Marijuana is the most commonly used illicit substance, yet among the least studied in medication development research. Cocaine-dependent individuals frequently also use marijuana; however, little is known about the effect of this combined use on treatment presentation.
Marijuana use was assessed in 1183 individuals seeking outpatient treatment for cocaine dependence. Based on past 30 days of use, the sample was divided into three groups: (1) patients reporting no recent marijuana use (n = 634); (2) occasional use (n = 403); (3) and frequent concurrent marijuana use (n = 146). Differences on baseline measures of substance use, addiction severity (ASI), psychopathology, and sociodemographic characteristics were examined as a function of level of marijuana use.
Frequent marijuana users were more likely to be female, Caucasian, and younger than other groups. Cocaine-dependent patients with frequent marijuana use also used more cocaine and alcohol, and reported more medical, legal, and psychiatric problems, including antisocial personality disorder.
Conclusion and Scientific Significance
Cocaine-dependent patients with frequent marijuana use present for treatment with more severe impairment. Accounting for this heterogeneity among participants may improve treatment outcome.
Clinical treatment trial; cocaine dependence; dual substance abuse; marijuana
Background and objective
This article explores the aspects of spirituality and religious involvement that may be the protective factors against substance use among urban American Indian (AI) youth.
Data come from AI youth (N = 123) in five urban middle schools in a southwestern metropolis.
Ordinary least squares regression analyses indicated that following Christian beliefs and belonging to the Native American Church were associated with lower levels of substance use.
Conclusions and Scientific Significance
Following AI traditional spiritual beliefs was associated with antidrug attitudes, norms, and expectancies. Having a sense of belonging to traditions from both AI cultures and Christianity may foster integration of the two worlds in which urban AI youth live.
urban American Indian; substance use; youth; spirituality; religion; Native American
Underage drinking is associated with a number of social and public health consequences. Preventing access to alcohol is one approach to reducing underage drinking.
This study assesses the efficacy of a culturally tailored “reward and reminder” program aimed at reducing convenience store alcohol sales to youth living on or near nine American Indian reservations.
First, tribal council proclamations were sought to support underage drinking prevention, including reward and reminder efforts. Then, decoys (volunteers over 21 years of age but judged to look younger) attempted to purchase alcohol without identification. Clerks who asked for identification were given “rewards” (gift cards and congratulatory letters), whereas clerks who did not were given “reminders” of the law regarding sales to minors. Following an initial baseline of 12 purchase attempts, three repeated reward and reminder visits were made to 13 convenience stores selling alcohol within ten miles of the reservations (n=51 total attempts).
Five of nine tribal councils passed resolutions in support of the program. The baseline sales rate without requesting ID was 33%. Similarly, 38% of stores in the first reward and reminder visit round failed to request identification. However, in the following two reward and reminder rounds, 0% of the stores failed to request identification.
These results indicate that environmental community-level underage drinking prevention strategies to reduce alcohol sales near rural reservations are feasible and can be effective.
Environmental prevention strategies within reservation communities support integrated supply and demand reduction models for reducing underage drinking.
Underage drinking prevention; off-premise alcohol sales; alcohol availability; environmental interventions; American Indians
Concerns in some settings regarding the accuracy and ethics of employing direct questions about alcohol use suggest need for alternative assessment approaches with youth. Umyuangcaryaraq is a Yup’ik Alaska Native word meaning “Reflecting.” The Reflective Processes Scale is a youth measure tapping awareness and thinking over potential negative consequences of alcohol misuse as a protective factor that includes cultural elements often shared by many other Alaska Native and American Indian cultures. A bifactor model of the scale items with three content factors provided excellent fit to observed data. Item response theory analysis suggested a binary response format as optimal. Evidence of convergent and discriminant validity is presented.
American Indian and Alaska Native; adolescents; alcohol; alcohol expectancies
Ethanol is primarily metabolized in the liver by 2 rate-limiting reactions: conversion of ethanol to acetaldehyde by alcohol dehydrogenase (ADH) and subsequent conversion of acetaldehyde to acetate by aldehyde dehydrogenase (ALDH). ADH and ALDH exist in multiple isozymes that differ in their kinetic properties. Notably, polymorphisms within the genes that encode for these isozymes vary in their allele frequencies between ethnic groups, and thus, they have been considered as candidate genes that may differentially influence risk for the development of alcohol dependence across ethnic groups.
