Addiction最新文献

{"title":"Associations between non-daily smoking and motivation to stop smoking: A population study in England 2021-2024.","authors":"Sarah E Jackson, Jamie Brown, Lion Shahab, Sharon Cox","doi":"10.1111/add.70159","DOIUrl":"https://doi.org/10.1111/add.70159","url":null,"abstract":"<p><strong>Background and aims: </strong>An increasing proportion of adults in England who smoke cigarettes do not smoke every day and may see quitting smoking as less important than those who smoke daily. This study aimed to examine whether motivation to stop smoking differs between those who smoke cigarettes daily vs. non-daily, and to explore differences in this association by relevant sociodemographic, smoking and vaping-related factors.</p><p><strong>Design and setting: </strong>Observational study using data drawn from the Smoking Toolkit Study, a representative cross-sectional survey in England, 2021-2024.</p><p><strong>Participants: </strong>13 277 cigarette smokers (≥16 y).</p><p><strong>Measures: </strong>Outcome variables were level of motivation to stop smoking (Motivation to Stop Scale), analysed as a 7-level ordinal variable and dichotomised to assess (1) no desire to stop smoking and (2) high motivation to stop smoking. The exposure variable was daily vs. non-daily smoking. Covariates and potential moderators were age, gender, socioeconomic position, presence of children in the household, strength of urges to smoke, vaping status, harm perceptions of e-cigarettes vs. cigarettes and survey year.</p><p><strong>Results: </strong>Non-daily (vs. daily) smoking was associated with greater motivation to stop smoking [adjusted odds ratio (OR_adj) = 1.22 (95% confidence interval, CI = 1.13-1.32)]. Non-daily smokers were both less likely than daily smokers to report no desire to stop smoking [40.4% vs. 44.0%; OR_adj = 0.85 (95% CI = 0.77-0.95)] and more likely to report high motivation to stop smoking [21.0% vs. 14.8%; OR_adj = 1.78 (95% CI = 1.55-2.03)]. These differences in motivation-especially in the odds of reporting no desire to stop smoking-between non-daily and daily smokers were more pronounced among those who were older and less advantaged. Differences were less pronounced among those who reported no urges to smoke, those who vaped and those who perceived e-cigarettes to be less harmful than cigarettes.</p><p><strong>Conclusions: </strong>In England, adults who smoke cigarettes non-daily appear to tend to be more motivated to quit smoking than those who smoke every day, especially among older and less advantaged people.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793019","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":"Statement on the publication of research with a focus on Indigenous peoples","authors":"","doi":"10.1111/add.70167","DOIUrl":"10.1111/add.70167","url":null,"abstract":"<p>Addiction aims to respectfully advance the academic scholarship of significance to Indigenous peoples in disciplines related to addictions. Where possible, manuscripts submitted to Addiction that report research focussed on Indigenous peoples should include a statement regarding Indigenous involvement in methodologies, governance, and ethics. For guidance please refer to the CONSIDER statement https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-019-0815-8 or https://tobaccocontrol.bmj.com/content/tobaccocontrol/33/e2/e240.full.pdf for a framework for ethical publishing of research involving Indigenous peoples.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787889","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":"Externalizing as a common genetic influence for a broad spectrum of substance use and behavioral conditions: A developmental perspective from the Avon Longitudinal Study of Parents and Children.","authors":"Wei Q Deng, Kyla Belisario, Amanda Doggett, Marie Pigeyre, Guillaume Pare, Marcus R Munafò, James MacKillop","doi":"10.1111/add.70163","DOIUrl":"https://doi.org/10.1111/add.70163","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Recent large studies have established the genetic basis of several conceptually linked phenotypes of externalizing. Polygenic risk scores (PRSs) for these constructs are associated with a range of substance use and mental disorder phenotypes but have not been examined with both pharmacological and non-pharmacological addictive behaviors, or across a developmental window. This study identified biological pathways responsible for observed associations between PRSs and addiction phenotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, participants: &lt;/strong&gt;We selected genome-wide association studies of 22 phenotypes, including substance use, general factors of externalizing and addiction, impulsivity and psychiatric conditions. Using summary statistics, we constructed PRSs in the offspring