humulene and Alcoholism

To develop effective interventions for people with coexisting mental disorders (MD) and substance use, it may be beneficial to understand their attitudes and perceptions of substances.. A systematic literature search regarding attitudes and perceptions towards tobacco, alcohol or cannabis among people with MD was conducted. Studies' methodological quality was assessed using the Newcastle-Ottawa Scale.. Twenty-one papers were included in the review and found to have generally low methodological quality. Papers investigated reasons for substance use, substance use expectancies, substances' perceived effects and reasons for quitting. People with psychotic disorders reported using substances primarily for relaxation and pleasure. Among people with mood disorders, alcohol was used primarily for social motives and tobacco for negative affect reduction.. For substance use interventions among people with MD to be more effective, it may be necessary to tailor interventions specifically for this population and customize by substance type. Gaps in the literature regarding attitudes and perceptions towards substance use among people with MD were identified, which future research should aim to address. These include designing and conducting methodologically rigorous research, investigating perceived harmfulness and knowledge of substances, and broadening recruitment of participants to include people with MD other than psychosis.

Topics: Alcoholic Beverages; Alcoholism; Attitude to Health; Cannabis; Humans; Marijuana Abuse; Mental Disorders; Nicotiana; Substance-Related Disorders; Tobacco Use Disorder

This article reviews neuropsychological performance in frequent users of cocaine, (meth)amphetamines, ecstasy, opiates, alcohol, and cannabis. We searched the scientific literature published in the last five years, focusing on studies that required at least 2 weeks of abstinence from drug use, and included a control group. All substances of abuse, except cannabis, were associated with sustained deficits in executive functioning, especially inhibition. In addition, verbal memory decrements were consistently found in cocaine, (meth)amphetamines and ecstasy users, but not in heroin or cannabis users. More specific executive functioning deficits were reported depending on the substance of abuse. Cocaine was associated with diminished cognitive flexibility, whereas (meth)amphetamines were associated with worse cognitive planning functions compared to controls. Opiate studies showed lower scores on verbal fluency in opiate dependent subjects compared to controls. Working memory and visuospatial abilities were compromised in alcohol abusers. In ecstasy users, inconsistent findings have been reported across neuropsychological domains, with the exception of inhibition and verbal memory. There was little evidence for sustained cognitive impairments in adult abstinent cannabis users. Recognition of neuropsychological problems related to different substances can help to select subjects that will benefit most from treatment. Furthermore, a better understanding of the neuropsychological impairments in drug abusing individuals could help to explain the remitting course of substance abuse disorders and to improve psychological interventions.

Topics: Alcoholism; Amphetamine-Related Disorders; Cannabis; Central Nervous System Stimulants; Cocaine; Cocaine-Related Disorders; Drug Users; Hallucinogens; Heroin Dependence; Humans; Marijuana Abuse; Memory Disorders; Methadone; Methamphetamine; N-Methyl-3,4-methylenedioxyamphetamine; Neuropsychological Tests; Opioid-Related Disorders; Psychomotor Performance; Recognition, Psychology; Substance-Related Disorders; Verbal Behavior

Very little addiction treatment research has been done concerning smoking cessation, illicit drugs, or even alcohol abuse in liver transplant patients. Our data suggest that a surprising number of patients who are awaiting a liver transplant for alcohol-related end-stage liver disease will return to drinking before transplantation. We found that motivational enhancement therapy afforded no marked benefit over treatment as usual for drinking, smoking, mood, or general health outcomes in alcoholics awaiting liver transplantation. Stably abstinent methadone-maintained opiate-dependent patients should not be tapered off methadone; are generally good candidates for liver transplant; show low relapse rates into illicit use of opiates; and may be at risk for more medical complications than their counterparts. Pre- and posttransplantation smoking rates are high and cause marked morbidity and mortality. Transplant teams should encourage smoking cessation treatments.Marijuana use in liver transplant recipients is not uncommon, and apart from the risk of developing aspergillosis, additional health risks have not yet been identified.

Topics: Alcoholism; Analgesics, Opioid; Behavior, Addictive; Cannabis; Humans; Liver Diseases; Liver Transplantation; Opioid-Related Disorders; Pain Management; Tobacco Use Disorder

The final common pathway of addiction (the dopamine hypothesis of reward) has recently been evolving, with the mesocorticolimbic dopaminergic system now seen as key to natural rewards and drug-seeking behaviour, though perhaps having less of a role in the maintenance of such behaviour. The perception of a common pathway has meant that treatments for one drug of addiction have 'crossed-over' and become possible treatments for other addictive drugs.

Topics: Alcoholism; Amphetamine-Related Disorders; Animals; Benzodiazepines; Cannabis; Cocaine-Related Disorders; Dopamine; Humans; Narcotics; Substance Withdrawal Syndrome; Substance-Related Disorders; Tobacco Use Disorder

It is clear that a number of CNS agents, including drugs of abuse, can inhibit reproductive function. Figure 1 shows the chemical diversity of some of the drug groups that affect reproductive hormones. Their structural dissimilarity to the steroid hormones is also readily apparent in the figure. These chemically diverse drugs share an important pharmacologic property: they are highly potent neuroactive drugs, and they can disrupt hypothalamic-pituitary function. Although it is frequently difficult to distinguish between direct drug actions on the hypothalamic-pituitary axis and subsequent effects on gonadal hormones and sex accessory gland function, the distinction is an important one. Most neuroactive drugs produce only transient effects on the central nervous pathways necessary for normal gonadotropin secretion. The disruptive effects of these drugs are likely to be transient and completely reversible, and tolerance to the inhibitory drug effects may occur even with continued drug use. Under these circumstances, normal adults may experience only subtle changes in sexual function. However, individuals with compromised reproductive function may exhibit major problems. It is also likely that adolescents may be at substantial risk for reproductive damage from these neuroactive drugs since the endocrine events associated with puberty are dependent on the normal development of the hypothalamic-pituitary axis.

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cannabis; Child Development; Cocaine; Embryonic and Fetal Development; Female; Fetal Alcohol Spectrum Disorders; Gonadotropin-Releasing Hormone; Hallucinogens; Humans; Hypothalamo-Hypophyseal System; Pregnancy; Reproduction; Substance-Related Disorders; Sudden Infant Death

Topics: Affect; Alcoholism; Animals; Cannabinoids; Cannabis; Ethanol; Female; Humans; Macaca; Menstrual Cycle; Premenstrual Syndrome; Pulse; Recurrence; Risk; Sex Factors; Substance-Related Disorders

This article is a review of the principal drug-induced psychiatric symptoms that are likely to be encountered in daily clinical practice as a result of drug abuse, overdoses or side effects of drugs prescribed for treatment. Many categories of medication have the potential to produce psychiatric symptoms, but antitubercular drugs, hypotensive agents and steroids have the highest incidence in clinical practice. Additionally, the problems of alcohol are all too frequently overlooked. The variety and frequency of secondary psychiatric symptoms which may be drug-related emphasise the importance of a careful consideration of all drugs taken by a patient with psychiatric complaints, to determine causal association with symptoms.

Topics: Alcoholic Intoxication; Alcoholism; Amphetamines; Analgesics; Antihypertensive Agents; Antiparkinson Agents; Antitubercular Agents; Barbiturates; Bromides; Cannabis; Cocaine; Hallucinations; Histamine H1 Antagonists; Humans; Lysergic Acid Diethylamide; Mental Disorders; Parasympatholytics; Psychotropic Drugs; Steroids; Substance Withdrawal Syndrome

Topics: Adolescent; Alcohol Drinking; Alcoholism; Cannabis; Conditioning, Operant; Female; Humans; Juvenile Delinquency; Male; Psychological Theory; Reinforcement, Psychology; Social Behavior; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Emotions; Ethnicity; Female; Hallucinogens; Heroin Dependence; Humans; Intelligence Tests; Male; MMPI; Perception; Personality; Personality Inventory; Rorschach Test; Sex Factors; Substance-Related Disorders; Thematic Apperception Test

The estimate of drug abuse by alcoholics and problem drinkers in the literature varies from a low of 1% to a high of 90%. These studies, coupled with data from the National Drug/Alcohol Collaborative Project (NDACP), led us to estimate the figure to lie somewhere between 60 and 80%, being somewhat higher for individuals under 40 than over 40. Some explanations for the increased occurrence of this form of multiple substance abuse are provided. Problems associated with investigating this phenomenon are discussed and illustrated. Physiological and medical complications associated with drug and alcohol abuse are also cited.

Topics: Alcoholism; Amphetamines; Cannabis; Humans; Hypnotics and Sedatives; Opium; Socioeconomic Factors; Substance-Related Disorders; Time Factors

Topics: Airway Resistance; Alcoholism; Animals; Asthma; Cannabinoids; Cannabis; Depression; Dose-Response Relationship, Drug; Epilepsy; Glaucoma; Humans; Intraocular Pressure; Neoplasms, Experimental; Pain; Preanesthetic Medication; Seizures; Sleep

Topics: Abnormalities, Drug-Induced; Alcoholism; Animals; Anticonvulsants; Cannabis; Environmental Exposure; Enzyme Activation; Female; Genetic Code; Gestational Age; Gonadal Steroid Hormones; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Maternal-Fetal Exchange; Organ Specificity; Pregnancy; Teratogens; Thalidomide

Topics: Administration, Oral; Alcoholism; Amphetamine; Animals; Behavior, Animal; Cannabis; Chlorpromazine; Cocaine; Dextroamphetamine; Drinking Behavior; Dronabinol; Ethanol; Humans; Imipramine; Injections, Intravenous; Macaca mulatta; Morphine; Pentobarbital; Reinforcement Schedule; Secobarbital; Social Environment; Substance-Related Disorders; Time Factors

A minority of alcohol abusers develop severe cerebral dysfunction in the form of Wernicke-Korsakoff syndrome. There is also evidence to suggest that cerebral dysfunction, particularly impaired abstracting ability, occurs in that larger population of heavy drinkers who do not go on to develop the Wernicke-Korsakoff syndrome. There is no consistent evidence that long-term marijuana, hallucinogen, or sedative use causes lasting neuropsychological disturbance. The deficits in abstract thinking reported by some LSD studies are similar to deficits others have reported among alcoholics. Since the LSD studies were not controlled for alcohol use, their interpretation is difficult. It appears that cerebrovascular accidents occur more frequently and at a younger age among amphetamine abusers. There is no reliable information about possible other long-term effects of stimulants on the brain per se (i.e., nonvascular complications). Abuse of intravenous narcotics has been associated with case reports of transverse myelitis and encephalitis. It is not known whether this pathology is a direct or hypersensitivity effect of narcotic drugs, of adulterants, or of infection.

Topics: Alcoholism; Amphetamines; Barbiturates; Brain Diseases; Cannabis; Cerebrovascular Disorders; Cocaine; Humans; Hypnotics and Sedatives; Lysergic Acid Diethylamide; Mescaline; Methylphenidate; Narcotics; Phenmetrazine; Psilocybin; Psychological Tests; Psychoses, Alcoholic; Substance-Related Disorders

Topics: Alcoholism; Ambulatory Care; Amphetamines; Aversive Therapy; Barbiturates; Cannabis; Follow-Up Studies; Hallucinogens; Heroin; Heroin Dependence; Humans; Legislation, Drug; Methadone; Smoking; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adult; Aging; Alcoholism; Amphetamine; Cannabis; Child; Child Development; Child, Preschool; Cognition; Dose-Response Relationship, Drug; Environment; Female; Humans; Infant; Infant, Newborn; Intelligence; Male; Mental Disorders; Motivation; Narcotics; Nutrition Disorders; Personality; Personality Development; Psychological Theory; Psychoses, Substance-Induced; Research Design; Sex Factors; Substance-Related Disorders

Topics: Adolescent; Adult; Alcoholism; Anxiety; Canada; Cannabis; Community Health Services; Epidemiology; Family Characteristics; Female; Health Education; Humans; Lysergic Acid Diethylamide; Male; Parents; Personality Inventory; Phytotherapy; Population Density; Sex Factors; Smoking; Social Alienation; Substance-Related Disorders

Topics: Absenteeism; Accidents, Occupational; Achievement; Alcoholism; Amphetamine; Cannabis; Career Mobility; Efficiency; Employment; Heroin Dependence; Humans; Occupational Medicine; Occupations; Social Behavior Disorders; Social Class; Substance-Related Disorders

The past 3 years of renewed research on the effects of marihuana in man has added little not previously known about the clinical syndromes produced by the drug. The major advance has been a quantification of dose in relation to clinical phenomena, and a beginning of an understanding of the drug's metabolism. The crucial clinical experiments in regard to the social questions about marihuana, such as the possible deleterious effects from chronic use, cannot be answered by laboratory experiments. These must be settled by close observations made on those who experiment on themselves. It should be possible, within a relatively short time, to determine whether marihuana has any medical utility, but the future would appear to be no more promising than the past in this regard. The mechanisms by which marihuana alters mental functions are not likely to be answered in man, nor even answered soon by animal studies. As marihuana may be unique among drugs in that more experimentation has been accomplished in man than in animals, it may be necessary to look to additional animal studies to provide leads for pertinent future studies in man.

Topics: Alcoholism; Cannabis; Chemistry; Culture; Dosage Forms; France; History, 19th Century; History, 20th Century; Humans; India; Perception; Physiology; Phytotherapy; Psychometrics; Psychophysiology; Smoking; Social Problems; United States

Topics: Adolescent; Alcoholism; Amphetamine; Amphetamines; Barbiturates; Cannabis; Child; Epidemiology; Hallucinogens; Heroin; Humans; Inhalant Abuse; Personality; Smoking; Social Conditions; Substance-Related Disorders; Toxicology; United States

Determine whether a culturally tailored contingency management (CM) intervention targeting alcohol abstinence resulted in secondary effects on cannabis use among American Indian and Alaska Native (AI/AN) adults.. The research team conducted this secondary data analysis to examine cannabis abstinence using data from a randomized control trial of CM for alcohol use among three AI/AN-serving organizations. One hundred and fifty-eight adults met the randomization criteria (i.e., submission of 50% or more urine samples and one alcohol-positive urine test during a 4-week, pre-randomization, observation period). For 12 weeks after randomization, participants received incentives for submitting a urine test negative for ethyl glucuronide (EtG < 150 ng/mL, CM group) or incentives for submitting a urine sample regardless of abstinence (Non-contingent [NC] Control group). Generalized linear mixed effects models assessed group differences in cannabis abstinence during the intervention, verified by urine tetrahydrocannabinol negative tests (11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid <50 ng/mL).. At baseline, 42.2% (n = 35) of participants in the NC group and 40.0% (n = 30) of those in the CM group had a cannabis positive urine test. An overall intervention by time interaction was detected for a cannabis negative urine test (χ. CM addressing alcohol misuse may be an effective strategy for decreasing cannabis use among AI/AN adults.. ClinicalTrials.gov number, Identifier: NCT02174315.

Topics: Adult; Alaskan Natives; Alcoholism; American Indian or Alaska Native; Cannabis; Dronabinol; Humans

Individuals with alcohol use disorder (AUD) do not always respond to currently available treatments, and evaluation of new candidate pharmacotherapies is indicated. N-acetylcysteine (NAC), an over-the-counter supplement, has shown promise in treating a variety of substance use disorders, but little research has evaluated its merits as a treatment for AUD. This secondary analysis from the National Drug Abuse Treatment Clinical Trials Network examined the effects of NAC versus placebo on alcohol use among participants with cannabis use disorder (CUD) enrolled in a 12-week, multi-site cannabis cessation trial.. Participants (N = 302, ages 18-50) were randomized to double-blind NAC (1200 mg, twice daily) or placebo. Neither alcohol use nor desire for alcohol cessation were requirements for participation. Participants that returned for at least one treatment visit and had recorded alcohol use data (i.e., total drinks per week, drinking days per week, and binge drinking days per week) were included in the analysis (n = 277).. Compared to the placebo group, participants in the NAC group had increased odds of between-visit alcohol abstinence [OR = 1.37; 95% CI = 1.06-1.78; p = 0.019], fewer drinks per week [RR = 0.67; 95% CI = 0.48-0.99; p = 0.045], and fewer drinking days per week [RR = 0.69; 95% CI = 0.51-0.92; p = 0.014]. Changes in concurrent cannabis use amounts were not correlated to any of the alcohol use variables.. These findings indicate that NAC may be effective at reducing consumption of alcohol by ∼30% among treatment-seeking adults with CUD, suggesting a need for further trials focused on the effects of NAC on alcohol consumption among individuals seeking treatment for AUD.

Topics: Acetylcysteine; Adolescent; Adult; Alcohol Drinking; Alcoholism; Cannabis; Double-Blind Method; Female; Humans; Male; Marijuana Abuse; Middle Aged; Treatment Outcome; Young Adult

To evaluate whether pain was associated with increased risk of using heroin, stimulants or cannabis among HIV-infected drinkers in Russia.. Secondary analysis of longitudinal data from the HERMITAGE study (HIV's Evolution in Russia-Mitigating Infection Transmission and Alcoholism in a Growing Epidemic), a behavioral randomized controlled trial, with data collected at baseline, 6-month and 12-month visits.. Recruitment occurred at HIV and addiction treatment sites in St Petersburg, Russian Federation.. Six hundred and ninety-nine HIV-infected adult drinkers.. The primary outcome was past month illicit drug use; secondary outcomes examined each drug (heroin, stimulants and cannabis) separately. The main predictor was pain that interfered at least moderately with daily living. General estimating equations (GEE) logistic regression models were used to evaluate the association between pain and subsequent illicit drug use, adjusting for potential confounders.. Participants reporting pain appeared to have higher odds of using illicit drugs, although the results did not reach statistical significance [adjusted odds ratio (OR) = 1.32; 95% confidence interval (CI) = 0.99, 1.76, P = 0.06]. There was a significant association between pain and heroin use (OR = 1.54; 95% CI = 1.11-2.15, P = 0.01) but not use of other drugs (OR = 0.75; 95% CI =0.40-1.40, P = 0.35 for stimulants and OR = 0.70; 95% CI = 0.45-1.07, P = 0.09 for cannabis).. HIV-infected Russian drinkers who report pain are more likely to use heroin over time than HIV-infected Russian drinkers who do not report pain. Pain may be an unrecognized risk factor for persistent heroin use with implications for HIV transmission in Russia.

Topics: Adult; Alcohol Drinking; Alcoholism; Cannabis; Central Nervous System Stimulants; Female; Heroin Dependence; HIV Infections; Humans; Longitudinal Studies; Male; Pain; Risk Factors; Russia; Substance-Related Disorders

Emerging adult alcohol and cannabis co-use is on the rise and enacts risk for alcohol misuse/alcohol use disorder (AUD). However, few studies have differentiated whether levels of cannabis use (rather than any cannabis use) moderate between-person risk. Considering low-frequency co-users may use both substances via substitution, low-risk/frequency co-use may not enact the same risk for AUD as higher risk co-use. The present study sought to test this assertion. Public access data on emerging adults from the National Study on Drug Use and Health were used (2002-2019;

Topics: Adult; Alcohol Drinking; Alcoholism; Cannabis; Humans; Risk; Substance-Related Disorders

With changes in state laws, cannabis is now more accessible in many parts of the United States. The drug has previously been associated with a higher incidence of acute ischemic stroke (AIS). Our study analyzed the effect of cannabis use on AIS outcomes.. The 2019 National Inpatient Sample from Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality was used to evaluate the AIS patients ages 25 and more. Cannabis users were compared with nonusers. Their mortality risks were also assessed.. Five hundred thirty-nine thousand eight hundred eighty patients with AIS were in our study and 8850 used cannabis. Among the cannabis users with AIS, 69.8% were males, 50.6% were white, 61.8% were aged 46 to 65, 32.1% used Medicaid, 86.1% were nonobese, 72.0% were nondiabetics, 81.7% had hypertension, 80.7% did not have a history of alcohol abuse, and 77.5% were smokers (nicotine). Only 12.8% of cannabis users reported any cardiac dysrhythmia, whereas 5.4% required mechanical thrombectomy, and 8.0% received intravenous tissue plasminogen activator (tPA).After adjusting the variables, cannabis users covered by Medicare, with diabetes, a history of alcohol abuse, cardiac dysrhythmias, and who underwent mechanical thrombectomy had a higher risk of dying. The overall adjusted odds ratio of dying among cannabis users with AIS was 0.603 (95% CI, 0.504-0.722, P <0.01).. Although the overall mortality risk seems to be lower among cannabis users, those with certain risk factors still present higher mortality risks. Patients with cannabis use should therefore be monitored closely for possible complications and mortality after AIS.

