Addiction最新文献

{"title":"Systematic review and meta-analysis investigating nicotine, cotinine and carbon monoxide exposures in people who both smoke and use nicotine replacement therapy","authors":"Anna Podlasek,&nbsp;Ravinder Claire,&nbsp;Katarzyna A. Campbell,&nbsp;Sophie Orton,&nbsp;Ross Thomson,&nbsp;Tim Coleman","doi":"10.1111/add.16279","DOIUrl":"https://doi.org/10.1111/add.16279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine effects of concurrent smoking and nicotine replacement therapy (NRT) use on reported heaviness of smoking, nicotine (cotinine) body fluid and exhaled air carbon monoxide (CO) concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic review and meta-analysis of RCTs, which test interventions permitting concurrent NRT use and smoking and comparing, within participants, outcomes when smoking with those when smoking and using NRT concurrently. Measurements included reported number of cigarettes smoked per day (CPD), body fluid cotinine and expired air CO concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine studies were included in the review. Meta-analysis of nine showed that, compared with when solely smoking, fewer cigarettes were smoked daily when NRT was used (mean difference during concurrent smoking and NRT use, −2.06 CPD [95% CI = −3.06 to −1.07, <i>P</i> &lt; 0.0001]). Meta-analysis of seven studies revealed a non-significant reduction in exhaled CO during concurrent smoking and NRT use (mean difference, −0.58 ppm [95% CI = −2.18 to 1.03, <i>P</i> = 0.48]), but in the three studies that tested NRT used in the lead-up to quitting (i.e. as preloading), a similar reduction in exhaled CO was statistically significant (mean difference, −2.54 ppm CO [95% CI = −4.14 to −0.95, <i>P</i> = 0.002]). Eleven studies reported cotinine concentrations, but meta-analysis was not possible because of data reporting heterogeneity; of these, seven reported lower cotinine concentrations with concurrent NRT use and smoking, four reported no differences, and none reported higher concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People who smoke and also use nicotine replacement therapy report smoking less heavily than people who solely smoke. When nicotine replacement therapy is used in the lead-up to quitting (preloading), this reported smoking reduction has been biochemically confirmed. There is no evidence that concurrent smoking and nicotine replacement therapy use result in greater nicotine exposure than solely smoking.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 11","pages":"2076-2092"},"PeriodicalIF":6.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41085107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implementation and public health impacts of cannabis legalization in Canada: a systematic review","authors":"Wayne Hall,&nbsp;Daniel Stjepanovi?,&nbsp;Danielle Dawson,&nbsp;Janni Leung","doi":"10.1111/add.16274","DOIUrl":"https://doi.org/10.1111/add.16274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We provide a narrative summary of research on changes in cannabis arrests, cannabis products and prices, cannabis use and cannabis-related harm since legalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched for research on the impacts of cannabis legalization in Canada in PubMed, Embase, Statistics Canada and government websites and Google Scholar, published between 2006 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cannabis legalization in Canada has been followed by substantial reductions in cannabis-related arrests and cannabis prices. It has also increased adults’ access to a diverse range of cannabis products, including edibles and extracts. The prevalence of cannabis use among young adults has increased, but there have been no marked increases or decreases in use among high school students or changes in the prevalence of daily or near-daily use. Legalization has been associated with increased adult hospital attendances for psychiatric distress and vomiting, unintentional ingestion of edible cannabis products by children and hospitalizations for cannabis use disorders in adults. There is conflicting evidence on whether cannabis-impaired driving has increased since legalization. There is suggestive evidence that presentations to emergency departments with psychoses and cannabis use disorders may have increased since legalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Legalization of cannabis in Canada appears to have reduced cannabis arrests and increased access to a variety of more potent cannabis products at lower prices. Since 2019, recent cannabis use in Canada has modestly increased among adults but not among adolescents. There is evidence of increased acute adverse effects of cannabis among adults and children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 11","pages":"2062-2072"},"PeriodicalIF":6.