1
|
Yang Y. Lifetime use of multiple substances and youth suicide risk: assessing the role of depressive symptoms using structural equation modeling. Public Health 2024; 234:71-76. [PMID: 38964128 DOI: 10.1016/j.puhe.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVES This study assessed the direct and indirect effects (via depressive symptoms) of lifetime use of a broad range of substances on suicide risk among US adolescents. STUDY DESIGN This was a cross-sectional study. METHODS Data from the 2021 Youth Risk Behavior Survey were used (N = 12,303, 48.7% female). Associations between five types of substance use (cigarette, e-cigarette, alcohol, marijuana, and prescription pain medicine) and three dimensions of suicide risk (suicidal ideation, suicide plan, and suicide attempt) were measured by multivariate logistic regression models. The role of depressive symptoms was further examined by structural equation modeling. RESULTS Almost three in five (57.5%) adolescents had used one or more substances in their lifetime (18.1% one type, 12.2% two types, 13.1% three types, 10.2% four types, and 3.8% five types). Adolescents using five substances were up to 16 times more likely to experience suicidal ideation and behaviors. Depressive symptoms significantly linked the pathway from substance use to suicide risk, resulting in much stronger indirect effects than the direct effects. Collectively, the five substance use behaviors and depressive symptoms explained about 60.4% of variance in suicidal ideation, 53.6% of variance in suicide plan, and 55.0% of variance in suicide attempt. CONCLUSIONS Lifetime use of multiple substances is significantly correlated with suicidal ideation and behaviors among adolescents via the pathway of depressive symptoms. Routine screening for a broad range of substance use behaviors is needed to identify adolescents at risk for suicide and accessible mental health services could potentially attenuate the linkage between substance use and suicide risk.
Collapse
Affiliation(s)
- Yingwei Yang
- Social Science Research Institute, Duke University, Durham, NC, USA.
| |
Collapse
|
2
|
Yang Y. Suicidal Thoughts and Behaviors Among US Adolescents: The Cumulative Effects of Polysubstance Use Behaviors. Subst Use Misuse 2024:1-8. [PMID: 39155480 DOI: 10.1080/10826084.2024.2392504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Background: The linkage between substance use and youth suicidality is less developed due to the predominant focus on certain types of substances (e.g., alcohol consumption, prescription opioid misuse). This study examines polysubstance use and its mutual impact on suicidal thoughts and behaviors among US adolescents. Methods: Data from 2019 Youth Risk Behavior Survey were utilized. Associations between the concurrent use of five substances (cigarette, e-cigarette, alcohol, marijuana, and prescription opioid) and suicidality (suicidal thoughts, suicide plans, and suicide attempts) were measured by logistic regression models. The combined effect of polysubstance use on suicidality was further assessed by structural equation modeling. Results: About two in five (42.1%) adolescents used at least one type of substances in the past month and one in seven (13.5%) used three or more types concurrently (polysubstance use). Adolescents with polysubstance use behaviors were three to five times more likely to experience suicidal thoughts (OR=3.8, p < 0.05), make a suicide plan (OR=3.5, p < 0.05), or attempt suicide (OR=4.6, p < 0.05) than non-users. In the final structural model, polysubstance use and suicidality were significantly correlated with each other (β=0.37, p < 0.05). Collectively, polysubstance use explained about 14% of variance in youth suicidality. Conclusions: Polysubstance use shows a significant impact on youth suicidality. School-based health centers and educational programs are recommended to reduce substance use and suicidal behaviors among adolescents. Accessible mental health services and targeted treatments are needed for polysubstance users to mitigate their risk of suicide.
