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Article ; Online: Partner incarceration, maternal substance use, and the mediating role of social support: A longitudinal analysis using the future of families and child wellbeing study.

Marziali, Megan E / Prins, Seth J / Gutkind, Sarah / Martins, Silvia S

Social science & medicine (1982)

2024 Volume 349, Page(s) 116896

Abstract: Introduction: The United States is responsible for the highest incarceration rate globally. This study aimed to explore the impact of partner incarceration on maternal substance use and whether social support mediates the relationship between partner ... ...

Abstract	Introduction: The United States is responsible for the highest incarceration rate globally. This study aimed to explore the impact of partner incarceration on maternal substance use and whether social support mediates the relationship between partner incarceration and maternal substance use. Methods: Using data from the Future of Families and Child Wellbeing Study, a longitudinal cohort following new parents and children, this analysis quantifies the relationship between paternal incarceration and maternal substance use (N = 2823). We analyzed maternal responses in years 3 (2001-2003), 5 (2003-2006), 9 (2007-2010), and 15 (2014-2017). We explored the role of financial support and emergency social support as potential mediators. Confirmatory factor analysis (CFA) was employed to construct support-related mediators. We modeled the impact of partner incarceration and maternal substance use using generalized estimating equations (GEE) to account for repeated measures, adjusting for appropriate confounders (age of mother at child's birth, race, education, employment, and history of intimate partner violence). Results: Nearly half (44.2%, N = 1247) of participants reported partner incarceration. Among mothers who experienced partner incarceration, the odds of reporting substance use were 110% greater than those who reported no partner incarceration (adjusted Odds Ratio [aOR]: 2.10; 95% Confidence Interval (CI):1.67-2.63). Financial support at year 5 accounted for 19.5% (95% CI: 6.03-33.06%) of the association between partner incarceration at year 3 and substance use at year 9; emergency social support at year 5 accounted for 6.4% (95% CI: 0.51-12.25%) of the association between partner incarceration and substance use at year 9. Neither financial nor emergency social support at year 9 were significant mediators between partner incarceration at year 3 and substance use at year 15. Conclusions: These findings demonstrate that partner incarceration impacts maternal substance use. Financial and emergency support may partially mediate this relationship in the short term, which has important implications for families disrupted by mass incarceration.
Language	English
Publishing date	2024-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	4766-1
ISSN	1873-5347 ; 0037-7856 ; 0277-9536
ISSN (online)	1873-5347
ISSN	0037-7856 ; 0277-9536
DOI	10.1016/j.socscimed.2024.116896
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Article ; Online: Sex differences in Cannabis use disorder and associated psychosocial problems among US adults, 2012-2013.

Gutkind, Sarah / Shmulewitz, Dvora / Hasin, Deborah

Preventive medicine

2023 Volume 168, Page(s) 107422

Abstract: While men show greater prevalence of cannabis use disorder (CUD) than women, whether cannabis use frequency drives this difference is unknown, and little is known about sex differences in problems associated with CUD. We therefore assessed the ... ...

Abstract	While men show greater prevalence of cannabis use disorder (CUD) than women, whether cannabis use frequency drives this difference is unknown, and little is known about sex differences in problems associated with CUD. We therefore assessed the association of CUD with sex, adjusted for frequency of use, and compared the association of psychosocial and health-related problems with CUD between men and women. We included US adults age ≥ 18 who reported past-year cannabis use in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 3701). Cannabis use frequency, DSM-5 CUD and problems (interpersonal, financial, legal, health-related) were assessed. Associations between psychosocial problems, sex and DSM-5 CUD were assessed using prevalence differences (PD) and 95% confidence intervals (CI) from logistic regression models, controlling for demographics and cannabis use frequency, and effect modification by sex was assessed. We found that the prevalence of CUD among men versus women was not significantly greater after adjusting for use frequency. Women had significantly higher prevalence of interpersonal, financial and health-related problems than men, adjusting for frequency of use. Women showed significantly greater association of CUD with interpersonal problems with a boss or co-workers (p < 0.05) and a neighbor, relative or friend (p < 0.05) compared to men. Lack of sex differences in CUD after adjusting for frequency of use suggests use frequency may be an important target of CUD prevention efforts. CUD showed stronger associations for interpersonal problems among women than men, suggesting the need for particular emphasis on treating interpersonal problems related to cannabis use among women.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Marijuana Abuse/epidemiology ; Sex Characteristics ; Substance-Related Disorders/complications ; Cannabis ; Prevalence
Language	English
Publishing date	2023-01-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2023.107422
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Zs.A 878: Show issues

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Article ; Online: Use of Medication for Opioid Use Disorder Among US Adolescents and Adults With Need for Opioid Treatment, 2019.

