Search

Background and aims: There are concerns that availability of recreational cannabis dispensaries (RCDs) and point‐of‐sale marketing may lead to increased cannabis use in jurisdictions where cannabis retail sale is legal. This paper examined whether the availability RCDs and the presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs were associated with cannabis use and risk perceptions. Design: Cross‐sectional, secondary data analysis. Setting: California, USA. Participants: A representative sample of 3385 adults in California who participated in the 2020 probability‐based Marijuana Use and Environment Survey. Measurements Binary outcomes included past‐month overall cannabis use, perceiving cannabis smoking as harmful and past‐month cannabis use by purpose (medical only, recreational only and dual). The objectively assessed predictors included proximity and density of RCDs and presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs. Findings In terms of proximity, thepresence of storefront signage in the nearest RCD was associated with smaller odds of perceiving cannabis smoking as harmful [odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.39, 0.99] if the RCD was located within 2 miles of home. Presence of health benefit signs in the nearest RCD was associated with greater odds of overall cannabis use (OR = 2.45, 95% CI = 1.17, 5.16) and recreational use (OR = 3.50, 95% CI = 1.027, 11.91) if the RCD was located within 2–4 miles of home. In terms of density, count of RCDs, count of RCDs with storefront signage and count of RCDs with health benefit signs within 2 miles of home were each separately associated with greater odds of overall cannabis use and cannabis use for dual purposes. Conclusions: The availability of recreational cannabis dispensaries within 2 miles of one's home and the presence of storefront signage indicating the availability of cannabis and signs promoting health benefits of cannabis appear to be associated with increased cannabis use and reduced risk perceptions among adults in California, USA. [ABSTRACT FROM AUTHOR]

Background and aims Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug-related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly funded treatment for OUD to compare total costs of crime during a hypothetical 6-month period following initiation of opioid agonist treatment (OAT) versus detoxification. Design Retrospective, administrative data-based cohort study with comprehensive information on drug treatment and criminal justice systems interactions. Setting Publicly funded drug treatment facilities in California, USA (2006-10). Participants A total of 31 659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women and 37.1% primarily used prescription opioids. Measurements Daily costs of crime (US$2014) were calculated from a societal perspective and were composed of the costs of policing, court, corrections and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time-varying confounders, including drug use and criminal justice system involvement prior to treatment initiation. Findings Daily costs of crime during treatment compared with after treatment were $126 lower for OAT [95% confidence interval (CI) = $116, $136] and $144 lower for detoxification (95% CI = $135, $154). Summing the costs of crime during and after treatment over a hypothetical 6-month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17 550 ($16 840, $18 383). Conclusions In publicly funded drug treatment facilities in California, USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the 6 months following initiation of treatment, and the economic benefits were far greater for individuals receiving time-unlimited treatment. [ABSTRACT FROM AUTHOR]

Background and Aims: The increasing trend in alcohol consumption among women, exacerbated by the COVID‐19 pandemic, is of growing concern. Screening, brief intervention, and referral to treatment in primary care is an efficacious and cost‐effective treatment approach for unhealthy alcohol use. However, disparities exist in delivery of brief interventions by sex, age and race/ethnicity. This study measures brief intervention rates among eligible patients by sex, age and race/ethnicity and their intersectionality, in the context of a program of systematic alcohol screening and brief intervention program in adult primary care in a large, integrated health‐care delivery system. Design, Setting and Participants: This was a population‐based observational study among primary care clinics in an integrated health‐care delivery system in Northern California, USA. The participants comprised adult (18+) patients (n = 287 551) screening positive for unhealthy alcohol use between January 2014 and December 2017. Measurements: Receipt of brief intervention, patient and provider characteristics from electronic health records. Findings Multi‐level logistic regression showed that women had lower odds of receiving brief intervention than men among all age, racial/ethnic groups and drinking levels. Sex differences were greater among those aged 35–49 years [odds ratio (OR) = 0.67, 95% confidence interval (CI) = 0.64, 0.69]) and 50–65 years (OR = 0.69, 95% CI =0.66, 0.72) than among other age groups. Sex differences in odds of receiving brief intervention were greater for the Latino/Hispanic group for women versus men (OR = 0.69, 95% CI = 0.66, 0.72) and smaller for the Asian/Pacific Islander group (OR = 0.76, 95% CI = 0.72, 0.81). Conclusion: In the United States, compared with men, women appear to have lower odds of receiving brief intervention for unhealthy alcohol use across all age groups, particularly during middle age. Black women and Latina/Hispanic women appear to be less likely to receive brief intervention than women in other race/ethnicity groups. Receipt of brief intervention does not appear to differ by drinking levels between men and women. [ABSTRACT FROM AUTHOR]