Topics: Aged; Alcoholism; Brain Ischemia; Cannabis; Female; Humans; Ischemic Stroke; Male; Medicare; Risk Factors; Stroke; Tissue Plasminogen Activator; Treatment Outcome; United States

Topics: Adolescent; Adolescent Behavior; Adult; Alcoholism; Cannabis; Female; Goals; Humans; Male; Marijuana Use; Protective Factors; Risk Factors; Substance-Related Disorders; Surveys and Questionnaires; Young Adult

Risk for cannabis use and schizophrenia is influenced in part by genetic factors, and there is evidence that genetic risk for schizophrenia is associated with subclinical psychotic-like experiences (PLEs). Few studies to date have examined whether genetic risk for schizophrenia is associated with cannabis-related PLEs.. We tested whether measures of cannabis involvement and polygenic risk scores (PRS) for schizophrenia were associated with self-reported cannabis-related experiences in a sample ascertained for alcohol use disorders (AUDs), the Collaborative Study on the Genetics of Alcoholism (COGA). We analyzed 4832 subjects (3128 of European ancestry and 1704 of African ancestry; 42% female; 74% meeting lifetime criteria for an AUD).. Cannabis use disorder (CUD) was prevalent in this analytic sample (70%), with 40% classified as mild, 25% as moderate, and 35% as severe. Polygenic risk for schizophrenia was positively associated with cannabis-related paranoia, feeling depressed or anhedonia, social withdrawal, and cognitive difficulties, even when controlling for duration of daily cannabis use, CUD, and age at first cannabis use. The schizophrenia PRS was most robustly associated with cannabis-related cognitive difficulties (β = 0.22, SE = 0.04, P = 5.2e-7). In an independent replication sample (N = 1446), associations between the schizophrenia PRS and cannabis-related experiences were in the expected direction and not statistically different in magnitude from those in the COGA sample.. Among individuals who regularly use cannabis, genetic liability for schizophrenia-even in those without clinical features-may increase the likelihood of reporting unusual experiences related to cannabis use.

Topics: Alcoholism; Cannabis; Female; Genetic Predisposition to Disease; Humans; Male; Multifactorial Inheritance; Risk Factors; Schizophrenia

Polysubstance use is common among people with HIV infection (PWH) and with substance use disorder (SUD), but its effects are understudied. We aimed to identify polysubstance use patterns over time and assess their associations with HIV disease severity.. In 233 PWH with current or past SUD, latent class analysis identified polysubstance use patterns based on the Alcohol Use Disorders Identification Test-Consumption and past-30-day use of cannabis, cocaine, opioids, and tranquilizers at baseline. We categorized changes in use patterns and tested associations between those changes and CD4 count and HIV viral suppression at 12 months in linear and logistic regressions.. Three patterns were identified at baseline: 18% did not use any substance (NONE--a priori defined); 63% used mostly cannabis and alcohol (CA); and 19% used opioids along with other drugs, including cocaine, tranquilizers, cannabis, and alcohol (MULTI). At 12 months, 40% moved from a high to a lower substance use class (MULTI to CA, either to NONE) or remained as NONE, 43% were in CA both times and 17% increased (NONE to CA, either to MULTI) or remained as MULTI. The adjusted mean CD4 count (for baseline covariates and baseline CD4 count) was significantly lower among participants increasing or remaining in MULTI (523, 95% CI [448, 598], cells/mm3) compared with those who decreased/abstained throughout (607, 95% CI [552, 663],. We identified distinct polysubstance use patterns among PWH with SUD: cannabis/alcohol and opioids with alcohol and other drugs. Changes over time toward fewer substances/no use were associated with lower HIV disease severity based on CD4 count but not based on HIV viral suppression.

Topics: Alcoholism; Cannabis; Cocaine; Hallucinogens; HIV Infections; Humans; Latent Class Analysis; Patient Acuity; Substance-Related Disorders

Experiences of racial discrimination among Black Americans are associated with numerous adverse behavioral health outcomes, including risk for substance use. Research has shown ethnic identity to be directly related to reduced substance use risk among Black Americans, as well as mitigate substance use risk as a consequence of exposure to racial discrimination. However, whether the specific facet of ethnic identity (affirmation and exploration), is related to the relationship between racial discrimination and problem substance use based on substance type is unclear. Thus, the current study examined 1) the association between ethnic identity (affirmation and exploration) and problem alcohol and cannabis use, and 2) whether ethnic identity affirmation or exploration moderates the association between racial discrimination and problem substance use among a sample of Black young adults.. Three-hundred and ninety Black young adults ages 18-24 (M = 20.6, 62 % female, 85 % monoracial) completed an online survey that included measures on past-year experiences of racial discrimination, ethnic identity affirmation and exploration, and problem alcohol and cannabis use. Utilizing multiple linear regression and the PROCESS macro, the study examined the promotive (direct) association between ethnic identity and problem substance use, and the protective (moderating) effect of ethnic identity on the relationship between racial discrimination and problem substance use.. After accounting for the demographic covariates of age, gender (male, female, and other), and race (monoracial and bi/multiracial), higher ethnic identity affirmation was significantly associated with lower problem alcohol, and higher ethnic identity exploration was significantly associated with lower problem alcohol and cannabis use. The study also observed a moderating effect of ethnic identity affirmation and exploration on the relationship between racial discrimination and problem alcohol use. Specifically, the association between racial discrimination and problem alcohol use weakened at higher levels of ethnic identity affirmation and exploration. Neither ethnic identity affirmation nor exploration significantly moderated the relationship between racial discrimination and problem cannabis use.. Findings suggest that ethnic identity is associated with problem alcohol use and may also reduce the strength of the association between racial discrimination and problem alcohol use, although these findings need to be confirmed with longitudinal study designs. If supported, interventions focused on strengthening one's ethnic identity affirmation and exploration may offer a potential target for interventions addressing alcohol misuse among Black young adults. However, more research should seek to understand promotive and protective factors for problem cannabis use among Black young adults.

Topics: Alcohol-Related Disorders; Alcoholism; Cannabis; Ethnicity; Female; Humans; Longitudinal Studies; Male; Social Identification; Substance-Related Disorders; Young Adult

Some patterns of cannabis use may presage risk for long-term negative effects. We examined associations between a novel adolescent cannabis misuse scale and early-adult life course outcomes.. We performed a secondary data analysis of a cohort of Los Angeles, CA high school students from grade 9 through age 21. Participants reported baseline individual demographic and family characteristics at grade 9, adolescent cannabis misuse (8-items) and alcohol misuse (12-items) at grade 10, and outcomes at age 21. We used multivariable regression to model the associations of cannabis misuse scale score with problem substance use (defined as any of: 30-day illegal drug use, 30-day use of another's prescription to get high, hazardous drinking) and several secondary outcomes (behavioral, mental health, academic, social determinants of health), adjusting for covariates. Parallel analyses were conducted for alcohol misuse.. The 1,148 participants (86% retention) were 47% male, 90% Latinx, 87% US born, and 40% native English speakers. Approximately 11.4% and 15.9% of participants reported at least one item on the cannabis and alcohol misuse scales, respectively. At age 21, approximately 6.7% of participants reported problem substance use, which was associated with both Cannabis and Alcohol Misuse Scales (OR 1.31, 95%CI[1.16, 1.49] and OR 1.33, 95%CI[1.18, 1.49], respectively). Both scales were similarly associated with outcomes in all four categories.. The Adolescent Cannabis Misuse Scale is a promising tool for identifying early patterns of substance use that predict future negative outcomes and enabling early intervention at a critical period in youth development.

Topics: Adolescent; Adult; Alcoholism; Cannabis; Female; Humans; Male; Mental Health; Social Determinants of Health; Substance-Related Disorders; Young Adult

This study tested how individuals anticipate they will respond to opportunities to engage in simultaneous alcohol and marijuana (SAM) use.. Two studies utilizing a within-subjects design were conducted. Study 1 was conducted in Spring 2021 and a replication (Study 2) was conducted in Fall 2021. Participants were presented with pairs of scenarios. One scenario pair compared how willing participants expected to be to get drunk if they were sober. In Study 1 participants reported greater willingness to get drunk when sober than when high. This was qualified by a statistically significant interaction whereby differences were greater among those who had more experience with past 30-day heavy drinking. Similar findings emerged for willingness to use marijuana. Participants anticipated greater willingness to use marijuana when sober than when drunk. This was also qualified by a statistically significant interaction whereby differences were greater among experimental or established users of marijuana than among abstainers. Study 2 findings replicated those from Study 1.. College attending young adults state greater willingness to remain under the influence of one substance than to engage in SAM use when opportunities arise. Simultaneous use of alcohol and marijuana among college students is likely an exception, not the rule. Implications for prevention are discussed.

Topics: Alcohol Drinking; Alcoholic Intoxication; Alcoholism; Cannabis; Ethanol; Female; Hallucinogens; Humans; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

Simultaneous alcohol and cannabis use (SAM) is associated with riskier drinking. However, little is known regarding mechanisms of risk during drinking episodes. The current study tested whether subjective responses to simultaneous vs. alcohol-only use (i.e., high arousal positive/reward, high arousal negative/aggression, low arousal positive/relaxation, low arousal negative/impairment) were mechanisms through which SAM use was associated with daily drinking.. Emerging adults who co-use alcohol and cannabis (N=85) completed 21 days of ecological momentary assessment with drink-contingent reports during drinking episodes. Participants reported on their simultaneous use and current subjective effects during drink reports and past-night total drinks consumed and negative consequences experienced the next morning. Three-level multilevel models (momentary, daily, person level) tested whether SAM use predicted subjective responses, and whether subjective responses mediated associations between SAM use, heavier drinking and negative consequences.. At the momentary and day-level, SAM (vs. alcohol-only) use predicted increased high arousal positive/rewarding, low arousal positive/relaxing, and low arousal negative/impairing subjective effects. SAM use indirectly predicted heavier day-level drinking and further negative consequences through high arousal positive/rewarding response. SAM use also indirectly predicted day-level negative consequences through low arousal negative/impairing response. At the person-level, more frequent SAM use predicted higher person-average high arousal positive/rewarding and low arousal positive/relaxing responses, and high arousal positive/rewarding response mediated relation between SAM frequency and heavier drinking.. Simultaneous use was associated with reward, relief, and impairment, and reward and impairment were mechanisms of risk between SAM use and riskier drinking. Findings may inform theory and just-in-time interventions seeking to reduce alcohol misuse.

Topics: Adult; Alcohol Drinking; Alcoholism; Cannabis; Ethanol; Humans; Reward

Sexual minority individuals are at substantially elevated risk for both cannabis use disorder (CUD) and alcohol use disorder (AUD). Although recent increases in the legalization of cannabis have been linked to increases in cannabis use among the general population, few studies have examined if changes in cannabis use and CUD vary by sexual identity. The purpose of the current study was to examine sexual identity differences in trends for CUD and compare them to trends for AUD.. We used data from 2015-2019 National Survey on Drug Use and Health to examine annual prevalence and year-specific disparities in cannabis use, CUD, heavy episodic drinking, and AUD. We also examined sex-specific sexual identity differences in linear trends for these substance use outcomes over this 5-year period.. All groups except lesbian females experienced significant increases in cannabis use rates from 2015 to 2019. Heterosexual males, heterosexual females, and bisexual females also experienced significant increases in CUD rates. In contrast, no group exhibited significant increases in heavy episodic drinking or AUD rates. Bisexual women exhibited some of the largest year-specific disparities in cannabis use and CUD as well as the largest growth in disparities across time.. The few changes in heavy episodic drinking and AUD alongside numerous changes in cannabis use and CUD suggest that changes in cannabis use may be attributable to legalization of cannabis use in many states during this period. Given profound disparities and increasing rates of CUD affecting bisexual females, further research is needed to identify factors that may explain their disproportionate burden.

Topics: Alcohol Drinking; Alcoholism; Bisexuality; Cannabis; Female; Humans; Male; Sexual and Gender Minorities; Substance-Related Disorders

Alcohol use disorder (AUD) is associated with steeper delay discounting rates; however, it is unknown whether substance co-use, particularly cannabis use, has an additive effect on discounting rates among heavy drinkers. Furthermore, it is unclear whether substance co-use and delay discounting are independently associated with AUD severity.. The purpose of this study was to determine whether alcohol, tobacco, and cannabis co-use impacts delay discounting rates. We also sought to determine whether substance co-use and delay discounting were associated with AUD symptom counts.. The study sample was culled from several human laboratory studies and consisted of 483 heavy drinking individuals who completed a baseline visit (prior to experimental procedures). Participants were divided into groups based on self-reported alcohol, tobacco, and cannabis use during the past 30 days: alcohol only (n = 184), alcohol + cigarettes (n = 89), alcohol + cannabis (n = 82), and tri-use (n = 128). We examined discounting rates across the 4 groups and used multiple linear regression to test whether co-use and delay discounting were associated with AUD symptoms.. After adjusting for covariates, individuals in the alcohol + cannabis group and the tri-use group had steeper discounting rates relative to the alcohol-only group. In addition, tri-use and delay discounting rates were independently correlated with a greater number of AUD symptoms.. Delay discounting rates were significantly greater among subgroups reporting cannabis use providing partial support for an additive effect, while also highlighting the importance of co-use substance type. Both tri-use and delay discounting were associated with greater AUD severity, which may provide relevant intervention targets.

Topics: Alcohol Drinking; Alcoholic Intoxication; Alcoholism; Cannabis; Delay Discounting; Ethanol; Hallucinogens; Humans; Nicotiana; Substance-Related Disorders; Tobacco Products

Research has shown that people living with HIV/AIDS (PLWHA) engage in increased rates of substance use, which has a number of potential negative health outcomes. Increased legalization of cannabis is likely to further increase the availability and use of cannabis in this population. Efforts have been made to integrate screening and intervention resources as part of an individual's routine healthcare visits. Though brief approaches such as Screening and Brief Intervention (SBIRT) have shown promise in addressing alcohol use, results are mixed in addressing cannabis use. The present study investigated how individuals reporting cannabis use responded to an invitation to engage in a brief negotiated intervention (BNI).. PLWHA participated in a self-administered tablet computer-based version of SBIRT. Patients screened as having at-risk, high-risk, or dependent substance use (N = 331) were eligible to receive the BNI. Of these patients, 101 reported cannabis-only use, with or without alcohol.. Binary logistic regressions controlling for Alcohol Use Disorders Identification Test and Drug Abuse Screening Test score and demographics, found that cannabis-only use was significantly related to declining the BNI.. Cannabis-only engagement predicts lower BNI acceptance rates than other substance use profiles; inappropriate screening tools may be one reason for this discrepancy. Implications and directions for future research are discussed.. Findings are relevant in modifying SBIRT for cannabis use. To our knowledge, this is the first work to evaluate acceptance of brief interventions for cannabis as compared to other substances and brief intervention acceptance in a sample of PLWHA.

Topics: Alcoholism; Cannabis; Crisis Intervention; HIV Infections; Humans; Mass Screening; Referral and Consultation; Substance-Related Disorders

Cannabis is often used in combination with alcohol; yet, whether cannabis use impacts risk factors for alcohol use disorder (AUD) remains unknown. Subjective response (SR) to alcohol represents a biobehavioral risk factor for subsequent heavy drinking and for developing AUD. Given the high prevalence of alcohol and cannabis co-use, it is plausible to hypothesize that cannabis users differ in SR to alcohol compared to non-cannabis users. The purpose of this study is to examine the influence of past-month cannabis use on subjective response to alcohol in the human laboratory.. This study culled data from multiple alcohol administration trials to test whether cannabis users, compared to non-cannabis users, differed in subjective response to alcohol, comprised of four domains: stimulation, sedation, negative affect, and craving. Non-treatment-seeking heavy drinkers (N = 168) completed a battery of self-report scales of mood and alcohol/cigarette/cannabis use and problems. All participants completed an intravenous alcohol administration session wherein SR domains were measured at the following breath alcohol concentrations (BrAC): baseline (i.e., 0), 20, 40, and 60 mg%.. Multilevel statistical analyses revealed that cannabis users had a greater reduction in negative affect during alcohol administration, compared to non-cannabis users. No significant differences were found for the other SR domains.. Using a large sample and advanced data analytic methods, this study extends the literature by suggesting that cannabis users are more sensitive to alcohol-induced reductions in negative affect compared to non-cannabis users. This work extends research on how cannabis use may influence risk factors for AUD, such as subjective response to alcohol.

Topics: Alcohol Drinking; Alcoholism; Analgesics; Cannabis; Craving; Ethanol; Hallucinogens; Humans

Topics: Alcohol Drinking; Alcoholism; Cannabinoid Receptor Agonists; Cannabis; Cocaine; Cocaine-Related Disorders; Cross-Sectional Studies; Hospitals, General; Humans; Inpatients; Prospective Studies; Quality of Life

There are few studies on mortality on individuals entering treatment for cannabis use disorders.. To estimate mortality risk for individuals treated for cannabis use disorders comparing patients with concomitant alcohol use disorders to those with only cannabis use disorders.. Follow-up study on 1136 residents in Northern Italy who turned to health services following problems caused by cannabis use disorders between 2009 and 2019. Individuals with concomitant use of opioids, amphetamines, cocaine, or injecting drugs were excluded. Crude mortality rates per 1000 Person Years (CMR), and standardized mortality ratios adjusted for age, sex and calendar year (SMR) were calculated.. Elevated CMRs (CMR 4.4, 3-6.4), higher among patients with concomitant alcohol use disorders (CMR 10.2, 6.6-15.6) compared to those with only cannabis use disorders (CMR 1.8, 0.9-3.6) were found. Regarding excess mortality with respect to the general population, SMRs were higher and statistically significant (SMR 5.4, 3.7-7.8), both among patients with concomitant alcohol use disorders (SMR 10.2, 6.6-15.6) and among those with only cannabis use disorders (SMR 2.3, 1.1-4.5).. The results of this study show that individuals with only cannabis use disorders have a lower mortality risk compared to those with both cannabis and alcohol use disorders.

Topics: Alcoholism; Analgesics, Opioid; Cannabis; Cause of Death; Follow-Up Studies; Humans; Substance-Related Disorders

The main objective of this study was to test the longer-term and differential efficacy of a mobile phone‒based life-skills training program designed to prevent substance use among adolescents.. A 2-arm, parallel-group, cluster RCT with assessments at baseline and follow-up after 6 and 18 months was conducted. The efficacy of the intervention was compared with that of an assessment-only control condition.. A total of 1,473 students with a mean age of 15.4 years were recruited in 2019/2020 within 89 Swiss secondary and upper secondary school classes.. The automated intervention program included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management, social, and substance use resistance skills.. Primary outcomes included 30-day prevalence rates for problem drinking and tobacco use.. The 18-month follow-up assessments were completed by 1,232 study (83.6%) participants. Those in the intervention group reported lower tobacco-smoking prevalence than the controls (OR=0.67; 95% CI=0.47, 0.96), but no significant difference in problem drinking (OR=0.84; 95% CI=0.61, 1.17) was observed. Among secondary outcomes, the intervention was effective at reducing cannabis-smoking prevalence (OR=0.55; 95% CI=0.39, 0.76) and cannabis use days (Cohen's d= -0.19; 95% CI= -0.29, -0.09), whereas no effects were observed for quantity of alcohol use, quantity of cigarettes smoked, well-being, or social skills. No significant moderators of the primary outcomes were observed.. An automated mobile phone‒based life-skills training program produced longer-term effectiveness in preventing tobacco smoking and cannabis use, whereas no effects were observed for problem drinking. These results suggest that digitally delivered life-skills training programs are similarly effective and are an easy-to-implement alternative to training conducted within a school curriculum.. This study is registered at ISRCTN41347061 (registration date: 21/07/2018).

