151
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Rusby JC, Westling E, Crowley R, Light JM. Legalization of recreational marijuana and community sales policy in Oregon: Impact on adolescent willingness and intent to use, parent use, and adolescent use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 32:84-92. [PMID: 29144146 DOI: 10.1037/adb0000327] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Studies investigating the impact of medical marijuana legalization have found no significant changes in adolescent use. In one of the few studies focused on recreational marijuana, we investigated how recreational marijuana legalization and community sales policy influenced factors that likely impact youth use (youth willingness and intent to use, parent use) as well as youth use. Legalization of recreational marijuana in Oregon coincided with our study on adolescent substance use. Cohort 1 transitioned from 8th to 9th grade prior to legalization and Cohort 2 made this transition during legalization (N = 444; 53% female). Communities were allowed to opt out of sales. Multivariate linear regression models estimated the impact of legalization and community sales policy on changes in attitudes and parent use (2 time points 1 year apart). Zero-inflated Poisson growth curve models estimated the effects on initial levels and rate of change from 8th through 9th grade (4 time points). In communities opting out of sales, the prior-to-legalization cohort was less likely to increase their willingness and intent to use marijuana, and the legalization cohort was more likely to increase intent to use. For youth who used marijuana, legalization was associated with increased use, and those in communities opting out of sales had greater growth in marijuana use. Community policy appears to impact youth attitudes toward, and use of, marijuana. Results suggest that legalization of recreational marijuana did not increase marijuana use for youth who did not use marijuana but did increase use in youth who were already using. (PsycINFO Database Record
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152
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Hindocha C, Freeman TP, Xia JX, Shaban NDC, Curran HV. Acute memory and psychotomimetic effects of cannabis and tobacco both 'joint' and individually: a placebo-controlled trial. Psychol Med 2017; 47:2708-2719. [PMID: 28558859 PMCID: PMC5647681 DOI: 10.1017/s0033291717001222] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/07/2017] [Accepted: 04/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research. METHOD The individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions. RESULTS Cannabis alone impaired verbal memory. A priori contrasts indicated that tobacco offset the effects of cannabis on delayed recall. However, this was not supported by linear mixed model analysis. Cannabis load-dependently impaired WM. By contrast, tobacco improved WM across all load levels. The acute psychotomimetic effects and ratings of 'stoned' and 'dizzy' induced by cannabis were not altered by tobacco. Cannabis and tobacco had independent effects on increasing heart rate and interacting effects on increasing diastolic blood pressure. CONCLUSIONS Relative to placebo, acute cannabis impaired verbal memory and WM. Tobacco enhanced performance on WM, independently of cannabis. Moreover, we found some preliminary evidence that tobacco may offset the effects of cannabis on delayed, but not immediate, verbal recall. In contrast, the psychotomimetic and subjective effects of cannabis were unaffected by tobacco co-administration. By reducing the cognitive impairment from cannabis, tobacco co-administration may perpetuate use despite adverse health consequences.
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Affiliation(s)
- C. Hindocha
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - T. P. Freeman
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - J. X. Xia
- The Sophie Davis School of Biomedical Education,
The City College of New York, NY,
USA
| | - N. D. C. Shaban
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - H. V. Curran
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
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153
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Does Cannabis Use Cause Declines in Neuropsychological Functioning? A Review of Longitudinal Studies. J Int Neuropsychol Soc 2017; 23:893-902. [PMID: 29198276 PMCID: PMC8100918 DOI: 10.1017/s1355617717000789] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cannabis use has been linked to impairments in neuropsychological functioning across a large and continually expanding body of research. Yet insight into underlying causal relations remains limited due to the historically cross-sectional nature of studies in this area. Recently, however, studies have begun to use more informative design strategies to delineate these associations. The aim of this article is to provide a critical evaluation and review of research that uses longitudinal designs to examine the link between cannabis use and neuropsychological functioning. In summarizing the primary findings across these studies, this review suggests that cannabis use leads to neuropsychological decline. However, across most studies, these associations were modest, were present only for the group with the heaviest cannabis use, and were often attenuated (or no longer significant) after controlling for potential confounding variables. Future studies with neuropsychological data before and after initiation of cannabis use, along with careful measurement and control of "shared risk factors" between cannabis use and poorer neuropsychological outcomes, are needed to better understand who, and under what conditions, is most vulnerable to cannabis-associated neuropsychological decline. (JINS, 2017, 23, 893-902).
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154
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Skalski LM, Gunn RL, Caswell A, Maisto S, Metrik J. Sex-related marijuana expectancies as predictors of sexual risk behavior following smoked marijuana challenge. Exp Clin Psychopharmacol 2017; 25:402-411. [PMID: 29048189 PMCID: PMC5657572 DOI: 10.1037/pha0000138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Marijuana use has been associated with sexual risk behavior, but the mechanisms that underlie this relationship are not well understood. The present study examined whether marijuana acutely increased sexual risk on a behavioral decision-making task and whether sex-related marijuana outcome expectancies influenced sexual risk decisions after marijuana administration. Participants were heterosexual marijuana users (n = 126) who were randomly assigned to 1 of 4 study conditions using a 2 × 2 factorial design crossing drug administration (received 2.8% delta-9-tetrahydrocannabinol [THC] or 0% THC) with instructional set (told THC or told placebo). Participants completed a self-report measure of sex-related marijuana outcome expectancies at baseline and estimated likelihood of using condoms with a new and a steady partner in an interactive sexual role-play task (SRT) after smoking. In gender-specific analyses, there was a significant interaction of drug administration by sex-related outcome expectancies, such that for men in the received-placebo conditions, more salient sex-related marijuana outcome expectancies were associated with increased likelihood for sex without a condom with a new partner. Among women, there was no interaction or main effect of drug administration but more salient sex-related marijuana outcome expectancies were associated with increased likelihood of sex without a condom with a steady but not new partner. Findings suggest marijuana does not acutely increase risk for engaging in sexual risk behaviors. By contrast, sex-related marijuana outcome expectancies may play a more significant role in sexual decision-making process among marijuana users. (PsycINFO Database Record
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Affiliation(s)
- Linda M. Skalski
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912
- Providence VA Medical Center, Providence, RI, 02908
| | - Rachel L. Gunn
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912
| | - Amy Caswell
- Department of Psychology, University of Bath, UK BA2 7AY
| | - Stephen Maisto
- Department of Psychology, Syracuse University, Syracuse, NY 13244
| | - Jane Metrik
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912
- Providence VA Medical Center, Providence, RI, 02908
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
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155
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Saenz SR, Lewis RJ, Angier MK, Wagner JR. Postmortem Fluid and Tissue Concentrations of THC, 11-OH-THC and THC-COOH†. J Anal Toxicol 2017; 41:508-516. [DOI: 10.1093/jat/bkx033] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Indexed: 11/15/2022] Open
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156
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Vidot DC, Lerner B, Gonzalez R. Cannabis Use, Medication Management and Adherence Among Persons Living with HIV. AIDS Behav 2017; 21:2005-2013. [PMID: 28456895 DOI: 10.1007/s10461-017-1782-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.
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Affiliation(s)
- Denise C Vidot
- School of Nursing and Health Sciences, University of Miami, 5030 Brunson Ave, Coral Gables, FL, 33146, USA.
| | - Brenda Lerner
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Raul Gonzalez
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
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157
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Gonzales R, Steinberg J, Winters KC, Murphy DA, Ang A, Hernandez M, Mugahwi M. Examining Treatment Outcomes: Differences Between Primary and Non-Primary Marijuana-Using Youths Transitioning Into Recovery. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2017. [DOI: 10.1080/1067828x.2017.1305929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rachel Gonzales
- University of California, Los Angeles, CA, USA
- Azusa Pacific University, Azusa, CA, USA
| | | | | | | | - Alfonso Ang
- University of California, Los Angeles, CA, USA
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158
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Sherman BJ, McRae-Clark AL. Treatment of Cannabis Use Disorder: Current Science and Future Outlook. Pharmacotherapy 2017; 36:511-35. [PMID: 27027272 DOI: 10.1002/phar.1747] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cannabis is the most commonly used illicit substance in the United States. Rates of cannabis use and cannabis use disorder (CUD) have increased in the past decade, paralleling changes in the legal and political climate favoring legalization. Almost 20 million people 12 years or older report past-month cannabis use, and 8 million report daily or near-daily use. Concurrently, the perception that cannabis use poses a significant risk of negative consequences has decreased. Contrary to this perception, heavy cannabis use is associated with cognitive impairment, increased risk for psychotic disorders and other mental health problems, lower education attainment, and unemployment. Clinical trials of various treatments for CUD have likewise increased, focusing primarily on psychotherapy treatments, specifically motivational enhancement therapy, cognitive behavioral therapy, and contingency management. Their findings suggest that a combination of these three modalities produces the best abstinence outcomes, although abstinence rates remain modest and decline after treatment. More recently, pharmacotherapy trials have been conducted as adjunctive interventions to psychosocial treatment. N-acetylcysteine and gabapentin are two of the most promising medications, although no pharmacologic treatment has emerged as clearly efficacious. In this review, we provide a detailed summary of clinical trials that evaluated psychotherapy and pharmacotherapy for treating CUD and discuss emerging areas of clinical research and cannabis-specific barriers to treatment.
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Affiliation(s)
- Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Aimee L McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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159
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Abstract
BACKGROUND Substance use disorders in older adults are expected to increase dramatically in the coming years. Given the increased susceptibility to cognitive deficits in older substance users (defined here as aged 50+ years due to the accelerated health decline observed in this population), it is important to consider the functional correlates of cognitive impairment in these older adults. This study details the cognitive status of older individuals attending outpatient drug and alcohol (D&A) treatment services and seeks to determine of the association of cognitive impairment to self-reported daily functioning. METHODS Ninety nine clients aged 50 years or over attending outpatient D&A treatment services in Sydney, Australia participated. Cognition was assessed using the Addenbrooke's Cognitive Examination - Revised (ACE-R). Recent substance use (Australian Treatment Outcome Profile), physical and mental health (SF12, Geriatric Depression Scale), social isolation (Lubben Social Network Scale), and activities of daily living (Bayer ADL Scale) were also assessed. RESULTS Nearly two-thirds of participants screened positive for cognitive impairment on the ACE-R; 41% and 65% of clients met the cut-off scores for mild cognitive impairment (MCI) and more severe cognitive impairment, respectively. Self-reported seizure history was a predictor of cognitive impairment. CONCLUSIONS The results suggest that cognitive impairment in this group is common. The assessment of cognitive status for this older group of patients should not only include the identification of cognitive impairment but also encompass mental health and social functioning. A greater understanding of the needs of this cohort will also enable better co-ordination with other health and welfare services tailored to this population.
