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    Research News Roundup: March 28, 2024

    The Prevalence of Cannabis Use Disorders in People Who Use Medicinal Cannabis: A Systematic Review and Meta-Analysis

    Journal: Drug and Alcohol Dependence, 2024, doi: 10.1016/j.drugalcdep.2024.111263

    Authors: Danielle Dawson, Daniel Stjepanović, Valentina Lorenzetti, Christy Cheung, Wayne Hall, & Janni Leung


    Background: The prevalence of cannabis use disorders (CUDs) in people who use cannabis recreationally has been estimated at 22%, yet there is a dearth of literature exploring CUDs among people who use medicinal cannabis. We aimed to systematically review the prevalence of CUDs in people who use medicinal cannabis.

    Methods: In our systematic review and meta-analysis, we followed PRISMA guidelines and searched three databases (PsychInfo, Embase and PubMed) to identify studies examining the prevalence of CUDs in people who use medicinal cannabis. Meta-analyses were calculated on the prevalence of CUDs. Prevalence estimates were pooled across different prevalence periods using the DSM-IV and DSM-5.

    Results: We conducted a systematic review of 14 eligible publications, assessing the prevalence of CUDs, providing data for 3681 participants from five different countries. The systematic review demonstrated that demographic factors, mental health disorders and the management of chronic pain with medicinal cannabis were associated with an elevated risk of CUDs. Meta-analyses were conducted on the prevalence of CUDs. For individuals using medicinal cannabis in the past 6-12 months, the prevalence of CUDs was 25% (CI: 18-33%) as per DSM-5 criteria. Similar prevalence was observed using DSM-IV (24%, CI: 14-38%) for the same period. When including all prevalence periods and using the DSM-5, the prevalence of CUDs in people who use medicinal cannabis was estimated at 25% (CI: 18-33%).

    Conclusions: The prevalence of CUDs in people who use medicinal cannabis is substantial and comparable to people who use cannabis for recreational reasons, emphasizing the need for ongoing research to monitor the prevalence of CUDs in people who use medicinal cannabis.

    To read the full text of the article, please visit the publisher’s website.

    Problematic Substance Use in Depressed Adolescents: Prevalence and Clinical Correlates

    Journal: Addictive Behaviors Reports, 2024, doi: 10.1016/j.abrep.2024.100539

    Authors: Elise N. Marino, Manish K. Jha, Abu Minhajuddin, Emine Rabia Ayvaci, Sara Levinson, Ronny Pipes, Graham J. Emslie, & Madhukar H. Trivedi


    Background: Substance use among adolescents is common and associated with significant consequences, including depression. Adolescents can experience myriad problems related to early onset substance use and depression, making further understanding of this comorbidity necessary.

    Method: Participants were a subset from a large-scale performance improvement project and consisted of adolescents aged 12-18 who screened positive for depression during their routine medical or psychiatric appointment and who then completed the substance use assessment Car, Relax, Alone, Forget, Friends, Trouble Version 2.1 (CRAFFT). Participants with problematic substance use had a CRAFFT score ≥2.

    Results: A total of 621 participants were included in this study, and 105 (16.9%) reported problematic substance use. Compared with participants without problematic substance use, those with problematic use were more likely to have moderate to severe depression and anxiety, as well as significantly higher irritability, impulsivity, suicidal propensity, and suicidal thoughts scores. Controlling for age at screening, sex, race, and ethnicity, problematic substance use remained a significant predictor of depression severity, impulsivity, suicidal propensity, and suicidal thoughts.

    Limitations: Participants were from a large, metropolitan area of the Southwest United States who must have screened positive for depression, so results may not generalize. Because all participants were underage, they may have been wary in responding to the substance use assessment accurately.

    Conclusions: By using a large, diverse sample in a real-world clinical setting, findings strengthen the association between problematic substance use and depression and depression-associated symptoms among adolescents, highlighting the need for early detection and universal depression screening.

    To read the full text of the article, please visit the publisher’s website.

    Reducing Alcohol Use to Prevent Cancer Deaths: Estimated Effects Among U.S. Adults

    Journal: American Journal of Preventive Medicine, 2024, doi: 10.1016/j.amepre.2023.12.003

    Authors: Marissa B. Esser, Adam Sherk, Yong Liu, S. Jane Henley, & Timothy S. Naimi


    Introduction: The Dietary Guidelines for Americans, 2020-2025 recommends non-drinking or no more than 2 drinks for men or 1 drink for women in a day. However, even at lower levels, alcohol use increases the risk for certain cancers. This study estimated mean annual alcohol-attributable cancer deaths and the number of cancer deaths that could potentially be prevented if all U.S. adults who drank in excess of the Dietary Guidelines had instead consumed alcohol to correspond with typical consumption of those who drink within the recommended limits.

    Methods: Among U.S. residents aged ≥20 years, mean annual alcohol-attributable cancer deaths during 2020-2021 that could have been prevented with hypothetical reductions in alcohol use were estimated. Mean daily alcohol consumption prevalence estimates from the 2020-2021 Behavioral Risk Factor Surveillance System, adjusted to per capita alcohol sales to address underreporting of drinking, were applied to relative risks to calculate population-attributable fractions for cancers that can occur from drinking alcohol. Analyses were conducted during February-April 2023.

    Results: In the U.S., an estimated 20,216 cancer deaths were alcohol-attributable/year during 2020-2021 (men: 14,562 [72.0%]; women: 5,654 [28.0%]). Approximately 16,800 deaths (83% of alcohol-attributable cancer deaths, 2.8% of all cancer deaths) could have been prevented/year if adults who drank alcohol in excess of the Dietary Guidelines had instead reduced their consumption to ≤2 drinks/day for men or ≤1 drink/day for women. Approximately 650 additional deaths could have been prevented annually if men consumed 1 drink/day, instead of 2.

