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Kasza KA, Tang Z, Seo YS, Benson AF, Creamer MR, Edwards KC, Everard C, Chang JT, Cheng YC, Das B, Oniyide O, Tashakkori NA, Weidner AS, Xiao H, Stanton C, Kimmel HL, Compton W, Hyland A. Divergence in Cigarette Discontinuation Rates by Use of Electronic Nicotine Delivery Systems (ENDS): Longitudinal Findings From the United States PATH Study Waves 1-6. Nicotine Tob Res 2024:ntae027. [PMID: 38566367 DOI: 10.1093/ntr/ntae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION We compare real-world trends in population-level cigarette discontinuation rates among adults (ages ≥21) who smoked cigarettes, by electronic nicotine delivery systems (ENDS) use. AIMS AND METHODS U.S nationally representative data from adults in the Population Assessment of Tobacco and Health (PATH) Study (2013/14-2021, Waves 1-6) who smoked cigarettes in the past 30 days (P30D) were analyzed (n = 13 640). The exposure was P30D ENDS use. The outcome was P30D cigarette discontinuation at biennial follow-up. Weighted trend analyses were conducted to test for differences in cigarette discontinuation trends by ENDS use. RESULTS Between 2013/14 and 2015/16, cigarette discontinuation rates were both 16% for those who used ENDS and for those who did not; between 2018/19 and 2021, rates were ~30% for those who used ENDS and ~20% for those who did not; the time by ENDS use interaction was significant. CONCLUSIONS The relationship between adults' ENDS use and cigarette discontinuation in the context of an expanded ENDS marketplace, new tobacco regulatory actions, and COVID-19 differs from the relationship in earlier years. IMPLICATIONS It is important for public health decisions to be informed by research based on the contemporary ENDS marketplace and circumstances.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy, Westat, Rockville, MD, USA
| | - Young Sik Seo
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Adam F Benson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - MeLisa R Creamer
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | | | - Colm Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Joanne T Chang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Yu-Ching Cheng
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Babita Das
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Olusola Oniyide
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Nicole A Tashakkori
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Anna-Sophie Weidner
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Haijun Xiao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Compton W, Weiss S. Commentary on Petrilli et al.: Assessing cannabis use in real-world settings - advances using standard THC units. Addiction 2024; 119:784-785. [PMID: 38263762 DOI: 10.1111/add.16440] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/25/2024]
Affiliation(s)
- Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, US Department of Health and Human Services, Gaithersburg, MD, USA
| | - Susan Weiss
- National Institute on Drug Abuse, National Institutes of Health, US Department of Health and Human Services, Gaithersburg, MD, USA
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Paulin LM, Halenar MJ, Edwards KC, Lauten K, Taylor K, Brunette M, Tanski S, MacKenzie T, Stanton CA, Hatsukami D, Hyland A, Mahoney MC, Niaura R, Trinidad D, Blanco C, Compton W, Gardner LD, Kimmel HL, Cummings KM, Lauterstein D, Roh EJ, Marshall D, Sargent JD. Relationship Between Tobacco Product Use and Health-Related Quality of Life Among Individuals With COPD in Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study. Chronic Obstr Pulm Dis 2024; 11:68-82. [PMID: 38113525 PMCID: PMC10913919 DOI: 10.15326/jcopdf.2023.0422] [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] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
Introduction We examined the association between tobacco product use and health-related quality of life (HRQoL) among individuals with chronic obstructive pulmonary disease (COPD) in Waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study. Methods Adults ≥40 years with an ever COPD diagnosis were included in cross-sectional (Wave 5) and longitudinal (Waves 1 to 5) analyses. Tobacco use included 13 mutually exclusive categories of past 30-day (P30D) single use and polyuse with P30D exclusive cigarette use and ≥5-year cigarette cessation as reference groups. Multivariable linear regression and generalized estimating equations (GEE) were used to examine the association between tobacco use and HRQoL as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 questionnaire. Results Of 1670 adults, 79.4% ever used cigarettes; mean (standard error [SE]) pack years was 30.9 (1.1). In cross-sectional analysis, P30D exclusive cigarette use, and e-cigarette/cigarette dual use were associated with worse HRQoL compared to ≥5-year cigarette cessation. Compared to P30D exclusive cigarette use, never tobacco use and ≥5-year cigarette cessation were associated with better HRQoL, while e-cigarette/cigarette dual use had worse HRQoL. Longitudinally (n=686), e-cigarette/cigarette dual use was associated with worsening HRQoL compared to both reference groups. Only never tobacco use was associated with higher HRQoL over time compared to P30D exclusive cigarette use. Conclusions E-cigarette/cigarette dual use was associated with worse HRQoL compared to ≥5-year cigarette cessation and exclusive cigarette use. Never use and ≥5-year cigarette cessation were the only categories associated with higher HRQoL compared to exclusive cigarette use. Findings highlight the importance of complete smoking cessation for individuals with COPD.