Background and aims: Retail alcohol outlets appear to open in neighborhoods with low land and structure rents near sources of demand; they may 'agglomerate', open near to one another or 'churn', replace one another, over time. We used the turnover in numbers of outlets over time to measure agglomeration and churning and the impacts of openings and closings of outlets on neighborhood crime. Design: Interrupted quasi‐experiments using spatial panel population data from 3768 synthetic block areas over 6 years. Setting: City of Oakland, CA, USA. Participants: City population. Measurements Census‐based socio‐demographic estimates and counts of openings and closings of bars/pubs, restaurants and off‐premises outlets related to assault, burglary and robbery crime incidents across synthetic Census blocks. Bayesian space–time models were used to assess agglomeration and churning and measure impacts of openings/closings on crime. Findings Churning was substantial; openings followed closings for all outlets [bars/pubs, relative risk (RR) = 50.9, 95% credible interval (CI) = 3.0–449.9; restaurants, RR = 3.1, CI = 1.5–6.1; off‐premises, RR = 23.5, CI = 2.0–129.8]. Bars/pub and restaurant openings agglomerated with other outlets (e.g., RR = 1.02, CI = 1.00–1.03 and RR = 1.01, CI = 1.00–1.01), but off‐premises outlets did not. Covarying out effects related to outlet densities, bar/pub openings were related to a 3.5% increase in assaults (RR = 1.04, CI = 1.01–1.06) and 6.9% increase in robberies (RR = 1.07, CI = 1.03–1.11). Restaurant openings were related to a 5.3% increase in burglaries (RR = 1.05, CI = 1.04–1.06). Openings and closings of off‐premises outlets were unrelated to all three crime types. Conclusions: Retail alcohol outlets appear to follow a pattern of opening near to one another and replacing each other over time. Bar, pub and restaurant openings appear to be related to increases in neighborhood crime. [ABSTRACT FROM AUTHOR]

Background and Aims: For electronic cigarettes (e‐cigarettes) to be a viable substitute for combustible cigarettes, it is likely that they must be rewarding enough for regular use, indicated by factors such as craving and dependence, important aspects of reinforcement. This study aimed to understand short‐term changes in measures of nicotine dependence between groups differing by use trajectory in a switching trial, and within group changes of these measures. Design Secondary data analysis of one arm of an e‐cigarette randomized clinical trial. Setting: San Diego, California and Kansas City, Missouri, United States. Participants: 114 African American (n = 60) and Latinx (n = 54) smokers (58.8% male) attempting to switch to nicotine salt pod system (NSPS) e‐cigarettes in a 6‐week trial. Measurements At week 6, participants were classified by use trajectory: exclusive smokers (n = 16), exclusive e‐cigarette (n = 32), or dual users (n = 66). E‐cigarette, cigarette, and total nicotine dependence (cigarette + e‐cigarette), use patterns, cigarette craving and nicotine withdrawal, and cotinine were assessed at baseline and week 6 using standard measures. Findings In between group comparisons, exclusive e‐cigarette and dual users showed greater reductions in cigarette dependence (e‐cigarette: −32.38, 95% CI = −37.7,−27.1; dual: −18.48, 95% CI = −22.2,−14.7), withdrawal (e‐cigarette: −6.25, 95% CI = −8.52,−3.98; dual: −3.18, 95% CI = −5.02,−1.34), craving (e‐cigarette: −11.44, 95% CI = −14.2,8.7; dual: −9.59, 95% CI = −11.6,−7.59), and cigarettes per day (CPD; e‐cigarette: −11.19, 95% CI = −13.1,−9.27; dual: −9.39, 95% CI = −11.3, −7.52) compared with exclusive smokers. In within group analyses, e‐cigarette and dual users showed reductions in craving and withdrawal from baseline to week 6. Exclusive e‐cigarette and dual users, maintained cotinine levels (all Ps > 0.05) and showed reductions in CPD and cigarette dependence (all Ps < 0.01). Findings were inconclusive regarding changes in total nicotine dependence from baseline to week 6 among exclusive e‐cigarette users (P = 0.123). Dual users showed increased total nicotine dependence (P < 0.001) and smokers showed decreased total dependence (P = 0.004). Conclusions: Smokers who switch to nicotine salt pod system e‐cigarettes maintain their nicotine levels and transfer their dependence, suggesting that nicotine salt pod system e‐cigarettes have a similar reinforcement potential to cigarettes and facilitate switching. [ABSTRACT FROM AUTHOR]