Mauro, Pia M / Gutkind, Sarah / Annunziato, Erin M / Samples, Hillary

JAMA network open

2022 Volume 5, Issue 3, Page(s) e223821

Abstract: Importance: Medication for opioid use disorder (MOUD) is the criterion standard treatment for opioid use disorder (OUD), but nationally representative studies of MOUD use in the US are lacking.: Objective: To estimate MOUD use rates and identify ... ...

Abstract	Importance: Medication for opioid use disorder (MOUD) is the criterion standard treatment for opioid use disorder (OUD), but nationally representative studies of MOUD use in the US are lacking. Objective: To estimate MOUD use rates and identify associations between MOUD and individual characteristics among people who may have needed treatment for OUD. Design, setting, and participants: Cross-sectional, nationally representative study using the 2019 National Survey on Drug Use and Health in the US. Participants included community-based, noninstitutionalized adolescent and adult respondents identified as individuals who may benefit from MOUD, defined as (1) meeting criteria for a past-year OUD, (2) reporting past-year MOUD use, or (3) receiving past-year specialty treatment for opioid use in the last or current treatment episode. Main outcomes and measures: The main outcomes were treatment with MOUD compared with non-MOUD services and no treatment. Associations with sociodemographic characteristics (eg, age, race and ethnicity, sex, income, and urbanicity); substance use disorders; and past-year health care or criminal legal system contacts were analyzed. Multinomial logistic regression was used to compare characteristics of people receiving MOUD with those receiving non-MOUD services or no treatment. Models accounted for predisposing, enabling, and need characteristics. Results: In the weighted sample of 2 206 169 people who may have needed OUD treatment (55.5% male; 8.0% Hispanic; 9.9% non-Hispanic Black; 74.6% non-Hispanic White; and 7.5% categorized as non-Hispanic other, with other including 2.7% Asian, 0.9% Native American or Alaska Native, 0.2% Native Hawaiian or Pacific Islander, and 3.8% multiracial), 55.1% were aged 35 years or older, 53.7% were publicly insured, 52.2% lived in a large metropolitan area, 56.8% had past-year prescription OUD, and 80.0% had 1 or more co-occurring substance use disorders (percentages are weighted). Only 27.8% of people needing OUD treatment received MOUD in the past year. Notably, no adolescents (aged 12-17 years) and only 13.2% of adults 50 years and older reported past-year MOUD use. Among adults, the likelihood of past-year MOUD receipt vs no treatment was lower for people aged 50 years and older vs 18 to 25 years (adjusted relative risk ratio [aRRR], 0.14; 95% CI, 0.05-0.41) or with middle or higher income (eg, $50 000-$74 999 vs $0-$19 999; aRRR, 0.18; 95% CI, 0.07-0.44). Compared with receiving non-MOUD services, receipt of MOUD was more likely among adults with at least some college (vs high school or less; aRRR, 2.94; 95% CI, 1.33-6.51) and less likely in small metropolitan areas (vs large metropolitan areas, aRRR, 0.41; 95% CI, 0.19-0.93). While contacts with the health care system (85.0%) and criminal legal system (60.5%) were common, most people encountering these systems did not report receiving MOUD (29.5% and 39.1%, respectively). Conclusions and relevance: In this cross-sectional study, MOUD uptake was low among people who could have benefited from treatment, especially adolescents and older adults. The high prevalence of health care and criminal legal system contacts suggests that there are critical gaps in care delivery or linkage and that cross-system integrated interventions are warranted.
MeSH term(s)	Adolescent ; Aged ; Analgesics, Opioid/therapeutic use ; Buprenorphine/therapeutic use ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Opiate Substitution Treatment ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/epidemiology
Chemical Substances	Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ)
Language	English
Publishing date	2022-03-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.3821
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Article ; Online: Prospective effects of loneliness on frequency of alcohol and marijuana use.

