Showing papers in "American Journal of Drug and Alcohol Abuse in 2015"
TL;DR: The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs, including psychological, behavioral, neurobiological, nearly universal safety profile, and overall positive health effects.
Abstract: Background: Epidemiological studies reveal that individuals who report risky substance use are generally less likely to meet physical activity guidelines (with the exception of certain population segments, such as adolescents and athletes). A growing body of evidence suggests that individuals with substance use disorders (SUDs) are interested in exercising and that they may derive benefits from regular exercise, in terms of both general health/fitness and SUD recovery. Objectives: The aims of this paper were to: (i) summarize the research examining the effects of exercise-based treatments for SUDs; (ii) discuss the theoretical mechanisms and practical reasons for investigating this topic; (iii) identify the outstanding relevant research questions that warrant further inquiry; and (iv) describe potential implications for practice. Methods: The following databases were searched for peer-reviewed original and review papers on the topic of substance use and exercise: PubMed Central, MEDLINE, EMBASE, P...
127 citations
TL;DR: Tamadol use was common among adolescents and over one third of tramadol users had drug-related problems, and there was a significant association between tramdol use and older age, male gender, and smoking.
Abstract: Background: Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has...
96 citations
TL;DR: In this exploratory analysis without control for multiple comparisons, viewing a quit plan (CBT) as well as tracking practice of letting urges pass (ACT) were both appealing to app users and associated with successful quitting.
Abstract: Background: Currently, there are over 400 smoking cessation smartphone apps available, downloaded an estimated 780,000 times per month. No prior studies have examined how individuals engage with specific features of cessation apps and whether use of these features is associated with quitting. Objectives: Using data from a pilot trial of a novel smoking cessation app, we examined: (i) the 10 most-used app features, and (ii) prospective associations between feature usage and quitting. Methods: Participants (n = 76) were from the experimental arm of a randomized, controlled pilot trial of an app for smoking cessation called “SmartQuit,” which includes elements of both Acceptance and Commitment Therapy (ACT) and traditional cognitive behavioral therapy (CBT). Utilization data were automatically tracked during the 8-week treatment phase. Thirty-day point prevalence smoking abstinence was assessed at 60-day follow-up. Results: The most-used features – quit plan, tracking, progress, and sharing – were mo...
91 citations
TL;DR: Changes are underway in the perception and use of marijuana among American youth, however, changes differ in important ways among youth from distinct developmental subgroups.
Abstract: Background: Despite policy changes related to the use and distribution of marijuana in cities and states across the country, few studies have examined changes in disapproval and use of marijuana among American youth. Objectives: To examine trends in disapproval and use of marijuana among adolescents and young adults in the United States. Method: We employed nationally representative data spanning the period of 2002–2013. Analyses were based on self-reported measurements from 105,903 younger adolescents (aged 12–14); 110,949 older adolescents (aged 15–17); and 221,976 young adults (aged 18–25). Results: Between 2002 and 2013 the proportion of adolescents aged 12–14 reporting “strong disapproval” of marijuana use initiation increased significantly from 74.4–78.9%. Concurrently, a significant decrease in past 12-month marijuana use (OR = 0.98, 95% CI = 0.97–0.99) was observed among younger adolescents. No significant trend was observed for marijuana use disapproval among adolescents aged 15–17 betwee...
70 citations
TL;DR: Findings indicate that cocaine and methamphetamine dependence are significantly and differentially associated with gray matter abnormalities, and point to possible gray matter recovery after abstinence from methamphetamine.
Abstract: Background: Voxel-based morphometry has been used to explore gray matter alterations in cocaine and methamphetamine dependence. However, the results of this research are inconsistent. Objectives: The current study meta-analytically examined neuroimaging findings of all studies published before 2014 using the Anisotropic Effect-Size Signed Differential Mapping (ES-SDM). Methods: Independent investigators searched four major databases for relevant neuroimaging studies involving cocaine and methamphetamine dependence. Nine cocaine and four methamphetamine studies met inclusion criteria. Results: Results indicated that cocaine- and methamphetamine-dependent patients share overlapping regional gray matter abnormalities compared to healthy controls. However, subgroup analysis showed some regional differences; with methamphetamine showing more prominent reductions in the left superior temporal gyrus and the right inferior parietal lobe. Reductions in the right insula and the left superior frontal gyrus w...
