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Mateo Pinones M, González-Santa Cruz A, Castillo-Carniglia A, Bond C, Payne J, McGee TR. Substance use treatment completion and criminal justice system contact in Chile: A retrospective, linked data cohort study. Addiction 2024. [PMID: 38532650 DOI: 10.1111/add.16488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/25/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND AIMS Substance use treatment (SUT) has shown to be effective in reducing self-reported offending; however, the association between SUT completion and criminal justice system (CJS) contact has been underexplored, especially in Latin America. This study aimed to estimate the association between SUT completion status and (1) any subsequent CJS contact and (2) CJS contact leading to imprisonment, at 1, 3 and 5 years post-discharge, in Chile. DESIGN Retrospective cohort study using multivariable survival analysis based on linked administrative data from 2010 to 2019. SETTING This study took place in Chile, where SUT is available at no cost through Chile's publicly funded health-care, and is provided in outpatient and inpatient modalities in public and private centres. PARTICIPANTS A total of 70 854 individuals received their first SUT from 2010 to 2019. They were mainly males (76.3%), and their main substance used at admission was cocaine paste (39.2%). MEASUREMENTS SUT completion status included completion, late dropout (≥ 3 months) and early dropout (< 3 months). Outcomes were (1) any CJS contact and (2) CJS contact leading to imprisonment after baseline treatment. We estimated the association between treatment completion and CJS contact through flexible parametric Royston-Parmar models while adjusting for several covariates. FINDINGS Those who completed SUT (27.2%) were less likely to have any CJS contact at 5 years post-SUT compared with those who dropped out late [with a gap of -9.5%, 95% confidence interval (CI) = -8.7, -10.3] and early (-11.2%, 95% CI = -10.1, -12.3). Also, those who completed SUT were less likely to have CJS contact leading to imprisonment at 5 years post-SUT compared with those who dropped out late (-2.6%, 95% CI = -2.2, -3.1) and early (-4.0%, 95% CI = -3.3, -4.6). These differences were also observed at 1 and 3 years post-SUT for each outcome. CONCLUSIONS In Chile, completion of substance use treatment appears to be associated with lower probabilities of both any criminal justice system contact and contact leading to imprisonment.
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Affiliation(s)
- Mariel Mateo Pinones
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Australia
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
| | - Andrés González-Santa Cruz
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
- Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
- School of Public Health, Universidad de Chile, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
- Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - Christine Bond
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Australia
| | - Jason Payne
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Australia
| | - Tara Renae McGee
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Australia
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Chuchueva N, Carta F, Nguyen HN, Luevano J, Lewis IA, Rios-Castillo I, Fanos V, King E, Swistushkin V, Reshetov I, Rusetsky Y, Shestakova K, Moskaleva N, Mariani C, Castillo-Carniglia A, Grapov D, Fahrmann J, La Frano MR, Puxeddu R, Appolonova SA, Brito A. Metabolomics of head and neck cancer in biofluids: an integrative systematic review. Metabolomics 2023; 19:77. [PMID: 37644353 DOI: 10.1007/s11306-023-02038-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Head and neck cancer (HNC) is the fifth most common cancer globally. Diagnosis at early stages are critical to reduce mortality and improve functional and esthetic outcomes associated with HNC. Metabolomics is a promising approach for discovery of biomarkers and metabolic pathways for risk assessment and early detection of HNC. OBJECTIVES To summarize and consolidate the available evidence on metabolomics and HNC in plasma/serum, saliva, and urine. METHODS A systematic search of experimental research was executed using PubMed and Web of Science. Available data on areas under the curve was extracted. Metabolic pathway enrichment analysis were performed to identify metabolic pathways altered in HNC. Fifty-four studies were eligible for data extraction (33 performed in plasma/serum, 15 in saliva and 6 in urine). RESULTS Metabolites with high discriminatory performance for detection of HNC included single metabolites and combination panels of several lysoPCs, pyroglutamate, glutamic acid, glucose, tartronic acid, arachidonic acid, norvaline, linoleic acid, propionate, acetone, acetate, choline, glutamate and others. The glucose-alanine cycle and the urea cycle were the most altered pathways in HNC, among other pathways (i.e. gluconeogenesis, glycine and serine metabolism, alanine metabolism, etc.). Specific metabolites that can potentially serve as complementary less- or non-invasive biomarkers, as well as metabolic pathways integrating the data from the available studies, are presented. CONCLUSION The present work highlights utility of metabolite-based biomarkers for risk assessment, early detection, and prognostication of HNC, as well as facilitates incorporation of available metabolomics studies into multi-omics data integration and big data analytics for personalized health.
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Affiliation(s)
- Natalia Chuchueva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Central State Medical Academy, Moscow, Russia
| | - Filippo Carta
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University of Cagliari, Cagliari, Italy
| | - Hoang N Nguyen
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jennifer Luevano
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Isaiah A Lewis
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, USA
| | | | - Vassilios Fanos
- Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliero-Universitaria Di Cagliari, Cagliari University, Cagliari, Italy
| | - Emma King
- Cancer Research Center, University of Southampton, Southampton, UK
- Department of Otolaryngology, Poole Hospital National Health Service Foundation Trust, Longfleet Road, Poole, UK
| | | | - Igor Reshetov
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yury Rusetsky
- Central State Medical Academy, Moscow, Russia
- Otorhinolaryngological Surgical Department With a Group of Head and Neck Diseases, National Medical Research Center of Children's Health, Moscow, Russia
| | - Ksenia Shestakova
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology. I.M. Sechenov First, Moscow State Medical University, Moscow, Russia
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Natalia Moskaleva
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology. I.M. Sechenov First, Moscow State Medical University, Moscow, Russia
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Cinzia Mariani
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University of Cagliari, Cagliari, Italy
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP) and Millennium Nucleus on Sociomedicine (SocioMed), Santiago, Chile
| | | | | | - Michael R La Frano
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, USA
- Cal Poly Metabolomics Service Center, California Polytechnic State University, San Luis Obispo, CA, USA
- Roy J.Carver Metabolomics Core Facility, University of Illinois, Urbana-Champaign, IL, USA
| | - Roberto Puxeddu
- King's College Hospital London, Dubai, United Arab Emirates
- Section of Otorhinolaryngology, Department of Surgery, University of Cagliari, Cagliari, Italy
| | - Svetlana A Appolonova
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology. I.M. Sechenov First, Moscow State Medical University, Moscow, Russia
- Russian Center of Forensic-Medical Expertise of Ministry of Health, Moscow, Russia
| | - Alex Brito
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology. I.M. Sechenov First, Moscow State Medical University, Moscow, Russia.
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
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Castillo-Carniglia A, Rivera-Aguirre A, Santaella-Tenorio J, Fink DS, Crystal S, Ponicki W, Gruenewald P, Martins SS, Keyes KM, Cerdá M. Changes in Opioid and Benzodiazepine Poisoning Deaths After Cannabis Legalization in the US: A County-level Analysis, 2002-2020. Epidemiology 2023; 34:467-475. [PMID: 36943813 DOI: 10.1097/ede.0000000000001609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Cannabis legalization for medical and recreational purposes has been suggested as an effective strategy to reduce opioid and benzodiazepine use and deaths. We examined the county-level association between medical and recreational cannabis laws and poisoning deaths involving opioids and benzodiazepines in the US from 2002 to 2020. METHODS Our ecologic county-level, spatiotemporal study comprised 49 states. Exposures were state-level implementation of medical and recreational cannabis laws and state-level initiation of cannabis dispensary sales. Our main outcomes were poisoning deaths involving any opioid, any benzodiazepine, and opioids with benzodiazepines. Secondary analyses included overdoses involving natural and semi-synthetic opioids, synthetic opioids, and heroin. RESULTS Implementation of medical cannabis laws was associated with increased deaths involving opioids (rate ratio [RR] = 1.14; 95% credible interval [CrI] = 1.11, 1.18), benzodiazepines (RR = 1.19; 95% CrI = 1.12, 1.26), and opioids+benzodiazepines (RR = 1.22; 95% CrI = 1.15, 1.30). Medical cannabis legalizations allowing dispensaries was associated with fewer deaths involving opioids (RR = 0.88; 95% CrI = 0.85, 0.91) but not benzodiazepine deaths; results for recreational cannabis implementation and opioid deaths were similar (RR = 0.81; 95% CrI = 0.75, 0.88). Recreational cannabis laws allowing dispensary sales was associated with consistent reductions in opioid- (RR = 0.83; 95% CrI = 0.76, 0.91), benzodiazepine- (RR = 0.79; 95% CrI = 0.68, 0.92), and opioid+benzodiazepine-related poisonings (RR = 0.83; 95% CrI = 0.70, 0.98). CONCLUSIONS Implementation of medical cannabis laws was associated with higher rates of opioid- and benzodiazepine-related deaths, whereas laws permitting broader cannabis access, including implementation of recreational cannabis laws and medical and recreational dispensaries, were associated with lower rates. The estimated effects of the expanded availability of cannabis seem dependent on the type of law implemented and its provisions.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- From the Society and Health Research Center and School of Public Health, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile
- Millennium Nucleus on Sociomedicine (Sociomed), Chile
- Department of Population Health, New York University Grossman School of Medicine, NY
| | - Ariadne Rivera-Aguirre
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile
- Department of Population Health, New York University Grossman School of Medicine, NY
| | | | | | - Stephen Crystal
- Center for Health Services Research, Institute for Health, Rutgers University, New Brunswick, NJ
| | - William Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
| | | | | | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, NY
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4
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Rivera-Aguirre A, Castillo-Carniglia A, Laqueur HS, Rudolph KE, Martins SS, Ramírez J, Queirolo R, Cerdá M. On generating adequate counterfactuals for national policy evaluations. A response to Mundt et al. Addiction 2023; 118:192-194. [PMID: 36239882 PMCID: PMC9841828 DOI: 10.1111/add.16068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 01/18/2023]
Affiliation(s)
- Ariadne Rivera-Aguirre
- Department of Population Health, Division of Epidemiology, NYU School of Medicine, New York City, NY, USA
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies, nDP, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Department of Population Health, Division of Epidemiology, NYU School of Medicine, New York City, NY, USA
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies, nDP, Santiago, Chile
- Society and Health Research Center and School of Public Health, Universidad Mayor, Santiago, Chile
| | - Hannah S Laqueur
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Kara E Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Silva S Martins
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA, USA
| | - Jessica Ramírez
- National Drug Observatory of Uruguay, National Drug Board, Montevideo, Uruguay
| | - Rosario Queirolo
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies, nDP, Santiago, Chile
- Department of Social Sciences, Universidad Católica del Uruguay, Montevideo, Uruguay
| | - Magdalena Cerdá
- Department of Population Health, Division of Epidemiology, NYU School of Medicine, New York City, NY, USA
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5
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Calvo E, Córdova C, Shura R, Allel K, Castillo-Carniglia A, Keyes KM, Mauro C, Mauro PM, Medina JT, Mielenz T, Taramasco C, Martins SS. Global pain and aging: A cross-sectional study on age differences in the intensity of chronic pain among middle-aged and older adults in 20 countries. J Gerontol B Psychol Sci Soc Sci 2022; 78:1098-1108. [PMID: 36562345 DOI: 10.1093/geronb/gbac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This study aims to examine age differences in the intensity of chronic pain among middle-aged and older adults, where intensity is measured on a scale differentiating between chronic pain that is often troubling and likely requires intervention versus more endurable sensations. We aim to explore whether individual health and national gross domestic product (GDP) explain these differences as well. METHODS Cross-nationally harmonized data from 20 countries on self-reported intensity of chronic pain (0=no, 1=mild, 2=moderate, 3=severe) in 104,826 individuals aged 50+ observed in 2012-2013. Two-level hierarchical ordinal linear models with individuals nested within countries were used to isolate estimations from heterogeneity explained by methodological differences across single-country studies. RESULTS Overall, mean participant age was 66.9 (SD=9.9), 56.1% were women, and 41.9% of respondents reported any chronic pain. Chronic pain intensity rose sharply with age in some countries (e.g., Korea and Slovenia), but this association waned or reversed in other countries (e.g., the USA and Denmark). Cross-country variation and age differences in chronic pain were partly explained (85.5% and 35.8%, respectively) by individual-level health (especially arthritis), country-level wealth (as indicated by GDP per capita), and demographics. DISCUSSION Chronic pain intensity is not an inevitable consequence of chronological age, but the consequence of potential selection effects and lower activity levels combined with individual-level health and country-level wealth. Our findings suggest further investigation of health conditions and country affluence settings as potential targets of medical and policy interventions aiming to prevent, reduce, or manage chronic pain among older patients and aging populations.