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160
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Silveira MM, Arnold JC, Laviolette SR, Hillard CJ, Celorrio M, Aymerich MS, Adams WK. Seeing through the smoke: Human and animal studies of cannabis use and endocannabinoid signalling in corticolimbic networks. Neurosci Biobehav Rev 2017; 76:380-395. [PMID: 27639448 PMCID: PMC5350061 DOI: 10.1016/j.neubiorev.2016.09.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 08/02/2016] [Accepted: 09/13/2016] [Indexed: 02/07/2023]
Abstract
Public opinion surrounding the recreational use and therapeutic potential of cannabis is shifting. This review describes new work examining the behavioural and neural effects of cannabis and the endocannabinoid system, highlighting key regions within corticolimbic brain circuits. First, we consider the role of human genetic factors and cannabis strain chemotypic differences in contributing to interindividual variation in the response to cannabinoids, such as THC, and review studies demonstrating that THC-induced impairments in decision-making processes are mediated by actions at prefrontal CB1 receptors. We further describe evidence that signalling through prefrontal or ventral hippocampal CB1 receptors modulates mesolimbic dopamine activity, aberrations of which may contribute to emotional processing deficits in schizophrenia. Lastly, we review studies suggesting that endocannabinoid tone in the amygdala is a critical regulator of anxiety, and report new data showing that FAAH activity is integral to this response. Together, these findings underscore the importance of cannabinoid signalling in the regulation of cognitive and affective behaviours, and encourage further research given their social, political, and therapeutic implications.
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Affiliation(s)
- Mason M Silveira
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
| | - Jonathon C Arnold
- The Brain and Mind Centre and Discipline of Pharmacology, University of Sydney, Sydney, NSW, Australia
| | - Steven R Laviolette
- Addiction Research Group and Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Marta Celorrio
- Program of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona 31008, Spain; Department of Biochemistry and Genetics, School of Science, University of Navarra, Pamplona 31008, Spain
| | - María S Aymerich
- Program of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona 31008, Spain; Department of Biochemistry and Genetics, School of Science, University of Navarra, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona 31008, Spain
| | - Wendy K Adams
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
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161
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Ridley N, Batchelor J, Draper B, Demirkol A, Lintzeris N, Withall A. Cognitive screening in substance users: Diagnostic accuracies of the Mini-Mental State Examination, Addenbrooke's Cognitive Examination-Revised, and Montreal Cognitive Assessment. J Clin Exp Neuropsychol 2017; 40:107-122. [PMID: 28436744 DOI: 10.1080/13803395.2017.1316970] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Despite the considerable prevalence of cognitive impairment in substance-using populations, there has been little investigation of the utility of cognitive screening measures within this context. In the present study the accuracy of three cognitive screening measures in this population was examined-the Mini-Mental State Examination (MMSE), the Addenbrooke's Cognitive Examination-Revised (ACE-R), and the Montreal Cognitive Assessment (MoCA). METHOD A sample of 30 treatment-seeking substance users and 20 healthy individuals living in the community were administered the screening measures and a neuropsychological battery (NPB). Agreement of classification of cognitive impairment by the screening measures and NPB was examined. RESULTS Results indicated that the ACE-R and MoCA had good discriminative ability in detection of cognitive impairment, with areas under the receiver-operating characteristic (ROC) curve of .85 (95% confidence interval, CI [.75. .94] and .84 (95% CI [.71, .93]) respectively. The MMSE had fair discriminative ability (.78, 95% CI [.65, .93]). The optimal cut-score for the ACE-R was 93 (impairment = score of 92 or less), at which it correctly classified 89% of individuals as cognitively impaired or intact, while the optimal cut-score for the MoCA was <26 or <27 depending on preference for either specificity or sensitivity. The optimal cut-score for the MMSE was <29; however, this had low sensitivity despite good specificity. CONCLUSIONS These findings suggest that the MoCA and ACE-R are both valid and time-efficient screening tools to detect cognitive impairment in the context of substance use.
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Affiliation(s)
- Nicole Ridley
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia
| | - Jennifer Batchelor
- b Department of Psychology , Macquarie University , North Ryde , NSW , Australia
| | - Brian Draper
- c School of Psychiatry, Faculty of Medicine , UNSW Australia , NSW , Sydney , Australia.,d Academic Department for Old Age Psychiatry , Prince of Wales Hospital , Randwick , NSW , Australia
| | - Apo Demirkol
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,e School of Public Health & Community Medicine, Faculty of Medicine , UNSW Australia , Sydney , NSW , Australia
| | - Nicholas Lintzeris
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,f Discipline of Addiction Medicine, Central Clinical School , Sydney Medical School, The University of Sydney , Sydney , NSW , Australia
| | - Adrienne Withall
- e School of Public Health & Community Medicine, Faculty of Medicine , UNSW Australia , Sydney , NSW , Australia
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162
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Scott JC, Wolf DH, Calkins ME, Bach EC, Weidner J, Ruparel K, Moore TM, Jones JD, Jackson CT, Gur RE, Gur RC. Cognitive functioning of adolescent and young adult cannabis users in the Philadelphia Neurodevelopmental Cohort. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:423-434. [PMID: 28414475 DOI: 10.1037/adb0000268] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cannabis use in youth is rising and has been linked to deficits in cognitive functioning. However, cognitive findings have primarily been based on small samples of users seeking treatment, and few studies have evaluated cognition in occasional cannabis users. Here, we examined 4,568 adolescents and young adults (ages 14-21 years) drawn from the Philadelphia Neurodevelopmental Cohort, a prospective, population-based study. Participants were classified as cannabis Non-Users (n = 3,401), Occasional Users (twice per week or less; n = 940), or Frequent Users (>3 times per week; n = 227). Mixed-model analyses examined main effects of cannabis use and interactions between age and cannabis use on cognitive functioning. There was a significant interaction between cannabis group and age such that adolescent (but not young adult) Frequent Users performed worse than Non-Users on measures of executive control (p = .002). Earlier age of cannabis use was associated with worse performance in executive control in Occasional Users (p = .04). Unexpectedly, Occasional Users exhibited better executive control, memory, and social cognition than Non-Users (ps < .05). Although mild executive control deficits in adolescent frequent users and a relation between early cannabis initiation and cognitive performance are partially consistent with prior research, cognitive deficits were not found in other hypothesized domains in this community-based sample. Moreover, occasional cannabis users displayed equivalent or even slightly better executive control, social-cognitive, and memory abilities compared with nonusers, suggesting complex relationships between cannabis use and cognition in youth. Longitudinal studies with community samples are needed to identify variables affecting risk and resilience to cognitive deficits associated with cannabis. (PsycINFO Database Record
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Emily C Bach
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Jennifer Weidner
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Tyler M Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Jason D Jones
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Chad T Jackson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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163
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Mizrahi R, Watts JJ, Tseng KY. Mechanisms contributing to cognitive deficits in cannabis users. Neuropharmacology 2017; 124:84-88. [PMID: 28414051 DOI: 10.1016/j.neuropharm.2017.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/13/2017] [Indexed: 12/19/2022]
Abstract
Studies from preclinical animal models indicate that sustained activation of CB1 receptor signaling is a major contributing factor for the onset of cognitive deficits associated to chronic cannabis use, in particular within the working memory and decision-making domains. Yet, very few studies have been designed to directly assess the role of CB1 receptors in mediating the effects of cannabis on human brain function. This perspective review article provides an overview of current state of knowledge on possible neurobiological mechanisms accounting for the detrimental effects of chronic cannabis use on cognition and related changes in brain structure and functional connectivity. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- Romina Mizrahi
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, ON, Canada; Research Imaging Center, CAMH, PET Centre, Toronto, ON, Canada
| | - Jeremy J Watts
- Department of Pharmacology & Toxicology, University of Toronto, ON, Canada; Research Imaging Center, CAMH, PET Centre, Toronto, ON, Canada
| | - Kuei Y Tseng
- Department of Cellular & Molecular Pharmacology, The Chicago Medical School at Rosalind Franklin University, North Chicago, IL, USA.
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164
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Zielinski L, Bhatt M, Sanger N, Plater C, Worster A, Varenbut M, Daiter J, Pare G, Marsh DC, Desai D, MacKillop J, Steiner M, McDermid Vaz S, Thabane L, Samaan Z. Association between cannabis use and methadone maintenance treatment outcomes: an investigation into sex differences. Biol Sex Differ 2017; 8:8. [PMID: 28367308 PMCID: PMC5372283 DOI: 10.1186/s13293-017-0130-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 03/07/2017] [Indexed: 12/29/2022] Open
Abstract
Background Cannabis will soon become legalized in Canada, and it is currently unclear how this will impact public health. Methadone maintenance treatment (MMT) is the most common pharmacological treatment for opioid use disorder (OUD), and despite its documented effectiveness, a large number of patients respond poorly and experience relapse to illicit opioids. Some studies implicate cannabis use as a risk factor for poor MMT response. Although it is well established that substance-use behaviors differ by sex, few of these studies have considered sex as a potential moderator. The current study aims to investigate sex differences in the association between cannabis use and illicit opioid use in a cohort of MMT patients. Methods This multicentre study recruited participants on MMT for OUD from Canadian Addiction Treatment Centre sites in Ontario, Canada. Sex differences in the association between any cannabis use and illicit opioid use were investigated using multivariable logistic regression. A secondary analysis was conducted to investigate the association with heaviness of cannabis use. Results The study included 414 men and 363 women with OUD receiving MMT. Cannabis use was significantly associated with illicit opioid use in women only (OR = 1.82, 95% CI 1.18, 2.82, p = 0.007). Heaviness of cannabis use was not associated with illicit opioid use in men or women. Conclusions This is the largest study to date examining the association between cannabis use and illicit opioid use. Cannabis use may be a sex-specific predictor of poor response to MMT, such that women are more likely to use illicit opioids if they also use cannabis during treatment. Women may show improved treatment outcomes if cannabis use is addressed during MMT.
