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Jandac T, Stastna L. Analysis of the Relationship between Psychiatric and Addiction-Related Disorders in Patients of an Outpatient Addiction Treatment Clinic for Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2024; 11:414. [PMID: 38671631 PMCID: PMC11049041 DOI: 10.3390/children11040414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Dual diagnosis is used in addiction medicine to refer to the co-occurrence of an addiction-related disorder and another psychiatric disorder in the same individual. Adolescence is a key period for the development of both mental disorders and addictions. OBJECTIVE The aim of this study is to describe the relationships between psychiatric and addiction-related disorders in patients of the Outpatient Addiction Treatment Clinic for Children and Adolescents at the 1st Faculty of Medicine, Charles University in Prague in 2015-2022. METHODS Data were retrospectively analyzed from the hospital's medical system, which collects basic diagnostic data on patients. Descriptive statistics and cluster analysis were performed to identify relationships between psychiatric and addiction-related disorders. RESULTS Of the 450 patients, 153 patients (34%) met the criteria for dual diagnosis. The most common addiction-related disorders were mental and behavioural disorders due to the use of cannabinoids (35%) and internet gaming disorder (35%). The most common psychiatric diagnoses were behavioural and emotional disorders with usual onset in childhood and adolescence (64%), with a lower prevalence in girls than in boys. CONCLUSIONS These findings may be important for the diagnosis and treatment of risky behaviours and addictions in children and adolescents.
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Affiliation(s)
- Tomas Jandac
- Department of Addictology, First Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic;
- Department of Addictology, General University Hospital in Prague, 128 00 Prague, Czech Republic
| | - Lenka Stastna
- Department of Addictology, First Faculty of Medicine, Charles University, 128 00 Prague, Czech Republic;
- Department of Addictology, General University Hospital in Prague, 128 00 Prague, Czech Republic
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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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Courtney D, Hammond CJ, Rizwan B, Giasson S, Gupta M. The Cannabis Ask: What's a Psychiatrist to Do? JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2022; 31:28-37. [PMID: 35251194 PMCID: PMC8862599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Halter N, Abar CC. Motivations for marijuana use: use and associated negative consequences. PSYCHOL HEALTH MED 2022:1-8. [PMID: 35068275 DOI: 10.1080/13548506.2022.2029920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Marijuana use has increased significantly among adolescents and young adults. It is important for prevention scientists to understand youth motivations for marijuana use in order to refine and/or create intervention to limit harm. The current study surveyed 114 marijuana using college students (67% women; 78% White) on their motivations for using marijuana, frequency of use and associated negative consequences, and theoretical and empirical influences on motivations and use. Results indicated that students most frequently endorsed enjoyment, sleep, and low-risk motivations for use. Variables associated with the Theory of Planned Behavior and Strain Theory were associated with a variety of motivations for use. Motivations, perceived behavioral control regarding marijuana, and parental active tracking were associated with frequency of use, while negative consequences were predicted by frequency of use and attitudes regarding marijuana. Researchers seeking to develop programs to prevent marijuana-related harm may benefit from focusing on the differential motivations for use observed.
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Affiliation(s)
- Nathan Halter
- Department of Psychology, SUNY Brockport, United States of America
| | - Caitlin C Abar
- Department of Psychology, SUNY Brockport, United States of America
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Crook CL, Savin MJ, Byrd D, Summers AC, Guzman VA, Morris EP, Tureson K, Aghvinian M, Cham H, Mindt MR. The neurocognitive effects of a past cannabis use disorder in a diverse sample of people living with HIV. AIDS Care 2021; 33:1482-1491. [PMID: 32951441 PMCID: PMC10310357 DOI: 10.1080/09540121.2020.1822504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 09/07/2020] [Indexed: 12/11/2022]
Abstract
People living with HIV (PLWH) report higher rates of cannabis use than the general population, a trend likely to continue in light of recent policy changes and the reported therapeutic benefits of cannabis for PLWH. Therefore, it is important to better understand cannabis-associated effects on neurocognition, especially as PLWH are at heightened risk for neurocognitive impairment. This study aimed to elucidate the effects of a past cannabis use disorder on current neurocognition in a diverse sample of PLWH. This cross-sectional study included 138 PLWH (age M(SD) = 47.28(8.06); education M(SD) = 12.64(2.73); 73% Male; 71% Latinx) who underwent neuropsychological, DSM-diagnostic, and urine toxicology evaluations. One-way ANCOVAs were conducted to examine effects of a past cannabis use disorder (CUD+) on tests of attention/working memory, processing speed, executive functioning, verbal fluency, learning, memory, and motor ability. Compared to the past CUD- group, the past CUD+ group performed significantly better on tests of processing speed, visual learning and memory, and motor ability (p's < .05). Findings suggest PLWH with past cannabis use have similar or better neurocognition across domains compared to PLWH without past use.