Aims: To estimate associations between both current‐ and prior‐year medical cannabis dispensary densities and hospitalizations for cannabis use disorder in California, USA between 2013 and 2016. Design Spatial analysis of ZIP code‐level hospitalization discharge data using Bayesian Poisson hierarchical space–time models over 4 years. Setting and cases: California, USA from 2013 to 2016 (6832 space–time ZIP code units). Measurements We assessed associations of annual hospitalizations for cannabis use disorder [assignment of a primary or secondary code for cannabis abuse and/or dependence using ICD‐9‐CM or ICD‐10‐CM (outcome)] with the total number of medical cannabis dispensaries per square mile in a ZIP code as well as dispensary temporal and spatial lags (primary exposures). Other exposure covariates included alcohol outlet densities, manual labor and retail sales densities and ZIP code‐level economic and demographic conditions. Findings One additional dispensary per square mile was associated with a median risk ratio of 1.021 (95% credible interval 1.001, 1.041). Prior‐year dispensary density did not appear to be associated with hospitalizations (median risk ratio = 1.006, 95% CrI = 0.986, 1.026). Higher median household income, higher unemployment, greater off‐premises alcohol outlet density and lower on‐premises alcohol outlet density and poverty were all associated with decreased ZIP code‐level risk of cannabis abuse/dependence hospitalizations. Conclusions: In California, USA, the increasing density of medical cannabis dispensaries appears to be positively associated with same‐year but not next‐year hospitalizations for cannabis use disorder. [ABSTRACT FROM AUTHOR]

Aims: To test the efficacy of a brief intervention to reduce alcohol or drug use and to promote use of addiction services among patients seeking mental health treatment. Design and setting: A multi‐centre, longitudinal, two‐group randomized controlled trial with randomization within each of two mental health treatment systems located in Ventura County and Los Angeles County in California, USA. Participants: A total of 718 patients (49.2% female) aged 18 and older with a mental health diagnosis and either a heavy drinking day or any use of cannabis or stimulants in the past 90 days. Intervention and comparator: A motivation‐based brief intervention with personalized feedback (screening, brief intervention and referral to treatment (SBIRT) condition) (n = 354) or a health education session (control condition) (n = 364). Measurements Primary outcomes included frequency of heavy drinking days, days of cannabis use and days of stimulant use at the primary end‐point 3 months post‐baseline. Secondary outcomes included frequency and abstinence from substance use out to a 12‐month follow‐up and the use of addiction treatment services. Findings Participants in the SBIRT condition had fewer heavy drinking days [odds ratio (OR) = 0.53; 95% credible interval (CrI) = 0.48–0.6] and fewer days of stimulant use (OR = 0.58; 95% CrI = 0.50–0.66) at the 3‐month follow‐up compared with participants in the health education condition. Participants in the SBIRT condition did not comparatively reduce days of cannabis use at the 3‐month follow‐up (OR = 0.93; 95% CrI = 0.85–1.01). Secondary outcomes indicated sustained effects of SBIRT on reducing the frequency of heavy drinking days and days of stimulant use. No effects were observed on abstinence rates or use of addiction treatment services. Conclusions: Screening and brief intervention for unhealthy alcohol and drug use in mental health treatment settings were effective at reducing the frequency of heavy drinking and stimulant use. [ABSTRACT FROM AUTHOR]

