Showing papers in "American Journal of Drug and Alcohol Abuse in 2014"
TL;DR: It is indicated that medical cannabis users use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and report similar rates of disordered use as compared with population estimates among regular users.
Abstract: Objectives: Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use. Methods: In the present cross-secti...
214 citations
TL;DR: The findings support previous research indicating that emotion-regulation difficulties are broadly associated with alcohol-related consequences and suggest exposure and/or mindfulness based prevention/interventions with emotion focused psychoeducation may offer one path to reducing alcohol- related consequences among college students.
Abstract: Background: Understanding factors associated with alcohol-related consequences is an important area of research. Emotional functioning has been associated with alcohol-related consequences but there is less research examining a comprehensive underlying model of emotional regulation. The Difficulties in Emotion Regulation Scale (DERS) is a recent measure developed to assess six facets of emotion regulation difficulties that contribute to overall emotional functioning. Objectives: The current study examines associations between these six facets of emotion regulation difficulties and problematic alcohol use. Methods: Participants (n = 1758 college students) were recruited as part of a larger study and were asked to complete online questionnaires assessing demographics, alcohol use and problems, and emotion regulation difficulties. Results: Negative binomial hurdle models for alcohol use and alcohol-related consequences were estimated. Impulse control difficulties were positively related to the number...
164 citations
TL;DR: Findings are consistent with other findings suggesting that people with higher self-stigma may have a lowered sense of self-efficacy and heightened fear of being stigmatized and therefore retreat into more protected settings such as residential treatment, potentially resulting in higher treatment costs.
Abstract: Background: Stigma has been suggested as a possible contributor to the high rates of treatment attrition in substance-dependent individuals, but no published empirical studies have examined this association. Objectives: The present paper assessed the relationship between baseline stigma variables and length of treatment stay in a sample of patients in a residential addictions treatment unit. Methods: The relationship between baseline stigma variables (self-stigma, enacted stigma, and shame) and length of stay for participants (n = 103) in a residential addictions treatment unit was examined. Results: Higher self-stigma predicted longer stay in residential addictions treatment, even after controlling for age, marital status, race, overall mental health, social support, enacted stigma, and internalized shame. However, other stigma variables (i.e. internalized shame, stigma-related rejection) did not reliably predict length of treatment stay. Conclusion: These results are consistent with other findin...
70 citations
TL;DR: The proposed role of ΔFosB is described and discussed, as well as the implications of recent findings, as a biomarker for the evaluation of potential therapeutic interventions for addiction.
Abstract: The transcription factor ΔFosB is upregulated in numerous brain regions following repeated drug exposure. This induction is likely to, at least in part, be responsible for the mechanisms underlying addiction, a disorder in which the regulation of gene expression is thought to be essential. In this review, we describe and discuss the proposed role of ΔFosB as well as the implications of recent findings. The expression of ΔFosB displays variability dependent on the administered substance, showing region-specificity for different drug stimuli. This transcription factor is understood to act via interaction with Jun family proteins and the formation of activator protein-1 (AP-1) complexes. Once AP-1 complexes are formed, a multitude of molecular pathways are initiated, causing genetic, molecular and structural alterations. Many of these molecular changes identified are now directly linked to the physiological and behavioral changes observed following chronic drug exposure. In addition, ΔFosB induction is being considered as a biomarker for the evaluation of potential therapeutic interventions for addiction.
66 citations
TL;DR: This essay presents eight of these design choices which all conveniently begin with the letter “P”: production, profit motive, promotion, prevention, potency, purity, price, and permanency.
Abstract: The cannabis policy landscape is changing rapidly. In November 2012 voters in Colorado and Washington State passed ballot initiatives to remove the prohibition on the commercial production, distribution, and possession of cannabis. This paper does not address the question of whether cannabis should be legal; it instead focuses on the design considerations confronting jurisdictions that are pondering a change in cannabis policy. Indeed, whether or not cannabis legalization is net positive or negative for public health and public safety largely depends on regulatory decisions and how they are implemented. This essay presents eight of these design choices which all conveniently begin with the letter “P”: production, profit motive, promotion, prevention, potency, purity, price, and permanency.
54 citations
TL;DR: Self-reported craving for opioids was modestly associated with subsequent relapse to opioid use among a cohort of patients treated with buprenorphine and may provide clinical utility in predicting relapse among treated opioid-dependent patients.
