Addiction最新文献

Background and aims: Gambling is a public health issue and widespread advertising of gambling products may contribute to gambling harms. Sports-related gambling advertising includes advertising around sports games or for sports betting products. This review aimed to provide the most systematic and up-to-date review of the literature on the association between sports-related gambling advertising and gambling behaviour.

Methods: A systematic literature search of quantitative studies up to 13 February 2024 was undertaken following PRISMA guidelines. Inclusion criteria were quantitative studies published in the English language exploring the association between sports-related gambling advertising and gambling behaviour. Traditional database searches (Medline, Scopus, PsychInfo, Web of Science, CINAHL and The Cochrane Library) were undertaken alongside citation, author and website searches. Studies were narratively synthesised, and the overall quality of the evidence was assessed using the Mixed Methods Appraisal Tool (MMAT).

Results: Twenty-two studies were included in this review covering traditional, digital, direct, embedded, inducement and aggregate advertising. The majority (n = 16) of research was undertaken in Australia on adult populations. Results suggest that sports-related gambling advertising is associated with increases in perceived, intended and actual frequency of (n = 6 studies) and expenditure on (n = 3) gambling, unplanned or unintended gambling (n = 2), the likelihood of gambling (n = 2), the likelihood of using a sponsor's product (n = 2) and, in some cases, the complexity or riskiness of bets placed (n = 2). Studies suggest that the self-reported effect may be more pronounced in higher-risk gamblers (n = 7). Preliminary evidence suggests that specific inducements which reduce the riskiness or cost of gambling appear to be particularly influential (n = 3). Limitations of the evidence base include the lack of standardised measures and use of observational designs.

Conclusions: Exposure to sports-related gambling advertising appears to be associated with increased gambling behaviour for a wide range of advertising media. This association may be more pronounced in higher-risk gamblers who are already at increased risk of harm.

Background and aim: Cannabis use disorder (CUD) is strongly influenced by genetic factors; however the mechanisms underpinning this association are not well understood. This study investigated whether a polygenic risk score (PRS) based on a genome-wide association study for CUD in adults predicts cannabis use in adolescents and whether the association can be explained by inter-individual variation in structural properties of brain white matter or risk-taking behaviors.

Design and setting: Longitudinal and cross-sectional analyses using data from the IMAGEN cohort, a European longitudinal study integrating genetic, neuroimaging and behavioral measures. We measured associations between PRS for CUD, novelty and sensation seeking traits and fractional anisotropy (FA) of white matter tracts. Mediation modeling explored whether novelty seeking and FA mediated the association between the PRS and cannabis use.

Participants: Participants were assessed at 14 (n = 1762), 19 (n = 1175) and 23 (n = 1139) years old.

Measurements: European School Survey Project on Alcohol and Other Drugs, substance use risk profile scale, Fagerstrom Test for Nicotine Dependence, temperament and character inventory, Kirby Monetary Questionnaire, diffusor tensor imaging and CUD-PRS.

Findings: CUD-PRS was associated with adolescent total cannabis exposure [P < 0.001, beta = 0.098 (95% confidence interval = 0.059, 0.137)] as well as with other substance use measures [alcohol P = 0.002, beta = 0.058 (0.020, 0.096); cigarettes smoked P < 0.001, beta = 0.086 (0.044, 0.128); fargestrom score P < 0.001, beta = 0.062 (0.028, 0.096); drug score P < 0.001, beta = 0.106 (0.065, 0.147)]. CUD-PRS was also associated with impulsivity, risk-taking behaviors [impulsivity P < 0.001, beta = 0.106 (0.060, 0.142); sensation seeking P < 0.001, beta = 0.094 (0.0523, 0.1357); novelty seeking P < 0.001, beta = 0.105 (0.064, 0.146); discounting task P < 0.001, beta = 0.051 (0.013, 0.089)] and average FA [P < 0.001, beta = -0.010 (-0.015, -0.005)]. Longitudinal mediation models showed that these behaviors and brain measures could mediate the association of PRS with cannabis use [overall indirect effect for novelty seeking P < 0.001, beta = 0.048 (0.028, 0.068); impulsivity P = 0.016, beta = 0.019 (0.004, 0.035); sensation seeking P < 0.001, beta = 0.034 (0.017, 0.05)].

Conclusions: The genetic risk of adult cannabis use disorder appears to be associated with substance use behavior and white matter structure as early as age 14. The observed mediation effect is consistent with the notion that genetic risk increases novelty seeking in a way that leads to more cannabis use in adolescents.

Background and aims: Medication is the gold standard to support a healthy pregnancy for pregnant people with opioid use disorder (OUD). This study measured inequities and differences in OUD medication treatment among pregnant people in Oregon, USA.

Design, setting, participants and measurements: Our study population consisted of Medicaid enrollees across the US state of Oregon who had at least one live hospital birth between 2012 and 2020 and one diagnosis of OUD prenatally (n = 4363). We measured differences in demographic characteristics (age, race, ethnicity, location) among those with and without medication for OUD in the prenatal through 3-months postpartum period (any medication use, and by type), and compared exclusive methadone versus buprenorphine receipt. We report unadjusted and adjusted odds ratios.

Findings: Adjusted odds ratios for medication for OUD were lower among American Indian/Alaska Native pregnant people compared with White pregnant people [adjusted odds ratio (aOR) 0.59 (95% confidence interval [CI] = 0.42, 0.83)], younger pregnant people compared with those aged 30-34 years [aOR, ages 15-19: 0.1 (95 CI = 0.06, 0.18); aOR, ages 20-24: 0.58 (95 CI = 0.49, 0.69)] and rural pregnant people compared with those in urban communities [aOR 0.58 (95 CI = 0.5-0.67)]. Rural pregnant people with OUD also had lower odds of methadone receipt [aOR 0.23 (95 CI = 0.17, 0.3)] and higher odds of buprenorphine receipt [aOR 3.99 (95 CI = 2.97, 5.35)] than other people in this study. Among those who received medication, Black pregnant people had increased odds of receiving methadone compared with buprenorphine [aOR 2.09 (95 CI = 1.1-3.97)].