Objectives and Methods
Associations between alcohol dependence and polymorphisms in ADH1B, ADH1C, and ALDH2, were compared in a community sample of Native Americans living on reservations (n=791) and Mexican Americans (n=391) living within the same county.
Two Mexican Americans and no Native Americans possessed one ALDH2*2 allele. Presence of at least one ADH1B*2 allele was found in 7% of the Native Americans and 13% of the Mexican Americans, but was only associated with protection against alcohol dependence in the Mexican Americans. Presence of at least one ADH1B*3 allele was found in 4% if the Native Americans and 2% of the Mexican Americans, but was associated with protection against alcohol dependence only in the Native Americans. No associations between alcohol dependence and polymorphisms in ADH1C were found.
Conclusions and Scientific Significance
Polymorphisms in ADH1B are protective against alcoholism in these two populations; however, these findings do not explain the high prevalence of alcoholism in these populations.
ADH; ALDH; Alcohol dependence; candidate genes; Mexican Americans; Native Americans; population genetics
Community-based participatory research (CBPR) with American Indian and Alaska Native communities creates distinct interventions, complicating cross-setting comparisons. In this study, coding CBPR intervention activities from three communities for protective factors and latent class analysis identified five patterns of exposure to protective factors: Internal, External, Limits on alcohol, Community and family, and Low probabilities of all protective factors. Patterns differed significantly by community and youth age. Standardizing protective factors by the functions an intervention serves instead of its form or components can assist in refining CBPR interventions and evaluating effects in culturally distinct settings.
Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research.
Objectives and Methods
We developed a framework for studying these substance abuse treatment programs (n = 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve.
Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research.
Conclusion and Scientific Significance
This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies.
Indians; North American; substance abuse treatment centers; research methods
Little is known about the relationship of gender with cocaine use in rural areas. This study describes these relationships among stimulant users residing in rural areas of Arkansas, Kentucky and Ohio.
Understanding characteristics of crack and powder cocaine users in rural areas may help inform prevention, education and treatment efforts to address rural stimulant use.
Participants were 690 stimulant users, including 274 (38.6%) females, residing in 9 rural counties. Cocaine use was measured by self-report of cocaine use, frequency of use, age of first use, and cocaine abuse/dependence. Powder cocaine use was reported by 49% of this sample of stimulant users and 59% reported using crack cocaine.
Differing use patterns emerged for female and male cocaine users in this rural sample; females began using alcohol, marijuana, and cocaine at later ages than males but there were no gender differences in current powder cocaine use. Females reported more frequent use of crack cocaine and more cocaine abuse/dependence than males, and in regression analyses, female crack cocaine users had 1.8 times greater odds of reporting frequent crack use than male crack users.
Conclusions and Scientific Significance
These findings suggest differing profiles and patterns of cocaine use for male and female users in rural areas, supporting previous findings in urban areas of gender-based vulnerability to negative consequences of cocaine use. Further research on cocain use in rural areas can provide insights into gender differences that can inform development and refinement of effective interventions in rural communities.
cocaine; rural; substance abuse; gender
Risk for substance use disorder is frequently transmitted across generations due to significant heritability.
This longitudinal study tests the hypothesis that initial exposure to cannabis in youths having high transmissible risk is a signal event promoting development of cannabis use disorder (CUD).
At age 22, 412 men were classified into three groups: (1) lifetime CUD, (2) cannabis use without CUD, and (3) no lifetime cannabis use. Transmissible risk, quantified on a continuous scale using the previously validated transmissible liability index (TLI), along with cannabis use and CUD were documented at 10–12, 12–14, 16, 19, and 22 years of age.
The CUD group scored higher on the TLI before they began cannabis use compared to the other two groups. In addition, a progressive increase in TLI severity was evinced by the CUD group beginning at the time of initiation of cannabis use whereas cannabis users who did not subsequently develop CUD exhibited a decline in transmissible risk following first exposure.
Initial use of cannabis potentiates development of CUD in youths who are at high transmissible risk but is inconsequential in youths having low risk. The practical ramifications of these results for prevention are discussed.
Transmissible Liability; Addiction; Cannabis use disorder; Longitudinal modeling
Attrition in studies of substance use disorder treatment is problematic, potentially introducing bias into data analysis.
This study aimed to determine the effect of participant compensation amounts on rates of missing data and observed rates of drug use.