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Affiliation(s)
- Esteban Calvo
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States.,Robert N. Butler Columbia Aging Center, Columbia University, 722 W 168th St, New York, NY 10032, United States.,Society and Health Research Center, School of Public Health, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Millennium Nucleus on Sociomedicine, Badajoz 130, Santiago, RM 7560908, Chile.,Millennium Nucleus for the Evaluation and Analysis of Drug Policies, Badajoz 130, Santiago, RM 7560908, Chile
| | - Cynthia Córdova
- Society and Health Research Center, School of Public Health, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile
| | - Robin Shura
- Department of Sociology, Kent State University at Stark, 6000 Frank Avenue NW, North Canton, OH
| | - Kasim Allel
- Society and Health Research Center, School of Public Health, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,College of Medicine and Health, University of Exeter, Magdalen Road EX1 2LU, Exeter, United Kingdom.,Institute for Global Health, University College London, 30 Guilford Street WC1N 1EH, London, United Kingdom.,Millennium Nucleus on Sociomedicine, Badajoz 130, Santiago, RM 7560908, Chile
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, School of Public Health, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Department of Population Health, New York University School of Medicine, 550 1st Ave, New York, NY 10016, United States.,Millennium Nucleus on Sociomedicine, Badajoz 130, Santiago, RM 7560908, Chile.,Millennium Nucleus for the Evaluation and Analysis of Drug Policies, Badajoz 130, Santiago, RM 7560908, Chile
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States.,Society and Health Research Center, School of Public Health, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile
| | - Christine Mauro
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States
| | - Pia M Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States
| | - José T Medina
- Society and Health Research Center, School of Public Health, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Laboratory on Aging and Social Epidemiology, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Santiago, RM 7560908, Chile.,Millennium Nucleus on Sociomedicine, Badajoz 130, Santiago, RM 7560908, Chile
| | - Thelma Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States
| | - Carla Taramasco
- Millennium Nucleus on Sociomedicine, Badajoz 130, Santiago, RM 7560908, Chile.,Facultad de Ingeniería, Universidad Andres Bello, Santiago, RM 8370136, Chile
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States
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Rivera-Aguirre A, Castillo-Carniglia A, Laqueur HS, Rudolph KE, Martins SS, Ramírez J, Queirolo R, Cerdá M. Does recreational cannabis legalization change cannabis use patterns? Evidence from secondary school students in Uruguay. Addiction 2022; 117:2866-2877. [PMID: 35491741 DOI: 10.1111/add.15913] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS In 2013, Uruguay became the first country to legalize and regulate the production and distribution of cannabis for recreational use. We measured whether Uruguay's non-commercial model of recreational cannabis legalization was associated with changes in the prevalence of risky and frequent cannabis use among secondary school students. DESIGN We used data from repeated cross-sectional surveys of secondary students in Uruguay and Chile (2007-2018). Using a difference-in-difference approach, we evaluated changes in the prevalence of past-year, past-month, any risky and frequent cannabis use following enactment (2014) and implementation (2016) of cannabis legalization among the full sample of secondary students and among students who reported past-year/month use. We examined changes separately for students ages 12 to 17, and students for whom cannabis became legally accessible, ages 18 to 21. SETTING Uruguay and Chile (2007-2018). PARTICIPANTS Secondary school students in 8th, 10th and 12th grade (n = 204 730). MEASUREMENTS Past-year and past-month cannabis use; any risky cannabis use measured with the Cannabis Abuse Screening Test (CAST); and frequent cannabis use (10+ days in the past-month). FINDINGS We found a decrease in past-year and past-month use following enactment or implementation. Among students ages 18 to 21, post-enactment, we observed a transitory increase in 2014 that decreased thereafter for: any risky use among those who reported past-year use (prevalence difference [PD] = 13.5%; 95% CI: 2.0, 24.9), frequent use in the full sample (PD = 4.5%; 95% CI: 1.0, 8.1), and frequent use among those who reported past-month use (PD = 16.8%; 95% CI: 1.9, 31.8). CONCLUSION The legalization of recreational cannabis in Uruguay was not associated with overall increases in either past-year/past-month cannabis use or with multi-year changes in any risky and frequent cannabis use among young people.
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Affiliation(s)
- Ariadne Rivera-Aguirre
- Department of Population Health, Division of Epidemiology, NYU Grossman School of Medicine, New York, USA.,Millennium Nucleus for the Evaluation and Analysis of Drug Policies, nDP, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Department of Population Health, Division of Epidemiology, NYU Grossman School of Medicine, New York, USA.,Millennium Nucleus for the Evaluation and Analysis of Drug Policies, nDP, Santiago, Chile.,Society and Health Research Center and School of Public Health, Universidad Mayor, Santiago, Chile
| | - Hannah S Laqueur
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, USA
| | - Kara E Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Silva S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Jessica Ramírez
- National Drug Observatory of Uruguay, National Drug Board, Montevideo, Uruguay
| | - Rosario Queirolo
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies, nDP, Santiago, Chile.,Department of Social Sciences, Universidad Católica del Uruguay, Montevideo, Uruguay
| | - Magdalena Cerdá
- Department of Population Health, Division of Epidemiology, NYU Grossman School of Medicine, New York, USA
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7
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Mateo Pinones M, González-Santa Cruz A, Portilla Huidobro R, Castillo-Carniglia A. Evidence-based policymaking: Lessons from the Chilean Substance Use Treatment Policy. International Journal of Drug Policy 2022; 109:103860. [DOI: 10.1016/j.drugpo.2022.103860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022]
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8
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Wiederkehr K, Mai C, Cabezas JM, Rocha-Jiménez T, Otzen T, Montalva N, Calvo E, Castillo-Carniglia A. The Epidemiology of Violent Deaths in Chile between 2001 and 2018: Prevalence, Trends, and Correlates. Int J Environ Res Public Health 2022; 19:12791. [PMID: 36232089 PMCID: PMC9564384 DOI: 10.3390/ijerph191912791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite its enormous health and social burden, there are limited published studies describing the epidemiology of violent deaths in Chile. We described violent mortality rate trends in Chile between 2001 and 2018, its current spatial distribution and ecological level correlates. METHODS A population-based study using publicly accessible data. We calculated age-adjusted mortality rates per 100,000 persons for sex, age, intention, and mechanism of death. Next, we used linear regression to estimate time trends for sex and intention. We then employed hierarchical Poisson analyses to model the spatial distribution across 345 municipalities and the influence of six ecological level variables. RESULTS The average rate of violent death in Chile between 2001 and 2018 was 15.9 per 100,000 people, with the majority (70.3%) of these attributed to suicide. Suffocation was the most common mechanism of death for suicide (82.3%) and cut/pierce for homicide (43.1%), followed by firearm (33.2%). Violent deaths are trending downward in Chile across all categories except suicides by women, which have remained stable. Poverty rates and urban population were positively associated with violent mortality rates. CONCLUSIONS Although violence-related deaths seem to be decreasing, disparities across gender, age group, and geographic location may have continuing effects on mortality rates.
