1
|
Wallace AL, Courtney KE, Wade NE, Doran N, Delfel EL, Baca R, Hatz LE, Thompson C, Andrade G, Jacobus J. A preliminary investigation of physical and mental health features of cannabis & nicotine co-use among adolescents and young adults by sex. Addict Behav 2024; 156:108064. [PMID: 38821010 DOI: 10.1016/j.addbeh.2024.108064] [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: 11/27/2023] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
INTRODUCTION Cannabis and nicotine/tobacco products (NTP) are commonly co-used in adolescence and young adulthood; however, limited research has been done on predictive health behaviors to co-use. The current study is a preliminary investigation into the relationships of modifiable health behaviors on cannabis and NTP co-use in adolescents and young adults. METHOD 221 participants (ages 16-22) were characterized into cannabis use only (N = 55), NTP use only (N = 20), cannabis and NTP co-use (used cannabis and NTP; N = 96) and control (no use; N = 50) groups based on past 30-day use. Self-report measures for physical activity, sleep quality, mental health, and reward responsivity were utilized. Participants were given a comprehensive neurocognitive battery. Logistic regressions of self-report measures and fluid intelligence composite scores on substance use group status were run stratified by sex. RESULTS Higher approach reward sensitivity traits were associated with increased likelihood of cannabis use only (Odds Ratio (OR) = 1.15, p = .036) in female participants. Increased aerobic activity was associated with decreased likelihood of cannabis use only (OR = 0.91, p = .047) and cannabis and NTP co-use (OR = 0.88, p = .007) in female participants. Higher anxiety was associated with increased likelihood of cannabis NTP co-use (OR = 1.51, p = 0.025) in male participants. DISCUSSION Several health behaviors were linked with cannabis use and cannabis and NTP co-use in both females and male adolescents and young adults. Health markers differed by sex suggesting differing mechanisms of substance co-use. This study informs targetable health behaviors for prevention and intervention efforts.
Collapse
Affiliation(s)
- Alexander L Wallace
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Kelly E Courtney
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Natasha E Wade
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Neal Doran
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA; Psychology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Everett L Delfel
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA; SDSU / UC San Diego Joint Doctoral Program in Clinical Psychology, USA
| | - Rachel Baca
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Laura E Hatz
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Courtney Thompson
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Gianna Andrade
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Joanna Jacobus
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA.
| |
Collapse
|
2
|
McArthur JC, Stitt DW. Neurological Aspects of Substance Use Disorder: An Introduction. Semin Neurol 2024; 44:414-418. [PMID: 39013393 DOI: 10.1055/s-0044-1787551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Affiliation(s)
- Justin C McArthur
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Derek W Stitt
- Division of Neurology Education, Department of Neurology, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
3
|
Goodman S, Dann MJ, Fataar F, Abramovici H. How have cannabis use and related indicators changed since legalization of cannabis for non-medical purposes? Results of the Canadian Cannabis Survey 2018-2022. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104385. [PMID: 38520961 DOI: 10.1016/j.drugpo.2024.104385] [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: 09/18/2023] [Revised: 02/20/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Cannabis use for non-medical purposes was legalized and regulated in Canada through the Cannabis Act in October 2018. This paper examined trends in use of cannabis for non-medical purposes and related indicators from pre- to post-legalization in Canada (2018-2022). METHODS Data from 5 years of the Canadian Cannabis Survey, an annual web-based survey administered to Canadians 16 years of age or older, were used in the analysis (n2018=12,952; n2019=11,922; n2020=10,821; n2021=10,733; n2022=10,048). Cannabis measures include questions about use, types of products, sources, risk perceptions and beliefs, and exposure to public education campaigns and health warnings. Adjusted logistic regression models tested differences in outcomes over time. RESULTS Past 12-month cannabis consumption increased among Canadians from 22 % in 2018 to 27 % in 2022 (AOR=1.41;99 % CI:1.28-1.54). Similarly, daily/almost daily (DAD) consumption increased from 5 % in 2018 to 7 % in 2022 (AOR=1.36;99 % CI:1.16-1.59). Consumption of dried flower, hash/kief, and concentrates/extracts (e.g., wax, shatter, budder) decreased since 2018, whereas consumption of edibles, beverages and vape pens/cartridges increased (p < 0.001). Legal purchasing increased from 4 % in 2018 to 69 % in 2022, while accessing cannabis through social and illegal sources decreased over time (p < 0.001). CONCLUSION More Canadians are reporting cannabis consumption since legalization and regulation of cannabis for non-medical purposes, continuing a pre-existing trend despite an increase in awareness of the risks of consuming cannabis. Trends in product use indicate a transition from dried flower and concentrates/extracts towards consumption of cannabis foods, drinks and vape pens/cartridges. The legal market is increasingly displacing the illicit cannabis market in Canada.
