Showing papers in "American Journal of Drug and Alcohol Abuse in 2016"
TL;DR: Depression, anxiety, and anhedonia were elevated at baseline but reduced to normal within the first 1–2 months for patients who remained in treatment and did not relapse.
Abstract: Background: Naltrexone is a μ-opioid receptor antagonist that blocks opioid effects. Craving, depression, anxiety, and anhedonia are common among opioid dependent individuals and concerns have been raised that naltrexone increases them due to blocking endogenous opioids. Here, we present data that address these concerns. Objective: Assess the relationship between affective responses and naltrexone treatment. Methods: Opioid dependent patients (N = 306) were enrolled in a three cell (102ss/cell) randomized, double blind, double dummy, placebo-controlled 6-month trial comparing extended release implantable naltrexone with oral naltrexone and placebo (oral and implant). Monthly assessments of affective responses used a Visual Analog Scale for opioid craving, the Beck Depression Inventory, Spielberger Anxiety Test, and the Ferguson and Chapman Anhedonia Scales. Between-group outcomes were analyzed using mixed model analysis of variance (Mixed ANOVA) and repeated measures and the Tukey test for those w...
67 citations
TL;DR: Exposures reported to the poison center that involve NPS are increasing and the majority involve SCRAs, and these findings should inform prevention and harm reduction approaches.
Abstract: Background: Novel psychoactive substances (NPS) are emerging at an unprecedented rate. Likewise, prevalence of use and poisonings has increased in recent years. Objective: To compare characteristics of NPS exposures and non-NPS-drug-related exposures and to examine whether there are differences between exposures involving synthetic cannabinoid receptor agonists (SCRAs) and other NPS. Methods: Poison control center data from the five counties of New York City and Long Island were examined from 2011–2014. We examined prevalence and characteristics of NPS exposures (classified as intentional abuse) and compared characteristics of cases involving SCRAs and other NPS. Results: Prevalence of NPS exposures was 7.1% in 2011, rising to 12.6% in 2014. Most exposures (82.3%) involved SCRA use. The second and third most prevalent classes were phenethylamines/synthetic cathinones (“bath salts”; 10.2%) and psychedelic phenethylamines (4.3%). Compared to other drug-related exposures (i.e. involving licit and ill...
65 citations
TL;DR: NPS use is prevalent in the nightclub and festival scenes in NYC and individuals in these scenes—especially frequent attendees—are at high risk for use, prevention and harm reduction services need to be geared toward this population.
Abstract: Background: Novel psychoactive substances (NPSs) continue to emerge in the United States and worldwide. Few epidemiological studies have examined the prevalence and correlates of use. Objective: We examined the extent of NPS use in a high-risk population—attendees of electronic dance music (EDM) parties at nightclubs and festivals. Methods: We surveyed 682 adults (age 18–25) entering EDM events at nightclubs and festivals in New York City (NYC) in 2015. A variation of time–space sampling was used. We examined the prevalence of self-reported use of 196 NPS and correlates of any NPS use. Results: Over a third (35.1%) of participants reported lifetime use of any NPS. Self-reported use of synthetic cannabinoids was most prevalent (16.3%), followed by psychedelic phenethylamines (14.7%; 2C series: 10.3%, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine [NBOMe] series: 9.0%, Dox series: 3.5%), synthetic cathinones (“bath salts”, 6.9%), other psychedelics (6.6%), tryptamines (5.1%), a...
61 citations
TL;DR: The data suggest that the psychometric properties of the PANAS are retained in substance using populations and suggest that Positive Affect may also be an important factor in substance use treatment outcomes.
Abstract: Background: The Positive and Negative Affect Schedule (PANAS) is a widely used measure of affect. A comprehensive psychometric evaluation among substance users, however, has not been published. Objective: To examine the psychometric properties of the PANAS in a sample of outpatient treatment substance users. Methods: We used pooled data from four randomized clinical trials (N = 416; 34% female, 48% African American). Results: A confirmatory factor analysis indicated adequate support for a two-factor correlated model comprised of Positive Affect and Negative Affect with correlated item errors (Comparative Fit Index = 0.93, Root Mean Square Error of Approximation = 0.07, χ2 = 478.93, df = 156). Cronbach’s α indicated excellent internal consistency for both factors (0.90 and 0.91, respectively). The PANAS factors had good convergence and discriminability (Composite Reliability > 0.7; Maximum Shared Variance < Average Variance Extracted). A comparison from baseline to Week 1 indicated acceptable test-...
