Transitioning from First Drug Use to Dependence Onset: Illustration of a Multiparametric Approach for Comparative Epidemiology

Abstract

Studying transitions from first drug use (DU) to drug dependence (DD) onset, we estimate a parsimonious set of parameters based on epidemiological data, with plans for future longitudinal research on newly incident drug users and with tracking of self-administration frequencies and DD clinical features. Our expectation is a distinctive sigmoid pattern with one asymptote for lower DD probability (when DU is insubstantial), upturning slopes of DD risk beyond a middle value (PD50), and eventual higher DD risk asymptotes at higher DU frequencies. We illustrate this novel approach using cross-sectional data from the United States National Surveys on Drug Use and Health, 2002-2011. Empirical DD probabilities observed soon after newly incident use are estimated across DU frequency values, using parametric Hill functions and four governing parameters for differential comparison across drugs and DU subgroups. Among drug subtypes considered, cocaine shows larger estimates, especially among females (estimated P(min)=7% for females vs 3% for males; p<0.001), for whom PD50 is shorter by 8 days of use (p=0.027), conditional on the same rate of use in the past 30 days. Clear alcohol male-female differences also are observed (eg, female PD50 < male PD50; p=0.002). Although based on cross-sectional snapshots soon after DU onset, this novel multiparametric statistical approach for comparative epidemiological DD research creates new opportunities in planned studies with prospectively gathered longitudinal data. The cross-sectional estimates provide starting values needed to plan future longitudinal research programs on transitions from initial DU until formation of a DD syndrome.

Peer Review #2 of "Does our legal minimum drinking age modulate risk of first heavy drinking episode soon after drinking onset? Epidemiological evidence for the United States, 2006–2014 (v0.1)"

“…Manuscript to be reviewed drinkers who initiated drinking at a specific age, all events conceptualized to occur within 12 months of the assessment date, including 1 st HED occurrences. In this study, we defined rapid transition as the first HED occurring within 12 months of drinking onset, which is consistent with our previous research on drug-related outcomes (Reboussin & Anthony 2006;Vsevolozhskaya & Anthony 2015). [We note that NSDUH discloses assessment quarter (but not assessment month).…”

Marijuana use disorder symptoms among recent onset marijuana users

“…It is possible that emerging symptoms lead to increased levels of marijuana use in addition to increased use leading to the emergence of symptoms. As described by Vsevolozhskaya and Anthony, 2016, focusing analyses on the first months after onset of a newly incident substance may reduce the magnitude of these feedback effects. Still, the present study was only able to examine past month marijuana use as a function of marijuana use disorder symptoms that may have been experienced at any time during the past year, possibly limiting the precision of our findings.…”

“…Still, the present study was only able to examine past month marijuana use as a function of marijuana use disorder symptoms that may have been experienced at any time during the past year, possibly limiting the precision of our findings. 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, 2016), Finally, it is important to note that the NSDUH does not measure all marijuana use symptoms as defined by the current Diagnostic and Statistical Manual (Verion 5) making prevalence of a diagnosable disorder difficult to estimate. Further, other negative consequences of marijuana use that are not adequately captured by these criteria may not be captured by these measures.…”

Effect of Compassion-Focused Therapy (CFT) on Blood Cortisol and Cognitive-Emotion Regulation in Drug Abusers

“…Drug dependence is a global problem. Statistics from international organizations, notably the World Health Organization, the World Narcotics Control Committee, and UNESCO, indicate increasing use of drugs worldwide (1). Every year, many people with drug abuse disorder lose their lives through its direct and indirect consequences (2).…”