Showing papers by "Wayne Hall published in 2003"
TL;DR: Heavy cannabis use and depression are associated and evidence from longitudinal studies suggests that heavy cannabis use may increase depressive symptoms among some users, but it is still too early, however, to rule out the hypothesis that the association is due to common social, family and contextual factors that increase risks of both heavy cannabis Use and depression.
Abstract: Aim To examine the evidence on the association between cannabis and depression and evaluate competing explanations of the association. Methods A search of Medline, Psychinfo and EMBASE databases was conducted. All references in which the terms 'cannabis', 'marijuana' or 'cannabinoid', and in which the words 'depression/depressive disorder/depressed', 'mood', 'mood disorder' or 'dysthymia' were collected. Only research studies were reviewed. Case reports are not discussed. Results There was a modest association between heavy or problematic cannabis use and depression in cohort studies and well-designed cross-sectional studies in the general population. Little evidence was found for an association between depression and infrequent cannabis use. A number of studies found a modest association between early-onset, regular cannabis use and later depression, which persisted after controlling for potential confounding variables. There was little evidence of an increased risk of later cannabis use among people with depression and hence little support for the self-medication hypothesis. There have been a limited number of studies that have controlled for potential confounding variables in the association between heavy cannabis use and depression. These have found that the risk is much reduced by statistical control but a modest relationship remains. Conclusions Heavy cannabis use and depression are associated and evidence from longitudinal studies suggests that heavy cannabis use may increase depressive symptoms among some users. It is still too early, however, to rule out the hypothesis that the association is due to common social, family and contextual factors that increase risks of both heavy cannabis use and depression. Longitudinal studies and studies of twins discordant for heavy cannabis use and depression are needed to rule out common causes. If the relationship is causal, then on current patterns of cannabis use in the most developed societies cannabis use makes, at most, a modest contribution to the population prevalence of depression.
560 citations
TL;DR: Changes in suicide rates and exposure to antidepressants in Australia for 1991-2000 are significantly associated, and the rate of suicide fell in older people, the age group most heavily exposed to antidepressants.
Abstract: Objective: To examine the association between trends in antidepressant prescribing and suicide rates in Australia for 1991-2000 Design: Analysis of databases of suicide and rates of antidepressant prescribing according to age and sex Setting: Australian Bureau of Statistics data, sales data from the Australian pharmaceutical industry, prescribing data in general practice Subjects: Men and women aged 15 years and over in 10 year age groups Main outcome measures: Trends in suicide rates and trends in antidepressant prescribing Association measured by Spearman9s rank correlations Results: While overall national rates of suicide did not fall significantly, incidence decreased in older men and women and increased in younger adults In both men (rs=−091; P Conclusions: Changes in suicide rates and exposure to antidepressants in Australia for 1991-2000 are significantly associated This effect is most apparent in older age groups, in which rates of suicide decreased substantially in association with exposure to antidepressants The increase in antidepressant prescribing may be a proxy marker for improved overall management of depression If so, increased prescribing of selective serotonin reuptake inhibitors in general practice may have produced a quantifiable benefit in population mental health What is already known on this topic There has been a substantial increase in antidepressant prescribing by general practitioners in Australia since the introduction of selective serotoin reuptake inhibitors in the early 1990s Previous studies have indicated an association between increased antidepressant prescribing and reduced suicide rate What this study adds In Australia the rate of suicide fell in older people, the age group most heavily exposed to antidepressants Most antidepressants are now prescribed by general practitioners The association may indicate the improved treatment of depression by general practitioners
316 citations
TL;DR: Recent research into heroin overdose is examined to inform interventions that will reduce the rate of overdose death and overdose-related morbidity, including factors associated with overdose: polydrug use, drug purity, drug tolerance, routes of administration, and suicide.
Abstract: Drug overdose is a major cause of premature death and morbidity among heroin users. This article examines recent research into heroin overdose to inform interventions that will reduce the rate of overdose death. The demographic characteristics of overdose cases are discussed, including factors associated with overdose: polydrug use, drug purity, drug tolerance, routes of administration, and suicide. Responses by heroin users at overdoses are also examined. Potential interventions to reduce the rate of overdose and overdose-related morbidity are examined in light of the emerging data in this field.
311 citations
TL;DR: Cannabis use does not appear to be causally related to the incidence of schizophrenia, but its use may precipitate disorders in persons who are vulnerable to developing psychosis and worsen the course of the disorder among those who have already developed it.