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Affiliation(s)
- Katjana Wiederkehr
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Caroline Mai
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - José M. Cabezas
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago 7560908, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago 7560908, Chile
| | - Teresita Rocha-Jiménez
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago 7560908, Chile
- Millennium Nucleus on Sociomedicine (SocioMed), Santiago 7560908, Chile
| | - Tamara Otzen
- Millennium Nucleus on Sociomedicine (SocioMed), Santiago 7560908, Chile
- Center of Morphological and Surgical Studies (CEMyQ), Ph.D. Program in Medical Sciences, Universidad de la Frontera, Temuco 4811230, Chile
| | - Nicolás Montalva
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago 7560908, Chile
- Millennium Nucleus on Sociomedicine (SocioMed), Santiago 7560908, Chile
| | - Esteban Calvo
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago 7560908, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago 7560908, Chile
- Millennium Nucleus on Sociomedicine (SocioMed), Santiago 7560908, Chile
- CalvoLab, Laboratory on Aging and Social Epidemiology, Santiago 7560908, Chile
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago 7560908, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago 7560908, Chile
- Millennium Nucleus on Sociomedicine (SocioMed), Santiago 7560908, Chile
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9
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Mauro PM, Gutkind S, Rivera-Aguirre A, Gary D, Cerda M, Santos EC, Castillo-Carniglia A, Martins SS. Trends in cannabis or cocaine-related dependence and alcohol/drug treatment in Argentina, Chile, and Uruguay. Int J Drug Policy 2022; 108:103810. [PMID: 35939947 PMCID: PMC9912990 DOI: 10.1016/j.drugpo.2022.103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 07/09/2022] [Accepted: 07/19/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed cannabis/cocaine-related dependence and treatment in Argentina, Chile, and Uruguay. METHODS Nationally representative cross-sectional household surveys of people ages 15-64 in Argentina (4 surveys, 2006-2017), Chile (7 surveys, 2006-2018), and Uruguay (4 surveys, 2006-2018) were harmonized. We estimated weighted prevalences of cannabis or cocaine-related (cocaine or cocaine paste) dependence, based on meeting 3+ past-year ICD-10 dependence criteria. We estimated weighted prevalences of past-year alcohol/drug treatment use (Argentina, Chile) or use/seeking (Uruguay) among people with past-year cannabis/cocaine-related dependence. We tested model-based prevalence trends over time and described individual-level treatment correlates by country. RESULTS Cannabis/cocaine dependence prevalence increased in the region starting in 2010-2011, driven by cannabis dependence. Adjusted cannabis dependence prevalence increased from 0.7% in 2010 to 1.5% in 2017 in Argentina (aPD=0.8, 95% CI= 0.3, 1.2), from 0.8% in 2010 to 2.8% in 2018 in Chile (aPD=2.0, 95% CI= 1.4, 2.6), and from 1.4% in 2011 to 2.4% in 2018 in Uruguay (aPD=0.9, 95% CI= 0.2, 1.6). Cocaine-related dependence increased in Uruguay, decreased in Argentina, and remained stable in Chile. Among people with past-year cannabis/cocaine dependence, average alcohol/drug treatment use prevalence was 15.3% in Argentina and 6.0% in Chile, while treatment use/seeking was 14.7% in Uruguay. Alcohol/drug treatment prevalence was lower among people with cannabis dependence than cocaine-related dependence. Treatment correlates included older ages in all countries and male sex in Argentina only. CONCLUSION Alcohol/drug treatment use among people with cannabis/cocaine-related dependence remained low, signaling an ongoing treatment gap in the context of growing cannabis dependence prevalence in the region. Additional resources may be needed to increase treatment access and uptake. Future studies should assess contributors of low treatment use, including perceived need, stigma, and service availability.
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Affiliation(s)
- Pia M Mauro
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA.
| | - Sarah Gutkind
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York NY 10016 USA; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile
| | - Dahsan Gary
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA
| | - Magdalena Cerda
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York NY 10016 USA
| | - Erica Chavez Santos
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA; University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA 98195 USA
| | - Alvaro Castillo-Carniglia
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York NY 10016 USA; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile; Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Room 1306, Las Condes, Santiago, Chile; Millennium Nucleus on Sociomedicine (SocioMed), Chile
| | - Silvia S Martins
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA
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10
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Schleimer JP, Smith N, Zaninovic V, Keyes KM, Castillo-Carniglia A, Rivera-Aguirre A, Cerdá M. Trends in the sequence of initiation of alcohol, tobacco, and marijuana use among adolescents in Argentina and Chile from 2001 to 2017. Int J Drug Policy 2022; 100:103494. [PMID: 34666217 DOI: 10.1016/j.drugpo.2021.103494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/08/2021] [Accepted: 10/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Variation in drug policies, norms, and substance use over time and across countries may affect the normative sequences of adolescent substance use initiation. We estimated relative and absolute time-varying associations between prior alcohol and tobacco use and adolescent marijuana initiation in Argentina and Chile. Relative measures quantify the magnitude of the associations, whereas absolute measures quantify excess risk. METHODS We analyzed repeated, cross-sectional survey data from the National Surveys on Drug Use Among Secondary School Students in Argentina (2001-2014) and Chile (2001-2017). Participants included 8th, 10th, and 12th grade students (N = 680,156). Linear regression models described trends over time in the average age of first use of alcohol, tobacco, and marijuana. Logistic regression models were used to estimate time-varying risk ratios and risk differences of the associations between prior alcohol and tobacco use and current-year marijuana initiation. RESULTS Average age of marijuana initiation increased and then decreased in Argentina and declined in Chile. In both countries, the relative associations between prior tobacco use and marijuana initiation weakened amid declining rates of tobacco use; e.g., in Argentina, the risk ratio was 19.9 (95% CI: 9.0-30.8) in 2001 and 11.6 (95% CI: 9.0-13.2) in 2014. The relative association between prior alcohol use and marijuana initiation weakened Chile, but not in Argentina. On the contrary, risk differences (RD) increased substantially across both relationships and countries, e.g., in Argentina, the RD for tobacco was 3% (95% CI: 0.02-0.03) in 2001 and 12% (95% CI: 0.11-0.13) in 2014. CONCLUSION Diverging trends in risk ratios and risk differences highlight the utility of examining multiple measures of association. Variation in the strength of the associations over time and place suggests the influence of environmental factors. Increasing risk differences indicate alcohol and tobacco use may be important targets for interventions to reduce adolescent marijuana use.
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Affiliation(s)
- Julia P Schleimer
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine, 2315 Stockton Blvd., Sacramento, CA 95817, USA.
| | - Nathan Smith
- Department of Psychology, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
| | - ViniNatalie Zaninovic
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St. NY, NY 10032, New York, NY, USA
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Badajoz 130, Las Condes, Santiago, Chile; School of Public Health, Universidad Mayor, Jose Toribio Medina #38, Santiago, Chile; Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
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11
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Olivari CF, Gaete J, Rodriguez N, Pizarro E, Del Villar P, Calvo E, Castillo-Carniglia A. Polydrug Use and Co-occurring Substance Use Disorders in a Respondent Driven Sampling of Cocaine Base Paste Users in Santiago, Chile. J Psychoactive Drugs 2021; 54:348-357. [PMID: 34724873 DOI: 10.1080/02791072.2021.1976886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We characterized substance use patterns and co-occurring substance use disorders among active cocaine base paste (CBP) users in Santiago, Chile using data from respondent-driven sampling (RDS) in three areas of Metropolitan Santiago. Recruitment began with nine seeds, reaching 398 active CBP users (18% women; mean age 37.7 years), defined as persons consuming CBP at least twice per week in the last three months. Population proportions and uncertainty were estimated accounting for individuals' social network and homophily. The median CBP age of initiation was 21 years, and the median number of years using CBP was 7 for women and 15 for men. The median days of use in the past month was 25 days, with a median of 56 doses per week. The proportion of monthly income spent on CBP was 65%. The prevalence of substance use disorders (SUDs) were: 98% for CBP, 67% for alcohol, 60% for marijuana, and 41% for cocaine hydrochloride. Heavy polydrug use patterns and co-occurring SUDs are frequent among active CBP users in the metropolitan area of Santiago. Traditional surveillance strategies may have underestimated polysubstance use and co-occurring SUDs in active CBP users. RDS proved to be a feasible methodology that could be effectively used for substance use surveillance among hard-to-reach populations.
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Affiliation(s)
- Carla F Olivari
- Society and Health Research Center, Universidad Mayor, Santiago, Chile
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, MI, USA
| | - Nicolás Rodriguez
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Esteban Pizarro
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Paloma Del Villar
- Centro de estudios Justicia y Sociedad, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Esteban Calvo
- Society and Health Research Center, Universidad Mayor, Santiago, Chile.,School of Public Health, Universidad Mayor, Santiago, Chile.,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.,Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Santiago, Chile.,School of Public Health, Universidad Mayor, Santiago, Chile.,Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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12
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Gajardo AI, Wagner TD, Howell KD, González-Santa Cruz A, Kaufman JS, Castillo-Carniglia A. Effects of 2019's social protests on emergency health services utilization and case severity in Santiago, Chile: a time-series analysis. Lancet Reg Health Am 2021; 5:100082. [PMID: 36776456 PMCID: PMC9903909 DOI: 10.1016/j.lana.2021.100082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 10/19/2022]
Abstract
Background On October 18th, 2019, protestors gathered across Chile to call for social equity, resulting in widespread civil unrest and violent confrontation with the police. In this study, we quantify the effects of the 2019 Chilean protests on emergency health services utilization and inpatient admission in Santiago. Methods We used weekly emergency department (ED) admissions (2015-2019) from three large public hospitals near the focal point of protests in Santiago. The exposure period was from October 18th to December 31st, 2019. The outcomes were the number of weekly consultations and hospitalizations by trauma and respiratory causes and the proportion of hospitalizations among consultants per 1,000. We implemented Bayesian structural time series models to calculate the absolute and relative effects and 95% credible intervals (CrI). Findings During the first ten weeks of protests ED consultations declined on average by 14% for trauma (95%CrI: -40·2%, 11·5%) and 30% for respiratory causes (95%CrI: -89·4%, 30·2%), 7% for respiratory hospitalizations (95%CrI: -43·6%, 30·8%); however, none of these three results were statistically distinguishable from the null. Trauma hospitalizations, on the other hand, increased by 15% (95%CrI: 4·0%, 26·4%), and the proportion of hospitalizations per consultations increased by 40% for trauma (95%CrI: 13·1%, 68·0%) and 59% for respiratory causes (95%CrI: 29·4%, 87·9%). Interpretation The 2019 Chilean protests affected the use of emergency health services by increasing the trauma hospitalizations and the case hospitalization ratio per 1,000 consultations for trauma and respiratory causes. Crowd-control protocols must be reviewed to prevent the negative effects of civil unrest.