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Affiliation(s)
- Laura M. Paulin
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Michael J. Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Kathryn C. Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Kristin Lauten
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Kristie Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Mary Brunette
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Susanne Tanski
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Todd MacKenzie
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Cassandra A. Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Dorothy Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, United States
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Martin C. Mahoney
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Ray Niaura
- School of Global Public Health, New York University, New York, New York, United States
| | - Dennis Trinidad
- University of California at San Diego, La Jolla, California, United States
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
| | - Lisa D. Gardner
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States
| | - Dana Lauterstein
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Esther J. Roh
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
- Axle Informatics, Rockville, Maryland, United States
| | - James D. Sargent
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
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Hjorthøj C, Compton W, Starzer M, Nordholm D, Einstein E, Erlangsen A, Nordentoft M, Volkow ND, Han B. Association between cannabis use disorder and schizophrenia stronger in young males than in females. Psychol Med 2023; 53:7322-7328. [PMID: 37140715 PMCID: PMC10719679 DOI: 10.1017/s0033291723000880] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/19/2022] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Previous research suggests an increase in schizophrenia population attributable risk fraction (PARF) for cannabis use disorder (CUD). However, sex and age variations in CUD and schizophrenia suggest the importance of examining differences in PARFs in sex and age subgroups. METHODS We conducted a nationwide Danish register-based cohort study including all individuals aged 16-49 at some point during 1972-2021. CUD and schizophrenia status was obtained from the registers. Hazard ratios (HR), incidence risk ratios (IRR), and PARFs were estimated. Joinpoint analyses were applied to sex-specific PARFs. RESULTS We examined 6 907 859 individuals with 45 327 cases of incident schizophrenia during follow-up across 129 521 260 person-years. The overall adjusted HR (aHR) for CUD on schizophrenia was slightly higher among males (aHR = 2.42, 95% CI 2.33-2.52) than females (aHR = 2.02, 95% CI 1.89-2.17); however, among 16-20-year-olds, the adjusted IRR (aIRR) for males was more than twice that for females (males: aIRR = 3.84, 95% CI 3.43-4.29; females: aIRR = 1.81, 95% CI 1.53-2.15). During 1972-2021, the annual average percentage change in PARFs for CUD in schizophrenia incidence was 4.8 among males (95% CI 4.3-5.3; p < 0.0001) and 3.2 among females (95% CI 2.5-3.8; p < 0.0001). In 2021, among males, PARF was 15%; among females, it was around 4%. CONCLUSIONS Young males might be particularly susceptible to the effects of cannabis on schizophrenia. At a population level, assuming causality, one-fifth of cases of schizophrenia among young males might be prevented by averting CUD. Results highlight the importance of early detection and treatment of CUD and policy decisions regarding cannabis use and access, particularly for 16-25-year-olds.
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Affiliation(s)
- Carsten Hjorthøj
- Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Section of Epidemiology, Copenhagen, Denmark
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, USA
| | - Marie Starzer
- Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Emily Einstein
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, USA
| | - Annette Erlangsen
- Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Nora D. Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, USA
| | - Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, USA
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Edwards KC, Halenar MJ, Delnevo CD, Villanti AC, Bansal-Travers M, O'Connor R, Del Valle-Pinero AY, Creamer MR, Donaldson EA, Hammad HT, Lagasse L, Anesetti-Rothermel A, Taylor KA, Kimmel HL, Compton W, Cheng YC, Ambrose BK, Hyland A. Patterns of Premium and Nonpremium Cigar Use in the United States: Findings from Wave 6 (2021) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2023; 25:S5-S15. [PMID: 37506243 PMCID: PMC10885408 DOI: 10.1093/ntr/ntad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 09/06/2022] [Revised: 12/30/2022] [Accepted: 01/26/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Understanding the characteristics of premium cigar use patterns is essential for minimizing public health harms. Typically, premium cigars are handmade, larger, more expensive, and without the characterizing flavors that are present in other cigar types: Nonpremium traditional cigars, cigarillos, and filtered cigars. AIMS AND METHODS Self-reported brand and price data were used from Wave 6 of the Population Assessment of Tobacco and Health (PATH) Study to define and estimate premium versus nonpremium cigar use among U.S. adults, as well as to explore cigar smoking patterns, purchasing behavior, and reasons for use by cigar type. RESULTS In 2021, 0.9% (95% CI = 0.7-1.0) of adults were premium cigar users, compared to 0.4% of nonpremium traditional cigar users (95% CI = 0.3-0.5), 1.1% of cigarillo users (95% CI = 1.0-1.2), and 0.6% filtered cigar users (95% CI = 0.5-0.7). Premium cigar users were overwhelmingly male (97.7%), and 35.8% were aged ≥55 years. The average premium cigar price/stick was $8.67, $5.50-7.00 more than other cigar types. Compared to other cigar types, significantly fewer premium cigar users had a regular brand with a flavor other than tobacco (~15% vs. 38%-53%). Though flavors remained the top reason for premium cigar use, they were less likely to endorse flavors as a reason for use than other cigar users (~40% vs. 68-74%). Premium cigar users had a lower prevalence (aRR: 0.37, 95% CI = 0.25-0.55) of dual use of cigars and cigarettes. CONCLUSIONS Although <1% of U.S. adults use premium cigars, their use and purchasing characteristics continue to differ from other cigar types, highlighting the importance of capturing data specific to premium cigar use. IMPLICATIONS This manuscript extends previous research from the National Academies of Science, Engineering, and Medicine report, "Premium cigars: Patterns of use, marketing, and health effects" by utilizing the most recent PATH Study data (Wave 6) to examine patterns of cigar use, including purchasing behavior and reasons for use, by cigar type (eg, premium traditional cigars, nonpremium traditional cigars, cigarillos, and filtered cigars). The findings support continued research on patterns of premium cigar use, which differ from use patterns of other cigar types.
