Association of Cohort and Individual Substance Use With Risk of Transitioning to Drug Use, Drug Use Disorder, and Remission From Disorder: Findings From the World Mental Health Surveys

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art_DEGENHARDT_Association_of_Cohort_and_Individual_Substance_Use_With_2019.PDF (286.61 KB)
Citações na Scopus
24
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
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Título do Volume
Editora
AMER MEDICAL ASSOC
Autores
DEGENHARDT, Louisa
BHARAT, Chrianna
GLANTZ, Meyer D.
SAMPSON, Nancy A.
AL-HAMZAWI, Ali
ALONSO, Jordi
BUNTING, Brendan
CIA, Alfredo
GIROLAMO, Giovanni de
JONGE, Peter De
Citação
JAMA PSYCHIATRY, v.76, n.7, p.708-720, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
ImportanceLimited empirical research has examined the extent to which cohort-level prevalence of substance use is associated with the onset of drug use and transitioning into greater involvement with drug use. ObjectiveTo use cross-national data to examine time-space variation in cohort-level drug use to assess its associations with onset and transitions across stages of drug use, abuse, dependence, and remission. Design, Setting, and ParticipantsThe World Health Organization World Mental Health Surveys carried out cross-sectional general population surveys in 25 countries using a consistent research protocol and assessment instrument. Adults from representative household samples were interviewed face-to-face in the community in relation to drug use disorders. The surveys were conducted between 2001 and 2015. Data analysis was performed from July 2017 to July 2018. Main Outcomes and MeasuresData on timing of onset of lifetime drug use, DSM-IV drug use disorders, and remission from these disorders was assessed using the Composite International Diagnostic Interview. Associations of cohort-level alcohol prevalence and drug use prevalence were examined as factors associated with these transitions. ResultsAmong the 90027 respondents (48.1% [SE, 0.2%] men; mean [SE] age, 42.1 [0.1] years), 1 in 4 (24.8% [SE, 0.2%]) reported either illicit drug use or extramedical use of prescription drugs at some point in their lifetime, but with substantial time-space variation in this prevalence. Among users, 9.1% (SE, 0.2%) met lifetime criteria for abuse, and 5.0% (SE, 0.2%) met criteria for dependence. Individuals who used 2 or more drugs had an increased risk of both abuse (odds ratio, 5.17 [95% CI, 4.66-5.73]; P<.001) and dependence (odds ratio, 5.99 [95% CI, 5.02-7.16]; P<.001) and reduced probability of remission from abuse (odds ratio, 0.86 [95% CI, 0.76-0.98]; P=.02). Birth cohort prevalence of drug use was also significantly associated with both initiation and illicit drug use transitions; for example, after controlling for individuals' experience of substance use and demographics, for each additional 10% of an individual's cohort using alcohol, a person's odds of initiating drug use increased by 28% (odds ratio, 1.28 [95% CI, 1.26-1.31]). Each 10% increase in a cohort's use of drug increased individual risk by 12% (1.12 [95% CI, 1.11-1.14]). Conclusions and RelevanceBirth cohort substance use is associated with drug use involvement beyond the outcomes of individual histories of alcohol and other drug use. This has important implications for understanding pathways into and out of problematic drug use.
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https://observatorio.fm.usp.br/handle/OPI/33646
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Coleções
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/23
Artigos e Materiais de Revistas Científicas - ODS/03