287 citations
Book•
28 Nov 2003TL;DR: The impact of illegality in drug use and compares it with the policies of the U.S., Europe and Australia as well as other developed societies are compared.
Abstract: Exploring the relationship between health policy, public health and the law regarding the controversial use of cannabis, this study assesses the impact of illegality in drug use and compares it with the policies of the U.S., Europe and Australia as well as other developed societies. Current debates about "safe use" and "harm minimization" approaches are evaluated, as well as the experiences of differing prevention, treatment and education policies. Written by two leading drug advisors, the analysis contributes to an important field of research.
235 citations
TL;DR: Consideration should be given to the introduction of prison methadone programs particular where community based programs exist for reduced heroin use, syringe sharing and HIV or hepatitis C incidence among prisoners.
203 citations
TL;DR: The reduction in the availability of heroin provides a unique opportunity to investigate the impact of supply reduction, and almost all IDUs reported that heroin was harder to obtain at the time of interview than it was before Christmas 2000 and KIs concurred.
Abstract: Aim To examine the veracity of reports of a substantial decrease in the availability of heroin in Sydney in January 2001
79 citations
TL;DR: In this article, the authors describe patterns of co-morbidity between alcohol use and other substance use problems in the Australian population using data from the 1997 National Survey of Mental Health and Well-Being.
Abstract: The present study describes patterns of co-morbidity between alcohol use and other substance use problems in the Australian population using data from the 1997 National Survey of Mental Health and Well-Being. Multiple regression analyses examined whether the observed associations between alcohol and other drug use disorders were explained by other variables, including demographic characteristics and neuroticism. We also assessed whether the presence of co-morbid substance use disorders affected treatment seeking for a mental health problem. Alcohol use was related strongly to the use of other substances. Those who did not report alcohol use within the past 12 months were less likely to report using tobacco, cannabis, sedatives, stimulants or opiates. Higher rates again were observed among those with alcohol use disorders: half (51%) of those who were alcohol-dependent were regular tobacco smokers, one-third had used cannabis (32%); 15% reported other drug use; 15% met criteria for a cannabis use disorder and 7% met criteria for another drug use disorder. These associations were not accounted for by the demographic and other variables considered here. Co-morbid substance use disorders (sedatives, stimulants or opioids) predicted a high likelihood of seeking treatment for a mental health problem among alcohol-dependent people.
78 citations
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01 Jan 2003
TL;DR: While the most recent studies show a decrease in youth use in 2020, the rate is still alarmingly high with nearly one in five high school students reporting current e-cigarette use.
Abstract: 2020 4.7 E-cigarette use has increased in recent years, especially among youth and young adults, who use e-cigarettes more than any other age group. In 2018, the rapid rise of tobacco products led the U.S. surgeon general to issue an advisory about the youth e-cigarette “epidemic.”1 In 2019, youth e-cigarette use increased to even higher levels. While the most recent studies show a decrease in youth use in 2020, the rate is still alarmingly high with nearly one in five high school students reporting current e-cigarette use.2
76 citations
Journal Article•
TL;DR: Management of the Metabolic Syndrome consists primarily of modification or reversal of the root causes and direct therapy of the risk factors to further improve BP, lipids, and glucose thereby decreasing the risk of cardiovascular disease.
Abstract: The Metabolic Syndrome represents a specific clustering of cardiovascular risk factors. One of several recently proposed definitions encompasses 3 or more of the following 5 abnormalities: waist circumference > 102 cm in men or > 88 cm in women, serum triglyceride level > or = 150 mg/dL, high-density lipoprotein cholesterol level or = 130/> or = 85 mm Hg and serum glucose > or = 110 mg/dL. The diagnosis of Metabolic Syndrome allows early recognition of an increased risk of cardiovascular disease. African Americans have the highest coronary heart disease mortality of any ethnic group in the United States. African-American women and Hispanic men and women have the highest prevalence of the Metabolic Syndrome. This phenomenon is attributable mainly to the disproportionate occurrence of elevated BP, obesity, and diabetes in African Americans, and the high prevalence of obesity and diabetes in Hispanics. Management of the Metabolic Syndrome consists primarily of modification or reversal of the root causes and direct therapy of the risk factors. The first strategy involves weight reduction and increased physical activity, both of which can improve all components of the syndrome. The second strategy often involves drug treatment of the individual risk factors to further improve BP, lipids, and glucose thereby decreasing the risk of cardiovascular disease. This comprehensive review is provided as part of the educational activities of the African-American Lipid and Cardiovascular Council (AALCC).
