Heavy Substance Use Research Articles

Within-person and between-person associations of access to environmental reward with alcohol and cannabis use and consequences among young adults

BackgroundRecent behavioural economic models of substance use suggest that low access to environmental reward may increase risk for heavy substance use and associated harms. Most prior studies of these associations have been cross-sectional and have focused on alcohol. The current study extends this research using longitudinal data to examine the within-person and between-person associations of environmental reward access with both alcohol and cannabis outcomes. MethodYoung adults (N = 119, 64.71 % female) completed an online survey at three time points, spaced six months apart. The survey included measures of alcohol and cannabis use and consequences, and two facets of environmental reward access: reward probability (i.e., likelihood of experiencing environmental reward) and environmental suppression (i.e., diminished availability of environmental reward). ResultsMultilevel models revealed that at the between-person level (i.e., averaged across time points), greater environmental suppression (but not reward probability) was significantly associated with more frequent cannabis use, and greater reward probability (but not environmental suppression) was significantly associated with heavier alcohol use. Higher environmental suppression (but not reward probability) was also associated with greater alcohol and cannabis consequences at the between-person level, over and above level of use. A significant within-person association also was observed, wherein participants reported relative increases in cannabis consequences during time periods when they also reported relative decreases in the availability of environmental reward. ConclusionsResults highlight environmental suppression as a risk factor for more frequent cannabis use and for both alcohol and cannabis consequences, and provide novel support for a within-person association between environmental suppression and cannabis consequences over time. Findings may inform contextual interventions for young adult substance use.

The Role of Positive and Negative Affect in Illicit Substance Use and Alcohol Use: An Ecological Momentary Assessment Study.

Theories suggest that experiences of negative and positive affect are important precursors to alcohol and illicit substance use. Research utilizing ecological momentary assessments (EMA) has generally supported the relation between momentary experiences of positive affect, but not negative affect, and subsequent substance use. Unfortunately, most of these studies have focused on alcohol use and not other substance use. The goal of this paper was to further explore the relation between momentary affect and use of both alcohol and illicit substances within a population of individuals with a history of substance use. Additionally, this study aimed to understand whether the relations between affect and substance use would vary depending on the timing of EMA assessments of affect prior to substance use. Participants with a history of heavy substance use (N = 59) completed EMA's measuring affect and substance use using random prompts 4 times a day for 14 days. We found that positive affect was significantly related to later engagement in drinking, illicit substance use, and marijuana use. Moreover, timing of the affect was important. When affect was assessed in the last hour prior to substance use, relative to 7 hours prior, the relation between positive affect and illicit substance use was stronger. Negative affect was related to a lower likelihood of subsequent marijuana use, but more so when it was measured a few hours versus several hours before the use. This study further supported the relation between positive affect and both alcohol and illicit substance use.

Personality changes related to presence and treatment of substance use (disorders): a systematic review.

Heavy substance use (SU) and substance use disorders (SUD) have complex etiologies and often severe consequences. Certain personality traits have been associated with an increased risk for SU(D), but far less is known about personality changes related to SU(D). This review aims to synthesize the existing literature on this research question. A systematic literature search was conducted from November 2022 to February 2023 in PubMed, EbscoHost, and Web of Science. Peer-reviewed original papers on SU(D)-related personality changes were included. Of 55 included studies, 38 were observational population-based studies and 17 were intervention studies. Overall, personality and SU measures, samples, study designs, and statistical approaches were highly heterogenous. In observational studies, higher SU was most consistently related to increases in impulsivity-related traits and (less so) neuroticism, while interventions in the context of SU(D) were mostly associated with increases in conscientiousness and self-efficacy and lasting decreases in neuroticism. Findings for traits related to extraversion, openness, conscientiousness, and agreeableness were mixed and depended on SU measure and age. Studies on bidirectional associations suggest that personality and SU(D) both influence each other over time. Due to their strong association with SU(D), impulsivity-related traits may be important target points for interventions. Future work may investigate the mechanisms underlying personality changes related to SU(D), distinguishing substance-specific effects from general SU(D)-related processes like withdrawal, craving, and loss of control. Furthermore, more research is needed to examine whether SU(D)-related personality changes vary by developmental stage and clinical features (e.g. initial use, onset, remission, and relapse).