Abstract: Background: Few studies have assessed associations between craving and subsequent opioid use. We prospectively evaluated the relative utility of two craving questionnaires to predict opioid use among opioid-dependent patients in outpatient treatment. Method: Opioid-dependent patients (n = 147) initiating buprenorphine treatment were assessed every two weeks for 3 months. Craving was measured using the: (1) Desires for Drug Questionnaire (DDQ) and (2) Penn Alcohol-Craving Scale adapted for opioid craving (PCS). Multi-level logistic regression models estimated the effects of craving on the likelihood of opioid use. Craving assessed at time t was entered as a time-varying predictor of opioid use at time t + 1. Results: Craving scores plateaued at approximately 2 weeks after initiation of buprenorphine. In adjusted regression models, a 1-point increase in PCS scores (on a 7-point scale) was associated with a significant increase in the odds of opioid use at the subsequent assessment (OR = 1.27, 95% CI...
50 citations
TL;DR: Being female or younger increase the likelihood of having co-occurring PTSD symptoms and prescription opioid use problem were nearly three times greater among females versus males, and patients with prescription opioids use problems should be carefully evaluated for PTSD symptoms.
Abstract: Background: Prescription opioids are the most rapidly growing category of abused substances, and result in significant morbidity, mortality and healthcare costs. Co-occurring with psychiatric disorders, persons with prescription opioid problems have negative treatment outcomes. Data are needed on the prevalence of co-occurring prescription opioid abuse and specific disorders, such as posttraumatic stress disorder (PTSD), to better inform clinical practice. Objective: To determine prevalence rates of current co-occurring prescription opioid use problems and PTSD symptom severity among patients in community addiction treatment settings. Methods: We abstracted administrative and chart information on 573 new admissions to three addictive treatment agencies during 2011. Systematic data were collected on PTSD symptoms, substance use, and patient demographics. Results: Prescription opioid use was significantly associated with co-occurring PTSD symptom severity (OR: 1.42, p < 0.05). Use of prescription op...
49 citations
TL;DR: Risperidone had the greater effect on positive psychotic symptoms while patients with negative symptoms may respond better to aripiprazole, and there is a case for further studies evaluating the efficacy of atypical antipsychotics in this disorder.
Abstract: Background: Lifetime prevalence of amphetamine-induced psychotic disorder is reported as being up to 23% for methamphetamine (MA) abusers. Approximately 25% of those with a baseline DSM-IV diagnosis of substance-induced psychosis are diagnosed with primary psychosis at one-year follow-up. Evidence on the treatment of amphetamine psychosis is very limited. Objectives: To investigate the efficacy of risperidone versus aripiprazole in treatment of amphetamine-induced psychotic symptoms. Methods: In a double-blind study, 45 participants were randomly allocated to either aripiprazole 15 mg or risperidone 4 mg daily over a six-week trial. Positive and negative symptoms of psychosis were assessed using the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS) at baseline and completion of the trial. Results: SANS and SAPS scores decreased significantly in both groups. Mean SAPS score reduction in risperidone and aripiprazole group was 16.20 and 10.80, r...
41 citations
TL;DR: It is premature to conclude that selective serotonin reuptake inhibitors are not effective for treatment of the cannabis withdrawal syndrome, but a high dropout rate and effects of low abstinence rates on measures of anxiety, depression and withdrawal are premature.
Abstract: Background: Cannabis is the most frequently used illegal substance in the United States and Europe. There is a dramatic increase in the demand for treatment for cannabis dependence. Cannabis users frequently have co-morbid mood symptoms, especially depression and anxiety, and regular cannabis users may self-medicate for such symptoms. Objectives: We report a double-blind, placebo-controlled treatment study, for the prevention of cannabis use in cannabis-dependent individuals. Method: Regular cannabis-dependent users (n = 52) were treated for 9 weeks with weekly cognitive-behavior and motivation-enhancement therapy sessions together with escitalopram 10 mg/day. Urine samples were collected to monitor delta-9 tetrahydrocannabinol (THC) during treatment and questionnaires were administered to assess anxiety and depression. Results: We observed a high rate of dropout (50%) during the 9-week treatment program. Fifty-two patients were included in the intention-to-treat analysis. Of these, ten (19%) rema...
