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Zvolensky MJ, Kauffman BY, Garey L, Buckner JD, Businelle MS, Reitzel LR. Financial strain among adult African American/Black cannabis users. J Ethn Subst Abuse 2024; 23:365-377. [PMID: 35793071 DOI: 10.1080/15332640.2022.2092924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
African American/Black persons belong to the second largest racial/ethnic minority group in the United States. This group evinces significant disparities related to cannabis use problems. Social determinants of health may be potentially relevant to better understand cannabis use problems among African American/Black adults. As such, the current study sought to provide an initial test of the role of financial strain, a prominent social determinant of health, in cannabis use problems and perceived barriers for cannabis cessation among African American/Black adults. Participants were 76 (32.9% female, Mage = 38.64, SD = 10.82) African American/Black adult, current cannabis users. Hierarchical regression results indicated that greater financial strain was associated with more cannabis use problems and greater perceived barriers for cannabis cessation; such effects were evident above and beyond the variance explained by a range of relevant covariates, including age, sex, income, education, and depressive symptoms. These findings suggest addressing financial strain (e.g., financial planning, psychoeducation about the handling financial stress) may be a useful therapeutic tactic in the larger landscape of treatment programming when targeting cannabis use behaviors and beliefs among African American/Black adult cannabis users.
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Affiliation(s)
- Michael J Zvolensky
- University of Houston, Houston, Texas
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | | | - Michael S Businelle
- University of Houston, Houston, Texas
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Stephenson Cancer Center, Oklahoma City, Oklahoma
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Mauro PM, Gutkind S, Askari MS, Hasin DS, Samples H, Mauro CM, Annunziato EM, Boustead AE, Martins SS. Associations between cannabis policies and state-level specialty cannabis use disorder treatment in the United States, 2004-2019. Drug Alcohol Depend 2024; 257:111113. [PMID: 38382162 DOI: 10.1016/j.drugalcdep.2024.111113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Cannabis use disorder (CUD) treatment prevalence decreased in the US between 2002 and 2019, yet structural mechanisms for this decrease are poorly understood. We tested associations between cannabis laws becoming effective and self-reported CUD treatment. METHODS Restricted-use 2004-2019 National Surveys on Drug Use and Health included people ages 12+ classified as needing CUD treatment (i.e., past-year DSM-5-proxy CUD or last/current specialty treatment for cannabis). Time-varying indicators of medical cannabis laws (MCL) with/without cannabis dispensary provisions differentiated state-years before/after laws using effective dates. Multi-level logistic regressions with random state intercepts estimated individual- and state-adjusted CUD treatment odds by MCLs and model-based changes in specialty CUD treatment state-level prevalence. Secondary analyses tested associations between CUD treatment and MCL or recreational cannabis laws (RCL). RESULTS Using a broad treatment need sample definition in 2004-2014, specialty CUD treatment prevalence decreased by 1.35 (95 % CI = -2.51, -0.18) points after MCL without dispensaries and by 2.15 points (95 % CI = -3.29, -1.00) after MCL with dispensaries provisions became effective, compared to before MCL. Among people with CUD in 2004-2014, specialty treatment decreased only in MCL states with dispensary provisions (aPD = -0.91, 95 % CI = -1.68, -0.13). MCL were not associated with CUD treatment use in 2015-2019. RCL were associated with lower CUD treatment among people classified as needing CUD treatment, but not among people with past-year CUD. CONCLUSIONS Policy-related reductions in specialty CUD treatment were concentrated in states with cannabis dispensary provisions in 2004-2014, but not 2015-2019, and partly driven by reductions among people without past-year CUD. Other mechanisms (e.g., CUD symptom identification, criminal-legal referrals) could contribute to decreasing treatment trends.
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Affiliation(s)
- Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States.
| | - Sarah Gutkind
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States
| | - Melanie S Askari
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States
| | - Deborah S Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States; New York State Psychiatric Institute, United States
| | - Hillary Samples
- Center for Pharmacoepidemiology and Treatment Science, Rutgers Institute for Health, Health Care Policy and Aging Research, United States; Department of Health Behavior, Society & Policy, Rutgers University School of Public Health, United States
| | - Christine M Mauro
- Department of Biostatistics, Columbia University Mailman School of Public Health, United States
| | - Erin M Annunziato
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States
| | - Anne E Boustead
- School of Government & Public Policy, University of Arizona, United States
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States
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Asano T, Takemoto H, Horita T, Tokutake T, Izuo N, Mochizuki T, Nitta A. Sleep disturbance after cessation of cannabis administration in mice. Neuropsychopharmacol Rep 2023; 43:505-512. [PMID: 36905178 PMCID: PMC10739061 DOI: 10.1002/npr2.12329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023] Open
Abstract
Cannabis withdrawal syndrome (CWS) in humans is characterized by various somatic symptoms, including sleep disturbances. In the present study, we investigated sleep alterations in mice after the cessation of arachidonylcyclopropylamide (ACPA), a cannabinoid type 1 receptor agonist, administration. ACPA-administered mice (ACPA mice) displayed an increased number of rearings after the cessation of ACPA administration compared to saline-administered mice (Saline mice). Moreover, the number of rubbings was also decreased in ACPA mice compared with those of the control mice. Electroencephalography (EEG) and electromyography (EMG) were measured for 3 days after the cessation of ACPA administration. During ACPA administration, there was no difference in the relative amounts of total sleep and wake time between ACPA and Saline mice. However, ACPA-induced withdrawal decreased total sleep time during the light period in ACPA mice after ACPA cessation. These results suggest that ACPA cessation induces sleep disturbances in the mouse model of CWS.
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Affiliation(s)
- Takashi Asano
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical SciencesGraduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyamaJapan
| | - Hiroki Takemoto
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical SciencesGraduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyamaJapan
| | - Tomoya Horita
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical SciencesGraduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyamaJapan
| | - Tomohiro Tokutake
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical SciencesGraduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyamaJapan
| | - Naotaka Izuo
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical SciencesGraduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyamaJapan
| | - Takatoshi Mochizuki
- Department of BiologyGraduate School of Science & Engineering, University of ToyamaToyamaJapan
| | - Atsumi Nitta
- Department of Pharmaceutical Therapy and Neuropharmacology, Faculty of Pharmaceutical SciencesGraduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyamaJapan
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Chatton A, Khazaal Y, Penzenstadler L. A 13-item Health of the Nation Outcome Scale (HoNOS-13): validation by item response theory (IRT) in patients with substance use disorder. Addict Sci Clin Pract 2023; 18:64. [PMID: 37876018 PMCID: PMC10594779 DOI: 10.1186/s13722-023-00416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND The Health of the Nation Outcome Scale (HoNOS) is a widely used 12-item tool to assess mental health and social functioning. The French version has an added 13th item measuring adherence to psychotropic medication. The aim of the current study is to uncover the unknown pattern of the new item 13 and to compare the unidimensional and multidimensional fit of the new HoNOS-13 using Item Response Theory (IRT). This research question was studied among inpatients with substance use disorder (SUD). METHODS Six hundred and nine valid questionnaires of HoNOS-13 were analyzed using unidimensional (one-factor) and multidimensional (two-factor) IRT modeling. RESULTS The multidimensional model suggesting a first factor capturing psychiatric/impairment-related issues and a second factor reflecting social-related issues yielded better goodness-of-fit values compared to the unidimensional solution. This resulted in an improvement of all slope parameters which in turn translates to better discriminative power. Significant improvement in item location parameters were observed as well. The new item 13 had a good discriminative power (1.17) and covered a wide range of the latent trait (- 0.14 to 2.64). CONCLUSIONS We were able to validate the 13-item questionnaire including medication compliance and suggest that the HoNOS-13 can be recommended as a clinical evaluation tool to assess the problems and treatment needs for inpatients with SUD. Interestingly, the majority of item response categories are endorsed by respondents who are below and above the average levels of HoNOS. This indicates that the scale is able to discriminate between participants both at the low and at the high ends of the latent trait continuum. More importantly, the new item 13 has a good discriminative power and covers a broad range of the latent trait below and above the mean. It therefore has the desired profile of a good item and is a useful measure for the assessment of mental health and social functioning. Trial registration ClinicalTrials.gov, Identifier: NCT03551301. Registered: 11.06.2018. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03551301 .
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Affiliation(s)
- Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Rue du Bugnon 23A, 1011, Lausanne, Switzerland.
- Department of Psychiatry and Addictology, Montréal University, Montréal, Canada.
- Department of Medicine, University of Geneva, Geneva, Switzerland.
| | - Louise Penzenstadler
- Division of Addiction Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
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Collins AB, Beaudoin FL, Metrik J, Wightman RS. "I still partly think this is bullshit": A qualitative analysis of cannabinoid hyperemesis syndrome perceptions among people with chronic cannabis use and cyclic vomiting. Drug Alcohol Depend 2023; 246:109853. [PMID: 36996524 PMCID: PMC10121940 DOI: 10.1016/j.drugalcdep.2023.109853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Cannabis is the most widely used psychoactive substance in the United States (US), with reported use patterns increasing among adults in recent years. Cannabinoid hyperemesis syndrome (CHS) has been one concern related to increased cannabis use patterns. US emergency departments have reported an increase of CHS cases over the last decade, yet little is known about CHS. This study explores the experiences of people with chronic cannabis use and cyclic vomiting and their perceptions of CHS. METHODS Semi-structured interviews were conducted with 24 people recruited from a prospective cohort of patients presenting to Rhode Island emergency departments with symptomatic cyclic vomiting and chronic cannabis use. Data were analyzed thematically using NVivo. FINDINGS Participants characterized their cyclic vomiting as related to food and alcohol consumption patterns, stress, and existing gastrointestinal issues. Despite recurrent episodes of cyclic vomiting, nausea, and abdominal pain, many participants remained uncertain whether their symptoms were driven by cannabis. Many participants relied on at-home research to assess their symptoms and seek out management approaches. Clinical treatment recommendations focused on cannabis cessation. However, most participants felt clinical recommendations failed to consider the complexity and challenge of stopping cannabis use given the chronicity of use and therapeutic benefits some perceived cannabis to have. CONCLUSIONS Although cannabis cessation is the only reported CHS cure to date, additional clinical and non-clinical treatment approaches are needed to better support people with chronic cannabis use and cyclic vomiting to meet their ongoing needs.
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Affiliation(s)
- Alexandra B Collins
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA; Providence VA Medical Center, Providence, RI, 02908, USA
| | - Rachel S Wightman
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA
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Zhao J, Goodhines PA, Park A. The intersection of neighborhood and race in urban adolescent health risk behaviors. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1785-1802. [PMID: 36434809 PMCID: PMC10081941 DOI: 10.1002/jcop.22963] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 05/23/2023]
Abstract
AIMS Racial variability in associations of neighborhood socioeconomic disadvantage and neighborhood disorder with adolescent health risk behaviors remains under-researched, which this study examined over 1 year among racially diverse adolescents. METHODS High school students (N = 345; 18% Asian, 44% Black, 16% Multiracial, 22% White) completed surveys assessing neighborhood socioeconomic disadvantage and neighborhood disorder, and health risk behaviors (lifetime alcohol, cannabis, and cigarette use, number of sexual partners) at baseline (Year 1) and 1-year follow-up (Year 2). RESULTS Asian, Black, and Multiracial adolescents were more likely to endorse health risk behaviors in Year 2 compared to White adolescents living in similarly disadvantaged neighborhoods at Year 1. Associations of neighborhood disorder with health risk behavior did not differ by race. CONCLUSION Neighborhood socioeconomic disadvantage (but not neighborhood disorder) may predispose Asian, Black, and Multiracial adolescents to health risk behaviors. Findings may inform interventions to address racial disparities in adolescent health risk behaviors.
