51
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Dunbar MS, Siconolfi D, Rodriguez A, Seelam R, Davis JP, Tucker JS, D’Amico EJ. Alcohol and Cannabis Use Trajectories and Outcomes in a Sample of Hispanic, White, and Asian Sexual and Gender Minority Emerging Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042059. [PMID: 35206249 PMCID: PMC8871829 DOI: 10.3390/ijerph19042059] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 02/05/2023]
Abstract
Substance use disproportionately affects health and psychosocial outcomes for some racial/ethnic groups, but few longitudinal studies examine the extent to which sexual and gender minority (SGM) emerging adults of different racial/ethnic groups may experience disparities in outcomes at similar levels of alcohol or cannabis use. This study used five waves of annual survey data (spanning 2015 (average age 18) to 2020 (average age 23)) from an ongoing longitudinal cohort study of emerging adults. In the subset of 359 SGM emerging adults, separate sequelae of change models assessed differences in trajectories of alcohol or cannabis use (past 30-day frequency) and multiple health and psychosocial outcomes across Hispanic, Asian, and White individuals. White SGM emerging adults showed higher baseline levels of alcohol and cannabis frequency compared to Hispanic and Asian peers, but all groups showed similar rates of change (slope) over time. We observed few racial/ethnic differences in SGM emerging adult outcomes at the same levels of alcohol or cannabis use; that is, racial/ethnic groups showed similar patterns on most health and psychosocial outcomes; however, some differences emerged. For example, Asian respondents reported less engagement in sex with casual partners after using alcohol, marijuana, or other drugs compared to their White peers, at the same levels of alcohol use (β = −0.579, p = 0.03) or cannabis use (β = −0.737, p = 0.007). Findings underscore a need to consider multiple outcome domains and factors beyond additive stress in examining the effects of substance use across different groups of SGM individuals. More longitudinal studies with large, contemporary, and diverse samples of SGM emerging adults are needed to better characterize similarities and differences in patterns of substance use and use-related consequences in relation to intersecting SGM, racial/ethnic, and other identities.
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Affiliation(s)
- Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA;
- Correspondence:
| | - Daniel Siconolfi
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA;
| | | | - Rachana Seelam
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th Street, Los Angeles, CA 90089, USA;
| | - Joan S. Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
| | - Elizabeth J. D’Amico
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
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52
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Salama E, Castaneda AE, Suvisaari J, Rask S, Laatikainen T, Niemelä S. Substance use, affective symptoms, and suicidal ideation among Russian, Somali, and Kurdish migrants in Finland. Transcult Psychiatry 2022; 59:37-51. [PMID: 32164497 PMCID: PMC8859688 DOI: 10.1177/1363461520906028] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Comorbidity of substance use with affective symptoms and suicidality has been well documented in the general population. However, population-based migrant studies about this association are scarce. We examined the association of affective symptoms and suicidal ideation with binge drinking, daily smoking, and lifetime cannabis use among Russian, Somali, and Kurdish migrants in comparison with the Finnish general population. Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu, n = 1307) and comparison group data of the general Finnish population (n = 860) from the Health 2011 Survey were used. Substance use included self-reported current binge drinking, daily smoking, and lifetime cannabis use. Affective symptoms and suicidal ideation were measured using the Hopkins Symptom Checklist-25 (HSCL-25). We performed multivariate logistic regression analyses, including age, gender, and additional socio-demographic and migration-related factors. Suicidal ideation (OR 2.4 95% CI 1.3-4.3) was associated with binge drinking among Kurds and lifetime cannabis use among Russians (OR 5.6, 95% CI 1.9-17.0) and Kurds (OR 5.5, 95% CI 1.9-15.6). Affective symptoms were associated with daily smoking (OR 1.6, 95% CI 1.02-2.6) and lifetime cannabis use (OR 6.1, 95% CI 2.6-14.5) among Kurdish migrants. Our results draw attention to the co-occurrence of suicidal ideation, affective symptoms, and substance use, especially among Kurdish migrants. These results highlight the variation of comorbidity of substance use and affective symptoms between the different populations. This implies that screening for substance use in mental healthcare cannot be neglected based on presumed habits of substance use.
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Affiliation(s)
- Essi Salama
- Doctoral Programme in Clinical Research, Faculty of Medicine, University of Turku, Finland.,Child Psychiatry, Turku University Hospital, Finland
| | - Anu E Castaneda
- National Institute for Health and Welfare (THL), Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | | | - Shadia Rask
- National Institute for Health and Welfare (THL), Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare (THL), Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,Joint municipal authority for North Karelia social and health services (Siun sote), Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Finland.,Addiction Psychiatry Unit, Turku University Hospital, Finland
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53
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Kirkpatrick M, O'callaghan F. Epilepsy and cannabis: so near, yet so far. Dev Med Child Neurol 2022; 64:162-167. [PMID: 34498262 DOI: 10.1111/dmcn.15032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 12/26/2022]
Abstract
Following media attention on children with refractory epilepsies reportedly deriving benefit from cannabis-based medicinal products (CBMPs), the UK government changed the law in 2018 so that CBMPs could be legally prescribed. Subsequently, a pure cannabidiol (CBD) product has been licensed for two epilepsy syndromes. However, despite pressure from campaign groups and allied politicians, almost no children have received unlicensed CBMPs under the UK NHS. This review explores the science behind CBMPs in paediatric epilepsies and highlights the areas that warrant further research. It identifies a lack of level I evidence for efficacy and safety as, currently, the major obstacle to prescribing. Unlicensed medicines are often used in paediatrics but almost all are used 'off-label', with supporting evidence of efficacy and safety derived either from other age-groups or from disease conditions. CBMPs, except for pure CBD, are unique in that they are currently both unlicensed and fall outside the 'off-label' category. The review acknowledges the treatment gap in refractory epilepsies and the potential use of CBMPs. However, it argues against exceptionally circumventing the usual standard of evidence required by regulatory prescribing authorities and warns against allowing vulnerable children to become the 'trojan horse' for deregulation of the commercial cannabis market.
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Affiliation(s)
- Martin Kirkpatrick
- Tayside Children's Hospital, Dundee, UK.,School of Medicine, University of Dundee, Dundee, UK
| | - Finbar O'callaghan
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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54
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Barry KM, Gomajee R, Kousignian I, Bustamante JJH, Lakrout P, Mary-Krause M, Melchior M. Adolescent cannabis experimentation and unemployment in young to mid-adulthood: Results from the French TEMPO Cohort study. Drug Alcohol Depend 2022; 230:109201. [PMID: 34864566 DOI: 10.1016/j.drugalcdep.2021.109201] [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: 04/28/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND France accounts for one of the highest levels of recreational cannabis use, with almost 40% of youth aged 17 reporting having experimented with cannabis. We investigated the impact of early cannabis experimentation (defined as first-time use ≤ 16 years) on future probability of unemployment in young to mid-adulthood using a longitudinal, community sample over the span of 9 years. METHODS Data were obtained from the French TEMPO Cohort study, set up in 2009 among young adults aged 22-25 years old. Participants who reported information on age of cannabis experimentation and employment status in at least one study wave (2009, 2011, 2015 and 2018) were included in the statistical analyses (N = 1487, 61.2% female). RESULTS In A-IPW-adjusted analyses, early cannabis experimenters (≤ 16 years) had 1.71 (95% CI: 1.46-2.02) times higher odds of experiencing unemployment compared to late cannabis experimenters (> 16 years) and 2.40 (95% CI: 2.00 - 2.88) times higher odds of experiencing unemployment compared to non-experimenters. Late cannabis experimenters experienced 1.39 (95% CI: 1.17-1.68) times higher odds of being unemployed compared to non-experimenters, and early cannabis experimenters experienced 3.84 (95%CI: 2.73-5.42) times higher odds of experiencing long-term unemployment (defined as unemployed at least twice) compared to non-experimenters. CONCLUSIONS Participants who ever used cannabis, especially at or before the age of 16, had higher odds of experiencing unemployment, even when accounting for many psychological, academic and family characteristics which preceded cannabis initiation.
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Affiliation(s)
- Katharine M Barry
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France.
| | - Ramchandar Gomajee
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Isabelle Kousignian
- Université de Paris, Unité de Recherche " Biostatistique, Traitement et Modélisation des données biologiques ", BioSTM - 4 avenue de l'Observatoire, 75006 Paris, France
| | - Joel José Herranz Bustamante
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Paula Lakrout
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Murielle Mary-Krause
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
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55
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Quednow BB, Steinhoff A, Bechtiger L, Ribeaud D, Eisner M, Shanahan L. High Prevalence and Early Onsets: Legal and Illegal Substance Use in an Urban Cohort of Young Adults in Switzerland. Eur Addict Res 2022; 28:186-198. [PMID: 34864731 DOI: 10.1159/000520178] [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: 03/09/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Debates about the legalization of illegal substances (e.g., cannabis) continue around the globe. A key consideration in these debates is the adequate protection of young people, which could be informed by current prevalence and age-of-onset patterns. For Switzerland, such information is limited, which is particularly true for women, despite advanced political efforts to legalize cannabis. The objective of the current study was to investigate substance use prevalence rates and ages of onset in a community-representative sample of female and male young adults in Switzerland. METHODS Data came from the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). In 2018, participants (N = 1,180, 50.8% females) were ∼20 years old. Lifetime and past-year use of alcohol, tobacco, cannabinoids, stimulants, hallucinogens, opioids, and benzodiazepines were assessed with an extensive substance use questionnaire. Additionally, ages of onsets of the respective substances were estimated by averaging participants' self-reported ages of onsets from ages 13 to 20 (max. 4 assessments). RESULTS 57% of 20-year-olds had used cannabinoids, 16% stimulants, 15% opioids (mostly codeine), and 8% hallucinogens in the past year. Males had higher prevalence than females for most drugs; nevertheless, females' prevalence rates were notably high. Legal substance use was typically initiated 1.3-2.7 years before legal selling age. Thus, almost half of the sample had consumed alcohol and tobacco by age 14. More than 40% of the total sample had smoked cannabis by age 16. Males initiated use of legal substances and cannabis earlier than females. DISCUSSION Our recent community-representative data suggested unexpectedly high levels and early onsets of substance use compared to a previous Swiss surveys and also the European average. Drug policy debates should consider urban substance use patterns when considering legalization efforts.