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Affiliation(s)
- Laura Zielinski
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
| | - Meha Bhatt
- Health Research Methodology Graduate Program, McMaster University, Hamilton, ON Canada
| | - Nitika Sanger
- Medical Science Graduate Program, McMaster University, Hamilton, ON Canada
| | - Carolyn Plater
- Canadian Addiction Treatment Centres, Hamilton, ON Canada
| | - Andrew Worster
- Canadian Addiction Treatment Centres, Hamilton, ON Canada.,Department of Medicine, McMaster University, Hamilton, ON Canada
| | | | - Jeff Daiter
- Canadian Addiction Treatment Centres, Hamilton, ON Canada
| | - Guillaume Pare
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - David C Marsh
- Canadian Addiction Treatment Centres, Hamilton, ON Canada.,Northern Ontario School of Medicine, Sudbury, ON Canada
| | - Dipika Desai
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON Canada
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
| | - Meir Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada.,Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON Canada
| | - Stephanie McDermid Vaz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Cleghorn Early Intervention Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
| | - Lehana Thabane
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada.,Biostatistics Unit, Research Institute at St Joes, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
| | - Zainab Samaan
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
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165
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Walsh Z, Gonzalez R, Crosby K, S. Thiessen M, Carroll C, Bonn-Miller MO. Medical cannabis and mental health: A guided systematic review. Clin Psychol Rev 2017; 51:15-29. [DOI: 10.1016/j.cpr.2016.10.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 10/06/2016] [Accepted: 10/10/2016] [Indexed: 12/28/2022]
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166
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Abstract
Maladaptive decision-making is a cardinal feature of drug use, contributing to ongoing use, and reflecting alterations in how drug users assess uncertain reward value. Accumulating evidence indicates the consequences of heavy marijuana use are worse for female versus male animals and humans, but research assessing sex differences in reward-related decision-making among marijuana users remains scarce. We examined sex differences in the subjective valuation of certain and uncertain rewards among heavy marijuana users (52; 26 male and 26 female) and controls (52; 26 male and 26 female). We offered male and female heavy marijuana users and controls monetary rewards of certain and uncertain (probabilistic) values. We measured how preferences for uncertain rewards varied by the objective value of those rewards, moderators of reward uncertainty, Marijuana Group and Sex. Men were more sensitive to changes in the objective value of uncertain rewards than women. However, this effect of Sex differed by Marijuana Group. Female heavy marijuana users were more sensitive to changes in uncertain reward value, particularly when the "stakes" were high (i.e., greater difference between potential uncertain rewards), than female controls. Female heavy marijuana users' sensitivity to changes in the value of high stakes uncertain rewards was comparable to male marijuana users and controls. In contrast, male marijuana users' sensitivity to changes in the value of high stakes uncertain rewards did not differ from male controls. These results suggest sex differences in sensitivity to high risk rewards may be one pathway contributing to severer consequences of heavy marijuana use among women. (PsycINFO Database Record
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Affiliation(s)
- Kathryn R. Hefner
- Mental Illness Research, Education & Clinical Centers, VA Connecticut Healthcare System, West Haven, CT, United States,Yale University, School of Medicine, Department of Psychiatry, 950 Campbell Avenue, West Haven, CT 06516, USA,Department of Psychology, University of Wisconsin-Madison, 1202 W Johnson Street, Madison, WI 53076, USA
| | - Mark. J. Starr
- Department of Psychology, University of Wisconsin-Madison, 1202 W Johnson Street, Madison, WI 53076, USA
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167
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Aston ER, Merrill JE, McCarthy DM, Metrik J. Risk Factors for Driving After and During Marijuana Use. J Stud Alcohol Drugs 2016; 77:309-16. [PMID: 26997189 DOI: 10.15288/jsad.2016.77.309] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Use of marijuana before or while driving significantly contributes to driving impairment and elevated risk of motor vehicle accidents; however, this risk behavior is common among users. Little is known about the etiology of driving while under the influence of marijuana. METHOD Guided by social learning theory, this study examined marijuana outcome expectancies and other driving-related cognitions as predictors of the frequency of driving after smoking marijuana (DASM) and smoking marijuana while driving (SMWD). A community sample of 151 (64% male) non-treatment-seeking frequent marijuana users completed questionnaires on variables of interest. RESULTS Perceived driving-related peer norms (i.e., perception that fewer friends disapprove of DASM and SMWD and of riding with a driver under the influence of marijuana) were associated with lower frequency of both DASM and SMWD. Perceived dangerousness of DASM was also associated with decreased frequency of DASM. CONCLUSIONS Our findings suggest a range of potentially important targets for interventions intended to reduce the likelihood and frequency of driving while under the influence of marijuana.
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Affiliation(s)
- Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Denis M McCarthy
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Jane Metrik
- Providence Veterans Affairs Medical Center, Providence, Rhode Island.,Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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168
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Dahlgren MK, Sagar KA, Racine MT, Dreman MW, Gruber SA. Marijuana Use Predicts Cognitive Performance on Tasks of Executive Function. J Stud Alcohol Drugs 2016; 77:298-308. [PMID: 26997188 DOI: 10.15288/jsad.2016.77.298] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Despite growing evidence that chronic marijuana use is associated with cognitive impairment, particularly when use is initiated at an early age, national trends demonstrate significant decreases in the perceived risk of marijuana corresponding with increased use, especially among youth. The current study assessed the impact of marijuana use on executive function and whether patterns of marijuana use, including earlier age at onset, higher frequency, and increased magnitude of use, predict impairment. METHOD Forty-four chronic, heavy marijuana smokers (37 male, 7 female) and 32 healthy, nonsmoking control participants (20 male, 12 female) recruited from the Greater Boston area completed two assessments of executive function: the Stroop Color Word Test and Wisconsin Card Sorting Test (WCST). RESULTS Marijuana smokers had poorer executive function relative to control participants, a between-group difference that was primarily driven by individuals with early onset of marijuana use (before age 16; n = 21); significance remained even when controlling for frequency and magnitude of use. Further, earlier age at marijuana onset and increased marijuana use predicted poorer neurocognitive performance, and perseverative errors on the WCST significantly predicted marijuana group membership. CONCLUSIONS These findings underscore the impact of early onset of marijuana use on executive function impairment independent of increased frequency and magnitude of use. In addition, poorer performance on the WCST may serve as a neuropsychological marker for heavy marijuana users. These results highlight the need for additional research to identify predictors associated with early marijuana use, as exposure to marijuana during a period of developmental vulnerability may result in negative cognitive consequences.
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Affiliation(s)
- Mary Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts.,Department of Psychology, Tufts University, Medford, Massachusetts
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Megan T Racine
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Meredith W Dreman
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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169
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McKetin R, Parasu P, Cherbuin N, Eramudugolla R, Anstey KJ. A longitudinal examination of the relationship between cannabis use and cognitive function in mid-life adults. Drug Alcohol Depend 2016; 169:134-140. [PMID: 27810656 DOI: 10.1016/j.drugalcdep.2016.10.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The relationship between cannabis use and cognitive function in mid-life has rarely been examined despite verbal learning deficits in young adults. METHOD A longitudinal cohort study of 1,897 Australians recruited at 40-46 years of age and followed up 4 years (94%) and 8 years (87%) later. Random effects regression was used to assess within- and between-person associations between cannabis use and cognitive function across waves of data, and examine whether age-related changes in cognitive performance were modified by cannabis use. The first list of the California Verbal Learning Test (immediate and delayed recall), Symbol Digit Modality Test, Digit Backwards, simple and choice reaction time tasks, were administered at each wave. The Spot-the-Word test was used to assess premorbid verbal ability. Self-reported cannabis use in the past year (no use, < weekly use,≥weekly use) was assessed at each wave. FINDINGS Participants who used cannabis≥weekly had worse immediate recall (b=-0.68, p=0.014) and showed a trend toward worse delayed recall (b=-0.55, p=0.062) compared to non-users after adjusting for correlates of cannabis use and premorbid verbal ability. These effects were due to between-person differences. There were no significant within-person associations between cannabis use and recall, nor was there evidence of greater cognitive decline in cannabis users with age. CONCLUSIONS Mid-life cannabis users had poorer verbal recall than non-users, but this was not related to their current level of cannabis use, and cannabis use was not associated with accelerated cognitive decline.
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Affiliation(s)
- Rebecca McKetin
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia; Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
| | - Praneeth Parasu
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
| | - Ranmalee Eramudugolla
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
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170
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Mokrysz C, Freeman TP, Korkki S, Griffiths K, Curran HV. Are adolescents more vulnerable to the harmful effects of cannabis than adults? A placebo-controlled study in human males. Transl Psychiatry 2016; 6:e961. [PMID: 27898071 PMCID: PMC5290352 DOI: 10.1038/tp.2016.225] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 12/18/2022] Open
Abstract
Preclinical research demonstrates that cannabinoids have differing effects in adolescent and adult animals. Whether these findings translate to humans has not yet been investigated. Here we believe we conducted the first study to compare the acute effects of cannabis in human adolescent (n=20; 16-17 years old) and adult (n=20; 24-28 years old) male cannabis users, in a placebo-controlled, double-blind cross-over design. After inhaling vaporized active or placebo cannabis, participants completed tasks assessing spatial working memory, episodic memory and response inhibition, alongside measures of blood pressure and heart rate, psychotomimetic symptoms and subjective drug effects (for example, 'stoned', 'want to have cannabis'). Results showed that on active cannabis, adolescents felt less stoned and reported fewer psychotomimetic symptoms than adults. Further, adults but not adolescents were more anxious and less alert during the active cannabis session (both pre- and post-drug administration). Following cannabis, cognitive impairment (reaction time on spatial working memory and prose recall following a delay) was greater in adults than adolescents. By contrast, cannabis impaired response inhibition accuracy in adolescents but not in adults. Moreover, following drug administration, the adolescents did not show satiety; instead they wanted more cannabis regardless of whether they had taken active or placebo cannabis, while the opposite was seen for adults. These contrasting profiles of adolescent resilience (blunted subjective, memory, physiological and psychotomimetic effects) and vulnerability (lack of satiety, impaired inhibitory processes) show some degree of translation from preclinical findings, and may contribute to escalated cannabis use by human adolescents.