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Affiliation(s)
- Jin Zhao
- Department of Psychology, Syracuse University
| | | | - Aesoon Park
- Department of Psychology, Syracuse University
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Preparedness for healthy ageing and polysubstance use in long-term cannabis users: a population-representative longitudinal study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e703-e714. [PMID: 36202130 PMCID: PMC9552770 DOI: 10.1016/s2666-7568(22)00201-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cannabis is often characterised as a young person's drug. However, people who began consuming cannabis in the 1970s and 1980s are no longer young and some have consumed it for many years. This study tested the preregistered hypothesis that long-term cannabis users show accelerated biological ageing in midlife and poorer health preparedness, financial preparedness, and social preparedness for old age. METHODS In this longitudinal study, participants comprised a population-representative cohort of 1037 individuals born in Dunedin, New Zealand, between April, 1972, and March, 1973, and followed to age 45 years. Cannabis, tobacco, and alcohol use and dependence were assessed at ages 18 years, 21 years, 26 years, 32 years, 38 years, and 45 years. Biological ageing and health, financial, and social preparedness for old age were assessed at age 45 years. Long-term cannabis users were compared using independent samples t tests with five groups: lifelong cannabis non-users, long-term tobacco users, long-term alcohol users, midlife recreational cannabis users, and cannabis quitters. In addition, regression analyses tested dose-response associations for continuously measured persistence of cannabis dependence from age 18 years to 45 years, with associations adjusted for sex, childhood socioeconomic status, childhood IQ, low childhood self-control, family substance dependence history, and persistence of alcohol, tobacco, and other illicit drug dependence. FINDINGS Of 997 cohort members still alive at age 45 years, 938 (94%) were assessed at age 45 years. Long-term cannabis users showed statistically significant accelerated biological ageing and were less equipped to manage a range of later-life health, financial, and social demands than non-users. Standardised mean differences between long-term cannabis users and non-users were large: 0·70 (95% CI 0·46 to 0·94; p<0·0001) for biological ageing, -0·72 (-0·96 to -0·49, p<0·0001) for health preparedness, -1·08 (-1·31 to -0·85; p<0·0001) for financial preparedness, and -0·59 (-0·84 to -0·34, p<0·0001) for social preparedness. Long-term cannabis users did not fare better than long-term tobacco or alcohol users. Tests of dose-response associations suggested that cannabis associations could not be explained by the socioeconomic origins, childhood IQ, childhood self-control, and family substance-dependence history of long-term cannabis users. Statistical adjustment for long-term tobacco, alcohol, and other illicit drug dependence suggested that long-term cannabis users' tendency toward polysubstance dependence accounted for their accelerated biological ageing and poor financial and health preparedness, although not for their poor social preparedness (β -0·10, 95% CI -0·18 to -0·02; p=0·017). INTERPRETATION Long-term cannabis users are underprepared for the demands of old age. Although long-term cannabis use appears detrimental, the greatest challenge to healthy ageing is not use of any specific substance, but rather the long-term polysubstance use that characterises many long-term cannabis users. Substance-use interventions should include practical strategies for improving health and building financial and social capital for healthy longevity. FUNDING The National Institute on Aging and the UK Medical Research Council. The Dunedin Research Unit is supported by the New Zealand Health Research Council and the New Zealand Ministry of Business, Innovation and Employment.
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Mauro PM, Gutkind S, Rivera-Aguirre A, Gary D, Cerda M, Santos EC, Castillo-Carniglia A, Martins SS. Trends in cannabis or cocaine-related dependence and alcohol/drug treatment in Argentina, Chile, and Uruguay. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 108:103810. [PMID: 35939947 PMCID: PMC9912990 DOI: 10.1016/j.drugpo.2022.103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 07/09/2022] [Accepted: 07/19/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed cannabis/cocaine-related dependence and treatment in Argentina, Chile, and Uruguay. METHODS Nationally representative cross-sectional household surveys of people ages 15-64 in Argentina (4 surveys, 2006-2017), Chile (7 surveys, 2006-2018), and Uruguay (4 surveys, 2006-2018) were harmonized. We estimated weighted prevalences of cannabis or cocaine-related (cocaine or cocaine paste) dependence, based on meeting 3+ past-year ICD-10 dependence criteria. We estimated weighted prevalences of past-year alcohol/drug treatment use (Argentina, Chile) or use/seeking (Uruguay) among people with past-year cannabis/cocaine-related dependence. We tested model-based prevalence trends over time and described individual-level treatment correlates by country. RESULTS Cannabis/cocaine dependence prevalence increased in the region starting in 2010-2011, driven by cannabis dependence. Adjusted cannabis dependence prevalence increased from 0.7% in 2010 to 1.5% in 2017 in Argentina (aPD=0.8, 95% CI= 0.3, 1.2), from 0.8% in 2010 to 2.8% in 2018 in Chile (aPD=2.0, 95% CI= 1.4, 2.6), and from 1.4% in 2011 to 2.4% in 2018 in Uruguay (aPD=0.9, 95% CI= 0.2, 1.6). Cocaine-related dependence increased in Uruguay, decreased in Argentina, and remained stable in Chile. Among people with past-year cannabis/cocaine dependence, average alcohol/drug treatment use prevalence was 15.3% in Argentina and 6.0% in Chile, while treatment use/seeking was 14.7% in Uruguay. Alcohol/drug treatment prevalence was lower among people with cannabis dependence than cocaine-related dependence. Treatment correlates included older ages in all countries and male sex in Argentina only. CONCLUSION Alcohol/drug treatment use among people with cannabis/cocaine-related dependence remained low, signaling an ongoing treatment gap in the context of growing cannabis dependence prevalence in the region. Additional resources may be needed to increase treatment access and uptake. Future studies should assess contributors of low treatment use, including perceived need, stigma, and service availability.
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Affiliation(s)
- Pia M Mauro
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA.
| | - Sarah Gutkind
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York NY 10016 USA; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile
| | - Dahsan Gary
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA
| | - Magdalena Cerda
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York NY 10016 USA
| | - Erica Chavez Santos
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA; University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA 98195 USA
| | - Alvaro Castillo-Carniglia
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York NY 10016 USA; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile; Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Badajoz 130, Room 1306, Las Condes, Santiago, Chile; Millennium Nucleus on Sociomedicine (SocioMed), Chile
| | - Silvia S Martins
- Columbia University Mailman School of Public Health, 722 W 168(th) St, New York NY 10032 USA
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Identifying risk-thresholds for the association between frequency of cannabis use and development of cannabis use disorder: A systematic review and meta-analysis. Drug Alcohol Depend 2022; 238:109582. [PMID: 35932748 DOI: 10.1016/j.drugalcdep.2022.109582] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cannabis use disorder (CUD) affects one-in-five cannabis users, presenting a major contributor to cannabis-associated disease burden. Epidemiological data identify the frequency of cannabis use as a risk factor for CUD. This review aimed to determine quantifiable risk-thresholds of the frequency of cannabis use for developing CUD. METHODS Systematic search of Medline, EMBASE, PsycInfo, CINAHL, and Web of Science for cohort/case-control studies that assessed the association between frequency of cannabis use and CUD from 2000 to 2022. Effect estimates were converted to risk ratios (RR). A random-effects multi-level multivariate meta-analytic approach was utilized, and sensitivity analyses conducted. Quality of included studies was assessed with the Newcastle Ottawa Scale. RESULTS Six prospective cohort studies were included in this review, drawn from two main source studies. Random-effect modeling showed a significant log-linear dose-response association between the frequency of cannabis use and CUD risk (p < 0.0001). The risk of CUD increased from RR:2.03 (95% CI:1.85-2.22) for 'yearly' use, to RR:4.12 (95% CI:3.44-4.95) for 'monthly" use, RR:8.37 (95% CI:6.37-11.00) for 'weekly' use, and RR:16.99 (95% CI:11.80-24.46) for 'daily' use. Multi-level modeling showed an absolute risk increase (ARI) from 3.5% (95% CI:2.6-4.7) for 'yearly' use, to 8.0% (95% CI:5.3-12.1) for 'monthly' use, to 16.8% (95% CI:8.8-32.0) for 'weekly' use, and 36% (95% CI:27.047.9) for 'daily' use. CONCLUSION A limited risk of CUD as a potential outcome of cannabis use exists even at infrequent levels of use, but significantly increases as frequency of use increases. Corresponding information should be conveyed to cannabis users as part of targeted prevention messaging to promote safer cannabis use.
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Keyes KM, Kaur N, Kreski NT, Chen Q, Martins SS, Hasin D, Olfson M, Mauro PM. Temporal trends in alcohol, cannabis, and simultaneous use among 12th-grade U.S. adolescents from 2000 to 2020: Differences by sex, parental education, and race and ethnicity. Alcohol Clin Exp Res 2022; 46:1677-1686. [PMID: 36125706 PMCID: PMC9635013 DOI: 10.1111/acer.14914] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/14/2022] [Accepted: 07/16/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Simultaneous use of alcohol and cannabis to enhance each other's effect can cause potential harm. Time trends are diverging in adolescent use of alcohol, which is declining, and cannabis, which is increasing among certain subgroups. However, little is known about trends in their simultaneous and non-simultaneous use. Racial and socioeconomic disparities are emerging in cannabis use, which may portend consequences to public health. METHODS The 2000 to 2020 Monitoring the Future surveys included approximately 38,000 U.S. 12th-grade students with information on simultaneous use and pertinent demographic factors. A 5-level alcohol/cannabis measure included past-year simultaneous use (i.e., alcohol and cannabis use at the same time), non-simultaneous alcohol and cannabis use, alcohol-use-only, cannabis-use-only, and no use. Multinomial logistic regressions estimated associations (adjusted relative risk ratios; aRRR) with time period (2000 to 2004, 2005 to 2009, 2010 to 2014, 2015 to 2020). Models were adjusted and included interactions with sex, race/ethnicity, and parental education. RESULTS Between 2000 and 2020, simultaneous alcohol/cannabis use among 12th graders decreased from 24.4% to 18.7%. From 2015 to 2020 compared to 2000 to 2004, the odds of simultaneous use (adjusted relative risk ratio (aRRR) vs. no use = 0.57, 95% CI [0.50, 0.66]) and alcohol-use-only (aRRR = 0.55, 95% CI [0.49, 0.61]) decreased, while cannabis-use-only odds increased (aRRR = 2.59, 95% CI [1.87, 3.59]). Notably, the prevalence of cannabis-use-only more than doubled from 2011 to 2019. The odds of simultaneous use, alcohol-use-only, and non-simultaneous use of alcohol and cannabis declined more rapidly among males than females, whereas the odds for cannabis-use-only increased faster for females than males. Increases in cannabis-use-only were faster for non-white adolescents. CONCLUSION Simultaneous use of alcohol and cannabis is declining among U.S. adolescents, but the decline is slower among females than males. Declines in simultaneous use are largely concomitant with historical declines in alcohol use, indicating that a continued focus on reducing alcohol use among adolescents and young adults has extended benefits to other adolescent substance use. However, cannabis use without any reported past-year alcohol use more than doubled in the last decade, a concerning trend.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Navdep Kaur
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Deborah Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, New York, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, New York, USA
| | - Pia M Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Relationship perceptions and conflict behavior among cannabis users. Drug Alcohol Depend 2022; 237:109502. [PMID: 35680504 PMCID: PMC9816374 DOI: 10.1016/j.drugalcdep.2022.109502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cannabis use is increasingly common, yet few studies have examined its associations with couple functioning. To address this gap, we used actor-partner interdependence modeling to examine the associations between cannabis use, relationship perceptions, and observed conflict behavior in a community-based sample of cannabis users and their partners. METHODS Cannabis users (N = 232; 96 males; 122 females; 14 undisclosed biological sex) and their partners completed self-reports of cannabis frequency and global relationship satisfaction and commitment. At a laboratory visit, couples engaged in a 10 min conflict discussion and a 5 min discussion of areas of agreement, and reported on their post-conflict perceptions. Each partner's parasympathetic activity was assessed during the conflict task, and trained raters coded conflict and recovery behavior RESULTS: More frequent actor cannabis use was associated with more negative engagement and avoidance behavior during conflict, less parasympathetic withdrawal during conflict, and less effective behavioral recovery immediately after conflict. More frequent cannabis use was also associated with greater satisfaction with conflict resolution following the conflict discussion, but was not associated with perceived overall relationship satisfaction or commitment. Cannabis effects were independent of alcohol use CONCLUSIONS: Among cannabis users, there are discrepancies between perceived and objective measures of relationship functioning, such that cannabis users viewed their relationships as better functioning compared to independent raters' reports. These findings highlight the need for a nuanced understanding of the associations between cannabis and relationship functioning, which appear to be distinct from alcohol, as well as an organizing theoretical framework to stimulate future research.