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Affiliation(s)
- Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.,Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.,Department of Psychology, University of Zurich, Zurich, Switzerland
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56
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Kaur N, Bastien G, Gagnon L, Graham J, Mongeau-Pérusse V, Bakouni H, Morissette F, Theriault C, Fischer B, Jutras-Aswad D. Variations of cannabis-related adverse mental health and addiction outcomes across adolescence and adulthood: A scoping review. Front Psychiatry 2022; 13:973988. [PMID: 36299544 PMCID: PMC9590692 DOI: 10.3389/fpsyt.2022.973988] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Evidence supporting associations between cannabis use and many health outcomes is growing, however it remains unclear how such associations vary across the lifespan. We therefore aim to answer the following questions: (1) Are the risks of cannabis's adverse effects on mental health and addiction-related outcomes different in adolescents than in adults? (2) What are the relationships between these cannabis's adverse effects and (a) an individual's age at first cannabis use, (b) age at assessment, and (c) duration of cannabis use? METHODS We searched Medline, Embase, CINAHL, and PsychINFO from inception to 18 October 2021. Two reviewers independently screened studies and descriptively synthesized results. RESULTS We included 140 studies. Cannabis effects on mental health and addiction-related outcomes were worse in adolescents, early cannabis initiators and cannabis users who consumed for longest periods. Evidence of worse long-term adverse effects in adolescents was substantial for psychosis, cannabis, and nicotine use disorders; mixed for depression, suicidality, other substance use and disorders; and limited for anxiety. Additionally, acute cannabis exposure had the opposite trend with adults more often reporting adverse effects than adolescents. CONCLUSION The available evidence suggests that cannabis use should be delayed as late as possible in adulthood and shortened in duration across the lifespan to decrease the risk of negative outcomes, while emphasizing the need for adapted harm reduction approaches. This scoping review provides evidence on the role of age and duration of exposure as determinants of cannabis-related adverse effects, which may inform prevention and harm reduction strategies. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/BYG72.
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Affiliation(s)
- Navdeep Kaur
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Gabriel Bastien
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Lea Gagnon
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Johann Graham
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Violaine Mongeau-Pérusse
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Hamzah Bakouni
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Florence Morissette
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Camille Theriault
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Benedikt Fischer
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.,Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Didier Jutras-Aswad
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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Flores MW, Granados S, Cook BL. US trends in the association of suicide ideation/behaviors with marijuana use among adolescents ages 12-17 and differences by gender and race/ethnicity. Front Psychiatry 2022; 13:1057784. [PMID: 36684023 PMCID: PMC9849946 DOI: 10.3389/fpsyt.2022.1057784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In the US over the past decade, there has been a steady increase in marijuana use rates among adolescents, in part due to marijuana legalization laws. It is unknown whether these greater marijuana use rates are associated with rising rates of adolescent suicide ideation and behaviors (plan and attempt) or whether these associations differ by gender or race/ethnicity. OBJECTIVE To determine whether marijuana use is associated with suicide ideation/behaviors among adolescents and if differences exist by gender and race/ethnicity. MATERIALS AND METHODS Using the 2015-2019 National Surveys on Drug Use and Health, we assessed the relationship between marijuana use frequency and suicide ideation/behaviors among adolescents (12-17, n = 73,986). We also examined the association with marijuana use disorder (MUD) and assessed differences by gender and race/ethnicity. Marijuana use frequency in the past year was categorized as no use, non-weekly use, and weekly-plus use. We estimated multivariable logistic regression models, adjusting for sociodemographics, health status, common co-occurring behavioral health disorders, and criminal history. For interpretability, regression coefficients were converted into predicted probabilities using predictive margin methods. RESULTS In primary analyses, adolescents with non-weekly use and weekly-plus use had higher rates of any suicide ideation, 61.5% (+ 10.4 percentage-points; 95% CI: 7.0-13.8%) and 64.5% (+ 13.4 percentage-points; 95% CI: 9.1-17.7%), relative to no use (51.1%). Non-weekly and weekly-plus use was associated with higher rates of any suicide plan 58.2% (+ 11.8 percentage-points; 95% CI: 7.8-16.0%) and 59.0% (+ 12.6 percentage-points; 95% CI: 6.4-18.9%), and any suicide attempt, 42.0% (+ 11.6 percentage-points; 95% CI: 7.0-16.2%) and 47.3% (+ 16.9 percentage-points; 95% CI: 10.9-22.9%) compared to no use (46.4 and 30.4%, respectively). Similar results were found among adolescents with a MUD (all p < 0.05). Positive associations between marijuana use and suicide ideation/behaviors persisted among males and females as well as White, Black, and Latinx adolescents (all p < 0.05). CONCLUSION Between 2015 and 2019, suicide ideation/behaviors increased for adolescents that used marijuana. As marijuana is legalized in more states, public health efforts are needed to curb increases in marijuana use among adolescents and to better understand the causal linkages between marijuana use and suicide ideation/behaviors.
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Affiliation(s)
- Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Saul Granados
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States
| | - Benjamin Lê Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Ahuja M, Awasthi M, Gim S, Records K, Cimilluca J, Al-Ksir K, Tremblay J, Doshi RP, Sathiyasaleen T, Fernandopulle P. Early Age of Cannabis Initiation and Its Association With Suicidal Behaviors. Subst Abuse 2022; 16:11782218221116731. [PMID: 35966616 PMCID: PMC9373116 DOI: 10.1177/11782218221116731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
Background: Suicide rates in the U.S. have continued to rise over the last 2 decades. The increased availability and broader legalization of cannabis is a public health concern, particularly among adolescents. The objective of this study was to examine the association between the age of cannabis initiation and lifetime suicidal ideations and attempts in a sample of adults aged 18 or older. Methods: Data are from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001 to 2003 (N = 15 238). The primary objective of the CPES was to collect data about the prevalence of mental disorders, impairments associated with these disorders, and their treatment patterns from representative samples of majority and minority adult populations in the U.S. Logistic regression analyses were conducted to test the association between cannabis initiation age (early ⩽14 years old; later >14 years old) and outcomes of lifetime suicide ideation and attempts. Cigarette use, cannabis use, gender, income, race, education, and age were controlled for the analyses. Results: Overall, 12.5% of participants reported suicide ideation, while 4.2% reported attempt. Early cannabis use was associated with a higher risk of suicide ideation (AOR = 3.32, 95% CI [2.75, 3.80]) than later cannabis use (AOR = 2.15, 95% CI [1.92, 2.39]). Early cannabis use was associated with a higher risk of suicide attempt (AOR = 4.38, 95% CI [3.48, 5.52]) than later cannabis use (AOR = 2.56, 95% CI [2.14, 3.06]). Wald chi-squared tests revealed significant differences between the early and late initiation for both ideation (χ2 = 26.99; P < .001) and attempts (χ2 = 26.02; P < .001). Conclusions: Significant associations were found between early initiation of cannabis and suicide behaviors. As suicide rates continue to rise, it is recommended that clinicians, treatment providers, and other professionals consider the use of cannabis at an early age as a risk for subsequent suicide behaviors.
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Affiliation(s)
- Manik Ahuja
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Manul Awasthi
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Suzanna Gim
- LUI Pharmacy, Long Island University, Brooklyn, NY, USA
| | - Kathie Records
- School of Nursing, College of Natural and Health Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Johanna Cimilluca
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kawther Al-Ksir
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Johnathan Tremblay
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Riddhi P Doshi
- Center for Population Health, UConn Health, Farmington, CT, USA
| | | | - Praveen Fernandopulle
- Department of Psychiatry and Behavioral Sciences, East Tennessee State University, Johnson City, TN, USA
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59
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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: 18] [Impact Index Per Article: 6.0] [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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López-Méndez M, Ospina-Escobar A, Iskandar R, Alarid-Escudero F. Age-specific rates of onset of cannabis use in Mexico. Addict Behav 2021; 122:107038. [PMID: 34325204 PMCID: PMC8645182 DOI: 10.1016/j.addbeh.2021.107038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/24/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Over the previous two decades, the lifetime prevalence of cannabis use has risen among Mexico's population. AIMS Estimate the sex- and age-specific rates of onset of cannabis use over time. DESIGN Five nationally representative cross-sectional surveys, the Mexican National Surveys of Addictions (1998, 2002, 2008, 2012) and the Mexican National Survey on Drugs, Alcohol, and Tobacco Consumption (2016). SETTING Mexico. PARTICIPANTS Pooled sample of 141,342 respondents aged between 12 and 65 years of which 43.6%(n = 61,658) are male and 56.4% (n = 79,684) are female. MEASUREMENTS We estimated the age-specific rates of onset of cannabis as the conditional rate of consuming cannabis for the first time at a specific age. METHODS Time-to-event flexible-parametric models with spline specifications of the hazard function. Stratified analysis by sex and control for temporal trends by year of data collection or decennial birth cohort. FINDINGS Age-specific rates of onset of cannabis use per 1,000 individuals increased over time for females and males. Peak rates of onset of cannabis use per 1,000 ranged from 0.935 (95%CI = [0.772, 1.148]) in 1998, to 5.391 (95%CI = [4.924, 5.971]) in 2016 for females; and from 7.513 (95%CI = [6.732, 10.063]) in 1998, to 26.107 (95%CI = [25.918,30.654]) in 2016 for males. Across decennial birth-cohorts, peak rates of onset of cannabis use per 1,000 individuals for females ranged from 0.234 (95%CI = [0.078, 0.768]) for those born in the 1930s, to 14.611 (95%CI = [13.243, 16.102]) for those born in the 1990s; and for males, from 4.086 (95%CI = [4.022, 7.857]) for those born in the 1930s, to 38.693 (95%CI = [24.847, 48.670]) for those born in the 1990s. CONCLUSION Rates of onset of cannabis increased over the previous two decades for both females and males but remained higher for males. Across recent cohorts, the rates of onset have increased at a faster rate among females than males.
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Affiliation(s)
| | - Angélica Ospina-Escobar
- Programa de Cátedras CONACyT, Mexico; Drug Policy Program, Center for Research and Teaching in Economics (CIDE), Aguascalientes, Mexico; Division of Multidisciplinary Studies, Center for Research and Teaching in Economics (CIDE), Aguascalientes, Mexico
| | - Rowan Iskandar
- Center for Evidence Synthesis in Health, Brown University, Providence, RI, USA; Center of Excellence in Decision-Analytic Modeling and Health Economics Research, sitem-insel, Bern, Switzerland
| | - Fernando Alarid-Escudero
- Drug Policy Program, Center for Research and Teaching in Economics (CIDE), Aguascalientes, Mexico; Division of Public Administration, Center for Research and Teaching in Economics (CIDE), Aguascalientes, Mexico.