TL;DR: The adverse respiratory effects of smoking cannabis are similar to those of smoking tobacco, even although it remains to be confirmed that smoking cannabis alone leads to the development of chronic lung disease as mentioned in this paper.
Abstract: Both the gaseous and the particulate phases of tobacco and cannabis smoke contain a similar range of harmful chemicals. However, differing patterns of inhalation mean that smoking a 'joint' of cannabis results in exposure to significantly greater amounts of combusted material than with a tobacco cigarette. The histopathological effects of cannabis smoke exposure include changes consistent with acute and chronic bronchitis. Cellular dysplasia has also been observed, suggesting that, like tobacco smoke, cannabis exposure has the potential to cause malignancy. These features are consistent with the clinical presentation. Symptoms of cough and early morning sputum production are common (20-25%) even in young individuals who smoke cannabis alone. Almost all studies indicate that the effects of cannabis and tobacco smoking are additive and independent. Public health education should dispel the myth that cannabis smoking is relatively safe by highlighting that the adverse respiratory effects of smoking cannabis are similar to those of smoking tobacco, even although it remains to be confirmed that smoking cannabis alone leads to the development of chronic lung disease.
TL;DR: The best prospects for the medical use of cannabinoids lie in finding ways to deliver THC that do not involve smoking and in developing synthetic cannabinoids that produce therapeutic effects with a minimum of psychoactive effects.
Abstract: The principal constituent of cannabis, Delta(9)-tetrahydrocannabinol (THC), is moderately effective in treating nausea and vomiting, appetite loss, and acute and chronic pain. Oral THC (dronabinol) and the synthetic cannabinoid, nabilone, have been registered for medical use in the US and UK, but they have not been widely used because patients find it difficult to titrate doses of these drugs. Advocates for the medical use of cannabis argue that patients should be allowed to smoke cannabis to relieve these above-mentioned symptoms. Some US state governments have legislated to allow the medical prescription of cannabis, but the US federal government has tried to prevent patients from obtaining cannabis and threatened physicians who prescribe it with criminal prosecution or loss of their licence to practise. In the UK and Australia, committees of inquiry have recommended medical prescription (UK) and exemption from criminal prosecution (New South Wales, Australia), but governments have not accepted these recommendations. The Canadian government allows an exemption from criminal prosecution to patients with specified medical conditions. It has recently legislated to provide cannabis on medical prescription to registered patients, but this scheme so far has not been implemented. Some advocates argue that legalising cannabis is the only way to ensure that patients can use it for medical purposes. However, this would be contrary to international drug control treaties and is electorally unpopular. The best prospects for the medical use of cannabinoids lie in finding ways to deliver THC that do not involve smoking and in developing synthetic cannabinoids that produce therapeutic effects with a minimum of psychoactive effects. While awaiting these developments, patients with specified medical conditions could be given exemptions from criminal prosecution to grow cannabis for their own use, at their own risk.
TL;DR: Specific issues faced by older-aged individuals with alcohol and other drug use problems are discussed, including: interactions with prescribed medications, under-recognition and treatment of alcohol and drug problems, unintentional injury and social isolation.
Abstract: In Australia people aged 65 years or older currently comprise 12.1% of the population. This has been estimated to rise to 24.2% by 2051. Until recently there has been relatively little research on alcohol and other drug use disorders among these individuals but, given the ageing population, this issue is likely to become of increasing importance and prominence. Epidemiological research shows a strong age-related decline in the prevalence of alcohol and other drug use disorders with age. Possible reasons for this include: age-related declines in the use and misuse of alcohol and other drugs; increased mortality among those with a lifetime history of alcohol and other drug use disorders; historical differences in exposure to and use of alcohol and other drugs. Despite the age-related decline in the prevalence of these disorders, they do still occur among those aged 65 years or older and, given historical changes in exposure to and use of illicit drugs, it likely that the prevalence of these disorders among older-aged individuals will rise. Specific issues faced by older-aged individuals with alcohol and other drug use problems are discussed. These include: interactions with prescribed medications, under-recognition and treatment of alcohol and drug problems, unintentional injury and social isolation. Finally, a brief discussion of treatment issues is provided.