Background and aims: The construct of susceptibility to substance use initiation (i.e. cognitive proclivity to future use) is critical for prevention efforts in adolescent populations. This study aimed to provide empirical evidence for the validity of the susceptibility construct for different cannabis products (i.e. combustible, edible or vaporized cannabis), and evaluate whether susceptibility measures are predictive of subsequent initiation. Design Prospective cohort study including baseline data (Spring 2015) and four follow‐up surveys administered every 6 months through Spring 2017. Setting: Ten schools in the Los Angeles, California metropolitan area. Participants: Adolescents [n = 2100; mean age = 16.1; standard deviation (SD) = 0.41; 54% female] who reported never having used any cannabis product at baseline. Measurements We assessed five indices of a susceptibility to use cannabis composite index at baseline, adapted from a validated tobacco use index (intention to use, willingness, curiosity and positive/negative cannabis use outcome expectancies, with four response categories, definitely not [1] to definitely yes [4]), by cannabis product (combustible, edible or vaporized). A composite index was created for each product by averaging responses across the five susceptibility items. Subsequent initiation of use of each cannabis product was assessed at each follow‐up wave. Findings Factorial validity for unidimensionality for each five‐item index (by product) was confirmed. The composite index for susceptibility to cannabis use was greatest for combustible (mean = 1.44; SD = 0.58), moderate for edible (mean = 1.37; SD = 0.53) and lowest for vaporized cannabis (mean = 1.30; SD = 0.44). The associations of each composite susceptibility index with subsequent initiation of that product and each of the other cannabis products over follow‐up (i.e. cross‐product associations) were statistically significant, with hazard ratios ranging from 2.30 to 2.80 across 24 months of follow‐up (all Ps < 0.05). Conclusions: A five‐item susceptibility to cannabis use composite index (by product) appears to be useful for characterizing and predicting youth at risk for cannabis use initiation across a spectrum of cannabis products. [ABSTRACT FROM AUTHOR]

Aims: To examine whether daily exposure to tobacco outlets within activity spaces is associated with cigarette smoking and with the number of cigarettes smoked by youth that day. Design The study used geographic ecological momentary assessment (GEMA) data that combined daily surveys with ecological momentary assessment of global positioning systems (GPS) using geographic information systems (GIS) to allow for real‐time data collection of participants' environments and behaviors. Setting: Eight mid‐sized California (USA) city areas. Participants: The analytical sample included 1065 days, which were clustered within 100 smoker and non‐smoker participants (aged 16–20 years, 60% female). Measurements Any cigarette smoking and number of cigarettes smoked on a given day, the number of tobacco outlets within 100 m of activity space polylines each day, the number of minutes participants spent within 100 m of tobacco outlets each day and demographic characteristics (age, sex, race/ethnicity and perceived socio‐economic status). Findings Controlling for demographic characteristics, the findings of multi‐level mixed effects logistic models were inconclusive, whether or not the number of tobacco outlets within 100 m of youths' activity space polylines or the number of minutes spent within 100 m of tobacco outlets were associated with whether the participant smoked cigarettes on a given day [odds ratio (OR) = 1.05, P = 0.24; OR = 0.99, P = 0.81, respectively]. However, in multi‐level zero‐inflated negative binomial models, the risk of smoking an additional cigarette on a given day increased with each additional tobacco outlet [incidence rate ratio (IRR) = 1.04, P < 0.05] and each additional minute spent within 100 m of tobacco outlets (IRR = 1.01, P < 0.001) each day. Conclusions: Among young people in urban California, differences in day‐to‐day exposure to tobacco outlets within activity spaces does not seem to be significantly associated with whether a person smokes a cigarette on a given day, but higher exposure to tobacco outlets appears to be positively associated with the number of cigarettes smoked on that day. [ABSTRACT FROM AUTHOR]