Topics: Adolescent; Alcoholism; Cannabis; Humans; Schools; Substance-Related Disorders; Tobacco Use

Topics: Alcoholism; Benzodiazepines; Cannabis; Cocaine; COVID-19; Hallucinogens; Humans; Opioid-Related Disorders; Retrospective Studies; Substance-Related Disorders

Pain is associated with increased risk for harmful substance use. Substance use also may increase levels of pain, suggesting that these two factors may reciprocally increase risk. The current study examined the reciprocal association between pain and substance use outcomes (i.e., alcohol, cannabis, and painkillers/sedatives/tranquilizers [PSTs]) longitudinally in a nationally representative cohort of non-incarcerated U.S. citizens.. Adult (≥18 years old) survey data from Waves 2-4 of the Population Assessment of Tobacco and Health (PATH) study were used. The PATH is a nationally representative multiwave cohort survey (Wave 2: October 2014-October 2015, Wave 3: October 2015-October 2016, Wave 4: December 2016-January 2018). Cross-lagged panel models were used to estimate the reciprocal effects of pain intensity and substance use on subsequent changes in both variables. Substance use outcomes were substance use problems and greater-than-weekly use for cannabis and PSTs, total past-month drinks, and alcohol use exceeding moderate drinking guidelines. All models controlled for autoregressive effects and demographic covariates.. Pain intensity showed a positive prospective association with all substance use outcomes. All cannabis and PST use were positively associated with subsequent pain intensity. Alcohol use problems also predicted higher levels of pain intensity. Neither total past-month drinks nor exceeding moderate drinking guidelines predicted subsequent pain intensity.. Pain and substance use show a reciprocal association and may act in a positive feedback loop to worsen both conditions over time in people with a history of use.

Topics: Adolescent; Adult; Alcohol Drinking; Alcoholism; Cannabis; Cohort Studies; Humans; Pain; Substance-Related Disorders; United States

The main objective of the research was to examine the associations between problematic alcohol use, tobacco use and cannabis use among Czech and Slovak university students during the early COVID-19 pandemic. The research sample consisted of 1422 participants from the Czech Republic (CZ) and 1677 from the Slovak Republic (SK). The analyses included university students who drank alcohol in the past year (CZ: 1323 (93%); SK: 1526 (91%)). Regarding the analysed measures, the Alcohol Use Disorders Identification Test (AUDIT) and its subscales, the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) and the Cannabis Abuse Screening Test (CAST) were selected to identify substance-related behaviour. Age, gender and residence were included in the analyses as socio-demographic variables. Correlation and regression analyses were used to achieve the main objective of the research. The main results revealed that the use of tobacco and cannabis were positively associated with alcohol use disorders among Czech and Slovak university students. Additionally, males were more likely to report alcohol use disorders. In the Czech Republic, it was found that students living in dormitories were characterized by a lower AUDIT score. The opposite situation was found in the Slovak Republic. Czech and Slovak policy-makers are encouraged to develop alcohol use prevention programs for university students in line with these findings.

Topics: Alcohol Drinking; Alcoholism; Cannabis; COVID-19; Cross-Sectional Studies; Czech Republic; Demography; Humans; Pandemics; SARS-CoV-2; Slovakia; Students; Substance-Related Disorders; Tobacco Use; Universities

Alcohol use disorder (AUD) and cannabis use disorder (CUD) are each associated with increased suicidal behavior, but it is unclear how their comorbidity relates to suicide risk. Understanding these associations in U.S. military veterans is especially important, given their heightened risk for suicide, high prevalence of AUD, and increasing access to cannabis. We compared associations of probable AUD, CUD, and AUD/CUD with suicide ideation, plan(s), and attempt(s) in a nationally representative sample of 4,069 veterans surveyed in 2019-2020 as part of the National Health and Resilience in Veterans Study. Among veterans who screened positive for current AUD, 8.7% also screened positive for current CUD. Among veterans who screened positive for current CUD, 33.3% screened positive for current AUD. Current and lifetime positive screens for AUD, CUD, and AUD/CUD were each strongly and independently associated with past-year suicide ideation and lifetime suicide ideation, plan(s), and attempt(s) [odds ratios (ORs) = 1.6-8.7]. Relative to veterans who screened positive for AUD only, veterans who screened positive for AUD/CUD and CUD only had higher odds of past-year suicide ideation (AUD/CUD: OR = 3.3; CUD only: OR = 2.4), lifetime suicide ideation (AUD/CUD: OR = 1.9; CUD only: OR = 2.6) and lifetime suicide plan(s) (AUD/CUD: OR = 1.7; CUD only: OR = 6.1). Collectively, findings suggest that screening positive for CUD might be an especially strong indicator of suicide ideation and planning in veterans with and without AUD, independent of sociodemographic, military, trauma, and other psychiatric factors. These findings underscore the importance of routine screening for CUD in suicide prevention efforts, especially as cannabis becomes more widely available.

Topics: Alcoholism; Cannabis; Comorbidity; Humans; Risk Factors; Suicidal Ideation; Veterans

Alcohol and cannabis are commonly used by adolescents in the United States. Both alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with an increased risk of aggression. One form of aggression seen during retaliation is reactive aggression to social provocation. This study investigated the association between AUD and CUD symptom severity and recruitment of neural regions implicated in retaliation.. In this study, 102 youths aged 13-18 years (67 male; 84 in residential care) completed self-report measures of aggression-related constructs and participated in a retaliation task during functional magnetic resonance imaging to investigate the association between relative severity of AUD/CUD and atypical recruitment of regions implicated in retaliation.. AUD Identification Test scores were positively associated with irritability and reactive aggression scores. CUD Identification Test scores were positively associated with callous-unemotional traits and both proactive and reactive aggression scores. In functional magnetic resonance imaging analyses, only AUD Identification Test (not CUD Identification Test) scores were associated with an exaggerated recruitment of regions implicated in retaliation (dorsomedial frontal, anterior insula cortices, caudate, and, to a lesser extent, periaqueductal gray).. These data suggest that relative severity of AUD is associated with a disinhibited, exaggerated retaliation response that relates to an increased risk for reactive aggression. Similar findings were not related to severity of CUD.

Topics: Adolescent; Aggression; Alcoholism; Cannabis; Humans; Magnetic Resonance Imaging; Male; Marijuana Abuse; United States

Two of the most commonly used illegal substances by adolescents are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with poorer decision-making in adolescents. In adolescents, level of AUD symptomatology has been negatively associated with striatal reward responsivity. However, little work has explored the relationship with striatal reward prediction error (RPE) representation and the extent to which any augmentation of RPE by novel stimuli is impacted. One-hundred fifty-one adolescents participated in the Novelty Task while undergoing functional magnetic resonance imaging (fMRI). In this task, participants learn to choose novel or non-novel stimuli to gain monetary reward. Level of AUD symptomatology was negatively associated with both optimal decision-making and BOLD response modulation by RPE within striatum and regions of prefrontal cortex. The neural alterations in RPE representation were particularly pronounced when participants were exploring novel stimuli. Level of CUD symptomatology moderated the relationship between novelty propensity and RPE representation within inferior parietal lobule and dorsomedial prefrontal cortex. These data expand on an emerging literature investigating individual associations of AUD symptomatology levels versus CUD symptomatology levels and RPE representation during reinforcement processing and provide insight on the role of neuro-computational processes underlying reinforcement learning/decision-making in adolescents.

Topics: Adolescent; Alcoholism; Cannabis; Depressive Disorder, Major; Female; Humans; Magnetic Resonance Imaging; Male; Marijuana Abuse; Reward; Underage Drinking

Increases in cannabis use among young people has heightened concern about the potential interactive health effects of cannabis with other drugs. We examined the longitudinal association between concurrent and simultaneous (SAM) co-use of alcohol and cannabis in young adulthood on mental health symptoms, substance use behaviors, and substance-related harms two years later. Data were drawn from Time 5 (T5;

Topics: Adolescent; Adult; Alcohol Drinking; Alcoholism; Cannabis; Ethanol; Female; Humans; Male; Outcome Assessment, Health Care; Substance-Related Disorders; Young Adult

Substance use disorders (SUDs) are prevalent and result in an array of negative consequences. They are influenced by genetic factors (h2 = ~50%). Recent years have brought substantial progress in our understanding of the genetic etiology of SUDs and related traits. The present review covers the current state of the field for SUD genetics, including the epidemiology and genetic epidemiology of SUDs, findings from the first-generation of SUD genome-wide association studies (GWAS), cautions about translating GWAS findings to clinical settings, and suggested prioritizations for the next wave of SUD genetics efforts. Recent advances in SUD genetics have been facilitated by the assembly of large GWAS samples, and the development of state-of-the-art methods modeling the aggregate effect of genome-wide variation. These advances have confirmed that SUDs are highly polygenic with many variants across the genome conferring risk, the vast majority of which are of small effect. Downstream analyses have enabled finer resolution of the genetic architecture of SUDs and revealed insights into their genetic relationship with other psychiatric disorders. Recent efforts have also prioritized a closer examination of GWAS findings that have suggested non-uniform genetic influences across measures of substance use (e.g. consumption) and problematic use (e.g. SUD). Additional highlights from recent SUD GWAS include the robust confirmation of loci in alcohol metabolizing genes (e.g. ADH1B and ALDH2) affecting alcohol-related traits, and loci within the CHRNA5-CHRNA3-CHRNB4 gene cluster influencing nicotine-related traits. Similar successes are expected for cannabis, opioid, and cocaine use disorders as sample sizes approach those assembled for alcohol and nicotine.

Topics: Alcohol Dehydrogenase; Alcoholism; Aldehyde Dehydrogenase, Mitochondrial; Cannabis; Gene-Environment Interaction; Genome-Wide Association Study; Humans; Molecular Epidemiology; Nicotine; Substance-Related Disorders

More than half of U.S. states legalized medical or recreational sale and possession of cannabis since the prevalence of cannabis use was last estimated among U.S. military veterans in 2014. To provide updated estimates of the prevalence and correlates of cannabis use, cannabis use disorder (CUD), and medical cannabis card possession in this population, data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative survey of 4,069 veterans ages 22-99 years who reported on their past-6-month cannabis use, CUD symptoms, and possession of a medical cannabis card. An estimated 11.9% [95% confidence interval (CI) = 10.9-12.9%)] of veterans reported using cannabis, 2.7% (95% CI = 2.3-3.3%) screened positive for CUD, and 1.5% (95% CI = 1.2-2.0%) reported possessing a medical card. Prevalence of cannabis use, CUD, and card possession were higher among younger veterans (use: 20.2%, CUD: 5.6%, card: 2.1%) and those with psychiatric conditions (use: 24.0%-30.0%, CUD: 8.9%-13.0%, card: 3.1%-4.0%). Younger age, alcohol use disorder, and childhood adversity explained a large proportion of variance in cannabis use and CUD, and depression was independently associated with CUD (odds ratio [OR] = 2.76). Physical disability (OR = 3.59), combat veteran status (OR = 2.84), and non-Hispanic black (OR = 0.23) relative to white race/ethnicity most strongly predicted using cannabis with a medical card. The estimated prevalence of cannabis use in veterans-nearly 12%-is higher than the most recently reported estimate (9% in 2014). Veteran cannabis use may be increasing and is particularly prevalent among veterans with psychiatric conditions.

Topics: Adult; Aged; Aged, 80 and over; Alcoholism; Cannabis; Humans; Middle Aged; Prevalence; United States; Veterans; White People; Young Adult

Topics: Adolescent; Aggression; Alcohol-Related Disorders; Alcoholism; Cannabis; Humans; Marijuana Abuse

Alcohol and cannabis co-use is a between-group risk factor for heavier drinking and negative consequences, but only one study has tested links between co-use and AUD. In addition, few studies focus on risk profiles within co-users, despite heterogeneity in levels of co-use. The current study tested between-group (co-users vs. alcohol-/cannabis-only users) and within-group (patterns of co-use) risk profiles for AUD and CUD in a large, nationally representative sample.. Data from the 2002-2019 National Study on Drug Use and Health (NSDUH) were used for analyses (N = 1,005,421). Analyses tested 1) whether co-users had greater odds of AUD/CUD than alcohol- and cannabis-only users, respectively, 2) whether there were latent profiles of co-use patterns within co-users, and 3) whether profile membership conferred within-group risk for AUD/CUD.. Co-users were at 3.38 greater odds of having an AUD, but co-use did not confer risk for CUD. Within co-users, five latent profiles emerged: weekly alcohol/cannabis use, weekly alcohol/monthly cannabis, weekly cannabis/occasional alcohol, weekly alcohol/occasional cannabis, and occasional use of both. Multiple comparisons suggested that, generally as frequency of each substance use increased, odds of both AUD and CUD became greater.. Primary alcohol users who also use cannabis are at risk for AUD, but the opposite effect was not observed in primary cannabis users. Higher frequency of each substance also conferred risk within co-users for both AUD and CUD. Findings add novel contributions that should be considered within both alcohol and cannabis use interventions. Future studies using prospective data are needed.

Topics: Alcoholism; Cannabis; Humans; Marijuana Abuse; Prospective Studies; Substance-Related Disorders

While there is robust evidence for strategies to reduce harms of illicit drug use, less attention has been paid to alcohol harm reduction for people experiencing severe alcohol use disorder (AUD), homelessness, and street-based illicit drinking. Managed Alcohol Programs (MAPs) provide safer and regulated sources of alcohol and other supports within a harm reduction framework. To reduce the impacts of heavy long-term alcohol use among MAP participants, cannabis substitution has been identified as a potential therapeutic tool.. To determine the feasibility of cannabis substitution, we conducted a pre-implementation mixed-methods study utilizing structured surveys and open-ended interviews. Data were collected from MAP organizational leaders (n = 7), program participants (n = 19), staff and managers (n = 17) across 6 MAPs in Canada. We used the Consolidated Framework for Implementation Research (CFIR) to inform and organize our analysis.. Five themes describing feasibility of CSP implementation in MAPs were identified. The first theme describes the characteristics of potential CSP participants. Among MAP participants, 63% (n = 12) were already substituting cannabis for alcohol, most often on a weekly basis (n = 8, 42.1%), for alcohol cravings (n = 15, 78.9%,) and withdrawal (n = 10, 52.6%). Most MAP participants expressed willingness to participate in a CSP (n = 16, 84.2%). The second theme describes the characteristics of a feasible and preferred CSP model according to participants and staff. Participants preferred staff administration of dry, smoked cannabis, followed by edibles and capsules with replacement of some doses of alcohol through a partial substitution model. Themes three and four highlight organizational and contextual factors related to feasibility of implementing CSPs. MAP participants requested peer, social, and counselling supports. Staff requested education resources and enhanced clinical staffing. Critically, program staff and leaders identified that sustainable funding and inexpensive, legal, and reliable sourcing of cannabis are needed to support CSP implementation.. Cannabis substitution was considered feasible by all three groups and in some MAPs residents are already using cannabis. Partial substitution of cannabis for doses of alcohol was preferred. All three groups identified a need for additional supports for implementation including peer support, staff education, and counselling. Sourcing and funding cannabis were identified as primary challenges to successful CSP implementation in MAPs.

Topics: Alcoholism; Canada; Cannabis; Feasibility Studies; Harm Reduction; Humans

Persons with severe opioid or cocaine use disorders are particularly vulnerable to morbidity and mortality. Heaviest use of mu-opioid receptor agonists and cocaine typically commences in early adulthood and is preceded by substantial adolescent exposure to cannabis and/or alcohol. Little information exists on the age trajectories of exposure to cannabis or alcohol in persons diagnosed with severe opioid or cocaine use disorders, compared to persons diagnosed with other substance use disorders (unrelated to opioids or cocaine).. This observational study had n = 854 volunteers (male = 581, female = 273; ≥18 years of age at the time of interview) and examined the ages of onset of heaviest use of cannabis and alcohol in persons diagnosed by DSM-IV criteria with opioid dependence (OD), both opioid and cocaine dependence (OD + CD) and cocaine dependence (CD). These age trajectory measures were compared to persons with other substance use disorders (primarily cannabis and alcohol use disorders, termed "Any Other Diagnoses").. Unadjusted survival analyses showed persons diagnosed with either OD + CD or CD had earlier onset of heaviest use of cannabis (mean ages of 16.2 and 17.8, respectively) compared to the "Any Other Diagnoses" reference group (mean age = 19.5). A multivariate logistic regression showed that later onset of heaviest use of cannabis was associated with lower odds of being in the OD + CD or CD groups, when compared to the reference group.. Persons diagnosed with severe cocaine use disorders or dual opioid and cocaine use disorders exhibit a pattern of heavy and especially early adolescent exposure to cannabis, compared to persons with other substance use disorders.

Topics: Adolescent; Adult; Age of Onset; Alcoholism; Analgesics, Opioid; Cannabis; Cocaine; Humans; Marijuana Abuse; Opioid-Related Disorders; Substance-Related Disorders; Young Adult

Pregnant women with a substance-related diagnosis, such as an alcohol use disorder, are a vulnerable population that may experience higher rates of severe maternal morbidity, such as hemorrhage and eclampsia, than pregnant women with no substance-related diagnosis.. This retrospective cross-sectional study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live birth or stillbirth at ≥ 20 weeks of gestation from March 1, 2016, to August 30, 2019. Women with and without a substance-related diagnosis were matched on key demographic characteristics, such as age, at a 1:1 ratio. Adjusting for these covariates, odds ratios and 95% confidence intervals were calculated.. A total of 10,125 deliveries met the eligibility criteria for this study. In the matched cohort of 1,346 deliveries, 673 (50.0%) had a substance-related diagnosis, and 94 (7.0%) had severe maternal morbidity. The most common indicators in women with a substance-related diagnosis included hysterectomy (17.7%), eclampsia (15.8%), air and thrombotic embolism (11.1%), and conversion of cardiac rhythm (11.1%). Having a substance-related diagnosis was associated with severe maternal morbidity (adjusted odds ratio = 1.81 [95% CI, 1.14-2.88], p-value = 0.0126). In the independent matched cohorts by substance type, an alcohol-related diagnosis was significantly associated with severe maternal morbidity (adjusted odds ratio = 3.07 [95% CI, 1.58-5.95], p-value = 0.0009), while the patterns for stimulant- and nicotine-related diagnoses were not as well resolved with severe maternal morbidity and opioid- and cannabis-related diagnoses were not associated with severe maternal morbidity.. We found that an alcohol-related diagnosis, although lowest in prevalence of the substance-related diagnoses, had the highest odds of severe maternal morbidity of any substance-related diagnosis assessed in this study. These findings reinforce the need to identify alcohol-related diagnoses in pregnant women early to minimize potential harm through intervention and treatment.

Topics: Adolescent; Adult; Alcoholism; Arrhythmias, Cardiac; Cannabis; Cohort Studies; Cross-Sectional Studies; Eclampsia; Female; Humans; Hysterectomy; Nicotine; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Retrospective Studies; Socioeconomic Factors; Stillbirth; Substance-Related Disorders; Thrombosis; Young Adult

There is no evidence in the literature relating to the evolution of e-cigarette use among cannabis users and multi-users (of alcohol, tobacco or cannabis).. To describe the evolution over 12 months of e-cigarette use in cannabis users and multi-users.. A prospective observational cohort study in general practice, between 2015 and 2016.. A total of 4.8% of monitored cannabis users remained or became current users of e-cigarettes by the end of the monitoring period versus 4.5% among non-users of cannabis, with no statistically significant difference. A total of 5.1% of monitored multi-users remained or became current users of e-cigarettes by the end of the monitoring period versus 2.4% among the non-multi-users, with no statistically significant difference. Cannabis users and multi-users reported more e-cigarette experimentation through curiosity and following someone's suggestion, compared to non-cannabis users or non multi-users. No statistically significant association was found between cannabis or multi-drug use and staying or becoming a current e-cigarette user over 12 months.. Cannabis users and multi-users would tend to experiment with e-cigarettes more than other patients but this use would not be sustained.