40 citations
TL;DR: Findings provide novel insight into the patterns of substance use among adolescents presenting to low-income urban primary care clinics and the efficacy of interventions that address the complex patterns of substances use and concomitant health concerns among adolescents.
Abstract: Background: Polysubstance use during adolescence is a significant public health concern. However, few studies have investigated patterns of substance use during this developmental window within the primary care setting. Objectives: This study used an empirical method to classify adolescents into substance use groups, and examines correlates of the empirically defined groups. Methods: Data came from patients, ages 12–18 years, presenting to an urban, primary care community health clinics (Federally Qualified Health Centers) in two cities in the Midwestern United States (n = 1664). Latent class analysis (LCA) was used to identify classes of substance users. Multinomial logistic regression was used to examine variables associated with class membership. Results: LCA identified three classes: class 1 (64.5%) exhibited low probabilities of all types of substance use; class 2 (24.6%) was characterized by high probabilities of cannabis use and consequences; and class 3 (10.9%) had the highest probabilitie...
39 citations
TL;DR: Precollege perceptions of the college drinking culture are a stronger predictor of subsequent alcohol use than social norms and interventions that target these beliefs may reduce peak intoxication and associated harms experienced during the first 30 days of college.
Abstract: Background: The transition from high school to college is a critical period for developing college drinking habits. Hazardous alcohol consumption increases during this period, as well as participation in drinking games, pregaming, and tailgating. All of these risky drinking practices are associated with higher levels of intoxication as well as an increased risk of alcohol-related problems. Objective: The current study aimed to evaluate pre-college predictors (personality, social norms, and beliefs reflecting the internalization of the college drinking culture [ICDC]) of estimated peak BAC (pBAC) reached during drinking games, pregaming, and tailgating, as well as pBAC and alcohol-related problems during the first 30 days of college. Methods: Participants (n = 936) were incoming freshmen at a large university who completed a baseline assessment prior to college matriculation and a follow-up assessment after they had been on campus for 30 days. Results: Using path analysis, ICDC was significantly as...
TL;DR: Those interested in preventing initiation and adverse consequences of cocaine use should take into account the overlapping, yet different risk profiles of powder cocaine and crack users when developing programming.
Abstract: Objectives: Rates of powder cocaine and crack use have fluctuated among adolescents over recent decades. Little attention has been paid to recent trends, particularly regarding differences between ...
TL;DR: Social networks of individuals with AUD may be different than individuals with no AUD, but this claim is dependent on specific AUD diagnosis and how social networks are measured.
Abstract: Background: While some argue that social network ties of individuals with alcohol use disorders (AUD) are robust, there is evidence to suggest that individuals with AUDs have few social network ties, which are a known risk factor for health and wellness. Objectives: Social network ties to friends, family, co-workers and communities of individuals are compared among individuals with a past-year diagnosis of alcohol dependence or alcohol abuse to individuals with no lifetime diagnosis of AUD. Method: Respondents from Wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC) were assessed for the presence of past-year alcohol dependence or past-year alcohol abuse, social network ties, sociodemographics and clinical characteristics. Results: Bivariate analyses showed that both social network size and social network diversity was significantly smaller among individuals with alcohol dependence, compared to individuals with alcohol abuse or no AUD. When social and clinical factor...
TL;DR: Gender-specific adolescent alcohol and substance use prevention programs are warranted, and classification in any drinking class was a strong risk factor for adolescent and adulthood illicit drug use, with heavy drinkers at greatest risk of drug use.
Abstract: OBJECTIVES: The study objective was to use latent class analyses (LCAs) to identify gender- and racial/ethnic-specific groups of adolescent alcohol users and associations between alcohol use group and adolescent and adulthood illicit drug use in a nationally-representative US sample. METHODS: We used Wave I (1994-1995, adolescence) of the National Longitudinal Study of Adolescent Health to conduct LCAs by gender and race/ethnicity and measure associations between class membership and Wave I and Wave III (2001-2002, young adulthood) drug use. Participants included white (n = 9548), African American (n = 4005) and Hispanic (n = 3184) participants. LCAs were based on quantity and frequency of adolescent alcohol use; physiological and social consequences of use; and peer use. RESULTS: Males and females were characterized by different alcohol use typologies and consequences. Males in the highest severity class (i.e. drank both heavily and frequently) experienced disproportionate risk of alcohol-related consequences compared with abstainers and other alcohol-using groups. Females who drank heavily when drinking even if only occasionally, experienced high risk of alcohol-related consequences. Substantial proportions of males reported diverse alcohol-related problems, whereas females most commonly reported alcohol-related problems with dating and sexual experiences. Though levels of alcohol use and report of problems associated with use were higher among white versus minority populations, other racial/ethnic differences in patterns of alcohol use were minimal. Classification in any drinking class was a strong risk factor for adolescent and adulthood illicit drug use, with heavy drinkers at greatest risk of drug use. CONCLUSIONS: Gender-specific adolescent alcohol and substance use prevention programs are warranted. Language: en
TL;DR: Prescription opioid–dependent patients with a co-occurring psychiatric disorder had a better response to buprenorphine-naloxone treatment despite demonstrating greater impairment at baseline.
