2018; 11:54-66. [PMID: 29997687 PMCID: PMC6038015 DOI: 10.1177/1753495x17750299] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/20/2017] [Indexed: 01/04/2023] Open
Abstract
Substance use contributes significantly to the global burden of disease. Growing numbers of women use nicotine, alcohol, and illicit substances. Women are the most vulnerable to problematic substance use in their reproductive years. The first 1000 days of life, starting at conception, have been established as a critical window of time for long-term health and development. Substance use in pregnancy is associated with negative pregnancy and child health outcomes. The impact of antenatal substance use on these outcomes needs to be considered within a challenging and complex context. This review provides an overview of the current literature on the impact of substances on pregnancy and child outcomes as well as the evidence and guidelines on screening and interventions for women using substances during pregnancy.
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Affiliation(s)
- Kerry-Ann Louw
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
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Marks KR, Clark CD. The Telescoping Phenomenon: Origins in Gender Bias and Implications for Contemporary Scientific Inquiry. Subst Use Misuse 2018; 53:901-909. [PMID: 29161174 PMCID: PMC6129392 DOI: 10.1080/10826084.2017.1385079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND In an article published in International Journal of the Addictions in 1989, Nick Piazza and his coauthors described "telescoping," an accelerated progression through "landmark symptoms" of alcoholism, among a sample of recovering women. OBJECTIVES The aim of this critical analysis is to apply a feminist philosophy of science to examine the origins of the framework of telescoping research and its implications for contemporary scientific inquiry. METHODS A feminist philosophy of science framework is outlined and applied to key source publications of telescoping literature drawn from international and United States-based peer-reviewed journals published beginning in 1952. RESULTS A feminist philosophy of science framework identifies gender bias in telescoping research in three ways. First, gender bias was present in the early conventions that laid the groundwork for telescoping research. Second, a "masculine" framework was present in the methodology guiding telescoping research. Third, gender bias was present in the interpretation of results as evidenced by biased comparative language. CONCLUSIONS Telescoping research contributed to early evidence of critical sex and gender differences helping to usher in women's substance abuse research more broadly. However, it also utilized a "masculine" framework that perpetuated gender bias and limited generative, novel research that can arise from women-focused research and practice. A feminist philosophy of science identifies gender bias in telescoping research and provides an alternative, more productive approach for substance abuse researchers and clinicians.
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Affiliation(s)
- Katherine R Marks
- a Department of Behavioral Science , University of Kentucky , Lexington , Kentucky , USA
| | - Claire D Clark
- a Department of Behavioral Science , University of Kentucky , Lexington , Kentucky , USA
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Tonn Eisinger KR, Larson EB, Boulware MI, Thomas MJ, Mermelstein PG. Membrane estrogen receptor signaling impacts the reward circuitry of the female brain to influence motivated behaviors. Steroids 2018; 133:53-59. [PMID: 29195840 PMCID: PMC5864533 DOI: 10.1016/j.steroids.2017.11.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/20/2017] [Accepted: 11/23/2017] [Indexed: 12/12/2022]
Abstract
Within the adult female, estrogen signaling is well-described as an integral component of the physiologically significant hypothalamic-pituitary-gonadal axis. In rodents, the timing of ovulation is intrinsically entwined with the display of sexual receptivity. For decades, the importance of estradiol activating intracellular estrogen receptors within the hypothalamus and midbrain/spinal cord lordosis circuits has been appreciated. These signaling pathways primarily account for the ability of the female to reproduce. Yet, often overlooked is that the desire to reproduce is also tightly regulated by estrogen receptor signaling. This lack of emphasis can be attributed to an absence of nuclear estrogen receptors in brain regions associated with reward, such as the nucleus accumbens, which are associated with motivated behaviors. This review outlines how membrane-localized estrogen receptors affect metabotropic glutamate receptor signaling within the rodent nucleus accumbens. In addition, we discuss how, as estrogens drive increased motivation for reproduction, they also produce the untoward side effect of heightening female vulnerability to drug addiction.