    Conclusions: Implementing evidence-based alcohol policies (e.g., increasing alcohol taxes, regulating alcohol outlet density) to decrease drinking could reduce alcohol-attributable cancers, complementing clinical interventions.

    To read the full text of the article, please visit the publisher’s website.

    Provider Perceptions of Systems-Level Barriers and Facilitators to Utilizing Family-Based Treatment Approaches in Adolescent and Young Adult Opioid Use Disorder Treatment

    Journal: Addiction Science & Clinical Practice, 2024, doi: 10.1186/s13722-024-00437-x

    Authors: Melissa Pielech, Crosby Modrowski, Jasper Yeh, Melissa A. Clark, Brandon D. L. Marshall, Francesca L. Beaudoin, Sara J. Becker, & Robert Miranda Jr


    Background: Amidst increasing opioid-related fatalities in adolescents and young adults (AYA), there is an urgent need to enhance the quality and availability of developmentally appropriate, evidence-based treatments for opioid use disorder (OUD) and improve youth engagement in treatment. Involving families in treatment planning and therapy augments medication-based OUD treatment for AYA by increasing treatment engagement and retention. Yet, uptake of family-involved treatment for OUD remains low. This study examined systems-level barriers and facilitators to integrating families in AYA OUD treatment in Rhode Island.

    Methods: An online survey was administered to clinic leaders and direct care providers who work with AYA in programs that provide medication and psychosocial treatments for OUD. The survey assessed attitudes towards and experiences with family-based treatment, barriers and facilitators to family-based treatment utilization, as well as other available treatment services for AYA and family members. Findings were summarized using descriptive statistics.

    Results: A total of 104 respondents from 14 distinct treatment programs completed the survey. Most identified as White (72.5%), female (72.7%), and between 25 and 44 years of age (59.4%). Over half (54.1%) of respondents reported no experience with family based treatment and limited current opportunities to involve families. Barriers perceived as most impactful to adopting family-based treatment were related to limited available resources (i.e. for staff training, program expansion) and lack of prioritization of family-based treatment in staff productivity requirements. Barriers perceived as least impactful were respondent beliefs and attitudes about family-based treatment (e.g., perception of the evidence strength and quality of family-based treatment, interest in implementing family-based treatment) as well as leadership support of family-based treatment approaches. Respondents identified several other gaps in availability of comprehensive treatment services, especially for adolescents (e.g. services that increase social recovery capital).

    Conclusions: Family-based treatment opportunities for AYA with OUD in Rhode Island are limited. Affordable and accessible training programs are needed to increase provider familiarity and competency with family-based treatment. Implementation of programming to increase family involvement in treatment (i.e. psychoeducational and skills-based groups for family members) rather than adopting a family-based treatment model may be a more feasible step to better meet the needs of AYA with OUD.

    To read the full text of the article, please visit the publisher’s website.

    Journal: Alcohol Research: Current Reviews, 2024, doi: 10.35946/arcr.v44.1.02

    Authors: Brant P. Hasler, Christina T. Schulz, & Sarah L. Pedersen


    Purpose: Growing evidence supports sleep and circadian rhythms as influencing alcohol use and the course of alcohol use disorder (AUD). Studying sleep / circadian-alcohol associations during adolescence and young adulthood may be valuable for identifying sleep / circadian-related approaches to preventing and / or treating AUD. This paper reviews current evidence for prospective associations between sleep / circadian factors and alcohol involvement during adolescence and young adulthood with an emphasis on the effects of sleep / circadian factors on alcohol use.

    Search methods: The authors conducted a literature search in PsycInfo, PubMed, and Web of Science using the search terms “sleep” and “alcohol” paired with “adolescent” or “adolescence” or “young adult” or “emerging adult,” focusing on the title / abstract fields, and restricting to English-language articles. Next, the search was narrowed to articles with a prospective / longitudinal or experimental design, a sleep-related measure as a predictor, an alcohol-related measure as an outcome, and confirming a primarily adolescent and / or young adult sample. This step was completed by a joint review of candidate article abstracts by two of the authors.

    Search results: The initial search resulted in 720 articles. After review of the abstracts, the list was narrowed to 27 articles reporting on observational longitudinal studies and three articles reporting on intervention trials. Noted for potential inclusion were 35 additional articles that reported on studies with alcohol-related predictors and sleep-related outcomes, and / or reported on candidate moderators or mediators of sleep-alcohol associations. Additional articles were identified via review of relevant article reference lists and prior exposure based on the authors’ previous work in this area.

    Discussion and conclusions: Overall, the review supports a range of sleep / circadian characteristics during adolescence and young adulthood predicting the development of alcohol use and/or alcohol-related problems. Although sleep treatment studies in adolescents and young adults engaging in regular and / or heavy drinking show that sleep can be improved in those individuals, as well as potentially reducing alcohol craving and alcohol-related consequences, no studies in any age group have yet demonstrated that improving sleep reduces drinking behavior. Notable limitations include relatively few longitudinal studies and only two experimental studies, insufficient consideration of different assessment timescales (e.g., day-to-day vs. years), insufficient consideration of the multidimensional nature of sleep, a paucity of objective measures of sleep and circadian rhythms, and insufficient consideration of how demographic variables may influence sleep / circadian-alcohol associations. Examining such moderators, particularly those related to minoritized identities, as well as further investigation of putative mechanistic pathways linking sleep / circadian characteristics to alcohol outcomes, are important next steps.

    To read the full text of the article, please visit the publisher’s website.


    March 2024