***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE Cannabis use is common among opioid-dependent patients , but studies of its association with treatment outcome are mixed . In this secondary analysis , the association of cannabis use with opioid treatment outcome is assessed . METHODS In the main study , participants ( n=152 ) aged 15 - 21 years were r and omized to receive  psychosocial treatments  and either a 12-week course of buprenorphine-naloxone with a dose taper to zero in weeks 9 - 12 , or a 2-week detoxification with buprenorphine-naloxone .  Drug use was assessed by self-report and urine drug screen at baseline and during study weeks 1 - 12 . The association between cannabis and opioid use at weeks 4 , 8 , and 12 was examined using logistic regression models . RESULTS Participants reported a median of 3.0 days ( range=0 - 30 ) cannabis use in the past month ; half ( 50.3 % ; n=77 ) reported occasional use , one-third reported no use ( 33.1 % ; n=50 ) , and one-sixth reported daily cannabis use ( 16.6 % ; n=25 ) . Median lifetime cannabis use was 4.0 years ( range=0 - 11 ) and median age of initiation of use was 15.0 years ( range 9 - 21 ) . Neither past cannabis use ( age of initiation and use in the month prior to baseline ) nor concurrent use was associated with level of opioid use . CONCLUSIONS Overall , cannabis use had no association with opioid use over 12 weeks in this sample of opioid-dependent youth . While cannabis use remains potentially harmful , it was not a predictor of poor opioid treatment outcome AIMS Information concerning the association between marijuana use and opioid dependence and its treatment is needed to determine effective clinical guidelines for addressing marijuana use among opioid abusers . SETTING AND PARTICIPANTS Marijuana use was assessed in 107 people enrolled in treatment for opioid dependence . DESIGN AND MEASUREMENT Univariate comparisons of marijuana users and non-users and multivariate regression analyses were performed to examine associations between marijuana use and socio-demographic , psychosocial , medical and substance-use variables . The relationship between marijuana use and treatment outcome was also explored in a subset of this sample who received treatment that included buprenorphine detoxification and behavior therapy ( N = 79 ) . FINDINGS Sixty-six per cent of participants were current marijuana users and almost all ( 94 % ) continued to use during treatment . Users were less likely to be married than non-users , and more likely to report financial difficulties , be involved in drug dealing and engage in sharing of needles ( p < 0.05 ) . A unique effect of marijuana use on drug dealing and sharing needles was retained after statistically controlling for the influence of heroin and alcohol use and other socio-demographic variables . No significant adverse relations were observed between marijuana use and treatment outcome . CONCLUSION Pending a more comprehensive underst and ing of the function and consequences of marijuana use on psychosocial functioning , it appears that progress in treatment for opioid dependence can be made without m and ating that patients abstain from marijuana use BACKGROUND Whereas the role of externalizing disorders is relatively well established in predicting the onset of cannabis use ( CU ) or cannabis use disorder ( CUD ) , the status of anxiety and mood disorders in predicting CU and CUD remains controversial . OBJECTIVE ( 1 ) To examine cross-sectional and prospect i ve associations of CU and CUD with a range of mental disorders and whether anxiety and mood disorders are associated with CU/CUD after adjusting for externalizing disorders . METHODS N=1395 community subjects aged 14 - 17 at baseline were followed-up at three waves prospect ively over 10 years . Substance use , substance disorders and mental disorders were assessed using the DSM-IV/M-CIDI . RESULTS ( 1 ) The baseline prevalence rates where 19.3 % at t(0 ) for CU and 2.6 % for CUD . Cumulative incidence rates at t(3 ) were 54.3 % for CU and 13.7 % for CUD . ( 2 ) In cross-sectional and prospect i ve analyses other substance use disorders , mood and anxiety disorders were associated with CU and CUD . ( 3 ) Associations of panic-anxiety with CU and of depressive and bipolar disorders with CU and CUD were significant after controlling for externalizing disorders . CONCLUSION A range of psychopathological conditions , including depressive , bipolar and less consistently anxiety disorders as well as the degree of their comorbidity are significantly associated with incident CU and progression to CUD , even when controlling for externalising disorders . A better underst and ing of this complex interplay may result in better aetiological models and intervention strategies This prospect i ve , observational study investigated factors predicting a lapse to heroin use in 74 heroin-abstinent methadone maintenance patients . After baseline data collection , participants were assessed twice per week for 7 weeks and again at 6 months after baseline . Proportional hazards regression and logistic regression were used to investigate the effects of study predictors on heroin use . A goal of absolute heroin abstinence consistently predicted a lower risk of a lapse , whereas marijuana use was associated with a greater risk . Stress variables were not predictive . The abstinence goal and stress results were consistent with the authors ' previous studies of other drug treatment sample s. This line of research suggests that factors influencing lapses are similar across drug treatment population s and the role of stress in precipitating relapse remains unresolved 
    Output:
    
Discussion Results of this systematic review will eluci date the association between cannabis use and methadone maintenance treatment outcomes .
We will provide evidence that will be useful to clinicians regarding whether monitoring cannabis use during MMT is advantageous for optimizing MMT outcomes .