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Affiliation(s)
- Cara L Crook
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Micah J Savin
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Desiree Byrd
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Queens College and The Graduate Center, CUNY, Queens, NY, USA
| | - Angela C Summers
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanessa A Guzman
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Kayla Tureson
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Maral Aghvinian
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Heining Cham
- Department of Psychology, Fordham University, New York, NY, USA
| | - Monica Rivera Mindt
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Zuckermann AM, Gohari MR, de Groh M, Jiang Y, Leatherdale ST. Cannabis cessation among youth: rates, patterns and academic outcomes in a large prospective cohort of Canadian high school students. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2021; 40:95-103. [PMID: 32270667 DOI: 10.24095/hpcdp.40.4.01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Following cannabis legalization in Canada, a better understanding of the prevalence of unprompted cannabis use reduction and subsequent effects on youth academic outcomes is needed to inform harm reduction and health promotion approaches. METHODS We analyzed a longitudinally linked sample (n = 91774) from the COMPASS prospective cohort study of Canadian high school students attending Grades 9-12 in Ontario and Alberta between 2013-2014 and 2016-2017. We investigated the prevalence of spontaneous cannabis use reduction and cessation between grade transitions (Grades 9-10, 10-11, 11-12) and the effect of cessation on academic achievement (current or recent math and English course marks) and rigour (usual homework completion and past-month truancy). RESULTS Only 14.8% of cannabis users decreased their use between grades. Of these, two-thirds made only incremental downward changes, a pattern which held true for all three transitions. Cessation rates from daily and weekly use decreased every year. After cessation, students had better odds than continuing users (OR = 1.23, 95% CI: 1.03- 1.48) and worse odds than never-users (OR = 0.55, 95% CI: 0.31-0.97) for some subcategories of math performance. Students who quit cannabis universally improved class attendance (OR = 2.48, 95% CI: 1.93-3.19) and homework completion (OR = 2.32, 95% CI: 1.85-2.92) compared to continuing users. CONCLUSION Increased academic rigour may underlie any improvements seen in academic performance after cannabis cessation. High school students who use cannabis likely need targeted support to facilitate reduction or cessation and subsequent academic recovery. This indicates that a school-based focus on cannabis harm reduction is justified.