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Affiliation(s)
- Abraham I.J. Gajardo
- Intensive Care Unit, Department of Medicine, Hospital Clínico Universidad de Chile, Universidad de Chile. Dr. Carlos Lorca Tobar 999, Independencia, Santiago, Chile
| | - Thomas D. Wagner
- Vagelos College of Physicians & Surgeons, Columbia University. 630 W 168th St, New York, NY 10032, USA
| | - Kristina Devi Howell
- Mailman School of Public Health, Columbia University. 722 W 168th St, New York, NY 10032, USA
| | - Andrés González-Santa Cruz
- Society and Health Research Center and School of Public Health, Universidad Mayor, Chile. Badajoz 130, Las Condes, Santiago, Chile
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University. 1020 Pine Avenue West, Montreal, QC H3A1A2, Canada
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center and School of Public Health, Universidad Mayor, Chile. Badajoz 130, Las Condes, Santiago, Chile,Department of Population Health, New York University Grossman School of Medicine. 180 Madison Avenue, New York, NY 10016, USA,Corresponding author: Alvaro Castillo-Carniglia, Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Chile. Badajoz 130, Suite 1305, Las Condes, Santiago, Chile. Phone: +56.2.2518.9800
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13
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Olivari CF, Gonzáles-Santa Cruz A, Mauro PM, Martins SS, Sapag J, Gaete J, Cerdá M, Castillo-Carniglia A. Treatment outcome and readmission risk among women in women-only versus mixed-gender drug treatment programs in Chile. J Subst Abuse Treat 2021; 134:108616. [PMID: 34483012 PMCID: PMC9052114 DOI: 10.1016/j.jsat.2021.108616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/20/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
Introduction: Traditional treatment programs for substance use disorder (SUD) tend to be male-dominated environments, which can negatively affect women’s access to treatment and related outcomes. Women’s specific treatment needs have led some providers to develop women-only SUD treatment programs in several countries. In Chile, women-only programs were only fully implemented in 2010. We compared treatment outcomes and readmission risk for adult women admitted to state-funded women-only versus mixed-gender SUD treatment programs in Chile. Methods: We used a registry-based retrospective cohort design of adult women in women-only (N = 8200) and mixed-gender (N = 13,178) SUD treatment programs from 2010 to 2019. The study obtained data from the National Drug and Alcohol Service from Chile. We used a multistate model to estimate the probabilities of experiencing treatment completion, discharge without completion (i.e., patient-initiated discharge and administrative discharge), or readmission, as well as the likelihood of being readmitted, conditioned on prior treatment outcome. We adjusted models for multiple baseline characteristics (e.g., substance use, socioeconomic). Results: Overall, 24% of women completed treatment and 54% dropped out of treatment. The proportion of patient-initiated discharges within the first three month was larger in women-only than in mixed-gender programs (19% vs. 12%). In both programs, women who completed treatment were more likely to experience readmission at three months, and one and three years. In the long term, women in the women-only programs were more likely to complete treatment than women in mixed-gender programs (34% vs. 23%, respectively). The readmission probability was higher among women who previously completed treatment than those who had a discharge without completion (40% vs 21% among women in women-only programs; 38% vs. 19% among women in mixed-gender programs, respectively); no differences occurred in the risk of readmission between women-only and mixed-gender programs. Conclusions: In terms of treatment outcomes and readmission risk, women-only programs had similar results to mixed-gender programs in Chile. The added value of these specialized programs should be addressed in further research.
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Affiliation(s)
- Carla F Olivari
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Suite 1305, Las Condes, Santiago, Chile; Faculty of Education, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, Santiago, Chile
| | - Andrés Gonzáles-Santa Cruz
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Suite 1305, Las Condes, Santiago, Chile
| | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032, United States.
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032, United States.
| | - Jaime Sapag
- Department of Public Health and Family Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, Santiago, Chile; Research Center for School Mental Health, Faculty of Education (ISME), Universidad de los Andes, Chile; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.
| | - Magdalena Cerdá
- Department of Population Health and Center for Opioid Epidemiology and Policy, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, United States.
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Suite 1305, Las Condes, Santiago, Chile; Department of Population Health and Center for Opioid Epidemiology and Policy, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, United States; School of Public Health, Universidad Mayor, José Toribio Medina 38, Santiago, Chile.
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14
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Calvo E, Allel K, Staudinger UM, Castillo-Carniglia A, Medina JT, Keyes KM. Cross-country differences in age trends in alcohol consumption among older adults: a cross-sectional study of individuals aged 50 years and older in 22 countries. Addiction 2021; 116:1399-1412. [PMID: 33241648 PMCID: PMC8131222 DOI: 10.1111/add.15292] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/01/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Age-related changes in physiological, metabolic and medication profiles make alcohol consumption likely to be more harmful among older than younger adults. This study aimed to estimate cross-national variation in the quantity and patterns of drinking throughout older age, and to investigate country-level variables explaining cross-national variation in consumption for individuals aged 50 years and older. DESIGN Cross-sectional observational study using previously harmonized survey data. SETTING Twenty-two countries surveyed in 2010 or the closest available year. PARTICIPANTS A total of 106 180 adults aged 50 years and over. MEASUREMENTS Cross-national variation in age trends were estimated for two outcomes: weekly number of standard drink units (SDUs) and patterns of alcohol consumption (never, ever, occasional, moderate and heavy drinking). Human Development Index and average prices of vodka were used as country-level variables moderating age-related declines in drinking. FINDINGS Alcohol consumption was negatively associated with age (risk ratio = 0.98; 95% confidence interval = 0.97, 0.99; P-value < 0.001), but there was substantial cross-country variation in the age-related differences in alcohol consumption [likelihood ratio (LR) test P-value < 0.001], even after adjusting for the composition of populations. Countries' development level and alcohol prices explained 31% of cross-country variability in SDUs (LR test P-value < 0.001) but did not explain cross-country variability in the prevalence of heavy drinkers. CONCLUSIONS Use and harmful use of alcohol among older adults appears to vary widely across age and countries. This variation can be partly explained both by the country-specific composition of populations and country-level contextual factors such as development level and alcohol prices.
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Affiliation(s)
- Esteban Calvo
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, NY, USA
| | - Kasim Allel
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Institute for Global Health, University College London, London, UK
| | - Ursula M. Staudinger
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, NY, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, NY, USA
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Department of Population Health, New York University School of Medicine, NY, USA
| | - José T. Medina
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Katherine M. Keyes
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
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15
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Castillo-Carniglia A, Cruz AGS, Cerdá M, Delcher C, Shev AB, Wintemute GJ, Henry SG. Corrigendum to "Changes in opioid prescribing after implementation of mandatory registration and proactive reports within California's prescription drug monitoring program" [Drug Alcohol Depend. 218 (2021) 108405]. Drug Alcohol Depend 2021; 221:108606. [PMID: 33611026 PMCID: PMC8045981 DOI: 10.1016/j.drugalcdep.2021.108606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Chile; School of Public Health, Universidad Mayor, Chile; Department of Population Health, New York University, United States.
| | | | - Magdalena Cerdá
- Department of Population Health, New York University,
United States
| | - Chris Delcher
- Department of Pharmacy Practice and Science, University of
Kentucky, United States
| | - Aaron B. Shev
- Violence Prevention Research Program, University of
California, Davis, United States
| | - Garen J. Wintemute
- Violence Prevention Research Program, University of
California, Davis, United States
| | - Stephen G. Henry
- Department of Internal Medicine, University of California,
Davis, United States,Center for Healthcare Policy and Research, University of
California, Davis, United States
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16
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Ahumada M, Ansoleaga E, Castillo-Carniglia A. [Workplace bullying and mental health in Chilean workers: the role of gender]. CAD SAUDE PUBLICA 2021; 37:e00037220. [PMID: 33729302 DOI: 10.1590/0102-311x00037220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/17/2020] [Indexed: 11/21/2022] Open
Abstract
Mobbing, or bullying in the workplace, has gained relevance in recent decades due to its growing magnitude and negative effects on workers' health. There are various approaches for studying the issue. However, thus far the evidence is scarce in Latin America and is focused on specific samples. This study aims to analyze workplace bullying and its association with mental health in the wage-earning population and to determine the extent to which this association is modified by gender. A survey was conducted with a sample of 1,995 male and female salaried workers in Chile's three main metropolitan areas (Greater Santiago, Greater Valparaíso, and Greater Concepción) with three-stage random selection (blocks, households, and individuals). Prevalence rates for depressive symptoms, use of psychotropic medication, and stress were 10.9%, 12.8%, and 13%, respectively, and there was a strong relationship between mental health variables and workplace bullying, which persisted in the adjusted models. When comparing this association in the models stratified by gender, no significant differences were observed between men and women.
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Affiliation(s)
| | | | - Alvaro Castillo-Carniglia
- Centro de Investigación en Sociedad y Salud, Universidad Mayor, Santiago, Chile.,Escuela de Salud Pública, Universidad Mayor, Santiago, Chile
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17
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Castillo-Carniglia A, González-Santa Cruz A, Cerdá M, Delcher C, Shev AB, Wintemute GJ, Henry SG. Changes in opioid prescribing after implementation of mandatory registration and proactive reports within California's prescription drug monitoring program. Drug Alcohol Depend 2021; 218:108405. [PMID: 33234299 PMCID: PMC7750250 DOI: 10.1016/j.drugalcdep.2020.108405] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND In 2016, California updated its prescription drug monitoring program (PDMP), adding two key features: automated proactive reports to prescribers and mandatory registration for prescribers and pharmacists. The effects of these changes on prescribing patterns have not yet been examined. We aimed to evaluate the joint effect of these two PDMP features on county-level prescribing practices in California. METHODS Using county-level quarterly data from 2012 to 2017, we estimated the absolute change associated with the implementation of these two PDMP features in seven prescribing indicators in California versus a control group comprising counties in Florida and Washington: opioid prescription rate per 1000 residents; patients' mean daily opioid dosage in milligrams of morphine equivalents[MME]; prescribers' mean daily MME prescribed; prescribers' mean number of opioid prescriptions per day; percentage of patients getting >90 MME/day; percentage of days with overlapping prescriptions for opioids and benzodiazepines; multiple opioid provider episodes per 100,000 residents. RESULTS Proactive reports and mandatory registration were associated with a 7.7 MME decrease in patients' mean daily opioid dose (95 %CI: -11.4, -2.9); a 1.8 decrease in the percentage of patients prescribed high-dose opioids (95 %CI: -2.3, -0.9); and a 6.3 MME decrease in prescribers' mean daily dose prescribed (95 %CI: -10.0, -1.3). CONCLUSIONS California's implementation of these two PDMP features was associated with decreases in the total quantity of opioid MMEs prescribed, and indicators of patients prescribed high-dose opioids compared to states that had PDMP's without these features. Rates of opioid prescribing and other high-risk prescribing patterns remained unchanged.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Chile; School of Public Health, Universidad Mayor, Chile; Department of Population Health, New York University, United States.