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41085135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of cognitive-behavioral techniques for problem gambling and gambling disorder: A systematic review and meta-analysis","authors":"Rory A. Pfund,&nbsp;David P. Forman,&nbsp;Shelby K. Whalen,&nbsp;James M. Zech,&nbsp;Meredith K. Ginley,&nbsp;Samuel C. Peter,&nbsp;Nicholas W. McAfee,&nbsp;James P. Whelan","doi":"10.1111/add.16221","DOIUrl":"https://doi.org/10.1111/add.16221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To measure the effect of cognitive-behavioral techniques (CBTs) on gambling disorder severity and gambling behavior at post-treatment and follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Seven databases and two clinical trial registries were searched to identify peer-reviewed studies and unpublished studies of randomized controlled trials. The Cochrane Risk of Bias tool assessed risk of bias in the included studies. A random effect meta-analysis with robust variance estimation was conducted to measure the effect of CBTs relative to minimally treated or no treatment control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine studies representing 3991 participants were identified. CBTs significantly reduced gambling disorder severity (<i>g</i> = −1.14, 95% CI = −1.68, −0.60, 95% prediction interval [PI] = −2.97, 0.69), gambling frequency (<i>g</i> = −0.54, 95% CI = −0.80, −0.27, 95% PI = −1.48, 0.40) and gambling intensity (<i>g</i> = −0.32, 95% CI = −0.51, −0.13, 95% PI = −0.76, 0.12) at post-treatment relative to control. CBTs had no significant effect on follow-up outcomes. Analyses supported the presence of publication bias and high heterogeneity in effect size estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cognitive-behavioral techniques are a promising treatment for reducing gambling disorder and gambling behavior; however, the effect of cognitive-behavioral techniques on gambling disorder severity and gambling frequency and intensity at post-treatment is overestimated, and cognitive-behavioral techniques may not be reliably efficacious for all individuals seeking treatment for problem gambling and gambling disorder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 9","pages":"1661-1674"},"PeriodicalIF":6.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6086898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Galanis et al.: When age could make the difference—let's not sweep violence under the keyboard","authors":"Amandine Luquiens,&nbsp;Jorge Lopez Castroman","doi":"10.1111/add.16272","DOIUrl":"https://doi.org/10.1111/add.16272","url":null,"abstract":"&lt;p&gt;In an interesting meticulously designed study, Galanis &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;1&lt;/span&gt;] investigated the effect of gaming health information on stigma related to gaming disorder using three different vignettes of young male adults (problem, regular and casual gamers). The effect of biomedical accounts of gaming disorders on the stigma associated to this condition is apparently scarce, while biases linked to diagnostic confirmation probably play a more important role. The problem gamer vignette depicts a young male adult mainly characterized by social withdrawal and internalization symptoms, although he is also ill-tempered and tends to argue with his girlfriend. However, this vignette could be substantially different from pre-existing representations of gaming disorder among survey participants.&lt;/p&gt;&lt;p&gt;The population with gaming disorder is highly heterogeneous, and more than 50% of people seeking treatment exhibit externalizing behaviour [&lt;span&gt;2&lt;/span&gt;]. Clinical presentation depends upon the person's age and living environment. Possibly due to different organization, places and settings of care for children and adults [&lt;span&gt;3&lt;/span&gt;], and due to methodological and regulatory constraints, few data are available from mixed samples of children and adults with gaming disorder, and very few data comparing clinical presentations between children and adults are available. The two most typical profiles are adolescents living with their parents and independent young adults living by themselves [&lt;span&gt;4&lt;/span&gt;]. In adolescents, parent–child conflict is a risk factor for gaming disorder [&lt;span&gt;5&lt;/span&gt;]. Indeed, conflict with parents over excessive gaming activity is part of the usual description of gaming disorder in children and adolescents [&lt;span&gt;6&lt;/span&gt;]. Maladaptive behaviour, and in particular impulsive aggression such as verbal threats and throwing objects, triggered by an ordinary request to turn off the game [&lt;span&gt;7&lt;/span&gt;], is also a common reason for seeking help for gaming disorder in children and adolescents [&lt;span&gt;8&lt;/span&gt;]. Comorbidities such as