Demographic Characteristics, Components of Sexuality and Gender, and Minority Stress and Their Associations to Excessive Alcohol, Cannabis, and Illicit (Noncannabis) Drug Use Among a Large Sample of Transgender People in the United States.

Background Although use of illicit drugs shows varying degree of heritability, the influence of shared and unique environmental factors predominate among adolescents. We explored factors predicting use of cannabis and other illicit drugs among Finnish adolescent twins. Methods We used longitudinal data from the FinnTwin12–17 study with baseline at age 11–12 and follow-up at ages 14 and 17½, including 4138 individuals. The outcome was self-reported ever use of cannabis or other illicit drugs at age 17½. The potential predictors were measures reported by the twins, their parents or teachers. As individual factors we tested smoking, alcohol use, behavioral and emotional problems; as peer factors: number of smoking friends and acquaintances with drug experience; as family factors: parental substance use, socio-economic status and pre-natal exposure to nicotine. We used logistic regression models, controlling for twinship, age and sex, to compute odds ratios (OR) for each potential predictor. To adjust for within-family confounds, we conducted conditional logistic regressions among 246 twin pairs discordant for drug use. Results 13.5% of subjects had initiated use of cannabis or other illicit drugs by age of 17½. When adjusted for within-family confounds, smoking, drinking, and aggressiveness, as well as smoking and drug use among peers predicted use of illicit drugs. In the final regression model, the significant predictors were female sex, early smoking onset, drinking to intoxication, having smoking peers and acquaintances with drug experience, father's weekly drinking to intoxication, and aggressive behavior among boys. Smoking initiation by age of 12 was the most powerful predictor among individuals (OR = 26, p < 0.001) and within discordant pairs (OR = 22, p < 0.001). Conclusions Early onset smoking is a powerful predictor for subsequent use of illicit drugs among Finnish adolescents, but the causal nature of this relationship needs to be clarified.

In the era of effective antiretroviral therapy, HIV-positive patients experience an increase in non-AIDS associated comorbidities. Causes of death are now more frequently associated with ageing and smoking; alcohol and drug use are strongly linked to many of these causes. An almost equal life expectancy among HIV-positive people compared with HIV-negative population has been recently reported. However, life expectancy is reduced among HIV-positive smokers by at least 16 years and further reduced for people who have a history of excessive alcohol and drug use. Cohort studies report between a 1.5- and two-fold or greater increased mortality risk as a result of smoking. In a Danish population study, 61% of deaths in HIV-positive people were associated with smoking. Excessive alcohol and drug use are also elevated among specific HIV subpopulations and significantly impact morbidity and mortality. In the Veteran Affairs cohort study, moderate and excessive alcohol use increased mortality by 25-35% compared with low alcohol use. Despite the effective therapy, smoking, alcohol and drug use have a significant role in increased mortality and reduced life expectancy among HIV-positive people. These factors need to be in continued focus for the management and care of HIV-positive people.

Genetically informative studies of 'environment'.

Poster Abstracts from the AAAP 20th Annual Meeting and Symposium

Although cannabis is well studied in the scientific literature, relatively little is known about the relationship between the frequency of cannabis use and the use of alcohol and other drugs. The aim of this study was to identify differences between frequent and occasional cannabis users with respect to the use of other illicit drugs, hazardous alcohol use, and unauthorized use of prescription drugs. Results from a questionnaire on drug use taken by 22,095 individuals in the Swedish general population were analyzed with a logistic regression model. Active cannabis use was defined as having used cannabis in the past 12 months. Use of cannabis two-to-three times per week or more was classified as frequent use. Cannabis users were more likely to report hazardous alcohol use, use of other illicit drugs, and unauthorized use of prescription drugs than were non-users. Within the group of active cannabis users, frequent cannabis use, compared to occasional use, was associated with the use of other illicit drugs and negatively associated with hazardous alcohol use. The association between cannabis use and hazardous alcohol use, use of other illicit drugs, and unauthorized use of prescription drugs was expected. However, the negative association between frequent cannabis use and hazardous alcohol use among active cannabis users was surprising. This indicates that frequent cannabis users may differ from more occasional users in clinical needs. These results show a previously unknown characteristic of the association between frequency of cannabis use and hazardous alcohol use in the general population.