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Henderson JL, Wilkins LK, Hawke LD, Wang W, Sanches M, Brownlie EB, Beitchman JH. Longitudinal Emergence of Concurrent Mental Health and Substance Use Concerns in an Ontario School-Based Sample: The Research and Action for Teens Study. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:249-263. [PMID: 34777508 PMCID: PMC8561851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study characterizes patterns of mental health, substance use and their co-occurrence, and identifies developmental trajectories associated with progression from single to concurrent mental health and substance use concerns in an Ontario school-based population. It is a longitudinal extension of the Ontario Student Drug Use and Mental Health Survey, as part of the RAFT collaborative project. METHODS In this study, an Ontario-wide survey was administered to students across three biennial waves starting in grades 7-8 (ages 12-14). We explored how developmental patterns of externalizing, internalizing and co-occurring symptoms were differentially associated with late-adolescent (ages 17-19) problematic substance use. RESULTS On average, students exhibited early (ages 12-14) moderate risk of an internalizing and/or externalizing disorder and approached the low threshold for a diagnostic concern for substance use disorder at age 17-19. The pattern confirmed a potential pathway from early mental health concerns to later adolescent problematic substance use, with rates of co-occurrence increasing with age. Youth with early moderate-to high externalizing and co-occurring internalizing and externalizing symptomology had the highest levels of problematic substance use, with scores indicating high likelihood of a substance use disorder diagnosis. CONCLUSIONS Given the overall pattern of progression, early identification and referral of at-risk youth, especially youth with co-occurring mental health concerns, is of critical importance. Findings support the importance of integrated and co-located mental health and substance use services for youth to more effectively serve a diverse population of youth with varying levels of need.
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Affiliation(s)
- Joanna L Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
| | | | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Marcos Sanches
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
| | - E B Brownlie
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Joseph H Beitchman
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
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Stiles-Shields C, Archer J, Zhang J, Burnside A, Draxler J, Potthoff LM, Reyes KM, Summersett Williams F, Westrick J, Karnik NS. A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults. Child Psychiatry Hum Dev 2021; 54:639-658. [PMID: 34724134 PMCID: PMC9310430 DOI: 10.1007/s10578-021-01280-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/22/2022]
Abstract
Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.
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Affiliation(s)
- Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Joseph Archer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA,School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Jim Zhang
- Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Amanda Burnside
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Janel Draxler
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Karen M. Reyes
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Jennifer Westrick
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
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Cederbaum JA, Lee WJ, Okine L, Duan L, Lee JO. Using the Theory of Reasoned Action to examine grandparent and maternal substance use on the cannabis use of children of teen mothers. Drug Alcohol Depend 2021; 228:109019. [PMID: 34509738 PMCID: PMC8713458 DOI: 10.1016/j.drugalcdep.2021.109019] [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: 02/01/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Parental cannabis use is associated with increased risks of cannabis use among offspring, yet few studies have explored the mechanisms influencing intergenerational continuity in cannabis use. To understand the mechanism by which intergenerational cannabis use is influenced, this work explores cannabis use across three generations using a family expansion of the Theory of Reasoned Action (TRA). METHODS Data come from the Young Women and Child Development Study which began when teen mothers were pregnant and followed mother-child dyads for 17 years (N = 240). Constructs include cannabis use of grandparents, mothers, and teens, and TRA constructs of behavioral and normative beliefs, intention, and behavior. Hypotheses were tested using Structural Equation Modeling. RESULTS Grandfather's cannabis use was significantly linked to mother's normative beliefs (β = .22, p = .006), but not attitudes (β = .12, p = .182). Teen mothers' attitude was associated with intention (β = .79, p < .001); intention predicted cannabis behavior (β = .61, p < .001). Teen mothers' cannabis use was predictive of adolescent's attitude (β = .21, p = .002); attitude predicted intention (β = .73, p < .001) and intention predicted behavior (β = .60, p < .001). DISCUSSION Parents play an influential role in the cannabis use behaviors of adolescents. Future work should consider interventions that target both parent and adolescents, increasing knowledge and skills related to parent-child communication, parental monitoring, and positive parental role modeling to reduce intergenerational continuity of cannabis use.
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Affiliation(s)
| | - Woo Jung Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Lucinda Okine
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Lei Duan
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Jungeun Olivia Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
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64
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Leal-López E, Sánchez-Queija I, Rivera F, Moreno C. Trends in Cannabis Use among Adolescents in Spain 2006–2018. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2021. [DOI: 10.1080/1067828x.2021.1988021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eva Leal-López
- Universidad de Sevilla (University of Seville), Sevilla, Spain
| | | | | | - Carmen Moreno
- Universidad de Sevilla (University of Seville), Sevilla, Spain
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Merrin GJ, Leadbeater BJ, Sturgess CMB, Ames ME, Thompson K. Predictors of Early-Onset Cannabis Use in Adolescence and Risks for Substance Use Disorder Symptoms in Young Adulthood. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211049356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Early detection of risks for substance use disorders is essential to lifelong health and well-being for some youth. Very early-onset use is proposed as an indicator of risk for substance use disorders, but risk and protective factors related to early-onset use have not been identified. The current study compared risk and protective factors that distinguish early- and late-onset cannabis users from abstainers using data collected from a large community sample. The study also examined onset-group differences in participants’ reports of substance use disorder symptoms a decade later. Heavy episodic drinking (early-onset: OR = 7.29 CI = [1.60, 33.19]) and engagement with peers involved in deviant behaviors (early-onset: OR = 2.50 CI = [1.50, 4.13]) are risk factors for early-onset cannabis use. Protective factors, including parent monitoring (early-onset: OR = 0.73 CI = [0.58, 0.93]), engagement with peers involved in positive behaviors (early-onset: OR = 0.54 CI = [0.39, 0.76]), school engagement (early-onset: OR = 0.83 CI = [0.72, 0.96]), and academic grades (early-onset: OR = 0.37 CI = [0.21, 0.65]) also predicted early versus later onset-group differences. Early age of onset may be distinctly related to risk and protective factors previously associated with risks for substance use in all adolescents.
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Affiliation(s)
- Gabriel J. Merrin
- Department of Human Development and Family Science, Syracuse University, NY, USA
| | | | | | - Megan E. Ames
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Kara Thompson
- Department of Psychology, St Francis Xavier University, Antigonish, Nova Scotia, Canada
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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: 11] [Impact Index Per Article: 3.7] [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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67
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Butelman ER, Chen CY, Brown KG, Lake KJ, Kreek MJ. Age of onset of heaviest use of cannabis or alcohol in persons with severe opioid or cocaine use disorders. Drug Alcohol Depend 2021; 226:108834. [PMID: 34216857 DOI: 10.1016/j.drugalcdep.2021.108834] [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: 09/08/2020] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Persons with severe opioid or cocaine use disorders are particularly vulnerable to morbidity and mortality. Heaviest use of mu-opioid receptor agonists and cocaine typically commences in early adulthood and is preceded by substantial adolescent exposure to cannabis and/or alcohol. Little information exists on the age trajectories of exposure to cannabis or alcohol in persons diagnosed with severe opioid or cocaine use disorders, compared to persons diagnosed with other substance use disorders (unrelated to opioids or cocaine). METHOD This observational study had n = 854 volunteers (male = 581, female = 273; ≥18 years of age at the time of interview) and examined the ages of onset of heaviest use of cannabis and alcohol in persons diagnosed by DSM-IV criteria with opioid dependence (OD), both opioid and cocaine dependence (OD + CD) and cocaine dependence (CD). These age trajectory measures were compared to persons with other substance use disorders (primarily cannabis and alcohol use disorders, termed "Any Other Diagnoses"). RESULTS Unadjusted survival analyses showed persons diagnosed with either OD + CD or CD had earlier onset of heaviest use of cannabis (mean ages of 16.2 and 17.8, respectively) compared to the "Any Other Diagnoses" reference group (mean age = 19.5). A multivariate logistic regression showed that later onset of heaviest use of cannabis was associated with lower odds of being in the OD + CD or CD groups, when compared to the reference group. CONCLUSIONS Persons diagnosed with severe cocaine use disorders or dual opioid and cocaine use disorders exhibit a pattern of heavy and especially early adolescent exposure to cannabis, compared to persons with other substance use disorders.
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Affiliation(s)
- Eduardo R Butelman
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA.
| | - Carina Y Chen
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA
| | - Kate G Brown
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA
| | - Kimberly J Lake
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA
| | - Mary Jeanne Kreek
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Ave, New York, NY, 10065, USA
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Hines LA, Spry EA, Moreno-Betancur M, Mohamad Husin H, Becker D, Middleton M, Craig JM, Doyle LW, Olsson CA, Patton G. Cannabis and tobacco use prior to pregnancy and subsequent offspring birth outcomes: a 20-year intergenerational prospective cohort study. Sci Rep 2021; 11:16826. [PMID: 34413325 PMCID: PMC8376878 DOI: 10.1038/s41598-021-95460-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/20/2021] [Indexed: 11/15/2022] Open
Abstract
There is increasing evidence that the life-course origins of health and development begin before conception. We examined associations between timing and frequency of preconception cannabis and tobacco use and next generation preterm birth (PTB), low birth weight (LBW) and small for gestational age. 665 participants in a general population cohort were repeatedly assessed on tobacco and cannabis use between ages 14-29 years, before pregnancy. Associations were estimated using logistic regression. Preconception parent (either maternal or paternal) daily cannabis use age 15-17 was associated with sixfold increases in the odds of offspring PTB (aOR 6.65, 95% CI 1.92, 23.09), and offspring LBW (aOR 5.84, 95% CI 1.70-20.08), after adjusting for baseline sociodemographic factors, parent sex, offspring sex, family socioeconomic status, parent mental health at baseline, and concurrent tobacco use. There was little evidence of associations with preconception parental cannabis use at other ages or preconception parental tobacco use. Findings support the hypothesis that the early life origins of growth begin before conception and provide a compelling rationale for prevention of frequent use during adolescence. This is pertinent given liberalisation of cannabis policy.
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Affiliation(s)
- Lindsey A Hines
- Centre for Academic Mental Health, Population Health Sciences Institute, University of Bristol, Bristol, UK.
- MRC Integrative Epidemiology Unit, Population Health Sciences Institute, University of Bristol, Bristol, UK.
| | - Elizabeth A Spry
- Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Margarita Moreno-Betancur
- University of Melbourne, Melbourne, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Hanafi Mohamad Husin
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Denise Becker
- Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Australia
| | - Melissa Middleton
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jeffrey M Craig
- Centre for Molecular and Medical Research, Deakin University School of Medicine, Geelong, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paedatrics, University of Melbourne, Melbourne, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
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Millar SR, Mongan D, O’Dwyer C, Smyth BP, Perry IJ, Galvin B. Relationships between patterns of cannabis use, abuse and dependence and recent stimulant use: Evidence from two national surveys in Ireland. PLoS One 2021; 16:e0255745. [PMID: 34370775 PMCID: PMC8351952 DOI: 10.1371/journal.pone.0255745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background and objectives Epidemiological studies show that the use of cannabis is related to the use of other illicit drugs, including stimulants such as cocaine and ecstasy. However, few studies have examined how patterns of cannabis use relate to the use of stimulants. In this research we determined relationships between patterns of cannabis use and recent stimulant use, drawing on data from two large nationally representative surveys. We also explored how frequency of cannabis use relates to stimulant use and whether subjects with a cannabis use disorder (CUD)–defined as cannabis abuse or dependence–are more likely to be recent users of cocaine or ecstasy. Materials and methods We analysed data from Ireland’s 2010/11 and 2014/15 National Drug Prevalence Surveys,which recruited 5,134 and 7,005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported some past cannabis use. Multivariable logistic regression analysis was used to examine associations between patterns of cannabis use and recent stimulant use. Results Among survey participants who had used cannabis in the last month, 17.9% reported recent cocaine use, while almost one-quarter (23.6%) reported recent ecstasy use. There was a significant linear relationship between patterns of cannabis use and recent use of cocaine, ecstasy or any stimulant, with last month cannabis users displaying greater odds (OR = 12.03, 95% CI: 8.15–17.78) of having recent stimulant use compared to last year (OR = 4.48, 95% CI: 2.91–6.91) and former (reference) cannabis users. Greater frequency of cannabis use in the last 30 days was also significantly related to the use of stimulants. In addition, results demonstrated an association between CUD and recent use of cocaine or ecstasy (OR = 2.28, 95% CI: 1.55–3.35). Conclusions Findings from this study suggest a relationship between patterns and frequency of cannabis use and recent use of stimulants and an association between CUD and stimulant use. As the use of cannabis with stimulants may increase the risk of negative health consequences, education in community and medical settings about polydrug use and its increased risks may be warranted.