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Affiliation(s)
| | | | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Andrea C Villanti
- Department of Health Behavior, Society and Policy, Rutgers University, New Brunswick, NJ, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Richard O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | - MeLisa R Creamer
- Division of Epidemiology, Services and Prevention, National Institute on Drug Abuse, Bethesda, MD, USA
| | | | - Hoda T Hammad
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lisa Lagasse
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | | | | | - Heather L Kimmel
- Division of Epidemiology, Services and Prevention, National Institute on Drug Abuse, Bethesda, MD, USA
| | | | - Yu-Ching Cheng
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Bridget K Ambrose
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Jones CM, Olsen Y, Ali MM, Sherry TB, Mcaninch J, Creedon T, Juliana P, Jacobus-Kantor L, Baillieu R, Diallo MM, Thomas A, Gandotra N, Sokolowska M, Ling S, Compton W. Characteristics and Prescribing Patterns of Clinicians Waivered to Prescribe Buprenorphine for Opioid Use Disorder Before and After Release of New Practice Guidelines. JAMA Health Forum 2023; 4:e231982. [PMID: 37477926 PMCID: PMC10362471 DOI: 10.1001/jamahealthforum.2023.1982] [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] [Indexed: 07/22/2023] Open
Abstract
Importance In April 2021, the US Department of Health and Human Services (HHS) released practice guidelines exempting educational requirements to obtain a Drug Addiction Treatment Act (DATA) waiver to treat up to 30 patients with opioid use disorder with buprenorphine. Objective To compare demographic and practice characteristics of clinicians who received traditional DATA waivers before and after release of the education-exempted HHS practice guidelines and those who were approved under the guidelines. Design, Setting, and Participants This survey study was conducted electronically from February 1 to March 1, 2022. Eligible survey recipients were US clinicians who obtained an initial DATA waiver between April 2020 and November 2021. Exposure DATA waiver approval pathway. Main Outcome and Measures The outcomes were clinician demographic and practice characteristics, buprenorphine prescribing barriers, and strategies to treat patients with opioid use disorder, measured using χ2 tests and z tests to assess for differences among the waivered groups. Results Of 23 218 eligible clinicians, 4519 (19.5%) responded to the survey. This analysis was limited to 2736 respondents with a 30-patient limit at the time of survey administration who identified their DATA waiver approval pathway. Among these respondents, 1365 (49.9%; female, 831 [61.9%]; male, 512 [38.1%]) received their DATA waiver prior to the education-exempted practice guidelines (prior DATA waiver), 550 (20.1%; female, 343 [63.4%]; male, 198 [36.6%]) received their waiver after guidelines were released but met education requirements (concurrent DATA waiver), and 821 (30.0%; female, 396 [49.2%]; male, 409 [50.8%]) received the waiver under the education-exempted guidelines (practice guidelines). Among practice guidelines clinicians, 500 (60.9%) reported that traditional DATA waiver educational requirements were a reason for not previously obtaining a waiver. Demographic and practice characteristics differed by waiver approval type. Across all groups, a large minority had not prescribed buprenorphine since obtaining a waiver (prior DATA waiver, 483 [35.7%]; concurrent DATA waiver, 226 [41.2%]; practice guidelines, 359 [44.3%]; P < .001). Clinicians who prescribed buprenorphine in the past 6 months reported treating few patients in an average month: 27 practice guidelines clinicians (6.0%) prescribed to 0 patients and 338 (75.1%) to 1 to 4 patients compared with 16 (2.2%) and 435 (59.9%) for prior and 11 (3.6%) and 166 (55.0%) for concurrent DATA waiver clinicians, respectively (P < .001). Across waiver types, clinicians reported multiple challenges to buprenorphine prescribing. Conclusions and Relevance In this survey of DATA-waivered clinicians, clinician- and systems-level challenges that limit buprenorphine prescribing were observed, even among clinicians approved under the education-exempted guidelines pathway. The findings suggest that as implementation of legislation removing the DATA waiver begins, addressing these barriers could be essential to increasing buprenorphine access.
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Affiliation(s)
| | - Yngvild Olsen
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | - Mir M Ali
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC
| | - Tisamarie B Sherry
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC
| | - Jana Mcaninch
- US Food and Drug Administration, Silver Spring, Maryland
| | - Timothy Creedon
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC
| | - Patti Juliana
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | - Laura Jacobus-Kantor
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC
| | - Robert Baillieu
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | | | - Anita Thomas
- Centers for Medicare & Medicaid Services, Baltimore, Maryland
| | - Neeraj Gandotra
- Substance Abuse and Mental Health Services Administration, Rockville, Maryland
| | | | - Shari Ling
- Centers for Medicare & Medicaid Services, Baltimore, Maryland
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Mahoney MC, Rivard C, Kimmel HL, Hammad HT, Sharma E, Halenar MJ, Sargent J, Cummings KM, Niaura R, Goniewicz ML, Bansal-Travers M, Hatsukami D, Gaalema D, Fong G, Gravely S, Christensen CH, Haskins R, Silveira ML, Blanco C, Compton W, Stanton CA, Hyland A. Cardiovascular Outcomes among Combustible-Tobacco and Electronic Nicotine Delivery System (ENDS) Users in Waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) Study, 2013-2019. Int J Environ Res Public Health 2022; 19:4137. [PMID: 35409819 PMCID: PMC8998731 DOI: 10.3390/ijerph19074137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prior studies have not clearly established risk of cardiovascular disease (CVD) among smokers who switch to exclusive use of electronic nicotine delivery systems (ENDS). We compared cardiovascular disease incidence in combustible-tobacco users, those who transitioned to ENDS use, and those who quit tobacco with never tobacco users. METHODS This prospective cohort study analyzes five waves of Population Assessment of Tobacco and Health (PATH) Study data, Wave 1 (2013-2014) through Wave 5 (2018-2019). Cardiovascular disease (CVD) incidence was captured over three intervals (Waves 1 to 3, Waves 2 to 4, and Waves 3 to 5). Participants were adults (40+ years old) without a history of CVD for the first two waves of any interval. Change in tobacco use status, from exclusive past 30 day use of any combustible-tobacco product to either exclusive past 30 day ENDS use, dual past 30 day use of ENDS and combustible-tobacco, or no past 30 day use of any tobacco, between the first two waves of an interval was used to predict onset of CVD between the second and third waves in the interval. CVD incidence was defined as a new self-report of being told by a health professional that they had congestive heart failure, stroke, or a myocardial infarction. Generalized estimating equation (GEE) analyses combined 10,548 observations across intervals from 7820 eligible respondents. RESULTS Overall, there were 191 observations of CVD among 10,548 total observations (1.7%, standard error (SE) = 0.2), with 40 among 3014 never users of tobacco (1.5%, SE = 0.3). In multivariable models, CVD incidence was not significantly different for any tobacco user groups compared to never users. There were 126 observations of CVD among 6263 continuing exclusive combustible-tobacco users (adjusted odds ratio [AOR] = 1.44; 95% confidence interval (CI) 0.87-2.39), 15 observations of CVD among 565 who transitioned to dual use (AOR = 1.85; 0.78-4.37), and 10 observations of CVD among 654 who quit using tobacco (AOR = 1.18; 0.33-4.26). There were no observations of CVD among 53 who transitioned to exclusive ENDS use. CONCLUSIONS This study found no difference in CVD incidence by tobacco status over three 3 year intervals, even for tobacco quitters. It is possible that additional waves of PATH Study data, combined with information from other large longitudinal cohorts with careful tracking of ENDS use patterns may help to further clarify this relationship.