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Affiliation(s)
- C Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - S Korkki
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - K Griffiths
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
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171
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Phillips JG, Ogeil RP. Cannabis, alcohol use, psychological distress, and decision-making style. J Clin Exp Neuropsychol 2016; 39:670-681. [PMID: 27876440 DOI: 10.1080/13803395.2016.1255311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION There have been suggestions of hypofrontality in cannabis users. To understand cannabis-related differences in decisional processes, Janis and Mann's conflict model of decision making was applied to recreational cannabis smokers who varied in their alcohol use and level of psychological distress. METHOD An online sample of recreational substance users (114 male, 119 female) completed the Melbourne Decision Making Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), Kessler's Psychological Distress Scale (K10), and the Severity of Dependence Scale (SDS) for cannabis. RESULTS Multivariate analysis of variance examined self-reported decision-making styles as a function of gender, recent cannabis use, risky alcohol consumption, and levels of psychological distress. Psychological distress was associated with lower decisional self-esteem and higher levels of procrastination and buck-passing. There were gender differences associated with cannabis use. Female cannabis users reported higher levels of hypervigilance, while male cannabis users reported lower levels of buck-passing. CONCLUSIONS Although there was little indication of an avoidant decisional style in cannabis users, the results suggest that cannabis affects decisional processes, contributing to panic in females and impulsivity in males.
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Affiliation(s)
- James G Phillips
- a Psychology Department , Auckland University of Technology , Auckland , New Zealand
| | - Rowan P Ogeil
- b Eastern Health Clinical School , Monash University, and Turning Point, Eastern Health , Clayton , Australia
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172
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Bloomfield MAP, Ashok AH, Volkow ND, Howes OD. The effects of Δ 9-tetrahydrocannabinol on the dopamine system. Nature 2016; 539:369-377. [PMID: 27853201 PMCID: PMC5123717 DOI: 10.1038/nature20153] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 10/10/2016] [Indexed: 12/21/2022]
Abstract
The effects of Δ9-tetrahydrocannabinol (THC), the main psychoactive ingredient in cannabis, are a pressing concern for global mental health. Patterns of cannabis use are changing drastically owing to legalization, the availability of synthetic analogues (commonly termed spice), cannavaping and an emphasis on the purported therapeutic effects of cannabis. Many of the reinforcing effects of THC are mediated by the dopamine system. Owing to the complexity of the cannabinoid-dopamine interactions that take place, there is conflicting evidence from human and animal studies concerning the effects of THC on the dopamine system. Acute THC administration causes increased dopamine release and neuron activity, whereas long-term use is associated with blunting of the dopamine system. Future research must examine the long-term and developmental dopaminergic effects of THC.
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Affiliation(s)
- Michael A P Bloomfield
- Psychiatric Imaging Group, Robert Steiner MR Unit, MRC Clinical Sciences Centre, Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Psychiatric Imaging Group, Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London WC1T 7NF, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology &Neuroscience, Kings College London, De Crespigny Park, London SE5 8AF, UK
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Abhishekh H Ashok
- Psychiatric Imaging Group, Robert Steiner MR Unit, MRC Clinical Sciences Centre, Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Psychiatric Imaging Group, Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology &Neuroscience, Kings College London, De Crespigny Park, London SE5 8AF, UK
| | - Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Bethesda, Maryland 20892-9561, USA
| | - Oliver D Howes
- Psychiatric Imaging Group, Robert Steiner MR Unit, MRC Clinical Sciences Centre, Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Psychiatric Imaging Group, Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology &Neuroscience, Kings College London, De Crespigny Park, London SE5 8AF, UK
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173
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Shalit N, Shoval G, Shlosberg D, Feingold D, Lev-Ran S. The association between cannabis use and suicidality among men and women: A population-based longitudinal study. J Affect Disord 2016; 205:216-224. [PMID: 27449554 DOI: 10.1016/j.jad.2016.07.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/08/2016] [Accepted: 07/03/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence regarding the role of sex differences in the association between cannabis use and suicidality is lacking. We explored sex differences in the bidirectional association between cannabis use and suicidality in a 3-year longitudinal study. METHODS Data were drawn from waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Bidirectional analyses were conducted separately by sex, exploring incidence of suicidality among cannabis users (n=963 vs. 30,586 non-users) as well as initiation of cannabis use among suicidal individuals (n=1805 vs. 25,729 non-suicidal). Cannabis use was categorized based on frequency of use. Multivariate logistic regression analyses controlling for multiple covariates were conducted. RESULTS Cannabis use was significantly associated with increased incidence of suicidality among men (Adjusted Odds Ratio [AOR] for any cannabis use =1.91[1.02-3.56]) but not among women (AOR=1.19[0.64-2.20]). Daily cannabis use was significantly associated with increased incidence of suicidality among men (AOR=4.28[1.32-13.82]) but not among women (AOR=0.75[0.28-2.05]). Conversely, baseline suicidality was associated with initiation of cannabis use among women (AOR=2.34[1.42-3.87]) but not among men (AOR=1.10[0.57-2.15]). Separate analyses of suicidal ideation and suicide attempts demonstrated a significant association between cannabis use and subsequent incidence of suicidal ideation in men, and a significant association between baseline suicidal ideation and subsequent initiation of cannabis use in women. No significant association was found for the bidirectional association between cannabis use and suicide attempts in either sex. LIMITATIONS Suicidality was assessed only in individuals reporting depressed mood and/or anhedonia. CONCLUSIONS Our findings support a longitudinal association between heavy cannabis use and the incidence of suicidality in men, but not in women. Conversely, baseline suicidality is longitudinally associated with the initiation of cannabis use in women, but not in men. This may have implications on clinical and social aspects of cannabis use and merit further research into the unique effects of sex differences on cannabis induced psychopathology.
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Affiliation(s)
- Nadav Shalit
- Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Gal Shoval
- Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Dan Shlosberg
- Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Daniel Feingold
- Ariel University, Ariel, Israel; Addiction Medicine Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel
| | - Shaul Lev-Ran
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Addiction Medicine Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel
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174
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Jacobs DS, Kohut SJ, Jiang S, Nikas SP, Makriyannis A, Bergman J. Acute and chronic effects of cannabidiol on Δ⁹-tetrahydrocannabinol (Δ⁹-THC)-induced disruption in stop signal task performance. Exp Clin Psychopharmacol 2016; 24:320-330. [PMID: 27690502 PMCID: PMC5119678 DOI: 10.1037/pha0000081] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Recent clinical and preclinical research has suggested that cannabidiol (CBD) and Δ9-tetrahydrocannabinol (Δ9-THC) have interactive effects on measures of cognition; however, the nature of these interactions is not yet fully characterized. To address this, we investigated the effects of Δ9-THC and CBD independently and in combination with proposed therapeutic dose ratios of 1:1 and 1:3 Δ9-THC:CBD in adult rhesus monkeys (n = 6) performing a stop signal task (SST). Additionally, the development of tolerance to the effects of Δ9-THC on SST performance was evaluated by determining the effects of acutely administered Δ9-THC (0.1-3.2 mg/kg), during a 24-day chronic Δ9-THC treatment period with Δ9-THC alone or in combination with CBD. Results indicate that Δ9-THC (0.032-0.32 mg/kg) dose-dependently decreased go success but did not alter go reaction time (RT) or stop signal RT (SSRT); CBD (0.1-1.0 mg/kg) was without effect on all measures and, when coadministered in a 1:1 dose ratio, did not exacerbate or attenuate the effects of Δ9-THC. When coadministered in a 1:3 dose ratio, CBD (1.0 mg/kg) attenuated the disruptive effects of 0.32 mg/kg Δ9-THC but did not alter the effects of other Δ9-THC doses. Increases in ED50 values for the effects of Δ9-THC on SST performance were apparent during chronic Δ9-THC treatment, with little evidence for modification of changes in sensitivity by CBD. These results indicate that CBD, when combined with Δ9-THC in clinically available dose ratios, does not exacerbate and, under restricted conditions may even attenuate, Δ9-THC's behavioral effects. (PsycINFO Database Record
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Affiliation(s)
| | - Stephen J. Kohut
- Preclinical Pharmacology Laboratory, McLean Hospital,Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Shan Jiang
- Center for Drug Discovery, Northeastern University, Boston, MA, USA
| | - Spyros P. Nikas
- Center for Drug Discovery, Northeastern University, Boston, MA, USA
| | | | - Jack Bergman
- Preclinical Pharmacology Laboratory, McLean Hospital,Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
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175
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Agabio R, Campesi I, Pisanu C, Gessa GL, Franconi F. Sex differences in substance use disorders: focus on side effects. Addict Biol 2016; 21:1030-42. [PMID: 27001402 DOI: 10.1111/adb.12395] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 02/24/2016] [Indexed: 12/19/2022]
Abstract
Although sex differences in several aspects of substance use disorders (SUDs) have been identified, less is known about the importance of possible sex differences in side effects induced by substances of abuse or by medications used to treat SUDs. In the SUD field, the perception of certain subjective effects are actively sought, while all other manifestations might operationally be considered side effects. This article was aimed at reviewing sex differences in side effects induced by alcohol, nicotine, heroin, marijuana and cocaine and by medications approved for alcohol, nicotine and heroin use disorders. A large body of evidence suggests that women are at higher risk of alcohol-induced injury, liver disease, cardiomyopathy, myopathy, brain damages and mortality. The risk of tobacco-induced coronary heart disease, lung disease and health problems is higher for women than for men. Women also experience greater exposure to side effects induced by heroin, marijuana and cocaine. In addition, women appear to be more vulnerable to the side effects induced by medications used to treat SUDs. Patients with SUDs should be advised that the risk of developing health problems may be higher for women than for men after consumption of the same amount of substances of abuse. Doses of medications for SUD women should be adjusted at least according to body weight. The sex differences observed also indicate an urgent need to recruit adequate numbers of female subjects in pre-clinical and clinical studies to improve our knowledge about SUDs in women.