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Affiliation(s)
- Seán R. Millar
- Health Research Board, Dublin, Ireland
- School of Public Health, University College Cork, Cork, Ireland
- * E-mail:
| | | | | | - Bobby P. Smyth
- Department of Public Health & Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Ivan J. Perry
- School of Public Health, University College Cork, Cork, Ireland
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Mustonen A, Hielscher E, Miettunen J, Denissoff A, Alakokkare AE, Scott JG, Niemelä S. Adolescent cannabis use, depression and anxiety disorders in the Northern Finland Birth Cohort 1986. BJPsych Open 2021; 7:e137. [PMID: 36043688 PMCID: PMC8329769 DOI: 10.1192/bjo.2021.967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Cannabis use has been associated with increased risk of psychiatric disorders. However, associations between adolescent cannabis use, depression and anxiety disorders are inconsistently reported in longitudinal samples. AIMS To study associations of adolescent cannabis use with depression and anxiety disorders. METHOD We used data from the Northern Finland Birth Cohort 1986, linked to nationwide registers, to study the association between adolescent cannabis use and depression and anxiety disorders until 33 years of age (until 2018). RESULTS We included 6325 participants (48.8% male) in the analyses; 352 (5.6%) participants reported cannabis use until 15-16 years of age. By the end of the follow-up, 583 (9.2%) participants were diagnosed with unipolar depression and 688 (10.9%) were diagnosed with anxiety disorder. Cannabis use in adolescence was associated with an increased risk of depression and anxiety disorders in crude models. After adjusting for parental psychiatric disorder, baseline emotional and behavioural problems, demographic factors and other substance use, using cannabis five or more times was associated with increased risk of anxiety disorders (hazard ratio 2.01, 95% CI 1.15-3.82), and using cannabis once (hazard ratio 1.93, 95% CI 1.30-2.87) or two to four times (hazard ratio 2.02, 95% CI 1.24-3.31) was associated with increased risk of depression. CONCLUSIONS Cannabis use in adolescence was associated with an increased risk of future depression and anxiety disorders. Further research is needed to clarify if this is a causal association, which could then inform public health messages about the use of cannabis in adolescence.
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Affiliation(s)
- Antti Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Finland; Center for Life Course Health Research, University of Oulu, Finland; and Department of Psychiatry, Seinäjoki Central Hospital, Finland
| | - Emily Hielscher
- QIMR Berghofer Medical Research Institute, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Australia; and Queensland Centre for Mental Health Research, Australia
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Finland; and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | | | - Anni-Emilia Alakokkare
- Center for Life Course Health Research, University of Oulu, Finland; and Department of Psychiatry, University of Turku, Finland
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Australia; Queensland Centre for Mental Health Research, Australia; and Metro North Mental Health Service, Australia
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Finland; and Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Finland
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Meisel SN, Carpenter RW, Treloar Padovano H, Miranda R. Day-level shifts in social contexts during youth cannabis use treatment. J Consult Clin Psychol 2021; 89:251-263. [PMID: 34014688 DOI: 10.1037/ccp0000647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Social context plays a critical role in youth cannabis use. Yet few studies have examined if and when social contexts shift during cannabis use treatment. This study examined daily shifts in youths' social contexts with the goal of characterizing how specific social contexts (e.g., time with cannabis-using friends or siblings) relate to cannabis craving and use during cannabis treatment. METHOD Participants were 65 cannabis users (51% male), ages 15-24 years, who participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral therapies plus either adjunctive pharmacotherapy or placebo on cannabis craving and use. Ecological momentary assessment (EMA) data, collected from a pre-randomization period through the completion of the six-week intervention, assessed youths' social contexts, cannabis use, and craving. RESULTS Time-varying effects models identified shifts in social contexts during treatment. Overall, time spent with cannabis-using friends and siblings decreased, where time spent with non-using friends or alone increased across the trial. Time with parents or non-using siblings was unchanged. Comparing the relative associations of social contexts with same-day craving and use, more time with cannabis-using friends and with siblings was uniquely associated with greater craving and use. CONCLUSIONS Social context is an important factor in youth substance-use treatment. While time spent with cannabis-using friends and siblings decreased over treatment for all participants, those who continued to spend time with using individuals reported greater craving and use. This research supports increased attention to shifting youths' social contexts to enhance treatment success. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Initiation of Moderately Frequent Cannabis use in Adolescence and Young Adulthood is Associated with Declines in Verbal Learning and Memory: A Longitudinal Comparison of Pre- versus Post-Initiation Cognitive Performance. J Int Neuropsychol Soc 2021; 27:621-636. [PMID: 34261549 PMCID: PMC8486043 DOI: 10.1017/s1355617721000631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Cannabis use is associated with relative cognitive weaknesses as observed by cross-sectional as well as longitudinal research. Longitudinal studies, controlling for relevant confounds, are necessary to differentiate premorbid from post-initiation contributions to these effects. METHODS We followed a sample of adolescents and young adults across ten years. Participants provided neurocognitive data and substance use information at two-year intervals. Participants who initiated cannabis and/or alcohol use were identified (n = 86) and split into alcohol-only initiators (n = 39) and infrequent (n = 29) and moderately frequent (n = 18) cannabis initiators. Participants completed the Rey Auditory Verbal Learning Task (RAVLT) and the Iowa Gambling Task (IGT). Group differences before and after substance use initiation and the extent to which alcohol, nicotine, and cannabis use frequencies contributed to cognitive functions over time were examined. RESULTS After controlling for parental education, RAVLT new learning was worse in moderately frequent cannabis users prior to use initiation. RAVLT total learning and delayed recall showed significant declines from pre- to post-initiation in moderately frequent cannabis users. Regression analyses confirmed that frequencies of cannabis, but not alcohol, use contributed to post-initiation variations. Nicotine use showed an independent negative association with delayed memory. Findings for the IGT were not significant. CONCLUSIONS Verbal learning and memory may be disrupted following the initiation of moderately frequent cannabis use while decreased new learning may represent a premorbid liability. Our use of a control group of alcohol-only users adds interpretive clarity to the findings and suggests that future studies should carefully control for comorbid substance use.
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Han B, Compton WM, Einstein EB, Volkow ND. Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status. JAMA Netw Open 2021; 4:e2113025. [PMID: 34156452 PMCID: PMC8220498 DOI: 10.1001/jamanetworkopen.2021.13025] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPORTANCE During the past decade, cannabis use among US adults has increased markedly, with a parallel increase in suicidality (ideation, plan, attempt, and death). However, associations between cannabis use and suicidality among young adults are poorly understood. OBJECTIVE To determine whether cannabis use and cannabis use disorder (CUD) are associated with a higher prevalence of suicidality among young adults with or without depression and to assess whether these associations vary by sex. DESIGN, SETTING, AND PARTICIPANTS This survey study examined data from 281 650 adults aged 18 to 34 years who participated in the National Surveys on Drug Use and Health. Data were collected from January 1, 2008, to December 31, 2019. EXPOSURES Prevalence of past-year daily or near-daily cannabis use (≥300 days in the past year), CUD, and major depressive episode (MDE). Past-year CUD and MDE were based on DSM-IV diagnostic criteria. MAIN OUTCOMES AND MEASURES Past-year suicidal ideation, plan, and attempt. RESULTS Among the 281 650 adults aged 18 to 34 (men, 49.9% [95% CI, 49.6%-50.2%]; women, 50.1% [95% CI, 49.8%-50.4%]) included in the analysis, past-year suicidal ideation and plan along with daily cannabis use increased among all examined sociodemographic subgroups (except daily cannabis use among current high-school students), and past-year suicide attempt increased among most subgroups. National trends in adjusted prevalence of past-year suicidal ideation, plan, and attempt varied by daily and nondaily cannabis use and CUD among adults with or without MDE. After controlling for MDE, CUD, cannabis use status, and potential confounding factors, the adjusted prevalence of suicidal ideation, plan, and attempt increased 1.4 to 1.6 times from the 2008-2009 to 2018-2019 periods (adjusted risk ratio [ARR] for suicidal ideation, 1.4 [95% CI, 1.3-1.5]; ARR for suicide plan, 1.6 [95% CI, 1.5-1.9]; ARR for suicide attempt, 1.4 [95% CI, 1.2-1.7]), with 2008 to 2009 as the reference period. Past-year CUD, daily cannabis use, and nondaily cannabis use were associated with a higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes (eg, among individuals without MDE, prevalence of suicidal ideation for those with vs without CUD was 13.9% vs 3.5% among women and 9.9% vs 3.0% among men; P < .001), but significantly more so in women than men (eg, suicide plan among those with CUD and MDE was 52% higher for women [23.7%] than men [15.6%]; P < .001). CONCLUSIONS AND RELEVANCE From 2008 to 2019, suicidal ideation, plan, and attempt increased 40% to 60% over increases ascribed to cannabis use and MDE. Future research is needed to examine this increase in suicidality and to determine whether it is due to cannabis use or overlapping risk factors.
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Affiliation(s)
- Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Emily B. Einstein
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Nora D. Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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Influence of Cannabis Use Disorder Symptoms on Suicidal Ideation in College Students. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-019-00201-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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75
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The why behind the high: determinants of neurocognition during acute cannabis exposure. Nat Rev Neurosci 2021; 22:439-454. [PMID: 34045693 DOI: 10.1038/s41583-021-00466-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/08/2022]
Abstract
Acute cannabis intoxication may induce neurocognitive impairment and is a possible cause of human error, injury and psychological distress. One of the major concerns raised about increasing cannabis legalization and the therapeutic use of cannabis is that it will increase cannabis-related harm. However, the impairing effect of cannabis during intoxication varies among individuals and may not occur in all users. There is evidence that the neurocognitive response to acute cannabis exposure is driven by changes in the activity of the mesocorticolimbic and salience networks, can be exacerbated or mitigated by biological and pharmacological factors, varies with product formulations and frequency of use and can differ between recreational and therapeutic use. It is argued that these determinants of the cannabis-induced neurocognitive state should be taken into account when defining and evaluating levels of cannabis impairment in the legal arena, when prescribing cannabis in therapeutic settings and when informing society about the safe and responsible use of cannabis.
