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      Multiple Substance Use Disorders and Self-Reported Cognitive Function in U.S. Adults: Associations and Sex-Differences in a Nationally Representative Sample

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          Abstract

          Polysubstance use is a growing public health concern that has been associated with poor clinical outcomes. Compared to single-drug users, this population suffers greater deficits in cognitive function, which hinder treatment success and recovery. Despite its high prevalence and poor prognosis, epidemiological research on polysubstance use and accompanying cognitive profile is lacking. We investigated associations between numbers of past-year co-occurring substance use disorders (SUDs) and self-reported cognitive function using data from the National Epidemiologic Survey for Alcohol and Related Conditions III (NESARC-III). Regression analyses revealed a significant negative association between cognitive scores and numbers of past-year SUDs, which was moderated by sex. After adjusting for confounding variables, greater numbers of SUDs were associated with declining self-reported cognitive function, and this relationship was stronger among females. Our findings expand on current literature on cognitive impairments among polysubstance users and provide a novel, nuanced description of this relationship among the general population. We highlight the need for targeted and individualized treatment approaches in order to improve outcomes in this population.

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          Most cited references53

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          Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III.

          National epidemiologic information from recently collected data on the new DSM-5 classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed.
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            Analysis of Complex Survey Samples

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              Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions–III

              Objective Attitudes towards marijuana are changing, the prevalence of DSM-IV cannabis use disorder has increased, and DSM-5 modified the diagnostic criteria for cannabis use disorders. Therefore, updated information is needed on the prevalence, demographic characteristics, psychiatric comorbidity, disability and treatment for DSM-5 cannabis use disorders in the US adult population. Method In 2012–2013, a nationally representative sample of 36,309 participants ≥18 years were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Psychiatric and substance use disorders were assessed using the Alcohol Use Disorders and Associated Disabilities Interview Schedule-5. Results Prevalence of 12-month and lifetime marijuana use disorder was 2.5% and 6.3%. Among those with 12-month and lifetime marijuana use disorder, marijuana use was frequent; mean days used per year was 225.3 (SE=5.69) and 274.2 (SE=3.76). Odds of 12-month and lifetime marijuana use disorder were higher for men, Native Americans, those unmarried, with low incomes, and young adults, (e.g., OR=7.2, 95% CI 5.5–9.5 for 12-month disorder among those 18–24 years compared to those ≥45 years). Marijuana use disorder was associated with other substance disorders, affective, anxiety and personality disorders. Twelve-month marijuana use disorder was associated with disability. As disorder severity increased, virtually all associations became stronger. Only 24.3% with lifetime marijuana use disorder participated in 12-step programs or professional treatment. Conclusions DSM-5 marijuana use disorder is prevalent, associated with comorbidity and disability, and often untreated. Findings suggest the need to improve prevention methods, and educate the public, professionals and policy makers about the harms associated with marijuana use disorders and available interventions.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                11 January 2022
                2021
                : 12
                Affiliations
                [1] 1Translational Addiction Research Laboratory, Centre for Addiction and Mental Health , Toronto, ON, Canada
                [2] 2Department of Pharmacology and Toxicology, University of Toronto , Toronto, ON, Canada
                [3] 3Department of Psychiatry, Faculty of Medicine, University of Toronto , Toronto, ON, Canada
                [4] 4Child and Youth Mental Health Division, Centre for Addiction and Mental Health , Toronto, ON, Canada
                [5] 5Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health , Toronto, ON, Canada
                [6] 6Department of Psychiatry, King Abdul-Aziz University , Jeddah, Saudi Arabia
                [7] 7Biostatistics Core, Centre for Addiction and Mental Health , Toronto, ON, Canada
                [8] 8Departments of Family and Community Medicine, University of Toronto , Toronto, ON, Canada
                [9] 9Institute of Medical Science, University of Toronto , Toronto, ON, Canada
                Author notes

                Edited by: Saulo Gantes Tractenberg, Pontifical Catholic University of Rio Grande do Sul, Brazil

                Reviewed by: Felix Henrique Paim Kessler, Federal University of Rio Grande do Sul, Brazil; Ruben David Baler, National Institutes of Health (NIH), United States; Florence Vorspan, Université de Paris, France

                *Correspondence: Bernard Le Foll bernard.lefoll@ 123456camh.ca

                This article was submitted to Addictive Disorders, a section of the journal Frontiers in Psychiatry

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fpsyt.2021.797578
                8791062
                ede0a96c-6eca-4aa7-857f-f714381dbd68
                Copyright © 2022 Bourgault, Rubin-Kahana, Hassan, Sanches and Le Foll.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 53, Pages: 9, Words: 6874
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                polysubstance use,substance use disorder,cognition,sex differences,addiction

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