Collapse
Affiliation(s)
- Samantha Goodman
- Office of Cannabis Science and Surveillance, Controlled Substances and Cannabis Branch, Health Canada, Canada
| | - Matthew J Dann
- Office of Cannabis Science and Surveillance, Controlled Substances and Cannabis Branch, Health Canada, Canada
| | - Fathima Fataar
- Office of Cannabis Science and Surveillance, Controlled Substances and Cannabis Branch, Health Canada, Canada
| | - Hanan Abramovici
- Office of Cannabis Science and Surveillance, Controlled Substances and Cannabis Branch, Health Canada, Canada.
| |
Collapse
|
4
|
Willoughby JF, Hust SJT, Li J, Couto L. Exposure to Pro and Anti-Cannabis Social Media Messages and Teens' and College Students' Intentions to Use Cannabis. HEALTH COMMUNICATION 2024; 39:183-194. [PMID: 36628502 DOI: 10.1080/10410236.2022.2162707] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Content analyses have documented that posts about cannabis are increasingly common on social media. The relationship between the cannabis-related content to which teens and college students are exposed on social media and how such content may be associated with intentions to use and use of cannabis is less known, however. We conducted an online survey with teens (N = 350) who lived in Washington state using online survey panel participants in June 2018 and with college students (N = 966) in a Washington state-wide university system in February and March 2019. Participants in both samples reported seeing both pro-cannabis and anti-cannabis messages on social media platforms. Exposure to pro-cannabis messages on social media was associated with an increased intention to use cannabis. Exposure to anti-cannabis messages on social media was indirectly associated with decreased intentions to use cannabis through negative outcome beliefs of cannabis use and, among college students, through perceived norms. Among college students specifically, exposure to pro-cannabis messages on social media was also associated with more frequent cannabis use. Health communicators could focus anti-cannabis messaging on negative outcome beliefs among teens and college students as well as norms among college students to potentially influence constructs associated with intentions and use.
Collapse
Affiliation(s)
| | - Stacey J T Hust
- The Edward R. Murrow College of Communication, Washington State University
| | - Jiayu Li
- The Edward R. Murrow College of Communication, Washington State University
| | - Leticia Couto
- The Edward R. Murrow College of Communication, Washington State University
| |
Collapse
|
5
|
Wallace AL, Courtney KE, Wade NE, Hatz LE, Baca R, Jacobson A, Liu TT, Jacobus J. Neurite Orientation Dispersion and Density Imaging (NODDI) of Brain Microstructure in Adolescent Cannabis and Nicotine Use. Behav Sci (Basel) 2024; 14:231. [PMID: 38540534 PMCID: PMC10968201 DOI: 10.3390/bs14030231] [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: 12/06/2023] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Despite evidence suggesting deleterious effects of cannabis and nicotine tobacco product (NTP) use on white matter integrity, there have been limited studies examining white matter integrity among users of both cannabis and nicotine. Further, updated white matter methodology provides opportunities to investigate use patterns on neurite orientation dispersion and density (NODDI) indices and subtle tissue changes related to the intra- and extra-neurite compartment. We aimed to investigate how cannabis and NTP use among adolescents and young adults interacts to impact the white matter integrity microstructure. MATERIALS AND METHODS A total of 221 participants between the ages of 16 and 22 completed the Customary Drinking and Drug Use Record (CDDR) to measure substance use, and underwent a magnetic resonance imaging (MRI) session. Participants were divided into NTP-control and NTP groupings and cannabis-control and cannabis groupings (≥26 NTP/cannabis uses in past 6 months). Tract-Based Spatial Statistics (TBSS) and two-way between-subjects ANOVA investigated the effects of NTP use group, cannabis use group, and their interaction on fractional anisotropy (FA) and NODDI indices while controlling for age and biological sex. RESULTS NTP use was associated with decreased FA values and increased orientation dispersion in the left anterior capsule. There were no significant effects of cannabis use or the interaction of NTP and cannabis use on white matter outcomes. DISCUSSION NTP use was associated with altered white matter integrity in an adolescent and young adult sample. Findings suggest that NTP-associated alterations may be linked to altered fiber tract geometry and dispersed neurite structures versus myelination, as well as differential effects of NTP and cannabis use on white matter structure. Future work is needed to investigate how altered white matter is related to downstream behavioral effects from NTP use.
Collapse
Affiliation(s)
- Alexander L Wallace
- Psychiatry Department, University of California San Diego, La Jolla, CA 92093, USA; (A.L.W.)
| | - Kelly E. Courtney
- Psychiatry Department, University of California San Diego, La Jolla, CA 92093, USA; (A.L.W.)
| | - Natasha E. Wade
- Psychiatry Department, University of California San Diego, La Jolla, CA 92093, USA; (A.L.W.)
| | - Laura E. Hatz
- Psychiatry Department, University of California San Diego, La Jolla, CA 92093, USA; (A.L.W.)
| | - Rachel Baca
- Psychiatry Department, University of California San Diego, La Jolla, CA 92093, USA; (A.L.W.)
| | - Aaron Jacobson
- Center for Functional MRI and Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Thomas T. Liu
- Center for Functional MRI and Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Joanna Jacobus
- Psychiatry Department, University of California San Diego, La Jolla, CA 92093, USA; (A.L.W.)