64 citations
TL;DR: There was some evidence to support the effectiveness of programs that utilize intensive supervision and education in DUI prevention programs, but there is a need for future evaluations to adopt more scientifically rigorous research designs to establish the effects of these programs.
Abstract: Background: Driving under the influence (DUI) is a major cause of death and disability. Although a broad array of programs designed to curb DUI incidents are currently offered to both first-time and recidivist DUI offenders, existing evaluations of the effectiveness of these programs have reported mixed results. Objective: To synthesize the results of DUI program evaluations and determine the strength of the available evidence for reducing recidivism for different types of programs. Methods: A systematic review of all EBSCO databases, EMBASE, PubMed, ProQuest, Sociological Abstracts and TRIS was conducted to identify evaluations of treatments/interventions to prevent DUI offenses. Additional articles were identified from reference lists of relevant articles. Results: A total of 42 relevant studies were identified by the search strategy. Of these, 33 utilized non-experimental evaluation designs or reported insufficient data to allow effect sizes to be calculated, making meta-analysis unfeasible. Ev...
62 citations
TL;DR: heightened exteroceptive processes may underlie cue-elicited craving, which in turn may lead to the maintenance and worsening of substance use disorders and provide a testable framework from which novel targets for interventions can be identified.
Abstract: Background: Exteroception involves processes related to the perception of environmental stimuli important for an organism’s ability to adapt to its environment. As such, exteroception plays a critical role in conditioned response. In addiction, behavioral and neuroimaging studies show that the conditioned response to drug-related cues is often associated with alterations in brain regions including the precuneus/posterior cingulate cortex, an important node within the default mode network dedicated to processes such as self-monitoring. Objective: This review aimed to summarize the growing, but largely fragmented, literature that supports a central role of exteroceptive processes in addiction. Methods: We performed a systematic review of empirical research via PubMed and Google Scholar with keywords including ‘addiction’, ‘exteroception’, ‘precuneus’, and ‘self-awareness’, to identify human behavioral and neuroimaging studies that report mechanisms of self-awareness in healthy populations, and alter...
53 citations
TL;DR: PTSD is a significant risk factor for PO misuse for both men and women, and men with PTSD are in addition at increased risk for PO abuse and dependence, and these findings have implications for harm reduction and substance abuse prevention efforts.
Abstract: Background: Prescription opioid (PO) misuse is a significant concern in the United States Objectives: This study describes the prevalence and timing of PO misuse, diagnoses of opiate abuse and dependence, and their associations with psychiatric disorders in a sample of young people who inject drugs (PWID) Methods: Participants were 570 young (18–25 years) PWID, primarily heroin users, recruited through outreach and respondent-driven sampling Trained interviewers administered a semi-structured psychiatric interview Diagnoses of substance use and mental disorders were based on DSM-IV diagnostic criteria Results: Estimated rates of lifetime PO abuse and dependence were 19% and 17%, respectively Past year PO misuse was significantly associated with anti-social personality disorder (ASPD, OR = 215, 95% CI 143–324), past year substance-induced major depression (SIMD, OR = 181, 95% CI 116–283), and prior post-traumatic stress disorder (PTSD, OR = 245, 95% CI 131–460) Among male PO users,
45 citations
TL;DR: Policy analysis showed that both tamper-resistant formulations and interventions to reduce informal sharing could significantly reduce nonmedical user populations and overdose deaths in the long term, but the modeled effect sizes require additional empirical support.
Abstract: Background: Nonmedical use of pharmaceutical opioid analgesics (POA) increased dramatically over the past two decades and remains a major health problem in the United States, contributing to over 16 000 accidental poisoning deaths in 2010. Objectives: To create a systems-oriented theory/model to explain the historical behaviors of interest, including the various populations of nonmedical opioid users and accidental overdose mortality within those populations. To use the model to explore policy interventions including tamper-resistant drug formulations and strategies for reducing diversion of opioid medicines. Methods: A system dynamics model was constructed to represent the population of people who initiate nonmedical POA usage. The model incorporates use trajectories including development of use disorders, transitions from reliance on informal sharing to paying for drugs, transition from oral administration to tampering to facilitate non-oral routes of administration, and transition to heroin use...