from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n&lt;sub&gt;max&lt;/sub&gt; = 4995). Participants were genetically confirmed to be unrelated and of European-like genetic similarity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;We examined the associations between PRSs and addiction-related phenotypes including substance use, gambling, eating behaviors and internet use across different life stages, from adolescence to young adulthood. PRSs were partitioned by biological pathways to examine the common and unique mechanisms underlying the genetics of addiction-related phenotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The PRS of externalizing factor (PRS&lt;sub&gt;EXT&lt;/sub&gt;) showed the strongest association across phenotypes for substance use (minP = 2.6 × 10&lt;sup&gt;-31&lt;/sup&gt;, adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.10-4.72%), gambling (minP = 1.0 × 10&lt;sup&gt;-9&lt;/sup&gt;, adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.18-1.50%), eating behaviors (minP = 8.2 × 10&lt;sup&gt;-4&lt;/sup&gt;, adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.11-0.65%) and internet use (minP = 1.4 × 10&lt;sup&gt;-7&lt;/sup&gt;, adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.17-1.04%). Sensitivity analyses excluding a small subset of ALSPAC participants who also contributed to the externalizing summary statistics, yielded consistent association effect sizes (R&lt;sup&gt;2&lt;/sup&gt; = 0.98), suggesting minimal bias. The results also revealed several time-varying associations between several PRSs and addiction phenotypes. Notably, the genetic influence of externalizing factor on alcohol and tobacco use was significantly stronger at younger ages. Finally, we identified multiple biological pathways that contribute to the link between addiction-related phenotypes and PRS&lt;sub&gt;EXT&lt;/sub&gt;, emphasizing the importance of synaptic functions and neuronal plasticity in the context of gambling and substance use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There appears to be genetic evidence implicating externalizing as a common mechanism of substance and behavioral addictive behaviors. These results support the shared genetic liability across substance misuse, problematic gambling and internet use, and demonstrate the potential utility of externalizing traits as a transdiagnostic dimension across diverse forms of ","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787888","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":"Genetic risk for alcohol use disorder in relation to individual symptom criteria: Do polygenic indices provide unique information for understanding severity and heterogeneity?","authors":"Yongguk M Sarles, Sean P Lane, Alex P Miller, Kirk C Wilhelmsen, Ian R Gizer","doi":"10.1111/add.70157","DOIUrl":"10.1111/add.70157","url":null,"abstract":"<p><strong>Background and aims: </strong>Previous studies have suggested that Alcohol Use Disorder (AUD) might result from separable genetic influences with symptoms reflecting differing degrees of genetic risk related to distinct risk mechanisms. The present study aimed to examine the genetic risk for individual AUD symptom criteria using a polygenic risk score (PRS) approach to assess the relative severity of each symptom and test for a multidimensional genetic structure of AUD.</p><p><strong>Design: </strong>This retrospective study examined the correlation between genetic severity (i.e. PRS) and Item Response Theory (IRT) severity indices for each AUD symptom. Multiple Indicators Multiple Causes (MIMIC) models were employed to examine the effect of the PRS on individual AUD symptoms after accounting for overall AUD severity.</p><p><strong>Setting and participants: </strong>The study made use of summary-level data produced in Finland, United Kingdom and the United States of America as well as individual-level data from 1639 participants of the University of California - San Francisco Family Alcoholism Study.</p><p><strong>Measurements: </strong>Phenotypic measures included the 11 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) AUD symptom criteria assessed using a modified version of the Semi-Structured Assessment for the Genetics of Alcoholism. AUD, Problematic Alcohol Use (PAU) and alcohol consumption [i.e. drinks per week (DPW)] PRSs were created using summary statistics obtained from published genome-wide association studies (GWAS).</p><p><strong>Findings: </strong>Phenotypic and genotypic severities of AUD symptoms were statistically significantly correlated for the PAU PRS and AUD PRS (r range = 0.77-0.89), but not for the DPW PRS (r = 0.45). MIMIC models indicated that the PRSs statistically significantly predicted the AUD factor. Regression paths testing the direct effects of the PRSs on individual AUD symptoms, independent of the latent AUD factor, were statistically nonsignificant.