Topics: Adult; Alcoholism; Cannabis; Cohort Studies; Comorbidity; Electronic Nicotine Delivery Systems; Female; France; Humans; Male; Marijuana Smoking; Middle Aged; Psychotropic Drugs; Smoking; Substance-Related Disorders; Vaping

The two most commonly used illegal substances by adolescents in the United States are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with dysfunction in decision-making processes in adolescents. One potential mechanism for these impairments is thought to be related to abnormalities in reward and punishment processing. However, very little work has directly examined potential differential relationships between AUD and CUD symptom severity and neural dysfunction during decision making in adolescents.. In the current study, 154 youths participated in a passive avoidance learning task during functional magnetic resonance imaging to investigate the relationship between relative severity of AUD/CUD and dysfunction in processing reward and punishment feedback.. Increasing Alcohol Use Disorder Identification Test scores were associated with reduced neural differentiation between reward and punishment feedback within regions of striatum, posterior cingulate cortex, and parietal cortex. However, increasing Cannabis Use Disorder Identification Test scores were not associated with any neural dysfunction during the passive avoidance task.. These data expand on emerging literature that relative severity of AUD is associated with reduced responsivity to rewards in adolescents and that there are differential associations between AUD and CUD symptoms and neurocircuitry dysfunction in the developing adolescent brain.

Topics: Adolescent; Alcoholism; Cannabis; Conditioning, Operant; Feedback; Humans; Punishment; Reward; United States

The effect of concomitant cocaine and cannabis use on monocyte activation and inflammation in patients with alcohol use disorder (AUD) is unknown.. To analyze the impact of cocaine and cannabis use on levels of markers of monocyte activation (sCD163 and sCD14) and systemic inflammation (interleukin-6 [IL-6]) in AUD patients admitted for hospital treatment between 2013 and 2018. Clinical and laboratory parameters were obtained upon admission. IL-6, sCD163, and sCD14 were measured in frozen plasma samples. We performed logistic regression to detect associations between cocaine and cannabis use and markers of monocyte activation and inflammation in the highest quartile.. In this series of AUD patients the concomitant use of cannabis use was associated with sCD163 levels that were in the highest quartile, consistent with monocyte activation.

Topics: Adult; Alcohol Drinking; Alcoholism; Biomarkers; Cannabis; Female; Humans; Inflammation; Interleukin-6; Lipopolysaccharide Receptors; Male; Marijuana Abuse; Middle Aged; Monocytes; Substance-Related Disorders

Growing numbers of older adult marijuana users make understanding the marijuana-related treatment needs and treatment-related characteristics of this age group increasingly important. In this study, we examined four types of marijuana-involved admissions (marijuana as the only substance; marijuana as the primary substance with other secondary/tertiary substances; marijuana as the secondary substance; and marijuana as the tertiary substance) by treatment setting.. Data came from the 2012-2017 Treatment Episode Data Set-Admissions (TEDS-A), which includes 851,652 admissions by those aged 55+. Using multinomial logistic regression analysis, we focused on the 120,286 marijuana-involved admissions to test the hypothesis that polysubstance use would be associated with a higher likelihood of using detoxification and rehabilitation settings than ambulatory/outpatient settings.. Of all marijuana-involved admissions, 7.5% were marijuana-only, 12.7% were marijuana-primary, 58.4% were marijuana-secondary, and 21.4% were marijuana-tertiary admissions. Compared to marijuana-only admissions, admissions involving other substances were associated with a higher likelihood of detoxification and rehabilitation than ambulatory/outpatient treatment (e.g., RRR = 5.79, 95% CI = 5.08-6.61 for detoxification and RRR = 3.19, 95% CI = 2.89-3.52 for rehabilitation among marijuana-tertiary admissions). Referral source, first age of marijuana use, race/ethnicity, and homelessness were significant covariates.. Given increasing numbers of older-adult marijuana users, healthcare providers should screen older adults for marijuana and other substance use, and substance abuse treatment programs should become more responsive to older adults' needs.

Topics: Aged; Alcoholism; Cannabis; Female; Hospitalization; Humans; Male; Marijuana Abuse; Middle Aged; Opiate Alkaloids; Substance Abuse Treatment Centers; Substance-Related Disorders

The non-medical use of over-the-counter or prescribed analgesics (NMUA) is a significant public health problem. Little is known about the genetic and environmental etiology of NMUA and how these risks relate to other classes of substance use and misuse. Our aims were to estimate the heritability NMUA and sources of genetic and environmental covariance with cannabis and nicotine use, cannabis and alcohol use disorders and nicotine dependence in Australian twins.. Biometrical genetic analyses or twin methods using structural equation univariate and multivariate modeling.. Australia.. A total of 2007 young adult twins [66% female; μ. Self-reported NMUA (non-opioid or opioid-based), life-time nicotine, cannabis and opioid use, DSM-V cannabis and alcohol use disorders and the Fagerström Test for Nicotine Dependence.. Life-time NMUA was reported by 19.4% of the sample. Univariate heritability explained 46% [95% confidence interval (CI) = 0.29-0.57] of the risks in NMUA. Multivariate analyses revealed that NMUA is moderately associated genetically with cannabis (r. In young male and female adults in Australia, the non-medical use of over-the-counter or prescribed analgesics appears to have moderate heritability. NMUA is moderately associated with cannabis and nicotine use and nicotine dependence. Its genetic etiology is largely distinct from that of cannabis and alcohol use disorders.

Topics: Adolescent; Adult; Alcoholism; Analgesics; Australia; Cannabis; Drug Misuse; Female; Gene-Environment Interaction; Genetic Predisposition to Disease; Humans; Latent Class Analysis; Longitudinal Studies; Male; Nicotine; Prescription Drug Misuse; Retrospective Studies; Risk Factors; Substance-Related Disorders; Tobacco Use Disorder; Young Adult

Topics: Alcoholism; Animals; Biomedical Research; Brazil; Cannabidiol; Cannabis; Dronabinol; Epilepsy; Freedom; Humans; Medical Marijuana; Police; Psychopharmacology; Research Personnel

The aim of this study is to investigate associations between use of cigarettes, cannabis, and alcohol (CCA) and psychosocial problems among adolescents with different cultural backgrounds living in Nordic countries. Data from six questionnaire-based surveys conducted in Denmark, Norway, and Greenland, with participants from different cultural and religious backgrounds, were compared. A total of 2212 adolescents between 15 and 18 years of age participated in the study. The surveys were carried out nationally and in school settings. All adolescents answered a 12-item questionnaire (YouthMap12) with six questions identifying externalizing behavior problems and six questions identifying internalizing behavior problems, as well as four questions regarding childhood neglect and physical or sexual abuse, and questions about last month use of CCA. Externalizing behavior problems were strongly associated with all types of CCA use, while childhood history of abuse and neglect was associated with cigarette and cannabis use. The associations did not differ by sample. Despite differences between samples in use of CCA, national, cultural, and socioeconomic background, very similar associations were found between psychosocial problems and use of CCA. Our findings highlight the need to pay special attention to adolescents with externalizing behavior problems and experiences of neglect and assault in CCA prevention programs, across different ethnic and socioeconomic backgrounds.

Topics: Adolescent; Alcoholism; Cannabis; Child Abuse; Child Behavior Disorders; Denmark; Female; Greenland; Humans; Internal-External Control; Interviews as Topic; Male; Marijuana Smoking; Norway; Problem Behavior; Risk Factors; Smoking; Substance-Related Disorders; Surveys and Questionnaires; Telephone

Neuroimaging studies have demonstrated gray matter (GM) volume abnormalities in substance users. While the majority of substance users are polysubstance users, very little is known about the relation between GM volume abnormalities and polysubstance use.. In this study we assessed the relation between GM volume, and the use of alcohol, tobacco, cocaine and cannabis as well as the total number of substances used, in a sample of 169 males: 15 non-substance users, 89 moderate drinkers, 27 moderate drinkers who also smoke tobacco, 13 moderate drinkers who also smoke tobacco and use cocaine, 10 heavy drinkers who smoke tobacco and use cocaine and 15 heavy drinkers who smoke tobacco, cannabis and use cocaine.. Regression analyses showed that there was a negative relation between the number of substances used and volume of the dorsal medial prefrontal cortex (mPFC) and the ventral mPFC. Without controlling for the use of other substances, the volume of the dorsal mPFC was negatively associated with the use of alcohol, tobacco, and cocaine. After controlling for the use of other substances, a negative relation was found between tobacco and cocaine and volume of the thalami and ventrolateral PFC, respectively.. These findings indicate that mPFC alterations may not be substance-specific, but rather related to the number of substances used, whereas, thalamic and ventrolateral PFC pathology is specifically associated with tobacco and cocaine use, respectively. These findings are important, as the differential alterations in GM volume may underlie different cognitive deficits associated with substance use disorders.

Topics: Adolescent; Adult; Alcohol Drinking; Alcoholism; Cannabis; Cocaine; Cocaine-Related Disorders; Drug Users; Ethanol; Gray Matter; Humans; Magnetic Resonance Imaging; Male; Marijuana Abuse; Middle Aged; Neuroimaging; Nicotiana; Organ Size; Self Report; Substance-Related Disorders; Tobacco Use; Tobacco Use Disorder; Young Adult

Cannabis use is increasing in the United States, as are its adverse effects. We investigated the genetics of an adverse consequence of cannabis use: cannabis-related aggression (CRA) using a genome-wide association study (GWAS) design. Our GWAS sample included 3269 African Americans (AAs) and 2546 European Americans (EAs). An additional 89 AA subjects from the Grady Trauma Project (GTP) were also examined using a proxy-phenotype replication approach. We identified genome-wide significant risk loci contributing to CRA in AAs at the serotonin receptor 2B receptor gene (HTR2B), and the lead SNP, HTR2B*rs17440378, showed nominal association to aggression in the GTP cohort of cannabis-exposed subjects. A priori evidence linked HTR2B to impulsivity/aggression but not to cannabis response. Human functional data regarding the HTR2B variant further supported our finding. Treating an Htr2b

Topics: Adult; Aggression; Alcoholism; Animals; Black or African American; Cannabis; Cohort Studies; Female; Genome-Wide Association Study; Humans; Male; Marijuana Abuse; Marijuana Smoking; Mice; Mice, Knockout; Middle Aged; Receptor, Serotonin, 5-HT2B; Risk Factors; White People

Polysubstance use (PSU) is common among patients with cannabis use (CU) and is related to more severe CU problems. However, it is unclear how PSU predicts CU treatment outcomes beyond CU patterns. We examined the frequency, amount, and class of additionally used substances as predictors for primary and secondary outcomes.. We conducted crude and adjusted regression analyses for PSU variables as predictors of remission, abstinence, -reduction, and secondary outcomes in 166 help-seeking -patients from a randomized clinical trial of CANDIS, a -cognitive behavioral treatment program.. Patients with recent illegal PSU experienced more difficulties in reducing their CU (B = -1.22, p < 0.001). In contrast, remission rates were slightly higher in patients with a wide variety of -last-year-PSU (RD = 0.04, p < 0.001). Amphetamine use -predicted poorer outcomes regarding CU-related problems (B = -4.22, p = 0.019), and the use of opiates, inhalants, and dissociative substances predicted poorer physical health outcomes (B = -0.62, p = 0.009; B = -0.96, p = 0.039; B = -1.18, p = 0.007).. CU treatment is also effective for patients with moderate PSU. However, treatment effects may be enhanced by addressing specific PSU characteristics as part of a modularized program.

Topics: Adult; Alcoholism; Cannabis; Cognitive Behavioral Therapy; Female; Humans; Male; Randomized Controlled Trials as Topic; Substance-Related Disorders; Young Adult

The Kreek-McHugh-Schluger-Kellogg (KMSK) scales provide a rapid assessment of maximal self-exposure to specific drugs and can be used as a dimensional instrument. This study provides a re-evaluation of the KMSK scales for cannabis, alcohol, cocaine, and heroin in a relatively large multi-ethnic cohort, and also the first systematic comparison of gender-specific profiles of drug exposure with this scale.. This was an observational study of n = 1,133 consecutively ascertained adult volunteers. The main instruments used were the SCID-I interview (DSM-IV criteria) and KMSK scales for cannabis, alcohol, cocaine, and heroin.. Participants were 852 volunteers (297 female) with specific DSM-IV abuse or dependence diagnoses, and 281 volunteers without any drug diagnoses (154 female). Receiver operating characteristic (ROC) curves were calculated for concurrent validity of KMSK scores with the respective DSM-IV dependence diagnoses. The areas under the ROC curves for men and women combined were 99.5% for heroin, 97% for cocaine, 93% for alcohol, and 85% for cannabis. Newly determined optimal KMSK "cutpoint" scores were identical for men and women for cocaine and heroin dependence diagnoses, but were higher in men than in women, for cannabis and alcohol dependence diagnoses.. This study confirms the scales' effectiveness in performing rapid dimensional analyses for cannabis, alcohol, cocaine, and heroin exposure, in a cohort larger than previously reported, with "cutpoints" changed from initial determinations, based on this larger sample. The KMSK scales also detected gender differences in self-exposure to alcohol and cannabis that are associated with the respective dependence diagnoses.

Topics: Adult; Alcoholism; Cannabis; Cocaine; Cohort Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Heroin; Heroin Dependence; Humans; Male; Marijuana Abuse; Middle Aged; ROC Curve; Sex Characteristics; Substance-Related Disorders; Young Adult

Topics: Adult; Alcoholism; Aortic Coarctation; Cannabis; Cocaine-Related Disorders; Epilepsy; Female; Fetal Alcohol Spectrum Disorders; Gestational Age; Humans; Hydrops Fetalis; Hypoplastic Left Heart Syndrome; Infant, Newborn; Male; Oxazolidinones; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prenatal Care; Prognosis; Substance-Related Disorders; Tobacco Use; Ultrasonography, Prenatal

Accumulating evidence suggests that brain white matter (WM) abnormalities may be central to the pathophysiology of psychotic disorders. In addition, there is evidence that cannabis use and alcohol use each is associated with WM abnormalities. However, there are very limited data on the effects of these substances on WM microstructure in patients with psychosis, especially for those at the early phase of illness. This project aimed to examine the impact of cannabis use and alcohol use on WM tissue in early-phase psychosis (EPP). WM was investigated in 21 patients with EPP using diffusion tensor imaging (DTI) and transverse relaxation time of tissue water (T2), with the primary outcomes being mean fractional anisotropy (FA) and T2. DTI analyses were performed at the full-brain level using tract-based spatial statistics with both DTI and T2 analysis done within a WM volume of interest (VOI) implicated in psychosis (containing the left superior longitudinal fasciculus). Our findings revealed that younger age of onset of regular alcohol use (more than one drink per week) was associated with lower FA values in the left thalamic radiation and left parahippocampal and left amygdalar WM. More frequent lifetime cannabis use was correlated with increased mean full-brain FA. There was no significant relationship found between FA and alcohol or cannabis use within the VOI. Relaxometry analysis revealed trend-level evidence of shortened T2 with later onset of regular alcohol use and with more frequent cannabis use. This study provides novel data demonstrating cortical and subcortical WM findings related to alcohol use in EPP and is the first to combine DTI and relaxometry, relating to this patient population.

Topics: Adult; Alcoholism; Anisotropy; Brain; Cannabis; Diffusion Tensor Imaging; Ethanol; Female; Humans; Male; Nerve Net; Psychoses, Substance-Induced; Psychotic Disorders; White Matter

The emergency department (ED) and hospital settings represent crucial opportunities for engaging treatment for cannabis use disorder (CUD). Thus, there is a need to identify factors associated with healthcare utilization among persons with CUD to improve screening and intervention approaches. Problematic alcohol use may be a salient risk factor.. Using data from the 2005-2013 National Surveys on Drug Use and Health, we determined factors, including different patterns of alcohol use, associated with past-year ED admission and inpatient hospitalization among persons aged 12 years or older meeting criteria for CUD in the past year (N=16,757). We also determined the prevalence and correlates of problem alcohol use among persons with CUD to further inform its association with healthcare utilization.. Among persons with CUD, 40.15% and 10.04% reported past-year ED admission and inpatient hospitalization, respectively. Severe alcohol use disorder (AUD) (≥6 AUD symptoms), female sex, Black race, low income, major depressive episode (MDE), and other substance use disorders were associated with increased odds of healthcare utilization; current (i.e., last month) alcohol use patterns were not. Persons with CUD that were males, ages 18-25 (vs. ages 12-17), Hispanic (vs. White), and with low income, other drug use disorders, or MDE had increased odds of AUD.. Findings suggest that screening and intervention efforts for improving treatment initiation or engagement for CUD may target cannabis-using women, blacks, low-income adults or those with severe AUD in the past year, another substance use disorder, or MDE.

Topics: Adult; Alcoholism; Cannabis; Depressive Disorder, Major; Female; Hispanic or Latino; Humans; Male; Marijuana Abuse; Marijuana Smoking; Patient Acceptance of Health Care; Prevalence; Risk Factors; Substance-Related Disorders; United States; White People

There are limited data about the extent of DSM-5 substance use disorders (SUDs) among primary care patients.. This study analyzed data from a multisite validation study of a substance use screening instrument conducted in a diverse sample of 2000 adults aged ≥18 years recruited from five primary care practices in four states. Prevalence and correlates of 12-month DSM-5 SUDs were examined.. Overall, 75.5% of the sample used any substance, including alcohol (62.0%), tobacco (44.1%), or illicit drugs/nonmedical medications (27.9%) in the past 12 months (marijuana 20.8%, cocaine 7.3%, opioids 4.8%, sedatives 4.1%, heroin 3.9%). The prevalence of any 12-month SUD was 36.0% (mild disorder 14.2%, moderate/severe disorder 21.8%): tobacco 25.3% (mild 11.5%, moderate/severe 13.8%); alcohol 13.9% (mild 6.9%, moderate/severe 7.0%); and any illicit/nonmedical drug 14.0% (mild 4.0%, moderate/severe 10.0%). Among past 12-month users, a high proportion of tobacco or drug users met criteria for a disorder: tobacco use disorder 57.4% (26.1% mild, 31.3% moderate/severe) and any drug use disorder 50.2% (14.3% mild, 35.8% moderate/severe); a lower proportion of alcohol users (22.4%) met criteria for alcohol use disorder (11.1% mild, 11.3% moderate/severe). Over 80% of adults with opioid/heroin use disorder met criteria for a moderate/severe disorder. Younger ages, male sex, and low education were associated with increased odds of having SUD.. These findings reveal the high prevalence of SUDs in primary care and underscore the need to identify and address them.

Topics: Adult; Alcoholism; Cannabis; Diagnostic and Statistical Manual of Mental Disorders; Heroin; Humans; Hypnotics and Sedatives; Illicit Drugs; Opioid-Related Disorders; Prevalence; Primary Health Care; Substance-Related Disorders; Tobacco Use Disorder

We investigated contexts of simultaneous use of alcohol and marijuana and the impact of simultaneous use on problems among adolescents. Ecological momentary assessment data were obtained over two weekends from 150 adolescents in California (47% female, M age=16.36years), using smartphone surveys administered early and late in the evening and again the following morning. We assessed whether, in what context, and with whom adolescents drank alcohol and used other substances over 3 evening hours. We assessed problems they experienced each evening on the following morning. Results showed that greater adult supervision in every context was associated with a 55% lower risk of simultaneous use (RRR=0.45, p≤.05). Contexts with no other underage drinkers were associated with 99% lower risk of simultaneous use (RRR=0.01, p≤.005). Each occasion of simultaneous use was related to 110% increase in the number of problems (IRR=2.10, p≤.005), with 83%, 221% and 311% greater odds of violence (OR=1.83, p≤.05), driving under the influence or riding with a drunk driver (OR=3.21, p≤.05), or being drunk (OR=4.11, p≤.005). Additional analyses showed that these problems may be attributed largely to the alcohol consumed in each context. Results demonstrate that it is essential to consider situational and social characteristics of substance use contexts to better understand adolescent simultaneous use of alcohol and drugs and problems.