Collapse
Affiliation(s)
- Yingwei Yang
- Social Science Research Institute, Duke University, Durham, North Carolina, USA
| |
Collapse
|
3
|
Bleyer A, Barnes B, Finn K. United States marijuana legalization and opioid mortality trends before and during the first year of the COVID-19 pandemic. J Opioid Manag 2024; 20:119-132. [PMID: 38700393 DOI: 10.5055/jom.0829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
BACKGROUND To determine if marijuana legalization was associated with reduced opioid mortality. STUDY DESIGN The United States (US) opioid mortality trend during the 2010-2019 decade was compared in states and District of Columbia (jurisdictions) that had implemented marijuana legalization with states that had not. Acceleration of opioid mortality during 2020, the first year of the coronavirus disease 2019 (COVID-19) pandemic, was also compared in recreational and medicinal-only legalizing jurisdictions. METHODS Joinpoint methodology was applied to the Centers for Disease Control and Prevention WONDER data. Trends in legalizing jurisdictions were cumulative aggregates. RESULTS The overall opioid and fentanyl death rates and the percentage of opioid deaths due to fentanyl increased more during 2010-2019 in jurisdictions that legalized marijuana than in those that did not (pairwise comparison p = 0.007, 0.05, and 0.006, respectively). By 2019, the all-opioid and fentanyl death rates were 44 and 50 percent greater in the legalizing than in the nonlegalizing jurisdictions, respectively. When the COVID-19 pandemic hit in 2020, jurisdictions that implemented recreational marijuana legalization before 2019 had significantly greater increases in both overall opioid and fentanyl death rates than jurisdictions with medicinal-only legalization. For all-opioids, the mean (95 percent confidence interval) 2019-to-2020 increases were 46.5 percent (36.6, 56.3 percent) and 29.1 percent (20.2, 37.9 percent), respectively (p = 0.02). For fentanyl, they were 115.6 percent (80.2, 151.6 percent) and 55.4 percent (31.6, 79.2 percent), respectively (p = 0.01). CONCLUSIONS During the past decade, marijuana legalization in the US was associated at the jurisdiction level with a greater acceleration in opioid death rate. An even greater increase in opioid mortality occurred in recreational-legalizing jurisdictions with the onset of the COVID-19 pandemic. Marijuana legalization is correlated with worsening of the US opioid epidemic.
Collapse
Affiliation(s)
- Archie Bleyer
- Oregon Health and Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas. ORCID: https://orcid.org/0000-0001-7738-5146
| | - Brian Barnes
- St. Charles Healthcare System, Bend, Oregon; PhD Candidate, Integral and Transpersonal Psychology, California Institute of Integral Studies, San Francisco, California
| | - Kenneth Finn
- Springs Rehabilitation, Colorado Springs, Colorado
| |
Collapse
|
4
|
Rhew IC, Le VT, Ramirez JJ, Fleming CB, Kilmer JR, Delawalla MLM, Hultgren BA, Lee CM, Larimer ME, Guttmannova K. The association between cannabis use and risk of non-medical pain reliever misuse onset among young adults in a legal cannabis context. Addict Behav 2023; 143:107711. [PMID: 37011567 PMCID: PMC10168644 DOI: 10.1016/j.addbeh.2023.107711] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Little is known about the prospective relationship between cannabis use and pain reliever misuse. This study examined associations of non-medical and medical cannabis use with onset of non-medical pain reliever misuse among young adults in Washington State (WA), where non-medical cannabis is legal. METHODS Data were from a cohort-sequential study of adults 18-25 residing in WA. Four annual surveys were used from cohorts recruited in 2014, 2015, and 2016. Participants who had not reported non-medical pain reliever misuse at baseline were included in discrete time survival analyses (N = 4,236). Odds ratios (ORs) were estimated for new onset of non-medical pain reliever misuse in any given follow-up year over the course of three years according to baseline non-medical and medical cannabis use. RESULTS When included separately in models, non-medical and medical cannabis use at baseline were associated with increased risk of non-medical pain reliever misuse adjusting for demographic characteristics as well as past year cigarette use and alcohol use (non-medical OR = 5.27; 95 % CI: 3.28, 8.48; medical OR = 2.21; 95 % CI: 1.39, 3.52). Including both forms of use in the model, associations of non-medical and medical cannabis use with non-medical pain reliever misuse onset remained (non-medical OR = 4.64; 95 % CI: 2.88, 7.49; medical OR = 1.65; 95 % CI: 1.04, 2.62). CONCLUSIONS Despite claims that cannabis use may reduce opioid use and related harms, findings suggest that cannabis use, including medical use, may not be protective, but instead may increase risk for non-medical pain reliever misuse.