| |
Collapse
|
6
|
Wade NE, Wallace AL, Huestis MA, Lisdahl KM, Sullivan RM, Tapert SF. Cannabis use and neurocognitive performance at 13-14 Years-Old: Optimizing assessment with hair toxicology in the Adolescent brain cognitive development (ABCD) study. Addict Behav 2024; 150:107930. [PMID: 38091780 PMCID: PMC10829878 DOI: 10.1016/j.addbeh.2023.107930] [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: 09/01/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE Cannabis is widely used, including in early adolescence, with prevalence rates varying by measurement method (e.g., toxicology vs. self-report). Critical neurocognitive development occurs throughout adolescence. Given conflicting prior brain-behavior results in cannabis research, improved measurement of cannabis use in younger adolescents is needed. METHODS Data from the Adolescent Brain Cognitive Development (ABCD) Study Year 4 follow-up (participant age: 13-14 years-old) included hair samples assessed by LC-MS/MS and GC-MS/MS, quantifying THCCOOH (THC metabolite), THC, and cannabidiol concentrations, and the NIH Toolbox Cognitive Battery. Youth whose hair was positive for cannabinoids or reported past-year cannabis use were included in a Cannabis Use (CU) group (n = 123) and matched with non-using Controls on sociodemographics (n = 123). Standard and nested ANCOVAs assessed group status predicting cognitive performance, controlling for family relationships. Follow-up correlations assessed cannabinoid hair concentration, self-reported cannabis use, and neurocognition. RESULTS CU scored lower on Picture Memory (p = .03) than Controls. Within the CU group, THCCOOH negatively correlated with Picture Vocabulary (r = -0.20, p = .03) and Flanker Inhibitory Control and Attention (r = -0.19, p = .04), and past-year cannabis use was negatively associated with List Sorting Working Memory (r = -0.33, p = .0002) and Picture Sequence Memory (r = -0.19, p = .04) performances. CONCLUSIONS Youth who had used cannabis showed lower scores on an episodic memory task, and more cannabis use was linked to poorer performances on verbal, inhibitory, working memory, and episodic memory tasks. Combining hair toxicology with self-report revealed more brain-behavior relationships than self-report data alone. These youth will be followed to determine long-term substance use and neurocognition trajectories.
Collapse
Affiliation(s)
- Natasha E Wade
- Department of Psychiatry, University of California, San Diego, USA.
| | | | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Ryan M Sullivan
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, USA
| |
Collapse
|
7
|
Gripe I, Pape H, Norström T. Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study. J Adolesc Health 2024; 74:479-486. [PMID: 38069929 DOI: 10.1016/j.jadohealth.2023.10.003] [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: 01/24/2023] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE Despite a large number of studies on the relation between cannabis use and mental distress in adolescence, results are inconclusive regarding the nature of this association. The aim of the present study is to expand this body of research by analyzing the within-person association between changes in cannabis use and changes in mental distress among young people. METHODS We used longitudinal data from a national sample of young people in Norway. The cohort was assessed in 1992 (T1), 1994 (T2), 1999 (T3), and 2005 (T4). The cumulative response rate was 60%. Respondents who participated in all four waves, aged 11-18 years at T1 (N = 1,988) were analyzed. Within-person association between changes in cannabis use and changes in mental distress in terms of symptoms of depression, anxiety, suicidal ideation, and deliberate self-harm were estimated by applying fixed-effects modeling. RESULTS For males, an increase in cannabis use from no use to more than 10 times/year was significantly associated with increased risk for anxiety (relative risk [RR]: 1.72, p = .009), depressed mood (RR: 1.49, p < .001), and suicidal ideation (RR: 3.43, p = .012). For females, the corresponding increase in cannabis use yielded an increased risk for anxiety (RR: 1.38, p = .023) and suicidal ideation (RR: 2.47, p = .002). DISCUSSION Increased cannabis use during adolescence and young adulthood seem to increase the risk for symptoms of mental distress. Although the associations appear to be more pronounced among males, it was only for depression that there was a statistically significant gender difference in the association.
Collapse
Affiliation(s)
- Isabella Gripe
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden; The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden.
| | - Hilde Pape
- University College of Norwegian Correctional Service, Lillestrøm, Norway
| | - Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| |
Collapse
|
8
|
Saavedra MS, Thota P, Peresuodei TS, Gill A, Orji C, Reghefaoui M, Khan S. Neurocognitive Impact of Exposure to Cannabis Concentrates and Cannabinoids Including Vaping in Children and Adolescents: A Systematic Review. Cureus 2024; 16:e52362. [PMID: 38361722 PMCID: PMC10867711 DOI: 10.7759/cureus.52362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
During adolescence, significant changes unfold in the brain's maturation process. The density of white matter increases, accompanied by the pruning back of gray matter. This critical and vulnerable period becomes especially noteworthy in the context of drug use, as adolescents are extensively exposed to substances such as tobacco, alcohol, and cannabis. The concern is heightened now that cannabis has been legalized for recreational use in many places, leading to increased exposure levels. Additionally, knowledge about the impact of cannabis on neurocognitive development during this stage is limited. This knowledge gap compounds the issue, making it even more concerning. Therefore, a systematic review was carried out based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using medical databases such as PubMed, PubMed Central (PMC), Medline, Cochrane Library, Internet Archive Scholar, and Embase-Elsevier for relevant medical literature. The identified articles were reviewed, eligibility criteria were applied, and 19 research articles were identified. The final papers explored the correlation between children's and adolescents' exposure to cannabis-containing compounds and subsequent changes in the central nervous system (CNS). Findings revealed a considerable impact, ranging from transient alterations in mood to permanent cognitive function and sensory processing changes, affecting the deterioration of the quality of life of these individuals in adulthood. Presently, most studies were conducted on animals, and the few studies on humans have considerable limitations, such as the type of study, age of the population, and small samples, among others. For this reason, it is essential for the scientific community and public health organizations, in general, to conduct more studies that demonstrate the true neurobiological impact of this drug and its accessibility to young people and, based on the results, consider its legalization or propose regulations for its use and commercialization.
