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Rabinowitz JA, Reboussin BA, Thrul J, Drabick DAG, Kahn G, Green KM, Ialongo NS, Huhn AS, Maher BS. Early Childhood Behavioral and Academic Antecedents of Lifetime Opioid Misuse among Urban Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:864-876. [PMID: 33688771 PMCID: PMC8977050 DOI: 10.1080/15374416.2021.1875324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Opioid misuse has become an epidemic in the United States. In the present study, we examine potential malleable early childhood predictors of opioid misuse including whether childhood achievement, aggressive behavior, attention problems, and peer social preference/likability in first grade predicted opioid misuse and whether these relationships differed depending on participant sex. METHOD Data are drawn from three cohorts of participants (N = 1,585; 46.7% male) recruited in first grade as part of a series of elementary school-based, universal preventive interventions conducted in a Mid-Atlantic region of the US. In first grade, participants completed standardized achievement tests, teachers reported on attention problems, and peers nominated their classmates with respect to their aggressive behavior and social preference/likability. At approximately age 20, participants reported on their misuse of opioids defined as lifetime use of heroin or misuse of prescription opioids. RESULTS Higher levels of peer nominations for aggressive behavior in first grade predicted a greater likelihood of opioid misuse. An interaction between participant sex and attention problems was observed such that females higher in attention problems were more likely to misuse opioids, particularly prescription opioids, than females lower in attention problems. An interaction was also found between participant sex and peer likability such that males lower in peer-nominated likability were more likely to misuse opioids relative to males higher in likability. CONCLUSION Given the malleable nature of attention problems, aggression, and social skills in early childhood, prevention programs that target these behaviors during this developmental period may attenuate risk for opioid misuse.
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Affiliation(s)
- Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Geoffrey Kahn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Services, Johns Hopkins Bloomberg School of Public Health
| | - Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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Archambault L, Bertrand K, Perreault M. Problematic Opioid Use: A Scoping Literature Review of Profiles. Subst Abuse 2022; 16:11782218221103581. [PMID: 35923179 PMCID: PMC9340351 DOI: 10.1177/11782218221103581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Problematic opioid use can be defined as opioid use behaviors leading to social, medical, or psychological consequences. In some instances, people presenting problematic opioid use can also meet criteria for an opioid use disorder. A growing body of literature highlights different types of people who use opioids, with contrasting characteristics and initiation patterns. In recent years, dynamic trends in opioid use have been documented and studies have demonstrated a shift in profiles. Methods: A scoping literature review was conducted to identify profiles of people presenting problematic opioid use, in order to support the development of tailored interventions and services. Results: Nine articles met the inclusion criteria. Five classifications emerge from the literature reviewed to distinguish types of people presenting problematic opioid use, according to: (1) the type of opioids used, (2) the route of opioid administration, (3) the level of quality of life, (4) patterns of other drugs used, and (5) dependence severity. While samples, concepts, and measurement tools vary between studies, the most salient finding might be the distinct profile of people presenting problematic use of pharmaceutical-type opioids. Discussion and Conclusions: This scoping review highlights that few studies address distinctive profiles of people presenting problematic opioid use. Geographical and chronological differences suggest that local timely assessments may be needed to tailor the service offer to specific needs. Scientific Significance: Future studies should focus on providing a deep understanding of distinct experiential perspectives and service needs, through exploratory quantitative and qualitative designs.
