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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 Individuals with methamphetamine dependence ( MD) exhibit dysfunction in brain regions involved in goal maintenance and reward processing when compared with healthy individuals. We examined whether these characteristics also reflect relapse vulnerability within a sample of MD patients. Design Longitudinal, with functional magnetic resonance imaging ( fMRI) and clinical interview data collected at baseline and relapse status collected at 1-year follow-up interview. Setting Keck Imaging Center, University of California San Diego, USA. Participants MD patients ( n = 60) enrolled into an in-patient drug treatment program at baseline. MD participants remaining abstinent at 1-year follow-up (abstinent MD group; n = 42) were compared with MD participants who relapsed within this period (relapsed MD group; n = 18). Measurements Behavioral and neural responses to a reinforcement learning (paper-scissors-rock) paradigm recorded during an fMRI session at time of treatment. Findings The relapsed MD group exhibited greater bilateral inferior frontal gyrus ( IFG) and right striatal activation than the abstinent MD group during the learning of reward contingencies ( Cohen's d range: 0.60-0.83). In contrast, the relapsed MD group displayed lower bilateral striatum, bilateral insula, left IFG and left anterior cingulate activation than the abstinent MD group ( Cohen's d range: 0.90-1.23) in response to winning, tying and losing feedback. Conclusions Methamphetamine-dependent individuals who achieve abstinence and then relapse show greater inferior frontal gyrus activation during learning, and relatively attenuated striatal, insular and frontal activation in response to feedback, compared with methamphetamine-dependent people who remain abstinent. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims No modern jurisdiction has ever legalized commercial production, distribution and possession of cannabis for recreational purposes. This paper presents insights about the effect of legalization on production costs and consumption and highlights important design choices. Methods Insights were uncovered through our analysis of recent legalization proposals in California. The effect on the cost of producing cannabis is largely based on existing estimates of current wholesale prices, current costs of producing cannabis and other legal agricultural goods, and the type(s) of production that will be permitted. The effect on consumption is based on production costs, regulatory regime, tax rate, price elasticity of demand, shape of the demand curve and non-price effects (e.g. change in stigma). Results Removing prohibitions on producing and distributing cannabis will dramatically reduce wholesale prices. The effect on consumption and tax revenues will depend on many design choices, including: the tax level, whether there is an incentive for a continued black market, whether to tax and/or regulate cannabinoid levels, whether there are allowances for home cultivation, whether advertising is restricted, and how the regulatory system is designed and adjusted. Conclusions The legal production costs of cannabis will be dramatically below current wholesale prices, enough so that taxes and regulation will be insufficient to raise retail price to prohibition levels. We expect legalization will increase consumption substantially, but the size of the increase is uncertain since it depends on design choices and the unknown shape of the cannabis demand curve. [ABSTRACT FROM AUTHOR]

Aims In order to examine the degree to which heavy drinking contributes to risks for problems among college drinkers this paper develops and tests a dose–response model of alcohol use that relates frequencies of drinking specific quantities of alcohol to the incidence of drinking problems. Methods A mathematical model was developed that enabled estimation of dose–response relationships between drinking quantities and drinking problems using self-report data from 8698 college drinkers across 14 campuses in California, USA. The model assumes that drinking risks are a direct monotone function of the amount consumed per day and additive across drinking days. Drinking problems accumulate across drinking occasions and are the basis for cumulative reports of drinking problems reported by college drinkers. Results Statistical analyses using the model showed that drinking problems were related to every drinking level, but increased fivefold at three drinks and more gradually thereafter. Problems were associated most strongly with occasions on which three drinks were consumed, and more than half of all reported problems were related to occasions on which four or fewer drinks were consumed. There were some important differences in dose–responsiveness between men and women and between different groups of ‘light’, ‘moderate’ and ‘heavier’ drinkers. Conclusion Many problems among college students are associated with drinking relatively small amounts of alcohol (two to four drinks). Programs to reduce college drinking problems should emphasize risks associated with low drinking levels. [ABSTRACT FROM AUTHOR]

Aims This paper considers statistical relationships often observed between densities of bars and pubs and rates of violence as suggested by two general approaches: (i) social influence and (ii) social selection. Methods A stratified sample of 36 zip code areas in California was identified as having ‘high’, ‘medium’ and ‘low’ densities of bars and pubs. Aggregate US Census 2000 data were used to characterize population demographics of each zip code area. Telephone surveys were conducted assessing respondent demographics, drinking patterns, utilization of different places for drinking, self-report measures of hostility, norms for aggression and norms for alcohol-related aggression. Hierarchical linear models assessed the degree to which densities of bars and pubs were related to self-reports of hostility and norms for aggression, and if the individual measures of hostility and norms for aggression were related to choice of drinking venue. Results Respondents living in areas with greater densities of bars and pubs reported lower norms for aggression and greater norms for alcohol-related aggression. Greater peak drinking levels were related directly to greater levels of hostility and norms for both aggression and alcohol-related aggression. Self-reported hostility and norms for alcohol-related aggression were related directly to drinking at bars and pubs, parties and friends' homes. Aggressive norms were related to drinking at parties. Conclusions Whether bars serve to concentrate aggressive people into selected environments, whether these environments serve to increase levels of aggression, or whether both these processes reinforce each other mutually is not known. However, our findings do indicate relationships between certain exogenous measures, including alcohol outlet densities and social–psychological characteristics associated with violence. Many of these measures are also associated with the social contexts in which people drink. [ABSTRACT FROM AUTHOR]

Aims In order to increase the number of investigative teams and sites conducting research on pharmacological treatments for methamphetamine use disorders, the National Institute on Drug Abuse (NIDA) established an infrastructure of clinical sites in areas where methamphetamine addiction is prevalent. This multi-site infrastructure would serve to run multiple Phases II and III protocols effectively and expeditiously. Methods NIDA collaborated with investigators from the University of California at Los Angeles (UCLA) to set up the Methamphetamine Clinical Trials Group (MCTG). This paper describes the development process, as well as data from a test trial to assess the capability of research-naive sites to recruit research participants and conduct study procedures according to research protocol. Subsequent trials are also described. Results A total of 151 candidates signed consent; 65 individuals were enrolled and 35 (53.8%) completed the 12 weeks' behavioral trial. Self-reported substance use report (SUR) showed comparable use of methamphetamine across sites with the individual site means ranging from 59% (site 5) to 80% (site 3). Drug use as measured by urinalysis was greatly reduced at week 13 compared to the baseline measure; the average rate of methamphetamine-free urine samples across all participants in sites at week 13 was 53%. The highest percentage of methamphetamine-free samples was 85% at site 5; the lowest was at site 1 (40%). Addiction severity index (ASI) composite scores at baseline and protocol completion for all participants demonstrated improvement in all categories over time, except for the medical composite score. The largest composite score reduction in baseline-protocol completion was in the drug domain (0.23 versus 0.15). The changes in the ASI scores from baseline to week 13 were consistent across all five sites. Conclusions Outcomes of the behavioral trial indicated that the MCTG recruited well; collected study data accurately and reliably; and created a vehicle that can assess promising pharmacotherapies for methamphetamine addiction treatment medications. The MCTG strategy appears to be a feasible approach to increase NIDA's capacity to conduct clinical trials to evaluate potential pharmacotherapies for methamphetamine addiction. [ABSTRACT FROM AUTHOR]