Silvia Martins
Columbia University, Epidemiology, Faculty Member
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Prescription drug monitoring programs (PDMP), defined as state-level databases used in the United States that collect prescribing information when controlled substances are dispensed, have varied substantially between states and over... more
Prescription drug monitoring programs (PDMP), defined as state-level databases used in the United States that collect prescribing information when controlled substances are dispensed, have varied substantially between states and over time. Little is known about the combinations of PDMP features that, collectively, may produce the greatest impact on prescribing and overdose. We aimed to (1) identify the types of PDMP models that have developed from 1999 to 2016, (2) estimate whether states have transitioned across PDMP models over time and (3) examine whether states have adopted different types of PDMP models in response to the burden of opioid overdose. A latent transition analysis of PDMP models based on an adaptation of nine PDMP characteristics classified by prescription opioid policy experts as potentially important determinants of prescribing practices and prescription opioid overdose events. We divided the time-period into three intervals (1999-2004, 2005-09, 2010-16), and fou...
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Background and aimsAmong adolescents, risk preference and deviant behaviors are associated with marijuana use, which exhibit substantial historical trends. We examined (1) trends, (2) effect modification by sex and age, (3) associations... more
Background and aimsAmong adolescents, risk preference and deviant behaviors are associated with marijuana use, which exhibit substantial historical trends. We examined (1) trends, (2) effect modification by sex and age, (3) associations of marijuana use with deviant behaviors and risk preferences and (4) differences by sex, age and year.DesignAdjusted logistic and relative risk regression models, using data from the 2002–14 National Survey on Drug Use and Health, annual cross‐sectional surveys of US households.SettingUnited States.ParticipantsA nationally representative sample of adolescents aged 12–17 years (n = 230 452).MeasurementsWe estimated associations between past‐year marijuana use [self‐reported using computer‐assisted personal interviewing/audio computer‐assisted self‐interviewing (CAPI/ACASI)], deviant behavior (i.e. selling drugs; stealing; attacking someone) and risk preference (i.e. getting a kick; testing oneself).FindingsMarijuana use, deviant behaviors and risk pre...
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Parenting behaviors have been shown to moderate the association between sensation seeking and antisocial behaviors. Data were obtained from the Boricua Youth Study, a longitudinal study of 2,491 Puerto Rican youth living in the South... more
Parenting behaviors have been shown to moderate the association between sensation seeking and antisocial behaviors. Data were obtained from the Boricua Youth Study, a longitudinal study of 2,491 Puerto Rican youth living in the South Bronx, New York, and the metropolitan area of San Juan, Puerto Rico. First, we examined the prospective relationship between sensation seeking and antisocial behaviors across 3 yearly waves and whether this relationship varied by sociodemographic factors. Second, we examined the moderating role of parenting behaviors-including parental monitoring, warmth, and coercive discipline-on the prospective relationship between sensation seeking and antisocial behaviors. Sensation seeking was a strong predictor of antisocial behaviors for youth across two different sociocultural contexts. High parental monitoring buffered the association between sensation seeking and antisocial behaviors, protecting individuals with this trait. Low parental warmth was associated ...
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The purpose of this paper is to analyze characteristics of marijuana concentrate users, describe patterns and reasons of use, and identify factors associated with daily use of concentrates among U.S.-based cannabis users recruited via a... more
The purpose of this paper is to analyze characteristics of marijuana concentrate users, describe patterns and reasons of use, and identify factors associated with daily use of concentrates among U.S.-based cannabis users recruited via a Twitter-based online survey. An anonymous Web-based survey was conducted in June 2017 with 687 U.S.-based cannabis users recruited via Twitter-based ads. The survey included questions about state of residence, socio-demographic characteristics, and cannabis use including marijuana concentrates. Multiple logistic regression analyses were conducted to identify characteristics associated with lifetime and daily use of marijuana concentrates. Almost 60% of respondents were male, 86% were white, and the mean age was 43.0 years. About 48% reported marijuana concentrate use. After adjusting for multiple testing, significant predictors of concentrate use included: living in "recreational" (AOR = 2.04; adj. p = .042) or "medical, less restricti...