Collapse
Affiliation(s)
- Michell S Saavedra
- Medicine, University of Cuenca, Cuenca, ECU
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Priyanka Thota
- Medicine, Siddhartha Medical College, Vijayawada, IND
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Tariladei S Peresuodei
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Abhishek Gill
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Chijioke Orji
- Trauma and Orthopedics, Betsi Cadwaladr University Health Board, Wrexham, GBR
- Trauma and Orthopedics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Maiss Reghefaoui
- Internal Medicine, University of Debrecen, Debrecen, HUN
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| |
Collapse
|
9
|
Ren W, Fishbein D. Prospective, longitudinal study to isolate the impacts of marijuana use on neurocognitive functioning in adolescents. Front Psychiatry 2023; 14:1048791. [PMID: 37255687 PMCID: PMC10225520 DOI: 10.3389/fpsyt.2023.1048791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/19/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Policies to legalize possession and use of marijuana have been increasingly supported across the United States. Although there are restrictions on use in minors, many substance abuse scientists anticipate that these policy changes may alter use patterns among adolescents due to its wider availability and a softening of beliefs about its potentially harmful consequences. Despite the possibility that these policies may increase the prevalence of use among adolescents, the effects of marijuana on neurodevelopment remain unclear, clouding arguments in favor of or opposition to these policies. Methods The present prospective, longitudinal study was designed to isolate the neurodevelopmental consequences of marijuana use from its precursors during adolescence-a period of heightened vulnerability for both substance use and disrupted development due to environmental insults. Early adolescents who were substance-naïve at baseline (N = 529, aged 10-12) were recruited and tracked into adolescence when a subgroup initiated marijuana use during one of three subsequent waves of data collection, approximately 18 months apart. Results Results suggest that marijuana use may be specifically related to a decline in verbal learning ability in the short term and in emotion recognition, attention, and inhibition in the longer-term. Discussion These preliminary findings suggest that marijuana use has potential to adversely impact vulnerable neurodevelopmental processes during adolescence. Intensive additional investigation is recommended given that state-level policies regulating marijuana use and possession are rapidly shifting in the absence of good scientific information.
Collapse
Affiliation(s)
- Wen Ren
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Diana Fishbein
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| |
Collapse
|
10
|
González-Cano-Caballero M, Torrejón-Guirado MC, Cano-Caballero MD, Mac Fadden I, Barrera-Villalba MDC, Lima-Serrano M. Adolescents and youths' opinions about the factors associated with cannabis use: a qualitative study based on the I-Change model. BMC Nurs 2023; 22:114. [PMID: 37046264 PMCID: PMC10091594 DOI: 10.1186/s12912-023-01283-z] [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: 12/18/2022] [Accepted: 03/31/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND To learn about the experiences and opinions of adolescent non-consumers and regular cannabis users about cannabis use and the factors that determine its use, using the I-Change explanatory model as a basis. METHODS Qualitative methodology with a content analysis was used. Focus groups were conducted with adolescents who were non-regular cannabis users (those who had not tried cannabis or had only experimented with it before) and semi-structured interviews were conducted with adolescent and young adult in recovery who were in a detoxification program. A deductive analysis of the audio-recorded and transcribed interviews was performed, using the domains of the I-Change Model as a reference. RESULTS Personal problems, social problems or family problems can lead to cannabis use. There was a lack of knowledge and low risk perception about consumption of this drug. There are other factors that influence consumption, the perception of advantages, such as the feeling of freedom and the influence of the peer group. The consumption of this substance in girls is changing, becoming more and more equal to that of boys. The family has an important role to play in preventing drug use. CONCLUSION Knowledge of these factors is of vital importance as a prior step to the development of efficient intervention measures adjusted to the needs identified and the characteristics of the population.
Collapse
Affiliation(s)
| | - María-Carmen Torrejón-Guirado
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, 41009, Spain
- Department of Health Promotion, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - María Dolores Cano-Caballero
- Deputy Directorate of Care. Virgen de las Nieves University Hospital, Granada, 18014, Spain.