Gutkind, Sarah / Gorfinkel, Lauren R / Hasin, Deborah S

Addictive behaviors

2021 Volume 124, Page(s) 107115

Abstract: Background: Loneliness is a widespread problem, with demonstrated negative health effects. However, prospective data on the relationship between loneliness and problematic substance use are lacking, and few studies have examined specific commonplace ... ...

Abstract	Background: Loneliness is a widespread problem, with demonstrated negative health effects. However, prospective data on the relationship between loneliness and problematic substance use are lacking, and few studies have examined specific commonplace substances, such as alcohol and cannabis. This study used prospective data from a community sample of US adults with problematic alcohol or cannabis use to examine whether loneliness was a predictor of subsequent increased substance use. Methods: Participants (N = 210) were recruited between 05/2016-06/2019 from a New York City medical center. At baseline, 3-month, and 6-month follow-ups, participants completed identical computerized questionnaires. We used generalized estimating equations to assess the average effect of past 2-week loneliness on subsequent number of days of alcohol or cannabis use, controlling for baseline days of use, demographic characteristics, and past 2-week DSM-5 depression. Results: Compared with individuals who were never lonely, participants with moderate or severe loneliness had a significantly higher frequency of alcohol or cannabis use at the subsequent assessment (β = 0.25 95% CI: 0.08-0.42). Conclusion: Individuals experiencing loneliness at least a few times in the past 2 weeks reported more days of subsequent alcohol or cannabis use compared with individuals who were not lonely. This is cause for concern, as national surveys of US adults indicate increasing rates of loneliness, depression and substance use during the COVID-19 pandemic. These results suggest the need for health care providers to screen for feelings of loneliness and potentially harmful coping behaviors such as substance use, and to offer healthier alternative coping strategies.
MeSH term(s)	Adult ; COVID-19 ; Humans ; Loneliness ; Marijuana Use/epidemiology ; Pandemics ; SARS-CoV-2 ; Substance-Related Disorders
Language	English
Publishing date	2021-09-17
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	197618-7
ISSN	1873-6327 ; 0306-4603
ISSN (online)	1873-6327
ISSN	0306-4603
DOI	10.1016/j.addbeh.2021.107115
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Article ; Online: Associations between relative deprivation with opioid use among working-age adults during the great recession.

Gutkind, Sarah / Askari, Melanie S / Perlmutter, Alexander S / Nesoff, Elizabeth D / Mauro, Pia M / Martins, Silvia S

Journal of psychiatric research

2023 Volume 160, Page(s) 101–109

Abstract: Recessions, poverty, and unemployment have been associated with opioid use. However, these measures of financial hardship may be imprecise, limiting our ability to understand this relationship. We tested associations between relative deprivation and non- ... ...

Abstract	Recessions, poverty, and unemployment have been associated with opioid use. However, these measures of financial hardship may be imprecise, limiting our ability to understand this relationship. We tested associations between relative deprivation and non-medical prescription opioid use (NMPOU) and heroin use among working-age adults (ages 18-64) during the Great Recession. Our sample included working-age adults in the 2005-2013 United States National Survey of Drug Use and Health (n = 320,186). Relative deprivation compared the lowest limit of participants' income category to the national 25th percentile individual income for people with similar socio-demographic characteristics (race and ethnicity, gender, year). We distinguished the period before (1/2005-11/2007), during (12/2007-06/2009), and after (07/2007-12/2013) the Great Recession. We estimated odds of past-year NMPOU and heroin use for each past-year exposure (i.e., relative deprivation, poverty, unemployment) using separate logistic regressions adjusting for individual-level covariates (gender, age, race/ethnicity, marital status, and education) and national-level annual Gini coefficient. Our results show that NMPOU was higher among people experiencing relative deprivation (aOR = 1.13, 95% CI = 1.06-1.20), poverty (aOR = 1.22, 95% CI = 1.16-1.29), and unemployment (aOR = 1.42, 95% CI = 1.32-1.53) between 2005 and 2013, as was heroin use (aORs = 2.54, 2.09, 3.55, respectively). The association between relative deprivation and NMPOU was modified by recession timing, and was significantly higher after the Recession (aOR = 1.21, 95% CI = 1.11-1.33). Relative deprivation was associated with higher odds of NMPOU and heroin use, and higher odds of NMPOU after the Great Recession. Our findings suggest contextual-level factors may modify the relationship between relative deprivation and opioid use, and support the need for new measures of financial hardship.
MeSH term(s)	Humans ; Adult ; United States ; Adolescent ; Young Adult ; Middle Aged ; Analgesics, Opioid ; Heroin ; Opioid-Related Disorders ; Educational Status ; Logistic Models
Chemical Substances	Analgesics, Opioid ; Heroin (70D95007SX)
Language	English
Publishing date	2023-02-08
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2023.02.010
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Article ; Online: Economic Cost of the HealthCall Smartphone Intervention to Reduce Heavy Alcohol Drinking in Adults With HIV.

