Estimated probability of becoming a case of drug dependence in relation to duration of drug-taking experience: a functional analysis approach

Abstract

Measured as elapsed time from first use to dependence syndrome onset, the estimated ‘induction interval’ for cocaine is thought to be short relative to the cannabis interval, but little is known about risk of becoming dependent during first months after onset of use. Virtually all published estimates for this facet of drug dependence epidemiology are from life histories elicited years after first use. To improve estimation, we turn to new month-wise data from nationally representative samples of newly incident drug users identified via probability sampling and confidential computer-assisted self-interviews for the United States National Surveys on Drug Use and Health, 2004–2013. Standardized modules assessed first and most recent use, and dependence syndromes, for each drug subtype. A four-parameter Hill function depicts the drug dependence transition for subgroups defined by units of elapsed time from first to most recent use, with an expectation of greater cocaine dependence transitions for cocaine versus cannabis. This study’s novel estimates for cocaine users one month after first use show 2%–4% with cocaine dependence; 12%–17% are dependent when use has persisted. Corresponding cannabis estimates are 0%–1% after 1 month, but 10%–23% when use persists. Duration or persistence of cannabis smoking beyond an initial interval of a few months of use seems to be a signal of noteworthy risk for, or co-occurrence of, rapid-onset cannabis dependence, not too distant from cocaine estimates, when we sort newly incident users into subgroups defined by elapsed time from first to most recent use.

Predictive Modelling of Service Pathways to Admission in Psychiatric Residential Treatment Facilities

“…With regard to medication utilization, consistent with existing literature, 7,13 we found that polypharmacy was highly associated with increased risk of PRTF admission. Moreover, post discharge polypharmacy prescribing practices persisted.…”

Nicotine dependence predicts cannabis use disorder symptoms among adolescents and young adults

“…Finally, the cross-sectional nature of the data cannot inform the direction of the relationship between cannabis/tobacco exposure and associated symptoms. Future longitudinal research that asks newly incident substance users to give month-by-month reports of frequency of use and occurrence of clinical features might help to avoid these inherent limitations of cross-sectional data (Vsevolozhskaya and Anthony, 2017).…”

Cannabis Epidemiology: A Selective Review

“…For many years, progress in the field of treating cannabis dependence was retarded by a widespread belief that ‘cannabis dependence’ syndromes did not exist. This belief continues to be challenged by emerging evidence on the coherence of the dependence syndrome and related conditions such as ‘cannabis use disorder’, the biological plausibility of these conditions, and their clinical implications [77–85]. Early forms of cannabis dependence treatment were introduced, as described in a review article by Budney and colleagues [86], published more than a decade ago.…”