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Affiliation(s)
- Roberta Agabio
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology; University of Cagliari; Cagliari Italy
| | - Ilaria Campesi
- National Laboratory of Gender Medicine of the National Institute of Biostructures and Biosystems; Osilo, Sassari Italy
- Department of Biomedical Sciences; University of Sassari; Sassari Italy
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology; University of Cagliari; Cagliari Italy
| | - Gian Luigi Gessa
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology; University of Cagliari; Cagliari Italy
- Neuroscience Institute, Section of Cagliari; National Research Council of Italy; Cagliari Italy
| | - Flavia Franconi
- National Laboratory of Gender Medicine of the National Institute of Biostructures and Biosystems; Osilo, Sassari Italy
- Department of Biomedical Sciences; University of Sassari; Sassari Italy
- Assessorato alle Politiche per la Persona; Regione Basilicata Italy
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176
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Silveira MM, Adams WK, Morena M, Hill MN, Winstanley CA. Δ9-Tetrahydrocannabinol decreases willingness to exert cognitive effort in male rats. J Psychiatry Neurosci 2016; 41:150363. [PMID: 27557094 PMCID: PMC5373702 DOI: 10.1503/jpn.150363] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/15/2016] [Accepted: 04/19/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Acceptance of cannabis use is growing. However, prolonged use is associated with diminished psychosocial outcomes, potentially mediated by drug-induced cognitive impairments. Δ9-Tetrahydrocannabinol (THC) is the main psychoactive ingredient in cannabis, yet other phytocannabinoids in the plant, such as cannabidiol (CBD), have unique properties. Given that CBD can modulate the undesirable effects of THC, therapeutic agents, such as nabiximols, contain higher CBD:THC ratios than illicit marijuana. We tested the hypothesis that THC impairs a relevant cognitive function for long-term success, namely willingness to exert cognitive effort for greater rewards, and that CBD could attenuate such decision-making impairments. METHODS Male Long-Evans rats (n = 29) performing the rat cognitive effort task (rCET) received acute THC and CBD, independently and concurrently, in addition to other cannabinoids. Rats chose between 2 options differing in reward magnitude, but also in the cognitive effort (attentional load) required to obtain them. RESULTS We found that THC decreased choice of hard trials without impairing the animals' ability to accurately complete them. Strikingly, this impairment was correlated with CB1 receptor density in the medial prefrontal cortex - an area previously implicated in effortful decision-making. In contrast, CBD did not affect choice. Coadministration of 1:1 CBD:THC matching that in nabiximols modestly attenuated the deleterious effects of THC in "slacker" rats. LIMITATIONS Only male rats were investigated, and the THC/CBD coadministration experiment was carried out in a subset of individuals. CONCLUSION These findings confirm that THC, but not CBD, selectively impairs decision-making involving cognitive effort costs. However, coadministration of CBD only partially ameliorates such THC-induced dysfunction.
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Affiliation(s)
- Mason M. Silveira
- From the Department of Psychology, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); and the Hotchkiss Brain Institute, Departments of Cell Biology and Anatomy & Psychiatry, University of Calgary, Calgary, Alta. (Hill)
| | - Wendy K. Adams
- From the Department of Psychology, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); and the Hotchkiss Brain Institute, Departments of Cell Biology and Anatomy & Psychiatry, University of Calgary, Calgary, Alta. (Hill)
| | - Maria Morena
- From the Department of Psychology, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); and the Hotchkiss Brain Institute, Departments of Cell Biology and Anatomy & Psychiatry, University of Calgary, Calgary, Alta. (Hill)
| | - Matthew N. Hill
- From the Department of Psychology, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); and the Hotchkiss Brain Institute, Departments of Cell Biology and Anatomy & Psychiatry, University of Calgary, Calgary, Alta. (Hill)
| | - Catharine A. Winstanley
- From the Department of Psychology, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, B.C. (Silveira, Adams, Winstanley); and the Hotchkiss Brain Institute, Departments of Cell Biology and Anatomy & Psychiatry, University of Calgary, Calgary, Alta. (Hill)
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Okafor CN, Zhou Z, Burrell LE, Kelso NE, Whitehead NE, Harman JS, Cook CL, Cook RL. Marijuana use and viral suppression in persons receiving medical care for HIV-infection. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:103-110. [PMID: 27398989 DOI: 10.1080/00952990.2016.1191505] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Marijuana use is common among persons living with HIV (PLWH), but studies on its effect on HIV clinical outcomes are limited. OBJECTIVES We determined the association between marijuana use and HIV viral suppression among PLWH. METHODS Data came from five repeated cross-sections (2009-2013) of the Florida Medical Monitoring Project, a population-based sample of PLWH in Florida. Data were obtained via interview and medical record abstraction (MRA). Weighted logistic regression models were used to determine the association between marijuana use (past 12 months) and durable viral suppression (HIV-1 RNA value of ≤ 200 copies/milliliter in all measurements within the past 12 months). RESULTS Of the 1,902 PLWH receiving antiretroviral therapy, completed an interview, and had a linked MRA, 20% reported marijuana use (13% less than daily and 7% daily use) and 73% achieved durable viral suppression. In multivariable analysis, marijuana use was not significantly associated with durable viral suppression in daily [Adjusted Odds Ratio (AOR): 0.87, 95% confidence interval (CI): 0.58, 1.33] or in less than daily [AOR: 0.83, 95% CI: 0.51, 1.37] users as compared to non-users when adjusting for sociodemographic factors, time since HIV diagnosis, depressive symptoms, alcohol, cigarette and other substance use. CONCLUSION In this sample of PLWH receiving medical care in Florida, there was no statistically significant association between marijuana use and viral suppression. However, as the limits of the confidence intervals include effects that may be considered to be clinically important, there is a need for additional evidence from other samples and settings that include more marijuana users.
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Affiliation(s)
- Chukwuemeka N Okafor
- a Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , FL , USA
| | - Zhi Zhou
- a Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , FL , USA
| | - Larry E Burrell
- b Department of Clinical and Health Psychology , College of Public Health and Health Professions, University of Florida , Gainesville , FL , USA
| | - Natalie E Kelso
- a Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , FL , USA
| | - Nicole E Whitehead
- b Department of Clinical and Health Psychology , College of Public Health and Health Professions, University of Florida , Gainesville , FL , USA
| | - Jeffery S Harman
- c Department of Behavioral Sciences & Social Medicine , College of Medicine, Florida State University , Tallahassee , FL , USA
| | - Christa L Cook
- d Department of Family, Community, and Health System Science , College of Nursing, University of Florida , Gainesville , FL , USA
| | - Robert L Cook
- a Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , FL , USA
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Abstract
Background Tetrahydrocannabinol (Δ9-THC), the primary ingredient in marijuana, exerts its effects across several neurological and biological systems that interact with the endocrine system. Thus, differential effects of Δ9-THC are likely to exist based on sex and hormone levels. Methods We reviewed the existing literature to determine sex-based effects of Δ9-THC on neural structure and functioning. Results The literature demonstrates differences in male and female marijuana users on brain structure, reward processing, attention, motor coordination, and sensitivity to withdrawal. However, inconsistencies exist in the literature regarding how marijuana affects men and women differentially, and more work is needed to understand these mechanisms. While extant literature remains inconclusive, differentiation between male and female marijuana users is likely due to neurological sexual dimorphism and differential social factors at play during development and adulthood. Conclusions Sex has important implications for marijuana use and the development of cannabis use disorders and should be considered in the development of prevention and treatment strategies.
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Affiliation(s)
- Ariel Ketcherside
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235 USA
| | - Jessica Baine
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235 USA
| | - Francesca Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235 USA
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Spronk DB, Verkes RJ, Cools R, Franke B, Van Wel JHP, Ramaekers JG, De Bruijn ERA. Opposite effects of cannabis and cocaine on performance monitoring. Eur Neuropsychopharmacol 2016; 26:1127-39. [PMID: 27106715 DOI: 10.1016/j.euroneuro.2016.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 12/16/2015] [Accepted: 03/24/2016] [Indexed: 01/10/2023]
Abstract
Drug use is often associated with risky and unsafe behavior. However, the acute effects of cocaine and cannabis on performance monitoring processes have not been systematically investigated. The aim of the current study was to investigate how administration of these drugs alters performance monitoring processes, as reflected in the error-related negativity (ERN), the error positivity (Pe) and post-error slowing. A double-blind placebo-controlled randomized three-way crossover design was used. Sixty-one subjects completed a Flanker task while EEG measures were obtained. Subjects showed diminished ERN and Pe amplitudes after cannabis administration and increased ERN and Pe amplitudes after administration of cocaine. Neither drug affected post-error slowing. These results demonstrate diametrically opposing effects on the early and late phases of performance monitoring of the two most commonly used illicit drugs of abuse. Conversely, the behavioral adaptation phase of performance monitoring remained unaltered by the drugs.
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Affiliation(s)
- Desirée B Spronk
- Department of Psychiatry, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500 GL Nijmegen, The Netherlands.
| | - Robbert J Verkes
- Department of Psychiatry, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500 GL Nijmegen, The Netherlands; Pompestichting for Forensic Psychiatry, 6532 CN Nijmegen, The Netherlands; Department of Criminal Law & Criminology, Radboud University, 6500 KK Nijmegen, The Netherlands
| | - Roshan Cools
- Department of Psychiatry, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500 GL Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500 GL Nijmegen, The Netherlands; Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Janelle H P Van Wel
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Ellen R A De Bruijn
- Department of Clinical Psychology, Leiden Institute for Brain and Cognition, Leiden University, 2333 AK Leiden, The Netherlands
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180
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Sagar KA, Dahlgren MK, Racine MT, Dreman MW, Olson DP, Gruber SA. Joint Effects: A Pilot Investigation of the Impact of Bipolar Disorder and Marijuana Use on Cognitive Function and Mood. PLoS One 2016; 11:e0157060. [PMID: 27275781 PMCID: PMC4898690 DOI: 10.1371/journal.pone.0157060] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/05/2016] [Indexed: 11/18/2022] Open
Abstract
Marijuana is the most widely used illicit substance in those diagnosed with bipolar I disorder. However, there is conflicting evidence as to whether marijuana may alleviate or exacerbate mood symptomatology. As bipolar disorder and marijuana use are individually associated with cognitive impairment, it also remains unclear whether there is an additive effect on cognition when bipolar patients use marijuana. The current study aimed to determine the impact of marijuana on mood in bipolar patients and to examine whether marijuana confers an additional negative impact on cognitive function. Twelve patients with bipolar disorder who smoke marijuana (MJBP), 18 bipolar patients who do not smoke (BP), 23 marijuana smokers without other Axis 1 pathology (MJ), and 21 healthy controls (HC) completed a neuropsychological battery. Further, using ecological momentary assessment, participants rated their mood three times daily as well as after each instance of marijuana use over a four-week period. Results revealed that although the MJ, BP, and MJBP groups each exhibited some degree of cognitive impairment relative to HCs, no significant differences between the BP and MJBP groups were apparent, providing no evidence of an additive negative impact of BPD and MJ use on cognition. Additionally, ecological momentary assessment analyses indicated alleviation of mood symptoms in the MJBP group after marijuana use; MJBP participants experienced a substantial decrease in a composite measure of mood symptoms. Findings suggest that for some bipolar patients, marijuana may result in partial alleviation of clinical symptoms. Moreover, this improvement is not at the expense of additional cognitive impairment.