- Department of Nursing, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071, Granada, Spain.
| | | | | | - Marta Lima-Serrano
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, 41009, Spain
| |
Collapse
|
11
|
Britch SC, Walsh SL, Vickers-Smith R, Babalonis S, Slavova S. Cannabinoid Poisoning-Related Emergency Department Visits and Inpatient Hospitalizations in Kentucky, 2017 to 2019. Subst Use Misuse 2022; 58:66-76. [PMID: 36453437 PMCID: PMC9890590 DOI: 10.1080/10826084.2022.2148478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background and objectives: Cannabis is the most used federally illicit substance. Due to widespread medicinal use and state-level legalization, public perceptions of cannabis have shifted toward the assumption that cannabis is safe. However, cannabinoids can cause adverse medical complications that may lead people to seek treatment. This study characterized cannabinoid poisoning-related medical encounters, poisoning involving cannabinoids and other psychoactive substances, and cannabinoid poisoning-related cardiac complications. Methods: Administrative billing data for emergency department visits and inpatient hospitalizations in acute care facilities with a discharge date from January 1, 2017 to December 31, 2019 were used to characterize cannabinoid poisoning events in Kentucky, identified by ICD-10-CM diagnosis code T40.7X. Results: There were 1,490 encounters of cannabinoid poisoning; patients were primarily non-Hispanic White males, ages 15-44, who had Medicaid and lived in a metropolitan area. Of those, 31.21% involved poisoning with a second psychoactive substance, primarily stimulants and/or opioids, and 17.72% experienced a cardiac complication. Cannabinoid-polydrug poisoning was associated with inpatient treatment (χ2=199.18, p < 0.001) and cardiac complications (χ2=4.58, p < 0.001). Discussion and Conclusions: These results are consistent with other state-level data. Patients who were diagnosed with cannabis-polydrug poisoning, compared to cannabis alone poisoning, had greater odds of hospital admission and cardiac complications, and longer length of hospital stays. Scientific Significance: The health risks of cannabinoid use must be more broadly recognized, while timely and accurate data need to be shared to guide policies on cannabis access. Future research on cannabinoid poisoning should consider the involvement of other psychoactive drugs.
Collapse
Affiliation(s)
- Stevie C. Britch
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Sharon L. Walsh
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Department of Pharmacology, University of Kentucky, Lexington, KY, USA
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, USA
- Department of Psychiatry, University of Kentucky, Lexington, KY, USA
| | - Rachel Vickers-Smith
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Epidemiology and Environmental Health, University of Kentucky, Lexington, KY, USA
| | - Shanna Babalonis
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Svetla Slavova
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
- Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
12
|
Kelleghan AR, Sofis MJ, Budney A, Ceasar R, Leventhal AM. Associations of cannabis product source and subsequent cannabis use among adolescents. Drug Alcohol Depend 2022; 233:109374. [PMID: 35272186 PMCID: PMC8999876 DOI: 10.1016/j.drugalcdep.2022.109374] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Cannabis is obtained from a variety retail and illicit sources, with unknown implications for youth cannabis use. This study assessed whether source of obtaining cannabis was associated with future cannabis use among adolescents. METHODS High-schoolers (N = 835) completed 3 semiannual surveys, reporting use of 7 cannabis sources (i.e., free, bought from someone, from an online dispensary, with a [valid/invalid] medical card, self-grown, or other; separate dichotomous exposure variables) at wave 1 (n = 621; M[SD] age=17.14[.40]) or wave 2 (n = 622; M[SD] age=17.51[.39]). Past-6-month (yes/no) and number of past-30-day (0-30) non-medical use of any cannabis product, combustible, edible, and vaporized cannabis, blunts, and concentrates (i.e., dabs) were reported at waves 2-3. Random-effect time-lagged repeated-measures regression was used to test longitudinal associations of youth's cannabis source (waves 1-2; time-varying exposure) with cannabis use outcomes 6 months later (waves 2-3). RESULTS Most youth (72.1%) received cannabis for free; 50.9% bought cannabis from someone, 15.9% used a valid medical card at a brick-and-mortar dispensary, and 3.9% grew cannabis. Buying cannabis from someone (OR=1.46, 95% CI: 1.07-1.99, p = .02) or using a valid medical card (OR=1.99, 95% CI: 1.20-3.31, p = .008) conferred greater odds of any cannabis product use 6 months later. Buying from someone predicted subsequent past-30-day use frequency (RR=1.25, 95% CI:1.05-1.48, p = .01). Some associations between particular cannabis sources and products were observed. CONCLUSIONS Adolescents may access cannabis from several sources. Those who purchase cannabis illicitly from someone or from a brick-and-mortar dispensary using a valid medical card may be at increased risk for more persistent and frequent patterns of non-medical cannabis use.
