Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis

Background: The impact of increasing non-medical cannabis use on vulnerability to develop opioid use disorders has received considerable attention, with contrasting findings. A dimensional analysis of self-exposure to cannabis and other drugs, in individuals with and without opioid dependence (OD) d...

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Main Authors: Eduardo R. Butelman, Angelo G. I. Maremmani, Silvia Bacciardi, Carina Y. Chen, Joel Correa da Rosa, Mary Jeanne Kreek
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-06-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fpsyt.2018.00283/full
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author Eduardo R. Butelman
Angelo G. I. Maremmani
Silvia Bacciardi
Carina Y. Chen
Joel Correa da Rosa
Mary Jeanne Kreek
author_facet Eduardo R. Butelman
Angelo G. I. Maremmani
Silvia Bacciardi
Carina Y. Chen
Joel Correa da Rosa
Mary Jeanne Kreek
author_sort Eduardo R. Butelman
collection DOAJ
description Background: The impact of increasing non-medical cannabis use on vulnerability to develop opioid use disorders has received considerable attention, with contrasting findings. A dimensional analysis of self-exposure to cannabis and other drugs, in individuals with and without opioid dependence (OD) diagnoses, may clarify this issue.Objective: To examine the age of onset of maximal self-exposure to cannabis, alcohol, cocaine, and heroin, in volunteers diagnosed with OD, using a rapidly administered instrument (the KMSK scales). To then determine whether maximal self-exposure to cannabis, alcohol, and cocaine is a dimensional predictor of odds of OD diagnoses.Methods: This outpatient observational study examined maximal self-exposure to these drugs, in volunteers diagnosed with DSM-IV OD or other drug diagnoses, and normal volunteers. In order to focus more directly on opioid dependence diagnosis as the outcome, volunteers who had cocaine dependence diagnoses were excluded. Male and female adults of diverse ethnicity were consecutively ascertained from the community, and from local drug treatment programs, in 2002–2013 (n = 574, of whom n = 94 had OD diagnoses). The age of onset of maximal self-exposure of these drugs was examined. After propensity score matching for age at ascertainment, gender, and ethnicity, a multiple logistic regression examined how increasing self-exposure to non-medical cannabis, alcohol and cocaine affected odds of OD diagnoses.Results: Volunteers with OD diagnoses had the onset of heaviest use of cannabis in the approximate transition between adolescence and adulthood (mean age = 18.9 years), and onset of heaviest use of alcohol soon thereafter (mean age = 20.1 years). Onset of heaviest use of heroin and cocaine was detected later in the lifespan (mean ages = 24.7 and 25.3 years, respectively). After propensity score matching for demographic variables, we found that the maximal self-exposure to cannabis and cocaine, but not to alcohol, was greater in volunteers with OD diagnoses, than in those without this diagnosis. Also, a multiple logistic regression detected that increasing self-exposure to cannabis and cocaine, but not alcohol, was a positive predictor of OD diagnosis.Conclusions/Importance: Increasing self-exposure to non-medical cannabis, as measured with a rapid dimensional instrument, was a predictor of greater odds of opioid dependence diagnosis, in propensity score-matched samples.
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spelling doaj.art-41c2f17cd74d4b7b9ba65988a412bf402022-12-22T01:38:04ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402018-06-01910.3389/fpsyt.2018.00283378618Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched AnalysisEduardo R. Butelman0Angelo G. I. Maremmani1Silvia Bacciardi2Carina Y. Chen3Joel Correa da Rosa4Mary Jeanne Kreek5Laboratory on the Biology of Addictive Diseases, Rockefeller University, New York, NY, United States“VP Dole” Dual Diagnosis Unit, Azienda Ospedaliera-Universitaria Pisana, Pisa, Italy“VP Dole” Dual Diagnosis Unit, Azienda Ospedaliera-Universitaria Pisana, Pisa, ItalyLaboratory on the Biology of Addictive Diseases, Rockefeller University, New York, NY, United StatesCenter for Clinical and Translational Science, The Rockefeller University Hospital, Rockefeller University, New York, NY, United StatesLaboratory on the Biology of Addictive Diseases, Rockefeller University, New York, NY, United StatesBackground: The impact of increasing non-medical cannabis use on vulnerability to develop opioid use disorders has received considerable attention, with contrasting findings. A dimensional analysis of self-exposure to cannabis and other drugs, in individuals with and without opioid dependence (OD) diagnoses, may clarify this issue.Objective: To examine the age of onset of maximal self-exposure to cannabis, alcohol, cocaine, and heroin, in volunteers diagnosed with OD, using a rapidly administered instrument (the KMSK scales). To then determine whether maximal self-exposure to cannabis, alcohol, and cocaine is a dimensional predictor of odds of OD diagnoses.Methods: This outpatient observational study examined maximal self-exposure to these drugs, in volunteers diagnosed with DSM-IV OD or other drug diagnoses, and normal volunteers. In order to focus more directly on opioid dependence diagnosis as the outcome, volunteers who had cocaine dependence diagnoses were excluded. Male and female adults of diverse ethnicity were consecutively ascertained from the community, and from local drug treatment programs, in 2002–2013 (n = 574, of whom n = 94 had OD diagnoses). The age of onset of maximal self-exposure of these drugs was examined. After propensity score matching for age at ascertainment, gender, and ethnicity, a multiple logistic regression examined how increasing self-exposure to non-medical cannabis, alcohol and cocaine affected odds of OD diagnoses.Results: Volunteers with OD diagnoses had the onset of heaviest use of cannabis in the approximate transition between adolescence and adulthood (mean age = 18.9 years), and onset of heaviest use of alcohol soon thereafter (mean age = 20.1 years). Onset of heaviest use of heroin and cocaine was detected later in the lifespan (mean ages = 24.7 and 25.3 years, respectively). After propensity score matching for demographic variables, we found that the maximal self-exposure to cannabis and cocaine, but not to alcohol, was greater in volunteers with OD diagnoses, than in those without this diagnosis. Also, a multiple logistic regression detected that increasing self-exposure to cannabis and cocaine, but not alcohol, was a positive predictor of OD diagnosis.Conclusions/Importance: Increasing self-exposure to non-medical cannabis, as measured with a rapid dimensional instrument, was a predictor of greater odds of opioid dependence diagnosis, in propensity score-matched samples.https://www.frontiersin.org/article/10.3389/fpsyt.2018.00283/fullopioidcocainecannabisheroinalcoholdimensional
spellingShingle Eduardo R. Butelman
Angelo G. I. Maremmani
Silvia Bacciardi
Carina Y. Chen
Joel Correa da Rosa
Mary Jeanne Kreek
Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis
Frontiers in Psychiatry
opioid
cocaine
cannabis
heroin
alcohol
dimensional
title Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis
title_full Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis
title_fullStr Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis
title_full_unstemmed Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis
title_short Non-medical Cannabis Self-Exposure as a Dimensional Predictor of Opioid Dependence Diagnosis: A Propensity Score Matched Analysis
title_sort non medical cannabis self exposure as a dimensional predictor of opioid dependence diagnosis a propensity score matched analysis
topic opioid
cocaine
cannabis
heroin
alcohol
dimensional
url https://www.frontiersin.org/article/10.3389/fpsyt.2018.00283/full
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