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Affiliation(s)
- Martin C. Mahoney
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Cheryl Rivard
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | - Hoda T. Hammad
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Eva Sharma
- Westat, Rockville, MD 20850, USA; (E.S.); (M.J.H.); (C.A.S.)
| | | | - Jim Sargent
- The C. Everette Koop Institute at Dartmouth, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA;
| | | | - Ray Niaura
- NYU School of Global Public Health, New York, NY 10003, USA;
| | - Maciej L. Goniewicz
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Maansi Bansal-Travers
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | | | | | - Geoffrey Fong
- University of Waterloo, Waterloo, ON N2L 3G1, Canada; (G.F.); (S.G.)
| | - Shannon Gravely
- University of Waterloo, Waterloo, ON N2L 3G1, Canada; (G.F.); (S.G.)
| | - Carol H. Christensen
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Ryan Haskins
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
- Kelly Government Solutions, Troy, MI 48084, USA
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
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Huntley K, Einstein E, Postma T, Thomas A, Ling S, Compton W. Advancing emergency department-initiated buprenorphine. J Am Coll Emerg Physicians Open 2021; 2:e12451. [PMID: 34179878 PMCID: PMC8208651 DOI: 10.1002/emp2.12451] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/01/2021] [Accepted: 04/23/2021] [Indexed: 01/10/2023] Open
Abstract
Opioids are the main driver of drug overdose deaths in the United States, and there has been a marked increase in opioid-related overdoses during the COVID-19 public health emergency. Many emergency departments (EDs) across the country are implementing ED-initiated buprenorphine programs, and this is a method to address and prevent opioid overdoses. Resources are available to overcome barriers and take action.
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Affiliation(s)
- Kristen Huntley
- Center for the Clinical Trials NetworkThe National Institute on Drug AbuseBethesdaMarylandUSA
| | - Emily Einstein
- Office of Science Policy and CommunicationsThe National Institute on Drug AbuseBethesdaMarylandUSA
| | - Terri Postma
- Center for MedicareCenters for Medicare & Medicaid ServicesBaltimoreMarylandUSA
| | - Anita Thomas
- Center for Clinical Standards and QualityCenters for Medicare & Medicaid ServicesBaltimoreMarylandUSA
| | - Shari Ling
- Center for Clinical Standards and QualityCenters for Medicare & Medicaid ServicesBaltimoreMarylandUSA
| | - Wilson Compton
- Office of the DirectorThe National Institute on Drug AbuseBethesdaMarylandUSA
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Jones CM, Underwood N, Compton W. Increases in methamphetamine use among heroin treatment admissions in the United States, 2008-17. Addiction 2020; 115:347-353. [PMID: 31503384 PMCID: PMC6982538 DOI: 10.1111/add.14812] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [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: 03/21/2019] [Revised: 05/13/2019] [Accepted: 09/02/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Due to their small sample sizes, geographic specificity and limited examination of socio-demographic characteristics, recent studies of methamphetamine use among people using heroin in the United States are limited in their ability to identify national and regional trends and to characterize populations at risk for using heroin and methamphetamine. This study aimed to examine trends and correlates of methamphetamine use among heroin treatment admissions in the United States. DESIGN Longitudinal analysis of data from the 2008 to 2017 Treatment Episode Data Set. Descriptive statistics, trend analyses and multivariable logistic regression were used to examine characteristics associated with methamphetamine use among heroin treatment admissions. SETTING United States. PARTICIPANTS Treatment admissions of people aged ≥ 12 years whose primary substance of use is heroin. MEASUREMENTS Primary measurement was heroin treatment admissions involving methamphetamine. Secondary measurements were demographics of sex, age, race/ethnicity, US census region, living arrangement and employment status. FINDINGS The percentage of primary heroin treatment admissions reporting methamphetamine use increased each year from 2.1% in 2008 to 12.4% in 2017, a relative percentage increase of 490% and an annual percentage change (APC) of 23.4% (P < 0.001). During the study period, increases were seen among males and females and among all demographic and geographic groups examined. Among primary heroin treatment admissions reporting methamphetamine use in 2017, 47.1% reported injecting, 46.0% reported smoking, 5.1% reporting snorting and 1.8% reported oral/other as their usual route of methamphetamine use. CONCLUSIONS Methamphetamine use among heroin treatment admissions in the United States increased from one in 50 primary heroin treatment admissions in 2008 to one in 8 admissions in 2017.
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Affiliation(s)
- Christopher M. Jones
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natasha Underwood
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
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Jones CM, Warner M, Hedegaard H, Compton W. Data quality considerations when using county-level opioid overdose death rates to inform policy and practice. Drug Alcohol Depend 2019; 204:107549. [PMID: 31518886 PMCID: PMC9190240 DOI: 10.1016/j.drugalcdep.2019.107549] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 07/27/2019] [Accepted: 08/02/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Margaret Warner
- National Center for Health Statistics, Centers for Disease Control
and Prevention, Hyattsville, MD, United States
| | - Holly Hedegaard
- National Center for Health Statistics, Centers for Disease Control
and Prevention, Hyattsville, MD, United States
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health,
Rockville, MD, United States
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Jones CM, Compton W, Vythilingam M, Giroir B. Naloxone Co-prescribing to Patients Receiving Prescription Opioids in the Medicare Part D Program, United States, 2016-2017. JAMA 2019; 322:462-464. [PMID: 31386124 PMCID: PMC6686765 DOI: 10.1001/jama.2019.7988] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study uses Medicare Part D data to compare US national and state rates of co-prescribing of naloxone with opioids and benzodiazepines in 2016-2017.