Starbird, Laura E / Gutkind, Sarah / Teixeira, Paul / Murphy, Sean / Aharonovich, Efrat / Zingman, Barry S / Hasin, Deborah / Schackman, Bruce R

Journal of studies on alcohol and drugs

2023 Volume 84, Issue 6, Page(s) 814–822

Abstract: Objective: Alcohol use among people living with HIV (PLWH) can reduce adherence and worsen health outcomes. We evaluated the economic cost of an effective smartphone application (HealthCall) to reduce drinking and improve antiretroviral adherence among ... ...

Abstract	Objective: Alcohol use among people living with HIV (PLWH) can reduce adherence and worsen health outcomes. We evaluated the economic cost of an effective smartphone application (HealthCall) to reduce drinking and improve antiretroviral adherence among heavy-drinking PLWH participating in a randomized trial. Method: Participants were randomized to receive a brief drinking-reduction intervention, either (a) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Clinician's Guide (CG-only, Results: Participants attended three intervention visits, and each visit cost on average $29 for CG-only, $32 for CG+HealthCall, and $15 for MI+HealthCall. The total intervention cost per participant was $94 for CG-only, $114 for CG+HealthCall, and $57 for MI+HealthCall; the incremental cost of CG+HealthCall compared with CG-only was $20 per participant, and the incremental savings of MI+HealthCall compared with CG-only was $37 per participant. No significant differences in health care utilization occurred among the three groups over 12 months. Conclusions: The cost of enhancing CG with the HealthCall application for heavy-drinking PLWH was modestly higher than using the CG alone, whereas MI enhanced with HealthCall delivered by a nonclinician had a lower cost than CG alone. HealthCall may be a low-cost enhancement to brief interventions addressing alcohol use and antiretroviral adherence among PLWH.
MeSH term(s)	Humans ; Adult ; Smartphone ; Motivational Interviewing/methods ; Patient Acceptance of Health Care ; Alcohol Drinking ; HIV Infections
Language	English
Publishing date	2023-07-11
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2266450-6
ISSN	1938-4114 ; 1934-2683 ; 1937-1888 ; 0096-882X
ISSN (online)	1938-4114 ; 1934-2683
ISSN	1937-1888 ; 0096-882X
DOI	10.15288/jsad.22-00377
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Article ; Online: Associations between cannabis policies and state-level specialty cannabis use disorder treatment in the United States, 2004-2019.

Mauro, Pia M / Gutkind, Sarah / Askari, Melanie S / Hasin, Deborah S / Samples, Hillary / Mauro, Christine M / Annunziato, Erin M / Boustead, Anne E / Martins, Silvia S

Drug and alcohol dependence

2024 Volume 257, Page(s) 111113

Abstract: Background: Cannabis use disorder (CUD) treatment prevalence decreased in the US between 2002 and 2019, yet structural mechanisms for this decrease are poorly understood. We tested associations between cannabis laws becoming effective and self-reported ... ...