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Affiliation(s)
- Léonie Archambault
- Douglas Research Center and Université de Sherbrooke, Montréal, QC, Canada
| | - Karine Bertrand
- Institut universitaire sur les dépendances and Université de Sherbrooke, Longueuil, QC, Canada
| | - Michel Perreault
- Douglas Research Center and McGill University, Montréal, QC, Canada
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Cavazos-Rehg P, Grucza R, Krauss MJ, Smarsh A, Anako N, Kasson E, Kaiser N, Sansone S, Winograd R, Bierut LJ. Utilizing social media to explore overdose and HIV/HCV risk behaviors among current opioid misusers. Drug Alcohol Depend 2019; 205:107690. [PMID: 31778902 PMCID: PMC6894427 DOI: 10.1016/j.drugalcdep.2019.107690] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Opioid misuse has evolved into an American health crisis over the past decade, becoming a public health epidemic. Measures need to be taken to prevent overdoses by opioid misuse as well as prevent the transition into injection drug use, a high risk factor for contracting HIV/HCV. This study utilized social media to survey individuals currently misusing opioids to identify groups of individuals with different risk and use patterns. METHODS We recruited participants for our online survey from Reddit. Five risk behaviors were used to characterize overdose and HIV/HCV risk groups. Gender, age, and socioeconomic status were also included in the analyses, as well as items outlining social media use surrounding opioids. RESULTS Two groups of participants were characterized by high likelihoods of different combinations of risky behaviors: (1) Overdose Risk Group and (2) Sexual Risk Group. Those in the Overdose Risk Group were more likely to be younger in age and female, and this group was more likely to desire or be ready for treatment relative to the lowest risk group. Those in the Sexual Risk Group were more likely to be of a minority race/ethnicity, to desire or be ready for treatment, and to post more often on Reddit about opioid use. DISCUSSION The results of this study illustrate patterns of opioid use and risk behaviors to inform tailored outreach and treatment efforts for groups of opioid misusers and suggests the potential for utilizing social media as a tool to engage these individuals into treatment and recovery activities.
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Affiliation(s)
- Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, United States.
| | - Richard Grucza
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, United States.
| | - Melissa J. Krauss
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110
| | - Austin Smarsh
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Nnenna Anako
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, United States; George Warren Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States.
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, United States.
| | - Nina Kaiser
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, United States.
| | - Samantha Sansone
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, United States.
| | - Rachel Winograd
- Missouri Institute of Mental Health, University of Missouri St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134, United States.
| | - Laura J. Bierut
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110
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Degenhardt L, Charlson F, Ferrari A, Santomauro D, Erskine H, Mantilla-Herrara A, Whiteford H, Leung J, Naghavi M, Griswold M, Rehm J, Hall W, Sartorius B, Scott J, Vollset SE, Knudsen AK, Haro JM, Patton G, Kopec J, Carvalho Malta D, Topor-Madry R, McGrath J, Haagsma J, Allebeck P, Phillips M, Salomon J, Hay S, Foreman K, Lim S, Mokdad A, Smith M, Gakidou E, Murray C, Vos T. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry 2018; 5:987-1012. [PMID: 30392731 PMCID: PMC6251968 DOI: 10.1016/s2215-0366(18)30337-7] [Citation(s) in RCA: 783] [Impact Index Per Article: 130.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alcohol and drug use can have negative consequences on the health, economy, productivity, and social aspects of communities. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to calculate global and regional estimates of the prevalence of alcohol, amphetamine, cannabis, cocaine, and opioid dependence, and to estimate global disease burden attributable to alcohol and drug use between 1990 and 2016, and for 195 countries and territories within 21 regions, and within seven super-regions. We also aimed to examine the association between disease burden and Socio-demographic Index (SDI) quintiles. METHODS We searched PubMed, EMBASE, and PsycINFO databases for original epidemiological studies on alcohol and drug use published between Jan 1, 1980, and Sept 7, 2016, with out language restrictions, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to estimate population-level prevalence of substance use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990-2016. We also used a comparative assessment approach to estimate burden attributable to alcohol and drug use as risk factors for other health outcomes. FINDINGS Globally, alcohol use disorders were the most prevalent of all substance use disorders, with 100·4 million estimated cases in 2016 (age-standardised prevalence 1320·8 cases per 100 000 people, 95% uncertainty interval [95% UI] 1181·2-1468·0). The most common drug use disorders were cannabis dependence (22·1 million cases; age-standardised prevalence 289·7 cases per 100 000 people, 95% UI 248·9-339·1) and opioid dependence (26·8 million cases; age-standardised prevalence 353·0 cases per 100 000 people, 309·9-405·9). Globally, in 2016, 99·2 million DALYs (95% UI 88·3-111·2) and 4·2% of all DALYs (3·7-4·6) were attributable to alcohol use, and 31·8 million DALYs (27·4-36·6) and 1·3% of all DALYs (1·2-1·5) were attributable to drug use as a risk factor. The burden of disease attributable to alcohol and drug use varied substantially across geographical locations, and much of this burden was due to the effect of substance use on other health outcomes. Contrasting patterns were observed for the association between total alcohol and drug-attributable burden and SDI: alcohol-attributable burden was highest in countries with a low SDI and middle-high middle SDI, whereas the burden due to drugs increased with higher S DI level. INTERPRETATION Alcohol and drug use are important contributors to global disease burden. Effective interventions should be scaled up to prevent and reduce substance use disease burden. FUNDING Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.