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Keyes KM, Kreski NT, Ankrum H, Cerdá M, Chen Q, Hasin DS, Martins SS, Olfson M, Miech R. Frequency of adolescent cannabis smoking and vaping in the United States: Trends, disparities and concurrent substance use, 2017-19. Addiction 2022; 117:2316-2324. [PMID: 35588004 PMCID: PMC10037679 DOI: 10.1111/add.15912] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/07/2022] [Indexed: 01/24/2023]
Abstract
AIM To quantify the trends in frequent and occasional cannabis vaping, demographic differences and concurrent nicotine and alcohol use. DESIGN Observational study. Survey-weighted multinomial logistic regression models assessed trends and disparities in past 30-day cannabis use. Trends were assessed overall and by sex, race/ethnicity, parental education and urbanicity. Multinomial logistic regression models also estimated associations of cannabis use (none, use without vaping, use with vaping) with past 2-week binge drinking and past 30-day nicotine/tobacco use. SETTING United States, 2017-19. PARTICIPANTS Participants in the national Monitoring the Future (n = 51 052) survey. MEASUREMENTS Past 30-day frequent cannabis use (six or more times/30 days) and past 30-day occasional use (one to five times/30 days), with and without vaping. FINDINGS Past 30-day frequent cannabis use with vaping and occasional use with vaping rose from 2017 to 2019. Past 30-day frequent and occasional cannabis use without vaping declined. Certain groups, such as Hispanic/Latino or lower socio-economic status adolescents, experienced particularly notable increases in frequent cannabis use with vaping (e.g. prevalence among Hispanic/Latino adolescents). Adolescents who reported smoking and vaping nicotine, and 10+ occasions of binge drinking, were 42.28 [95% confidence interval (CI) = 33.14-53.93] and 10.09 (95% CI = 4.51-22.53) times more likely to report past 30-day cannabis use with vaping, respectively, compared with no use. DISCUSSION Cannabis use without vaping appears to be declining among adolescents in the United States, while cannabis use with vaping is accelerating; frequent cannabis vaping is especially increasing, with consistent increases across almost all adolescent demographic groups. Cannabis use among US adolescents remains highly associated with other substance use.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Noah T. Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hadley Ankrum
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Deborah S. Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Richard Miech
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Déguilhem A, Leclerc A, Goldberg M, Lemogne C, Roquelaure Y, Zins M, Airagnes G. Cannabis Use Increases the Risk of Sickness Absence: Longitudinal Analyses From the CONSTANCES Cohort. Front Public Health 2022; 10:869051. [PMID: 35712263 PMCID: PMC9197417 DOI: 10.3389/fpubh.2022.869051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Aims To examine the longitudinal associations between cannabis use and risks of short (<7 days), medium (7-28 days), and long (>28 days) sickness absences at one-year follow-up. Methods 87,273 participants aged 18-65 years from the French CONSTANCES cohort reported their frequency of cannabis use at inclusion between 2012 and 2018. Sickness absences occurring during one year of follow-up were collected from national medico-administrative registries. Multivariable generalized linear regressions were used to compute the Odds Ratios (OR) with their 95% Confidence Intervals (CI) of having at least one sickness absence at follow-up compared to no sickness absence, while controlling for sociodemographic factors, chronic conditions and occupational factors. Results Cannabis use more than once a month was associated with an increased risk of short (OR, [95% CI]: 1.56 [1.32–1.83]) and medium (1.29 [1.07–1.54]) sickness absences at one-year follow-up, with dose-dependent relationships for short sickness absences (1.13 [1.08–1.18], p-for-trend <0.001). In stratified analyses, cannabis use was associated with an increased risk of sickness absences in older individuals, men, participants with good self-rated health, living or having lived as a couple, and having an open-ended contract. Conclusions Cannabis use prospectively increased the risk of short and medium sickness absences, even from once a month and with a dose-dependent relationship for short sickness absences. These findings should be considered in information and prevention public health campaigns to alert the general population and workers to this increased risk.
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Affiliation(s)
- Amélia Déguilhem
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Annette Leclerc
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Cédric Lemogne
- Université Paris Cité, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institute of Psychiatry and Neuroscience of Paris, UMR_S1266, Paris, France
| | - Yves Roquelaure
- Centre Hospitalier Universitaire d'Angers, Pathologie Professionnelle et Médecine du Travail, Research Institute for Environmental and Occupational Health, INSERM, Ester, Epidemiology in Occupational Health and Ergonomics, UMR_S 1085, Angers, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Guillaume Airagnes
- Université Paris Cité, AP-HP, Hôpital Européen Georges Pompidou, DMU Psychiatrie et Addictologie, Centre Ambulatoire d'Addictologie, INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
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14
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Ramer NE, Colder CR. Contextualizing Cannabis Implicit Associations: Consideration of Peers and Personality. EMERGING ADULTHOOD (PRINT) 2022; 10:581-594. [PMID: 36970728 PMCID: PMC10035208 DOI: 10.1177/21676968211021672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Implicit cannabis associations (ICAs) inconsistently predict cannabis use (CU), and little is known about their formation. Personality, behavioral approach and inhibition, were tested as predictors of ICAs, which in turn, was expected to predict CU (mediation). Peer context was tested as a moderator. METHOD Data were taken from three annual assessments of a larger longitudinal study. The community sample (314 emerging adults, mean age = 19.13, 54% female, 76% White/non-Hispanic at the first assessment) completed an ICA task and questionnaire assessments of CU, personality, and peer norms. RESULTS ICAs were positively associated with CU at high but not low levels of perceived peer approval/use. Behavioral inhibition was negatively associated ICAs, which in turn, predicted infrequent CU at high levels of peer approval/use (moderated mediation). Behavioral approach was marginally associated with ICAs. CONCLUSIONS Peer context and personality are important for understanding the formation of ICAs and their association with CU.
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Affiliation(s)
- Nolan E. Ramer
- Department of Psychology, University at Buffalo, The State University of New York, NY, USA
| | - Craig R. Colder
- Department of Psychology, University at Buffalo, The State University of New York, NY, USA
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15
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Ball J, Crossin R, Boden J, Crengle S, Edwards R. Long-term trends in adolescent alcohol, tobacco and cannabis use and emerging substance use issues in Aotearoa New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2060266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jude Ball
- Department of Public Health, University of Otago, Wellington
| | - Rose Crossin
- Department of Population Health, University of Otago, Christchurch
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington
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16
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Copeland WE, Hill SN, Shanahan L. Adult Psychiatric, Substance, and Functional Outcomes of Different Definitions of Early Cannabis Use. J Am Acad Child Adolesc Psychiatry 2022; 61:533-543. [PMID: 34416291 PMCID: PMC8850538 DOI: 10.1016/j.jaac.2021.07.824] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/09/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Research on associations of early cannabis use with adult functioning reports mixed findings. This may be due, in part, to wide variations in the definitions of early cannabis use. This study aims to compare associations of 4 commonly used definitions of early cannabis use-related to timing, dose, duration, and associated symptoms-with adult outcomes. METHOD Analyses were based on a 20+-year longitudinal, community-representative study of 1,420 participants. Between ages 9 and 21 years (8,806 observations), participants were assessed for cannabis use and DSM-5 cannabis use disorder. In early adulthood (ages 24-26 and 30; 2,424 observations of 1,266 subjects), participants were also assessed for psychiatric, substance use, and functional outcomes. RESULTS All definitions of early use were associated with multiple adult outcomes in models that adjusted for sex and race/ethnicity. In models that also adjusted for childhood psychiatric problems and family adversities, only daily use and a persistent developmental subtype (defined as daily/problematic use that began in adolescence and continued into early adulthood) were associated with later substance use/disorders, poorer functional outcomes, and derailments in the transition to adulthood. CONCLUSION Daily, continued-over-time cannabis use beginning on adolescence was most problematic for a range of adult outcomes. Cessation of early use did not fully eliminate later risks; but was associated with fewer negative outcomes, with weaker effect sizes.
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Affiliation(s)
| | - Sherika N. Hill
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
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17
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Bryant VE, Fieo RA, Fiore AJ, Richards VL, Porges EC, Williams R, Lu H, Zhou Z, Cook RL. Subjective Cognitive Complaints: Predictors and Health Outcomes in People Living with HIV. AIDS Behav 2022; 26:1163-1172. [PMID: 34550502 DOI: 10.1007/s10461-021-03469-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
There is a paucity of research on the prevalence of subjective cognitive complaints in people living with human immunodeficiency virus, along with the predictors and outcomes related to these complaints. We assessed demographics, substance use and psychiatric predictors, and HIV-related outcomes associated with subjective cognitive complaint items from the Cognitive Difficulties Scale. The sample consisted of 889 people living with HIV in the survey-based Florida Cohort. Results of multivariable regression models indicated that age (45-54), hazardous alcohol consumption, more frequent marijuana use and psychiatric symptoms (depression, anxiety, PTSD) were significant predictors of subjective cognitive complaints. Subjective cognitive complaints were associated with lower adherence to antiretroviral therapy in bivariate analyses, but this relationship was no longer significant after controlling for depression, race, alcohol and drug use. Further research into the relationship between depressive and subjective cognitive complaints may provide additional avenues for intervention.
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18
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Associations of cannabis retail outlet availability and neighborhood disadvantage with cannabis use and related risk factors among young adults in Washington State. Drug Alcohol Depend 2022; 232:109332. [PMID: 35123361 PMCID: PMC8890768 DOI: 10.1016/j.drugalcdep.2022.109332] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/20/2022] [Accepted: 01/22/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study examined associations of local cannabis retail outlet availability and neighborhood disadvantage with cannabis use and related risk factors among young adults. METHODS Data were from annual cross-sectional surveys administered from 2015 to 2019 to individuals ages 18-25 residing in Washington State (N = 10,009). As outcomes, this study assessed self-reported cannabis use at different margins/frequencies (any past year, at least monthly, at least weekly, at least daily) and perceived ease of access to cannabis and acceptability of cannabis use in the community. Cannabis retail outlet availability was defined as the presence of at least one retail outlet within a 1-kilometer road network buffer of one's residence. Sensitivity analyses explored four other spatial metrics to define outlet availability (any outlet within 0.5-km, 2-km, and the census tract; and census tract density per 1000 residents). Census tract level disadvantage was a composite of five US census variables. RESULTS Adjusting for individual- and area-level covariates, living within 1-kilometer of at least one cannabis retail outlet was statistically significantly associated with any past year and at least monthly cannabis use as well as high perceived access to cannabis. Results using a 2-km buffer and census tract-level metrics for retail outlet availability showed similar findings. Neighborhood disadvantage was statistically significantly associated with at least weekly and at least daily cannabis use and with greater perceived acceptability of cannabis use. CONCLUSIONS Results may have implications for regulatory and prevention strategies to reduce the population burden of cannabis use and related harms.