Collapse
Affiliation(s)
- Annemarie R Kelleghan
- Department of Psychology, University of Southern California, 3620S. McClintock Ave. SGM 501, Los Angeles, CA 90089, USA; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Michael J Sofis
- Department of Psychiatry, Geisel School of Medicine, Dartmouth, 46 Centerra Pkwy, Suite 315, HB 7255, Lebanon, NH 03766, USA
| | - Alan Budney
- Department of Psychiatry, Geisel School of Medicine, Dartmouth, 46 Centerra Pkwy, Suite 315, HB 7255, Lebanon, NH 03766, USA
| | - Rachel Ceasar
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| |
Collapse
|
13
|
Foletto VS, Serafin MB, Bottega A, da Rosa TF, Marion SDL, da Mota AD, Hörner R. Repositioning of Cannabis sativa: A topic under construction. J Clin Pharm Ther 2022; 47:1297-1298. [PMID: 35322448 DOI: 10.1111/jcpt.13649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | | | | | - Rosmari Hörner
- Federal University of Santa Maria, Santa Maria, Brazil.,Department of Clinical and Toxicological Analysis, Federal University of Santa Maria, Santa Maria, Brazil
| |
Collapse
|
14
|
Willoughby JF, Hust SJT, Li J, Couto L. Social Media, Marijuana and Sex: An Exploratory Study of Adolescents' Intentions to Use and College Students' Use of Marijuana. JOURNAL OF SEX RESEARCH 2022; 59:85-97. [PMID: 33034543 DOI: 10.1080/00224499.2020.1827217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recreational marijuana continues to be legalized in U.S. states, with popular media discussing connections between cannabis and the facilitation of sexual activity. We conducted two surveys with adolescents and college students in Washington state to examine the role of viewing social media and pro-marijuana content on sex-related marijuana expectancies and intentions to use. In Study 1, among adolescents (N = 350), we found connections between social media use, exposure to pro-marijuana content, and sex-related marijuana expectancies, with boys' sex-related marijuana expectancies predicting intentions to use marijuana. In Study 2, we expanded this research to college students (N = 966), with the addition of frequency of marijuana use as an outcome. For men, sex-related marijuana expectancies were negatively associated with marijuana use. Sex-related marijuana expectancies were not associated with intentions to use or use of marijuana among adolescent girls and college women. Our findings highlight how social media use is associated with increased exposure to pro-marijuana content for adolescents and college students, and how such content is associated with sex-related marijuana expectancies. The mixed relationships in our data between sex-related marijuana expectancies and intentions and use highlight potential gender and developmental differences.
Collapse
Affiliation(s)
| | - Stacey J T Hust
- The Edward R. Murrow College of Communication, Washington State University
| | - Jiayu Li
- The Edward R. Murrow College of Communication, Washington State University
| | - Leticia Couto
- The Edward R. Murrow College of Communication, Washington State University
| |
Collapse
|
15
|
Fischer B, Robinson T, Bullen C, Curran V, Jutras-Aswad D, Medina-Mora ME, Pacula RL, Rehm J, Room R, van den Brink W, Hall W. Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103381. [PMID: 34465496 DOI: 10.1016/j.drugpo.2021.103381] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cannabis use is common, especially among young people, and is associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public health goals. Evidence-based 'Lower Risk Cannabis Use Guidelines' (LRCUG) and recommendations were previously developed to reduce modifiable risk factors of cannabis-related adverse health outcomes; related evidence has evolved substantially since. We aimed to review new scientific evidence and to develop comprehensively up-to-date LRCUG, including their recommendations, on this evidence basis. METHODS Targeted searches for literature (since 2016) on main risk factors for cannabis-related adverse health outcomes modifiable by the user-individual were conducted. Topical areas were informed by previous LRCUG content and expanded upon current evidence. Searches preferentially focused on systematic reviews, supplemented by key individual studies. The review results were evidence-graded, topically organized and narratively summarized; recommendations were developed through an iterative scientific expert consensus development process. RESULTS A substantial body of modifiable risk factors for cannabis use-related health harms were identified with varying evidence quality. Twelve substantive recommendation clusters and three precautionary statements were developed. In general, current evidence suggests that individuals can substantially reduce their risk for adverse health outcomes if they delay the onset of cannabis use until after adolescence, avoid the use of high-potency (THC) cannabis products and high-frequency/-intensity of use, and refrain from smoking-routes for administration. While young people are particularly vulnerable to cannabis-related harms, other sub-groups (e.g., pregnant women, drivers, older adults, those with co-morbidities) are advised to exercise particular caution with use-related risks. Legal/regulated cannabis products should be used where possible. CONCLUSIONS Cannabis use can result in adverse health outcomes, mostly among sub-groups with higher-risk use. Reducing the risk factors identified can help to reduce health harms from use. The LRCUG offer one targeted intervention component within a comprehensive public health approach for cannabis use. They require effective audience-tailoring and dissemination, regular updating as new evidence become available, and should be evaluated for their impact.
