1
|
Balneaves LG, Hammond D, Turner S, Nickel N, Woodgate RL, Watling CZ. Youth and Young Adults' Knowledge and Perceptions of Risks and Benefits Regarding Cannabis Products: A Cross-Sectional Analysis of Over 1,700 Individuals. J Psychoactive Drugs 2024:1-10. [PMID: 38946663 DOI: 10.1080/02791072.2024.2371028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/06/2024] [Indexed: 07/02/2024]
Abstract
Canada legalized the use of non-medical cannabis in 2018. This study examines youth and young adults' knowledge and perceptions of harms, benefits, and education around cannabis use since legalization. An online survey was completed by a convenience sample of 1,759 individuals aged 12-25 years living in Manitoba, Canada. Most participants (n = 1,525, 86.7%) reported receiving education on the potential effects/harms related to cannabis; the most common topics included driving and cannabis use (79.9%), the mental harms of cannabis (67.4%), and addiction and dependency (66.3%). Youth who reported using cannabis more than once (n = 1,203) were more knowledgeable about the effects of cannabis than youth who never used cannabis or used cannabis once (n = 580; mean score: 6.6 versus 5.7 out of 8, respectively; p < .001). Vaping cannabis oil was perceived as the most harmful cannabis product among all participants. Among participants with experience using cannabis, the most frequently reported benefits were relaxation, improved sleep, and enhanced enjoyment of food/music. Half of the participants reported ever being in a car with someone driving high, of which, 40% of these participants reported doing so in the last 30 days. Future tailored education is needed to address knowledge related to cannabis use among youth and young adults who use and do not use cannabis.
Collapse
Affiliation(s)
- Lynda G Balneaves
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shelley Turner
- Ekosi Health Centre, Winnipeg, MB, Canada
- Department of Family Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Nathan Nickel
- Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Roberta L Woodgate
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Cody Z Watling
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
2
|
Thorpe HHA, Fontanillas P, Meredith JJ, Jennings MV, Cupertino RB, Pakala S, Elson SL, Khokhar JY, Davis LK, Johnson EC, Palmer AA, Sanchez-Roige S. Genome-wide association studies of lifetime and frequency cannabis use in 131,895 individuals. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.14.24308946. [PMID: 38947071 PMCID: PMC11213095 DOI: 10.1101/2024.06.14.24308946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Cannabis is one of the most widely used drugs globally. Decriminalization of cannabis is further increasing cannabis consumption. We performed genome-wide association studies ( GWASs ) of lifetime ( N= 131,895) and frequency ( N= 73,374) of cannabis use. Lifetime cannabis use GWAS identified two loci, one near CADM2 (rs11922956, p =2.40E-11) and another near GRM3 (rs12673181, p =6.90E-09). Frequency of use GWAS identified one locus near CADM2 (rs4856591, p =8.10E-09; r 2 =0.76 with rs11922956). Both traits were heritable and genetically correlated with previous GWASs of lifetime use and cannabis use disorder ( CUD ), as well as other substance use and cognitive traits. Polygenic scores ( PGSs ) for lifetime and frequency of cannabis use associated cannabis use phenotypes in AllofUs participants. Phenome-wide association study of lifetime cannabis use PGS in a hospital cohort replicated associations with substance use and mood disorders, and uncovered associations with celiac and infectious diseases. This work demonstrates the value of GWASs of CUD transition risk factors.
Collapse
|
3
|
Poliakova N, Shrier LA, Harris SK, Bélanger RE. Predicting Time to Return to Cannabis Use After a Cessation Attempt: Impact of Cumulated Exposure to Nicotine-Containing Products. Tob Use Insights 2024; 17:1179173X241259603. [PMID: 38846268 PMCID: PMC11155328 DOI: 10.1177/1179173x241259603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
Objective: Cannabis is frequently co-used with tobacco/nicotine products, especially among young adults. Little is known about the effects of this co-use on cannabis cessation outcomes. Within a sample of young adults using cannabis frequently (current use of ≥5 days/week in the past 3 months), this study aimed to (a) document sources of exposure to tobacco/nicotine products, whether used simultaneously with cannabis or on different occasions, (b) examine if the level of cumulated exposure to tobacco/nicotine (self-reported or from biochemical testing) could predict time to cannabis lapse during a cannabis abstinence period, and (c) explore the relationship between nicotine/tobacco exposure and time to cannabis lapse according to tobacco cigarette smoking status. Method: Urine cotinine measures and self-reported data on use of different tobacco/nicotine products, collected from 32 participants (aged 19 to 23), were analyzed to predict time to lapse during a 2-week period of attempted abstinence from cannabis, controlling for cannabis dependence and sex. Results: Half of participants (56.3%) used at least one tobacco/nicotine product. Higher urine cotinine, representing higher cumulated tobacco/nicotine exposure, was related to a higher risk of lapsing (Hazard Ratio [HR] = 1.64; 95%CI [1.04, 2.58]). The risk of lapsing was even higher ([HR] = 3.46; 95%CI [1.17, 10.25]) among heavily tobacco/nicotine exposed (>600 ng/mL, urine cotinine) participants than among unexposed (<50 ng/mL) or lightly/moderately exposed (50-600 ng/mL) participants. Among those smoking cigarettes (solely or in combination with other products), there was no relation between cotinine level and time to lapse, likely due to a reduced variability in abstinence probability and a high likelihood of lapse observed for higher cotinine levels, mainly achieved by cigarette use. Conclusions: With a rapidly changing landscape of tobacco/nicotine use, our results underscore the need to consider all sources of tobacco/nicotine exposure to fully understand the specific and cumulative contributions of tobacco/nicotine to cannabis cessation outcomes.
Collapse
Affiliation(s)
- Natalia Poliakova
- Research Centre of CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Lydia A. Shrier
- Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sion Kim Harris
- Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Richard E. Bélanger
- Research Centre of CHU de Québec-Université Laval, Quebec City, QC, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| |
Collapse
|
4
|
Mosandl CF, Baltes-Flückiger L, Kronschnabel J, Meyer M, Guessoum A, Herrmann O, Vogel M, Walter M, Pichler EM. Cannabis use and its association with psychopathological symptoms in a Swiss adult population: a cross-sectional analysis. Front Public Health 2024; 12:1356988. [PMID: 38841675 PMCID: PMC11151851 DOI: 10.3389/fpubh.2024.1356988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/10/2024] [Indexed: 06/07/2024] Open
Abstract
Background As the most commonly used illicit substance, cannabis is gaining global acceptance through increasing legalization efforts. This shift intensifies the need for research to guide policymakers and healthcare providers in harm reduction and treatment strategies. Nonetheless, the relationship between psychopathological symptoms and cannabis use remains inadequately understood. Methods A sample of regular cannabis consumers completed self-reported assessments for depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), Attention-Deficit/Hyperactivity Disorder (ADHD; Adult ADHD Self-Report Scale V1.1), and psychosis (Early Recognition Inventory based on IRAOS) as well as previous black-market cannabis use patterns. Cannabis Use Disorder Identification Test Revised (CUDIT-R) was used to identify cannabis use disorder (CUD). To understand psychopathological symptom load related to cannabis consumption as well as cannabis use motives, multiple regression models were performed to identify psychopathological variables predicting cannabis use frequency and quantity. Linear regression and correlation analyses were conducted, adjusting for relevant covariates (age, gender, education, alcohol, other substance use). Results Three-hundred-sixty regular cannabis users interested in a study on regulated cannabis access in Basel, Switzerland were examined. In bivariate analysis, cannabis use frequency correlated with depressive (r(358) = 0.16, p = 0.003) and anxiety symptom load (r(358) = 0.11, p = 0.034). Cannabis quantity correlated with depressive (r(358) = 0.15, p = 0.005), ADHD (r(358) = 0.14, p = 0.008), and psychosis symptom load (r(358) = 0.16, p = 0.002). However, in the adjusted regression models only depressive and ADHD symptom loads were significantly associated with cannabis use frequency (p = 0.006 and p = 0.034, respectively) and quantity (p = 0.037 and p = 0.019, respectively). No significant correlations between cannabis consumption and anxiety or psychosis remained after adjustment. Conclusion ADHD and depressive symptoms correlate with increased cannabis use in a cohort of regular users, suggesting potential self-medication in nonclinical populations. With the rising availability of cannabis worldwide, these results highlight the necessity for longitudinal studies to disentangle the complex dynamics between cannabis consumption and mental health symptoms.
Collapse
Affiliation(s)
- Christoph Felix Mosandl
- Clinic of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | | | - Jens Kronschnabel
- Clinic of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
| | - Maximilian Meyer
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Adrian Guessoum
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Oliver Herrmann
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Marc Vogel
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Marc Walter
- Clinic of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
| | - Eva-Maria Pichler
- Clinic of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
| |
Collapse
|
5
|
Manzo LL, Sarkar S, Nicholson NR, Sanft T, Poghosyan H. Prevalence and Correlates of Cannabis Use among U.S. Veterans during the Second Wave of the COVID-19 Pandemic. Mil Med 2024; 189:e1230-e1239. [PMID: 37715685 DOI: 10.1093/milmed/usad360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/09/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023] Open
Abstract
INTRODUCTION Military veterans are at increased risk of substance use disorders. Limited research is available about veterans' cannabis use (CU) during the coronavirus disease 2019 (COVID-19) pandemic. This study estimated the prevalence of past 30-day CU, investigated individual-level correlates of past 30-day CU, and evaluated the reasons (medical, recreational, or both) of past 30-day CU among U.S. Veterans during the second wave of the COVID-19 pandemic. MATERIALS AND METHODS We used population-based, cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System Survey Marijuana Use model. The sample included nationally representative military veterans aged 18+ years (n = 11,167). The outcome was past 30-day CU. Individual-level demographic, socioeconomic, behavioral, and clinical correlates were examined. Analyses were weighted to account for the survey's complex design with results generalizable to nearly 2.9 million veterans. We conducted weighted descriptive statistics, prevalence estimates, and multivariable logistic regression analyses. RESULTS Out of 2.9 million veterans, 11.1% self-reported as non-Hispanic Black, 3.7% Hispanic, and 79.1% non-Hispanic White; 88.5% were men, and 72.8% were aged 50+ years. About 14.6% were current tobacco smokers, 4.7% were current e-cigarette users, 12.5% were binge alcohol drinkers, and 43.4% had three or more comorbid conditions. Overall, 8.5% reported CU in the past 30 days, of which 30.4% used it for medical reasons and 25.8% used it for nonmedical reasons. The prevalence of past 30-day CU decreased with age, education, and income level. Compared to their counterparts, the odds of past 30-day CU were greater among men, those living in urban areas, those with frequent mental distress, infrequent physical distress, and those who had at least one comorbid condition. Non-Hispanic Black veterans had 89% increased odds of past 30-day CU (adjusted odds ratio [AOR] =1.89, 95% confidence interval [CI], 1.19-3.0) compared with non-Hispanic White veterans. Current tobacco smokers had 3.54 (95% CI, 2.40-5.24) and former smokers had 1.78 (95% CI, 1.28-2.47) times higher odds of reporting past 30-day CU than never smokers. Current e-cigarette use (AOR = 3.37, 95% CI, 2.20-5.16) and binge drinking (AOR = 3.18, 95% CI, 2.29-4.41) were also statistically significantly associated with increased odds of past 30-day CU compared to no e-cigarette use and no binge drinking. CONCLUSIONS CU is prevalent among veterans, and certain subgroups are at higher risk of CU. Thus, identifying high-risk subgroups of veterans and adequately educating them about CU's benefits, risks, and safety is crucial.