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Affiliation(s)
| | | | | | - Brett Giroir
- US Department of Health and Human Services, Washington, DC
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12
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Abstract
PURPOSE OF REVIEW In light of the current crisis in opioid involved overdose deaths, the federal Department of Health and Human Services operating divisions are working together to implement a data-driven, research-based strategy to reduce opioid misuse and its consequences. RECENT FINDINGS The strategy has five elements: (1) strengthening public health data collection and reporting; (2) advancing the practice of pain management; (3) improving access to addiction prevention, treatment, and recovery support services; (4) increasing availability of overdose-reversing drugs; and (5) supporting cutting-edge research in treatment of pain, opioid use disorder, and associated conditions. The Department of Health and Human Services has developed a concerted, coordinated evidence-based effort across department divisions to reduce opioid misuse, prevalence of opioid use disorder, and reduce deaths due to opioid use.
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Affiliation(s)
- Kimberly Johnson
- Substance Abuse Mental Health Services Administration (SAMHSA), Rockville, MD, USA.
- University of South Florida, Tampa, Florida, USA.
| | - Chris Jones
- Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, DC, USA
| | | | - Grant Baldwin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer Fan
- Substance Abuse Mental Health Services Administration (SAMHSA), Rockville, MD, USA
| | - Jonathan Mermin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jean Bennett
- Substance Abuse Mental Health Services Administration (SAMHSA), Rockville, MD, USA
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13
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Chou SP, Saha TD, Zhang H, Ruan WJ, Huang B, Grant BF, Blanco C, Compton W. Prevalence, correlates, comorbidity and treatment of electronic nicotine delivery system use in the United States. Drug Alcohol Depend 2017; 178:296-301. [PMID: 28686988 DOI: 10.1016/j.drugalcdep.2017.05.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 07/27/2016] [Revised: 05/15/2017] [Accepted: 05/17/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION This study presents nationally representative data on the prevalence, correlates, psychiatric comorbidity and treatment (including pharmacological and nonpharmacological) among electronic nicotine delivery system (ENDS) users. METHODS Face-to-face interviews in the National Epidemiologic Survey on Alcohol and Related Conditions-III. RESULTS Prevalences of 12-month and lifetime ENDS use were 3.8% (SE=0.14) and 5.4% (SE=0.17). Odds of ENDS use were greater among men than women, regardless of timeframe. Rates were lower among Blacks, Hispanics and Asians/Pacific Islanders relative to Whites. Odds of 12-month and lifetime ENDS use was also higher among younger (<65years) than older (≥65years) individuals and higher among individuals with high school education relative to these with some college education. Odds of 12-month and lifetime ENDS use was also higher among individuals with incomes <$70,000.00 compared with those with incomes≥$70,000.00 and higher among the previously married relative to those who were currently married. Associations between 12-month ENDS use and severe nicotine use disorder were strong, whereas associations with other substance use disorders and borderline and antisocial personality disorders were modest (AORs=1.3-2.6). Rates of treatment seeking to cut down or quit tobacco or nicotine use (12-month, 25.0% (SE=1.6); lifetime, 24.4% (SE=1.4)) were low. CONCLUSIONS ENDS use is substantially comorbid, especially with nicotine use disorder. Virtually all ENDS users smoked cigarettes. Research is needed to understand their role in smoking cessation, adverse effects on bodily systems and their potential for addiction and comorbidity.
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Affiliation(s)
- S Patricia Chou
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3071, Rockville, MD, 20852, United States.
| | - Tulshi D Saha
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3071, Rockville, MD, 20852, United States.
| | - Haitao Zhang
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3071, Rockville, MD, 20852, United States.
| | - W June Ruan
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3071, Rockville, MD, 20852, United States.
| | - Boji Huang
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3071, Rockville, MD, 20852, United States.
| | - Bridget F Grant
- Epidemiology and Biometry Branch, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3071, Rockville, MD, 20852, United States.
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, 6001 Executive Boulevard, Rockville, MD, 20852, United States.
| | - Wilson Compton
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, 6001 Executive Boulevard, Rockville, MD, 20852, United States.
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Shi Y, Pierce JP, White M, Vijayaraghavan M, Compton W, Conway K, Hartman AM, Messer K. E-cigarette use and smoking reduction or cessation in the 2010/2011 TUS-CPS longitudinal cohort. BMC Public Health 2016; 16:1105. [PMID: 27769302 PMCID: PMC5073733 DOI: 10.1186/s12889-016-3770-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 01/21/2016] [Accepted: 10/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background Electronic cigarettes (e-cigarettes) are heavily marketed and widely perceived as helpful for quitting or reducing smoking intensity. We test whether ever-use of e-cigarettes among early adopters was associated with: 1) increased cigarette smoking cessation; and 2) reduced cigarette consumption. Methods A representative cohort of U.S. smokers (N = 2454) from the 2010 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) was re-interviewed 1 year later. Outcomes were smoking cessation for 30+ days and change in cigarette consumption at follow-up. E-cigarettes use was categorized as for cessation purposes or for another reason. Multivariate regression was used to adjust for demographics and baseline cigarette dependence level. Results In 2011, an estimated 12 % of adult U.S. smokers had ever used e-cigarettes, and 41 % of these reported use to help quit smoking. Smokers who had used e-cigarettes for cessation were less likely to be quit for 30+ days at follow-up, compared to never-users who tried to quit (11.1 % vs 21.6 %; ORadj = 0.44, 95 % CI = 0.2–0.8). Among heavier smokers at baseline (15+ cigarettes per day (CPD)), ever-use of e-cigarettes was not associated with change in smoking consumption. Lighter smokers (<15 CPD) who had ever used e-cigarettes for quitting had stable consumption, while increased consumption was observed among all other lighter smokers, although this difference was not statistically significant. Conclusions Among early adopters, ever-use of first generation e-cigarettes to aid quitting cigarette smoking was not associated with improved cessation or with reduced consumption, even among heavier smokers.