60 citations
TL;DR: Poisonings by prescription opioids largely impact both young children and adolescents in pediatric patients, and can be used to help target this population for future preventive efforts.
Abstract: Background: Prescription medication abuse is an increasingly recognized problem in the United States. As more opioids are being prescribed and abused by adults, there is an increased risk of both accidental and intentional exposure to children and adolescents. The impact of pediatric exposures to prescription pain pills has not been well studied. Objectives: We sought to evaluate emergency department (ED) visits for poisoning by prescription opioids in pediatric patients. Methods: This retrospective study looked at clinical and demographic data from the Nationwide Emergency Department Sample (NEDS) from 2006 to 2012. Results: There were 21,928 pediatric ED visits for prescription opioid poisonings and more than half were unintentional. There was a bimodal age distribution of patients, with slightly more than half occurring in females. The majority of patients were discharged from the ED. More visits in the younger age group (0–5 years) were unintentional, while the majority of visits in the adoles...
52 citations
TL;DR: The current results offer direction for potentially modifying brief alcohol interventions in efforts to reduce students’ engagement in problem drinking behaviors, and might incorporate information on the risks of using alcohol as a means of emotion regulation and offer alternative emotion regulation strategies.
Abstract: Background: Problem drinking in college places students at an increased risk for a wealth of negative consequences including alcohol use disorders. Most research has shown that greater emotion regulation difficulties are related to increased problem drinking, and studies generally assume that drinking is motivated by efforts to cope with or enhance affective experiences. However, there is a lack of research specifically testing this assumption. Objectives: The current study sought to examine the mediating potential of drinking motives, specifically coping and enhancement, on the relationship between emotion regulation and problem drinking. Method: College participants (N = 200) completed an online survey, consisting of a battery of measures assessing alcohol use behaviors and related variables. Results: Coping drinking motives fully mediated the emotion regulation/problem drinking relationship, and enhancement motives partially mediated this relationship. Exploratory analyses indicated that all fo...
44 citations
TL;DR: Findings suggest that alcohol advertising influences an important aspect of drinking behavior – brand choice – among youth who consume alcohol.
Abstract: Background: Marketing is increasingly recognized as a potentially important contributor to youth drinking, yet few studies have examined the relationship between advertising exposure and alcohol consumption among underage youth at the brand level. Objectives: To examine the relationship between brand-specific exposure to alcohol advertising among underage youth and the consumption prevalence of each brand in a national sample of underage drinkers. Methods: We analyzed the relationship between population-level exposure of underage youth ages 12–20 to brand-specific alcohol advertising in national magazines and television programs and the 30-day consumption prevalence – by brand – among a national sample of underage drinkers ages 13–20. Underage youth exposure to alcohol advertising by brand for each month in 2011, measured in gross rating points (GRPs, a standard measure of advertising exposure), was obtained from GfK MRI (a media consumer research company) and Nielsen for all measured national iss...
36 citations
TL;DR: Subgroup analyses suggest that this combination may be more beneficial in males and patients with higher baseline nicotine dependence than varenicline monotherapy, though further safety analysis is warranted to rule out additive psychiatric adverse effects.
Abstract: Background: Tobacco is the leading cause of preventable death in the world. Current cessation medications include nicotine replacement therapy (NRT), varenicline, and bupropion, while combination therapy primarily entails NRT with either varenicline or bupropion. However, recent studies have examined varenicline and bupropion in combination. Objectives: A systematic review assessing the efficacy and safety of combination varenicline and bupropion was conducted. Methods: PubMed and Clinicaltrials.gov were searched using terms: “varenicline combination”, “bupropion combination”, “bupropion AND varenicline”, and “bupropion AND varenicline combination smoking cessation”, yielding four studies including 1193 total patients. Results: Combination therapy yielded greater efficacy than varenicline monotherapy in two randomized controlled trials and one retrospective outcomes study. One single-arm Phase II trial provided additional efficacy and safety data. Of the prospective trials, one displayed a greater...
36 citations
TL;DR: Exploratory analyses showed adolescents who were aggressive, impulsive, had deviant peers, poor family functioning or more people living at home were at greater risk for heavy binge alcohol use, but confirmatory analysis concluded that school attendance and residential stability reduce the probability of heavy bingealcohol use, even among those already at low risk.