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Affiliation(s)
- Katherine R Tonn Eisinger
- Department of Neuroscience and Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Erin B Larson
- Department of Neuroscience and Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Marissa I Boulware
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Mark J Thomas
- Department of Neuroscience and Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Paul G Mermelstein
- Department of Neuroscience and Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA.
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Hildebrandt T, Heywood A, Wesley D, Schulz K. Defining the Construct of Synthetic Androgen Intoxication: An Application of General Brain Arousal. Front Psychol 2018; 9:390. [PMID: 29651261 PMCID: PMC5885244 DOI: 10.3389/fpsyg.2018.00390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/08/2018] [Indexed: 01/01/2023] Open
Abstract
Synthetic androgens (i. e., anabolic-androgenic steroids) are the primary component to the majority of problematic appearance and performance enhancing drug (APED) use. Despite evidence that these substances are associated with increased risk for aggression, violence, body image disturbances, and polypharmacy and can develop a pattern of chronic use consistent with drug dependence, there are no formal definitions of androgen intoxication. Consequently, the purpose of this paper is to establish a testable theory of androgen intoxication. We present evidence and theorize that synthetic androgen intoxication can be defined by a pattern of poor self-regulation characterized by increased propensity for a range of behaviors (e.g., aggression, sex, drug seeking, exercise, etc.) via androgen mediated effects on general brain arousal. This theory posits that androgens reduce threshold for emotional reactivity, motor response, and alertness to sensory stimuli and disrupt inhibitory control over the behaviors associated with synthetic androgen use. These changes result from alteration to basic neurocircuitry that amplifies limbic activation and reduces top-down cortical control. The implications for this definition are to inform APED specific hypotheses about the behavioral and psychological effects of APED use and provide a basis for establishing clinical, legal, and public health guidelines to address the use and misuse of these substances.
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Affiliation(s)
- Tom Hildebrandt
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashley Heywood
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Daniel Wesley
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kurt Schulz
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Campollo O, Sheikhattari P, Alvarez C, Toro-Guerrero J, Sanchez Avila H, Wagner FA. Factors associated with tobacco, alcohol, and other drug use among youth living in West Central Mexico. World J Psychiatry 2018; 8:33-42. [PMID: 29568730 PMCID: PMC5862653 DOI: 10.5498/wjp.v8.i1.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/19/2018] [Accepted: 02/08/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To determine the prevalence of drug and substance abuse among high school students in Jalisco and its association with the severity of health, behavior and psychosocial problems in order to provide evidence for possible prevention and treatment needs.
METHODS A multi-stage random sample of Jalisco high school students was given a paper-and-pencil survey based upon an adapted version of the drug use screening inventory (DUSI) (n = 24699; n = 2832). The DUSI showed adequate psychometric characteristics in this population. The statistical analyses accommodated the complex survey design with attention to unequal probability of selection and clustering of participants within schools and regions.
RESULTS An estimated 44% of the students had smoked tobacco, one in five students was a current smoker, and one in four students used to smoke but had not smoked for one year or more. By contrast, 6.8% of the students reported having used marijuana, cocaine, or both. Behavioral problems, deviant peer affiliation, and troubled families were independently associated with drug use. One in two students who used tobacco or alcohol had used these drugs in the past year (46% and 54%, respectively), and one in four students who used marijuana or cocaine in their lifetime had used those drugs in the past year (28% in both cases).
CONCLUSION The rates of cocaine use as well as the proportion of current users were higher than expected among high school students and indicate changing patterns of drug use in Mexico. These results corroborate that the general trend of drug use by youth in Mexico is increasing. Results from this study help us better understand the needs of at-risk youth and the need for new treatment and prevention strategies.