Research Interests: Psychology, Demography, Computer Engineering, Social Media, Medicine, and 15 moreLogistic Regression, Survey, Humans, RECREATION, Female, Male, Medical Marijuana, Cannabis, Adult, Residence, Internet, Electrical and Computer Engineering, Marijuana use, Psychology and Cognitive Sciences, and Medical and Health Sciences
In states that have passed medical marijuana laws (MMLs), marijuana use (MU) increased after MML enactment among people ages 26 and older, but not among ages 12-25. We examined whether the age-specific impact of MMLs on MU varied by... more
In states that have passed medical marijuana laws (MMLs), marijuana use (MU) increased after MML enactment among people ages 26 and older, but not among ages 12-25. We examined whether the age-specific impact of MMLs on MU varied by gender. Data were obtained from the 2004-2013 restricted-use National Survey on Drug Use and Health, aggregated at the state level. The exposure was a time-varying indicator of state-level MML (0 = No Law, 1 = Before Law, 2 = After Law). Outcomes included past-month MU prevalence, daily MU prevalence among past-year users (i.e., 300+ days/year), and past-year marijuana use disorder (MUD) prevalence. Linear models tested the state-level MML effect on outcomes by age (12-17, 18-25, 26+) and gender. Models included a state-level random intercept and controlled for time- and state-level covariates. Past-month MU did not increase after enactment of MML in men or women ages 12-25. Among people 26+, past-month MU increased for men from 7.0% before to 8.7% after...
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The rapid growth of urban areas in China in the past few decades has introduced profound changes in family structure and income distribution that could plausibly affect mental health. Although multilevel studies of the influence of... more
The rapid growth of urban areas in China in the past few decades has introduced profound changes in family structure and income distribution that could plausibly affect mental health. Although multilevel studies of the influence of area-level socioeconomic factors on mental health have become more common in other parts of the world, a study of this sort has not been carried out in Chinese cities. Our objectives were to examine the associations of two key neighbourhood-level variables-median income and percentage of married individuals living in the neighbourhood-with mental disorders net of individual-level income and marital status in three Chinese cities. Household interviews in Beijing, Shanghai and Shenzhen, PRC, as part of the cross-sectional World Mental Health Surveys. 4072 men and women aged 18-88 years. Lifetime and past-year internalising and externalising mental disorders. Each one-point increase in neighbourhood-level percentage of married residents was associated with a...
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Ecstasy/MDMA has been one of the most prevalent party drugs for decades, and powder ecstasy recently increased in popularity. We examined trends in use to determine who to best target for prevention and harm reduction. Secondary analysis... more
Ecstasy/MDMA has been one of the most prevalent party drugs for decades, and powder ecstasy recently increased in popularity. We examined trends in use to determine who to best target for prevention and harm reduction. Secondary analysis of the 2007-2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample, was conducted. Linear trends in past-year ecstasy use and trends in demographic and other past-year substance use characteristics among ecstasy users were examined among participants ages 12-34 (N=332,560). Past-year prevalence of ecstasy use was stable across years at 2% (P=0.693). Over time, the proportion of ecstasy users with a college degree increased from 11.5% in 2007/08 to 24.5% in 2013/14 (P<0.001). The proportion of users who were age 12-17 decreased, as did proportions of users who are non-Hispanic black, and reported income <$20,000/year (Ps<0.001). Prevalence of past-year use of marijuana, LSD, keta...
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To determine the association of medical marijuana laws (MMLs) with traffic fatality rates. Using data from the 1985-2014 Fatality Analysis Reporting System, we examined the association between MMLs and traffic fatalities in multilevel... more
To determine the association of medical marijuana laws (MMLs) with traffic fatality rates. Using data from the 1985-2014 Fatality Analysis Reporting System, we examined the association between MMLs and traffic fatalities in multilevel regression models while controlling for contemporaneous secular trends. We examined this association separately for each state enacting MMLs. We also evaluated the association between marijuana dispensaries and traffic fatalities. On average, MML states had lower traffic fatality rates than non-MML states. Medical marijuana laws were associated with immediate reductions in traffic fatalities in those aged 15 to 24 and 25 to 44 years, and with additional yearly gradual reductions in those aged 25 to 44 years. However, state-specific results showed that only 7 states experienced post-MML reductions. Dispensaries were also associated with traffic fatality reductions in those aged 25 to 44 years. Both MMLs and dispensaries were associated with reductions i...
