Anees BahjiThe University of Calgary · Department of Community Health Sciences
Anees Bahji
HBSc MD CISAM CCSAM DABPN FRCPC
About
197
Publications
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Introduction
Current research interests include addictions epidemiology, concurrent disorders, and health service use. Focus on learning diverse research methods, ranging from systematic reviews and meta-analyses to randomized controlled trials.
Additional affiliations
Education
July 2021 - June 2022
British Columbia Centre on Substance Use
Field of study
- Addiction Medicine
July 2020 - June 2021
July 2015 - June 2020
Publications
Publications (197)
In this invited commentary, we provide an overview of safer opioid supply (SOS) initiatives, specifically aiming to examine the evidence base for SOS programs and the ensuing implications for clinical practice, particularly in the context of psychiatric care.
Objective
To characterize mortality after hospital discharge in cohorts with and without anorexia nervosa (AN).
Methods
We obtained data for all hospitalizations for psychiatric reasons in Canada (except Quebec) between April 1, 2006, and March 31, 2021 ( n = 1.3 million admissions). Cases of AN were identified using ICD‐10 (F50.0 and F50.1) codes...
Background
The Canadian Network for Mood and Anxiety Treatments (CANMAT) last published clinical guidelines for the management of major depressive disorder (MDD) in 2016. Owing to advances in the field, an update was needed to incorporate new evidence and provide new and revised recommendations for the assessment and management of MDD in adults.
M...
Importance
Several factors may place people with mental health disorders, including substance use disorders, at increased risk of experiencing homelessness and experiencing homelessness may also increase the risk of developing mental health disorders. Meta-analyses examining the prevalence of mental health disorders among people experiencing homele...
Objective: To evaluate the impact of depressive symptom severity on opioid use and treatment retention in individuals with prescription-type opioid use disorder (POUD).
Method: We analyzed data from a multi-centric, pragmatic, open-label, randomized controlled trial comparing buprenorphine/naloxone to methadone models of care in 272 individuals wi...
The co-occurrence of substance use disorders (SUDs) and psychiatric conditions, often referred to as comorbidity or concurrent disorders, presents intricate challenges in both diagnosis and treatment. This comprehensive narrative review aims to synthesize and critically evaluate the existing evidence surrounding the management of individuals with c...
The co-occurrence of substance use disorders (SUDs) and psychiatric conditions, often referred to as comorbidity or concurrent disorders, presents intricate challenges in both diagnosis and treatment. This comprehensive narrative review aims to synthesize and critically evaluate the existing evi-dence surrounding the management of individuals with...
Background: This study, conducted in October 2017 at two Canadian universities, aimed to explore the relationships between gender expression, protective coping strategies, alcohol saliency, and high-risk alcohol use. Methods: Validated scales were employed to assess these variables using survey data. Multivariate analyses were conducted to investig...
Background
The Canadian Society of Addiction Medicine La Societe medicale canadienne sur l’addiction Policy Committee created a task force to conduct a systematic review examining the effectiveness of involuntary treatment for individuals with substance use disorders (SUDs).
Methods
We followed Preferred Reporting Items for Systematic Reviews & Me...
Objective
We aimed to conduct a systematic review to identify curricular and educational interventions to build research competency among Canadian psychiatry residents and fellows transitioning to the competency-by-design framework.
Methods
The PRISMA guidelines were followed, searching five databases from their inception to February 2023 for rele...
Background: This study, conducted in October 2017 at two Canadian universities, aimed to explore the relationships between gender expression, protective coping strategies, alcohol saliency, and high-risk alcohol use. Methods: Validated scales were employed to assess these variables using survey data. Multivariate analyses were conducted to investig...
Amidst the opioid epidemic, harm reduction-oriented approaches have gained traction, including interventions that focus on prescribing pharmaceutical-grade psychoactive substances, such as opioids, instead of illicit versions, intending to mitigate fatal overdose risks arising from the variability in potency and additives found in illicit drugs. St...
Aim
To measure the association between cannabis use disorder (CUD) and adverse cardiovascular disease (CVD) outcomes.
Design and Setting
We conducted a matched, population‐based retrospective cohort study involving five linked administrative health databases from Alberta, Canada.