43 citations
TL;DR: The findings from this pilot study suggests that re-training approach biases toward cigarettes shows promise for smoking cessation among adolescent smokers.
Abstract: Background: This pilot study conducted a preliminary examination of whether Cognitive Bias Modification (CBM), a computerized task to retrain cognitive-approach biases towards smoking stimuli (a) c...
43 citations
TL;DR: It may be useful in clinical settings to identify those experiencing problems with tanning and in research to further clarify the conceptualization of addiction-like tanning, however, the CTQ needs further evaluation.
Abstract: Background: Researchers and clinicians suggest that excessive tanning may be a behavioral addiction. Given the significance of craving in substance use, craving may be a useful construct to assess in those who tan. Objective: We designed this study to assess the psychometric properties of an alcohol craving measure adapted to measure past-week craving to tan. Methods: Undergraduate students (n = 421) who reported past-month tanning completed a battery of questionnaires that assessed demographics, tanning-related characteristics, and psychopathology, in addition to the Craving to Tan Questionnaire (CTQ). Results: Analyses provided support for a single factor CTQ with good internal consistency, construct validity and convergent validity. CTQ scores were significantly higher among problematic versus non-problematic and dependent versus non-dependent tanners. CTQ scores were also associated with several tanning-related characteristics, such money spent on tanning in a typical month, frequency of tanni...
TL;DR: The findings suggest that treatment quality differs between urban and rural centers in complex ways that are subject to resource availability.
Abstract: Background: While previous research has added to the understanding of rural residents’ unique health challenges, much remains to be learned about the provision of substance use disorder (SUD) treatment in rural areas. A key question is difference in structural resources and quality of care between rural and urban treatment centers. Objective: To examine differences in treatment quality in rural and urban centers and to determine if differences in treatment quality are contextualized by centers’ structural resources. Methods: Utilizing combined data from two representative samples of SUD treatment centers (n = 591), we used a series of multivariate regressions to analyze the association between center rurality and various indicators of structural characteristics and treatment quality. Interaction effects were further examined between structural characteristics and treatment quality indicators. Results: We found that structural and quality differences between rural and urban treatment centers were p...
TL;DR: Preliminary data provide the first demonstration of safety and feasibility of the co-administration of NAC and VAR in cigarette smokers, and support future efficacy research on N-acetylcysteine and Var for smoking cessation.
Abstract: Background: Varenicline (VAR) has demonstrated superior efficacy over other smoking cessation pharmacotherapies, though 50–60% of those treated do maintain abstinence. Some preclinical findings suggest that new nicotine dependence pharmacotherapies should target the glutamatergic system, given its demonstrated role in addiction. Attention has been given to N-acetylcysteine (NAC), which appears to restore normal glutamate signaling in animal models. It is possible that NAC and VAR may work in concert to promote abstinence at higher rates than with either medication alone. Objective: To demonstrate the feasibility and safety of co-administering NAC and VAR in nicotine-dependent participants. Methods: Participants (n = 19) were daily cigarette smokers, and did not need to be seeking treatment. They received 4 weeks of open-label treatment with NAC (1200 mg twice daily) and VAR (1 mg twice daily, following titration) and were assessed weekly for adverse events (AEs), smoking, craving and withdrawal. R...
TL;DR: Policy actions should focus on the development of effective risk communication strategies that target college-age adults and on limiting the accessibility of hookah tobacco products to these adults.