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Reddon H, Milloy MJ, Wood E, Nosova E, Kerr T, DeBeck K. High-intensity cannabis use and hospitalization: a prospective cohort study of street-involved youth in Vancouver, Canada. Harm Reduct J 2021; 18:53. [PMID: 34001159 PMCID: PMC8130127 DOI: 10.1186/s12954-021-00501-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is concern that cannabis use negatively affects vulnerable groups such as youth; however, the relationship between cannabis use and health care utilization has not been well characterized in this population. We longitudinally evaluated the association between daily cannabis use and hospitalization among a prospective cohort of street-involved youth. METHODS Data were collected from the At-Risk Youth Study (ARYS) in Vancouver, Canada, from September 2005 to May 2015. Participants were interviewed semi-annually and multivariable generalized estimating equation (GEE) logistic regression was used to examine the relationship between daily cannabis use and hospitalization. RESULTS A total of 1216 participants (31.2% female) were included in this analysis, and 373 (30.7%) individuals reported hospitalization at some point during the study period. In a multivariable GEE analysis, daily cannabis use was not significantly associated with hospitalization (Adjusted Odds Ratio [AOR] = 1.17, 95% Confidence interval [CI] = 0.84, 1.65). We did observe a significant interaction between daily cannabis use and sex (AOR = 0.51, 95% CI = 0.34, 0.77), whereby cannabis use was associated with a decreased odds of hospitalization among males (AOR = 0.60, 95% CI = 0.47, 0.78), yet was not significantly associated with hospitalization among females (AOR = 1.19, 95% CI = 0.84, 1.67). CONCLUSIONS The finding that daily cannabis use was not associated with hospitalization among street-involved youth is encouraging given the high rates of cannabis use in this population and the expansion of cannabis legalization and regulation. Future studies, however, are warranted to monitor possible changes in the consequences of cannabis use as cannabis legalization and regulation increase internationally.
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Affiliation(s)
- Hudson Reddon
- BC Centre on Substance Use, University of British Columbia, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, BC, V6B 3E6, Canada
| | - M-J Milloy
- BC Centre on Substance Use, University of British Columbia, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, ,Vancouver, BC, V6Z 1Y6, Canada
| | - Evan Wood
- BC Centre on Substance Use, University of British Columbia, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, ,Vancouver, BC, V6Z 1Y6, Canada
| | - Ekaterina Nosova
- BC Centre on Substance Use, University of British Columbia, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
| | - Thomas Kerr
- BC Centre on Substance Use, University of British Columbia, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, ,Vancouver, BC, V6Z 1Y6, Canada
| | - Kora DeBeck
- BC Centre on Substance Use, University of British Columbia, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada.
- School of Public Policy, SFU Harbour Centre, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada.
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Swaim RC, Stanley LR. Latent Class Analysis and Predictors of Marijuana Use among Reservation-based American Indian High School Students. J Psychoactive Drugs 2021; 54:99-109. [PMID: 33944694 DOI: 10.1080/02791072.2021.1918806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
American Indian (AI) youth residing on reservations report higher rates of marijuana use compared to national youth. Latent class analysis (LCA) was used to identify unique types of marijuana use among 2,884 AI high school students surveyed from 26 schools across six indigenous geographic regions. Predictors of class membership were then assessed using social, cultural, and individual measures relevant to adolescent substance use. Classes and predictors were examined separately for males and females. Four-class models fit the data best for both male and female AI students. Classes differed by sex, as did predictors. Overall, social predictors related to family and peers and the individual predictor, using marijuana to cope, were the best predictors of class membership. Based on these results, prevention and intervention efforts should provide alternative coping methods for these adolescents who often live in difficult situations, and should focus on encouraging parents to effectively monitor their adolescent children and communicate clear sanctions against marijuana use.
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Affiliation(s)
- Randall C Swaim
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Linda R Stanley
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
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Duffy SS, Hayes JP, Fiore NT, Moalem-Taylor G. The cannabinoid system and microglia in health and disease. Neuropharmacology 2021; 190:108555. [PMID: 33845074 DOI: 10.1016/j.neuropharm.2021.108555] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022]
Abstract
Recent years have yielded significant advances in our understanding of microglia, the immune cells of the central nervous system (CNS). Microglia are key players in CNS development, immune surveillance, and the maintenance of proper neuronal function throughout life. In the healthy brain, homeostatic microglia have a unique molecular signature. In neurological diseases, microglia become activated and adopt distinct transcriptomic signatures, including disease-associated microglia (DAM) implicated in neurodegenerative disorders. Homeostatic microglia synthesise the endogenous cannabinoids 2-arachidonoylglycerol and anandamide and express the cannabinoid receptors CB1 and CB2 at constitutively low levels. Upon activation, microglia significantly increase their synthesis of endocannabinoids and upregulate their expression of CB2 receptors, which promote a protective microglial phenotype by enhancing their production of neuroprotective factors and reducing their production of pro-inflammatory factors. Here, we summarise the effects of the microglial cannabinoid system in the CNS demyelinating disease multiple sclerosis, the neurodegenerative diseases Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis, chronic inflammatory and neuropathic pain, and psychiatric disorders including depression, anxiety and schizophrenia. We discuss the therapeutic potential of cannabinoids in regulating microglial activity and highlight the need to further investigate their specific microglia-dependent immunomodulatory effects.
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Affiliation(s)
- Samuel S Duffy
- Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales, UNSW Sydney, NSW, 2052, Australia
| | - Jessica P Hayes
- Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales, UNSW Sydney, NSW, 2052, Australia
| | - Nathan T Fiore
- Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales, UNSW Sydney, NSW, 2052, Australia
| | - Gila Moalem-Taylor
- Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales, UNSW Sydney, NSW, 2052, Australia.
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79
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Schaefer JD, Hamdi NR, Malone SM, Vrieze S, Wilson S, McGue M, Iacono WG. Associations between adolescent cannabis use and young-adult functioning in three longitudinal twin studies. Proc Natl Acad Sci U S A 2021; 118:e2013180118. [PMID: 33782115 PMCID: PMC8040790 DOI: 10.1073/pnas.2013180118] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Observational studies have linked cannabis use to an array of negative outcomes, including psychiatric symptoms, cognitive impairment, and educational and occupational underachievement. These associations are particularly strong when cannabis use occurs in adolescence. Nevertheless, causality remains unclear. The purpose of the present study was thus to examine associations between prospectively assessed adolescent cannabis use and young-adult outcomes (psychiatric, cognitive, and socioeconomic) in three longitudinal studies of twins (n = 3,762). Twins reporting greater cumulative cannabis use in adolescence reported higher levels of psychopathology as well as poorer socioeconomic outcomes in young adulthood. However, cannabis use remained associated only with socioeconomic outcomes (i.e., educational attainment, occupational status, and income) in monozygotic-cotwin control analyses, which account fully for shared genetic and environmental confounding. Follow-up analyses examining associations between twin differences in adolescent cannabis use and longitudinal change in academic functioning during the middle- and high-school years provided a possible mechanism for these associations, indicating that greater cannabis use during this period was associated with decreases in grade point average and academic motivation as well as increases in academic problem behavior and school disciplinary problems. Our findings thus suggest that cannabis use in adolescence has potentially causal, deleterious effects on adolescent academic functioning and young-adult socioeconomic outcomes despite little evidence suggesting a strong, causal influence on adult mental health or cognitive ability.
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Affiliation(s)
- Jonathan D Schaefer
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455;
| | - Nayla R Hamdi
- Northwest Metro VA Clinic, Minneapolis Veterans Affairs Health Care System, Ramsey, MN 55303
| | - Stephen M Malone
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Scott Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
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Effects of daily Δ 9-Tetrahydrocannabinol (THC) alone or combined with cannabidiol (CBD) on cognition-based behavior and activity in adolescent nonhuman primates. Drug Alcohol Depend 2021; 221:108629. [PMID: 33640678 PMCID: PMC8204682 DOI: 10.1016/j.drugalcdep.2021.108629] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Daily use of marijuana is rising in adolescents, along with consumption of high potency marijuana products (high % Δ-9-tetrahydrocannabinol or THC). These dual, related trends have opened gaps in understanding the long-term effects of daily consumption of a high dose of THC in adolescents and whether a therapeutic dose of cannabidiol (CBD) modulates THC effects. METHODS Adolescent squirrel monkeys (Saimiri boliviensis) were treated daily for four months with vehicle (n = 4), a high THC dose (1 mg/kg i.m.; n = 4), or THC + CBD (1 mg/kg +3 mg/kg i.m.; n = 4), to investigate whether: (1) a daily high THC dose affects performance in tasks of cognition (repeated acquisition, discrimination reversal); (2) a daily high THC dose affects spontaneous behavior and day/night activity (3) tolerance develops to the behavioral effects of THC; (4) whether CBD modulates THC effects. RESULTS THC impaired performance of adolescent monkeys in a cognitive test initially, but not performance on a task of cognitive flexibility. THC reduced motor activity and increased sedentary behavior, with tolerance developing after weeks of daily treatment. Co-administered with THC, CBD did not modulate THC effects on cognitive performance, activity or tolerance, but prevented THC-induced emesis on the first day of daily treatment. CONCLUSIONS Daily high dosing with THC compromised performance on a task of cognition, and reduced activity in adolescent primates, with tolerance developing within weeks. Whether our observations are relevant to a broader range of cognitive tasks vital for daily function in human adolescents is uncertain.