Participants
We identified participants with CUD diagnosis codes an...
Background:
Prescription-type opioid use disorder (POUD) is often accompanied by comorbid anxiety, yet the impact of anxiety on retention in opioid agonist therapy (OAT) is unclear. Therefore, this study investigated whether baseline anxiety severity affects retention in OAT and whether this effect differs by OAT type (methadone maintenance therap...
Background:
Intranasal esketamine has received regulatory approvals for the treatment of depression. Recently a large trial of repeated dose racemic ketamine also demonstrated efficacy in severe depression. However, uncertainties remain regarding comparative efficacy, dosage, and the time course of response.
Methods:
In this systematic review an...
Although the scientific community, particularly academic publishing, claims to be gender-neutral and based on meritocracy, it mirrors other parts of modern society, wherein residual gender imbalances and implicit and explicit gender biases are reproduced. In this report, we address gender imbalances (in particular, men’s over-representation) in the...
Background
Addiction Consult Services (ACS) have become an emergent clinical intervention for persons with substance use disorders (SUD) requiring hospital-based care. However, there have been few recent evaluations of the evidence for the effectiveness of ACS on SUD outcomes.
Objective
We aimed to assess the effectiveness of ACS for persons with...
Background
Involuntary treatment for adults not in the criminal justice system with substance use disorders (SUD) is controversial. Canadian governments recently have proposed involuntary treatment for adult nonoffenders with SUD based on their morbidity and mortality and impacts on public safety and health care utilization. However, the effectiven...
In 2018, Canada enacted the Cannabis Act, becoming only the second country (after Uruguay) to legalize the recreational consumption of cannabis. Although there is ongoing global disagreement on the risk-benefit profile of cannabis with increasing legalization in many parts of the world, the evidence of rising cannabis use prevalence postlegalizatio...
Background:
While substance use is common among medical students, there is limited research on this topic involving Canadian medical students or exploring its associations with professional outcomes. The present study examines the association between Canadian medical students' substance use and related counselling attitudes and practices, career s...
Objectives
Attention-deficit/hyperactivity disorder (ADHD) has its onset before 12 years but often persists into adulthood. Adult ADHD is overrepresented in persons with substance use disorders (SUD). Yet, diagnosis is challenging due to proneness to overdiagnosis, where substance use and other etiologies of attentional symptoms are misattributed t...
Smoking and tobacco use disorder (TUD) is highly prevalent among individuals with serious and persistent mental illness, particularly those with schizophrenia spectrum disorders. In this clinical case column, we highlight an encounter involving a successful initiation of bupropion for smoking cessation in an individual with schizophrenia. We also r...
Bothersome symptoms potentially related to drinking are commonly reported by people with and without HIV (PWH/PWoH). However, the relationship between bothersome symptoms and level of alcohol use is often not appreciated by patients or providers. Therefore, among persons reporting prior-year alcohol use, we assessed whether alcohol use level (AUDIT...
Background:
Antipsychotic medications are the mainstay of treatment for schizophrenia and are associated with a reduction in psychiatric hospitalization and overall mortality. Some evidence suggest that antipsychotic medications might have a varying effect on the improvement of comorbid substance use disorders (SUDs), with clozapine showing more f...
Aim
We undertook this systematic review to determine the efficacy and safety of cannabis-based medicine as a treatment for behavioral, psychological, and motor symptoms associated with neurocognitive disorders.
Methods
We conducted a PRISMA-guided systematic review to identify studies using cannabis-based medicine to treat behavioral, psychologica...
We present the case of a young man with acute-onset chest and back pain to the emergency department with what was initially thought to be a myocardial infarction complicated by mixed respiratory failure. However, several days into the admission, the patient disclosed using a substance known as “kratom,” a novel psychoactive substance with mu-opioid...
We thank the authors for submitting a recent letter to the editor about our meta-analysis on the comparative efficacy of racemic and esketamine for depression. We address their concerns point-by-point below.
Background
Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP rema...
Background
Cannabis withdrawal syndrome (CWS) is a recognized psychiatric disorder that can interfere with recovery from cannabis use disorder (CUD).
Objectives
To identify factors differentially associated with the prevalence of lifetime and past-year CWS.
