American Journal on Addictions最新文献

Background and objectives: Since 2019, the drug overdose death rate among adolescents 14-18 years of age in the United States more than doubled. That cannabis legalization may have contributed to this tragedy is investigated by comparing the death rate in jurisdictions that have legalized medicinal or both medicinal and recreational use with those that have not.

Methods: Unintentional drug overdose death data for each state and District of Columbia (jurisdictions) were obtained from CDC WONDER and separately evaluated according to the jurisdiction legalization implementation of cannabis: recreational legalization, medicinal legalization but not recreational legalization, and nonlegalization.

Results: After a decade of similar and decreasing overdose death rates, jurisdictions that implemented cannabis legalization had a statistically significant greater increase in overdose deaths than nonlegalizing states. Those that implemented recreational legalization had the greatest increase, in which the rate was 88%, 479%, and 115% greater in 2019, 2020, and 2021, respectively, than in nonlegalizing jurisdictions. The overdose death rate versus cannabis legalization correlations are apparent in both females and males and in White, Black, and Hispanic individuals, and a statistically significant greater rate increases between recreational cannabis legalization implementation and nonlegalization.

Conclusion and scientific significance: Legalization of cannabis is associated with overdose deaths in American adolescents, especially recreational legalization, and regardless of sex or White-Black-Hispanic race/ethnicity. Cause and effect relationships of these previously unreported correlations, if verified, merit investigation of biologic and psychosocial mechanisms, interventions, and prevention strategies.

Background and objectives: With the rise in cannabis use over the last couple of decades and shifting social views around drug use, the characterization of potential predictors for the development of cannabis use disorder (CUD) may be of high relevance for the implementation of preventive measures toward this condition. We conducted a study with the aim of analyzing possible associations between personality traits and CUD.

Methods: Our sample consisted of 1335 inpatients admitted to The Menninger Clinic between September 2016 and December 2021. All participants completed the Big Five Inventory for the characterization of their personalities. The presence of a diagnosis of CUD and other substance use disorders was established through the administration of the Structured Clinical Interview for DSM-5 (SCID-5). Patients with and without a lifetime diagnosis of CUD were compared with regard to their scores in the five personality dimensions. We utilized analysis of covariance for the statistical inference, with age, sex, and use of other substances as covariates.

Results: Our findings revealed that low conscientiousness, low agreeableness, and high open-mindedness were associated with the presence of CUD. The relationships between CUD and the remaining personality dimensions explored (extraversion and neuroticism) were not statistically significant.

Conclusions and scientific significance: This study indicates that certain personality dimensions are potential predictors for the risk for developing CUD. An inpatient population was sampled for this study, allowing for the comparison with other community-based studies. These findings have important preventative and treatment implications from a clinical and research standpoint.

Background and objectives: Both β-arrestin2 and nicotinic acetylcholine receptor (nAChR) have been implicated in cognitive processes, particularly in relation to psychiatric disorders, including addiction. Previous studies have suggested that nAChR may be regulated by β-arrestin2. However, no study has investigated the interaction of β-arrestin2 and nAChR on cognition. We aimed to examine the main and interactive effects of their respective encoding genes, ARRB2 and CHRNA5, on cognitive function in MUD patients.

Methods: We recruited 559 patients with methamphetamine use disorder (MUD) and 459 healthy controls, assessed their cognitive functioning using the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and genotyped ARRB2 rs1045280 and CHRNA5 rs3829787 polymorphisms in MUD patients.

Results: Compared to healthy controls, MUD patients scored significantly lower on all RBANS indexes. Neither ARRB2 rs1045280 nor CHRNA5 rs3829787 had main effects on cognitive function in MUD patients, but there were significant interactive effects between the two single nucleotide polymorphisms (SNPs) on multiple RBANS indexes, including immediate memory, visuospatial/constructional, delayed memory, and total score. In detail, among carriers of CHRNA5 rs3829787 T allele, ARRB2 rs1045280 TT carriers had higher RBANS scores than the C allele carriers, whereas among carriers of CHRNA5 rs3829787 CC genotype, ARRB2 rs1045280 TT carriers performed worse in RBANS.

