Risk and protective factors for cannabis, cocaine, and opioid use

New publication in Neuroscience & Biobehavioural Reviews with contribution by Prof Borgwardt!



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.


In the methods group we aim to identify novel and robust markers for translational use cases in psychiatry.

Research focus

The overarching goal is to obtain more reliable neural, physiological and behavioral predictors that help explaining the foundations of psychiatric conditions and could be used to increase confidence for treatment options and outcomes. We thereby continuously explore novel experimental settings such as virtual reality and direct social interactions to model human behavior under more natural conditions.

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Group members

  • Professor Frieder M. Paulus (psychologist)
  • David Sören Stolz (psychologist)
  • Annalina Valpuri Mayer (psychologist)
  • Finn Lübber (psychologist; collaborative supervision with Tanja Lange)

Publications & Funding

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