Collapse
Affiliation(s)
- Laura L Manzo
- US Army, AMEDD Student Detachment, 187th Medical Battalion, Joint Base San Antonio, TX 78234, USA
- Yale School of Nursing, Orange, CT 06477, USA
| | | | | | - Tara Sanft
- Yale School of Medicine, New Haven, CT 06520, USA
| | - Hermine Poghosyan
- Yale School of Nursing, Orange, CT 06477, USA
- Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER), Yale School of Medicine, New Haven, CT 06520, USA
| |
Collapse
|
6
|
Carlini BH, Kellum LB, Garrett SB, Nims LN. Threaten, Distract, and Discredit: Cannabis Industry Rhetoric to Defeat Regulation of High-THC Cannabis Products in Washington State. J Stud Alcohol Drugs 2024; 85:322-329. [PMID: 38270913 PMCID: PMC11218453 DOI: 10.15288/jsad.23-00277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/21/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE Washington State legislators have attempted to regulate high delta-9-tetrahydrocannabinol (THC) cannabis to reduce cannabis-related harms. Historically, industry actors of other health-compromising products have influenced governments' adoption of evidence-based regulation policies. A better understanding of the industry rhetoric can be used by public health advocates to develop counterarguments and disseminate alternative narratives that protect the public's health. We analyzed the arguments used by cannabis industry actors opposing regulations to de-incentivize the availability and use of high-THC products in Washington State. METHOD We analyzed 41 testimonies transcribed from 33 cannabis industry actors in 3 public bill hearings and one legislative work session that occurred between 2020 and 2023. Using a deductive thematic analysis, informed by industry actors' arguments opposing regulation of alcohol, tobacco, and high-sugar beverages, we developed a codebook to analyze and identify themes within cannabis industry rhetorical strategies. RESULTS We identified three main rhetorical strategies used by cannabis industry actors to oppose THC content regulation: threaten, distract, discredit. The most frequently used rhetorical strategy was threats to economic benefits, public health, and the will of the people. The other two most apparent strategies were distracting from the bill's focus by introducing a tangential topic and discrediting the science that supported regulation of cannabis products with high THC concentration or its advocates. CONCLUSIONS Cannabis industry actors have leveraged several arguments used by industry actors of other health-compromising products to undermine initiatives to advance public health. They have also adapted rhetoric from other industries to the unique conditions of the cannabis regulatory landscape.
Collapse
Affiliation(s)
- Beatriz H. Carlini
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Lyndsey B. Kellum
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Sharon B. Garrett
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Lexi N. Nims
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| |
Collapse
|
7
|
Wilkinson ML, Karbassi N, Juarascio AS. Latent classes of alcohol and cannabis use among adults with binge-spectrum eating disorders: Associations with eating disorder symptom severity and personality features. EUROPEAN EATING DISORDERS REVIEW 2024; 32:440-449. [PMID: 38030958 PMCID: PMC10994745 DOI: 10.1002/erv.3056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/12/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Alcohol and cannabis use are prevalent among individuals with binge-spectrum eating disorders (B-ED) and vary in terms of frequency and associated problems. The current study aimed to identify latent classes of alcohol and cannabis use patterns among B-ED and examine associations between latent classes and demographic characteristics, eating disorder symptoms, and personality features. METHODS Participants (N = 236) were treatment-seeking adults with B-ED who completed a clinical interview of eating pathology and self-report measures of alcohol and cannabis use in the past 3 months, alcohol and cannabis-related problems, and personality features (i.e., impulsivity, affect lability). RESULTS Latent class analysis identified three heterogeneous classes, labelled as (a) Low Alcohol, (b) Moderate Drinking and Problems with Occasional Cannabis Use, and (c) No Alcohol and Cannabis Use. Latent classes significantly differed in terms of substance use engagement and problems, demographic characteristics, dietary restraint, impulsive personality features, and affect lability. CONCLUSIONS Study findings support heterogeneity in alcohol and cannabis use among B-ED and suggest patient characteristics and clinical severity associated with specific substance use presentations. Future research should replicate results using larger, diverse samples engaging in a broader range of alcohol and cannabis use symptoms.
Collapse
Affiliation(s)
- M L Wilkinson
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - N Karbassi
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - A S Juarascio
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| |
Collapse
|
8
|
Wang Y, Romm KF, Edberg MC, Bingenheimer JB, LoParco CR, Cui Y, Berg CJ. Two-part models identifying predictors of cigarette, e-cigarette, and cannabis use and change in use over time among young adults in the US. Am J Addict 2024. [PMID: 38685757 DOI: 10.1111/ajad.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 04/01/2024] [Accepted: 04/14/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Limited longitudinal research has examined differential interpersonal and intrapersonal correlates of young adult use and use frequency of cigarettes, e-cigarettes, and cannabis. This study aimed to address these limitations. METHODS We analyzed five waves of longitudinal data (2018-2020) among 3006 US young adults (Mage = 24.55, 44% male, 32% sexual minority, ~30% racial/ethnic minority). Two-part latent growth models examined likelihood of past-month cigarette, e-cigarette, and cannabis use (binary part) and days used (continuous part) and identified predictors (depressive symptoms, personality traits, adverse childhood experiences [ACEs], parental use) of baseline use and changes over time. RESULTS Regarding baseline past-month use (27% cigarettes, 38% e-cigarettes, 39% cannabis), depressive symptoms, ACEs, and parental substance use predicted use outcomes (i.e., likelihood, frequency) for each product; extraversion predicted cigarette and e-cigarette use outcomes; openness predicted e-cigarette and cannabis use outcomes; conscientiousness negatively predicted cigarette and cannabis use outcomes; and agreeableness negatively predicted cannabis use frequency. Regarding longitudinal changes, conscientiousness predicted accelerated increase of cigarette use frequency at later timepoints; depressive symptoms predicted increases in likelihood of e-cigarette use but the association weakened over time; and parental cannabis use predicted decreased cannabis use frequency but the association weakened over time. DISCUSSION AND CONCLUSIONS Young adult substance use interventions should target high-risk subgroups and focus on distinct factors impacting use, including chronic, escalating, and decreasing use. SCIENTIFIC SIGNIFICANCE This study advances the literature regarding distinct predictors of different substance use outcomes and provides unique data to inform interventions targeting young adult cigarette, e-cigarette, and cannabis use.
Collapse
Affiliation(s)
- Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
- George Washington Cancer Center, George Washington University, Washington, District of Columbia, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Mark C Edberg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Jeffrey B Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
- George Washington Cancer Center, George Washington University, Washington, District of Columbia, USA
| |
Collapse
|
9
|
Dai HD, Idoate R, Mahroke A, Abresch C. Racial Disparities in Patterns and Modes of Current and Daily Marijuana Use among Adults Living with Children. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02008-x. [PMID: 38656451 DOI: 10.1007/s40615-024-02008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/28/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study sought to examine racial disparities in marijuana use among U.S. adults living with children. METHODS Data are drawn from the 2022 Behavioral Risk Factor Surveillance System to examine the prevalence of current (past month) and frequent (≥20 days in the last 30 days) marijuana use along with the mode of marijuana use by 7 racial and ethnic groups (non-Hispanic [NH] White, NH-Black, Hispanic, NH American Indian or Alaskan Native [AI/AN], NH-Asian, NH Native Hawaiian or other Pacific Islander only [NH/PI], and other/multiple races, n=22,659). RESULTS Compared to NH White adults with children, NH Black adults had a higher prevalence of current marijuana use (23.1% vs. 16.9%, p=0.003) and NH AI/AN adults had two times higher prevalence of frequent use (17.3% vs. 8.4%, p=0.0003). Adults living in recreational marijuana legal states (vs. no) were also more likely to report marijuana use, and there were significant age × race/ethnicity and education × race/ethnicity interactions (p<0.05) on marijuana use. Regarding the mode of use, racial minority users except Asians also reported a higher prevalence of smoking marijuana than their White counterparts. CONCLUSIONS AND RELEVANCE Substantial racial disparities in marijuana use patterns among adults who live with children highlight a potential risk for adolescents' health. Addressing these differences is essential for promoting equitable health outcomes in diverse communities.
Collapse
Affiliation(s)
- Hongying Daisy Dai
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Regina Idoate
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Avina Mahroke
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
- College of Osteopathic Medicine, Kansas City University, Kansas City, Kansas, USA
| | - Chad Abresch
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
10
|
Vila-Farinas A, Pérez-Ríos M, Montes-Martínez A, Ahluwalia JS, Mourino N, Rey-Brandariz J, Triñanes-Pego Y, Candal-Pedreira C, Ruano-Ravina A, Gómez-Salgado P, Miguez-Varela C, Tajes-Alonso M, Loureiro-Fuentes I, Riesgo-Martín J, Valverde-Trillo A, Fernández-Lema I, Rey-Arijón M, Freiría-Somoza I, Rodríguez-Pampín M, Varela-Lema L. Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study. BMC Public Health 2024; 24:990. [PMID: 38594646 PMCID: PMC11003004 DOI: 10.1186/s12889-024-18397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.
Collapse
Affiliation(s)
- Andrea Vila-Farinas
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain.
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain.
| | - Agustín Montes-Martínez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| | - Jasjit S- Ahluwalia
- Departament of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Nerea Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
| | - Yolanda Triñanes-Pego
- Scientific-technical Assessment Unit [Avalia-t]. Galician Health Knowledge Management Agency, Agencia Gallega de Conocimiento en Salud/ACIS, A Coruna, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| | - Patricia Gómez-Salgado
- Scientific-technical Assessment Unit [Avalia-t]. Galician Health Knowledge Management Agency, Agencia Gallega de Conocimiento en Salud/ACIS, A Coruna, Spain
| | - Carmen Miguez-Varela
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruna, Spain
| | - María Tajes-Alonso
- Mental Health Department, Regional Health Authority, Galician Regional Authority [Xunta de Galicia], A Coruna, Spain
| | - Isabel Loureiro-Fuentes
- Ordes Health Center, Galician Health Service [Servicio Galego de Saúde/SERGAS], A Coruna, Spain
| | - Juan Riesgo-Martín
- Catalonian Health Institute, Institut Català de la Salut/ICS, Barcelona, Spain
| | - Araceli Valverde-Trillo
- Department of Health, Catalonian Public Health Agency, Catalonian Regional Authority [Generalitat de Cataluña], A Coruna, Spain
| | | | - Mercedes Rey-Arijón
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - Isabel Freiría-Somoza
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - María Rodríguez-Pampín
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| |
Collapse
|
11
|
Alshaarawy O, Balasubramanian G, Venkatesan T. Cannabis use in the United States and its impact on gastrointestinal health. Nutr Clin Pract 2024; 39:281-292. [PMID: 38142306 DOI: 10.1002/ncp.11111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/13/2023] [Accepted: 11/17/2023] [Indexed: 12/25/2023] Open
Abstract
In recent years, the legalization and social acceptability of cannabis use have increased in the United States. Concurrently, the prevalence of cannabis use has continued to rise, and cannabis products have diversified. There are growing concerns regarding the health effects of regular and high-potency cannabis use, and new research has shed light on its potentially negative effects. Here, we review evidence of the gastrointestinal (GI) effects of cannabis and cannabinoids. Dysregulation of the endocannabinoid system might contribute to various GI disorders, including irritable bowel syndrome and cyclic vomiting syndrome, and endocannabinoids have been found to regulate visceral sensation, nausea, vomiting, and the gut microbiome. Cannabis has been shown to have antiemetic properties, and the US Food and Drug Administration has approved cannabis-based medications for treating chemotherapy-induced nausea and vomiting. Yet, chronic heavy cannabis use has been linked to recurrent episodes of severe nausea and intractable vomiting (cannabinoid hyperemesis syndrome). Given the considerable heterogeneity in the scientific literature, it is unclear if cannabinoid hyperemesis syndrome is truly a distinct entity or a subtype of cyclic vomiting that is unmasked by heavy cannabis use and the associated dysregulation of the endocannabinoid system. The changes in cannabis legalization, availability, and public risk perceptions have outpaced research in this area and there is a need for robust, prospective, large-scale studies to understand the effects of cannabis use on GI health.
Collapse
Affiliation(s)
- Omayma Alshaarawy
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Gokulakrishnan Balasubramanian
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Thangam Venkatesan
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| |
Collapse
|
12
|
Froude AM, Fawcett EJ, Coles A, Drakes DH, Harris N, Fawcett JM. The prevalence of cannabis use disorder in attention-deficit hyperactivity disorder: A clinical epidemiological meta-analysis. J Psychiatr Res 2024; 172:391-401. [PMID: 38452637 DOI: 10.1016/j.jpsychires.2024.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
Studies have shown that individuals with attention-deficit hyperactivity disorder (ADHD) pose an increased risk for developing substance use disorders. Increased cannabis product accessibility and recent legislative changes have led to increased cannabis consumption, thereby increasing the risk of cannabis use disorder (CUD). The present meta-analysis explored the lifetime and current prevalence of CUD in ADHD. A systematic review was conducted using the following databases: PubMed, PsycINFO and Web of Science. A total of 14 articles were included and used to estimate the aggregate lifetime and current prevalence of CUD in ADHD alongside risk ratios comparing increased risk of CUD in ADHD versus control samples. Mixed and random-effects models indicated that lifetime and current prevalence rates of CUD in ADHD populations were 26.9% and 19.2%, respectively (although prediction intervals ranged from 12.4% to 48.8% and 5.5%-39.1%, respectively). Analysis of the risk ratios indicated that those with ADHD were at 2.85- and 2.91-times greater risk of a lifetime or current diagnosis of CUD, respectively, than those in the general population. Our findings support the need for additional research on the prevalence of CUD in those with ADHD, as well as the inclusion of CUD screening in the treatment of ADHD.