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Affiliation(s)
- Alexandra M Zuckermann
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Mahmood R Gohari
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Ying Jiang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Cooke ME, Gilman JM, Lamberth E, Rychik N, Tervo-Clemmens B, Evins AE, Schuster RM. Assessing Changes in Symptoms of Depression and Anxiety During Four Weeks of Cannabis Abstinence Among Adolescents. Front Psychiatry 2021; 12:689957. [PMID: 34276449 PMCID: PMC8280499 DOI: 10.3389/fpsyt.2021.689957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/07/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Cannabis use is prevalent among adolescents, and many report using in attempts to alleviate negative mood and anxiety. Abstinence from substances such as alcohol and tobacco has been reported to improve symptoms of anxiety and depression. Few studies have examined the effect of cannabis abstinence on symptoms of anxiety and depression. Objective: To test the effect of 4 weeks of continuous cannabis abstinence on depressive and anxious symptoms. Methods: Healthy, non-treatment seeking adolescents who used cannabis at least weekly (n = 179) were randomized to either 4 weeks of cannabis abstinence achieved through a contingency management paradigm (CB-Abst) or cannabis use monitoring without an abstinence requirement (CB-Mon). Abstinence was assessed by self-report verified with quantitative assay of urine for cannabinoids. Anxiety and depressive symptoms were assessed weekly with the Mood and Anxiety Symptom Questionnaire (MASQ). Results: Symptoms of depression and anxiety decreased throughout the study for all participants (MASQ-AA: stnd beta = -0.08, p = 0.01, MASQ-GDA: stnd beta = -0.11, p = 0.003, MASQ-GDD: stnd beta = -0.08, p = 0.02) and did not differ significantly between randomization groups (p's > 0.46). Exploratory analyses revealed a trend that abstinence may be associated with greater improvement in symptoms of anxiety and depression among those using cannabis to cope with negative affect and those with potentially hazardous levels of cannabis use. Conclusions: Among adolescents who use cannabis at least weekly, 4 weeks of cannabis abstinence was not associated with a significant change in anxiety or depressive symptoms compared to continued use. For recreational cannabis users who may be concerned about reducing their use for fear of increased symptoms of anxiety and depression, findings suggest that significant symptom worsening may not occur within the first 4 weeks of abstinence. Further studies are needed in clinical populations where anxiety and depression symptoms are measured more frequently and for a longer period of abstinence. Future studies are also needed to determine whether there are subgroups of adolescents who are uniquely impacted by sustained cannabis abstinence.
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Affiliation(s)
- Megan E Cooke
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Jodi M Gilman
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Erin Lamberth
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Natali Rychik
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Brenden Tervo-Clemmens
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - A Eden Evins
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Randi M Schuster
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
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8
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Abstract
There is a growing body of evidence pointing to the co-occurrence of cannabis use and depression. There is also some evidence that the use of cannabis may lead to the onset of depression; however, strong evidence points to the inverse association; i.e. that depression may lead to the onset or increase in cannabis use frequency. Observational and epidemiological studies have not indicated a positive long-term effect of cannabis use on the course and outcome of depression. The association between cannabis use and depression may be stronger among men during adolescence and emerging adulthood and stronger in women during midlife. There is an indication for potential genetic correlation contributing to the comorbidity of cannabis dependence and major depression, namely that serotonin (5-HT) may mediate such association and there is also evidence for specific risk alleles for cannabis addiction. There is preclinical evidence that alteration in the endocannabinoid system could potentially benefit patients suffering from depression. However, the issue of using cannabis as an anti-depressant is at an early stage of examination and there is little evidence to support it. Finally, there has been little support to the notion that selective serotonin reuptake inhibitors (SSRIs) may be effective in decreasing depressive symptoms or rates of substance use in adolescents treated for depression and a co-occurring substance use disorder. In conclusion, despite methodological limitations, research in the past decades has broadened our knowledge on the association between cannabis use and depression from epidemiological, neurological, genetic, and pharmacological perspectives.
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9
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Halladay J, Woock R, El-Khechen H, Munn C, MacKillop J, Amlung M, Ogrodnik M, Favotto L, Aryal K, Noori A, Kiflen M, Georgiades K. Patterns of substance use among adolescents: A systematic review. Drug Alcohol Depend 2020; 216:108222. [PMID: 32971420 DOI: 10.1016/j.drugalcdep.2020.108222] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This review characterizes empirically derived patterns of multiple (multi-) substance use among adolescents. A secondary objective was to examine the extent to which mental health symptomatology was included in the empirical analyses examining substance use patterns. METHODS Eligible studies included those that used cluster-based approaches, included the assessment of at least two different substances, and were based on study samples with mean ages between 11 and 18 years. 4665 records were screened including 461 studies for full-text screening. RESULTS 70 studies were included with common clusters being: low use, single or dual substance use, moderate general multi-use, and high multi-use. The most common patterns of single or multi-substance use were: alcohol only, alcohol with cannabis and/or tobacco, and use of alcohol, tobacco, and cannabis with and without other drugs. Lower socioeconomic status, older age, and male gender were consistent predictors of multi-use clusters. Only 37 % of studies compared differences in levels of mental health across clusters with symptoms consistently associated with a greater likelihood of multi-use. Only 29 % of studies included mental health indicators in cluster-based analyses, with over half identifying distinct mental health and substance use clusters. Fit indices in cluster analyses and measurement properties of substance use were heterogeneous and inconsistently reported across studies. CONCLUSIONS Distinct patterns of substance use were derived but methodological differences prevented direct comparison and reduced capacity to generalize across studies. There is a need to establish standardized methodological approaches to identify robust patterns of substance use to enhance etiological, prognostic, and intervention research.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - R Woock
- Department of Social Sciences, McMaster University, Canada.