Abstract: Background: American Indian (AI) adolescents are disproportionately burdened by alcohol abuse and heavy binge use, often leading to problematic drinking in adulthood. However, many AI communities also have large proportions of adults who abstain from alcohol. Objective: To understand these concurrent and divergent patterns, we explored the relationship between risk and protective factors for heavy binge alcohol use among a reservation-based sample of AI adolescents. Methods: Factors at individual, peer, family, and cultural/community levels were examined using a cross-sectional case–control study design. Cases were adolescents with recent heavy binge alcohol use that resulted in necessary medical care. Controls had no lifetime history of heavy binge alcohol use. 68 cases and 55 controls were recruited from emergency health services visits. Participants were 50% male; average age 15.4 years old, range 10 to 19. Independent variables were explored using logistic regression; those statistically signi...
36 citations
TL;DR: Tai Chi is a promising exercise that improves quality of life for individuals with amphetamine-type stimulant (stimulant) dependence and this study demonstrates it.
Abstract: Background: Tai Chi is a traditional Chinese sport that is classified as a moderate exercise. Recent studies have evaluated the effectiveness of Tai Chi in substance abuse rehabilitation. Objectives: The aim of this study was to assess the quality of life and physical effects of a Tai Chi intervention on individuals with amphetamine-type stimulant (stimulant) dependence. Methods: Sixty male subjects with stimulant dependence from a Shanghai Mandatory Detoxification and Rehabilitation Center participated in a 12-week trial. Tai Chi was used as an intervention in the experimental group (n = 30). The control group (n = 29) underwent standard care, which included recreation activity, gesture language exercise, and self-education. Outcome measures included the quality of life for drug addiction (QOL-DA) questionnaire [four scales consisting of physiology (e.g., energy level), psychology (e.g., depression), symptoms (e.g., physical symptoms), society (e.g., interpersonal) and fitness evaluations (assess...
30 citations
TL;DR: The strength of the beneficial effects of brief alcohol interventions on youth’s alcohol use may vary depending upon the outcome measure utilized, but significant effects were observed across measures.
Abstract: Background: Brief alcohol interventions are one approach for reducing drinking among youth, but may vary in effectiveness depending on the type of alcohol assessments used to measure effects. Objectives: To conduct a meta-analysis that examined the effectiveness of brief alcohol interventions for adolescents and young adults, with particular emphasis on exploring variability in effects across outcome measurement characteristics. Method: Eligible studies were those using an experimental or quasi-experimental design to examine the effects of a brief alcohol intervention on a post-intervention alcohol use measure for youth aged 11–30. A comprehensive literature review identified 190 unique samples that were included in the meta-analysis. Taking a Bayesian approach, we used random-effects multilevel models to estimate the average effect and model variability across outcome measurement types. Results: Brief alcohol interventions led to significant reductions in self-reported alcohol use among adolescen...
TL;DR: Women who use drugs in Malaysia report high levels of polysubstance use and injection-related risk behaviors, including sharing of injection equipment and being injected by others, suggesting the need for improved access to OAT services and other harm reduction measures that prioritize women.
Abstract: Background: While drug use is associated with HIV risk in Southeast Asia, little is known about substance use behaviors among women, including drug injection. Objectives: To describe patterns of substance use among women using alcohol and drugs in Malaysia and identify correlates of lifetime and active drug injection, a risk factor for HIV transmission. Methods: A survey of 103 women who used drugs in the last 12 months assessed drug use history and frequency, including drug injection and drug use during pregnancy, self-reported HIV-status, childhood and adulthood physical and sexual abuse, and access to and utilization of harm reduction services, including needle-syringe exchange programs (NSEP) and opioid agonist maintenance therapy (OAT). Principal component analyses (PCA) were conducted to assess drug use grouping. Results: Amphetamine-type substances (ATS; 82.5%), alcohol (75.7%) and heroin (71.8%) were the most commonly used drugs across the lifetime. Drug injection was reported by 32.0% (n ...
TL;DR: Findings support the role of the coping motive in problematic outcomes associated with drinking and suggest that expectancies, negative affect personality styles, maladaptive coping, and drinking motives are potential targets of prevention and intervention.
