Predictors of the initiation and persistence of Internet addiction among adolescents in Taiwan

Purpose

The present study examined the psychosocial factors associated with the initiation and persistence of Internet addiction among adolescents in Taiwan.

Methods

A total of 2315 students from 26 high schools were assessed in the 10th grade, with follow-up performed in the 11th grade, in Taipei, Taiwan. Self-administered questionnaires were collected in each year to assess the pattern of changes in Internet addiction and psychosocial factors.

Results

Of the 1602 students without an Internet addiction in the 10th grade, 253 (15.8%) had initiated Internet addiction by grade 11. Multivariate analysis results indicated that greater engagement in online activities (i.e., social network website use, online gaming), depression, and lower school bonding in grade 10 coupled with an increase in online activities, depression, and smoking from grades 10 to 11 predicted the initiation of Internet addiction. Of the 605 students with Internet addiction in the 10th grade, the addiction had persisted for 383 students (63.3%) in grade 11. An increase in the existence of depression and alcohol use from grades 10 to 11 predicted the persistence of Internet addiction.

Conclusions

Online activities, depression, and substance use were important predictors of youth initiation and of the persistence of Internet addiction.     

Tobacco, alcohol, cannabis and other illegal drug use among young adults: the socioeconomic context

Background

Low socioeconomic position predicts risk of substance abuse, yet few studies tested the role of preexisting familial and individual characteristics.

Methods

Data come from the TEMPO (Trajectoires Epidémiologiques en Population) study (community sample in France, 1991–2009, n = 1103, 22–35 years in 2009) set up among offspring of participants of an epidemiological study (GAZEL). Past 12-month substance use was assessed in 2009 by self-completed mail survey: regular tobacco smoking, alcohol abuse (AUDIT), cannabis use, problematic cannabis use (CAST), other illegal drug use. Socioeconomic position was defined by educational attainment, occupational grade, employment stability and unemployment. Covariates included demographics (age, sex, relationship status, parenthood), family background (parental income, parental tobacco smoking, parental alcohol use), and juvenile characteristics (psychological problems, academic difficulties) measured longitudinally.

Results

35.8% of study participants were regular smokers, 14.3% abused alcohol, 22.6% used cannabis (6.3% had problematic cannabis use) and 4.1% used other illegal drugs. Except for alcohol abuse, substance use rates were systematically higher in individuals with low, rather than intermediate/high, socioeconomic position (age and sex-adjusted ORs from 1.75 for cannabis use to 2.11 for tobacco smoking and 2.44 for problematic cannabis use). In multivariate analyses these socioeconomic disparities were decreased, but remained statistically significant (except for illegal drugs other than cannabis).

Conclusions

Tobacco smoking, alcohol, cannabis and polysubstance use are common behaviors among young adults, particularly those experiencing socioeconomic disadvantage. Interventions aiming to decrease substance abuse and reduce socioeconomic inequalities in this area should be implemented early in life.     

Simultaneous alcohol and marijuana use among US high school seniors from 1976 to 2011: Trends,reasons, and situations

Background

Simultaneous alcohol and marijuana (SAM) use raises significant concern due to the potential for additive or interactive psychopharmacological effects. However, no nationally representative studies are available that document prevalence, trends, or related factors in US youth SAM use.

Methods

Nationally representative cross-sectional samples of 12th grade students surveyed in the Monitoring the Future project from 1976 to 2011 provided data on SAM use. Analyses were conducted in 2012.

Results

In 2011, 23% of all US high school seniors reported any SAM use. Among seniors reporting any past 12-month marijuana use, 62% reported any SAM use and 13% reported SAM use most or every time they used marijuana. SAM use consistently followed trends for past 30-day alcohol use over time. SAM use showed significant variation by psychosocial and demographic characteristics and was strongly associated with higher substance use levels, but occurred across the substance use spectrum. Certain reasons for alcohol or marijuana use (to increase effects of another drug; I’m hooked) and situations of alcohol or marijuana use (park/beach, car, party) were strongly associated with SAM use.

Conclusions

A sizable proportion of US high school seniors reported SAM use, and it appeared to occur frequently in social use situations that could impact both the public as well as youth drug users. SAM use appears to be a complex behavior that is incidental to general substance use patterns as well as associated with (a) specific simultaneous reasons (or expectancies), and (b) heavy substance use and perceived dependence, especially on alcohol.     