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Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant... more
Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant women and women planning to become pregnant. We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12-44 years old, by pregnancy status. The women (n=97,788) were participants in the National Survey of Drug Use and Health (NSDUH) in 2010-2013. Logistic regression models assessed the association between health insurance (insured versus uninsured), past month tobacco and alcohol use, and whether this was modified by pregnancy status. Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value≤0.01) and alcohol use (p-value≤0.01). Among pregnant women, being insured was associated with lowe...
Research Interests: Reproduction, Environmental Health, Health insurance, Adolescent, Medicine, and 15 moreLogistic Regression, Pregnancy, Humans, Child, Female, Alcohol Drinking, Adult, Odds ratio, Odds, Cross Sectional Studies, Prenatal Care, Confidence Interval, Insurance Coverage, Psychology and Cognitive Sciences, and Medical and Health Sciences
Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate... more
Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate alcohol, tobacco, and marijuana use by 15-18-year-old high school Brazilian students and to estimate associations with psychiatric symptoms. A cross-sectional survey of 4,034 students from 128 public and private schools in São Paulo State was carried out using a two-step probability sample. Data were collected through self-report standardized questionnaires including questions on substance use patterns and the Strengths and Difficulties Questionnaire (SDQ). Key outcome variables were past-month use and past-month frequent use of alcohol, tobacco and marijuana. Questionnaires with missing information were excluded, resulting in a final sample of 2,532 adolescents. Weighted data was analyzed through logistic regressions, adjusted by gender and by socio-ec...
Research Interests: Psychology, Psychiatry, Psychopathology, Brazil, Adolescent, and 15 moreMedicine, Logistic Regression, Schools, Marijuana, Humans, Alcohol, Psychiatric Comorbidity, Male, Adolescents, Psychosocial, Self report, Cross Sectional Studies, Adolescent Behavior, Logistic Models, and Psychiatric Status Rating Scales
To determine (1) whether prescription opioid poisoning (PO) hospital discharges spread across space over time, (2) the locations of "hot spots" of PO-related hospital discharges, (3) how features of the local environment... more
To determine (1) whether prescription opioid poisoning (PO) hospital discharges spread across space over time, (2) the locations of "hot spots" of PO-related hospital discharges, (3) how features of the local environment contribute to the growth in PO-related hospital discharges and (4) where each environmental feature makes the strongest contribution. Hierarchical Bayesian Poisson space-time analysis to relate annual discharges from community hospitals to postal code characteristics over ten years. California, USA. Residents of 18,517 postal codes in California, 2001-2011. Annual postal code level counts of hospital discharges due to PO poisoning were related to postal code pharmacy density, measures of medical need for POs (i.e., rates of cancer and arthritis-related hospital discharges), economic stressors (i.e., median household income, percent of families in poverty, and the unemployment rate) and concentration of manual labor industries. PO-related hospital discharge...
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<p>Data from the São Paulo Megacity Mental Health Survey (SPMHS), Brazil, 2005–2007 (n = 5037).</p>1<p>Among past-year users.</p>2<p>Among regular users.</p><p>Estimated subgroup-specific... more
<p>Data from the São Paulo Megacity Mental Health Survey (SPMHS), Brazil, 2005–2007 (n = 5037).</p>1<p>Among past-year users.</p>2<p>Among regular users.</p><p>Estimated subgroup-specific prevalence proportions for recently active alcohol use, drinking patterns and related disturbances.</p
Research Interests: Science Policy, Influence, DSM, Biological Sciences, Outcome, and 13 moreDMS, Status, Frequency, Dependence, Neighborhood, Abuse, Association, Disturbance, ODD, Drinking, Ru, Alcohol Use Disorders, and Paulo
There is considerable interest in the effects of medical marijuana laws (MML) on marijuana use in the USA, particularly among youth. The article by Stolzenberg et al. (2015) "The effect of medical cannabis laws on juvenile cannabis... more
There is considerable interest in the effects of medical marijuana laws (MML) on marijuana use in the USA, particularly among youth. The article by Stolzenberg et al. (2015) "The effect of medical cannabis laws on juvenile cannabis use" concludes that "implementation of medical cannabis laws increase juvenile cannabis use". This result is opposite to the findings of other studies that analysed the same US National Survey on Drug Use in Households data as well as opposite to studies analysing other national data which show no increase or even a decrease in youth marijuana use after the passage of MML. We provide a replication of the Stolzenberg et al. results and demonstrate how the comparison they are making is actually driven by differences between states with and without MML rather than being driven by pre and post-MML changes within states. We show that Stolzenberg et al. do not properly control for the fact that states that pass MML during 2002-2011 tend to a...