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Affiliation(s)
- Kelly A. Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
| | - M. Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
| | - Megan T. Racine
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, United States of America
| | - Meredith W. Dreman
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, United States of America
| | - David P. Olson
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Staci A. Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
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181
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Cannabis and tolerance: acute drug impairment as a function of cannabis use history. Sci Rep 2016; 6:26843. [PMID: 27225696 PMCID: PMC4881034 DOI: 10.1038/srep26843] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/09/2016] [Indexed: 01/27/2023] Open
Abstract
Cannabis use history as predictor of neurocognitive response to cannabis intoxication remains subject to scientific and policy debates. The present study assessed the influence of cannabis on neurocognition in cannabis users whose cannabis use history ranged from infrequent to daily use. Drug users (N = 122) received acute doses of cannabis (300 μg/kg THC), cocaine HCl (300 mg) and placebo. Cocaine served as active control for demonstrating neurocognitive test sensitivity. Executive function, impulse control, attention, psychomotor function and subjective intoxication were significantly worse after cannabis administration relative to placebo. Cocaine improved psychomotor function and attention, impaired impulse control and increased feelings of intoxication. Acute effects of cannabis and cocaine on neurocognitive performance were similar across cannabis users irrespective of their cannabis use history. Absence of tolerance implies that that frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.
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182
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Mitchell JT, Sweitzer MM, Tunno AM, Kollins SH, McClernon FJ. "I Use Weed for My ADHD": A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD. PLoS One 2016; 11:e0156614. [PMID: 27227537 PMCID: PMC4882033 DOI: 10.1371/journal.pone.0156614] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/17/2016] [Indexed: 01/27/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for problematic cannabis use. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resources. Given that the Internet is increasingly utilized as a source of healthcare information and may influence perceptions, we conducted a qualitative analysis of online forum discussions, also referred to as threads, on the effects of cannabis on ADHD to systematically characterize the content patients and caregivers may encounter about ADHD and cannabis. Methods A total of 268 separate forum threads were identified. Twenty percent (20%) were randomly selected, which yielded 55 separate forum threads (mean number of individual posts per forum thread = 17.53) scored by three raters (Cohen’s kappa = 0.74). A final sample of 401 posts in these forum threads received at least one endorsement on predetermined topics following qualitative coding procedures. Results Twenty-five (25%) percent of individual posts indicated that cannabis is therapeutic for ADHD, as opposed to 8% that it is harmful, 5% that it is both therapeutic and harmful, and 2% that it has no effect on ADHD. This pattern was generally consistent when the year of each post was considered. The greater endorsement of therapeutic versus harmful effects of cannabis did not generalize to mood, other (non-ADHD) psychiatric conditions, or overall domains of daily life. Additional themes emerged (e.g., cannabis being considered sanctioned by healthcare providers). Conclusions Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD—this is the first study to identify such a trend. This type of online information could shape ADHD patient and caregiver perceptions, and influence cannabis use and clinical care.
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Affiliation(s)
- John T. Mitchell
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
- * E-mail:
| | - Maggie M. Sweitzer
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
| | - Angela M. Tunno
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Scott H. Kollins
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
| | - F. Joseph McClernon
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
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183
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Abstract
Several empirical studies suggest that recreational marijuana is popularly perceived as an essentially harmless rite of passage that ends as young people settle into their careers and their adult intimate relationships. Is this perception accurate? To answer this question, we evaluate the morality of recreational marijuana use from a virtue perspective guided by the theological synthesis of St. Thomas Aquinas. Since the medical data reveals that recreational marijuana use is detrimental to the well-being of the user, we conclude that it is a vicious activity, an instance of the vice of intoxication, and as such would be morally illicit. LAY SUMMARY In contrast to its medical use, the recreational use of marijuana cannot be justified for at least three reasons. First, as scientists have amply documented, it harms the organic functioning of the human body. Second, it impedes our ability to reason and in so doing does harm to us. Finally, it has lasting detrimental effects on the user and his neighbor, even when it occurs in a casual setting. Intoxication is always contrary to the integral good of the person. Thus, the use of marijuana is never warranted even for good, non-medical reasons.
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Affiliation(s)
- Ezra Sullivan
- Pontifical University of St. Thomas Aquinas, Rome, Italy
| | - Nicanor Austriaco
- Departments of Biology and of Theology, Providence College, Providence, RI, USA
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184
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Ganzer F, Bröning S, Kraft S, Sack PM, Thomasius R. Weighing the Evidence: A Systematic Review on Long-Term Neurocognitive Effects of Cannabis Use in Abstinent Adolescents and Adults. Neuropsychol Rev 2016; 26:186-222. [DOI: 10.1007/s11065-016-9316-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 04/14/2016] [Indexed: 11/29/2022]
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185
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King KA, Merianos AL, Vidourek RA. Characteristics of Marijuana Acquisition Among a National Sample of Adolescent Users. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2016.1157535] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Keith A. King
- Health Promotion and Education, University of Cincinnati
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186
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Curran HV, Freeman TP, Mokrysz C, Lewis DA, Morgan CJA, Parsons LH. Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci 2016; 17:293-306. [PMID: 27052382 DOI: 10.1038/nrn.2016.28] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In an increasing number of states and countries, cannabis now stands poised to join alcohol and tobacco as a legal drug. Quantifying the relative adverse and beneficial effects of cannabis and its constituent cannabinoids should therefore be prioritized. Whereas newspaper headlines have focused on links between cannabis and psychosis, less attention has been paid to the much more common problem of cannabis addiction. Certain cognitive changes have also been attributed to cannabis use, although their causality and longevity are fiercely debated. Identifying why some individuals are more vulnerable than others to the adverse effects of cannabis is now of paramount importance to public health. Here, we review the current state of knowledge about such vulnerability factors, the variations in types of cannabis, and the relationship between these and cognition and addiction.
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Affiliation(s)
- H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - David A Lewis
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK.,Psychopharmacology and Addiction Research Centre, University of Exeter, Perry Road, Exeter EX4 4QG, UK
| | - Loren H Parsons
- The Scripps Research Institute, 10550 N. Torrey Pines Road, SP30-2001, La Jolla, California 92037, USA
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187
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Schuster RM, Hoeppner SS, Evins AE, Gilman JM. Early onset marijuana use is associated with learning inefficiencies. Neuropsychology 2016; 30:405-15. [PMID: 26986749 DOI: 10.1037/neu0000281] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Verbal memory difficulties are the most widely reported and persistent cognitive deficit associated with early onset marijuana use. Yet, it is not known what memory stages are most impaired in those with early marijuana use. METHOD Forty-eight young adults, aged 18-25, who used marijuana at least once per week and 48 matched nonusing controls (CON) completed the California Verbal Learning Test, Second Edition (CVLT-II). Marijuana users were stratified by age of initial use: early onset users (EMJ), who started using marijuana at or before age 16 (n = 27), and late onset marijuana user group (LMJ), who started using marijuana after age 16 (n = 21). Outcome variables included trial immediate recall, total learning, clustering strategies (semantic clustering, serial clustering, ratio of semantic to serial clustering, and total number of strategies used), delayed recall, and percent retention. RESULTS Learning improved with repetition, with no group effect on the learning slope. EMJ learned fewer words overall than LMJ or CON. There was no difference between LMJ and CON in total number of words learned. Reduced overall learning mediated the effect on reduced delayed recall among EMJ, but not CON or LMJ. Learning improved with greater use of semantic versus serial encoding, but this did not vary between groups. EMJ was not related to delayed recall after adjusting for encoding. CONCLUSIONS Young adults reporting early onset marijuana use had learning weaknesses, which accounted for the association between early onset marijuana use and delayed recall. No amnestic effect of marijuana use was observed. (PsycINFO Database Record
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Affiliation(s)
| | - Susanne S Hoeppner
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital
| | - A Eden Evins
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital
| | - Jodi M Gilman
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital
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188
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Núñez C, Ochoa S, Huerta-Ramos E, Baños I, Barajas A, Dolz M, Sánchez B, Del Cacho N, Usall J. Cannabis use and cognitive function in first episode psychosis: differential effect of heavy use. Psychopharmacology (Berl) 2016; 233:809-21. [PMID: 26621349 DOI: 10.1007/s00213-015-4160-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/15/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE First episode patients and patients with schizophrenia exhibit increased rates of cannabis use compared to the general population. Contrary to what has been reported in studies with healthy people, most of the published studies so far have reported no impairments or even beneficial effects on neurocognition associated with cannabis consumption in psychotic patients. However, these studies did not address the effects of very high cannabis consumption. OBJECTIVES Our aim in this study was to assess the effects on neurocognition of medium and heavy cannabis consumption in first psychotic episode patients. METHODS A total of 74 patients were included in the study and assigned to three different groups according to their mean cannabis consumption during the last year (non-users, medium users, and heavy users). Participants were administered verbal memory and other neurocognitive tasks. RESULTS Heavy cannabis users were significantly impaired in all the verbal memory measures with respect to non-users, including immediate (p = .026), short-term (p = .005), and long-term (p = .002) memory. There were no significant differences between medium and non-users. Moreover, non-users performed better than all cannabis users in the arithmetic task (p = .020). Heavy cannabis consumption was associated with more commission errors in the continuous performance task (CPT) (p = .008) and more time to complete trail making test A (TMT-A) (p = .008), compared to the group of medium users. CONCLUSIONS Heavy cannabis consumption seems to impair verbal memory in first psychotic episode patients. Heavy users also perform worse than medium users in other neurocognitive tasks. Based on the results and the available evidence, a dose-related effect of cannabis consumption is suggested.
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Affiliation(s)
- Christian Núñez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
- Universitat de Barcelona, Barcelona, Spain.
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Elena Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Iris Baños
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana Barajas
- Research Unit, Centre d'Higiene Mental Les Corts, Barcelona, Spain
| | - Montserrat Dolz
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Bernardo Sánchez
- Psychiatry Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Núria Del Cacho
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
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189
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Wang JB, Cataldo JK. Medical Marijuana Legalization and Co-use in Adult Cigarette Smokers. Am J Health Behav 2016; 40:205-14. [PMID: 26931752 DOI: 10.5993/ajhb.40.2.5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We examined effects of long-term medical marijuana legalization on cigarette co-use in a sample of adults. METHODS We conducted secondary analysis using data from the 2014 US Tobacco Attitudes and Beliefs Survey, which consisted of cigarette smokers, aged ≥ 45 years (N = 506). Participants were categorized by their state residence, where medical marijuana was (1) illegal, (2) legalized < 10 years, and (3) legalized ≥ 10 years. The Web-based survey assessed participants' marijuana use, beliefs and attitudes on marijuana, and nicotine dependence using Fagerstrom Tolerance for Nicotine Dependence (FTND) and Hooked on Nicotine Checklist (HONC) scores. RESULTS In cigarette smokers aged ≥ 45 years, long-term legalization of medical marijuana was associated with stable positive increases in marijuana use prevalence (ever in a lifetime) (p = .005) and frequency (number of days in past 30 days) (unadjusted p = .005; adjusted p = .08). Those who reported marijuana co-use had greater FTND and HONC scores after adjusting for covariates (p = .05). CONCLUSIONS These preliminary findings warrant further examination of the potential impact of long-term legalization of medical marijuana on greater cigarette and marijuana co-use in adults and higher nicotine dependence among co-users at the population level.