The effects of simultaneous alcohol and cannabis use on subjective drug effects: A narrative review across methodologies.

Over 75% of young adults who use cannabis also report drinking alcohol, leading to increased risks that include impaired cognition, substance use disorders, and more heavy and frequent substance use. Studies suggest that subjective responses to either alcohol or cannabis can serve as a valuable indicator for identifying individuals at risk of prolonged substance use and use disorder. While laboratory studies show additive effects when alcohol and cannabis are used together, the impact of co-using these substances, specifically with respect to cannabidiol, on an individual's subjective experience remains unclear. This narrative review explores the effects of simultaneous alcohol and cannabis (SAM) use on subjective drug effects, drawing from qualitative research, laboratory experiments, and naturalistic studies. Experimental findings are inconsistent regarding the combined effects of alcohol and cannabis, likely influenced by factors such as dosage, method of administration, and individual substance use histories. Similarly,findings from qualitative and naturalistic studies are mixed regarding subjective drug effects following SAMuse. These discrepancies may be due to recall biases, variations in assessment methods, and the measurement in real-world contexts of patterns of SAM use and related experiences. Overall, this narrative review highlights the need for more comprehensive research to understand more fully subjective drug effects of SAM use in diverse populations and settings, emphasizing the importance of frequent and nuanced assessment of SAM use and subjective responses in naturalistic settings.

Toxic-Induced Encephalopathy Following Chemsex in a Young HIV-Positive Male: A Complex Case of Acute Cognitive Impairment with Anterograde Amnesia and Behavioral Alterations.

A broadened clinical spectrum of concomitant complications emerges among the escalating incidence of substance use, particularly within the 'chemsex' context. This case exemplifies the profound neurotoxic repercussions and neurological risk of chemsex in a young HIV-positive male and addresses the multifaceted challenges of such evolving paradigms in substance utilization. After consuming cannabis, poppers, methamphetamine, and cocaine, a 28-year-old HIV-positive male exhibited significant neurological and cognitive impairment. The initial presentation included dysarthria and profound anterograde amnesia. Laboratory findings showed leukocytosis with a PCR of 3mg/dl - elevated cerebrospinal fluid protein levels with no cells. Urine toxicology returned positive for cannabis and amphetamines. A brain CT scan revealed bilateral and symmetrical hippocampi and pale globes hypodensity, indicative of toxic-metabolic encephalopathy. MRI further identified lesions in the globus pallidus, cerebellum, and hippocampi. Following the detection of toxic encephalopathy, Initial neuropsychological was performed screening using the Montreal Cognitive Assessment (MoCA), which highlighted immediate memory deficits. An in-depth neuropsychological assessment conducted 3weeks later included the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), the Rey Auditory Verbal Learning Test (RAVLT), and tests for visuospatial skills, motor functions, and memory recall. The evaluations revealed pronounced anterograde amnesia, persistent long-term memory inconsistencies, and notable executive function challenges, detailed in Table 1. The detailed analysis of this case underpins the severe neurological consequences that can manifest from heavy substance use. Comprehensive diagnostic evaluations, including neuroimaging and neuropsychological assessments, are crucial in elucidating the full spectrum of substance-induced cognitive impairments. There is an urgent need for enhanced public awareness and preventative measures, especially in the context of chemsex, to bring forth multifaceted health, social, and government implications that modern society must adeptly navigate.