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Rogers CJ, Steinberg JK, Vos RO, Soto DW, Unger JB. Associations between Local Jurisdiction Ordinances and Current Use of Cannabis Products in California Adolescents. Subst Use Misuse 2022; 57:373-379. [PMID: 34903134 DOI: 10.1080/10826084.2021.2012693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Cannabis use among adolescents may have detrimental effects and use among this age group is increasing. It is important to understand how expansion of laws permitting cannabis sales may impact adolescent use. Much of the current research has explored how state-level policy decisions may impact adolescents' use behaviors; however, there is a gap in the understanding of how differences in local jurisdictional policies may also influence underage cannabis use.Procedures: The present study cross-sectionally assesses local variation in cannabis policies to explore the potential effects of local policy on underage use behaviors. Data were collected from (N = 1,573) adolescents representing 120 different localities across California, collected as a part of Project Cal Teens. Linear regression models were used to assess associations between local jurisdiction's allowance of retail sale of cannabis for adult-use and past 30-day use of non-medical (adult use) cannabis and perceived access to cannabis products. FINDINGS Local policy allowing cannabis retail was associated with adolescents' significantly higher past 30-day use of cannabis (β = 0.25 95% CI = 0.08, 0.42) and perceived access (β = 0.60 95% CI = 0.27, 0.94). CONCLUSIONS Results highlight the impact of local cannabis policies on adolescent cannabis use and perception. Considering the effects of cannabis use on adolescent development, this is an important public health concern because 14 states have already legalized recreational retail sales and growing numbers of local jurisdictions are allowing the retail sale of recreational cannabis.
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Affiliation(s)
- Christopher J Rogers
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Jane K Steinberg
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Robert O Vos
- Department of Spatial Sciences, University of Southern California, Los Angeles, California, USA
| | - Daniel W Soto
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Jennifer B Unger
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California, USA
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20
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Shanahan L, Steinhoff A, Bechtiger L, Copeland WE, Ribeaud D, Eisner M, Quednow BB. Frequent teenage cannabis use: Prevalence across adolescence and associations with young adult psychopathology and functional well-being in an urban cohort. Drug Alcohol Depend 2021; 228:109063. [PMID: 34601277 DOI: 10.1016/j.drugalcdep.2021.109063] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Amidst cannabis legalization efforts and laws, we do not fully understand how the youngest frequent cannabis users fare during young adulthood. This study aims to 1) examine the prevalence of cannabis use during adolescence, and 2) investigate links of frequent (i.e., weekly or daily) teenage cannabis use with psychopathology and functional well-being at age 20-compared to no or occasional use. METHODS Data came from a prospective-longitudinal cohort study (assessments from 2004 to 2018, from ages 7-20) in an urban setting (N = 1482). Substance use was assessed with self-reports between ages 13 and 20. At age 20, participants reported on psychopathology (psychotic symptoms, problematic substance use, aggression, and internalizing symptoms) and functional well-being (delinquency, financial difficulties, social exclusion, general well-being, and not being in education, employment, or training). Covariates were based on self-, parent-, teacher-, and behavioral measures. FINDINGS Almost one in five adolescents had used cannabis frequently between ages 13 and 17 (26.6% of males, 9.8% of females). Adjusting nearly 20 potential confounders, frequent teenage cannabis use was associated with age 20 problematic substance use and poorer functional well-being compared to the no cannabis use and the occasional use groups. Frequent teenage cannabis use was more consistently associated with age 20 functional outcomes compared to frequent teenage nicotine or alcohol use. CONCLUSIONS Frequent teenage cannabis use was common and associated with problematic substance use, more delinquency, and poorer functional well-being at age 20. Accordingly, frequent teenage cannabis users could experience increased difficulties in mastering the transitions of young adulthood.
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Affiliation(s)
- Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland; Department of Psychology, University of Zurich, Binzmühlestrasse 14, Box 1, 8050 Zurich, Switzerland.
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - William E Copeland
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont College of Medicine, Box 3454, 1 South Prospect Street, MC 446AR6, Burlington VT 05401, USA
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland; Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge CB3 9DA, UK
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, PO Box 1931, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Winterthurerstr. 190, Y55 J04, 8057 Zurich, Switzerland
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21
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Meier MH, Beardslee J, Pardini D. Associations between Recent and Cumulative Cannabis Use and Internalizing Problems in Boys from Adolescence to Young Adulthood. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:771-782. [PMID: 32219606 DOI: 10.1007/s10802-020-00641-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study tested whether increases in recent and cumulative cannabis use were each associated with increases in internalizing problems from adolescence to young adulthood. Participants were boys from a community sample that was assessed annually from ~age 15-26 (N = 506). Boys reported on their cannabis use, depression symptoms, and anxiety/depression problems each year. Exposures were frequency of cannabis use in a given year (no use, < weekly use, weekly or more frequent use) and cumulative prior years of weekly cannabis use. Outcomes were depression symptoms and anxiety/depression problems in a given year. Analyses examined within-person associations between changes in exposures and outcomes over time, which eliminated "fixed" (unchanging) individual differences as potential confounds. Analyses also accounted for time-varying factors as potential confounds (other substance use, externalizing problems, subclinical psychotic symptoms). Results showed that increases in recent cannabis use and cumulative prior years of weekly cannabis use were each associated with increases in depression symptoms and anxiety/depression problems. After controlling for time-varying covariates, increases in cumulative prior years of weekly cannabis use, but not recent cannabis use, remained associated with increases in depression symptoms and anxiety/depression problems. Specifically, each additional year of prior weekly cannabis use was associated with a small increase in depression symptoms (b = 0.012, p = .005) and anxiety/depression problems (b = 0.009, p = .001). Associations did not vary systematically across time. There was also no evidence of reverse causation. As boys engaged in weekly cannabis use for more years, they showed increases in internalizing problems, suggesting the importance of preventing chronic weekly cannabis use.
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Affiliation(s)
- Madeline H Meier
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ, 85287-1104, USA.
| | - Jordan Beardslee
- Department of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ, USA
| | - Dustin Pardini
- Department of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ, USA
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Schizophrenia and substance use disorder: Characteristics of coexisting issues in a forensic setting. Drug Alcohol Depend 2021; 226:108850. [PMID: 34198133 DOI: 10.1016/j.drugalcdep.2021.108850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/29/2021] [Accepted: 05/08/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Recent research has identified higher prevalence of offending behavior in patients with comorbid schizophrenia spectrum disorder (SSD) and substance use disorder (SUD) compared to patients with SSD only and to the general population. However, findings on the subgroup of patients with SUD, SSD and offending behavior in forensic psychiatric care are scarce and inconsistent. The present study used machine learning to uncover more detailed characteristics of offender patients in forensic psychiatric care with comorbid SSD and SUD. METHODS Using machine learning algorithms, 370 offender patients (91.6 % male, mean age of M = 34.1, SD = 10.2) and 558 variables were explored in order to build three models to differentiate between no substance use disorder, cannabis use disorder and any other substance use disorder. To counteract the risk of overfitting, the dataset was split, employing variable filtering, machine learning model building and selection embedded in a nested resampling approach on one subset. The best model was then selected and validated on the second data subset. RESULTS Distinguishing between SUD vs. no drug use disorder yielded models with an AUC of 70 and 78. Variables assignable to demographics, social disintegration, antisocial behavior and illness were identified as most influential for the distinction. The model comparing cannabis use disorder with other substance use disorders provided no significant differences. CONCLUSIONS From a clinical perspective, offender patients suffering from schizophrenia spectrum and comorbid substance use disorder seem particularly challenging to treat, but initial differences in psychopathology will dissipate over inpatient treatment. Our data suggest that offender patients may benefit from appropriate treatment that focuses on illicit drug abuse to reduce criminal behavior and improve social integration.
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Ullrich HS, Torbati A, Fan W, Arbona C, Cano MA, Essa S, Harvey L, Vaughan EL, de Dios MA. Race, psychosocial characteristics, and treatment outcomes among individuals undergoing treatment for cannabis use disorder: A latent profile analysis based on preferred method of using cannabis. J Subst Abuse Treat 2021; 131:108561. [PMID: 34275690 DOI: 10.1016/j.jsat.2021.108561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There are a wide variety of methods for using combustible cannabis which may impact an individual's pattern of use as well as their response to cannabis use disorder (CUD) treatment. Previous research has noted racial/ethnic differences in cannabis users' preferred method of use. METHOD The current study examined data from a randomized placebo-controlled trial of a pharmacological intervention for adults with CUD. Latent profile analysis classified participants (N = 302) based on their primary method of combustible cannabis use. RESULTS A four profile solution emerged which identified participants who demonstrated 1) Primarily Joint (n = 50), 2) Primarily Blunt (n = 106), 3) Mixed MoU (n = 30), and 4) Primarily Pipe (i.e., pipe or bong; n = 116) use. Profiles were compared on socio-demographic characteristics and racial differences were found among the four latent profiles as well as differences in their level of use. Cannabis users with a preference for joints were more likely to be White as compared to other racial groups. In contrast, a greater proportion of participants with a preference for blunts were African American. The Primarily Joint profile was found to have the highest cannabis relapse rate at 1-month follow-up (94%) which was significantly greater than the Mixed MoU (74%, x2 = 5.06, p < .05) and Primarily Pipe (78%, x2 = 9.24, p < .01) profiles. Interestingly, there was no difference in 1-Month Follow-up cannabis relapse rates between the Primarily Joint and Blunt profiles (87%, x2 = 9.24, p > .05). CONCLUSIONS Findings suggest that treatment-seeking individuals who primarily use joints or blunts may face unique challenges that may impact cannabis abstinence. Along with other cannabis-related characteristics, an individual's preferred method of use may represent an important factor to consider in the treatment of CUD.
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Affiliation(s)
- Helen S Ullrich
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
| | - Autena Torbati
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
| | - Weihua Fan
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
| | - Consuelo Arbona
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
| | - Miguel A Cano
- Department of Epidemiology, Florida International University, 11200 SW 8(th) St AHC5, Miami, FL 33199, United States.
| | - Saman Essa
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
| | - Laura Harvey
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
| | - Ellen L Vaughan
- Department of Counseling and Educational Psychology, Indiana University, 201 N Rose Ave, Bloomington, IN 47405, United States.
| | - Marcel A de Dios
- Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Blvd, Houston, TX 77204, United States.
