The American journal of drug and alcohol abuse
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Am J Drug Alcohol Abuse · Jan 2019
Comparative StudyAdverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only.
Background: While there is growing interest in the possibility that cannabis may be a partial substitute for opioids, studies have yet to examine whether individuals with co-occurring opioid and cannabis use disorders (OUD and CUD) have less risk of negative outcomes than those with OUD only. Objective: This study sought to compare the sociodemographic and clinical characteristics of patients diagnosed with co-occurring OUD and CUD to patients with OUD only, CUD only, and patients with any other drug use disorders. We hypothesized that co-occurring OUD and CUD would be associated with lower risk of inpatient admissions and emergency department (ED) visits, lower rates of homelessness, and fewer opioid prescriptions. ⋯ Results: Of the 234,181 (94% male) patients diagnosed with drug use disorders, 8.6% were diagnosed with co-occurring OUD and CUD; 33.3% with OUD only; 26.5% with CUD only; and 31.6% with other drug use disorders. Compared to the OUD only group (Mean = 4.8 (SD = 8.84)), the group with co-occurring OUD and CUD was associated with a lower number of opioid prescriptions (Mean = 3.79 (SD = 8.22)) (d = -0.16), but higher likelihood of inpatient psychiatric admission (RR = 1.95) and homelessness (RR = 1.52), and no significant difference in ED visits. Conclusions: These data highlight the need to further investigate whether the complex effects of cannabis use on patients with OUD are counterbalanced by potential benefits of reduced in opioid prescribing.
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Am J Drug Alcohol Abuse · Jan 2019
Anxiety sensitivity and opioid misuse among opioid-using adults with chronic pain.
Background: The opioid epidemic is a significant public health crisis, and this problem is particularly prevalent among individuals with chronic pain. Accordingly, there is an urgent need for interventions to mitigate the risk for opioid misuse and opioid use disorder among people with pain. Given that mental health problems, specifically anxiety, are common among people who misuse opioids, it is important to examine factors that link mental health problems with opioid misuse to ultimately inform the development of novel interventions. ⋯ Associations between anxiety sensitivity and opioid misuse were observed over and above the variance accounted for by age, sex, income, education, perceived health, and pain severity. Conclusion: These findings suggest that anxiety sensitivity may be an important treatment target among adults with chronic pain who misuse opioids. Future research should continue to explore the explanatory relevance of anxiety sensitivity in opioid misuse among individuals with chronic pain.
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Am J Drug Alcohol Abuse · Jan 2019
Comparative StudyPerceived prevalence of peer marijuana use: changes among college students before and after Oregon recreational marijuana legalization.
Background: Oregon students' rates of marijuana use have increased following recreational marijuana legalization (RML), but the relation between RML and students' perceived peer use of marijuana - or descriptive norms - is unknown. Objectives: This study examined whether perceived peer use of marijuana changed more following RML for college students in Oregon than in states without RML. Methods: Repeated cross-sectional data were collected from the National College Health Assessment-II surveys from 2008 to 2016 to assess changes in descriptive norms ("Within the last 30 days, what percent of students at your school used marijuana?") among 18-26 year-old undergraduates from two Oregon institutions and 123 institutions in non-RML states (N = 280,006; 66.23% female; 33.19% male) following Oregon RML (7/1/2015). ⋯ The effect was significant for respondents who had never used marijuana [Percent Increase = 3.72, p < .001], but not for respondents who recently or ever previously used marijuana. Respondents who had recently used marijuana had higher descriptive norms than those who had never used [Percent Increase = 12.83, p < .001]. Conclusions: Given the association between descriptive norms and personal use, RML-related increases in descriptive norms among non-using students could contribute to future marijuana use initiation and may be one mechanism linking RML with higher rates of marijuana use among college students.
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Am J Drug Alcohol Abuse · Jan 2019
A retrospective cohort study of mortality rates in patients with an opioid use disorder treated with implant naltrexone, oral methadone or sublingual buprenorphine.
Sustained release naltrexone has been shown to be a safer alternative to oral naltrexone in terms of mortality in patients with an opioid use disorder; however, a direct large-scale comparison has not been made between sustained release naltrexone and the more popular opioid pharmacotherapies: methadone and buprenorphine. ⋯ Crude mortality rates are comparable in patients with an opioid use disorder treated with implant naltrexone, methadone, and buprenorphine. However, implant naltrexone may be associated benefits during the first 28 days of treatment and in female patients compared to methadone.