Collapse
Affiliation(s)
- Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Vi T Le
- Social Development Research Group, University of Washington, Seattle, WA, USA.
| | - Jason J Ramirez
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Charles B Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Miranda L M Delawalla
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Brittney A Hultgren
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| |
Collapse
|
5
|
Lensch T, Drake C, Clements-Nolle K, Pearson J. Multilevel Risk and Protective Factors for Frequent and Nonfrequent Past-30-Day Marijuana Use: Findings From a Representative Sample of High School Youth. J Stud Alcohol Drugs 2023; 84:508-519. [PMID: 36971761 PMCID: PMC10488312 DOI: 10.15288/jsad.22-00240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/27/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Research has identified many factors associated with past-30-day (P30D) marijuana use among youth but has not assessed factors that may differentiate youth who use frequently from youth who do not. We took a multilevel approach to identify and compare risk and protective factors associated with frequent and nonfrequent P30D marijuana use among high school students. METHOD Individual-level data were obtained from the 2019 Nevada Youth Risk Behavior Survey (completed by 4,980 high school youth from 99 schools); school-level data were obtained from the state's Department of Education. A multinomial, multilevel model was used to estimate the association between risk and protective factors at the individual and school levels and a three-level frequency of use outcome: no P30D use (0 times), nonfrequent P30D use (1-19 times), and frequent P30D use (≥20 times). RESULTS At the individual level, other P30D substance use, exposure to adverse childhood experiences (ACEs), perceived ease of access, and perceived risk were associated with both frequent and nonfrequent use, but the relationships were generally stronger for frequent use. P30D nonprescription drug use and school connectedness were associated with frequent use only. At the school level, number of students with individualized education programs, number of incidents involving possession of controlled substances, and school type were associated with frequent use only. CONCLUSIONS Individual and school-based interventions designed to address the factors uniquely or strongly associated with frequent marijuana use may prevent escalation from occasional use to more frequent use among high school youth.
Collapse
Affiliation(s)
- Taylor Lensch
- School of Public Health, University of Nevada, Reno, Reno, Nevada
| | - Cara Drake
- School of Public Health, University of Nevada, Reno, Reno, Nevada
| | | | - Jennifer Pearson
- School of Public Health, University of Nevada, Reno, Reno, Nevada
| |
Collapse
|
6
|
Fuss C, Romm KF, Crawford ND, Harrington KRV, Wang Y, Ma Y, Taggart T, Ruiz MS, Berg CJ. Psychosocial Correlates of Opioid Use Profiles among Young Adults in a Longitudinal Study across 6 US Metropolitan Areas. Subst Use Misuse 2023; 58:981-988. [PMID: 37082785 PMCID: PMC10645480 DOI: 10.1080/10826084.2023.2201839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: Examining opioid use profiles over time and related factors among young adults is crucial to informing prevention efforts. Objectives: This study analyzed baseline data (Fall 2018) and one-year follow-up data from a cohort of 2,975 US young adults (Mage=24.55, 42.1% male; 71.7% White; 11.4% Hispanic). Multinomial logistic regression was used to examine: 1) psychosocial correlates (i.e. adverse childhood experiences [ACEs], depressive symptoms, parental substance use) of lifetime opioid use (i.e. prescription use vs. nonuse, nonmedical prescription [NMPO] use, and heroin use, respectively); and 2) psychosocial correlates and baseline lifetime use in relation to past 6-month use at one-year follow-up (i.e. prescription use vs. nonuse and NMPO/heroin use, respectively). Results: At baseline, lifetime use prevalence was: 30.2% prescription, 9.7% NMPO, and 3.1% heroin; past 6-month use prevalence was: 7.6% prescription, 2.5% NMPO, and 0.9% heroin. Compared to prescription users, nonusers reported fewer ACEs and having parents more likely to use tobacco, but less likely alcohol; NMPO users did not differ; and heroin users reported more ACEs and having parents more likely to use cannabis but less likely alcohol. At one-year follow-up, past 6-month use prevalence was: 4.3% prescription, 1.3% NMPO, and 1.4% heroin; relative to prescription users, nonusers were less likely to report baseline lifetime opioid use and reported fewer ACEs, and NMPO/heroin users were less likely to report baseline prescription opioid use but more likely heroin use. Conclusions: Psychosocial factors differentially correlate with young adult opioid use profiles, and thus may inform targeted interventions addressing different use patterns and psychosocial risk factors.
