Jürgen Rehm

Jürgen Rehm
Centre for Addiction and Mental Health · Social and Epidemiological Research Department (SER)

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1,049
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Publications

Publications (1,049)
Article
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Importance: The US has experienced increasing socioeconomic inequalities and stagnating life expectancy. Past studies have not disentangled 2 mechanisms thought to underlie socioeconomic inequalities in health, differential exposure and differential vulnerability, that have different policy implications. Objective: To evaluate the extent to whic...
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Objective To assess the immediate impact of the introduction of minimum unit pricing in Scotland on household alcohol purchases. Design Controlled interrupted time series analysis. Setting Purchase data from Kantar Worldpanel’s household shopping panel for 2015-18. Participants 5325 Scottish households, 54 807 English households as controls, and...
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INTRODUCTION: There is evidence to suggest that tobacco use is associated with suicide attempts. However, it is unclear whether such an association can be extended to include second-hand smoke exposure. Using nationally representative data of school-attending adolescents from 33 countries, we examined the association of tobacco use and exposure to...
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On 18 February 2019, for the first time in their history Thailand enacted a law governing medical marijuana use. Various related stakeholders are subsequently forced to think clearly in order to design and implement health and social systems so as to get the most benefits and to protect potential negative consequences caused by this policy. This ar...
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The recent article of Bujdosó et al. [1] compares analytical data of a collective of recorded spirits (n=119) with unrecorded spirits (n=87) regarding the contents of ethanol, methanol and selected higher alcohol such as 1-propanol (termed other aliphatic alcohols, OAA). The results were used to obtain a quantitative risk assessment using the margi...
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Background Alcohol use has been identified as a risk factor for dementia and cognitive decline. However, some patterns of drinking have been associated with beneficial effects. Methods and Results To clarify the relationship between alcohol use and dementia, we conducted a scoping review based on a systematic search of systematic reviews published...
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This study describes the association among lifetime traumatic brain injury (TBI) and past year hazardous/harmful drinking, as well as their unique and synergistic effects, on mental health problems and roadway aggression among Canadian adults. A cross-sectional sample of 6074 Ontario adults aged 18 years or older were surveyed between 2011 and 2013...
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Aims: To analyze disparities in age at death and cause-specific mortality in a sample of patients registered with alcohol use disorders (AUDs) in state-run addiction treatment centers in Novosibirsk, Russia. Methods: Database: 92,269 deaths recorded by medical facilities in Novosibirsk between 2000 and 2010, comprising cause of death (per ICD-10),...
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Background: Evidence suggests that cannabis use may be associated with suicidality in adolescence. Nevertheless, very few studies have assessed this association in low- and middle-income countries (LMICs). In this cross-sectional survey, we investigated the association of cannabis use and suicidal attempts in adolescents from 21 LMICs, adjusting fo...
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Background: Cancer is a major cause of premature illness and death in France. To quantify how cancer prevention could reduce the burden, we present estimates of the contribution of lifestyle and environmental risk factors to cancer incidence in France in 2015, comparing these with other high-income countries. Method: Prevalences of, and relative...
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Aim To compare the injury alcohol‐attributable fractions (AAFs) estimated using emergency department (ED) data to AAFs estimated by combining population alcohol consumption data with corresponding relative risks (RRs). Design Comparative Risk Assessment Setting and participants ED studies in 27 countries (n = 24,971) Measurements AAFs were estim...
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Background: The use of illicit and prescription drugs for non-medical purposes among youth and young adults living in Northern Ontario communities is a major public health concern. This problem is amplified in that there is insufficient knowledge on the types of services and treatment centers available for and utilized by young people with substanc...
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Background: Heat-not-burn (HNB) tobacco products are not burnt but instead are inserted into a tobacco-heating system, which heats the tobacco at temperatures below that required to initiate combustion. This mechanism potentially results in significantly reduced concentrations of heat-generated toxicants in the inhalable aerosol. Method: The margin...
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Introduction and Aims The relationship between cannabis use and diabetes is puzzling. Although cannabis users versus non‐users should theoretically have a higher likelihood of diabetes, epidemiological studies suggest otherwise. However, previous epidemiological studies have not considered the potential confounding effects of mental health disorder...