Abstract: Background: Given the growing prevalence of prescription opioid dependence and the considerable rates of additional psychopathology in drug dependence, we examined the association between the presence of a co-occurring Axis I psychiatric disorder and sociodemographic and clinical characteristics in this secondary analysis of patients entering a treatment study for dependence on prescription opioids. Treatment outcomes were also compared. Methods: Patients dependent on prescription opioids participated in a multi-site, two-phase, randomized, controlled trial to assess different lengths of buprenorphine-naloxone pharmacotherapy and different intensities of counseling (Clinicaltrials.gov identifier: NCT00316277). Among the 653 participants entering the first phase of the trial, 360 entered the second phase, receiving 12 weeks of buprenorphine-naloxone treatment; they are reported here. Half of those participants (180/360) had a current co-occurring psychiatric disorder in addition to substance depend...
TL;DR: The efficacy of an innovative employment intervention tailored for drug-involved offenders is demonstrated by showing positive changes in 12-month employment outcomes, most strongly for those who have not had recent employment success.
Abstract: Background: Employment has been identified as an important part of substance abuse treatment and is a predictor of treatment retention, treatment completion, and decreased relapse. Although employment interventions have been designed for substance abusers, few interventions have focused specifically on drug-involved offenders. Objectives: The purpose of this study was to examine employment outcomes for drug-involved offenders who received a tailored employment intervention. Methods: In a randomized controlled trial, baseline and follow-up data were collected from 500 drug-involved offenders who were enrolled in a drug court program. Participants were randomly assigned to drug court as usual (control group) or to the employment intervention in addition to drug court. Results: Intent-to-treat analyses found that the tailored intervention was associated only with more days of paid employment at follow-up (210.1 vs. 199.9 days). When focusing on those with greater employment assistance needs, a work t...
TL;DR: Binge drinking was highly prevalent among the sampled medical students, especially during an after-exam party, and identifying healthy coping strategies among medical students is warranted to reduce binge drinking.
Abstract: Background: Alcohol consumption is the third leading cause of preventable death in the US. Limited research has been conducted examining drinking habits of medical students. Objective: This study was designed to measure the prevalence and associated risk factors of binge drinking among a sample of medical students. Methods: A total of 485 medical students at a private, Jesuit medical school in the US participated in a confidential web-based survey in April 2011. Univariate and multivariate generalized linear regressions with robust error variance were performed for estimated prevalence ratio (PR) of binge drinking. Results: The prevalence of binge drinking was 58.1% among the sampled medical students with the majority being white (67.0%) and between 18 and 25 years old (60.0%). After adjusting for age, gender, race/ethnicity, and year in medical school, there were statistically significant (p < 0.05) associations of drinking during an after-exam party (PR = 2.82), protective behavioral strategy (P...
TL;DR: Although rates of initiation into injecting drug use were similar for male and female street youth, the risk factors for initiation were distinct and suggest a possible benefit of uniquely tailoring prevention efforts to high-risk males and females.
Abstract: Background and objectives: Gender differences in illicit drug use patterns and related harms (e.g. HIV infection) are becoming increasingly recognized. However, little research has examined gender differences in risk factors for initiation into injecting drug use. We undertook this study to examine the relationship between gender and risk of injection initiation among street-involved youth and to determine whether risk factors for initiation differed between genders. Methods: From September 2005 to November 2011, youth were enrolled into the At-Risk Youth Study, a cohort of street-involved youth aged 14–26 in Vancouver, Canada. Cox regression analyses were used to assess variables associated with injection initiation and stratified analyses considered risk factors for injection initiation among male and female participants separately. Results: Among 422 street-involved youth, 133 (32.5%) were female, and 77 individuals initiated injection over study follow-up. Although rates of injection initiatio...