Conclusions and scientific significance: Our study identified for the first time an interactive effect between ARRB2 and CHRNA5 on cognitive function in MUD patients, which would enlarge our knowledge of genetic interaction on cognitive function.

Background and objectives: Nonmedical use of prescription tranquilizers/sedatives (NMUPTS) is associated with a 15-times increased likelihood of polysubstance use (PSU). This is correlated with an increased risk for use disorders and death, therefore, to inform prevention efforts, we identified PSU profiles among adults reporting sleep-related NMUPTS.

Methods: National Survey on Drug Use and Health 2015-2019 participants with past 12-month sleep-related NMUPTS and use of an additional drug(s) (n = 2603) were studied. Latent class analyses identified unique latent profiles, and multivariable logistic regressions identified covariates associated with each profile.

Results: Alcohol (90.4%), tobacco (61.5%), and marijuana (55.5%) were most commonly reported, with an average of 3.6 additional substances. Two latent PSU profiles were identified: marijuana/alcohol/tobacco (MAT) (68.3%) and MAT + cocaine/hallucinogens/prescription drugs (MAT + CHPR) (31.7%). In comparison to those likely in the MAT profile, those likely in the MAT + CHPR profile had lower odds of being older than 18-25 years (26-34: adjusted odds ratio [AOR]: 0.5, 95% confidence interval [CI]: 0.3, 0.6; 35-49: AOR: 0.2, 95% CI: 0.1, 0.2; 50+: AOR: 0.1, 95% CI: 0.0, 0.1), female (AOR: 0.4, 95% CI: 0.3, 0.6), non-Hispanic Black (AOR: 0.5, 95% CI: 0.4, 0.8) or Hispanic in comparison to non-Hispanic White (AOR: 0.5, 95% CI: 0.4, 0.8), and to not have past 12-month insurance coverage (AOR: 1.7, 95% CI: 1.3, 2.3).

Conclusions and scientific significance: Two PSU profiles were identified among people with NMUPTS, with noted variations in sociodemographic characteristics. In comparison to previous studies, sleep-related NMUPTS was associated with higher rates of stimulant use, suggesting stimulant use and sleep-related NMUPTS may be related.

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Background and objectives: Limited evidence guides the efficacy and safety of cannabis for therapeutic purposes (CTP). Healthcare providers lack requisite knowledge to advise and support patients. This study aimed to describe and compare several aspects of initial CTP interactions across different provider types.

Methods: Adult cannabis consumers (N = 507) from the United States completed an anonymous online survey about their initial CTP interaction with their healthcare provider. Providers were categorized into four groups (Mental Health [MH], Family Medicine [FM], Medical Clinics [MC], and Other Specialty [OS]). Analyses compared several aspects of the interaction (e.g., risk mitigation, recommendations, satisfaction/confidence) across groups.

Results: Less than half of the sample reported discussion of cannabis risks (44.0%) or follow-ups at subsequent visits (46.7%). Recommendations (where to obtain, consumption method, dose, frequency, and authorization) were uncommon (9.7%-25.2%). While the MH group reported the highest rates of risk mitigation behaviors, regression models adjusted for sociodemographic and cannabis characteristics were largely nonsignificant. For recommendations, the MC group was more likely than the MH group to report receiving all recommendations (p < .05). Younger age and greater cannabis-related problems increased likelihood of risk mitigation and recommendations.

Discussion and conclusions: CTP interactions focused on risk but generally lacked comprehensive recommendations that could potentially promote safe use. Data from provider perspectives could support the need for CTP guidelines and develop training for healthcare providers to promote safe CTP practices.

Scientific significance: For the first time, this study explored several aspects of CTP interactions and compared experiences across a variety of providers.

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