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that it increased well-being/life satisfaction (94, 94%) than those in the CE group (31% for spiritually significant; 76% for well-being). Conclusions: The phenomenology of psilocybin experiences in the LS group was more similar to that... more
that it increased well-being/life satisfaction (94, 94%) than those in the CE group (31% for spiritually significant; 76% for well-being). Conclusions: The phenomenology of psilocybin experiences in the LS group was more similar to that in the ME group than the CE group, suggesting that laboratory procedures are effective at minimizing negative experiences andmaximizing positive experiences. Financial support: NIH grants T32DA007209 and R01DA003889, the Heffter Research Institute and the Council on Spiritual Practices.
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Research Interests: Psychology, Psychiatry, Epidemiology, Adolescent, Medicine, and 15 moreLinear models, Humans, Child, Minority Groups, New York City, Female, Male, Child Psychiatry, Normative, Longitudinal Studies, Adolescent Psychiatry, Adolescent Behavior, Child preschool, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Epidemiology, Drugs And Addiction, Depression, Alcohol Studies, Drugs and drug culture, and 15 moreDrugs And Alcohol, Drug Policy, Drugs, Humans, Alcohol, Female, Alcohol Drinking, Addictive Behaviours, Drug Addiction, Drug abuse, Health Status, Aged, Alcohol Abuse, Addictive Behaviors, and Alcohol Addiction
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Little is known about drug use patterns among people living with HIV in comparison to an uninfected group in the general population. The aim of this study was to investigate the association between legal and illegal drug use and HIV... more
Little is known about drug use patterns among people living with HIV in comparison to an uninfected group in the general population. The aim of this study was to investigate the association between legal and illegal drug use and HIV infection in a nationally representative sample of adults in the United States. Public use data files (2005-2014) from the National Survey on Drug Use and Health (NSDUH) were used. Respondents were asked whether a medical professional had ever told them that they had HIV/AIDS. Ever (lifetime), past-year, and past month use of cigarettes, alcohol, marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of psychotherapeutics was assessed. Logistic regression was used to estimate adjusted odds ratios (aOR) of the relationship between drug use and HIV infection, adjusting for demographics. Of 377,787 respondents age 18 and older, 548 (0.19%) were categorized as HIV-infected. Ever use of cigarettes, tobacco, marijuana, cocaine, heroin, halluc...
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Relatively little is known about the temporal relation between at-risk gambling or problem gambling (PG) and mental and substance use disorders (SUDs) in young adulthood. Our study aimed to examine whether past-year, at-risk, or PG is... more
Relatively little is known about the temporal relation between at-risk gambling or problem gambling (PG) and mental and substance use disorders (SUDs) in young adulthood. Our study aimed to examine whether past-year, at-risk, or PG is associated with incident mental disorders and SUDs (that is, depression, generalized anxiety disorder, obsessive-compulsive disorder [OCD], or alcohol dependence) and illegal drug use, and whether past-year mental disorders and SUDs and illegal drug use is associated with incident at-risk or PG. Data for this longitudinal study were drawn from the Manitoba Longitudinal Study of Young Adults (MLSYA). Respondents aged 18 to 20 years in 2007 were followed prospectively for 5 years. In cross-sectional analyses, at-risk or PG was associated with increased odds of depression, OCD, alcohol dependence, and illegal drug use. In longitudinal analysis at-risk or PG at cycle 1 was associated with incident major depressive disorder, alcohol dependence, and illegal ...
