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

Author(s):Show less -

Bharat, Chrianna ^[1] ; Glantz, Meyer D. ^[2] ; Sampson, Nancy A. ^[3] ; Andrade, Laura H. ; Cia, Alfredo ^[4] ; De Jonge, Peter ^{[5, 6]} ; Harris, Meredith G. ^{[7, 8]} ; He, Yanling ^[9] ; Lasebikan, Victor ^[10] ; Medina-Mora, Maria Elena ^[11] ; Scott, Kate ; Tachimori, Hisateru ^[12] ; Tintle, Nathan ^[13] ; Aguilar-Gaxiola, Sergio ^[14] ; Al-Hamzawi, Ali ^[15] ; Al-Kaisy, Mohammed Salih ^[16] ; Alonso, Jordi ^{[17, 18, 19, 20, 21]} ; Andrade, Laura Helena ^[22] ; Benjet, Corina ^[23] ; Borges, Guilherme ^[24] ; Bromet, Evelyn J. ^[25] ; Bruffaerts, Ronny ^[26] ; Bunting, Brendan ^[27] ; Caldas de Almeida, Jose Miguel ^{[28, 29]} ; Cardoso, Graca ^{[30, 31]} ; Chatterji, Somnath ^[32] ; Cia, Alfredo H. ^[4] ; Degenhardt, Louisa ^[1] ; Demyttenaere, Koen ^[33] ; Fayyad, John ; Florescu, Silvia ^[34] ; de Girolamo, Giovanni ^[35] ; Gureje, Oye ^[36] ; Haro, Josep Maria ^[37] ; Hinkov, Hristo ^[38] ; Hu, Chi-yi ^[38] ; de Jonge, Peter ^[5] ; Karam, Aimee Nasser ^[39] ; Karam, Elie G. ^{[40, 41, 39]} ; Kawakami, Norito ^[42] ; Kessler, Ronald C. ^[3] ; Kiejna, Andrzej ^{[43, 44]} ; Kovess-Masfety, Viviane ^[45] ; Lee, Sing ^[46] ; Lepine, Jean-Pierre ^{[47, 48, 49]} ; Levinson, Daphna ^[50] ; McGrath, John ^{[51, 52]} ; Elena Medina-Mora, Maria ; Mneimneh, Zeina ^[53] ; Moskalewicz, Jacek ^[54] ; Navarro-Mateu, Fernando ^{[55, 56, 19]} ; Pennell, Beth-Ellen ^[53] ; Piazza, Marina ^{[57, 58]} ; Posada-Villa, Jose ^[57] ; Scott, Kate M. ^[59] ; Slade, Tim ^[1] ; Carlos Stagnaro, Juan ^[60] ; Stein, Dan J. ^{[61, 62, 63, 64]} ; ten Have, Margreet ^[65] ; Torres, Yolanda ^[66] ; Viana, Maria Carmen ^[67] ; Whiteford, Harvey ^[68] ; Williams, David R. ^[69] ; Wojtyniak, Bogdan ^[70] ; Col, WHO World Mental Hlth Survey

Affiliation:Show less -

^[1] Univ New South Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW - Australia

^[2] Natl Inst Drug Abuse, Dept Epidemiol Serv & Prevent Res, NIH, Bethesda, MD - USA

^[3] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA 02115 - USA

^[4] Anxiety Disorders Ctr, Buenos Aires, DF - Argentina

^[5] Univ Med Ctr Groningen, Dept Psychiat, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen - Netherlands

^[6] Univ Groningen, Dept Psychol, Dev Psychol, Groningen - Netherlands

^[7] Univ Queensland, Sch Publ Hlth, Brisbane, Qld - Australia

^[8] Pk Ctr Mental Hlth, Queensland Ctr Mental Hlth Res, Brisbane, Qld - Australia

^[9] Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Shanghai - Peoples R China

^[10] Univ Ibadan, Coll Med, Dept Psychiat, Ibadan - Nigeria

^[11] Natl Inst Psychiat Ramon Fuente Muniz, Mexico City, DF - Mexico

^[12] Natl Ctr Neurol & Psychiat, Natl Inst Mental Hlth, Kodaira, Tokyo - Japan

^[13] Dordt Coll, Dept Math Stat & Comp Sci, Sioux Ctr, IA - USA

^[14] Univ Calif Davis, Ctr Reducing Hlth Dispar, Hlth Syst, Sacramento, CA 95817 - USA

^[15] Al Qadisiya Univ, Coll Med, Diwaniya Governorate - Iraq

^[16] Ibn Seena Teaching Hosp, Day Care & Rehabil Ctr, Mosul - Iraq

^[17] Pompeu Fabra Univ, Barcelona - Spain

^[18] Ctr Invest Biomed Red Epidemiol & Salud Publ, Barcelona - Spain

^[19] Ctr Invest Biomed ERed Epidemiol & Salud Publ, Murcia - Spain

^[20] Inst Hosp del Mar Invest Med, Hlth Serv Res Unit, Barcelona - Spain

^[21] Hosp del Mar, Med Res Inst, Hlth Serv Res Unit, Barcelona - Spain

^[22] Univ Sao Paulo, Med Sch, Sect Psychiat Epidemiol, Inst Psychiat, Lab Invest Med 23, Sao Paulo - Brazil

^[23] Natl Inst Psychiat Ramon Fuente, Dept Epidemiol & Psychosocial Res, Mexico City, DF - Mexico