Collapse
Affiliation(s)
- Anna M Froude
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
| | - Emily J Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Ashlee Coles
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Dalainey H Drakes
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Nick Harris
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Jonathan M Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| |
Collapse
|
13
|
Zaman T, Bravata DM, Byers A, Krebs E, Leonard S, Austin C, Sandbrink F, Hasin DS, Keyhani S. A national study of clinical discussions about cannabis use among Veteran patients prescribed opioids. J Cannabis Res 2024; 6:12. [PMID: 38493111 PMCID: PMC10943860 DOI: 10.1186/s42238-024-00221-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/15/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The Veterans Health Administration tracks urine drug tests (UDTs) among patients on long-term opioid therapy (LTOT) and recommends discussing the health effects of cannabis use. OBJECTIVE To determine the occurrence of cannabis-related discussions between providers and patients on LTOT during six months following UDT positive for cannabis, and examine factors associated with documenting cannabis use. DESIGN We identified patients prescribed LTOT with a UDT positive for cannabis in 2019. We developed a text-processing tool to extract discussions around cannabis use from their charts. SUBJECTS Twelve thousand seventy patients were included. Chart review was conducted on a random sample of 1,946 patients. MAIN MEASURES The presence of a cannabis term in the chart suggesting documented cannabis use or cannabis-related discussions. Content of those discussions was extracted in a subset of patients. Logistic regression was used to examine the association between patient factors, including state of residence legal status, with documentation of cannabis use. KEY RESULTS Among the 12,070 patients, 65.8% (N = 7,948) had a cannabis term, whereas 34.1% (N = 4,122) of patients lacked a cannabis term, suggesting that no documentation of cannabis use or discussion between provider and patient took place. Among the subset of patients who had a discussion documented, 47% related to cannabis use for medical reasons, 35% related to a discussion of VA policy or legal issues, and 17% related to a discussion specific to medical risks or harm reduction strategies. In adjusted analyses, residents of states with legalized recreational cannabis were less likely to have any cannabis-related discussion compared to patients in non-legal states [OR 0.73, 95% CI 0.64-0.82]. CONCLUSIONS One-third of LTOT patients did not have documentation of cannabis use in the chart in the 6 months following a positive UDT for cannabis. Discussions related to the medical risks of cannabis use or harm reduction strategies were uncommon.
Collapse
Affiliation(s)
- Tauheed Zaman
- Addiction Recovery and Treatments Services, San Francisco VA Health Care System, 4150 Clement Street, #116F, San Francisco VA Medical Center, San Francisco, CA, 94121, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
| | - Dawn M Bravata
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Departments of Medicine and Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, IN, USA
| | - Amy Byers
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
- Medical Service, San Francisco VA Health Care System, San Francisco, USA
| | - Erin Krebs
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Samuel Leonard
- Medical Service, San Francisco VA Health Care System, San Francisco, USA
| | - Charles Austin
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Friedhelm Sandbrink
- National Pain Management, Opioid Safety and Prescription Drug Monitoring Program, Veterans Health Administration, Washington, DC, USA
- Department of Neurology, George Washington University, Washington, DC, USA
| | - Deborah S Hasin
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Salomeh Keyhani
- Medical Service, San Francisco VA Health Care System, San Francisco, USA
- Division of General Internal Medicine, Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
| |
Collapse
|
14
|
Livne O, Budney A, Borodovsky J, Shmulewitz D, Walsh C, Struble CA, Habib M, Aharonovich E, Hasin DS. Age differences in patterns of cannabis use among an online US sample of adults who consume cannabis frequently. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:242-251. [PMID: 38640463 DOI: 10.1080/00952990.2024.2309340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/19/2024] [Indexed: 04/21/2024]
Abstract
Background: Cannabis use is increasing among middle-aged and older US adults, populations that are particularly vulnerable to the adverse effects of cannabis. Risks for adverse effects differ by cannabis use patterns, which have become increasingly heterogeneous. Nevertheless, little is known about age differences in such patterns.Objective: To investigate age differences in cannabis use patterns, comparing younger (age 18-49), middle-aged (age 50-64), and older adults (age ≥65).Methods: A total of 4,151 US adults with past 7-day cannabis consumption completed an online survey (35.1% male; 60.1% female; 4.8% identified as "other"). Regression models examined age differences in cannabis use patterns.Results: Compared to younger adults, middle-aged and older adults were more likely to consume cannabis during evening hours (50-64: adjusted odds ratio [aOR] = 2.98, 95% CI 2.24-3.96; ≥65: aOR = 4.23, 95 CI 2.82-6.35); by only one method (50-64: aOR = 1.67, 95% CI 1.34-2.09; ≥65: aOR = 3.38, 95 CI 2.24-5.09); primarily by smoking as the only method (50-64: aOR = 1.52, 95% CI 1.29-1.78; ≥65: aOR = 2.12, 95 CI 1.64-2.74); but less likely to consume concentrated cannabis products (concentrates) with extremely high %THC (50-64: aOR = 0.71, 95% CI 0.54-0.93; ≥65: aOR = 0.30, 95 CI 0.16-0.55). Age differences in cannabis use patterns were also observed between middle-aged and older adults.Conclusion: Findings suggest that middle-aged and older adults may engage in less risky cannabis use patterns compared to younger groups (e.g. lower likelihood of consuming highly potent concentrates). However, findings also underscore the importance of recognizing risks unique to these older demographics, such as smoking-related health events. Consequently, prevention strategies targeting such use patterns are needed.
Collapse
Affiliation(s)
- Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Alan Budney
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Jacob Borodovsky
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY, USA
| | - Cara A Struble
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Mohammad Habib
- Departments of Psychiatry and Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Hanover, NH, Lebanon
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| |
Collapse
|
15
|
Adley NC, Brasky TM, Conroy SR, Newton AM, Plascak JJ, Strassels SA, Hays JL, Krok-Schoen JL. Associations of Cancer Patients' Demographic and Clinical Characteristics With Cannabis-Related Interest and Behaviors. J Palliat Med 2024; 27:394-399. [PMID: 38157334 DOI: 10.1089/jpm.2023.0490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Background: Cannabis interest and use is increasing in the United States, yet research on its use among cancer patients is limited. Methods: Individuals with cancer completed an anonymous cross-sectional questionnaire. Multivariable logistic regressions estimated odds ratios (OR) between patients' demographic and clinical characteristics with cannabis-related interest, current use, and provider recommendation. Results: Participants (n = 943) were, on average, 61.7 years old. Older patients were less likely to use cannabis products (OR = 0.42, confidence interval [95% CI]: 0.26-0.69) and less likely to be interested in cannabis (OR = 0.60, 95% CI: 0.44-0.84) than younger patients. Those with higher education were less likely to be using cannabis (OR = 0.41, 95% CI: 0.25-0.67) and less likely to have received a provider recommendation of cannabis use than the least educated (OR = 0.38, 95% CI: 0.19-0.76). Cancer spread and type were significant correlates of provider recommendation of cannabis use. Conclusions: Additional research is warranted to better understand cancer patients' motivations for cannabis use and interest.
Collapse
Affiliation(s)
- Neema C Adley
- Department of Neuroscience, The Ohio State University College of Arts and Sciences, Columbus, Ohio, USA
| | - Theodore M Brasky
- Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Sara R Conroy
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Alison M Newton
- Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Jesse J Plascak
- Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - John L Hays
- Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Jessica L Krok-Schoen
- School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio, USA
| |
Collapse
|
16
|
Worster B, Meghani SH, Leader AE, Nugent SM, Jones KF, Yeager KA, Liou K, Ashare RL. Toward reducing racialized pain care disparities: Approaching cannabis research and access through the lens of equity and inclusion. Cancer 2024; 130:497-504. [PMID: 37941524 PMCID: PMC11212108 DOI: 10.1002/cncr.35115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
There is growing interest in cannabis use for cancer pain. This commentary aims to discuss the evidence surrounding cannabis use for cancer pain in the context of the long-racialized landscape of cannabis policies and the disparity in pain control among cancer patients holding minoritized racial identities. Much evidence surrounding both the benefits and harms of cannabis use in cancer patients, and all patients in general, is lacking. Although drawing on the research in cancer that is available, it is also important to illustrate the broader context about how cannabis' deep roots in medical, political, and social history impact patient use and health care policies. There are lessons we can learn from the racialized disparities in opioid risk mitigation strategies, so they are not replicated in the settings of cannabis for cancer symptom management. Additionally, the authors intentionally use the term "cannabis" here rather than "marijuana.: In the early 1900s, the lay press and government popularized the use of the word "marijuana" instead of the more common "cannabis" to tie the drug to anti-Mexican prejudice.
Collapse
Affiliation(s)
- Brooke Worster
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Jefferson Health, Philadelphia, Pennsylvania, USA
| | - Salimah H Meghani
- Department of Biobehavioral Health Science, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amy E Leader
- Sidney Kimmel Cancer Center, Department of Medical Oncology, Jefferson Health, Philadelphia, Pennsylvania, USA
| | - Shannon M Nugent
- Department of Psychiatry, Oregon Health and Science University, Portland, Oregon, USA
- Knight Cancer Institution, Oregon Health and Science University, Portland, Oregon, USA
| | - Katie Fitzgerald Jones
- Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Katherine A Yeager
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Kevin Liou
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rebecca L Ashare
- Department of Psychology, State University of New York at Buffalo, Buffalo, New York, USA
| |
Collapse
|
17
|
Goodwin RD, Zhou C, Silverman KD, Rastogi D, Borrell LN. Cannabis use and the prevalence of current asthma among adolescents and adults in the United States. Prev Med 2024; 179:107827. [PMID: 38128769 DOI: 10.1016/j.ypmed.2023.107827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/27/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Cannabis use has increased among adolescents and adults in the United States (US) in recent years. Few data are available on the prevalence of asthma by frequency of cannabis use. This study aimed to estimate the prevalence of asthma by frequency of past 30-day cannabis use among US individuals. METHODS Data were drawn from the 2020 National Survey on Drug Use and Health (NSDUH), a nationally representative, annual cross-sectional survey of US individuals aged 12 and older in the United States (N = 32,893). Logistic regression models were used to examine the relationship between frequency of any cannabis and/or blunt (i.e., cannabis smoked in a hollowed-out cigar) use in the past 30 days and current asthma, adjusting for demographics and current cigarette smoking. RESULTS Current asthma was more common among US individuals who reported cannabis use in the past 30-days, relative to those who did not (9.8% vs. 7.4%, p < 0.0001). The odds of asthma was significantly greater among individuals reporting cannabis use 20-30 days/month (Adjusted Odds Ratio [AOR] = 1.67, 95% CI:1.21, 2.31), blunt use 6-15 and 20-30 days/month (AOR = 1.9, 95% CI:1.1, 3.2; AOR = 2.2, 95% CI:1.4, 3.6), respectively, than among those without. A positive linear relationship was observed between frequency of a) cannabis use (p < 0.0001) and b) blunt use (p < 0.0001) and current asthma prevalence. CONCLUSIONS Findings suggest a dose-response relationship between frequency of current cannabis use and the prevalence of current asthma in the US individuals.