attention deficit hyperactivity disorder (ADHD) could be more frequent in impulsive aggressions in this context [&lt;span&gt;9&lt;/span&gt;]. Conversely, in lay people, a long-standing concern since the 1990s is the link between violent games and aggression [&lt;span&gt;10&lt;/span&gt;], possibly boosted by scientific sensationalistic statements [&lt;span&gt;11&lt;/span&gt;]; however, it has gained credence in recent findings, leading the scientific community to encourage further exploration of this association [&lt;span&gt;12, 13&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Stigma is frequently reported in illnesses manifesting behavioural disturbances or socially odd behaviour [&lt;span&gt;14&lt;/span&gt;]. Moreover, the stereotype of violence is one of the pillars of stigma in mental disorders [&lt;span&gt;15&lt;/span&gt;]. Additionally, manifestations of dangerousness through aggression in the clinical vignettes describing severe mental disorders, including addictive disorders, are ass","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 9","pages":"1699-1700"},"PeriodicalIF":6.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5880941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A timely piece of global relevance, but shouldn't we move towards more real-world studies of the effect of multiple policy interventions and ongoing monitoring of alcohol policy impacts?","authors":"Charles D. H. Parry","doi":"10.1111/add.16282","DOIUrl":"https://doi.org/10.1111/add.16282","url":null,"abstract":"&lt;p&gt;Holmes [&lt;span&gt;1&lt;/span&gt;] reviews a broad range of studies using different methodologies and data sources to evaluate the impact of minimum unit pricing (MUP) on alcohol consumption and harms in Scotland. This article is timely, coming out several months before the expected release of Public Health Scotland (PHS)’s anticipated final evaluation report on MUP. As such it provides a possible indication of what we might expect in the PHS report, although Holmes [&lt;span&gt;1&lt;/span&gt;] includes data not included in the PHS evaluation.&lt;/p&gt;&lt;p&gt;With the risk of MUP enabling legislation in Scotland not being renewed after its automatic expiration at the end of April 2024 if the evaluation of the goals of implementing MUP in Scotland are not deemed to have been realized, this could affect not only the future of MUP in Scotland, but could also have negative ramifications for decisions around the implementation of MUP in other parts of the world, including the Western Cape, South Africa [&lt;span&gt;2&lt;/span&gt;]. This is because the Scottish MUP ‘project’ is widely seen as one of the best case-studies for assessing the impact of MUP because it is one of a few examples where MUP has been directly linked to alcoholic content for its whole alcohol market, not just for certain drink types (such as spirits) and because of the breadth of research undertaken to evaluate it. Desired outcomes included decreasing consumption of alcohol by reducing overall consumption of alcohol, especially among people drinking at hazardous and harmful levels [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;While much can be learnt from the emerging data on the effect of the introduction of MUP in Scotland, including the findings that reported ‘that MUP reduces alcohol sales by ~3.0 to 3.5%, with larger effects on cider and spirits than other beverage types’ [&lt;span&gt;1&lt;/span&gt;], this may not provide a full picture of the impact of MUP in parts of the word such as Africa, where beer consumption is substantially higher than in the United Kingdom [&lt;span&gt;4&lt;/span&gt;] and where there is a greater risk of drinkers moving towards unrecorded alcohol following the introduction of MUP.&lt;/p&gt;&lt;p&gt;There is tremendous value in research assessing the impact of single interventions such as the impact of MUP upon alcohol consumption and harm. However, these interventions occur in a context of changing socio-economic, political and other conditions, including other alcohol policy responses. It would have been useful for Holmes [&lt;span&gt;1&lt;/span&gt;] to have situated the evaluation of MUP in Scotland in terms of these conditions. How might factors such as Brexit, the COVID19 pandemic and increasing energy prices have impacted the findings?&lt;/p&gt;&lt;p&gt;This review of evidence from multiple sources assessing the impact of MUP in Scotland, despite methodological weaknesses of some of the studies, is extremely useful, timely and broadly points to the value of MUP. However, the real impact of policies such as MUP, especially on heavy drinkers and high-intensity drinker","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 9","pages":"1620-1621"},"PeriodicalIF":6.