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Liu J, Tan ASL, Winickoff JP, Rees VW. Correlates of adolescent sole-, dual- and poly-use of cannabis, vaped nicotine, and combusted tobacco. Addict Behav 2023; 146:107804. [PMID: 37478525 PMCID: PMC10528055 DOI: 10.1016/j.addbeh.2023.107804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/01/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Compared to single substance use, adolescents' use of multiple substances is associated with more severe dependence, cessation outcomes, and health risks. This study examined correlates of use and co-use of e-cigarettes, combusted tobacco, and cannabis among high school-aged (9th-12th grade, approximately aged 14-18) adolescents. METHODS We analyzed the 2019 Massachusetts Youth Health Survey (MYHS) data to calculate the weighted means of any past 30-day sole-use of e-cigarettes, sole-use of combusted tobacco, sole-use of cannabis, dual-use of two of the above substances, and poly-use of all three substances. We then used weighted multinomial logistic regression to examine the associations between demographic, social and behavioral factors and sole-, dual-, and poly-use (vs. no use) of these substances. RESULTS Among N = 1614 respondents, any past 30-day dual-use of e-cigarettes and cannabis was the most prevalent (17.2%, SE: 1.3%). Sole-use of combusted tobacco was less than 1%, whereas 4.5% (SE: 0.7%) of respondents reported poly-use of e-cigarettes, cannabis, and combusted tobacco. Lower academic grades and self-reported depression (1 item on persistent feelings of sadness or hopelessness) were associated with increased odds of dual-use of e-cigarettes and cannabis and poly-use (vs. sole-use of any substance). Adolescents who self-reported having "any long-term emotional problems or learning disabilities" had greater odds of poly-use. CONCLUSION Different sets of correlates were associated with sole-, dual-, and poly-use, suggesting that certain adolescents may be more vulnerable than others to multiple substance use. Future research should examine potentially modifiable upstream influences, such as the home environment and socioeconomic factors that may affect the relationship between adolescent mental health, school performance, and multiple addictive substance use.
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Affiliation(s)
- Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Andy S L Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, United States; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, PA, United States
| | - Jonathan P Winickoff
- MassGeneral Hospital Division of General Academic Pediatrics, Boston, MA, United States; MGH Tobacco Research and Treatment Center, Boston, MA, United States; American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, United States
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Liebregts N, Rigoni R, Petruželka B, Barták M, Rowicka M, Zurhold H, Schiffer K. Different phases of ATS use call for different interventions: a large qualitative study in Europe. Harm Reduct J 2022; 19:36. [PMID: 35413972 PMCID: PMC9004030 DOI: 10.1186/s12954-022-00617-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Amphetamine-type stimulants (ATS) are globally widely used. Scientific literature generally defines four phases of substance use (initiation, continuation, increase and decrease); however, there is limited understanding of what influences these different phases of ATS use. The ATTUNE study investigated which factors shape individual phases of use, or ATS use patterns. In this article, we report on these phases into and out of ATS use, and propose a set of recommendations for prevention, harm reduction and treatment of the different phases of ATS use. METHODS Qualitative, semi-structured interviews (n = 237) were conducted in five different European countries with participants who had used ATS, varying from a few times in a lifetime to daily. RESULTS Amphetamine and MDMA were the most commonly used ATS. Yet, types of ATS used differed between the countries. We found that people who use ATS have various motives for and dynamic patterns of ATS use with alternating phases of increase, continuation, decrease and sometimes dependence. Cessation was pursued in different ways and for diverse reasons, such as mental health problems and maturing out. Availability seemed not an issue, regardless of the type of ATS, phase or country. CONCLUSIONS These findings demonstrate that tailor-made interventions are needed for the diverse types of people who use ATS and different phases or patterns of ATS use, to reduce possible harms of use. We recommended a set of interventions for the different ATS phases. These include drug checking services, peer-led information, self-management of ATS use, mental health support to help people cope with stressful life events and prevent uncontrolled use, and follow-up support after treatment.
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Affiliation(s)
- Nienke Liebregts
- Correlation-European Harm Reduction Network, Amsterdam, The Netherlands. .,Bonger Institute of Criminology, University of Amsterdam, Amsterdam, The Netherlands.