| | - H El-Khechen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - C Munn
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - J MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Ogrodnik
- NeuroFit Lab, Department of Kinesiology, McMaster University, Canada.
| | - L Favotto
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - K Aryal
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - A Noori
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - M Kiflen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Population Health Research Institute, Hamilton, ON, Canada.
| | - K Georgiades
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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10
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Temporal dynamics of the relationship between change in depressive symptoms and cannabis use in adolescents receiving psychosocial treatment for cannabis use disorder. J Subst Abuse Treat 2020; 117:108087. [DOI: 10.1016/j.jsat.2020.108087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 06/09/2020] [Accepted: 07/13/2020] [Indexed: 01/12/2023]
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Hammond CJ, Chaney A, Hendrickson B, Sharma P. Cannabis use among U.S. adolescents in the era of marijuana legalization: a review of changing use patterns, comorbidity, and health correlates. Int Rev Psychiatry 2020; 32:221-234. [PMID: 32026735 PMCID: PMC7588219 DOI: 10.1080/09540261.2020.1713056] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Decriminalization, medicalization, and legalization of cannabis use by a majority of U.S. states over the past 25 years have dramatically shifted societal perceptions and use patterns among Americans. How marijuana policy changes have affected population-wide health of U.S. youth and what the downstream public health implications of marijuana legalization are topics of significant debate. Cannabis remains the most commonly used federally illicit psychoactive drug by U.S. adolescents and is the main drug for which U.S. youth present for substance use treatment. Converging evidence indicates that adolescent-onset cannabis exposure is associated with short- and possibly long-term impairments in cognition, worse academic/vocational outcomes, and increased prevalence of psychotic, mood, and addictive disorders. Odds of negative developmental outcomes are increased in youth with early-onset, persistent, high frequency, and high-potency Δ-9-THC cannabis use, suggesting dose-dependent relationships. Cannabis use disorders are treatable conditions with clear childhood antecedents that respond to targeted prevention and early intervention strategies. This review indicates that marijuana policy changes have had mixed effects on U.S. adolescent health including potential benefits from decriminalization and negative health outcomes evidenced by increases in cannabis-related motor vehicle accidents, emergency department visits, and hospitalizations. Federal and state legislatures should apply a public health framework and consider the possible downstream effects of marijuana policy change on paediatric health.
