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1.
Psychol Med ; 52(3): 446-456, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-32546286

RESUMEN

BACKGROUND: Posttraumatic stress disorder (PTSD) is the most highly co-occurring psychiatric disorder among veterans with cannabis use disorder (CUD). Despite some evidence that cannabis use prospectively exacerbates the course of PTSD, which in turn increases the risk for CUD, the causal nature of the relationship between cannabis and psychiatric comorbidity is debated. The longitudinal relationship between PTSD diagnosis and traumatic intrusion symptoms with cannabis use and CUD was examined using cross-lagged panel model (CLPM) analysis. METHODS: Prospective data from a longitudinal observational study of 361 veterans deployed post-9/11/2001 included PTSD and CUD diagnoses, cannabis use, and PTSD-related traumatic intrusion symptoms from the Inventory of Depression and Anxiety Symptoms. RESULTS: A random intercept CLPM analysis that leveraged three waves (baseline, 6 months and 12 months) of cannabis use and PTSD-related intrusion symptoms to account for between-person differences found that baseline cannabis use was significantly positively associated with 6-month intrusion symptoms; the converse association was significant but reduced in magnitude (baseline use to 6-month intrusions: ß = 0.46, 95% CI 0.155-0.765; baseline intrusions to 6-month use: ß = 0.22, 95% CI -0.003 to 0.444). Results from the two-wave CLPM reveal a significant effect from baseline PTSD to 12-month CUD (ß = 0.15, 95% CI 0.028-0.272) but not from baseline CUD to 12-month PTSD (ß = 0.12, 95% CI -0.022 to 0.262). CONCLUSIONS: Strong prospective associations capturing within-person changes suggest that cannabis use is linked with greater severity of trauma-related intrusion symptoms over time. A strong person-level directional association between PTSD and CUD was evident. Findings have significant clinical implications for the long-term effects of cannabis use among individuals with PTSD.


Asunto(s)
Cannabis , Abuso de Marihuana , Trastornos por Estrés Postraumático , Veteranos , Humanos , Estudios Longitudinales , Abuso de Marihuana/complicaciones , Trastornos por Estrés Postraumático/psicología , Veteranos/psicología
2.
Alcohol Clin Exp Res ; 46(11): 2110-2120, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36124876

RESUMEN

BACKGROUND: The impact of alcohol and cannabis co-use on college student drinking and related outcomes is complex. Specific characteristics or patterns of co-use events beyond drinking quantity may be important to the experience of consequences. The present study used repeated daily surveys to examine the association between co-use (versus use of alcohol only) and drinking rate on negative consequences. METHODS: The sample included 318 college students (Mage  = 19.8, 47% female, 76% non-Hispanic White) who were co-users of alcohol and cannabis, recruited from three U.S. college campuses. Participants completed 56 days of data collection (number of drinking days ranged from 1 to 38). Two measures of drinking rate were examined: (1) daily rate (number of drinks divided by number of hours spent drinking per day); and (2) peak hour rate (maximum number of drinks consumed in a single hour) to account for anomalous drinking days of long duration. Generalized linear mixed models examined: (1) associations of co-use with peak hour rate (model 1a) and daily rate (model 1b); (2) associations of peak hour rate (model 2a) and daily rate (model 2b) with experiencing any negative consequence; and (3) interactions of co-use with peak hour rate (model 3a) and daily rate (model 3b) on experiencing a consequence. RESULTS: Co-use was positively associated with peak hour rate but not daily rate. Both peak hour and daily rate positively predicted likelihood of experiencing a negative consequence. The interaction of both peak hour and daily rate by co-use was significant such that the association of rate with experiencing a consequence was stronger on alcohol-only days compared to co-use days. CONCLUSIONS: Daily drinking rate and peak hour drinking rate are unique and should be considered when discussing drinking patterns. Both predict negative consequences and may be important aspects of interventions for negative drinking-related outcomes among college students.