| | - Rafaela Rigoni
- Correlation-European Harm Reduction Network, Amsterdam, The Netherlands
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Magdalena Rowicka
- Institute of Psychology, Maria Grzegorzewska University, Warsaw, Poland
| | - Heike Zurhold
- Centre of Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Schiffer
- Correlation-European Harm Reduction Network, Amsterdam, The Netherlands
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Introduction. CRITICAL STUDIES IN RISK AND UNCERTAINTY 2021. [PMCID: PMC7552730 DOI: 10.1007/978-3-030-57081-1_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The everyday lives of contemporary youth are awash with chemicals to boost pleasure, energy, sexual performance, appearance, and health. What do pills, drinks, sprays, powders, and lotions do for youth? What effects are youth seeking? The ChemicalYouth ethnographies presented here, based on more than five years of fieldwork conducted in Amsterdam, Brooklyn, Cayagan de Oro, Paris, Makassar, Puerto Princesa, and Yogyakarta, show that young people try out chemicals together, compare experiences, and engage in collaborative experiments. ChemicalYouth: Navigating Uncertainty: In Search of the Good Life makes a case for examining a broader range of chemicals that young people use in their everyday lives. It focuses not just on psychoactive substances—the use of which is viewed with concern by parents, educators, and policymakers—but all the other chemicals that young people use to boost pleasure, moods, vitality, appearance, and health, purposes for using chemicals that have received far less scholarly attention. It takes the use of chemicals as situated practices that are embedded in social relations and that generate shared understandings of efficacy. More specifically, it seeks to answer the question: how do young people balance the benefits and harms of chemicals in their quest for a good life?
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Lu CY, Chiang CY, Yao Y, Sun FK. Modeling Body-Mind-Spirit Well-Being and the Possibility of Relapse Intention in Adults Who Have a History of Substance Use in Taiwan. J Am Psychiatr Nurses Assoc 2020; 26:196-205. [PMID: 31104578 DOI: 10.1177/1078390319844565] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Substance use is a global mental health issue. There has been limited research exploring the relationships among body, mind, and spirit well-being and the possibility of relapse across different categories of substance users. AIMS: The purpose of the current path analysis was to examine the relationship between body-mind-spirit well-being and the possibility of relapse intention as well as other relevant predictors in people who had a history of substance use. METHODS: A cross-sectional survey was used. Participants were recruited in Southern Taiwan between December 2015 and June 2016. Data were collected from 467 participants who had a history of using controlled substances. RESULTS: Path analysis results revealed that body-mind-spirit well-being was negatively predictive of the possibility of relapse intention. Out of several predictors, stress influence and duration of substance use had direct effects on body-mind-spirit well-being and the possibility of relapse intention, respectively. Stress influence and duration of substance use were associated with decreased body-mind-spirit well-being and increased relapse intention scores. In addition, no history of health problems and male gender were associated with increased body-mind-spirit well-being. CONCLUSIONS: Stress management and the duration of substance use play an important role in body-mind-spirit well-being and relapse intention in people with a history of substance use. Health care professionals could teach substance users coping strategies to address their stress and problems, which may improve their health and reduce the possibility of relapse intention.
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Affiliation(s)
- Chu-Yun Lu
- Chu-Yun Lu, RN, PhD, I-Shou University, Kaohsiung City
| | | | - YuChun Yao
- YuChun Yao, RN, EDD, I-Shou University, Kaohsiung City
| | - Fan-Ko Sun
- Fan-Ko Sun, RN, PhD, I-Shou University, Kaohsiung City
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Fatima H, Howlett AC, Whitlow CT. Reward, Control & Decision-Making in Cannabis Use Disorder: Insights from Functional MRI. Br J Radiol 2019; 92:20190165. [PMID: 31364398 PMCID: PMC6732906 DOI: 10.1259/bjr.20190165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 01/22/2023] Open
Abstract
The recreational consumption of cannabis has increased significantly across the world with an estimated 180 million people currently using. In the United States, 4.1 million are currently diagnosed with cannabis use disorder. Cannabis dependence and abuse was combined into a single entity as a behavioral disorder with a problematic pattern of cannabis use and termed cannabis use disorder by the Diagnostic and Statistical Manual of Mental Disorders. Chronic use of cannabis has been linked with region-specific effects across the brain mediating reward processing, cognitive control and decision-making that are central to understanding addictive behaviors. This review presents a snapshot of the current literature assessing the effects of chronic cannabis use on human brain function via functional MRI. Studies employing various paradigms and contrasting cognitive activation amongst cannabis users and non-users were incorporated. The effects of trans-del-ta-9-tetrahydrocannabinol (Δ9-THC) in marijuana and other preparations of cannabis are mediated by the endocannabinoid system, which is also briefly introduced.Much variation exists in the current literature regarding the functional changes associated with chronic cannabis use. One possible explanation for this variation is the heterogeneity in study designs, with little implementation of standardized diagnostic criteria when selecting chronic users, distinct time points of participant assessment, differing cognitive paradigms and imaging protocols. As such, there is an urgent requirement for future investigations that further characterize functional changes associated with chronic cannabis use.