</p><p><strong>Conclusions: </strong>Polygenic risk scores derived from genome-wide association studies (GWAS) of alcohol use disorder (AUD) appear to influence AUD symptom expression through a single genetic factor that is highly correlated with the relative severity of individual symptoms measured at the phenotypic level. Item-level GWAS of AUD symptoms are needed to further parse heterogeneous symptom expression and allow for more nuanced tests of these conclusions.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751910","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":"The emerging landscape of etomidate e-cigarettes use","authors":"Chong Zheng Ng,&nbsp;Harith Hamood Said Al-Aamari,&nbsp;Lambert Tchern Kuang Low,&nbsp;Melvyn Weibin Zhang","doi":"10.1111/add.70151","DOIUrl":"10.1111/add.70151","url":null,"abstract":"&lt;p&gt;The emergence of etomidate, an imidazole-derived hypnotic agent indicated for anaesthetic induction [&lt;span&gt;1&lt;/span&gt;], as an adulterant in electronic cigarettes (e-cigarettes) represents a critical public health concern. In Singapore, the emergence of e-cigarette pods laced with etomidate, also known as ‘Kpods’, have been increasingly detected [&lt;span&gt;2, 3&lt;/span&gt;], against a backdrop of wider global concerns surrounding the illegal production and distribution of etomidate and analogues [&lt;span&gt;4&lt;/span&gt;]. Unlike the precise dosing and supervised administration of etomidate in clinical settings, when inhaled through e-cigarettes, effects can be unpredictable and dangerous. Given this, the aim of this letter is to illustrate some of the acute psychiatric manifestation associated with the use of these e-cigarettes (through a review of the existing published case studies), and to highlight potential testing methods to detect for the presence of etomidate.&lt;/p&gt;&lt;p&gt;Etomidate is a positive allosteric modulator of the gamma-aminobutyric acid type A (GABA-A) receptor, enhancing inhibitory neurotransmission in the central nervous system [&lt;span&gt;1, 5&lt;/span&gt;]. By inducing a rapid-onset hypnotic effect [&lt;span&gt;5&lt;/span&gt;], etomidate leads to incoordination, drowsiness and confusion frequently reported in harmful use. At higher doses, seizures, impaired consciousness and a comatose state may occur. Although not fully understood, the harmful use of etomidate may trigger psychiatric symptoms through altering GABA-A receptor equilibrium, a disturbance linked to increased impulsivity in magnetic resonance spectroscopy studies [&lt;span&gt;6&lt;/span&gt;]. Given this, it is unsurprising that case reports have documented severe psychiatric disturbances linked to etomidate-laced e-cigarettes including suicidal behaviour, agitation, aggression and mood lability [&lt;span&gt;7, 8&lt;/span&gt;]. In addition, neurological effects including drowsiness, confusion, weakness, dizziness and falls [&lt;span&gt;7-10&lt;/span&gt;] have been observed, along with tremors and involuntary movements [&lt;span&gt;8, 9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Aside from neuropsychiatric effects, there have been associations with medical comorbidities. Case reports have linked etomidate-laced e-cigarettes to adrenal insufficiency through inhibiting adrenal 11β-hydroxylase, an enzyme crucial for cortisol production [&lt;span&gt;11&lt;/span&gt;]. Adrenal dysfunction may cause blood pressure changes, adrenal hyperplasia and hypokalemia—resulting in muscle weakness, hypokalemic paralysis, cardiac arrhythmias and potentially death [&lt;span&gt;10&lt;/span&gt;]. It is, therefore, necessary for healthcare professionals to have a heightened index of suspicion when individuals present with the above physical or medical manifestations, especially in a context when e-cigarettes have been used, given the rising trend.&lt;/p&gt;&lt;p&gt;Detecting recent etomidate use is possible, but challenging and not routine. Standard immunoassays do not detect etomidate and its metabolites [&lt;span&gt;12&lt;/span&gt;]. Currently, d","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"2154-2155"},"PeriodicalIF":5.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751911","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":"Alcohol and drug use and attainment of pregnancy preferences in the southwestern United States: A longitudinal cohort study.","authors":"Sarah Raifman, Sarah C M Roberts, Corinne H Rocca","doi":"10.1111/add.70135","DOIUrl":"10.1111/add.70135","url":null,"abstract":"<p><strong>Aims: </strong>Addressing design and measurement limitations of prior studies, we examined whether individuals who use alcohol or drugs are less likely to attain their pregnancy preferences over one year.</p><p><strong>Design: </strong>Longitudinal cohort study.</p><p><strong>Setting: </strong>Five southwestern US states.