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Affiliation(s)
- Octavio Campollo
- Center of Studies on Alcohol and Addictions, Antiguo Hospital Civil de Guadalajara, Department of Medical Clinics, Universidad de Guadalajara, Guadalajara, Jal CP 44280, Mexico
| | - Payam Sheikhattari
- Prevention Sciences Research Center and School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, United States
| | - Cesar Alvarez
- Charité - Universitätsmedizin Berlin, NeuroCure Clinical Research Center, Berlin 10117, Germany
| | - Jaime Toro-Guerrero
- Center of Studies on Alcohol and Addictions, Antiguo Hospital Civil de Guadalajara, Department of Medical Clinics, Universidad de Guadalajara, Guadalajara, Jal CP 44280, Mexico
| | - Hector Sanchez Avila
- Center of Studies on Alcohol and Addictions, Antiguo Hospital Civil de Guadalajara, Department of Medical Clinics, Universidad de Guadalajara, Guadalajara, Jal CP 44280, Mexico
| | - Fernando A Wagner
- School of Social Work, University of Maryland, Baltimore, MD 21250, United States
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Cannella N, Cosa-Linan A, Büchler E, Falfan-Melgoza C, Weber-Fahr W, Spanagel R. In vivo structural imaging in rats reveals neuroanatomical correlates of behavioral sub-dimensions of cocaine addiction. Addict Biol 2018; 23:182-195. [PMID: 28231635 DOI: 10.1111/adb.12500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 01/31/2017] [Accepted: 02/01/2017] [Indexed: 12/31/2022]
Abstract
Cocaine addiction is a multi-dimensional behavioral disorder characterized by a loss of control over cocaine taking despite of detrimental consequences. Structural MRI studies have revealed association between cocaine consumption and gray matter volume (GMV) in cocaine-addicted patients. However, the behavioral correlates of GMV in cocaine addiction are poorly understood. Here, we used a DSM-IV-based rat model of cocaine addiction with high face validity for structural imaging. According to three behavioral sub-dimensions of addiction, rats were separated into two groups showing either addict-like or non-addict-like behavior. These behavioral sub-dimensions were (1) the inability to refrain from drug-seeking and taking, (2) high motivation for the drug, and (3) maintained drug use despite negative consequences. In these rats, we performed structural MRI with voxel-based morphometry and analyzed the interaction of GMV with behavioral sub-dimensions in cocaine-addicted rats. Our major findings are that GMV differentially correlate with the inability to refrain from drug-seeking and taking in addict-like and non-addict-like rats within the somatosensory cortices and the amygdala. High motivation for the drug differentially correlates with GMV in addict-like and non-addict-like rats within the medial prefrontal cortex, and maintained drug use despite negative consequences differentially correlates with GMV in these two groups of rats within the periaqueductal gray. Our results demonstrate that the behavioral differences characterizing addict-like and non-addict-like rats in each behavioral sub-dimension of addiction are reflected by divergent covariance with GMV. We conclude that structural imaging provides specific neuroanatomical correlates of behavioral sub-dimensions of addiction.
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Affiliation(s)
- Nazzareno Cannella
- Institute of Psychopharmacology, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Alejandro Cosa-Linan
- Institute of Psychopharmacology, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Elena Büchler
- Institute of Psychopharmacology, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Claudia Falfan-Melgoza
- Research Group Translational Imaging, Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Wolfgang Weber-Fahr
- Research Group Translational Imaging, Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Rainer Spanagel
- Institute of Psychopharmacology, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
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McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev 2017; 66:12-23. [PMID: 29174306 DOI: 10.1016/j.cpr.2017.10.012] [Citation(s) in RCA: 437] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022]
Abstract
The gender gap in substance use disorders (SUDs), characterized by greater prevalence in men, is narrowing, highlighting the importance of understanding sex and gender differences in SUD etiology and maintenance. In this critical review, we provide an overview of sex/gender differences in the biology, epidemiology and treatment of SUDs. Biological sex differences are evident across an array of systems, including brain structure and function, endocrine function, and metabolic function. Gender (i.e., environmentally and socioculturally defined roles for men and women) also contributes to the initiation and course of substance use and SUDs. Adverse medical, psychiatric, and functional consequences associated with SUDs are often more severe in women. However, men and women do not substantively differ with respect to SUD treatment outcomes. Although several trends are beginning to emerge in the literature, findings on sex and gender differences in SUDs are complicated by the interacting contributions of biological and environmental factors. Future research is needed to further elucidate sex and gender differences, especially focusing on hormonal factors in SUD course and treatment outcomes; research translating findings between animal and human models; and gender differences in understudied populations, such as those with co-occurring psychiatric disorders and gender-specific populations, such as pregnant women.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States.