Methods
We conducted a secondary analysis of a 2020 systematic literature review on the pr...
Background: While six U.S. states have already officially authorized cannabinoids to substitute opioids and treat opioid use disorder, the therapeutic benefits of cannabinoids remain unclear, especially when weighted against their adverse effects.
Methods: We conducted a systematic review of studies examining the association between opioid withdr...
Aims
To estimate temporal trends in cannabis consumption in the Canadian household population using national survey data and map changes in cannabis consumption postlegalization in 2018.
Methods
In a 2-step meta-analysis approach, we first analyzed each survey year separately by estimating the weighted past-year prevalence (%) of self-reported can...
Electroconvulsive therapy (ECT) is one of the most effective treatments for depression. However, significant stigma from the media and the antipsychiatry movement has biased the public toward ECT, leading to underutilization, particularly among those most in need. This report reviews some of the key historical events in the rise, fall, and resurgen...
Introduction
Unlike sex, the association between gender and high-risk drinking has been relatively understudied in post-secondary students. Gender expression may influence the use of protective coping strategies and beliefs about alcohol.
Objectives
This study evaluated associations between gender expression, protective coping strategies, beliefs...
The critical role of peer reviewers in the publishing process is examined. Examples of typical challenges are provided, including the relative lack of rewards for this important task. Particular attention is paid to the need to consider the diversity of the peer reviewers recruited and impediments to the selection beyond Areas of Competence, often...
Introduction
Polypharmacy is commonly associated with adverse health outcomes. There are currently no meta-analyses of the prevalence of polypharmacy or factors associated with polypharmacy. We aimed to estimate the pooled prevalence of polypharmacy and factors associated with polypharmacy in a systematic review and meta-analysis.
Methods
MEDLINE,...
Objective:
This article reviews research on post-acute alcohol withdrawal syndrome (PAWS) management.
Method:
We conducted a PRISMA (Preferred Reporting Items for Systematic Revision and Meta-Analyses)-guided scoping review of the published PAWS literature, searching six electronic databases (from their inception through December 2020) for Engli...
Objective:
This study aims to review the neurobiology and symptomatology of post-acute alcohol withdrawal syndrome (PAWS).
Method:
We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-guided systematic review of articles from two databases for English-language randomized and nonrandomized studies involving P...
Background: While English is only the native language of 7.3% of the world's population and less than 20% can speak the language, nearly 75% of all scientific publications are English. Aim: To describe how and why scientific contributions from the non-English-speaking world have been excluded from addiction literature, and put forward suggestions f...
Background:
We aimed to determine medications' comparative efficacy and safety for adults with alcohol use disorders.
Methods:
We searched eleven electronic data sources for randomized clinical trials with at least 4 weeks of treatment reporting on alcohol consumption (total abstinence and reduced heavy drinking), dropouts, and dropouts due to a...
Background: The association between cannabis use and HIV-1 RNA (viral load) among people with HIV (PWH) engaged in care is unclear. Methods: We used data collected from 2002 to 2018 on PWH receiving antiretroviral therapy (ART) enrolled in the Veterans Aging Cohort Study. Generalized estimating equations were used to estimate associations between s...
Background:
Racemic ketamine and esketamine have demonstrated rapid antidepressant effects. We aimed to review the efficacy and safety of racemic and esketamine for depression.
Research design and methods:
We conducted a PRISMA-guided review for relevant randomized controlled trials of racemic or esketamine for unipolar or bipolar major depressi...
Background and aim:
There have been few head-to-head clinical trials of pharmacotherapies for alcohol withdrawal (AW). We therefore aimed to evaluate the comparative performance of pharmacotherapies for AW.
Methods:
Six databases were searched for randomized clinical trials through November 2021. Trials were included after a blinded review by tw...
In the context of the US overdose crisis, improving access to medications for opioid use disorder is urgently needed. The Canadian model of methadone treatment, whereby clinicians can prescribe methadone for opioid use disorder in office-based settings and methadone can be dispensed through community pharmacies, offers a compelling model for adopti...