Collapse
Affiliation(s)
- Caroline Fuss
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Department of Pediatrics, College of Medicine,University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Natalie D Crawford
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin R V Harrington
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tamara Taggart
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Monica S Ruiz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
| |
Collapse
|
7
|
Thrul J, Rabinowitz JA, Reboussin BA, Maher BS, Anthony JC, Ialongo NS. Longitudinal associations between age 20 problematic substance use and opioid use disorder incidence at age 30 - findings from an urban cohort. J Psychiatr Res 2023; 160:1-7. [PMID: 36764195 PMCID: PMC10023426 DOI: 10.1016/j.jpsychires.2023.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/15/2022] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
This study used data from a longitudinal prevention study in an urban cohort to examine associations between nicotine dependence, alcohol, and cannabis use disorder and disorder criteria at age 20, with opioid use disorder (OUD) incidence or criteria onset by age 30. The study sample included 1408 participants (57.5% female, 72.5% African American) drawn from two cohorts of participants in a mid-Atlantic region of the U.S. as part of a series of randomized controlled trials of elementary school-based universal prevention interventions. Lifetime cannabis use disorder (CUD), alcohol use disorder (AUD; both DSM-IV), and current nicotine dependence (Fagerstrom Test for Nicotine Dependence, FTND) assessed at age 20 were used to predict (1) DSM-IV lifetime OUD at age 30, and (2) OUD criteria between ages 20 and 30 in multivariable logistic regression models. Covariates for all analyses included sociodemographics (sex, race, and free/reduced-priced lunch status), community disadvantage, and intervention status. Nicotine dependence (FTND≥3) at age 20 predicted age 30 DSM-IV lifetime OUD (aOR = 2.37; 95% CI 1.02,5.54). The number of CUD criteria (aOR = 1.30; 95% CI 1.09,1.57) and nicotine dependence severity scores (aOR = 1.22; 95% CI = 1.05,1.41) at age 20 predicted any OUD criteria between the ages of 20 and 30. Findings are consistent with previous research on opioid use behavior in young adulthood and suggest that nicotine dependence and CUD criteria among urban young people predict onset of OUD and OUD criteria in young adulthood.
Collapse
Affiliation(s)
- Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James C Anthony
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
8
|
Galán CA, Shaw DS, O'Rourke F, Reynolds MD, Gill A, Bogen DL, Ridenour TA. Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care: A Randomized Clinical Trial using the Family Check-Up. Res Child Adolesc Psychopathol 2023; 51:151-163. [PMID: 36208361 PMCID: PMC10146025 DOI: 10.1007/s10802-022-00978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
This study evaluated acceptability, engagement in prevention, and efficacy of a primary care screening-and-referral-to-prevention program to reduce substance use in early adolescence. Screening tools were the Youth Risk Index and Transmissible Liability Index and prevention consisted of the Family Check-Up (FCU). Three hundred sixty-one 10- to 13-year-olds from low resource neighborhoods (85.9% African American; 52.4% female) screened "at risk" during primary care visits and were randomized to the FCU (n = 123) or usual care (n = 238). Screening was acceptable to parents and youths: nearly 95% of each rated it as important, about 90% of each were happy with or did not mind it, and only 2.4% of parents did not want their child to be screened at their next check-up. Of parents who had a chance to receive the FCU (or waitlist-control), 87.5% followed through with researchers while 93.5% who were offered FCU engaged in it. FCU efficacy primarily involved interactions such that youth with greater risk at baseline experienced larger benefits. At 12-month follow-up, FCU was associated with 11% reduced risk of initiating a new substance per substance that had been initiated before baseline; greater reductions in tolerance of deviance among those with higher tolerance of deviance at baseline; and a main effect of reduced anxiety, but no effect for conduct problems. Pediatric well-child check-up screening can identify high-risk youth before, or in the initial stages of, problematic SU; engage families in a preventive intervention; and reduce rates of substance use and related risk factors.