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Objective: To examine health services use on the basis of alcohol consumption. Material and methods: A cross-sectional study was carried out on patients visiting the Primary Health Care (PHC) settings in Catalonia during 2011 and 2012; these patients had a history of alcohol consumption. Information about outpatient visits in the PHC setting, ho...
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Background: Motor vehicle collisions are an important contributor to prescription opioid use-related morbidity and mortality. The purpose of the current study was to estimate the prevalence of driving under the influence of prescription opioids (DUIPO) in Ontario, Canada, and to measure the association between this behaviour and the risk of a moto...
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The third UN High-Level Meeting on Non-Communicable Diseases (NCDs) on Sept 27, 2018, will review national and global progress towards the prevention and control of NCDs, and provide an opportunity to renew, reinforce, and enhance commitments to reduce their burden. NCD Countdown 2030 is an independent collaboration to inform policies that aim to r...
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Beverage fraud involving counterfeiting of brand spirits is an increasing problem not only due to deception of the consumer but also because it poses health risks e.g. from possible methanol admixture. Suspicious spirit samples from Russia and Kenya were analysed using 1H nuclear magnetic resonance (NMR) spectroscopy in comparison to authentic prod...
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Background and aims Estimated alcohol consumption from national self‐report surveys is often only 30% to 40% of official estimates based on sales or taxation data. Global burden of disease (GBD) estimates for alcohol adjust survey estimates up to 80% of total per capita consumption. This assumes that cohort studies needed to estimate relative risks...
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Background: Although it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear. Methods and results: We searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of h...
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Remedial programs for impaired driving offenders have proved valuable in reducing subsequent alcohol and other drug use and preventing recidivism in this population. Many of these programs are based on a severity-based assignment scheme, where individuals assessed to have greater problems or be at higher risk are assigned to longer, more intensive...
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Women and men with alcohol dependence and very high risk drinking level (VHRDL; defined as drinking >60 or 100 g of ethanol per day, respectively) experience severe health consequences; however, data on the number of these individuals and their health risks are limited. This study estimated (1) the prevalence of VHRDL in 13 European Union (EU) coun...
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Medication development for alcohol relapse prevention or reduction of consumption is highly challenging due to methodological issues of pharmacotherapy trials. Existing approved medications are only modestly effective with many patients failing to benefit from these therapies. Therefore, there is a pressing need for other effective treatments with...
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Objective: Evidence on the comparative cost-effectiveness of alcohol control strategies is a relevant input into public policy and resource allocation. At the global level, this evidence has been used to identify so-called best buys for noncommunicable disease prevention and control. This article uses global evidence on alcohol use exposures and r...
Data
Table S1. Search Strategy for Medline(R) (1946–Most Recent) and Embase (Embase+Embase Classic) Table S2. Risk of Bias in Nonrandomized Studies—of Interventions (ROBINS‐I) Assessment Tool, Modified Version Figure S1. Incidence of hypertension in former drinkers compared with lifetime abstainers at baseline by sex, 1989–2017. Figure S2. Incidence...
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Background: Globally, illness and life expectancy follow a social gradient that puts people of lower socioeconomic status (SES) at higher risk of dying prematurely. Alcohol consumption has been shown to be a factor contributing to socioeconomic differences in mortality. However, little evidence is available from low- and middle-income countries. T...
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Background: In 2013, an Integrated Care Pathway (ICP) for concurrent Major Depressive (MDD) and Alcohol Use (AUD) Disorders was developed at the Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada. The ICP was further implemented at 8 other clinical sites across Ontario (the DA VINCI Project) in 2015-2017. The goal of this stud...
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Background Although it has been purported that HIV‐positive individuals may experience a greater degree of intoxication than HIV‐negative individuals following acute alcohol consumption, no research to date has empirically tested this supposition. The present investigation entailed a randomized controlled experiment to identify whether the administ...
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Purpose of review: To discuss the health risks due to exposure to alcohol, illegal drugs and nicotine and how these risks might be reduced. Recent findings: In 2016, worldwide, alcohol, illegal drugs and nicotine were responsible for some 10 million deaths. There is evolutionary and biological evidence that humans are predisposed to consuming al...
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With the epidemiological transition, causes of death shifted from communicable to non-communicable diseases (NCDs) and life expectancy increased, as these NCD deaths occurred later in life. However, in the United States, over the past years, life expectancy has been stagnating or decreasing despite decreasing NCD mortality rates. Analyses of the mo...
