Novel phenotype issues raised in cross‐national epidemiological research on drug dependence

“…The result is a figure that resembles a dose-response or dose-effect curve from laboratory experiments designed so that dosage level or number of dosage days are "fixed effect" exogenous explanatory variables that are under the control of the experimenter. In truth, the variable on the x-axis in epidemiological research generally is an endogenous variable that is interdependent with the probability of being drug dependent, with likely feedback loops, as explained elsewhere (Anthony, 2010).…”

Section: Introductionmentioning

confidence: 99%

Transitioning from First Drug Use to Dependence Onset: Illustration of a Multiparametric Approach for Comparative Epidemiology

Vsevolozhskaya

Anthony

2015

Neuropsychopharmacol

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Studying transitions from first drug use (DU) to drug dependence (DD) onset, we estimate a parsimonious set of parameters based on epidemiological data, with plans for future longitudinal research on newly incident drug users and with tracking of self-administration frequencies and DD clinical features. Our expectation is a distinctive sigmoid pattern with one asymptote for lower DD probability (when DU is insubstantial), upturning slopes of DD risk beyond a middle value (PD50), and eventual higher DD risk asymptotes at higher DU frequencies. We illustrate this novel approach using cross-sectional data from the United States National Surveys on Drug Use and Health, 2002-2011. Empirical DD probabilities observed soon after newly incident use are estimated across DU frequency values, using parametric Hill functions and four governing parameters for differential comparison across drugs and DU subgroups. Among drug subtypes considered, cocaine shows larger estimates, especially among females (estimated P(min)=7% for females vs 3% for males; p<0.001), for whom PD50 is shorter by 8 days of use (p=0.027), conditional on the same rate of use in the past 30 days. Clear alcohol male-female differences also are observed (eg, female PD50 < male PD50; p=0.002). Although based on cross-sectional snapshots soon after DU onset, this novel multiparametric statistical approach for comparative epidemiological DD research creates new opportunities in planned studies with prospectively gathered longitudinal data. The cross-sectional estimates provide starting values needed to plan future longitudinal research programs on transitions from initial DU until formation of a DD syndrome.

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“…Whereas cannabis incidence estimates from prospective or longitudinal studies might be considered a gold standard, we note that this study’s incidence estimates are free of follow-up attrition biases and involve no measurement reactivity of the type that is faced when an individual is assessed repeatedly in a longitudinal design such that the answers in an earlier assessment can influence answers in a later assessment (Anthony, 2010). Finally, when compared to the information value of previous state-specific estimates for cannabis prevalence, this study’s use of the incidence parameter constrains potentially confounding influences of in-migration and out-migration after onsets have occurred (Lapouse, 1967).…”

Section: Discussionmentioning

confidence: 99%

Newly incident cannabis use in the United States, 2002–2011: a regional and state level benchmark

Leinweber

Cheng

López-Quintero

et al. 2017

PeerJ

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BackgroundCannabis use and cannabis regulatory policies recently re-surfaced as noteworthy global research and social media topics, including claims that Mexicans have been sending cannabis and other drug supplies through a porous border into the United States. These circumstances prompted us to conduct an epidemiological test of whether the states bordering Mexico had exceptionally large cannabis incidence rates for 2002–2011. The resulting range of cannabis incidence rates disclosed here can serve as 2002–2011 benchmark values against which estimates from later years can be compared.MethodsThe population under study is 12-to-24-year-old non-institutionalized civilian community residents of the US, sampled and assessed with confidential audio computer-assisted self-interviews (ACASI) during National Surveys on Drug Use and Health, 2002–2011 (aggregate n ∼ 420,000) for which public use datasets were available. We estimated state-specific cannabis incidence rates based on independent replication sample surveys across these years, and derived meta-analysis estimates for 10 pre-specified regions, including the Mexico border region.ResultsFrom meta-analysis, the estimated annual incidence rate for cannabis use in the Mexico Border Region is 5% (95% CI [4%–7%]), which is not an exceptional value relative to the overall US estimate of 6% (95% CI [5%–6%]). Geographically quite distant from Mexico and from states of the western US with liberalized cannabis policies, the North Atlantic Region population has the numerically largest incidence estimate at 7% (95% CI [6%–8%]), while the Gulf of Mexico Border Region population has the lowest incidence rate at 5% (95% CI [4%–6%]). Within the set of state-specific estimates, Vermont’s and Utah’s populations have the largest and smallest incidence rates, respectively (VT: 9%; 95% CI [8%–10%]; UT: 3%; 95% CI [3%–4%]).DiscussionBased on this study’s estimates, among 12-to-24-year-old US community residents, an estimated 6% start to use cannabis each year (roughly one in 16). Relatively minor variation in region-wise and state-level estimates is seen, although Vermont and Utah might be exceptional. As of 2011, proximity to Mexico, to Canada, and to the western states with liberalized policies apparently has induced little variation in cannabis incidence rates. Our primary intent was to create a set of benchmark estimates for state-specific and region-specific population incidence rates for cannabis use, using meta-analysis based on independent US survey replications. Public health officials and policy analysts now can use these benchmark estimates from 2002–2011 for planning, and in comparisons with newer estimates.

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Novel phenotype issues raised in cross‐national epidemiological research on drug dependence

Cited by 25 publications

References 38 publications

Extramedical Use of Prescription Pain Relievers by Youth Aged 12 to 21 Years in the United States

Extramedical Use of Prescription Pain Relievers by Youth Aged 12 to 21 Years in the United States

Transitioning from First Drug Use to Dependence Onset: Illustration of a Multiparametric Approach for Comparative Epidemiology

Newly incident cannabis use in the United States, 2002–2011: a regional and state level benchmark

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