| | | | - Magdalena Cerdá
- Department of Population Health, New York University, United States
| | - Chris Delcher
- Department of Pharmacy Practice and Science, University of Kentucky, United States
| | - Aaron B Shev
- Violence Prevention Research Program, University of California, Davis, United States
| | - Garen J Wintemute
- Violence Prevention Research Program, University of California, Davis, United States
| | - Stephen G Henry
- Department of Internal Medicine, University of California, Davis, United States; Center for Healthcare Policy and Research, University of California, Davis, United States
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Castillo-Carniglia A, Rivera-Aguirre A, Calvo E, Queirolo R, Keyes KM, Cerdá M. Trends in marijuana use in two Latin American countries: an age, period and cohort study. Addiction 2020; 115:2089-2097. [PMID: 32196789 PMCID: PMC7502472 DOI: 10.1111/add.15058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/09/2019] [Accepted: 03/16/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Uruguay and Chile have the highest levels of marijuana use in Latin America, and have experienced consistent increases during the last two decades. We aim to calculate separate age-period-cohort (APC) effects for past-year marijuana use in Uruguay and Chile, which have similar epidemiologica, and demographic profiles but diverging paths in cannabis regulation. DESIGN APC study in which period and cohort effects were estimated as first derivative deviations from their linear age trend, separately by country and gender. SETTING Uruguay and Chile. PARTICIPANTS General population between 15 and 64 years. MEASUREMENTS Past-year marijuana use from household surveys with five repeated cross-sections between 2001 and 2018 in Uruguay (median n = 4616) and 13 between 1994 and 2018 in Chile (median n = 15 895). FINDINGS Marijuana use prevalence in both countries peaked at 20-24 years of age and increased consistently across calendar years. Period effects were strong and positive, indicating that increases in use were evident across age groups. Relative to 2006 (reference year), Chilean period effects were approximately 48% lower in 1994 and approximately four times higher in 2018; in Uruguay, these effects were approximately 56% lower in 2001 and almost quadrupled in 2018. We observed non-linear cohort effects in Chile and similar patterns in Uruguay for the overall sample and women. In both countries, marijuana use increased for cohorts born between the mid-1970s and early 1990s, even in the context of rising period effects. Prevalence was consistently larger for men, but period increases were stronger in women. CONCLUSIONS Age-period-cohort effects on past-year marijuana use appear to have been similar in Chile and Uruguay, decreasing with age and increasing over time at heterogeneous growth rates depending on gender and cohort. Current levels of marijuana use, including age and gender disparities, seem to be associated with recent common historical events in these two countries.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Santiago, Chile,School of Public Health, Universidad Mayor, Santiago, Chile,Department of Population Health, New York University Grossman School of Medicine. New York, NY, United States,Correspondence to: Alvaro Castillo-Carniglia, Society and Health Research Center, Universidad Mayor, Chile. Badajoz 130, room 1306, Las Condes, Santiago, Chile. Phone: +56.2.2518.9826.
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine. New York, NY, United States
| | - Esteban Calvo
- Society and Health Research Center, Universidad Mayor, Santiago, Chile,School of Public Health, Universidad Mayor, Santiago, Chile,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University. New York, NY, United States,Laboratory on Aging and Social Epidemiology, Universidad Mayor, Santiago, Chile
| | - Rosario Queirolo
- Department of Social and Political Sciences, Universidad Católica Uruguay, Montevideo, Uruguay
| | - Katherine M. Keyes
- Society and Health Research Center, Universidad Mayor, Santiago, Chile,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University. New York, NY, United States
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine. New York, NY, United States
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Santaella-Tenorio J, Wheeler-Martin K, DiMaggio CJ, Castillo-Carniglia A, Keyes KM, Hasin D, Cerdá M. Association of Recreational Cannabis Laws in Colorado and Washington State With Changes in Traffic Fatalities, 2005-2017. JAMA Intern Med 2020; 180:1061-1068. [PMID: 32568378 PMCID: PMC7309574 DOI: 10.1001/jamainternmed.2020.1757] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE An important consequence of cannabis legalization is the potential increase in the number of cannabis-impaired drivers on roads, which may result in higher rates of traffic-related injuries and fatalities. To date, limited information about the effects of recreational cannabis laws (RCLs) on traffic fatalities is available. OBJECTIVE To estimate the extent to which the implementation of RCLs is associated with traffic fatalities in Colorado and Washington State. DESIGN, SETTING, AND PARTICIPANTS This ecological study used a synthetic control approach to examine the association between RCLs and changes in traffic fatalities in Colorado and Washington State in the post-RCL period (2014-2017). Traffic fatalities data were obtained from the Fatality Analysis Reporting System from January 1, 2005, to December 31, 2017. Data from Colorado and Washington State were compared with synthetic controls. Data were analyzed from January 1, 2005, to December 31, 2017. MAIN OUTCOME(S) AND MEASURES The primary outcome was the rate of traffic fatalities. Sensitivity analyses were performed (1) excluding neighboring states, (2) excluding states without medical cannabis laws (MCLs), and (3) using the enactment date of RCLs to define pre-RCL and post-RCL periods instead of the effective date. RESULTS Implementation of RCLs was associated with increases in traffic fatalities in Colorado but not in Washington State. The difference between Colorado and its synthetic control in the post-RCL period was 1.46 deaths per 1 billion vehicle miles traveled (VMT) per year (an estimated equivalent of 75 excess fatalities per year; probability = 0.047). The difference between Washington State and its synthetic control was 0.08 deaths per 1 billion VMT per year (probability = 0.674). Results were robust in most sensitivity analyses. The difference between Colorado and synthetic Colorado was 1.84 fatalities per 1 billion VMT per year (94 excess deaths per year; probability = 0.055) after excluding neighboring states and 2.16 fatalities per 1 billion VMT per year (111 excess deaths per year; probability = 0.063) after excluding states without MCLs. The effect was smaller when using the enactment date (24 excess deaths per year; probability = 0.116). CONCLUSIONS AND RELEVANCE This study found evidence of an increase in traffic fatalities after the implementation of RCLs in Colorado but not in Washington State. Differences in how RCLs were implemented (eg, density of recreational cannabis stores), out-of-state cannabis tourism, and local factors may explain the different results. These findings highlight the importance of RCLs as a factor that may increase traffic fatalities and call for the identification of policies and enforcement strategies that can help prevent unintended consequences of cannabis legalization.
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Affiliation(s)
- Julian Santaella-Tenorio
- Center for Opioid Epidemiology and Policy,Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York.,School of Basic Sciences, Universidad del Valle, Cali, Colombia
| | - Katherine Wheeler-Martin
- Center for Opioid Epidemiology and Policy,Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York
| | - Charles J DiMaggio
- Center for Opioid Epidemiology and Policy,Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York.,Department of Surgery, New York University School of Medicine, New York, New York
| | - Alvaro Castillo-Carniglia
- Center for Opioid Epidemiology and Policy,Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York.,Society and Health Research Center and School of Public Health, Universidad Mayor, Santiago, Chile
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Deborah Hasin
- Division of Translational Epidemiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.,Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York
| | - Magdalena Cerdá
- Center for Opioid Epidemiology and Policy,Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York
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20
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Laqueur H, Rivera-Aguirre A, Shev A, Castillo-Carniglia A, Rudolph KE, Ramirez J, Martins SS, Cerdá M. The impact of cannabis legalization in Uruguay on adolescent cannabis use. Int J Drug Policy 2020; 80:102748. [PMID: 32388170 PMCID: PMC10686048 DOI: 10.1016/j.drugpo.2020.102748] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND In 2013, Uruguay became the first country in the world to legalize recreational cannabis, instituting a non-commercial state regulatory model of production and supply. This study provides the first empirical evidence on its impacts on adolescent use of cannabis and related risks. METHODS We use a generalization of the synthetic control method (SCM) to estimate the impact of legalization in Uruguay on adolescent past year and month cannabis use, perceived availability of cannabis and perceived risk of cannabis use. We compare biennial high school student self-reported survey data from Montevideo and regions in the interior of Uruguay post-legalization (2014-2018) and post initial implementation (2015-2018) to a synthetic counterfactual constructed using a weighted combination of 15 control regions in Chile. RESULTS We find no evidence of an impact on cannabis use or the perceived risk of use. We find an increase in student perception of cannabis availability (58% observed vs. 51% synthetic control) following legalization. CONCLUSION Our findings provide some support for the thesis that Uruguay's state regulatory approach to cannabis supply may minimize the impact of legalization on adolescent cannabis use. At the same time, our study period represents a period of transition: pharmacy access, by far the most popular means of access, was not available until the summer of 2017. Additional study will be important to assess the longer-term impacts of the fully implemented legalization regime on substance use outcomes.