Abstract: Background: About 30% of college students have smoked hookah tobacco. Although most students perceive this product to be innocuous and non-addictive, hookah tobacco increases the risk for disease and nicotine dependence. Currently, the US Food and Drug Administration (FDA) does not regulate the manufacture, distribution, or sale of hookah tobacco. Objective: Empirical literature pertaining to hookah tobacco smoking is reviewed with a focus on the implications for regulatory policy. Methods: PubMed, PsycINFO, and Scopus databases were searched to locate articles published in English. The literature search combined several key words including “hookahs”, “college”, “advertising”, “health effects”, and “health policy”. Results: Smoking hookah tobacco may play a role in the initiation of smoking among tobacco-naive college students and may portend persistent smoking among those who have smoked cigarettes. College students are typically nondaily, social smokers. They do not perceive that their heightene...
TL;DR: Preliminary findings suggest that heroin abuse is significantly associated with damage to white matter integrity, and these results are considered preliminary and analyses should be revisited with more primary studies focusing on either long- or short-term abuse as well as abstinence.
Abstract: Background: Diffusion tensor imaging has been used to explore white matter changes in heroin-dependent patients; however, results have been inconsistent Objectives: The current study meta-analytically examines the neuroimaging findings of all studies published before 2014 using the novel technique of Effect Size Signed Differential Mapping (ES-SDM) Methods: Two independent investigators searched three databases for whole-brain voxel-based fractional anisotropy morphometric studies involving heroin use without comorbid polysubstance abuse Of 59 initial primary studies, four met stringent inclusion criteria Results: Results from this preliminary analysis indicate that heroin abusers may have significant reductions in fractional anisotropy in the bilateral frontal sub-gyral regions extending from the limbic structures to the prefrontal association cortices, implicating damage to the cingulum and superior longitudinal fasciculus Exploratory moderator analyses indicate that the potential damage in
TL;DR: There is currently no evidence to suggest that buprenorphine is better suited to treatment of prescription opioid abuse than methadone, and despite its perennial popularity, there is noEvidence to recommend detoxification as an efficacious approach to Treatment of opioid dependence during pregnancy.
Abstract: The past decade has seen an increase in rates of opioid abuse during pregnancy. This clinical challenge has been met with debate regarding whether or not illicit and prescription opioid-dependent individuals require different treatment approaches; whether detoxification is preferable to maintenance; and the efficacy of methadone versus buprenorphine as treatment options during pregnancy. The clinical recommendations resulting from these discussions are frequently influenced by the comparative stigma attached to heroin abuse and methadone maintenance versus prescription opioid abuse and maintenance treatment with buprenorphine. While some studies have suggested that a subset of individuals who abuse prescription opioids may have different characteristics than heroin users, there is currently no evidence to suggest that buprenorphine is better suited to treatment of prescription opioid abuse than methadone. Similarly, despite its perennial popularity, there is no evidence to recommend detoxification as an efficacious approach to treatment of opioid dependence during pregnancy. While increased access to treatment is important, particularly in rural areas, there are multiple medical and psychosocial reasons to recommend comprehensive substance abuse treatment for pregnant women suffering from substance use disorders rather than office-based provision of maintenance medication. Both methadone and buprenorphine are important treatment options for opioid abuse during pregnancy. Methadone may still remain the preferred treatment choice for some women who require higher doses for stabilization, have a higher risk of treatment discontinuation, or who have had unsuccessful treatment attempts with buprenorphine. As treatment providers, we should advocate to expand available treatment options for pregnant women in all States.
TL;DR: The results suggest that hazardous drinkers who completed the specific training and received personalized feedback seemed to do better on frequency and quantity of alcohol use than hazardous drinkers (college students) who received only personalized feedback.
Abstract: Background: Although motivational processes may influence the intervention effects and help prevention programmes identify students at great risk for alcohol-related problems, no computerized alcohol intervention has yet to be tailored to drinking motives. Objective: To describe the development and initial pilot testing of a computer-delivered intervention tailored to drinking motives, to prevent alcohol abuse and its adverse consequences among university students in general and among baseline hazardous drinkers specifically. Methods: 124 college students attending a public university in northeastern Italy participated in this study in October of 2012 (89.2% female- mean age = 21.64–34% baseline hazardous drinkers). Two classes (one undergraduate, one graduate) were assigned to one of two conditions: intervention and control group. Both groups received profile-specific feedback and then the intervention group received profile-specific online training for 4 weeks. This profile was based on their ri...