Background: Globally, there is growing concern regarding workers’ illicit drug use and its implications for health and workplace safety. Young workers in male-dominated industries, such as construction, may be more susceptible to illicit drug use, risky drinking and its associated harms. Purpose/objectives: To investigate drug use and perceptions of risk among male construction workers, drawing comparisons between workers under 25 years with older age groups. Methods: Workers in Sydney, Australia (N = 511) completed a survey measuring past year illicit drug and alcohol use, psychological distress and perceptions of drug-related risks to health and safety. Prevalence in the total sample was compared with national estimates, and differences between younger and older survey respondents were examined using logistic regression models. Results: Survey respondents’ cocaine, meth/amphetamine and cannabis use was significantly higher than estimates of male employees nationally (OR = 6.60, 3.58, 1.61, respectively). Young workers ≤24 were more likely to frequently use illicit drugs, drink heavily, and report psychological distress than those aged 35+. Workers ≤24 were least likely to perceive that drug use posed high risks to health or safety when compared with 25-34 and 35+ age groups. Conclusions/importance: The findings highlight the high prevalence of illicit drug use amongst young construction workers, representing threats to workplace safety even if used outside work hours. Greater emphasis on potential adverse effects of alcohol and drug use and closer examination of contributory workplace factors are required. These findings have practical implications to inform occupational health and safety programs and interventions in high-risk workplaces.

To The Editor: Most national estimates of adult DSM-IV substance use disorder (e.g., National Epidemiologic Survey on Alcohol and Related Conditions [1], and National Survey on Drug Use and Health [2]) are based on household samples that exclude prison and jail inmates, populations known to have high rates of substance use disorders. To estimate the effect of excluding inmates, we present estimates of alcohol and drug use disorders for household and inmate populations and calculate the change in the overall prevalence of substance use disorder when these two populations are pooled. Prevalence estimates for the combined U.S. household and inmate population are weighted averages of the survey-weighted prevalence estimates for the household population, state prison population, federal prison population, and jail population (1, 3–5). As seen in Table 1, details about interviewing and how weighted averages and standard errors were calculated are reported (also see the data supplement accompanying the online version of this letter). Table 1 Effect of Adding the Inmate Population to Household Prevalence and Population Estimates of the Prevalence of Past 12 Month DSM-IV Alcohol and Drug Use Disorders in U.S. Adults Including inmates increased overall projected estimates of the number of persons in the United States aged ≥18 years with an alcohol use disorder by 877,000, from 17,580,000 to 18,457,000, a 5.0% increase over the base. Estimates of the number with an illicit drug use disorder increased by 1,043,000, from 4,159,000 to 5,202,000, a 25.1% increase. Overall prevalence of the specific alcohol abuse and dependence disorders increased over the base by 4.2% and 5.9% respectively, and illicit drug abuse and dependence increased by 12.0% and 53.8%. High rates of DSM-IV substance use disorders among inmates combined with a large inmate population means that many persons with alcohol and drug use disorders are missed by major U.S. national general population surveys. The undercount for both alcohol and illicit drug disorders is significant, but proportionately the undercount for alcohol disorders is modest while the proportionate undercount for illicit drug disorders, particularly illicit drug dependence (i.e., addiction), is large. These results likely would be accentuated for substances such as cocaine, methamphetamine, and heroin, which are rare in the household population (2) but common among inmates (4–5). In addition, prevalence rates may be particularly underestimated for men and for those minority populations that are overrepresented in the inmate population. To improve accuracy and cover the full range of cases, the U.S. surveillance system may need to be modified. In addition, further investigation of the effect of incarceration on estimates for specific subpopulations is warranted.