Predicting the transition from frequent cannabis use to cannabis dependence: A three-year prospective study

Background

Frequent cannabis users are at high risk of dependence, still most (near) daily users are not dependent. It is unknown why some frequent users develop dependence, whereas others do not. This study aims to identify predictors of first-incidence DSM-IV cannabis dependence in frequent cannabis users.

Methods

A prospective cohort of frequent cannabis users (aged 18–30, n = 600) with baseline and two follow-up assessments (18 and 36 months) was used. Only participants without lifetime diagnosis of DSM-IV cannabis dependence at baseline (n = 269) were selected. Incidence of DSM-IV cannabis dependence was established using the Composite International Diagnostic Interview version 3.0. Variables assessed as potential predictors of the development of cannabis dependence included sociodemographic factors, cannabis use variables (e.g., motives, consumption habits, cannabis exposure), vulnerability factors (e.g., childhood adversity, family history of mental disorders or substance use problems, personality, mental disorders), and stress factors (e.g., life events, social support).

Results

Three-year cumulative incidence of cannabis dependence was 37.2% (95% CI = 30.7–43.8%). Independent predictors of the first incidence of cannabis dependence included: living alone, coping motives for cannabis use, number and type of recent negative life events (major financial problems), and number and type of cannabis use disorder symptoms (impaired control over use). Cannabis exposure variables and stable vulnerability factors did not independently predict first incidence of cannabis dependence.

Conclusions

In a high risk population of young adult frequent cannabis users, current problems are more important predictors of first incidence cannabis dependence than the level and type of cannabis exposure and stable vulnerability factors.     

Types of polydrug use among Spanish adolescents

Objective

This study examined the types of polydrug use among Spanish adolescents.

Method

1501 high school students (50.6% female) aged 12 to 17 years old (mean age = 14.03, SD = 1.28), from public schools in the city of Girona (Catalonia, Spain), completed the survey.

Results

In the previous six months 20.9% of the Spanish adolescents used alcohol, 18.8% tobacco, 10.5% cannabis and 0.7% cocaine. Specifically, 28.6% of the sample (n = 429; 29% males and 28.2% females) used at least one drug and 13.9% reported polydrug use (n = 208; 12.6% males and 15.1% females). The present research also found that the most critical ages for starting polydrug use were 14 and 15 years old. More than one quarter (27.9%) of the adolescent polydrug users were type A (tobacco and alcohol), 67.8% were type B (cannabis together with tobacco and/or alcohol) and 3.4% were type C (cannabis together with tobacco and/or alcohol, and cocaine).

Conclusions

These results suggest that Spanish adolescents, particularly males, commence polydrug use at an earlier age than other European adolescents. Early preventative strategies and a multisubstance perspective are greatly needed in Spain to avoid the initiation of polydrug use or to prevent progress onto heavier drugs.     

A comparison of Cambodian-American adolescent substance use behavior to national and local norms

Introduction

This study was designed to compare rates of alcohol, marijuana, and cigarette use in Cambodian-American adolescents with norms from nationally- and regionally-representative peers.

Methods

Substance use data from 439 10th grade Cambodian-American adolescents in Long Beach, California were compared to grade- and gender-matched nationally representative data from the Monitoring the Future study and data from the California Healthy Kids Survey of students within the same school district.

Results

Overall, the Cambodian-American youth were less likely than nationally- and regionally-representative youth to use alcohol, marijuana, and cigarettes. Specifically, relative to estimates obtained for the general population and students attending school in the same school district, Cambodian-American youth were significantly less likely to use alcohol and marijuana. Cambodian-American youth were also less likely than youth in the general population to smoke cigarettes, but did not differ statistically from youth within their same school district.

Conclusions

As a group, Cambodian-American youth may not be at especially high risk for substance use. As is the case with virtually all populations, some individuals within the Cambodian-American group are likely to have more difficulty than others with substance use concerns. Thus, additional research is needed to identify factors that might help to identify high users with potential service needs.     

Very young adolescents and alcohol: evidence of a unique susceptibility to peer alcohol use

Aim

The aim of this study is to examine the susceptibility of very young adolescents (10–12 years of age) to peer alcohol-related influences, compared to older adolescents (13–14 years of age).

