A Male Mouse Model of WIN 55,212-2 Self-Administration to Study Cannabinoid Addiction.

ABSTRACTBackground: The Problem Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse subscale has been validated with high school students, adolescents with criminal justice involvement, and adolescent substance use treatment samples using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R and DSM-IV. This study examines the concurrent validity of the POSIT's standard 17-item substance use/abuse subscale and a revised, shorter 11-item version using DSM-5 substance use disorder diagnoses. Methods: Adolescents (N = 525; 93% African American, 55% female) 12–17 years of age awaiting primary care appointments at a Federally Qualified Health Center in Baltimore, Maryland completed the 17-item POSIT substance use/abuse subscale and items from a modified World Mental Health Composite International Diagnostic Interview corresponding to DSM-5 alcohol use disorder (AUD) and cannabis use disorder (CUD). Receiver operating characteristic curves, sensitivities, and specificities were examined with DSM-5 AUD, CUD, and a diagnosis of either or both disorders for the standard and revised subscales using risk cutoffs of either 1 or 2 POSIT “yes” responses. Results: For the 17-item subscale, sensitivities were generally high using either cutoff (range: 0.79–1.00), although a cutoff of 1 was superior (sensitivities were 1.00 for AUD, CUD, and for either disorder). Specificities were also high using either cutoff (range: 0.81–0.95) but were higher using a cutoff of 2. For the 11-item subscale, a cutoff of 1 yielded higher sensitivities than a cutoff of 2 (ranges for 1 and 2: 0.96–1.00 and 0.79–0.86, respectively). Specificities for this subscale were higher using a cutoff of 2 (ranges for 1 and 2: 0.82–0.89 and 0.89–0.96, respectively). Conclusions: Findings suggest that the POSIT's substance use/abuse subscale is a potentially useful tool for screening adolescents in primary care for AUD or CUD using a cutoff of 1 or 2. The briefer, revised subscale may be preferable to the standard subscale in busy pediatric practices.

Racial and ethnic discrimination is a risk factor for substance use among U.S. adults. However, whether discrimination is associated with substance use disorders (SUDs) overall and by race and ethnicity is less understood. We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,355) and defined past-year discrimination as a summary scale (range: 0-4). Past-year SUDs included alcohol use disorder (AUD), tobacco use disorder (TUD), cannabis use disorder (CUD), and illicit drug use disorder (IDUD) based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; number of SUDs included one, two, or three or more SUDs. We estimated associations between discrimination and each SUD outcome using logistic and multinomial logistic regression and examined effect modification by race and ethnicity. Discrimination was associated with each substance-specific SUD (odds ratio [OR] range: 1.36-1.78) and with one, two, and three or more SUDs (OR range: 1.34-2.19). Models stratified by race and ethnicity revealed that discrimination was associated with AUD among all groups (OR range: 1.42-1.52), with TUD only among adults who were non-Hispanic White, non-Hispanic Black, and another non-Hispanic race; with CUD only among non-Hispanic White and non-Hispanic Black adults; and with IDUD only among Hispanic, non-Hispanic White, and non-Hispanic Black adults. In addition, discrimination was associated with three or more SUDs among all groups. Discrimination was associated with all SUD outcomes, with variation in these relationships by race and ethnicity. Understanding this heterogeneity can guide efforts to prevent problematic substance use and reduce health disparities.

Cannabis use disorder and substance use treatment among U.S. adults

DSM-5 substance use disorder: how conceptual missteps weakened the foundations of the addictive disorders field.

Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol

DSM-5 cannabis use disorder, substance use and DSM-5 specific substance-use disorders: Evaluating comorbidity in a population-based sample

Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings

Although they often co-occur, the longitudinal relationship between depression and substance use disorders during adolescence remains unclear. This study estimated the effects of cumulative depression during early adolescence (ages 13-15years) on the likelihood of cannabis use disorder (CUD) and alcohol use disorder (AUD) at age 18. Prospective cohort study of youth assessed at least annually between 6th and 9th grades (~ age 12-15) and again at age 18. Marginal structural models based on a counterfactual framework that accounted for both potential fixed and time-varying confounders were used to estimate cumulative effects of depressive symptoms over early adolescence. The sample originated from four public middle schools in Seattle, Washington, USA. The sample consisted of 521 youth (48.4% female; 44.5% were non-Hispanic White). Structured in-person interviews with youth and their parents were conducted to assess diagnostic symptom counts of depression during early adolescence; diagnoses of CUD and AUD at age 18 was based the Voice-Diagnostic Interview Schedule for Children. Cumulative depression was defined as the sum of depression symptom counts from grades 7-9. The past-year prevalence of cannabis and alcohol use disorder at the age 18 study wave was 20.9 and 19.8%, respectively. A 1 standard deviation increase in cumulative depression during early adolescence was associated with a 50% higher likelihood of CUD [prevalence ratio (PR)=1.50; 95% confidence interval (CI)=1.07, 2.10]. Although similar in direction, there was no statistically significant association between depression and AUD (PR=1.41; 95% CI=0.94, 2.11). Further, there were no differences in associations according to gender. Youth with more chronic or severe forms of depression during early adolescence may be at elevated risk for developing cannabis use disorder compared with otherwise similar youth who experience fewer depressive symptoms during early adolescence.

Screening for cannabis use disorder among young adults: Sensitivity, specificity, and item-level performance of the Cannabis Use Disorders Identification Test – Revised

Using genetic information to inform policy on cannabis

Outcomes of Infrainguinal Bypass in Patients with Cannabis vs Opioid Use Disorder

Cannabis Use, Use Disorder, and Workplace Absenteeism in the U.S., 2021–2022

The association between cannabis use and anxiety disorders: Results from a population-based representative sample

Concordance between DSM-5 and DSM-IV nicotine, alcohol, and cannabis use disorder diagnoses among pediatric patients

Integrated cognitive behavioral therapy for cannabis use and anxiety disorders: Rationale and development