Aim: To describe systemic nicotine exposure and subjective effects of electronic cigarettes (e‐cigarettes) in people who use both e‐cigarettes and cigarettes (dual users), including within‐subject comparisons of e‐cigarette and cigarette use. Design Two‐arm, counterbalanced cross‐over study. Participants used their usual brand of e‐cigarette or cigarette during a standardized session in a 2‐week study. Setting: Hospital research ward, San Francisco, CA, USA. Participants: Thirty‐six healthy (eight women, 28 men) participants. Measurements Plasma nicotine was analyzed by gas chromatography–tandem mass spectrometry; nicotine withdrawal, urge to smoke and vape, affective states, craving, satisfaction and psychological reward were measured by standardized questionnaires. Findings Compared with cigarettes, average maximum plasma nicotine concentration (Cmax) was lower with e‐cigarettes [6.1 ± 5.5 ng/ml, mean ± standard deviation (SD) versus 20.2 ± 11.1 ng/ml, P < 0.001] and time of maximal concentration (Tmax) was longer (6.5 ± 5.4 versus 2.7 ± 2.4 minutes, P < 0.001). Use of both products resulted in a reduction in the severity of withdrawal symptoms, negative affect and urge to use either product. E‐cigarettes were less rewarding and satisfying and reduced craving to a lesser degree than cigarettes. We were not able to detect any differences in withdrawal symptoms, affective states and urge to smoke cigarettes between e‐cigarette and cigarette use. Conclusion: Systemic nicotine exposure was, on average, lower with single use of e‐cigarettes compared with cigarettes, and e‐cigarettes were judged to be less satisfying and rewarding and reduced craving less than cigarettes. [ABSTRACT FROM AUTHOR]

Aims: We investigated associations between the density of medical marijuana dispensaries (MMDs) around young adults' homes and marijuana use outcomes. Design Secondary data analysis. Setting: Los Angeles County, CA, USA. Participants: A total of 1887 participants aged 18–22 years, surveyed online in 2016–17. Measurements Outcomes were past‐month marijuana use (number of days used, number of times each day), positive expectancies and perceived peer use. Density was measured as the total number of MMDs and number of MMDs with storefront signage indicative of marijuana sales, within 4 miles of respondents' homes. Findings Eighty‐four per cent of respondents had 10 or more MMDs within 4 miles of their homes. Multiple linear regression analyses that adjusted for individual‐level socio‐demographic characteristics and neighborhood socio‐economic status indicated that living near a higher number of MMDs was associated with greater number of days used in the past month [β = 0.025; 95% confidence interval (CI) = 0.001, 0.049; P = 0.04] and higher positive marijuana expectancies (β = 0.003; 95% CI = 0.001, 0.007; P = 0.04). Living near more MMDs with storefront signage had a four‐ to six‐fold larger effect on number of times used per day and positive expectancies, respectively, compared with associations with the total MMD count. Adjusting for medical marijuana card ownership attenuated the association with number of days used in the past month and positive expectancies, and an unexpected association emerged between higher MMD density and fewer number of times used each day (β = −0.005; 95% CI = –0.009, −0.001; P = 0.03). Conclusions: For young adults in Los Angeles County, living near more medical marijuana dispensaries (MMDs) is positively associated with more frequent use of marijuana within the past month and greater expectations of marijuana's positive benefits. MMDs with signage show stronger associations with number of times used each day and positive expectancies. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To determine whether diminished alternative reinforcement (i.e. engagement and enjoyment from substance‐free activities) mediated the longitudinal association of conduct problems with substance use in early–mid‐adolescence. Design: Structural equation modeling tested whether the association between wave 1 (baseline) conduct problems and wave 3 (24‐month follow‐up) substance use outcomes was mediated by diminished alternative reinforcement at wave 2 (12‐month follow‐up). Additional analyses tested whether sex and socio‐economic status moderated this association. Setting: Ten high schools in Los Angeles, CA, USA, 2013–15. Participants: Students (n = 3396, 53.5% female, mean [standard deviation (SD)] age at wave 1 baseline = 14.1 (0.42) years). Measurements: Self‐reported conduct problems (11‐item questionnaire), alternative reinforcement (44‐item questionnaire) and use of alcohol, marijuana and combustible cigarettes during the past 6 months (yes/no) and the past 30 days (nine‐level ordinal response based on days used in past 30 days). Results: Significant associations of wave 1 conduct problems with wave 3 marijuana use during the past 6 months (β = 0.25) and past 30 days (β = 0.26) were mediated by wave 2 diminished alternative reinforcement (βindirect effect: 6 months = 0.013, 30 days = 0.017, Ps < 0.001). Associations of conduct problems with alcohol or combustible cigarette use were not mediated by alternative reinforcement. All associations did not differ by sex and socio‐economic status. Conclusions: Diminished alternative reinforcement may be a modifiable mechanism linking early adolescent conduct problems and subsequent marijuana use that could be targeted in prevention programs to offset the adverse health and social sequelae associated with comorbid conduct problems and marijuana use in early‐mid adolescence. [ABSTRACT FROM AUTHOR]

