Publications by authors named "Dvora Shmulewitz"

Background: Among those with common mental health disorders (e.g. mood, anxiety, and stress disorders), comorbidity of substance and other addictive disorders is prevalent.

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Importance: Research has shown evidence of increased substance use (ISU) in populations affected by mass terrorism; however, less is known regarding how psychosocial factors interact to estimate ISU following such events.

Objective: To examine which factors are associated with reporting ISU, test whether psychological distress (PD) mediated the association between exposure to trauma and reporting ISU, and whether the mediation effect differed among those with prior mental health (MH) difficulties and those without.

Design, Setting, And Participants: A partially representative cross-sectional survey of the adult Jewish population in Israel (aged 18-70 years) was conducted 4 weeks after October 7, 2023 (October 31 to November 5, 2023).

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Article Synopsis
  • - Cannabis use is rising among middle-aged and older adults in the US, who are more vulnerable to its negative effects, but little is known about the specific patterns of use across different age groups.
  • - A study of 4,151 US adults found that middle-aged (50-64) and older adults (65+) are more likely to consume cannabis in the evening and prefer smoking over other methods, but are less likely to use high-potency concentrates compared to younger adults (18-49).
  • - The findings indicate that while older users may adopt safer consumption habits, they still face unique risks, emphasizing the need for targeted prevention strategies to address these age-related differences in cannabis use.
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Purpose Of Review: Veterans are a large population that is disproportionately affected by various physical and mental health conditions. The primary aim of this review is to provide a concise overview of recent literature on the prevalence of cannabis use and cannabis use disorder (CUD) among US Veterans, and associations with mental and physical health conditions. We also addressed gaps in the literature by investigating associations between CUD and mental and physical health conditions in 2019 data from the Veterans Health Administration (VHA; N=5,657,277).

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Background: Substance use is a leading cause of preventable morbidity and mortality worldwide. Population-wide screening for problematic substance use in primary health care may mitigate the serious health and socio-economic consequences of such use, but the standard Alcohol, Smoking and Substance Involvement Screening Test (ASSIST 3.1) may be too long for wide-scale screening.

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Importance: Renewed interest in the clinical potential of hallucinogens may lead people with depression to a generally more positive view of the use of lysergic acid diethylamide (LSD). Therefore, past-year LSD use among people with depression may be increasing in prevalence.

Objective: To assess time trends in the prevalence of past-year nonmedical LSD use by past-year major depression status and the variation in this association by sociodemographic characteristics.

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Objective: Underreporting of substance use is a frequent concern about studies based on self-report, but few robust studies have examined the agreement between different methods for capturing self-reported substance use. The current study therefore used repeated measures to compare self-reported substance use using (a) clinician interviewers and (b) self-administered computerized surveys in a sample that included both inpatients and community residents.

Method: Adults age 18 years and older with problematic substance use were recruited from the community or an inpatient addiction treatment facility.

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Researchers need accurate measurements of cannabis consumption quantities to assess risks and benefits. Survey methods for measuring cannabis flower and concentrate quantities remain underdeveloped. We examined "grams" and "hits" units for measuring flower and concentrate quantities, and calculating milligrams of THC (mgTHC).

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Background: Increased consumption of food that are high in energy and sugar have been pointed as a major factor in the obesity epidemic. Impaired control of food intake and the concept of food addiction has been developed as a potential contributor. Our objective was to evaluate the dimensionality and psychometric validity of diagnostic criteria for food addiction adapted from the 11 DSM-5 substance use disorder (SUD) criteria (i.

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Gender and sex can influence cannabis behaviors and consequences (Cannabis Use Disorder [CUD]). Research typically examines sex and gender independently. Gender analyses often exclude transgender and gender diverse (TGD) populations.

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Background: Cannabis use and cannabis use disorder (CUD) are associated with mental health disorders, however the extent of this matter among pregnant and recently postpartum (e.g., new moms) women in the US is unknown.

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The DSM-5 criteria for cannabis use disorder (CUD) combine DSM-IV dependence and abuse criteria (without legal problems) and new withdrawal and craving criteria. Information on dimensionality, internal reliability, and differential functioning of the DSM-5 CUD criteria is lacking. Additionally, dimensionality of the DSM-5 withdrawal items is unknown.

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Background: The diversity in characteristics of cannabis products and behavior patterns make evaluation of cannabis exposure in population-based, self-report surveys challenging. Accurate identification of cannabis exposure and related outcomes necessitates a thorough understanding of participants' interpretations of survey questions assessing cannabis consumption behaviors.