The aging United States population, which includes the large Baby Boomer generation, is leading to an increasing number of middle-aged and older adults who engage in psychoactive substance use. Due to the size of this cohort, and their changing attitudes around psychoactive substance use, there has been a sharp increase in prevalence of past-month cannabis use among adults aged ≥50; however, little is understood about recent trends in the use of both cannabis and excess alcohol use, such as binge drinking, in this population. The current use of both alcohol and cannabis has important health implications for older adults, given their higher prevalence of chronic diseases and prescribed medications. This study aimed to 1) estimate national trends among older adults who report both past-month binge drinking and cannabis use, and 2) examine correlates of reporting both. We examined aggregated data from a nationally representative sample of noninstitutionalized adults aged ≥50 from the 2015 to 2019 National Survey on Drug Use and Health. During the study period, there was an estimated 2.5% increase (a 64.1% relative increase) in past-month cannabis use (linear trend p < 0.001), a non-significant decrease in past-month binge drinking, and a 0.5% estimated increase in both past-month cannabis use and binge drinking (a 26.3% relative increase) (p = 0.03). The sharpest increase in both past-month cannabis use and binge drinking was among adults aged ≥65, with the estimated prevalence increasing from 0.2% in 2015 to 1.1% in 2019 (a 450% relative increase, p < 0.001). Those engaging in past-month binge drinking and cannabis use were more likely to be younger, male, non-Hispanic Black, use tobacco, and report past-year mental health treatment. Results suggest that the prevalence of both past-month cannabis use and binge drinking among middle-aged and older adults increased between 2015 and 2019, especially among adults aged ≥65, which indicates an increased need to screen for both excess alcohol and cannabis use to minimize potential harm.

Are the adverse consequences of cannabis use age-dependent?

ImportanceIllicit and nonmedical (use in ways other than instructed) drug use is common in adolescents and young adults and increases the risk of harmful outcomes such as injuries, violence, and poorer academic performance.ObjectiveTo review the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force.Data SourcesMEDLINE, PubMED, PsycINFO, and the Cochrane Central Register of Controlled Trials (January 1, 2013, to January 31, 2019 [children and adolescents]; January 1, 1992, to January 31, 2019 [young adults <25 years]); surveillance through March 20, 2020.Study SelectionClinical trials of behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among young people.Data Extraction and SynthesisCritical appraisal was completed independently by 2 investigators. Data were extracted by 1 reviewer and checked by a second. Random-effects meta-analysis was used to estimate the effect sizes associated with the interventions.Main Outcomes and MeasuresNumber of times illicit drugs were used; any illicit drug or any cannabis use.ResultsTwenty-nine trials (N = 18 353) met inclusion criteria. Health, social, or legal outcomes such as mental health symptoms, family functioning, consequences of drug use, and arrests were reported in 19 trials and most showed no group differences. The effects on illicit drug use in 26 trials among nonpregnant youth (n = 17 811) were highly variable; the pooled result did not show a clinically important or statistically significant association with illicit drug use (standardized mean difference, −0.08 [95% CI, −0.16 to 0.001]; 24 effects [from 23 studies]; n = 12 801; I2 = 57.0%). The percentage of participants using illicit drugs ranged from 2.3% to 38.6% in the control groups and 2.4% to 33.7% in the intervention groups at 3 to 32 months’ follow-up. The median absolute risk difference between groups was –2.8%, favoring the intervention group (range, –11.5% to 14.8%). The remaining 3 trials provided a perinatal home-visiting intervention to pregnant Native American youth. One trial (n=322) found a reduction in illicit drug use at 38 months (eg, cannabis use in the previous month, 10.7% in the intervention group and 15.6% in the control group) but not at earlier follow-up assessments. Across all 29 trials, only 1 trial reported on harms and found no statistically significant group differences.Conclusions and RelevanceThe evidence for behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Health, social, and legal outcomes were sparsely reported, and few showed improvements.