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5850110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABC-training as a new intervention for hazardous alcohol drinking: Two proof-of-principle randomized pilot studies","authors":"Pieter Van Dessel,&nbsp;Jamie Cummins,&nbsp;Reinout W. Wiers","doi":"10.1111/add.16271","DOIUrl":"https://doi.org/10.1111/add.16271","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;ABC-training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof-of-principle study was to test the effectiveness of web-based ABC-training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;One exploratory and one confirmatory experiment with two between-subject conditions (online ABC- and control-training) and assessments at baseline and 1 week later (after three sessions of training).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants recruited on Prolific Academic completed the web-based study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adults with self-reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Intervention and Comparator&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;ABC-training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control-training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Measurements&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Primary outcome was change in automatic and self-reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self-efficacy, craving and motivation (and approach-alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Findings of this study are as follows: stronger increase in negative outcome expectancies after ABC- than control-training (Experiment 1: self-report, 95% confidence interval of difference scores (CI&lt;sub&gt;diff&lt;/sub&gt;) = [0.04, Inf]; automatic, CI&lt;sub&gt;diff&lt;/sub&gt; = [0.01, Inf]; Experiment 2: self-report, CI&lt;sub&gt;diff&lt;/sub&gt; = [0.16, Inf]; automatic, CI&lt;sub&gt;diff&lt;/sub&gt; = [0.002, Inf]). Stronger reduction in self-reported positive outcome expectancies after ABC- th","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 11","pages":"2141-2155"},"PeriodicalIF":6.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41085076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in alcohol-related liver disease mortality in Australia: An age–period–cohort perspective","authors":"Michael Livingston,&nbsp;Robin Room,&nbsp;Tanya Chikritzhs,&nbsp;Nicholas Taylor,&nbsp;Wing See Yuen,&nbsp;Paul Dietze","doi":"10.1111/add.16275","DOIUrl":"https://doi.org/10.1111/add.16275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>There have been few systematic attempts to examine how alcohol-related mortality has changed in Australia, and no studies that have explored cohort effects in alcohol-related mortality. This study uses more than 50 years of data to measure age, period and cohort trends in alcohol-related liver disease (ALD) mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, Setting and Cases</h3>\u0000 \u0000 <p>This was a retrospective age–period–cohort analysis of total Australian ALD mortality data from 1968 to 2020 in Australia. There was a total of 35 822 deaths—27 208 men (76%) and 8614 women (24%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Deaths from ALD were grouped into 5-year age groups and periods (e.g. deaths for 20–24-year-olds between 1968 and 1972 were combined).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>ALD mortality peaked in the late 1970s and early 1980s for both men and women. In age–period–cohort models, mortality was highest for cohorts born 1915–30. For example, men born between 1923 and 1927 had a relative risk of 1.58 [95% confidence interval (CI) = 1.52, 1.64] compared with men born between 1948 and 1952. For women, there was an increase in risk for cohorts born in the 1960s [e.g. the 1963–67 cohort had a relative risk (RR) of 1.16 (95% CI = 1.07, 1.25) compared with women born in 1948–52]. For men, there was a broad decline in mortality over time [e.g. in 2020, the RR was 0.87 (95% CI = 0.82, 0.92) compared with the reference year of 2000]. For women, mortality declined until 2000 and has been stable since.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Alcohol-related liver disease mortality has declined across the Australian population since the 1970s and 1980s partly due to cohort-specific shifts as the highest-risk birth cohorts age. For women, this decline had stalled by the year 2000, and cohorts of women born during the 1960s were at higher risk than earlier cohorts, suggesting the need for thoughtful interventions as this population enters its highest-risk years for ALD mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 11","pages":"2156-2163"},"PeriodicalIF":6.