Asunto(s)
Consumo de Alcohol en la Universidad , Cannabis , Femenino , Humanos , Adulto Joven , Adulto , Masculino , Consumo de Bebidas Alcohólicas/epidemiología , Universidades , Etanol
3.
Alcohol Clin Exp Res ; 45(10): 2167-2178, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34762304

RESUMEN

BACKGROUND: The reasons for college students to abstain from alcohol and cannabis use on a given day can inform efforts to prevent or intervene in those behaviors. Research on reasons for alcohol nonuse remains in its nascent stages and no study to date has examined reasons for cannabis nonuse on a given day. Here we examine reasons for nonuse among college students after they planned to use alcohol and/or cannabis. METHODS: College students (N = 341; Mage  = 19.79; 53% women; 74% White) from 3 universities completed 54 days of data collection across which approximately 50% were nonuse days. Each morning, participants indicated whether they planned to use that day; nonuse reasons were assessed the next morning, if applicable. Generalized linear mixed-effects models were used to disentangle within- and between-person effects. RESULTS: On a given nonuse day (at the within-person level), "work" and "school" were reasons associated with having no plan to use alcohol and "to feel in control" was linked to having no plan to use cannabis. "Did not want to get high" was related to forgoing plans (did not use when originally planned) for alcohol use at the within-person level. At the between-person level, "no desire" was associated with no plans for alcohol or cannabis use and "did not want to get high" was related to no plans for cannabis use. "School" and "could not get" were related to forgoing plans for alcohol and cannabis use, respectively, at the between-person level. CONCLUSION: An examination of earlier intentions for alcohol and/or cannabis use on nonuse days yielded novel findings on the intention-behavior gap. Reasons for nonuse can inform intervention and prevention strategies (e.g., those involving social norms or just-in-time adaptive efforts) for alcohol and cannabis use on college campuses.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Intención , Uso de la Marihuana/psicología , Estudiantes/psicología , Universidades , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Alcohol en la Universidad/psicología , Conducta , Femenino , Humanos , Masculino , Uso de la Marihuana/epidemiología , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
4.
Alcohol Clin Exp Res ; 45(1): 181-193, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33242220

RESUMEN

BACKGROUND: Alcohol and marijuana/cannabis are frequently used simultaneously (i.e., SAM use). SAM use is complex, and the ways in which alcohol and cannabis are simultaneously used may reveal differential effects. The purpose of this study was to examine day-level effects of distinct alcohol and cannabis product combinations on simultaneous use and consequences on that day. METHODS: College student SAM users (N = 274; 50% women; Mage  = 19.82 years) were recruited to complete 54 days of data collection, including 5 repeated daily surveys each day. We identified 12 distinct product combinations reported during SAM-use days. We tested 4 reference groups, with one reflecting the most common use pattern and 3 potentially risky use patterns. We considered 3 outcomes (negative consequences, number of drinks, and number of cannabis uses) and used generalized linear mixed-effects models disentangling within- from between-person effects in all analyses. RESULTS: Using multiple products (≥2) of alcohol was consistently linked to higher odds of experiencing a negative consequence. Combining beer with only one cannabis product (leaf or concentrate) was consistently associated with lower odds of a consequence. Combining cannabis with multiple alcohol products was associated with heavier alcohol consumption. Using dual cannabis products also was associated with heavier cannabis consumption, but this pattern was not significantly different than using concentrate only on a given day. CONCLUSION: This is the first study to examine day-level influences of distinct alcohol and cannabis product combinations on consumption and consequences among young adult SAM users. Findings suggest that mixing alcohol products confers greater risk for negative consequences and heavier consumption, whereas there is little difference in cannabis consumption when using concentrate only vs. 2 cannabis products on a given day, except for concentrate + beer. Our findings support existing protective strategies of not mixing alcohol products and avoiding use of cannabis concentrate for SAM use as well.


Asunto(s)
Consumo de Alcohol en la Universidad , Cannabis , Uso de la Marihuana , Consumo de Alcohol en Menores , Adolescente , Cerveza , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Adulto Joven
5.
Alcohol Clin Exp Res ; 42(12): 2432-2441, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30247753

RESUMEN

BACKGROUND: Low working memory (WM) capacity is associated with alcohol use disorders (AUDs). The importance of WM to adaptive functioning has led to a recent influx of studies attempting to improve individual WM capacity using various cognitive training methods. The present study aimed to examine the efficacy of complex WM training for improving WM capacity among individuals with AUD. METHODS: Individuals were randomized to complete either adaptive WM training or active control training. We applied a methodologically rigorous and structured approach, including a battery of near and moderate transfer measures in those with AUDs and a control group. Additionally, we examined cognitive factors (at baseline) and other predictors of adherence, training task improvement, and transfer. RESULTS: Results suggest improved WM in individuals with AUDs and controls, as evidenced by improved scores on several transfer measures, after adaptive WM training. However, individuals with AUDs showed poorer adherence and less improvement on the training tasks themselves. Neither IQ, WM, sex, nor condition predicted adherence. Level of training task performance, baseline WM, and IQ predicted transfer task improvement. CONCLUSIONS: This is the first study to rigorously examine both the efficacy of WM training in those with AUDs, and predictors of successful training program adherence and transfer in a large sample. Among study completers, results suggest that AUD status does not predict training improvement and transfer. However, AUD status did predict lower program adherence. WM training was more effective in those with higher cognitive ability at baseline. This study provides direct translation to the development of cognitive interventions for treating AUD.