TL;DR: DG play is an event-specific risk factor for increased alcohol use among first-year students, regardless of individual DG play tendencies, and event DG play signals increased risk for blackout drinking consequences for all students, and social-interpersonal consequences for women, aside from the amount of alcohol consumed on those occasions.
Abstract: Background: College students who play drinking games (DGs) more frequently report higher levels of alcohol use and experience more alcohol-related harm. However, the extent to which they are at risk for increased consumption and harm as a result of DG play on a given event after accounting for their typical DG participation, and typical and event drinking, is unclear. Objectives: We examined whether first-year students consumed more alcohol and were more likely to experience consequences on drinking occasions when they played DGs. Methods: Participants (n = 336) completed up to six web-based surveys following weekend drinking events in their first semester. Alcohol use, DG play, and consequences were reported for the Friday and Saturday prior to each survey. Typical DG tendencies were controlled in all models. Typical and event alcohol use were controlled in models predicting risk for consequences. Results: Participants consumed more alcohol on DG versus non-DG events. All students were more likel...
TL;DR: The results reveal impulsivity traits specific to each group, which may provide better criteria to define spectrums and trajectories – instead of categories – of symptoms for substance use and eating disorders.
Abstract: Background: Impulsivity is a complex trait often studied in substance abuse and overeating disorders, but the exact nature of impulsivity traits and their contribution to these disorders are still debated Thus, understanding how to measure impulsivity is essential for comprehending addictive behaviors Objectives: Identify unique impulsivity traits specific to substance use and overeating Methods: Impulsive Sensation Seeking (ImpSS) and Barratt’s Impulsivity scales (BIS) Scales were analyzed with a non-parametric factor analytic technique (discriminant correspondence analysis) to identify group-specific traits on 297 individuals from five groups: Marijuana (n = 88), Nicotine (n = 82), Overeaters (n = 27), Marijuauna + Nicotine (n = 63), and Controls (n = 37) Results: A significant overall factor structure revealed three components of impulsivity that explained respectively 5019% (pperm < 00005), 2418% (pperm < 00005), and 1598% (pperm < 00005) of the variance All groups were significantl
TL;DR: The legalization of medical marijuana may not have an adverse impact on suicide rates, and this finding may have significant public health implications for the presumable increase in marijuana use that may follow legalization.
Abstract: Introduction: Suicide is among the 10 most common causes of death in the United States Researchers have identified a number of factors associated with completed suicide, including marijuana use, and increased land elevation Colorado is an ideal state to test the strength of these associations The state has a completed suicide rate well above the national average and over the past 15 years has permitted first the medical and, as 2014, the recreational use of marijuana Objectives: To determine if there is a correlation between medical marijuana use, as assessed by the number of medical marijuana registrants and completed suicides per county in Colorado Methods: The number of medical marijuana registrants was used as a proxy for marijuana use Analysis variables included total medical marijuana registrants, medical marijuana dispensaries per county, total suicide deaths, mechanism of suicide death, gender, total suicide hospitalizations, total unemployment, and county-level information such as m
TL;DR: Being a cigarette smoker did not appear to influence the effects of NAC on cannabis abstinence, though there was a trend in the placebo group of poorer cannabis outcomes for cigarette smokers vs. non-smokers.
Abstract: Background and objectives: Tobacco and cannabis use are both highly prevalent worldwide. Their co-use is also common in adults and adolescents. Despite this frequent co-occurrence, cessation from both substances is rarely addressed in randomized clinical trials. Given evidence that tobacco use may increase during cannabis cessation attempts, and additionally that tobacco users have poorer cannabis cessation outcomes, we explored tobacco outcomes, specifically cigarette smoking, from an adolescent cannabis cessation trial that tested the efficacy of N-acetylesteine (NAC). Methods: Cannabis-dependent adolescents (ages 15–21; n = 116) interested in cannabis treatment were randomized to NAC (1200 mg bid) or matched placebo for 8 weeks. Participants did not need to be cigarette smokers or be interested in smoking cessation to qualify for inclusion. Results: Approximately 59% of enrolled participants were daily and non-daily cigarette smokers, and only differed from non-smoking participants on the compu...