Objectives: The current study utilized cognitive interviewing to gain insight on participants' interpretation of items in a self-reported survey instrument used to estimate the quantity of THC consumed in population samples.

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Background: Gender is an important factor in understanding cannabis patterns, yet few studies have explored cannabis patterns among gender minority (GM) individuals - particularly among high-risk age groups including young adults. The evolving cannabis market is reshaping typical patterns of cannabis use in the U.S.

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Background: Compared to plant/flower cannabis products, cannabis concentrates have higher average potency of delta-9-tetrahydrocannabinol (Δ9-THC), which may be associated with greater likelihood of cannabis-related harms. Information on factors associated with use of cannabis concentrates is needed.

Methods: Respondents were 4,328 adult past-7-day cannabis users from all 50 U.

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While men show greater prevalence of cannabis use disorder (CUD) than women, whether cannabis use frequency drives this difference is unknown, and little is known about sex differences in problems associated with CUD. We therefore assessed the association of CUD with sex, adjusted for frequency of use, and compared the association of psychosocial and health-related problems with CUD between men and women. We included US adults age ≥ 18 who reported past-year cannabis use in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 3701).

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Standardized survey measures that capture diverse cannabis consumption patterns are needed to inform public health and policy. Our team is developing a flexible, personalized, low-burden survey item inventory to measure cannabis use patterns and estimate milligrams of THC (mgTHC) consumption in large samples. This study aimed to identify measurement gaps and analysis implications associated with an initial pool of candidate items that assessed use of cannabis flower and concentrate products (smoked and/or vaporized).

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Quantification of consumption patterns of the primary psychoactive compounds in cannabis, which cause euphoria or intoxication, is sorely needed to identify potential risks and benefits of use and to provide meaningful safety information to the public. The diversity of products available, multiple methods of administration, and lack of labeling of products have made such quantification challenging. Our group is developing a survey instrument for estimating the quantity of delta 9-tetrahydrocannabinol (THC) consumed in population samples, which is flexible and incorporates individualized reports of patterns of consumption.

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Objective: The Department of Veterans Affairs' (VA) electronic health records (EHR) offer a rich source of big data to study medical and health care questions, but patient eligibility and preferences may limit generalizability of findings. We therefore examined the representativeness of VA veterans by comparing veterans using VA healthcare services to those who do not.

Methods: We analyzed data on 3051 veteran participants age ≥ 18 years in the 2019 National Health Interview Survey.

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The DSM-5 definition of cannabis use disorder (CUD) differs from DSM-IV by combining abuse and dependence criteria (without the legal criterion) and including withdrawal and craving criteria. Information on construct validity of the DSM-5 CUD diagnosis and severity levels is lacking. This study examines the associations between DSM-5 CUD and severity classification and a set of concurrent validators.

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Aims: Information on time trends in use of different plant-based hallucinogens is lacking. The current study used nationally representative U.S.

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Background And Aims: Hallucinogen use is potentially harmful. Information on whether such use has increased in recent decades is lacking. This study assessed overall and age-specific time trends in the prevalence of 12-month hallucinogen use in the US general population.

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Background: Screen use is part of daily life worldwide and morbidity related to excess use of screens has been reported. Some use of screens in excess could indicate a screen use disorder (ScUD). An integrative approach to ScUD could better fit the polymodal reality of screens, and concurrent problems with screens, than a split approach, activity by activity.

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Objective: The diagnostic criteria for opioid use disorder, originally developed for heroin, did not anticipate the surge in prescription opioid use and the resulting complexities in diagnosing prescription opioid use disorder (POUD), including differentiation of pain relief (therapeutic intent) from more common drug use motives, such as to get high or to cope with negative affect. The authors examined the validity of the Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 opioid version, an instrument designed to make this differentiation.

Methods: Patients (N=606) from pain clinics and inpatient substance treatment who ever received a ≥30-day opioid prescription for chronic pain were evaluated for DSM-5 POUD (i.

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Background: Use of novel cannabis products whose primary active compound is Delta-8 tetrahydrocannabinol (Delta-8 THC), an isomer of Delta-9 THC has recently surged. While Delta-8 THC has psychoactive effects and is potentially harmful, little is known about its use. We examined sociodemographic characteristics, motivations, and consumption patterns of Delta-8 THC in US adult cannabis users.

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