Our current approach to drug abuse--progress, problems, proposals

Adolescent Cannabis Users Who Have Never Smoked A Combustible Cigarette: Trends and Level of Addictive Drug Use from 1976 to 2020

Background

Adolescents cannabis users are at a substantially elevated risk for use of highly addictive drugs such as cocaine, heroin, and nonmedical use of prescription drugs. Unknown is whether this elevated risk applies to adolescent cannabis users who have never smoked a combustible cigarette, a group that has grown considerably in size in recent years. This study documents the recent growth in the proportion of adolescent cannabis users who abstain from combustible cigarette use, and examines their probability for use of addictive drugs.

Methods

Data are annual, cross-sectional, nationally-representative Monitoring the Future surveys of 607,932 U.S. 12th grade students from 1976-2020.

Results

Among ever cannabis users, the percentage who had never smoked a combustible cigarette grew from 11% in 2000 to 58% in 2020. This group had levels of addictive drug use that were 8% higher than their peers. In comparison, adolescents who had ever used cannabis - regardless of whether they had ever smoked a cigarette - had levels of addictive drug use 500% higher than their peers.

Conclusions

Adolescent cannabis users who have not smoked a combustible cigarette have much lower levels of addictive drug use than the group of cannabis users as a whole. These results suggest policies and laws aimed at reducing adolescent prevalence of addictive drugs may do better to focus on cigarette use of adolescent cannabis users rather than cannabis use per se.

Use of illicit substances among schoolchildren in colombo district, Sri Lanka

OBJECTIVE

This study aimed to understand the usage patterns and correlates of illicit drug use among schoolchildren in Colombo district, Sri Lanka.

METHODS

A cross-sectional study was carried out among grade 10 and 12 students using a self-administered questionnaire.

RESULTS

From the 6000 students selected, 5353(89.22%) responded. Betel chewing with tobacco was seen in 28.48% males and 10.44% females. Substances such as Barbul, Madana Modaka, and cough syrups that are not established as illicit drugs were used as psychoactive substances. Ingredients of some of these compounds are not fully understood or regulated. Prevalence of cannabis use was 3.85% in males and 0.24% in females. Studying nonscience subjects for Advanced Level, doing sports, low academic performance, and peer smoking significantly increased the odds of using one or more substances (P < .05).

CONCLUSIONS

Many types of illicit substances were used by schoolchildren. More strategies to prevent further aggravation of these behaviors are needed. Constituents of some compounds are not understood and need further evaluation. Recognized high-risk groups can be targets for preventive and cessation programs.

Drug use, misuse, and the urban environment

Urbanization is probably the single most important demographic shift world-wide throughout the past and the new century and represents a sentinel change from how most of the world's population has lived for the past several thousand years. As urban living becomes the predominant social context for the majority of the world's population, the very ubiquity of urban living promises to shape health directly and to indirectly affect what we typically consider risk factors or determinants of population health. Although a growing body of research is exploring how characteristics of the urban environment may be associated with health (e.g. depression) and risk behaviours (e.g. exercise patterns), relatively little research has systematically assessed how the urban environment may affect drug use and misuse. In this paper we will propose a conceptual framework for considering how different characteristics of the urban environment (e.g. collective efficacy, the built environment) may be associated with drug use and misuse, summarize the existing empiric literature that substantiates elements of this framework, and identify potential directions for future research.

Neurocognitive deficits in cocaine users: a quantitative review of the evidence

Studies on the neurocognitive effects of cocaine abuse are equivocal with respect to the specific types of deficits observed, although the vast majority of studies indicate that at least some deficits in certain broad functions such as attention, learning and memory, executive functions, and response speed exist. All of these studies based their results on null hypothesis statistical significance testing (NHSST). It is argued that effect size analysis, which provides information about the magnitude of difference, offers a more valid index of cognitive impairments in a population when compared to NHSST. Accordingly, the objective of the current study was to conduct an effect size analysis (or a meta-analysis in cases where the same test measure was utilized in more than one study) to determine the type and the magnitude of the specific cognitive deficits found as a result of cocaine use. Effect sizes were calculated for each test variable across 15 empirical studies that met inclusion criteria. The results from 481 cocaine users and 586 healthy normal controls revealed that cocaine use had the largest effect on several measures of attention (0.40 < d < 1.10). Moderate to large effect sizes (d > 0.50) were also obtained on tests of visual memory and working memory. Minimal effect sizes (d < 0.30) were obtained on tests of verbal fluency and other language functions and sensory-perceptual functions. Tests of executive functioning produced mixed findings and were interpreted in terms of degree rather than nature of impairment. The results are consistent with findings from neuroimaging and neurochemical studies that have found cocaine use to be associated with dysfunctions in the anterior cingulate gyrus and orbitofrontal cortex; these regions are highly implicated in the mediation of attentional and executive functions, respectively. Methodological limitations of the empirical studies included in the analysis are discussed.