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Affiliation(s)
- Christopher J. Hammond
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Corresponding Author address: Christopher Hammond, MD PhD, Johns Hopkins Bayview, 5500 Lombard Street, Baltimore, MD 21224, , Phone: 410-550-0048
- Fax: 410-550-0030
| | - Aldorian Chaney
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brian Hendrickson
- Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pravesh Sharma
- Department of Psychiatry, Mayo Clinic Health System and University of Wisconsin-Eau Claire, Eau Claire, WI
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Depressive symptoms and cannabis use in a placebo-controlled trial of N-Acetylcysteine for adult cannabis use disorder. Psychopharmacology (Berl) 2020; 237:479-490. [PMID: 31712969 PMCID: PMC7024037 DOI: 10.1007/s00213-019-05384-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023]
Abstract
RATIONALE Depression is common among individuals with cannabis use disorder (CUD), particularly individuals who present to CUD treatment. Treatments that consider this comorbidity are essential. OBJECTIVES The goal of this secondary analysis was to examine whether N-acetylcysteine (NAC) reduced depressive symptoms among adults (age 18-50) with CUD (N = 302) and whether the effect of NAC on cannabis cessation varied as a result of baseline levels of depression. Bidirectional associations between cannabis use amount and depression were also examined. METHODS Data for this secondary analysis were from a National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) multi-site clinical trial for CUD. Adults with CUD (N = 302) were randomized to receive 2400 mg of NAC daily or matched placebo for 12 weeks. All participants received abstinence-based contingency management. Cannabis quantity was measured by self-report, and weekly urinary cannabinoid levels (11-nor-9-carboxy-Δ9-tetrahydrocannabinol) confirmed abstinence. Depressive symptoms were measured by the Hospital Anxiety and Depression Scale. RESULTS Depressive symptoms did not differ between the NAC and placebo groups during treatment. There was no significant interaction between treatment and baseline depression predicting cannabis abstinence during treatment. Higher baseline depression was associated with decreased abstinence throughout treatment and a significant gender interaction suggested that this may be particularly true for females. Cross-lagged panel models suggested that depressive symptoms preceded increased cannabis use amounts (in grams) during the subsequent month. The reverse pathway was not significant (i.e., greater cannabis use preceding depressive symptoms). CONCLUSIONS Results from this study suggest that depression may be a risk factor for poor CUD treatment outcome and therefore should be addressed in the context of treatment. However, results do not support the use of NAC to concurrently treat co-occurring depressive symptoms and CUD in adults. TRIAL REGISTRATION Clinicaltrials.gov: NCT01675661.
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Kluwe-Schiavon B, Schote AB, Vonmoos M, Hulka LM, Preller KH, Meyer J, Baumgartner MR, Grünblatt E, Quednow BB. Psychiatric symptoms and expression of glucocorticoid receptor gene in cocaine users: A longitudinal study. J Psychiatr Res 2020; 121:126-134. [PMID: 31812111 DOI: 10.1016/j.jpsychires.2019.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chronic cocaine users (CU) display reduced peripheral expression of the glucocorticoid receptor gene (NR3C1), which is potentially involved in stress-related psychiatric symptoms frequently occurring in CU. However, it is unknown whether psychiatric symptoms and lower NR3C1 expression are related to each other and whether reduction of drug consumption reverse them. METHOD At baseline, NR3C1 mRNA expression was measured in 68 recreational CU, 30 dependent CU, and 68 stimulant-naïve controls. Additionally, the Revised Symptom Checklist (SCL-90R) and the Barratt Impulsiveness Scale (BIS) were assessed. At a one-year follow-up, the association between change in NR3C1 expression and psychiatric symptoms was examined in 48 stimulant-naïve controls, 19 CU who increased and 19 CU who decreased their consumption. At both test sessions, cocaine concentrations in hair samples were determined. Mixed-effects models were used to investigate how changes in drug use intensity affect severity of psychiatric symptoms and NR3C1 expression over time. RESULTS At baseline, recreational and dependent CU displayed elevated impulsivity and considerable symptom burden across most of the SCL-90R subscales. Time-group interaction effects were found for several impulsivity scores, SCL-90R Global Severity Index, Paranoid Thoughts, and Depression subscales as well as for NR3C1 expression. Pairwise comparisons showed that decreasing CU specifically improved in these SCL-90R subscales, while their NR3C1 expression was adapted. Finally, changes in NR3C1 expression were negatively correlated with changes in impulsivity but not SCL-90R scores. CONCLUSION Our findings suggest that NR3C1 expression changes and some psychiatric symptoms are reversible upon reduction of cocaine intake, thus favouring abstinence-oriented treatment approaches.
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Affiliation(s)
- B Kluwe-Schiavon
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - A B Schote
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - M Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - L M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - K H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - J Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - M R Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Switzerland
| | - E Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland
| | - B B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland.