University of Miami1, Smith College2, University of Southern California3, California State University, Monterey Bay4, University of Arkansas5, Florida International University6, University of Texas MD Anderson Cancer Center7, University of Massachusetts Amherst8, University of Illinois at Chicago9, Barry University10, Pomona College11, University of Kentucky12, University of Missouri13
TL;DR: It is essential for college student alcohol research to examine US culture acquisition and Hispanic culture retention separately and within the domains of cultural practices, values, and identifications.
Abstract: Objective: This cross-sectional study was conducted to investigate which components of acculturation relate to drinking games participation among Hispanic college students. We also sought to examine whether the relationships between acculturation and drinking games would differ from the associations between acculturation and other alcohol-related outcomes. Method: A sample of 1,397 Hispanic students aged 18–25 (75% women; 77% US-born) from 30 US colleges and universities completed a confidential online survey. Results: Associations among acculturative processes, drinking games participation, general alcohol consumption, and negative drinking consequences differed across gender. Most significant findings emerged in the domain of cultural practices. For women, US cultural practices were associated with greater general alcohol consumption, drinking games frequency, and amount of alcohol consumed while gaming, whereas for men, US cultural practices were associated with general alcohol consumption and ...
TL;DR: Marijuana and alcohol are associated with unique adverse psychosocial outcomes that differ by sex and race/ethnicity, and public health interventions may be more effective by focusing on harm reduction strategies for these drug-specific outcomes.
Abstract: Objectives: There is debate about whether marijuana (cannabis) use is more dangerous than alcohol use. Although difficult to make objective comparisons, research is needed to compare relative dangers in order to help inform preventive efforts and policy. Methods: Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2007–2011; Weighted n = 7437; modal age: 18) who reported lifetime use of alcohol or marijuana. Students were asked to indicate whether they experienced various adverse psychosocial outcomes resulting from use of each substance. We examined which outcomes were more prevalent for each substance. Results: Compared to alcohol use, marijuana use was more commonly reported to compromise relationships with teachers or supervisors, result in less energy or interest, and result in lower school or job performance. Compared to marijuana use, alcohol was more commonly reported to compromise relationships with friends and significant ...
TL;DR: Flavored alcoholic beverages are highly popular among underage drinkers, and the FAB brand preferences of this group are highly concentrated among a small number of brands, so all states should reclassify these beverages as distilled spirits rather than beer.
Abstract: BACKGROUND: Although several studies have identified flavored alcoholic beverages (FABs) as being popular among underage drinkers, no previous study has ascertained the prevalence of brand-specific FAB consumption among a national sample of underage youth. OBJECTIVES: To ascertain the brand-specific consumption prevalence and consumption share of FABs among a national sample of underage drinkers in the United States. METHODS: In 2012, we conducted an online, self-administered survey of a national sample of 1031 underage drinkers, ages 13-20 years, to determine the prevalence of past 30-day consumption for each of 898 alcoholic beverage brands, including 62 FABs, and each brand's youth consumption share, based on the estimated total number of standard drinks consumed. There were three brand-specific outcome measures: prevalence of consumption, prevalence of consumption during heavy episodic drinking, and consumption share, defined as the percentage of the total drinks consumed by all respondents combined that was attributable to a particular brand. RESULTS: The FAB brands with the highest prevalence of past 30-day consumption were Smirnoff malt beverages, 17.7%; Mike's, 10.8%; Bacardi malt beverages, 8.0%; and Four Loko/Four MaXed, 6.1%. Just five brands accounted for almost half (49.1%) of the total consumption share by volume within the FAB category. CONCLUSION: Flavored alcoholic beverages are highly popular among underage drinkers, and the FAB brand preferences of this group are highly concentrated among a small number of brands. To decrease the consumption of FABs by underage youth, all states should reclassify these beverages as distilled spirits rather than beer. Language: en
TL;DR: Among older trauma patients, this study shows significant associations with multiple trauma outcomes, including one between elevated ethanol concentrations and improved outcomes, and future research into the causes of these findings could inform the care of Older trauma patients and aid in prevention of injuries.