Background:
Psychotic disorders produce important morbidity and disability in children and adolescents. There have been few relevant treatment trials, encouraging assessment of research aimed at testing efficacy and safety of antipsychotics for juveniles. We aimed to compare the short- and long-term efficacy and safety of antipsychotics to treat p...
Aim: Individuals with eating disorders (EDs) may present with impulse control disorders (ICDs) and behavioral addictions (BAs), which may result in additional suffering and treatment resistance. However, the prevalence of ICDs and BAs in EDs has not been systematically examined. Therefore, this systematic review and meta-analysis aimed to assess th...
Aim: Individuals with anorexia nervosa (AN) often present with substance use and substance use disorders (SUDs). However, the prevalence of substance use and SUDs in AN has not been studied in-depth, especially the differences in the prevalence of SUDs between AN types [e.g., AN-R (restrictive type) and AN-BP (binge-eating/purge type]. Therefore, t...
A young adult presented to the emergency department (ED) for the fourth time in 6 months with intermittent abdominal pain, nausea, and vomiting. During previous visits, cannabis use history was not obtained, and after undergoing a basic medical examination and receiving supportive treatment, the patient had been discharged without a diagnosis.
INTRODUCTION: Polypharmacy is common associated with several adverse health outcomes. There are currently no systematic reviews or meta-analyses on the prevalence of polypharmacy and associated factors. We aimed to identify population-based observational studies reporting on the prevalence of polypharmacy and factors associated with polypharmacy.
M...
This cross-sectional study investigates the national prevalence of tobacco, alcohol, cannabis, and nonmedical prescription stimulant use among Canadian medical students.
Background:
Individuals with severe and persistent mental illness (SPMI) have a higher risk of contracting COVID-19 than individuals without SPMI. In combination with physical distancing, hygiene protocols, and vaccines, quarantine and self-isolation are primary means of viral containment. However, individuals with SPMI may experience more difficu...
The relationship between psychiatry and spirituality, particularly in organised religion, has been a controversial one. However, in recent years, the association has slowly transformed into an increasingly positive bond. Yet, one of the world’s newest independent religions—the Bahá’í Faith—is mostly unknown to many clinicians. This is particularly...
Background
Globally, depression impacts nearly 300 million people, and roughly half do not achieve remission with standard first-line therapies. For such individuals, augmentation strategies are often helpful at reducing the severity of depression. While there are many potential adjunctive medication choices, psychostimulants are among the more con...
Background:
Emerging epidemiological evidence suggests an association between cannabis use and bipolar disorder (BD). To date, the prevalence of comorbid cannabis use disorder (CUD) has not been well described, nor has the association between CUD and the clinical course of BD.
Aim:
To estimate the prevalence of CUD comorbidity among individuals...
Despite increased awareness of the prevalence and burden of substance use disorders, there is limited access to addiction treatment services in Canada, including in psychiatric settings. While substance use disorders are highly comorbid and confer a poorer prognosis on psychiatric illnesses, psychiatric services are often ill-equipped in managing c...
Background:
Successful treatment of major depressive disorder (MDD) can be challenging, and failures ("treatment-resistant depression" [TRD]) are frequent. Steps to address TRD include increasing antidepressant dose, combining antidepressants, adding adjunctive agents, or using nonpharmacological treatments. Their relative efficacy and tolerabilit...
Aim
Robust evidence suggests that depression, and risk for depression, are associated with the generation of stressful life events. This tendency to generate stress may be genetically determined. This systematic review aimed to identify specific molecular genetic markers associated with the generation of interpersonal stressful life events, at leas...
Background: Persons who use drugs (PWUD) are facing an epidemic during the global COVID-19 pandemic. In recent months, many medical institutions have released guidance documents to inform the management of PWUD as it pertains to COVID-19. Given the flurry of increasing guidance documents, we sought to synthesize the recommendations and identify con...
Background
Opioid use disorder (OUD) disproportionately affects individuals with schizophrenia, who are less likely to receive opioid agonist therapy (OAT) and have a poorer overall prognosis. To date, there is little specific clinical guidance in managing concurrent schizophrenia and OUD.
Aims
We performed a systematic review to summarize the cur...
Objective:
This study aimed to determine the efficacy and acceptability of pharmacotherapies for cannabis use disorder (CUD).
