Are specific dependence criteria necessary for different substances: how can research on cannabis inform this issue?
ABSTRACT Research on cannabis dependence is used to comment on the similarities and differences among the substance dependence disorders, and to address the issue of whether specific versus generic substance dependence diagnostic criteria might offer the most fruitful approach to diagnosis. If cannabis dependence can be diagnosed and characterized adequately using the extant generic Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) dependence criteria, then one could argue that these diagnostic guidelines are valid and of high utility for substances with more well-accepted dependence syndromes.
A brief, selective critical review of research on cannabis withdrawal and on the validity and internal consistency of cannabis dependence as assessed via DSM criteria for cannabis dependence was performed.
Findings from these reports indicate that cannabis dependence is much more similar to than different from other types of substance dependence, even with regard to withdrawal. The generic DSM-IV dependence criteria can be applied fairly well to cannabis, and yield findings similar to that observed with other substance dependence disorders. However, across substances, the generic criteria may not discriminate cases in a manner consistent with the underlying constructs of abuse and dependence, and cross-substance differences probably exist in the general dependence severity level and specific symptom profiles.
The use of generic DSM-IV criteria appears to work as well for cannabis dependence as for other substances, yet the more important question might be as to whether we can do better by developing more sophisticated generic criteria or by using substance specific criteria.
Full-textDOI: · Available from: Alan Budney, May 30, 2015
SourceAvailable from: Wim van den BrinkAddiction 05/2007; 102(5). DOI:10.1111/j.1360-0443.2007.01819.x · 4.60 Impact Factor
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ABSTRACT: This study examined the response to cannabis withdrawal symptoms and use of quitting strategies to maintain abstinence in people with schizophrenia. A convenience sample of 120 participants with schizophrenia who had at least weekly cannabis use and a previous quit attempt without formal treatment were administered the 176-item Marijuana Quit Questionnaire to characterize their "most serious" (self-defined) quit attempt. One hundred thirteen participants had withdrawal symptoms, of whom 104 (92.0%) took some action to relieve a symptom, most commonly nicotine use (75%). 90% of withdrawal symptoms evoked an action for relief in a majority of participants experiencing them, most frequently anxiety (95.2% of participants) and cannabis craving (94.4%). 96% of participants used one or more quitting strategies to maintain abstinence during their quit attempt, most commonly getting rid of cannabis (72%) and cannabis paraphernalia (67%). Religious support or prayer was the quitting strategy most often deemed "most helpful" (15%). Use of a self-identified most helpful quitting strategy was associated with significantly higher one-month (80.8% vs. 73.6%) and one-year (54.9% vs. 41.3%) abstinence rates. Actions to relieve cannabis withdrawal symptoms in people with schizophrenia are common. Promotion of effective quitting strategies may aid relapse prevention.08/2013; 209(3). DOI:10.1016/j.psychres.2013.07.044
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ABSTRACT: We explore the factor structure of DSM-5 cannabis use disorders, examine its prevalence across European- and African-American respondents as well as its genetic underpinnings, utilizing data from a genome-wide study of single nucleotide polymorphisms (SNPs). We also estimate the heritability of DSM-5 cannabis use disorders explained by these common SNPs. Data on 3053 subjects reporting a lifetime history of cannabis use were utilized. Exploratory and confirmatory factor analyses were conducted to create a factor score, which was used in a genome-wide association analysis. p-values from the single SNP analysis were examined for evidence of gene-based association. The aggregate effect of all SNPs was also estimated using Genome-Wide Complex Traits Analysis. The unidimensionality of DSM-5 cannabis use disorder criteria was demonstrated. Comparing DSM-IV to DSM-5, a decrease in prevalence of cannabis use disorders was only noted in European-American respondents and was exceedingly modest. For the DSM-5 cannabis use disorders factor score, no SNP surpassed the genome-wide significance testing threshold. However, in the European-American subsample, gene-based association testing resulted in significant associations in 3 genes (C17orf58, BPTF and PPM1D) on chromosome 17q24. In aggregate, 21% of the variance in DSM-5 cannabis use disorders was explained by the genome-wide SNPs; however, this estimate was not statistically significant. DSM-5 cannabis use disorder represents a unidimensional construct, the prevalence of which is only modestly elevated above the DSM-IV version. Considerably larger sample sizes will be required to identify individual SNPs associated with cannabis use disorders and unequivocally establish its polygenic underpinnings.Drug and alcohol dependence 11/2013; 134. DOI:10.1016/j.drugalcdep.2013.11.008 · 3.28 Impact Factor