Abstract: Aims: (1) To characterize the amount of prescription opioids prescribed for high‐risk patients by low‐volume prescribers; (2) to quantify how high‐ and low‐volume prescribers differ systematically in their prescribing patterns. Design: Cross‐sectional study using 2015 longitudinal, all‐payer QuintilesIMS pharmacy claims. We conducted an aggregated analysis for the first aim and an individual‐level analysis for the second aim. Setting: California, Florida, Georgia, Maryland, and Washington, USA. Participants: Among 4 046 275 patients, we identified 375 848 concomitant users (filling more than 30‐days of concomitant opioids and benzodiazepines), 150 814 chronic users (using 100+ morphine milligram equivalents (MMEs) per day for more than 90 days), and 3190 patients prescribed opioids by > 3 prescribers and filling opioids at > 3 pharmacies during any 90‐day period. Among 192 126 prescribers, we identified 8023 high‐volume prescribers, who comprised the highest fifth percentile of opioid volume during four calendar quarters. Measurements: (1) MME dose per transaction, (2) days supplied per transaction, (3) total opioid volume per patient and (4) number of prescriptions per patient. We also examined differences in opioid dispensing between high‐ and low‐volume prescribers among patients receiving opioids from both. Findings: Low‐volume prescribers accounted for 15–29% of opioid volume and 18–56% of opioid prescriptions for high‐risk patients, compared with 28–37% and 53–58% for low‐risk patients. After accounting for state of residence, comorbid burden, prescriber specialty and care sequence, patients were more likely to receive higher doses (60.9 versus 53.2 MMEs per day, P < 0.01), longer supplies (22.1 versus 15.6 days, P < 0.01), more prescriptions (4.0 versus 2.6 prescriptions, P < 0.01) and greater opioid volume (5.6 versus 1.9 g, P < 0.01) from high‐ than low‐volume prescribers. Conclusions: In the United States, high‐risk patients obtain a substantial proportion of prescription opioids from low‐volume prescribers. The differences in prescribing patterns between high‐ and low‐volume prescribers suggest the importance of interventions targeting prescriber behaviors. [ABSTRACT FROM AUTHOR]

Background and aims Anhedonia-a transdiagnostic psychopathological trait indicative of inability to experience pleasure-could lead to and result from adolescent marijuana use, yet this notion has not been tested. This study aimed to estimate the association of: (1) anhedonia at age 14 with rate of change in marijuana use over an 18-month follow-up, and (2) marijuana use at age 14 with rate of change in anhedonia over follow-up. Secondary aims were to test whether gender, baseline marijuana use history and peer marijuana use moderated these associations. Design Observational longitudinal cohort repeated-measures design, with baseline (age 14 years), 6-month, 12-month and 18-month follow-up assessments. Settings Ten public high schools in Los Angeles, CA, USA, 2013-15. Participants Students [ n = 3394; 53.5% female, mean (standard deviation) age at baseline = 14.1 (0.42)]. Measurements Self-report level of anhedonia on the Snaith-Hamilton Pleasure Scale and frequency of marijuana use in the past 30 days. Findings Parallel process latent growth curve models adjusting for confounders showed that baseline anhedonia level was associated positively with the rate of increase in marijuana use frequency across follow-ups [β, 95% confidence interval (CI) = 0.115 (0.022, 0.252), P = 0.03]. Baseline marijuana use frequency was not related significantly to the rate of change in anhedonia across follow-ups [β, 95% CI = −0.015 (−0.350, 0.321), P = 0.93]. The association of baseline anhedonia with faster marijuana use escalation was amplified among adolescents with (versus without) friends who used marijuana at baseline [β, 95% CI = 0.179 (0.043, 0.334) versus 0.064 (−0.071, 0.187), interaction P = 0.04], but did not differ by gender or baseline ever marijuana use. Conclusions In mid-adolescence, anhedonia is associated with subsequent marijuana use escalation, but marijuana use escalation does not appear to be associated with subsequent anhedonia. [ABSTRACT FROM AUTHOR]