Contexts of social alcohol and cannabis use among sexual minority cisgender women and gender diverse individuals: Event-level differences in alcohol and cannabis use patterns based on the sexual orientations and gender identities of substance use companions

PurposeSexual minority women and gender diverse individuals assigned female at birth (SMWGD) are at elevated risk for alcohol and cannabis use disorders. It has been posited that characteristics of SMWGD’s substance use companions (i.e., sexual orientation, gender identity) may influence their own use, but few studies have tested this. The current study aimed to examine whether quantity and consequences of substance use varied based on sexual orientations and gender identities (SOGI) of SMWGD’s substance use companions. MethodsWe utilized a 30-day ecological momentary assessment study of substance use among a sample of 429 SMWGD. We examined event-level associations between characteristics of substance use companions and quantity and consequences of substance use. ResultsWhen SMWGD used alcohol/cannabis with most SOGI groups, they engaged in heavier drinking and cannabis use. Drinking with heterosexual men and SMW was associated with more drinking consequences. Drinking in settings with more SOGI groups and with both LGBTQ+ and heterosexual individuals was associated with heavier drinking and more consequences. Many contextual aspects of cannabis use settings predicted an increased likelihood of alcohol and cannabis co-use, while few contextual aspects of drinking settings were associated with co-use. ConclusionResults suggest that SMWGD engage in heavier substance use when individuals from a range of SOGI groups are present, highlighting that heavy alcohol and cannabis use is not limited to use with SMW and nonbinary individuals. Drinking in setting with more SOGI groups present (e.g., parties and bars) appears to be associated with particularly heavy drinking and consequences.

Functional Outcomes Among Young People With Trajectories of Persistent Childhood Psychopathology

Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies. To investigate the odds of poor outcomes in emerging adulthood (ages 17 to 20 years) for children with different mental health trajectories at ages 9 to 13 years. Growing Up in Ireland is a longitudinal, nationally representative population-based cohort study. Data collection began in August 2007 and was repeated most recently in September 2018. All results were weighted to account for sampling bias and attrition and were adjusted for socioeconomic factors. Data analysis took place from October 2022 to April 2023. Four latent classes captured variation in mental health in children aged 9 and 13 years, based on the parent-completed Strengths and Difficulties Questionnaire. Classes included no psychopathology, internalizing, externalizing, and high (comorbid) psychopathology. Those who remained in the same class from ages 9 to 13 years were included. Poor functional outcomes in emerging adulthood were measured at approximate ages 17 years (range, 16 to 18 years) and 20 years (range, 19 to 21 years). Outcomes included poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective well-being, and adverse educational/economic outcomes. Of 5141 included participants, 2618 (50.9%) were male. A total of 3726 (72.5%) were classed as having no childhood psychopathology, 1025 (19.9%) as having persistent externalizing psychopathology, 243 (4.7%) as having persistent internalizing psychopathology, and 147 (2.9%) as having persistent high psychopathology. Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalizing group had elevated odds of most outcomes except for heavy substance use (range of odds ratios [ORs]: 1.38 [95% CI, 1.05-1.81] for frequent health service use to 3.08 [95% CI, 2.33-4.08] for poor mental health). The externalizing group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (range of ORs: 1.38 [95% CI, 1.19-1.60] for frequent health service use to 1.98 [95% CI, 1.67-2.35] for adverse educational/economic outcomes). The high psychopathology group had elevated odds of all outcomes (nonsignificantly for frequent health service use), though with wide confidence intervals (range of ORs: 1.53 [95% CI, 1.06-2.21] for poor physical health to 2.91 [95% CI, 2.05-4.12] for poor mental health). Female participants with any psychopathology had significantly higher odds of poor physical health and frequent health service use compared with male participants with any psychopathology. In this longitudinal cohort study, childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need for a wider range of preventive interventions in child and adolescent mental health services.

Using a Smartwatch App to Understand Young Adult Substance Use: Mixed Methods Feasibility Study.

Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated with a host of acute and chronic health and mental health concerns. Recent advances in ubiquitous technologies have prompted interest and innovation in using technology-based data collection instruments to understand substance use and associated harms. Existing methods for collecting granular, real-world data primarily rely on the use of smartphones to study and understand substance use in young adults. Wearable devices, such as smartwatches, show significant potential as platforms for data collection in this domain but remain underused. This study aims to describe the design and user evaluation of a smartwatch-based data collection app, which uses ecological momentary assessments to examine young adult substance use in daily life. This study used a 2-phase iterative design and acceptability evaluation process with young adults (aged 18-25 y) reporting recent alcohol or cannabis use. In phase 1, participants (8/15, 53%) used the data collection app for 14 days on their Apple Watches to report their substance use patterns, social contexts of substance use, and psychosocial risk factors (eg, affect). After this 14-day deployment, the participants completed a user experience survey and a semistructured interview to record their perspectives and experiences of using the app. Formative feedback from this phase informed feature modification and refinement of the app. In phase 2, an additional cohort (7/15, 47%) used the modified app for 14 days and provided feedback through surveys and interviews conducted after the app use period. Analyses of overall app use patterns indicated high, consistent use of the app, with participants using the app for an average of 11.73 (SD 2.60) days out of 14 days of data collection. Participants reported 67 instances of substance use throughout the study, and our analysis indicates that participants were able to respond to ecological momentary assessment prompts in diverse temporal and situational contexts. Our findings from the user experience survey indicate that participants found the app usable and functional. Comparisons of app use metrics and user evaluation scores indicate that the iterative app design had a measurable and positive impact on users' experience. Qualitative data from the participant interviews highlighted the value of recording substance use patterns, low disruption to daily life, minimal overall burden, preference of platforms (smartphones vs smartwatches), and perspectives relating to privacy and app use in social contexts. This study demonstrated the acceptability of using a smartwatch-based app to collect intensive, longitudinal substance use data among young adults. The findings document the utility of smartwatches as a novel platform to understand sensitive and often-stigmatized behaviors such as substance use with minimal burden.

Service users' perception and attitude toward telemedicine-based treatment for substance use disorders: A qualitative study from India.

We aimed to assess the service user's acceptability, feasibility, and attitude toward telemedicine practice and compare it with in-person consultation in substance use disorder (SUD). We recruited 15 adult patients with SUD who accessed both telemedicine and in-person care. We conducted in-depth interviews on awareness and access, facilitators and barriers, treatment satisfaction, and therapeutic relationship in the telemedicine context. We performed a conventional content analysis of the interview excerpts and used inductive and deductive coding. We assumed that social, personal, and logistic contexts influence patients' perceptions and experiences with telemedicine-based addiction care (TAC). Most participants were middle-aged men (40.5 years, 86.7%), dependent on two or more substances (86.7%), and had a history of chronic, heavy substance use (use ~16 years, dependence ~11.5 years). Patients' perspectives on TAC could broadly be divided into three phases: pre-consultation, consultation, and post-consultation. Patients felt that TAC improved treatment access with adequate autonomy and control; however, there were technical challenges. Patients expressed privacy concerns and feared experiencing stigma during teleconsultation. They reported missing the elaborate inquiry, physical examination, and ritual of visiting their doctors in person. Additionally, personal comfort and technical difficulties determine the satisfaction level with TAC. Overall perception and suitability of TAC and the decision to continue it developed in the post-consultation phase. Our study provides an in-depth insight into the barriers and facilitators of telemedicine-based SUD treatment access, use, and retention; it also helps to understand better the choices and preferences for telehealth care vis-à-vis standard in-person care for SUDs.

Performance on Cognitive Screening Tests and Long-Term Substance Use Outcomes in Patients with Polysubstance Use Disorder

