Alcohol confounds relationship between cannabis misuse and psychosis conversion in a high-risk sample

Acta Psychiatrica Scandinavica, January 2015

Objective:
Cannabis use has been examined as a predictor of psychosis in clinical high-risk (CHR) samples, but little is known about the impact of other substances on this relationship.

Method:
Substance use was assessed in a large sample of CHR participants (N = 370, mean age = 18.3) enrolled in the multisite North American Prodrome Longitudinal Study Phase 1 project. Three hundred and forty-one participants with cannabis use data were divided into groups: No Use (NU, N = 211); Cannabis Use without impairment (CU, N = 63); Cannabis Abuse/Dependence (CA/CD, N = 67). Participants (N = 283) were followed for ≥2 years to determine psychosis conversion.

Results:
Alcohol (45.3%) and cannabis (38.1%) were the most common substances. Cannabis use groups did not differ on baseline attenuated positive symptoms. Seventy-nine of 283 participants with cannabis and follow-up data converted to psychosis. Survival analysis revealed significant differences between conversion rates in the CA/CD group compared with the No Use (P = 0.031) and CU group (P = 0.027). CA/CD also significantly predicted psychosis in a regression analysis, but adjusting for alcohol use weakened this relationship.

Conclusion:
The cannabis misuse and psychosis association was confounded by alcohol use. Non-impairing cannabis use was not related to psychosis. Results highlight the need to control for other substance use, so as to not overstate the cannabis/psychosis connection.

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Alcohol calorie content: Labels needed, say doctors

BBC News, 31 October 2014

Alcohol should have a calorie content label in order to reduce obesity, according to public health doctors…

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“I think you need to show someone what help there is: Understanding parental alcohol misuse at a local level

Children’s Commissioner, October 2014

This study was commissioned to investigate gaps in knowledge highlighted through Silent Voices (Adamson and Templeton, 2012), a review into supporting children and young people affected by parental alcohol misuse. The present study engaged with three local areas in order to learn about the challenges and the ways forward for improvements in meeting the needs of children and young people.  The project aims to identify and promote good practice in response to the needs of affected children and their families, with key questions as to how local areas can discover the extent and need among children and young people and how services, including universal provision, can best respond.

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Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study

BMJ, 30 September 2014

An article to evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. 

The results of the study show that the proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45p minimum unit price. Below cost selling is estimated to reduce harmful drinkers’ mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health—saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45p minimum unit price is estimated to save 624 deaths and 23 700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers.

The study concludes that the ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at expected levels between 40p and 50p per unit, is estimated to have an approximately 40-50 times greater effect.

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Ambitious for recovery: tackling drug and alcohol addiction in the UK

The King’s Fund Blog, 21 August 2014

Centre for Social Justice – This report outlines and forecasts addiction problems in the UK and warns that deaths linked to ‘legal highs’ could overtake those linked to heroin by 2016. Amongst some of the recommendations suggested is a ‘treatment tax’ which should be added to the cost of alcohol in shops to fund a new generation of rehabilitation centres…

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All Party Parliamentary Group on Alcohol Misuse manifesto 2015

The King’s Fund, 11 August 2014

All-Party Parliamentary Group on Alcohol Misuse – This manifesto calls for the introduction of key measures to effectively reduce alcohol-related harm and demands that political parties of all colours recognise the personal, social and financial costs associated with alcohol misuse today. Key measures include, greater investment in treatment, stronger advertising regulation to protection children and young people and minimum unit…

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