Aims We tested race/ethnic differences in alcohol and marijuana (AM) trajectories (comprising an intercept term, reflecting overall probability of use, and a slope term, reflecting change in probability of use) during adolescence, whether AM use trajectories predicted high school outcomes, and whether outcomes differed by race/ethnicity after controlling for trajectory of AM use. Design This longitudinal study involved 6509 youth from 16 middle schools in Southern California surveyed from age 11.5 (2008) to age 17 (2015) years; all surveys assessed AM use, and the final survey also examined high school outcomes. Setting Youth completed five surveys in middle school and two on-line surveys in high school. Participants The sample was 50% male and 80% non-white. Measurements Intercept (at 2.75 years post-baseline) and slope of AM use were examined as outcomes for race/ethnic differences. AM use trajectories were examined as predictors of academic performance and unpreparedness, social functioning, mental and physical health and delinquency. Findings We found differences in trajectories of use by race/ethnicity, with white youth reporting a higher overall intercept of alcohol use compared to all other groups (versus Asian P < 0.001, black P = 0.001, multi-ethnic P = 0.008). Overall, examination of trajectories of use showed that adolescents with a higher alcohol use intercept term reported greater academic unpreparedness ( P < 0.001) and delinquency ( P < 0.001) at wave 7 in high school. In addition, youth with a higher intercept for marijuana use reported greater academic unpreparedness ( P < 0.001) and delinquency ( P < 0.001), and poorer academic performance ( P = 0.032) and mental health ( P = 0.002) in high school. At wave 7, compared to white youth, Hispanic and multi-ethnic youth reported poorer academic performance ( P < 0.001 and P = 0.034, respectively); Asian, black and Hispanic youth reported higher academic unpreparedness ( P < 0.001, P = 0.019, and P = 0.001); and Asian youth and multi-ethnic youth reported poorer physical health ( P = 0.012 and P = 0.018) controlling for AM use. Conclusions Greater AM use was associated with worse functioning in high school for all youth. After controlling for AM use, non-white youth reported worse outcomes in high school for academics and health. [ABSTRACT FROM AUTHOR]

Aims To examine the safety and effectiveness of buprenorphine + naloxone sublingual tablets (BUP, as Suboxone®) provided after administration of extended-release injectable naltrexone (XR-NTX, as Vivitrol®) to reduce cocaine use in participants who met DSM-IV criteria for cocaine dependence and past or current opioid dependence or abuse. Methods This multi-centered, double-blind, placebo-controlled study, conducted under the auspices of the National Drug Abuse Treatment Clinical Trials Network, randomly assigned 302 participants at sites in California, Oregon, Washington, Colorado, Texas, Georgia, Ohio, New York and Washington DC, USA to one of three conditions provided with XR-NTX: 4 mg/day BUP (BUP4, n = 100), 16 mg/day BUP (BUP16, n = 100, or no buprenorphine (placebo; PLB, n = 102). Participants received pharmacotherapy for 8 weeks, with three clinic visits per week. Cognitive behavioral therapy was provided weekly. Follow-up assessments occurred at 1 and 3 months post-intervention. The planned primary outcome was urine drug screen (UDS)-corrected, self-reported cocaine use during the last 4 weeks of treatment. Planned secondary analyses assessed cocaine use by UDS, medication adherence, retention and adverse events. Results No group differences were found between groups for the primary outcome (BUP4 versus PLB, P = 0.262; BUP16 versus PLB, P = 0.185). Longitudinal analysis of UDS data during the evaluation period using generalized linear mixed equations found a statistically significant difference between BUP16 and PLB [ P = 0.022, odds ratio (OR) = 1.71] but not for BUP4 ( P = 0.105, OR = 1.05). No secondary outcome differences across groups were found for adherence, retention or adverse events. Conclusions Buprenorphine + naloxone, used in combination with naltrexone, may be associated with reductions in cocaine use among people who meet DSM-IV criteria for cocaine dependence and past or current opioid dependence or abuse. [ABSTRACT FROM AUTHOR]

This section offers news briefs on relating to addiction as of June 2016. It announces the implementation of the Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules 2014 in India. It reports the prescription drug monitoring to be introduced in Victoria to prevent overdoses, as well as the ruling by the Texas Supreme Court upholding a state Supreme Court decision to impose a special tax on cigarette makers.

