Comparing Cannabis Use Disorder in the General Population with Cannabis Treatment Seekers Using Multi-Source National Datasets: Who Receives Treatment?

Association of childhood mental health and cognition with longitudinal patterns of cannabis problems in adolescence

BACKGROUND

Adolescence is a key developmental period associated with an increased risk of experiencing cannabis-related problems. Identifying modifiable risk factors prior to the onset of cannabis use could help inform preventative interventions.

METHOD

Analysis nested within a UK prospective birth cohort study, the Avon Longitudinal Study of Parents and Children. Participants (n = 6,049) provided data on cannabis use and symptoms of cannabis problems using the Cannabis Abuse Screening Test at two or more time points between the ages of 15-24 years. Risk factors included internalizing and externalizing disorders assessed at age 10 years, and cognitive function assessed at age 8 years via short-term memory, emotion recognition, divided attention, and listening comprehension.

RESULTS

Participants were mostly female (59.1%) and white (95.73%). Five patterns of adolescent cannabis use problems were identified using longitudinal latent class analysis: stable-no problems (n = 5,157, 85%), early-onset high (n = 104, 2%), late-onset high (n = 153, 3%), early onset low (n = 348, 6%), and late-onset low (n = 287, 5%). In adjusted models, externalizing disorders were associated with early-onset high [RR, 95% CI: 2.82 (1.72, 4.63)], late-onset high [RR, 95% CI: 1.62 (1.02, 2.57)], and early-onset low [RR, 95% CI: 1.82 (1.30, 2.55)] compared to the stable-no problems class. Internalizing disorders were associated with late-onset low only [RR, 95% CI: .50 (.26, .96)], and short-term memory with late-onset high only [RR, 95% CI: 1.09 (1.01, 1.18) compared to the stable-no problems class.

CONCLUSIONS

Childhood externalizing disorders were consistently associated with increased risk of problematic patterns of cannabis use over adolescence, particularly early-onset and high levels of problems.

Help-seeking behaviours among cannabis consumers in Canada and the United States: Findings from the international cannabis policy study

Background

Little literature exists on what sources of help individuals utilize for cannabis-related problems. The current study examined the percentage of consumers who sought help to manage cannabis-related problems, such as perceived cannabis use disorder, the most common sources of help sought, and factors associated with help-seeking.

Methods

Past 12-month cannabis consumers (N = 13,209) completed an online survey from the International Cannabis Policy Study. Past 3-month help-seeking behaviours, respondent's perceived addiction to cannabis, legal status of cannabis in their jurisdiction, and risky behaviours associated with cannabis use was assessed.

Results

A minority sought help from any source (9.2 %) with the most likely being a doctor/physician (44.9 %). Help-seekers were most likely to be younger, mixed race (p = .011), more educated, financially stable, male, and higher perceived addiction to cannabis (all contrasts p < .001). In comparison to consumers in Canada and 'legal' US states, respondents in 'illegal' US states were more likely to seek help from family and friends (Canada: AOR = 5.73, 2.21-14.91; US: AOR = 4.76, 2.00-11.11) and less likely to seek help from a doctor/physician (Canada: AOR = 0.46, 0.24-0.90; US: AOR = 0.51, 0.27-0.99).

Conclusion

Roughly 1 in 10 cannabis consumers sought help from a range of sources, including a third who are at high risk of problematic use. More informal sources of help, such as seeking help from online sources are frequently used. Future research should examine these frontline sources of help for cannabis consumers.

Gambling in Ireland: profile of treatment episodes from a national treatment reporting system

OBJECTIVES

Globally, problem gambling prevalence is estimated at between 0.1% and 5.8%. Problem gambling can have many negative consequences; including on physical, and psychological health, and social functioning. There is a need to better understand treatment uptake as only a small proportion seek treatment. This is the first Irish national study using routinely gathered health surveillance data to describe treated problem gambling. Results will inform service policy and planning.

METHODS

An analysis of episodes treated for problem gambling collected by the National Drug Treatment Reporting System was undertaken. Included were episodes entering treatment between 2008 and 2019 (n = 2999). Variables of interest included service types accessed, demographics, socioeconomic information, referral and assessment details, current problems (up to five) and treatment history.

RESULTS

The majority (93.8%) were male. One fifth (20.9%) lived with dependent children, 7.4% were homeless. There were high levels of employment (35.4%) and formal education qualifications; half (53.8%) had completed second or third level education. Problem gambling frequently co-occurred with problem use of other substances (47.3%), which was most commonly alcohol (85.6%), followed by cannabis (32.3%), cocaine (28.0%) and benzodiazepines (10.9%). The majority were treated at inpatient settings (56.1%) with many self-referrals (46.3%).

CONCLUSIONS

This study provides insights into treated problem gambling nationally. Monitoring and surveillance can play a crucial role in measuring the successful efforts and help inform planning and treatment. The findings may have implications for treatment pathways.