Topics: Adolescent; Adult; Alcoholic Intoxication; Alcoholism; Automobile Driving; California; Cannabis; Female; Humans; Substance-Related Disorders; Surveys and Questionnaires; Violence

Drugs of abuse stimulate striatal dopamine release and activate reward pathways. This study examined the impact of alcohol and cannabis marketing on the reward circuit in alcohol and cannabis users while sober and intoxicated. It was predicted that alcohol and cannabis marketing would increase striatal activation when sober and that reward sensitivity would be less during alcohol and cannabis intoxication. Heavy alcohol (n = 20) and regular cannabis users (n = 21) participated in a mixed factorial study involving administration of alcohol and placebo in the alcohol group and cannabis and placebo in the cannabis group. Non-drug users (n = 20) served as between group reference. Brain activation after exposure to alcohol and cannabis marketing movies was measured using functional magnetic resonance imaging and compared between groups while sober and compared with placebo while intoxicated. Implicit alcohol and cannabis cognitions were assessed by means of a single-category implicit association test. Alcohol and cannabis marketing significantly increased striatal BOLD activation across all groups while sober. Striatal activation however decreased during intoxication with alcohol and cannabis. Implicit associations with cannabis marketing cues were significantly more positive in alcohol and cannabis users as compared with non-drug using controls. Public advertising of alcohol or cannabis use elicits striatal activation in the brain's reward circuit. Reduction of marketing would reduce brain exposure to reward cues that motivate substance use. Conversely, elevated dopamine levels protect against the reinforcing potential of marketing.

Topics: Adult; Alcoholic Beverages; Alcoholic Intoxication; Alcoholism; Brain; Cannabis; Cues; Female; Humans; Magnetic Resonance Imaging; Male; Marijuana Abuse; Marketing; Reward; Young Adult

With rising rates of marijuana use in the general population and an increasing number of states legalizing recreational marijuana use and authorizing medical marijuana programs, there are renewed clinical and policy concerns regarding the mental health effects of cannabis use.. To examine prospective associations between cannabis use and risk of mental health and substance use disorders in the general adult population.. A nationally representative sample of US adults aged 18 years or older was interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-2002; wave 2, 2004-2005). The primary analyses were limited to 34 653 respondents who were interviewed in both waves. Data analysis was conducted from March 15 to November 30, 2015.. We used multiple regression and propensity score matching to estimate the strength of independent associations between cannabis use at wave 1 and incident and prevalent psychiatric disorders at wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). In both analyses, the same set of wave 1 confounders was used, including sociodemographic characteristics, family history of substance use disorder, disturbed family environment, childhood parental loss, low self-esteem, social deviance, education, recent trauma, past and present psychiatric disorders, and respondent's history of divorce.. In the multiple regression analysis of 34 653 respondents (14 564 male [47.9% weighted]; mean [SD] age, 45.1 [17.3] years), cannabis use in wave 1 (2001-2002), which was reported by 1279 respondents, was significantly associated with substance use disorders in wave 2 (2004-2005) (any substance use disorder: odds ratio [OR], 6.2; 95% CI, 4.1-9.4; any alcohol use disorder: OR, 2.7; 95% CI, 1.9-3.8; any cannabis use disorder: OR, 9.5; 95% CI, 6.4-14.1; any other drug use disorder: OR, 2.6; 95% CI, 1.6-4.4; and nicotine dependence: OR, 1.7; 95% CI, 1.2-2.4), but not any mood disorder (OR, 1.1; 95% CI, 0.8-1.4) or anxiety disorder (OR, 0.9; 95% CI, 0.7-1.1). The same general pattern of results was observed in the multiple regression analyses of wave 2 prevalent psychiatric disorders and in the propensity score-matched analysis of incident and prevalent psychiatric disorders.. Within the general population, cannabis use is associated with an increased risk for several substance use disorders. Physicians and policy makers should take these associations of cannabis use under careful consideration.

Topics: Adult; Aged; Alcoholism; Cannabis; Evidence-Based Medicine; Female; Humans; Longitudinal Studies; Male; Marijuana Abuse; Mental Disorders; Middle Aged; Odds Ratio; Prevalence; Propensity Score; Prospective Studies; Risk; Substance-Related Disorders; United States

Little is known about the effects of polysubstance use and cigarette smoking on brain morphometry. This study examined neocortical brain morphometric differences between abstinent polysubstance dependent and alcohol-only dependent treatment seekers (ALC) as well as light drinking controls (CON), the associations of cigarette smoking in these polysubstance users (PSU), and morphometric relationships to cognition and inhibitory control.. All participants completed extensive neuropsychological assessments and 4 Tesla brain magnetic resonance imaging. PSU and ALC were abstinent for one month at the time of study. Parcellated morphological data (volume, surface area, thickness) were obtained with FreeSurfer methodology for the following bilateral components: dorso-prefrontal cortex (DPFC), anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and insula. Regional group differences were examined and structural data correlated with domains of cognition and inhibitory control.. PSU had significantly smaller left OFC volume and surface area and trends to smaller right DPFC volume and surface area compared to CON; PSU did not differ significantly from ALC on these measures. PSU, however, had significantly thinner right ACC than ALC. Smoking PSU had significantly larger right OFC surface area than non-smoking PSU. No significant relationships between morphometry and quantity/frequency of substance use, alcohol use, or age of onset of heavy drinking were observed. PSU exhibited distinct relationships between brain structure and processing speed, cognitive efficiency, working memory and inhibitory control that were not observed in ALC or CON.. Polysubstance users have unique morphometric abnormalities and structure-function relationships when compared to individuals dependent only on alcohol and light drinking controls. Chronic cigarette smoking is associated with structural brain irregularities in polysubstance users. Further elucidation of these distinctive characteristics could help inform the development of targeted and thus potentially more effective treatments in this large but understudied population.

Topics: Adult; Alcoholism; Amphetamines; Analgesics, Opioid; Cannabis; Central Nervous System Stimulants; Cocaine; Cognition; Humans; Inhibition, Psychological; Magnetic Resonance Imaging; Middle Aged; Neocortex; Neuropsychological Tests; Smoking

Sleep problems are commonly reported following alcohol and cannabis abuse, but our understanding of sleep in non-clinical drug using populations is limited. The present study examined the sleep characteristics of alcohol and cannabis users recruited from the wider community.. Two hundred forty-eight self-identified alcohol and/or cannabis users (131 women and 117 men) with a mean age of 26.41 years completed an online study that was advertised via online forums, print media and flyers. As part of the study, participants completed validated sleep scales assessing sleep quality (Pittsburgh Sleep Quality Index) and excessive daytime sleepiness (Epworth Sleepiness Scale) in addition to validated drug scales assessing alcohol (Alcohol Use Disorders Identification Test) and cannabis (Marijuana Screening Inventory) use.. Problems with sleep quality were more commonly reported than were complaints of excessive daytime sleepiness. Clinically significant poor sleep quality was associated with comorbid problem alcohol and cannabis use. Women reporting problem alcohol and cannabis use had poorer sleep outcomes than men.. Social drug users who report risky alcohol and cannabis use also report poor sleep. Poor sleep quality likely exacerbates any drug-associated problems in non-clinical populations.

Topics: Adult; Alcohol Drinking; Alcoholism; Cannabis; Comorbidity; Disorders of Excessive Somnolence; Female; Humans; Male; Marijuana Abuse; Risk-Taking; Sleep Initiation and Maintenance Disorders

The relative contributions of cannabis and alcohol use to educational outcomes are unclear. We examined the extent to which adolescent cannabis or alcohol use predicts educational attainment in emerging adulthood.. Participant-level data were integrated from three longitudinal studies from Australia and New Zealand (Australian Temperament Project, Christchurch Health and Development Study, and Victorian Adolescent Health Cohort Study). The number of participants varied by analysis (N=2179-3678) and were assessed on multiple occasions between ages 13 and 25. We described the association between frequency of cannabis or alcohol use prior to age 17 and high school non-completion, university non-enrolment, and degree non-attainment by age 25. Two other measures of alcohol use in adolescence were also examined.. After covariate adjustment using a propensity score approach, adolescent cannabis use (weekly+) was associated with 1½ to two-fold increases in the odds of high school non-completion (OR=1.60, 95% CI=1.09-2.35), university non-enrolment (OR=1.51, 95% CI=1.06-2.13), and degree non-attainment (OR=1.96, 95% CI=1.36-2.81). In contrast, adjusted associations for all measures of adolescent alcohol use were inconsistent and weaker. Attributable risk estimates indicated adolescent cannabis use accounted for a greater proportion of the overall rate of non-progression with formal education than adolescent alcohol use.. Findings are important to the debate about the relative harms of cannabis and alcohol use. Adolescent cannabis use is a better marker of lower educational attainment than adolescent alcohol use and identifies an important target population for preventive intervention.

Topics: Achievement; Adolescent; Alcohol Drinking; Alcoholism; Australia; Cannabis; Cohort Studies; Educational Status; Female; Humans; Longitudinal Studies; Male; Marijuana Abuse; Marijuana Smoking; New Zealand; Risk Factors; Substance-Related Disorders; Underage Drinking

Topics: Adolescent; Adult; Alcoholic Beverages; Alcoholism; Cannabis; Humans; Marijuana Abuse; Risk Factors; Young Adult

Topics: Adolescent; Adult; Alcoholism; Brain; Cannabis; Humans; Illicit Drugs; Marijuana Abuse; Marijuana Smoking; National Institutes of Health (U.S.); United States; Young Adult

Population-based input function (PBIF) may be a valid alternative to full blood sampling for quantitative PET imaging. PBIF is typically validated by comparing its quantification results with those obtained via arterial sampling. However, for PBIF to be employed in actual clinical research studies, its ability to faithfully capture the whole spectrum of results must be assessed. The present study validated a PBIF for [(18)F]FMPEP-d 2, a cannabinoid CB1 receptor radioligand, in healthy volunteers, and also attempted to utilize PBIF to replicate three previously published clinical studies in which the input function was acquired with arterial sampling.. The PBIF was first created and validated with data from 42 healthy volunteers. This PBIF was used to assess the retest variability of [(18)F]FMPEP-d 2, and then to quantify CB1 receptors in alcoholic patients (n = 18) and chronic daily cannabis smokers (n = 29). Both groups were scanned at baseline and after 2-4 weeks of monitored drug abstinence.. PBIF yielded accurate results in the 42 healthy subjects (average Logan-distribution volume (V T) was 13.3±3.8 mL/cm(3) for full sampling and 13.2±3.8 mL/cm(3) for PBIF; R(2) = 0.8765, p<0.0001) and test-retest results were comparable to those obtained with full sampling (variability: 16%; intraclass correlation coefficient: 0.89). PBIF accurately replicated the alcoholism study, showing a widespread ∼20% reduction of CB1 receptors in alcoholic subjects, without significant change after abstinence. However, a small PBIF-V T bias of -9% was unexpectedly observed in cannabis smokers. This bias led to substantial errors, including a V T decrease in regions that had shown no downregulation in the full input function. Simulated data showed that the original findings could only have been replicated with a PBIF bias between -6% and +4%.. Despite being initially well validated in healthy subjects, PBIF may misrepresent clinical protocol results and be a source of variability between different studies and institutions.

Topics: Alcoholism; Cannabis; Drug Inverse Agonism; Female; Humans; Kinetics; Ligands; Male; Models, Biological; Positron-Emission Tomography; Pyrrolidinones; Receptor, Cannabinoid, CB1; Smoking

This study aims to estimate general and racial-ethnic specific cumulative probability of developing dependence among nicotine, alcohol, cannabis or cocaine users, and to identify predictors of transition to substance dependence.. Analyses were done for the subsample of lifetime nicotine (n=15,918), alcohol (n=28,907), cannabis (n=7389) or cocaine (n=2259) users who participated in the first and second wave of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Discrete-time survival analyses were implemented to estimate the cumulative probability of transitioning from use to dependence and to identify predictors of transition to dependence.. The cumulative probability estimate of transition to dependence was 67.5% for nicotine users, 22.7% for alcohol users, 20.9% for cocaine users, and 8.9% for cannabis users. Half of the cases of dependence on nicotine, alcohol, cannabis and cocaine were observed approximately 27, 13, 5 and 4 years after use onset, respectively. Significant racial-ethnic differences were observed in the probability of transition to dependence across the four substances. Several predictors of dependence were common across the four substances assessed.. Transition from use to dependence was highest for nicotine users, followed by cocaine, alcohol and cannabis users. Transition to cannabis or cocaine dependence occurred faster than transition to nicotine or alcohol dependence. The existence of common predictors of transition dependence across substances suggests that shared mechanisms are involved. The increased risk of transition to dependence among individuals from minorities or those with psychiatric or dependence comorbidity highlights the importance of promoting outreach and treatment of these populations.

Topics: Adolescent; Adult; Alcoholism; Cannabis; Cocaine; Cocaine-Related Disorders; Female; Health Surveys; Humans; Male; Marijuana Abuse; Mental Disorders; Middle Aged; Nicotine; Predictive Value of Tests; Probability; Risk Factors; Smoking; Socioeconomic Factors; Tobacco Use Disorder; Young Adult

This study describes the factors associated with self-reported substance use in pregnant young women attending a hospital clinic and evaluates 3 ways in its identification.. A cross-sectional study of 30 pregnant young adults who responded to a mail survey containing the CRAFFT screening tool. All completed a diagnostic interview that included self-report information on their use of alcohol and drugs before and during pregnancy, the T-ACE screening tool, and the contexts in which they would be likely to use. Medical records were reviewed.. One-third of participants consumed alcohol, marijuana, or both while pregnant. Many had lifetime diagnoses of alcohol (23%) or cannabis (30%) use disorders, but only 1 met criteria for current diagnosis. Age, race, education, and children at home were not associated with either prenatal alcohol or cannabis use. Before pregnancy, alcohol drinking was associated with prenatal alcohol use (P = .02) and prenatal cannabis use (P = .06). Another trend of the before-pregnancy cannabis use being associated with prenatal cannabis use (P = .08) was observed. Most participants indicated little likelihood of substance use in convivial, intimate, or negative coping contexts while pregnant. However, participants with prenatal substance use had significantly higher convivial (P = .02) and intimate (P = .01) subscale scores of the Drinking Context Scale before pregnancy. Compared to the medical record and the T-ACE, the CRAFFT was best in identifying prenatal substance use (c-statistic = 0.9).. The CRAFFT screening instrument and asking about the contexts during which alcohol might have been consumed before pregnancy are promising approaches in the identification of prenatal substance use.

Topics: Adolescent; Adult; Alcohol Drinking; Alcoholism; Cannabis; Cross-Sectional Studies; Female; Humans; Massachusetts; Pilot Projects; Pregnancy; Pregnancy Complications; Pregnancy in Adolescence; Prenatal Care; Self Report; Substance-Related Disorders; Surveys and Questionnaires; Young Adult

We report a case of a 19 year-old man with stroke, who was taking cocaine, marihuana and alcohol for a few days before hospitalisation. Diagnostic tests showed protein C insufficiency and patent foramen ovale (PFO). As a result of the therapy neurological symptoms have regressed.

Topics: Adult; Alcoholism; Cannabis; Cocaine; Foramen Ovale, Patent; Humans; Male; Protein C; Stroke; Vasoconstrictor Agents

HIV infection is prevalent among substance abusers. The effects of specific illicit drugs on HIV disease progression have not been established. We evaluated the relationship between substances of abuse and HIV disease progression in a cohort of HIV-1-positive active drug users.. A prospective, 30-month, longitudinal study was conducted on 222 HIV-1 seropositive drug users in Miami, FL. History of illicit drug, alcohol, and medication use, CD4+ cell count, and viral load were performed every 6 months.. Crack-cocaine users were 2.14 times [95% confidence interval (CI): 1.08 to 4.25, P = 0.029] more likely to present a decline of CD4 to

Topics: Adult; Alcoholism; Antiretroviral Therapy, Highly Active; Cannabis; CD4 Lymphocyte Count; Cocaine-Related Disorders; Cohort Studies; Crack Cocaine; Disease Progression; Female; Heroin; HIV Infections; Humans; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Substance-Related Disorders; Viral Load

To investigate the possible linkages between deliveries, abortions and subsequent nicotine dependence, alcohol problems and use of cannabis and other illegal drugs from the ages of 15-27 years.. Data were gathered as part of the Young in Norway Longitudinal Study, an 11-year follow-up of a representative sample of Norwegian adolescents and young adults.. Information was obtained on (i) the history of childbirths and induced abortions for the participants between the ages of 15-27 years; (ii) measures of nicotine dependence, alcohol problems and use of cannabis and other illegal drugs; and (iii) socio-demographic, family and individual confounding factors.. Those who had had an abortion had elevated rates of substance use and problems. Those who gave birth to a child had reduced rates of alcohol problems and cannabis use. These associations persisted after control for confounders. However, those women who still lived with the father of the aborted fetus were not at increased risk.. Abortion in women may, under some circumstances, be associated with increased risk of nicotine dependence, alcohol problems and use of cannabis and other illegal drugs. The birth of a child may reduce the use of some substances.

Topics: Abortion, Induced; Adolescent; Adult; Alcoholism; Cannabis; Female; Follow-Up Studies; Humans; Longitudinal Studies; Norway; Parturition; Pregnancy; Regression Analysis; Risk Factors; Socioeconomic Factors; Substance-Related Disorders; Tobacco Use Disorder

Topics: Adolescent; Alcoholism; Amygdala; Brain; Cannabis; Cognition Disorders; Hippocampus; Humans; Magnetic Resonance Imaging; Marijuana Abuse; Saliva

Research studies that collect biological measures of drug use have traditionally utilized laboratory urinalysis. Several recent studies have also documented the utility of laboratory oral fluid (OF) analysis. A new method of drug testing-instant OF technology--may offer a quicker, equally accurate alternative to laboratory OF assays. To date, however, no field studies have compared the two methods. In the current study, an instant OF test (ORALscreen) was administered to 65 adult arrestees surveyed through Maryland's Substance Abuse Need for Treatment among Arrestees (SANTA) study. Following a research interview, a second OF sample was collected (ORALconfirm) and shipped to the manufacturer's laboratory for analysis. The instant OF test was 96% sensitive and 83% specific for cocaine, 100% sensitive and 75% specific for opiates, and 100% sensitive and 94% specific for marijuana. Kappa statistics were low for all three drugs, suggesting poor agreement between the two tests. Moreover, while the marijuana sensitivity and specificity coefficients in the current study were high, a growing body of research has indicated that OF analysis is not as accurate as the gold standard of urinalysis in detecting recent marijuana use. Implications for these findings are discussed.

Topics: Adult; Alcoholism; Cannabis; Clinical Laboratory Techniques; Cocaine; Female; Humans; Male; Maryland; Narcotics; Prisoners; Saliva; Substance-Related Disorders

Over recent decades the drink problem in the British Isles has grown to become arguably the worst in the Western world, combining the high average alcohol intake of southern Europe with binge-drinking typical of extreme latitudes. Since the problem continues to worsen, and traditional strategies regulating price and access are probably untenable, radical new alcohol policies are required. The drug-substitution strategy is based on an assumption that most people use lifestyle drugs rationally for self-medication purposes, to achieve specific desired psychological effects, especially enhanced well-being. When there is access to an equally effective, but safer, alternative drug, then people would tend to switch to it (especially when the substitute is legal and socially-acceptable). There are several safer lifestyle drug-substitutes for alcohol, including benzodiazepines, SSRIs and marijuana. Southern Europeans use alcohol mainly as an anxiolytic social lubricant, taken in low but frequent doses with high annual per capita consumption, and for this pattern, benzodiazepines might be a medically safer lifestyle drug-substitute. Northern Europeans traditionally use alcohol in high doses as a euphoric intoxicant, and for this pattern, marijuana might be a safer and less-antisocial substitute. Since this risk-benefit calculus implies that there are better alternatives to alcohol, government policy should promote safer lifestyle drug-substitutes by removing legal barriers and altering the balance of economic and social incentives.

