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Journal ArticleDOI

Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

TL;DR: Transition from use to dependence was highest for nicotine users, followed by cocaine, alcohol and cannabis users, and the existence of common predictors of transition dependence across substances suggests that shared mechanisms are involved.
About: This article is published in Drug and Alcohol Dependence.The article was published on 2011-05-01 and is currently open access. It has received 540 citations till now. The article focuses on the topics: Substance dependence & Cannabis.
Citations
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Journal ArticleDOI
TL;DR: As marijuana use becomes legal in some states, the dominant public opinion is that marijuana is a harmless source of mood alteration, but enough information is available to cause concern.
Abstract: As marijuana use becomes legal in some states, the dominant public opinion is that marijuana is a harmless source of mood alteration. Although the harms associated with marijuana use have not been well studied, enough information is available to cause concern.

2,069 citations

Journal ArticleDOI
TL;DR: An overview of sex/gender differences in the biology, epidemiology and treatment of SUDs is provided, especially focusing on hormonal factors in SUD course and treatment outcomes.

485 citations

Journal ArticleDOI
Kevin P. Hill1
23 Jun 2015-JAMA
TL;DR: Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence, and Physicians should educate patients about medical marijuana to ensure that it is used appropriately and that patients will benefit from its use.
Abstract: Importance As of March 2015, 23 states and the District of Columbia had medical marijuana laws in place. Physicians should know both the scientific rationale and the practical implications for medical marijuana laws. Objective To review the pharmacology, indications, and laws related to medical marijuana use. Evidence Review The medical literature on medical marijuana was reviewed from 1948 to March 2015 via MEDLINE with an emphasis on 28 randomized clinical trials of cannabinoids as pharmacotherapy for indications other than those for which there are 2 US Food and Drug Administration–approved cannabinoids (dronabinol and nabilone), which include nausea and vomiting associated with chemotherapy and appetite stimulation in wasting illnesses. Findings Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence. Six trials that included 325 patients examined chronic pain, 6 trials that included 396 patients investigated neuropathic pain, and 12 trials that included 1600 patients focused on multiple sclerosis. Several of these trials had positive results, suggesting that marijuana or cannabinoids may be efficacious for these indications. Conclusions and Relevance Medical marijuana is used to treat a host of indications, a few of which have evidence to support treatment with marijuana and many that do not. Physicians should educate patients about medical marijuana to ensure that it is used appropriately and that patients will benefit from its use.

451 citations

Journal ArticleDOI
TL;DR: The current state of knowledge about vulnerability factors, the variations in types of cannabis, and the relationship between these and cognition and addiction are reviewed.
Abstract: In an increasing number of states and countries, cannabis now stands poised to join alcohol and tobacco as a legal drug. Quantifying the relative adverse and beneficial effects of cannabis and its constituent cannabinoids should therefore be prioritized. Whereas newspaper headlines have focused on links between cannabis and psychosis, less attention has been paid to the much more common problem of cannabis addiction. Certain cognitive changes have also been attributed to cannabis use, although their causality and longevity are fiercely debated. Identifying why some individuals are more vulnerable than others to the adverse effects of cannabis is now of paramount importance to public health. Here, we review the current state of knowledge about such vulnerability factors, the variations in types of cannabis, and the relationship between these and cognition and addiction.

303 citations

Journal ArticleDOI
TL;DR: The associations between increases in marijuana use and decreases in perceiving great risk of harm from smoking marijuana suggest the need for education regarding the risk of smoking marijuana and prevention messages.

287 citations

References
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Book ChapterDOI
Rona J. Hu1
01 Jan 2003
TL;DR: This material was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.

5,722 citations

Journal ArticleDOI
TL;DR: The delineation of the neurocircuitry of the evolving stages of the addiction syndrome forms a heuristic basis for the search for the molecular, genetic, and neuropharmacological neuroadaptations that are key to vulnerability for developing and maintaining addiction.

4,160 citations

Journal ArticleDOI
TL;DR: Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States, suggesting that treatment for a comorbid mood or anxiety disorder should be withheld from individuals with substance use disorders.
Abstract: Background Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. Objective To present nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). Design Face-to-face survey. Setting The United States. Participants Household and group quarters' residents. Main Outcome Measures Prevalence and associations of substance use disorders and independent mood and anxiety disorders. Results The prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant ( P Conclusions Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.

2,617 citations

Journal ArticleDOI
TL;DR: The results show that alcohol abuse and dependence are often associated with other lifetime NCS/DSM-III-R disorders and suggest that, at least in recent cohorts, the alcohol use disorders are usually temporally secondary.
Abstract: Objective: To study patterns of co-occurrence of lifetimeDSM-III-Ralcohol disorders in a household sample. Methods: Data came from the National Comorbidity Survey (NCS), a nationally representative household survey. Diagnoses were based on a modified version of the Composite International Diagnostic Interview. Results: Respondents with lifetimeNCS/DSM-III-Ralcohol abuse or dependence had a high probability of carrying at least 1 other lifetimeNCS/DSM-III-Rdiagnosis. Retrospective reports have suggested that most lifetime co-occurring alcohol disorders begin at a later age than at least 1 other NCS/DSM-III-Rdisorder. Earlier disorders are generally stronger predictors of alcohol dependence than alcohol abuse and stronger among women than men. Lifetime co-occurrence is positively, but weakly, associated with the persistence of alcohol abuse among men and of alcohol dependence among both men and women. Conclusions: Caution is needed in interpreting the results due to the fact that diagnoses were made by nonclinicians and results are based on retrospective reports of the age at onset. Within the context of these limitations, though, these results show that alcohol abuse and dependence are often associated with other lifetimeDSM-III-Rdisorders and suggest that, at least in recent cohorts, the alcohol use disorders are usually temporally secondary. Prospective data and data based on clinically confirmed diagnoses are needed to verify these findings.

1,947 citations


"Probability and predictors of trans..." refers background in this paper

  • ...Psychiatric comorbidity, a consistent predictor of transition in many studies (Kessler et al., 1997; Merikangas et al., 1998) has been often examined as a single category (Merikangas et al., 1998) or analyzed as invariant over time (Breslau, 1995; Sintov et al., 2009)....

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  • ...Psychiatric comorbidity, a consistent predictor of transition in many studies (Kessler et al., 1997; Merikangas et al., 1998) has been often examined as a single category (Merikangas et al....

    [...]

Journal ArticleDOI
TL;DR: The relationship between age at first use of alcohol and the prevalence of lifetime alcohol abuse and alcohol dependence, among all U.S. adults and within subgroups defined by sex and race is examined.

1,791 citations


"Probability and predictors of trans..." refers background in this paper

  • ...…substance, and cooccurrence of a psychiatric disorder (Behrendt et al., 2009; Breslau et al., 2001; Chen et al., 2005; Dawson et al., 2008; Grant and Dawson, 1997, 1998; Kandel et al., 1997; O'Brien and Anthony, 2005; Reardon and Buka, 2002; Wagner and Anthony, 2002a, 2007; Warner et al.,…...

    [...]