Collapse
Affiliation(s)
| | | | | | | | - Anne Gill
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Ty A Ridenour
- University of Pittsburgh, Pittsburgh, PA, USA. .,Research Triangle Institute, Research Triangle Park, NC, USA. .,University of North Carolina, Chapel Hill, NC, USA.
| |
Collapse
|
9
|
Osibogun O, Erinoso O, Gautam P, Bursac Z, Osibogun A. Marijuana use modifies the association between heavy alcohol consumption and tobacco use patterns among US adults: Findings from Behavioral Risk Factor Surveillance System, 2020. Addict Behav 2022; 135:107435. [DOI: 10.1016/j.addbeh.2022.107435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 11/01/2022]
|
10
|
Bedene A, Dahan A, Rosendaal FR, van Dorp ELA. Opioid epidemic: lessons learned and updated recommendations for misuse involving prescription versus non-prescription opioids. Expert Rev Clin Pharmacol 2022; 15:1081-1094. [PMID: 36068971 DOI: 10.1080/17512433.2022.2114898] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In the past decades, the opioid crisis has heavily impacted parts of the US society and has been followed by an increase in the use of opioids worldwide. It is of paramount importance that we explore the origins of the US opioid epidemic to develop best practices to tackle the rising tide of opioid overdoses. AREAS COVERED In this expert review, we discuss opioid (over)prescription, change in perception of pain, and false advertisement of opioid safety as the leading causes of the US opioid epidemic. Then, we review the evidence about opioid dependence and addiction potential and provide current knowledge about predictors of aberrant opioid-related behavior. Lastly, we discuss different approaches that were considered or undertaken to combat the rising tide of opioid-related deaths by regulatory bodies, pharmaceutical companies, and health-care professionals. For this expert review, we considered published articles relevant to the topic under investigation that we retrieved from Medline or Google scholar electronic database. EXPERT OPINION The opioid epidemic is a dynamic process with many underlying mechanisms. Therefore, no single approach may be best suited to combat it. In our opinion, the best way forward is to employ multiple strategies to tackle different underlying mechanisms.
Collapse
Affiliation(s)
- Ajda Bedene
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eveline L A van Dorp
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
11
|
Time trends and associated factors of global burden due to drug use disorders in 204 countries and territories, 1990-2019. Drug Alcohol Depend 2022; 238:109542. [PMID: 35780623 DOI: 10.1016/j.drugalcdep.2022.109542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Drug use disorders (DUDs) have been a public health crisis which strongly impacted community health and socio-economic development. However, there are few studies based on the latest global data to show changes in the disease burden due to DUDs, specifically investigating associations between the country-level socio-economic factors and the burden of DUDs. METHODS Data of DUDs were extracted from the Global Burden of Disease Study 2019 database to explore the trends of the disease burden due to DUDs from 1990 to 2019. Univariate linear regression and stepwise multiple linear regression analysis were performed to analyze the correlations between burden due to DUDs and country-level socio-economic factors. RESULTS Globally, the number of disability-adjusted life-years (DALYs) caused by DUDs approximately increased by 2.6% yearly from 1990 to 2019, though the age-standardized DALY rate has not changed significantly in the past 30 years. The age-standardized DALY rate of opioid use disorders showed an upward trend during the past 30 years and was highest among 5 types of DUDs in 2019. Inequality-adjusted human development index (β = 15.9, 95% confidence interval [CI]: 12.9-18.9, P < 0.001) was identified as the key risk factor associated with square-root transformed age-standardized DALY rate of DUDs. CONCLUSIONS Global burden due to DUDs has increased significantly over the past 30 years. More effective targeted public health policies should be formulated to manage the public health challenge of DUDs, especially in developed countries and territories.
Collapse
|
12
|
Baiden P, Eugene DR, Nicholas JK, Spoor S, Brown FA, LaBrenz CA. Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01369-5. [PMID: 35861928 DOI: 10.1007/s40615-022-01369-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Although some studies have examined the association between prescription opioid misuse and mental health outcomes, few have investigated the effects of prescription opioid misuse on suicidal behaviors among Black adolescents. The objective of this study was to investigate the cross-sectional association between prescription opioid misuse and suicidal ideation, suicide plan, and suicide attempt among Black adolescents. METHODS Data for this study came from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 4798 Black adolescents aged 14-18 years (51.2% female) was analyzed using binary logistic regression. The outcome variables investigated were suicidal ideation, suicide plan, and suicide attempt, and the main explanatory variable was prescription opioid misuse. RESULTS Of the 4798 Black adolescents, 15% reported ever misusing prescription opioids; 16.2% experienced suicidal ideation; 14% made a suicide plan; and 11.3% attempted suicide during the past 12 months. In the multivariate logistic regression models, Black adolescents who misused prescription opioids had 1.39 times higher odds of making a suicide plan and 1.65 times higher odds of making a suicide attempt during the past 12 months when compared to their counterparts who did not misuse prescription opioids. Other significant factors associated with suicidal behaviors include female sex, school bullying, cyberbullying, depressive symptoms, and illicit drug use. In addition, physical activity had a protective effect on suicide attempt. CONCLUSION The findings of the present study demonstrate the effects of prescription opioid misuse and its association with suicidal behaviors among Black adolescents.