Aims To determine whether the density of marijuana dispensaries in California, USA, in 2012-13 was related to violent and property crimes, both locally and in adjacent areas, during a time in which local law enforcement conducted operations to reduce the number of storefront medical marijuana dispensaries. Design Data on locations of crimes and medical marijuana dispensaries as well as other covariates were collected for a sample of 333 Census block groups. Setting Long Beach, California, USA from January 2012 to December 2013. Observations A total of 7992 space-time observations (from 333 Census block groups over 24 time-points). Measurements Outcome measures focused on block-group counts of violent and property crimes. Predictors were numbers of local and adjacent-area medical marijuana dispensaries. Covariates included markers of alcohol availability as well as area demographic and economic characteristics. Findings After adjustment for covariates, density of medical marijuana dispensaries was unrelated to property and violent crimes in local areas but related positively to crime in spatially adjacent areas [incident rate ratio (IRR) = 1.0248, CI (1.0097, 1.0402) for violent crime, IRR = 1.0169, CI (1.0071, 1.0268) for property crime]. Conclusions Using law enforcement to reduce medical marijuana dispensaries in California appears to have reduced crime in residential areas near to, but not in, these locations. [ABSTRACT FROM AUTHOR]

Aims To estimate the relationships of tobacco outlet density, cigarette sales without ID checks and local enforcement of underage tobacco laws with youth's life-time cigarette smoking, perceived availability of tobacco and perceived enforcement of underage tobacco laws and changes over time. Design The study involved: (a) three annual telephone surveys, (b) two annual purchase surveys in 2000 tobacco outlets and (c) interviews with key informants from local law enforcement agencies. Analyses were multi-level models (city, individual, time). Setting A sample of 50 mid-sized non-contiguous cities in California, USA. Participants A total of 1478 youths (aged 13-16 at wave 1, 52.2% male); 1061 participated in all waves. Measurements Measures at the individual level included life-time cigarette smoking, perceived availability and perceived enforcement. City-level measures included tobacco outlet density, cigarette sales without ID checks and compliance checks. Findings Outlet density was associated positively with life-time smoking [OR = 1.12, P < 0.01]. An interaction between outlet density and wave (OR = 0.96, P < 0.05) suggested that higher density was associated more closely with life-time smoking at the earlier waves when respondents were younger. Greater density was associated positively with perceived availability (β = 0.02, P < 0.05) and negatively with perceived enforcement (β = −0.02, P < 0.01). Sales rate without checking IDs was related to greater perceived availability (β = 0.01, P < 0.01) and less perceived enforcement (β = −0.01, P < 0.01). Enforcement of underage tobacco laws was related positively to perceived enforcement (β = 0.06, P < 0.05). Conclusions Higher tobacco outlet density may contribute to life-time smoking among youths. Density, sales without ID checks and enforcement levels may influence beliefs about access to cigarettes and enforcement of underage tobacco sales laws. [ABSTRACT FROM AUTHOR]

Background and aims Previous research demonstrates that the number of problems related to each additional drink consumed on any drinking occasion, dose-response, varies non-linearly across average drinking quantities. We test predictions from a dynamic model of drinking behavior that locates this heterogeneity in drinkers' efforts to equilibrate between costs and benefits of use. Design Equations derived from the theoretical model are used to assess dose-response across drinking quantity subgroups using censored regressions. Setting Fourteen California, USA, college campuses surveyed from 2003 to 2011. Participants A total of 37 762 undergraduate college students 18 years of age and older. Measurements Drinking patterns, five physiological problems related to alcohol use (hangover, memory loss, medical treatment for overdose, nausea/vomiting, passing out) and student demographics. Findings The number of physiological problems related to each additional drink consumed was an inverse function of average drinking quantities ( b = 0.2947, Z = 21.92, P<0.001), differed by drinker age (of-age drinker b = -0.1144, Z = -3.95, P < 0.001) and gender (male b = -0.3379, Z = -18.56, P<0.001) and, at the population level, drinking three drinks per occasion was associated with the greatest number of problems. Conclusions Among US college students, all drinkers exhibit greater risks for physiological problems related to alcohol use (hangover, memory loss, medical treatment for overdose, nausea/vomiting, passing out) when drinking greater amounts of alcohol, but heavier drinkers (those who consume more on average) exhibit fewer problems for each additional drink consumed (less dose-response) than light and moderate drinkers. Light and moderate drinkers exhibit greater dose-response, with three drinks per occasion associated with the greatest number of problems. [ABSTRACT FROM AUTHOR]