We performed a secondary analysis of a clinical trial of buprenorphine/naloxone among 152 treatment-seeking opioid-dependent subjects aged 15–21 during participation in a randomized trial. Subjects were randomized to a 2-week detoxification with buprenorphine/naloxone (DETOX; N = 78) or 12 weeks buprenorphine/naloxone (BUP; N = 74). Participants were compensated $5 for weekly urine drug screens and self-reported drug use information and $75 for more extensive assessments at weeks 4, 8, and 12.
Though BUP assignment decreased the likelihood of missing data, there were significantly less missing data at 4, 8, and 12 weeks than other weeks, and the effect of compensation on the probability of urine screens being positive was more pronounced in DETOX subjects.
These findings suggest that variations in the amount of compensation for completing assessments can differentially affect outcome measurements, depending on treatment group assignment.
Adequate financial compensation may minimize bias when treatment condition is associated with differential dropout and may be a cost-effective way to reduce attrition. Moreover, active users may be more likely than non-active users to drop out if compensation is inadequate, especially in control groups or in groups who are not receiving active treatment.
compensation; incentives; missing data; attrition; substance use disorder treatment
Binge drinking is common among adolescents. Alcohol use, and binge-drinking in particular, has been associated with neurocognitive deficits as well as risk-taking behaviors, which may contribute to negative driving outcomes among adolescents even while sober.
To examine differences in self-reported driving behaviors between adolescent binge-drinkers and a matched sample of controls, including (a) compliance with graduated licensing laws, (b) high risk driving behaviors, and (c) driving outcomes (crashes, traffic tickets).
The present study examined driving behaviors and outcomes in adolescent recent binge drinkers (n=21) and demographically and driving history matched controls (n=17), ages 16-18.
Binge drinkers more frequently violated graduated licensing laws (e.g., driving late at night), and engaged in more “high risk” driving behaviors, such as speeding and using a cell-phone while driving. Binge drinkers had more traffic tickets, crashes and “near crashes” than the control group. In a multivariate analysis, binge drinker status and speeding were the most robust predictors of a crash.
Binge drinking teens consistently engage in more dangerous driving behaviors and experience more frequent crashes and traffic tickets. They are also less compliant with preventative restrictions placed on youth while they are learning critical safe driving skills.
These findings highlight a need to examine the contribution of underlying traits (such as sensation seeking) and binge-related cognitive changes to these high-risk driving behaviors, which may assist researchers in establishing alternative prevention and policy efforts targeting this population.
adolescent alcohol use; graduated licensing laws; risky driving
Background & Objectives
Rates of treatment seeking for alcohol use disorders are notably low. In order to elucidate the clinical correlates of treatment seeking for alcoholism, this study compared patients with current alcohol dependence and a primary psychiatric diagnosis who endorsed a desire for alcoholism treatment to patients who refused treatment or who were unsure.
A total of 131 (54 females) psychiatric outpatients with current alcohol dependence completed an intake assessment at a large hospital-based psychiatric clinic and at the end of the intake were asked whether they would like to receive treatment for alcohol problems.
As compared to alcohol dependent patients who refused treatment for alcoholism or who were unsure (n = 46), patients who expressed a desire for treatment (n = 85) were older, more likely to be female, reported higher levels of social impairments, and were more likely to endorse the following alcohol dependence symptoms: (a) multiple unsuccessful efforts or persistent desire to stop or cut down on their drinking; and (b) drinking more than intended.
Approximately 35% of patients who met current DSM-IV criteria for alcohol dependence reported no interest (or were unsure) in alcoholism treatment despite being engaged in treatment-seeking for another psychiatric disorder.
These findings extend previous epidemiological studies documenting treatment seeking patterns for alcoholism by identifying clinical features associated with interest in treatment for this disorder among psychiatric outpatients.
alcohol dependence; treatment; diagnosis; desire for treatment
Qualitative and quantitative data and participatory research approaches might be most valid and effective for assessing substance use/abuse and related trends in American Indian and Alaska Native (AIAN) communities.
29 federally recognized AIAN Tribes in Washington (WA) State were invited to participate in Health Directors interviews and State treatment admissions data analyses. Ten Tribal Health Directors (or designees) from across WA participated in 30–60 minute qualitative interviews. State treatment admissions data from 2002–2008 were analyzed for those who identified with one of 11 participating AIAN communities to explore admission rates by primary drug compared to non-AIANs. Those who entered treatment and belonged to one of the 11 participating tribes (n=4,851) represented 16% of admissions for those who reported a tribal affiliation.
