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Shrier LA, McCaskill NH, Smith MC, O'Connell MM, Gluskin BS, Parker S, Everett V, Burke PJ, Harris SK. Telehealth counseling plus mHealth intervention for cannabis use in emerging adults: Development and a remote open pilot trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 166:209472. [PMID: 39111371 DOI: 10.1016/j.josat.2024.209472] [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: 12/22/2023] [Revised: 06/27/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION To improve treatment access for emerging adults with cannabis use disorder (CUD), we developed a telehealth counseling-plus-mHealth intervention and remotely conducted a single-arm open pilot study to preliminarily evaluate its feasibility in primary care. METHODS A multidisciplinary team including youth developed the intervention using the structure of the MOMENT intervention: two weekly counselor-delivered Motivational Enhancement Therapy (MET) sessions, then two weeks of smartphone surveys (4 prompted/day) querying socioemotional contexts and cannabis use, with pre-programmed messages on report of personal triggers for use (Ecological Momentary Intervention; EMI). The team adapted the MET for virtual delivery; created material to enhance self-reflection, plan behavior change, and anticipate withdrawal; shortened the sessions; and tested them with five youth actors. EMI messages were created to align with the MET and programmed to minimize repetition. Patients aged 18-25 using recreational cannabis ≥3 days/week were recruited from an urban medical practice. Participants received the intervention and responded to surveys on satisfaction and burden. At baseline, post-intervention, and two months, participants reported behavior change readiness/importance/confidence and cannabis use. EMI engagement was calculated as % days with ≥1 phone survey completed. RESULTS Fourteen eligible patients enrolled; 79 % used cannabis daily/near-daily and 100 % reported use problems. All completed both MET sessions and responded to EMI surveys. All agreed/strongly agreed that they felt respected by, comfortable with, and trust for the counselor and that the activities and discussion were helpful; all rated the MET sessions as very good/excellent. Technical issues were infrequent and minor. Median EMI engagement was 100 % (≥1 report/day) in each week. Behavior change confidence was higher post-intervention and importance and confidence were higher at two months vs. baseline. By two months, 11 participants had started to change cannabis use; median percent days of use in the past 30 days declined by 27 % and average times of use per use day declined by 28 %. All rated intervention quality as good, very good, or excellent. CONCLUSIONS Emerging adults were highly satisfied and engaged with a telehealth MET counseling-plus-mHealth EMI intervention for cannabis use and reported higher motivation to change cannabis use and less use post-intervention and at 2-month follow-up.
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Affiliation(s)
- Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Nicholas H McCaskill
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Madeline C Smith
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Madison M O'Connell
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Brittany S Gluskin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Sarah Parker
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Veronica Everett
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Pamela J Burke
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Sion Kim Harris
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Dacosta-Sánchez D, Michelini Y, Pilatti A, Fernández-Calderón F, Lozano ÓM, González-Ponce BM. The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective. Addict Behav 2024; 157:108103. [PMID: 39018615 DOI: 10.1016/j.addbeh.2024.108103] [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: 03/26/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Gender-specific interventions are crucial in addressing substance use disorders -particularly cannabis use disorder - as they allow for tailored therapeutic approaches and increase the likelihood of successful outcomes. However, differences in therapeutic processes and outcomes between males and females are often not observed, making the prognosis and development of such interventions more difficult. OBJECTIVE This study aimed to examine the moderating role of sex in the relationship between treatment admission profile characterized by indicators of cannabis use and sociodemographic sources of gender inequality (e.g., employment status) and adherence and outcome at discharge. METHOD A multicentric retrospective observational study was conducted with a sample of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records were used for data analysis. RESULTS The interaction between sex and the number of children, as well as pre-treatment cannabis use, predicted lower treatment adherence, particularly among females. Additionally, the interaction between sex and the number of children predicted outcomes at discharge, with females showing a higher likelihood of dropout compared to males. DISCUSSION AND CONCLUSION Enhanced comprehensive treatment with intensified contingency management programs should be prioritized for females (especially those with children) who have consumed cannabis in the month before treatment. Adopting a treatment policy framework incorporating sex/gender-sensitive therapist training and evaluative measures is essential for optimizing treatment outcomes for all patients.
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Affiliation(s)
- Daniel Dacosta-Sánchez
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| | - Yanina Michelini
- Faculty of Psychology, National University of Cordoba, Córdoba 5000, Argentina; Institute of Psychological Research, IIPsi-CONICET-UNC, National University of Córdoba, Córdoba 5000, Argentina.
| | - Angelina Pilatti
- Faculty of Psychology, National University of Cordoba, Córdoba 5000, Argentina; Institute of Psychological Research, IIPsi-CONICET-UNC, National University of Córdoba, Córdoba 5000, Argentina.
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| | - Óscar M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| | - Bella M González-Ponce
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
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Murray CH, Gannon BM, Winsauer PJ, Cooper ZD, Delatte MS. The Development of Cannabinoids as Therapeutic Agents in the United States. Pharmacol Rev 2024; 76:915-955. [PMID: 38849155 PMCID: PMC11331953 DOI: 10.1124/pharmrev.123.001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
Cannabis is one of the oldest and widely used substances in the world. Cannabinoids within the cannabis plant, known as phytocannabinoids, mediate cannabis' effects through interactions with the body's endogenous cannabinoid system. This endogenous system, the endocannabinoid system, has important roles in physical and mental health. These roles point to the potential to develop cannabinoids as therapeutic agents while underscoring the risks related to interfering with the endogenous system during nonmedical use. This scoping narrative review synthesizes the current evidence for both the therapeutic and adverse effects of the major (i.e., Δ9-tetrahydrocannabinol and cannabidiol) and lesser studied minor phytocannabinoids, from nonclinical to clinical research. We pay particular attention to the areas where evidence is well established, including analgesic effects after acute exposures and neurocognitive risks after acute and chronic use. In addition, drug development considerations for cannabinoids as therapeutic agents within the United States are reviewed. The proposed clinical study design considerations encourage methodological standards for greater scientific rigor and reproducibility to ultimately extend our knowledge of the risks and benefits of cannabinoids for patients and providers. SIGNIFICANCE STATEMENT: This work provides a review of prior research related to phytocannabinoids, including therapeutic potential and known risks in the context of drug development within the United States. We also provide study design considerations for future cannabinoid drug development.
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Affiliation(s)
- Conor H Murray
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Brenda M Gannon
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Peter J Winsauer
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Ziva D Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
| | - Marcus S Delatte
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences (C.H.M.) and Departments of Anesthesiology and Perioperative Medicine (Z.D.C.), David Geffen School of Medicine, University of California, Los Angeles, California; Department of Pharmacology and Toxicology, College of Medicine (B.M.G.) and Office of Research Regulatory Affairs, Division of Research and Innovation (B.M.G.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Departments of Pharmacology and Experimental Therapeutics and Biochemistry and Molecular Biology, School of Medicine (P.J.W.), and Alcohol and Drug Abuse Center of Excellence (P.J.W.) Louisiana State University Health Sciences Center, New Orleans, Louisiana; and Regulatory and Drug Development Consulting, Allucent, Carey, North Carolina (M.S.D.)
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Boer OD, El Marroun H, Muetzel RL. Adolescent substance use initiation and long-term neurobiological outcomes: insights, challenges and opportunities. Mol Psychiatry 2024; 29:2211-2222. [PMID: 38409597 DOI: 10.1038/s41380-024-02471-2] [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: 04/30/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/28/2024]
Abstract
The increased frequency of risk taking behavior combined with marked neuromaturation has positioned adolescence as a focal point of research into the neural causes and consequences of substance use. However, little work has provided a summary of the links between adolescent initiated substance use and longer-term brain outcomes. Here we review studies exploring the long-term effects of adolescent-initiated substance use with structural and microstructural neuroimaging. A quarter of all studies reviewed conducted repeated neuroimaging assessments. Long-term alcohol use, as well as tobacco use were consistently associated with smaller frontal cortices and altered white matter microstructure. This association was mostly observed in the ACC, insula and subcortical regions in alcohol users, and for the OFC in tobacco users. Long-term cannabis use was mostly related to altered frontal cortices and hippocampal volumes. Interestingly, cannabis users scanned more years after use initiation tended to show smaller measures of these regions, whereas those with fewer years since initiation showed larger measures. Long-term stimulant use tended to show a similar trend as cannabis in terms of years since initiation in measures of the putamen, insula and frontal cortex. Long-term opioid use was mostly associated with smaller subcortical and insular volumes. Of note, null findings were reported in all substance use categories, most often in cannabis use studies. In the context of the large variety in study designs, substance use assessment, methods, and sample characteristics, we provide recommendations on how to interpret these findings, and considerations for future studies.
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Affiliation(s)
- Olga D Boer
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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Do VV, Ling PM, Chaffee BW, Nguyen N. Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths. JAMA Netw Open 2024; 7:e2419976. [PMID: 38958977 PMCID: PMC11222996 DOI: 10.1001/jamanetworkopen.2024.19976] [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: 03/07/2024] [Accepted: 05/01/2024] [Indexed: 07/04/2024] Open
Abstract
Importance Little is known about whether concurrent use of tobacco and cannabis is associated with higher or lower levels of mental health problems than use of either substance alone among youths. Objective To examine the association between concurrent use of tobacco and cannabis and mental health problems in a national sample of US youths. Design, Setting, and Participants This cross-sectional study analyzed publicly available wave 6 data within the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study of US youths aged 14 to 17 years, collected from March to November 2021. This analysis used wave 6 single-wave weights to obtain statistically valid estimates for cross-sectional analyses generalizable to the wave 4 cohort sample. Data were analyzed from November 15, 2023, to April 20, 2024. Exposure Past 30-day use of any tobacco and cannabis products was self-reported and categorized into 4 exclusive patterns: concurrent, tobacco only, cannabis only, and nonuse. Main Outcomes and Measures Self-reported past-year internalizing and externalizing mental health problems were measured using the modified version of the Global Appraisal of Individual Needs-Short Screener and separately categorized into 3 levels: low (0-1 symptoms), moderate (2-3 symptoms), and high (≥4 symptoms). Results A total of 5585 youths were included in the study, with a weighted proportion of 51.3% being male and 72.5% aged 15 to 17 years. In terms of race and ethnicity, 1606 youths (25.7%) were Hispanic, 626 (12.7%) were non-Hispanic Black, 2481 (50.5%) were non-Hispanic White, and 555 (11.0%) were non-Hispanic other. The prevalence of concurrent use (3.4% [95% CI, 2.9%-4.0%]) was comparable to tobacco-only use (3.9% [95% CI, 3.2%-4.6%]), but greater than cannabis-only use (2.5% [95% CI, 2.1%-2.9%]). High levels of internalizing and externalizing problems were most common for the concurrent use group (internalizing: 47.4% [95% CI, 39.2%-55.9%]; externalizing: 61.6% [95% CI, 54.1%-68.7%]), followed by the cannabis-only use group (internalizing: 44.8% [95% CI, 35.7%-54.1%]; externalizing: 48.5% [95% CI, 39.1%-57.9%]), the tobacco-only use group (internalizing: 41.4% [95% CI, 33.7%-49.5%]; externalizing: 46.3% [95% CI, 38.3%-54.5%]), and the nonuse group (internalizing: 22.4% [95% CI, 21.1%-23.8%]; externalizing: 30.4% [95% CI, 28.9%-31.9%]). After controlling for covariates in ordinal logistic regression models, concurrent use of tobacco and cannabis was associated with greater odds of reporting higher levels of externalizing problems compared with tobacco-only use (adjusted odds ratio [AOR], 1.83 [95% CI, 1.15-2.91]) and cannabis-only use (AOR, 1.85 [95% CI, 1.11-3.06]). However, there were no statistically significant differences in the odds of internalizing problems between concurrent use and use of tobacco or cannabis alone. Conclusions and Relevance In this cross-sectional study of the PATH Study wave 6 youth data, concurrent use of tobacco and cannabis was linked to higher levels of externalizing mental health problems than use of single substances, indicating a potential need to combine mental health support with tobacco and cannabis cessation interventions for youths.