Asunto(s)
Alcoholismo/psicología , Alcoholismo/terapia , Aprendizaje , Memoria a Corto Plazo , Adolescente , Adulto , Cognición , Función Ejecutiva , Femenino , Humanos , Pruebas de Inteligencia , Masculino , Cooperación del Paciente , Desempeño Psicomotor , Transferencia de Experiencia en Psicología , Resultado del Tratamiento , Adulto Joven
6.
Alcohol Clin Exp Res ; 42(6): 1096-1104, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29656401

RESUMEN

BACKGROUND: The study aims were to examine daily associations between marijuana and alcohol use and the extent to which the association differs as a function of cannabis use disorder (CUD) and/or alcohol use disorder (AUD) diagnosis. METHODS: Timeline Followback interview data was collected in a study of veterans (N = 127) recruited from a Veterans Affairs hospital who reported at least 1 day of co-use of marijuana and alcohol in the past 180 days (22,860 observations). Participants reported 40% marijuana use days, 28% drinking days, with 37% meeting DSM-5 criteria for CUD, 40% for AUD, and 15% for both. Use of marijuana on a given day was used to predict a 3-level gender-adjusted drinking variable (heavy: ≥5 (men)/4 (women) drinks; moderate: 1 to 4/3 drinks; or none: 0 drinks). A categorical 4-level variable (no diagnosis, AUD, CUD, or both) was tested as a moderator of the marijuana-alcohol relationship. RESULTS: Multilevel modeling analyses demonstrated that participants were more likely to drink heavily compared to moderately (OR = 2.34) and moderately compared to not drinking (OR = 1.61) on marijuana use days relative to nonuse days. On marijuana use days, those with AUD and those with AUD + CUD were more likely to drink heavily (OR = 1.91; OR = 2.51, respectively), but those with CUD were less likely to drink heavily (OR = 0.32) compared to moderately, nonsignificant differences between any versus moderate drinking in interaction models. CONCLUSIONS: Heavy drinking occurs on days when marijuana is also used. This association is particularly evident in individuals diagnosed with both AUD and CUD and AUDs alone but not in those with only CUDs. Findings suggest that alcohol interventions may need to specifically address marijuana use as a risk factor for heavy drinking and AUD.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Abuso de Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Adulto , Consumo de Bebidas Alcohólicas/psicología , Alcoholismo/psicología , Comorbilidad , Femenino , Humanos , Masculino , Abuso de Marihuana/psicología , Uso de la Marihuana/psicología , Veteranos/psicología , Adulto Joven
7.
Alcohol Clin Exp Res ; 41(10): 1768-1774, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28792623

RESUMEN

BACKGROUND: Alcohol use disorders (AUDs) are associated with increased discounting of delayed rewards and reduced executive working memory (eWM) capacity. This association is amplified when comorbid with antisocial psychopathology (AP). Furthermore, recent studies suggest that reduced WM capacity is associated with disinhibited decisions reflected by increased impulsive decision making on the delay discounting of rewards task. While discounting of delayed rewards is well studied, the discounting of delayed losses has received significantly less experimental attention. METHODS: The current study investigated (i) the rate of discounting of delayed losses in individuals with AUD only (n = 61), AUD with comorbid AP (n = 79) and healthy controls (n = 64); (ii) the relationship between eWM capacity and discounting of delayed losses; and (iii) the effect of a WM load on discounting of delayed losses. Discounting performance was assessed using a computerized discounting of delayed losses task. RESULTS: Results showed that the AUD-only and AUD-AP groups had higher rates of discounting of delayed losses and lower eWM capacity compared to the control groups. Lower individual eWM capacity was associated with increased discounting of delayed losses. However, WM load did not increase discounting rates overall. CONCLUSIONS: These results support the hypothesis that greater discounting of delayed losses is associated with AUD and comorbid AP problems and lower individual eWM capacity.