Background:The impact of COVID has been felt by everyone. Yet, as the pandemic has dragged on, it has become more and more clear that there are those for whom the exacerbation of existing inequalities, or the increased upheaval and uncertainty of their lives means that although we have all been touched by pandemic, we are not ‘all in this together'.<br/><br/>Methods:This paper will introduce the experiences of 12 young people (aged 18–25) from a wider study of 52 adults in the Middlesbrough area of the UK during the pandemic, exploring issues including mental health, wellbeing and drug and alcohol taking behaviour (and the risk factors for such behaviours). Results:Showed increased pressure of disruption to socialisation during one's essential ‘formative years', the worries over wholesale changes to education—which have themselves widened pre-existing inequalities of access and achievement—the unknown impact of the pandemic on the future, and the added stigma of blame for spikes in infection have all contributed to a significant decrease in the health and wellbeing of young people. Interviewees spoke of changes to the way in which they socialised and connected with others, and how this in turn affected the way in which they used alcohol and drugs during this time. "Alcoholism and drug taking has skyrocketed during this lockdown, you see if people were allowed to go out and about and socialise with other people, then maybe they wouldn't be taking so many drugs, maybe they wouldn't be drinking the odd case [of beer]."<br/><br/>Conclusions:As we start to exit from the pandemic lockdown more work is needed to develop brief interventions for young people to tackle the multiple health and social needs they have encountered.

Comparison of the Substance Use Brief Screen (SUBS) to the AUDIT-C and ASSIST for detecting unhealthy alcohol and drug use in a population of hospitalized smokers