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Affiliation(s)
- Julie B Wang
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA.
| | - Janine K Cataldo
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
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190
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Mokrysz C, Landy R, Gage SH, Munafò MR, Roiser JP, Curran HV. Are IQ and educational outcomes in teenagers related to their cannabis use? A prospective cohort study. J Psychopharmacol 2016; 30:159-68. [PMID: 26739345 PMCID: PMC4724860 DOI: 10.1177/0269881115622241] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
There is much debate about the impact of adolescent cannabis use on intellectual and educational outcomes. We investigated associations between adolescent cannabis use and IQ and educational attainment in a sample of 2235 teenagers from the Avon Longitudinal Study of Parents and Children. By the age of 15, 24% reported having tried cannabis at least once. A series of nested linear regressions was employed, adjusted hierarchically by pre-exposure ability and potential confounds (e.g. cigarette and alcohol use, childhood mental-health symptoms and behavioural problems), to test the relationships between cumulative cannabis use and IQ at the age of 15 and educational performance at the age of 16. After full adjustment, those who had used cannabis ⩾ 50 times did not differ from never-users on either IQ or educational performance. Adjusting for group differences in cigarette smoking dramatically attenuated the associations between cannabis use and both outcomes, and further analyses demonstrated robust associations between cigarette use and educational outcomes, even with cannabis users excluded. These findings suggest that adolescent cannabis use is not associated with IQ or educational performance once adjustment is made for potential confounds, in particular adolescent cigarette use. Modest cannabis use in teenagers may have less cognitive impact than epidemiological surveys of older cohorts have previously suggested.
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Affiliation(s)
- C Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - R Landy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - SH Gage
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - MR Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - JP Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - HV Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
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191
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Hippocampal harms, protection and recovery following regular cannabis use. Transl Psychiatry 2016; 6:e710. [PMID: 26756903 PMCID: PMC5068875 DOI: 10.1038/tp.2015.201] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 11/05/2015] [Indexed: 11/09/2022] Open
Abstract
Shifting policies towards legalisation of cannabis for therapeutic and recreational use raise significant ethical issues for health-care providers seeking evidence-based recommendations. We investigated whether heavy cannabis use is associated with persistent harms to the hippocampus, if exposure to cannabidiol offers protection, and whether recovery occurs with abstinence. To do this, we assessed 111 participants: 74 long-term regular cannabis users (with an average of 15.4 years of use) and 37 non-user healthy controls. Cannabis users included subgroups of participants who were either exposed to Δ9-tetrahydrocannabinol (THC) but not to cannabidiol (CBD) or exposed to both, and former users with sustained abstinence. Participants underwent magnetic resonance imaging from which three measures of hippocampal integrity were assessed: (i) volume; (ii) fractional anisotropy; and (iii) N-acetylaspartate (NAA). Three curve-fitting models across the entire sample were tested for each measure to examine whether cannabis-related hippocampal harms are persistent, can be minimised (protected) by exposure to CBD or recovered through long-term abstinence. These analyses supported a protection and recovery model for hippocampal volume (P=0.003) and NAA (P=0.001). Further pairwise analyses showed that cannabis users had smaller hippocampal volumes relative to controls. Users not exposed to CBD had 11% reduced volumes and 15% lower NAA concentrations. Users exposed to CBD and former users did not differ from controls on any measure. Ongoing cannabis use is associated with harms to brain health, underpinned by chronic exposure to THC. However, such harms are minimised by CBD, and can be recovered with extended periods of abstinence.
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192
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Skalski LM, Towe SL, Sikkema KJ, Meade CS. The Impact of Marijuana Use on Memory in HIV-Infected Patients: A Comprehensive Review of the HIV and Marijuana Literatures. CURRENT DRUG ABUSE REVIEWS 2016; 9:126-141. [PMID: 27138170 PMCID: PMC5093083 DOI: 10.2174/1874473709666160502124503] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 03/11/2016] [Accepted: 04/29/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The most robust neurocognitive effect of marijuana use is memory impairment. Memory deficits are also high among persons living with HIV/AIDS, and marijuana is the most commonly used drug in this population. Yet research examining neurocognitive outcomes resulting from co-occurring marijuana and HIV is limited. OBJECTIVE The primary objectives of this comprehensive review are to: (1) examine the literature on memory functioning in HIV-infected individuals; (2) examine the literature on memory functioning in marijuana users; (3) synthesize findings and propose a theoretical framework to guide future research. METHOD PubMed was searched for English publications 2000-2013. Twenty-two studies met inclusion criteria in the HIV literature, and 23 studies in the marijuana literature. RESULTS Among HIV-infected individuals, memory deficits with medium to large effect sizes were observed. Marijuana users also demonstrated memory problems, but results were less consistent due to the diversity of samples. CONCLUSION A compensatory hypothesis, based on the cognitive aging literature, is proposed to provide a framework to explore the interaction between marijuana and HIV. There is some evidence that individuals infected with HIV recruit additional brain regions during memory tasks to compensate for HIV-related declines in neurocognitive functioning. Marijuana is associated with disturbance in similar brain systems, and thus it is hypothesized that the added neural strain of marijuana can exhaust neural resources, resulting in pronounced memory impairment. It will be important to test this hypothesis empirically, and future research priorities are discussed.
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Affiliation(s)
- Linda M. Skalski
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Sheri L. Towe
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Kathleen J. Sikkema
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Christina S. Meade
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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193
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Sagar KA, Dahlgren MK, Gönenç A, Racine MT, Dreman MW, Gruber SA. The impact of initiation: Early onset marijuana smokers demonstrate altered Stroop performance and brain activation. Dev Cogn Neurosci 2015; 16:84-92. [PMID: 25936584 PMCID: PMC4596753 DOI: 10.1016/j.dcn.2015.03.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/24/2015] [Accepted: 03/29/2015] [Indexed: 01/17/2023] Open
Abstract
Marijuana (MJ) use is on the rise, particularly among teens and emerging adults. This poses serious public health concern, given the potential deleterious effects of MJ on the developing brain. We examined 50 chronic MJ smokers divided into early onset (regular MJ use prior to age 16; n=24) and late onset (age 16 or later; n=26), and 34 healthy control participants (HCs). All completed a modified Stroop Color Word Test during fMRI. Results demonstrated that MJ smokers exhibited significantly poorer performance on the Interference subtest of the Stroop, as well as altered patterns of activation in the cingulate cortex relative to HCs. Further, early onset MJ smokers exhibited significantly poorer performance relative to both HCs and late onset smokers. Additionally, earlier age of MJ onset as well as increased frequency and magnitude (grams/week) of MJ use were predictive of poorer Stroop performance. fMRI results revealed that while late onset smokers demonstrated a more similar pattern of activation to the control group, a different pattern was evident in the early onset group. These findings underscore the importance of assessing age of onset and patterns of MJ use and support the need for widespread education and intervention efforts among youth.
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Affiliation(s)
- K A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States.
| | - M K Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States.
| | - A Gönenç
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States.
| | - M T Racine
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States.
| | - M W Dreman
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States.
| | - S A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States.
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194
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Campbell LF, Wilmoth K, Mason M. Association of exposure to neighborhood drug activity, neurobehavioral traits, and marijuana use among at-risk African American females. Addict Behav 2015; 50:45-50. [PMID: 26101077 PMCID: PMC10176802 DOI: 10.1016/j.addbeh.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/29/2015] [Accepted: 06/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Theories of relative deprivation suggest African Americans in disadvantaged communities are at increased risk for drug use. This increased risk may be due, in part, to exposure to drugs and drug subcultures. Given the significance of the prefrontal cortex (PFC) functioning in yielding behavior that is strategically guided rather than reactive to environmental demands, it is important to examine the relationship between PFC functioning, neighborhood drug activity and substance use among African Americans residing in high risk communities. METHODS A sample of 120 young adult African American females was recruited from high-risk neighborhoods. Each completed the modified version of the neighborhood environment scale, a neurobehavioral assessment designed to measure apathy, behavioral disinhibition and executive dysfunction, and provided a urine sample that was tested for the presence of psychoactive drugs. RESULTS Logistic regression analyses indicated that females with higher scores on behavioral disinhibition were 2.6 times more likely to test positive for marijuana (95%CI = 1.02, 6.57). Neither apathy nor executive dysfunction was related to marijuana use. No relationship emerged between neighborhood drug activity and marijuana use. CONCLUSIONS Among the neurobehavioral traits considered only behavioral disinhibition was associated with marijuana use, suggesting that different neurobehavioral domains may be uniquely related to marijuana use. For females living in high risk environments, the extent to which they are able to control impulses may provide some protection against marijuana use. Future studies focused on the moderating effects of behavioral disinhibition on the association of exposure to risk environments and marijuana use may prove beneficial. Further, the study adds to the small base of literature supporting the Frontal Systems Behavior Scale as a brief assessment to evaluate frontally-mediated neurobehavioral traits relevant to substance use. However, future studies aimed at examining the influence of neighborhood drug activity might benefit from more precise measures of exposure to neighborhood drug activity. More research to replicate and expand on the present findings is warranted.