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Cannabis use and psychosocial functioning: evidence from prospective longitudinal studies. Curr Opin Psychol 2021; 38:19-24. [DOI: 10.1016/j.copsyc.2020.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/31/2023]
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Bourque J, Potvin S. Cannabis and Cognitive Functioning: From Acute to Residual Effects, From Randomized Controlled Trials to Prospective Designs. Front Psychiatry 2021; 12:596601. [PMID: 34177633 PMCID: PMC8222623 DOI: 10.3389/fpsyt.2021.596601] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 05/17/2021] [Indexed: 12/30/2022] Open
Abstract
In recent years, several jurisdictions have revised their regulation policy toward both medical and recreational use of cannabis. These changes have elicited concerns regarding how legalization impacts academic achievement and work performance. This review evaluates the acute and long-term (residual) association between cannabis use and cognitive functioning that underlies poor academic and work performance. Relative to other reviews, this article focuses on cross-over randomized controlled trials and prospective designs given that they allow to test the impairing effects of cannabis exposure at the within-subject level. Acute cannabis cognitive effects are discussed separately for known confounding factors such as levels of delta-9-tetrahydrocannabinol (Δ9-THC), Δ9-THC:cannabidiol ratio, previous cannabis use and, comorbidity with psychosis-spectrum disorders. The cognitive residual effects of cannabis are detailed in relation to duration of abstinence, frequency of use, comorbidity with psychosis-spectrum disorders, types of cognitive domains assessed, and age of cannabis use initiation. Moreover, considering the fact that adequate longitudinal studies can make inferences about causality between cannabis use and impaired cognitive functioning when disentangling between-subject from within-subject variation, proofs for the three main non-mutually exclusive hypotheses about this relationship will be presented: i) the cognitive vulnerability hypothesis as part of the more general common antecedent hypothesis, ii) the concurrent cannabis impairing hypothesis, and iii) the neurotoxic hypothesis of cannabis. Current research provides evidence for mild to moderate acute cannabis effects on episodic and working memory, processing speed, and executive functions. Mild residual impairing effects were also observed in these exact same cognitive domains, suggesting that adverse effects following cannabis intoxication persist at least days or weeks following cannabis abstinence. Relative to adult-onset, adolescent-onset cannabis use seems to explain the dose-response relationship and is associated with longer lasting residual effects even in mild users (<weekly). The association between cannabis and cognition is likely explained by common antecedents, such that genetic and shared environment factors predispose individuals to both cannabis use and cognitive deficits, and to a lesser degree, neurotoxic effects.
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Affiliation(s)
- Josiane Bourque
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Stéphane Potvin
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
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Cleverley K, Brennenstuhl S, Henderson J. Measuring functional impairment: Preliminary psychometric properties of the Columbia Impairment Scale-Youth Version with youth accessing services at an outpatient substance use programme. Early Interv Psychiatry 2020; 14:535-543. [PMID: 31770825 DOI: 10.1111/eip.12875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 04/30/2019] [Accepted: 08/25/2019] [Indexed: 11/30/2022]
Abstract
AIM Functional impairment is a key aspect of mental disorders, yet it is poorly defined and operationalized, particularly for youth. The Columbia Impairment Scale (CIS) has been indicated as a potentially useful measure to assess functional impairment. This study provides an initial psychometric evaluation of the CIS-Youth (CIS-Y) Version in a sample of youth accessing an outpatient substance use programme. METHODS The CIS-Y Version was administered to youth aged 15 to 24 years accessing an outpatient substance use programme in Ontario, Canada. Demographic data on age, sex, ethnicity and current occupational and/or educational status were also collected. Exploratory factor analysis (EFA) was used to identify what factor structure best fits our sample of youth. RESULTS The sample included 134 youth, with a mean age of 19.3 (SD = 2.1; range = 15-24). Over 34% of the sample had at least some item-level missing data, overwhelming this was item-level "not applicable" responses. The CIS-Y exhibited good internal consistency (α = .84), and EFA revealed that a one-factor structure was the best fit for the data. CONCLUSIONS Results suggest that continued use of the CIS-Y with populations of youth, including emerging adults, is warranted. The scale has good internal consistency, loads onto one factor and discriminates between groups known to have lower and higher functioning. Further research is recommended that uses larger and more varying samples, as well as research that investigates optimal coding of non-applicable responses.
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Affiliation(s)
- Kristin Cleverley
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.,Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Brennenstuhl
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Crummy EA, O'Neal TJ, Baskin BM, Ferguson SM. One Is Not Enough: Understanding and Modeling Polysubstance Use. Front Neurosci 2020; 14:569. [PMID: 32612502 PMCID: PMC7309369 DOI: 10.3389/fnins.2020.00569] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/08/2020] [Indexed: 12/19/2022] Open
Abstract
Substance use disorder (SUD) is a chronic, relapsing disease with a highly multifaceted pathology that includes (but is not limited to) sensitivity to drug-associated cues, negative affect, and motivation to maintain drug consumption. SUDs are highly prevalent, with 35 million people meeting criteria for SUD. While drug use and addiction are highly studied, most investigations of SUDs examine drug use in isolation, rather than in the more prevalent context of comorbid substance histories. Indeed, 11.3% of individuals diagnosed with a SUD have concurrent alcohol and illicit drug use disorders. Furthermore, having a SUD with one substance increases susceptibility to developing dependence on additional substances. For example, the increased risk of developing heroin dependence is twofold for alcohol misusers, threefold for cannabis users, 15-fold for cocaine users, and 40-fold for prescription misusers. Given the prevalence and risk associated with polysubstance use and current public health crises, examining these disorders through the lens of co-use is essential for translatability and improved treatment efficacy. The escalating economic and social costs and continued rise in drug use has spurred interest in developing preclinical models that effectively model this phenomenon. Here, we review the current state of the field in understanding the behavioral and neural circuitry in the context of co-use with common pairings of alcohol, nicotine, cannabis, and other addictive substances. Moreover, we outline key considerations when developing polysubstance models, including challenges to developing preclinical models to provide insights and improve treatment outcomes.
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Affiliation(s)
- Elizabeth A Crummy
- Graduate Program in Neuroscience, University of Washington, Seattle, WA, United States.,Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Timothy J O'Neal
- Graduate Program in Neuroscience, University of Washington, Seattle, WA, United States.,Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Britahny M Baskin
- Graduate Program in Neuroscience, University of Washington, Seattle, WA, United States.,Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Susan M Ferguson
- Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States.,Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, United States
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Poulton R, Robertson K, Boden J, Horwood J, Theodore R, Potiki T, Ambler A. Patterns of recreational cannabis use in Aotearoa-New Zealand and their consequences: evidence to inform voters in the 2020 referendum. J R Soc N Z 2020. [DOI: 10.1080/03036758.2020.1750435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Kirsten Robertson
- Department of Marketing, Division of Commerce, University of Otago, Dunedin, New Zealand
| | - Joseph Boden
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - John Horwood
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Reremoana Theodore
- National Centre for Lifecourse Research, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Tuari Potiki
- Office of Maori Development, University of Otago, Dunedin, New Zealand
| | - Antony Ambler
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
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Cougle JR, McDermott KA, Hakes JK, Joyner KJ. Personality disorders and social support in cannabis dependence: A comparison with alcohol dependence. J Affect Disord 2020; 265:26-31. [PMID: 31957689 PMCID: PMC7065916 DOI: 10.1016/j.jad.2020.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 12/05/2019] [Accepted: 01/05/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Cannabis use disorder (CUD) has been linked to personality disorders (PDs) and interpersonal problems, though these relationships have been understudied. We examined PDs and social support associated with cannabis dependence and how it may be distinguishable from alcohol dependence on these indices in a large representative sample. METHOD Data on social support and Diagnostic and Statistical Manual of Mental Disorders-IV substance dependence and PDs were assessed in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N > 34,500). RESULTS Cannabis dependence was associated with higher rates of personality disorders and lower social support. Lifetime cannabis dependence without alcohol dependence was associated with higher rates of all PDs than alcohol dependence without cannabis dependence (with the exception of borderline PD). Cannabis dependence alone was also associated with lower social support than alcohol dependence alone. LIMITATIONS The survey was conducted in 2004-2005 and relied on DSM-IV criteria. CONCLUSIONS These findings highlight a broad range of PDs as well as deficits in social support in cannabis dependence. The potential interrelationships between interpersonal dysfunction and CUD as well as the relevance of PDs to treatment for CUD warrant further research.
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Affiliation(s)
- Jesse R Cougle
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee 32304, FL, USA.
| | - Katherine A McDermott
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee 32304, FL, USA.
| | - Jahn K Hakes
- Center for Economic Studies, US Census Bureau, Suitland, Maryland, USA.
| | - Keanan J Joyner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee 32304, FL, USA.
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Cerdá M, Mauro C, Hamilton A, Levy NS, Santaella-Tenorio J, Hasin D, Wall MM, Keyes KM, Martins SS. Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016. JAMA Psychiatry 2020; 77:165-171. [PMID: 31722000 PMCID: PMC6865220 DOI: 10.1001/jamapsychiatry.2019.3254] [Citation(s) in RCA: 307] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Little is known about changes in marijuana use and cannabis use disorder (CUD) after recreational marijuana legalization (RML). OBJECTIVES To examine the associations between RML enactment and changes in marijuana use, frequent use, and CUD in the United States from 2008 to 2016. DESIGN, SETTING, AND PARTICIPANTS This survey study used repeated cross-sectional survey data from the National Survey on Drug Use and Health (2008-2016) conducted in the United States among participants in the age groups of 12 to 17, 18 to 25, and 26 years or older. INTERVENTIONS Multilevel logistic regression models were fit to obtain estimates of before-vs-after changes in marijuana use among respondents in states enacting RML compared to changes in other states. MAIN OUTCOMES AND MEASURES Self-reported past-month marijuana use, past-month frequent marijuana use, past-month frequent use among past-month users, past-year CUD, and past-year CUD among past-year users. RESULTS The study included 505 796 respondents consisting of 51.51% females and 77.24% participants 26 years or older. Among the total, 65.43% were white, 11.90% black, 15.36% Hispanic, and 7.31% of other race/ethnicity. Among respondents aged 12 to 17 years, past-year CUD increased from 2.18% to 2.72% after RML enactment, a 25% higher increase than that for the same age group in states that did not enact RML (odds ratio [OR], 1.25; 95% CI, 1.01-1.55). Among past-year marijuana users in this age group, CUD increased from 22.80% to 27.20% (OR, 1.27; 95% CI, 1.01-1.59). Unmeasured confounders would need to be more prevalent in RML states and increase the risk of cannabis use by 1.08 to 1.11 times to explain observed results, indicating results that are sensitive to omitted variables. No associations were found among the respondents aged 18 to 25 years. Among respondents 26 years or older, past-month marijuana use after RML enactment increased from 5.65% to 7.10% (OR, 1.28; 95% CI, 1.16-1.40), past-month frequent use from 2.13% to 2.62% (OR, 1.24; 95% CI, 1.08-1.41), and past-year CUD from 0.90% to 1.23% (OR, 1.36; 95% CI, 1.08-1.71); these results were more robust to unmeasured confounding. Among marijuana users in this age group, past-month frequent marijuana use and past-year CUD did not increase after RML enactment. CONCLUSIONS AND RELEVANCE This study's findings suggest that although marijuana legalization advanced social justice goals, the small post-RML increase in risk for CUD among respondents aged 12 to 17 years and increased frequent use and CUD among adults 26 years or older in this study are a potential public health concern. To undertake prevention efforts, further studies are warranted to assess how these increases occur and to identify subpopulations that may be especially vulnerable.