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Affiliation(s)
- Vuong V. Do
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
| | - Benjamin W. Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- School of Dentistry, University of California, San Francisco
| | - Nhung Nguyen
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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Li Y, Rhubart D. Cannabis use, social support and social engagement among working-age adults in rural America. Prev Med Rep 2024; 43:102794. [PMID: 38975281 PMCID: PMC11225026 DOI: 10.1016/j.pmedr.2024.102794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Cannabis use has been linked to physical, psychological, and behavioral changes. Although research indicates separately that informal social support and formal social engagement - which are correlated measures - serve as protective factors in cannabis use, much of this research focuses on youth and more urban samples, limiting our understanding of if these findings are true for rural populations where social support and social engagement are particularly important for health and health behaviors. To fill the research gap, this study examines the effects of informal social support (tangible support and emotional support) and formal social engagement on cannabis use among rural working-age adults. Methods This research analyzed 1,122 observations from a cross-sectional online survey conducted in 2022 of working-age adults (18-64) from rural America. Multilevel logistic regression models were used to predict cannabis use in the past 12 months using informal social support (tangible support and emotional support) and formal social engagement and other sociodemographic covariates and state legalization status. Results Multilevel logistic modeling indicates that low emotional support and low formal social engagement are associated with a higher odds of reporting cannabis use in the past 12 months among rural working-age adults, net of other sociodemographic variables and state legalization status. Conclusions The study suggests that emotional support and social engagement may contribute to cannabis use prevention among rural working-age adults. These findings should inform future research as well as the development of tailored health interventions targeting rural working-age adults.
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Affiliation(s)
- Yiping Li
- Department of Biobehavioral Health, The Pennsylvania State University, Biobehavioral Health Building, University Park, PA 16802, USA
| | - Danielle Rhubart
- Department of Biobehavioral Health, The Pennsylvania State University, Biobehavioral Health Building, University Park, PA 16802, USA
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Vidal C, Simon KM, Brooks C, White J, Hinckley JD. A systematic review of evidence on integrated management of psychiatric disorders in youth who use cannabis. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 10:100216. [PMID: 38288007 PMCID: PMC10823056 DOI: 10.1016/j.dadr.2023.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024]
Abstract
Given the risks to mental health associated with cannabis use in youth and the increase in cannabis legalization worldwide and in the U.S., there is a need to understand existing evidence-based approaches to integrated management of psychiatric disorders in youth who use cannabis. This systematic review aimed to appraise the current evidence on integrated treatment for adolescents and young adults with common psychiatric disorders who engage in regular cannabis use. A total of 989 studies were screened for inclusion. Study's titles and abstracts were screened and advanced to full text review for further screening by two independent reviewers. Thirty-five full-text articles were reviewed, with five articles ultimately meeting all criteria for inclusion. Five randomized controlled trials examined the effects of therapeutic interventions in youth with common psychiatric disorders who used cannabis, including two studies on depression, one on bipolar disorder, one on anxiety and one on PTSD were reviewed. No studies were considered high in risk of bias. Overall, there is a paucity of research on the treatment of comorbid adolescent mental health disorders and cannabis use, which limits the ability to draw evidence-based treatment recommendations.
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Affiliation(s)
- Carol Vidal
- Johns Hopkins School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | - Kevin M Simon
- Harvard Medical School, Department of Psychiatry, USA
| | - Caroline Brooks
- Johns Hopkins School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | - Jacob White
- SOM Admin Welch Informationist Services, USA
| | - Jesse D Hinckley
- University of Colorado School of Medicine, Department of Psychiatry, USA
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Kerr DCR, Levy NS, Bae H, Boustead AE, Martins SS. Cannabis and Alcohol Use by U.S. Young Adults, 2008-2019: Changes in Prevalence After Recreational Cannabis Legalization. Am J Prev Med 2023; 65:983-992. [PMID: 37331488 PMCID: PMC10725514 DOI: 10.1016/j.amepre.2023.06.009] [Citation(s) in RCA: 6] [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: 12/15/2022] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Young adults' cannabis and alcohol use patterns have changed after state recreational cannabis legalization according to studies based on college samples but not nationally representative samples. Associations between recreational cannabis legalization and changes in cannabis and alcohol use outcomes among young adults were examined, including differences by college enrollment and minor status (ages 18-20 vs 21-23 years). METHODS Repeated cross-sectional data (2008-2019) were collected from college-eligible participants aged 18-23 years in the National Survey on Drug Use and Health. Self-reported past-month cannabis use and frequent use (≥20 days) and a proxy for past-year DSM-5 cannabis use disorder were primary outcomes; past-month frequent alcohol use and binge drinking were secondary outcomes. Multilevel logistic regression models quantified changes in outcome prevalence from the study years before to after recreational cannabis legalization, adjusting for secular trends. Analyses were conducted on March 22, 2022. RESULTS Prevalence increased from before to after recreational cannabis legalization for past-month cannabis use (from 21% to 25%) and past-year proxy cannabis use disorder (from 11% to 13%); the increases were statistically significant [adjusted odds ratio (95% CI) = 1.20 (1.08-1.32) and 1.14 (1.003-1.30), respectively]. Increases were detected for young adults who were not in college and who were aged 21-23 years. Recreational cannabis legalization impacts were not detected for secondary outcomes. CONCLUSIONS Some young adults appear sensitive to state recreational cannabis legalization, including in terms of cannabis use disorder risk. Additional prevention efforts should be directed to young adults who are not in college and timed to occur before age 21 years.
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Affiliation(s)
- David C R Kerr
- School of Psychological Science, Oregon State University, Corvallis, Oregon
| | - Natalie S Levy
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Harold Bae
- Biostatistics Program, School of Behavioral and Population Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon
| | - Anne E Boustead
- School of Government and Public Policy, University of Arizona, Tucson, Arizona
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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Baumer AM, Nestor BA, Potter K, Knoll S, Evins AE, Gilman J, Kossowsky J, Schuster RM. Assessing changes in sleep across four weeks among adolescents randomized to incentivized cannabis abstinence. Drug Alcohol Depend 2023; 252:110989. [PMID: 37839357 PMCID: PMC10691527 DOI: 10.1016/j.drugalcdep.2023.110989] [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: 07/07/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Withdrawal from cannabis use is associated with sleep disturbances, often leading to resumption of use. Less is known about the impact of abstinence on sleep in adolescence, a developmental window associated with high rates of sleep disturbance. This study investigated effects of sustained abstinence on self-reported sleep quality and disturbance in adolescents reporting frequent cannabis use. METHODS Non-treatment seeking adolescents, recruited from school screening surveys and the community, with frequent cannabis use (MAge=17.8, SDAge=1.7, 47% female, 45% non-white) were randomized to four weeks of biochemically-verified abstinence, motivated via contingency management (CB-Abst, n=53), or monitoring without an abstinence requirement (CB-Mon, n=63). A mixed-effects model was used to predict change in Pittsburgh Sleep Quality Index (PSQI) scores. RESULTS Participants in CB-Abst reported higher overall PSQI scores than those in CB-Mon (M=1.06, p=0.01) indicating worse sleep during the four-week trial. Sleep disruptions in CB-Abst increased during Week 1 of abstinence (d=0.34, p=0.04), decreased during Week 2 (d=0.36, p=0.04), and remained constant for the rest of the trial. At Week 4, sleep was comparable to baseline levels for those in CB-Abst (p=0.87). Withdrawal-associated sleep disruption in the CB-Abst group was circumscribed to increases in sleep latency (b=0.35; p=0.05). CONCLUSIONS Cannabis abstinence in adolescents was associated with transient delayed onset of sleep initiation falling asleep during the first week of abstinence. Findings highlight withdrawal-associated changes in sleep latency as an intervention target for supporting adolescents attempting abstinence. Future research should use objective measures of sleep and focus on elucidating mechanisms underlying sleep disturbances with cannabis use and withdrawal.
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Affiliation(s)
- Andreas M Baumer
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, 333 Longwood Ave, Massachusetts 02115, USA
| | - Bridget A Nestor
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, 333 Longwood Ave, Massachusetts 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Kevin Potter
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - Sarah Knoll
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - A Eden Evins
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - Jodi Gilman
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, 333 Longwood Ave, Massachusetts 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Randi M Schuster
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
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10
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Chandwani B, Bradley BA, Pace A, Buse DC, Singh R, Kuruvilla D. The Exploration of Cannabis and Cannabinoid Therapies for Migraine. Curr Pain Headache Rep 2023; 27:339-350. [PMID: 37515745 DOI: 10.1007/s11916-023-01144-z] [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] [Accepted: 06/27/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE OF REVIEW There is increasing interest in the use of cannabis and cannabinoid therapies (CCT) by the general population and among people with headache disorders, which results in a need for healthcare professionals to be well versed with the efficacy and safety data. In this manuscript, we review cannabis and cannabinoid terminology, the endocannabinoid system and its role in the central nervous system (CNS), the data on efficacy, safety, tolerability, and potential pitfalls associated with use in people with migraine and headache disorders. We also propose possible mechanisms of action in headache disorders and debunk commonly held myths about its use. RECENT FINDINGS Preliminary studies show that CCT have evidence for the management of migraine. While this evidence exists, further randomized, controlled studies are needed to better support its clinical use. CCT can be considered an integrative treatment added to mainstream medicine for people with migraine who are refractory to treatment and/or exhibit disability and/or interest in trying these therapies. Further studies are warranted to specify appropriate formulation, dosage, and indication(s). Although not included in guidelines or the AHS 2021 Consensus Statement on migraine therapies, with the legalization of CCT for medical or unrestricted use across the USA, recent systematic reviews highlighting the preliminary evidence for its use in migraine, it is vital for clinicians to be well versed in the efficacy, safety, and clinical considerations for their use. This review provides information which can help people with migraine and clinicians who care for them make mutual, well-informed decisions on the use of cannabis and cannabinoid therapies for migraine based on the existing data.
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Affiliation(s)
- Brijesh Chandwani
- Department of Diagnostic Sciences, Tufts University, 1 Kneeland St, Boston, MA, 02111, USA.
- Attending, Orofacial Pain Service, St. Barnabas Hospital, Bronx, NY, USA.
| | | | - Anna Pace
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
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11
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Dan-Glauser E, Framorando D, Solida-Tozzi A, Golay P, Gholam MM, Alameda L, Conus P, Moulin V. Evolution of impulsivity levels in relation to early cannabis use in violent patients in the early phase of psychosis. Psychol Med 2023; 53:3210-3219. [PMID: 35142601 PMCID: PMC10235661 DOI: 10.1017/s0033291721005316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 09/27/2021] [Accepted: 12/07/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Prevention of violent behaviors (VB) in the early phase of psychosis (EPP) is a real challenge. Impulsivity was shown to be strongly related to VB, and different evolutions of impulsivity were noticed along treatments. One possible variable involved in the relationship between VB and the evolution of impulsivity is cannabis use (CU). The high prevalence of CU in EPP and its relationship with VB led us to investigate: 1/the impact of CU and 2/the impact of early CU on the evolution of impulsivity levels during a 3-year program, in violent and non-violent EPP patients. METHODS 178 non-violent and 62 violent patients (VPs) were followed-up over a 3 year period. Age of onset of CU was assessed at program entry and impulsivity was assessed seven times during the program. The evolution of impulsivity level during the program, as a function of the violent and non-violent groups of patients and CU precocity were analyzed with linear mixed-effects models. RESULTS Over the treatment period, impulsivity level did not evolve as a function of the interaction between group and CU (coef. = 0.02, p = 0.425). However, when including precocity of CU, impulsivity was shown to increase significantly only in VPs who start consuming before 15 years of age (coef. = 0.06, p = 0.008). CONCLUSION The precocity of CU in VPs seems to be a key variable of the negative evolution of impulsivity during follow-up and should be closely monitored in EPP patients entering care since they have a higher risk of showing VB.