Methods

The analysis sample consisted of 7064 adolescents in grade 6 (modal age 11) or grade 8 (modal age 13) from 231 schools in 30 communities across three Australian States. Key measures were adolescent reports of alcohol use (past 30 days) and the number of peers who consume alcohol without their parent's awareness. Control variables included parent alcohol use, family relationship quality, pubertal advancement, school connectedness, sensation seeking, depression, length of time in high school, as well as age, gender, father/mother education, and language spoken at home. A multi-level model of alcohol use was used to account for school-level clustering on the dependent variable.

Results

For both groups, the number of peers who consumed alcohol was associated with alcohol use, but Grade 6 students showed a unique susceptibility to peripheral involvement with peer drinking networks (having one friend who consumed alcohol).

Conclusion

The results point to the importance of monitoring and responding to comparatively minor shifts in the proportion of peers who use alcohol, particularly among very young adolescents.     

Alcohol use problem among patients in methadone maintenance treatment in Taiwan

Aims

To examine the prevalence rate and predictors of alcohol use problems among patients undergoing methadone maintenance treatment (MMT).

Design

This was a prospective follow-up study.

Participants

Study population included 438 patients who underwent more than 6 months of MMT.

Measurements

Demographic and clinical characteristics were collected for each patient prior to treatment, and treatment-related variables were collected during treatment process. Hazardous drinking, alcohol abuse, and dependence were measured using a Chinese version of the Alcohol Use Disorders Identification Test (AUDIT) and by measuring breath alcohol concentration.

Findings

The prevalence rates of alcohol use problems, indicated by hazardous drinking are 31.4%. The protective predictors of alcohol use problems among MMT patients include an attendance rate of more than 90% (odds ratio [OR] = 0.54, 95% confidence interval [CI] = 0.30–0.97) and being older than 36 years (OR = 0.48, 95% CI = 0.27–0.86), and alcohol drinking problem at intake of study is a risk factor (OR = 5.30, 95% CI = 2.87–9.76).

Conclusions

High attendance rate, which is regarded as a component of clinical policy and a key component of therapeutic context, should be incorporated with brief interventions to lower alcohol use problems among MMT patients.     

C-reactive protein and substance use disorders in adolescence and early adulthood: A prospective analysis

Background

Dysregulated immune function and elevated inflammation markers are seen in adults with chronic diseases, including some psychiatric disorders, but evidence on inflammation in the case of drug abuse is conflicting.

Objective

To test the concurrent and predictive relations between C-reactive protein (CRP) and use and abuse of alcohol, nicotine and cannabis in a longitudinal, population sample of adolescents and young adults, at the period of highest increase in drug use.

Methods

Data from the prospective population-based Great Smoky Mountains Study (N = 1420) were used, covering children in the community assessed at ages 9–16, 19, and 21. Structured interviews were used to assess substance abuse symptoms and DSM-IV substance use disorders. Bloodspots were collected at each assessment and assayed for CRP.

Results

CRP levels were higher in the presence of nicotine, alcohol, and cannabis use and nicotine dependence. In prospective analyses, higher CRP levels predicted cannabis use and nicotine dependence, and nicotine use predicted higher CRP levels, once covariates were included in the models. Significant covariates were age, race (American Indian), and obesity.

Conclusions

The inter-relationship of CRP and substance abuse has implications for the later health risks associated with early drug and alcohol use and abuse.     

All-cause mortality in criminal justice clients with substance use problems—A prospective follow-up study

Background

Mortality in previously incarcerated individuals is known to be elevated, with high proportions of drug-related deaths. However, there is less documentation of whether specific substance use patterns and other clinical characteristics predict increased mortality in the group.

Methods

This is a follow-up study of mortality and causes of death in ex-prisoners with substance use problems prior to incarceration (N = 4081), who were followed during an average of 3.6 years from release from prison until death or until data were censored. Baseline predictors of mortality, derived from interviews with Addiction Severity Index (ASI) in prison, were studied in a Cox regression analysis.

Results

During follow-up, 166 subjects (4.1%) died. Standardized mortality ratios were 7.0 (3.6–12.2) for females and 7.7 (5.6–9.0) for males. In 84% of cases, deaths were unnatural or due to substance-related disease. Most common causes of death were accidental poisoning (27%), transport accidents (13%), poisoning/injury with undetermined intent (12%), and suicide (10%). Death was positively predicted by heroin use, overdose, and age, and negatively predicted by a history of depression.

Conclusions

A vast majority of deaths after release from prison in individuals with substance use are due to violent or substance-related causes. Significant predictors identified were mainly related to patterns of drug use, and need to be addressed upon incarceration as risk factors of death. The findings have implications for referral and treatment upon release from prison.     