Asunto(s)
Alcoholismo/epidemiología , Alcoholismo/psicología , Trastorno de Personalidad Antisocial/epidemiología , Trastorno de Personalidad Antisocial/psicología , Descuento por Demora , Memoria a Corto Plazo , Adolescente , Adulto , Alcoholismo/diagnóstico , Trastorno de Personalidad Antisocial/diagnóstico , Toma de Decisiones/fisiología , Descuento por Demora/fisiología , Femenino , Humanos , Masculino , Memoria a Corto Plazo/fisiología , Desempeño Psicomotor/fisiología , Distribución Aleatoria , Adulto Joven
8.
Pers Individ Dif ; 75: 210-215, 2015 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-25530648

RESUMEN

This study tested a dual-process model of self-control where the combination of high impulsivity (negative urgency - NU), weak reflective / control processes (low executive working memory capacity - E-WMC), and a cognitive load is associated with increased failures to inhibit pre-potent responses on a cued go/no-go task. Using a within-subjects design, a cognitive load with and without negative emotional load was implemented to consider situational factors. Results suggested that: (1) high NU was associated with low E-WMC; (2) low E-WMC significantly predicted more inhibitory control failures across tasks; and (3) there was a significant interaction of E-WMC and NU, revealing those with low E-WMC and high NU had the highest rates of inhibitory control failures on all conditions of the task. In conclusion, results suggest that while E-WMC is a strong independent predictor of inhibitory control, NU provides additional information for vulnerability to problems associated with self-regulation.

9.
J Stud Alcohol Drugs ; 85(2): 210-217, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38095172

RESUMEN

OBJECTIVE: Pregnant and postpartum people want more and higher quality information about the effects of perinatal cannabis use (PCU) on child health, and they turn to anonymous sources of information, such as online pregnancy forums, to make decisions about its use. This study characterized perceptions of the developmental impact of PCU on children via a narrative evaluation of a public forum on which people discuss a range of issues around cannabis use. METHOD: A random sample of 10 threads per month from June 2020 to May 2021 were scraped from the "Ganja Mamas" forum on Whattoexpect.com. Posts were analyzed if they discussed use of cannabis during pregnancy or lactation and children. A qualitative coding structure was developed from a literature review on PCU and was refined for inclusion of emergent topics. Posts were evaluated by two coders using applied thematic analysis and were assessed using an open coding process to identify key topics. Associated codes were grouped into themes. RESULTS: Posters (a) discussed the negative and positive impact of PCU on child physical, cognitive, and socioemotional development; (b) garnered information about PCU from sources other than medical providers; and (c) discussed harm-reduction approaches to reduce impacts of PCU on child health. CONCLUSIONS: There is a need for stigma-free support around PCU decision-making for people who select into discussion forums designed for communication and support around parental cannabis use. This forum presents a fruitful opportunity for intervention to encourage health-promoting behaviors through the provision of evidence-based information.


Asunto(s)
Cannabis , Femenino , Embarazo , Niño , Humanos , Cannabis/efectos adversos , Comunicación
10.
Cannabis ; 6(4): 33-48, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38883280

RESUMEN

Objective: Simultaneous alcohol and cannabis use (i.e., marijuana, [SAM], using alcohol and cannabis so effects overlap) is associated with increased consumption and consequences compared to single-substance use. SAM use prevalence is increasing, yet there is heterogeneity in use patterns among those engaging in SAM use, which may lead to differential consequences. Method: This study drew on daily data to characterize latent profiles of cannabis, alcohol, and SAM use patterns and to test class differences on related consequences after 3 months among college students engaging in SAM use (77.08% White, 51.67% female). Class indicators were 10 person-level substance use variables derived from repeated daily surveys. Results: Results yielded a three-class solution: Heavy Alcohol, Cannabis, and SAM (Heavy Use, n = 105); Heavy Alcohol-Light Cannabis (n = 75); and Light Alcohol-Heavy Cannabis (n = 60). There were significant person-level differences between classes on all substance use indicators (e.g., quantity and frequency of alcohol, cannabis, and SAM) but not sex or race/ethnicity. At 3-month follow-up, the Heavy Use class endorsed more SAM consequences than the other classes. The Heavy Use class did not differ on alcohol or cannabis consequences compared to the Heavy Alcohol-Light Cannabis or Light Alcohol-Heavy Cannabis classes, respectively. The Light Alcohol-Heavy Cannabis class endorsed the fewest alcohol consequences. The Heavy Alcohol-Light Cannabis class endorsed the fewest cannabis consequences. Conclusions: Findings highlight distinct patterns of co-use and their association with consequences at follow-up. Heavy alcohol or cannabis use was associated with consequences for that substance, but heavy use of only one substance was not indicative of SAM-specific consequences.