</p><p><strong>Participants: </strong>2015 individuals ages 15-34 years, capable of pregnancy and non-pregnant at enrollment from 23 primary and reproductive healthcare facilities (2019-2022).</p><p><strong>Measurements: </strong>Data were collected over 13.5 months. Past-month alcohol, cannabis and other drug use were self-reported at baseline; prospective pregnancy preferences (prior to pregnancy) were reported quarterly using the Desire to Avoid Pregnancy (DAP) scale (range 0-4, 4 representing higher desire to avoid pregnancy); and incident pregnancy was reported every 6 weeks. We used adjusted mixed effects linear regression models to assess associations between baseline substance use and quarterly DAP scores and Cox proportional hazard models to investigate differential attainment of pregnancy preferences by substance use.</p><p><strong>Findings: </strong>At baseline, 40% (795/1968) of participants reported drinking heavily, 16% (308/1968) reported cannabis use and 3% (53/1968) reported other drug use. Heavy (vs. moderate, low or no) drinking and daily cannabis (vs. no use) were associated with higher desire to avoid pregnancy [coefficient = 0.06, 95% confidence interval (95% CI) = 0.01-0.12], P = 0.02; coefficient = 0.14, 95% CI = 0.07-0.22, P < 0.001], but DAP scores did not differ by other drug use (coefficient = 0.13, 95% CI = -0.07 to 0.33, P = 0.21). 282 participants reported incident pregnancies; of these, 46% (130/282), 29% (81/282) and 25% (71/282) were among participants with low, mid-range and high DAP scores. Among those with high DAP scores, heavy drinking was positively associated with pregnancy [adjusted hazard ratio (aHR) = 1.51, 95% CI = 1.12-2.04, P < 0.01]. Among those with low DAP scores, less than daily versus no cannabis use was associated with pregnancy (aHR = 1.64, 95% CI = 1.13-2.38, P = <0.01). Among those with mid-range DAP scores, heavy drinking was inversely associated with pregnancy (aHR 0.62, 95% CI = 0.42-0.90, P = 0.01). Other drug use was not associated with pregnancy regardless of DAP score.</p><p><strong>Conclusions: </strong>Heavy drinking, but not cannabis use or other drug use, appears to be associated with elevated pregnancy risk among those who most desire to avoid pregnancy.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751908","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":"Commentary on Baltes-Flueckiger et al.: Rethinking expectations and evidence in cannabis policy","authors":"Sharon R. Sznitman,&nbsp;Reto Auer,&nbsp;Barbara Broers","doi":"10.1111/add.70161","DOIUrl":"10.1111/add.70161","url":null,"abstract":"&lt;p&gt;Recreational cannabis regulation (RCR) should be guided by evidence and grounded in public health principles. However, few jurisdictions with liberal RCR have relied on evidence to guide the process [&lt;span&gt;1, 2&lt;/span&gt;]. Switzerland’s 2021 legal change allowing pilot RCR trials has made it possible to conduct randomized comparisons between individuals with and without legal cannabis access, offering a unique opportunity to inform on individual-level effects of RCR [&lt;span&gt;3&lt;/span&gt;]. Baltes-Flueckiger &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;4&lt;/span&gt;] present findings from the first such randomized controlled trial (RCT). While this offers valuable insights into the relationship between cannabis regulation and mental health outcomes, it opens the door for a broader conversation about how we evaluate RCR impacts. In this commentary, we build on these findings to reflect on outcomes that matter, explore the strengths and limitations of RCTs in this context, and advocate for a pluralistic approach to evidence that captures both individual and societal dimensions of legalization.&lt;/p&gt;&lt;p&gt;Baltes &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;4&lt;/span&gt;] tested a public health model with regulated pharmacy sales, 20% tetrahydrocannabinol (THC) caps, no advertising and harm reduction measures. The intervention group had access to regulated cannabis while the control group remained on a 6-month waiting list, purchasing from illegal markets. Their key finding showed that legal pharmacy access to cannabis did not significantly improve self-reported mental health outcomes and only modestly reduced cannabis misuse, as measured by the Cannabis Use Disorders Identification Test – Revised (CUDIT-R). These findings balance polarized expectations: neither confirming fears of widespread harm nor hopes of significant mental health benefits.&lt;/p&gt;&lt;p&gt;The methodological rigor of the study strengthens the authors’ claim that differences in outcomes likely reflect the effects of the intervention, rather than being artifacts of the study design.