Abstract	Background: Cannabis use disorder (CUD) treatment prevalence decreased in the US between 2002 and 2019, yet structural mechanisms for this decrease are poorly understood. We tested associations between cannabis laws becoming effective and self-reported CUD treatment. Methods: Restricted-use 2004-2019 National Surveys on Drug Use and Health included people ages 12+ classified as needing CUD treatment (i.e., past-year DSM-5-proxy CUD or last/current specialty treatment for cannabis). Time-varying indicators of medical cannabis laws (MCL) with/without cannabis dispensary provisions differentiated state-years before/after laws using effective dates. Multi-level logistic regressions with random state intercepts estimated individual- and state-adjusted CUD treatment odds by MCLs and model-based changes in specialty CUD treatment state-level prevalence. Secondary analyses tested associations between CUD treatment and MCL or recreational cannabis laws (RCL). Results: Using a broad treatment need sample definition in 2004-2014, specialty CUD treatment prevalence decreased by 1.35 (95 % CI = -2.51, -0.18) points after MCL without dispensaries and by 2.15 points (95 % CI = -3.29, -1.00) after MCL with dispensaries provisions became effective, compared to before MCL. Among people with CUD in 2004-2014, specialty treatment decreased only in MCL states with dispensary provisions (aPD = -0.91, 95 % CI = -1.68, -0.13). MCL were not associated with CUD treatment use in 2015-2019. RCL were associated with lower CUD treatment among people classified as needing CUD treatment, but not among people with past-year CUD. Conclusions: Policy-related reductions in specialty CUD treatment were concentrated in states with cannabis dispensary provisions in 2004-2014, but not 2015-2019, and partly driven by reductions among people without past-year CUD. Other mechanisms (e.g., CUD symptom identification, criminal-legal referrals) could contribute to decreasing treatment trends.
MeSH term(s)	Adult ; Humans ; United States/epidemiology ; Cannabis ; Marijuana Abuse/epidemiology ; Marijuana Abuse/therapy ; Marijuana Abuse/diagnosis ; Substance-Related Disorders/drug therapy ; Medical Marijuana/therapeutic use ; Hallucinogens/therapeutic use ; Policy
Chemical Substances	Medical Marijuana ; Hallucinogens
Language	English
Publishing date	2024-02-02
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	519918-9
ISSN	1879-0046 ; 0376-8716
ISSN (online)	1879-0046
ISSN	0376-8716
DOI	10.1016/j.drugalcdep.2024.111113
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Article ; Online: Psychosocial and health problems associated with alcohol use disorder and cannabis use disorder in U.S. adults.

Gutkind, Sarah / Fink, David S / Shmulewitz, Dvora / Stohl, Malka / Hasin, Deborah

Drug and alcohol dependence

2021 Volume 229, Issue Pt B, Page(s) 109137

Abstract: Background: Although the problems associated with alcohol use disorder (AUD) are well known, little is known about the psychosocial problems associated with cannabis use disorder (CUD), and the harmfulness of CUD relative to AUD. We compared the odds of ...

Abstract	Background: Although the problems associated with alcohol use disorder (AUD) are well known, little is known about the psychosocial problems associated with cannabis use disorder (CUD), and the harmfulness of CUD relative to AUD. We compared the odds of psychosocial and health-related problems between individuals with DSM-5 AUD-only, CUD-only and co-occurring AUD+CUD. Methods: The 2012-2013 NESARC-III, a nationally representative cross-sectional survey of non-institutionalized US adults (n = 36,309), assessed participants for DSM-5 AUD, CUD, and psychosocial (interpersonal, financial, legal) and health-related problems. Based on their responses, participants were categorized into mutually exclusive groups: no AUD/CUD, AUD-only, CUD-only, and AUD+CUD. Multivariable logistic regression models examined the associations between psychosocial problems and the four AUD/CUD groups, adjusting for sociodemographic characteristics. Results: People with AUD-only, CUD-only, and AUD+CUD had higher odds of most interpersonal problems (adjusted odds ratio [aORs] 1.07-4.01), financial problems (aORs 1.53-4.28), legal problems (aORs 3.34-7.71), and health-related problems (aORs 1.29-1.92). The odds of psychosocial and health-related problems were similar for CUD-only and AUD-only in direct comparisons. Compared to those with AUD-only, those with AUD+CUD had higher odds of most problems examined (aORs 1.42-2.31). In contrast, there were few differences when comparing AUD+CUD with CUD-only. Conclusions: AUD and CUD were similarly associated with interpersonal, financial, and legal problems, emergency treatment and suicide attempt. People with AUD+CUD had higher odds of certain problems than individuals with either AUD-only or CUD-only. Although most people who use cannabis do not experience harms, our results indicate that CUD does not appear to be less harmful than AUD.
MeSH term(s)	Adult ; Alcohol Drinking ; Alcoholism/epidemiology ; Comorbidity ; Cross-Sectional Studies ; Humans ; Marijuana Abuse/complications ; Marijuana Abuse/epidemiology
Language	English
Publishing date	2021-10-28
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	519918-9
ISSN	1879-0046 ; 0376-8716
ISSN (online)	1879-0046
ISSN	0376-8716
DOI	10.1016/j.drugalcdep.2021.109137
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Article ; Online: Mental health and economic stressors associated with high-risk drinking and increased alcohol consumption early in the COVID-19 pandemic in the United States.