11.
Psychol Assess ; 36(10): 606-617, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39101913

RESUMEN

Research on real-world patterns of substance use increasingly involves intensive longitudinal data (ILD) collection, requiring long assessment windows. The present study extends limited prior research examining event- and person-level influences on compliance and response consistency by investigating how these behaviors are sustained over time in an ILD study of alcohol and cannabis co-use in college students. Participants (n = 316) completed two 28-day bursts of ILD comprising five daily surveys, which included a morning survey of prior-day drinking. We used linear mixed effects models in a multilevel interrupted time series framework to evaluate the associations of time and measurement burst with (a) noncompliance (count of missed surveys) and (b) response consistency (difference between same-day report of drinking and morning report of prior-day drinking). We observed that time was positively associated with noncompliance, with no discontinuity associated with measurement burst. The slope of time was more positive in the second burst. Neither time nor measurement burst were significantly associated with consistent reporting. However, survey nonresponse and consistency of responding appeared to be impacted by the same-day use of substances. Overall, compliance decreased while consistency was stable across the duration of a lengthy ILD protocol. Shorter assessment windows or adaptive prompting strategies may improve overall study compliance. Further work examining daily burden and context is needed to inform future ILD design. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Estudiantes , Humanos , Femenino , Masculino , Estudios Longitudinales , Adulto Joven , Adulto , Estudiantes/psicología , Adolescente , Universidades , Encuestas y Cuestionarios , Consumo de Bebidas Alcohólicas/psicología , Recolección de Datos , Uso de la Marihuana/psicología
12.
J Stud Alcohol Drugs ; 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38517753

RESUMEN

OBJECTIVE: Pregaming is common among college students and is associated with heavy drinking and negative alcohol-related consequences. The use of cannabis on pregaming days may exacerbate negative alcohol-related consequences, and the ordering of when cannabis is used on these days may buffer against or intensify these consequences. Considering the growing rates of simultaneous use of cannabis and alcohol among college students, it is necessary to examine the role of pregaming behaviors in the context of cannabis use and resulting effects on alcohol-related consequences. METHOD: In the present study, college students (N=485) completed a baseline survey and 14 days of daily surveys, reporting on daily alcohol and cannabis use and alcohol-related negative consequences. Multilevel Structural Equation Models were fit to evaluate cannabis outcomes on pregaming versus non-pregaming drinking days and ordering effects on alcohol-related consequences controlling for number of drinks, age, and sex. RESULTS: Across all drinking days, pregaming on that day as well as cannabis use during drinking on that day were associated with greater risk for alcohol-related consequences. On days that did not involve pregaming, use of cannabis before drinking was associated with greater risk for negative alcohol-related consequences, while cannabis use after drinking was associated with less risk for consequences. These effects were observed on non-pregaming days only and not on days with pregaming. CONCLUSIONS: Findings have implications for brief interventions with students, as analyses suggested that both cannabis use and pregaming, independent of number of drinks consumed, are risky behaviors associated with alcohol-related consequences.

13.
JMIR Res Protoc ; 13: e58685, 2024 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-39321460

RESUMEN

BACKGROUND: There is significant conflicting evidence as to how using cannabis while drinking alcohol (ie, simultaneous alcohol and cannabis use) impacts alcohol volume consumed, patterns of drinking, and alcohol-related consequences. The impact of simultaneous use on drinking outcomes may be influenced by several within-person (eg, contextual) and between-person (individual) factors. OBJECTIVE: This study was designed to examine naturalistic patterns of alcohol and cannabis use to understand how simultaneous use may impact drinking outcomes. The primary aims were to understand the following: (1) if simultaneous use is associated with increased alcohol consumption and riskier patterns of drinking, (2) if simultaneous use leads to increased alcohol consequences, and (3) how contextual circumstances moderate the impact of simultaneous use on consumption and consequences. METHODS: Data collection involves a 28-day ambulatory assessment protocol in which a sample of non-treatment-seeking young adults who report simultaneous use of alcohol and cannabis complete ecological momentary assessments (random, event-contingent, and time-contingent surveys) of alcohol and cannabis use, contexts, motives, and consequences on their personal smartphones while continuously wearing an alcohol biosensor bracelet. Participants also complete a baseline assessment, brief internet-based check-in on day 14, and a final session on day 28. Community-based recruitment strategies (eg, social media and flyers) were used to enroll 95 participants to obtain a target sample of 80, accounting for attrition. RESULTS: Recruitment and data collection began in May 2021 and continued through June 2024. Initial results for primary aims are expected in October 2024. As of March 2024, the project had recruited 118 eligible participants, of whom 94 (79.7%) completed the study, exceeding initial projections for the study time frame. Remaining recruitment will provide the capacity to probe cross-level interactions that were not initially statistically powered. Strengths of the project include rigorous data collection, good retention and compliance rates, faster-than-expected enrollment procedures, use of a novel alcohol biosensor, and successful adaptation of recruitment and data collection procedures during the COVID-19 pandemic. CONCLUSIONS: This is the first investigation to assess the key momentary predictors and outcomes of simultaneous use as well as self-reported and objective (via alcohol biosensor) measures of alcohol consumption and patterns. The results of this study will inform prevention efforts and studies of individuals who use cannabis who are engaged in alcohol treatment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58685.