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Affiliation(s)
- Yuyan Shi
- Cancer Prevention and Control Program, Moores UC San Diego Cancer Center, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA.,Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0628, La Jolla, CA, 92093-0628, USA
| | - John P Pierce
- Cancer Prevention and Control Program, Moores UC San Diego Cancer Center, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA.,Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0628, La Jolla, CA, 92093-0628, USA
| | - Martha White
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0628, La Jolla, CA, 92093-0628, USA
| | - Maya Vijayaraghavan
- Division of General Internal Medicine/San Francisco General Hospital, University of California, San Francisco, 1545 Divisadero St, San Francisco, CA, 94115, USA
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Bethesda, MD, 20892-9589, USA
| | - Kevin Conway
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Bethesda, MD, 20892-9589, USA
| | - Anne M Hartman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA
| | - Karen Messer
- Cancer Prevention and Control Program, Moores UC San Diego Cancer Center, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA. .,Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0628, La Jolla, CA, 92093-0628, USA.
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16
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Brooks-Russell A, Conway KP, Liu D, Xie Y, Vullo GC, Li K, Iannotti RJ, Compton W, Simons-Morton B. Dynamic Patterns of Adolescent Substance Use: Results From a Nationally Representative Sample of High School Students. J Stud Alcohol Drugs 2016; 76:962-70. [PMID: 26562606 DOI: 10.15288/jsad.2015.76.962] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Use of tobacco, alcohol, marijuana, and other drugs increases during the high school years, yet little is known about individual patterns over time, particularly patterns of contemporaneous multiple-substance use. This study examined trajectories of contemporaneous substance use and how individual and social factors differentially predict patterns of substance use. METHOD Longitudinal trajectories of substance use were examined in a nationally representative sample of students (N = 2,512) over a 3-year period (10th through 12th grades) using latent class analysis. Individual, parental, and peer risk factors in 10th grade were examined in relation to membership in trajectory classes. RESULT A five-class model was identified: nonusers (45.5%); tobacco, alcohol, and other drug users (9.2%); alcohol and other drug users (9.2%); increasing multiple-substance users (16.7%); and decreasing multiple-substance users (19.4%). Depressive symptoms at baseline were associated with a higher likelihood of membership in all classes except the increasing multiple-substance-user class, but the association becomes insignificant when social influence factors were adjusted. Parental-monitoring knowledge was associated with a lower likelihood of membership in all classes except increasing multiple-substance-user class, whereas perceived parental disapproval was associated with a lower likelihood of membership in the tobacco, alcohol, and other drug user class. Peer substance use was associated with a higher likelihood of membership in each of the substance use classes. CONCLUSIONS The identified longitudinal profiles highlight the pervasiveness and dynamic patterns of contemporaneous multiple-substance use during 10th through 12th grades. Negative peer influence increased risk, whereas positive parenting behaviors decreased risk. The findings are consistent with the need to foster social influences and protective factors against adolescent substance use.
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Affiliation(s)
- Ashley Brooks-Russell
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kevin P Conway
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Danping Liu
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Yunlong Xie
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.,Glotech, Inc., Bethesda, Maryland
| | - Genevieve C Vullo
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.,Kelly Government Solutions, Bethesda, Maryland
| | - Kaigang Li
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Ronald J Iannotti
- College of Nursing and Health Sciences, University of Massachusetts, Boston, Massachusetts
| | - Wilson Compton
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Bruce Simons-Morton
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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17
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Thomas D, Frascella J, Hall T, Smith W, Compton W, Koroshetz W, Briggs J, Grady P, Somerman M, Volkow N. Reflections on the role of opioids in the treatment of chronic pain: a shared solution for prescription opioid abuse and pain. J Intern Med 2015; 278:92-4. [PMID: 25556772 PMCID: PMC4964933 DOI: 10.1111/joim.12345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D Thomas
- Division of Clinical Neuroscience and Behavioral Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - J Frascella
- Division of Clinical Neuroscience and Behavioral Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - T Hall
- Division of Clinical Neuroscience and Behavioral Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - W Smith
- Office of Behavior and Social Sciences Research, National Institutes of Health, Bethesda, MD, USA
| | - W Compton
- Office of the Director, National Institute on Drug Abuse, Bethesda, MD, USA
| | - W Koroshetz
- Office of the Director, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - J Briggs
- Office of the Director, National Center for Complementary and Integrative Health, Bethesda, MD, USA
| | - P Grady
- Office of the Director, National Institute of Nursing Research, Bethesda, MD, USA
| | - M Somerman
- Office of the Director, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA
| | - N Volkow
- Office of the Director, National Institute on Drug Abuse, Bethesda, MD, USA
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18
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Valdiserri R, Khalsa J, Dan C, Holmberg S, Zibbell J, Holtzman D, Lubran R, Compton W. Confronting the emerging epidemic of HCV infection among young injection drug users. Am J Public Health 2014; 104:816-21. [PMID: 24625174 DOI: 10.2105/ajph.2013.301812] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hepatitis C virus infection is a significant public health problem in the United States and an important cause of morbidity and mortality. Recent reports document HCV infection increases among young injection drug users in several US regions, associated with America's prescription opioid abuse epidemic. Incident HCV infection increases among young injectors who have recently transitioned from oral opioid abuse present an important public health challenge requiring a comprehensive, community-based response. We summarize recommendations from a 2013 Office of HIV/AIDS and Infectious Disease Policy convening of experts in epidemiology, behavioral science, drug prevention and treatment, and other research; community service providers; and federal, state, and local government representatives. Their observations highlight gaps in our surveillance, program, and research portfolios and advocate a syndemic approach to this emerging public health problem.