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Affiliation(s)
- Hannah Laqueur
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, United States.
| | - Ariadne Rivera-Aguirre
- Department of Population Health, Division of Epidemiology, New York University School of Medicine, United States
| | - Aaron Shev
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, United States
| | - Alvaro Castillo-Carniglia
- Department of Population Health, Division of Epidemiology, New York University School of Medicine, United States; Society and Health Research Center and School of Public Health, Universidad Mayor, Chile
| | - Kara E Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States
| | - Jessica Ramirez
- National Drug Observatory of Uruguay, Executive Tower Building, 10th Floor, Plaza Independencia 710, Montevideo C11000, Uruguay
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States
| | - Magdalena Cerdá
- Department of Population Health, Division of Epidemiology, New York University School of Medicine, United States
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Perlmutter AS, Rivera-Aguirre AE, Mauro PM, Castillo-Carniglia A, Rodriguez N, Cadenas N, Cerdá M, Martins SS. Sex differences in nonmedical prescription tranquilizer and stimulant use trends among secondary school students in Argentina, Chile, and Uruguay. Drug Alcohol Depend 2019; 205:107607. [PMID: 31606591 PMCID: PMC6943976 DOI: 10.1016/j.drugalcdep.2019.107607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Little is known about recent nonmedical prescription tranquilizer and stimulant use trends in Latin America. We tested whether recent trends among students in three South American countries differed by sex over time. METHODS Three countries independently collected National School Students Survey on Drugs. Students in 8th, 10th, and 12th grades were sampled in Argentina (2007-2014, N = 328,202), Chile (2007-2015, N = 136,379), and Uruguay (2007-2016, N = 32,371). Weighted linear regression models predicted the prevalences and trends over time of past-year nonmedical tranquilizer and stimulant use by country, and tested whether trends differed by sex, adjusting for school type and grade. RESULTS In Argentina from 2007 to 2014, past-year nonmedical prescription tranquilizer (girls: 2.8 to 2.6%, boys: 2.5 to 2.3%) and stimulant (girls: 1.7 to 1.3%, boys: 1.9 to 1.5%) use trends did not differ by sex. In Chile from 2007 to 2015, nonmedical prescription tranquilizer use trends significantly differed comparing girls (3.9 to 10%) with boys (3.2 to 6.9%); stimulant use trends did not differ comparing girls (1.6 to 2.0%) with boys (2.0 to 1.3%). In Uruguay from 2007 to 2014 and 2014-2016, past-year nonmedical prescription tranquilizer (girls: 5.1 to 6.6%; boys: 2.8 to 4.2%) and stimulant (girls: 1.8 to 0.7%; boys: 1.8 to 0.7%) use trends did not differ by sex. CONCLUSIONS Trends of nonmedical prescription tranquilizer use recently increased in Chile and Uruguay, widening by sex over time in Chile only. The drivers of increasing tranquilizer use among girls in Chile and Uruguay merit further investigation.
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Affiliation(s)
- Alexander S Perlmutter
- Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA; Université Paris Descartes UMR1153, Hôpital Hôtel-Dieu, 1 Place du Parvis Notre-Dame, Paris, 75004, France.
| | - Ariadne E Rivera-Aguirre
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA; Department of Population Health, New York University School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
| | - Pia M Mauro
- Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
| | - Alvaro Castillo-Carniglia
- Department of Population Health, New York University School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA; Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 30, Santiago, Chile
| | - Nicolás Rodriguez
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Use (SENDA), Agustinas 1235, 9th floor, Santiago, Chile
| | - Nora Cadenas
- Dirección de Epidemiologia, Observatorio Argentino de Drogas, Calle Sarmiento 546, Ciudad Autónoma de Buenos Aires, C1041AAL, Argentina
| | - Magdalena Cerdá
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA; Department of Population Health, New York University School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
| | - Silvia S Martins
- Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
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22
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Martins SS, Ponicki W, Smith N, Rivera-Aguirre A, Davis CS, Fink DS, Castillo-Carniglia A, Henry SG, Marshall BDL, Gruenewald P, Cerdá M. Prescription drug monitoring programs operational characteristics and fatal heroin poisoning. Int J Drug Policy 2019; 74:174-180. [PMID: 31627159 PMCID: PMC6897357 DOI: 10.1016/j.drugpo.2019.10.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/29/2019] [Accepted: 10/01/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Prescription drug monitoring programs (PDMP), by reducing access to prescribed opioids (POs), may contribute to a policy environment in which some people with opioid dependence are at increased risk for transitioning from POs to heroin/other illegal opioids. This study examines how PDMP adoption and changes in the characteristics of PDMPs over time contribute to changes in fatal heroin poisoning in counties within states from 2002 to 2016. METHODS Latent transition analysis to classify PDMPs into latent classes (Cooperative, Proactive, and Weak) for each state and year, across three intervals (1999-2004, 2005-2009, 2010-2016). We examined the association between probability of PDMP latent class membership and the rate of county-level heroin poisoning death. RESULTS After adjustment for potential county-level confounders and co-occurring policy changes, adoption of a PDMP was significantly associated with increased heroin poisoning rates (22% increase by third year post-adoption). Findings varied by PDMP type. From 2010-2016, states with Cooperative PDMPs (those more likely to share data with other states, to require more frequent reporting, and include more drug schedules) had 19% higher heroin poisoning rates than states with Weak PDMPs (adjusted rate ratio [ARR] = 1.19; 95% CI = 1.14, 1.25). States with Proactive PDMPs (those more likely to report outlying prescribing and dispensing and provide broader access to law enforcement) had 6% lower heroin poisoning rates than states with No/Weak PDMPs (ARR = 0.94; 95% CI = 0.90, 0.98). CONCLUSION There is a consistent, positive association between state PDMP adoption and heroin poisoning mortality. However, this varies by PDMP type, with Proactive PDMPs associated with a small reduction in heroin poisoning deaths. This raises questions about the potential for PDMPs to support efforts to decrease heroin overdose risk, particularly by using proactive alerts to identify patients in need of treatment for opioid use disorder. Future research on mechanisms explaining the reduction in heroin poisonings after enactment of Proactive PDMPs is merited.
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Affiliation(s)
- Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
| | - William Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, United States
| | - Nathan Smith
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, CA, United States
| | - Ariadne Rivera-Aguirre
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, CA, United States; Department of Population Health, NYU School of Medicine, New York, NY, United States
| | - Corey S Davis
- Network for Public Health Law, Los Angeles, CA, United States
| | - David S Fink
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | | | - Stephen G Henry
- Department of Internal Medicine, University of California Davis, Sacramento, CA, United States
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, United States
| | - Magdalena Cerdá
- Department of Population Health, NYU School of Medicine, New York, NY, United States
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Castillo-Carniglia A, Keyes KM, Hasin DS, Cerdá M. Psychiatric comorbidities in alcohol use disorder. Lancet Psychiatry 2019; 6:1068-1080. [PMID: 31630984 PMCID: PMC7006178 DOI: 10.1016/s2215-0366(19)30222-6] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/13/2019] [Accepted: 05/30/2019] [Indexed: 01/10/2023]
Abstract
Alcohol use disorder is a major contributor to the morbidity and mortality burden worldwide. It often coexists with other psychiatric disorders; however, the nature of this comorbidity is still a matter of debate. In this Series paper, we examine the main psychiatric disorders associated with alcohol use disorder, including the prevalence of co-occurring disorders, the temporal nature of the relationship, and mechanisms that might explain comorbidity across the lifespan. Overall, this disorder co-occurs with a wide range of other psychiatric disorders, especially those disorders involving substance use and violent or aggressive behaviour. The causal pathways between alcohol use disorder and other psychiatric disorders are heterogeneous. Hypotheses explaining these relationships include reciprocal direct causal associations, shared genetic and environmental causes, and shared psychopathological characteristics of broader diagnostic entities (eg, externalising disorders). Efforts to untangle the associations between alcohol use disorder and other disorders across the lifespan remain a crucial avenue of research.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile; Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Katherine M Keyes
- Department of Epidemiology, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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Castillo-Carniglia A, Webster DW, Wintemute GJ. Effect on background checks of newly-enacted comprehensive background check policies in Oregon and Washington: a synthetic control approach. Inj Epidemiol 2019; 6:45. [PMID: 31799102 PMCID: PMC6880454 DOI: 10.1186/s40621-019-0225-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/19/2019] [Indexed: 01/01/2023] Open
Abstract
Background Comprehensive background check (CBC) laws extend background check requirements to private party firearm transfers to prevent firearm acquisitions by prohibited persons. The aim of our study was to estimate the association between CBC policies and changes in background check rates for firearm acquisition in two states (Oregon and Washington) that have newly-enacted CBC policies. Methods We used data on handgun background checks from January 1999 to December 2018 from the National Instant Criminal Background Check System. Observed trends in exposed states were contrasted with counterfactual trends estimated with the synthetic control group method. Findings CBC policies were associated with increases in background checks in Oregon (by 18.0%; p = 0.074), but not in Washington (4%; p = 0.321). A gradual increase in private party checks was seen following enactment in Washington; however, firearm transactions coded as “private” represent less than 5% of total background checks in that state. Conclusions Comprehensive background check policies appear to be effective in increasing pre-firearm-sale background checks in Oregon but not in Washington. Differences appear to be related to variations in the proportion of firearm sales that are private party transfers and to gradual adaptation to the new law by private gun sellers.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- 1Society and Health Research Center, Universidad Mayor, Badajoz 130, office 1306, Las Condes, Santiago, Chile.,2School of Public Health, Universidad Mayor, Santiago, Chile.,3Department of Population Health, New York University School of Medicine, New York, NY USA
| | - Daniel W Webster
- 4Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Garen J Wintemute
- 5Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA USA
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Castillo-Carniglia A, Pear VA, Tracy M, Keyes KM, Cerdá M. Limiting Alcohol Outlet Density to Prevent Alcohol Use and Violence: Estimating Policy Interventions Through Agent-Based Modeling. Am J Epidemiol 2019; 188:694-702. [PMID: 30608509 DOI: 10.1093/aje/kwy289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 12/27/2022] Open
Abstract
Increasing alcohol outlet density is well-documented to be associated with increased alcohol use and problems, leading to the policy recommendation that limiting outlet density will decrease alcohol problems. Yet few studies of decreasing problematic outlets and outlet density have been conducted. We estimated the association between closing alcohol outlets and alcohol use and alcohol-related violence, using an agent-based model of the adult population in New York City. The model was calibrated according to the empirical distribution of the parameters across the city's population, including the density of on- and off-premise alcohol outlets. Interventions capped the alcohol outlet distribution at the 90th to the 50th percentiles of the New York City density, and closed 5% to 25% of outlets with the highest levels of violence. Capping density led to a lower population of light drinkers (42.2% at baseline vs. 38.1% at the 50th percentile), while heavy drinking increased slightly (12.0% at baseline vs. 12.5% at the 50th percentile). Alcohol-related homicides and nonfatal violence remained unchanged. Closing the most violent outlets was not associated with changes in alcohol use or related problems. Results suggest that focusing solely on closing alcohol outlets might not be an effective strategy to reduce alcohol-related problems.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Chile, Santiago, Chile
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California