Asunto(s)
Consumo de Bebidas Alcohólicas , Humanos , Consumo de Bebidas Alcohólicas/epidemiología , Adulto Joven , Masculino , Femenino , Adulto , Evaluación Ecológica Momentánea , Adolescente , COVID-19/epidemiología , COVID-19/prevención & control , Uso de la Marihuana/epidemiología
14.
J Addict Med ; 18(1): 28-32, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37801372

RESUMEN

OBJECTIVE: This study aimed to assess agreement between self-report and urine toxicology measures assessing use of 2 illicit simulants (methamphetamine and cocaine) during early pregnancy. METHODS: This cross-sectional study of 203,053 pregnancies from 169,709 individuals receiving prenatal care at Kaiser Permanente Northern California between January 1, 2011, and December 31, 2019, assessed agreement ( κ , sensitivity, and specificity) between self-reported frequency and urine toxicology measures of methamphetamine and cocaine early in pregnancy. RESULTS: Prenatal use of the illicit stimulants was rare according to toxicology (n = 244 [0.12%]) and self-report measures (n = 294 [0.14%]). Agreement between these measures was low ( κ < 0.20). Of the 498 positive pregnancies, 40 (8.03%) screened positive on both measures, 204 (40.96%) screened positive on toxicology tests only, and 254 (51.00%) screened positive by self-report only. Relative to toxicology tests, sensitivity of any self-reported use was poor with 16.39% (95% confidence interval [CI], 11.75%-21.04%) of pregnancies with a positive toxicology test self-reporting any use in pregnancy. Relative to self-report, sensitivity of toxicology tests was also poor with 13.61% (95% CI, 9.69%-17.52%) of pregnancies who self-reported any use having positive urine toxicology tests. The sensitivity improved slightly at higher frequencies of self-reported use: daily, 17.50% (95% CI, 5.72%-29.29%); weekly, 25.00% (95% CI, 11.58%-38.42%); and monthly or less, 11.06% (95% CI, 6.89%-15.23%). Specificity was high (>99%), reflecting the high negative rate of use. CONCLUSIONS: Findings suggest that using self-report and toxicology measures in combination likely provides the most accurate information on methamphetamine and cocaine use in early pregnancy. Findings also highlight the need to provide supportive nonstigmatizing environments in which pregnant individuals feel comfortable disclosing substance use without fear of punishment.


Asunto(s)
Trastornos Relacionados con Cocaína , Cocaína , Metanfetamina , Femenino , Embarazo , Humanos , Metanfetamina/efectos adversos , Autoinforme , Estudios Transversales , Detección de Abuso de Sustancias , Trastornos Relacionados con Cocaína/diagnóstico , Trastornos Relacionados con Cocaína/epidemiología
15.
Drug Alcohol Depend ; 251: 110922, 2023 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-37625332

RESUMEN

BACKGROUND: Young adults frequently use alcohol, cannabis, and tobacco together. Given the increased prevalence of e-cigarette use and recreational cannabis use, we investigated daily patterns of alcohol, cannabis, and tobacco use and distinguished combustible tobacco from e-cigarettes. METHODS: Young adult college students (N=341) reporting past-month alcohol and cannabis use "at the same time so that their effects overlapped" completed two 28-day bursts of repeated daily surveys. Exposures were day- and person-level use of each substance. Outcomes were (1) same-day co-use of each remaining substance or (2) poly-use of the other substances. RESULTS: Daily use of alcohol, cannabis, combustible cigarettes, and e-cigarettes increased the odds of same-day co-use of the other substances (except combustible tobacco with e-cigarettes) and each poly-use outcome. The influence of person-level substance use on daily substance use was less consistent. Only e-cigarette use increased the odds of daily alcohol use. Use of either tobacco product but not alcohol increased the odds of daily cannabis use. Person-level alcohol and cannabis use increased the odds of daily use of either tobacco product but use of one tobacco product was not associated with daily use of the other product. CONCLUSIONS: These findings increase our understanding of emerging daily patterns of alcohol, cannabis, and tobacco co-use, and the impact of different tobacco products. Future work is needed to extend this research into non-college samples and people who use tobacco but do not use alcohol and cannabis simultaneously, and examine daily chronologies of multiple substances that could serve as dynamic markers of risk.