The Guardian reports that Non-Governmental organisations from across the globe have released an expose highlighting new tobacco industry tactics to undermine the implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). The document, produced by Corporate Accountability International and the Network for Accountability of Tobacco Transnationals (NATT), also criticised FCTC parties such as Lebanon and the Philippines for collaborating with tobacco corporations and falling short of commitments under the treaty. FCTC Article 5.3 obligates treaty parties to ‘protect (public health) policies from commercial and other vested interests of the tobacco industry in accordance with national law.’ Guidelines for the implementation of this measure were adopted at the third Conference of Parties in November 2008. It was reported that the tobacco industry is trying to get governments to ignore their obligations under the treaty and make exceptions to these new rules. The statement added that ‘NGOs are calling on treaty parties to follow through on their commitments. Meanwhile the tobacco lobby is present and visible at this week's negotiations in full force, seeking to influence the content of the protocol to its own advantage and chip away at the safeguards of Article 5.3.’ Source: The Guardian, 12 July 2009 New research published in the journal Schizophrenia Research[1] has found no evidence of increasing schizophrenia or psychoses in the general population from 1996 to 2005, despite increased cannabis use at the same time. The study cohort comprised almost 600,000 patients each year, representing approximately 2.3% of the UK population aged 16 to 44. Between 1996 and 2005 the incidence and prevalence of schizophrenia and psychoses were either stable or declining. Explanations other than a genuine stability or decline were considered, but appeared less plausible. Source: http://www.ncbi.nlm.nih.gov/pubmed/19560900 The Washington Post reports that the Food and Drug Administration (FDA) in the United States has announced that smoking-cessation drugs Chantix and Zyban are to carry the strongest type of safety warning possible to alert patients that the medications can cause serious mental health problems, including depression and suicide. It was reported that about 100 suicides in patients taking Chantix have been reported to the FDA since 2006. On the other hand, there have been 14 reports of suicide in patients taking Zyban. Despite the figures, both pharmaceutical companies claim that there is no evidence that their drugs actually cause suicides or mood swings. However, it is worth noting that the FDA has also stressed that the warnings aren't meant to advise smokers not to use the drugs. Unfortunately, it is already apparent that there are problems associated with the new Family Smoking Prevention and Tobacco Control legislation. An essay in PLoS Medicine has argued that it represents a serious compromise on the part of tobacco control advocates [1]. Stanton Glantz and colleagues from the University of California, San Francisco say that the new policy is another example of legislative compromise with the tobacco industry that can lead to short-term public health gains at the expense of long-term progress. The new policy repeals federal pre-emption of state and local regulation of tobacco advertising, which is a positive move, but it also allows the tobacco industry an opportunity to rehabilitate its image and products because they are now ‘FDA regulated,’ say the authors. The authors say it will make it difficult to develop and implement effective regulation in the United States and beyond because tobacco interests are represented on the Scientific Advisory Committee that plays a central role in the development of FDA regulations-violating the World Health Organization Framework Convention on Tobacco Control. The challenge moving forward, say the authors, will be for the compromise law's advocates ‘to accept responsibility for these problems and to see that their negative consequences do not materialize.’ Source: The Washington Post, 1 July 2009 The US National Survey on Drug Use and Health (NSDUH) has reported that about one fifth of young adults aged 18 to 25 (21.1%) were classified as needing treatment for alcohol or illicit drug use and 17.2% were in need of alcohol use treatment. The NSDUH provides the latest data on prevalence and correlates of substance use, serious mental illness, related problems, and treatment in the civilian population aged 12 or older in the US, and classifies persons as needing treatment for alcohol or illicit drug use if they met the criteria for dependence or abuse or if they received specialty treatment in the past year. The survey has also reported that 8.4% were in need of illicit drug use treatment and 4.4% were in need of both alcohol and illicit drug use treatment. It was found that less than one tenth (7.0%) of the young adults who were in need of alcohol or illicit drug use treatment in the past year received it at a specialty facility in the past year. Less than one third of those who did not receive treatment in a specialty facility but thought they needed it made an attempt to obtain it. Of the young adults who needed but did not receive alcohol or illicit drug use treatment in a specialty facility in the past year, 96.0% did not perceive the need. Source: http://oas.samhsa.gov/2k9/157/YoungAdultsDrugTxt.htm RAND Europe and the Trimbos Institute have published a technical report that provides key findings of the RAND Europe study which assesses how the global market for illicit drugs has developed from 1998 to 2007, and describes worldwide drug policies implemented during that period to address the problem. There is a summary of the main research findings and six other reports, detailing specific aspects of the issue. The study has found no evidence that the global drug problem was reduced during the UNGASS (United Nations General Assembly Special Session) period from 1998 to 2007. For some nations the problem declined but for others it worsened and for some of those it worsened sharply and substantially. The drug problem generally lessened in rich countries and worsened in a few large developing or transitional countries. Production of opium was relatively stable until 2006, after which estimates show a large increase in Afghanistan. The global number of users of cocaine and heroin expanded over the period. In most Western countries the number of frequent users of heroin has