Collapse
Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, NY 10027, United States of America; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Chaoqun Zhou
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Kevin D Silverman
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, NY 10027, United States of America
| | - Deepa Rastogi
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, United States of America
| | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, NY 10027, United States of America
| |
Collapse
|
18
|
Osaghae I, Talluri R, Chido‐Amajuoyi OG, Tanco K, Shah DP, Pande M, Shete S. Awareness and interest in cannabis use for cancer management among cancer survivors. Cancer Med 2024; 13:e6902. [PMID: 38180296 PMCID: PMC10807618 DOI: 10.1002/cam4.6902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/16/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND We examined the awareness, interest, and information sources relating to cannabis use for cancer management (including management of cancer symptoms and treatment-related side effects) and determined factors associated with cancer survivors' awareness and interest in learning about cannabis use for cancer management. METHODS This was a cross-sectional study of adult cancer survivors (N = 1886) receiving treatment at a comprehensive cancer center. Weighted prevalence and multivariable logistic regression analyses were conducted. RESULTS Among cancer survivors, 88% were aware and 60% were interested in learning about cannabis use for cancer management. Common sources of information to learn about cannabis use for cancer management were cancer doctors/nurses (82%), other patients with cancer (27%), websites/blogs (26%), marijuana stores (20%), and family/friends (18%). The odds of being aware of cannabis use for cancer management was lower among male compared to female survivors (adjusted odds ratio [AOR]: 0.61; 95% confidence interval [CI]: 0.41-0.90), non-Hispanic Blacks compared to non-Hispanic Whites (AOR: 0.36; 95% CI: 0.21-0.62), and survivors who do not support the legalization of cannabis for medical use compared to those who do (AOR: 0.10; 95% CI: 0.04-0.23). On the other hand, the odds of being interested in cannabis use for cancer management was higher among non-Hispanic Blacks compared to non-Hispanic Whites (AOR: 1.65; 95% CI: 1.04-2.62), and among cancer survivors actively undergoing cancer treatment compared to patients on non-active treatment (AOR: 2.25; 95% CI: 1.74-2.91). CONCLUSION Awareness of cannabis use for cancer management is high within the cancer survivor population. Results indicated health care providers are leading information source and should receive continued medical education on cannabis-specific guidelines. Similarly, tailored educational interventions are needed to guide survivors on the benefits and risks of cannabis use for cancer management.
Collapse
Affiliation(s)
- Ikponmwosa Osaghae
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Division of Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Rajesh Talluri
- Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of Data ScienceUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | | | - Kimberson Tanco
- Department of Palliative, Rehabilitation and Integrative MedicineThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Dimpy P. Shah
- Mays Cancer Center, UT Health San Antonio MD Anderson Cancer CenterSan AntonioTexasUSA
| | - Mala Pande
- Department of Gastroenterology, Hepatology and NutritionThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Sanjay Shete
- Department of EpidemiologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Division of Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| |
Collapse
|
19
|
Music J, Sterling B, Charlebois S, Goedhart C. Comparison of perceptions in Canada and USA regarding cannabis and edibles. J Cannabis Res 2024; 6:1. [PMID: 38167591 PMCID: PMC10763328 DOI: 10.1186/s42238-023-00213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Canada took a national approach to recreational cannabis that resulted in official legalization on October 17, 2018. In the United States (US), the approach has been more piecemeal, with individual states passing their own laws regulating adult use. The objective of this study was to compare the two jurisdictions. METHODS Two exploratory, quantitative surveys were administered in May of 2021 in both Canada and the US. One thousand forty-seven Canadian and 1037 US residents (age 19 and older) were surveyed on approaches to and attendant regulations of consumer cannabis. Tests of significance were performed to analyze differences between two groups. RESULTS No statistically significant differences exist between the two countries in terms of cannabis legalization acceptance. Usage rates among adults was similar with 45% of Canadians and 42% of Americans confirming they consume cannabis. Respondents maintain that they intend to increase their usage, with edibles attracting a rising level of interest from consumers. CONCLUSIONS Results suggest that public policy in both Canada and the USA needs to change to reflect rapidly evolving acceptance of cannabis products in North America to realize potential economic returns.
Collapse
Affiliation(s)
- Janet Music
- Faculty of Arts & Social Sciences, Dalhousie University, Halifax, NS, Canada.
| | | | | | | |
Collapse
|
20
|
Miller-Matero LR, Ross K, Arellano C, Zelenak L, DePascale E, Gavrilova L, Braciszewski JM, Hecht LM, Haley EN, Brescacin C, Carlin AM. Cannabis use following bariatric surgery is associated with anxiety and maladaptive eating. Surg Obes Relat Dis 2024; 20:91-97. [PMID: 37863791 DOI: 10.1016/j.soard.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND There are limited data regarding the association of cannabis use with outcomes after bariatric surgery. As such, it is challenging to know how to counsel patients using cannabis. OBJECTIVES The purpose of this study was to examine whether postsurgical cannabis use was associated with psychiatric symptoms and maladaptive eating among individuals up to 4 years after bariatric surgery. SETTING Single health system. METHODS All patients who underwent bariatric surgery over a 4-year period were invited to participate. Participants (N = 765) completed questionnaires online regarding postsurgical cannabis use, psychiatric symptoms, and maladaptive eating. RESULTS Any cannabis use after bariatric surgery was associated with increased likelihood of having elevated symptoms of anxiety (odds ratio [OR] = 1.88, P = .003; 37.8% versus 24.4%), increased likelihood of grazing behaviors (OR = 1.77, P = .01; 71.2% versus 58.2%), and higher scores for eating in response to depression (P = .01; 12.13 versus 10.75). Weekly cannabis use was associated with loss of control eating (OR = 1.81, P = .04; 37.2% versus 24.7%), binge eating (OR = 2.16, P = .03; 20.0% versus 10.4%), and night eating behaviors (OR = 2.11, P = .01; 40.0% versus 24.0%). Cannabis use was not associated with depression (P > .05). CONCLUSIONS Cannabis use after bariatric surgery was associated with anxiety symptoms and engaging in maladaptive eating behaviors. Frequent cannabis use (i.e., ≥1 per week) was associated with additional types of maladaptive eating. Clinicians involved in presurgical and postsurgical care may want to counsel patients currently using cannabis, especially those who are engaging in frequent use.
Collapse
Affiliation(s)
- Lisa R Miller-Matero
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan.
| | - Kaitlin Ross
- Wayne State University School of Medicine, Detroit, Michigan
| | - Camila Arellano
- Wayne State University School of Medicine, Detroit, Michigan
| | - Logan Zelenak
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Eve DePascale
- Henry Ford Health, Behavioral Health, Detroit, Michigan
| | - Lyubov Gavrilova
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Jordan M Braciszewski
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Leah M Hecht
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Erin N Haley
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Carly Brescacin
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
| | - Arthur M Carlin
- Wayne State University School of Medicine, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
| |
Collapse
|
21
|
Buckner JD, Zvolensky MJ, Scherzer CR. Alcohol and cannabis dual use among Black adults: Associations with alcohol use, use-related problems, and race-based discrimination. Am J Addict 2024; 33:65-70. [PMID: 37689991 PMCID: PMC10846665 DOI: 10.1111/ajad.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Black adults who drink alcohol appear at risk for poor alcohol-related outcomes, yet little research has examined whether cannabis use among those who consume alcohol (alcohol-cannabis dual use) is related to worse alcohol-related consequences, as observed in predominantly White samples. Further, it may be that experiencing more race-based discrimination may be related to using multiple substances to cope with such experiences; however, no known studies have examined the impact of race-based discrimination on alcohol-cannabis dual use. METHODS Participants were 270 Black undergraduates who endorsed past-month drinking, 112 of whom endorsed alcohol-cannabis dual use. RESULTS The dual use group reported heavier drinking, more drinking-related problems, and more race-based microaggressions (but not overt racism) than the alcohol-only group. CONCLUSIONS The use of cannabis among Black young adults who drink alcohol was related to heavier drinking and more alcohol-related problems. Further, experiencing more microaggressions may place these individuals at risk for using multiple substances, presumably to cope with these experiences. SCIENTIFIC SIGNIFICANCE Considering models suggesting that the dual use of cannabis may result in less alcohol use, the current study highlights that for Black adults who consume alcohol, cannabis dual use is related to heavier drinking and more alcohol-related problems, which can inform intervention and treatment efforts.
Collapse
Affiliation(s)
- Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- HEALTH Institute, University of Houston, Houston, TX, United States
| | - Caroline R. Scherzer
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| |
Collapse
|
22
|
Patrick ME, Peterson SJ, Terry-McElrath YM, Rogan SEB, Solberg MA. Trends in coping reasons for marijuana use among U.S. adolescents from 2016 to 2022. Addict Behav 2024; 148:107845. [PMID: 37696065 PMCID: PMC10870514 DOI: 10.1016/j.addbeh.2023.107845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE This study examines historical trends in coping reasons for marijuana use among adolescents (1976-2022) and explores sociodemographic variations in recent years (2016-2022). METHOD Data from U.S. national samples of 12th grade adolescents in the Monitoring the Future (MTF) study were used to examine long-term trends (1976-2022, N = 43,237) and recent differences by sociodemographic characteristics (2016-2022, N = 3,816). Measures included marijuana use, coping reasons for use, and sociodemographic characteristics. RESULTS The most prevalent coping reason across time was "relax," endorsed by 52.9% of past 12-month users. Coping reasons mostly exhibited significant increases over time. Sociodemographic factors were associated with coping reasons. Females had higher odds of using marijuana to escape problems and get through the day (vs. males). Black respondents were more likely to use marijuana to get through the day, and Hispanic respondents were more likely to use to relax (vs. White respondents). Those with lower (vs. higher) parental education were more likely to use due to anger/frustration and to escape problems. Adolescents who used marijuana frequently (vs. less often) had higher odds of endorsing all coping reasons. There was no robust evidence of interactions between sociodemographic characteristics and year. CONCLUSIONS Results indicate a consistent increase in coping reasons for adolescent marijuana use over time, with variations based on sociodemographic characteristics. The findings highlight the importance of understanding subpopulations of adolescents who have higher risk of coping-related marijuana use.
Collapse
Affiliation(s)
- Megan E Patrick
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48106-1248, USA.
| | - Sarah J Peterson
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48106-1248, USA.
| | - Yvonne M Terry-McElrath
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48106-1248, USA.
| | - Shanna Elaine B Rogan
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48106-1248, USA.
| | - Marvin A Solberg
- Wayne State University College of Nursing, 5557 Cass Ave., Detroit, MI 48202, USA.
| |
Collapse
|
23
|
Dang JHT, Chen S, Hall S, Campbell JE, Chen MS, Doescher MP. Tobacco and marijuana use during the COVID-19 pandemic lockdown among American Indians residing in California and Oklahoma. Tob Induc Dis 2023; 21:171. [PMID: 38125581 PMCID: PMC10731663 DOI: 10.18332/tid/174819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/21/2023] [Accepted: 11/04/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION American Indian (AI) people experience a disproportionate tobacco and marijuana burden which may have been exacerbated by the COVID-19 pandemic. Little is known about the tobacco and marijuana habits of American Indian individuals during the COVID-19 pandemic. The objective of this study is to examine tobacco and marijuana use as well as change in use during the COVID-19 pandemic among the American Indian community. METHODS This cross-sectional study analyzes survey data from a convenience sample of American Indian individuals residing in California and Oklahoma and included adults with and without cancer that resided in both rural and urban areas (n=1068). RESULTS During October 2020 - January 2021, 36.0% of participants reported current use of tobacco products, 9.9% reported current use of marijuana products, and 23.7% reported increased use of tobacco and/or marijuana in the past 30 days, with no difference between those with cancer and those without cancer. Tobacco use was associated with marital status, age, employment status, COVID-19 exposure, COVID-19 beliefs, and alcohol consumption. Marijuana use was associated with COVID-19 beliefs, alcohol consumption, and income level. Increased tobacco and/or marijuana use was associated with baseline use of those products. Nearly a quarter of participants reported increased use of tobacco and/or marijuana products during the COVID-19 pandemic. CONCLUSIONS We observed high rates of tobacco use during the COVID-19 pandemic, consistent with other studies. Research is needed to examine whether tobacco and marijuana use will decrease to pre-pandemic levels post-pandemic or if these behaviors will persist post-pandemic. Given these findings, there is a pressing need to increase access to evidence-based tobacco and marijuana treatment services in the AI population post COVID-19 pandemic.