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41085077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivational interviewing and problem-solving therapy intervention for patients on antiretroviral therapy for HIV in Tshwane, South Africa: A randomized controlled trial to assess the impact on alcohol consumption","authors":"Charles D. H. Parry,&nbsp;Bronwyn Myers,&nbsp;Mukhethwa Londani,&nbsp;Paul A. Shuper,&nbsp;Charl Janse van Rensburg,&nbsp;Samuel O. M. Manda,&nbsp;Sebenzile Nkosi,&nbsp;Connie T. Kekwaletswe,&nbsp;Judith A. Hahn,&nbsp;Jürgen Rehm,&nbsp;Katherine Sorsdahl,&nbsp;Neo K. Morojele","doi":"10.1111/add.16278","DOIUrl":"https://doi.org/10.1111/add.16278","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Reduction of alcohol consumption is important for people undergoing treatment for HIV. We tested the efficacy of a brief intervention for reducing the average volume of alcohol consumed among patients on HIV antiretroviral therapy (ART).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design, Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study used a two-arm multi-centre randomized controlled trial with follow-up to 6 months. Recruitment occurred between May 2016 and October 2017 at six ART clinics at public hospitals in Tshwane, South Africa.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Participants were people living with HIV, mean age 40.8 years [standard deviation (SD) = 9.07], 57.5% female, and on average 6.9 years (SD = 3.62) on ART. At baseline (BL), the mean number of drinks consumed over the past 30 days was 25.2 (SD = 38.3). Of 756 eligible patients, 623 were enrolled.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Intervention&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants were randomly assigned to a motivational interviewing (MI)/problem-solving therapy (PST) intervention arm (four modules of MI and PST delivered over two sessions by interventionists) or a treatment as usual (TAU) comparison arm. People assessing outcomes were masked to group assignment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Measurements&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The primary outcome was the number of standard drinks (15 ml pure alcohol) consumed during the past 30 days assessed at 6-month follow-up (6MFU).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of the 305 participants randomized to MI/PST, 225 (74%) completed the intervention (all modules). At 6MFU, retention was 88% for the control and 83% for the intervention arm. In support of the hypothesis, an intention-to-treat-analysis for the primary outcome at 6MFU was −0.410 (95% confidence interval = −0.670 to −0.149) units lower on log scale in the intervention group than in the control group (&lt;i&gt;P&lt;/i&gt; = 0.002), a 34% relative reduction in the number of drinks. Sensitivity analyses were undertaken for patients who had alcohol use disorders identification test (AUDIT) scores ≥ 8 at BL (&lt;i&gt;n&lt;/i&gt; = 299). Findings were similar to those of the whole sample.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In South Africa, a motivational interviewing/problem-solving therapy intervention significantly reduced drinking levels in HIV-infected patients on antiretroviral therapy","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 11","pages":"2164-2176"},"PeriodicalIF":6.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41085213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort effects of women's mid-life binge drinking and alcohol use disorder symptoms in the United States: Impacts of changes in timing of parenthood","authors":"Rachel Sayko Adams,&nbsp;Sarah C. McKetta,&nbsp;Justin Jager,&nbsp;Maureen T. Stewart,&nbsp;Katherine M. Keyes","doi":"10.1111/add.16262","DOIUrl":"https://doi.org/10.1111/add.16262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Alcohol use is increasing among women in mid-life concurrently with societal changes in timing of parenthood and changing cultural norms, which may influence alcohol use. The aim of this study was to determine if age of first parenting was associated with excessive drinking [i.e. past 2-week binge drinking and past 5-year alcohol use disorder (AUD) symptoms] among women during mid-life in the United States and to determine if there were pronounced cohort effects influencing these relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This was a retrospective cohort, longitudinal study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting, Participants and Measurements</h3>\u0000 \u0000 <p>Data were drawn from the Monitoring the Future survey, an annual ongoing survey of high school students’ substance use behaviors in the United States. Participants were women who completed the age 35 survey between 1993 and 2019, corresponding to high school senior years 1976–2002 (<i>n</i> = 9988). Past 2-week binge drinking and past 5-year AUD symptoms were self-reported. Age of first parenting was self-reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Binge drinking and AUD symptoms were higher among women in