declined through most of the last ten years, while a serious epidemic of opiate use occurred in some countries in Eastern Europe and Central Asia. The total number of cannabis users worldwide has probably declined. The markets for illegal drugs are mostly competitive, not vertically integrated or dominated by major dealers or cartels. The ties to terrorism and armed insurrection are important but only in a few places, such as Afghanistan and Colombia. For cocaine and heroin the cost of production and refining in the source countries is only one to two percent of retail price in developing or transitional countries. The same is true for Amphetamine Type Stimulants manufacturers in rich countries. Though illicit drug markets generate more than one hundred billion Euros in sales, the overwhelming majority of those involved in the drug trade make very modest incomes. Only a few individuals in the trafficking, smuggling and wholesale sector make great fortunes but that accounts for a small share of the total income. The study concludes that the total revenues generated by illicit drug sales are smaller than the €285 Billion estimated by the United Nations Office on Drugs and Crime in 2002/2003. Source: http://www.rand.org/pubs/technical_reports/2009/RAND_TR704.pdf A new study has reported that young men who stay at home with their parents are more violent than those who live independently [1]. According to the research, men still living at home in their early twenties have fewer responsibilities and more disposable income to spend on alcohol. This group makes up only four percent of the UK's male population but they are responsible for 16 per cent of all violent injuries in the last five years. Delaying social independence and remaining in the parental home have become more common over the past 40 years in both the UK and the USA. Professor Jeremy Coid and Dr Ming Yang surveyed over 8000 men and women. Participants answered questions about violent behaviour over the past 5 years and mental health problems. Their results showed for the first time that staying in the parental home is a stronger risk factor for young men's violence than any other factor. Professor Coid said ‘Violence outside of the home, mainly involving strangers, is the most common scenario and just one of a series of hedonistic and negative social behaviours such as hazardous drinking, drug misuse, sexual risk taking, and non-violent antisocial behaviour’. Doctors attending the British Medical Association's 2009 annual conference in Liverpool have backed calls to introduce a minimum price for a unit of alcohol. The motion also included calls for clearer labelling and a total ban on alcohol advertising. Source: http://www.ias.org.uk/resources/publications/alcoholalert/alert200902/al200902_p12a.html The Washington Post reports that US congress has approved a bill that would lift the 21-year ban on using federal money for needle exchange programs. This move means that the proven cost-effectiveness and impact of syringe exchange as an important tool for prevention of HIV infection and viral hepatitis is on the verge of recognition by the US federal government. But the bill, sponsored by Rep. David Obey, includes a restriction against using the money to assist any program that distributes needles within 1,000 feet of day-care centers, schools, parks, playgrounds, pools and youth centers. The federal Centers for Disease Control and Prevention has endorsed needle exchange as a method of fighting the spread of AIDS. Source: The Washington Post, 25 July 2009 The Financial Times reports that Elsevier has said that it had failed to meet its own standards for ‘accuracy and transparency'’ in producing a publication sponsored by Merck, the US pharmaceutical group, but presented as an independent academic journal. The Australasian Journal of Bone and Joint Medicine, complete with an honorary editorial board of academics from Australia and New Zealand, contained a selection of reprinted articles from other journals concerning Merck's medicines Fosamax and Vioxx, and no disclosure that it was funded by the company. The publication marks a fresh twist in tactics to promote medicines by pharmaceutical companies, which have long provided substantial income to academic journals by paying for large numbers of reprints of articles favourable to their drugs for distribution to doctors. Source: The Financial Times, 5 May 2009 Much invigorated after her recent rest, Iggy has noticed that: What do you get when you pay a consulting firm to do a policy analysis? Whatever you want of course! Alcohol industry heavyweight SABMiller brewing company has hired the ‘centre for economics and business research Ltd’ (CEBR) to do a hatchet job—sorry, they called it an analysis—on the recent report from the University of Sheffield, commissioned by the Department of Health [1]. Well there's no surprise there. Anyone with an ounce of common sense knows the alcohol industry is going to attack something which smacks of government interference. You can just feel the shareholders' blood pressure rising at the idea of minimum pricing, and the nervousness around such a well researched and scientifically robust report is palpable. Although, of course, the British government is still chummy with the industry. The prime minister's accelerated rejection of the Chief Medical Officer's minimum pricing recommendation (http://news.bbc.co.uk/2/hi/health/7945357.stm) before poor Sir Liam had the chance to even launch the report would have been another nice one for my column. An example of ‘I've made up my mind, don't confuse me with the facts’ maybe? Pity one little Iguana can only type so fast—it's the claws you see. CEBR seem to have missed the whole reason for U of Sheffield to do the study at all. As we all know, price has been researched for donkey's years, and there really would not have been a need for yet another study, were it not for the fact that minimum pricing only affects part of the market—the ‘bargain booze’ as the Brits like to call it. Your favourite in the local pub, your premium lager in the supermarket, and your cocktail in the night club are not going to cost any less, you'd notice soon enough, however your pound-a-bottle high-strength cider in the off-licence—well, you know what I mean. So the Sheffield crowd went to the trouble of estimating some 500-odd elasticities to account for on-and off-trade, different drinks, qualities, and switching behaviour, whilst CEBR go on to decide