Interviewees reported that prescription drugs, alcohol and marijuana are primary community concerns, each presenting similar and distinct challenges. Additionally, community health is tied to access to resources, services, and culturally appropriate and effective interventions. Treatment data results were consistent with interviewee reported substance use/abuse trends, with alcohol as the primary drug for 56% of AIAN adults compared to 46% of non-AIAN, and other opiates as second most common for AIAN adults in 2008 with 15% of admissions.
Findings are limited to those tribal communities/community members who agreed to participate.
Analyses suggest that some diverse AIAN communities in WA State share similar substance use/abuse, treatment, and recovery trends and continuing needs.
Appropriate and effective research with AIAN communities requires respectful and flexible approaches.
substance use; treatment; recovery; American Indian; Washington
Innovative health programs for injection drug users (IDUs), such as supervised injecting facilities (SIFs), are often preceded by evaluations of IDUs’ willingness to use the service. The validity of these surveys has not been fully evaluated. We sought to determine whether measures of willingness collected prior to the opening of a Canadian SIF accurately predicted subsequent use of the program.
Data were derived from a prospective cohort of IDUs. The sample size for this study was 640 IDUs. Using multivariate logistic regression, it was assessed if a history of reporting willingness to use the program, were it available, was associated with subsequent use. In sub-analysis restricted to individuals who had a history of reported willingness, we used multivariate longitudinal analysis to identify factors associated with not attending the SIF.
Among 442 IDUs, 72% of those who reported initial willingness to use a SIF later attended the program, and a prior willingness to use a SIF significantly predicted later attendance (adjusted odds ratio = 1.67). In sub-analyses restricted to those who had a history of reporting willingness to use the SIF, not using the program was predicted by not frequenting the neighborhood where the SIF was located.
Our findings indicate that reported willingness measures collected from IDUs regarding potential SIF program participation prior to its opening independently predicted later attendance even when variables that were likely determinants of willingness were adjusted for. These data suggest that willingness measures are reasonably valid tools for planning the delivery of health services among IDU populations.
injection drug use; supervised injection facilities; validity of willingness measures
Drumming has been utilized among American Indian/Alaska Native (AI/AN) tribes for centuries to promote healing and self-expression. Drum-Assisted Recovery Therapy for Native Americans (DARTNA), currently under development, is a substance abuse treatment utilizing drumming as a core component.
Focus groups were conducted to assist in the development of the DARTNA protocol. Feedback obtained from these focus groups will inform a subsequent pretest of DARTNA and an empirical study analyzing its effectiveness.
Three focus groups were conducted among AIs/ANs with substance use disorders (n = 6), substance abuse treatment providers (n = 8), and a community advisory board (n = 4) to solicit feedback prior to a pretest of the DARTNA protocol.
Overall, participants indicated that DARTNA could be beneficial for AIs/ANs with substance use disorders. Four overarching conceptual themes emerged across the focus groups: (1) benefits of drumming, (2) importance of a culture-based focus, (3) addressing gender roles in drumming activities, and (4) providing a foundation of common AI/AN traditions.
The DARTNA protocol is a potentially beneficial and culturally appropriate substance abuse treatment strategy for AIs/ANs. In order to optimize the potential benefits of a substance abuse treatment protocol utilizing drumming for AIs/ANs, adequate attention to tribal diversity and gender roles is needed. Scientific
Due to the shortage of substance abuse treatments utilizing traditional healing activities for AIs/ANs, including drumming, results from this study provide an opportunity to develop an intervention that may meet the unique treatment needs of AIs/ANs.
American Indians; Alaska Natives; Native Americans; Substance Abuse; Drumming
The endocannabinoid system modulates the hypothalamic–pituitary–adrenal (HPA) axis, but the effect of cannabinoid type 1 (CB1) receptor antagonism following chronic CB1 receptor stimulation in humans is unknown.
To evaluate effects of the CB1 receptor antagonist rimonabant on the HPA axis in cannabis-dependent individuals.
Fourteen daily cannabis smokers received increasingly frequent 20 mg oral Δ9-tetrahydrocannabinol (THC) doses (60–120 mg/day) over 8 days to standardize cannabis tolerance. Concurrent with the last THC dose, double-blind placebo or rimonabant (20 or 40 mg) was administered. Cannabinoid, rimonabant, and cortisol plasma concentrations were measured 1.5 hours prior to rimonabant administration and 2.0, 5.5, and 12.5 hours post-dose.