Collapse
Affiliation(s)
- Julie H T Dang
- Division of Health Policy and Management, Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, United States
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Spencer Hall
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Moon S Chen
- Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, United States
| | - Mark P Doescher
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma College of Health Science Center, Oklahoma City, United States
- Stephenson Cancer Center, Oklahoma City, United States
| |
Collapse
|
24
|
Egan KL, Cox MJ. Cannabinoid home storage practices among a national Qualtrics panel of adult users of cannabinoid products in the USA. Inj Prev 2023:ip-2023-044968. [PMID: 38124000 DOI: 10.1136/ip-2023-044968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION The presence of cannabinoid products in the home may increase the likelihood of unintended adverse consequences for children and adolescents. Secure storage of these products is one prevention method to decrease the risk of diversion and use of cannabinoid products among youth. We sought to examine cannabis, delta-8 tetrahydrocannabinol (THC), and cannabidiol (CBD) storage practices among a sample of adults 18-64 years old residing in the USA. METHODS In December 2021, we conducted an online cross-sectional survey of 1042 current (past 30 day) users of cannabinoid products (88.3% cannabis, 49.0% delta-8 THC, and 67.2% CBD). Participants were asked about where they typically keep products in their home (ie, in a locked container, unlocked container, or out in the open). We conducted multinomial regression analyses to examine the relationship between sociodemographic characteristics and cannabinoid use behaviours with home storage practices. RESULTS For all products, participants more frequently reported locking, followed by storing the product in an unlocked but not visible location. Storing the product in an unlocked and visible location was endorsed the least across all three products. Participants reported more frequent endorsement of locking cannabis products as compared with delta-8-THC and CBD. Storage practices varied by biological sex, sexual orientation, ethnicity, educational attainment, having a child who lives in the home, frequency of use, possession of a medical cannabis card and exposure to advertising. CONCLUSIONS Increasing the prevalence of secure storage practices of cannabinoid products may facilitate prevention of unanticipated consequences associated with diversion of these products.
Collapse
Affiliation(s)
- Kathleen Louise Egan
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Melissa J Cox
- Department of Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
25
|
Dhinsa J, Roman-Urrestarazu A, van Kessel R, Humphreys K. Understanding predictors of mental health and substance use treatment utilization among US adults: A repeated cross-sectional study. GLOBAL EPIDEMIOLOGY 2023; 5:100109. [PMID: 37638373 PMCID: PMC10445987 DOI: 10.1016/j.gloepi.2023.100109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 08/29/2023] Open
Abstract
Background Understanding discrepancies in mental health and substance use treatment utilization can help identify inequities in access to health services. We investigate mental health and substance use treatment utilization as function of demographic and social determinants, as well as pre-existing mental health and substance use disorders. Methods In this repeated cross-sectional study, we used the 2017-2019 National Survey on Drug Use and Health data on US adults above age 18. Two logistic regression models were conducted, using predictors of age, gender, race/Hispanicity, sexual identity, education, insurance, family income, and past year mental health and substance use disorders, with outcomes of mental health or substance use treatment utilization. Weighted estimates of substance use disorders and insurance types and Pearson's correlation tests of vulnerability among age, gender, and treatment type were reported. Findings Racial minorities, uninsured populations, sexual minorities, and females had lower odds of receiving mental health treatment, while older populations, lower income groups, and dual eligible enrollees had higher odds. Individuals with substance use disorders but no mental illness had higher odds of receiving mental health treatment. Those utilizing mental health treatment were mostly of high income, privately insured, and using cannabis, cocaine, and opioids. Older populations, men, and Medicaid only enrollees had higher odds of receiving substance use disorder treatment, whereas racial minorities had lower odds. Distribution of income, insurance type, and substance use were more widespread than mental health treatment. Interpretation Mental health treatment can be used as an avenue for substance use treatment, particularly opioid use disorders. It is important to target vulnerable populations, like racial minorities and uninsured populations to improve access to mental health and substance use treatment.
Collapse
Affiliation(s)
- Jaskiran Dhinsa
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Andres Roman-Urrestarazu
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Keith Humphreys
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| |
Collapse
|
26
|
Davis JP, Pedersen ER, Tucker JS, Prindle J, Dunbar MS, Seelam R, D’Amico EJ. Directional associations between posttraumatic stress disorder symptoms and cannabis use in young adults: Uncovering variation by sex, race, and ethnicity. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:1052-1065. [PMID: 38108802 PMCID: PMC10752216 DOI: 10.1037/adb0000973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Prevalence rates of cannabis use and PTSD vary, with men reporting greater cannabis use than females, females reporting higher rates of PTSD than males, and race and ethnic minority persons reporting higher rates of both cannabis and PTSD compared to non-Hispanic White individuals. This study extends our understanding of directional associations between cannabis use and PTSD from early to late young adulthood (18-26 years old) using two theoretical models: symptom-driven pathway and substance-induced pathway. METHOD Participants provided yearly data for 14 years, and the present study utilized data from Waves 9 through 14. Those endorsing Criterion A in at least one wave of data collection (n = 1,454) were included in the analytic sample. We used autoregressive latent trajectory with structured residuals to understand reciprocal associations for the full sample, as well as by sex and race or ethnicity. RESULTS For the full sample, we noted support for both symptom-driven and substance-induced pathways during early young adulthood (18-20) but only support for a symptom-driven pathway during late young adulthood (21-26). Males showed the same pattern as the full sample; however, for females, only a symptom-driven pathway during late young adulthood was found. For race and ethnic minority participants, we showed full cross-lagged effects during both early and late young adulthood and no associations for non-Hispanic White individuals. CONCLUSIONS Results indicate that both men and individuals from minoritized racial and ethnic groups are more likely to report heightened PTSD symptomology, maladaptive coping, and worsening symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Eric R. Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
| | | | - John Prindle
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | | | | | | |
Collapse
|
27
|
Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Psychiatr Clin North Am 2023; 46:655-676. [PMID: 37879830 DOI: 10.1016/j.psc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
Collapse
Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
| |
Collapse
|
28
|
Mehra K, Rup J, Wiese JL, Watson TM, Bonato S, Rueda S. Changes in self-reported cannabis use during the COVID-19 pandemic: a scoping review. BMC Public Health 2023; 23:2139. [PMID: 37915021 PMCID: PMC10621278 DOI: 10.1186/s12889-023-17068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is affecting mental health and substance use (MHSU) issues worldwide. The purpose of this study was to characterize the literature on changes in cannabis use during the pandemic and the factors associated with such changes. METHODS We conducted a scoping review by searching peer-reviewed databases and grey literature from January 2020 to May 2022 using the Arksey and O'Malley Framework. Two independent reviewers screened a total of 4235 documents. We extracted data from 129 documents onto a data extraction form and collated results using content analytical techniques. RESULTS Nearly half (48%) of the studies reported an increase/initiation of cannabis use, while 36% studies reported no change, and 16% reported a decrease/cessation of cannabis use during the pandemic. Factors associated with increased cannabis use included socio-demographic factors (e.g., younger age), health related factors (e.g., increased symptom burden), MHSU factors (e.g., anxiety, depression), pandemic-specific reactions (e.g., stress, boredom, social isolation), cannabis-related factors (e.g., dependence), and policy-related factors (e.g., legalization of medical/recreational cannabis). CONCLUSION Public health emergencies like the COVID-19 pandemic have the potential to significantly impact cannabis use. The pandemic has placed urgency on improving coping mechanisms and supports that help populations adapt to major and sudden life changes. To better prepare health care systems for future pandemics, wide-reaching education on how pandemic-related change impacts cannabis use is needed.
Collapse
Affiliation(s)
- Kamna Mehra
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jennifer Rup
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jessica L Wiese
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Tara Marie Watson
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Institute of Health Policy, Management and Evaluation, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A1, Canada.
| |
Collapse
|
29
|
Azizoddin DR, Cohn AM, Ulahannan SV, Henson CE, Alexander AC, Moore KN, Holman LL, Boozary LK, Sifat MS, Kendzor DE. Cannabis use among adults undergoing cancer treatment. Cancer 2023; 129:3498-3508. [PMID: 37354093 PMCID: PMC11070130 DOI: 10.1002/cncr.34922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/06/2023] [Accepted: 03/14/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Little is known about the risks and benefits of cannabis use in the context of cancer care. This study characterized the prevalence, reasons for use, and perceived benefits of cannabis and compared symptoms and perceived risks between those who reported past 30-day cannabis use and those who did not. METHODS Adults undergoing cancer treatment at a National Cancer Institute-designated cancer center completed measures of sociodemographic characteristics, cannabis use, use modalities, reasons for use, perceived harms/benefits of use, physical and psychological symptoms, and other substance/medication use. Analyses compared patients who used or did not use cannabis in the past 30 days. RESULTS Participants (N = 267) were 58 years old on average, primarily female (70%), and predominantly White (88%). Over a quarter of respondents (26%) reported past 30-day cannabis use, and among those, 4.5% screened positive for cannabis use disorder. Participants who used cannabis most often used edibles (65%) or smoked cannabis (51%), and they were younger and more likely to be male, Black, and disabled, and to have lower income and Medicaid insurance than participants who did not use cannabis. Those who used cannabis reported more severe symptoms and perceived cannabis as less harmful than those who did not use cannabis. The most common medical reasons for cannabis use were pain, cancer, sleep problems, anxiety, nausea/vomiting, and poor appetite. Participants reported the greatest cannabis-related symptom relief from sleep problems, nausea/vomiting, headaches, pain, muscle spasms, and anxiety. CONCLUSIONS Patients with cancer who used cannabis perceived benefits for many symptoms, although they showed worse overall symptomatology. PLAIN LANGUAGE SUMMARY Among adults undergoing cancer treatment, 26% reported cannabis use in the past 30 days. Those who used cannabis were more likely to be male and disabled and to have lower income and Medicaid insurance than those who did not use cannabis. Participants most commonly reported using cannabis for pain, cancer, sleep, anxiety, and nausea/vomiting and reported the greatest perceived benefits for sleep, nausea/vomiting, headaches, pain, muscle spasms, and anxiety, yet participants who used cannabis also reported feeling worse physically and psychologically compared to those who did not use cannabis. Participants who used cannabis were more likely to report that cannabis was less risky to their health than alcohol, smoking, and opioids than those who did not use cannabis.
Collapse
Affiliation(s)
- Desiree R. Azizoddin
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Amy M. Cohn
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Susanna V. Ulahannan
- Hematology‐Oncology Section, Department of Internal Medicine, Stephenson Cancer Center, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Christina E. Henson
- Department of Radiation Oncology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Adam C. Alexander
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kathleen N. Moore
- Gynecologic Oncology Section, Department of Obstetrics and Gynecology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Laura L. Holman
- Gynecologic Oncology Section, Department of Obstetrics and Gynecology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Laili Kharazi Boozary
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
- Cellular and Behavioral Neurobiology, Department of Psychology, The University of Oklahoma, Norman, Oklahoma, USA
| | - Munjireen S. Sifat
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Darla E. Kendzor
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| |
Collapse
|
30
|
Rotering T, Bialous S, Apollonio D. Cannabis industry campaign expenditures in Colorado, 2005-2021. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104156. [PMID: 37557020 DOI: 10.1016/j.drugpo.2023.104156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The cannabis industry has been described using the commercial determinants of health framework because it seeks to increase sales and profits through efforts to change the political environment. To increase understanding of these cannabis industry's efforts, this study describes cannabis industry campaign contributions in Colorado through an analysis of public records. METHODS We reviewed datasets posted online at the Colorado Secretary of State's Transparent in Contribution and Expenditure Reporting (TRACER) Campaign Finance System. We generated descriptive data on cannabis industry contributions to elections and conducted regressions to identify predictors of contributions, and associations between lagged contributions and a legislator's cannabis industry score (how closely aligned lawmaker's legislative history is with the cannabis industry from -1 to 1). RESULTS Between 2005-2021, 429 cannabis-affiliated contributors gave $4,658,385 (2021 inflation-adjusted) to 512 electoral committees. Contributions came primarily from non-profits (45%), businesses (27%), and individuals (25%). After recreational legalization in 2012, contributions from non-profit donors with industry ties gave way to contributions from cannabis businesses, business owners, and lobbyists. Cannabis industry contributions to local and state-wide ballot initiative campaigns historically made up the majority of the industry spending, but contributions to candidate committees more than tripled between the 2009-2010 legislative cycle and the 2019-2020 cycle. From 2017-2020, every $10,000 in lagged campaign donations from cannabis industry affiliated contributors was associated with a 0.245-point increase in a legislator's cannabis industry score (p=0.04). CONCLUSION Cannabis-affiliated interests made substantial campaign contributions in Colorado. Public health advocates should monitor industry connections to lawmakers and industry tactics used to mask the source of political contributions. Continued surveillance of the cannabis industry is essential to exposing conflicts of interest and preventing undue industry influence.