that all this effort should best be ignored. Having decided this, they turn back to the front of the report and pick out—eh, wait—the 2 aggregate high-level alcohol price elasticities for moderate and for harmful drinkers, on which they base their revised estimates. However, these are far too crude an estimate to use as basis for the appraisal for these particular policy options. But really, this is all just smoke and mirrors. Even an Iguana can work out why light drinkers are less affected by price changes than heavy drinkers, no economic background required. Minimum pricing affects cheap booze, and guess who drinks pretty much all of that stuff? That's right—most of the cheap booze finds its way into the shopping basket of the heavy drinker. Seeing that CEBR is an independent research organisation and there is a trust-inspiring note in their report saying that ‘the report does not necessarily reflect the views of SAB Miller plc’, we might if unguarded be inclined to believe their headline finding that pricing in general, and minimum pricing in particular, is an ‘incredibly blunt instrument’ that will punish the poor innocent moderate drinker. Well, the moderate drinker will indeed see a huge increase in their weekly supermarket bill:—about 15p (and that's all of US$0.24, EUR 0.18). And that is not the end of the story—I really wonder why it is so difficult for government (and CEBR too, for that matter) to understand that if supermarkets discount alcohol big time, as they currently do, they have to make their profits elsewhere, and the shopper is bound to pay more for other goods. Really, given these tactics are so similar to the behaviour of the tobacco industry denying that smoking caused cancer, it hardly comes as a surprise that SABMiller is controlled by the former Phillip Morris company (now Altria). Honestly, if an Iguana could yawn . . . The Fifth European Association of Addiction Therapy Conference, 5–7 October 2009, Ljubljana, Slovenia. Website http://www.eaat.org European Science Foundation-Linköping University Conference on The changing use and misuse of Catha Edulis (khat) in a changing world: tradition, trade and tragedy, 5–9 October 2009, Scandic Linköping Väst Hotel, Linköping, Sweden. Website: http://www.esf.org/conferences/09274 6th Annual Conference of the International Network on Brief Interventions for Alcohol Problems (INEBRIA): Breaking New Ground. Baltic Centre for Contemporary Art, Newcastle/Gateshead, 7–9 October, 2009. Website: http://www.inebria2009.co.uk Shaping the Future—A Multisectorial Challenge: 52nd International Council on Alcohol and Addictions (ICAA) Conference on Dependencies, 11—16 October 2009, Estoril, Portugal. Website: http://www.icaa.ch/ICAA_Estoril_2009.html UK National Conference on Injecting Drug Use, 26–27 October 2009, The Radisson Hotel, Glasgow, Scotland. Website: http://www.exchangesupplies.org Living on the Edge: Australian Professional Society on Alcohol and other Drugs (APSAD) annual conference, 1–4 November 2009, Darwin Convention Centre, Darwin, Australia. Website: http://www.apsadconference.com.au 33rd Annual Association for Medical Education and Research in Substance Abuse (AMERSA) National Conference, 5–7 November 2009, DoubleTree Hotel, Betheseda, MD, USA. Website: http://www.amersa.org or contact Doreen MacLane-Baeder, email: doreen@amersa.org 1st Asia Pacific Behavioural & Addiction Medicine Conference: The Art &Science of Behavioural Change, 5–7 November 2009, Singapore. Website http://www.apbam.org American Public Health Association 137th Annual Meeting & Exposition, 7–11 November 2009, Philadelphia, USA Reform 2009: The International Drug Policy Reform Conference, 11–14 November 2009, Albuquerque Convention Center, USA. Organised by the Drug Policy Alliance. Website: http://www.drugpolicyevent.com Society for the Study of Addiction Annual Symposium, 12–13 November 2009, Park Inn, York, UK. Theme: treatment policy; sub-themes: service-user involvement, young people and families, what does the Alcohol Education and Research Council do? Submissions for delegates' posts and oral presentations are welcome, any addictions subject considered. Further details and application forms on the website http://www.addiction-ssa.org/ssa_10.htm A Practical Guide to Improving the Management of Dual Diagnosis, 17 November 2009, 76 Portland Place, London, UK. For more information email georgina@healthcare-events.co.uk American Academy of Addiction Psychiatry 20th Annual Meeting & Symposium, 3–6 December 2009, Hyatt Regency Century Plaza, Los Angeles, California. Website http://www.aaap.org Kettil Bruun Society thematic meeting: Episodic heavy drinking amongst adolescents, 10–12 December 2009, Nijmegen, the Netherlands. Website: http://www.ru.nl/kbsmeeting/english/. Contact: Jacqueline Berns, j.berns@fb.ru.nl 12th International Conference on Treatment of Addictive Behaviors (ICTAB-12), 7–10 February 2010, Santa Fe, New Mexico (USA). Contact: dyao@unm.edu. Website: http://casaa.unm.edu Society for Research on Nicotine and Tobacco Annual Meeting, 24–27 February 2010, Hilton Hotel Baltimore, USA. Website: http://www.srnt.org Alcohol and violence: relationships, causality and policy, 15–18 March 2010, Melbourne, Australia. A thematic meeting of the Kettil Bruun Society, hosted by the AER Alcohol Policy Research Centre at Turning Point Alcohol and Drug Centre. Website: http://www.kettilbruun.org/Violence_Melb.htm Harm Reduction: The Next Generation. The 21st annual conference of the International Harm Reduction Association, 25–29 April 2010, Liverpool, UK. Website http://www.ihraconferences.net College on Problems of Drug Dependence 72nd annual meeting, 12–17 June 2010, The Fairmont Scottsdale Princess: Scottsdale, Arizona, USA. Website: http://www.cpdd.vcu.edu 33rd Annual Scientific Meeting of the Research Society on Alcoholism, 26–30 June 2010, San Antonio, Texas, USA. Website: http://www.rsoa.org/2010meet-Futures.htm News and Notes welcomes contributions from its readers. Send your material to Peter Miller, News and Notes Editor, Addiction, National Addiction Centre PO48, 4 Windsor Walk, London SE5 8AF. Fax +44 (0)20 7848 5966; e-mail louisa@addictionjournal.org Conference entries should be sent to Molly Jarvis at molly@addictionjournal.org. Subject to editorial review, we will be glad to print, free of charge, details of your conference or event, up to 75 words and one entry only. Please send your notification three months before you wish the entry to appear.