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The latent trait of ICD-11 nicotine dependence criteria: Dimensional and categorical phenotypes. Psychiatry Res 2018; 266:275-283. [PMID: 29605101 DOI: 10.1016/j.psychres.2018.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 12/22/2017] [Accepted: 03/05/2018] [Indexed: 12/11/2022]
Abstract
We aimed to identify phenotypes of DSM-ICD nicotine dependence among a representative sample of lifetime weekly smokers in the largest metropolitan area in South America. Data came from 1,387 lifetime weekly smokers in the São Paulo Megacity Mental Health Survey. We used exploratory factor analysis (EFA) and latent class analysis (LCA) on ICD-11 nicotine dependence proposed criteria to explore dimensionality and phenotypes profiles, followed by logistic regression models to examine the association between latent classes and socio-demographic, psychiatric and chronic medical conditions. Analyses were performed using Mplus taking into account the complex survey design features. An unidimensional model had the best EFA fit with high loadings on all criteria. Response patterns detected by LCA indicated class differences based on severity continuum: a "non-symptomatic class" (32.0%), a "low-moderate symptomatic class" (34.9%)-with high probability of the criterion "use in larger amounts", and a "high-moderate symptomatic class" (33.1%). We found an association between high-income and the intermediate class that differs from findings in high-income countries, and high likelihood of psychiatric comorbidity among the most symptomatic smokers. The best dimensional model that pulled together nicotine dependence criteria supported a single factor, in concordance with the changes proposed for ICD-11.
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The long-term impact of post traumatic stress disorder on recovery from heroin dependence. J Subst Abuse Treat 2018; 89:60-66. [DOI: 10.1016/j.jsat.2018.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/01/2018] [Accepted: 04/02/2018] [Indexed: 12/30/2022]
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Eastwood B, Strang J, Marsden J. Effectiveness of treatment for opioid use disorder: A national, five-year, prospective, observational study in England. Drug Alcohol Depend 2017; 176:139-147. [PMID: 28535456 DOI: 10.1016/j.drugalcdep.2017.03.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/03/2017] [Accepted: 03/07/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND This the first 5-year effectiveness study of publicly funded treatment for opioid use disorder (OUD) in England. METHODS All adults initiating treatment in 2008/09 in all 149 local treatment systems reporting to the National Drug Treatment Monitoring System (n=54,347). Admission polydrug use sub-populations were identified by Latent Class Analysis. The treatment outcome measure was 'successful completion and no re-presentation within six months' (SCNR) analysed by multilevel, multivariable logistic regression and funnel plots to contrast outcome by treatment system. RESULTS SCNR was achieved by 21.9%. Heroin and crack cocaine users were significantly less likely to achieve this outcome than patients who used heroin only (adjusted odds ratio [AOR] 0.90; 95% confidence interval [CI] 0.85-0.95). Older patients (AOR 1.09; CI 1.07-1.11), those employed (AOR 1.27; CI 1.18-1.37) and those enrolled for longer treatment were more likely to achieve the outcome measure. After risk adjustment, the local treatment systems that achieved substantially better outcome performance (14/149) had a lower rate of opiate prevalence in the local population at time of study initiation (incidence rate difference [IRD] 4.1; CI 4.0-4.2), fewer criminal offences per thousand (IRD 28.5; CI 28.1-28.8) and lower drug-related deaths per million (IRD 5.9; CI 5.9-5.9). CONCLUSIONS In an English national study, one fifth of patients successful completed treatment for OUD and did not present for further treatment within six months. Longer time in treatment increases the probability of achieving and maintaining clinical benefit from treatment. After risk-adjustment, an important minority of treatment systems achieve substantially better outcome performance.