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81
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Poulia N, Delis F, Brakatselos C, Polissidis A, Koutmani Y, Kokras N, Dalla C, Politis PK, Antoniou K. Detrimental effects of adolescent escalating low-dose Δ 9 -tetrahydrocannabinol leads to a specific bio-behavioural profile in adult male rats. Br J Pharmacol 2021; 178:1722-1736. [PMID: 33496341 DOI: 10.1111/bph.15394] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/27/2020] [Accepted: 01/18/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND PURPOSE Adolescent cannabis use is associated with adult psychopathology. When Δ9 -tetrahydrocannabinol (THC), mainly in high doses, is administered to adolescence rats there are also long lasting effects in adults. This study aims to determine the specific adult bio-behavioural profile after adolescent low-dose THC, which better mirrors adolescent recreational cannabis use. EXPERIMENTAL APPROACH Adolescent male Sprague-Dawley rats were treated with escalating low-dose of THC. In adulthood, they were evaluated for their spontaneous locomotion, sensorimotor gating, higher order and spatial cognitive functions. Dopaminergic activity and cannabinoid receptor expression were measured in distinct brain regions. Hippocampal neurogenic activity of neural stem cells was determined and protein levels of neuroplasticity-related biomarkers were quantified. Adolescent low-dose THC exposure increased spontaneous open-field activity, without affecting prepulse inhibition and attentional set-shifting performance. Region-specific dopaminergic alterations and CB1 receptor up-regulation in the prefrontal cortex were observed. Impaired spatial memory, as assessed with the object location task and Morris water maze test, was associated with significantly decreased proliferative activity (SOX2-positive cells), neurogenic potential (decreased doublecortin-positive cells) in the adult hippocampus and defective neuroplasticity, including reduced BDNF expression in the hippocampus and prefrontal cortex. KEY RESULTS Our findings reveal the adverse impact of adolescent low-dose THC on the psychomotor profile, dopaminergic neurotransmission, compensatory cannabinoid receptor response, cognition-related neurobiological and behavioural functions. CONCLUSION AND IMPLICATIONS Our adolescent low-dose THC animal model does not induce tangible psychotic-like effects, such as those reported in high-dose THC studies, but it impairs cognitive functions and points to hippocampal vulnerability and disrupted neurogenesis.
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Affiliation(s)
- Nafsika Poulia
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Foteini Delis
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Charalampos Brakatselos
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Alexia Polissidis
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Yassemi Koutmani
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Kokras
- Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,First Department of Psychiatry, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Dalla
- Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis K Politis
- Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Katerina Antoniou
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Hawke LD, Henderson J. Legalization of cannabis use in Canada: Impacts on the cannabis use profiles of youth seeking services for substance use. J Subst Abuse Treat 2021; 126:108340. [PMID: 34116825 DOI: 10.1016/j.jsat.2021.108340] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/17/2020] [Accepted: 02/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cannabis is a highly used substance among youth, but has the potential to negatively impact the developing brain. Recreational cannabis use was legalized in Canada in October 2018. This exploratory study examines cannabis use profiles of high-risk youth before and after the national legalization of recreational cannabis use. METHOD This cross-sectional cohort study examines the cannabis use profiles of two cohorts of youth, one recruited prior to legalization (N = 101) and one recruited after legalization (N = 168). RESULTS This study found few changes in cannabis use patterns after legalization. The rate of high-frequency cannabis use, polysubstance use, social circles of use, and mental health and substance use challenges showed no change, and the study found no associations with age. Exceptions were that youth were more likely to report purchasing cannabis from a legal source after legalization. Concealment of cannabis use from legal authorities declined after legalization among youth over the age of majority (19+ years), but not among younger youth (<19 years). CONCLUSIONS Minimal changes have occurred in the cannabis use patterns of service-seeking youth in the short term following legalization. This holds true both for youth who have reached the age of majority and those who have not. Nevertheless, this population has overlapping substantial mental health and substance use challenges. Integrated services should address cannabis use and other concurrent challenges and be sensitive to the postlegalization social climate.
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Affiliation(s)
- Lisa D Hawke
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
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83
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Onaemo VN, Fawehinmi TO, D'Arcy C. Comorbid Cannabis Use Disorder with Major Depression and Generalized Anxiety Disorder: A Systematic Review with Meta-analysis of Nationally Representative Epidemiological Surveys. J Affect Disord 2021; 281:467-475. [PMID: 33360749 DOI: 10.1016/j.jad.2020.12.043] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/06/2020] [Accepted: 12/11/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Studies have shown a high degree of comorbidity between cannabis use disorder (CUD) and other mental illnesses. However, there is a paucity of research on the comorbidity between CUD with major depression (MD) and generalized anxiety disorder (GAD). This systematic review with meta-analysis aimed to assess the prevalence and strength of association between co-morbid CUD with MD and GAD. METHODS An extensive search of Medline, CINAHL, PsycINFO, EMBASE, and grey literature were conducted to cover articles published between January 1st, 1980, and July 31st, 2020. Inclusion criteria were publications in English Language, original research, nationally representative samples, and non-clinical randomly selected adult populations. A systematic review and meta-analysis for the prevalence and ORs for comorbid CUD with MD or GAD were done. RESULTS A total of 67 articles were identified by the electronic searches. A full-text review yielded 8 publications on nationally representative epidemiological surveys. 12-month and lifetime comorbidity estimates were extracted and used for the meta-analysis. CUD was strongly associated with MDE (OR 3.22; 2.31 - 4.49) and with GAD (OR 2.99; 2.14 - 4.16). LIMITATIONS Limitations of this study include the heterogeneity observed due to the combination of studies from different geographic regions with different modifications of diagnostic criteria and varied response rates. This was addressed with a random-effects model. CONCLUSION This review confirms the evidence of high prevalence and a 3-fold comorbid association between CUD with MD and CUD with GAD. Implementation of evidence-based policy interventions with effective, integrated management of comorbid CUDs with psychiatric disorders may contribute to positive patient outcomes.
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Affiliation(s)
- Vivian N Onaemo
- Government of Saskatchewan, Ministry of Health, 3475 Albert Street, Regina, Canada, S4S 6X6; School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
| | - Timothy O Fawehinmi
- Government of Nunavut, Department of Health, Iqaluit, Nunavut. X0A 0H0, Nunavut, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; Department of Psychiatry, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 2Z4, Canada
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Lloyd GL, Wiesen B, Atwell M, Malykhina A. Marijuana, Alcohol, and ED: Correlations with LUTS/BPH. Curr Urol Rep 2021; 22:21. [PMID: 33554319 PMCID: PMC8054558 DOI: 10.1007/s11934-020-01031-9] [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] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH. RECENT FINDINGS LUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well studied but recent results support short-term benefit and long-term caution. Depression, a form of central nervous dysfunction, and ED, which is likely mediated via endothelial dysfunction, are independently associated with LUTS/BPH. The presence of cannabinoid receptors in urologic organs, coupled with recent population studies, supports a modulatory effect of marijuana on voiding although an enormous knowledge gap remains.
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Affiliation(s)
- Granville L Lloyd
- Rocky Mountain Regional Veterans Hospital, Aurora, CO, USA.
- Department of Surgery/Urology, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA.
| | - Brett Wiesen
- University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
| | - Mike Atwell
- Division of Urology, Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
| | - Anna Malykhina
- Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
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85
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Montalto GJ, Cius EG, Rahmandar MH. Cannabinoids and the Adolescent Patient: A Pragmatic Guide for Pediatric Practitioners. Pediatr Ann 2021; 50:e57-e64. [PMID: 33576830 DOI: 10.3928/19382359-20210120-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Primary care and emergency medicine practitioners frequently care for adolescents with acute or chronic effects of cannabinoids. Cannabinoid epidemiology and pharmacology are changing as new laws and regulations, new products, and new means of delivery are rapidly developed. A grasp of basic cannabinoid terminology, which is also constantly shifting, helps clinicians obtain histories and discuss diagnoses, treatments, and outcomes with their patients. The ability to identify and treat cannabinoid-associated illnesses such as cannabinoid hyperemesis syndrome, withdrawal syndrome, and acute intoxication with synthetic cannabinoids can reduce morbidity. Research on neurodevelopmental, cognitive, and psychological effects of adolescent cannabinoid use helps clinicians to have informed conversations with their patients, while providing anticipatory guidance. This article is designed with busy clinicians in mind and highlights the practical information necessary to provide care to their adolescent patients. [Pediatr Ann. 2021;50(2):e57-e64.
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86
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Stringfield SJ, Torregrossa MM. Disentangling the lasting effects of adolescent cannabinoid exposure. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110067. [PMID: 32791165 DOI: 10.1016/j.pnpbp.2020.110067] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
Cannabis is the most widely used illicit substance among adolescents, and adolescent cannabis use is associated with various neurocognitive deficits that can extend into adulthood. A growing body of evidence supports the hypothesis that adolescence encompasses a vulnerable period of development where exposure to exogenous cannabinoids can alter the normative trajectory of brain maturation. In this review, we present an overview of studies of human and rodent models that examine lasting effects of adolescent exposure. We include evidence from meta-analyses, longitudinal, or cross-sectional studies in humans that consider age of onset as a factor that contributes to the behavioral dysregulation and altered structural or functional development in cannabis users. We also discuss evidence from preclinical rodent models utilizing well-characterized or innovative routes of exposure, investigating the effects of dose and timing to produce behavioral deficits or alterations on a neuronal and behavioral level. Multiple studies from both humans and animals provide contrasting results regarding the magnitude of residual effects. Combined evidence suggests that exposure to psychoactive cannabinoids during adolescence has the potential to produce subtle, but lasting, alterations in neurobiology and behavior.
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Affiliation(s)
- Sierra J Stringfield
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA
| | - Mary M Torregrossa
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA.
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87
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Andersson HW, Lauvsnes ADF, Nordfjærn T. Emerging Adults in Inpatient Substance Use Treatment: A Prospective Cohort Study of Patient Characteristics and Treatment Outcomes. Eur Addict Res 2021; 27:206-215. [PMID: 33279896 PMCID: PMC8220923 DOI: 10.1159/000512156] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Compared to older adults, emerging adults treated for substance use disorders (SUDs) are more likely to have unfavorable outcomes. However, few studies have investigated the baseline characteristics and treatment outcomes of emerging adults in inpatient SUD treatment. AIMS This study investigated differences in demographic and clinical characteristics and treatment outcomes (relapse or treatment discontinuation) among emerging adult and adult inpatients. Prospective associations between baseline characteristics and unfavorable treatment outcomes were also analyzed across both patient groups. METHODS A prospective cohort study was conducted among inpatients (n = 499) at 4 SUD treatment centers in Norway. The sample included emerging adult patients aged 18-25 years (n = 149) and adult patients above 25 years (n = 350). Medical records provided data on sociodemographic variables, substance use characteristics, diagnoses, and treatment completion status. Self-reported measures, including age of onset of substance use, motivation, and mental distress, were completed within 2 weeks of admission to treatment. A telephone interview 3 months after discharge provided information about relapses. RESULTS Emerging adults had a more adverse risk profile in terms of demographic characteristics, clinical variables, and treatment outcomes. Multivariable results showed that polysubstance use and an attention deficit hyperactivity disorder (ADHD) diagnosis were the strongest predictors of unfavorable treatment outcomes for emerging adults. For older adults, only baseline mental distress was a significant predictor of unfavorable treatment outcomes. CONCLUSIONS Treatment and follow-up initiatives could be better tailored for emerging adults. Identification of treatment needs among emerging adults manifesting polysubstance use and ADHD may reduce the likelihood of unfavorable treatment outcomes in this patient group.