Collapse
Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA.
| | - Danielle R Eugene
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA
| | - Julia K Nicholas
- Department of Psychological and Brain Sciences, University of Louisville, Room 317 Life Sciences Building, Louisville, KY, 40292, USA
| | - Samantha Spoor
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA
| | - Fawn A Brown
- Department of Psychology, The University of Texas at Arlington, 501 Nedderman Dr, Box 19528, Arlington, TX, 76019, USA
| | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA
| |
Collapse
|
13
|
Gutierrez A, Nguyen JD, Creehan KM, Javadi-Paydar M, Grant Y, Taffe MA. Effects of combined THC and heroin vapor inhalation in rats. Psychopharmacology (Berl) 2022; 239:1321-1335. [PMID: 34160641 PMCID: PMC8219787 DOI: 10.1007/s00213-021-05904-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/27/2021] [Indexed: 12/23/2022]
Abstract
RATIONALE Opioids are effective medications, but they have several key limitations including the development of tolerance, establishment of dependence, diversion for non-medical use, and the development of addiction. Therefore, any drugs which act in an additive or synergistic fashion with opioids to address medical applications have the potential to reduce opioid-related harms. OBJECTIVES To determine if heroin and Δ9-tetrahydrocannabinol (THC) interact in an additive or independent manner to alter nociception, body temperature, and spontaneous locomotor activity when inhaled or injected. METHODS Groups of female and male rats, implanted with radiotelemetry transmitters, were exposed to vapor generated from heroin (50 mg/mL in propylene glycol vehicle; PG), THC (50 mg/mL), or the combination for assessment of effects on temperature and activity. Thermal nociception was assessed with a warm water tail-withdrawal assay. RESULTS Heroin inhalation increased temperature and activity whereas THC inhalation decreased temperature and activity in both female and male Sprague-Dawley rats. Effects of combined inhalation were in opposition, and additional experiments found the same outcome for the injection of heroin (0.5 mg/kg, s.c.) and THC (10 mg/kg, i.p.) alone and in combination. In contrast, the co-administration of heroin and THC by either inhalation or injection produced additive effects on thermal nociception in both male and female Sprague-Dawley and Wistar rats. CONCLUSIONS This study shows that additive effects of THC with an opioid on a medical endpoint such as analgesia may not generalize to other behavioral or physiological effects, which may be a positive outcome for unwanted side effects.
Collapse
Affiliation(s)
- Arnold Gutierrez
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
- Department of Psychiatry, University of California, 9500 Gilman Drive, San Diego, La Jolla, CA, 92093, USA
| | - Jacques D Nguyen
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
- Department of Psychiatry, University of California, 9500 Gilman Drive, San Diego, La Jolla, CA, 92093, USA
| | - Kevin M Creehan
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
- Department of Psychiatry, University of California, 9500 Gilman Drive, San Diego, La Jolla, CA, 92093, USA
| | | | - Yanabel Grant
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
- Department of Psychiatry, University of California, 9500 Gilman Drive, San Diego, La Jolla, CA, 92093, USA
| | - Michael A Taffe
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA.
- Department of Psychiatry, University of California, 9500 Gilman Drive, San Diego, La Jolla, CA, 92093, USA.