Abstract: Background: Drinking among college-aged individuals can be problematic. The motivational model of use, which examines various cognitive factors, personal characteristics, and environmental factors, can provide a greater understanding of what contributes toward the decision to drink in these young adults. Objectives: The current study evaluates proposed paths from risk factors for alcohol use, motives for drinking, and subsequent outcomes of alcohol use, drawing from seminal research on the motivational model and drinking motives. Methods: This model was tested in a sample of 303 undergraduate drinkers (77.9% female, mean age = 19.8 years), and evaluated the potential impact of gender and pattern of use. Results: Results indicate that expectancies, maladaptive coping, and negative affect personality styles are associated with coping motives for drinking, and that coping motives are significantly related to problems associated with use. These results are similar for males and females, and among heav...
TL;DR: Prevalence of nonmedical opioid use may be underreported on some surveys, particularly among specific subpopulations in a national sample of high school seniors.
Abstract: Background: Nonmedical opioid use has become a major public health concern due to increases in treatment admissions, overdoses, and deaths. Use has also been linked to heroin initiation. Reliable data on nonmedical opioid use are needed to continue to inform prevention. Objective: To determine the prevalence and correlates of discordant self-report of nonmedical use of opioids in a national sample. Methods: Utilizing a nationally representative sample of 31,149 American high school seniors in the Monitoring the Future study (2009–2013), discordant responses between self-reported 12-month nonmedical opioid use and self-reported 12-month nonmedical Vicodin and OxyContin use (reporting Vicodin/OxyContin use, but not reporting “opioid” use) were assessed. We also used multivariable logistic regression to determine the characteristics of students who were most likely to provide a discordant response. Results: 37.1% of those reporting nonmedical Vicodin use and 28.2% of those reporting nonmedical OxyCon...
TL;DR: Given growing public acceptance of recreational and medical marijuana, coupled with negative perceptions and increasing regulation of synthetic cannabinoid compounds, botanical marijuana is likely to remain more available and more popular than synthetic cannabinoids.
Abstract: Background: Although initially developed for medical purposes, synthetic cannabinoids have also been consumed for recreational purposes. Objective: To evaluate whether agreement with positive and negative outcome expectancies differed for synthetic cannabinoids versus botanical marijuana, and assess reported reasons for using synthetic cannabinoids. Method: Using a web-based recruitment and data collection procedure, 186 adults who had used both synthetic cannabinoids and botanical marijuana and 181 adults who had used botanical marijuana but not synthetic cannabinoids, completed measures of outcome expectancies and other relevant questionnaires. Results: A significant interaction revealed that participants who had used both synthetic cannabinoids and botanical marijuana indicated lower agreement with positive expectancies for synthetic cannabinoids, and higher agreement with positive expectancies for botanical marijuana, than did those participants who used only botanical marijuana. There was no ...
TL;DR: Using interactive tools such as pledges and reporting on smoking status were predictive of cessation, and further study of program features is required to understand how to optimally design text messaging programs.
Abstract: Background: Text2Quit, an interactive text-messaging program aimed at smoking cessation, has been shown to increase quit rates, but engagement has not been thoroughly explored. Understanding the program features associated with engagement and behavior change is integral for effective program design. Objectives: This study explored participants’ interaction with the Text2Quit text-messaging program and associations between engagement and smoking cessation. Methods: The study included the 262 participants who received the Text2Quit intervention. Self-reported engagement measures, primarily usage of Text2Quit keywords and survey responses, were collected through computer records of participant use. Demographic variables and self-reported smoking abstinence were recorded in surveys at baseline and 6-month assessment. Results: The majority of participants (73%) maintained their subscription during the 6-month intervention. On average, participants received 210.51 text messages, 23.75 emails, and logged...
TL;DR: The high rates at which youth report engaging in a range of risky drinking behaviors suggest a need for a more nuanced approach to substance use and mental health screening and interventions in clinical practice.
Abstract: Background: Underage drinking and its effects have been researched extensively. However, no study to date has examined how the levels of drinking that have been defined as risky for adults might relate to youth who have a heightened physiological vulnerability to alcohol. Objectives: To examine a range of drinking measures that go beyond common measures of youth alcohol use to gain a more detailed understanding of the nature of underage drinking and its associated correlates and outcomes. Methods: Analyzing data from a 2013 nationally representative US survey, we examined a variety of measures of alcohol use among 24,445 youth (weighted N = 381,155,562), the demographic groups most likely to have reported drinking in these ways, and associations between these measures of drinking and a number of adverse outcomes. Results: On all measures of potentially risky drinking, including meeting diagnostic criteria for an alcohol use disorder, underage drinkers exceeded the rates found for adults. Independe...