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Affiliation(s)
- Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway,*Helle Wessel Andersson, Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Sluppen Pb 3250, NO–7006 Trondheim (Norway),
| | - Anders D. Forsmo Lauvsnes
- Kvamsgrind Addiction Treatment Centre, Trondheim, Norway,Department of Mental Health, Faculty of Medicine and Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trond Nordfjærn
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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88
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Abstract
Objectives: This paper reviews research on the topic of cannabis use and mental health harms in older adults and illustrates potential contributing factors and special clinical considerations for working with this population. Known risk factors for cannabis-related mental disorders and mental health problems are outlined, first for the general population and then specifically for older adults. Methods: Studies were identified through online databases using a variety of search words. Articles were included in the review if they were peer-reviewed or published by a reputable national organization, published in English, and were pertinent to the topic of mental health harms of cannabis use. Results: Risk factors that emerged from the literature review aligned with the following categories: (1) patterns of use (i.e., potency of product, frequency of use), (2) personal characteristics (i.e., age, sex, social demographics), (3) psychosocial constructs (motivations, perceptions), and (4) morbidities (mental health, medication interactions). Conclusions: Frequent use was associated with increased risk for mental health consequences related to cannabis use. Certain motives for use (i.e., using to cope, using as a sleep aid) may increase susceptibility to cannabis-related harms, although more empirical work is required. Mental health conditions may predispose to cannabis-related harms through a variety of mechanisms, including increased vulnerability for cannabis-related psychiatric disorders, poorer prognosis for preexisting psychiatric disorders, and possibility of cannabis-medication interactions. Personal characteristics (younger age, being male, lower socioeconomic status) predict more frequent cannabis use, which may dispose to adverse outcomes. Clinical Implications: Predictors of cannabis-related harms hold relevance for public health messaging, as well as clinical interventions. Understanding how cannabis interacts with sociodemographic factors, mental health morbidities, and medications is crucial in providing accurate guidance to patients about their recreational cannabis use and in informing prescriber decisions about medicinal cannabis.
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Affiliation(s)
- Amanda Hudson
- Mental Health and Addictions, Health PEI , Charlottetown, Canada.,Department of Health Management, University of Prince Edward Island , Charlottetown, Canada
| | - Pamela Hudson
- Mental Health and Addictions, Health PEI , Charlottetown, Canada.,Family Medicine, Health PEI , Charlottetown, Canada.,Department of Medicine, Dalhousie University , Halifax, Canada
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89
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Allick A, Park G, Kim K, Vintimilla M, Rathod K, Lebo R, Nanavati J, Hammond CJ. Age- and Sex-Related Cortical Gray Matter Volume Differences in Adolescent Cannabis Users: A Systematic Review and Meta-Analysis of Voxel-Based Morphometry Studies. Front Psychiatry 2021; 12:745193. [PMID: 34925090 PMCID: PMC8671465 DOI: 10.3389/fpsyt.2021.745193] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Adolescent-onset cannabis use is rising in the era of marijuana legalization. Recent imaging studies have identified neuroanatomical differences between adult cannabis users and controls that are more prominent in early-onset users. Other studies point to sex-dependent effects of cannabis. Methods: A systematic review following PRISMA guidelines and subsequent effect-size seed-based d mapping (SDM) meta-analyses were conducted to investigate relationships between age (across the 12-to-21-year-old developmental window), sex, and gray matter volume (GMV) differences between cannabis using (CU) and typically developing (TD) youth. Results: Our search identified 1,326 citations, 24 of which were included in a qualitative analysis. A total of 6 whole-brain voxel-based morphometry (VBM) studies comparing regional GMV between 357 CU [mean (SD) age = 16.68 (1.28); 71% male] and 404 TD [mean (SD) age = 16.77 (1.36); 63% male] youth were included in the SDM-meta-analysis. Meta-analysis of whole-brain VBM studies identified no regions showing significant GMV difference between CU and TD youth. Meta-regressions showed divergent effects of age and sex on cortical GMV differences in CU vs. TD youth. Age effects were seen in the superior temporal gyrus (STG), with older-aged CU youth showing decreased and younger-aged CU youth showing increased STG GMV compared to age-matched TD youth. Parallel findings in the STG were also observed in relation to duration of CU (years) in supplemental meta-regressions. Regarding sex effects, a higher proportion of females in studies was associated with increased GMV in the middle occipital gyrus in CU vs. TD youth. Conclusions: These findings suggest that GMV differences between CU and TD youth, if present, are subtle, and may vary as a function of age, cumulative cannabis exposure, and sex in young people. Whether age- and sex-related GMV differences are attributable to common predispositional factors, cannabis-induced neuroadaptive changes, or both warrant further investigation.
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Affiliation(s)
- Aliyah Allick
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Grace Park
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kwon Kim
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michelle Vintimilla
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Krutika Rathod
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rachael Lebo
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,I.D. Weeks Library, Health Sciences Department, University of South Dakota, Vermillion, SD, United States
| | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christopher J Hammond
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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90
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Duncan MJ, Patte KA, Leatherdale ST. Hit the chronic… physical activity: are cannabis associated mental health changes in adolescents attenuated by remaining active? Soc Psychiatry Psychiatr Epidemiol 2021; 56:141-152. [PMID: 33150455 DOI: 10.1007/s00127-020-01900-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE High-frequency cannabis use in adolescents has been associated with adult mental illness. In contrast, physical activity has been demonstrated to benefit mental health status. The purpose of this study was to examine whether, within a 1-year prospective study design, changes in cannabis use frequency are associated with changes in mental health, and whether meeting physical activity guidelines moderates these associations. METHODS COMPASS (2012-2021) is a hierarchical longitudinal health data survey from a rolling cohort of secondary school students across Canada; student-level mental health data linked from Years 5 (2016/17) and 6 (2017/18) were analysed (n = 3173, 12 schools). Multilevel conditional change regression models were used to assess associations between mental health scores change, cannabis use change and physical activity guideline adherence change after adjusting for covariates. RESULTS Adopting at least weekly cannabis use was associated with increases in depressive and anxiety symptoms and decreases in psychosocial well-being. Maintaining physical activity guidelines across both years improved psychosocial well-being regardless of cannabis use frequency, and offset increases in depressive symptoms among individuals who adopted high frequency cannabis use. Physical activity adherence had no apparent relationship with anxiety symptoms. CONCLUSION Regardless of the sequence of events, adopting high frequency cannabis use may be a useful behavioural marker of current or future emotional distress, and the need for interventions to address mental health. Physical activity adherence may be one approach to minimizing potential changes in mental health associated with increasing cannabis use.
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Affiliation(s)
- Markus J Duncan
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Niagara Region, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
| | - Karen A Patte
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Niagara Region, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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91
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Teen Reports of Cannabis for Medical Reasons-What Does That Mean? J Adolesc Health 2021; 68:9-10. [PMID: 33349361 DOI: 10.1016/j.jadohealth.2020.09.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 11/21/2022]
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92
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Abstract
There is a growing body of evidence pointing to the co-occurrence of cannabis use and depression. There is also some evidence that the use of cannabis may lead to the onset of depression; however, strong evidence points to the inverse association; i.e. that depression may lead to the onset or increase in cannabis use frequency. Observational and epidemiological studies have not indicated a positive long-term effect of cannabis use on the course and outcome of depression. The association between cannabis use and depression may be stronger among men during adolescence and emerging adulthood and stronger in women during midlife. There is an indication for potential genetic correlation contributing to the comorbidity of cannabis dependence and major depression, namely that serotonin (5-HT) may mediate such association and there is also evidence for specific risk alleles for cannabis addiction. There is preclinical evidence that alteration in the endocannabinoid system could potentially benefit patients suffering from depression. However, the issue of using cannabis as an anti-depressant is at an early stage of examination and there is little evidence to support it. Finally, there has been little support to the notion that selective serotonin reuptake inhibitors (SSRIs) may be effective in decreasing depressive symptoms or rates of substance use in adolescents treated for depression and a co-occurring substance use disorder. In conclusion, despite methodological limitations, research in the past decades has broadened our knowledge on the association between cannabis use and depression from epidemiological, neurological, genetic, and pharmacological perspectives.
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93
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Hasin D, Walsh C. Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review. J Clin Med 2020; 10:E15. [PMID: 33374666 PMCID: PMC7793504 DOI: 10.3390/jcm10010015] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/10/2020] [Accepted: 12/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. METHODS A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. RESULTS A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. CONCLUSIONS Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.
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Affiliation(s)
- Deborah Hasin
- New York State Psychiatric Institute, New York, NY 10032, USA;
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY 10032, USA;
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94
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Allen HK, Lilly F, Green KM, Zanjani F, Vincent KB, Arria AM. Graduate Student Burnout: Substance Use, Mental Health, and the Moderating Role of Advisor Satisfaction. Int J Ment Health Addict 2020; 20:1130-1146. [PMID: 35400127 PMCID: PMC8992873 DOI: 10.1007/s11469-020-00431-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Substance use and mental health problems are associated with academic difficulties among high school and undergraduate students, but little research has been conducted on these relationships among graduate students. The sample consisted of 2,683 graduate students attending two large, public universities. Standard measures were used to collect data on demographic and program characteristics, mental health, substance use, advisor satisfaction, and burnout (i.e., exhaustion, cynicism, and inefficacy). Linear regression models evaluated relationships between each mental health and substance use variable with burnout, as well as the moderating role of advisor satisfaction. Students with a greater number of substance use and mental health problems had higher levels of exhaustion, cynicism, and inefficacy. No statistically significant relationships between substance use and burnout were found. High levels of stress, moderate or severe anxiety symptoms, and moderate or severe depressive symptoms were associated with increased levels of burnout. Advisor support moderated the relationships between stress and both cynicism and inefficacy such that the effects of stress on these dimensions of burnout were lower among those who were satisfied with their advisor. Graduate students with mental health problems might be at increased risk for burnout; however, having a supportive advisor might buffer this association.
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Affiliation(s)
- Hannah K. Allen
- Pennsylvania State University College of Health and Human Development, University Park, PA 16802, USA
- University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Flavius Lilly
- University of Maryland Baltimore Graduate School, Baltimore, MD 21201, USA
| | - Kerry M. Green
- University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Faika Zanjani
- Virginia Commonwealth University College of Health Professions, Richmond, VA 23298, USA
| | - Kathryn B. Vincent
- University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Amelia M. Arria
- University of Maryland School of Public Health, College Park, MD 20742, USA
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95
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Perisetti A, Gajendran M, Dasari CS, Bansal P, Aziz M, Inamdar S, Tharian B, Goyal H. Cannabis hyperemesis syndrome: an update on the pathophysiology and management. Ann Gastroenterol 2020; 33:571-578. [PMID: 33162734 PMCID: PMC7599351 DOI: 10.20524/aog.2020.0528] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
Cannabis hyperemesis syndrome (CHS) is a form of functional gut-brain axis disorder characterized by bouts of episodic nausea and vomiting worsened by cannabis intake. It is considered as a variant of cyclical vomiting syndrome seen in cannabis users especially characterized by compulsive hot bathing/showers to relieve the symptoms. CHS was reported for the first time in 2004, and since then, an increasing number of cases have been reported. With cannabis use increasing throughout the world as the threshold for legalization becomes lower, its user numbers are expected to rise over time. Despite this trend, a strict criterion for the diagnosis of CHS is lacking. Early recognition of CHS is essential to prevent complications related to severe volume depletion. The recent body of research recognizes that patients with CHS impose a burden on the healthcare systems. Understanding the pathophysiology of the endocannabinoid system (ECS) remains central in explaining the clinical features and potential drug targets for the treatment of CHS. The frequency and prevalence of CHS change in accordance with the doses of tetrahydrocannabinol and other cannabinoids in various formulations of cannabis. CHS is unique in presentation, because of the cannabis’s biphasic effect as anti-emetic at low doses and pro-emetic at higher doses, and the association with pathological hot water bathing. In this narrative review, we elaborate on the role of the ECS, its management, and the identification of gaps in our current knowledge of CHS to further enhance its understanding in the future.