Research Interests: Anxiety Disorders, Adolescent, Medicine, Comorbidity, Canadian Psychiatry, and 15 moreAnxiety, Humans, Major Depressive Disorder, Alcoholism, Gambling, Female, Manitoba, Male, Obsessive Compulsive Disorder, Longitudinal Studies, Adult, Longitudinal Study, ANXIETY, Alcohol use disorder, and Medical and Health Sciences
Research Interests: Drugs And Addiction, Child and adolescent mental health, Alcohol Studies, Drugs and drug culture, Drugs And Alcohol, and 15 moreAdolescent, Drug Use, Drug Policy, Drugs, Child, Alcohol, Academic achievement, Addictive Behaviours, Adolescents, Drug Addiction, Cannabis, Addictive Behaviors, Child and Adolescent Mental Health, Alcohol Addiction, and attitude to health
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Prescription drug monitoring programs (PDMPs) are a key component of the president's Prescription Drug Abuse Prevention Plan to prevent opioid overdoses in the United States. To examine whether PDMP implementation is associated with... more
Prescription drug monitoring programs (PDMPs) are a key component of the president's Prescription Drug Abuse Prevention Plan to prevent opioid overdoses in the United States. To examine whether PDMP implementation is associated with changes in nonfatal and fatal overdoses; identify features of programs differentially associated with those outcomes; and investigate any potential unintended consequences of the programs. Eligible publications from MEDLINE, Current Contents Connect (Clarivate Analytics), Science Citation Index (Clarivate Analytics), Social Sciences Citation Index (Clarivate Analytics), and ProQuest Dissertations indexed through 27 December 2017 and additional studies from reference lists. Observational studies (published in English) from U.S. states that examined an association between PDMP implementation and nonfatal or fatal overdoses. 2 investigators independently extracted data from and rated the risk of bias (ROB) of studies by using established criteria. Conse...
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OBJECTIVES: In this study, we examined the prevalence and correlates of current synthetic cannabinoid (SC) use among high school seniors in the United States. METHODS: Monitoring the Future, an annual nationally representative survey of... more
OBJECTIVES: In this study, we examined the prevalence and correlates of current synthetic cannabinoid (SC) use among high school seniors in the United States. METHODS: Monitoring the Future, an annual nationally representative survey of high school seniors, began querying current (30-day) SC use in 2014. Data were examined from the 2 most recent cohorts (2014–2015; N = 7805). Prevalence of self-reported use was examined and differences in demographics and recency and frequency of other drug use was compared between current marijuana-only users and current SC (plus marijuana) users using χ2 and generalized linear model using Poisson. RESULTS: We found that 2.9% of students reported current SC use; 1.4% of students (49.7% of users) reported using SCs on ≥3 days in the past month. SC users were more likely to report more recent (and often more frequent) use of lysergic acid diethylamide, cocaine, heroin, and/or nonmedical use of opioids compared with marijuana-only users. Compared with...
Research Interests: Pediatrics, Adolescent, Medicine, Linear models, Cannabinoids, and 15 moreHumans, Demographics, Female, Male, Risk factors, Cannabis, Prevalence, Health surveys, Risk Factors, Heroin, Self report, Cross Sectional Studies, Adolescent Behavior, Psychology and Cognitive Sciences, and Medical and Health Sciences
Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups... more
Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups while accounting for whether states enacted medicalized (highly regulated) or non-medical mml programs. Difference-in-differences estimates with time-varying state-level MML coded by program type (medicalized versus non-medical). Multi-level linear regression models adjusted for state-level random effects and covariates as well as historical trends in use. Nation-wide cross-sectional survey data from the US National Survey of Drug Use and Health (NSDUH) restricted use data portal aggregated at the state level. Participants comprised 2004-13 NSDUH respondents (n ~ 67 500/year); age groups 12-17, 18-25 and 26+ years. States had implemented eight medicalized and 15 non-medical MML programs. Primary outcome measures included (1) active (past-month) mari...
Research Interests: Demography, Addiction, Adolescent, Medicine, Linear models, and 15 moreHumans, Child, Female, Male, Medical Marijuana, Cannabis, Prevalence, Adult, Multilevel Analysis, Cross Sectional Studies, Marijuana use, Marijuana abuse, Surveys and Questionnaires, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Psychology, Cognitive Science, Demography, Epidemiology, Public Health, and 15 moreEmployment, Medicine, Logistic Regression, Prescription drug misuse, Humans, Female, Male, Clinical Sciences, Middle Aged, Adult, Odds ratio, Odds, Cross Sectional Studies, Marital Status, and Central nervous system stimulants
Research Interests: Demography, Epidemiology, Employment, Medicine, Global Financial Crisis, and 15 moreMarijuana, Recession, Humans, Female, Male, Cannabis, Recessions, Prevalence, Middle Aged, Adult, Health surveys, Cross Sectional Studies, Marijuana abuse, Psychology and Cognitive Sciences, and Medical and Health Sciences
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To assess the association between medical marijuana laws (MMLs) and the odds of a positive opioid test, an indicator for prior use. We analyzed 1999-2013 Fatality Analysis Reporting System (FARS) data from 18 states that tested for... more
To assess the association between medical marijuana laws (MMLs) and the odds of a positive opioid test, an indicator for prior use. We analyzed 1999-2013 Fatality Analysis Reporting System (FARS) data from 18 states that tested for alcohol and other drugs in at least 80% of drivers who died within 1 hour of crashing (n = 68 394). Within-state and between-state comparisons assessed opioid positivity among drivers crashing in states with an operational MML (i.e., allowances for home cultivation or active dispensaries) versus drivers crashing in states before a future MML was operational. State-specific estimates indicated a reduction in opioid positivity for most states after implementation of an operational MML, although none of these estimates were significant. When we combined states, we observed no significant overall association (odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.61, 1.03). However, age-stratified analyses indicated a significant reduction in opioid positiv...