| | - Victoria R Votaw
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Dawn E Sugarman
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
| | - Shelly F Greenfield
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
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Pavarin RM, Fioritti A. Mortality Trends among Cocaine Users Treated between 1989 and 2013 in Northern Italy: Results of a Longitudinal Study. J Psychoactive Drugs 2017; 50:72-80. [PMID: 28846059 DOI: 10.1080/02791072.2017.1365976] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A total of 852 participants attending 11 centers for addiction treatment in north Italy following problems due to cocaine abuse between 1989 and 2013 were recruited. Two typologies were created: cocaine users (never heroin) (CU) and heroin and cocaine users (HCU). During the 38-year follow-up period, 4.8% of the whole cohort died. Over the whole period, tumors were the main causes of death; starting in 2010, suicide deaths became the first cause of death. Among CUs, most deaths were due to road accidents and suicide; among HCUs, most of the deaths were from opiate overdose and from cardio-circulatory system diseases. The excess mortality observed for all causes in either sex was 6.24; higher in females (15.03) as compared in males (6.23), higher in HCUs (9.06) as compared in CUs (5.21). The directly age-sex standardized mortality rates were 5.31 per 100, higher for females, declining after 2009 for all patients and after 2004 for HCUs. Multivariate analysis confirms the decreasing trend in the risk of death and shows a higher mortality risk for participants in the under-25 age group. Among cocaine users, special attention should be paid to the prevention of suicide deaths.
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Affiliation(s)
- Raimondo Maria Pavarin
- a Doctor, Health Sociologist, and Chief of Epidemiological Monitoring Center on Addiction, Mental Health DSM-DP , Azienda USL, Bologna , Italy
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Araos P, Vergara-Moragues E, González-Saiz F, Pedraz M, García-Marchena N, Romero-Sanchiz P, Ruiz JJ, Campos-Cloute R, Serrano A, Pavón FJ, Torrens M, Rodriguez De Fonseca F. Differences in the Rates of Drug Polyconsumption and Psychiatric Comorbidity among Patients with Cocaine Use Disorders According to the Mental Health Service. J Psychoactive Drugs 2017; 49:306-315. [PMID: 28682218 DOI: 10.1080/02791072.2017.1342151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Cocaine continues to be a worldwide public health concern in Europe. To improve prognosis and intervention, it is necessary to understand the characteristics of the patients who depend on the services where they receive care. The objective is to analyze the differences among patients who use cocaine and between ambulatory and residential resources to better adapt treatment. This is a descriptive, observational study of two populations of cocaine users in treatment: the ambulatory therapeutic community (ATC) and the therapeutic community (TC). The PRISM diagnostic interview was used for both groups. An analysis of both populations indicates a high prevalence of cocaine, heroin, cannabis, sedative, psychostimulant, and hallucinogen use disorders in the TC population compared to the ATC. In alcohol use disorder, differences between both mental health services were not observed. The degree of severity of cocaine use disorders (CUD) is greater in the TC population. The prevalence of psychiatric comorbidity is not statistically significant between the two populations, except for primary psychotic disorders, which are more prevalent in the TC population. This difference in the prevalence of psychotic disorders may be related to the high prevalence of cannabis use disorders in TC patients. Differences in the prevalence of substance use disorders, severity of CUD, and psychiatric comorbidity may limit the efficiency of mental health services involved in substance use disorder therapeutics. These results suggest the need for careful and extensive phenotyping of patients to improve intervention and prognosis in a clinical resource-dependent manner.