Topics: Alcohol Drinking; Alcoholism; Anti-Anxiety Agents; Cannabis; Diazepam; Health Policy; Humans; Life Style; Selective Serotonin Reuptake Inhibitors

This paper takes a Health Education perspective to analyze a debate forum on the Brazilian Internet site entitled "Universo On-Line", in which the following questions were addressed: "Do you believe that marijuana is harmful to one's health?" "In your opinion, should marijuana use be decriminalized?" By applying qualitative discourse analysis techniques to responses from the forum, we were able to identify six main types of discourse, reflecting the opinions of six "collective subjects" concerning drugs, health, disease, and freedom and existing as social representations in the current Brazilian collective imagination. Research on these social representations allows one to establish criteria for intervention in the field of Health Education.

Topics: Alcoholism; Attitude to Health; Brazil; Cannabis; Female; Freedom; Health Education; Humans; Illicit Drugs; Internet; Male; Marijuana Abuse; Smoking; Substance-Related Disorders

We have studied the occurrence of dual diagnoses (psychoses as well as abuse of either amphetamine, cannabis or opiates) during a 15-year period, among patients treated at Huddinge Hospital, Stockholm, Sweden. The purpose of the study is to evaluate if the different drugs were coupled to different rates of psychiatric co-morbidity. During the period in question, 461, 425 and 371 different patients respectively had been admitted at least once due to dependency on amphetamine, cannabis and opiates. Approximately 30% of the patients with a pure abuse of amphetamine or cannabis and less than 6% of the opiate abusers had been diagnosed at least once with any of the psychoses studied. Comparing the frequency of psychoses among mixed and pure abusers of illegal drugs, with and without a concomitant abuse of alcohol, we found that the co-morbidity rate for mixed opiate abusers increased significantly from 7.2 to 20.2% when alcohol abuse was also present. For abusers of amphetamine and cannabis (both pure and mixed), no differences in co-morbidity rates were seen when an abuse of alcohol was added to that of the drugs. It is difficult to find an explanation for the significant difference between the co-morbidity of pure abuse of amphetamine or cannabis on the one hand and opiates on the other. In conclusion, our findings show that the distribution of psychotic illness is high among abusers of amphetamine and cannabis, in contrast to the generally lower co-morbidity among abusers of opiates. Although these findings are consistent with earlier studies that have shown a propensity for developing psychoses among abusers of amphetamine and cannabis, one should bear in mind that this study is based on inpatients, and is not necessarily representative for all abusers of the drugs in question.

Topics: Alcoholism; Amphetamines; Cannabis; Diagnosis, Dual (Psychiatry); Dopamine Agonists; Humans; Narcotics; Psychoses, Substance-Induced; Risk Factors; Substance-Related Disorders

(i) To describe illegal drug use patterns in an adolescent normal population sample with special emphasis on MDMA, ecstasy; (ii) to investigate where ecstasy is introduced in a hypothesized drug use sequence, and (iii) to contrast the predictors of ecstasy use with those of other illegal substances. Special attention was given to the relationship to subcultural music preferences and house-party-going.. A school-based survey of the total cohort of adolescents enrolled in the school system in a city.. 10,812 adolescents, age 14-17 years, response rate 94.3%.. Oslo, the capital and only metropolitan town in Norway.. Social class was measured by the occupation standard ISCO 88, questions were posed as regards frequency of alcohol use and alcohol intoxication, cigarette smoking and use of cannabis, amphetamines, ecstasy and heroin. Alcohol problems were measured by a shortened version of Rutgers Alcohol Problem Index (RAPI), conduct problems were measured according to the four categories of acts forming the basis of the diagnosis conduct disorder in DSM-IV, internalizing mental health problems were measured using items from Hopkins Symptoms Checklist (HCL). A number of questions were asked as regards subcultural music preferences and house-party-going. STATISTICAL MODELS: A hypothesized cumulative sequence in drug use was investigated by means of latent class analysis, and the predictors of the various patterns of drug use were estimated and compared by means of multinominal logistic regression analysis.. The use of ecstasy was often intermingled with the use of cannabis, amphetamines and heroin, in a pattern of polydrug use. The latent class analysis revealed the following drug use sequence: (1) alcohol, (2) cigarettes, (3) cannabis, (4) amphetamines, (5) ecstasy and (6) heroin. There was no significant association between ecstasy use and parental social class or residential area of the town. All patterns of illegal drug use were highly associated with cigarette smoking, alcohol use, alcohol problems and conduct problems, whereas the associations with internalizing mental health problems were of less magnitude. Multinominal logistic regression analysis revealed that the use of ecstasy (E) was significantly more weakly associated with cigarette smoking than were the use of cannabis only (C), amphetamines (A) and the combination of ecstasy and amphetamines (A + E). The association between E and conduct problems (CP) was weaker than the association between CP and A and A + E. Finally, there were associations between E and A + E and House/Techno preferences and house-party-going, which were not found for C and A.. Ecstasy is used by adolescents who use other legal and illegal substances in a polydrug-use pattern. The substance is introduced late in a hypothesized drug use sequence. Even so, ecstasy use seems to differ from the use of, e.g. amphetamines, in that the association with smoking and conduct problems is weaker and that the associations with subcultural music preferences and house-party-going are much stronger.

Topics: Adolescent; Alcoholism; Amphetamines; Cannabis; Cohort Studies; Female; Hallucinogens; Heroin; Humans; Logistic Models; Male; N-Methyl-3,4-methylenedioxyamphetamine; Norway; Prevalence; Smoking; Social Behavior; Substance-Related Disorders

Attention-deficit hyperactivity disorder (ADHD) has been considered a mental and behavioral disorder of childhood and adolescence. It is being increasingly recognized in adults, who may have psychiatric co-morbidity with secondary depression, or a tendency to drug and alcohol abuse. We describe a 32-year-old woman known for years as suffering from borderline personality disorder and drug dependence (including hashish, marijuana, LSD and "ecstasy") and alcohol abuse that did not respond to treatment. Only when correctly diagnosed as ADHD and appropriately treated with the psychotropic stimulant, methylphenidate (Ritalin), was there significant improvement. She succeeded academically, which had not been possible previously, the craving for drugs diminished and a drug-free state was reached. Although administration of psychostimulants to drug abusers is controversial, as they are addictive, in cases of ADHD they have promoted drug abstinence.

Topics: Adult; Alcoholism; Attention Deficit Disorder with Hyperactivity; Cannabis; Central Nervous System Stimulants; Female; Humans; Lysergic Acid Diethylamide; Marijuana Abuse; Methylphenidate; N-Methyl-3,4-methylenedioxyamphetamine; Substance-Related Disorders

Twenty-three methadone-maintained individuals seeking admission into a cocaine study were interviewed using the Pattern-of-Drug-Use assessment. Sample characteristics included: 96% male, 91% Caucasian, and 36 +/- 5 mean years of age. Mean methadone dose was 81 +/- 20 mg. On average, subjects reported using greater than $200 or 5 grams of cocaine per week. "Binge/crash" cocaine use did not appear to be the typical pattern of use. However, during daily periods of cocaine use, repeated injections of large amounts of cocaine were taken, which may place patients at risk for medical complications. These findings emphasize the importance of developing novel treatment strategies to treat these dually-addicted individuals.

Topics: Adult; Alcoholism; Cannabis; Cocaine; Female; Heroin; Humans; Male; Methadone; Narcotics; Substance-Related Disorders; Time Factors

In the period 1987-1991 a total of 739 fatalities among drug addicts was investigated at the three University Institutes of Forensic Medicine in Denmark. The annual number rose from 130-140 in the first 4 years to 192 in 1991, and 80% were males. The mean and median age for both males and females increased by 1 year in the period. The main drug of abuse was heroin, in most cases supplemented by various other drugs, and in almost all cases taken intravenously. In about one-third of the cases each year there was information of abuse of alcohol in addition. In the poisoning cases, the main drug of poisoning was morphine/heroin, constituting 35-55% of the cases each year. As regards methadone-poisoning cases, the number increased significantly in 1991 compared to the first 4 years. Furthermore, the number and proportion of addicts dying while in methadone treatment increased during the 5-year period. In about half of the methadone poisoning cases, there was information of methadone treatment at the time of death. The other half obviously obtained the methadone completely illegally. Ketobemidone was the third most frequent drug of poisoning, while propoxyphene and barbituric acid only were found in a very few cases each. The results are compared to those from an earlier investigation concerning drug deaths in Denmark in 1968-1986. The importance of registering drug deaths is emphasized.

Topics: Adolescent; Adult; Alcoholism; Amphetamine; Analgesics, Opioid; Barbiturates; Cannabis; Cause of Death; Denmark; Dextropropoxyphene; Female; Heroin; Humans; Male; Meperidine; Methadone; Morphine; Substance-Related Disorders; Suicide; Survival Rate

Topics: Alcoholism; Attitude to Health; Behavior, Addictive; Cannabis; Female; Health Promotion; Humans; Liver Cirrhosis, Alcoholic; Male; Substance-Related Disorders

As part of DSM-IV field trials for substance use disorders, 100 inpatients from two psychiatric substance abuse units were interviewed using a modified version of the Substance Abuse Module (SAM) to ascertain substance use diagnoses according to ICD-10 and DSM-III-R criteria. Both criteria sets developed from the theoretical framework presented by Gross and Edwards (1976) and thus, they should demonstrate close concurrence in diagnoses of dependence and abuse/harmful use. The kappa scores obtained in these analyses demonstrate good to excellent agreement on the diagnoses of dependence across substances. There was poor agreement between DSM-III-R and ICD-10 for abuse/harmful use diagnoses. Although there is generally good agreement between DSM-III-R and ICD-10 for substance dependence diagnoses, important differences exist between the two criteria sets both for the diagnoses of abuse and harmful use, and for the diagnosis of marijuana dependence. These differences are primarily due to the inclusion of social problems and repeated use of substances in hazardous situations as DSM-III-R criteria.

Topics: Alcoholism; Amphetamines; Cannabis; Cocaine; Female; Humans; Male; Psychiatric Status Rating Scales; Substance Abuse Treatment Centers; Substance-Related Disorders

A prospective study of a representative sample of nearly 2000 young people aged 17-20 years was started in 1985. It was followed up twice, in 1987 and in 1989. The Central Bureau of Statistics in Norway was responsible for the data collection. Sixty-five per cent of the stratified sample (1985) participated in all the three surveys. The aim of this paper has been to explore the relationship between unemployment and the use of drugs and alcohol. The results show that unemployment does not appear to influence the consumption of alcohol. In a high consumption group, unemployment seems to lead to a decrease in alcohol consumption, though there was a clear tendency to increase use of cannabis. The results seem to indicate that there was no increase in use of alcohol or drugs in response to stress as a result of unemployment, though unemployment may lead to a stronger identification with or joining marginalized or deviant subcultures which in turn leads to an increased use of cannabis.

Topics: Adolescent; Alcohol Drinking; Alcoholism; Attitude to Health; Cannabis; Female; Humans; Longitudinal Studies; Male; Norway; Regression Analysis; Social Problems; Substance-Related Disorders; Surveys and Questionnaires; Unemployment

National drug use surveys of medical students and resident physicians in 1987 found that medical school was not a time when students began to use drugs, nor was it a time when they engaged in heavy use. Medical students and resident physicians reported lower rates of illicit drug use than their age and gender counterparts. Although males generally were more likely to use substances than females, young male and female physicians resembled one another in their current rates of substance use more than they resembled their gender counterparts in society.

Topics: Adult; Alcoholism; Amphetamines; Cannabis; Cocaine; Female; Humans; Internship and Residency; Male; Physician Impairment; Smoking; Students, Medical; Substance-Related Disorders; United States

This article examines the commonly used laboratory indicators of heavy alcohol use (elevated MCV, GGTP and AST values) in subgroups of drug-using and non-drug-using alcoholic men admitted to an inpatient alcoholism treatment program. A total of 380 consecutive admissions meeting DSM-III diagnostic criteria for alcohol use or dependence were studied. Of these subjects, 75% used both alcohol and drugs. The most frequently used drugs were marijuana, cocaine, amphetamines and tranquilizers. Overall, subjects who used drugs with alcohol had significantly lower MCV and GGTP values than subjects who used alcohol alone. More specifically, cocaine use was associated with lower MCV values, marijuana use with lower AST values and heroin use with higher AST and GGTP values. These differences between drug-using and non-drug-using alcoholics were significant even after controlling for variables that affect the laboratory values such as age, quantity, frequency and duration of alcohol consumption. These findings indicate that any study of laboratory markers of alcoholism needs to consider concomitant illicit drug use patterns.

Topics: Adult; Aged; Alcoholism; Amphetamines; Analysis of Variance; Barbiturates; Biomarkers; Cannabis; Cocaine; Hallucinogens; Heroin; Humans; Male; Middle Aged; Narcotics; Substance-Related Disorders

Topics: Adult; Alcoholism; Cannabis; Cocaine; Female; Humans; Interview, Psychological; Male; Opioid-Related Disorders; Substance-Related Disorders; Syndrome

Topics: Alcoholism; Amphetamines; Barbiturates; Cannabis; Cocaine; Diazepam; Heroin Dependence; Humans; Male; Methadone; Substance-Related Disorders

Topics: Adult; Alcohol Drinking; Alcoholism; Cannabis; Choice Behavior; Conditioning, Operant; Female; Humans; Male; Marijuana Abuse; Prospective Studies; Sex Factors

367 new cases of drug abuse and related cases were admitted to the teaching hospital within the study period. These cases comprised approximately 11% of all new admissions during the period. 80% were between 15 and 30 years, and 76% of them were single. People in this age group tend to abuse cannabis and amphetamine more than alcohol, whereas those in the age range 31 years and over, tend to abuse alcohol more, and about 76% of them are married. Cocaine or heroin abuse, did not occur. The use of cannabis was more commonly associated with alcohol than with amphetamine. Abuse of amphetamine in association with alcohol, though present, was not significant. 15 of 367 cases were females (4%), 11 of whom were married.

Topics: Adolescent; Adult; Age Factors; Alcoholism; Amphetamines; Cannabis; Child; Female; Humans; Male; Middle Aged; Nigeria; Sex Factors; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Cocaine; Female; Fetal Alcohol Spectrum Disorders; Humans; Infant, Newborn; Narcotics; Pregnancy; Pregnancy Complications; Prenatal Care; Substance Withdrawal Syndrome; Substance-Related Disorders

A six-month survey of the urinary concentrations of drugs and alcohol of 176 patients within one hour of their admission to the acute psychiatric wards of the Macquarie Hospital, Sydney, is reported. Non-prescribed drugs were detected in the urine specimens of 29.5% of patients and alcohol in the urine specimens of 13.6% of patients. The survey demonstrated inconsistencies between patients' reports of their recent drug or alcohol intake and the laboratory findings, and inadequacies in the information recorded and relayed to the laboratory at the time of patients' admission to the hospital.

Topics: Adolescent; Adult; Aged; Alcoholism; Australia; Cannabis; Central Nervous System Agents; Drug Utilization; Ethanol; Female; Hospitals, Psychiatric; Humans; Male; Marijuana Abuse; Middle Aged; Patient Admission; Phenothiazines; Salicylates

The research literature suggests that adolescents placed in residential programs due to their delinquent behavior are at high risk for drug and alcohol use and abuse. Research is rare, however, on the effects of residential delinquency-treatment programs on drug- and alcohol-related behaviors. This study examined the comparative effects of community-based, group-home, delinquency-treatment programs in Kansas on participants' self-report measures of drug and alcohol use and abuse, and of some prosocial behaviors. The results indicated that youths (n = 82) participating in group homes using the broadly disseminated Teaching-Family approach had better during-treatment outcomes than youths (n = 103) participating in a set of comparison group homes. Corroboratively, a sample of Teaching-Family youths (n = 28) also had better during-treatment outcomes than a matched no-treatment comparison group of their friends (n = 28), while, in contrast, a sample of youths (n = 33) in the comparison group homes did not differ on during-treatment measures from a matched no-treatment comparison group of their friends (n = 33). In the post-treatment year, however, no outcome difference was evident for any of the comparisons. Regression analyses were conducted to attempt to account for variation in the during treatment drug use and prosocial behavior measures. Significant regression coefficients were found for some measures of treatment process and for measures of youths' pretreatment behavior. In a second set of regression equations, the process and pretreatment measures were less effective in accounting for variance in posttreatment outcomes. The limitations of the research and its implications for the treatment and prevention of drug and alcohol use and abuse in group-home delinquency-treatment programs are discussed.

Topics: Adolescent; Alcoholism; Cannabis; Community Health Services; Female; Humans; Juvenile Delinquency; Kansas; Male; Regression Analysis; Substance-Related Disorders; Time Factors

This article examines survey data on alcohol and drug use, stress and other risk factors of impairment in nonclinical samples of physicians and medical students. Previously unpublished data on a sample of physicians-in-training showed they were healthy nonsmokers, experiencing many feelings of job stress, but were generally light drinkers and suffered few adverse effects of drinking. Young physicians and medical students were not very different from comparable non-physician populations in their use of recreational and therapeutic drugs, although the medical professionals had slightly below average use rates. Regression analyses found that recreational drug use and drinking stemmed mainly from sensation seeking, whereas therapeutic drug use was stress-related.

Topics: Adult; Alcoholism; Cannabis; Cocaine; Epidemiologic Methods; Female; Health; Humans; Male; Middle Aged; Models, Psychological; Physician Impairment; Risk; Smoking; Socioeconomic Factors; Stress, Psychological; Students, Medical; Substance-Related Disorders

This research was carried out in the shantytowns of the capital city of Costa Rica. Magnitude and main features of alcohol and drug use among the population aged 15 up were studied. The sample was composed by 469 people interviewed: The instruments used were questionnaires and interview forms. Field observation was also practiced. The results pointed out a 14% of the population as having alcohol problems (9% heavy drinking, 5% physical dependence on alcohol). Furthermore an 8% was regularly using different drugs, such as marijuana, solvents, common plants psychoactively effective, etc. Frequent intake of medicaments without any therapeutic aim was also high. From a point of view focusing on the individuals and the assistance, the problem has a better prognosis when social and community treatment is considered. When seen from the collectivity and prevention perspective the problem surpasses the health sphere and demands the attention of several social and economical complex factors. This is the only way to set up a prevention program well organized, systematical and with possibilities of success. Finally, it is stated that the development of new studies on the ecology of the problem will precisely permit the working out of a preventive-assisting program especially directed to the groups specifically affected or menaced by alcohol and drugs.

Topics: Adolescent; Adult; Alcoholism; Barbiturates; Cannabis; Costa Rica; Female; Humans; Male; Poverty; Poverty Areas; Solvents; Substance-Related Disorders

Topics: Adult; Alcoholism; B-Lymphocytes; Cannabis; Humans; Immunosuppression Therapy; Leukocyte Count; Macrophages; Middle Aged; Narcotics; Substance-Related Disorders; T-Lymphocytes

Prisoners deserve to be taken seriously and treated with respect by the physician, as does any person seeking medical care. Treatment should include an adequate history and physical examination as well as indicated laboratory tests. Anxiety is a ubiquitous problem in prison life and can adversely affect any medical condition. The diagnosis of malingering is and should be one of exclusion, and the physician should keep in mind that a seemingly healthy prisoner might have several other reasons for seeking medical help. The physician needs to be confident of the diagnosis before returning the person to the cell block, as prisoners do not have freedom of access to medical care. New standards, programs, literature, journals, and conferences have drawn attention to the jail as a place where the physician can intervene in a positive way to decrease the recycling of crime and illness. It is not enough to be able to practice good medicine in a jail. Such practice must recognize the special needs of prisoners and the special problems inherent in the jail environment.