^[24] Inst Nacl Psiquiatria, Calzada Mexico Xochimilco 101, Mexico City, DF - Mexico

^[25] SUNY Stony Brook, Dept Psychiat, Sch Med, Stony Brook, NY 11794 - USA

^[26] Katholieke Univ Leuven, Univ Psychiatr Centrum, Leuven - Belgium

^[27] Ulster Univ, Sch Psychol, Coleraine, Londonderry - North Ireland

^[28] Univ Nova Lisboa, Fac Ciencias Med, Dept Mental Hlth, Lisbon - Portugal

^[29] Univ Nova Lisboa, Chron Dis Res Ctr, Lisbon - Portugal

^[30] NOVA Univ Lisbon, NOVA Med Sch, Lisbon Inst Global Mental Hlth, Lisbon - Portugal

^[31] NOVA Univ Lisbon, NOVA Med Sch, Chron Dis Res Ctr, Lisbon - Portugal

^[32] WHO, Dept Informat Evidence & Res, Geneva - Switzerland

^[33] Katholieke Univ Leuven, Univ Hosp Gasthuisberg, Dept Psychiat, Leuven - Belgium

^[34] Natl Sch Publ Hlth Management & Dev, Bucharest - Romania

^[35] IRCCS Ist Ctr San Giovanni Dio Fatebenefratelli, Brescia - Italy

^[36] Univ Coll Hosp, Dept Psychiat, Ibadan - Nigeria

^[37] Univ Barcelona, Ctr Invest Biomed Red Salud Mental, Parc Sanitari St Joan de Deu, Barcelona - Spain

^[38] Natl Ctr Publ Hlth & Analyses, Sofia - Bulgaria

^[39] Inst Dev Res Advocacy & Appl Care, Beirut - Lebanon

^[40] Balamand Univ, Fac Med, Dept Psychiat & Clin Psychol, Beirut - Lebanon

^[41] St George Hosp Univ, Med Ctr, Dept Psychiat & Clin Psychol, Beirut - Lebanon

^[42] Univ Tokyo, Sch Publ Hlth, Dept Mental Hlth, Tokyo - Japan

^[43] Wroclaw Med Univ, Wroclaw - Poland

^[44] Univ Lower Silesia, Wroclaw - Poland

^[45] Paris Descartes Univ, Ecole Hautes Etud Sante Publ, EA 4057, Paris - France

^[46] Chinese Univ Hong Kong, Dept Psychiat, Tai Po, Hong Kong - Peoples R China

^[47] Hop Lariboisiere Fernand Widal, AP HP, Paris - France

^[48] Univ Paris Descartes Paris Diderot, Paris - France

^[49] Inst Natl Sante & Rech Med, UMR S 1144, Paris - France

^[50] Minist Hlth, Mental Hlth Serv, Jerusalem - Israel

^[51] Univ Queensland, Queensland Brain Inst, St Lucia, Qld - Australia

^[52] Aarhus Univ, Natl Ctr Register based Res, Aarhus - Denmark

^[53] Univ Michigan, Inst Social Res, Survey Res Ctr, Ann Arbor, MI - USA

^[54] Inst Psychiat & Neurol, Warsaw - Poland

^[55] Serv Murciano Salud, Unidad Docencia Invest & Formac Salud Mental, Murcia - Spain

^[56] Inst Murciano Invest Biosanitaria Virgen Arrixaca, Murcia - Spain

^[57] Colegio Mayor Cundinamarca Univ, Fac Social Sci, Bogota - Colombia

^[58] Univ Peruana Cayetano Heredia, Lima - Peru

^[59] Univ Otago, Dept Psychol Med, Dunedin, Otago - New Zealand

^[60] Univ Buenos Aires, Fac Med, Dept Psiquiatria & Salud Mental, Buenos Aires, DF - Argentina

^[61] Univ Cape Town, Dept Psychiat & Mental Hlth, Cape Town - South Africa

^[62] Univ Cape Town, South African Med Council Res Unit Risk & Resilie, Dept Psychiat & Mental Hlth, Neurosci Inst, Cape Town - South Africa

^[63] Groote Schuur Hosp, Cape Town - South Africa

^[64] Univ Cape Town, South African Med Council Res Unit Risk & Resilie, Cape Town - South Africa

^[65] Netherlands Inst Mental Hlth & Addict, Trimbos Inst, Utrecht - Netherlands

^[66] CES Univ, Ctr Excellence Res Mental Hlth, Medellin - Colombia

^[67] Univ Fed Espirito Santo, Postgrad Program Publ Hlth, Dept Social Med, Vitoria - Brazil

^[68] Queensland Ctr Mental Hlth Res, Brisbane, Qld - Australia

^[69] Harvard TH Chan Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA - USA

^[70] Natl Inst Hyg, Natl Inst Publ Hlth, Ctr Monitoring & Analyses Populat Hlth, Warsaw - Poland

• Document type: Journal article
• Source: JAMA PSYCHIATRY; v. 76, n. 7, p. 708-720, JUL 2019.
• Web of Science Citations: 1

Abstract

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. (AU)

• FAPESP's process: 03/00204-3 - Epidemiological study of psychiatric disorders in the São Paulo Metropolitan Region: prevalence, risk factors, and social and economical burden
• Grantee: Laura Helena Silveira Guerra de Andrade
• Support Opportunities: Research Projects - Thematic Grants