Mortality risk in a cohort of subjects reported by authorities for cannabis possession for personal use. Results of a longitudinal study.

OBJECTIVE: to study mortality risk in a cohort of cannabis consumers. DESIGN: longitudinal study on a cohort of 2,511 subjects reported to the Drug Addiction Control Force (DACF) for cannabis possession for personal use between 1990 and 2004 residents in the metropolitan area of Bologna. METHODS: to identify people already treated for drug dependence, the cohort was linked with the clinical archive of the public treatment centers for drug addiction (PTC) in the metropolitan area of Bologna and the results were separated into PTC clients (subjects in treatment at a PTC, all heroin users) and non-PTC clients (subjects not in treatment at a PTC, no knowledge regarding other illicit drugs being used besides cannabis). RESULTS: an excess of mortality was observed for all causes in the cohort compared to the general population, both among PTC clients (SMR 14.61 CI 95% 9.21-23.19) and non-clients (SMR 2.43 CI 95% 1.67-3.55). Among PTC clients the highest and most statistically significant SMRs were for overdose, suicide, and AIDS. Among non PTC clients there was an excess for traffic accidents and overdose. CONCLUSION: the results of the study show an elevated risk of death for consumers of cannabis, a percentage of which probably also consumed other substances, and a very few which presented themselves for treatment at a public drug treatment center

Uno studio sulla mortalit\ue0 dei soggetti segnalati alla Prefettura per uso di cannabis

studio epidemiologico sulla mortalit\ue0 dei soggetti abusatori di cannabis e seganalati alla prefettura. confronto tra soggetti con sola cannabis e soggetti con poliabuso. I risultati dello studio evidenziano un elevato rischio di decesso per i consumatori di cannabis

Determinants of Seeking Treatment for Cocaine Abuse: A Case-Control Study

The objective of this study, which targeted long-term socially integrated cocaine users (in powder form, no heroin), was to analyze potential determinants of request for treatment for primary cocaine abuse. Two hundred and twenty-three cases (users who sought treatment for primary cocaine abuse) and 223 controls (users who did not seek treatment) were interviewed in Italy. A semistructured interview was created. Conditional logistic regression models were used. Cases had begun consuming illicit substances later, started using cocaine quicker, had high-risk drinking habits, had more intense recent use of cocaine, and used alone and at work. Some of the motivations of use that characterize subjects who seek treatment (to experience a 'high', disinhibition, avoidance, and to feel more confident) seem specifically to obtain immediate gratification, without concern for future consequences. Variability in cocaine abusers seeking treatment has been a long-recognized feature of this population and the results show that the appropriate target population (cocaine users experiencing problems and using more frequently) is reached by treatment services

Differences between subjects with socially integrated drug use: a study in Italy and Portugal

Background: Italian and Portuguese drug policies are similar\u2013demand reduction\u2013but the law seems to be applied quite differently: Italian law pays particular attention to decreasing substance use, while the Portuguese legal framework focuses on health-related issues rather than legal aspects. Methods: To describe national differences in terms of phenomenology of substances use, feared/unwanted consequences and most common rules to avoid harms, 44 Italian and 44 Portuguese drug users who have never been referred to specialist treatment services and had recently used an illegal substance over the previous year on a weekly basis were interviewed. A questionnaire was used, with different scales. Results: All participants are afraid of suffering from psychological disorders and physical problems, of having money-related problems and of being stigmatized as a consequence of drug use. The Portuguese individuals mostly fear opiate overdoses, while the Italians fear having problems with the law and being caught in possession of the substance. Conclusions: We observe a different way of perceiving and applying the drug legislation that determines particular attitudes and precaution among drug users at the national level

Identification of harmful drinking in subjects who have had their driving license suspended due to alcohol use: a retrospective Italian study

OBJECTIVE: Early identification of Harmful Drinking (HD) is difficult, and underestimated. The aim of our retrospective study was to investigate the presence of HD in a population of subjects who had their driving license suspended due to driving under the influence of alcohol. MATERIALS AND METHODS: We retrospectively recruited 979 subjects. During the first appointment (T0), clinical and laboratory characteristics of patients were evaluated, and the AUDIT questionnaire was administered. Two groups were then defined: Harmful Drinking (HD) and non-HD, and all subjects underwent a brief interview for 5-10 minutes before being assigned to a group. RESULTS: 95.9% of our sample were identified as non-HD, whereas 4.1% of them were HD; twenty-one (2.1%) of the HD underwent a control appointment (T1), and 17 (1.7%) of them were diagnosed with alcohol use disorder (AUD); there was a statistically significant reduction in mean daily alcohol intake (p<0.009), and in the mean values of the blood markers of HD between T0 and T1 in HD. CONCLUSIONS: The present study shows that 4.1%, and 1.7% of subjects presented a diagnosis of HD and AUD, respectively, and their entry in a protocol of drinking monitoring proved beneficial in reducing alcohol intake. Thus, the implementation of strict surveillance of subjects found driving under the influence of alcohol involving a network of professional figures (from police forces to specialists in alcohol addiction treatment) may help to detect and to treat subjects with HD and AUD, and to monitor their alcohol use over time