Conclusions: In Oregon, USA, inequities in receipt of any medication for opioid use disorder were observed among pregnant people who identified as American Indian or Alaska Native, younger than 25, and living in rural communities. Black pregnant people in Oregon, USA, were more likely to receive methadone than buprenorphine.

Background: This paper invites discussion on whether pleasure should receive more attention in public health-oriented research on alcohol. While there is a history of sociological and anthropological literature exploring alcohol and pleasure, this is much less common in public health-oriented alcohol research, and associated advocacy.

Argument: We propose three broad reasons why more extensive engagement with issues of pleasure may be important for public health-oriented research. The first is epistemological: because overlooking pleasure risks leaving a gap in knowledge of a key component of, and motive for, drinking. The second is ethical: because the prioritisation of long-term health over shorter-term pleasures is not uncontested, and needs to be explicitly justified. The third is pragmatic: because ceding the discourse on pleasure to other actors (including commercial ones) risks undermining effective engagement with target populations.

Conclusions: There is strong case for more attention to pleasure in public health-oriented alcohol research. Key to this is the further development of interdisciplinary perspectives and mixed-methods research. This brings both conceptual and methodological challenges, many of which remain unresolved; however, bringing these issues to the surface may enable greater clarity on both normative principles (including arguments against research engaging with pleasure) and practical questions concerning the design of research and analysis in this area.

Background and aims: Evidence from high-income countries has linked duration and compliance with treatment for substance use disorders (SUDs) with reductions in substance use and improvements in mental health. Generalizing these findings to other regions like South America, where opioid and injection drug use is uncommon, is not straightforward. We examined if length of time in treatment and compliance with treatment reduced subsequent substance use and presence of psychiatric comorbidities.

Design: Prospective cohort analysis (3 assessments, 18 months) using inverse probability weighting to account for confounding and loss to follow-up.

Settings: Outpatient/inpatient programs in Región Metropolitana, Chile.

Participants: Individuals initiating publicly funded treatment (n = 399).

Measurements: Exposures included length of time in (0-3, 4-7, 8 + months, currently in) and compliance with treatment (not completed, completed, currently in) measured in the intermediate assessment (12 months). Primary outcomes were past-month use of primary substance (most problematic) and current psychiatric comorbidities (major depressive episode, panic, anxiety or post-traumatic stress disorders) measured 6 months later (18 months). Secondary outcomes included past month use of alcohol, cannabis, cocaine powder and cocaine paste.

Findings: 18.3% [95% confidence interval (CI) = 14.7%-22.6%] of individuals participated for 3 or fewer months in treatment and 50.1% (95% CI = 45.2%-55.1%) did not complete their treatment plan at 12 months. Participating for 8 + months in treatment was associated with lower risk of past month use of primary substance at 18 months [vs. 0-3 months, risk ratio (RR) = 0.62, 95% CI = 0.38-1.00] and completion of treatment (vs. not completed, RR = 0.49, 95% CI = 0.30-0.80). Neither participating 8 + months (vs. 0-3 months, RR = 0.83, 95% CI = 0.57-1.22) nor treatment completion (vs. not completed, RR = 1.02, 95% CI = 0.72-1.46) were associated with lower risk of psychiatric comorbidity at 18 months.

Conclusions: Longer time in treatment and compliance with treatment for substance use disorders in Chile appears to be associated with lower risk of substance use but not current comorbid psychiatric conditions 18 months after treatment initiation.

Aims: This study aimed to determine the effect of vaporized cannabidiol (CBD) on visual function and vehicle driving performance, given the growing popularity of CBD use worldwide.

Design: Randomized, double-blind, placebo-controlled cross-over experimental study.

Setting: Laboratory of Vision Sciences and Applications, University of Granada, Spain.

Participants: Thirty participants were recruited through advertisements placed in the local newspaper and distributed among the university community. They had a mean age of 26.2 (6.2) years, and 70% were male. All of them were occasional users of CBD or cannabis, and held valid driving licenses.

Interventions: Three experimental sessions, conducted one week apart, in which a placebo, 15% CBD (16 mg) or 30% CBD (32 mg) was vaporized.

Measurements: The primary endpoint for driving performance was the overall driving performance score (ODPS). Secondary outcomes included visual function variables such as static and dynamic visual acuity, stereoacuity, contrast sensitivity, motion detection and other driving performance parameters such as mean speed, lateral vehicle control or reaction time.

Findings: Comparisons revealed no statistically significant changes in ODPS after vaporizing CBD at 15% or 30% compared with the placebo (χ² = 0.479; P = 0.787). Visual function remained largely unchanged, with only a statistically significant decrease in motion detection (χ² = 7.980; P = 0.018). Similarly, no statistically significant differences were found in driving performance secondary outcomes, such as the standard deviation of lateral lane position (χ² = 0.068; P = 0.966), distance travelled outside the lane (χ² = 2.530; P = 0.282), reaction time (χ² = 1.000; P = 0.607), or collisions (χ² = 0.987; P = 0.610). Additionally, correlations between ODPS and visual function did not yield statistically significant results.

Conclusions: Consumption of vaporized cannabidiol in 16 mg and 32 mg doses does not appear to affect simulated vehicle driving performance and visual function.