Demographic, emotional and social determinants of cannabis use in early pregnancy: the Generation R study

Aims

To ascertain demographic, emotional and social determinants of cannabis use in early pregnancy.

Design

This study was embedded in the Generation R study, a multiethnic population-based cohort of parents and their children, followed from pregnancy to childhood.

Setting

Rotterdam, The Netherlands.

Participants

Mothers enrolled in pregnancy who answered questions about their own and their partners substance use before and during pregnancy (n = 7610).

Measurements

Using self-report questionnaires, information was collected on maternal demographics, psychopathology, delinquency, childhood trauma, social stress, family functioning, and parental alcohol, tobacco and substance use. Multinomial logistic regression analysis was used, with non-using women as reference.

Findings

246 (3.2%) women used cannabis before pregnancy and 220 (2.9%) women used cannabis both before and during pregnancy. The strongest determinant for maternal cannabis use during pregnancy was cannabis use by the biological father of the child (OR = 38.56; 95%CI = 26.14–58.88). Maternal cannabis use during pregnancy was also independently associated with being single (OR = 4.25; 95%CI = 2.33–7.75) or having a partner without being married (OR = 2.75; 95%CI = 1.56–4.85), childhood trauma (OR = 1.39; 95%CI = 1.22–1.57) and delinquency (OR = 3.37; 95%CI = 1.90–5.98), but not with maternal age, ethnicity, psychopathology, family functioning and perceived stress. Being religious was protective (Islam: OR = 0.25; 95%CI = 0.09–0.65) for maternal cannabis use during pregnancy. Additionally, lower educational level determined continued cannabis use in ever-users (OR = 3.22; 95%CI = 1.54–6.74).

Conclusions

Our results showed that multiple demographic, emotional and social characteristics were associated with maternal cannabis use. These characteristics should be considered when investigating offspring exposed to cannabis in utero, as they may play an important role in mother–child interaction and child development.     

Reasons for substance use among people with mental disorders

Background

Comorbidity of mental disorders and substance use continues to be a major problem. To inform the development of more effective interventions for these co-existing disorders, this paper aimed to determine if there are clear variations in the reasons for tobacco, alcohol or cannabis use across people with different mental disorders.

Methods

Data from five randomized controlled trials on co-existing disorders that measured reasons for tobacco, alcohol or cannabis use using the Drug Use Motives Questionnaire, Reasons for Smoking Questionnaire or via free response are reported and combined. Two studies involved participants with depression, two involved participants with a psychotic disorder and one involved participants with a range of mental disorders. A series of logistic regressions were conducted to examine differences in reasons for tobacco, alcohol or cannabis use and to compare these reasons between people with psychotic disorders or depression.

Results

Participants had a mean age of 38 (SD = 12) and just over half (60%) were male. Forty-six percent of participants had a psychotic disorder and 54% experienced depression. Data from 976 participants across the five studies were included in the analyses. Tobacco and alcohol were primarily used to cope, while cannabis was primarily used for pleasure. People with psychotic disorders were more likely than people with depression to use tobacco for coping, pleasure and illness motives. People with depression, in contrast, were more likely to use alcohol for these reasons and social reasons.

Conclusions

It may be important to tailor interventions for co-existing mental disorders and substance use by substance type and type of mental disorder. For example, interventions might be improved by including alternative coping strategies to tobacco and/or alcohol use, by addressing the social role of alcohol and by helping people with mental disorders using cannabis to gain pleasure from their lives in other ways.     

The role of cannabis use within a dimensional approach to cannabis use disorders

Context

Cannabis consumption is central to diagnosis of cannabis use disorders; yet, most research on cannabis disorders has focused just on diagnosis or criteria. The present study examines the ability of a frequency and quantity measure of cannabis use as well as cannabis abuse and dependence criteria to discriminate between individuals across the cannabis use disorder continuum.

Method

A representative sample of USA adults in 2001–2002 (N = 43,093) were queried about the past year frequency of cannabis use and each Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) cannabis abuse and dependence criterion. Factor analysis and item response theory (IRT) models were used to define the relationship between observed responses and the underlying unobserved latent trait (cannabis use disorder severity) among past year cannabis users (n = 1603).