TL;DR: Initial evidence of alcohol cue-elicited habituation in fronto-temporal regions, despite continued craving, following a priming dose of alcohol is provided, adding to the understanding of the function of alcohol priming in alcohol dependence.
Abstract: Background: Priming doses of alcohol are associated with increased desire to drink and disinhibitory effects on subsequent control over drinking. Despite the importance of alcohol priming in the cue-reactivity literature, the effects of priming on brain responses to alcohol cues remains unclear. Furthermore, evidence suggests this relationship may be moderated by OPRM1 genotype. Methods: Twenty individuals with alcohol dependence (six females; 90% Caucasian; mean age = 29.4) who were prospectively genotyped on the OPRM1 gene underwent two functional magnetic resonance imaging (fMRI) sessions, before and after a priming dose of alcohol, each including a gustatory alcohol cue reactivity paradigm and self-reported craving measures. Results: Self-reported alcohol craving generally increased and remained higher for alcohol versus water cue presentations across pre- and post-priming scans. Compared to alcohol cues delivered during the post-priming scan, alcohol cues delivered pre-priming were associated...
TL;DR: Medical marijuana use is much more prevalent among adults hospitalized with a psychiatric emergency than in the general population; diversion is common.
Abstract: Background: Marijuana use is associated with anxiety, depressive, psychotic, neurocognitive, and substance use disorders. Many US states are legalizing marijuana for medical uses. Objective: To det...
TL;DR: Neuroimaging findings indicate that clinical studies of the combination of VAR + NTX for heavy drinkers trying to quit smoking may be warranted.
Abstract: Rationale: Heavy drinking smokers constitute a sizeable and hard-to-treat subgroup of smokers, for whom tailored smoking cessation therapies are not yet available. Objective: The present study used a double-blind, randomized, 2 × 2 medication design, testing varenicline alone (VAR; 1 mg twice daily), naltrexone alone (NTX; 25 mg once daily), varenicline plus naltrexone, and placebo for effects on neural activation to cigarette cues in a sample (n = 40) of heavy drinking daily smokers (≥10 cigarettes/day). Methods: All participants were tested after a 10–12-day titration period designed to reach steady state on the target medication. Participants underwent functional neuroimaging (fMRI) for examination of brain responses to visual smoking-related (vs. neutral) cues. Results: Region of interest (ROI) analyses of brain responses to Cigarette vs. Neutral Cues indicated that the combination of VAR + NTX was associated with reduced activation of the bilateral anterior cingulate cortex as compared to pla...
TL;DR: It is shown that no single distribution provides the best fit for all substances and the common procedure of aggregating use across different substances may not be ideal.
Abstract: Background: It is important to correctly understand the associations among addiction to multiple drugs and between co-occurring substance use and psychiatric disorders. Substance-specific outcomes (e.g. number of days used cannabis) have distributional characteristics which range widely depending on the substance and the sample being evaluated. Objectives: We recommend a four-part strategy for determining the appropriate distribution for modeling substance use data. We demonstrate this strategy by comparing the model fit and resulting inferences from applying four different distributions to model use of substances that range greatly in the prevalence and frequency of their use. Methods: Using Timeline Followback (TLFB) data from a previously-published study, we used negative binomial, beta-binomial and their zero-inflated counterparts to model proportion of days during treatment of cannabis, cigarettes, alcohol, and opioid use. The fit for each distribution was evaluated with statistical model sel...
TL;DR: Findings suggest that there may be a relationship between addiction severity, use of certain drugs of abuse and eating disorder symptoms, particularly those involving weight and shape concerns in women with comorbid PTSD and SUD.
Abstract: Background: Eating disorders (ED) and substance use disorders (SUD) commonly co-occur, especially in conjunction with posttraumatic stress disorder (PTSD), yet little is known about ED and ED symptoms in women presenting to addiction treatment programs. Objective: We examined the association between ED symptoms and substance use frequency and severity in a sample of women with a DSM IV diagnosis of current SUD and PTSD enrolled in SUD treatment. Method: Participants were 122 women from four substance abuse treatment sites who participated in a multi-site clinical trial through the National Institute of Drug Abuse Clinical Trials Network (NIDA CTN). The Eating Disorder Examination-Questionnaire (EDE-Q), the Clinician’s Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were administered at baseline and correlational analyses were performed. Variables that significantly correlated with EDE-Q total and subscale scores were entered into a linear regression analysis. Results: Scores ...