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Affiliation(s)
- Brian Eastwood
- Addictions Department, Box 48, Institute of Psychiatry, Psychology and Neuroscience, DeCrespigny Park, Denmark Hill, London SE5 8AF, United Kingdom; Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate, Public Health England, 2nd Floor, Skipton House, 80 London Road, London SE1 6LH, United Kingdom.
| | - John Strang
- Addictions Department, Box 48, Institute of Psychiatry, Psychology and Neuroscience, DeCrespigny Park, Denmark Hill, London SE5 8AF, United Kingdom.
| | - John Marsden
- Addictions Department, Box 48, Institute of Psychiatry, Psychology and Neuroscience, DeCrespigny Park, Denmark Hill, London SE5 8AF, United Kingdom; Alcohol, Drugs and Tobacco Division, Health and Wellbeing Directorate, Public Health England, 2nd Floor, Skipton House, 80 London Road, London SE1 6LH, United Kingdom
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Teesson M, Marel C, Darke S, Ross J, Slade T, Burns L, Lynskey M, Memedovic S, White J, Mills KL. Trajectories of heroin use: 10-11-year findings from the Australian Treatment Outcome Study. Addiction 2017; 112:1056-1068. [PMID: 28060437 DOI: 10.1111/add.13747] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/25/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Abstract
AIMS To identify trajectories of heroin use in Australia, predictors of trajectory group membership and subsequent outcomes among people with heroin dependence over 10-11 years. DESIGN Longitudinal cohort study. SETTING Sydney, Australia. PARTICIPANTS A total of 615 participants were recruited between 2001 and 2002 as part of the Australian Treatment Outcome Study (66.2% male; mean age 29 years). The predominance of the cohort (87.0%) was recruited upon entry to treatment (maintenance therapies, detoxification and residential rehabilitation), and the remainder from non-treatment settings (e.g. needle and syringe programmes). This analysis focused upon 428 participants for whom data on heroin use were available over 10-11 years following study entry. MEASUREMENTS Structured interviews assessed demographics, treatment history, heroin and other drug use, overdose, criminal involvement, physical health and psychopathology. Group-based trajectory modelling was used to: (i) identify trajectory groups based on use of heroin in each year, (ii) examine predictors of group membership and (iii) examine associations between trajectory group membership and 10-11-year outcomes. FINDINGS Six trajectory groups were identified [Bayesian Information Criterion (BIC) = -1927.44 (n = 4708); -1901.07 (n = 428)]. One in five (22.1%) were classified as having 'no decrease' in heroin use, with the probability of using remaining high during the 10-11 years (> 0.98 probability of use in each year). One in six (16.1%) were classified as demonstrating a 'rapid decrease to maintained abstinence'. The probability of heroin use among this group declined steeply in the first 2-3 years and continued to be low (< 0.01). The remaining trajectories represented other fluctuating patterns of use. Few baseline variables were found to predict trajectory group membership, but group membership was predictive of demographic, substance use and physical and mental health outcomes at 10-11 years. CONCLUSIONS Long-term trajectories of heroin use in Australia appear to show considerable heterogeneity during a decade of follow-up, with few risk factors predicting group membership. Just more than a fifth continued to use at high levels, while fewer than a fifth become abstinent early on and remained abstinent. The remainder showed fluctuating patterns.
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Affiliation(s)
- Maree Teesson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
| | - Christina Marel
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
| | - Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Joanne Ross
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
| | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
| | - Lucy Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Michael Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Sonja Memedovic
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
| | - Joanne White
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
| | - Katherine L Mills
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Australia
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Martins SS, Segura LE, Santaella-Tenorio J, Perlmutter A, Fenton MC, Cerdá M, Keyes KM, Ghandour LA, Storr CL, Hasin DS. Prescription opioid use disorder and heroin use among 12-34 year-olds in the United States from 2002 to 2014. Addict Behav 2017; 65:236-241. [PMID: 27614657 DOI: 10.1016/j.addbeh.2016.08.033] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/23/2016] [Accepted: 08/28/2016] [Indexed: 10/21/2022]
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Hayhurst KP, Pierce M, Hickman M, Seddon T, Dunn G, Keane J, Millar T. Pathways through opiate use and offending: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 39:1-13. [PMID: 27770693 PMCID: PMC5234472 DOI: 10.1016/j.drugpo.2016.08.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/07/2016] [Accepted: 08/29/2016] [Indexed: 11/02/2022]
Abstract
BACKGROUND Although evidence points to a strong link between illicit drug use and crime, robust evidence for temporal order in the relationship is scant. We carried out a systematic review to assess the evidence for pathways through opiate/crack cocaine use and offending to determine temporal order. METHODS A systematic review sourced five databases, three online sources, bibliographies and citation mapping. Inclusion criteria were: focus on opiate/crack use, and offending; pre-drug use information; longitudinal design; corroborative official crime records. Rate ratios (RR) of post-drug use initiation to pre-drug use initiation were pooled using random effects meta-analysis. RESULTS 20 studies were included; UK (9) and US (11). All were of opiate use. Mean age at (recorded) offending onset (16.7yrs) preceded mean age at opiate-use onset (19.6yrs). Substantial heterogeneity (over 80%: unexplained by meta-regression) meant that RRs were not pooled. The RR for total (recorded) offending ranged from 0.71 to 25.7 (10 studies; 22 subsamples: positive association, 4: equivocal, 1: negative association). Positive associations were observed in 14/15 independent samples; unlikely to be a chance finding (sign test p=0.001). Individual offence types were examined: theft (RR 0.63-8.3, 13 subsamples: positive, 9: equivocal, 1 negative); burglary (RR 0.74-50.0, 9 subsamples: positive, 13: equivocal); violence (RR 0.39-16.0, 6 subsamples: positive, 15: equivocal); and robbery (RR 0.50-5.0, 5 subsamples: positive, 15: equivocal). CONCLUSIONS Available evidence suggests that onset-opiate use accelerates already-existing offending, particularly for theft. However, evidence is out of date, with studies characterised by heterogeneity and failure to use a matched non-opiate-user comparison group to better-establish whether onset-opiate use is associated with additional crime.