Asunto(s)
Cannabis , Sistemas Electrónicos de Liberación de Nicotina , Trastornos Relacionados con Sustancias , Productos de Tabaco , Vapeo , Adulto Joven , Humanos , Vapeo/epidemiología , Uso de Tabaco/epidemiología , Etanol
16.
J Stud Alcohol Drugs ; 84(4): 535-545, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37096769

RESUMEN

OBJECTIVE: There is substantial evidence linking anxiety sensitivity and distress intolerance to depressive symptoms, and further evidence linking depressive symptoms to alcohol and cannabis use. However, the prospective indirect associations of anxiety sensitivity and distress intolerance with alcohol and cannabis use through depressive symptoms remain uncertain. Thus, the current study examined whether depressive symptoms mediated the associations between anxiety sensitivity and distress intolerance with alcohol and cannabis use frequency, quantity, and problems in a longitudinal sample of veterans. METHOD: Participants (N = 361; 93% male; 80% White) were military veterans with lifetime cannabis use recruited from a Veterans Health Administration in the Northeastern United States. Eligible veterans completed three semi-annual assessments. Prospective mediation models were used to test for the effects of baseline anxiety sensitivity and distress intolerance on alcohol and cannabis use quantity, frequency and problems at 12 months via depressive symptoms at 6 months. RESULTS: Baseline anxiety sensitivity was positively associated with 12-month alcohol problems. Baseline distress intolerance was positively associated with 12-month cannabis use frequency and quantity. Baseline anxiety sensitivity and distress intolerance significantly predicted increased alcohol problems and cannabis use frequency at 12 months through depressive symptoms at 6 months. There were no significant indirect effects of anxiety sensitivity and distress intolerance on alcohol use frequency or quantity, cannabis use quantity, or cannabis problems. CONCLUSIONS: Anxiety sensitivity and distress intolerance share a common pathway to alcohol problems and cannabis use frequency through depressive symptoms. Interventions focused on modulating negative affectivity may reduce cannabis use frequency and alcohol problems.


Asunto(s)
Trastornos Relacionados con Alcohol , Cannabis , Veteranos , Humanos , Masculino , Femenino , Depresión/epidemiología , Ansiedad/epidemiología
17.
Nat Ecol Evol ; 7(1): 82-91, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36604551

RESUMEN

Human-induced environmental changes, such as the introduction of invasive species, are driving declines in the movement of nutrients across ecosystems with negative consequences for ecosystem function. Declines in nutrient inputs could thus have knock-on effects at higher trophic levels and broader ecological scales, yet these interconnections remain relatively unknown. Here we show that a terrestrial invasive species (black rats, Rattus rattus) disrupts a nutrient pathway provided by seabirds, ultimately altering the territorial behaviour of coral reef fish. In a replicated ecosystem-scale natural experiment, we found that reef fish territories were larger and the time invested in aggression lower on reefs adjacent to rat-infested islands compared with rat-free islands. This response reflected changes in the economic defendability of lower-quality resources, with reef fish obtaining less nutritional gain per unit foraging effort adjacent to rat-infested islands with low seabird populations. These results provide a novel insight into how the disruption of nutrient flows by invasive species can affect variation in territorial behaviour. Rat eradication as a conservation strategy therefore has the potential to restore species interactions via territoriality, which can scale up to influence populations and communities at higher ecological levels.