Introduction: Cognitive impairments among patients with substance use disorders are prevalent and associated with adverse treatment outcomes. However, knowledge of the predictive value of broad cognitive screening instruments on long-term treatment outcomes is limited. The present study aimed to examine the predictive value of measures from the Montreal Cognitive Assessment® (MoCA®), Wechsler Abbreviated Scale of Intelligence (WASI), and the Behaviour Rating Inventory of Executive Function – Adult version (BRIEF-A) on self-reported long-term substance use and abstinence in patients with polysubstance use disorders (pSUD). Methods: A cohort (N = 164) of patients with pSUD who started a new treatment sequence in the Stavanger University Hospital catchment area were recruited and followed prospectively for 5 years. Participants completed neurocognitive testing with the MoCA®, WASI, and BRIEF-A at inclusion and were categorized as cognitively impaired or non-impaired according to recommended cut-off values. The sum score of the items from the Drug Use Disorders Identification Test Consumption scale (DUDIT-C) was used as a measure of substance use outcome 1 and 5 years after inclusion. We defined substance abstinence (DUDIT-C = 0) and heavy substance use (DUDIT-C ≥7) to determine whether cognitive impairments measured by the respective instruments were associated with and could predict abstinence and heavy substance use 1 and 5 years after baseline. Results: At the 1-year follow-up, 54% of the total sample reported total abstinence from substances. Conversely, 31% presented heavy substance use. At 5 years, 64% of the total sample reported abstinence from substances, while 25% presented heavy substance use. The results showed a statistically significant association between cognitive impairment defined from MoCA® and higher continuous scores on DUDIT-C at 1-year follow-up. There were no differences in substance abstinence or heavy substance use between patients with and without cognitive impairment at the 1- and 5-year follow-ups. Furthermore, cognitive impairment did not explain substance abstinence or heavy substance use at the 1- and 5-year follow-ups. Conclusion: Generally, individuals with pSUD may be burdened and lack psychosocial resources to such an extent that cognitive functioning plays a subordinate role in long-term recovery. The present study suggests that results on screening tools assessing broad cognitive domains at treatment initiation have limited clinical value in predicting long-term substance use outcomes. There is a need to establish clinically viable instruments to assess cognitive functions with well-established clinical and ecological validity in the SUD population.

Mental Health and Life Events among United States adolescents with Substance Use Disorders

IntroductionSubstance use during adolescence is linked to adverse biopsychosocial events, including poor mental health, cognitive deficits, low academic performance, and delinquency (Deas & Brown J Clin Psych 2006; 67 18; Armstrong & Costello JCCP 2002; 70 1224; Cox et al. JSH 2007; 77 109-115; Chassin JJSU 2008; 165-183). Identifying risks for these events is critical, given they are associated with adverse outcomes in adulthood.Post-pandemic, rates of adolescent depression and anxiety have more than doubled (Racine et al. JAMA Ped 2021; 175 1142-1150). Adolescents often use substances, most commonly alcohol and cannabis, to manage mental health (Colder et al. JCCP 2019; 87 629).Cannabis is increasingly viewed by adolescents as safe, while alcohol is viewed negatively (SAMHSA 2021). Non-disordered alcohol use (ND-AU), alcohol use below diagnostic criteria level, has adverse developmental impacts for adolescents, including increased risk-taking behavior and heavy substance use in adulthood (Marshall Alcohol Alcohol. 2014; 49 160-164).With growing normalization of cannabis use, important questions still remain whether non-disordered cannabis use (ND-CU) among adolescents is linked to adverse life events.ObjectivesUsing data from the 2018-2020 National Survey on Drug Use and Health (NSDUH), an annual US representative survey on substance use and mental health, we compared associations among common adolescent substance use and adverse life events.MethodsResponses from adolescents aged 12-17 (N=32,407) from the 2018-2020 NSDUH were analyzed. Logistic regression was used to evaluate associations between substance use disorder (SUD) diagnoses and adverse adolescent life events. Adjusted odds ratios (aOR) were obtained while controlling for age, sex, and race/ethnicity. Analyses included sampling weights to account for the US population. Adolescents in ND-CU and ND-AU groups were defined by either past-month or past-year use without their respective SUD diagnosis.ResultsApproximately 5% of adolescents had any SUD, and 1.3% had more than one SUD (Table 1). All SUD variables, including cannabis use disorder (CUD) and alcohol use disorder (AUD), were significant for all adverse adolescent life events (Table 2). Adolescents with a SUD were nearly 3 times more likely to have major depression in the past year, 2.5 times more likely to have a C+ or below grade average, and 10 times more likely to be arrested, than controls. These risks increased with more than one SUD (Table 2). Adverse events were similar between ND-CU and ND-AU. (Figure 1).Image:Image 2:Image 3:ConclusionsGiven the biopsychosocial risks to ND-CU and ND-AU in adolescents, there may be reason to reevaluate whether the DSM adequately captures the population of youth affected by their cannabis and alcohol use. Clinicians can use these nationally representative data to stratify risks and direct to appropriate treatment.Disclosure of InterestNone Declared