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Affiliation(s)
- Karen P Hayhurst
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester M13 9PL, UK.
| | - Matthias Pierce
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester M13 9PL, UK
| | - Matthew Hickman
- NIHR Health Protection Research Unit in Evaluation, School of Social and Community Medicine, The University of Bristol, Bristol BS8 2PS, UK
| | - Toby Seddon
- School of Law, The University of Manchester, Manchester M13 9PL, UK
| | - Graham Dunn
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester M13 9PL, UK
| | - John Keane
- School of Computer Science and Manchester Institute of Biotechnology, The University of Manchester, Manchester M13 9PL, UK
| | - Tim Millar
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester M13 9PL, UK
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Northrup TF, Stotts AL, Green C, Potter JS, Marino EN, Walker R, Weiss RD, Trivedi M. Opioid withdrawal, craving, and use during and after outpatient buprenorphine stabilization and taper: a discrete survival and growth mixture model. Addict Behav 2015; 41:20-8. [PMID: 25282598 DOI: 10.1016/j.addbeh.2014.09.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/30/2014] [Accepted: 09/17/2014] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Most patients relapse to opioids within one month of opioid agonist detoxification, making the antecedents and parallel processes of first use critical for investigation. Craving and withdrawal are often studied in relationship to opioid outcomes, and a novel analytic strategy applied to these two phenomena may indicate targeted intervention strategies. METHODS Specifically, this secondary data analysis of the Prescription Opioid Addiction Treatment Study used a discrete-time mixture analysis with time-to-first opioid use (survival) simultaneously predicted by craving and withdrawal growth trajectories. This analysis characterized heterogeneity among prescription opioid-dependent individuals (N=653) into latent classes (i.e., latent class analysis [LCA]) during and after buprenorphine/naloxone stabilization and taper. RESULTS A 4-latent class solution was selected for overall model fit and clinical parsimony. In order of shortest to longest time-to-first use, the 4 classes were characterized as 1) high craving and withdrawal, 2) intermediate craving and withdrawal, 3) high initial craving with low craving and withdrawal trajectories and 4) a low initial craving with low craving and withdrawal trajectories. Odds ratio calculations showed statistically significant differences in time-to-first use across classes. CONCLUSIONS Generally, participants with lower baseline levels and greater decreases in craving and withdrawal during stabilization combined with slower craving and withdrawal rebound during buprenorphine taper remained opioid-free longer. This exploratory work expanded on the importance of monitoring craving and withdrawal during buprenorphine induction, stabilization, and taper. Future research may allow individually tailored and timely interventions to be developed to extend time-to-first opioid use.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, JJL 324, Houston, TX 77030, USA.