Research Interests: Demography, Injury Prevention, Adolescent, Medicine, Humans, and 15 moreFemale, Male, Medical Marijuana, Young Adult, Prevalence, Adult, Odds ratio, Odds, Poison Control, Confidence Interval, Automobile driving, Blood Alcohol Content, Medical and Health Sciences, Case fatality rate, and Accidents Traffic
To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care. Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site,... more
To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care. Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use. Veterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC. A total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012. The primary outcome measure was self-reported incident heroin use and the primary exposure of intere...
Research Interests: Addiction, Medicine, Prospective studies, Prescription drug misuse, Humans, and 15 moreFemale, Male, Cohort Study, Heroin Dependence, Risk factors, Aged, Middle Aged, Adult, Risk Factors, Heroin, Confidence Interval, Prospective Cohort Study, Psychology and Cognitive Sciences, Medical and Health Sciences, and Medical prescription
There is a need to explore the dimensional and categorical phenotypes of criteria of opioid use disorder among frequent nonmedical users of prescription opioids (NMUPO) users. We used pooled data of 2011-2012 National Survey on Drug Use... more
There is a need to explore the dimensional and categorical phenotypes of criteria of opioid use disorder among frequent nonmedical users of prescription opioids (NMUPO) users. We used pooled data of 2011-2012 National Survey on Drug Use and Health to examine reliability and phenotypic variability in the diagnosis of OUD secondary to NMUPO in a nationally-representative sample of 18+ years-old frequent past-year NMUPO users (120+ days, n = 806). Through exploratory factor analysis (EFA) and latent class analysis (LCA), we examined 10 past-year OUD criteria. We examined associations between the latent classes and sociodemographic/psychiatric/NMUPO correlates. OUD criteria were unidimensional, and a three-class model was the overall best fitting solution for characterizing individuals into phenotypes along this unidimensional continuum: a "non-symptomatic class" (40.7%), "Tolerance-Time spent class" (29.0%) with high probability of endorsing Tolerance/Time Spent cri...
Research Interests: Psychiatry, Adolescent, Medicine, Prescription drug misuse, Humans, and 15 moreChild, Female, Male, Psychological Intervention, Young Adult, Adult, Age Factors, Health surveys, Psychiatric, Psychiatric Status Rating Scales, Surveys and Questionnaires, Psychology and Cognitive Sciences, Latent class model, Medical and Health Sciences, and Medical prescription
Research Interests: Psychiatry, Epidemiology, Injury Prevention, Adolescent, Medicine, and 15 moreComorbidity, Humans, Substance Abuse, Child Abuse, United States, Female, Male, Drug abuse, Psychological Trauma, Poison Control, Adolescent Behavior, Psychology and Cognitive Sciences, Prescription Drug, Medical and Health Sciences, and Medical prescription
Twenty-three states and the District of Columbia have passed laws implementing medical marijuana programs. The nineteen programs that were in operation as of October 2014 collectively had over one million participants. All states... more
Twenty-three states and the District of Columbia have passed laws implementing medical marijuana programs. The nineteen programs that were in operation as of October 2014 collectively had over one million participants. All states (including D.C.) with medical marijuana laws require physicians directly or indirectly to authorize the use of marijuana at their discretion, yet little is known about how medical marijuana programs vary regarding adherence to basic principles of medical practice and associated rates of enrollment. To explore this, we analyzed marijuana programs according to seven components of traditional medical care and pharmaceutical regulation. We then examined enrollment rates, while controlling for potentially confounding state characteristics. We found that fourteen of the twenty-four programs were nonmedical and collectively enrolled 99.4 percent of participants nationwide, with enrollment rates twenty times greater than programs deemed to be "medicalized.&quo...