Le cannabis et ses effets délétères : pour un débat plus nuancé / L. JOBIDON ; D. JUTRAS-ASWAD in Drogues, santé et société, Vol.16, n°1 (Mars 2018)  

Donner un avis [article]  inDrogues, santé et société > Vol.16, n°1 (Mars 2018) . - 5-30 Titre : Le cannabis et ses effets délétères : pour un débat plus nuancé Titre traduit : (Cannabis and its adverse effects: advocating for a nuanced debate) Type de document : Périodique Auteurs : L. JOBIDON ; D. JUTRAS-ASWAD Année de publication : 2018 Article en page(s) : 5-30 Langues : Français (fre) Mots-clés : Thésaurus TOXIBASE CANNABIS ; EFFET SECONDAIRE ; MECANISME D'ACTION ; COGNITION ; NEUROBIOLOGIE ; FACTEUR DE RISQUE ; PSYCHOSE ; PSYCHOPATHOLOGIE ; DEPENDANCE ; FACTEUR DE VULNERABILITE ; TETRAHYDROCANNABINOL ; CANNABINOIDES Discipline : PRO Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods Résumé : FRANÇAIS : Alors que plusieurs États américains ont fait le choix d'assouplir la législation entourant l'usage récréatif du cannabis et qu'au Canada, cette substance est encadrée par un programme fédéral pour son utilisation thérapeutique, le débat sur l'utilisation du cannabis et ses effets néfastes continue de faire couler beaucoup d'encre. S'éloignant souvent des données probantes, ce débat est généralement marqué par des positions clivées qui ne rendent pas compte des nuances récemment apportées par les données scientifiques sur le sujet. Afin de pouvoir bien évaluer les risques que pose cette substance, nous suggérons ici de délaisser le questionnement dichotomique quant au fait que le cannabis cause, ou pas, certains problèmes de santé au profit d'une discussion sur les facteurs modulant la relation entre le cannabis et certains effets délétères potentiels, notamment sur le plan de la cognition, de la psychose et de la toxicomanie. Nous discutons ainsi de certaines données sur la composition du cannabis, son mode d'utilisation, le type de population en faisant usage et la présence de stresseurs environnementaux, qui semblent tous moduler les risques associés à la consommation de cannabis. Devant les données indiquant que le cannabis est une substance psychoactive possédant à la fois des effets délétères et bénéfiques, et au regard du fait qu'une minorité d'individus éprouveront des difficultés après en avoir consommé, il nous semble crucial de faire bon usage et d'approfondir la littérature scientifique portant sur ces facteurs modulateurs. Nous pensons que cela pourrait permettre de mieux informer la population et prendre des décisions plus éclairées, notamment quant aux modalités entourant un éventuel changement au statut légal du cannabis. ENGLISH: While many American states recently changed the legal status of cannabis and the Canadian federal government instituted a national program to regulate its therapeutic use, the debate surrounding cannabis use and its adverse effects continues to spark interest, both among the experts and among the public at large. In order to properly assess the risks and benefits associated with cannabis use, we suggest not to focus on the question of whether cannabis is deleterious or not, but to focus instead on the factors modulating the relationship between cannabinoid use and its adverse effects on cognition, psychosis and addiction. We discuss here how the content of cannabis, patterns of use, characteristics of the user and exposure to environmental stressors all modify the risks associated with cannabis use. We also underline that growing evidence support both beneficial and deleterious properties of this substance, and the fact that only a portion of users will experience its negative effects. We thus suggest that a better usage and understanding of the literature on those modulating factors seems warranted in order to properly inform the population. This approach will also be critical to take evidence-based decisions regarding its legal status and how to implement the potential changes to current regulations pertaining to the legal status of cannabis. Domaine : Drogues illicites / Illicit drugs Sous-type de document : Revue de la littérature / Literature review Affiliation : Université de Montréal, Québec, Canada Lien : http://drogues-sante-societe.ca/le-cannabis-et-ses-effets-deleteres-pour-un-deba [...] Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=80016 [article]

Cannabis use correlates of syringe sharing among injection drug users / D. JUTRAS-ASWAD ; G. ZANG ; J. BRUNEAU in American Journal on Addictions, Vol.19, n°3 (May-June 2010)  

Donner un avis [article]  inAmerican Journal on Addictions > Vol.19, n°3 (May-June 2010) . - 231-237 Titre : Cannabis use correlates of syringe sharing among injection drug users Type de document : Périodique Auteurs : D. JUTRAS-ASWAD ; G. ZANG ; J. BRUNEAU Année de publication : 2010 Article en page(s) : 231-237 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique QUEBEC ; CANADA Thésaurus TOXIBASE CANNABIS ; INJECTION ; PARTAGE DE SERINGUE ; FACTEUR DE RISQUE ; ENQUETE ; COHORTE Discipline : EPI Epidémiologie / Epidemiology Résumé : This study examines whether the relation between acute cannabis use and syringe sharing during single injection days is similar among regular and nonregular users, participating in a cohort study of injection drug users in Montreal, Canada. 236 (36.6%) subjects were classified as regular cannabis users (RCUs), 227 (35.2%) as nonregular cannabis users (NRCUs), and 181 (28.1%) were abstinent. Cannabis use during a single injection day was associated with a fivefold increased risk of sharing (OR 4.92; 1.83-13.22) in NRCUs compared to RCUs. Our results indicate that cannabis use history should be considered when evaluating its potential effect on risk-taking behaviors. [Author's abstract] Domaine : Drogues illicites / Illicit drugs Refs biblio. : 38 Affiliation : CRCHUM, Centre Hospitalier de l'Université de Montréal, Québec, Canada Lien : http://www3.interscience.wiley.com/journal/123340067/abstract Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=63775 [article]