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Affiliation(s)
- Elise Dan-Glauser
- Department of psychiatry, Institute of Forensic Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Psychology, Lausanne University, Lausanne, Switzerland
| | - David Framorando
- Department of psychiatry, Institute of Forensic Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Solida-Tozzi
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Golay
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - M. Mehdi Gholam
- Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Instituto de Investigación Sanitaria de Sevilla, Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
- Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Valerie Moulin
- Department of psychiatry, Institute of Forensic Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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12
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Lambros AM, Sagar KA, Dahlgren MK, Kosereisoglu D, El-Abboud C, Smith RT, Gruber SA. CannaCount: an improved metric for quantifying estimates of maximum possible cannabinoid exposure. Sci Rep 2023; 13:5869. [PMID: 37041309 PMCID: PMC10090150 DOI: 10.1038/s41598-023-32671-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/31/2023] [Indexed: 04/13/2023] Open
Abstract
Increasing numbers of individuals have access to cannabinoid-based products containing various amounts of delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and other cannabinoids. Exposure to specific cannabinoids likely influences outcomes; however, current methods for quantifying cannabis exposure do not account for the cannabinoid concentrations of the products used. We developed CannaCount, an examiner-driven metric that quantifies estimated maximum possible cannabinoid exposure by accounting for variables related to cannabinoid concentration, duration, frequency, and quantity of use. To demonstrate feasibility and applicability, CannaCount was used to quantify estimated maximum THC and CBD exposure in 60 medical cannabis patients enrolled in a two-year, longitudinal, observational study. Medical cannabis patients reported using a variety of product types and routes of administration. Calculating estimated exposure to THC and CBD was possible for the majority of study visits, and the ability to generate estimated cannabinoid exposure improved over time, likely a function of improved product labeling, laboratory testing, and more informed consumers. CannaCount is the first metric to provide estimated maximum possible exposure to individual cannabinoids based on actual cannabinoid concentrations. This metric will ultimately facilitate cross-study comparisons and can provide researchers and clinicians with detailed information regarding exposure to specific cannabinoids, which will likely have significant clinical impact.
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Affiliation(s)
- Ashley M Lambros
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - M Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Deniz Kosereisoglu
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
| | - Celine El-Abboud
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
| | - Rosemary T Smith
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core (CCNC), McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA.
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA.
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA.
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Niloy N, Hediyal TA, Vichitra C, Sonali S, Chidambaram SB, Gorantla VR, Mahalakshmi AM. Effect of Cannabis on Memory Consolidation, Learning and Retrieval and Its Current Legal Status in India: A Review. Biomolecules 2023; 13:biom13010162. [PMID: 36671547 PMCID: PMC9855787 DOI: 10.3390/biom13010162] [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: 11/01/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023] Open
Abstract
Cannabis is one of the oldest crops grown, traditionally held religious attachments in various cultures for its medicinal use much before its introduction to Western medicine. Multiple preclinical and clinical investigations have explored the beneficial effects of cannabis in various neurocognitive and neurodegenerative diseases affecting the cognitive domains. Tetrahydrocannabinol (THC), the major psychoactive component, is responsible for cognition-related deficits, while cannabidiol (CBD), a non-psychoactive phytocannabinoid, has been shown to elicit neuroprotective activity. In the present integrative review, the authors focus on the effects of cannabis on the different cognitive domains, including learning, consolidation, and retrieval. The present study is the first attempt in which significant focus has been imparted on all three aspects of cognition, thus linking to its usage. Furthermore, the investigators have also depicted the current legal position of cannabis in India and the requirement for reforms.
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Affiliation(s)
- Nandi Niloy
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
| | - Tousif Ahmed Hediyal
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
| | - Chandrasekaran Vichitra
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
| | - Sharma Sonali
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
| | - Saravana Babu Chidambaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
| | - Vasavi Rakesh Gorantla
- Department of Anatomical Science, St. George’s University, University Centre, St. Georges FZ818, Grenada
- Correspondence: (V.R.G.); (A.M.M.)
| | - Arehally M. Mahalakshmi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
- Centre for Experimental Pharmacology and Toxicology, Central Animal Facility, JSS Academy of Higher Education & Research, SS Nagar, Mysore 570015, Karnataka, India
- Correspondence: (V.R.G.); (A.M.M.)
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14
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Ostlund I, Von Gunten M, Smith C, Edwards JG. Chronic Δ9-tetrahydrocannabinol impact on plasticity, and differential activation requirement for CB1-dependent long-term depression in ventral tegmental area GABA neurons in adult versus young mice. Front Neurosci 2023; 16:1067493. [PMID: 36699526 PMCID: PMC9869137 DOI: 10.3389/fnins.2022.1067493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
The ventral tegmental area (VTA) mediates incentive salience and reward prediction error through dopamine (DA) neurons that are regulated by local VTA GABA neurons. In young mice, VTA GABA cells exhibit a form of synaptic plasticity known as long-term depression (LTD) that is dependent on cannabinoid 1 (CB1) receptors preceded by metabotropic glutamate receptor 5 (mGluR5) signaling to induce endocannabinoid production. This LTD was eliminated following chronic (7-10 consecutive days) exposure to the marijuana derived cannabinoid Δ9 -tetrahydrocannabinol (THC). We now examine the mechanism behind THC-induced elimination of LTD in adolescents as well as plasticity induction ability in adult versus young male and female mice using whole-cell electrophysiology experiments of VTA GABA cells. Chronic THC injections in adolescents resulted in a loss of CB1 agonist-mediated depression, illustrating chronic THC likely desensitizes or removes synaptic CB1. We noted that seven days withdrawal from chronic THC restored LTD and CB1 agonist-induced depression, suggesting reversibility of THC-induced changes. Adult mice continue to express functional mGluR5 and CB1, but require a doubling of the synaptic stimulation compared to young mice to induce LTD, suggesting a quantitative difference in CB1-dependent plasticity between young and adult mice. One potential rationale for this difference is changes in AMPA and NMDA glutamate receptors. Indeed, AMPA/NMDA ratios were increased in in adults compared to young mice. Lastly, we performed quantitative reverse-transcription PCR and identified that CB1, DAGLα, and GluA1 levels increased following chronic THC exposure. Collectively, our data demonstrate the first age-dependent GABA neuron plasticity in the VTA, which could have implications for decreased THC dependence capacity in adults, as well as the mechanism behind chronic THC-induced synaptic alterations in young mice.
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Affiliation(s)
- Isaac Ostlund
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT, United States
| | | | - Calvin Smith
- Neuroscience Center, Brigham Young University, Provo, UT, United States
| | - Jeffrey G. Edwards
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT, United States
- Neuroscience Center, Brigham Young University, Provo, UT, United States
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15
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Murray CJ, Vecchiarelli HA, Tremblay MÈ. Enhancing axonal myelination in seniors: A review exploring the potential impact cannabis has on myelination in the aged brain. Front Aging Neurosci 2023; 15:1119552. [PMID: 37032821 PMCID: PMC10073480 DOI: 10.3389/fnagi.2023.1119552] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/22/2023] [Indexed: 04/11/2023] Open
Abstract
Consumption of cannabis is on the rise as public opinion trends toward acceptance and its consequent legalization. Specifically, the senior population is one of the demographics increasing their use of cannabis the fastest, but research aimed at understanding cannabis' impact on the aged brain is still scarce. Aging is characterized by many brain changes that slowly alter cognitive ability. One process that is greatly impacted during aging is axonal myelination. The slow degradation and loss of myelin (i.e., demyelination) in the brain with age has been shown to associate with cognitive decline and, furthermore, is a common characteristic of numerous neurological diseases experienced in aging. It is currently not known what causes this age-dependent degradation, but it is likely due to numerous confounding factors (i.e., heightened inflammation, reduced blood flow, cellular senescence) that impact the many cells responsible for maintaining overall homeostasis and myelin integrity. Importantly, animal studies using non-human primates and rodents have also revealed demyelination with age, providing a reliable model for researchers to try and understand the cellular mechanisms at play. In rodents, cannabis was recently shown to modulate the myelination process. Furthermore, studies looking at the direct modulatory impact cannabis has on microglia, astrocytes and oligodendrocyte lineage cells hint at potential mechanisms to prevent some of the more damaging activities performed by these cells that contribute to demyelination in aging. However, research focusing on how cannabis impacts myelination in the aged brain is lacking. Therefore, this review will explore the evidence thus far accumulated to show how cannabis impacts myelination and will extrapolate what this knowledge may mean for the aged brain.
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Affiliation(s)
- Colin J. Murray
- Neuroscience Graduate Program, University of Victoria, Victoria, BC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- *Correspondence: Colin J. Murray,
| | | | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Départment de Médicine Moléculaire, Université Laval, Québec City, QC, Canada
- Axe Neurosciences, Center de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
- Neurology and Neurosurgery Department, McGill University, Montréal, QC, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, BC, Canada
- Institute for Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
- Marie-Ève Tremblay,
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16
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Dahlgren MK, Gonenc A, Sagar KA, Smith RT, Lambros AM, El-Abboud C, Gruber SA. Increased White Matter Coherence Following Three and Six Months of Medical Cannabis Treatment. Cannabis Cannabinoid Res 2022; 7:827-839. [PMID: 36367574 PMCID: PMC9784607 DOI: 10.1089/can.2022.0097] [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] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have demonstrated abnormal white matter (WM) microstructure in recreational cannabis consumers; however, the long-term impact of medical cannabis (MC) use on WM coherence is unknown. Accordingly, this study assessed the longitudinal impact of MC treatment on WM coherence. Given results from preclinical studies, we hypothesized that MC treatment would be associated with increased fractional anisotropy (FA) and reduced mean diffusivity (MD). Methods: As part of a larger, longitudinal investigation, patients interested in treating at least one medical condition with commercially available MC products of their choosing were assessed before initiating MC use (baseline n=37; female=25, male=12) and following three (n=31) and six (n=22) months of treatment. WM coherence was assessed via diffusion tensor imaging for bilateral regions of interest including the genu of the corpus callosum, anterior limb of the internal capsule, external capsule, and anterior corona radiata, as well as an occipital control region not expected to change over time. Results: In MC patients, FA values significantly increased bilaterally in several callosal regions relative to baseline following both 3 and 6 months of treatment; MD values significantly decreased in all callosal regions but only following 6 months of treatment. No significant changes in WM coherence were observed in the control region or in a pilot sample of treatment-as-usual patients (baseline n=14), suggesting that increased WM coherence observed in MC patients may be attributed to MC treatment as opposed to confounding factors. Interestingly, significant reductions in MD values correlated with higher cannabidiol (CBD) exposure but not Δ-9-tetrahydrocannabinol exposure. Conclusions: Overall, MC treatment was associated with increased WM coherence, which contrasts with prior research examining recreational cannabis consumers, likely related to inherent differences between recreational consumers and MC patients (e.g., product choice, age of onset). In addition, increased CBD exposure was associated with reduced MD following 6 months of treatment, extending evidence from preclinical research indicating that CBD may be neuroprotective against demyelination. However, additional research is needed to elucidate the clinical efficacy of MC treatment and the risks and benefits of long-term MC use.
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Affiliation(s)
- Mary Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly A. Sagar
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Rosemary T. Smith
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
| | - Ashley M. Lambros
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
| | - Celine El-Abboud
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
| | - Staci A. Gruber
- Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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17
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Lichenstein SD, Shaw DS, Forbes EE. Cannabis, connectivity, and coming of age: Associations between cannabis use and anterior cingulate cortex connectivity during the transition to adulthood. Front Hum Neurosci 2022; 16:951204. [PMID: 36438638 PMCID: PMC9692120 DOI: 10.3389/fnhum.2022.951204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/26/2022] [Indexed: 08/10/2023] Open
Abstract
Cannabis use is common among adolescents and emerging adults and is associated with significant adverse consequences for a subset of users. Rates of use peak between the ages of 18-25, yet the neurobiological consequences for neural systems that are actively developing during this time remain poorly understood. In particular, cannabis exposure may interfere with adaptive development of white matter pathways underlying connectivity of the anterior cingulate cortex, including the cingulum and anterior thalamic radiations (ATR). The current study examined the association between cannabis use during adolescence and emerging adulthood and white matter microstructure of the cingulum and ATR among 158 male subjects enrolled in the Pitt Mother and Child Project, a prospective, longitudinal study of risk and resilience among men of low socioeconomic status. Participants were recruited in infancy, completed follow-up assessments throughout childhood and adolescence, and underwent diffusion imaging at ages 20 and 22. At age 20, moderate cannabis use across adolescence (age 12-19) was associated with higher fractional anisotropy (FA) of the cingulum and ATR, relative to both minimal and heavy adolescent use. Longitudinally, moderate and heavy extended cannabis use (age 12-21) was associated with reduced positive change in FA in the cingulum from age 20 to 22, relative to minimal use. These longitudinal results suggest that cannabis exposure may delay cingulum maturation during the transition to adulthood and potentially impact individuals' functioning later in development.