TL;DR: The challenge is to develop theories of addiction that take seriously the neurobiological bases for drug effects and addictive phenomena without depicting addicts as automatons whose behaviour is under the control of the drugs acting on the receptors sites in their brains.
Abstract: Neuroscience models have much to offer the field of addiction, but they will be self-defeating if they lead to severe restrictions on the type of neuroscience research that can conducted in future. A major challenge for the addiction field is to integrate the insights that neuroscience research has provided on drug use and addiction with those provided about drug use and addiction by clinical, epidemiological, sociological and economic research. The challenge is (1) to develop theories of addiction that take seriously the neurobiological bases for drug effects and addictive phenomena; (2) without depicting addicts as automatons whose behaviour is under the control of the drugs acting on the receptors sites in their brains; and (3) while recognizing the opportunities for individual decision, interpersonal influence and social policy to affect the drug use and the behaviour of drug-dependent people.
Journal Article•
TL;DR: The genetic evidence indicates that there is no single gene, or even a small number of genes, that predict an increased risk of antisocial behaviour, and where there have been some effects, the increase in risk associated with antissocial behaviour is modest.
Abstract: Debates about criminality have long focused on the relative contributions of environment and genetics as components of antisocial and destructive behaviour. The past decade or so has seen an increase in research on the genetics of behaviour, including antisocial behaviour. Many criminologists are understandably concerned about the potential misuse of this research given the earlier historical experiences with the eugenic use made of biological explanations of crime, and of genetic explanations in particular. This paper summarises this evidence. Recent twin studies show persuasive evidence that both genetic and environmental factors contribute to antisocial behaviour. However the genetic evidence indicates that there is no single gene, or even a small number of genes, that predict an increased risk of antisocial behaviour. Where there have been some effects, the increase in risk associated with antisocial behaviour is modest.
01 Jan 2003
TL;DR: This chapter will define the concept of comorbidity; discuss the implications of comorebidity for theories of mental health, treatment and prevention; give a brief overview of epidemiological research intocomorbidities; and examine the reasons why comor bidity might occur.
Abstract: Introduction:Comorbidity can be defined most generally as the co-occurrence of two or moremental health problems. It has emerged as a major clinical, public health andresearch issue over the past few decades. This is due in part to changes in psychiatricnomenclature, in which there is a greater focus upon elucidating any number ofmental health problems with which an individual might present, rather thandiagnosing one problem to the exclusion of others.Currently, mental health problems are conceptualised as patterns of behaviour orthought that are associated with significant disability, distress, loss of individualfreedom, or adverse events such as death; and which arise from dysfunction withinthe individual (Neugebauer, 1999). These problems can encompass a wide range ofbehaviours including substance use, mood disturbances, anxiety, and disturbances inthought and perception.According to current classification systems in psychology and psychiatry, mentaldisorders are diagnosed according to operationalised diagnostic criteria, and thediagnosis of one disorder does not necessarily preclude the diagnosis of another(American Psychiatric Association, 1994;World Health Organisation, 1993). Insome cases, more than one mental disorder is diagnosed — such comorbidity isexamined in this chapter. Specifically, this chapter will define the concept ofcomorbidity; discuss the implications of comorbidity for theories of mental health,treatment and prevention; give a brief overview of epidemiological research intocomorbidity; and examine the reasons why comorbidity might occur.
Journal Article•
TL;DR: The major competing ethical theories in the Australian stem cell debate have been utilitarianism and deontological theories, which have dominated the public debate because of the potential benefits it may provide for people with serious illnesses and disabilities.
Abstract: Ethical issues have been critical to the Australian policy debate about hES cells and therapeutic cloning. The deliberative process and the political negotiation between state premiers and the Prime Minister have produced compromise legislation that bans reproductive and therapeutic cloning while allowing limited research on hES cells extracted from surplus IVF embryos. Despite conflicting views on the morality of hES cell research, there appears to be majority support for hES cell research on IVF surplus embryos. The community seems to have been persuaded that it should be allowed because of the possibility it holds of developing effective treatments for hitherto untreatable conditions. There is as near as one gets to a consensus in favour of a ban on reproductive cloning in Australia. This is in the absence of agreement on the reasons why reproductive cloning should be prohibited. Opinion is much more divided on SCNT and therapeutic cloning. A moratorium on SCNT seems a reasonable compromise in the circumstances but it is likely to become a de facto prohibition because of the political difficulty in repealing a law that prohibits it on pain of criminal penalties.