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Affiliation(s)
- Ronald Valdiserri
- Ronald Valdiserri and Corinna Dan are with the Office of HIV/AIDS and Infectious Disease Policy, US Department of Health and Human Services, Washington, DC. Jag Khalsa and Wilson Compton are with the National Institute on Drug Abuse, Bethesda, MD. Robert Lubran is with the Substance Abuse and Mental Health Services Administration, Rockville, MD. Scott Holmberg, Jon Zibbell, and Deborah Holtzman are with the Centers for Disease Control and Prevention, Atlanta, GA
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21
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Abstract
We examined the use of Kratom (Mitragyna sp.), a dietary supplement with mu-opioid agonist activity, by members of a cybercommunity who self-treat chronic pain with opioid analgesics from Internet pharmacies. Within one year, an increase in the number of mentions on Drugbuyers.com, a Web site that facilitates the online purchase of opioid analgesics, suggested that members began managing opioid withdrawal with Kratom. This study demonstrates the rapidity with which information on psychoactive substances disseminates through online communities and suggests that online surveillance may be important to the generation of effective opioid analgesic abuse prevention strategies.
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Affiliation(s)
- Edward W Boyer
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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22
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Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2006; 67:247-57. [PMID: 16566620 DOI: 10.4088/jcp.v67n0211] [Citation(s) in RCA: 594] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To present nationally representative data on the lifetime prevalence and comorbidity of 8 specific drug use disorders, separately for abuse and dependence, and mood and anxiety disorders. METHOD Data come from a representative sample (N=43,093) of the United States civilian, noninstitutional population 18 years and older. Diagnoses of mood, anxiety, and drug use disorders were based upon face-to-face personal interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV). RESULTS Associations between specific mood and anxiety disorders and specific drug use disorders were virtually all positive and statistically significant (p<.05). In general, associations were greater for dependence than abuse, greater for mood than anxiety disorders, and in some instances stronger among women than men (p<.05). Large odds ratios also were observed for individuals with comorbid mood and anxiety disorders. CONCLUSION The comorbidity between specific mood and anxiety disorders and specific drug use disorders is pervasive in the U.S. population. Findings suggest that comorbid psychiatric disorders may increase the risk of greater involvement in more serious illicit drug use disorders and that the greater comorbidity between mood and anxiety and drug use disorders among women may reflect greater deviance and psychopathology among drug-using women than men. Findings also suggest that drug abuse prevention and intervention efforts should address other psychiatric conditions. Further, definitions of drug use disorder phenotypes should give careful consideration to other psychiatric conditions as meaningful characteristics of case heterogeneity.
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Affiliation(s)
- Kevin P Conway
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-9304, USA
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Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, Pickering RP, Kaplan K. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. ACTA ACUST UNITED AC 2004; 61:807-16. [PMID: 15289279 DOI: 10.1001/archpsyc.61.8.807] [Citation(s) in RCA: 1873] [Impact Index Per Article: 93.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. OBJECTIVE To present nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). DESIGN Face-to-face survey. SETTING The United States. PARTICIPANTS Household and group quarters' residents. MAIN OUTCOME MEASURES Prevalence and associations of substance use disorders and independent mood and anxiety disorders. RESULTS The prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant (P<.05). CONCLUSIONS Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.
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Affiliation(s)
- Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA.
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Affiliation(s)
- Shakeh Kaftarian
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland 20892-9589, USA.
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Cheng AT, Tien AY, Chang CJ, Brugha TS, Cooper JE, Lee CS, Compton W, Liu CY, Yu WY, Chen HM. Cross-cultural implementation of a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) in Taiwan. Br J Psychiatry 2001; 178:567-72. [PMID: 11388976 DOI: 10.1192/bjp.178.6.567] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are no published reports of cross-cultural equivalence and interrater reliability at the level of individual symptom items assessed by a semi-structured clinical interview employing operationalised clinician ratings. AIMS To assess the cross-cultural clinical equivalence and reliability of a Chinese version of the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN). METHOD UK-US and Taiwanese groups of psychiatrists used Chinese and English transcripts of videotape interviews of Taiwanese patients to discuss cross-cultural issues and ratings of SCAN items. Item ratings were compared quantitatively individually and pooled by SCAN section. RESULTS Chinese equivalents were found for all SCAN items. No between-group differences were found for most individual items, but there were differences for some scaled items. Average agreement between the two groups was 69-100%. CONCLUSIONS Cross-cultural implementation based on SCAN in Taiwan appears valid.
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Affiliation(s)
- A T Cheng
- Division of Epidemiology, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
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Stiffman AR, Horwitz SM, Hoagwood K, Compton W, Cottler L, Bean DL, Narrow WE, Weisz JR. The Service Assessment for Children and Adolescents (SACA): adult and child reports. J Am Acad Child Adolesc Psychiatry 2000; 39:1032-9. [PMID: 10939232 DOI: 10.1097/00004583-200008000-00019] [Citation(s) in RCA: 138] [Impact Index Per Article: 5.8] [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: 11/25/2022]
Abstract
OBJECTIVE To describe differences in parent-child responses to the Service Assessment for Children and Adolescents (SACA). METHOD Studies were done at UCLA and Washington University based on service-using and community subjects drawn from community households or public school student lists, respectively. Results are presented for 145 adult-youth pairs in which the youth was 11 or older. RESULTS The SACA adult-youth correspondence for lifetime use of any services, inpatient services, outpatient services, and school services ranged from fair to excellent (kappa = 0.43-0.86, with most at 0.61 or greater). Similarly, the SACA showed a good to excellent correspondence for services that had been used in the preceding year (kappa = 0.45-0.77, with most greater than 0.50). The parent-youth correspondence for use of specific service settings in the above generic categories ranged from poor to excellent (kappa = 0.25-0.83, with half at 0.50 or greater). CONCLUSIONS The SACA has better adult-youth correspondence than any service use questionnaire with published data, indicating that both adult and youth reports are not needed for all research on mental health services. This is especially encouraging news for researchers working with high-risk youth populations, in which a parent figure is often not available.
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Affiliation(s)
- A R Stiffman
- George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA.
