Examining the profile of high-potency cannabis and its association with severity of cannabis dependence.

BACKGROUND: Cannabis use is decreasing in England and Wales, while demand for cannabis treatment in addiction services continues to rise. This could be partly due to an increased availability of high-potency cannabis. METHOD: Adults residing in the UK were questioned about their drug use, including three types of cannabis (high potency: skunk; low potency: other grass, resin). Cannabis types were profiled and examined for possible associations between frequency of use and (i) cannabis dependence, (ii) cannabis-related concerns. RESULTS: Frequent use of high-potency cannabis predicted a greater severity of dependence [days of skunk use per month: b = 0.254, 95% confidence interval (CI) 0.161-0.357, p < 0.001] and this effect became stronger as age decreased (b = -0.006, 95% CI -0.010 to -0.002, p = 0.004). By contrast, use of low-potency cannabis was not associated with dependence (days of other grass use per month: b = 0.020, 95% CI -0.029 to 0.070, p = 0.436; days of resin use per month: b = 0.025, 95% CI -0.019 to 0.067, p = 0.245). Frequency of cannabis use (all types) did not predict severity of cannabis-related concerns. High-potency cannabis was clearly distinct from low-potency varieties by its marked effects on memory and paranoia. It also produced the best high, was preferred, and most available. CONCLUSIONS: High-potency cannabis use is associated with an increased severity of dependence, especially in young people. Its profile is strongly defined by negative effects (memory, paranoia), but also positive characteristics (best high, preferred type), which may be important when considering clinical or public health interventions focusing on cannabis potency.

Consumo de alcohol, sustancias ilegales y violencia hacia la pareja en una muestra de maltratadores en tratamiento psicológico / Alcohol consumption, illicit substances, and intimate partner violence in a sample of batterers in psychological treatment

Este estudio tiene como objetivo analizar las características de consumo de alcohol y sustancias ilegales en una muestra de 572 maltratadores en tratamiento por orden judicial. Los resultados indican que la prevalencia de consumo de alcohol en el último año fue de 89,3%, mientras que dentro de las sustancias ilegales las prevalencias más altas fueron para cannabis (27,8%) seguido de cocaína (20,3%). Con el objetivo de analizar el posible efecto del consumo sobre los niveles de perpetración y victimización de agresiones hacia la pareja, se dividió la muestra en 4 grupos: no consumidores (16,3%), consumidores de alcohol (58,6%), consumidores de drogas ilegales (3,5%) y consumidores de alcohol y drogas ilegales (21,7%), encontrándose que el grupo de los no consumidores y el de los consumidores de alcohol son los que presentan los niveles más bajos en perpetración de agresiones psicológicas, físicas y sexuales y victimización de agresiones psicológicas y físicas, mientras que el grupo de consumidores de alcohol e ilegales es el que presenta los niveles más elevados. Los resultados hallados ponen de manifiesto la necesidad de evaluar el consumo de sustancias a la hora de diseñar protocolos de intervención con maltratadores

The purpose of this study is to analyze the alcohol and illicit substance consumption characteristics in a sample of 572 batterers in treatment by court order. The results indicate that the prevalence of alcohol consumption in the past year was 89.3%, whereas within illicit substances, the prevalences were higher for cannabis (27.8%), followed by cocaine (20.3%). In order to analyze the possible effect of consumption on levels of perpetration and victimization of partneraggression, the sample was divided into 4 groups: nonconsumers (16.3%), alcohol consumers (58.6%), illicit drug consumers (3.5%), and consumers of alcohol and illicit drugs (21.7%), finding that the groups of nonconsumers and alcohol consumers presented the lowest level of perpetration of psychological, physical, and sexual aggression and of victimization of psychological and physical aggression, whereas the group of consumers of alcohol and illicit drugs presented the highest levels. The results reveal the need to assess substance consumption when designing intervention protocols with batterers

An item response theory modeling of alcohol and marijuana dependences: a National Drug Abuse Treatment Clinical Trials Network study.

OBJECTIVE: The aim of this study was to examine psychometric properties of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostics criteria for alcohol and marijuana dependences among 462 alcohol users and 311 marijuana users enrolled in two multisite trials of the National Drug Abuse Treatment Clinical Trials Network. METHOD: Diagnostic questions were assessed by the DSM-IV checklist. Data were analyzed by the item response theory and the multiple indicators-multiple causes method procedures. RESULTS: Criterion symptoms of alcohol and marijuana dependences exhibited a high level of internal consistency. All individual symptoms showed good discrimination in distinguishing alcohol or marijuana users between high and low severity levels of the continuum. In both groups, "withdrawal" appeared to measure the most severe symptom of the dependence continuum. There was little evidence of measurement nonequivalence in assessing symptoms of dependence by gender, age, race/ethnicity, and educational level. CONCLUSIONS: These findings highlight the clinical utility of the DSM-IV checklist in assessing alcohol- and marijuana dependence syndromes among treatment-seeking substance users.

Client matching: a severity-treatment intensity paradigm.

Despite considerable effort to develop matching strategies and client placement protocols, research studies fail to yield compelling results regarding the benefits of matching to treatment. The most consistent findings suggest a matching paradigm, which defines a successful placement as the least treatment intensity required addressing the severity of the disorder. The purpose of the present study is to provide further empirical support for the validity of a severity-intensity paradigm utilizing data from the Drug Abuse Treatment Outcome Studies. A "passive match" approach employed the Client Matching Protocol decision algorithm, which recommended clients to long-term residential or outpatient drug-free treatment. One-year outcomes for clients matched to long-term residential treatment were better on all outcome variables compared to those undertreated in outpatient drug-free treatment. Findings supported the validity of the severity-intensity paradigm in that undertreated clients showed less improvement compared to matched and overtreated clients.