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IMPORTANCE: Prevalence estimates are essential to effectively prioritize, plan, and deliver health care to high-needs populations such as children and youth with fetal alcohol spectrum disorder (FASD). However, most countries do not have population-level prevalence data for FASD. OBJECTIVE: To obtain prevalence estimates of FASD among children and...
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Life expectancy at birth for the USA has not increased in recent years. This commentary assesses the impact of substance use on this phenomenon. Although crude mortality rates of the most important causes of death (such as cardiovascular diseases or cancer) have declined between 2010 and 2014, crude mortality rates of drug‐ and alcohol‐induced caus...
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In Reply We thank Pichini et al for their comments on our article.¹ Pichini et al expressed concern that Italy was reported to be among the 5 countries with the highest prevalence of fetal alcohol spectrum disorder (FASD) globally (45.0 per 1000 or 4.5%; 95% CI, 35.1-56.1 per 1000 or 3.5%-5.6%). It is interesting that they expressed similar concern...
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Objectives (1) A comprehensive mortality assessment of alcoholic cardiomyopathy (ACM) and (2) examination of under-reporting using vital statistics data. Methods A modelling study estimated sex-specific mortality rates for each country, which were subsequently aggregated by region and globally. Input data on ACM mortality were obtained from death...
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Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social...
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Purpose of Review Alcohol use is a major risk factor for noncommunicable diseases (NCDs), annually causing more than 1.8 million deaths, and approximately 52 million disability-adjusted life years lost globally. This review examines the relationship between alcohol use and NCDs in the context of current United Nations (UN) and World Health Organiza...
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ABSTRACTObjectives:Integrated care pathways (ICP) have been successfully developed in multiple areas of medicine with evidence supporting their superior effectiveness when compared to treatment as usual (TAU). There are lack of data indicating that specifically integration of services plays a crucial role in ICP effectiveness rather than simple com...
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Background Though high rates of co-occurring cannabis use and depression are well-documented, data regarding the association between cannabis use and dysthymia is scarce. The aim of this cross-sectional study was to explore clinical correlations of cannabis use among individuals with dysthymia, as well as the changes in the association between cann...
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Background: Cannabis use has been reported to negatively affect the course and outcome of various psychiatric disorders, yet little is known on its effect on rates of remission from anxiety disorders and associated clinical and functional outcomes. Methods: In this study, data were drawn from Waves 1 and 2 of the National Epidemiologic survey on...
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Fetal alcohol spectrum disorders are a group of serious, chronic, systemic diseases that are caused by prenatal alcohol exposure and characterized by central nervous system damage and physical deficits that subsequently lead to a wide range of permanent and lifelong health consequences. Individuals exposed to alcohol prenatally are at greater risk...
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Plain English summary The purpose of this paper is to describe a patient engagement event designed to create an educational workbook with smokers who drink alcohol at harmful levels. The goal was to create a workbook that combined scientific evidence with patients’ values, preferences, and needs. Fourteen adult smokers who drink alcohol were invite...
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The following viewpoint updates on very recent developments regarding policies for unrecorded surrogate alcohol consumption in Russia. It is outlined how and why the current lack of an appropriate legal framework and poor enforcement of existing measures can potentially increase mortality among the most vulnerable populations of heavy drinkers.
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Background: Dementia is a prevalent condition, affecting 5–7% of people aged 60 years and older, and a leading cause of disability in people aged 60 years and older globally. We aimed to examine the association between alcohol use disorders and dementia risk, with an emphasis on early-onset dementia (1·7) in sensitivity analyses on dementia case de...
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Objectives To quantify HIV/AIDS mortality attributable to alcohol use in the adult general population of South Africa in 2012 by socioeconomic status (SES). Design Comparative risk assessment based on secondary individual data, aggregate data and risk relations reported in the literature. Setting South African adult general population. Participa...
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Background The current lack of pharmacological treatments for cannabis use disorder (CUD) warrants novel approaches and further investigation of promising pharmacotherapy. We previously showed that nabiximols (27 mg/ml Δ⁹-tetrahydrocannabinol (THC)/ 25 mg/ml cannabidiol (CBD), Sativex®) can decrease cannabis withdrawal symptoms. Here, we assessed i...