"I love having benzos after my coke shot": The use of psychotropic medication among cocaine users in downtown Montreal / R. MOTTA-OCHOA ; K. BERTRAND ; N. ARRUDA ; D. JUTRAS-ASWAD ; E. ROY in International Journal of Drug Policy, Vol.49 (November 2017) 

Donner un avis [article]  inInternational Journal of Drug Policy > Vol.49 (November 2017) . - 15-23 Titre : "I love having benzos after my coke shot": The use of psychotropic medication among cocaine users in downtown Montreal Type de document : Périodique Auteurs : R. MOTTA-OCHOA ; K. BERTRAND ; N. ARRUDA ; D. JUTRAS-ASWAD ; E. ROY Année de publication : 2017 Article en page(s) : 15-23 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique CANADA ; QUEBEC Thésaurus TOXIBASE COCAINE ; BENZODIAZEPINES ; ETHNOGRAPHIE ; ANXIOLYTIQUES ; POLYCONSOMMATION ; TYPE D'USAGE Discipline : SHS Sciences humaines et sociales / Human and social sciences Résumé : Background: Cocaine abuse is a major public health issue due to its role in the HIV and hepatitis C virus (HCV) epidemics in North America. A significant area of concern among people who use cocaine (PWUC), injected or smoked, is their frequent misuse of prescription drugs, particularly psychotropic medication (PM), such as tranquilizers, sedatives, stimulants, and antipsychotics. This paper aims to describe and understand practices of PM use among PWUC in downtown Montreal. Method: Ethnographic methods including participant observation and semi-structured interviews were used in an iterative manner. Results: Two thirds of the 50 participants were male. They ranged in age from 20 to 60 and most were homeless. A significant proportion of them reported polydrug use patterns that included frequent concomitant opioid use (heroin and/or prescription opioids (PO)). Benzodiazepine-based tranquilizers and the atypical antipsychotic quetiapine were the most frequently used PM. Routes of PM administration were oral, nasal and, to a lesser degree, intravenous. Five main PM use practices were identified: 1) "downers" from cocaine high (benzodiazepines and quetiapine); 2) enhancers of heroin/PO effects (benzodiazepines); 3) reducers or suppressors of heroin/PO withdrawal symptoms (benzodiazepines); 4) enablers of a different type of "trip" (benzodiazepines); and 5) treatment for mental and physical problems (benzodiazepines and quetiapine). Conclusion: PM use practices showed several complementary functions that PM fulfill in a context of polydrug use. The soothing and stimulating effects of PM reinforce the patterns of drug use among participants, posing various risks including overdose, HIV/HCV transmission, PM dependence and accidents. The results highlight the need for clinicians to assess clients' substance use patterns when prescribing PM and to question PWUC about PM use. The findings also underline certain unmet service needs in relation to overdose, HIV/HCV and mental health prevention/treatment among cocaine users. Domaine : Autres substances / Other substances ; Drogues illicites / Illicit drugs Affiliation : Addiction Unit, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada Cote : Abonnement Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=79618 [article]

Licit and illicit substance use among people who inject drugs and the association with subsequent suicidal attempt / A. A. ARTENIE ; J. BRUNEAU ; E. ROY ; G. ZANG ; F. LESPERANCE ; J. RENAUD ; J. TREMBLAY ; D. JUTRAS-ASWAD in Addiction, Vol.110, n°10 (October 2015)