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Affiliation(s)
- Abhilash Perisetti
- Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR (Abhilash Perisetti)
| | - Mahesh Gajendran
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso (Mahesh Gajendran)
| | - Chandra Shekhar Dasari
- Department of Gastroenterology and Hepatology, Kansas City VA Medical Center (Chandra Shekhar Dasari)
| | - Pardeep Bansal
- Division of Gastroenterology, Moses Taylor Hospital and Reginal Hospital of Scranton, Scranton, PA (Pardeep Bansal)
| | - Muhammad Aziz
- Department of Internal Medicine, The University of Toledo, Toledo, OH (Muhammad Aziz)
| | - Sumant Inamdar
- Endoscopy Fellowship, University of Arkansas for Medical Sciences, Little Rock, AR (Sumant Inamdar, Benjamin Tharian)
| | - Benjamin Tharian
- Endoscopy Fellowship, University of Arkansas for Medical Sciences, Little Rock, AR (Sumant Inamdar, Benjamin Tharian)
| | - Hemant Goyal
- The Wright Center for Graduate Medical Education, Scranton, PA (Hemant Goyal), USA
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96
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Bhatt A, Wang X, Cheng AL, Morris KL, Beyer L, Chestnut A, Steigerwalt K, Metzner J. Association of Changes in Missouri Firearm Laws With Adolescent and Young Adult Suicides by Firearms. JAMA Netw Open 2020; 3:e2024303. [PMID: 33146733 PMCID: PMC7643031 DOI: 10.1001/jamanetworkopen.2020.24303] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE Suicide by firearm is a major cause of mortality in young Missouri residents. Changes in statewide firearm policy may have contributed to changes in suicide rates. OBJECTIVE To evaluate if changes in Missouri permit-to-purchase (PTP) and concealed carry firearm laws were associated with changes in rates of suicide by firearms in young Missouri residents. DESIGN, SETTINGS, AND PARTICIPANTS This cross-sectional study examined rates of suicide by firearm in Missouri among adolescents (ages 14-18 years) and young adults (ages 19-24 years) from January 1999 to December 2018, following changes to state PTP and concealed carry law, in comparison with a donor state pool with existing firearm laws (13 states in PTP pool; 42 states in concealed carry pool) that did not make changes during this period. This study used a quasiexperimental, synthetic control design at the state level that defined Missouri as the treated state and treatment as changes in firearm laws. EXPOSURES Legislative changes to Missouri's PTP and concealed carry firearm laws. MAIN OUTCOMES AND MEASURES Age-adjusted annual rates of firearm-related suicide mortality per 100 000 people for adolescents (aged 14-18 years) and young adults (aged 19-24 years). RESULTS Repeal of the PTP law was associated with a 21.8% increase in firearm suicide rates in young adults aged 19 to 24 years in Missouri. Lowering the minimum age of concealed carry to 19 years in Missouri was associated with a 32.0% increase in firearm suicide rates and a 29.7% increase in nonfirearm suicide rates in adolescents aged 14 to 18 years, and a 7.2% increase in firearm suicide rates in young adults aged 19 to 24 years. CONCLUSIONS AND RELEVANCE Increases in rates of suicide by firearms in adolescents and young adults were seen following repeal of Missouri's PTP law and lowering of the minimum age for concealed carry in 2014. Changes in Missouri's firearm policies may be an important contributor to rates of suicide by firearm in young Missouri residents.
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Affiliation(s)
- Apurva Bhatt
- University of Missouri-Kansas City/Center for Behavioral Medicine, Kansas City
- Truman Medical Centers, Kansas City, Missouri
| | - Xi Wang
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City
| | - An-Lin Cheng
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City
- University of Missouri-Kansas City School of Medicine, Kansas City
| | - Kalee L. Morris
- Kansas City University of Medicine and Biosciences, Kansas City, Missouri
| | - Luke Beyer
- Kansas City University of Medicine and Biosciences, Kansas City, Missouri
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Association between the use of Cannabis and elevated suicide risk in high school adolescents from Santa Marta, Colombia. ACTA ACUST UNITED AC 2020; 40:569-577. [PMID: 33030835 PMCID: PMC7666853 DOI: 10.7705/biomedica.4988] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Indexed: 11/21/2022]
Abstract
Introducción. La prevalencia del consumo de Cannabis sigue en aumento en el mundo, especialmente, entre adolescentes. Dicho consumo se sobrepone al de cigarrillos y otras sustancias lícitas e ilícitas, y se ha asociado con síntomas depresivos e incremento del riesgo suicida. En el contexto colombiano poco se conoce sobre la relación entre el consumo de Cannabis y el riesgo de suicidio. Objetivo. Evaluar la asociación entre el consumo de Cannabis y el riesgo suicida en adolescentes escolarizados de Santa Marta, Colombia. Materiales y métodos. Se hizo un estudio transversal con una muestra probabilística de estudiantes de media vocacional entre los 13 y los 17 años de edad en colegios oficiales y privados. Se indagó sobre el consumo de Cannabis alguna vez en la vida y se cuantificó el riesgo suicida con la Center for Epidemiologic Studies on Depression Scale. Las puntuaciones superiores a ocho se categorizaron como riesgo suicida elevado. Se estimó la razón de oportunidad (OR) cruda y la ajustada. Resultados. Participaron 1.462 estudiantes. La media para la edad fue de 14,4 años (desviación estándar, DE=0,8) y el 60,3 % correspondía a mujeres. La prevalencia del consumo de Cannabis alguna vez en la vida fue del 11,6 % (IC95% 10,0-13,2) y el 13,3 % (IC95% 11,6-15,0) de los estudiantes presentó riesgo suicida elevado. El consumo de Cannabis se asoció con dicho riesgo ajustado por otras variables (OR=1,88; IC95% 1,23-2,88). Conclusiones. El consumo de Cannabis se asoció con el riesgo suicida elevado en adolescentes escolarizados de Santa Marta, Colombia. Es necesario analizar otras variables que pueden mediar esta asociación.
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Bolanis D, Orri M, Castellanos-Ryan N, Renaud J, Montreuil T, Boivin M, Vitaro F, Tremblay RE, Turecki G, Côté SM, Séguin JR, Geoffroy MC. Cannabis use, depression and suicidal ideation in adolescence: direction of associations in a population based cohort. J Affect Disord 2020; 274:1076-1083. [PMID: 32663935 DOI: 10.1016/j.jad.2020.05.136] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND To clarify the direction of the association between frequency of cannabis use, depressive symptoms and suicidal ideation from 15 to 20 years using cross-lagged analyses. METHOD We included 1606 adolescents from the province of Québec followed since 1997 with information on frequency of cannabis use (none/monthly/weekly), depression (defined as being in the top 10% symptoms) and serious suicidal ideation at ages 15, 17 and 20 years. RESULTS The prevalence of weekly cannabis use increased from 7.0% at age 15 years to 15.6% by age 20 years. Adolescents who reported using cannabis weekly at one age were 11 to 15 times more likely to continue using cannabis over time. In longitudinal cross-lagged analyses, weekly cannabis use at age 15 was associated with greater odds (OR=2.19, 95% CI=1.04-4.58) of suicidal ideation two years later. However, other substance use (alcohol, tobacco, other drugs) fully explained this association. Further, depression predicted subsequent weekly cannabis use, even after adjusting for comorbid other substance use (eg, for depression at 15 years predicting cannabis use at 17 years: OR=2.30, 95% CI=1.19-4.43). LIMITATIONS Quantity of cannabis consumed was not measured. CONCLUSION Findings suggest that depressive symptoms in adolescence may represent a risk factor for weekly cannabis consumption, which once initiated is likely to remain chronic. Weekly cannabis use increased risk for suicidal ideation, but not independently from other substance use including alcohol, tobacco and other drugs.
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Affiliation(s)
- Despina Bolanis
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Québec, Canada
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Québec, Canada; Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux
| | - Natalie Castellanos-Ryan
- School of Psychoeducation, University of Montreal, Montreal, Québec, Canada; CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Québec, Canada; Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montreal, Québec, Canada
| | - Tina Montreuil
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada;; Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Québec city, Québec, Canada
| | - Frank Vitaro
- School of Psychoeducation, University of Montreal, Montreal, Québec, Canada; CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Richard E Tremblay
- Department of Psychology, University of Montreal, Montreal, Québec, Canada; CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Québec, Canada
| | - Sylvana M Côté
- Department of Social and Preventive Medicine, University of Montreal, Québec, Canada; CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Jean R Séguin
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Québec, Canada; CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Québec, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada;.
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La funcionalidad política de la “ciencia” prohibicionista: El caso del cannabis y los psicodélicos. Salud Colect 2020; 16:e2493. [DOI: 10.18294/sc.2020.2493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 08/06/2020] [Indexed: 11/24/2022] Open
Abstract
Se analiza, desde una perspectiva externalista, el uso de la ciencia como herramienta política por parte de la lógica prohibicionista. El prohibicionismo trabaja para que sus preceptos político-morales sean considerados científicos, es decir, como el resultado de un proceso de investigación neutro a nivel ideológico. El artículo analiza el caso del cannabis y de los psicodélicos para mostrar cómo el prohibicionismo solo ha recurrido a la “ciencia” para ocultar su agenda político-moral, mientras ha ignorado todos los resultados de las investigaciones científicas que no se ajustaban a sus apriorismos. Finalmente planteamos que las políticas de drogas deben fundamentarse en la evidencia científica y en ciertos valores básicos –defensa de la salud pública, de la cohesión social, de los Derechos Humanos–, por lo que un análisis en términos de relaciones de poder permitiría entender mejor las contradictorias relaciones entre ciencia y políticas de drogas.
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Visuospatial Processing Decline Due to Cannabis Consumption in Nondependent High School Students. EDUCATIONAL PSYCHOLOGY REVIEW 2020. [DOI: 10.1007/s10648-020-09564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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