Results

Factor analyses demonstrated a good fit for a one-factor model both with and without the cannabis use criterion and no differential criterion functioning was demonstrated across sex. The IRT model including the cannabis use criterion had discriminatory power comparable to the model without the cannabis use criterion and exceeded the informational value of the model without the cannabis use criterion in mild and moderate ranges of the severity continuum.

Discussion

Factor and IRT analyses disprove the validity of the DSM-IV abuse and dependence distinction: A single dimension represented the criteria rather than the two implied by the separate abuse/dependence categories. IRT models identified some dependence criteria to be among the mildest and some abuse criteria to be among the most severe—results inconsistent with the interpretation of DSM-IV cannabis abuse as a milder disorder or prodrome of cannabis dependence. The consumption criterion defined the mild end of the cannabis use disorder continuum and its excellent psychometric properties supported its consideration for inclusion in the next edition of DSM as a criterion for cannabis use disorders. Additional work is needed to identify candidate consumption criteria across all drugs that apply to the milder end of the severity continuum while also improving overall model performance and clinical diagnostic utility.     

Dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria: implications for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition

Background

Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM-IV currently lacking empirical justification.

Methods

Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population.

Results

Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity.

Conclusion

Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse criterion.     

Prevalence of cannabis use in Brazil: Data from the I Brazilian National Alcohol Survey (BNAS)

Aims

To estimate the prevalence of cannabis use in the last 12 months in the Brazilian population and to examine its association with individual and geographic characteristics.

Design

Cross-sectional survey with a national probabilistic sample.

Participants

3006 individuals aged 14 to 65 years.

Measurements

Questionnaire based on well established instruments, adapted to the Brazilian population.

Findings

The 12-month prevalence of cannabis use was 2.1% (95%CI 1.3–2.9). Male gender, better educational level, unemployment and living in the regions South and Southeast were independently associated with higher 12-month prevalence of cannabis use.

Conclusion

While the prevalence of cannabis use in Brazil is lower than in many countries, the profile of those who are more likely to have used it is similar. Educational and prevention policies should be focused on specific population groups.     

Cannabis dimensionality: Dependence,abuse and consumption

Aims

Genetic research on substance use disorders usually defines phenotypes as a binary diagnosis, resulting in a loss of information if the disorder is inherently dimensional. The DSM-IV criteria for drug dependence were based on a theoretically dimensional (linear) model. Considerable investigation has been conducted on DSM-IV alcohol criteria, but less is known about the dimensionality of DSM-IV cannabis criteria for abuse and dependence. The aim of this study is to assess whether DSM-IV cannabis dependence (including withdrawal) and abuse criteria fit a linear measure of severity and whether a consumption criterion adds linearly to severity.

Design/setting/participants/measurements

Participants were 8172 in the National Epidemiologic Survey on Alcohol and Related Conditions who had ever used cannabis. Wald statistics were used to test whether categorical, dimensional or hybrid forms best fit the data. We examined the following as criterion sets: (1) dependence; (2) dependence and abuse; and (3) dependence, abuse and frequency of use. Validating variables included family history of drug problems, early onset of cannabis use, and antisocial personality disorder.

Findings

For cannabis dependence, no evidence was found for categorical or hybrid models; Wald tests indicated that models representing the seven DSM-IV dependence criteria as a linear severity measure best described the association between the criteria and validating variables. However, significant differences from linearity occurred after adding the four cannabis abuse criteria (p = 0.03) and the use indicator (p = 0.01) for family history and antisocial personality disorder.

Conclusion

With ample power to detect non-linearity, cannabis dependence was shown to form an underlying continuum of severity. However, adding abuse criteria, with and without a measure of consumption, resulted in a model that differed significantly from linearity for two of the three validating variables.     

Factors associated with variability and stability of cannabis use in young adulthood

Background

This study investigated the factors associated with initiating cannabis use, reverting to cannabis use and remaining a cannabis user in young adulthood. This is an important area of research as the risk for cannabis initiation is extending beyond adolescence and opportunities to influence cannabis use pathways can emerge throughout the life-course.

Methods

A large, community-based sample was followed prospectively. Data from two successive waves (mean age 23 years and 27 years respectively) of the Path Through Life Study (PATH) were analysed (n = 2045). The longitudinal design enabled change in cannabis use in young adulthood to be predicted based on factors assessed approximately four years prior.