| | - Angela L Stotts
- Department of Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, JJL 324, Houston, TX 77030, USA; Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston, 1941 East Road, Houston, TX 77054, USA
| | - Charles Green
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston, 1941 East Road, Houston, TX 77054, USA; Department of Pediatrics, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 3.020, Houston, TX 77030, USA
| | - Jennifer S Potter
- University of Texas Health Science Center at San Antonio, Department of Psychiatry, Mail Code 7792, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA; McLean Hospital, Division of Alcohol and Drug Abuse & Harvard Medical School, Department of Psychiatry, 115 Mill Street, Belmont, MA 02478, USA
| | - Elise N Marino
- University of Texas Health Science Center at San Antonio, Department of Psychiatry, Mail Code 7792, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Robrina Walker
- University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
| | - Roger D Weiss
- McLean Hospital, Division of Alcohol and Drug Abuse & Harvard Medical School, Department of Psychiatry, 115 Mill Street, Belmont, MA 02478, USA
| | - Madhukar Trivedi
- University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, USA
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Tarrahi MJ, Rahimi-Movaghar A, Zeraati H, Motevalian SA, Amin-Esmaeili M, Hajebi A, Sharifi V, Radgoodarzi R, Hefazi M, Fotouhi A. Latent class analysis of DSM-5 criteria for opioid use disorders: results from the Iranian National Survey on Mental Health. Eur Addict Res 2015; 21:144-52. [PMID: 25676055 DOI: 10.1159/000369338] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 10/22/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. METHODS Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). RESULTS A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. 'Legal problems' and 'desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7% higher than with DSM-IV. CONCLUSIONS RESULTS support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion.
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Affiliation(s)
- Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics, School of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran
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Wetherill L, Kapoor M, Agrawal A, Bucholz K, Koller D, Bertelsen SE, Le N, Wang JC, Almasy L, Hesselbrock V, Kramer J, Nurnberger JI, Schuckit M, Tischfield JA, Xuei X, Porjesz B, Edenberg HJ, Goate AM, Foroud T. Family-based association analysis of alcohol dependence criteria and severity. Alcohol Clin Exp Res 2014; 38:354-66. [PMID: 24015780 PMCID: PMC3946798 DOI: 10.1111/acer.12251] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 07/08/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND Despite the high heritability of alcohol dependence (AD), the genes found to be associated with it account for only a small proportion of its total variability. The goal of this study was to identify and analyze phenotypes based on homogeneous classes of individuals to increase the power to detect genetic risk factors contributing to the risk of AD. METHODS The 7 individual DSM-IV criteria for AD were analyzed using latent class analysis (LCA) to identify classes defined by the pattern of endorsement of the criteria. A genome-wide association study was performed in 118 extended European American families (n = 2,322 individuals) densely affected with AD to identify genes associated with AD, with each of the 7 DSM-IV criteria, and with the probability of belonging to 2 of 3 latent classes. RESULTS Heritability for DSM-IV AD was 61% and ranged from 17 to 60% for the other phenotypes. A single nucleotide polymorphism (SNP) in the olfactory receptor OR51L1 was significantly associated (7.3 × 10(-8) ) with the DSM-IV criterion of persistent desire to, or inability to, cut down on drinking. LCA revealed a 3-class model: the "low-risk" class (50%) rarely endorsed any criteria and none met criteria for AD; the "moderate-risk" class (33%) endorsed primarily 4 DSM-IV criteria and 48% met criteria for AD; and the "high-risk" class (17%) manifested high endorsement probabilities for most criteria and nearly all (99%) met criteria for AD. One SNP in a sodium leak channel NALCN demonstrated genome-wide significance with the high-risk class (p = 4.1 × 10(-8) ). Analyses in an independent sample did not replicate these associations. CONCLUSIONS We explored the genetic contribution to several phenotypes derived from the DSM-IV AD criteria. The strongest evidence of association was with SNPs in NALCN and OR51L1.
