201. Risk and protective factors for cannabis, cocaine, and opioid use disorders: An umbrella review of meta-analyses of observational studies
- Author
-
Paolo Fusar-Poli, André F. Carvalho, Marco Solmi, Giovanni Croatto, Anna Mosina, Joaquim Radua, Elena Dragioti, Jacopo Demurtas, Jae Il Shin, Peter Konstantin Kurotschka, and Stefan Borgwardt
- Subjects
medicine.medical_specialty ,Cognitive Neuroscience ,PsycINFO ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,Cocaine ,Meta-Analysis as Topic ,Risk Factors ,Humans ,Medicine ,0501 psychology and cognitive sciences ,050102 behavioral science & comparative psychology ,Risk factor ,Psychiatry ,Cannabis ,biology ,business.industry ,Opioid use ,05 social sciences ,Protective Factors ,Opioid-Related Disorders ,biology.organism_classification ,Mental health ,Observational Studies as Topic ,Neuropsychology and Physiological Psychology ,Opioid ,Meta-analysis ,Observational study ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Several meta-analyses of observational studies have addressed the association between risk and protective factors and cannabis/cocaine/opioid use disorders, but results are conflicting. No umbrella review has ever graded the credibility of this evidence (not significant/weak/suggestive/highly suggestive/convincing). We searched Pubmed-MEDLINE/PsycInfo, last search September 21, 2020. We assessed the quality of meta-analyses with the AMSTAR-2 tool. Out of 3,072 initial references, five were included, providing 19 associations between 12 putative risk/protective factors and cannabis/cocaine/opioid use disorders (cases: 4539; N = 1,118,872,721). While 84 % of the associations were statistically significant, none was convincing. One risk factor (smoking) had highly suggestive evidence for association with nonmedical use of prescription opioid medicines (OR = 3.07, 95 %CI:2.27 to 4.14). Convincing evidence emerged in sensitivity analyses on antisocial behavior and cannabis use disoder (OR 3.34, 95 %CI 2.53-4.41). Remaining associations had weak evidence. The quality of meta-analyses was rated as moderate in two (40 %), low in one (20 %), and critically low in two (40 %). Future research is needed to better profile risk/protective factors for cannabis/cocaine/opioid use disorders disorders informing preventive approaches.
- Published
- 2021