Violent injury prevention does not equal to violent crime prevention: an analysis of violence intervention program efficacy using propensity score methods

ObjectiveThe purpose of this study was to determine if exposure to Prescription for Hope (RxH), a hospital-based violence intervention program (HVIP), is associated with reduced violent reinjury and new convictions...

Associations between alcohol and cannabis use before and during the COVID-19 pandemic: Results of a community survey

The COVID-19 pandemic has impacted individuals around the world, creating unprecedented challenges. Due to lockdowns and social distancing measures, many people have turned to contactless modes of obtaining alcohol and other substances (e.g., home delivery). This study investigated associations between alcohol and cannabis use before and during the initial months of the COVID-19 pandemic and factors associated with use. An online, cross-sectional survey with a non-probability sample (N = 1126) was conducted in Northeast states during June-July 2020. Outcomes examined prevalence of alcohol and cannabis use for the overall sample and predictors of use in individuals who used substances. In the overall sample, we found that alcohol and cannabis use decreased from before to during the pandemic. For individuals who drank alcohol, higher pre-pandemic drinking, mid-range household income, and obtaining alcohol through home delivery were associated with higher alcohol drinking during the pandemic. For individuals who used cannabis, higher pre-pandemic cannabis use and obtaining cannabis through home delivery were associated with higher cannabis use during the pandemic. Overall, from before to during the pandemic, we found a decrease in the proportion of individuals who used substances and no changes in quantity for individuals who continued to use substances. Home delivery was associated with greater use of alcohol and marijuana, supporting a need for further research on risk factors for heavier substance use.

Substance use and common contributors to morbidity: A genetics perspective.

SummaryExcessive substance use and substance use disorders (SUDs) are common, serious and relapsing medical conditions. They frequently co-occur with other diseases that are leading contributors to disability worldwide. While heavy substance use may potentiate the course of some of these illnesses, there is accumulating evidence suggesting common genetic architectures. In this narrative review, we focus on four heritable medical conditions - cardiometabolic disease, chronic pain, depression and COVID-19, which are commonly overlapping with, but not necessarily a direct consequence of, SUDs. We find persuasive evidence of underlying genetic liability that predisposes to both SUDs and chronic pain, depression, and COVID-19. For cardiometabolic disease, there is greater support for a potential causal influence of problematic substance use. Our review encourages de-stigmatization of SUDs and the assessment of substance use in clinical settings. We assert that identifying shared pathways of risk has high translational potential, allowing tailoring of treatments for multiple medical conditions.FundingSSR acknowledges T29KT0526, T32IR5226 and DP1DA054394; RLK acknowledges AA028292; AA acknowledges DA054869 & K02DA032573. The funders had no role in the conceptualization or writing of the paper.

Family Structure, Unstructured Socializing, and Heavy Substance Use among Adolescents.

Background: Psychoactive substance use is a transient behavior among many adolescents and diminishes as they mature, but some engage in heavy forms of substance use, which increases their risk of health and behavioral challenges. A consistent predictor of substance use among youth is family structure, with adolescents living in single-parent, stepparent, or no-parent families at higher risk than others of several forms of substance use. The objective of this research was to investigate whether unstructured socializing mediated the association between family structure and heavy alcohol or substance use. Methods: Data from 30 nations (n = 65,737) were used to test the hypothesis using a generalized structural equation model and tests of mediation. Results: The analysis furnished clear support for a mediation effect among adolescents living with a single parent but less support among those living with a stepparent or neither parent. Conclusion: The association between living in a single-parent household and heavy alcohol or other substance use was mediated largely by time spent outside the home with friends in unsupervised activities. Additional research that uses longitudinal data and more nuanced measures of family structure is needed to validate this finding.