Abstract: Background: Substance use among older adults is an increasing concern, with the prevalence of substance use in older populations expected to double in the next decade. Drug and alcohol use is associated with trauma risk and outcomes, but little is known about the specific risk for older trauma patients. Objectives: To evaluate the association between drug and alcohol use and trauma outcomes among adults aged 55 years and older. Methods: This retrospective observational study included older adults from the Illinois Trauma Registry between 1999 and 2009. Exclusion criteria were age younger than 55 years or absent date of birth, ethanol level, or urine drug screen (UDS). Alcohol intoxication was defined as ethanol level greater than 80 mg/dL. UDS was used to screen cocaine and marijuana use. Analyses, for both the alcohol and the marijuana/cocaine groups, compared outcomes for patients with negative vs. positive screens. Results: 21 320 patients were included in the alcohol analysis and 17 077 in the...
TL;DR: Dental clinics may be an appropriate setting for provider education and patient-based intervention strategies to reduce nonmedical use of pain medications in adults seeking dental care from a low-cost dental training clinic.
Abstract: Background: Substance use is overrepresented in dental clinics that provide affordable care and dental clinics provide potential access to opioid analgesics. Research is needed to better understand prescription opioid misuse in this population. Objective: The purpose of this study was to assess the prevalence and correlates of the misuse of prescription opioids in adults seeking dental care from a low-cost dental training clinic. Methods: Patients were recruited from a university school’s dentistry patient emergency and admission services clinic. Patients (n = 369) within the waiting area of the clinic completed a self-report questionnaire about their nonmedical use of prescription pain medications, medication diversion and use of substances. Results: Approximately 37.9% (140/369) of those who completed the study survey reported at least some nonmedical use of pain medications within the past 30 days. Use was associated with diversion of medication, and use of tobacco, marijuana, and sedatives. Co...
TL;DR: Results indicate that the administration of retigabine may produce a decrease in ethanol consumption by rats at doses that do not significantly reduce the drinking of either water or a sucrose solution, consistent with the hypothesis that activation of Kv7 channels facilitates the reduction of alcohol consumption in the rat.
Abstract: Background: Activation of Kv7 potassium channels may decrease the reactivity of mesolimbic dopaminergic neurons that are implicated in mediating the reinforcing effects of ethanol. Objectives: The ...
TL;DR: citicoline appears to decrease craving and is associated with a reduction in cocaine use, at least at high doses in patients with both bipolar disorder and cocaine dependence, and limited data suggest citicoline may also hold promise for alcohol and cannabis dependence and in reducing food consumption.
Abstract: Background: Citicoline is a dietary supplement that has been used as a neuroprotective agent for neurological disorders such as stroke and dementia Citicoline influences acetylcholine, dopamine, and glutamate neurotransmitter systems; serves as an intermediate in phospholipid metabolism; and enhances the integrity of neuronal membranes Interest has grown in citicoline as a treatment for addiction since it may have beneficial effects on craving, withdrawal symptoms, and cognitive functioning, as well as the ability to attenuate the neurotoxic effects of drugs of abuse Objectives: To review the literature on citicoline’s use in addictive disorders Methods: Using PubMed we conducted a narrative review of the clinical literature on citicoline related to addictive disorders from the years 1900–2013 using the following keywords: citicoline, CDP-choline, addiction, cocaine, alcohol, substance abuse, and substance dependence Out of approximately 900 first hits, nine clinical studies have been include
TL;DR: There is variability across Asian and Latino subgroups in the frequency of binge drinking episodes, which is not evident in broad-group population studies.
Abstract: Background: This study provides binge drinking population estimates for California adults by gender and detailed race/ethnicity categories. This information may be helpful for planning targeted initiatives to decrease binge drinking. Method: Data were from the 2007 and 2009 California Health Interview Surveys. The 98 662 respondents represent an annual estimated population of 27.2 million adults. Survey adjusted binary logistic regression was used to calculate gender-specific binge drinking population rates and multinomial logit regression to estimate binge drinking frequency. Results: Adjusting for socio-demographics, any binge drinking during the past year was reported by 31.0% (95% Confidence Interval = 30.5–31.4%) of men and 18.0% (17.7–18.3%) of women. Rates among White men and women were 30.5% and 19.6%, respectively. Binge drinking rates ranged from 11.9% among Chinese to 42.9% among Mexican men and from 4.8% among Vietnamese to 25.7% among “Other Latino” women. Five race/ethnicity categori...