Topics: Adult; Alcoholism; Cannabis; Diazepam; Ethics, Medical; Female; Health Services; Heroin; Humans; Male; Mental Disorders; Physician-Patient Relations; Prisoners; Prisons; Seizures; Substance-Related Disorders; Tuberculosis; United States

Topics: Adolescent; Adult; Age Factors; Alcohol Drinking; Alcoholism; Cannabis; Child; Humans; Indians, North American; Manitoba; Smoking; Substance-Related Disorders

Personality, environmental, and behavioral variables representing psychosocial risk factors for adolescent problem behavior were assessed in a 1974 national sample study of over 10,000 junior and senior high school students. Significant correlations were found with marijuana use, and the relationships held across differences in age, sex, and ethnic group membership. Greater involvement in marijuana use was associated with greater value on independence than on academic achievement, lower expectations for academic achievement, lesser religiosity, greater tolerance of deviance, less compatibility between friends and parents, greater influence of friends relative to parents, greater models and support for problem behavior, greater actual involvement in other problem behaviors such as drunkenness, and less involvement in conventional behavior such as attending church. Multiple regression analyses show that this pattern of psychosocial correlates accounts for over 50 per cent of the variation in marijuana use. The pattern is nearly identical to the pattern that accounts for problem drinking in these same adolescents. The similarity of the patterns of psychosocial risk, and the substantial correlations of marijuana use with problem drinking and with other problem behaviors, suggest that marijuana use is best seen as part of a syndrome of adolescent problem behavior. (Am J Public Health 70:604- 613,1980.)

Topics: Adolescent; Alcoholism; Cannabis; Ethnicity; Female; Humans; Interpersonal Relations; Male; Personality Development; Psychology, Adolescent; Random Allocation; Social Behavior; Social Environment; Substance-Related Disorders; Surveys and Questionnaires; United States

The drug habits for 78 confirmed opiate addicts were studied on eight scales from the Process Association Test of Addiction (PATA) for many drug names. Through cluster analysis eight stages of addiction were defined: "to be clean", "to learn about drugs", "to hustle", "to chip" (also "to be high"), to be psychologically dependent or "to need a shot", "to be hooked" "to kick a habit" and "to be in treatment". Associations stimulated by the words heroin and morphine were very similar over the eight stages of addiction in opiate addicts. The subjects were especially inclined to associate morphine and heroin with the most severe level of addiction, "to be hooked". Associations to both methadone and cocaine were elevated at the "hooked" stage, but in other respects associations to these drugs were opposite. Thus, associations to cocaine were focused on the stage of psychological dependence and the lower intermediate stage of addiction, "to chip" and "to be high", whereas associations to methadone suggested a turning away from addiction as indicated by avoidance associations ("to come down" and "to kick a habit") as well as associations to "treatment" and "to be clean". Marijuana, Benzedrine, "goofball" (barbiturates) and alcohol habits were prominent at an intermediate stage of addiction ("to chip" and "to be high"). Avoidance associations were common for Benzedrine and "goofballs" (also pentobarbital) but not for marijuana or alcohol. "Hustling" associations were frequent for marijuana but not for alcohol.

Topics: Adult; Alcoholism; Amphetamines; Barbiturates; Cannabis; Cocaine; Heroin Dependence; Humans; Male; Methadone; Morphine Dependence; Opioid-Related Disorders; Pentobarbital; Psychological Tests; Substance-Related Disorders

In a survey of non-medical drug use by 266 non-students in the age range 10-24 years, tobacco, alcohol and cannabis were found to be the drugs more commonly used. Use was greater in males, older age groups, those with lower educational levels and those from urban areas. In comparison to students, among non-students use was practically limited to tobacco, alcohol and cannabis, the use was more regular and the age at onset lower. In a pilot trial of two additional strategies to identify drug users among non-student youth, namely cross-validation by fellow employees and verbal group administration of the questionnaire, the number of current users identified was very similar to that found by individual verbal administration, suggesting that these cheaper methods may be useful in some circumstances.

Topics: Adolescent; Adult; Alcoholism; Cannabis; Child; Humans; India; Rural Population; Smoking; Socioeconomic Factors; Students; Substance-Related Disorders; Urban Population

Topics: Adolescent; Alcoholism; Cannabis; Female; Humans; Illinois; Male; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cannabis; Cocaine; Humans; Inhibition, Psychological; Male; Opium; Smoking; Substance-Related Disorders

Topics: Adolescent; Adult; Aged; Alcoholism; Barbiturates; Cannabis; Child; Child, Preschool; Demography; Female; Humans; India; Infant; Infant, Newborn; Male; Middle Aged; Opium; Substance-Related Disorders

In 34 patients with polyaddiction, 30 with hashishaddiction and 10 opiateaddiction and in 6 patients with chronic alcoholism the author studies the content of serum immunoglobulins of class A. M. G. The studies established that the content of IgA is increased in patients with polyaddiction, chronic alcoholism. An increase of IgA in the blood serum is marked in hashishaddiction, opiateaddiction and chronic alcoholism and its increase in opiateaddiction and polyaddiction. The character of changed serum IgM depends upon the type of addiction: it is increased in opiateaddiction, decreased in hashishaddiction and chronic alcoholism and not changed in polyaddiction.

Topics: Adult; Alcoholism; Cannabis; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Middle Aged; Opium; Substance-Related Disorders

Topics: Administration, Oral; Alcoholism; Cannabis; Constipation; Humans; Male; Middle Aged; Urination Disorders

Prevalence of inhalant, marijuana, and alcohol abuse was studied in a sample of 457 male and female Mexican-American children and adolescents between the ages of 9 and 17 years. Subjects interviewed resided in four housing projects located in East Los Angeles. All interviews were conducted by adolescents who resided in the same housing projects. Results indicated that compared to a national sample, Mexican-American adolescents were at least 14 times more likely to be currently abusing inhalants. The prevalence rate of marijuana was double the national rate, but the prevalence of alcohol was equal to that found nationally. Reasons for elevated substance abuse rates are explored.

Topics: Adolescent; Aerosols; Alcoholism; California; Cannabis; Child; Female; Hispanic or Latino; Humans; Male; Solvents; Substance-Related Disorders; Surveys and Questionnaires

A treatment population of 1,544 drug/alcohol abusers at 10 combined treatment centers was studied to determine the various patterns of sequential use and their corresponding policy implications. Most of the persons who began their substance abuse with alcohol continued to use only alcohol. Alcoholics who did use another substance, either sequentially or concurrently, tended to select a drug other than opiates or marijuana. Although a majority of opiate users eventually became concurrent or sequential users of another substance, a sizable number remained mono-users. A miniscule number of the opiate users moved on to alcohol or marijuana. Most of the users initiated into regular use with marijuana eventually began to use a nonopiate, nonalcoholic substance. A majority of the users who started with a nonalcohol, nonopiate, nonmarijuana substance eventually used marijuana. Sequential and concurrent users in general were more similar to each other than to mono-users. The implications of the development of drug use typologies for direct treatment are discussed. Having identified target groups, the author then suggests policies for controlling substance abuse indirectly, such as those dealing with employment.

Topics: Adult; Alcoholism; Cannabis; Employment; Female; Humans; Male; Opioid-Related Disorders; Social Adjustment; Socioeconomic Factors; Substance-Related Disorders

Topics: Adult; Alcohol Drinking; Alcoholism; Cannabis; Female; Follow-Up Studies; Humans; Male

Topics: Alcohol Drinking; Alcoholism; Cannabis; Costs and Cost Analysis; Humans; Reinforcement Schedule; Self Administration; Substance-Related Disorders; Work

Topics: Adult; Alcoholism; Cannabis; Dextroamphetamine; Humans; Illicit Drugs; Life Style; Mental Disorders; Opium; Pentobarbital; Personality; Probability; Psychological Tests; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cannabis; Child; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Social Problems; Substance-Related Disorders; United States

Topics: Adult; Alcoholism; Cannabis; Conditioning, Operant; Humans; Male; Reward; Substance-Related Disorders

Cannabis, alone or in conjunction with disulfiram, was not particularly effective in inducing alcoholics to enter or remain in treatment.

Topics: Adult; Alcoholism; Cannabis; Disulfiram; Drug Therapy, Combination; Humans; Male; Time Factors

Topics: Adult; Alcoholism; Amphetamines; Behavior Therapy; Cannabis; Cyclazocine; Evaluation Studies as Topic; Follow-Up Studies; Humans; Methyltyrosines; Patient Compliance; Patient Participation; Substance-Related Disorders

Treatment effectiveness for drug dependance is evaluated and compared with success rates reported in the literature. Program differences and varying follow-up procedures make assessment difficult. Identical pre- and posttreatment quantitative adjustment indices are recommended in order to improve the measurement of improvement. Education and length of stay in treatment are among the most important predictors of posttreatment drug usage and work akjustment. Education and improved treatment success with lower class youth are discussed.

Topics: Adult; Alcoholism; Cannabis; Educational Status; Employment; Female; Heroin Dependence; Humans; Interpersonal Relations; Male; Motivation; Risk; Socioeconomic Factors; Substance-Related Disorders; Therapeutic Community

Legal control of drugs available in Australia varies according to the nature of the drug. This article considers the question whether the different degrees of legal control can be justified on the basis of the pharmacological effects of the drugs or on the basis of their correlation with violent behaviour.

Topics: Adult; Alcoholism; Australia; Barbiturates; Cannabis; Crime; Heroin Dependence; Humans; Legislation, Drug; Middle Aged; Substance Withdrawal Syndrome; Substance-Related Disorders; Violence

Topics: Adolescent; Adult; Alcoholism; Amphetamines; Australia; Barbiturates; Cannabis; Female; Hallucinogens; Humans; Male; Methadone; Nonprescription Drugs; Substance-Related Disorders

Topics: Adolescent; Adult; Alcoholism; Amphetamines; Canada; Cannabis; Cocaine; Female; Hallucinogens; Heroin Dependence; Humans; Male; Middle Aged; Substance-Related Disorders; Tranquilizing Agents

Groups of students, teachers, adult advisers to youth, civil-service supervisors and occupational-program consultants were in basic agreement on philosophies for educating about alcohol, marihuana, lysergide (LSD) and heroin.

Topics: Adolescent; Adult; Alcoholism; Attitude; Cannabis; Counseling; Female; Health Education; Heroin Dependence; Humans; Internal-External Control; Lysergic Acid Diethylamide; Male; Occupational Therapy; Psychotropic Drugs; Social Control, Formal; Students; Teaching; Universities

66 juvenile drug-consumers--development-crises (32%), neurotic developments (30%), abnormal juvenile personalities (38%) - with a predominantly polytoxicomanic drug-anamnesis of several years are examined as to their suicidal development. The quantitative and qualitative progression of drug-abuse, the duration of drug-anamnesis, frequent broken-home-situations, grave educational deficiencies together with lacking possibilities of identification, a distinct social decline and chronic conflict-situations indicate the serious degree of the suicidal development. Different suicidal syndromes are worked out which in the form of death-phantasies or suicidal thoughts and horror trips directly derive from drug-abuse or are accompanied and reinforced by a continuous and frequently increasing drug-consumption, and which extend from an increase in depressive irritations, further psychological disturbances and personality changes, doubts about one's personal value and a sense of guilt to the "sickness of death".

Topics: Adjustment Disorders; Adult; Alcoholism; Attitude to Death; Bipolar Disorder; Cannabis; Conflict, Psychological; Divorce; Fantasy; Female; Hallucinations; Humans; Identity Crisis; Lysergic Acid Diethylamide; Male; Parent-Child Relations; Personality Disorders; Sexual Behavior; Social Behavior Disorders; Substance-Related Disorders; Suicide, Attempted; Time Factors

Delta-THC (10 mg/kg, i.p.) administered to mice immediately after withdrawal from a 3-day exposure to ethanol vapor was found to intensify withdrawal reactions. No effect was seen when delta-THC was administered chronically during the exposure to ethanol.

Topics: Alcoholism; Animals; Cannabis; Dronabinol; Ethanol; Humans; Male; Mice; Pyrazoles; Substance Withdrawal Syndrome

Topics: Adolescent; Alcoholism; Attitude; Caffeine; Cannabis; Female; Heroin; Homosexuality; Humans; Lysergic Acid Diethylamide; Male; Nicotine; Sex; Sex Education; Sexual Behavior; Substance-Related Disorders

A survey of 497 women, all of whom solicited partners from among American soldiers, indicated that 15% of this Thai population uses drugs and/or alcohol daily. Since behavioral observation made during this interview, as well as inconsistencies in responses on the survey, strongly suggested a reluctance to report drug use, it is judged that reported drug use represents an underestimate of true daily usage rate. The influence of transactions between these Thai women and their American associates upon drug use in each group was assessed from the perspective of the Thai informants. There appears to neither a great deal of drug use by Americans induced by interpersonal relationships with these Thai women, nor a great deal of Thai drug use which can be directly attributed to the influence of American soldiers. Alternate methods of data collection are suggested to substantiate this finding. An in-depth study of the relations established between these respondents and their American partners is planned to better interpret these results.

Topics: Adolescent; Adult; Alcoholism; Amphetamines; Cannabis; Female; Humans; Interpersonal Relations; Middle Aged; Military Psychiatry; Substance-Related Disorders; Thailand; United States

Topics: Adult; Aging; Alcohol Drinking; Alcoholism; Amphetamines; Cannabis; Child; Coffee; Germany, West; Humans; Military Medicine; Opium; Smoking; Smoking Prevention; Substance-Related Disorders

The author describes a model of intoxicant use based on altered states of consciousness and reviews his own and others' research on marijuana to illustrate the utility of this model, which is derived from both introspective reports and observed data. The relationship of social behavior and cognitive functioning to the "intoxication state of consciousness" is discussed. This state of consciousness may have an adaptive value in engendering and stabilizing social cohesion. Possible treatment implications include cognitive labeling of cues that precipitate episodes of abuse, training for moderated drug use while patients are intoxicated, and providing abusers with altered consciousness through other means, such as meditation.

Topics: Alcoholic Intoxication; Alcoholism; Cannabis; Consciousness; Contingent Negative Variation; Humans; Models, Neurological; Models, Psychological; Social Behavior; Substance-Related Disorders

Results of personality inventories completed by patients in three alcoholism treatment and two control groups revealed differences between the personality profiles of these groups, suggesting that different types of programs attract different types of clients.

Topics: Adult; Alcoholism; Amphetamine; Barbiturates; Cannabis; Ego; Halfway Houses; Heroin Dependence; Hospitals, Psychiatric; Hospitals, Veterans; Humans; Ill-Housed Persons; Lysergic Acid Diethylamide; Male; Manifest Anxiety Scale; Middle Aged; MMPI; Personality; Self Concept; Social Desirability

Data collected from detailed autobiographies of 77 convicted rapists revealed that 50 percent of them were drinking at the time of the rape and that 35 percent were alcoholics. This strong association between alcoholism and forcible rape highlights the importance of follow-up treatment programs for the alcoholic sex offender; such programs should focus on adequate control of his drinking behavior as well as on his sexual adjustment.

Topics: Adult; Age Factors; Alcoholic Intoxication; Alcoholism; California; Cannabis; Educational Status; Ethnicity; Family Characteristics; Humans; Male; Rape; Religion; Social Class; Substance-Related Disorders

Samples of six specific groups (both students and adults) were intensively surveyed on their differential attitudes toward the use and sale of eight drug types. Resulting comparisons between groups, drugs, and attitudes provide a relative picture of the attitudes on drug sale and use held by those surveyed.

Topics: Adolescent; Adult; Alcoholism; Amphetamine; Attitude; Barbiturates; Cannabis; Cocaine; Drug and Narcotic Control; Faculty; Female; Hallucinogens; Heroin; Heroin Dependence; Humans; Legislation, Drug; Male; Parents; Smoking; Students; Substance-Related Disorders; United States

Five hundred eighty-nine adult participants in 10-day drug education courses held at the National Center for Drug Education in Oklahoma were tested before and after each course to assess changes in their attitudes toward drug use and abuse resulting from the course. Twenty-eight opinion statements were found to significantly distinguish the opinions of different occupational groups both before and after the course. Most participants changed their learning priorities for drug education as a result of the course. Participants' personal history of drug use correlated with changes in their learning priorities for drug education.

Topics: Adult; Alcoholism; Amphetamine; Attitude; Barbiturates; Caffeine; Cannabis; Curriculum; Female; Hallucinogens; Health Education; Humans; Male; Middle Aged; Military Medicine; Occupations; Oklahoma; Self Concept; Smoking; Social Perception; Substance-Related Disorders; Teaching Materials

Topics: Alcoholism; Animals; Cannabis; Genitalia, Male; Heroin; Heroin Dependence; Humans; Male; Methadone; Spermatogenesis; Substance-Related Disorders; Testosterone

Ninety-seven young non-psychotic men with intravenous opiate abuse, who had been admitted to a psychiatric hospital, were seen at follow-up 3 years after admission. All were traced. At follow-up, 19% were abstinent, 9% had died, whereas the remainder were still addicted. Those who had become abstinent had done so around the age of 20 and/or before they had been addicted to opiate for 3-4 years, almost regardless of the time at which their total drug abuse had started.

Topics: Adult; Age Factors; Alcoholism; Cannabis; Follow-Up Studies; Hospitalization; Humans; Lysergic Acid Diethylamide; Male; Morphine Dependence; Opium; Prognosis; Substance-Related Disorders; Time Factors

Comparisons were made between alcoholics and nonalcoholics in a sample of Danish adoptees (mean age 30) and it was found that the alcoholics, as children, were more often hyperactive, truant, antisocial, shy, aggressive, disobedient, and friendless. The literature suggesting a relationship between the hyperactive child syndrome and subsequent alcoholism is reviewed, as well as a possible relationship between these disorders and antisocial behavior. The adoptive parent of the two groups did not differ with regard to socioeconomic class, psychopathology, or drinking histories. However, 10 of the 14 alcoholics had biological parents who were alcoholic, with no known alcoholism among the biological parents of the nonalcoholics. As adults, the alcoholics differed from the nonalcoholics only with regard to drinking history, use of drugs, and overt expression of anger.

Topics: Adoption; Adult; Aggression; Alcoholism; Anger; Cannabis; Humans; Hyperkinesis; Hypnotics and Sedatives; Impulsive Behavior; Interpersonal Relations; Juvenile Delinquency; Male; Middle Aged; Social Behavior; Substance-Related Disorders

The authors surveyed the frequency of alcohol use in individuals identified as practitioners of Transcendental Meditation (N equals 126) and a matched control group (N equals 90). No control subjects reported discontinuation of beer and wine use; 40 percent of subjects who had meditated for more than 2 years reported discontinuation within the first 6 months. After 25-39 months of meditation, this figure increased to 60 percent. In addition, 54 percent of this group, versus 1 percent of the control group, had stopped drinking hard liquor. The authors suggest that meditation could be an effective preventive tool in the area of alcohol abuse.

Topics: Adult; Age Factors; Alcohol Drinking; Alcoholic Beverages; Alcoholism; Arousal; Cannabis; Female; Humans; Male; Periodicity; Phytotherapy; Relaxation; Sex Factors; Smoking Prevention; Substance-Related Disorders; Thinking

Topics: Adolescent; Alcoholism; Amphetamines; Cannabis; Drug Prescriptions; Female; Hallucinogens; Humans; Hypnotics and Sedatives; Male; Narcotics; Smoking; Substance-Related Disorders

A study of the correlates of drug use (marijuana, LSD, mescaline, speed) among high school youth in a rural, Midwestern community indicated that peer group factors were the most influential in such behavior. Also, youth from less intact families and whose parents were perceived to use various legal drugs were more prone to drug use. Drug education was seen as not having as significant an impact in differentiating between users and nonusers nor in deterring users from further involvement. In support of previous research, we conclude that drug use is a form of behavior learned through peer and family socialization.

Topics: Adolescent; Age Factors; Alcoholism; Barbiturates; Cannabis; Educational Status; Family; Female; Health Education; Humans; Illinois; Lysergic Acid Diethylamide; Male; Mescaline; Parent-Child Relations; Peer Group; Rural Population; Sex Factors; Smoking; Students; Substance-Related Disorders

Unsatisfactory intrafamilial relationships and child-rearing practices have frequently been implicated as prime determinants of personalities that are susceptible to drug and alcohol abuse. Five thousand forty-four US Army soldiers were surveyed by anonymous questionnaires. The reported occurrence of a variety of activities, events and behaviors in childhood among drug and alcohol abusers were compared to non users. Childhood antecedents that were associated with non-use of illegal drugs and which showed as much as a 20% difference in reported occurrence between abusers and non-users of illegal drugs were: spanking, church attendance, first alcoholic drink after 15 years, and perceived "happy" parental marriage. These associations were found uithin white and non-white groups and in subjects with divorced or separated parents. There was no antecedent that showed as much as a 20% difference in reported occurrence between alcohol abusers and non-users.