Performing normality in working life among heavy substance users.

Aim: Work is an important part of most people's everyday lives and well-being. Substance use by employees is associated with several negative consequences, such as absence from work and poor work performance. The study examines the strategies through which people who have problems with substance use produce a “normal” self and avoid becoming stigmatised in the workplace. Methods: The study uses data from in-depth unstructured life story interviews, which were conducted over phone with 13 people. The participants had developed various problematic heavy substance use habits. The interviews were analysed by applying interactional analysis and by using Goffman's concepts of “normality”, “embarrassment”, “face-work”, “stigma” and “performance”. Results: The analysis identified multiple strategies the participants used to produce normality and to avoid embarrassment and stigmatisation at work. These include skilful use of drugs in order not to show withdrawal symptoms, various ways of hiding their heavy substance use, frequent change of jobs, the maintenance of a clean and professional look, and attributing the absence from work to mental or physical illness. Moreover, the participants strategically avoided social contacts in which embarrassing situations could arise. When this was not possible, they manipulated their corporeal looks by hiding such kinds of bodily marks that would connote abnormality. Conclusion: The analysis points out that maintaining normality at work does not only refer to the efforts of trying to hide the effects of the drugs on behaviours and the body. It also reveals that the participants used substances to be able to perform energetically their work tasks, and in this way present themselves as normal workers. This ambivalence in performing normality makes the work life of people who use substances challenging.

Frequent Cannabis Use Moderates the Relationship Between Sexual Dysfunction and Depression Among Female German Adults

BackgroundSexual dysfunction and heavy substance use (alcohol, tobacco, and cannabis) play an important role in the development of depression, while frequent substance use affects sexual dysfunction. AimThis study aimed to investigate the association between sexual dysfunction and depression among German adults in a nationally representative sample and the effect of alcohol, tobacco, and cannabis use on this association using moderator analysis. MethodsData come from the German Health and Sexuality Survey (GeSiD) with N = 4,955 men and women aged between 18 and 75 years. We used multiple logistic regression analysis to examine the moderation effect of substance use between sexual dysfunction and depression by including an interaction term. OutcomesSelf-reported diagnosed and treated depression within the last 12 months and the moderation effect of substance use on the association between sexual dysfunction and depression. ResultsMen and women with at least 1 sexual dysfunction were more likely to be affected by depression as compared to those without sexual dysfunction. A moderation effect of frequent cannabis use was found between sexual dysfunction and depression among women. Clinical ImplicationsClinicians and therapists addressing addiction, depression, and dysfunction should keep the complex interactions in mind. Strengths & LimitationsThis study provides new data on the association between sexual dysfunction and depression among German adults in a nationally representative sample and the moderation effect of substance use on this association. Further studies should disentangle the pathways between sexual dysfunction, cannabis use, and depression through moderated mediation analyses. ConclusionFrequent cannabis use plays a moderating role in the association between sexual dysfunction and depression among German adult women. Belau MH, Wiessner C, Becher H, et al. Frequent Cannabis use Moderates the Relationship between Sexual Dysfunction and Depression Among Female German Adults. J Sex Med 2022;19:940–949.

Stoned

This article discusses a case study from my dissertation, “Drive Time,” which I am now expanding into a historical monograph. As a sensory historian, I am rereading the Watts rebellion of 1965, an event that officials, at the time, dismissed as “insensate.” By beginning with sensory data points, like the trajectories of the rocks that protesters threw, I foreground patterns of intentionality and meaning making that local law enforcement and others discounted or completely missed. For instance, protesters selectively pelted cars with white drivers and selected white-owned businesses for looting and burning. Local officials repeatedly focused attention on the intoxicated driver, who emerged as a racialized figure despite both statistical and anecdotal evidence that white Angelenos—especially police officers—also exhibited high rates of intoxication and even heavy substance use. As a book, I hope that Drive Time will illustrate the ways that historians can use historical evidence regarding sensation to reveal, for example, the level of consciousness (relative impairment) exhibited by drivers and others in such historical turning points as the Watts rebellion.