Methods:
We conducted a systematic review and frequentist network meta-analysis, searching five electronic databases for randomized placebo-controlled trials of individuals diagnosed with CUD receiving pharmacotherapy wit...
Background:
Current curriculum guidelines for addiction training in psychiatry need to be adapted to the competency by design framework to integrate clinical skills in addiction.
Objective:
We conducted a systematic review to identify curricular and educational interventions to build competency among psychiatry residents and fellows in addiction...
Importance Cannabis withdrawal syndrome (CWS)—a diagnostic indicator of cannabis use disorder—commonly occurs on cessation of heavy and prolonged cannabis use. To date, the prevalence of CWS syndrome has not been well described, nor have the factors potentially associated with CWS.
Objectives To estimate the prevalence of CWS among individuals wit...
Background:
Ketamine appears to have a therapeutic role in certain mental disorders, most notably unipolar major depressive disorder. However, the efficacy in bipolar depression is less clear.
Objectives:
This study aimed to assess the efficacy and tolerability of ketamine for bipolar depression.
Methods:
We conducted a systematic review of ex...
Background
Public safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTE) and developing posttraumatic stress injuries (PTSI, e.g., depression, anxiety) by the nature of their work. PTSI are also linked to increased absenteeism, suicidality, and performance dec...
Importance
Self-harm and suicidal behavior are associated with substantial morbidity and mortality among children and adolescents. The comparative performance of psychotherapies for suicidality is unclear because few head-to-head clinical trials have been conducted.
Objective
To compare the efficacy of psychotherapies for the treatment of self-har...
Background
Following several landmark rulings and increasing public support for physician-assisted death, in 2016, Canada became one of a handful of countries legalising medical assistance in dying (MAiD) with Bill C-14. However, the revised Bill C-7 proposes the specific exclusion of MAiD where a mental disorder is the sole underlying medical cond...
Background Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various posttraumatic stress injuries (PTSIs). There are many evidence-based psychological interventions for PTSI, but whether the interventions benefit PSP despite the repe...
Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as v...
This policy brief describes CSAM's position on the decriminalization of drugs in Canada. As well, it provides a recent synthesis of available research on the pros and cons of drug decriminalization.
Background & Aims: There is a growing need to identify and treat individuals with addictive disorders with the goal of improving outcomes for some of the most prevalent and stigmatized illnesses. Recently, international scientific advances have trended towards developing dimensional approaches in our understanding of addiction and addictive disorde...
Background:
Transcranial Direct Current Stimulation (tDCS) has been used to modulate empathy, but no studies have meta-analyzed the evidence base for its efficacy.
Objectives:
This study aimed to determine the efficacy of tDCS at modulating empathy.
Methods:
We conducted a systematic review and meta-analysis of randomized controlled trials inv...
Depression is the leading cause of disability in the world; however, a large proportion of individuals fail to respond to conventional antidepressant treatments. In recent years, the N-methyl-d-aspartate (NMDA) receptor antagonist ketamine has gained increasing popularity for its potent and rapid antidepressant effects, particularly in treatment-re...
Background
Ketamine appears to have a therapeutic role in certain mental disorders, most notably depression. However, the comparative performance of different formulations of ketamine is less clear.
Objectives
This study aimed to assess the comparative efficacy and tolerability of racemic and esketamine for the treatment of unipolar and bipolar ma...
Despite common perceptions that cannabis is safe, there is mounting evidence to support an association between cannabis use and several neuropsychiatric sequelae. The recently published Canadian Psychiatric Association position statement provides a timely review of the evidence for cannabinoid products in treating various psychiatric disorders.1 Dr...
Background: Several previous studies have explored patterns of emergency department (ED) utilization for alcohol-related physical conditions. However, the char- acteristics of those presenting with alcohol-induced psychiatric presentations are less clear.
Aims: To describe the sociodemographic features of patients seeking ED care for alcohol-relate...
Objective
We investigated the comparative efficacy and tolerability of augmentation strategies for bipolar depression.
Data Sources
We conducted a systematic review and network meta-analysis of 8 electronic databases for double-blind, randomized controlled trials of adjunctive pharmacotherapies for acute bipolar depression.
Data Extraction and Sy...