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14
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Aguinaldo LD, Squeglia LM, Gray KM, Coronado C, Lees B, Tomko RL, Jacobus J. Behavioral Treatments for Adolescent Cannabis Use Disorder: a Rationale for Cognitive Retraining. CURRENT ADDICTION REPORTS 2019; 6:437-442. [PMID: 32257767 DOI: 10.1007/s40429-019-00287-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose of Review Adolescent cannabis use represents a significant public health concern. Cannabis experimentation typically begins in adolescence and increases the odds of meeting criteria for cannabis use disorder. Cannabis use disorder is associated with numerous short- and long-term adverse consequences for adolescents, highlighting the critical need for efficacious behavioral treatments. This brief review aims to synthesize the state of the behavioral treatment literature on adolescents with cannabis use disorder and to discuss new pathways to leverage neuroscience to inform novel targets for behavioral intervention. Recent Findings To date, effective treatment options for adolescent cannabis use disorder that have been tested in randomized controlled trials include cognitive behavioral therapy, motivational enhancement therapy, and multidimensional family therapy. However, established behavioral treatment approaches focus on higher-order cognitive control and have only been modestly effective. Summary There is a need to develop new pathways that translate neuroscience findings into novel targets for behavioral interventions.
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Affiliation(s)
- Laika D Aguinaldo
- Department of Psychiatry, University of California, 9500 Gilman Drive (0862) La Jolla, San Diego, CA 92093-0862, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Clarisa Coronado
- Department of Psychiatry, University of California, 9500 Gilman Drive (0862) La Jolla, San Diego, CA 92093-0862, USA
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California, 9500 Gilman Drive (0862) La Jolla, San Diego, CA 92093-0862, USA
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15
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Halladay J, Scherer J, MacKillop J, Woock R, Petker T, Linton V, Munn C. Brief interventions for cannabis use in emerging adults: A systematic review, meta-analysis, and evidence map. Drug Alcohol Depend 2019; 204:107565. [PMID: 31751868 DOI: 10.1016/j.drugalcdep.2019.107565] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE This systematic review summarizes and critically appraises the existing literature on brief interventions (BIs) for cannabis use among emerging adults. METHODS Eligible BIs were operationalized as 1-2 sessions focused exclusively on cannabis use for samples with mean ages between 15 and 30. Outcomes related to cannabis use, other substance use, mental health, help-seeking, or functional status were included. Two independent reviewers screened a total of 3638 records, identifying 244 studies for full-text screening. In total, 32 BIs in 26 primary studies with 6318 participants were included. RESULTS Participants were typically not seeking treatment and using cannabis at least once a month. Most interventions were motivational, single sessions, and delivered in person. Few discussed concurrent psychiatric conditions. Pooling results at 1-3 months post-intervention, BIs compared to passive control slightly reduced symptoms of cannabis use disorder (SMD -0.14 [95% CI -0.26 to -0.01]) and increased the odds of abstinence (OR 1.73 [95% CI 1.13-2.66]). Other outcome results often favored BIs but were not significant. Results of studies comparing types of BIs (k = 8) or BIs to longer interventions (k = 1) are discussed narratively. Quality assessment suggested low to very low-quality evidence. CONCLUSIONS This review indicates that BIs targeting non-treatment seeking emerging adults result in significant reductions in symptoms of cannabis use disorder and an increased likelihood of cannabis abstinence, however evidence is of low quality.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada.
| | - Justin Scherer
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, L8N 3K7, Canada.
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, L8N 3K7, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada.
| | - Rachel Woock
- Department of Health, Aging, and Society, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada.
| | - Tashia Petker
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, L8N 3K7, Canada.
| | - Vanessa Linton
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada.