| |
Collapse
|
14
|
Reed ZE, Wootton RE, Munafò MR. Using Mendelian randomization to explore the gateway hypothesis: possible causal effects of smoking initiation and alcohol consumption on substance use outcomes. Addiction 2022; 117:741-750. [PMID: 34590374 PMCID: PMC9453475 DOI: 10.1111/add.15673] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Initial use of drugs such as tobacco and alcohol may lead to subsequent more problematic drug use-the 'gateway' hypothesis. However, observed associations may be due to a shared underlying risk factor, such as trait impulsivity. We used bidirectional Mendelian randomization (MR) to test the gateway hypothesis. DESIGN Our main method was inverse-variance weighted (IVW) MR, with other methods included as sensitivity analyses (where consistent results across methods would raise confidence in our primary results). MR is a genetic instrumental variable approach used to support stronger causal inference in observational studies. SETTING AND PARTICIPANTS Genome-wide association summary data among European ancestry individuals for smoking initiation, alcoholic drinks per week, cannabis use and dependence, cocaine and opioid dependence (n = 1749-1 232 091). MEASUREMENTS Genetic variants for exposure. FINDINGS We found evidence of causal effects from smoking initiation to increased drinks per week [(IVW): β = 0.06; 95% confidence interval (CI) = 0.03-0.09; P = 9.44 × 10-06 ], cannabis use [IVW: odds ratio (OR) = 1.34; 95% CI = 1.24-1.44; P = 1.95 × 10-14 ] and cannabis dependence (IVW: OR = 1.68; 95% CI = 1.12-2.51; P = 0.01). We also found evidence of an effect of cannabis use on the increased likelihood of smoking initiation (IVW: OR = 1.39; 95% CI = 1.08-1.80; P = 0.01). We did not find evidence of an effect of drinks per week on other substance use outcomes, except weak evidence of an effect on cannabis use (IVW: OR = 0.55; 95% CI = 0.16-1.93; P-value = 0.35). We found weak evidence of an effect of opioid dependence on increased drinks per week (IVW: β = 0.002; 95% CI = 0.0005-0.003; P = 8.61 × 10-03 ). CONCLUSIONS Bidirectional Mendelian randomization testing of the gateway hypothesis reveals that smoking initiation may lead to increased alcohol consumption, cannabis use and cannabis dependence. Cannabis use may also lead to smoking initiation and opioid dependence to alcohol consumption. However, given that tobacco and alcohol use typically begin before other drug use, these results may reflect a shared risk factor or a bidirectional effect for cannabis use and opioid dependence.
Collapse
Affiliation(s)
- Zoe E. Reed
- School of Psychological ScienceUniversity of BristolBristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Robyn E. Wootton
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Nic Waals InstituteLovisenberg Diaconal HospitalOsloNorway
| | - Marcus R. Munafò
- School of Psychological ScienceUniversity of BristolBristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- National Institute for Health Research Bristol Biomedical Research CentreUniversity Hospitals Bristol NHS Foundation Trust and University of BristolBristolUK
| |
Collapse
|
15
|
Montgomery L, Dixon S, Mantey DS. Racial and Ethnic Differences in Cannabis Use and Cannabis Use Disorder: Implications for Researchers. CURRENT ADDICTION REPORTS 2022; 9:14-22. [PMID: 35251891 PMCID: PMC8896813 DOI: 10.1007/s40429-021-00404-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Heavy and prolonged use of cannabis is associated with several adverse health, legal and social consequences. Although cannabis use impacts all U.S. racial/ethnic groups, studies have revealed racial/ethnic disparities in the initiation, prevalence, prevention and treatment of cannabis use and Cannabis Use Disorder (CUD). This review provides an overview of recent studies on cannabis and CUD by race/ethnicity and a discussion of implications for cannabis researchers. FINDINGS The majority of studies focused on cannabis use and CUD among African American/Black individuals, with the smallest number of studies found among Native Hawaiians/Pacific Islanders. The limited number of studies highlight unique risk and protective factors for each racial/ethnic group, such as gender, mental health status, polysubstance use and cultural identity. SUMMARY Future cannabis studies should aim to provide a deeper foundational understanding of factors that promote the initiation, maintenance, prevention and treatment of cannabis use and CUD among racial/ethnic groups. Cannabis studies should be unique to each racial/ethnic group and move beyond racial comparisons.