Topics: Adolescent; Adult; Alcoholism; Amphetamines; Cannabis; Child Rearing; Germany, West; Humans; Interpersonal Relations; Male; Military Psychiatry; Opium; Substance-Related Disorders; United States

Topics: Alcoholism; Amphetamines; Barbiturates; Canada; Cannabis; Hallucinogens; Humans; Lysergic Acid Diethylamide; Opium; Smoking; Substance-Related Disorders; Tranquilizing Agents

Topics: Adult; Alcoholism; Boston; Cannabis; Depression; Emotions; Follow-Up Studies; Heroin Dependence; Humans; Internal-External Control; Male; Naloxone; Naltrexone; Patient Acceptance of Health Care; Patient Dropouts; Psychotherapy; Self Concept; Sleep

Topics: Alcoholism; Animals; Cannabis; Central Nervous System Stimulants; Cocaine; Dogs; Haplorhini; Humans; Hypnotics and Sedatives; Lysergic Acid Diethylamide; Mescaline; Morphine Dependence; Rats; Substance Withdrawal Syndrome; Substance-Related Disorders; Tranquilizing Agents

Topics: Adolescent; Adult; Age Factors; Alcoholism; Attitude; Cannabis; Central Nervous System Stimulants; Demography; Educational Status; Ethnicity; Female; Georgia; Hallucinogens; Humans; Lysergic Acid Diethylamide; Male; Narcotics; Religion; Sex Factors; Smoking; Students; Substance-Related Disorders; Surveys and Questionnaires; Tranquilizing Agents; Universities

Topics: Adult; Alcoholism; Barbiturates; Cannabis; Diazepam; Drug Combinations; Drug Therapy, Combination; Female; Germany, West; Hospitals, General; Humans; Male; Methadone; Morphinans; Opium; Promethazine; Psychotherapy; Substance Withdrawal Syndrome; Substance-Related Disorders; Thiazines

Topics: Alcohol Drinking; Alcoholism; Automobile Driving; Cannabis; Ethanol; Humans; Scandinavian and Nordic Countries; United Kingdom; United States

Topics: Adolescent; Alcohol Drinking; Alcoholism; Attitude; Cannabis; Family Characteristics; Humans; Juvenile Delinquency; Maternal Deprivation; Parents; Paternal Deprivation; Psychotropic Drugs; Social Conformity; Substance-Related Disorders; United States

Topics: Adolescent; Adult; Age Factors; Alcohol Drinking; Alcoholism; Amphetamine; Attitude; Attitude of Health Personnel; Attitude to Health; Barbiturates; Cannabis; Communication; Drug and Narcotic Control; Faculty; Health Education; Heroin; Humans; Illinois; Lysergic Acid Diethylamide; Middle Aged; Smoking; Social Control, Informal; Students; Substance-Related Disorders

Topics: Adolescent; Adult; Aggression; Alcoholism; Amphetamine; Barbiturates; California; Cannabis; Cocaine; Criminal Psychology; Ethanol; Ethnicity; Heroin; Humans; Male; Prisoners; Psychotropic Drugs; Secobarbital; Sex Offenses; Social Class; Substance-Related Disorders; Violence

Topics: Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Female; Hallucinogens; Humans; Income; Male; Occupations; Opium; Sex Factors; Social Class; Social Values; Students; Substance-Related Disorders; Surveys and Questionnaires; United States; Universities

Topics: Achievement; Adolescent; Alcoholism; Amphetamine; Attitude; Barbiturates; California; Cannabis; Community Mental Health Services; Drug and Narcotic Control; Female; Hallucinogens; Humans; Male; Opium; Social Class; Social Values; Substance-Related Disorders

Topics: Alcoholism; Amphetamine; Barbiturates; Cannabis; Civil Rights; Community Health Services; Criminal Psychology; Ethnicity; Heroin Dependence; Homicide; Humans; Legislation, Drug; Methadone; Substance-Related Disorders; United States; Violence

Topics: Adolescent; Alcoholism; Amphetamine; Attitude; Awareness; Barbiturates; Cannabis; Cocaine; Female; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Male; Mescaline; Peer Group; Religion and Psychology; Self Concept; Smoking; Social Alienation; Students; Substance-Related Disorders; United States

Topics: Adolescent; Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Heroin; Humans; Lysergic Acid Diethylamide; New York City; Smoking; Students; Substance-Related Disorders; Tranquilizing Agents

Topics: Adolescent; Age Factors; Alcoholism; Cannabis; Child; Family Characteristics; Female; Germany, West; Humans; Lysergic Acid Diethylamide; Male; Personality Disorders; Smoking; Social Problems; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Absenteeism; Achievement; Adolescent; Aggression; Alcoholism; Cannabis; Criminal Psychology; Curriculum; Humans; Juvenile Delinquency; Male; New York; Self-Assessment; Social Class; Substance-Related Disorders

Topics: Alcoholism; Ambulatory Care; Amphetamines; Barbiturates; Cannabis; Cocaine; Financing, Government; Heroin Dependence; Hospitalization; Humans; Legislation, Drug; Lysergic Acid Diethylamide; Substance-Related Disorders; United States

Topics: Alcoholism; Attitude; Birth Order; Cannabis; Curriculum; Dominance-Subordination; Educational Status; Family; Female; Humans; Male; Personal Satisfaction; Personality; Politics; Religion; Sex Factors; Smoking; Social Adjustment; Social Class; Social Conformity; Students; Substance-Related Disorders; United Kingdom; Universities

Topics: Adolescent; Adult; Alcoholism; Analgesics; Barbiturates; Canada; Cannabis; Female; Humans; Lysergic Acid Diethylamide; Male; Self Disclosure; Sex Factors; Smoking; Substance-Related Disorders; Tranquilizing Agents

Complications resulting from drug abuse more frequently affect the lung than any other organ. The spectrum of pulmonary complications associated with drug abuse is wide. The current practice of using mixtures of drugs is mainly responsible for the increase in pulmonary complications. The chief complications observed in a series of 241 drug abuse patients were aspiration pneumonitis (12.9 percent), pulmonary edema (10.0 percent), and pneumonia (7.5 percent).

Topics: Adult; Alcoholism; Barbiturates; Cannabis; Cocaine; Coma; Female; Heroin; Humans; Lung Abscess; Lung Diseases; Male; Pneumonia; Pneumonia, Aspiration; Pulmonary Atelectasis; Pulmonary Edema; Pulmonary Embolism; Pulmonary Fibrosis; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cannabis; Cocaine; Female; Hallucinations; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Male; Memory Disorders; Opium; Sex Factors; Smoking; Substance-Related Disorders; Switzerland

Topics: Alcoholism; Amphetamine; Barbiturates; California; Cannabis; Cocaine; Drug Prescriptions; Ethanol; Hallucinogens; Humans; Hypnotics and Sedatives; Morphinans; Narcotics; Nicotiana; Nonprescription Drugs; Plants, Toxic; Societies, Medical; Solvents; Substance-Related Disorders; Tranquilizing Agents

Topics: Adolescent; Age Factors; Alcoholism; Amphetamine; Attitude of Health Personnel; Cannabis; Child; Coca; Community Mental Health Services; Culture; Environment; Evaluation Studies as Topic; Family Characteristics; Female; Hallucinogens; Humans; Life Style; Male; Opium; Peer Group; Plants, Medicinal; Research; Social Desirability; Socioeconomic Factors; Substance-Related Disorders; World Health Organization

Topics: Adolescent; Alcoholism; Amphetamine; Barbiturates; Cannabis; Hallucinogens; Humans; Motivation; Opium; Social Behavior Disorders; Substance-Related Disorders; Tranquilizing Agents

Topics: Affective Symptoms; Alcoholism; Attitude; Cannabis; Criminal Psychology; Extraversion, Psychological; Humans; Income; Jamaica; Mental Disorders; Occupations; Personality Inventory; Social Class; Social Mobility; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Drug and Narcotic Control; Health Education; Humans; Lysergic Acid Diethylamide; Netherlands; Personality; Physician-Patient Relations; Social Values; Substance-Related Disorders; United States

Topics: Alcoholism; Cannabis; Family; Female; Humans; Hypnotics and Sedatives; Male; Personality Inventory; Smoking; Socioeconomic Factors; Substance-Related Disorders; Switzerland

Topics: Adolescent; Adult; Age Factors; Alcoholism; Amphetamine; Cannabis; Child; Drug and Narcotic Control; Female; Heroin; Heroin Dependence; Humans; Hypnotics and Sedatives; Lysergic Acid Diethylamide; Male; Solvents; Substance-Related Disorders; Tranquilizing Agents; United States

Topics: Alcoholism; Attitude; Cannabis; Female; Humans; Male; Substance-Related Disorders; Voluntary Health Agencies

Topics: Adolescent; Alcoholism; Cannabis; Child; Family; Female; Hallucinogens; Humans; Indians, North American; Male; New Mexico; Petroleum; Social Environment; Substance-Related Disorders; Surveys and Questionnaires

Topics: Alcoholism; Animals; Cannabis; Conditioning, Operant; Dose-Response Relationship, Drug; Drinking Behavior; Dronabinol; Eating; Electric Stimulation; Ethanol; Humans; Hypothalamus; Male; Models, Biological; Neurons; Rats; Reinforcement Schedule; Self Stimulation; Substance-Related Disorders

Topics: Accidents, Traffic; Alcohol Drinking; Alcoholism; Attitude to Health; Australia; Automobile Driving; Cannabis; Costs and Cost Analysis; Dose-Response Relationship, Drug; Dronabinol; Drug and Narcotic Control; Ethanol; Humans; Legislation, Drug; Lung Neoplasms; Mental Processes; Smoking; Social Alienation; Social Values; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Attitude of Health Personnel; Cannabis; Ethnicity; Female; Health Education; Heroin Dependence; Humans; Male; Massachusetts; Middle Aged; Opium; Physicians; Social Control, Formal; Social Problems; Societies, Medical; Socioeconomic Factors; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcohol Drinking; Alcoholism; Amphetamine; Cannabis; Hallucinogens; Health Education; Humans; Hypnotics and Sedatives; Lysergic Acid Diethylamide; Occupational Health Services; Occupational Medicine; Opium; Oregon; Smoking; Students; Substance-Related Disorders

Topics: Adolescent; Age Factors; Alcoholism; Amphetamine; Arizona; Cannabis; Child; Ethanol; Female; Heroin; Humans; Internal-External Control; Juvenile Delinquency; Lysergic Acid Diethylamide; Male; Prisoners; Psychological Tests; Self Concept; Substance-Related Disorders

Topics: Administration, Oral; Adolescent; Adult; Alcoholism; Amphetamine; Cannabis; Educational Status; Family; Female; Humans; Injections, Intravenous; Lysergic Acid Diethylamide; Male; Meperidine; Methadone; Morphine; Narcotics; Norway; Opium; Phenmetrazine; Social Problems; Socioeconomic Factors; Substance-Related Disorders; Time Factors; Unemployment

Topics: Adolescent; Alcoholism; Amphetamine; California; Cannabis; Child; Community Health Services; Emergencies; Heart Massage; Heroin; Heroin Dependence; Humans; Interpersonal Relations; Lysergic Acid Diethylamide; Narcotic Antagonists; Respiration, Artificial; Scopolamine; Social Conformity; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcohol Drinking; Alcoholic Intoxication; Alcoholism; Amphetamine; Cannabis; Cross-Cultural Comparison; Defense Mechanisms; Family; Female; Germany, West; Humans; Lysergic Acid Diethylamide; Male; Military Medicine; Military Personnel; Sex Factors; Smoking; Stress, Psychological; Substance-Related Disorders; United States; Vietnam

Topics: Adolescent; Adult; Alcoholism; Amphetamine; Cannabis; Crime; Erotica; Female; Heroin Dependence; Humans; Legislation, Drug; Lysergic Acid Diethylamide; Male; Middle Aged; Narcotics; Substance-Related Disorders; United Kingdom; United States

Topics: Alcoholism; Cannabis; England; Ethics; Female; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Male; Mysticism; Opium; Smoking; Social Conformity; Socioeconomic Factors; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Barbiturates; Black or African American; Cannabis; Cocaine; Hallucinations; Heroin Dependence; Humans; Male; Medical History Taking; Morphine Dependence; Pennsylvania; Seizures; Substance-Related Disorders; Therapeutic Community; White People

Topics: Alcoholism; Cannabis; Carbon Tetrachloride Poisoning; Child; Female; Humans; Lysergic Acid Diethylamide; Psychoses, Substance-Induced; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Datura stramonium; Drug Combinations; Ephedrine; Expectorants; Fenfluramine; Humans; Lysergic Acid Diethylamide; Male; Military Medicine; Opium; Phytotherapy; Plants, Medicinal; Plants, Toxic; South Africa; Substance-Related Disorders; Time Factors

Topics: Affective Symptoms; Alcoholism; Analgesics; Cannabis; Cathartics; Humans; Hypnotics and Sedatives; Substance-Related Disorders

Topics: Alcoholism; Barbiturates; Cannabis; Cross-Cultural Comparison; Humans; Income; India; Meperidine; Meprobamate; Morphine Dependence; Occupations; Opium; Residence Characteristics; Socioeconomic Factors; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cannabis; Child; Drug and Narcotic Control; Humans; Legislation as Topic; Substance-Related Disorders; United States

Topics: Alcohol Drinking; Alcoholism; Cannabis; Delayed-Action Preparations; Disulfiram; Heroin; Humans; Methadone; Morphine Dependence; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Alcoholism; Amphetamine; Attitude to Health; Barbiturates; Cannabis; Demography; Hallucinogens; Health Education; Heroin; Humans; Male; Military Medicine; Substance-Related Disorders; Surveys and Questionnaires; United States

Topics: Alcoholism; Cannabis; Humans; Legislation, Drug; Lysergic Acid Diethylamide; Rehabilitation; Social Control, Formal; Social Problems; Social Values; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Humans; Phytotherapy

Topics: Adolescent; Alcoholism; Cannabis; Humans; Motivation; Psychopathology; Puberty; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cannabis; Humans; Lysergic Acid Diethylamide; Scotland; Substance-Related Disorders

Topics: Adolescent; Alcoholism; Cannabis; Drug and Narcotic Control; Heroin; Humans; Jurisprudence; Lysergic Acid Diethylamide; Physician-Patient Relations; Social Problems; Substance-Related Disorders; United States

Topics: Adolescent; Adult; Affective Symptoms; Age Factors; Aggression; Alcoholism; Cannabis; Europe; Exploratory Behavior; Family; Frustration; Heroin; Humans; Lysergic Acid Diethylamide; Middle Aged; Opium; Physical Therapy Modalities; Puberty, Precocious; Social Conditions; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Depression; Humans; Phytotherapy

Topics: Alcoholism; Cannabis; Heroin; Humans; Methadone; Phytotherapy; Substance-Related Disorders

Topics: Adult; Age Factors; Aged; Alcoholism; Amphetamine; Barbiturates; Cannabis; Family Characteristics; Female; Hospitalization; Humans; Male; Mental Disorders; Middle Aged; Narcotics; New Zealand; Occupations; Sex Factors; Socioeconomic Factors; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Disulfiram; Female; Humans; Middle Aged; Phytotherapy

Topics: Alcoholism; Cannabis; Humans; Lysergic Acid Diethylamide; Public Health; Social Problems; United States

Topics: Adolescent; Alcohol Drinking; Alcoholism; Amphetamine; Barbiturates; Black or African American; Cannabis; Crime; Educational Status; Follow-Up Studies; Heroin; Humans; Male; Occupations; Opium; Sexual Behavior; Substance-Related Disorders; Violence

Topics: Alcoholism; Cannabis; France; History, 19th Century; Humans; Substance-Related Disorders; United Kingdom

Topics: Alcoholism; Amphetamine; Cannabis; Humans; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adolescent Psychiatry; Adult; Alcoholism; Amphetamine; Cannabis; Ego; Female; Heroin; Homosexuality; Humans; Lysergic Acid Diethylamide; Male; Opium; Personality Development; Psychoanalytic Therapy; Psychotic Disorders; Substance-Related Disorders

Topics: Adolescent; Adult; Aged; Alcoholism; Amphetamine; Analgesics; Barbiturates; Cannabis; Cocaine; Female; Hallucinogens; Heroin; Humans; Hypnotics and Sedatives; Male; Middle Aged; Morphinans; Opium; Phytotherapy; Prognosis; Substance-Related Disorders; Tranquilizing Agents

Topics: Adult; Alcoholism; Anxiety; Cannabis; Combat Disorders; Emotions; Environment; Hospitals, Psychiatric; Humans; Interpersonal Relations; Male; Mental Disorders; Middle Aged; Milieu Therapy; Military Psychiatry; Motivation; Personality Disorders; Psychoses, Substance-Induced; Psychotic Disorders; Schizophrenia; Social Work, Psychiatric; Substance-Related Disorders; Vietnam; Warfare

Topics: Accidents, Traffic; Alcoholic Intoxication; Alcoholism; Cannabis; Humans; Substance-Related Disorders

Topics: Alcoholism; Cannabis; Humans; Nursing; Substance-Related Disorders; Uganda

Dr T H Bewley discusses recent increases in the incidence of all types of drug dependence in Great Britain.Dr P H Connell considers the problem of amphetamine dependence historically and in different age groups and draws attention to the sociocultural patterns of behaviour which have sprung up amongst the adolescent and young adult population. Treatment is discussed.Dr R H V Ollendorff outlines a theory of drug addiction based upon seven aetiological factors, and stresses the importance of the general practitioner in treating the addict.

Topics: Adult; Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Female; Hallucinogens; Heroin; Humans; Lysergic Acid Diethylamide; Middle Aged; Morphine Dependence; Substance-Related Disorders; United Kingdom

Topics: Adolescent; Adult; Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; Hepatitis A; Hepatitis B; Heroin; Humans; Lysergic Acid Diethylamide; Male; Middle Aged; Opium; Phenothiazines; Prisons; Psychotic Disorders; Sepsis; Smoking; Substance-Related Disorders; United Kingdom

Topics: Alcoholism; Cannabis; Humans; Lysergic Acid Diethylamide; Substance-Related Disorders

Topics: Alcoholism; Amphetamine; Barbiturates; Cannabis; Cocaine; England; Hallucinogens; Heroin; Humans; Morphine; Opium; Social Problems; Substance-Related Disorders; World Health Organization

Topics: Alcoholism; Caffeine; Cannabis; Central Nervous System; Cocaine; Drug Hypersensitivity; Hallucinogens; History, 16th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Lithium; Mercury Poisoning; Morphine Dependence; Penicillins; Pharmacology; Poisoning; Smoking; Substance-Related Disorders; Syphilis; Technology; Thalidomide; Triparanol

Topics: Adolescent; Adult; Alcoholism; Amphetamine; Cannabis; Denmark; Female; Hallucinogens; Humans; Hypnotics and Sedatives; Male; Opium; Psychoses, Substance-Induced; Substance-Related Disorders

Topics: Alcoholism; Amphetamine; Barbiturates; Cannabis; Compulsive Behavior; Ethanol; Glutethimide; Health Education; Health Surveys; Humans; Narcotics; Personality; Pharmacology; Physicians; Substance-Related Disorders; Toxicology; Tranquilizing Agents

Topics: Alcoholism; Cannabis; Cocaine; Humans; Opium; Substance-Related Disorders; Toxicology

Topics: Alcoholism; Amphetamine; Amphetamines; Analgesics; Analgesics, Non-Narcotic; Antipyretics; Barbiturates; Cannabis; Ergot Alkaloids; Humans; Hypnotics and Sedatives; Iatrogenic Disease; Legislation, Medical; Meprobamate; Procaine; Psychiatry; Substance-Related Disorders; United States

Topics: Alcoholism; Benzopyrans; Cannabis; Humans; Mental Health Services; North Carolina; Substance Withdrawal Syndrome; Substance-Related Disorders