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Pacheco-Colón I, Ramirez AR, Gonzalez R. Effects of Adolescent Cannabis Use on Motivation and Depression: A Systematic Review. CURRENT ADDICTION REPORTS 2019; 6:532-546. [PMID: 34079688 DOI: 10.1007/s40429-019-00274-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose of review This article reviews recent behavioral and neuroimaging studies to elucidate whether adolescent cannabis use is related to reduced motivation and increased risk of depression. Recent findings Recent work suggests that heavy adolescent cannabis use predicts poorer educational outcomes, often presumed to reflect reduced academic motivation, as well as increased levels of depressive symptoms. However, evidence of a link between cannabis use and general motivation was lacking. Factors such as concurrent alcohol and tobacco use, trajectories of cannabis use during adolescence, and cannabis-related changes in underlying neurocircuitry may impact associations among cannabis use, motivation, and depression. Summary Heavy adolescent cannabis use is associated with poorer educational outcomes and increased levels of depressive symptoms. The role of depression in how cannabis may affect motivation, broadly, is not yet clear, as most studies have not examined associations among all three constructs. Future work should explore possible overlap between cannabis effects on motivation and depression, and clarify the temporality of these associations.
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Affiliation(s)
- Ileana Pacheco-Colón
- Center for Children and Families, Department of Psychology, Florida International University
| | - Ana Regina Ramirez
- Center for Children and Families, Department of Psychology, Florida International University
| | - Raul Gonzalez
- Center for Children and Families, Department of Psychology, Florida International University
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17
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Jacobus J, Courtney KE, Hodgdon EA, Baca R. Cannabis and the developing brain: What does the evidence say? Birth Defects Res 2019; 111:1302-1307. [PMID: 31385460 DOI: 10.1002/bdr2.1572] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
Abstract
Cannabis use during adolescence has been linked to deleterious effects on brain integrity. This article summarizes findings from two prospective investigations (3 and 6 years, on average) on adolescent cannabis use from our laboratory that utilize structural neuroimaging and neurocognitive assessment approaches. Across most studies, findings suggest recency, frequency, and age of onset of cannabis use are likely key variables in predicting poorer neural health outcomes. There is some evidence that preexisting differences in brain architecture may also contribute to vulnerability and outcome differences. Ongoing large-scale prospective studies of youth will be able to disentangle how both cannabis use as well as pre and postexposure differences play a role in divergent outcomes among youth who use cannabis.
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Affiliation(s)
- Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, California
| | - Kelly E Courtney
- Department of Psychiatry, University of California, San Diego, California
| | | | - Rachel Baca
- Department of Psychiatry, University of California, San Diego, California
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18
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Cannabis Use in Patients Presenting to a Gastroenterology Clinic: Associations with Symptoms, Endoscopy Findings, and Esophageal Manometry. GASTROINTESTINAL DISORDERS 2019. [DOI: 10.3390/gidisord1030025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Recreational cannabis use is increasing with its legalization in many states. Animal studies suggest cannabis can reduce transient lower esophageal sphincter relaxations (TLESRS), reflux and vomiting, while human studies report conflicting findings. There are currently no large studies investigating gastrointestinal symptoms in patients with chronic cannabis use. This was a retrospective case-control study including patients who presented to an outpatient Gastroenterology office, with documented cannabis use. Their main presenting complaint, demographics, frequency and duration of cannabis use, endoscopic and high-resolution esophageal manometry (HREM) with impedance findings were recorded. Cannabis users were more likely to complain of abdominal pain (25% vs. 8%, p < 0.0001), heartburn (15% vs. 9%, p < 0.0001), and nausea & vomiting (7% vs. 1%, p < 0.0001). They were also more likely to have findings of esophagitis (8% vs. 3%, p = 0.0002), non-erosive gastritis (30% vs. 15%, p = 0.0001) and erosive gastritis (14% vs. 3%, p < 0.0001) on upper endoscopy. Cannabis users were more likely to have impaired esophageal bolus clearance (43% vs. 17%, p = 0.04) and a hypertensive lower esophageal sphincter (LES) (29% vs. 7%, p = 0.04). This study is the largest to date evaluating GI complaints of patients with chronic recreational cannabis use. Our results suggest that cannabis use may potentiate or fail to alleviate a variety of GI symptoms which goes against current knowledge.