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Affiliation(s)
- Sarah D. Lichenstein
- Yale Imaging and Psychopharmacology (YIP) Lab, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Daniel S. Shaw
- Pitt Parents and Children Laboratory (PPCL), Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Erika E. Forbes
- Affective Neuroscience and Developmental Psychopathology (ANDP) Lab, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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18
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Agunbiade K, Fonville L, McGonigle J, Elliott R, Ersche KD, Flechais R, Orban C, Murphy A, Smith DG, Suckling J, Taylor EM, Deakin B, Robbins TW, Nutt DJ, Lingford‐Hughes AR, Paterson LM, Nutt D, Lingford‐Hughes A, Paterson L, McGonigle J, Flechais R, Orban C, Deakin B, Elliott R, Murphy A, Taylor E, Robbins T, Ersche K, Suckling J, Smith D, Reed L, Passetti F, Faravelli L, Erritzoe D, Mick I, Kalk N, Waldman A, Nestor L, Kuchibatla S, Boyapati V, Metastasio A, Faluyi Y, Fernandez‐Egea E, Abbott S, Sahakian B, Voon V, Rabiner I. Alterations in white matter microstructure in alcohol and alcohol‐polydrug dependence: Associations with lifetime alcohol and nicotine exposure. Addict Biol 2022. [PMCID: PMC9540248 DOI: 10.1111/adb.13207] [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] [Indexed: 11/29/2022]
Abstract
Evidence suggests that alcohol dependence (AD) is associated with microstructural deficits in white matter, but the relationship with lifetime alcohol exposure and the impact of polydrug dependence is not well understood. Using diffusion tensor magnetic resonance (MR) imaging, we examined white matter microstructure in relation to alcohol and polydrug dependence using data from the Imperial College Cambridge Manchester (ICCAM) platform study. Tract‐based spatial statistics were used to examine fractional anisotropy (FA) in a cohort of abstinent AD participants, most of whom had a lifetime history of dependence to nicotine. A further subgroup also had a lifetime history of dependence to cocaine and/or opiates. Individuals with AD had lower FA throughout the corpus callosum, and negative associations with alcohol and nicotine exposure were found. A group‐by‐age interaction effect was found showing greater reductions with age in the alcohol‐dependent group within corpus callosum, overlapping with the group difference. We found no evidence of recovery with abstinence. A comparison of alcohol‐only‐ and alcohol‐polydrug‐dependent groups found no differences in FA. Overall, our findings show that AD is associated with lower FA and suggest that these alterations are primarily driven by lifetime alcohol consumption and cigarette smoking, showing no relationship with exposure to other substances such as cocaine, opiates or cannabis. Reductions in FA across the adult lifespan are more pronounced in AD and offer further support for the notion of accelerated ageing in relation to alcohol dependence. These findings highlight there may be lasting structural differences in white matter in alcohol dependence, despite continued abstinence.
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Affiliation(s)
- Kofoworola Agunbiade
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Leon Fonville
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - John McGonigle
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Karen D. Ersche
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychiatry University of Cambridge Cambridge UK
- Department of Systems Neuroscience University Medical Centre Hamburg‐Eppendorf Hamburg Germany
| | - Remy Flechais
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Csaba Orban
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Anna Murphy
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Dana G. Smith
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychology University of Cambridge Cambridge UK
| | - John Suckling
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychiatry University of Cambridge Cambridge UK
| | - Eleanor M. Taylor
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychology University of Cambridge Cambridge UK
| | - David J. Nutt
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | | | - Louise M. Paterson
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
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19
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Murray CH, Huang Z, Lee R, de Wit H. Adolescents are more sensitive than adults to acute behavioral and cognitive effects of THC. Neuropsychopharmacology 2022; 47:1331-1338. [PMID: 35110688 PMCID: PMC9117219 DOI: 10.1038/s41386-022-01281-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/09/2022]
Abstract
Increased cannabis availability has contributed to increased use with concomitant incidence of adverse effects. One risk factor for adverse drug reactions may be age. There is preclinical evidence that acute effects of delta-9-tetrahydrocannabinol (THC), the primary active constituent of cannabis, are greater during adolescence, but this has not been fully studied in humans. The present study sought to determine whether adolescent men and women are more sensitive than adults to acute THC. Adolescents aged 18-20 (N = 12) and adults aged 30-40 (N = 12), with less than 20 total lifetime uses of THC-containing products, received capsules of THC (7.5, 15 mg) and placebo across three study sessions in randomized order under double blind conditions. During each session, subjective, cardiovascular, behavioral, and EEG measures were obtained. Behavioral measures included Simple Reaction Time, Stop Task, Time Production and N-back and EEG measures included P300 amplitudes during an auditory oddball task and eyes-closed resting state. THC affected subjective state and heart rate similarly in both age groups. However, adolescents were more sensitive to performance impairing effects, exhibiting dose-dependent impairments on reaction time, response accuracy, and time perception. On EEG measures, THC dose-dependently decreased P300 amplitude in adolescents but not adults. Adolescents were more sensitive to behavioral and cognitive effects of THC, but not to cardiovascular effects or subjective measures. Thus, at doses that produce comparable ratings of intoxication, adolescents may exhibit greater cognitive impairment and alterations in brain function.
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Affiliation(s)
- Conor H. Murray
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Zhengyi Huang
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Royce Lee
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
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20
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Sex Differences in Substance Use, Prevalence, Pharmacological Therapy, and Mental Health in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci 2022; 12:brainsci12050590. [PMID: 35624977 PMCID: PMC9139081 DOI: 10.3390/brainsci12050590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.
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21
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Lichenstein SD, Manco N, Cope LM, Egbo L, Garrison KA, Hardee J, Hillmer AT, Reeder K, Stern EF, Worhunsky P, Yip SW. Systematic review of structural and functional neuroimaging studies of cannabis use in adolescence and emerging adulthood: evidence from 90 studies and 9441 participants. Neuropsychopharmacology 2022; 47:1000-1028. [PMID: 34839363 PMCID: PMC8938408 DOI: 10.1038/s41386-021-01226-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/21/2021] [Accepted: 10/28/2021] [Indexed: 11/09/2022]
Abstract
Cannabis use peaks in adolescence, and adolescents may be more vulnerable to the neural effects of cannabis and cannabis-related harms due to ongoing brain development during this period. In light of ongoing cannabis policy changes, increased availability, reduced perceptions of harm, heightened interest in medicinal applications of cannabis, and drastic increases in cannabis potency, it is essential to establish an understanding of cannabis effects on the developing adolescent brain. This systematic review aims to: (1) synthesize extant literature on functional and structural neural alterations associated with cannabis use during adolescence and emerging adulthood; (2) identify gaps in the literature that critically impede our ability to accurately assess the effect of cannabis on adolescent brain function and development; and (3) provide recommendations for future research to bridge these gaps and elucidate the mechanisms underlying cannabis-related harms in adolescence and emerging adulthood, with the long-term goal of facilitating the development of improved prevention, early intervention, and treatment approaches targeting adolescent cannabis users (CU). Based on a systematic search of Medline and PsycInfo and other non-systematic sources, we identified 90 studies including 9441 adolescents and emerging adults (n = 3924 CU, n = 5517 non-CU), which provide preliminary evidence for functional and structural alterations in frontoparietal, frontolimbic, frontostriatal, and cerebellar regions among adolescent cannabis users. Larger, more rigorous studies are essential to reconcile divergent results, assess potential moderators of cannabis effects on the developing brain, disentangle risk factors for use from consequences of exposure, and elucidate the extent to which cannabis effects are reversible with abstinence. Guidelines for conducting this work are provided.
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Affiliation(s)
| | - Nick Manco
- Medical University of South Carolina, Charleston, SC, USA
| | - Lora M Cope
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Leslie Egbo
- Neuroscience and Behavior Program, Wesleyan University, Middletown, CT, USA
| | | | - Jillian Hardee
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Ansel T Hillmer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Kristen Reeder
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA
| | - Elisa F Stern
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Patrick Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
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22
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Courtney KE, Sorg S, Baca R, Doran N, Jacobson A, Liu TT, Jacobus J. The Effects of Nicotine and Cannabis Co-Use During Late Adolescence on White Matter Fiber Tract Microstructure. J Stud Alcohol Drugs 2022; 83:287-295. [PMID: 35254252 PMCID: PMC8909919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Co-use of cannabis and nicotine and tobacco products (NTPs) in adolescence/young adulthood is common and associated with worse outcomes than the use of either substance in isolation. Despite this, little is known about the unique contributions of co-use to neurostructural microstructure during this neurodevelopmentally important period. This study sought to investigate the interactive effects of nicotine and cannabis co-use on white matter fiber tract microstructure in emerging adulthood. METHOD A total of 111 late adolescent (16-22 years old) nicotine (NTP; n = 55, all past-year cannabis users) and non-nicotine users (non-NTP; n = 56, 61% reporting cannabis use in the past year) completed demographic and clinical interviews and a neuroimaging session comprising anatomical and diffusion-weighted imaging scans. Group connectometry analysis identified white matter tracts significantly associated with the interaction between nicotine group and past-year cannabis use according to generalized fractional anisotropy (GFA). RESULTS Nicotine Group × Cannabis Use interactions were observed in the right and left cingulum and left fornix tracts (false discovery rate = 0.053), where greater cannabis use was associated with increased GFA in the cingulum and left fornix, but only when co-used with nicotine. CONCLUSIONS This report represents the first group connectometry analysis in late adolescent/young adult cannabis and/or NTP users. Results suggest that co-use of cannabis and NTPs results in a structurally distinct white matter phenotype as compared with cannabis use only, although to what extent this may change over time with more chronic nicotine and cannabis use remains to be examined in future work.
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Affiliation(s)
- Kelly E. Courtney
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Scott Sorg
- Department of Psychiatry, University of California, San Diego, La Jolla, California,Veterans Affairs San Diego Healthcare System, La Jolla, California
| | - Rachel Baca
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Neal Doran
- Department of Psychiatry, University of California, San Diego, La Jolla, California,Veterans Affairs San Diego Healthcare System, La Jolla, California
| | - Aaron Jacobson
- Department of Radiology, University of California San Diego, La Jolla, California
| | - Thomas T. Liu
- Department of Radiology, University of California San Diego, La Jolla, California
| | - Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, La Jolla, California,Correspondence may be sent to Joanna Jacobus at the Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA 92093, or via email at:
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23
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Courtney KE, Sorg S, Baca R, Doran N, Jacobson A, Liu TT, Jacobus J. The Effects of Nicotine and Cannabis Co-Use During Late Adolescence on White Matter Fiber Tract Microstructure. J Stud Alcohol Drugs 2022; 83:287-295. [PMID: 35254252 PMCID: PMC8909919 DOI: 10.15288/jsad.2022.83.287] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/24/2021] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE Co-use of cannabis and nicotine and tobacco products (NTPs) in adolescence/young adulthood is common and associated with worse outcomes than the use of either substance in isolation. Despite this, little is known about the unique contributions of co-use to neurostructural microstructure during this neurodevelopmentally important period. This study sought to investigate the interactive effects of nicotine and cannabis co-use on white matter fiber tract microstructure in emerging adulthood. METHOD A total of 111 late adolescent (16-22 years old) nicotine (NTP; n = 55, all past-year cannabis users) and non-nicotine users (non-NTP; n = 56, 61% reporting cannabis use in the past year) completed demographic and clinical interviews and a neuroimaging session comprising anatomical and diffusion-weighted imaging scans. Group connectometry analysis identified white matter tracts significantly associated with the interaction between nicotine group and past-year cannabis use according to generalized fractional anisotropy (GFA). RESULTS Nicotine Group × Cannabis Use interactions were observed in the right and left cingulum and left fornix tracts (false discovery rate = 0.053), where greater cannabis use was associated with increased GFA in the cingulum and left fornix, but only when co-used with nicotine. CONCLUSIONS This report represents the first group connectometry analysis in late adolescent/young adult cannabis and/or NTP users. Results suggest that co-use of cannabis and NTPs results in a structurally distinct white matter phenotype as compared with cannabis use only, although to what extent this may change over time with more chronic nicotine and cannabis use remains to be examined in future work.