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Affiliation(s)
- P Araos
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Esperanza Vergara-Moragues
- b Researcher, Facultad de Ciencias Jurídicas, Sociales y Humanidades , Universidad Internacional de la Rioja , Logroño , La Rioja , Spain.,c Researcher, Addictive Disorders Network, Grupo de Investigación en Neurociencias Traslacional en Adicciones , Universidad de Granada , Andalucía , Spain
| | - Francisco González-Saiz
- c Researcher, Addictive Disorders Network, Grupo de Investigación en Neurociencias Traslacional en Adicciones , Universidad de Granada , Andalucía , Spain.,d Researcher, Community Mental Health Unit of Villamartín , Hospital de Salud Mental de Cádiz , Andalucía , Spain
| | - María Pedraz
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Nuria García-Marchena
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Pablo Romero-Sanchiz
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Juan Jesus Ruiz
- f Researcher, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques and Department of Psychiatry , Universitat Autònoma de Barcelona , Barcelona , Spain
| | | | - Antonia Serrano
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Francisco Javier Pavón
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Marta Torrens
- f Researcher, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques and Department of Psychiatry , Universitat Autònoma de Barcelona , Barcelona , Spain.,g Researcher, School of Medicine , Universitat Autónoma de Barcelona, Barcelona , Spain
| | - Fernando Rodriguez De Fonseca
- a Researcher, Management Unit of the Mental Health Clinical , Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga , Málaga , Spain
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Bonner WIA, Andkhoie M, Thompson C, Farag M, Szafron M. Patterns and factors of problematic marijuana use in the Canadian population: Evidence from three cross-sectional surveys. Canadian Journal of Public Health 2017. [PMID: 28621645 DOI: 10.17269/cjph.108.5926] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objectives of this study are to describe marijuana use in Canada and explore factors associated with problematic use. METHODS Data from the 2010-2012 circulations of the Canadian Alcohol and Drug Use Monitoring Survey were used to create three logistic regression models for the purposes of identifying and comparing factors associated with the degree of marijuana use, as determined via the WHO Alcohol, Smoking and Substance Abuse Involvement Screening Test (non-problematic, problematic) and European Monitoring Centre for Drugs and Drug Addiction (experiential, recent, current) methods. RESULTS Canadians aged 15-24 years are 15 times (p < 0.001) more likely to be current users than Canadians aged 65 or older, with the odds of exhibiting problematic marijuana use being 10 times (p < 0.001) greater. The odds of a male exhibiting problematic marijuana use are 2.46 times (p < 0.001) greater than for females. The odds of exhibiting problematic marijuana use are 41.0% (p = 0.031) and 53.0% (p = 0.008) greater for marijuana users with household incomes $40,000-$80,000 and less than $40,000 respectively compared to those with household income over $80,000. An earlier age of first marijuana use is associated with problematic use but not necessarily with being a current user. CONCLUSION The majority of our findings are consistent with the literature, showing that Canadians who are: male, adolescent or young adult, smokers, heavy drinkers, other illicit drug users, and who have poorer mental health status are more likely to engage in any marijuana use, particularly higher levels of marijuana use. These findings can be used to inform the development of policy in Canada to address problematic marijuana use and prepare for its possible legalization.
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Forman-Hoffman VL, Glasheen C, Batts KR. Marijuana Use, Recent Marijuana Initiation, and Progression to Marijuana Use Disorder Among Young Male and Female Adolescents Aged 12-14 Living in US Households. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2017; 11:1178221817711159. [PMID: 28615948 PMCID: PMC5462494 DOI: 10.1177/1178221817711159] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/23/2017] [Indexed: 12/04/2022]
Abstract
Marijuana initiation during adolescence, and early adolescence in particular, is associated with adverse health consequences. Our study used 2005–2014 data from the annual, cross-sectional National Survey on Drug Use and Health to study the prevalence and correlates of marijuana initiation, use, and marijuana use disorder (MUD; abuse or dependence) among 12- to 14-year olds living in civilian US households (n = 84 954). Examined correlates included age, sex, race/ethnicity, poverty status, metropolitan status, year of survey, depression, tobacco use, alcohol use, and fighting at school. Sex differences in the correlates of lifetime use and past year marijuana initiation were tested via interaction. Lifetime prevalence of marijuana use was 5.5%; 3.2% reported past year initiation. About 1 in 6 (16.8%) past year initiates progressed to MUD within 12 months of first use. Although men had higher prevalence of lifetime use than women, past year initiation did not differ by sex. On examining the sex*race/ethnicity interaction effects, findings determined that non-Hispanic black and Hispanic men had higher prevalence estimates of ever using marijuana and incidence of past year initiation as compared with non-Hispanic white men; these race/ethnicity differences were not found among women. Identifying correlates of initiation and progression to MUD among young adolescents is critical to improve prevention and treatment program targets.