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Affiliation(s)
- Hudaisa Fatima
- Department of Radiology, Wake Forest School of Medicine, Section of Neuroradiology, Winston-Salem, North Carolina, United States
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Hill S, Shanahan L, Costello EJ, Copeland W. Predicting Persistent, Limited, and Delayed Problematic Cannabis Use in Early Adulthood: Findings From a Longitudinal Study. J Am Acad Child Adolesc Psychiatry 2017; 56:966-974.e4. [PMID: 29096779 PMCID: PMC5679452 DOI: 10.1016/j.jaac.2017.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/18/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify risk profiles associated with patterns of problematic cannabis use in early adulthood. METHOD Data came from 1,229 participants in the Great Smoky Mountains Study, a prospective 20-year cohort study from 1993 to 2015 that is representative of western North Carolina with yearly assessments conducted from ages 9 and 16 years, and assessments at ages 19, 21, 26, and 30 years. Patterns of problematic cannabis use (i.e., DSM-5 cannabis use disorder or daily use) in early adulthood included the following: nonproblematic use in late adolescence (ages 19-21) and early adulthood (ages 26-30); limited problematic use in late adolescence only; persistent problematic use in late adolescence and early adulthood; and delayed problematic use in early adulthood only. Multinominal logistic regression models examined pairwise associations between these patterns and risk factors in childhood/early adolescence (ages 9-16) and late adolescence (ages 19-21). Risk factors included psychiatric disorders (e.g., anxiety, depressive), other substance use (smoking, alcohol, illicit drugs), and challenging social factors (e.g., low socioeconomic status, family functioning, peers). Sex and race/ethnicity (white, African American, American Indian) interactions were tested. RESULTS The persistent pattern (6.7% of sample) was characterized by more anxiety disorders across development and more DSM-5 CUD symptoms during late adolescence compared to the limited pattern (13.3%), which, in turn, had more childhood family instability and dysfunction. The delayed pattern (3.7%) was characterized by more externalizing disorders, maltreatment, and peer bullying in childhood compared to those in nonproblematic users. There were no significant interactions of sex or race/ethnicity. CONCLUSION Problematic cannabis use patterns during early adulthood have distinctive risk profiles, which may be useful in tailoring targeted interventions.
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Affiliation(s)
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of
Zurich, Zurich, Switzerland
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Temple EC. Clearing the smokescreen: the current evidence on cannabis use. Front Psychiatry 2015; 6:40. [PMID: 25821437 PMCID: PMC4358058 DOI: 10.3389/fpsyt.2015.00040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 03/02/2015] [Indexed: 01/11/2023] Open
Affiliation(s)
- Elizabeth Clare Temple
- School of Health Sciences and Psychology, Federation University Australia , Ballarat, VIC , Australia
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van der Pol P, Liebregts N, de Graaf R, Korf DJ, van den Brink W, van Laar M. Three-Year Course of Cannabis Dependence and Prediction of Persistence. Eur Addict Res 2015; 21:279-90. [PMID: 26044258 DOI: 10.1159/000377625] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 02/01/2015] [Indexed: 11/19/2022]
Abstract
AIMS To examine the course and the predictors of the persistence of cannabis dependence. METHODS Through cannabis outlets and chain referral, a prospective enriched community cohort of 207 young adults (aged 18-30) with DSM-IV cannabis dependence at baseline (T0) was formed and followed-up after 1.5 (T1) and 3 (T2) years. The presence of cannabis dependence, cannabis-related problems, functional impairment and treatment was assessed using the Composite International Diagnostic Interview (CIDI 3.0) and the Sheehan Disability Scale (SDS). Predictors of persistence were lifetime cannabis abuse and dependence symptoms, cannabis use characteristics, distant vulnerability factors (e.g. childhood adversity, family history of psychological/substance use problems, impulsivity, mental disorders), and proximal stress factors (recent life events, social support). RESULTS Four groups were distinguished: persistent dependent (DDD: 28.0%), stable non-persistent (DNN: 40.6%), late non-persistent (DDN: 17.9%) and recurrent dependent (DND: 13.5%). At T2, persisters (DDD) reported significantly more (heavy) cannabis use and cannabis problems than non-persisters (DNN/DDN/DND). Treatment seeking for cannabis-related problems was rare, even among persisters (15.5%). The number (OR = 1.23 (1.03-1.48)) and type ('role impairment' OR = 2.85 (1.11-7.31), 'use despite problems' OR = 2.34 (1.15-4.76)) of lifetime cannabis abuse/dependence symptoms were the only independent predictors of persistence with a total explained variance of 8.8%. CONCLUSIONS Persistence of cannabis dependence in the community is low, difficult to predict, and associated with a negative outcome. The substantial proportion of stable non-persisters suggests that screening and monitoring or low-threshold brief interventions may suffice for many non-treatment-seeking cannabis-dependent people. However, those with many lifetime abuse/dependence symptoms may benefit from more intensive interventions.
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Affiliation(s)
- Peggy van der Pol
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Walburg V, Moncla D, Mialhes A. Burnout Among High-School Students and Cannabis Use, Consumption Frequencies, Abuse and Dependence. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9268-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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