Donner un avis [article]  inAddiction > Vol.110, n°10 (October 2015) . - 1636-1643 Titre : Licit and illicit substance use among people who inject drugs and the association with subsequent suicidal attempt Type de document : Périodique Auteurs : A. A. ARTENIE ; J. BRUNEAU ; E. ROY ; G. ZANG ; F. LESPERANCE ; J. RENAUD ; J. TREMBLAY ; D. JUTRAS-ASWAD Année de publication : 2015 Article en page(s) : 1636-1643 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique CANADA Thésaurus TOXIBASE TENTATIVE DE SUICIDE ; USAGER ; INJECTION ; ALCOOL ; PSYCHOTROPES ; PRODUIT ILLICITE ; COHORTE Discipline : EPI Epidémiologie / Epidemiology Résumé : Aim: To estimate associations between recent licit and illicit substance use and subsequent suicide attempt among people who inject drugs (PWID). Design: Secondary analysis of longitudinal data from a prospective cohort study of PWID followed bi-annually between 2004 and 2011. Setting: Montréal, Canada. Participants: Seven hundred and ninety-seven PWID who reported injection drug use in the previous 6 months, contributing to a total of 4460 study visits. The median number of visits per participant was five (interquartile range: 3-8). Measurements: An interviewer-administered questionnaire eliciting information on socio-demographic factors, detailed information on substance use patterns and related behaviours, mental health markers and suicide attempt. The primary exposure variables examined were past-month use of alcohol [heavy (>= 60 drinks); moderate (one to 59 drinks); none], sedative-hypnotics, cannabis, cocaine, amphetamine and opioids [regular (>= 4 days); occasional (1-3 days); none]. The outcome was a binary measure of suicide attempt assessed in reference to the previous 6 months. Findings: In multivariate analyses, a positive association was found among licit substances between heavy alcohol consumption [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI) = 1.12-3.75], regular use of sedative-hypnotics (AOR = 1.89; 95% CI = 1.21-2.95) and subsequent attempted suicide. Among illicit substances, occasional use of cannabis (AOR = 1.84; 95% CI = 1.09-3.13) had a positive association with subsequent suicide attempt. No statistically significant association was found for the remaining substances. Conclusion: Among people who inject drugs, use of alcohol, sedative-hypnotics and cannabis, but not cocaine, amphetamine or opioids, appears to be associated with an increased likelihood of later attempted suicide. Domaine : Alcool / Alcohol ; Autres substances / Other substances ; Drogues illicites / Illicit drugs Refs biblio. : 50 Affiliation : Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada Cote : Abonnement Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=76300 [article]

Short-term injection drug use changes following hepatitis C virus (HCV) assessment and treatment among persons who inject drugs with acute HCV infection / A. A. ARTENIE ; G. ZANG ; M. DANIEL ; E. FORTIER ; D. JUTRAS-ASWAD ; S. PUZHKO ; J. BRUNEAU in International Journal of Drug Policy, Vol.47 (September 2017) 

Donner un avis [article]  inInternational Journal of Drug Policy > Vol.47 (September 2017) . - 239-243 Titre : Short-term injection drug use changes following hepatitis C virus (HCV) assessment and treatment among persons who inject drugs with acute HCV infection Type de document : Périodique Auteurs : A. A. ARTENIE ; G. ZANG ; M. DANIEL ; E. FORTIER ; D. JUTRAS-ASWAD ; S. PUZHKO ; J. BRUNEAU Année de publication : 2017 Article en page(s) : 239-243 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique CANADA Thésaurus TOXIBASE HEPATITE ; INJECTION ; ANTIVIRAUX ; USAGER ; COHORTE ; INFECTION Discipline : MAL Maladies infectieuses / Infectious diseases Résumé : Background: It is unclear whether treatment and care for hepatitis C virus (HCV) infection can help people who inject drugs (PWID) modify their injection drug use behaviours. This study examined changes in injection drug use among PWID with acute HCV systematically referred for HCV clinical assessment and treatment and offered targeted health care services, over the course of one year. Methods: The study sample included PWID with documented acute HCV infection recruited and followed-up semi-annually at least twice in IMPACT (2007-2015), a longitudinal community-based prospective study in Montréal, Canada. Following enrolment, participants with contra-indications to treatment due to severe co-morbidity were offered targeted health care services. Pegylated interferon-alpha (12-24 weeks) was offered to all other participants who did not spontaneously resolve their infection. At each study visit, data were collected on socio-demographic factors and drug use patterns. Logistic regression was used to assess changes in injection drug use at one-year follow-up. Results: Of the 87 eligible participants (mean age: 35.6; 78.2% male), 21.8% received treatment [(RT), Sustained virological response: 84.2%], 25.3% spontaneously resolved their infection (SR), 14.9% had contra-indication(s) (CI) and 37.9% chose not to engage in HCV care post-diagnosis (NE). In multivariate analyses adjusting for age, gender and injection drug use at baseline, the RT [Adjusted odds ratio (AOR): 0.18; 95% Confidence interval (CI): 0.04-0.76], SR (AOR: 0.34; 95% CI: 0.08-1.40), and CI (AOR: 0.24; 95% CI: 0.05-1.22) groups were less likely to report injection drug use at follow-up relative to the NE group. Conclusion: PWID who received treatment, spontaneously resolved their infection or presented with treatment contra-indication(s) reported reduced injection drug use at one-year follow-up relative to those who did not engage in therapy. Findings suggest that the benefits of HCV assessment and treatment may extent to helping PWID modify their injection drug use patterns. Domaine : Drogues illicites / Illicit drugs Affiliation : Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada Cote : Abonnement Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=79384 [article]

Trajectory of adolescent cannabis use on addiction vulnerability / Y. L. HURD ; M. MICHAELIDES ; M. L. MILLER ; D. JUTRAS-ASWAD in Neuropharmacology, Vol.76, part B (January 2014)

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