Associations between cognition and polygenic liability to substance involvement in middle childhood: Results from the ABCD study

BackgroundCognition is robustly associated with substance involvement. This relationship is attributable to multiple factors, including genetics, though such contributions show inconsistent patterns in the literature. For instance, genome-wide association studies point to potential positive relationships between educational achievement and common substance use but negative relationships with heavy and/or problematic substance use. MethodsWe estimated associations between polygenic risk for substance involvement (i.e., alcohol, tobacco, and cannabis use and problematic use) and cognition subfacets (i.e., general ability, executive function, learning/memory) derived from confirmatory factor analysis among 3205 substance naïve children (ages 9–10) of European ancestry who completed the baseline session of the Adolescent Brain Cognitive Development (ABCD) Study. FindingsPolygenic risk for lifetime cannabis use was positively associated with all three facets of cognitive ability (Bs ≥ 0.045, qs ≤ 0.044). No other substance polygenic risk scores showed significant associations with cognition after adjustment for multiple testing (|Bs|≤0.033, qs ≥ 0.118). ConclusionsPolygenic liability to lifetime cannabis use, but not use disorder, was positively associated with cognitive performance among substance-naïve children, possibly reflecting shared genetic overlap with openness to experience or the influence of genetic variance associated with socioeconomic status. Our lack of findings for the other polygenic scores may reflect ascertainment differences between the genome-wide association study (GWAS) samples and the current sample and/or the young age of the present sample. As longitudinal data in ABCD are collected, this sample may be useful for disentangling putatively causal or predispositional influences of substance use and misuse on cognition.

Towards a reinforcement-sensitive multiple risk behavior change model

• Health behaviors are function of psychophysiological processes and social learning. • A behavioral taxonomy grounded in trait psychophysiology and context is proposed. • ROC analyses explain predictive accuracies of personality-behavior relationships. • Behaviors differentially conditionable by punishment- or reward-oriented messages. • A reinforcement-sensitive multiple-risk behavior change framework is advisable. The personality-behavior relationship, predictive accuracies of personality measures, and their links with behavior change require a systematic examination. Drawing on the Hippocrates-Galen-Avicennic tradition and the works of Pavlov, Skinner, Mowrer, Eysenck and Gray, this article proposes a three-dimensional behavioral typology and outlines a schema for multiple risk behavior change. It is argued that behaviors, as explained by psychophysiological processes, reinforcement-sensitive behavioral systems and social learning, shall be differentially conditionable by appropriate punishment- or reward-oriented messages. A cross-sectional survey was designed to explore the hypothesized role of psychobiological personality dimensions in smoking, alcohol-use and substance-use behaviors. Two standard personality inventories and a behavioral questionnaire were administered to a sample of college students. Descriptive, correlational, and Receiver Operating Characteristic analyses were performed. Extraversion and Psychoticism showed positive correlation with Reward-sensitivity but inversely correlated with Neuroticism and Punishment-sensitivity. High Extraversion and high Psychoticism scorers, thereby Indulgent and Delinquent Behaviors, were more likely to show appetitive associations. Psychobiological personality measures that reliably classified target groups with an area under the curve greater than 0.70 included Extraversion for heavy smoking, drinking and regular drinking, Psychoticism for heavy smoking, regular drinking, substance-use and heavy substance-use, and Reward-sensitivity for heavy smoking, substance-use and heavy substance-use. The findings have validated part of the posited behavior change model, as tested. Psychobiological personality measures indicated reasonable discriminative abilities and potential use in evaluating problem behaviors in individuals and groups, notwithstanding the value of mixed assessments and data integration. The next step is to investigate a wider mix of behaviors and test effectiveness of reinforcement-oriented message interventions in multiple risk behavior change which will have implications for health communication and social marketing.