Asunto(s)
Ecosistema , Especies Introducidas , Humanos , Animales , Ratas , Arrecifes de Coral , Peces/fisiología , Agresión
18.
J Stud Alcohol Drugs ; 84(2): 208-213, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36971729

RESUMEN

OBJECTIVE: Co-use of alcohol and cannabis has been associated with more total negative consequences than single-substance use, but results have been mixed depending on whether the single substance was alcohol or cannabis. The present study used within-person analyses to examine whether co-use increased the risk for experiencing specific acute negative consequences. METHOD: College students who were co-users of alcohol and cannabis (N = 341; M age = 19.8 years; 51.3% female; 74.8% White) completed 56 days of five daily surveys across two bursts. We used generalized linear mixed effects models to examine the effects of type of substance use day on specific negative consequences, controlling for consumption and covariates. RESULTS: Relative to both alcohol-only and co-use days, cannabis-only days were associated with decreased likelihood of experiencing hangover, blackout, nausea/vomiting, injury, rude/aggressive behavior, and unwanted sex. Relative to alcohol-only days, cannabis-only and co-use days were associated with an increased likelihood of driving high/drunk. Finally, there was an increased likelihood of hangovers on alcohol-only days compared with co-use days. CONCLUSIONS: Days with different types of substance use differed in specific consequences. Most of the negative co-use consequences investigated here appear to be driven by alcohol consumption rather than cannabis use. The results also indicated that these young adults were more likely to endorse driving under the influence of cannabis than alcohol. Interventions for co-use should target alcohol consumption to reduce negative consequences such as blackout, injury, rude/aggressive behavior, and unwanted sex and highlight the dangers of driving under the influence of cannabis.


Asunto(s)
Intoxicación Alcohólica , Cannabis , Alucinógenos , Trastornos Relacionados con Sustancias , Adulto Joven , Humanos , Femenino , Adulto , Masculino , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Etanol
19.
Sci Adv ; 9(49): eadj0390, 2023 12 08.
Artículo en Inglés | MEDLINE | ID: mdl-38055814

RESUMEN

Global climate change threatens tropical coral reefs, yet local management can influence resilience. While increasing anthropogenic nutrients reduce coral resistance and recovery, it is unknown how the loss, or restoration, of natural nutrient flows affects reef recovery. Here, we test how natural seabird-derived nutrient subsidies, which are threatened by invasive rats, influence the mechanisms and patterns of reef recovery following an extreme marine heatwave using multiyear field experiments, repeated surveys, and Bayesian modeling. Corals transplanted from rat to seabird islands quickly assimilated seabird-derived nutrients, fully acclimating to new nutrient conditions within 3 years. Increased seabird-derived nutrients, in turn, caused a doubling of coral growth rates both within individuals and across entire reefs. Seabirds were also associated with faster recovery time of Acropora coral cover (<4 years) and more dynamic recovery trajectories of entire benthic communities. We conclude that restoring seabird populations and associated nutrient pathways may foster greater coral reef resilience through enhanced growth and recovery rates of corals.


Asunto(s)
Antozoos , Resiliencia Psicológica , Animales , Ratas , Arrecifes de Coral , Teorema de Bayes , Aves , Ecosistema
20.
Addiction ; 118(8): 1586-1595, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37060272

RESUMEN

AIMS: Alcohol biosensors, including the BACtrack Skyn, provide an objective and passive method of continuously assessing alcohol consumption in the natural environment. Despite the many strengths of the Skyn, six key challenges in the collection and processing of data include (1) identifying consumed alcohol; (2) identifying environmental alcohol; (3) identifying and determining the source of missing or invalid data; (4) achieving high participant adherence; (5) integrating Skyn and self-report data; and (6) implications for statistical inference. In this report we outline these challenges, provide recommendations to address them and identify future needs. DESIGN AND SETTINGS: Procedures from several laboratory and field-based pilot studies are presented to demonstrate practical recommendations for Skyn use. Data from a pilot study including a 7-day ecological momentary assessment period are also presented to evaluate effects of environmental alcohol on BACtrack Skyn readings. CONCLUSIONS: To address challenges in the collection and processing of data from the BACtrack Skyn alcohol biosensor, researchers should identify goals in advance of data collection to anticipate the processing necessary to interpret Skyn data. The Transdermal Alcohol Sensor Data Macro (TASMAC) version 2.0 software can help to process data rapidly; identify drinking events, missing data and environmental alcohol; and integrate the sensor with self-report data. Thorough participant orientation and regular contact in field studies can reduce missing data and enhance adherence. Many recommended methods for Skyn use are applicable to other alcohol sensors and wearable devices.


Asunto(s)
Técnicas Biosensibles , Dispositivos Electrónicos Vestibles , Humanos , Proyectos Piloto , Etanol , Técnicas Biosensibles/métodos , Recolección de Datos , Consumo de Bebidas Alcohólicas
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