Collapse
Affiliation(s)
- Benedikt Fischer
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Tessa Robinson
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada; Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Chris Bullen
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; National Institute for Health Innovation (NIHI), The University of Auckland, Auckland, New Zealand
| | - Valerie Curran
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada; Research Centre of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Maria Elena Medina-Mora
- Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico; Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosalie Liccardo Pacula
- Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, United States
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction & Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Wim van den Brink
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Wayne Hall
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, QLD 4072, Australia; National Addiction Centre, Institute of Psychiatry, Kings College London, United Kingdom
| |
Collapse
|
16
|
Reversing the Psychiatric Effects of Neurodevelopmental Cannabinoid Exposure: Exploring Pharmacotherapeutic Interventions for Symptom Improvement. Int J Mol Sci 2021; 22:ijms22157861. [PMID: 34360626 PMCID: PMC8346164 DOI: 10.3390/ijms22157861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/16/2022] Open
Abstract
Neurodevelopmental exposure to psychoactive compounds in cannabis, specifically THC, is associated with a variety of long-term psychopathological outcomes. This increased risk includes a higher prevalence of schizophrenia, mood and anxiety disorders, and cognitive impairments. Clinical and pre-clinical research continues to identify a wide array of underlying neuropathophysiological sequelae and mechanisms that may underlie THC-related psychiatric risk vulnerability, particularly following adolescent cannabis exposure. A common theme among these studies is the ability of developmental THC exposure to induce long-term adaptations in the mesocorticolimbic system which resemble pathological endophenotypes associated with these disorders. This narrative review will summarize recent clinical and pre-clinical evidence that has elucidated these THC-induced developmental risk factors and examine how specific pharmacotherapeutic interventions may serve to reverse or perhaps prevent these cannabis-related risk outcomes.
Collapse
|
17
|
Hernandez Mejia M, Wade NE, Baca R, Diaz VG, Jacobus J. The Influence of Cannabis and Nicotine Co-use on Neuromaturation: A Systematic Review of Adolescent and Young Adult Studies. Biol Psychiatry 2021; 89:162-171. [PMID: 33334432 PMCID: PMC7749265 DOI: 10.1016/j.biopsych.2020.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/13/2022]
Abstract
Accumulating evidence suggests that the use of cannabis and nicotine and tobacco-related products (NTPs) during the adolescent years has harmful effects on the developing brain. Yet, few studies have focused on the developing brain as it relates to the co-administration of cannabis and NTPs, despite the high prevalence rates of co-use in adolescence. This review aims to synthesize the existing literature on neurocognitive, structural neuroimaging, and functional neuroimaging outcomes associated with cannabis and NTP co-use. A systematic search of peer-reviewed articles resulted in a pool of 1107 articles. Inclusion criteria were 1) data-based study; 2) age range of 13 to 35 years or, for preclinical studies, nonadult subjects; 3) cannabis and NTP group jointly considered; and 4) neurocognitive, structural neuroimaging, or functional neuroimaging as an outcome measure. Twelve studies met inclusion criteria. Consistent with the literature, cannabis and nicotine were found to have independent effects on cognition. The available research on the co-use of cannabis and NTPs demonstrates a potential nicotine-related masking effect on cognitive deficits associated with cannabis use, yet there is little research on co-use and associations with neuroimaging indices. In neuroimaging studies, there is preliminary evidence for hippocampal volume differences in co-users and a lack of evidence for co-use differences related to nucleus accumbens activity during reward processing. Notably, no structural neuroimaging studies were found to examine the combined effects of nicotine and cannabis in adolescent-only populations. Further research, including longitudinal studies, is warranted to investigate the influence of cannabis and NTP co-use on maturation.
Collapse
Affiliation(s)
- Margie Hernandez Mejia
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California
| | - Natasha E Wade
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Vanessa G Diaz
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, San Diego, California.
| |
Collapse
|
18
|
Stringfield SJ, Torregrossa MM. Disentangling the lasting effects of adolescent cannabinoid exposure. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110067. [PMID: 32791165 DOI: 10.1016/j.pnpbp.2020.110067] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
Cannabis is the most widely used illicit substance among adolescents, and adolescent cannabis use is associated with various neurocognitive deficits that can extend into adulthood. A growing body of evidence supports the hypothesis that adolescence encompasses a vulnerable period of development where exposure to exogenous cannabinoids can alter the normative trajectory of brain maturation. In this review, we present an overview of studies of human and rodent models that examine lasting effects of adolescent exposure. We include evidence from meta-analyses, longitudinal, or cross-sectional studies in humans that consider age of onset as a factor that contributes to the behavioral dysregulation and altered structural or functional development in cannabis users. We also discuss evidence from preclinical rodent models utilizing well-characterized or innovative routes of exposure, investigating the effects of dose and timing to produce behavioral deficits or alterations on a neuronal and behavioral level. Multiple studies from both humans and animals provide contrasting results regarding the magnitude of residual effects. Combined evidence suggests that exposure to psychoactive cannabinoids during adolescence has the potential to produce subtle, but lasting, alterations in neurobiology and behavior.
Collapse
Affiliation(s)
- Sierra J Stringfield
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA
| | - Mary M Torregrossa
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA.
| |
Collapse
|
19
|
Martínez-Vispo C, Dias PC. Risk Perceptions and Cannabis Use in a Sample of Portuguese Adolescents and Young Adults. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00392-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|
20
|
Hust SJT, Willoughby JF, Li J, Couto L. Youth's Proximity to Marijuana Retailers and Advertisements: Factors Associated with Washington State Adolescents' Intentions to Use Marijuana. JOURNAL OF HEALTH COMMUNICATION 2020; 25:594-603. [PMID: 33030100 DOI: 10.1080/10810730.2020.1825568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study explored the influences of advertising exposure, numbers of marijuana retailers, distance to retailers, and constructs from the integrative model of behavioral prediction, including outcome beliefs, perceived norms, and efficacy, on youth's intentions to use marijuana in a state in which the use of recreational marijuana is legal. A state-wide online cross-sectional survey of 350 adolescents ages 13-17, residing in Washington state, was conducted in June 2018. The results of the regression analysis suggest that exposure to marijuana advertising, positive and negative outcome beliefs, and perceived peer norms were associated with intention to use marijuana. Distances to retailers moderated the relationships between exposure to advertising and intentions, as well as between positive outcome beliefs and intentions. States that have legalized recreational marijuana should continue considering the location of retailers in relation to neighborhoods and advertising regulations to reduce the appeal to youth. Additionally, prevention efforts could aim to influence outcome beliefs and norms in an attempt to reduce adolescents' intentions to use recreational marijuana.