TL;DR: In this paper, the authors describe an experimental investigation into the contact patch behavior of an automobile tire, which aims to enhance understanding of tyre behaviour in the contact region with reference to the authors' need to validate advanced finite element simulations.
Abstract: This paper describes an experimental investigation into the contact patch behaviour of an automobile tyre. The investigation aims to enhance understanding of tyre behaviour in the contact region with reference to the authors' need to validate advanced finite element simulations. Physical tests were carried out with an experimental rolling tyre on flat bed and rolling drum machines, each instrumented with a tri-axial stress transducer. Many plots giving the normal pressure and shear stress distributions under free-rolling and cornering (slip and camber angle) conditions are presented for a high friction surface. A comparison is made between the contact patch behaviour when the tyre is rolled on the horizontal (at 0.18 km/h) and drum (10 to 50 km/h) surfaces. The characteristics of the stress distributions are discussed and related to the actual physical behaviour of the tyre.
TL;DR: The critical finding was the relation between decline in suicide rate and exposure to antidepressants across age groups in both sexes and the use of daily dependent doses.
Abstract: EDITOR—Our critical finding was the relation between decline in suicide rate and exposure to antidepressants across age groups in both sexes. We agree that time series data must be interpreted cautiously; that is why we considered alternative explanations.
We disagree with Moncrieff that we should have used ratios of daily dependent doses. This would have been an alternative measure of change in exposure but not of overall antidepressant exposure. We agree that the daily dependent doses will underestimate prescribing levels of tricyclic …
01 Jan 2003
01 Jan 2003
TL;DR: A large and growing body of evidence shows there is an association between cannabis use and psychotic disorders, and studies suggest that cannabis use increases the risk of psychosis-related outcomes later in life.
Abstract: A large and growing body of evidence shows there is an association between cannabis use and psychotic disorders1-3. Cannabis use disorders are highly prevalent in people with a diagnosis of schizophrenia, with a recent review showing up to 28.6% of people with schizophrenia have a current cannabis use disorder2. This is considerably higher than the prevalence of cannabis use disorders in the general population, which is 1.5% to 2.2%4, 5. Moreover, studies suggest that cannabis use increases the risk of psychosis-related outcomes later in life1.
Journal Article•
TL;DR: In this article, the authors identify key issues that researchers, funding bodies, ethics committees and ethicists might consider in contemplating research subject payment ethics, and explore these issues and how they relate to existing guidelines on voluntary consent, and arguments that have been proposed for and against research subject payments.
Abstract: The authors identify key issues that researchers, funding bodies, ethics committees and ethicists might consider in contemplating research subject payment ethics. They argue that what is missing from the broader debate is due consideration of ethics committee decision processes; research subject reasons for participation; and current research practices. The authors explore these issues and how they relate to existing guidelines on voluntary consent, and arguments that have been proposed for and against research subject payments. (non- author abstract)
TL;DR: The critical finding was the relation between decline in suicide rate and exposure to antidepressants across age groups in both sexes and the use of daily dependent doses.
Abstract: EDITOR—Our critical finding was the relation between decline in suicide rate and exposure to antidepressants across age groups in both sexes. We agree that time series data must be interpreted cautiously; that is why we considered alternative explanations.
We disagree with Moncrieff that we should have used ratios of daily dependent doses. This would have been an alternative measure of change in exposure but not of overall antidepressant exposure. We agree that the daily dependent doses will underestimate prescribing levels of tricyclic …
TL;DR: Carnwarth and Smith have aimed to write a “factual and easy to read” book that will improve public debate by reducing the exaggerated anxieties about heroin that have been created by the tabloid media.
Abstract: Tom Carnwath, Ian Smith
Routledge, £14.99, pp 224
ISBN 0 415 27899 6
H B Spear, ed Joy Mott
DrugScope, £35, pp 362
ISBN 1 904319 04 1
www.drugscope.org.uk
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These two books on heroin policy address two different audiences: the general public and drug policy buffs.
Carnwarth and Smith have aimed to write a “factual and easy to read” book that will improve public debate by reducing the exaggerated anxieties about heroin that have been created by the tabloid media. The book is certainly easier to read than many scholarly books on heroin but the authors make some dubious claims. They predict that rising heroin use will change attitudes, making it “quite likely” that heroin will be “decriminalised or legalised in the …
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