Ten participants completed before premature study termination due to rimonabant’s withdrawal from development. Five participants received 20 mg, three received 40 mg, and two placebo. There was a significant positive association between rimonabant concentration and change in cortisol concentration from baseline (r = .53, p < .01). There also was a borderline significant association between rimonabant dose and cortisol concentrations when the dose-by-time interaction was included. Four of eight participants receiving rimonabant (none of two receiving placebo) had greater cortisol concentrations 2 hours after dosing (at 11:30) than at 08:00, while normal diurnal variation should have peak concentrations at 08:00.
Rimonabant 20 or 40 mg did not significantly increase plasma cortisol concentrations, consistent with an absence of antagonist-elicited cannabis withdrawal.
Rimonabant doses >40 mg might elicit cortisol changes, confirming a role for CB1 receptors in modulating the HPA axis in humans.
cortisol; rimonabant; cannabis; antagonist; withdrawal
Few studies have addressed comorbid antisocial personality disorder (ASPD) and marijuana dependence in young adults, and results from previous studies are inconsistent.
This study evaluated differences in pretreatment characteristics and treatment outcomes between marijuana-dependent young adults with and without ASPD.
Data for this study were derived from a randomized trial, in which marijuana-dependent young adults (n = 136) between 18 and 25 years of age were randomized to four behavioral conditions: (1) MET/CBT with CM, (2) MET/CBT without CM, (3) DC with CM, and (4) DC without CM.
Forty-four percent of the participants met DSM-IV-TR criteria for ASPD. ASPD clients had significantly more lifetime alcohol dependence disorders, marijuana use in the 28 days pretreatment, arrests, and assault and weapon charges compared to those without ASPD. ASPD clients did not differ in retention or substance use outcomes at 8 weeks posttreatment or the 6-month follow-up. In general, both groups had more attendance in the voucher condition, but there were no significant ASPD by treatment interactions.
These data suggest that marijuana-dependent young adults with comorbid ASPD do not necessarily have poorer retention or substance use outcomes compared with marijuana-dependent young adults who do not have ASPD when treated in a well-defined behavioral therapy protocol.
Previous research has shown increased risks for clients with comorbid ASPD and marijuana dependence; however, our findings suggest that specialized programs for clients with ASPD may not be necessary if they are provided with empirically supported, structured treatments.
marijuana dependence; young adults; antisocial personality disorder; criminal behavior; treatment outcome
The purpose of the current analysis was to examine the factors associated with prescription opiate misuse among stimulant users from rural counties in Arkansas, Kentucky, and Ohio (N=714).
Multiple logistic regression was utilized to determine the independent correlates of recent (prior 6 months) prescription opiate misuse.
More than half of participants (53.2%) reported prescription opiate misuse in the previous 6 months. Other drug use (heroin, cocaine, methamphetamine and marijuana) and anxiety (Adjusted Odds Ratio: 2.04, 95% Confidence Interval: 1.60, 2.59) were independently associated with prescription opiate misuse. Chronic pain and other health indicators were not associated with prescription opiate misuse after adjustment for covariates.
Results indicate that illicit drug involvement and psychiatric symptoms may be driving the high rates of prescription opiate misuse among rural stimulant users. These findings have implications for the provision of treatment in resource-deprived rural areas.
prescription opiates; methamphetamine; cocaine; stimulants; rural
Delay discounting is a type of impulsivity in which smaller, immediate rewards are preferred over larger, delayed ones. Impulsivity is associated with harmful behaviors, including substance abuse and financial mismanagement.
Delay discounting as related to addiction and financial mismanagement was reviewed from psychological, neurobiological, and behavioral economic perspectives.
Addiction and financial mismanagement frequently co-occur, and elevated delay discounting may be a common mechanism contributing to both of these problematic behaviors.
Future research on the relationships between delay discounting, substance abuse, and financial mismanagement can provide important insights for developing improved prevention and treatment strategies.
delay discounting; impulsivity; substance abuse; financial mismanagement; addiction; neurobiology
To estimate, via meta-analysis, the influence of different methadone dose ranges and dosing strategies on retention rates in methadone maintenance treatment (MMT).