recent than in older cohorts. Women from the 2018–19 cohort had increased odds of binge drinking [odds ratio (OR) = 1.73, 95% confidence interval (CI) = 1.41–2.12] and AUD symptoms (OR = 1.51, CI = 1.27–1.80) relative to women from the 1993–97 cohort. Throughout cohorts, there was an inverse association between transition to parenthood and excessive drinking outcomes (e.g. range for ORs for binge drinking among those without children compared with those who had had children between the ages of 18 and 24: 1.22–1.55). Simultaneously, there was a population shift towards delaying parenting in recent cohorts (i.e. 54% of women in the 1993–97 cohort had children before age 30 compared with 39% in the two recent cohorts), increasing the size of the group at highest risk for excessive drinking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the United States, subgroups of women at highest risk of excessive drinking appear to be expanding, probably supported in part by a trend towards delayed parenting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 10","pages":"1932-1941"},"PeriodicalIF":6.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6240262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimizing double standards in assessing the adverse and beneficial effects of cannabis","authors":"Wayne Hall,&nbsp;Eva Hoch","doi":"10.1111/add.16267","DOIUrl":"https://doi.org/10.1111/add.16267","url":null,"abstract":"&lt;p&gt;Some critics of publicly funded research on cannabis use argue that it has been biased towards finding harms (such as increased risks of car crashes, impaired cognition and educational attainment, a dependence syndrome and psychosis) to justify the prohibition of adult use [&lt;span&gt;1&lt;/span&gt;]. Other critics have argued that this research has ignored alternative explanations of associations between cannabis and adverse health effects, such as shared risk factors (e.g. social disadvantage and genetic risks) and reverse causation (e.g. troubled young people using cannabis to treat psychological symptoms) [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Since around the turn of the millennium, however, research has focused more upon the putative medical benefits of cannabis that have been used to justify the legalization of its medical use [&lt;span&gt;4&lt;/span&gt;]. Some of this research has been of low quality, such as ecological associations between the presence or absence of state medical cannabis programmes and trends in opioid overdose deaths [&lt;span&gt;5&lt;/span&gt;], case series [&lt;span&gt;6&lt;/span&gt;] and poorly controlled observational studies of patient outcomes in the absence of comparison conditions [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In the United States, the legalization of adult cannabis use followed the legalization of medical cannabis use over the next several decades [&lt;span&gt;4&lt;/span&gt;]. The arguments that seem to have won public support for adult legalization have been that legalization removes criminal penalties that have been enforced in a discriminatory way against minorities and people of colour; it allows adults to enjoy the effects of cannabis without fear of arrest; it reduces the cost of law enforcement; it creates a new source of tax revenue for government; and it enables cannabis products to be better regulated in the interests of consumer health [&lt;span&gt;4, 8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;These arguments should not preclude research on the harms that may arise from cannabis use, especially the regular use of high-tetrahydrocannabinol (THC) cannabis products, under legalization [&lt;span&gt;4&lt;/span&gt;]. Nor should they warrant the use of different evidential standards to evaluate the risks and the benefits of cannabis use; such as, for example, uncritically accepting weak evidence for medical benefits while dismissing epidemiological evidence for causal relationships between cannabis use and adverse health effects as ‘correlational’ (e.g. [&lt;span&gt;5, 9&lt;/span&gt;]).&lt;/p&gt;&lt;p&gt;We should also avoid double evidential standards in deciding how to regulate cannabis potency. A popular argument for legalization was that the potency of cannabis products would decline, as high potency varieties and concentrates were thought to be a consequence of the greater risks of trading under legal prohibition. Since legalization in the United States and Canada, however, the THC content of cannabis products has substantially exceeded that in the illicit market, with sales of cannabis extracts, edibles and fortified pre-rolled joints [&lt;sp","PeriodicalId":109,"journal":{"name":"Addiction","volume":"118 9","pages":"1606-1608"},"PeriodicalIF":6.0,"publicationDate":"2023-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5919303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}