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Affiliation(s)
- Magdalena Cerdá
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York,Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento
| | - Christine Mauro
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Ava Hamilton
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Natalie S. Levy
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Julián Santaella-Tenorio
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Deborah Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York,Division of Translational Epidemiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York,Division of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Melanie M. Wall
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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Schluter RS, van Holst RJ, Goudriaan AE. Effects of Ten Sessions of High Frequency Repetitive Transcranial Magnetic Stimulation (HF-rTMS) Add-on Treatment on Impulsivity in Alcohol Use Disorder. Front Neurosci 2019; 13:1257. [PMID: 31866805 PMCID: PMC6904338 DOI: 10.3389/fnins.2019.01257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/06/2019] [Indexed: 01/11/2023] Open
Abstract
Introduction Alcohol use disorder (AUD) is characterized by increased impulsivity, which is multifactorial and can be assessed by tests like the delay discounting, Go-Nogo, and stop signal task (SST). Impulsivity has been related to poor treatment outcomes in substance use disorders, including AUD. In order to decrease impulsivity or improve inhibitory control, high frequency transcranial magnetic stimulation (HF-rTMS) has gained interest. Studies applying HF-rTMS over the DLPFC of individuals suffering from AUD assessing its effects on impulsivity measures are scarce, and results are inconclusive. Methods The current study (registered in Netherlands Trial Register with trial number 5291: https://www.trialregister.nl/trial/5151) applied 10 sessions of HF-rTMS [sixty 10 Hz trains of 5 s at 110% motor threshold (MT)] over the right DLPFC of 80 alcohol dependent patients in clinical treatment on 10 consecutive workdays. At baseline, halfway and after the HF-rTMS treatment, the delay discounting, Go-NoGo, and SST were assessed. Results Ten sessions of HF-rTMS over the right DLPFC versus sham HF-rTMS did not affect performance on the delay discounting, Go-NoGo, and SSTs. A significant effect of age was found for the Go-NoGo task, with higher age associated with better performance. Furthermore, no significant correlations were found between difference scores of task performance and baseline impulsivity or severity of AUD. Discussion Results of this study, in combination with other studies using HF-rTMS studies in alcohol and substance use disorder, indicate mixed and inconclusive findings of HF-rTMS on impulsivity. Future studies within patient groups hospitalized at the same department are recommended to consider using a sham coil that mimics the sensations on the scalp of active HF-rTMS and to measure motivation across test sessions.
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Affiliation(s)
- Renée S Schluter
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ruth J van Holst
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Department of Research and Quality of Care, Arkin, Amsterdam, Netherlands.,Jellinek, Amsterdam, Netherlands
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Evans M, Ogeil RP, Phillips JG. Cannabis, Decision-Making, and Online Assistance Seeking. Am J Addict 2019; 28:473-479. [PMID: 31532567 DOI: 10.1111/ajad.12960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/11/2019] [Accepted: 09/01/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Maladaptive decision-making strategies could contribute to cannabis-related problems, as some individuals may neither select safe patterns of cannabis use, nor seek treatment. METHODS To explore decision-making styles and their relationship to cannabis-related harm, 153 respondents completed the Cannabis Use Disorders Identification Test-Revised (CUDIT-R), the Melbourne Decision Making Questionnaire (MDMQ), and answered questions about their willingness to seek online: (1) further information or (2) treatment for cannabis-related issues. RESULTS Multiple regression considered relationships between problematic cannabis use, decision-making style, and cannabis use within the past month. Subscales of the CUDIT-R revealed that: (1) hazardous use was associated with higher hypervigilance and higher decisional self-esteem; (2) dependence symptoms were associated with lower vigilance and higher procrastination; and (3) harmful use was associated with higher procrastination. People with symptoms of CUD were less likely to seek further help or support online if prone to procrastination or buckpasssing. DISCUSSION AND CONCLUSIONS Decisional style influenced cannabis use and symptoms. Those people with cannabis-related problems that did not seek online assistance were defensively avoidant. SCIENTIFIC SIGNIFICANCE Procrastination is a feature of problematic cannabis use. Online offers of assistance may be ignored by defensively avoidant CUD clients. (Am J Addict 2019;00:1-7).
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Affiliation(s)
- Mark Evans
- Department of Psychology, Auckland University of Technology, Akoranga Campus, Auckland, New Zealand
| | - Rowan P Ogeil
- Population Health, Eastern Health Clinical School, Monash University and Turning Point, Melbourne, Victoria, Australia
| | - James G Phillips
- Department of Psychology, Auckland University of Technology, Akoranga Campus, Auckland, New Zealand
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Associations between adolescent cannabis use frequency and adult brain structure: A prospective study of boys followed to adulthood. Drug Alcohol Depend 2019; 202:191-199. [PMID: 31357120 DOI: 10.1016/j.drugalcdep.2019.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies have tested the hypothesis that adolescent cannabis users show structural brain alterations in adulthood. The present study tested associations between prospectively-assessed trajectories of adolescent cannabis use and adult brain structure in a sample of boys followed to adulthood. METHODS Data came from the Pittsburgh Youth Study - a longitudinal study of ˜1000 boys. Boys completed self-reports of cannabis use annually from age 13-19, and latent class growth analysis was used to identify different trajectories of adolescent cannabis use. Once adolescent cannabis trajectories were identified, boys were classified into their most likely cannabis trajectory. A subset of boys (n = 181) subsequently underwent structural neuroimaging in adulthood, when they were between 30-36 years old on average. For this subset, we grouped participants according to their classified adolescent cannabis trajectory and tested whether these groups showed differences in adult brain structure in 14 a priori regions of interest, including six subcortical (volume only: amygdala, hippocampus, nucleus accumbens, caudate, putamen, and pallidum) and eight cortical regions (volume and thickness: superior frontal gyrus; caudal and rostral middle frontal gyrus; inferior frontal gyrus, separated into pars opercularis, pars triangularis, and pars orbitalis; lateral and medial orbitofrontal gyrus). RESULTS We identified four adolescent cannabis trajectories: non-users/infrequent users, desisters, escalators, and chronic-relatively frequent users. Boys in different trajectory subgroups did not differ on adult brain structure in any subcortical or cortical region of interest. CONCLUSIONS Adolescent cannabis use is not associated with structural brain differences in adulthood.
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Chamberlain SR, Tiego J, Fontenelle LF, Hook R, Parkes L, Segrave R, Hauser TU, Dolan RJ, Goodyer IM, Bullmore E, Grant JE, Yücel M. Fractionation of impulsive and compulsive trans-diagnostic phenotypes and their longitudinal associations. Aust N Z J Psychiatry 2019; 53:896-907. [PMID: 31001986 PMCID: PMC6724459 DOI: 10.1177/0004867419844325] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Young adulthood is a crucial neurodevelopmental period during which impulsive and compulsive problem behaviours commonly emerge. While traditionally considered diametrically opposed, impulsive and compulsive symptoms tend to co-occur. The objectives of this study were as follows: (a) to identify the optimal trans-diagnostic structural framework for measuring impulsive and compulsive problem behaviours, and (b) to use this optimal framework to identify common/distinct antecedents of these latent phenotypes. METHOD In total, 654 young adults were recruited as part of the Neuroscience in Psychiatry Network, a population-based cohort in the United Kingdom. The optimal trans-diagnostic structural model capturing 33 types of impulsive and compulsive problem behaviours was identified. Baseline predictors of subsequent impulsive and compulsive trans-diagnostic phenotypes were characterised, along with cross-sectional associations, using partial least squares. RESULTS Current problem behaviours were optimally explained by a bi-factor model, which yielded dissociable measures of impulsivity and compulsivity, as well as a general disinhibition factor. Impulsive problem behaviours were significantly explained by prior antisocial and impulsive personality traits, male gender, general distress, perceived dysfunctional parenting and teasing/arguments within friendships. Compulsive problem behaviours were significantly explained by prior compulsive traits and female gender. CONCLUSION This study demonstrates that trans-diagnostic phenotypes of 33 impulsive and compulsive problem behaviours are identifiable in young adults, utilising a bi-factor model based on responses to a single questionnaire. Furthermore, these phenotypes have different antecedents. The findings yield a new framework for fractionating impulsivity and compulsivity, and suggest different early intervention targets to avert emergence of problem behaviours. This framework may be useful for future biological and clinical dissection of impulsivity and compulsivity.
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Affiliation(s)
- Samuel R Chamberlain
- Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK,Samuel R Chamberlain, Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK.
| | - Jeggan Tiego
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Leonardo F Fontenelle
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Roxanne Hook
- Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Linden Parkes
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Rebecca Segrave
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Tobias U Hauser
- The Max Planck UCL Centre for Computational Psychiatry and Ageing, University College London (UCL), London, UK
| | - Ray J Dolan
- The Max Planck UCL Centre for Computational Psychiatry and Ageing, University College London (UCL), London, UK
| | - Ian M Goodyer
- Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Ed Bullmore
- Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Jon E Grant
- Department of Psychiatry and Behavioural Neuroscience, University of Chicago, Chicago, IL, USA
| | - Murat Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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35
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Investigating how perceived risk and availability of marijuana relate to marijuana use among adolescents in Argentina, Chile, and Uruguay over time. Drug Alcohol Depend 2019; 201:115-126. [PMID: 31207452 PMCID: PMC7075484 DOI: 10.1016/j.drugalcdep.2019.03.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 01/30/2023]
Abstract
AIMS Amid changing marijuana policies in the Southern Cone, we examined relationships between marijuana-related risk factors and marijuana use among adolescents in Argentina, Chile, and Uruguay from 2001 to 2016. METHODS Using cross-sectional surveys from 8th, 10th, and 12th graders and weighted time-varying effect models, we estimated associations between perceived risk (no/low risk versus moderate/great risk) and perceived availability (easy/very easy versus difficult/very difficult/not able to obtain) of marijuana, and any past-month marijuana use. RESULTS In all countries, marijuana use increased over time and adolescents who perceived no/low risk and easy availability had higher odds of use. In Argentina, the bivariate risk/use association weakened from 2001 (OR = 15.24, 95%CI = 9.63, 24.12) to 2004 [OR = 3.86 (2.72, 5.48)] and strengthened until 2011 [OR = 8.22 (7.56, 10.30)]; the availability/use association strengthened from 2005 [OR = 5.32 (4.05, 6.98)] to 2009 [OR = 20.77 (15.57, 27.70)] and weakened until 2014 [OR = 11.00 (9.11, 13.27)]. In Chile, the risk/use association weakened from 2001 [OR = 7.22 (6.57, 7.95)] to 2015 [OR = 5.58 (4.82, 6.48)]; the availability/use association weakened from 2001 [OR = 5.92 (4.96, 7.06)] to 2015 [OR = 4.10 (3.15, 5.34)]. In Uruguay, the risk/use association weakened from 2003 [OR = 34.22 (22.76, 51.46)] to 2016 [OR = 6.23 (4.96, 7.83)]; the availability/use association weakened from 2005 [OR = 29.13 (13.39, 63.39) to 2007 [OR = 9.42 (3.85, 23.07)], and strengthened until 2016 [OR = 22.68 (12.03, 42.76)]. CONCLUSIONS Overall, the association between risk and use weakened in all countries, suggesting risk perceptions became a weaker determinant of marijuana use. Perceived availability remained strongly associated with use and may become an increasingly important driver of use (particularly in Uruguay and Argentina).
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Boumparis N, Loheide-Niesmann L, Blankers M, Ebert DD, Korf D, Schaub MP, Spijkerman R, Tait RJ, Riper H. Short- and long-term effects of digital prevention and treatment interventions for cannabis use reduction: A systematic review and meta-analysis. Drug Alcohol Depend 2019; 200:82-94. [PMID: 31112834 DOI: 10.1016/j.drugalcdep.2019.03.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/27/2019] [Accepted: 03/28/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Frequent Cannabis use has been linked to a variety of negative mental, physical, and social consequences. We assessed the effects of digital prevention and treatment interventions on Cannabis use reduction in comparison with control conditions. METHODS Systematic review with two separate meta-analyses. Thirty randomized controlled trials met the inclusion criteria for the review, and 21 were included in the meta-analyses. Primary outcome was self-reported Cannabis use at post-treatment and follow-up. Hedges's g was calculated for all comparisons with non-active control. Risk of bias was examined with the Cochrane risk-of-bias tool. RESULTS The systematic review included 10 prevention interventions targeting 8138 participants (aged 12 to 20) and 20 treatment interventions targeting 5195 Cannabis users (aged 16 to 40). The meta-analyses showed significantly reduced Cannabis use at post-treatment in the prevention interventions (6 studies, N = 2564, g = 0.33; 95% CI 0.13 to 0.54, p = 0.001) and in the treatment interventions (17 comparisons, N = 3813, g = 0.12; 95% CI 0.02 to 0.22, p = 0.02) as compared with controls. The effects of prevention interventions were maintained at follow-ups of up to 12 months (5 comparisons, N = 2445, g = 0.22; 95% CI 0.12 to 0.33, p < 0.001) but were no longer statistically significant for treatment interventions. CONCLUSIONS Digital prevention and treatment interventions showed small, significant reduction effects on Cannabis use in diverse target populations at post-treatment compared to controls. For prevention interventions, the post-treatment effects were maintained at follow-up up to 12 months later.