To determine the trends in sexual activity and unprotected sex among substance-using youth, we examined data from the 1991-2005 Youth Risk Behavior Surveys on drug and alcohol use and sexual risk behaviors. We examined the association of alcohol and illicit drug use with recent sexual activity and unprotected sex. We assessed linear trends in behaviors and assessed logistic regression models to examine the relationship of alcohol and illicit drug use on trends in the behavioral outcomes. Strong associations exist between recent sexual activity and alcohol and illicit drug use from 1991 to 2005. In the multivariate model, the odds ratio of having sex in the past 3 months for lifetime illicit drug users compared with nonusers was 3.84 (CI = 3.48-4.23). Among past-month alcohol users compared to nonusers, the odds ratio was 3.23 (CI = 2.93-3.58). Overall, the trend in sexual activity was downward but not for users of alcohol and illicit drugs. Among the sexually active, unprotected sex was not associated with alcohol use over this time period but was associated with illicit drug use. Illicit drug and alcohol use have a strong association with being recently sexually active. Trends in reported sexual activity declined during 1991-2005, but the trends among alcohol and drug users have not. Many youth remain at dual risk from both substance use and sexual behaviors.

Background Despite understanding the long-term risks associated with early substance use, less is known about the specific patterns of the age of onset (AO) across multiple substances and whether these patterns of early exposure are linked to substance use later in young adulthood. Consequently, the present study sought to (1) identify distinct classes regarding AO for alcohol, cannabis, and tobacco and (2) compare these classes on patterns of individual and simultaneous alcohol, cannabis, and tobacco use, other substance use, and mental health symptoms. Methods Participants were 510 emerging adults (M age = 21.35; 88.6% men) who reported past-year use of alcohol, cannabis, and tobacco. Results Latent profile analysis was used to identify classes based on three indicators: AO for alcohol, cannabis, and tobacco. Results revealed that four classes best fit the data: Earliest AO for Alcohol (19.8%); Latest AO for Substances (6.5%); Late AO for Substances (67.8%); Earliest AO for Cannabis and Tobacco (5.9%). Classes varied on current patterns of individual substance use, co-use of substances, other illicit drug use, and mental health symptomology. The Latest AO of Substances class reported the lowest alcohol use, cannabis use, other illicit drug use, and mental health symptomology than the other classes. The Earliest AO for Alcohol and the Late AO of Substances reported a lower frequency of tobacco compared to the other classes. The Late AO of Substance class reported the highest past-year frequency of simultaneous alcohol and cannabis use. Conclusions The current study contributed to the larger polysubstance literature by identifying profiles that may signify risky patterns of use. Findings may help guide prevention and intervention work with adolescents and young adults.