In an analysis of toxicology reports from fatal car accidents published in the American Journal of Epidemiology, Guohua Li, found that one in eight drivers tested positive for the drug — up three-fold from a decade ago. A study published in the journal Accident Analysis & Prevention, found that relative to drivers who tested positive for neither alcohol nor drugs, the odds of a fatal crash climbed 13-fold for drivers testing for alcohol alone, but 24 times for those positive for both alcohol and marijuana. Whether or not the driver was high was unknown — marijuana lingers in the system for days — but it does point to the fact that the driver uses marijuana. In the future Li says, a breathalyzer-type device might provide more accurate information on intoxication.
But the notion that alcohol is more dangerous than marijuana should be subjected to rigorous scrutiny and requires important qualification, argues Li, a professor of Epidemiology. "Although alcohol is more addictive and more impairing to cognitive functions than marijuana, moderate alcohol consumption may confer significant health benefits," he says. Whether marijuana has a similar upside remains to be seen. And there is always potential for its misuse. Says Li, "There is no such thing as safe substance abuse, regardless of the drugs involved."
10 percent of US adults have drug use disorder at some point in their lives, the NIH reports
75 percent report not receiving any form of treatment
"Based on these findings, more than 23 million adults in the United States have struggled with problematic drug use," said George F. Koob, Ph.D., NIAAA director. "Given these numbers, and other recent findings about the prevalence and under-treatment of alcohol use disorder in the US, it is vitally important that we continue our efforts to understand the underlying causes of drug and alcohol addiction, their relationship to other psychiatric conditions and the most effective forms of treatment."
A diagnosis of drug use disorder is based on a list of symptoms including craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer uses the terms abuse and dependence. Instead, DSM-5 uses a single disorder which is rated by severity (mild, moderate, and severe) depending on the number of symptoms met. Individuals must meet at least two of 11 symptoms to be diagnosed with a drug use disorder.
This includes the problematic use of amphetamines, marijuana, club drugs (e.g., ecstasy, ketamine, methamphetamine), cocaine, hallucinogens, heroin, non-heroin opioids (e.g., oxycodone, morphine), sedatives/tranquilizers, and solvents/inhalants. Face-to-face interviews were conducted to diagnose drug use disorder, as well as alcohol use disorder, nicotine use disorder, and various personality disorders.
The study, based on NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), found that drug use disorder was more common among men, white and Native American individuals, and those who are single or no longer married. Younger individuals and those with lower income and education levels were also at greater risk. Regional differences were found as well, with those living in the 13 Western-most states in the U.S. (including Alaska and Hawaii) more likely to have drug use disorder during their lives.
The study was led by Dr. Bridget Grant, Ph.D., Ph.D., (doctorates in psychology and epidemiology), of the NIAAA Laboratory of Epidemiology and Biometry. Dr. Grant’s lab conducts NESARC, a series of national epidemiological surveys that evaluate alcohol use, drug use and related psychiatric conditions. More than 36,000 people were evaluated using DSM-5 criteria. The study currently appears online in the Journal of the American Medical Association (JAMA) Psychiatry.
Similar to past research, the present study showed that people with drug use disorder were significantly more likely to have a broad range of psychiatric disorders, including mood, anxiety, post-traumatic stress and personality disorders. Individuals with drug use disorder in the past year were 1.3 times as likely to experience clinical depression, 1.6 times as likely to have post-traumatic stress disorder (PTSD) and 1.8 times as likely to have borderline personality disorder, when compared to people without drug use disorder. Drug use disorder was also linked to both alcohol and nicotine use disorder, with a three-fold increase in risk.
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