TL;DR: EtG-I can be considered a useful clinical monitoring tool for alcohol use in community-based addiction treatment settings as well as at a higher cut-off level recommended by most by commercial drug testing laboratories.
Abstract: Background: Immunoassay urine drug screening cups that detect use for two or more days are commonly used in addiction treatment settings. Until recently, there has been no comparable immunoassay test for alcohol use in these settings. Objectives: The aim of this study was to assess the agreement of a commercially available ethyl glucuronide immunoassay (EtG-I) test conducted at an outpatient addiction clinic and lab-based EtG mass spectrometry (EtG-MS) conducted at a drug testing laboratory at three cut-off levels. High agreement between these two measures would support the usefulness of EtG-I as a clinical tool for monitoring alcohol use. Methods: Forty adults with co-occurring alcohol dependence and serious mental illnesses submitted 1068 urine samples over a 16-week alcohol treatment study. All samples were tested using EtG-I on a benchtop analyzer and 149 were randomly selected for EtG-MS analysis at a local laboratory. Agreement was defined as the number of samples where EtG-I and EtG-MS were...
TL;DR: Light is shed on the neurobiological mechanisms that may underlie the alterations in eating and fat regulation in cocaine-dependent individuals, to open up potential new avenues to support these individuals in recovery.
Abstract: For many individuals in treatment for cocaine dependence, weight gain is a substantial problem during recovery. This weight gain causes significant distress and seems to increase the risk of relapse. The mechanisms underlying cocaine's effects on weight remain elusive. It is widely assumed that this weight gain reflects a metabolic or behavioural compensatory response to the cessation of cocaine use. Here we challenge this assumption and outline potential mechanisms by which chronic cocaine use produces disturbances in the regulation of fat intake and storage, through its effects on the central and peripheral nervous systems, specifically the sympathetic nervous system. We hypothesize that the cocaine-induced alteration in fat regulation results in cocaine users developing a pronounced appetite for fatty food but keeps their fat mass low. This altered fat appetite subsequently leads to excessive weight gain when individuals enter treatment and stop using cocaine. Our aim is to shed light on the neurobiological mechanisms that may underlie the alterations in eating and fat regulation in cocaine-dependent individuals, to open up potential new avenues to support these individuals in recovery.
TL;DR: This study hypothesized that the relations between emotion regulation difficulties and problem drinking would be most salient for college students with increased CASA exposure and decreased DRSE, and indicated that for students without trauma exposure, problem drinking was the greatest for those with decreasedDRSE and increased emotionregulation difficulties.
Abstract: Background: Problem drinking in college is a longstanding problem with potentially severe consequences. More recently, problem drinking has been linked to emotion regulation difficulties. However, these results are mixed and emphasize the need to examine moderating variables that may strengthen the problem drinking/emotion regulation relationship. Two such variables are child/adolescent sexual abuse (CASA) and drinking refusal self-efficacy (DRSE). Objectives: The current study hypothesized that the relations between emotion regulation difficulties and problem drinking would be most salient for college students with increased CASA exposure and decreased DRSE. Secondary analyses examined the hypothesis taking into consideration cumulative child/adolescent trauma exposure. Methods: Undergraduate students (n = 200) completed a large survey battery for course credit. Results: Three-way interactions across the CASA and cumulative trauma models were significant and in a similar direction. Results indica...
TL;DR: Dysphoria was indirectly, positively related to perceived barriers, cessation problems, negative reinforcement smoking expectancies, and motivation to quit indirectly through higher levels of AIS, which may explain a wide range of clinically-relevant smoking processes.