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Affiliation(s)
- Leah Floyd Campbell
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States; Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, PO Box 980489, Richmond, VA 23298-0489, United States.
| | - Kristin Wilmoth
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9044, United States
| | - Michael Mason
- Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, PO Box 980489, Richmond, VA 23298-0489, United States
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195
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Mahu IT, Doucet C, O'Leary‐Barrett M, Conrod PJ. Can cannabis use be prevented by targeting personality risk in schools? Twenty-four-month outcome of the adventure trial on cannabis use: a cluster-randomized controlled trial. Addiction 2015; 110:1625-33. [PMID: 26011508 PMCID: PMC5034824 DOI: 10.1111/add.12991] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/04/2014] [Accepted: 05/07/2015] [Indexed: 11/27/2022]
Abstract
AIMS To examine the effectiveness of a personality-targeted intervention program (Adventure trial) delivered by trained teachers to high-risk (HR) high-school students on reducing marijuana use and frequency of use. DESIGN A cluster-randomized controlled trial. SETTING Secondary schools in London, UK. PARTICIPANTS Twenty-one secondary schools were randomized to intervention (n = 12) or control (n = 9) conditions, encompassing a total of 1038 HR students in the ninth grade [mean (standard deviation) age = 13.7 (0.33) years]. INTERVENTIONS Brief personality-targeted interventions to students with one of four HR profiles: anxiety sensitivity, hopelessness, impulsivity and sensation-seeking. PRIMARY OUTCOME marijuana use. Secondary outcome: frequency of use. Assessed using the Reckless Behaviour Questionnaire at intervals of 6 months for 2 years. Personality risk was measured with the Substance Use Risk Profile Scale. FINDINGS Logistic regression analysis revealed significant intervention effects on cannabis use rates at the 6-month follow-up in the intent-to-treat sample [odds ratio (OR) = 0.67, P = 0.05, 95% confidence interval (CI) = 0.45-1.0] and significant reductions in frequency of use at 12- and 18-month follow-up (β = -0.14, P ≤ 0.05, 95% CI = -0.6 to -0.01; β = -0.12, P ≤ 0.05, 95% CI = -0.54 to 0.0), but this was not supported in two-part latent growth models. Subgroup analyses (both logistic and two-part models) reveal that the sensation-seeking intervention delayed the onset of cannabis use among sensation seekers (OR = 0.25, β = -0.833, standard error = 0.342, P = 0.015). CONCLUSIONS Personality-targeted interventions can be delivered effectively by trained school staff to delay marijuana use onset among a subset of high-risk teenagers: sensation-seekers.
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Affiliation(s)
- Ioan T. Mahu
- Université de MontréalCentre Hospitalier et Universitaire Ste‐Justine, Department of PsychiatryMontréalCanada
| | - Christine Doucet
- Université de MontréalCentre Hospitalier et Universitaire Ste‐Justine, Department of PsychiatryMontréalCanada
| | | | - Patricia J. Conrod
- Université de MontréalCentre Hospitalier et Universitaire Ste‐Justine, Department of PsychiatryMontréalCanada,Addictions Department, King's College LondonInstitute of PsychiatryLondonUK
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196
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Power BD, Dragovic M, Badcock JC, Morgan VA, Castle D, Jablensky A, Stefanis NC. No additive effect of cannabis on cognition in schizophrenia. Schizophr Res 2015; 168:245-51. [PMID: 26235754 DOI: 10.1016/j.schres.2015.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/18/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND We aimed to examine the association between lifetime cannabis use and estimates of both premorbid and current cognitive function in psychotic disorders in an Australian cohort. METHODS In an Australian multicenter cohort, 1237 participants with an established ICD-10 diagnosis of psychotic disorder were categorised according to history of lifetime cannabis use (non-users, n=354; cannabis users, n=221; cannabis dependency, n=662). Groups were analyzed according to available indices of cognitive ability: the National Adult Reading Test - Revised (NART-R) for ability prior to illness onset; and the Digit Symbol Coding Test (DSCT) for current ability. Two-way analysis of variance was conducted without any covariate, followed by a two-way analysis of covariance (using age, age at onset of psychiatric illness, premorbid IQ and the Socio-Economic Index for Areas (SEIFA) rankings). RESULTS Whilst there appeared to be a significant association between cannabis use and mean DSCT (higher DSCT scores in cannabis using groups) F(2,1080)=9.478, p<0.001, η2=0.017), once covariates were used in the analysis there were no significant differences between groups in mean DSCT scores (F(2,1011)=0.929, p=0.395, η2=0.002). Similarly there were no differences between groups in mean NART scores once, age, age at illness onset and SEIFA rankings were used as covariates (F(2,1032)=1.617, p=0.199, η2=0.003). CONCLUSIONS Confounding variables underpin the association between cannabis use and cognitive function in psychotic disorders. Taken together, it would appear that cannabis use or dependence has no additive effect on cognitive dysfunction in these disorders.
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Affiliation(s)
- Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, Australia; South Metropolitan Area Health Service, Perth, Australia; Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia.
| | - Milan Dragovic
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Johanna C Badcock
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Vera A Morgan
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - David Castle
- St. Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Assen Jablensky
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Nikos C Stefanis
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
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197
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Crane NA, Langenecker SA, Mermelstein RJ. Gender differences in the associations among marijuana use, cigarette use, and symptoms of depression during adolescence and young adulthood. Addict Behav 2015; 49:33-9. [PMID: 26036667 DOI: 10.1016/j.addbeh.2015.05.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 05/01/2015] [Accepted: 05/16/2015] [Indexed: 12/23/2022]
Abstract
INTRODUCTION As prevalence of marijuana use increases, it is important that we better understand how factors like gender, cigarette use, and depression are related to marijuana use during adolescence and young adulthood. We examined longitudinal relationships among these variables in adolescents moving into young adulthood who were studied longitudinally for six years. METHODS 1263 individuals were included in the study. Participants were oversampled for ever-smoking a cigarette at baseline, when they were 15-16 years old. Frequency of cigarette smoking and marijuana use, as well as depression symptoms, were assessed at baseline, 6, 15, 24, 60 and 72 months. RESULTS Cigarette use frequency and depression symptoms were associated with frequency of marijuana use (p-values<.001), particularly in adolescence, but there were important gender differences in these relationships. Specifically, symptoms of depression were related to marijuana use frequency among males (p<.001), but not females (p=.62). In addition, frequency of marijuana use was associated with increased cigarette use frequency, especially among males who had higher symptoms of depression (p<.001). However, this effect was not seen among females. Exploratory analyses suggested that relationships between frequency of use and depression are specific to marijuana, not cigarettes. CONCLUSIONS Marijuana use is strongly related to depression symptoms and cigarette use frequency in males, indicating that in males these detrimental factors converge, whereas in females they do not. Gender differences in the factors related to marijuana use may mean that there are different risks for and consequences from use and have implications for prevention and intervention efforts.
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Affiliation(s)
- Natania A Crane
- Department of Psychology, University of Illinois at Chicago, 1007 West Harrison Street (M/C 285), Chicago, IL 60607, United States; Department of Psychiatry, University of Illinois at Chicago, 1601 West Taylor Street (M/C 912), Chicago, IL 60612, United States; Center for Cognitive Neuroscience, University of Illinois at Chicago, 1601 West Taylor Street (M/C 912), Chicago, IL 60612, United States; Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road (M/C 275), Chicago, IL 60608, United States.
| | - Scott A Langenecker
- Department of Psychiatry, University of Illinois at Chicago, 1601 West Taylor Street (M/C 912), Chicago, IL 60612, United States; Center for Cognitive Neuroscience, University of Illinois at Chicago, 1601 West Taylor Street (M/C 912), Chicago, IL 60612, United States
| | - Robin J Mermelstein
- Department of Psychology, University of Illinois at Chicago, 1007 West Harrison Street (M/C 285), Chicago, IL 60607, United States; Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road (M/C 275), Chicago, IL 60608, United States
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Abstract
There is extensive research on the safety, toxicology, potency, and therapeutic potential of cannabis. However, uncertainty remains facilitating continued debate on medical and recreational cannabis policies at the state and federal levels. This review will include a brief description of cannabinoids and the endocannabinoid system; a summary of the acute and long-term effects of cannabis; and a discussion of the therapeutic potential of cannabis. The conclusions about safety and efficacy will then be compared with the current social and political climate to suggest future policy directions and general guidelines.
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Affiliation(s)
- Jane Sachs
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA.
| | - Erin McGlade
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA
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199
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Gonzalez R, Schuster RM, Mermelstein RM, Diviak KR. The role of decision-making in cannabis-related problems among young adults. Drug Alcohol Depend 2015. [PMID: 26199058 PMCID: PMC4536096 DOI: 10.1016/j.drugalcdep.2015.06.046] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Deficits in decision-making and episodic memory are often reported among heavy cannabis users, yet little is known on how they influence negative consequences from cannabis use. Individual differences in decision-making may explain, in part, why some individuals experience significant problems from their cannabis use whereas others do not. We hypothesized that poor decision-making would moderate relationships between amount of cannabis use and problems from cannabis use whereas episodic memory performance would not. METHOD Young adult cannabis users (n=52) with cannabis as their drug of choice and with minimal comorbidities completed semi-structured interviews, self-report questionnaires, and measures of neurocognitive functioning, with decision-making accessed via the Iowa Gambling Task (IGT), episodic memory via the Hopkins Verbal Learning Test - Revised (HVLT) and problems from cannabis use with the Marijuana Problems Scale. RESULTS Strong relationships were observed between amount of cannabis use (lifetime, 12-month, and 30-day) and problems reported from use, but only among participants with low (impaired) decision-making (R(2)=.39 to .51; p<.01). No significant relationships were observed among those with better (low average to high average) decision-making performance (p>.05). In contrast, episodic memory performance was not a significant moderator of the relationship between amount of cannabis use and cannabis problems (p>.05). CONCLUSIONS Cannabis users with poor decision-making may be at greater risk for experiencing significant negative consequences from their cannabis use. Our results lend further support to emerging evidence of decision-making as a risk factor for addiction and extend these findings to cannabis users.
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Affiliation(s)
- Raul Gonzalez
- Department of Psychology, Florida International University, Miami, 11200 SW 8th St, Miami, FL 33199, United States; Center for Children and Families, Florida International University, Miami, 11200 SW 8th St, Miami, FL 33199, United States.
| | - Randi M. Schuster
- Department of Psychiatry, Massachusetts General Hospital, Boston, 55 Fruit Street, Boston, MA 02114
| | - Robin M. Mermelstein
- Department of Psychology, University of Illinois at Chicago, Chicago, 1200 W Harrison St, Chicago, IL 60607,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, 1747 W Roosevelt Rd, Chicago, IL 60608
| | - Kathleen R. Diviak
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, 1747 W Roosevelt Rd, Chicago, IL 60608
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200
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Su SH, Wu YF, Lin Q, Yu F, Hai J. Cannabinoid receptor agonist WIN55,212-2 and fatty acid amide hydrolase inhibitor URB597 suppress chronic cerebral hypoperfusion-induced neuronal apoptosis by inhibiting c-Jun N-terminal kinase signaling. Neuroscience 2015; 301:563-75. [DOI: 10.1016/j.neuroscience.2015.03.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 02/13/2015] [Accepted: 03/11/2015] [Indexed: 11/15/2022]
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