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Affiliation(s)
- Nikolaos Boumparis
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
| | - Lisa Loheide-Niesmann
- Behavioural Science Institute, Radboud University, PO Box 9104, 6500 HE Nijmegen, the Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands; Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands; Trimbos Institute - Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, the Netherlands
| | - David D Ebert
- Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Schlossplatz 4, 91054 Erlangen, Germany
| | - Dirk Korf
- Bonger Institute of Criminology, Faculty of Law, University of Amsterdam, PO Box 1030, 1000 BA Amsterdam, the Netherlands
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Konradstrasse 32, 8031 Zurich, Switzerland
| | - Renske Spijkerman
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Care, PO Box 53002, 2505 AA The Hague, the Netherlands
| | - Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, 6845, Australia
| | - Heleen Riper
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
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Abstract
OBJECTIVE This study tested longitudinal associations between cannabis use and cardiometabolic risk factors that underlie the development of cardiovascular diseases. METHODS Participants were men from the youngest cohort of the Pittsburgh Youth Study who were followed prospectively from approximately age 7 to 32 years (N = 253). Frequency of cannabis use was assessed yearly from approximately ages 12 to 20 years and again at approximately ages 26, 29, and 32 years. The following cardiometabolic risk factors were assessed during a laboratory visit at approximately age 32 years: body mass index (BMI), waist-hip ratio, high- and low-density lipoprotein cholesterol, triglycerides, fasting glucose, insulin resistance, blood pressure, interleukin 6, and C-reactive protein. RESULTS Greater cannabis exposure was associated with relatively lower BMI (β = -0.31, p < .001), smaller waist-hip ratio (β = -0.23, p = .002), better high- (β = 0.14, p = .036) and low-density lipoprotein cholesterol (β = -0.15, p = .026), lower triglycerides (β = -0.17, p = .009), lower fasting glucose (β = -0.15, p < .001) and insulin resistance (β = -0.21, p = .003), lower systolic (β = -0.22, p < .001) and diastolic blood pressure (β = -0.15, p = .028), and fewer metabolic syndrome criteria (β = -0.27, p < .001). With exception of BMI, cannabis users' mean levels on cardiometabolic risk factors were generally below clinical cutoffs for high risk. Most associations between cannabis use and cardiometabolic risk factors remained after adjusting for tobacco use, childhood socioeconomic status, and childhood health. However, after adjusting for adult BMI, these associations were no longer apparent, and mediation tests suggested that cannabis users' relatively lower BMI might explain their lower levels of risk on other cardiometabolic risk factors. CONCLUSIONS Cannabis use is associated with lower BMI, and lower BMI is related to lower levels of risk on other cardiometabolic risk factors.
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Moss SL, Santaella-Tenorio J, Mauro PM, Keyes KM, Martins SS. Changes over time in marijuana use, deviant behavior and preference for risky behavior among US adolescents from 2002 to 2014: testing the moderating effect of gender and age. Addiction 2019; 114:674-686. [PMID: 30461115 PMCID: PMC6619500 DOI: 10.1111/add.14506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/23/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Among adolescents, risk preference and deviant behaviors are associated with marijuana use, which exhibit substantial historical trends. We examined (1) trends, (2) effect modification by sex and age, (3) associations of marijuana use with deviant behaviors and risk preferences and (4) differences by sex, age and year. DESIGN Adjusted logistic and relative risk regression models, using data from the 2002-14 National Survey on Drug Use and Health, annual cross-sectional surveys of US households. SETTING United States. PARTICIPANTS A nationally representative sample of adolescents aged 12-17 years (n = 230 452). MEASUREMENTS We estimated associations between past-year marijuana use [self-reported using computer-assisted personal interviewing/audio computer-assisted self-interviewing (CAPI/ACASI)], deviant behavior (i.e. selling drugs; stealing; attacking someone) and risk preference (i.e. getting a kick; testing oneself). FINDINGS Marijuana use, deviant behaviors and risk preferences declined among adolescents from 2002 to 2014. There were no significant sex or age differences in the decline of marijuana use over time. There were sex [sold drugs: β = 0.90, 95% confidence interval (CI) = 0.75, 1.04] and age (attacked someone: β = 0.32, 95% CI = 0.22, 0.42) differences in the prevalence of deviant behaviors, and trends over time differed by sex and age for attacking someone. CONCLUSIONS While marijuana use, deviant behavior and risk preferences among US adolescents declined from 2002 to 2014, associations have remained stable, with marijuana use positively associated with deviant behaviors and risk preferences.
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Affiliation(s)
- Shadiya L. Moss
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | | | - Pia M. Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Solomon DT, Nietert PJ, Calhoun C, Smith DW, Back SE, Barden E, Brady KT, Flanagan JC. Effects of Oxytocin on Emotional and Physiological Responses to Conflict in Couples with Substance Misuse. ACTA ACUST UNITED AC 2019; 7:91-102. [PMID: 30740265 DOI: 10.1037/cfp0000103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social stress, especially dyadic conflict among couples, is an important correlate of addiction. Several authors have suggested that the neuropeptide oxytocin (OT) may be useful in the treatment of couples with substance misuse. However, the literature examining OT among couples is scant and has yielded mixed findings. The current study examined the effects of OT versus placebo on emotional (e.g., warmth and anger) and physiological (e.g., skin conductance and heart rate) reactivity to a conflict resolution task in 30 heterosexual couples (N=60) in which one or both members misused substances. Using a randomized, double-blind, placebo-controlled design, both partners within each dyad were randomized to the same treatment condition. Participants completed a standardized conflict resolution task at baseline and 45 minutes following drug self-administration. Physiological measures were examined continuously during the laboratory tasks and emotional reactivity was self-reported at baseline and at 5 time points over the course of 1 hour following the second conflict resolution task. Results of a multi-level growth curve model accounting for baseline scores, gender and drug condition indicate that positive emotional experiences and skin conductance measures increased over the 5 time points. Neither drug condition nor gender was significantly related to outcomes, and no interaction effects were observed. These findings highlight the complexities involved in translational OT research and suggest that the impact of OT on key outcomes requires further exploration in regards to OT's potential therapeutic benefit.
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Affiliation(s)
| | | | - Casey Calhoun
- Medical University of South Carolina, Charleston, SC
| | | | - Sudie E Back
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
| | - Eileen Barden
- Medical University of South Carolina, Charleston, SC
| | - Kathleen T Brady
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
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Weymouth BB, Fosco GM, Feinberg ME. Nurturant-involved parenting and adolescent substance use: Examining an internalizing pathway through adolescent social anxiety symptoms and substance refusal efficacy. Dev Psychopathol 2019; 31:247-260. [PMID: 29212564 PMCID: PMC5991983 DOI: 10.1017/s0954579417001766] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Research has clearly established the important role of parents in preventing substance use among early adolescents. Much of this work has focused on deviance (e.g., antisocial behavior, delinquency, and oppositional behavior) as a central pathway linking parenting behaviors and early adolescent substance use. This study proposed an alternative pathway; using a four-wave longitudinal design, we examined whether nurturant-involved parenting (Fall sixth grade) was inversely associated with adolescent drunkenness, marijuana use, and cigarette use (eighth grade) through social anxiety symptoms (Spring sixth grade) and subsequent decreases in substance refusal efficacy (seventh grade). Nurturant-involved parenting is characterized by warmth, supportiveness, low hostility, and low rejection. Analyses were conducted with a sample of 687 two-parent families. Results indicated that adolescents who were in families where fathers exhibited lower levels of nurturant-involved parenting experienced subsequent increases in social anxiety symptoms and decreased efficacy to refuse substances, which in turn was related to more frequent drunkenness, cigarette use, and marijuana use. Indirect effects are discussed. Findings were not substantiated for mothers' parenting. Adolescent gender did not moderate associations. The results highlight an additional pathway through which parenting influences youth substance use and links social anxiety symptoms to reduced substance refusal efficacy.
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Fantus RJ, Helfand BT. AUTHOR REPLY. Urology 2019; 123:124-125. [PMID: 30598201 DOI: 10.1016/j.urology.2018.06.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/11/2018] [Accepted: 06/17/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Richard J Fantus
- Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL
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Rodriguez MFR, Khenti A. PERCEPTION OF HARM AND BENEFITS OF MARIJUANA AND ITS RELATIONSHIP WITH THE INTENTION OF USE AND CONSUMPTION IN COLOMBIAN ADOLESCENTS. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-cicad-15-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: analyze the relationship between the perception of harm and benefits associated with the use of marijuana and its relation to real consumption, as well as the intention to use it in a context of regulatory changes, in young students, between 15 and 17 years old, of a public school in Bogota Colombia. Method: a quantitative, cross-sectional survey was carried out. 268 students in grade 9th to 11th from a public school in the city of Bogotá, Colombia participated of the study. Results: results reveled that there is an association between the perception of benefits and the consumption of marijuana. In addition, how a low perception of risk is associated with an intention to use in a context of legalization. Conclusion: this is one of the first studies in Colombia which explores the intention to use (at age 18) in a context of regulatory changes, as well as the attitude of young people towards the legalization of marijuana for medicinal and recreational use.
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Affiliation(s)
| | - Akwatu Khenti
- University of Toronto, Canada; Centre for Addiction and Mental Health, Canada
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Clark TM, Jones JM, Hall AG, Tabner SA, Kmiec RL. Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in Cannabis Users. Cannabis Cannabinoid Res 2018; 3:259-271. [PMID: 30671538 PMCID: PMC6340377 DOI: 10.1089/can.2018.0045] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Obesity is treatment-resistant, and is linked with a number of serious, chronic diseases. Adult obesity rates in the United States have tripled since the early 1960s. Recent reviews show that an increased ratio of omega-6 to omega-3 fatty acids contributes to obesity rates by increasing levels of the endocannabinoid signals AEA and 2-AG, overstimulating CB1R and leading to increased caloric intake, reduced metabolic rates, and weight gain. Cannabis, or THC, also stimulates CB1R and increases caloric intake during acute exposures. Goals: To establish the relationship between Cannabis use and body mass index, and to provide a theoretical explanation for this relationship. Results: The present meta-analysis reveals significantly reduced body mass index and rates of obesity in Cannabis users, in conjunction with increased caloric intake. Theoretical explanation: We provide for the first time a causative explanation for this paradox, in which rapid and long-lasting downregulation of CB1R following acute Cannabis consumption reduces energy storage and increases metabolic rates, thus reversing the impact on body mass index of elevated dietary omega-6/omega-3 ratios.