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Affiliation(s)
- Kelly E. Courtney
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Scott Sorg
- Department of Psychiatry, University of California, San Diego, La Jolla, California
- Veterans Affairs San Diego Healthcare System, La Jolla, California
| | - Rachel Baca
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Neal Doran
- Department of Psychiatry, University of California, San Diego, La Jolla, California
- Veterans Affairs San Diego Healthcare System, La Jolla, California
| | - Aaron Jacobson
- Department of Radiology, University of California San Diego, La Jolla, California
| | - Thomas T. Liu
- Department of Radiology, University of California San Diego, La Jolla, California
| | - Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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24
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Cousijn J, Toenders YJ, Velzen LS, Kaag AM. The relation between cannabis use, dependence severity and white matter microstructure: A diffusion tensor imaging study. Addict Biol 2022; 27:e13081. [PMID: 34402136 PMCID: PMC9285423 DOI: 10.1111/adb.13081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/30/2021] [Accepted: 07/14/2021] [Indexed: 01/12/2023]
Abstract
Despite the significant societal and personal burden of cannabis use, the impact of long‐term use and Cannabis Use Disorder (CUD) on white matter microstructure is still unclear. Previous studies show inconsistent findings, in part due to heterogeneity in methodology, variable severity of cannabis use, and potential confounding effects of other mental health issues and substance use. The goal of this diffusion tensor imaging (DTI) study was to compare whole‐brain white matter microstructure between 39 near daily cannabis users and 28 controls closely matched on age, sex, alcohol use, cigarette use and mental health. Within the group of cannabis users, associations between white matter microstructure and recent cannabis use, dependence severity, and age of onset and duration of weekly use were investigated. White matter microstructure did not differ between cannabis users and controls and did not covary with recent cannabis use, dependence severity, or duration of use. Earlier onset of weekly cannabis use was related to lower fractional anisotropy (FA) in various sections of the right inferior longitudinal fasciculus and uncinate fasciculus. These findings suggest that long‐term near‐daily cannabis use does not necessarily affect white matter microstructure, but vulnerability may be higher during adolescence. These findings underscore the importance of sample composition and warrant further studies that investigate the moderating role of age of onset in the impact of cannabis on the brain.
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Affiliation(s)
- Janna Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies Erasmus University Rotterdam Rotterdam The Netherlands
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
| | - Yara J. Toenders
- Orygen, The National Centre of Excellence in Youth Mental Health Parkville Victoria Australia
- Centre for Youth Mental Health The University of Melbourne Parkville Victoria Australia
| | - Laura S. Velzen
- Orygen, The National Centre of Excellence in Youth Mental Health Parkville Victoria Australia
- Centre for Youth Mental Health The University of Melbourne Parkville Victoria Australia
| | - Anne Marije Kaag
- Department of Clinical, Neuro‐ and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Institute for Brain and Behavior Amsterdam Vrije Universiteit Amsterdam The Netherlands
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25
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Moulin V, Framorando D, Gasser J, Dan-Glauser E. The Link Between Cannabis Use and Violent Behavior in the Early Phase of Psychosis: The Potential Role of Impulsivity. Front Psychiatry 2022; 13:746287. [PMID: 35392388 PMCID: PMC8980530 DOI: 10.3389/fpsyt.2022.746287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Recently, the literature has shown that Cannabis Use (CU) was a risk factor for Violent Behavior (VB) in patients with psychosis, and those in the early phase of psychosis (EPP). These findings are relevant because of the high prevalence of CU in this EPP, and the potential for prevention during this phase of illness. However, there is still a lack of clear explanations, supported by empirical evidence, about what underlies the link between CU and VB against other. METHOD This viewpoint reviews the scientific literature on the link between CU and VB, and the involvement of impulsivity in this relationship. This last point will be addressed at clinical and neurobiological levels. RESULTS Recent studies confirmed that CU is particularly high in the EPP, and is a risk factor for VB in the EPP and schizophrenia. Studies have also shown that impulsivity is a risk factor for VB in psychosis, is associated with CU, and may mediate the link between CU and VB. Research suggests a neurobiological mechanism, as CU affects the structures and function of frontal areas, known to play a role in impulsive behavior. CONCLUSION Scientific evidence support the hypothesis of an involvement of impulsivity as a variable that could mediate the link between CU and aggression, particularly, when CU has an early onset. However, this hypothesis should be confirmed with longitudinal studies and by taking into account confounding factors. The studies highlight the relevance of early prevention in the EPP, in addition to interventions focusing on psychotic disorders.
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Affiliation(s)
- Valerie Moulin
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - David Framorando
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Jacques Gasser
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Elise Dan-Glauser
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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26
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Stark T, Di Martino S, Drago F, Wotjak CT, Micale V. Phytocannabinoids and schizophrenia: Focus on adolescence as a critical window of enhanced vulnerability and opportunity for treatment. Pharmacol Res 2021; 174:105938. [PMID: 34655773 DOI: 10.1016/j.phrs.2021.105938] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022]
Abstract
The recent shift in socio-political debates and growing liberalization of Cannabis use across the globe has raised concern regarding its impact on vulnerable populations such as adolescents. Concurrent with declining perception of Cannabis harms, more adolescents are using it daily in several countries and consuming marijuana strains with high content of psychotropic delta (9)-tetrahydrocannabinol (THC). These dual, related trends seem to facilitate the development of compromised social and cognitive performance at adulthood, which are described in preclinical and human studies. Cannabis exerts its effects via altering signalling within the endocannabinoid system (ECS), which modulates the stress circuitry during the neurodevelopment. In this context early interventions appear to circumvent the emergence of adult neurodevelopmental deficits. Accordingly, Cannabis sativa second-most abundant compound, cannabidiol (CBD), emerges as a potential therapeutic agent to treat neuropsychiatric disorders. We first focus on human and preclinical studies on the long-term effects induced by adolescent THC exposure as a "critical window" of enhanced neurophysiological vulnerability, which could be involved in the pathophysiology of schizophrenia and related primary psychotic disorders. Then, we focus on adolescence as a "window of opportunity" for early pharmacological treatment, as novel risk reduction strategy for neurodevelopmental disorders. Thus, we review current preclinical and clinical evidence regarding the efficacy of CBD in terms of positive, negative and cognitive symptoms treatment, safety profile, and molecular targets.
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Affiliation(s)
- Tibor Stark
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Stress Neurobiology & Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany
| | - Serena Di Martino
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Carsten T Wotjak
- Department of Stress Neurobiology & Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany; Central Nervous System Diseases Research (CNSDR), Boehringer Ingelheim Pharma GmbH & Co KG, 88397 Biberach an der Riss, Germany
| | - Vincenzo Micale
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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27
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Cannabis Use, Age of Initiation, and Neurocognitive Performance: Findings from a Large Sample of Heavy Drinking Emerging Adults. J Int Neuropsychol Soc 2021; 27:533-545. [PMID: 34261551 DOI: 10.1017/s1355617721000618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the associations between cannabis use and neurocognitive functioning, including self-reported attention deficit hyperactivity disorder (ADHD) symptoms, in a large sample of emerging adults (ages 21-25) using a cross-sectional design. A secondary objective was to examine age of cannabis initiation as a moderator. METHODS Participants were high-risk drinking emerging adults (n = 598) reporting past-month cannabis use in the following categories: 1) non-users (i.e., never or not in the past month; n = 276), 2) occasional users (i.e., monthly or weekly users; n = 201), and 3) daily users (n = 121). Categorical comparisons were conducted on working memory, attention, behavioral inhibition, delay and probability discounting, verbal intelligence, and ADHD symptoms. Complementary dimensional analyses examined cannabis severity in relation to neurocognition using regressions. Covariates were age, race, sex, income, years of education, tobacco use, and alcohol use. RESULTS Frequency of cannabis use was significantly associated with poorer working memory performance, more impulsive delay discounting, and greater endorsement of ADHD symptoms, but not other domains. Effect sizes were small and poorer performance was selectively present among daily, not occasional, cannabis users. Earlier age of initiation was not independently or interactively associated with neurocognitive performance. CONCLUSIONS Daily cannabis use was selectively adversely associated with aspects of memory, impulsivity, and subjective attentional functioning, but most cognitive indicators were not implicated, and evidence of amplification by earlier age of initiation was not observed. Ascertaining causal versus consequential roles of cannabis in neurocognitive functioning is an important priority.
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28
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Petker T, Ferro M, Van Ameringen M, Murphy J, MacKillop J. Daily, but not occasional, cannabis use is selectively associated with more impulsive delay discounting and hyperactive ADHD symptoms in binge-drinking young adults. Psychopharmacology (Berl) 2021; 238:1753-1763. [PMID: 33638699 DOI: 10.1007/s00213-021-05781-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
RATIONALE There is increasing interest in and evidence for the negative impacts of cannabis use in cognitive performance and symptoms of attention-deficit/hyperactivity disorder (ADHD), with age of first cannabis use as a potential amplifier of these associations. However, the existing literature is inconsistent, which may be due to methodological limitations, including small sample sizes. OBJECTIVE To examine current cannabis use and age of first cannabis use in relation to neurocognitive task performance and ADHD symptoms in a large sample of binge-drinking young adults. METHODS Participants were young adults (N=730, M age=21.44, 52.6% female) assessed for current cannabis use, neurocognitive task performance, and ADHD symptoms. Three-group ANCOVAs compared individuals reporting frequent (daily/multiple times daily), occasional (weekly/monthly), or no cannabis use. RESULTS Covarying alcohol use, tobacco use, age, sex, income, and education, daily cannabis users exhibited significantly more impulsive delay discounting and hyperactive-impulsive ADHD symptoms compared to both other groups. However, cannabis use was not associated with inattentive ADHD symptoms, verbal intelligence, working memory, probability discounting, short-term verbal memory, or behavioral inhibition. Age of initiation of cannabis use exhibited neither main effects nor interactions in relation to any domains of cognitive performance or ADHD symptomatology. CONCLUSIONS The current findings provide support for a link between cannabis use in relation to immediate reward preference and symptoms of hyperactive-impulsive ADHD in young adults, but only among frequent users. No other neurocognitive domains exhibited associations with cannabis and age of first use was neither independently nor interactively associated with cognitive outcomes.
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Affiliation(s)
- Tashia Petker
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada.,Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph's Health Care Hamilton, Hamilton, ON, Canada
| | - Mark Ferro
- School of Public Health and Systems, University of Waterloo, Waterloo, ON, Canada
| | - Michael Van Ameringen
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada.,Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph's Health Care Hamilton, Hamilton, ON, Canada
| | - James Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - James MacKillop
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3R2, Canada. .,Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph's Health Care Hamilton, Hamilton, ON, Canada. .,Homewood Research Institute, Guelph, ON, Canada.
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29
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Smith CL, Cooper BR, Miguel A, Hill L, Roll J, McPherson S. Predictors of cannabis and tobacco co-use in youth: exploring the mediating role of age at first use in the population assessment of tobacco health (PATH) study. J Cannabis Res 2021; 3:16. [PMID: 34074338 PMCID: PMC8170934 DOI: 10.1186/s42238-021-00072-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 05/12/2021] [Indexed: 11/11/2022] Open
Abstract
Background Adolescents often use substances such as tobacco and cannabis. Co-use of these substances can lead to physical, mental, and psychosocial difficulties beyond that which would be anticipated by simple additivity of their individual effects. Methods We aimed to examine the mediating role of age at first use of cannabis or tobacco (AU) between youth factors of internalizing, externalizing, and sensation seeking and two co-use outcomes (lifetime; last 30 days). Path analytic modeling using data from youth age 12–17 who had tried cannabis or tobacco at least once in their lives and participated in the Population Assessment of Tobacco Health (PATH) waves one and two (collected 2013–2015; n=3,847; approximately 46% female) study allowed us to examine these relationships. Results The lifetime use model indicated significant direct (internalizing (B = 0.18), externalizing (B = 0.30), sensation seeking (B = 0.15)) and indirect relationships (internalizing (B = 0.18), externalizing (B = 0.33), sensation seeking (B = 0.10)) between each of the three youth factors, the mediator (AU) and the lifetime co-use outcome (p < 0.05 for all). A direct relationship between AU and lifetime co-use was also observed (B = − 1.54). In the past 30-day use model, significant direct paths from AU (B = − 0.49) and sensation seeking (B = 0.06) to past 30-day use were present (p < 0.05 for all). Discussion Examination of mediation by AU in the relationships between youth factors and youth co-use of cannabis and tobacco is an important step in understanding these complex relationships. This study is strengthened by the use of a large, nationally representative sample, yet is limited by several factors, such as the use of a secondary dataset and the use of youth self-report. Conclusions Based on the findings, programs or interventions targeting youth factors of internalizing, externalizing, and sensation seeking as well as interventions aiming to stave off AU should promote decreased tobacco and cannabis co-use. Sensation seeking and AU appear to be the most influential factors and should be considered when developing and promoting prevention policies/programs for higher risk youth populations.