Collapse
Affiliation(s)
- Thomas Rotering
- Department of Clinical Pharmacy, University of California. UCSF Clinical Sciences Box 0622, 521 Parnassus Avenue, Floor 3 Room 3303, San Francisco, CA 94143, USA
| | - Stella Bialous
- School of Nursing, University of California. 490 Illinois St., Floor 12, Box 0612 San Francisco, CA 94143, USA
| | - Dorie Apollonio
- Department of Clinical Pharmacy, University of California. UCSF Clinical Sciences Box 0622, 521 Parnassus Avenue, Floor 3 Room 3303, San Francisco, CA 94143, USA.
| |
Collapse
|
31
|
Wingo E, Sarnaik S, Michel M, Hessler D, Frederiksen B, Kavanaugh ML, Dehlendorf C. The status of person-centered contraceptive care in the United States: Results from a nationally representative sample. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2023; 55:129-139. [PMID: 37654244 DOI: 10.1363/psrh.12245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
CONTEXT The Person-Centered Contraceptive Care measure (PCCC) evaluates patient experience of contraceptive counseling, a construct not represented within United States surveillance metrics of contraceptive care. We explore use of PCCC in a national probability sample and examine predictors of person-centered contraceptive care. METHODS Among 2228 women from the 2017-2019 National Survey of Family Growth who reported receiving contraceptive care in the last year, we conducted univariate and multivariable linear regression to identify associations between individual characteristics and PCCC scores. RESULTS PCCC scores were high (x ¯ : 17.84, CI: 17.59-18.08 on a 4-20 scale), yet varied across characteristics. In adjusted analyses, Hispanic identity with Spanish language primacy and non-Hispanic other or multiple racial identities were significantly associated with lower average PCCC scores compared to those of non-Hispanic white identity (B = -1.232 [-1.970, -0.493]; B = -0.792 [-1.411, -0.173]). Gay, lesbian, or bisexual identity was associated with lower average PCCC scores compared to heterosexual (B = -0.673 [-1.243, -0.103]). PCCC scores had a positive association with incomes of 150%-299% and ≥300% of the federal poverty level compared to those of income <150% (150%-299%: B = 0.669 [0.198, 1.141]; ≥300%: B = 0.892 [0.412, 1.372]). Cannabis use in the past year was associated with lower PCCC scores (B = -0.542 [-0.971, -0.113]). CONCLUSIONS The PCCC can capture differential experiences of contraceptive care to monitor patient experience and to motivate and track care quality over time. Differences in reported quality of care have implications for informing national priorities for contraceptive care improvements.
Collapse
Affiliation(s)
- Erin Wingo
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Shashi Sarnaik
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Martha Michel
- Health Service Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
| | - Danielle Hessler
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | | | - Christine Dehlendorf
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
32
|
Sedani AE, Campbell JE, Beebe LA. Cannabis use among cancer survivors in 22 states: Results from the Behavioral Risk Factor Surveillance System, 2020. Cancer 2023; 129:2499-2513. [PMID: 37029457 DOI: 10.1002/cncr.34793] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND This study identified factors associated with recent cannabis use and cannabis use for medical purposes among cancer survivors relative to individuals without a history of cancer. METHODS Data from the Behavioral Risk Factor Surveillance System were analyzed for the 22 states completing the optional cannabis module in 2020. Weighted multiple logistic regression was performed to explore variables associated with past 30-day cannabis use and cannabis use for medical purposes, stratified by history of cancer. Covariates included state-level cannabis policy, sociodemographic characteristics, health status indicators, and substance use. RESULTS Cannabis use was lower among cancer survivors compared to individuals with no history of cancer (7.57% vs. 10.83%). However, a higher proportion of cancer survivors reported use for medical purposes (82.23% vs. 62.58%). After adjusting for state-level policy, biological sex, age, educational attainment, self-reported race/ethnicity, home ownership, mental health status and physical health status, current smoking (odds ratio [OR], 5.14 vs. 3.74) and binge drinking (OR, 2.71 vs. 2.69) were associated with cannabis use in both groups. Characteristics associated with medical cannabis use varied for the two groups; however, daily use (20-30 days; OR, 1.72 vs. 2.43) was associated with cannabis use for medical purposes in both groups after adjusting for other variables in the model. CONCLUSIONS A high proportion of individuals report cannabis use for medical purposes with higher rates among cancer survivors. Findings support the urgent need for ongoing cannabis research to better understand and inform its use for medical purposes, as well as the development of high-quality standardized education materials and clinical practice guidelines.
Collapse
Affiliation(s)
- Ami E Sedani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| |
Collapse
|
33
|
Tavabi N, Raza M, Singh M, Golchin S, Singh H, Hogue GD, Kiapour AM. Disparities in cannabis use and documentation in electronic health records among children and young adults. NPJ Digit Med 2023; 6:138. [PMID: 37553423 PMCID: PMC10409778 DOI: 10.1038/s41746-023-00885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 07/26/2023] [Indexed: 08/10/2023] Open
Abstract
The legalizations of medical and recreational cannabis have generated a great deal of interest in studying the health impacts of cannabis products. Despite increases in cannabis use, its documentation during clinical visits is not yet mainstream. This lack of information hampers efforts to study cannabis's effects on health outcomes. A clear and in-depth understanding of current trends in cannabis use documentation is necessary to develop proper guidelines to screen and document cannabis use. Here we have developed and used a natural language processing pipeline to evaluate the trends and disparities in cannabis documentation. The pipeline includes a screening step to identify clinical notes with cannabis use documentation which is then fed into a BERT-based classifier to confirm positive use. This pipeline is applied to more than 23 million notes from a large cohort of 370,087 patients seen in a high-volume multi-site pediatric and young adult clinic over a period of 21 years. Our findings show a very low but growing rate of cannabis use documentation (<2%) in electronic health records with significant demographic and socioeconomic disparities in both documentation and positive use, which requires further attention.
Collapse
Affiliation(s)
- Nazgol Tavabi
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Marium Raza
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mallika Singh
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Shahriar Golchin
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Computer Science, University of Arizona, Tucson, USA
| | - Harsev Singh
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Grant D Hogue
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ata M Kiapour
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
34
|
Rhew IC, Le VT, Ramirez JJ, Fleming CB, Kilmer JR, Delawalla ML, Hultgren BA, Lee CM, Larimer ME, Guttmannova K. The association between cannabis use and risk of non-medical pain reliever misuse onset among young adults in a legal cannabis context. Addict Behav 2023; 143:107711. [PMID: 37011567 PMCID: PMC10168644 DOI: 10.1016/j.addbeh.2023.107711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Little is known about the prospective relationship between cannabis use and pain reliever misuse. This study examined associations of non-medical and medical cannabis use with onset of non-medical pain reliever misuse among young adults in Washington State (WA), where non-medical cannabis is legal. METHODS Data were from a cohort-sequential study of adults 18-25 residing in WA. Four annual surveys were used from cohorts recruited in 2014, 2015, and 2016. Participants who had not reported non-medical pain reliever misuse at baseline were included in discrete time survival analyses (N = 4,236). Odds ratios (ORs) were estimated for new onset of non-medical pain reliever misuse in any given follow-up year over the course of three years according to baseline non-medical and medical cannabis use. RESULTS When included separately in models, non-medical and medical cannabis use at baseline were associated with increased risk of non-medical pain reliever misuse adjusting for demographic characteristics as well as past year cigarette use and alcohol use (non-medical OR = 5.27; 95 % CI: 3.28, 8.48; medical OR = 2.21; 95 % CI: 1.39, 3.52). Including both forms of use in the model, associations of non-medical and medical cannabis use with non-medical pain reliever misuse onset remained (non-medical OR = 4.64; 95 % CI: 2.88, 7.49; medical OR = 1.65; 95 % CI: 1.04, 2.62). CONCLUSIONS Despite claims that cannabis use may reduce opioid use and related harms, findings suggest that cannabis use, including medical use, may not be protective, but instead may increase risk for non-medical pain reliever misuse.
Collapse
|
35
|
Leng QL, Lo JO, Rakshe S, Hildebrand AD, Doyle OJ, Seghete KM, Graham A. The association between preconception cannabis use and depression and anxiety during pregnancy. Gen Hosp Psychiatry 2023; 83:148-155. [PMID: 37196406 PMCID: PMC10428863 DOI: 10.1016/j.genhosppsych.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Cannabis use among individuals of reproductive age has increased with cannabis legalization and heightened stress during the COVID-19 pandemic. Our study provides data on preconception cannabis use and cannabis use disorder (CUD) during the pandemic and models the association between preconception cannabis use and depression and anxiety during pregnancy. METHODS Data on substance use and depression and anxiety symptoms were collected from questionnaires and the Structured Clinical Interview for DSM-5 (SCID-5) from pregnant individuals in Oregon in 2019-2022. Linear regression was used to model the association between the frequency of preconception cannabis use and scores on the Center for Epidemiological Studies of Depression-Revised (CESD-R) and Beck Anxiety Inventory (BAI). RESULTS The prevalence of preconception cannabis use was 27.8% among 227 study participants. CUD was diagnosed in 19% of cannabis users, or 5.3% of the overall sample. Daily cannabis use, compared to rare/never use, was associated with increases in CESD-R (β = 6.22, p 0.029) and BAI (β = 4.71, p 0.045) scores. CONCLUSIONS Cannabis use and CUD are common among individuals of reproductive age. Given the association between preconception cannabis use and depression and anxiety during pregnancy, more attention is needed on screening and counseling of cannabis use among people of reproductive age.
Collapse
Affiliation(s)
- Qian Liya Leng
- Center for Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR, USA.
| | - Jamie O Lo
- Department of Obstetrics and Gynecology, Oregon Health & Science University; Portland, OR, USA
| | - Shauna Rakshe
- Knight Cancer Institute Biostatistics Shared Resource and OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Andrea D Hildebrand
- Biostatistics & Design Program, OHSU/PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Olivia J Doyle
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | | | - Alice Graham
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
36
|
Lake S, Haney M, Cooper ZD. Sex differences in the subjective and reinforcing effects of smoked cannabis. Addict Biol 2023; 28:e13301. [PMID: 37369126 PMCID: PMC10300354 DOI: 10.1111/adb.13301] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/07/2023] [Accepted: 04/30/2023] [Indexed: 06/29/2023]
Abstract
Preclinical studies have shown sex-based differences in the reinforcing effects of cannabinoid 1 receptor agonists such as delta-9-tetrahydrocannabinol (THC). This study sought to test whether these sex differences translate to humans by assessing the subjective and reinforcing effects of smoked cannabis in male and female volunteers. We pooled data (n = 68; 55M, 13F) from two within-subject randomized controlled trials of healthy, ≥weekly cannabis users comparing the subjective and reinforcing effects of smoked active (~25 mg THC) versus placebo cannabis (0-mg THC). Subjective ratings of drug effects and mood were measured using visual analogue scales, and reinforcing effects were measured with a cannabis self-administration task. Sex-dependent outcomes were explored using generalized linear mixed models. Under active cannabis conditions, female participants reported greater reductions from baseline in cannabis craving and significantly higher cannabis-specific ratings of strength, liking, willingness to take again and good effect, compared with males (interaction p < 0.05). Placebo and active cannabis were self-administered by 22% and 36% of male participants, respectively, and by 15% and 54% of female participants, respectively. Receipt of active cannabis significantly increased likelihood of self-administration (p = 0.011), but a sex difference was not detected (p = 0.176). Although females were more sensitive to certain positive subjective effects of active cannabis, they were not more likely than males to self-administer it. These findings highlight the need to test sex differences as a primary objective in experimental studies and may shed light on accelerated trajectories from initiation to cannabis use disorder observed among women.