Abstract: Background: Emerging data suggest that dysphoria is one facet of depression that is especially related to various aspects of cigarette smoking. However, it is presently unknown what emotional processes may account for these relations. Objectives: In the current cross-sectional study, the impact of avoidance and inflexibility to smoking (AIS), a smoking-specific form of experiential avoidance, was tested on the relationship of dysphoria to four specific smoking processes that are key factors in cessation: perceived barriers to cessation, severity of problems during prior quit attempts, negative reinforcement smoking expectancies, and motivation to quit smoking. Methods: Participants (n = 465) were treatment-seeking adult daily smokers. Relative indirect effects were subjected to bootstrap analyses to test direct and indirect effects of dysphoria on smoking processes. Results: After controlling for gender, nicotine dependence severity, drinking problems, cannabis use, negative affectivity, tobacco-r...
TL;DR: Findings highlight the potential utility of interventions for individuals with cannabis use disorder and co-occurring PTSD, particularly early in a cessation attempt.
Abstract: Background: Though a growing number of US Veterans are being diagnosed with cannabis use disorders, with posttraumatic stress disorder (PTSD) observed as the most frequently co-occurring psychiatric disorder among this population, no research has investigated the impact of PTSD diagnosis on cannabis quit success. Objectives: The present study sought to determine the impact of PTSD on cannabis use following a self-guided quit attempt. Methods: Participants included 104, primarily male, cannabis-dependent US Veterans (Mage = 50.90 years, SDage = 9.90). The study design was prospective and included an assessment immediately prior to the quit attempt, and assessments weekly for the first 4 weeks post-quit, and then monthly through 6 months post-quit. Results: Results indicated that PTSD diagnosis was not associated with time to first lapse or relapse. However, individuals with PTSD used more cannabis at baseline and evidenced a slower initial decline in cannabis use immediately following the quit atte...
TL;DR: Universities should ensure that prevention efforts address current substance use, including K2/Spice, and that treatment options are available for first year students who use substances, as well as identify factors associated with lifetime K2 and Spice use at college entry and first use during college.
Abstract: Background: K2 and Spice consist of an herbal blend of plant matter and chemical synthetic cannabinoids. These substances emerged in the early 2000s as a popular alternative to marijuana among yout...
TL;DR: Shoppers travelled larger distances, visited more states and paid in cash for ADHD medications more often than non-shoppers, and data sharing among prescriptions monitoring programs can improve their effectiveness and drug utilization studies should take account of cash purchases.
Abstract: Background: Doctor shopping, defined by filling overlapping prescriptions from more than one prescriber at more than two pharmacies, is a way to obtain scheduled medications for diversion or abuse. Little is known about how far attention deficit hyperactivity disorder (ADHD) medication shoppers travel, how often they cross state lines to fill their ADHD prescriptions and how often they pay for their medication in cash, i.e. entirely out of pocket. Objective: We sought to describe the pattern of doctor shopping for ADHD medications: how far shoppers travel, how often they cross state lines to fill their prescriptions, and how often they pay in cash. Methods: Retrospective cohort study using LRx, a large US retail prescription database. We included subjects with any ADHD medication dispensed between 2011 and 2012. Subjects were followed for 18 months. Results: Of a total of 4 402 464 subjects exposed to ADHD medications, 0.4% developed shopping behavior. Women were more likely to become shoppers. Sh...
TL;DR: Findings of the very early onset of substance and polysubstance use indicated easy accessibility of legal and illicit substances by children and youth in Istanbul can be useful in developing preventive early interventions and treatment facilities.
Abstract: Background: Adolescent substance use is an increasing major health problem in developing countries. Objectives: To evaluate the sociodemographic characteristics and drug abuse patterns of children and youth seeking treatment in Turkey. Methods: This retrospective study reviewed the demographic and clinical data of substance users who visited the substance addiction treatment clinic for children and youth in Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery in Istanbul, between January 2011 and December 2012. Results: The sample comprised of 1969 children and youth aged between 11 and 20 (346 female and 1623 male). Cannabis (60.1%), followed by solvents/inhalants (38.3%) and ecstasy (33.4%), were the most prevalent substances used. The use of solvents/inhalants was more common among males, whereas ecstasy and cocaine use were more common among females. The mean age for the onset of substance use was 13 years. The proportion of polysubstance use was 60.2%. There was ...