TL;DR: ABMT was not more effective than the authors' control therapy at reducing attentional bias, reducing craving or changing other drug use behaviors, and additional replication studies are needed to assess ABMT's efficacy in reducing drug-use behaviors in CUD.
Abstract: Background: Attentional bias (i.e., differences in reaction time between drug and neutral cues) has been associated with a variety of drug-use behaviors (e.g., craving, abstinence). Reduction of bias may ultimately reduce use. Objective: The current study examined whether attentional bias modification therapy (ABMT) reduced the frequency of drug use behaviors in individuals with cocaine use disorder (CUD). Method: Participants (n = 37) were randomly assigned to ABMT or control therapy, which systematically varied how frequently probes replaced neutral (ABMT = 100%; control therapy = 50%) relative to drug stimuli. Each intervention included 5 training sessions comprising a total of 2640 trials over 4 weeks. Clinical assessments occurred at baseline, post-intervention, 2 weeks and 3 months posttreatment. Results: There were no baseline differences between groups on drug-use behaviors or other clinical measures. Contrary to predictions, both groups exhibited slower rather than faster reaction times f...
TL;DR: A decrease in the salience attribution of non-drug reinforcers may explain the positive relationship between IGT performance and post-relapse use and more comprehensive and global measures of impulsiveness may better assess relapse risk and use.
Abstract: Background: Decision-making processes have been posited to affect treatment outcome in addicted patients. Objective: The present multi-site study assessed whether two measures of decision-making predicted relapse and subsequent use in stimulant-dependent patients. Methods: A total of 160 methamphetamine- or cocaine-dependent patients participating in a multi-site clinical trial evaluating a modified 12-step facilitation intervention for stimulant-dependent patients (STAGE-12) were assessed. Decision-making processes of risk and delay (Iowa Gambling Task [IGT]) and response reversal (Wisconsin Card Sorting Task [WCST]) were obtained shortly after treatment admission followed by assessment of stimulant use over the next six months. The relationships of the IGT and WCST (Perseverative Errors) with relapse (yes/no) and days of stimulant use during the 6-month period following post-randomization were evaluated. Results: Performance on the IGT and WCST did not significantly predict relapse status or tim...
TL;DR: In this paper, the authors estimated concurrent alcohol and medication (alcohol/medication) hospitalizations in adults 50+ years, comparing age groups and rural/urban regions and found that older adults who reside in rural areas are at the highest risk of experiencing medication interactions.
Abstract: Background: Alcohol and medication interactions are projected to increase due to the growth of older adults that are unsafely consuming alcohol and medications. Plus, aging adults who reside in rural areas are at the highest risk of experiencing medication interactions. Objective: Estimate concurrent alcohol and medication (alcohol/medication) hospitalizations in adults 50+ years, comparing age groups and rural/urban regions. Methods: Kentucky nonfederal, acute care inpatient hospital discharge electronic records for individuals aged 50+ years from 2001 to 2012 were examined. Rate differences were estimated across age and regional strata. Differences in the underlying principal diagnosis, intent, and medications were also examined. Results: There were 2168 concurrent alcohol/medication hospitalizations among 50+ year olds identified. There was a 187% increase in alcohol/medication hospitalizations from 2001 (n = 104) to 2012 (n = 299). The per capita alcohol/medication hospitalization rate increas...
TL;DR: The harms most reported were unexpected confusion, memory impairment, and abrupt mood/behavior changes, and the most frequent strategies were spacing out sessions, spacing out doses within a session, and limiting the amount and not going over it.
Abstract: Background: Recent studies have shown that ketamine use has serious adverse consequences. However, no studies have focused on the strategies that users carry out to protect themselves from such potential harm. Objectives: (i) analyze harm reduction strategies, risk behaviors, and harms in nonmedical/recreational ketamine users; (ii) analyze the association of their harm reduction strategies and risk behaviors with harms they report. Methods: An anonymous cross-sectional web-based survey of 462 persons who had used ketamine in the past year. We designed a questionnaire to collect information on their risk behaviors, harm, and harm reduction strategies. Results: The harms most reported were unexpected confusion (58.2%), memory impairment (57.4%), and abrupt mood/behavior changes (49.6%). The most frequent strategies were spacing out sessions (60.8% always/almost always did this), spacing out doses within a session (54.5%), and limiting the amount and not going over it (41.3%). The use of these three...