Collapse
Affiliation(s)
- Stephanie Lake
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Suite 38-418, Los Angeles, CA, 90095
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095
| | - Margaret Haney
- Department of Psychiatry, Division on Substance Use Disorders, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 120, New York, NY, 10032
| | - Ziva D. Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Suite 38-418, Los Angeles, CA, 90095
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, 757 Westwood Plaza, Suite 3325, Los Angeles, CA, 90095
| |
Collapse
|
37
|
Lee JO, Lee WJ, Kritikos AF, Jin H, Leventhal AM, Pedersen ER, Cho J, Davis JP, Kapteyn A, Wilson JP, Pacula RL. Regular Cannabis Use During the First Year of the Pandemic: Studying Trajectories Rather Than Prevalence. Am J Prev Med 2023; 64:888-892. [PMID: 36805369 PMCID: PMC10200732 DOI: 10.1016/j.amepre.2023.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Cannabis use in the U.S. rose early in the COVID-19 pandemic, but it is unclear whether that rise was temporary or permanent. This study estimated the nature and sociodemographic correlates of U.S. adult subpopulations regularly using cannabis by examining weekly trajectories of use during the first year of the pandemic. METHODS Data came from the Understanding America Study, a nationally representative panel of U.S. adults (N=8,397; March 10, 2020-March 29, 2021). A growth mixture model was deployed to identify subgroups with similar regular cannabis use. Sociodemographic correlates of subgroups were examined using multinomial logistic regression. RESULTS Four cannabis-use groups were identified. Most participants did not regularly use cannabis (no regular use; 81.7%). The other groups increased regular use until April 2020 but then diverged. Some (7.1%) decreased thereafter, whereas others (3.4%) maintained their elevated use until October 26, 2020 before decreasing. The last group (7.7%) sustained their elevated use throughout. Individuals aged between 18 and 39 years, unmarried, living in poverty, without a college degree, and with longer unemployment or underemployment spells had higher odds of being in the other groups with more weekly use than in the no-regular-use group. CONCLUSIONS The analyses revealed population subgroups with prolonged regular cannabis use and a disproportionate concentration of socioeconomically vulnerable members of society in these subgroups. These findings elucidate important heterogeneity in the subpopulations using cannabis, highlighting the urgent need to tailor public health programs for subgroups that may have unique service needs.
Collapse
Affiliation(s)
- Jungeun Olivia Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California; Institute for Addiction Science, University of Southern California, Los Angeles, California.
| | - Woo Jung Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Alexandra F Kritikos
- Leonard D. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California
| | - Haomiao Jin
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Eric R Pedersen
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Junhan Cho
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California; Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Arie Kapteyn
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, California
| | - John P Wilson
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California; Dornsife Spatial Sciences Institute, University of Southern California, Los Angeles, California; Department of Civil and Environmental Engineering and Computer Science, Viterbi School of Engineering and Computing, University of Southern California, Los Angeles, California; Department of Sociology, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California; School of Architecture, University of Southern California, Los Angeles, California
| | - Rosalie L Pacula
- Institute for Addiction Science, University of Southern California, Los Angeles, California; Leonard D. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California
| |
Collapse
|
38
|
Gräfe EL, Reid HMO, Shkolnikov I, Conway K, Kit A, Acosta C, Christie BR. Women are Taking the Hit: Examining the Unique Consequences of Cannabis Use Across the Female Lifespan. Front Neuroendocrinol 2023; 70:101076. [PMID: 37217080 DOI: 10.1016/j.yfrne.2023.101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
Cannabis use has risen dramatically in recent years due to global decriminalization and a resurgence in the interest of potential therapeutic benefits. While emerging research is shaping our understanding of the benefits and harms of cannabis, there remains a paucity of data specifically focused on how cannabis affects the female population. The female experience of cannabis use is unique, both in the societal context and because of the biological ramifications. This is increasingly important given the rise in cannabis potency, as well as the implications this has for the prevalence of Cannabis Use Disorder (CUD). Therefore, this scoping review aims to discuss the prevalence of cannabis use and CUD in women throughout their lifespan and provide a balanced prospective on the positive and negative consequences of cannabis use. In doing so, this review will highlight the necessity for continued research that goes beyond sex differences.
Collapse
Affiliation(s)
- E L Gräfe
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - H M O Reid
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - I Shkolnikov
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - K Conway
- Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - A Kit
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - C Acosta
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - B R Christie
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada; Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada.
| |
Collapse
|
39
|
Wu JH, Radha Saseendrakumar B, Moghimi S, Sidhu S, Kamalipour A, Weinreb RN, Baxter SL. Epidemiology and factors associated with cannabis use among patients with glaucoma in the All of Us Research Program. Heliyon 2023; 9:e15811. [PMID: 37215923 PMCID: PMC10192773 DOI: 10.1016/j.heliyon.2023.e15811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/09/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose To examine the epidemiology and factors of cannabis use among open-angle glaucoma (OAG) patients. Methods In this cross-sectional study, OAG participants in the All of Us database were included. Cannabis ever-users were defined based on record of cannabis use. Demographic and socioeconomic data were collected and compared between cannabis ever-users and never-users using Chi-Square tests and logistic regression. Odds ratios (OR) of potential factors associated with cannabis use were examined in univariable and multivariable models. Results Among 3723 OAG participants, 1436 (39%) were cannabis ever-users. The mean (SD) age of never-users and ever-users was 72.9 (10.4) and 69.2 (9.6) years, respectively (P < 0.001). Compared to never-users, Black (34%) and male (55%) participants were better represented in ever-users, while Hispanic or Latino participants (6%) were less represented (P < 0.001). Diversity was also observed in socioeconomic characteristics including marital status, housing security, and income/education levels. A higher percentage of ever-users had a degree ≥12 grades (91%), salaried employment (26%), housing insecurity (12%), and history of cigar smoking (48%), alcohol consumption (96%), and other substance use (47%) (P < 0.001). In the multivariable analysis, Black race (OR [95% CI] = 1.33 [1.06, 1.68]), higher education (OR = 1.19 [1.07, 1.32]), and history of nicotine product smoking (OR: 2.04-2.83), other substance use (OR = 8.14 [6.63, 10.04]), and alcohol consumption (OR = 6.80 [4.45, 10.79]) were significant factors associated with cannabis use. Increased age (OR = 0.96 [0.95, 0.97]), Asian race (OR = 0.18 [0.09, 0.33]), and Hispanic/Latino ethnicity (OR = 0.43 [0.27, 0.68]) were associated with decreased odds of use (P < 0.02). Conclusions This study elucidated the previously uncharacterized epidemiology and factors associated with cannabis use among OAG patients, which may help to identify patients requiring additional outreach on unsupervised marijuana use.
Collapse
Affiliation(s)
- Jo-Hsuan Wu
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Bharanidharan Radha Saseendrakumar
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sophia Sidhu
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Robert N. Weinreb
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sally L. Baxter
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
40
|
Mattingly DT, Neighbors HW, Mezuk B, Elliott MR, Fleischer NL. Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 148:208958. [PMID: 37102192 PMCID: PMC11184515 DOI: 10.1016/j.josat.2023.208958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/11/2022] [Accepted: 01/09/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. METHODS We used cross-sectional data on adults (18+) from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0-24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). RESULTS Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07-1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12-1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. CONCLUSIONS Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations.
Collapse
Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Harold W Neighbors
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| |
Collapse
|
41
|
Hasin DS, Borodovsky J, Shmulewitz D, Walsh C, Struble CA, Livne O, Habib MI, Fink DS, Aharonovich E, Budney A. Adult use of highly-potent Δ9-THC cannabis concentrate products by U.S. state cannabis legalization status, 2021. Addict Behav 2023; 140:107617. [PMID: 36736229 PMCID: PMC9930475 DOI: 10.1016/j.addbeh.2023.107617] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Compared to plant/flower cannabis products, cannabis concentrates have higher average potency of delta-9-tetrahydrocannabinol (Δ9-THC), which may be associated with greater likelihood of cannabis-related harms. Information on factors associated with use of cannabis concentrates is needed. METHODS Respondents were 4,328 adult past-7-day cannabis users from all 50 U.S. states and Washington DC (DC) who participated in an online 2021 survey. Using logistic regression to generate adjusted odds ratios (aOR), we investigated whether participants in states that enacted recreational cannabis laws (RCL, 12 states plus DC [treated as a state], n = 1,236) or medical cannabis laws (MCL-only, 23 states, n = 2,030) by December 31, 2020 were more likely than those in states without cannabis laws (no-CL, 15 states, n = 1,062) to use cannabis concentrate products in the prior 7 days. RESULTS Most participants (92.4%) used plant material in the prior 7 days; 57.0% used cannabis concentrates. In RCL, MCL and no-CL states, concentrate use was reported by 61.5%, 56.6%, and 52.5%, respectively. Compared to participants in no-CL states, odds of using cannabis concentrate products were greater among those in RCL states (aOR = 1.47; CI = 1.17-1.84) and MCL-only states (aOR = 1.29; CI = 1.08-1.55). Whether states had legally-authorized dispensaries had little effect on results. CONCLUSION Results suggest that individuals in MCL-only and RCL states are more likely to use cannabis concentrate products. Determining mechanisms underlying these results, e.g., commercialization, could provide important information for prevention. Clinicians should be alert to patient use of concentrates, especially in MCL-only and RCL states. Continued monitoring is warranted as additional states legalize cannabis use.
Collapse
Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168(th) St, New York, NY 10032, USA.
| | - Jacob Borodovsky
- Department of Psychiatry, Dartmouth Geisel School of Medicine, One Medical Center Drive, Lebanon, NH 03756, USA.
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Claire Walsh
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Cara A Struble
- Department of Psychiatry, Dartmouth Geisel School of Medicine, One Medical Center Drive, Lebanon, NH 03756, USA.
| | - Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Mohammad I Habib
- Department of Psychiatry, Dartmouth Geisel School of Medicine, One Medical Center Drive, Lebanon, NH 03756, USA.
| | - David S Fink
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Alan Budney
- Department of Psychiatry, Dartmouth Geisel School of Medicine, One Medical Center Drive, Lebanon, NH 03756, USA.
| |
Collapse
|
42
|
González-Roz A, Martínez-Loredo V, Aston ER, Metrik J, Murphy J, Balodis I, Secades-Villa R, Belisario K, MacKillop J. Concurrent validity of the marijuana purchase task: a meta-analysis of trait-level cannabis demand and cannabis involvement. Addiction 2023; 118:620-633. [PMID: 36305652 PMCID: PMC10020890 DOI: 10.1111/add.16075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta-analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement. METHODS Electronic databases and pre-print repositories were searched for MPT studies that examined the cross-sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta-analyses of cross-sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta-regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples. RESULTS The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax , and elasticity showed the most robust concurrent validity (|r's| = 0.147-325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity-quantity and Pmax -problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed. CONCLUSIONS The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax , and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis.
Collapse
Affiliation(s)
- Alba González-Roz
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Providence VA Medical Center, Providence, RI, USA
| | - James Murphy
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Iris Balodis
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Roberto Secades-Villa
- Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| |
Collapse
|
43
|
Benny C, Steele BJ, Patte KA, Leatherdale ST, Pabayo R. Income inequality and daily use of cannabis, cigarettes, and e-cigarettes among Canadian secondary school students: Results from COMPASS 2018-19. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104014. [PMID: 37003193 DOI: 10.1016/j.drugpo.2023.104014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/24/2023] [Accepted: 03/16/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Cannabis, cigarette, and e-cigarette use among Canadian adolescents is a major public health concern. Income inequality has been associated with adverse mental health among youth and may contribute to the risk of frequent cannabis, cigarette, and e-cigarette use. We tested the association between income inequality and the risk of daily cannabis, cigarette, and e-cigarette use among Canadian secondary school students. METHODS We used individual-level survey data from Year 6 (2018/19) of Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary Behavior (COMPASS) and area-level data from the 2016 Canadian Census. Three-level logistic models were used to assess the relationship between income inequality and adolescent daily and current cannabis use, cigarette smoking, and e-cigarette use. RESULTS The analytic sample included 74,501 students aged 12-19. Students were most likely to report being male (50.4%), white (69.1%), and having weekly spending money over $100 (23.5%). We found that a standard deviation unit increase in Gini coefficient was significantly associated with increased likelihood of daily cannabis use (OR=1.25, 95% CI = 1.01-1.54) when adjusting for relevant covariates. We found no significant relationship between income inequality and daily smoking. While Gini was not significantly associated with daily e-cigarette use, we observed a significant interaction between Gini and gender (OR=0.87, 95% CI= 0.80-0.94), indicating that increased income inequality was associated with higher risk of reporting daily e-cigarette use among females only. DISCUSSION An association between income inequality and the likelihood of reporting daily cannabis use across all students and daily e-cigarette use in females were observed. Schools in higher income inequality areas may benefit from targeted prevention and harm reduction programs. Results emphasize the need for upstream discussion on policies that can mitigate the potential effects income inequality.