| | - Veronica A Pear
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Magdalena Cerdá
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California
- Department of Population Health, New York University School of Medicine, New York, New York
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Castillo-Carniglia A, Ponicki WR, Gaidus A, Gruenewald PJ, Marshall BDL, Fink DS, Martins SS, Rivera-Aguirre A, Wintemute GJ, Cerdá M. Prescription Drug Monitoring Programs and Opioid Overdoses: Exploring Sources of Heterogeneity. Epidemiology 2019; 30:212-220. [PMID: 30721165 PMCID: PMC6437666 DOI: 10.1097/ede.0000000000000950] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prescription drug monitoring program are designed to reduce harms from prescription opioids; however, little is known about what populations benefit the most from these programs. We investigated how the relation between implementation of online prescription drug monitoring programs and rates of hospitalizations related to prescription opioids and heroin overdose changed over time, and varied across county levels of poverty and unemployment, and levels of medical access to opioids. METHODS Ecologic county-level, spatiotemporal study, including 990 counties within 16 states, in 2001-2014. We modeled overdose counts using Bayesian hierarchical Poisson models. We defined medical access to opioids as the county-level rate of hospital discharges for noncancer pain conditions. RESULTS In 2010-2014, online prescription drug monitoring programs were associated with lower rates of prescription opioid-related hospitalizations (rate ratio 2014 = 0.74; 95% credible interval = 0.69, 0.80). The association between online prescription drug monitoring programs and heroin-related hospitalization was also negative but tended to increase in later years. Counties with lower rates of noncancer pain conditions experienced a lower decrease in prescription opioid overdose and a faster increase in heroin overdoses. No differences were observed across different county levels of poverty and unemployment. CONCLUSIONS Areas with lower levels of noncancer pain conditions experienced the smallest decrease in prescription opioid overdose and the faster increase in heroin overdose following implementation of online prescription drug monitoring programs. Our results are consistent with the hypothesis that prescription drug monitoring programs are most effective in areas where people are likely to access opioids through medical providers.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- From the Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - William R Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
| | - Andrew Gaidus
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - David S Fink
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Ariadne Rivera-Aguirre
- From the Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA
| | - Garen J Wintemute
- From the Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA
| | - Magdalena Cerdá
- From the Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA
- Department of Population Health, NYU School of Medicine, New York, NY
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Castillo-Carniglia A, Kagawa RM, Cerdá M, Crifasi CK, Vernick JS, Webster DW, Wintemute GJ. California's comprehensive background check and misdemeanor violence prohibition policies and firearm mortality. Ann Epidemiol 2019; 30:50-56. [DOI: 10.1016/j.annepidem.2018.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/13/2018] [Accepted: 10/03/2018] [Indexed: 11/30/2022]
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Smith N, Martins SS, Kim J, Rivera-Aguirre A, Fink DS, Castillo-Carniglia A, Henry SG, Mooney SJ, Marshall BD, Davis C, Cerdá M. A typology of prescription drug monitoring programs: a latent transition analysis of the evolution of programs from 1999 to 2016. Addiction 2019; 114:248-258. [PMID: 30207015 PMCID: PMC6314884 DOI: 10.1111/add.14440] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/20/2018] [Accepted: 08/31/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Prescription drug monitoring programs (PDMP), defined as state-level databases used in the United States that collect prescribing information when controlled substances are dispensed, have varied substantially between states and over time. Little is known about the combinations of PDMP features that, collectively, may produce the greatest impact on prescribing and overdose. We aimed to (1) identify the types of PDMP models that have developed from 1999 to 2016, (2) estimate whether states have transitioned across PDMP models over time and (3) examine whether states have adopted different types of PDMP models in response to the burden of opioid overdose. METHODS A latent transition analysis of PDMP models based on an adaptation of nine PDMP characteristics classified by prescription opioid policy experts as potentially important determinants of prescribing practices and prescription opioid overdose events. RESULTS We divided the time-period into three intervals (1999-2004, 2005-09, 2010-16), and found three distinct PDMP classes in each interval. The classes in the first and second interval can be characterized as 'no/weak', 'proactive' and 'reactive' types of PDMPs, and in the third interval as 'weak', 'cooperative' and 'proactive'. The meaning of these classes changed over time: until 2009, states in the 'no/weak' class had no active PDMP, whereas states in the 'proactive' class were more likely to proactively provide unsolicited information to PDMP users, provide open access to law enforcement, and require more frequent data reporting than states in the 'reactive' class. In 2010-16, the 'weak' class resembled the 'reactive' class in previous intervals. States in the 'cooperative' class in 2010-16 were less likely than states in the 'proactive' class to provide unsolicited reports proactively or to provide open access to law enforcement; however, they were more likely than those in the 'proactive' class to share PDMP data with other states and to report more federal drug schedules. CONCLUSIONS Since 1999, US states have tended to transition to more robust classes of prescription drug monitoring programs. Opioid overdose deaths in prior years predicted the state's prescription drug monitoring program class but did not predict transitions between prescription drug monitoring program classes over time.
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Affiliation(s)
- Nathan Smith
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, California
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - June Kim
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Ariadne Rivera-Aguirre
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, California
| | - David S Fink
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Alvaro Castillo-Carniglia
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, California,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor
| | - Stephen G Henry
- Department of Internal Medicine; University of California Davis; Sacramento, CA
| | - Stephen J Mooney
- Harborview Injury Research & Prevention Center, University of Washington,Seattle,USA
| | - Brandon D.L. Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Corey Davis
- Network for Public Health Law, Chapel Hill, NC, USA
| | - Magdalena Cerdá
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, California,Department of Population Health, NYU School of Medicine
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Fink DS, Schleimer JP, Sarvet A, Grover KK, Delcher C, Castillo-Carniglia A, Kim JH, Rivera-Aguirre AE, Henry SG, Martins SS, Cerdá M. Association Between Prescription Drug Monitoring Programs and Nonfatal and Fatal Drug Overdoses: A Systematic Review. Ann Intern Med 2018; 168:783-790. [PMID: 29801093 PMCID: PMC6015770 DOI: 10.7326/m17-3074] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Prescription drug monitoring programs (PDMPs) are a key component of the president's Prescription Drug Abuse Prevention Plan to prevent opioid overdoses in the United States. Purpose To examine whether PDMP implementation is associated with changes in nonfatal and fatal overdoses; identify features of programs differentially associated with those outcomes; and investigate any potential unintended consequences of the programs. Data Sources Eligible publications from MEDLINE, Current Contents Connect (Clarivate Analytics), Science Citation Index (Clarivate Analytics), Social Sciences Citation Index (Clarivate Analytics), and ProQuest Dissertations indexed through 27 December 2017 and additional studies from reference lists. Study Selection Observational studies (published in English) from U.S. states that examined an association between PDMP implementation and nonfatal or fatal overdoses. Data Extraction 2 investigators independently extracted data from and rated the risk of bias (ROB) of studies by using established criteria. Consensus determinations involving all investigators were used to grade strength of evidence for each intervention. Data Synthesis Of 2661 records, 17 articles met the inclusion criteria. These articles examined PDMP implementation only (n = 8), program features only (n = 2), PDMP implementation and program features (n = 5), PDMP implementation with mandated provider review combined with pain clinic laws (n = 1), and PDMP robustness (n = 1). Evidence from 3 studies was insufficient to draw conclusions regarding an association between PDMP implementation and nonfatal overdoses. Low-strength evidence from 10 studies suggested a reduction in fatal overdoses with PDMP implementation. Program features associated with a decrease in overdose deaths included mandatory provider review, provider authorization to access PDMP data, frequency of reports, and monitoring of nonscheduled drugs. Three of 6 studies found an increase in heroin overdoses after PDMP implementation. Limitation Few studies, high ROB, and heterogeneous analytic methods and outcome measurement. Conclusion Evidence that PDMP implementation either increases or decreases nonfatal or fatal overdoses is largely insufficient, as is evidence regarding positive associations between specific administrative features and successful programs. Some evidence showed unintended consequences. Research is needed to identify a set of "best practices" and complementary initiatives to address these consequences. Primary Funding Source National Institute on Drug Abuse and Bureau of Justice Assistance.
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Affiliation(s)
- David S Fink
- Columbia University, New York, New York (D.S.F., J.P.S., A.S., K.K.G., S.S.M.)
| | - Julia P Schleimer
- Columbia University, New York, New York (D.S.F., J.P.S., A.S., K.K.G., S.S.M.)
| | - Aaron Sarvet
- Columbia University, New York, New York (D.S.F., J.P.S., A.S., K.K.G., S.S.M.)
| | - Kiran K Grover
- Columbia University, New York, New York (D.S.F., J.P.S., A.S., K.K.G., S.S.M.)
| | | | | | - June H Kim
- New York University, New York, New York (J.H.K.)
| | | | - Stephen G Henry
- University of California, Davis, Sacramento, California (A.C., A.E.R., S.G.H., M.C.)
| | - Silvia S Martins
- Columbia University, New York, New York (D.S.F., J.P.S., A.S., K.K.G., S.S.M.)
| | - Magdalena Cerdá
- University of California, Davis, Sacramento, California (A.C., A.E.R., S.G.H., M.C.)
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Pear VA, Castillo-Carniglia A, Kagawa RM, Cerdá M, Wintemute GJ. Firearm mortality in California, 2000–2015: the epidemiologic importance of within-state variation. Ann Epidemiol 2018; 28:309-315.e2. [DOI: 10.1016/j.annepidem.2018.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/06/2018] [Accepted: 03/07/2018] [Indexed: 10/17/2022]
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Castillo-Carniglia A, Kagawa RMC, Webster DW, Vernick JS, Cerdá M, Wintemute GJ. Comprehensive background check policy and firearm background checks in three US states. Inj Prev 2017; 24:431-436. [DOI: 10.1136/injuryprev-2017-042475] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/22/2017] [Accepted: 08/30/2017] [Indexed: 11/04/2022]
Abstract
BackgroundComprehensive background check (CBC) policies are hypothesised to reduce firearm-related violence because they extend background checks to private party firearm sales, but no study has determined whether these policies actually increase background checks, an expected intermediary outcome. We evaluate the association between CBC policies and the rates of firearm background checks in three states that recently implemented these policies: Delaware (July 2013), Colorado (July 2013) and Washington (December 2014).MethodsWe used the synthetic control group method to estimate the difference from estimated counterfactual postintervention trends in the monthly rate of background checks per 1 00 000 people for handguns, long guns and both types combined, using data for January 1999 through December 2016. Inference was based on results from permutation tests. We conducted multiple sensitivity analyses to assess the robustness of our results.ResultsBackground check rates increased in Delaware, by 22%–34% depending on the type of firearm, following enactment of its CBC law. No overall changes were observed in Washington and Colorado. Our results were robust to changes in the comparison group and statistical methods.ConclusionsThe enactment of CBC policies was associated with an overall increase in firearm background checks only in Delaware. Data external to the study suggest that Washington experienced a modest, but consistent, increase in background checks for private party sales, and Colorado experienced a similar increase in checks for sales not at gun shows. Non-compliance may explain the lack of an overall increase in background checks in Washington and Colorado.
