Risk and protective factors for cannabis, cocaine, and opioid use disorders: An umbrella review of meta-analyses of observational studies.

Abstract

Several meta-analyses of observational studies have addressed the association between risk and protective factors and cannabis/cocaine/opioid use disorders, but results are conflicting. No umbrella review has ever graded the credibility of this evidence (not significant/weak/suggestive/highly suggestive/convincing). We searched Pubmed-MEDLINE/PsycInfo, last search September 21, 2020. We assessed the quality of meta-analyses with the AMSTAR-2 tool. Out of 3,072 initial references, five were included, providing 19 associations between 12 putative risk/protective factors and cannabis/cocaine/opioid use disorders (cases: 4539; N = 1,118,872,721). While 84 % of the associations were statistically significant, none was convincing. One risk factor (smoking) had highly suggestive evidence for association with nonmedical use of prescription opioid medicines (OR = 3.07, 95 %CI:2.27 to 4.14). Convincing evidence emerged in sensitivity analyses on antisocial behavior and cannabis use disoder (OR 3.34, 95 %CI 2.53-4.41). Remaining associations had weak evidence. The quality of meta-analyses was rated as moderate in two (40 %), low in one (20 %), and critically low in two (40 %). Future research is needed to better profile risk/protective factors for cannabis/cocaine/opioid use disorders disorders informing preventive approaches.

• Authors: Marco Solmi, Elena Dragioti, Giovanni Croatto, Joaquim Radua, Stefan Borgwardt, Andrè F Carvalho, Jacopo Demurtas, Anna Mosina, Peter Konstantin Kurotschka, Jae Il Shin, Paolo Fusar-Poli
• Journal: Neuroscience and biobehavioral reviews (Neurosci Biobehav Rev) Vol. 126 Pg. 243-251 (07 2021) ISSN: 1873-7528 [Electronic] United States
• PMID: 33737104 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2021. Published by Elsevier Ltd.

Chemical References

• Cocaine

Topics

• Cannabis (adverse effects)
• Cocaine
• Humans
• Meta-Analysis as Topic
• Observational Studies as Topic
• Opioid-Related Disorders (epidemiology)
• Protective Factors
• Risk Factors