Results

An environment of licit drug use was strongly associated with initiating cannabis use (tobacco: OR = 4.98, 95%CI: 2.31–10.76) and reverting to cannabis use in young adulthood (alcohol: OR = 2.13, 95%CI: 1.42–3.19). Greater fun seeking was found to orientate people towards initiating cannabis use in young adulthood (OR = 1.17, 95%CI: 1.04–1.30). Higher psychoticism increased the odds of remaining a cannabis user (OR = 1.19, 95%CI: 1.07–1.33). Religious involvement was protective of cannabis initiation (OR = 0.89, 95%CI: 0.83–0.95). Early childhood factors did not influence the pattern of cannabis use in young adulthood.

Conclusions

The findings make an important contribution to the development of prevention and intervention strategies for young adults by drawing attention to specific areas of risk and protection.     

Psychometric properties of the CAST and SDS scales in young adult cannabis users

Aim

To assess the validity of two cannabis use severity scales among young cannabis users and to evaluate their ability to detect Substance Use Disorders (SUD).

Participants

241 volunteers (18–25 years), with a wide spectrum of cannabis use in the last 12 months.

Measurements

The Cannabis Abuse Screening Test (CAST) and Severity of Dependence Scale (SDS) were self-administered. The Psychiatric Interview for Substance and Mental Disorders (PRISM) was used as gold standard for cannabis use disorders according to DSM-IV. Reliability and validity were assessed for two different CAST coding algorithms (b—binary and f—full) and for the SDS. In addition, the cannabis use diagnostic criteria contained in the PRISM were grouped to approximate forthcoming proposed DSM-V criteria to further evaluate these scales.

Findings

26.6% (95% CI: 21.0–32.2) of the subjects met criteria for cannabis dependence, and 49.0% (95% CI: 42.7–55.3) for cannabis use disorders. For both scales internal consistency (Cronbach's alpha > 0.71) and test–retest intraclass correlation coefficients (> 0.80) were good. The score 12 in the CAST-full discriminated better than others between presence and absence of dependence (27.0%; 95% CI: 21.4–32.6) while the score for discrimination of SUD was 9 (51.5%; 95% CI: 45.1–57.8). For the SDS the values were 7 (22.0%; 95% CI: 16.8–27.2) and 3 (64.7%; 95% CI: 58.7–70.8), respectively. According to proposed DSM-V criteria, for moderate and severe addiction the values for the CAST-f were 7 (68.5%; 95% CI: 62.5–74.3) and 12 (27%; 95% CI: 21.3–32.6) and for the SDS, 3 (65.0%; 95% CI: 58.7–70.8) and 7 (22%; 95% CI: 17.0–34.3), respectively.

Conclusions

The CAST and SDS applied to young cannabis users are reliable and valid measures to detect cannabis use disorders when compared to both DSM-IV and proposed DSM-V criteria.     

Cannabis use and suicidal ideations in high-school students

Background

The association of cannabis use and suicidal ideations in adolescents has been inconsistent. This discrepancy may reflect differences in controlled confounders. In particular, no study has controlled for personality disorder traits linked to both cannabis use and suicidality such as borderline and psychopathic personality traits.

Method

Participants were 972 high-school students who completed questionnaires assessing cannabis use, suicidal ideations, depressive symptoms, social anxiety symptoms, and borderline and psychopathic personality traits.

Results

Cannabis use was not a significant independent predictor of suicidal ideations after adjustment for confounding personality traits in the total sample and in the subsample of cannabis users.     

Is there any evidence of changes in patterns of concurrent drug use among young Australians 18–29 years between 2007 and 2010?

Background

A significant minority of Australians engage in concurrent drug use (using more than one drug in a given period). We examined clusters and correlates of concurrent drug use using the latest available nationally representative survey data on Australian young adults.

Sample

3836 participants aged 18–29 years (mean age 24 years) from the 2010 National Drug Strategy Household Survey (NDSHS).

Method

Clusters were distilled using latent class analysis of past year use of alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers and tranquillisers/sleeping pills.

Results

Concurrent drug use in this sample was best described using a 4-class solution. The majority (87.5%) of young adults predominantly used alcohol only (50.9%) or alcohol and tobacco (36.6%). 10.2% reported using alcohol, tobacco, marijuana, and ecstasy, and 2.3% reported using an extensive range of drugs.

Conclusion

Most drug use clusters were robust in their profile and stable in their prevalence, indicating little meaningful change at the population level from 2007. The targeting of alcohol and tobacco use remains a priority, but openness to experiencing diverse drug-related effects remains a significant concern for 12.5% of young people in this age group.