Data
Timeline followback (TLFB) for alcohol, tobacco and caffeine. Circles (in white placebo, in black nabiximols) represent average values (+SEM) of a) Alcohol (standard drinks), b) Tobacco (number of cigarettes) and c) Caffeine (number of soft drinks) during baseline (week 0) and weeks 1–12 of treatment. (TIF)
Data
Self-titrated medication as per vials’ weight assessments. Participants were instructed to bring the study medication vials each visit for weight assessments. Weight for each vial was determined before giving it to the participants, during their use and once they were returned to study staff. Circles (white placebo n = 20–14, black nabiximols n = 2...
Data
Supporting information and study protocol. (DOC)
Data
High/low study medication effects in cannabis withdrawal. Circles (in white placebo, in black nabiximols) represent average values (+SEM) for cannabis withdrawal as measured using the Cannabis Withdrawal Checklist (CWC). In a) high medication users subgroup (≥ 20 sprays at any treatment day) (n = 5 and 3 for nabiximols and placebo, respectively), i...
Data
Summary of study assessments. (DOCX)
Data
Study medication schedule and maximal number of sprays allowed by study day. The maximum dose of nabiximols for the first two days of treatment was five sprays per day. From the 3rd day, the dose of nabiximols was increased in five sprays per day until it reached a maximum number of 42 sprays per day by week 2 (Day 10). Day 21 was set as the target...
Data
Cannabinoids of interest in plasma were quantified using liquid chromatography–tandem mass spectrometry (LC-MS/MS) method. Table represents concentrations in plasma specimens for Δ9-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), 11-nor-9-carboxy-THC (THCCOOH), cannabidiol (CBD) and cannabinol (CBN), THC-glucuronide (THC-glu), THCCOOH-glucu...
Data
High/low study medication effects in cannabis craving. Circles (in white placebo, in black nabiximols) represent average values (+SEM) for craving scores as determined using the Marijuana Craving Questionnaire (MCQ). In a) high medication users subgroup (≥ 20 sprays at any treatment day) (n = 5 and 3 for nabiximols and placebo, respectively), in b)...
Data
Scores in the drug effects questionnaire (DEQ) during the supervised intake of the study medication. Participants were instructed in the use of study medication and took their first dose observed by study staff and remained at study site for two hours, DEQ measures were determined 30 min (Test #1), 60 min (Test #2), 90 min (Test #3) and 120 min (Te...
Data
CONSORT checklist and study Dataset. (ZIP)
Article
Full-text available
Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social...
Article
Full-text available
Background and aims: Alcohol use is among the most important risk factors for burden of disease globally. An estimated quarter of the total alcohol consumed globally is unrecorded. However, due partly to the challenges associated with its assessment, evidence concerning the magnitude of unrecorded alcohol use is sparse. This study estimated countr...
Article
Background: Public sector bodies have called for policies and programmes to shift collective social norms in disfavour of the harmful use of alcohol. This article aims to identify and summarize the evidence and propose how policies and programmes to shift social norms could be implemented and evaluated. Design: Review of reviews for all years to...
Article
Objectives We described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD. Methods This retrospective observational study included all Ontario res...
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Background: Most cost of illness studies are based on models where information on exposure is combined with risk information from meta-analyses, and the resulting attributable fractions are applied to the number of cases. Methods: This study presents data on alcohol and tobacco use for 2011 and 2012 obtained from a routine medical practice in Ca...
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Objective This study describes the association between history of lifetime traumatic brain injury (TBI) and current disabling functional restrictions among Ontario adults. Setting and design A two-stage rolling cross-sectional sample of 6,048 adults aged 18 to 93 were interviewed by computer assisted telephone interviewing between 2011–2013 regard...
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In a Perspective, Jürgen Rehm and Charlotte Probst examine the links between socioeconomic status, alcohol use, and cardiovascular mortality and discuss implications for policy.
Article
Objective: This study assessed four alcohol policy indicators and their associations with adolescent alcohol use in Latin America and the Caribbean. Method: A secondary data analysis of nationally representative, cross-sectional data sets (years 2007-2013) from 26 Latin American and Caribbean countries was performed (N = 55,248 13- to 15-year-ol...
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Aims: Previous work found that, among high-cost patients, those with a majority of mental health and addiction (MHA)-related costs (>50%) incur over 30% more costs than other high-cost patients. However, this work did not examine other high-cost patients in depth or whether they had any MHA-related costs. The objective of this analysis was to exami...