TL;DR: There is a need for increased vigilance and action to identify and counsel at-risk veterans about alcohol misuse in this population of veterans.
Abstract: Background: Binge drinking is a significant public health concern linked to a number of health and psychosocial problems. Military service in Afghanistan (OEF) and Iraq (OIF) has been associated with posttraumatic stress disorder (PTSD) and increased hazardous drinking. Brief alcohol interventions may reduce hazardous drinking but are infrequently provided to at-risk drinkers. Objectives: This study examined the association of combat exposure, PTSD symptoms, binge drinking, use of VA and non-VA healthcare services, and the incidence of provider drinking advice. Methods: OEF/OIF veterans (n = 1087) completed measures of demographics, military history, combat exposure, PTSD symptoms, and binge drinking as part of a confidential mail survey study conducted in 2009 and 2010 (response rate = 29%). Patient report of receiving advice in the past year from a provider about their drinking was queried for frequent binge drinkers. The association of demographic variables, combat exposure, PTSD, and use of he...
TL;DR: Delivery of SUD services in a public health setting represents a significant policy and practice change and benefits many individuals whose SUDs might otherwise be overlooked.
Abstract: Objective: This article reports the integration and outcomes of implementing intervention services for substance use disorder (SUD) in three New York City public sexually transmitted disease (STD) clinics. Methods: The screening, brief intervention, and referral to treatment (SBIRT) service model was implemented in the STD clinics in 2008. A relational database was developed, which included screening results, service dispositions, face-to-face interviews with 6-month follow-ups, and treatment information. Results: From February 2008 to the end of September 2012, 146 657 STD clinic patients 18 years or older were screened for current or past substance use disorders; 15 687 received a brief intervention; 954 received referrals to formal substance abuse treatment; 2082 were referred to substance abuse support services such as Alcoholics Anonymous (AA), and 690 were referred to mental health, social or HIV awareness services. Intervention services delivered through SBIRT resulted in improvements in mu...
TL;DR: There is a strong behavioral and physiological rationale to design studies which specifically assess the efficacy of exercise, in combination with other therapies, in treating CUD.
Abstract: Background: Despite cannabis being the most widely used illicit substance in the United States, individuals diagnosed with cannabis use disorder (CUD) have few well-researched, affordable treatment options available to them. Although found to be effective for improving treatment outcomes in other drug populations, exercise is an affordable and highly accessible treatment approach that has not been routinely investigated in cannabis users. Objectives: The aim of this paper is to inform the topic regarding exercise’s potential as an adjunctive treatment for individuals with CUD. Methods: We reviewed the evidence surrounding cannabis use and its current treatment in the United States, explored the rationale for including exercise in the treatment of substance use disorders (SUDs), and in particular, proposed a biological mechanism (i.e., endocannabinoids (eCBs)) that should be examined when utilizing exercise for the treatment of CUD. Results: Cannabis use is widespread and increasing in the United S...
TL;DR: It is suggested that methamphetamine users report more impulsivity when abstaining from drug use, an effect that is not significantly related to methamphetamine withdrawal.
Abstract: Background: Impulsivity has been proposed as an important factor in the initiation and maintenance of addiction. Indirect evidence suggests that some methamphetamine users report less impulsivity when they are using methamphetamine compared to when abstaining from drug use, but this hypothesis has not been directly tested. Objectives/Methods: In this study, self-reports of impulsivity were obtained from 32 methamphetamine-dependent (DSM-IV) research participants and 41 healthy control subjects, using the Barratt Impulsiveness Scale-11. The methamphetamine users were assessed during an active period of methamphetamine use, as determined through urinalysis, and again after approximately 1 week of confirmed abstinence. Control subjects likewise completed two assessments. A subset of participants also completed serial assessments of the Beck Depression Inventory (Methamphetamine Group, N = 17, Control Group, N = 38) and the Methamphetamine Withdrawal Questionnaire (Methamphetamine Group, N = 12). Resu...
TL;DR: Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on hot neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy.
