Short communicationPredicting violence among cocaine, cannabis, and alcohol treatment clients☆
Introduction
Although studies have often noted statistical relationships between alcohol, cocaine and cannabis use with violence, debate continues regarding whether these relationships are causal or correlational. Aggressive personality or risk-taking propensity, often elevated among substance users, are characteristics that might better explain violence than drug use. This study examines the use of alcohol, cocaine and cannabis along with several covariates in relation to violence in the past year among clients in treatment.
Substance abuse treatment samples have been shown to be particularly violent (see Macdonald et al., 2003, O'Farrell et al., 2003). Numerous studies have found significant relationships between the acute effects of alcohol and cocaine, and the likelihood of violence (see Boles and Miotto, 2003, Chermack and Blow, 2002, Friedman, 1998, Macdonald et al., 2005). Although disagreement continues over the exact nature of these relationships (e.g., Lipsey, Wilson, Cohen, & Derzon, 1997), there is a growing consensus that acute alcohol and cocaine effects are at least partially causally related to violence (Macdonald et al., 2003, Macdonald et al., 2005). Studies of the relationship between violent injuries and cannabis have yielded mixed results (Macdonald et al., 2003).
This study aims to better understand the relative importance of alcohol, cocaine and cannabis use and other selected psychosocial characteristics in explaining violence.
What are the univariate relationships between frequency of alcohol, cocaine and cannabis use, other psychosocial characteristics, and violence?
What are the multivariate relationships between frequency of substance use, other psychosocial factors, and violence?
Section snippets
Research design
A cross-sectional study design was used. A self-administered questionnaire that included questions on violence and potential risk factors was administered to patients upon admission to various treatment programs.
The sample
Subjects for this study were 18 years and over and in treatment for various addictions, including a primary problem with cocaine (n = 300), cannabis (n = 126), alcohol (n = 110), other drugs (33), tobacco (249) or gambling (n = 196). The subjects for this study, obtained from various treatment
Results
About two thirds of the subjects in treatment for a primary problem with cocaine or cannabis had additional substance use problems. Less than 10% of subjects in the tobacco and gambling groups had a substance abuse problem of any kind. Clients in treatment for cocaine alone most often reported involvement in an incident of violence (56.8%) while the cannabis alone group had the least amount of violence (26.5%) among the substance use groups, which in turn was much higher than either the
Discussion
Overall, the results of this study support a connection between alcohol and cocaine use with violence; however, more research is needed to determine the nature of the relationship. Aggressive personality also accounted for the differential likelihood of violence between groups. Prior studies confirm that populations in treatment for substance abuse are significantly more likely to be aggressive and risk-takers than the general population (see Conway et al., 2002, Macdonald and Mann, 1996). Such
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2018, Addictive Behaviors ReportsMedical cannabis and mental health: A guided systematic review
2017, Clinical Psychology ReviewCitation Excerpt :These reviews highlight discrepancies in the literature; whereas some research has suggested that NMC is positively associated with violence due to alterations in cognitive functioning (Moore & Stuart, 2005), negative consequences of withdrawal (Kouri, Pope, & Lukas, 1999), or associations with deviance and risk-taking behavior (Harrison, Erickson, Adlaf, & Freeman, 2001), other research has concluded that cannabis is not associated with violence because of its sedative and quieting nature, reducing irritability and hostility (Salzman, Van der Kolk, & Shader, 1976), and nonviolent expectancies (Alfonso & Dunn, 2007). Directionality and potential confounds further obscure the nature of the association, as cannabis users report use to attenuate aggression (Arendt et al., 2007), and use was unrelated to violence after controlling for other factors among patients in substance use treatment (Macdonald, Erickson, Wells, Hathaway, & Pakula, 2008). The results of longitudinal studies of NMC and violence are also inconsistent.
Cognitive Behavioral Therapy in Cannabis Use Disorder
2017, Handbook of Cannabis and Related Pathologies: Biology, Pharmacology, Diagnosis, and Treatment
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This paper received financial support from the Canadian Institutes of Health Research.