&lt;/p&gt;&lt;p&gt;While the study provides insights into the effects of one regulatory model, it is essential to recognize that RCR varies in form and impact. Baltes-Flueckiger &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;4&lt;/span&gt;] examined a public health-oriented regulatory model, while many other studies focus on commercial models [&lt;span&gt;5&lt;/span&gt;]. RCR effects likely depend on the specific regulatory model and implementation tested [&lt;span&gt;6&lt;/span&gt;]. Future research should therefore assess how public health-focused versus commercial RCR models produce different outcomes, rather than viewing access as simply legal or illegal.&lt;/p&gt;&lt;p&gt;The neutral RCT outcomes in the Baltes-Flueckiger &lt;i&gt;et al&lt;/i&gt;. [&lt;span&gt;4&lt;/span&gt;] study highlights the need to re-evaluate RCR assessment measures. Cannabis legalization affects multiple domains beyond mental health, including drug use norms, commercial practices and law enforcement. While RCTs establish causal effects on individual-level outcomes, they cannot fully capture broader social","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"1993-1994"},"PeriodicalIF":5.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751909","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":"High potency cannabis flower use is associated with heavier consumption and risk for cannabis use disorder among young adults in California, United States","authors":"Michael S. Dunbar,&nbsp;Elizabeth J. D'Amico,&nbsp;Rachana Seelam,&nbsp;Jordan P. Davis,&nbsp;Eric R. Pedersen,&nbsp;Anthony Rodriguez,&nbsp;Beau Kilmer","doi":"10.1111/add.70118","DOIUrl":"https://doi.org/10.1111/add.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To measure associations between frequency and quantity consumed of cannabis flower for different levels of delta-9-tetrahydrocannabinol (THC) concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>California, USA (survey fielded June 2022–July 2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Young adults (<i>n</i> = 512) with mean age 25.86 (standard deviation = 0.87) years, 48.04% female, from a California-based cohort study, who endorsed past-month cannabis flower use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Individuals completed survey items on cannabis use behavior (e.g. past-month use frequency, quantity consumed), symptoms of cannabis use disorder [using the Cannabis Use Disorder Identification Test - Revised (CUDIT-R)] and self-reported knowledge and perceived THC content (potency) of typical flower used. Multivariable linear and logistic regression models examined associations between perceived flower potency [rated on a scale from No THC (0) to Very High THC (5)], use behavior and CUDIT-R scores, adjusting for sociodemographic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Nearly one in five respondents (18.55%) indicated that they did not know the THC potency of flower typically used. Among those who endorsed knowing potency, nearly half (46.76%) endorsed typically using High or Very High THC flower. Results from separate adjusted linear regression models showed that a one-point increase in the perceived THC potency scale was associated with 3.33 more use days per month [B = 3.33, (standard error, SE = 0.46), <i>P</i> &lt; 0.0001], 0.13 more grams of flower used per day [B = 0.13 (SE = 0.04), <i>P</i> &lt; 0.01] and 1.21 greater CUDIT-R scores [B = 1.21 (SE = 0.29), <i>P</i> &lt; 0.0001].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self-reported use of higher potency cannabis flower appears to be associated with more frequent and higher-quantity cannabis consumption and greater Cannabis Use Disorder Identification Test - Revised (CUDIT-R) scores, which is inconsistent with the notion that individuals titrate use of higher-potency cannabis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 11","pages":"2329-2334"},"PeriodicalIF":5.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145297596","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":"Clinical predictors of mortality in dual diagnosis patients receiving integrated in-patient treatment—A cohort study with 21 years follow-up","authors":"Signe Wegmann Düring,&nbsp;Lei Blandin Jobe,&nbsp;Magnus R. Balleby,&nbsp;Solvej Mårtensson","doi":"10.1111/add.70125","DOIUrl":"10.1111/add.