Abstract: Background: Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies hot (i.e. affectively-mediated, reward-based) and cool (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. Objectives: The present study examined the associations of neurocognitive and psychiatric varieties of hot and cool impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. Methods: The study sample was comprised of drug users in protracted (> 1 year) abstinence: heroin mono-dependent (n = 61), amphetamine mono-dependent (n = 44), and polysubstance dependent (n = 73). Hot impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. Cool impulsivity was operationalized via neurocognitive tasks of response inhibition...
TL;DR: In outpatient methadone-maintained patients with benzodiazepine use disorder, gabapentin did significantly decrease benzodiazine use relative to placebo.
Abstract: Background: Benzodiazepine use disorders are a common clinical problem among methadone maintenance treatment patients and have adverse effects on clinical outcomes. Objectives: To evaluate gabapentin for the outpatient treatment of benzodiazepine abuse or dependence in methadone maintenance patients. Methods: Participants (n = 19) using benzodiazepines at least 4 days per week were enrolled into an 8-week randomized double-blind placebo-controlled outpatient pilot trial. All participants received a manual-guided supportive psychotherapy aimed to promote abstinence. Study medication was titrated over a 2-week period to a maximum dose of gabapentin 1200 mg or placebo three times a day. Benzodiazepine use was assessed using urine toxicology confirmed self-report. Benzodiazepines were not provided as part of study participation; participants were provided guidance to gradually reduce benzodiazepine intake. Results: Sixteen participants had post-randomization data for analysis. Retention at week eight ...
TL;DR: It is important to consider both use expectancies and cessation expectancies, as these two domains of marijuana-related cognitions appear to act independently, rather than as opposite ends of the same construct.
Abstract: Background: Research suggests that marijuana expectancies are associated with problematic marijuana use; however, these marijuana-related cognitions remain relatively understudied. Objective: This study examined marijuana-related decision-making among college students by exploring the relationships among marijuana expectancies and marijuana use variables. Method: College students (N = 357) endorsing lifetime marijuana use completed an online survey on marijuana use expectancies, marijuana cessation expectancies, marijuana use, and future marijuana use intentions. A simple regression framework was used to test the effect of each type of expectancies on marijuana outcome; a hierarchical regression framework tested the unique predictive validity when both types were entered into the same model. Results: Both marijuana use expectancies and marijuana cessation expectancies independently predicted a number of marijuana use variables. Additionally, marijuana use expectancies and marijuana cessation expec...
TL;DR: Acute intoxication, cardiac ischemia, excited delirium syndrome, pulmonary aspiration, and drowning are the major autopsy findings in synthetic cathinones/cannabinoids-related death in Japan.
Abstract: Background: Sixty-one autopsy cases involving cathinones and/or cannabinoids (synthetic cathinones/cannabinoids) use have been reported. However, little is known about the demographics and autopsy findings in fatal synthetic cathinones/cannabinoids users. Objectives: To elucidate demographic and autopsy findings (i.e. major organ pathology and causes of death) in synthetic cathinones/cannabinoids cases. Methods: We reviewed forensic autopsy reports in Department of Legal Medicine of Tokyo Women’s Medical University (Tokyo, Japan) between 2011 and 2015 (a total of 359). We compared demographic and autopsy findings between synthetic cathinones/cannabinoids and methamphetamine cases (as control subjects). Results: There were 12 synthetic cathinones/cannabinoids cases and 10 methamphetamine cases. Synthetic cathinones/cannabinoids users were significantly younger than methamphetamine users (p < 0.01), and there were no cases that used both synthetic cathinones/cannabinoids and methamphetamine. Acute i...
TL;DR: Hookah use is significantly more common among cigarette smokers and among various demographic subgroups among general adult population, and targeted public health efforts are recommended.
Abstract: Background: Hookah use may be increasing among adults in the US. Information on the prevalence and correlates of hookah use in the adult population is relatively limited. Objectives: To determine the prevalence of current (past 30-day) and lifetime use of hookah among adults ages 18–40 in the US and to investigate the socio-demographic characteristics associated with lifetime use. Methods: Data were drawn from the Tobacco Use Supplement of the Current Population Survey data from May 2010, August 2010, and January 2011 (n = 85,545). Logistic regression was used to examine various demographic correlates of lifetime hookah use. Results: Among 18–40 year olds, the past month prevalence rate of hookah use was 0.6% and the lifetime prevalence rate of hookah use was 3.9%. Being male, non-Hispanic white, having higher levels of educational attainment, having never been married, not having any children, earning less than $20,000 annually, residing in the Midwest or western US, being a student, and being a ...