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Affiliation(s)
- Crystal Lederhos Smith
- Elson S. Floyd College of Medicine, Washington State University, P.O. Box 1495, Spokane, WA, 99210-1495, USA.
| | | | - Andre Miguel
- Elson S. Floyd College of Medicine, Washington State University, P.O. Box 1495, Spokane, WA, 99210-1495, USA
| | - Laura Hill
- Human Development, Washington State University, Spokane, WA, USA
| | - John Roll
- Elson S. Floyd College of Medicine, Washington State University, P.O. Box 1495, Spokane, WA, 99210-1495, USA
| | - Sterling McPherson
- Elson S. Floyd College of Medicine, Washington State University, P.O. Box 1495, Spokane, WA, 99210-1495, USA
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Koenis MMG, Durnez J, Rodrigue AL, Mathias SR, Alexander‐Bloch AF, Barrett JA, Doucet GE, Frangou S, Knowles EEM, Mollon J, Denbow D, Aberizk K, Zatony M, Janssen RJ, Curran JE, Blangero J, Poldrack RA, Pearlson GD, Glahn DC. Associations of cannabis use disorder with cognition, brain structure, and brain function in African Americans. Hum Brain Mapp 2021; 42:1727-1741. [PMID: 33340172 PMCID: PMC7978126 DOI: 10.1002/hbm.25324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 08/31/2020] [Accepted: 12/10/2020] [Indexed: 01/29/2023] Open
Abstract
Although previous studies have highlighted associations of cannabis use with cognition and brain morphometry, critical questions remain with regard to the association between cannabis use and brain structural and functional connectivity. In a cross-sectional community sample of 205 African Americans (age 18-70) we tested for associations of cannabis use disorder (CUD, n = 57) with multi-domain cognitive measures and structural, diffusion, and resting state brain-imaging phenotypes. Post hoc model evidence was computed with Bayes factors (BF) and posterior probabilities of association (PPA) to account for multiple testing. General cognitive functioning, verbal intelligence, verbal memory, working memory, and motor speed were lower in the CUD group compared with non-users (p < .011; 1.9 < BF < 3,217). CUD was associated with altered functional connectivity in a network comprising the motor-hand region in the superior parietal gyri and the anterior insula (p < .04). These differences were not explained by alcohol, other drug use, or education. No associations with CUD were observed in cortical thickness, cortical surface area, subcortical or cerebellar volumes (0.12 < BF < 1.5), or graph-theoretical metrics of resting state connectivity (PPA < 0.01). In a large sample collected irrespective of cannabis used to minimize recruitment bias, we confirm the literature on poorer cognitive functioning in CUD, and an absence of volumetric brain differences between CUD and non-CUD. We did not find evidence for or against a disruption of structural connectivity, whereas we did find localized resting state functional dysconnectivity in CUD. There was sufficient proof, however, that organization of functional connectivity as determined via graph metrics does not differ between CUD and non-user group.
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Affiliation(s)
- Marinka M. G. Koenis
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
| | - Joke Durnez
- Department of PsychologyStanford UniversityStanfordCaliforniaUSA
| | - Amanda L. Rodrigue
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Department of PsychiatryBoston Children's Hospital & Harvard Medical SchoolBostonMassachusettsUSA
| | - Samuel R. Mathias
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Department of PsychiatryBoston Children's Hospital & Harvard Medical SchoolBostonMassachusettsUSA
| | | | - Jennifer A. Barrett
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
| | - Gaelle E. Doucet
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sophia Frangou
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Emma E. M. Knowles
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Department of PsychiatryBoston Children's Hospital & Harvard Medical SchoolBostonMassachusettsUSA
| | - Josephine Mollon
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Department of PsychiatryBoston Children's Hospital & Harvard Medical SchoolBostonMassachusettsUSA
| | - Dominique Denbow
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
| | - Katrina Aberizk
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
| | - Molly Zatony
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
| | - Ronald J. Janssen
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
| | - Joanne E. Curran
- Department of Human Genetics, and South Texas Diabetes and Obesity InstituteSchool of Medicine, University of Texas Rio Grande ValleyBrownsvilleTexasUSA
| | - John Blangero
- Department of Human Genetics, and South Texas Diabetes and Obesity InstituteSchool of Medicine, University of Texas Rio Grande ValleyBrownsvilleTexasUSA
| | | | - Godfrey D. Pearlson
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
- Department of NeuroscienceYale UniversityNew HavenConnecticutUSA
| | - David C. Glahn
- Department of PsychiatrySchool of Medicine, Yale UniversityNew HavenConnecticutUSA
- Olin Neuropsychiatry Research CenterInstitute of LivingHartfordConnecticutUSA
- Department of PsychiatryBoston Children's Hospital & Harvard Medical SchoolBostonMassachusettsUSA
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31
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Thomas MB, Raghava JM, Pantelis C, Rostrup E, Nielsen MØ, Jensen MH, Glenthøj BY, Mandl RCW, Ebdrup BH, Fagerlund B. Associations between cognition and white matter microstructure in first-episode antipsychotic-naïve patients with schizophrenia and healthy controls: A multivariate pattern analysis. Cortex 2021; 139:282-297. [PMID: 33933719 DOI: 10.1016/j.cortex.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 01/19/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive functions have been associated with white matter (WM) microstructure in schizophrenia, but most studies are limited by examining only select cognitive measures and single WM tracts in chronic, medicated patients. It is unclear if the cognition-WM relationship differs between antipsychotic-naïve patients with schizophrenia and healthy controls, as differential associations have not been directly examined. Here we examine if there are differential patterns of associations between cognition and WM microstructure in first-episode antipsychotic-naïve patients with schizophrenia and healthy controls, and we characterize reliable contributors to the pattern of associations across multiple cognitive domains and WM regions, in order to elucidate white matter contribution to the neural underpinnings of cognitive deficits. METHODS Thirty-six first-episode antipsychotic-naïve patients with schizophrenia and 52 matched healthy controls underwent cognitive tests and diffusion-weighted imaging on a 3T Magnetic Resonance Imaging scanner. Using a multivariate partial least squares correlation analysis, we included 14 cognitive variables and mean fractional anisotropy values of 48 WM regions. RESULTS Initial analyses showed significant group differences in both measures of WM and cognition. There was no group interaction effect in the pattern of associations between cognition and WM microstructure. The combined analysis of patients and controls lead to a significant pattern of associations (omnibus test p = .015). Thirty-four regions and seven cognitive functions contributed reliably to the associations. CONCLUSIONS The lack of an interaction effect suggests similar associations in first-episode antipsychotic-naïve patients with schizophrenia and healthy controls. This, together with the differences in both WM and cognitive measurements, supports the involvement of WM in cognitive deficits in schizophrenia. Our findings add to the field by showing a coherent picture of the overall pattern of association between cognition and WM. These findings increase our understanding of the impact of WM on cognition, contributing to the search for neuromarkers of cognitive deficits in schizophrenia.
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Affiliation(s)
- Marie B Thomas
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Jayachandra M Raghava
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark.
| | - Christos Pantelis
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia.
| | - Egill Rostrup
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark.
| | - Mette Ø Nielsen
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.
| | - Maria H Jensen
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.
| | - Birte Y Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - René C W Mandl
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; UMC Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Birgitte Fagerlund
- Centre for Neuropsychiatric Schizophrenia Research, CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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Rinehart L, Spencer S. Which came first: Cannabis use or deficits in impulse control? Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110066. [PMID: 32795592 PMCID: PMC7750254 DOI: 10.1016/j.pnpbp.2020.110066] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/16/2022]
Abstract
Impulse control deficits are often found to co-occur with substance use disorders (SUDs). On the one hand, it is well known that chronic intake of drugs of abuse remodels the brain with significant consequences for a range of cognitive behaviors. On the other hand, individual variation in impulse control may contribute to differences in susceptibility to SUDs. Both of these relationships have been described, thus leading to a "chicken or the egg" debate which remains to be fully resolved. Does impulsivity precede drug use or does it manifest as a function of problematic drug usage? The link between impulsivity and SUDs has been most strongly established for cocaine and alcohol use disorders using both preclinical models and clinical data. Much less is known about the potential link between impulsivity and cannabis use disorder (CUD) or the directionality of this relationship. The initiation of cannabis use occurs most often during adolescence prior to the brain's maturation, which is recognized as a critical period of development. The long-term effects of chronic cannabis use on the brain and behavior have started to be explored. In this review we will summarize these observations, especially as they pertain to the relationship between impulsivity and CUD, from both a psychological and biological perspective. We will discuss impulsivity as a multi-dimensional construct and attempt to reconcile the results obtained across modalities. Finally, we will discuss possible avenues for future research with emerging longitudinal data.
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Affiliation(s)
- Linda Rinehart
- University of Minnesota, Department of Psychiatry and Behavioral Sciences
| | - Sade Spencer
- University of Minnesota, Department of Pharmacology, Minneapolis, MN, USA.
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33
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Stringfield SJ, Torregrossa MM. Disentangling the lasting effects of adolescent cannabinoid exposure. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110067. [PMID: 32791165 DOI: 10.1016/j.pnpbp.2020.110067] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
Cannabis is the most widely used illicit substance among adolescents, and adolescent cannabis use is associated with various neurocognitive deficits that can extend into adulthood. A growing body of evidence supports the hypothesis that adolescence encompasses a vulnerable period of development where exposure to exogenous cannabinoids can alter the normative trajectory of brain maturation. In this review, we present an overview of studies of human and rodent models that examine lasting effects of adolescent exposure. We include evidence from meta-analyses, longitudinal, or cross-sectional studies in humans that consider age of onset as a factor that contributes to the behavioral dysregulation and altered structural or functional development in cannabis users. We also discuss evidence from preclinical rodent models utilizing well-characterized or innovative routes of exposure, investigating the effects of dose and timing to produce behavioral deficits or alterations on a neuronal and behavioral level. Multiple studies from both humans and animals provide contrasting results regarding the magnitude of residual effects. Combined evidence suggests that exposure to psychoactive cannabinoids during adolescence has the potential to produce subtle, but lasting, alterations in neurobiology and behavior.
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Affiliation(s)
- Sierra J Stringfield
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA
| | - Mary M Torregrossa
- Department of Psychiatry, University of Pittsburgh, 450 Technology Drive, Pittsburgh, PA 15219, USA; Center for Neuroscience, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15213, USA.
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34
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Siringil Perker S, Chester LEH. The Justice System and Young Adults With Substance Use Disorders. Pediatrics 2021; 147:S249-S258. [PMID: 33386327 DOI: 10.1542/peds.2020-023523h] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 11/24/2022] Open
Abstract
Young adults' heightened vulnerability to substance use disorders (SUD) corresponds with their disproportionate representation in the criminal justice system. It is paramount that the justice system systemically recognize young adults as a group with distinct developmental needs and align reform efforts with advancements made in medical and public health fields to better address the needs of justice-involved young adults with SUD. This article warns against reliance on the justice system for engaging young adults with SUD in treatment and presents 4 principles that were developed by a workgroup participating in a longitudinal meeting of experts sponsored by Boston Medical Center's Grayken Center for Addiction. The goal of the principles is to support and guide policy and practice initiatives for developmentally appropriate justice responses to young adults with SUD. The article also reviews the evidence that underlies these principles and offers policy and practice considerations for their implementation.