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Affiliation(s)
- Thomas M Clark
- Department of Biological Sciences, Indiana University South Bend, South Bend, Indiana
| | - Jessica M Jones
- Department of Biological Sciences, Indiana University South Bend, South Bend, Indiana
| | - Alexis G Hall
- Department of Biological Sciences, Indiana University South Bend, South Bend, Indiana
| | - Sara A Tabner
- Department of Biological Sciences, Indiana University South Bend, South Bend, Indiana
| | - Rebecca L Kmiec
- Department of Biological Sciences, Indiana University South Bend, South Bend, Indiana
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Montgomery L, Robinson C, Seaman EL, Haeny AM. A scoping review and meta-analysis of psychosocial and pharmacological treatments for cannabis and tobacco use among African Americans. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 31:922-943. [PMID: 29199844 DOI: 10.1037/adb0000326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The rates of co-occurring cannabis and tobacco use are higher among African Americans relative to other racial/ethnic groups. One plausible approach to treating co-use among African Americans is to examine the effectiveness of treatments for the sole use of cannabis and tobacco to identify effective approaches that might be combined to treat the dual use of these substances. The current meta-analysis sought to include studies that reported cannabis and/or tobacco use outcomes from randomized clinical trials (RCTs) with 100% African American samples. A total of 843 articles were considered for inclusion, 29 were reviewed by independent qualitative coders, and 22 were included in the review. There were no articles on cannabis use treatment with a 100% African American sample, resulting in a need to lower the threshold (60%) and conduct a scoping review of cannabis studies. Preliminary evidence from a small number of studies (k = 7) supports the use of Motivational Interviewing and Cognitive-Behavioral Therapy to treat cannabis use among African Americans, but not Contingency Management. Results from a meta-analysis of 15 tobacco studies found higher rates of smoking abstinence in the treatment condition relative to control conditions overall and across short and long-term follow-up periods. Significant differences in smoking abstinence were also found when examining the effects of pharmacological treatments relative to their control conditions. The clinical and research implications of these findings for future psychosocial and pharmacological trials for cannabis and tobacco use and co-use among African Americans are described. (PsycINFO Database Record
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Affiliation(s)
- LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine
| | - Cendrine Robinson
- Division Cancer Prevention, Cancer Control and Population Sciences, National Cancer Institute
| | - Elizabeth L Seaman
- Department of Behavioral and Community Health, University of Maryland School of Public Health
| | - Angela M Haeny
- Department of Psychological Sciences, University of Missouri
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Sarvet AL, Wall MM, Fink DS, Greene E, Le A, Boustead AE, Pacula RL, Keyes KM, Cerdá M, Galea S, Hasin DS. Medical marijuana laws and adolescent marijuana use in the United States: a systematic review and meta-analysis. Addiction 2018; 113:1003-1016. [PMID: 29468763 PMCID: PMC5942879 DOI: 10.1111/add.14136] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/14/2017] [Accepted: 12/01/2017] [Indexed: 12/14/2022]
Abstract
AIMS To conduct a systematic review and meta-analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past-month marijuana use prevalence among adolescents. METHODS A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta-analyzed. Estimates of MML effects on any past-month marijuana use prevalence from included studies were obtained from comparisons of pre-post MML changes in MML states to changes in non-MML states over comparable time-periods. These estimates were standardized and entered into a meta-analysis model with fixed-effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F-test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS None of the 11 studies found significant estimates of pre-post MML changes compared with contemporaneous changes in non-MML states for marijuana use prevalence among adolescents. The meta-analysis yielded a non-significant pooled estimate (standardized mean difference) of -0.003 (95% confidence interval = -0.012, +0.007). Four studies compared MML with non-MML states on pre-MML differences and all found higher rates of past-month marijuana use in MML states pre-MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non-significant results, although limited heterogeneity may warrant further study. CONCLUSIONS Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions.
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Affiliation(s)
- Aaron L. Sarvet
- Department of Psychiatry, College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
- New York State Psychiatric InstituteNew YorkNYUSA
| | - Melanie M. Wall
- Department of Psychiatry, College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
- New York State Psychiatric InstituteNew YorkNYUSA
- Department of Biostatistics, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - David S. Fink
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Emily Greene
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Aline Le
- New York State Psychiatric InstituteNew YorkNYUSA
| | - Anne E. Boustead
- School of Government and Public PolicyUniversity of ArizonaTucsonAZUSA
| | | | - Katherine M. Keyes
- Department of Psychiatry, College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Magdalena Cerdá
- Department of Emergency MedicineUniversity of California, DavisSacramentoCAUSA
| | - Sandro Galea
- Boston School of Public HealthBoston UniversityBostonMAUSA
| | - Deborah S. Hasin
- Department of Psychiatry, College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
- New York State Psychiatric InstituteNew YorkNYUSA
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
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Montgomery L, Yockey A. Rolling and scrolling: The portrayal of marijuana cigars (blunts) on YouTube. JOURNAL OF SUBSTANCE USE 2018; 23:436-440. [PMID: 29887756 DOI: 10.1080/14659891.2018.1444108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Blunts are partially or fully hollowed-out cigars or cigarillos that are filled with marijuana. Despite the high prevalence of blunt use, very few studies assess this specific method of cannabis administration. YouTube, a popular video-sharing website, has the potential to provide insights into blunt use. Methods The purpose of this study was to examine the content of YouTube videos that discuss blunts. A sample of 41 videos was coded for content. Results The 41 videos had a total of 27,579,636 views. Most of the individuals in the videos were male (85%) and many appeared to be White (80%) and under the age of 25 (46%). Only 34% of the videos had an age restriction. The majority of messages in the videos promoted blunt use (93%) and showed at least one person rolling (76%) and/or smoking (66%) a blunt. The videos mainly consisted of introductions to blunt use (76%) and tips and personal experiences with blunt use (73%). Conclusions YouTube videos on blunt use are readily available and primarily promote the use of blunts. Future research should continue to monitor YouTube content and develop videos on social media platforms that inform consumers of the health effects associated with blunt use.
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Affiliation(s)
- LaTrice Montgomery
- Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrew Yockey
- Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Perceived barriers for cannabis cessation: Relations to cannabis use problems, withdrawal symptoms, and self-efficacy for quitting. Addict Behav 2018; 76:45-51. [PMID: 28753466 PMCID: PMC10041786 DOI: 10.1016/j.addbeh.2017.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/10/2017] [Accepted: 07/11/2017] [Indexed: 11/24/2022]
Abstract
Cannabis is the most widely used illicit substance in the United States. Regular cannabis use appears to be a dynamic, chronic process consisting of multiple quit attempts, periods of reduction, periods of abstinence, and periods of continual use. Cannabis-related processes, including withdrawal, problematic consequences of use, and self-efficacy for quitting each contribute to the cycle of use and, in part, are maintained and reinforced by perceived barriers for cannabis cessation. Yet, no work has examined the association between perceived barriers for cannabis cessation and clinically-relevant processes related to cannabis use. To address this gap, the current study recruited a racially diverse sample (N=145, 63.4% Black or African American) of cannabis users from the community to test the hypothesis that greater perceived barriers for quitting cannabis was related to more cannabis use problems, more cannabis withdrawal symptoms, and lower self-efficacy for quitting cannabis. Structural equation modeling suggested that greater perceived barriers for quitting cannabis was uniquely associated with cannabis use problems (β=0.50, 95%CI [0.39, 0.65], p<0.001), greater withdrawal symptoms (β=0.39, 95%CI [0.30, 0.50], p<0.001), and lower self-efficacy for quitting (β=-0.17, 95%CI [-0.21, -0.02], p=0.028). The results of this study indicate perceived barriers for cannabis cessation may help in better understanding an array of clinically significant cannabis use processes. Indeed, the observed pattern of findings add to current theoretical models of substance use that aim to identify unique risk processes that may maintain substance use and provide valuable information that can be used to inform treatment for cannabis users.
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Carliner H, Brown QL, Sarvet AL, Hasin DS. Cannabis use, attitudes, and legal status in the U.S.: A review. Prev Med 2017; 104:13-23. [PMID: 28705601 PMCID: PMC6348863 DOI: 10.1016/j.ypmed.2017.07.008] [Citation(s) in RCA: 342] [Impact Index Per Article: 48.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/27/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
Abstract
Cannabis is widely used among adolescents and adults. In the U.S., marijuana laws have been changing, and Americans increasingly favor legalizing cannabis for medical and recreational uses. While some can use cannabis without harm, others experience adverse consequences. The objective of this review is to summarize information on the legal status of cannabis, perceptions regarding cannabis, prevalence and time trends in use and related adverse consequences, and evidence on the relationship of state medical (MML) and recreational (RML) marijuana laws to use and attitudes. Twenty-nine states now have MMLs, and eight of these have RMLs. Since the early 2000s, adult and adolescent perception of cannabis use as risky has decreased. Over the same time, the prevalence of adolescent cannabis use has changed little. However, adult cannabis use, disorders, and related consequences have increased. Multiple nationally representative studies indicate that MMLs have had little effect on cannabis use among adolescents. However, while MML effects have been less studied in adults, available evidence suggests that MMLs increase use and cannabis use disorders in adults. While data are not yet available to evaluate the effect of RMLs, they are likely to lower price, increase availability, and thereby increase cannabis use. More permissive marijuana laws may accomplish social justice aims (e.g., reduce racial disparities in law enforcement) and generate tax revenues. However, such laws may increase cannabis-related adverse health and psychosocial consequences by increasing the population of users. Dissemination of balanced information about the potential health harms of cannabis use is needed.
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Affiliation(s)
- Hannah Carliner
- Columbia University, Department of Psychiatry, United States; Columbia University Mailman School of Public Health, Department of Epidemiology, United States; New York State Psychiatric Institute, United States
| | - Qiana L Brown
- Columbia University Mailman School of Public Health, Department of Epidemiology, United States; Nathan Kline Institute for Psychiatric Research, New York State Office of Mental Health, United States; New York University School of Medicine, Department of Psychiatry, United States
| | | | - Deborah S Hasin
- Columbia University, Department of Psychiatry, United States; Columbia University Mailman School of Public Health, Department of Epidemiology, United States; New York State Psychiatric Institute, United States.
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How does marijuana affect outcomes after trauma in ICU patients? A propensity-matched analysis. J Trauma Acute Care Surg 2017; 83:846-849. [DOI: 10.1097/ta.0000000000001672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Polysubstance use by psychiatry inpatients with co-occurring mental health and substance use disorders. Drug Alcohol Depend 2017; 180:319-322. [PMID: 28942289 DOI: 10.1016/j.drugalcdep.2017.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Polysubstance use, the consumption of more than one substance over a defined period, is common and associated with psychiatric problems and poor treatment adherence and outcomes. This study examined past-month polysubstance use at intake among psychiatry inpatients with co-occurring mental health and substance use disorders, and outcomes 3 months later. METHODS Participants (n=406 psychiatry inpatients with documented mental health and substance use disorders) completed a baseline and a 3-month follow-up (84%) interview. With baseline data, a latent class analysis was conducted on substances used in the past 30days. Analyses of covariance tested for differences among classes on outcomes at 3-month follow-up. RESULTS At baseline, three classes were estimated: Cannabis+Alcohol (35.1%), Alcohol (49.3%), and Polysubstance, notably, cocaine plus alcohol and marijuana (15.7%). At follow-up, the Polysubstance class had more severe alcohol and drug use, support for abstinence, and motivation for help-seeking, but less abstinence self-efficacy; it was most likely to attend 12-step groups. The Cannabis+Alcohol class was least likely to obtain outpatient substance use treatment, and had the lowest percent days abstinent. CONCLUSIONS Psychiatry inpatients with co-occurring substance use and mental health disorders have varying substance use patterns that correspond to substance-related outcomes concurrently and over time. Many patients achieved abstinence for most days of the 3-month post-hospitalization period. To further increase abstinence, providers could build on polysubstance-using patients' high motivation to increase self-efficacy. In addition, because patients using mainly cannabis plus alcohol may perceive little harm from cannabis use, providers may consider modifying risk perceptions through effective education.
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