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Castillo-Carniglia A, Pizarro E, Marín JD, Rodríguez N, Casas-Cordero C, Cerdá M. The effects of using answer sheets on reported drug use and data quality in a classroom survey: A cluster-randomized study. Drug Alcohol Depend 2017; 178:194-200. [PMID: 28654872 PMCID: PMC5548613 DOI: 10.1016/j.drugalcdep.2017.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/01/2017] [Accepted: 05/05/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND We compare self-reported prevalence of drug use and indicators of data quality from two different response modes (with and without an independent answer sheet for recording responses) in a survey conducted in 2015 among secondary school students. METHODS Stratified cluster-randomized study conducted among students in grades 8-12 from public, private and subsidized schools in Chile (N=2317 students in 122 classes). Measurements included were: percentage reporting substance use (tobacco, alcohol, marijuana, cocaine, ecstasy); number of inconsistent responses; number of item nonresponses; percentage of extreme reports of drug use; percentage reporting using the nonexistent drug, relevón; and completion times. RESULTS Compared with those who responded directly in the questionnaire booklet, students who used a separate answer sheet took 17.6 more minutes (95% confidence interval [CI]: 14.4-20.8) to complete the survey and had on average 1.5 more inconsistent responses (95%CI: 0.91-2.14). The prevalence and variance of drug use was higher among those who used an answer sheet for all substances except tobacco; the prevalence ratio (PR) of reported substance use for low-prevalence substances during the past year were: cocaine PR=2.5 (95%CI: 1.6-4.1); ecstasy PR=5.0 (95%CI: 2.4-10.5); relevón PR=4.8 (95%CI: 2.5-9.3). CONCLUSIONS Using an answer sheet for a self-administered paper-and-pencil survey of drug use among students result in lower quality data and higher reports of drug use. International comparison of adolescent drug use from school-based surveys should be done with caution. The relative ranking of a country could be misleading if different mode of recording answers are used.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States.
| | - Esteban Pizarro
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - José D Marín
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Nicolás Rodríguez
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Carolina Casas-Cordero
- Instituto de Sociología (ISUC) y Centro de Encuestas y Estudios Longitudinales (CEEL), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Magdalena Cerdá
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States
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Poblete F, Barticevic NA, Zuzulich MS, Portilla R, Castillo-Carniglia A, Sapag JC, Villarroel L, Sena BF, Galarce M. A randomized controlled trial of a brief intervention for alcohol and drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary health care in Chile. Addiction 2017; 112:1462-1469. [PMID: 28239995 DOI: 10.1111/add.13808] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/11/2016] [Accepted: 02/20/2017] [Indexed: 11/28/2022]
Abstract
AIM To study the effectiveness of a brief intervention (BI) associated with the ASSIST (Alcohol Smoking and Substance Involvement Screening Test) for alcohol and illicit drug use as part of a systematic screening program implemented in primary care. DESIGN A multi-center randomized open-label trial stratified using the ASSIST-specific substance involvement score (for alcohol, scores ranged from 11 to 15 and 16 to 20; and for the other substances from 4 to 12 and 13 to 20). SETTING A total of 19 primary care centers (n = 520), eight emergency rooms (n = 195) and five police stations (n = 91) were evaluated. PARTICIPANTS A total of 12 217 people aged between 19 and 55 years were screened for moderate alcohol and drug use risk as defined by the ASSIST Chilean version. A total of 806 non-treatment-seekers were randomized. INTERVENTION AND COMPARISON ASSIST-linked BI (n = 400) compared with an informational pamphlet on risk associated with substance use (n = 406). MEASUREMENTS Total ASSIST alcohol and illicit involvement score (ASSIST-AI), and ASSIST-specific score for alcohol, cannabis and cocaine at baseline and at 3-month follow-up. FINDINGS Sixty-two per cent of participants completed follow-up. An intention-to-treat analysis showed no difference between the two groups for the ASSIST-AI score [mean difference (MD) = - 0.17, confidence interval (CI) = -1.87, 2.20], either for specific scores alcohol (MD = 0.18, CI = -1.45, 1.10), cannabis (MD = -0.62, CI = -0.89, 2.14) or cocaine (MD = -0.79, CI = -2.89, 4.47). CONCLUSION It is not clear whether a brief intervention associated with the Alcohol Smoking and Substance Involvement Screening Test is more effective than an informational pamphlet in reducing alcohol and illicit substance consumption in non-treatment-seeking, primary care users with moderate risk.
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Affiliation(s)
- Fernando Poblete
- School of Medicine, Department of Public Health, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolas A Barticevic
- School of Medicine, Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria Soledad Zuzulich
- School of Medicine, Nursing School, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Portilla
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Department of Emergency Medicine, UC Davis School of Medicine, Violence Prevention Research Program, Sacramento, CA, USA
| | - Jaime C Sapag
- School of Medicine, Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Villarroel
- School of Medicine, Department of Public Health, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Brena F Sena
- Columbia University School of Public Health, New York, NY, USA
| | - Magdalena Galarce
- School of Medicine, Center for Study of Addiction, Pontificia Universidad Catolica de Chile, Santiago, Chile
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Castillo-Carniglia A, Kaufman JS, Pizarro E, Marín JD, Wintemute G, Cerdá M. School collective occupation movements and substance use among adolescents: A school-level panel design. Drug Alcohol Depend 2017; 176:21-27. [PMID: 28511034 DOI: 10.1016/j.drugalcdep.2017.02.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/09/2017] [Accepted: 02/25/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recently, social movements across the world have demanded reforms to education systems and other institutions. Although such movements have affected large numbers of people across multiple countries, we know little about the impacts they have had on population health. We focus on one example: the massive strikes and collective occupation of secondary schools across Chile, which occurred contemporaneously with a large increase in marijuana use among students in this age group. We aimed to evaluate the causal effects that the 2011 Chilean school strikes had on adolescent substance use, including the initiation of marijuana use and the use of alcohol and marijuana. METHODS School-level, aggregated panel design using data from the National Drug Surveys among Secondary Students from 2005 to 2015 for students in grades 9-12. We used a fixed-effects difference-in-difference model to estimate the effect of school occupations on prevalence of self-reported indicators of drug use. RESULTS Reported marijuana use doubled between 2009 and 2013 among Chilean adolescents. After controlling for secular trends in outcomes and for school characteristics, there was no evidence of increased marijuana initiation, alcohol and marijuana use, or of an increase in heavy use among adolescents being directly attributable to school strikes and occupations in 2011. CONCLUSIONS The 2011 Occupy school movement in Chile had no detectable causal effect on substance use among Chilean adolescents. The increase in marijuana use from 2009 to 2013 seems to be part of broader social changes occurring among the school-age population.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States.
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Esteban Pizarro
- Research Department, National Service for the Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - José D Marín
- Research Department, National Service for the Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Garen Wintemute
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States
| | - Magdalena Cerdá
- Violence Prevention Research Program, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States
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Wintemute GJ, Wright MA, Castillo-Carniglia A, Shev A, Cerdá M. Firearms, alcohol and crime: convictions for driving under the influence (DUI) and other alcohol-related crimes and risk for future criminal activity among authorised purchasers of handguns. Inj Prev 2017; 24:68-72. [DOI: 10.1136/injuryprev-2016-042181] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/14/2016] [Accepted: 12/30/2016] [Indexed: 11/03/2022]
Abstract
Firearm violence frequently involves alcohol, but there are no studies of misuse of alcohol and risk for future violence among firearm owners. We examined the association between prior convictions for alcohol-related crimes, chiefly driving under the influence (DUI), and risk of subsequent arrest among 4066 individuals who purchased handguns in California in 1977. During follow-up through 1991, 32.8% of those with prior alcohol-related convictions and 5.7% of those with no prior criminal history were arrested for a violent or firearm-related crime; 15.9% and 2.7%, respectively, were arrested for murder, rape, robbery or aggravated assault. Prior alcohol-related convictions were associated with a fourfold to fivefold increase in risk of incident arrest for a violent or firearm-related crime, a relative increase greater than that seen for age, sex or prior violence. Prior convictions for alcohol-related crime may be an important predictor of risk for future criminal activity among purchasers of firearms.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- National Service for Prevention and Rehabilitation of Drug and Alcohol consumption, Research Department, Santiago, Chile.
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Castillo-Carniglia A, Weisstaub SG, Aguirre P, Aguilar AM, Araya M. Identifying cultural representations of families and the health team to improve the management of severe malnutrition in childhood. Qual Health Res 2010; 20:524-530. [PMID: 20147504 DOI: 10.1177/1049732310361465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Severe childhood malnutrition is no longer a priority in Latin America, but mortality of hospitalized malnourished children continues to be high, especially in Bolivia. The objective of the present study was to identify cultural representations in mothers and in health personnel that might influence the relationship between the family and the provider's health care services, thus affecting the treatment of malnourished children. We applied a flexible qualitative model of cases and controls (mothers or caregivers of both under- and well-nourished children), and in addition, health personnel. Results were analyzed following semiotics of statements. Mothers and health professionals based their cultural representations on different conceptions of health. The mothers' mindset indicated that traditional Andean medicine and public health systems are complementary and not contradictory. Conversely, health personnel expressed a univocal vision, accepting only biomedicine. Furthermore, they also expressed a negative attitude toward mothers of severely malnourished children. Results should be considered to improve ongoing local health programs.
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