Collapse
Affiliation(s)
- LaTrice Montgomery
- University of Cincinnati College of Medicine, Center for Addiction Research/Addiction Sciences Division, Cincinnati, Ohio
- Corresponding Author: LaTrice Montgomery, Ph.D., University of Cincinnati College of Medicine, Center for Addiction Research/Addiction Sciences Division, 3131 Harvey Avenue, Suite 204, Cincinnati, Ohio 45229; ; Phone: 513-585-8286
| | - Shapree Dixon
- University of Cincinnati College of Medicine, Center for Addiction Research/Addiction Sciences Division, Cincinnati, Ohio
| | - Dale S. Mantey
- Department of Health Promotion and Behavioral Science, University of Texas Health Science Center, Houston, Texas
| |
Collapse
|
16
|
McQuaid GA, Darcey VL, Patterson AE, Rose EJ, VanMeter AS, Fishbein DH. Baseline brain and behavioral factors distinguish adolescent substance initiators and non-initiators at follow-up. Front Psychiatry 2022; 13:1025259. [PMID: 36569626 PMCID: PMC9780121 DOI: 10.3389/fpsyt.2022.1025259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Background Earlier substance use (SU) initiation is associated with greater risk for the development of SU disorders (SUDs), while delays in SU initiation are associated with a diminished risk for SUDs. Thus, identifying brain and behavioral factors that are markers of enhanced risk for earlier SU has major public health import. Heightened reward-sensitivity and risk-taking are two factors that confer risk for earlier SU. Materials and methods We characterized neural and behavioral factors associated with reward-sensitivity and risk-taking in substance-naïve adolescents (N = 70; 11.1-14.0 years), examining whether these factors differed as a function of subsequent SU initiation at 18- and 36-months follow-up. Adolescents completed a reward-related decision-making task while undergoing functional MRI. Measures of reward sensitivity (Behavioral Inhibition System-Behavioral Approach System; BIS-BAS), impulsive decision-making (delay discounting task), and SUD risk [Drug Use Screening Inventory, Revised (DUSI-R)] were collected. These metrics were compared for youth who did [Substance Initiators (SI); n = 27] and did not [Substance Non-initiators (SN); n = 43] initiate SU at follow-up. Results While SI and SN youth showed similar task-based risk-taking behavior, SI youth showed more variable patterns of activation in left insular cortex during high-risk selections, and left anterior cingulate cortex in response to rewarded outcomes. Groups displayed similar discounting behavior. SI participants scored higher on the DUSI-R and the BAS sub-scale. Conclusion Activation patterns in the insula and anterior cingulate cortex may serve as a biomarker for earlier SU initiation. Importantly, these brain regions are implicated in the development and experience of SUDs, suggesting differences in these regions prior to substance exposure.
Collapse
Affiliation(s)
- Goldie A. McQuaid
- Department of Psychology, George Mason University, Fairfax, VA, United States
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
- *Correspondence: Goldie A. McQuaid,
| | - Valerie L. Darcey
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
- The Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States
| | - Amanda E. Patterson
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
| | - Emma Jane Rose
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Ashley S. VanMeter
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
| | - Diana H. Fishbein
- Frank Porter Graham Child Development Institute, The University of North Carolina, Chapel Hill, Chapel Hill, NC, United States
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| |
Collapse
|
17
|
The dopamine transporter gene SLC6A3: multidisease risks. Mol Psychiatry 2022; 27:1031-1046. [PMID: 34650206 PMCID: PMC9008071 DOI: 10.1038/s41380-021-01341-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
The human dopamine transporter gene SLC6A3 has been consistently implicated in several neuropsychiatric diseases but the disease mechanism remains elusive. In this risk synthesis, we have concluded that SLC6A3 represents an increasingly recognized risk with a growing number of familial mutants associated with neuropsychiatric and neurological disorders. At least five loci were related to common and severe diseases including alcohol use disorder (high activity variant), attention-deficit/hyperactivity disorder (low activity variant), autism (familial proteins with mutated networking) and movement disorders (both regulatory variants and familial mutations). Association signals depended on genetic markers used as well as ethnicity examined. Strong haplotype selection and gene-wide epistases support multimarker assessment of functional variations and phenotype associations. Inclusion of its promoter region's functional markers such as DNPi (rs67175440) and 5'VNTR (rs70957367) may help delineate condensate-based risk action, testing a locus-pathway-phenotype hypothesis for one gene-multidisease etiology.
Collapse
|
18
|
Leal-López E, Sánchez-Queija I, Rivera F, Moreno C. Trends in Cannabis Use among Adolescents in Spain 2006–2018. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2021. [DOI: 10.1080/1067828x.2021.1988021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eva Leal-López
- Universidad de Sevilla (University of Seville), Sevilla, Spain
| | | | | | - Carmen Moreno
- Universidad de Sevilla (University of Seville), Sevilla, Spain
| |
Collapse
|