Neuropsychological performance of individuals dependent on crack-cocaine, or crack-cocaine and alcohol, at 6 weeks and 6 months of abstinence

BACKGROUND

Little data exist on the neuropsychological effects of crack-cocaine dependence or crack-cocaine and alcohol dependence. This study examined cognitive function in abstinent crack dependent and crack and alcohol dependent individuals at 6 weeks and 6 months abstinence.

METHODS

a comprehensive neuropsychological battery, including the MicroCog computerized assessment, was administered to 20 abstinent crack dependent subjects, 37 abstinent crack and alcohol dependent subjects, and 29 normal controls. Depression was examined as a covariate, and the association between substance use variables and neuropsychological performance was examined.

RESULTS

the two substance dependent groups had similar neuropsychological profiles at 6 weeks abstinent, with both groups exhibiting significant cognitive impairment in a wide range of functions compared to controls. The substance dependent groups were still impaired significantly at 6 months of abstinence. Only mild effects of depression on neuropsychological performance were observed.

CONCLUSIONS

crack dependence and crack and alcohol dependence may lead to severe and persistent neuropsychological deficits over a wide range of domains. The strongest predictor of brain damage associated with substance dependence in this sample was dose (particularly quantity and duration of peak dose).

Changing patterns of drug use among US military recruits before and after enlistment

OBJECTIVES

The US armed forces adopted "zero tolerance" policies concerning illicit drug use in 1980 and later developed policies to discourage tobacco and alcohol abuse. This article examines drug use among young active-duty recruits both before and after enlistment, compared with nonmilitary age-mates, and documents historical shifts in such drug use across 2 decades.

METHODS

Analyses employed longitudinal panel data from 20 nationally representative samples of high school seniors (cohorts of 1976-1995), each surveyed just before graduation and again within 2 years. Separate analyses for men (n = 12,082) and women (n = 15,345) contrasted those who entered military service, college, and civilian employment.

RESULTS

Illicit drug use declined more among young military recruits than among their civilian counterparts. Analyses of male recruits at multiple time periods showed (1) declines in the prevalence of marijuana use and cocaine use after the initiation of routine military drug testing and (2) lower proportions of smokers of half a pack or more of cigarettes per day who entered service after the initiation of tobacco bans during basic training.

CONCLUSIONS

Recent military drug policies appear to deter illicit drug use among enlistees and discourage some smokers from enlisting.

The inner city and drug use: initial findings from an epidemiological study

Although scientific and policy statements regarding drugs often suggest that there are grave problems of drug use within America's inner cities, the evidence that supports these statements is often based on anecdotal or incomplete data. This study of African-American adults from the Woodlawn study followed longitudinally partially fills that gap, at least for learning more about those who spend some or all of their childhood within an inner city neighborhood. We found few differences between the lifetime prevalence of drug use and a national representative sample of adults of the same age range. Furthermore, a national household survey of African-Americans of similar age living in six central cities also reported low lifetime rates of illicit drug use. Nevertheless, those from the Woodlawn cohort had higher rates of use of illicit drugs in the past year than the national sample, especially those still living in areas with high rates of poverty. Additionally, reports of heavy drug trafficking were much greater in the inner city areas than in the suburbs.

Interpreting Dutch cannabis policy: reasoning by analogy in the legalization debate

The Dutch depenalization and subsequent de facto legalization of cannabis since 1976 is used here to highlight the strengths and limitations of reasoning by analogy as a guide for projecting the effects of relaxing drug prohibitions. While the Dutch case and other analogies have flaws, they appear to converge in suggesting that reductions in criminal penalties have limited effects on drug use-at least for marijuana-but that commercial access is associated with growth in the drug-using population.

The rules of drug taking: wine and poppy derivatives in the ancient world. I. General introduction

Many believe that the public attitude toward psychotropic drugs is easy to change because it depends upon transient socioeconomic and cultural contingencies. This belief is here tested by analyzing literary sources on the use of wine and poppy derivatives in the Greek and Roman civilizations. As expected, the existence of elaborated myths about the discover of wine supports the view that wine drinking played an important social role in the ancient world. Contingencies in which drinking was considered illicit were carefully selected with the ultimate aim of maintaining sobriety. Rules of drinking were often enforced by law. This first part of the study lists drunkenness outcomes considered particularly harmful by the Ancients.