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Affiliation(s)
| | - Cristie Glasheen
- Behavioral Health and Criminal Justice Division, RTI International, Durham, NC, USA
| | - Kathryn R Batts
- Behavioral Health and Criminal Justice Division, RTI International, Durham, NC, USA
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Vsevolozhskaya OA, Anthony JC. Estimated probability of becoming a case of drug dependence in relation to duration of drug-taking experience: a functional analysis approach. Int J Methods Psychiatr Res 2017; 26:e1513. [PMID: 27356948 PMCID: PMC5199633 DOI: 10.1002/mpr.1513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 04/04/2016] [Accepted: 04/14/2016] [Indexed: 01/13/2023] Open
Abstract
Measured as elapsed time from first use to dependence syndrome onset, the estimated "induction interval" for cocaine is thought to be short relative to the cannabis interval, but little is known about risk of becoming dependent during first months after onset of use. Virtually all published estimates for this facet of drug dependence epidemiology are from life histories elicited years after first use. To improve estimation, we turn to new month-wise data from nationally representative samples of newly incident drug users identified via probability sampling and confidential computer-assisted self-interviews for the United States National Surveys on Drug Use and Health, 2004-2013. Standardized modules assessed first and most recent use, and dependence syndromes, for each drug subtype. A four-parameter Hill function depicts the drug dependence transition for subgroups defined by units of elapsed time from first to most recent use, with an expectation of greater cocaine dependence transitions for cocaine versus cannabis. This study's novel estimates for cocaine users one month after first use show 2-4% with cocaine dependence; 12-17% are dependent when use has persisted. Corresponding cannabis estimates are 0-1% after one month, but 10-23% when use persists. Duration or persistence of cannabis smoking beyond an initial interval of a few months of use seems to be a signal of noteworthy risk for, or co-occurrence of, rapid-onset cannabis dependence, not too distant from cocaine estimates, when we sort newly incident users into subgroups defined by elapsed time from first to most recent use. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Olga A Vsevolozhskaya
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA.,Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - James C Anthony
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Abstract
This study examines the association between exposure to microaggressions and marijuana use, using original survey data from a sample of racial/ethnic minority college students (n = 332) from a large Division I university in the United States. Nearly all of our sample (96%) reported at least one experience with microaggressions in the past 6 months, while 33% reported using marijuana regularly. We modeled regular use of marijuana using multiple logistic regression, with consideration of sex, age, race/ethnicity, and microaggression scale scores as covariates. Age, sex, the microinvalidations subscale score, and the full microaggression scale score were significantly associated with marijuana use in our full models (p < .01; p = .01; p = .02; p = .03, respectively). With each additional experience of microaggression, the odds of regular marijuana use increase. Academic communities may consider the primary prevention of discriminatory behavior when addressing student substance use.
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Affiliation(s)
- George Pro
- a The University of Iowa , Iowa City , Iowa
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Cannella N, Cosa-Linan A, Roscher M, Takahashi TT, Vogler N, Wängler B, Spanagel R. [18F]-Fluorodeoxyglucose-Positron Emission Tomography in Rats with Prolonged Cocaine Self-Administration Suggests Potential Brain Biomarkers for Addictive Behavior. Front Psychiatry 2017; 8:218. [PMID: 29163237 PMCID: PMC5671955 DOI: 10.3389/fpsyt.2017.00218] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022] Open
Abstract
The DSM5-based dimensional diagnostic approach defines substance use disorders on a continuum from recreational drug use to habitual and ultimately addicted behavior. Biomarkers that are indicative of recreational drug use and addicted behavior are lacking. We performed a translational [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) study in the multi-dimensional 0/3crit model of cocaine addiction. Addict-like (3crit) and non-addict-like (0crit) rats, which shared identical life conditions and levels of cocaine self-administration, were acquired for FDG-PET under baseline conditions and following cocaine and yohimbine challenges. Compared to cocaine-naïve control rats, 0crit animals showed higher glucose uptake in the caudate putamen (CPu) and medial prefrontal cortex (mPFC) respect to naïve controls. 3crit animals did not show this adaptive higher glucose utilization, but had lower uptake in several cortical areas. Both cocaine and yohimbine challenges affected glucose uptake in control rats in several brain sites, but not in 0crit and 3crit rats, indicating that impaired glucose mobilization in response to these challenges is not specifically associated with addictive behavior. Compared to 0crit, 3crit rats showed higher reinstatement responses, which were negatively associated with glucose uptake in the ventral tegmental area. Data indicate that cocaine non-addict- and addict-like phenotypes are associated with several potential biomarkers. Specifically, we propose that increased glucose uptake in the CPu and mPFC is a function of controlled drug use, whereas a loss of striatal and prefrontal metabolic activity and reduced uptake in cortical areas are indicative of addictive behavior.