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Affiliation(s)
- Selen Siringil Perker
- Emerging Adult Justice Project, Justice Lab, Columbia University, New York, New York
| | - Lael E H Chester
- Emerging Adult Justice Project, Justice Lab, Columbia University, New York, New York
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35
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Sorkhou M, Bedder RH, George TP. The Behavioral Sequelae of Cannabis Use in Healthy People: A Systematic Review. Front Psychiatry 2021; 12:630247. [PMID: 33664685 PMCID: PMC7920961 DOI: 10.3389/fpsyt.2021.630247] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Cannabis is known to have a broad range of effects on behavior, including experiencing a "high" and tranquility/relaxation. However, there are several adverse behavioral sequalae that can arise from cannabis use, depending on frequency of use, potency (e.g., THC content), age of onset, and cumulative exposure. This systematic review examined evidence for cannabis-related adverse behavioral sequalae in otherwise healthy human subjects. Methods: Following PRISMA guidelines, we conducted a systematic review of cross-sectional and longitudinal studies from 1990 to 2020 that identified cannabis-related adverse behavioral outcomes in subjects without psychiatric and medical co-morbidities from PubMed and PsychInfo searches. Key search terms included "cannabis" OR "tetrahydrocannabinol" OR "cannabidiol" OR "marijuana" AND "anxiety" OR "depression" OR "psychosis" OR "schizophrenia" "OR "IQ" OR "memory" OR "attention" OR "impulsivity" OR "cognition" OR "education" OR "occupation". Results: Our search detected a total of 2,870 studies, from which we extracted 124 relevant studies from the literature on cannabis effects in the non-clinical population. Effects of cannabis on several behavioral sequelae including cognition, motivation, impulsivity, mood, anxiety, psychosis intelligence, and psychosocial functioning were identified. The preponderance of the evidence suggests that frequency of cannabis use, THC (but not CBD) content, age of onset, and cumulative cannabis exposure can all contribute to these adverse outcomes in individuals without a pre-existing medical condition or psychiatric disorder. The strongest evidence for the negative effects of cannabis are for psychosis and psychosocial functioning. Conclusions: Although more research is needed to determine risk factors for development of adverse behavioral sequelae of cannabis use, these findings underline the importance of understanding vulnerability to the adverse effects of cannabis, which has implications for prevention and treatment of problematic cannabis use.
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Affiliation(s)
- Maryam Sorkhou
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Rachel H Bedder
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Courtney KE, Baca R, Doran N, Jacobson A, Liu TT, Jacobus J. The effects of nicotine and cannabis co-use during adolescence and young adulthood on white matter cerebral blood flow estimates. Psychopharmacology (Berl) 2020; 237:3615-3624. [PMID: 32803367 PMCID: PMC7686080 DOI: 10.1007/s00213-020-05640-7] [Citation(s) in RCA: 8] [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: 05/07/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Abstract
RATIONALE Co-use of cannabis and nicotine is common among adolescents/young adults and is associated with poorer psychological and physical outcomes, compared with single substance use. Little is known about the impact of co-use on the developing brain. OBJECTIVES Preliminary investigation of the effects of nicotine on white matter (WM) cerebral blood flow (CBF) in adolescents/young adults and its potential moderation by cannabis use. METHODS Adolescent/young adult (16-22 years old) nicotine and tobacco product users (NTP; N = 37) and non-nicotine users (non-NTP; N = 26) underwent a neuroimaging session comprised of anatomical, optimized pseudo-continuous arterial spin labeling, and diffusion tensor imaging scans. Groups were compared on whole-brain WM CBF estimates and their relation to past-year cannabis use. Follow-up analyses assessed correlations between identified CBF clusters and corresponding fractional anisotropy (FA) values. RESULTS Group by cannabis effects were observed in five clusters (voxel-wise alpha < 0.001, cluster-wise alpha < 0.05; ≥ 11 contiguous voxels): non-NTP exhibited positive correlations between CBF and cannabis use in all clusters, whereas no significant relationships were observed for NTP. Greater CBF extracted from one cluster (including portions of right superior longitudinal fasciculus) was associated with reduced FA for non-NTP group only. CONCLUSIONS This is the first investigation of WM health as indexed by CBF, and its association with FA, in adolescents/young adults with nicotine and/or cannabis use. Results suggest that cannabis use by itself may be related to increased CBF in WM fiber tracts demonstrating poorer structural intergrity, yet the occurrence of even infrequent NTP use (greater than once per month) appears to diminish this relationship.
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Affiliation(s)
- Kelly E Courtney
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
| | - Neal Doran
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
- Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | - Aaron Jacobson
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Thomas T Liu
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA.
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Schauer GL, Clayton HB, Njai R, Grant AM. Adolescent Marijuana Use and Related Risk Behaviors, National Findings From 2015 to 2017. Am J Prev Med 2020; 59:714-724. [PMID: 32981767 DOI: 10.1016/j.amepre.2020.05.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION As policies legalizing nonmedical marijuana have increased in states, understanding the implications of marijuana use among adolescents is increasingly important. This study uses nationally representative data to assess behavioral risk factors among students with different patterns of marijuana use. METHODS Data from the 2015 and 2017 Youth Risk Behavior Surveys, cross-sectional surveys conducted among a nationally representative sample of students in Grades 9-12 (n=30,389), were used to examine the association between self-reported current marijuana use status and self-report of 30 risk behaviors across 3 domains: substance use, injury/violence, and sexual health. Among current marijuana users, authors assessed differences between established (≥100 lifetime uses) and nonestablished (<100 uses) users. Multivariable models were used to calculate adjusted prevalence ratios. Data were analyzed in 2019. RESULTS Current marijuana users (regardless of use pattern) had a significantly greater likelihood of engaging in 27 of the 30 behaviors assessed across the 3 domains than the noncurrent users. Those with established use patterns (versus nonestablished) had a greater risk of lifetime use of most other substances (licit and illicit, including tobacco, alcohol, heroin, misuse of opioids), some injury/violence behaviors (including driving while using marijuana and suicide ideation and attempt), and sexual risk behaviors. CONCLUSIONS Both established and nonestablished patterns of adolescent marijuana use are associated with a number of other risky behaviors. In addition to interventions focused on preventing youth initiation of marijuana, clinicians and public health professionals should consider interventions to help adolescents who have nonestablished use patterns to avoid continued, established use.
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Affiliation(s)
- Gillian L Schauer
- CDC Foundation, Atlanta, Georgia; Department of Health Services, School of Public Health, University of Washington, Seattle, Washington.
| | - Heather B Clayton
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Rashid Njai
- Deputy Director for Non-Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Althea M Grant
- Deputy Director for Non-Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia
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Subramaniam P, Yurgelun-Todd D. Neural and behavioral correlates associated with adolescent marijuana use. CURRENT ADDICTION REPORTS 2020; 7:475-485. [PMID: 33777643 DOI: 10.1007/s40429-020-00335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose of Review Marijuana (MJ) is one of the most commonly used drugs among adolescents. Exposure to MJ during adolescence can lead to alterations in brain development, and, subsequently to the behavioral correlates regulated by the affected brain regions. In this review, we discuss findings from preclinical and human studies examining the relationship between adolescent MJ use and the neurobiological and behavioral correlates associated with it. Recent Findings Current findings indicate that adolescent MJ use is associated with alterations in brain structure and function, especially in regions that express high levels of the cannabinoid 1 receptor such as the prefrontal cortex, hippocampus, cerebellum and limbic regions. These alterations are correlated with changes in affective, cognitive and reward-seeking behavior. Furthermore, evidence suggests that exposure to MJ during adolescence can have long-lasting and pronounced neural and behavioral effects into adulthood. Summary The wide ranging neural and behavioral correlates associated with MJ use during adolescence highlight the need for further studies to better understand the potential risk factors and/or neurotoxic effects of adolescent MJ use.
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Affiliation(s)
- Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT
| | - Deborah Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT.,VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City VA Health Care System, Salt Lake City, UT, USA
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Montoya Z, Conroy M, Vanden Heuvel BD, Pauli CS, Park SH. Cannabis Contaminants Limit Pharmacological Use of Cannabidiol. Front Pharmacol 2020; 11:571832. [PMID: 33013414 PMCID: PMC7516211 DOI: 10.3389/fphar.2020.571832] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/25/2020] [Indexed: 01/15/2023] Open
Abstract
For nearly a century, Cannabis has been stigmatized and criminalized across the globe, but in recent years, there has been a growing interest in Cannabis due to the therapeutic potential of phytocannabinoids. With this emerging interest in Cannabis, concerns have arisen about the possible contaminations of hemp with pesticides, heavy metals, microbial pathogens, and carcinogenic compounds during the cultivation, manufacturing, and packaging processes. This is of particular concern for those turning to Cannabis for medicinal purposes, especially those with compromised immune systems. This review aims to provide types of contaminants and examples of Cannabis contamination using case studies that elucidate the medical consequences consumers risk when using adulterated Cannabis products. Thus, it is imperative to develop universal standards for cultivation and testing of products to protect those who consume Cannabis.
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Affiliation(s)
- Zackary Montoya
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, United States
| | - Matthieu Conroy
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, United States
| | | | - Christopher S Pauli
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, United States
| | - Sang-Hyuck Park
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, United States
- Department of Biology, Colorado State University-Pueblo, Pueblo, CO, United States
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40
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Chye Y, Kirkham R, Lorenzetti V, McTavish E, Solowij N, Yücel M. Cannabis, Cannabinoids, and Brain Morphology: A Review of the Evidence. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:627-635. [PMID: 32948510 DOI: 10.1016/j.bpsc.2020.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/19/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
Abstract
Cannabis and cannabinoid-based products are increasingly being accepted and commodified globally. Yet there is currently limited understanding of the effect of the varied cannabinoid compounds on the brain. Exogenous cannabinoids interact with the endogenous cannabinoid system that underpins vital functions in the brain and body, and they are thought to perturb key brain and cognitive function. However, much neuroimaging research has been confined to observational studies of cannabis users, without examining the specific role of the various cannabinoids (Δ9-tetrahydrocannabinol, cannabidiol, etc.). This review summarizes the brain structural imaging evidence to date associated with cannabis use, its major cannabinoids (e.g., Δ9-tetrahydrocannabinol, cannabidiol), and synthetic cannabinoid products that have emerged as recreational drugs. In doing so, we seek to highlight some of the key issues to consider in understanding cannabinoid-related brain effects, emphasizing the dual neurotoxic and neuroprotective role of cannabinoids, and the need to consider the distinct role of the varied cannabinoids in establishing their effect on the brain.
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Affiliation(s)
- Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Kirkham
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Valentina Lorenzetti
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia; School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Eugene McTavish
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Nadia Solowij
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; Australian Centre for Cannabinoid Clinical and Research Excellence, New Lambton Heights, New South Wales, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia.
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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.
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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
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Dellazizzo L, Potvin S, Dou BY, Beaudoin M, Luigi M, Giguère CÉ, Dumais A. Association Between the Use of Cannabis and Physical Violence in Youths: A Meta-Analytical Investigation. Am J Psychiatry 2020; 177:619-626. [PMID: 32456503 DOI: 10.1176/appi.ajp.2020.19101008] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to investigate the extent to which cannabis use among youths is associated with the risk of perpetrating physical violence. METHODS Searches were conducted in PubMed, PsycINFO, Web of Science, and Google Scholar for articles published from the inception of each database to July 2019. All studies that examined both cannabis use and the perpetration of physical violence in a sample of youths and young adults <30 years old were included. The meta-analysis was performed with a random-effects model. Risk of publication bias was assessed with Egger's test. Guidelines from the Meta-Analysis of Observational Studies in Epidemiology were followed. RESULTS After screening 11,348 potential studies, 30 study arms were included, yielding a total of 296,815 adolescents and young adults. The odds ratio for the pooled studies was 2.11 (95% CI=1.64, 2.72). The pooled odds ratios were 2.15 (95% CI=1.58, 2.94) and 2.02 (95% CI=1.26, 3.23) for the cross-sectional and longitudinal studies, respectively. Preliminary evidence suggests that the risk of violence was higher for persistent heavy users (odds ratio=2.81, 95% CI=1.68, 4.74) compared with past-year users (odds ratio=2.05, 95% CI=1.5, 2.8) and lifetime users (odds ratio=1.94, 95% CI=1.29, 2.93). The odds ratio for unadjusted studies was 2.62 (95% CI=1.89, 3.62), and for studies using odds ratios adjusted for potential confounding factors, 2.01 (95% CI=1.57, 2.56). CONCLUSIONS These results demonstrate a moderate association between cannabis use and physical violence, which remained significant regardless of study design and adjustment for confounding factors (i.e., socioeconomic factors, other substance use). Cannabis use in this population is a risk factor for violence.