A systematic literature search identified 18 randomized controlled trials (RCTs) evaluating methadone dose and retention. Retention was defined as the percentage of patients remaining in treatment at a specified time point. After initial univariate analyses of retention by Pearson chi-squares, we used multilevel logistic regression to calculate summary odds ratios (ORs) and 95% confidence intervals for the effects of methadone dose (above or below 60 mg/day), flexible vs. fixed dosing strategy, and duration of follow-up.
The total number of opioid-dependent participants in the 18 studies was 2831, with 1797 in MMT and 1034 receiving alternative mediations or placebo. Each variable significantly predicted retention with the other variables controlled for. Retention was greater with methadone doses ≥ 60 than with doses <60 (OR: 1.74, 95% CI: 1.43–2.11). Similarly, retention was greater with flexible-dose strategies than with fixed-dose strategies (OR: 1.72, 95% CI: 1.41–2.11).
Higher doses of methadone and individualization of doses are each independently associated with better retention in MMT.
Dosing strategy; meta-analysis; methadone; opioid dependence; retention
Illicit drug users experience various forms of discrimination which may vary by type of drug used, as there are different levels of stigma associated with different types of drugs. This study investigated self-report of perceived discrimination by primary type of drug used. This analysis used data from “Social Ties Associated with Risk of Transition into Injection Drug Use” (START), a cross-sectional study of recently initiated injection drug users (IDUs) and prospective study of heroin/crack/cocaine-using non-IDUs (n=652). Using log binomial regression, the relationship between primary drug used (i.e., single drug used most often) with discrimination due to drug use was examined. Heroin users were significantly more likely (PR:1.54 (95% CI:1.15–2.07)) to report discrimination due to drug use compared to cocaine users. More research is needed to understand the mechanism through which discrimination affects heroin users, and its potential relation with other discrimination-related outcomes, namely depression and drug treatment.
illicit drug use; crack use; heroin use; social discrimination
Several studies indicate abnormalities in the hypothalamic-pituitary-adrenal axis (HPA) during acute opiate withdrawal, but protracted withdrawal has gotten less study. The current study further characterized the 24-hour time course of plasma cortisol levels in heroin-dependent individuals who were abstinent for 10–15 days, which is beyond the 5 days of acute withdrawal, compared to demographically matched healthy controls using samples collected every 3 hours over 24 hours and assessed with radioimmunoassay (RIA). The abstinent heroin-dependent participants had significantly higher plasma cortisol levels nocturnally suggesting a loss of diurnal variation in these heroin subjects.
Circadian rhythm; cortisol; detoxification; heroin abstainers
The current study assessed the extent to which mild to moderate pretreatment depressive symptoms could predict intervention outcomes in 284 first-time driving-while-intoxicated (DWI) offenders. After a 10-week intervention and at 6- and 12-month follow-ups, all participants reported declines in depressive symptoms, alcohol consumption, and negative drinking consequences and higher self-efficacy to avoid high-risk drinking. It was notable, however, that offenders with depressive symptoms reported more drinking-related consequences and lower self-efficacy at all time points, but greater motivation to change their drinking behavior. The findings suggest that offenders with depressive symptoms have more severe symptomatology than non-depressed offenders but may be more amenable to changing their drinking.
DWI; DUI; alcohol; BDI; depressive symptoms; self-efficacy; motivation
Little is known about whether the duration of cocaine use or an individual’s age may influence the acute effects of cocaine, patterns of use, and specific treatment needs.
This post hoc analysis determined whether the duration of cocaine use or current age influenced the acute subjective response to cocaine. Data from four smoked cocaine self-administration laboratory studies were combined and analyzed to determine whether the subjective effects of a 25-mg smoked cocaine dose varied as a function of years of cocaine use or current age.
Thirty-six nontreatment-seeking healthy cocaine users (ages 32–49) were admitted to studies lasting from 12 to 105 days. Participants rated the subjective effects of each cocaine dose from 0 to 100 by completing a computerized self-report visual analogue scale (VAS). The main outcome measures were the change in VAS ratings between a baseline placebo dose and the first 25-mg dose of smoked cocaine.
No significant relationship was found between the subjective effects of cocaine and years of cocaine use (mean 20.9, range 5–30) or current age (mean 41.1, range 32–49).
Among long-term cocaine users between the ages of 32 and 49, the acute subjective effects of cocaine did not vary as a function of years of cocaine use or current age.
These data fail to support the incentive sensitization theory for addiction by Robinson and Berridge, as cocaine “liking” and “wanting” remained the same regardless of age or years of cocaine use.
long-term use; years of use; subjective effects; smoked cocaine; human