Collapse
Affiliation(s)
- Claire Benny
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, T6G 1C9 Edmonton, Alberta, Canada.
| | - Brian J Steele
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, T6G 1C9 Edmonton, Alberta, Canada
| | - Karen A Patte
- Brock University Department of Health Sciences, 1812 Sir Isaac Brock Way, L2S 3A1 St. Catharines, Ontario, Canada
| | - Scott T Leatherdale
- University of Waterloo School of Public Health Sciences, 200 University Ave West, TJB 2317, N2L 3G1 Waterloo, Ontario, Canada
| | - Roman Pabayo
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, T6G 1C9 Edmonton, Alberta, Canada
| |
Collapse
|
44
|
Zaman T, Bravata DM, Byers AL, Krebs EE, Leonard SJ, Sandbrink F, Barker W, Keyhani S. A national population-based study of cannabis use and correlates among U.S. veterans prescribed opioids in primary care. BMC Psychiatry 2023; 23:177. [PMID: 36927526 PMCID: PMC10021973 DOI: 10.1186/s12888-023-04648-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Cannabis is marketed as a treatment for pain. There is limited data on the prevalence of cannabis use and its correlates among Veterans prescribed opioids. OBJECTIVE To examine the prevalence and correlates of cannabis use among Veterans prescribed opioids. DESIGN Cross-sectional study. PARTICIPANTS Veterans with a urine drug test (UDT) from Primary Care 2014-2018, in 50 states, Washington, D.C., and Puerto Rico. A total of 1,182,779 patients were identified with an opioid prescription within 90 days prior to UDT. MAIN MEASURES Annual prevalence of cannabis positive UDT by state. We used multivariable logistic regression to assess associations of demographic factors, mental health conditions, substance use disorders, and pain diagnoses with cannabis positive UDT. RESULTS Annual prevalence of cannabis positive UDT ranged from 8.5% to 9.7% during the study period, and in 2018 was 18.15% in Washington, D.C. and 10 states with legalized medical and recreational cannabis, 6.1% in Puerto Rico and 25 states with legalized medical cannabis, and 4.5% in non-legal states. Younger age, male sex, being unmarried, and marginal housing were associated with use (p < 0.001). Post-traumatic stress disorder (adjusted odds ratio [AOR] 1.17; 95% confidence interval [CI] 1.13-1.22, p < 0.001), opioid use disorder (AOR 1.14; CI 1.07-1.22, p < 0.001), alcohol use disorder or positive AUDIT-C (AOR 1.34; 95% CI 1.28-1.39, p < 0.001), smoking (AOR 2.58; 95% CI 2.49-2.66, p < 0.001), and other drug use disorders (AOR 1.15; 95% CI 1.03-1.29, p = 0.02) were associated with cannabis use. Positive UDT for amphetamines AOR 1.41; 95% CI 1.26-1.58, p < 0.001), benzodiazepines (AOR 1.41; 95% CI 1.31-1.51, p < 0.001) and cocaine (AOR 2.04; 95% CI 1.75-2.36, p < 0.001) were associated with cannabis positive UDT. CONCLUSIONS Cannabis use among Veterans prescribed opioids varied by state and by legalization status. Veterans with PTSD and substance use disorders were more likely to have cannabis positive UDT. Opioid-prescribed Veterans using cannabis may benefit from screening for these conditions, referral to treatment, and attention to opioid safety.
Collapse
Affiliation(s)
- Tauheed Zaman
- Addiction Recovery and Treatments Services, San Francisco VA Health Care System, San Francisco, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
| | - Dawn M Bravata
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Departments of Medicine and Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amy L Byers
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
- San Francisco VA Medical Center, San Francisco, CA, USA
| | - Erin E Krebs
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Samuel J Leonard
- Northern California Institute for Research and Education, San Francisco, CA, USA
| | - Friedhelm Sandbrink
- National Pain Management, Opioid Safety and Prescription Drug Monitoring Program, Veterans Health Administration, Washington, DC, USA
- Department of Neurology, George Washington University, Washington, DC, USA
| | - Wylie Barker
- Northern California Institute for Research and Education, San Francisco, CA, USA
| | - Salomeh Keyhani
- Department of Medicine, University of California, San Francisco, CA, USA
- San Francisco VA Medical Center, San Francisco, CA, USA
| |
Collapse
|
45
|
Toscano A, Ebo DG, Abbas K, Brucker H, Decuyper II, Naimi D, Nanda A, Nayak AP, Skypala IJ, Sussman G, Zeiger JS, Silvers WS. A review of cannabis allergy in the early days of legalization. Ann Allergy Asthma Immunol 2023; 130:288-295. [PMID: 36384984 PMCID: PMC9991982 DOI: 10.1016/j.anai.2022.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022]
Abstract
Cannabis allergy is a burgeoning field; consequently, research is still in its infancy and allergists' knowledge surrounding this topic is limited. As cannabis legalization expands across the world, it is anticipated that there will be an increase in cannabis use. Thus, we hypothesize that a concomitant rise in the incidence of allergy to this plant can be expected. Initiatives aimed at properly educating health care professionals are therefore necessary. This review presents the most up-to-date information on a broad range of topics related to cannabis allergy. Although the clinical features of cannabis allergy are becoming more well described and recognized, the tools available to make a correct diagnosis are meager and often poorly accessible. In addition, research on cannabis allergy is still taking its first steps, and new and potentially groundbreaking findings in this field are expected to occur in the next few years. Finally, although therapeutic approaches are being developed, patient and physician education regarding cannabis allergy is certainly needed.
Collapse
Affiliation(s)
- Alessandro Toscano
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Post-Graduate School of Allergology and Clinical Immunology, University of Milan, Milan, Italy.
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Khaldon Abbas
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Ine I Decuyper
- Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - David Naimi
- Naval Hospital Camp Pendleton, Oceanside, California
| | - Anil Nanda
- Asthma and Allergy Center, Lewisville and Flower Mound, Dallas, Texas; Division of Allergy and Immunology, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ajay P Nayak
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Isabel J Skypala
- Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Gordon Sussman
- Department of Medicine and Division of Clinical Immunology & Allergy, University of Toronto, Toronto, Ontario, Canada
| | | | | |
Collapse
|
46
|
Imtiaz S, Nigatu YT, Ali F, Douglas L, Hamilton HA, Rehm J, Rueda S, Schwartz RM, Wells S, Elton-Marshall T. Cannabis legalization and cannabis use, daily cannabis use and cannabis-related problems among adults in Ontario, Canada (2001-2019). Drug Alcohol Depend 2023; 244:109765. [PMID: 36652851 DOI: 10.1016/j.drugalcdep.2023.109765] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/28/2022] [Accepted: 12/24/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND In the context of cannabis legalization in Canada, we examined the effects on cannabis patterns of consumption, including cannabis use, daily cannabis use and cannabis-related problems. In addition, we examined differential effects of cannabis legalization by age and sex. METHODS A pre-post design was operationalized by combining 19 iterations of the Centre for Addiction and Mental Health (CAMH) Monitor Surveys (N = 52,260; 2001-2019): repeated, population-based, cross-sectional surveys of adults in Ontario. Participants provided self-reports of cannabis use (past 12 months), daily cannabis use (past 12 months) and cannabis-related problems though telephone interviews. The effects of cannabis legalization on cannabis patterns of consumption were examined using logistic regression analyses, with testing of two-way interactions to determine differential effects by age and sex. RESULTS Cannabis use prevalence increased from 11 % to 26 % (p < 0.0001), daily cannabis use prevalence increased from 1 % to 6 % (p < 0.0001) and cannabis-related problems prevalence increased from 6 % to 14 % (p < 0.0001) between 2001 and 2019. Cannabis legalization was associated with an increased likelihood of cannabis use (OR, 95 % CI: 1.62, 1.40-1.86), daily cannabis use (1.59, 1.21-2.07) and cannabis-related problems (1.53, 1.20-1.95). For cannabis-related problems, a significant two-way interaction was observed between cannabis legalization and age (p = 0.0001), suggesting differential effects among adults ≥55 years. CONCLUSIONS Cannabis legalization was associated with an increased likelihood of cannabis use, daily cannabis use and cannabis-related problems. Given increases in these cannabis patterns of consumption, broader dissemination and uptake of targeted prevention tools is indicated.
Collapse
Affiliation(s)
- Sameer Imtiaz
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Yeshambel T Nigatu
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Farihah Ali
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Laura Douglas
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Hayley A Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Room 2374, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, B. 2, 119992 Moscow, Russian Federation.
| | - Sergio Rueda
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
| | - Robert M Schwartz
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada.
| | - Samantha Wells
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, London, Ontario N6A 5C1, Canada; School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia.
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario M5T 3M7, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, London, Ontario N6A 5C1, Canada; Department of Health Sciences, Lakehead University, SN 1006, 955 Oliver Road, Thunder Bay, Ontario P7B 5E1, Canada.
| |
Collapse
|
47
|
Gimm G, Parekh T, Kitsantas P. Assessing the prevalence and risk factors of marijuana use in adults with disabilities. Addict Behav 2023; 138:107559. [PMID: 36459827 DOI: 10.1016/j.addbeh.2022.107559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/09/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Public support for the legalization of marijuana (cannabis) for medical or recreational use by adults has grown rapidly over the past two decades. Given the growing prevalence and concerns about potential harms, a better understanding is needed of disparities in marijuana use among adults by disability status. METHODS Using 2015-2019 data from the National Survey on Drug Use and Health (NSDUH), we obtained a national sample of 195,130 working-age (18-64 year) adults. Descriptive and multivariable analyses were conducted to assess the prevalence and risk factors associated with marijuana use among adults by disability status and type. RESULTS We found the prevalence of marijuana use was higher among adults with disabilities (16.6% vs 10.9%) compared to those without disabilities, and this disparity widened from 2015 to 2019. Furthermore, the odds of marijuana use varied by disability type. Specifically, adults with vision disability only (OR 1.28; 95% CI 1.14-1.44), cognitive disability only (OR 1.24; 95% CI 1.13-1.35), and those with multiple disabilities (OR 1.22; 95% CI 1.11-1.34) had higher odds of marijuana use compared to adults without any disability. CONCLUSIONS Adults with disabilities have a higher prevalence of marijuana use compared to those without disabilities. Living in a state with legalized medical marijuana also increased the odds of marijuana use. These findings can help to inform policy and public health surveillance of marijuana use in the U.S. Further studies are needed to monitor the rising prevalence of marijuana use and examine how intensity of marijuana use affects health outcomes in adults with and without disabilities.
Collapse
Affiliation(s)
- Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, United States.
| | - Tarang Parekh
- Department of Health Administration and Policy, George Mason University, United States
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, United States
| |
Collapse
|
48
|
Clendennen SL, Smith J, Sumbe A, Chen B, Wilkinson AV, Harrell MB. Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes. Subst Use Misuse 2023; 58:591-600. [PMID: 36912516 PMCID: PMC10155290 DOI: 10.1080/10826084.2023.2177110] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes. METHODS Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES. RESULTS Participants were 16-23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later. CONCLUSIONS Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.
Collapse
Affiliation(s)
- Stephanie L. Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Jacob Smith
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
- The University of Texas Rio Grande Valley School of Medicine, 1201 West University Dr., Edinburg, Texas 78541, USA
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Baojiang Chen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Anna V. Wilkinson
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| |
Collapse
|
49
|
Scott JC. Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development. Child Adolesc Psychiatr Clin N Am 2023; 32:21-42. [PMID: 36410904 DOI: 10.1016/j.chc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.
Collapse
Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, 5th Floor, Philadelphia, PA 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.
| |
Collapse
|
50
|
Hajjar ER, Lungen JM, Worster BK. Therapeutic Benefits of Medical Cannabis. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|