Nesoff, Elizabeth D / Gutkind, Sarah / Sirota, Safiya / McKowen, Anna Laura / Veldhuis, Cindy B

Preventive medicine

2021 Volume 153, Page(s) 106854

Abstract: Physical distancing measures to curb COVID-19 transmission introduced mental health and economic stressors, possibly impacting problematic drinking. This cross-sectional study examines mental health and economic stressors early in the COVID-19 pandemic ... ...

Abstract	Physical distancing measures to curb COVID-19 transmission introduced mental health and economic stressors, possibly impacting problematic drinking. This cross-sectional study examines mental health and economic stressors early in the COVID-19 pandemic which may be associated with heavy alcohol use and increased alcohol use. We administered an online survey of U.S. adults via social media April 5 to May 5, 2020. High-risk drinking was defined by WHO risk drinking levels, a daily average of ≥4 drinks for men and ≥3 drinks for women. Participants reported retrospective assessments of increased alcohol use if their past-week alcohol consumption exceeded their past-year average weekly alcohol consumption. We used logistic regression to assess possible covariates of high-risk drinking and increased alcohol use. Among 2175 participants, 10% (n = 222) reported high-risk drinking, and 36% (n = 775) reported increased alcohol consumption. In multivariable analysis, high-risk drinking was significantly associated with household job loss (OR = 1.41, 95%CI = (1.06, 1.88)) and depressive symptoms (OR = 1.05, 95% CI = (1.02, 1.07)), and women had higher odds of high-risk drinking than men (OR = 2.37, 95% CI = (1.32, 4.69)). Previous mental health diagnosis was not significantly associated with high-risk drinking during the pandemic (OR = 1.31, 95% CI = (0.98, 1.76)) in univariable analysis. High-risk drinkers were almost six times as likely to report retrospective assessments of increased alcohol consumption, controlling for mental health and economic stressors (OR = 5.97, 95% CI = (4.35, 8.32)). Findings suggest a need for targeted interventions to address the complex mental health and economic stressors that may increase alcohol consumption and high-risk drinking during and after the pandemic.
MeSH term(s)	Adult ; Alcohol Drinking/epidemiology ; COVID-19 ; Cross-Sectional Studies ; Female ; Humans ; Male ; Mental Health ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; United States/epidemiology
Language	English
Publishing date	2021-10-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2021.106854
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Article ; Online: Trends in cannabis or cocaine-related dependence and alcohol/drug treatment in Argentina, Chile, and Uruguay.

Mauro, Pia M / Gutkind, Sarah / Rivera-Aguirre, Ariadne / Gary, Dahsan / Cerda, Magdalena / Santos, Erica Chavez / Castillo-Carniglia, Alvaro / Martins, Silvia S

The International journal on drug policy

2022 Volume 108, Page(s) 103810

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!# ...

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.
MeSH term(s)	Adolescent ; Adult ; Argentina/epidemiology ; Cannabis ; Chile/epidemiology ; Cocaine ; Cocaine-Related Disorders/epidemiology ; Cocaine-Related Disorders/therapy ; Cross-Sectional Studies ; Ethanol ; Hallucinogens ; Humans ; Male ; Marijuana Abuse/epidemiology ; Marijuana Abuse/therapy ; Middle Aged ; Substance-Related Disorders/epidemiology ; Uruguay/epidemiology ; Young Adult
Chemical Substances	Hallucinogens ; Ethanol (3K9958V90M) ; Cocaine (I5Y540LHVR)
Language	English
Publishing date	2022-08-05
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2010000-0
ISSN	1873-4758 ; 0955-3959
ISSN (online)	1873-4758
ISSN	0955-3959
DOI	10.1016/j.drugpo.2022.103810
Database	MEDical Literature Analysis and Retrieval System OnLINE

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