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Affiliation(s)
- Laura Dellazizzo
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Stéphane Potvin
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Bo Yi Dou
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Mélissa Beaudoin
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Mimosa Luigi
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Charles-Édouard Giguère
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
| | - Alexandre Dumais
- Research Center, Montreal University Institute of Mental Health, Montreal (Dellazizzo, Potvin, Dou, Beaudoin, Luigi, Giguère, Dumais); Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal (Dellazizzo, Potvin, Beaudoin, Luigi, Dumais); Faculty of Medicine, University of Montreal (Dou [medical student]); and Philippe-Pinel National Institute of Legal Psychiatry, Montreal (Dumais)
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Dunn AL, Michie PT, Hodgson DM, Harms L. Adolescent cannabinoid exposure interacts with other risk factors in schizophrenia: A review of the evidence from animal models. Neurosci Biobehav Rev 2020; 116:202-220. [PMID: 32610181 DOI: 10.1016/j.neubiorev.2020.06.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022]
Abstract
Many factors and their interaction are linked to the aetiology of schizophrenia, leading to the development of animal models of multiple risk factors and adverse exposures. Differentiating between separate and combined effects for each factor could better elucidate schizophrenia pathology, and drive development of preventative strategies for high-load risk factors. An epidemiologically valid risk factor commonly associated with schizophrenia is adolescent cannabis use. The aim of this review is to evaluate how early-life adversity from various origins, in combination with adolescent cannabinoid exposure interact, and whether these interactions confer main, synergistic or protective effects in animal models of schizophrenia-like behavioural, cognitive and morphological alterations. Patterns emerge regarding which models show consistent synergistic or protective effects, particularly those models incorporating early-life exposure to maternal deprivation and maternal immune activation, and sex-specific effects are observed. It is evident that more research needs to be conducted to better understand the risks and alterations of interacting factors, with particular interest in sex differences, to better understand the translatability of these preclinical models to humans.
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Affiliation(s)
- Ariel L Dunn
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, NSW 2308, Australia; Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Patricia T Michie
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, NSW 2308, Australia; Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
| | - Deborah M Hodgson
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, NSW 2308, Australia; Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
| | - Lauren Harms
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW 2308, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
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44
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Gökharman FD, Aydin S, Paltun SC, Fatihoğlu E, Yalçin Şahiner Ş, Koşar PN. DTI-MRI findings in synthetic cannabinoid users. Turk J Med Sci 2020; 50:1022-1027. [PMID: 32336074 PMCID: PMC7379452 DOI: 10.3906/sag-1905-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 04/24/2020] [Indexed: 11/15/2022] Open
Abstract
Background/aim Synthetic cannabinoids (SCs) are full agonists of both cannabinoid receptors. Conventional magnetic resonance imaging (MRI) findings of SC users are mainly defined as diffusion restriction and T2/FLAIR hyperintensity. Diffusion tensor imaging (DTI) studies examining SC users have shown contradictory results. The aim of this study was to define white matter (WM) changes of SC users using DTI. Materials and methods The study included 22 patients with a history of using SC for 5–37 months, and 22 healthy, age and sex-matched control subjects. A total of 41 diffusion gradient directions were used in the acquisition of diffusion imaging data. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) values were obtained. ROIs were placed on WM areas of normal appearance. Results In the SC users, significantly lower FA values were determined in the left temporal lobe (216.2 ± 58.9 vs. 263 ± 27.4; P = 0.002) and right hippocampus (224.5 ± 61.5 vs. 255 ± 24.3; P = 0.040). The ADC values of the hippocampus and temporal lobe were significantly higher than those of the control group on both the left and right sides. Conclusion The SC use causes WM microstructural changes, especially in the hippocampus and temporal lobes. DTI is a useful tool to reveal WM changes in SC addicts and can be used earlier than conventional MRI.
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Affiliation(s)
| | - Sonay Aydin
- Department of Radiology, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Salih Cihat Paltun
- Department of Psychiatry, Ankara Numune Training and Research Hospital, Ankara Turkey
| | - Erdem Fatihoğlu
- Department of Radiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - Şafak Yalçin Şahiner
- Department of Psychiatry, Ankara Numune Training and Research Hospital, Ankara Turkey
| | - Pinar Nercis Koşar
- Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey
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45
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Scholes-Balog KE, Hemphill SA, Heerde JA, Toumbourou JW, Patton GC. Childhood social environmental and behavioural predictors of early adolescent onset cannabis use. Drug Alcohol Rev 2020; 39:384-393. [PMID: 32372532 DOI: 10.1111/dar.13077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS This study prospectively investigates behavioural and social antecedents of different patterns of adolescent cannabis use, specifically, early adolescent onset cannabis use and late onset occasional use. DESIGN AND METHODS The sample comprised 852 adolescents (53% female) drawn from the Australian arm of the International Youth Development Study. Data were collected via self-report surveys. Risk and protective factors from a modified version of the Communities That Care youth survey were measured in fifth grade (mean [M] = 10.9 years, SD = 0.4). Frequency of cannabis use was measured at six time-points throughout adolescence (ages 12-19 years). RESULTS Early adolescent onset cannabis use (10.7% of the sample [n = 91]) was predicted by childhood family-related factors including poor family management, family history of antisocial behaviour and attachment to parents. Cigarette use and drinking until drunk were the strongest predictors of early adolescent onset cannabis use. Cumulative risks associated with community, family, peer/individual environments and early substance use (cigarettes, alcohol) in childhood were predictive of early adolescent onset cannabis use (e.g. relative risk ratio = 2.64; 95% confidence interval 1.40-4.97 for early substance use). Family and early substance use-related cumulative risks were predictive of late adolescent onset occasional cannabis use (n = 231; 27%). Cumulative early substance use risk was the strongest independent predictor of both early adolescent onset and late adolescent onset occasional cannabis use. DISCUSSION AND CONCLUSIONS Primary prevention efforts should focus on reducing exposure and access to licit substances during late childhood and delaying the onset of use. Prevention and intervention targeted toward the family environment also appears likely to be important in the prevention of early adolescent onset cannabis use.
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Affiliation(s)
- Kirsty E Scholes-Balog
- Learning Sciences Institute Australia and School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Sheryl A Hemphill
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,School of Education, La Trobe University, Melbourne, Australia
| | - Jessica A Heerde
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - John W Toumbourou
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Melbourne, Australia
| | - George C Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
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Kangiser MM, Thomas AM, Kaiver CM, Lisdahl KM. Nicotine Effects on White Matter Microstructure in Young Adults. Arch Clin Neuropsychol 2020; 35:10-21. [PMID: 31009035 DOI: 10.1093/arclin/acy101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 03/11/2018] [Accepted: 12/06/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Nicotine use is widely prevalent among youth, and is associated with white matter microstructural changes as measured by diffusion tensor imaging (DTI). In adults, nicotine use is generally associated with lower fractional anisotropy (FA), but in adolescents/young adults (≤30 years), microstructure appears healthier, indicated by higher FA. This cross-sectional study examined associations between nicotine use and white matter microstructure using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in young adults. METHODS Fifty-three participants (18 nicotine users [10 female]/35 controls [17 female]) ages 18-25 underwent MRI scan, neuropsychological battery, toxicology screening, and drug use interview. Nicotine group associations with FA and MD were examined in various white matter tracts. In significant tracts, AD and RD were measured. Exploratory correlations were conducted between significant tracts and verbal memory and sustained attention/working memory performance. RESULTS Nicotine users exhibited significantly lower FA than controls in the left anterior thalamic radiation, left inferior longitudinal fasciculus, left superior longitudinal fasciculus-temporal, and left uncinate fasciculus. In these tracts, AD and RD did not differ, nor did MD differ in any tract. White matter quality was positively correlated with sustained attention/working memory performance. CONCLUSIONS Cigarette smoking may disrupt white matter microstructure. These results are consistent with adult studies, but inconsistent with adolescent/young adult studies, likely due to methodological and sample age differences. Further studies should examine longitudinal effects of nicotine use on white matter microstructure in a larger sample.
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Affiliation(s)
- Megan M Kangiser
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Alicia M Thomas
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Christine M Kaiver
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Krista M Lisdahl
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
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Bassiony MM, Fawzi M, Ammar HK, Khalil Y. The Negative Impact of Cannabis Use on School Grades and Intelligence Among Adolescents. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Barthelemy OJ, Richardson MA, Heeren TC, Chen CA, Liebschutz JM, Forman LS, Cabral HJ, Frank DA, Rose-Jacobs R. Do Differences in Learning Performance Precede or Follow Initiation of Marijuana Use? J Stud Alcohol Drugs 2020. [PMID: 30807269 DOI: 10.15288/jsad.2019.80.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Studies examining cross-sectional associations between age at marijuana initiation and memory deficits yield mixed results. Because longitudinal data are sparse, controversy continues regarding whether these deficits reflect premorbid risk factors or sequelae of early marijuana initiation; here, we examine this question in a community sample followed since birth. METHOD Masked examiners administered four subtests of the Wide Range Assessment of Memory and Learning (WRAML/WRAML2) from childhood until young adulthood to 119 urban, predominantly African American participants. Multivariable generalized estimated equation models measured longitudinal trajectories of learning. Participants were grouped as never users (n = 26), later initiators (≥16 years old; n = 31), and earlier initiators of marijuana use (n = 62). RESULTS Marijuana onset groups did not significantly differ on WRAML scaled scores or IQ in childhood, nor did they differ on WRAML scaled scores in adolescence. On most WRAML2 subtests, these groups did not significantly differ in young adulthood after taking into account sex and childhood IQ. However, on Story Memory, later initiators attained higher scaled scores in young adulthood, even after including additional covariates of anxiety, depression, postsecondary education, past-month marijuana use, and past-week high-risk drinking. They showed a significantly more positive trajectory than never users that was driven by within-group improvement after adolescence. Earlier initiators showed within-group decline in Story Memory after adolescence. CONCLUSIONS Differences in learning following earlier initiation of marijuana use may not be solely attributable to premorbid deficits.
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Affiliation(s)
- Olivier J Barthelemy
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Mark A Richardson
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Clara A Chen
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Jane M Liebschutz
- Boston Medical Center, Boston, Massachusetts.,Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.,Division of General Internal Medicine, Center for Research in Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Leah S Forman
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts
| | - Howard J Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Deborah A Frank
- Boston Medical Center, Boston, Massachusetts.,Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
| | - Ruth Rose-Jacobs
- Boston Medical Center, Boston, Massachusetts.,Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
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49
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Denoising scanner effects from multimodal MRI data using linked independent component analysis. Neuroimage 2020; 208:116388. [DOI: 10.1016/j.neuroimage.2019.116388] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 11/14/2019] [Accepted: 11/20/2019] [Indexed: 01/24/2023] Open
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50
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Dahlgren MK, Sagar KA, Smith RT, Lambros AM, Kuppe MK, Gruber SA. Recreational cannabis use impairs driving performance in the absence of acute intoxication. Drug Alcohol Depend 2020; 208:107771. [PMID: 31952821 PMCID: PMC9036916 DOI: 10.1016/j.drugalcdep.2019.107771] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Across the nation, growing numbers of individuals are exploring the use of cannabis for medical or recreational purposes, and the proportion of cannabis-positive drivers involved in fatal crashes increased from 8 percent in 2013 to 17 percent in 2014, raising concerns about the impact of cannabis use on driving. Previous studies have demonstrated that cannabis use is associated with impaired driving performance, but thus far, research has primarily focused on the effects of acute intoxication. METHODS The current study assessed the potential impact of cannabis use on driving performance using a customized driving simulator in non-intoxicated, heavy, recreational cannabis users and healthy controls (HCs) without a history of cannabis use. RESULTS Overall, cannabis users demonstrated impaired driving relative to HC participants with increased accidents, speed, and lateral movement, and reduced rule-following. Interestingly, however, when cannabis users were divided into groups based on age of onset of regular cannabis use, significant driving impairment was detected and completely localized to those with early onset (onset before age 16) relative to the late onset group (onset ≥16 years old). Further, covariate analyses suggest that impulsivity had a significant impact on performance differences. CONCLUSIONS Chronic, heavy, recreational cannabis use was associated with worse driving performance in non-intoxicated drivers, and earlier onset of use was associated with greater impairment. These results may be related to other factors associated with early exposure such as increased impulsivity.
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Affiliation(s)
- M. Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kelly A. Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rosemary T. Smith
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Ashley M. Lambros
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Madeline K. Kuppe
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Staci A. Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Imaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Corresponding author at: Cognitive and Clinical Neuroimaging Core, McLean Hospital, 115 Mill Street, Belmont, 021478, MA USA. (S.A. Gruber)
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