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Affiliation(s)
| | | | | | | | | | | | - Nhung Le
- Washington University School of Medicine
| | | | | | | | - John Kramer
- University of Iowa Carver College of Medicine
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Nelson EC, Lynskey MT, Heath AC, Wray N, Agrawal A, Shand FL, Henders AK, Wallace L, Todorov AA, Schrage AJ, Saccone NL, Madden PA, Degenhardt L, Martin NG, Montgomery GW. ANKK1, TTC12, and NCAM1 polymorphisms and heroin dependence: importance of considering drug exposure. JAMA Psychiatry 2013; 70:325-33. [PMID: 23303482 PMCID: PMC3789525 DOI: 10.1001/jamapsychiatry.2013.282] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT The genetic contribution to liability for opioid dependence is well established; identification of the responsible genes has proved challenging. OBJECTIVE To examine association of 1430 candidate gene single-nucleotide polymorphisms (SNPs) with heroin dependence, reporting here only the 71 SNPs in the chromosome 11 gene cluster (NCAM1, TTC12, ANKK1, DRD2) that include the strongest observed associations. DESIGN Case-control genetic association study that included 2 control groups (lacking an established optimal control group). SETTING Semistructured psychiatric interviews. PARTICIPANTS A total of 1459 Australian cases ascertained from opioid replacement therapy clinics, 531 neighborhood controls ascertained from economically disadvantaged areas near opioid replacement therapy clinics, and 1495 unrelated Australian Twin Registry controls not dependent on alcohol or illicit drugs selected from a twin and family sample. MAIN OUTCOME MEASURE Lifetime heroin dependence. RESULTS Comparison of cases with Australian Twin Registry controls found minimal evidence of association for all chromosome 11 cluster SNPs (P ≥ .01); a similar comparison with neighborhood controls revealed greater differences (P ≥ 1.8 × 10(-4)). Comparing cases (n = 1459) with the subgroup of neighborhood controls not dependent on illicit drugs (n = 340), 3 SNPs were significantly associated (correcting for multiple testing): ANKK1 SNP rs877138 (most strongly associated; odds ratio = 1.59; 95% CI, 1.32-1.92; P = 9.7 × 10(-7)), ANKK1 SNP rs4938013, and TTC12 SNP rs7130431. A similar pattern of association was observed when comparing illicit drug-dependent (n = 191) and nondependent (n = 340) neighborhood controls, suggesting that liability likely extends to nonopioid illicit drug dependence. Aggregate heroin dependence risk associated with 2 SNPs, rs877138 and rs4492854 (located in NCAM1), varied more than 4-fold (P = 2.7 × 10(-9) for the risk-associated linear trend). CONCLUSIONS Our results provide further evidence of association for chromosome 11 gene cluster SNPs with substance dependence, including extension of liability to illicit drug dependence. Our findings highlight the necessity of considering drug exposure history when selecting control groups for genetic investigations of illicit drug dependence.
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Affiliation(s)
| | | | | | - Naomi Wray
- University of Queensland, Brisbane, Australia
| | | | - Fiona L. Shand
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | | | - Leanne Wallace
- Queensland Institute of Medical Research, Brisbane, Australia
| | | | | | | | | | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Profiles of quality of life in opiate-dependent individuals after starting methadone treatment: a latent class analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2012; 24:342-50. [PMID: 23127664 DOI: 10.1016/j.drugpo.2012.09.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 09/04/2012] [Accepted: 09/17/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study aimed to identify classes of quality of life (QoL) among opiate-dependent individuals five to ten years after starting methadone treatment in order to tailor services to the needs of this population. METHODS A cross-sectional study of 159 opiate-dependent individuals who started outpatient methadone treatment in the region of Ghent, Belgium, between 1997 and 2002. A face-to-face structured interview was administered based on the Lancashire Quality of Life Profile, the EuropASI, Brief Symptom Inventory and the Verona Service Satisfaction Scale for Methadone Treatment. Latent class analysis was used to determine patterns of QoL. Analyses of variance and chi-square tests were used to test whether class membership was related to socio-demographic, health- and drug-related variables. RESULTS Based on fit criteria, a three-class model was selected. Class Low (14.5%), 'opiate-dependent individuals living in marginal conditions', is characterised by low QoL scores on all domains. Class Intermediate (25.8%), 'stabilized, but socially excluded opiate-dependent individuals' shows high scores on the domains 'safety' and 'living situation', but low scores on all other QoL domains. Class High (59.7%), 'socially included opiate-dependent individuals', is characterised by high QoL scores on all domains, except 'finances'. CONCLUSION The findings of this study illustrate the existence of different profiles of QoL among opiate-dependent individuals after starting methadone maintenance treatment and demonstrate the need for a continuing care approach. Insight into distinct classes of QoL can be used to design person-centred support, relevant to an individual's personal life.