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Abstract
Cross cultural research on substance use disorders (SUD) demands diagnostic measures and criteria that apply equally well to persons of different ethnic backgrounds. To evaluate the reliability of SUD in different ethnic groups, comparisons were made of the one week test/retest agreement on DSM-IV lifetime dependence disorders for 196 African-American (AA) and 107 Caucasian (C) respondents using the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Overall we found excellent reliability, using kappa (k) statistics, in diagnosing both AA and C respondents with alcohol dependence (AA k = 0.78; C k = 0.80) and opiate dependence (AA k = 0.77; C k = 0.71), good reliability for diagnosing both AA respondents (k = 0.63) and C respondents with cocaine dependence (k = 0.67), and to good reliability for both AA and C respondents with cannabis dependence (AA k = 0.50; C k = 0.69). Reliability of the dependence/abuse criteria was consistent with the overall diagnostic reliability but some variation was noted. No significant differences in the kappas were found between the two ethnic groups for any of the substance dependence diagnoses, and only one dependence or abuse criterion (continued use of cocaine despite physical/psychological problems) differed significantly between AA and C respondents. These initial results indicate that DSM-IV dependence diagnoses as measured by the CIDI-SAM apply equally well to AA and C respondents.
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Affiliation(s)
- J Horton
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63108, USA
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Abstract
BACKGROUND Somatisation is a common and frustrating clinical problem in primary care. METHOD Using structural diagnoses and functional measures, we examined the prevalence and associated features of somatisation disorder defined by three current nosologies and an abridged construct in subjects using primary care services. RESULTS Somatisation disorder, diagnosed according to the standard criteria, was found to have a very low prevalence (range 0.06-0.5%), while more than one-fifth of the sample (22%) met the criteria for the abridged diagnosis. There was poor agreement between succeeding versions of the DSM system for identifying cases of somatisation disorder, each system ending up with rather disparate sets of individuals as well as variable levels of psychopathology and disability. CONCLUSIONS According to these data, standard somatisation disorder diagnoses add little to the prediction of disability/psychopathology beyond the contributions of an abridged construct of somatisation.
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Affiliation(s)
- J I Escobar
- Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, Piscataway 08854-5635, USA
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Abstract
The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impaired in their physical functioning than patients without the disorder. Of the various psychopathologies examined, major depressive syndromes were the most frequent among patients with hypochondriasis. Interestingly, unlike somatization disorder, hypochondriasis was not related to any demographic factor. Hypochondriasis is a relatively rare condition in primary care that is largely separable from somatization disorder but seems closely intertwined with the more severe depressive syndromes.
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Affiliation(s)
- J I Escobar
- Department of Psychiatry, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway 08854-5635, USA
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Ustün B, Compton W, Mager D, Babor T, Baiyewu O, Chatterji S, Cottler L, Göğüş A, Mavreas V, Peters L, Pull C, Saunders J, Smeets R, Stipec MR, Vrasti R, Hasin D, Room R, Van den Brink W, Regier D, Blaine J, Grant BF, Sartorius N. WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results. Drug Alcohol Depend 1997; 47:161-9. [PMID: 9306042 DOI: 10.1016/s0376-8716(97)00087-2] [Citation(s) in RCA: 211] [Impact Index Per Article: 7.8] [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: 02/05/2023]
Abstract
The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments in an international study which has taken place in centres in ten countries, aiming to test the reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, kappa) were very good for dependence disorders (0.7-0.9), but were somewhat lower for the abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures.
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Affiliation(s)
- B Ustün
- Unit on Epidemiology, Classification and Assessment, World Health Organization, Geneva, Switzerland
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North CS, Hansen K, Wetzel RD, Compton W, Napier M, Spitznagel EL. Nonpsychotic thought disorder: objective clinical identification of somatization and antisocial personality in language patterns. Compr Psychiatry 1997; 38:171-8. [PMID: 9154374 DOI: 10.1016/s0010-440x(97)90071-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This report describes a new method of using language patterns to identify somatization and antisocial personality (ASPD) disorders in clinical practice. A set of definitions describing characteristic speech patterns was developed to identify "nonpsychotic thought disorder" (NPTD). Speech patterns of subjects with somatization disorder and/or ASPD were compared with those of controls. Blind raters assessed audiotaped samples of speech obtained through open-ended interviews for instances of elements of NPTD. Women with somatization or ASPD had significantly more NPTD speech responses than controls, and women with both disorders showed the greatest amount. Antisocial men did not demonstrate more NPTD than controls, nor was somatization in men associated with NPTD. Clinical attention to speech patterns in patients may help alert clinicians to these disorders in women and serve as indicators for screening for these disorders. More study is needed to develop psychometric properties of the instruments on larger samples, and to identify speech indicators of personality disorder in men. It is likely that other personality disorders, e.g., borderline personality disorder, can be identified through speech patterns, and they deserve study with these methods.
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Affiliation(s)
- C S North
- Department of Psychiatry, Washington University, St Louis, MO 63110, USA
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Abstract
To replicate prior descriptions of injection drug users (IDUs), 158 IDUs recruited via a street-outreach program were compared to 320 non-IDUs on measures of substance use, lifetime psychopathology, and HIV risk behavior. IDUs were more likely to receive a diagnosis of antisocial personality disorder, but not other psychiatric diagnoses, and to report dependence on multiple substances. IDUs reported more HIV risk behaviors, but perceived HIV risk did not differ from non-IDUs. Compared to IDUs who declined treatment, IDUs willing to accept treatment did not differ on drug-related problems, lifetime psychopathology, or perceived HIV risk.
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Affiliation(s)
- S H Dinwiddie
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO 63110-1093, USA
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Compton W. The Trade Institutes and Code Authorities. J Am Stat Assoc 1934. [DOI: 10.1080/01621459.1934.10506248] [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] [Indexed: 10/28/2022]
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Compton W. The Trade Institutes and Code Authorities. J Am Stat Assoc 1934. [DOI: 10.2307/2277828] [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] [Indexed: 11/10/2022]
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