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Affiliation(s)
- Nazzareno Cannella
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Alejandro Cosa-Linan
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Mareike Roscher
- Medical Faculty Mannheim, Department of Clinical Radiology and Nuclear Medicine, Heidelberg University, Mannheim, Germany
| | - Tatiane T Takahashi
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Nils Vogler
- Medical Faculty Mannheim, Department of Clinical Radiology and Nuclear Medicine, Heidelberg University, Mannheim, Germany
| | - Björn Wängler
- Medical Faculty Mannheim, Department of Clinical Radiology and Nuclear Medicine, Heidelberg University, Mannheim, Germany
| | - Rainer Spanagel
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
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Voloshyna DM, Bonar EE, Cunningham RM, Ilgen MA, Blow FC, Walton MA. Blackouts among male and female youth seeking emergency department care. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 44:129-139. [PMID: 28032801 PMCID: PMC6186526 DOI: 10.1080/00952990.2016.1265975] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/22/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Alcohol-related blackouts are a common consequence of heavy drinking, and these blackouts pose risk for injury and other adverse health outcomes. OBJECTIVE To examine the prevalence and correlates of blackouts among underage drinkers. METHODS Youth (ages 14-20) presenting to a suburban Emergency Department (ED) completed screening surveys. Among those reporting past-year alcohol consumption, we examined past 3-month blackouts in relation to: background characteristics (e.g., demographics, fraternity/sorority involvement), substance use, sexual risk behaviors and incapacitated sexual assault (unaware/unable to consent due to alcohol/drugs), forced sexual assault, positive depression screening, and reason for ED visit (injury vs. medical). RESULTS In total, 2,300 past-year drinkers participated: 58% female, 75% Caucasian, and mean age = 18.4. Regarding past 3-month blackouts, 72.7% reported none, 19.3% reported monthly or less, and 8% reported monthly or more. Multivariate cumulative logit regression indicated that blackout frequency was positively associated with: college involvement in Greek life, alcohol use severity, prescription drug misuse, marijuana, screening positive for depression, incapacitated sexual assault, and a gender by alcohol use severity interaction. CONCLUSION With one-quarter of this clinical sample reporting recent blackouts, as well as the association between blackout frequency and health risk behaviors and other outcomes, findings underscore the need for programs focusing on substance use, depression, and preventing sexual assault. Interventions should also address poly-substance use and drinking motives. Although findings highlight how college students in Greek life may be at high risk for blackouts, many participants not in college also reported blackouts, suggesting that interventions in other settings are also needed.
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Affiliation(s)
- Diana M. Voloshyna
- Department of Psychiatry, Narcology, Neurology and Medical Psychology, V.N. Karazin Kharkiv National University, Svobody Sq. 6 r. №694а, Kharkiv, Ukraine, 61077
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
| | - Erin E. Bonar
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
| | - Rebecca M. Cunningham
- University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, Michigan, 48109
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights 3790A SPHI, Ann Arbor, MI 48109
| | - Mark A. Ilgen
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105
| | - Frederic C. Blow
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105
| | - Maureen A. Walton
- University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109
- University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, Michigan, 48109
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