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine mortality, and identify predictors of mortality, in a cohort of dual diagnosis (co-existing psychiatric disorder and substance use disorder) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cohort study based on national register and electronic health record data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting and participants</h3>\u0000 \u0000 <p>Between 2002 and 2017, 2359 dual-diagnosis patients received treatment at a specialized Danish department and were followed until death, migration or a maximum of 21 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Data on diagnosis, substance use, demographics, medication use and mortality were linked to national registers. Kaplan–Meier plots illustrated mortality differences across diagnostic groups, while the Cox model identified factors associated with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>In this study, 23.5% of dual diagnosis patients died within ten years of discharge and 33.7% at end of follow-up. The highest mortality risk was among those with a primary substance use disorder (SUD) and no psychiatric diagnosis, with 45.9% dying. Alcohol [adjusted hazard ratio (aHR) = 1.42; 95% confidence interval (CI) = 1.18–1.71], opioids (aHR = 1.26; 95% CI = 1.03–1.54), as well as Charlson Comorbidity Index: 1 (aHR = 1.70; 95% CI = 1.41–2.04) and 2 + (aHR = 2.56; 95% CI = 1.94–3.36), increased mortality risk. In contrast, cannabis use disorder (aHR = 0.77; 95% CI = 0.65–0.93) and being female (aHR = 0.83; 95% CI = 0.71–0.97) reduced it. Psychiatric diagnoses F30–39 (aHR = 0.70; 95% CI = 0.56–0.87) and F40–49 (aHR = 0.76; 95% CI = 0.59–0.97) were associated with lower mortality risk compared with F20–29. Of 733 deaths with mortality cause data, nearly two-thirds were from natural causes, 8% from suicide and 20% from accidents or violence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The observed high mortality rates among clinically confirmed dual diagnosis patients (co-existing psychiatric disorder and substance use disorder) in Denmark highlight the urgent need for comprehensive treatment for this population. The risk of death appears to be related to type of substance use, with alcohol and opioids associated with higher mortality rates than other substances.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 11","pages":"2258-2269"},"PeriodicalIF":5.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726142","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":"A systematic review of reviews on comprehensive community initiatives to prevent or reduce alcohol and other drug harms.","authors":"Peter John Gates, Andrea C Zocco, Sara Farnbach","doi":"10.1111/add.70153","DOIUrl":"https://doi.org/10.1111/add.70153","url":null,"abstract":"<p><strong>Background and aims: </strong>Comprehensive community initiatives (CCI) aimed at reducing or preventing alcohol or other drug (AOD) harms incorporate multiple initiatives delivered to whole communities to effect community-level change on sociocultural and environmental factors. CCIs have gained in popularity and have been subject to extensive research; however, CCIs comprise multiple initiatives and evidence for effectiveness by substance type has been mixed. This umbrella review aimed to synthesise information from published reviews to describe the combination of CCIs with the most consistent evidence for impact for each substance type.</p><p><strong>Method: </strong>We searched Embase/Medline, PsycINFO, Cochrane Database of Systematic Reviews, two online registries and hand searched references for English language reviews without date restriction and conducted an umbrella review using mixed methods synthesis (PROSPERO CRD42023432567). We considered all types of reviews focused on CCIs and addressing AOD use or harms. Two reviewers independently screened all articles and conducted full text review. Extraction of main results relating to CCI impact and quality assessment using AMSTAR-2 and SANRA was completed by two independent reviewers and corrected covered area analysis conducted.</p><p><strong>Results: </strong>We identified 87 reviews spanning three decades; 14 were rated high quality. Most reviews considered individual substances [alcohol (43 reviews) or tobacco (35 reviews) and rarely illicit drugs (16 reviews)], and some limited scope to 'at-risk' community members [young people (26 reviews) and First Nations (8 reviews)]. Although the evidence did not meet criteria for consistent impact, communities should consider implementing school-based (supported by 36 of 50 reviews) and parenting-related (29 of 37 reviews) activities that are supported by media campaign where feasible (29 of 51 reviews). CCIs have the most consistent impact on alcohol (supported by 24 of 32 reviews) and tobacco-related outcomes (22 of 35 reviews), though illicit drugs are yet to be adequately assessed.</p><p><strong>Conclusions: </strong>Although the available evidence regarding comprehensive community initiatives is largely inconsistent, the addition of parenting-related activities to existing school-based education campaigns is likely to improve effectiveness. A media campaign may extend their reach to those outside school settings. Future evaluation of CCIs should measure impact of activities in isolation where possible and incorporate process measures to gauge community engagement and empowerment.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726066","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}