Collapse
Affiliation(s)
- Stacey J T Hust
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| | - Jessica Fitts Willoughby
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| | - Jiayu Li
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| | - Leticia Couto
- Edward R. Murrow College of Communication, Washington State University , Pullman, Washington, USA
| |
Collapse
|
21
|
Adolescent cannabis use, cognition, brain health and educational outcomes: A review of the evidence. Eur Neuropsychopharmacol 2020; 36:169-180. [PMID: 32268974 DOI: 10.1016/j.euroneuro.2020.03.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/10/2020] [Accepted: 03/13/2020] [Indexed: 01/13/2023]
Abstract
We review the findings of systematic reviews and meta-analyses of case-control studies that examine brain functioning and cognitive correlates of adolescent cannabis use using structural and functional neuroimaging tools and standardised neuropsychological tests. We also examine prospective epidemiological studies on the possible effects of adolescent and young adult cannabis use on cognitive performance in adult life and the completion of secondary education. We summarize the findings of studies in each of these areas that have been published since the most recent systematic review. Systematic reviews find that adolescent cannabis use is inconsistently associated with alterations in the structure of prefrontal and temporal brain regions. Meta-analyses reveal functional alterations in the parietal cortex and putamen. Differences in the orbitofrontal cortex predate cannabis use; it is unclear if they are affected by continued cannabis use and prolonged abstinence. Longitudinal and twin studies report larger declines in IQ among cannabis users than their non-using peers but it is unclear whether these findings can be attributed to cannabis use or to genetic, mental health and environmental factors. Several longitudinal studies and a meta-analysis of cross-sectional studies suggest that there is some cognitive recovery after abstinence from cannabis. Longitudinal studies and some twin studies have found that cannabis users are less likely to complete secondary school than their non-using controls. This association might reflect an effect of cannabis use and/or the social environment of cannabis users and their cannabis using peers. Cognitive performance is altered in some domains (e.g. IQ, verbal learning) in young people while they are regularly using cannabis. There are two important messages to adolescents and young adults: First, cannabis has potentially detrimental effects on cognition, brain and educational outcomes that persist beyond acute intoxication. Second, impaired cognitive function in cannabis users appears to improve with sustained abstinence.
Collapse
|
22
|
A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018. Epidemiol Psychiatr Sci 2020; 29:e115. [PMID: 32299531 PMCID: PMC7214527 DOI: 10.1017/s2045796020000281] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIMS The mental health of youth is continually changing and requires reliable monitoring to ensure that adequate social and economic resources are allocated. This study assessed trends in mental health among Canadian youth, 12-24 years old. Specifically, we examined the prevalence of poor/fair perceived mental health, diagnosis of mood and anxiety disorders, suicidality, perceived stress and sleep problems, substance use, and mental health consultations. METHODS Data were collected from eight cycles of the annual Canadian Community Health Survey (2011-2018). Prevalence of mental health outcomes was calculated from each survey, and meta-regression was used to assess trends over time. In the absence of a significant trend over time, the eight cycles were pooled together using meta-analysis techniques to gain precision. Trends in prevalence were assessed for the overall sample of youth (12-24 years) and separately for male and female adolescents (12-18 years) and young adults (19-24 years). RESULTS The prevalence of poor/fair perceived mental health, diagnosed mood and anxiety disorders, and past-year mental health consultations increased from 2011 to 2018, most strongly among young adult females. Past-year suicidality increased among young adult females but did not change for other age and sex groups. Notably, the prevalence of binge drinking decreased by 2.4% per year for young adult males, 1.0% for young adult females and 0.7% per year for adolescent males, while staying relatively stable for adolescent females. Prevalence of cannabis use declined among adolescents before legalisation (2011-2017); however, this trend did not persist in 2018. Instead, the 2018 prevalence was 5.6% higher than the 2017 prevalence (16.3 v. 10.7%). The combined prevalence of other illicit drug use was stable at 4.6%; however, cocaine use and hallucinogens increased by approximately 0.2% per year. CONCLUSIONS Our findings highlight a growing need for youth mental health services, as indicated by a rise in the prevalence of diagnosed mood and anxiety disorders and past-year mental health consultations. The reason for these observed increases is less apparent - it may represent a true rise in the prevalence of mental illness, or be an artefact of change in diagnostic practices, mental health literacy or diminishing stigma. Nonetheless, the findings indicate a need for the health care system to respond to the rising demand for mental health services among youth.
Collapse
|