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Hasin DS, Fenton MC, Beseler C, Park JY, Wall MM. Analyses related to the development of DSM-5 criteria for substance use related disorders: 2. Proposed DSM-5 criteria for alcohol, cannabis, cocaine and heroin disorders in 663 substance abuse patients. Drug Alcohol Depend 2012; 122:28-37. [PMID: 21963333 PMCID: PMC3755770 DOI: 10.1016/j.drugalcdep.2011.09.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 08/31/2011] [Accepted: 09/02/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND A number of changes have been proposed and investigated in the criteria for substance use disorders in DSM-5. However, although clinical utility of DSM-5 is a high priority, relatively little of the empirical evidence supporting the changes was obtained from samples of substance abuse patients. METHODS Proposed changes were examined in 663 patients in treatment for substance use disorders, evaluated by experienced clinicians using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). Factor and item response theory analysis was used to investigate the dimensionality and psychometric properties of alcohol, cannabis, cocaine and heroin abuse and dependence criteria, and craving. RESULTS The seven dependence criteria, three of the abuse criteria (hazardous use; social/interpersonal problems related to use; neglect of roles to use), and craving form a unidimensional latent trait for alcohol, cannabis, cocaine and heroin. Craving did not add significantly to the total information offered by the dependence criteria, but adding the three abuse criteria and craving together did significantly increase total information for the criteria sets associated with alcohol, cannabis and heroin. CONCLUSION Among adult patients in treatment for substance disorders, the alcohol, cannabis, cocaine and heroin criteria for dependence, abuse (with the exception of legal problems), and craving measure a single underlying dimension. Results support the proposal to combine abuse and dependence into a single diagnosis in the DSM-5, omitting legal problems. Mixed support was provided for the addition of craving as a new criterion, warranting future studies of this important construct in substance use disorders.
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Affiliation(s)
- Deborah S. Hasin
- College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032, United States
,Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, United States
,New York State Psychiatric Institute, New York, NY 10032, United States
,Corresponding author at: College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive #123, New York, NY 10032, United States. Tel.: +1 212 543 5035; fax: +1 212 543 5913. (D.S. Hasin)
| | - Miriam C. Fenton
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, United States
| | - Cheryl Beseler
- College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032, United States
,Department of Psychology, Colorado State University, Fort Collins, CO 80523-1879, United States
| | - Jung Yeon Park
- New York State Psychiatric Institute, New York, NY 10032, United States
| | - Melanie M. Wall
- College of Physicians and Surgeons, Department of Psychiatry, Columbia University, New York, NY 10032, United States
,Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, United States
,New York State Psychiatric Institute, New York, NY 10032, United States
,Mailman School of Public Health, Department of Biostatistics, Columbia University, New York, NY 10032, United States
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Grella CE, Lovinger K. 30-year trajectories of heroin and other drug use among men and women sampled from methadone treatment in California. Drug Alcohol Depend 2011; 118:251-8. [PMID: 21549528 PMCID: PMC3156933 DOI: 10.1016/j.drugalcdep.2011.04.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/28/2011] [Accepted: 04/03/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examines 30-year trajectories of heroin and other drug use among men and women who were in methadone maintenance treatment in California in the late 1970s and interviewed in 1978-1981. METHODS Nearly half (N=428; 46.8%) of the original study sample (N=914) was deceased. Of the remaining 486 subjects, 343 (44.3% female) completed a follow-up interview in 2005-2009 (70.6% of those not deceased). Average age at follow-up was 58.3 (SD=4.9) years for males and 55.0 (SD=4.1) years for females. Longitudinal data was obtained on their drug use, treatment participation, and criminal justice status over the follow-up period. Trajectory group modeling was used to identify distinctive trajectory groups based on monthly averages of heroin and other drug use per year; group differences were examined. RESULTS Four heroin and five alcohol and other drug (AOD) trajectory groups were identified. A greater proportion of women (60%) were in the "rapid decrease" heroin group (odds of use less than 10% by 10 years following initiation of use) as compared with the other groups. More rapid decrease of heroin use was associated with increases in AOD use, whereas a gradual decrease in heroin use was associated with a gradual decrease in AOD use. More school problems and earlier age at onset of heroin use and first arrest were associated with more persistent heroin use. CONCLUSION Heroin-use trajectories were linked with changes in AOD use. Childhood antecedents of heroin-use trajectories were identified as well as gender differences.
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Affiliation(s)
- Christine E Grella
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90025, USA.
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Hasin DS. Commentary on Shand et al. (2011): Opioid use disorder as a condition of graded severity, similar to other substance use disorders. Addiction 2011; 106:599-600. [PMID: 21299672 DOI: 10.1111/j.1360-0443.2010.03348.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Deborah S Hasin
- Columbia University, New York State Psychiatric Institute, New York, 10032, USA.
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