Citation

Compton WM, Dawson DA, Conway KP, Brodsky M, Grant BF. Am. J. Psychiatry 2013; 170(6): 660-670.

Copyright

(Copyright © 2013, American Psychiatric Association)

DOI

10.1176/appi.ajp.2012.12060737

PMID

unavailable

Abstract

OBJECTIVE: The authors examined 3-year transitions among nonuse, asymptomatic use, and problem use of illicit drugs for U.S. adults in the general household population.

METHOD: Data were from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions, a study of 34,653 adults interviewed twice, 3 years apart. Respondents were categorized on three mutually exclusive categories of baseline drug status: past-year nonusers (N=32,675), past-year asymptomatic drug users (N=861), and past-year symptomatic drug users (N=1,117). Symptomatic drug use, or problem use, was defined as presence of one or more symptoms that operationalize DSM-IV drug abuse and dependence criteria. The authors assessed sociodemographic, health, substance use, and psychiatric covariates for association with 3-year transitions to different status categories.

RESULTS: Among baseline nonusers, 95.4% continued to be nonusers at follow-up, 2.1% became asymptomatic users, and 2.5% developed problem use. Among baseline asymptomatic users, 66.6% had stopped using drugs at follow-up, 14.3% continued to be asymptomatic users, and 19.1% had developed problem use. Nearly half (49.0%) of those with problem use at baseline had stopped using drugs at follow-up, 10.9% had transitioned to asymptomatic use, and 40.1% continued to have problem use. Younger age, male sex,white race, and not beingmarriedwere associated with progression fromnonuse to use or problem use, as were alcohol and tobacco use and disorders, major depression, and schizotypal, borderline, and narcissistic personality disorders. Panic disorder and avoidant personality disorder were associated with less progression.

CONCLUSIONS: Transitions in drug use status are common. The finding that alcohol and tobacco variables and co-occurring psychopathology are important correlates of transitions suggests the value of addressing all co-occurring disorders and substance use in patient assessments and treatment planning, both to prevent adverse transitions and to promote positive transitions.

Keywords: Cannabis impaired driving; DUID; Ethanol impaired driving

Language: en

Keywords

Adult; Humans; Female; Male; Middle Aged; United States; adult; age; human; Alcohol Drinking; Prospective Studies; Age Factors; Sex Factors; female; male; Substance-Related Disorders; mental disease; alcohol abuse; cannabis; amphetamine; smoking; article; drinking behavior; middle aged; major clinical study; major depression; priority journal; addiction; disease association; opiate; sex difference; cocaine; psychedelic agent; prospective study; tobacco dependence; Smoking; drug traffic; asymptomatic disease; Asymptomatic Diseases; avoidant personality disorder; borderline state; correlation analysis; diamorphine; DSM-IV; ethnic difference; follow up; marriage; Mental Disorders; narcissism; panic; patient assessment; sedative agent; solvent; tranquilizer; treatment planning