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19
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Halladay JE, Boyle MH, Munn C, Jack SM, Georgiades K. Sex Differences in the Association Between Cannabis Use and Suicidal Ideation and Attempts, Depression, and Psychological Distress Among Canadians. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:345-350. [PMID: 30260680 PMCID: PMC6591888 DOI: 10.1177/0706743718804542] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depression, anxiety, and substance use disorders are leading causes of morbidity worldwide. The most commonly used illicit substance is cannabis and there is some evidence that the association between cannabis use and poor mental health is more pronounced among females compared with males. This analysis examines sex differences in the association between cannabis use and major depressive episode (MDE), suicidal thoughts and attempts, and psychological distress. METHODS This study uses data from the 2002 and 2012 Canadian Community Health Survey's Mental Health Component, repeated cross-sectional surveys of nationally representative samples of Canadians 15 years of age and older ( n = 43,466). Linear and binary logistic regressions were performed, applying weighting and bootstrapping. RESULTS There were significant sex differences in the strength of the association between cannabis use and suicidal thoughts and attempts and psychological distress, but not MDE. Females who reported using cannabis occasionally (defined as 1 to 4 times a month) reported higher levels of psychological distress than their male counterparts. Females who reported using regularly (defined as more than once per week) reported higher levels of psychological distress and were more likely to report suicidal thoughts and attempts. CONCLUSIONS Future research is needed to further our understanding of the nature of these sex differences. Public health messaging should incorporate being female as a potential risk factor for the co-occurrence of cannabis use and emotional problems, particularly at higher frequencies of use. Clinicians should also be aware of this association to better inform integrated mental health and substance use screening, discussions, and care, particularly for female patients.
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Affiliation(s)
- Jillian E. Halladay
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada
| | - Michael H. Boyle
- Department of Health Research Methods, Evidence, and Impact,
Psychiatry & Behavioural Neurosciences, Offord Centre for Child Studies,
McMaster University, Hamilton, Ontario, Canada
| | - Catharine Munn
- Department of Psychiatry and Behavioural Neurosciences, Peter Boris
Centre for Addictions Research, McMaster University, Hamilton, Ontario, Canada
| | - Susan M. Jack
- Department of Health Research Methods, Evidence, and Impact, School
of Nursing, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario,
Canada
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, David
R. (Dan) Offord Chair in Child Studies, Psychiatry & Behavioural Neurosciences,
Offord Centre for Child Studies, McMaster University, Hamilton, Ontario,
Canada
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20
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Weinberger AH, Pacek LR, Sheffer CE, Budney AJ, Lee J, Goodwin RD. Serious psychological distress and daily cannabis use, 2008 to 2016: Potential implications for mental health? Drug Alcohol Depend 2019; 197:134-140. [PMID: 30825793 PMCID: PMC6440801 DOI: 10.1016/j.drugalcdep.2019.01.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/14/2018] [Accepted: 01/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Daily cannabis use is increasing in the United States (US). Yet, it is not known whether daily cannabis use is disproportionately common, or whether it has increased differentially over time, by mental health status. This study estimated the prevalence of daily cannabis use among adults in the US with and without past-month serious psychological distress (SPD; measured by the Kessler Psychological Distress Scale (K6)) in 2016 and estimated trends in daily cannabis use by past-30-day SPD status from 2008 to 2016. METHODS Data were drawn from adults age 18 and older in the 2008-2016 National Survey on Drug Use and Health (combined total analytic sample n = 356,413). Linear time trends of daily cannabis use, stratified by SPD status, were assessed using logistic regression models with continuous year as the predictor. RESULTS In 2016, past-month daily cannabis use was significantly more common among those with past-month SPD (8.07%), compared to those without past-month SPD (2.66%). Daily cannabis use increased significantly from 2008 to 2016 among those both with and without SPD although use among those with SPD was persistently higher than use among those without SPD over the time period studied. CONCLUSIONS Daily cannabis use is significantly more common among persons with serious psychological distress and is increasing in this group, as well as among those without. Given this increase and the high prevalence of cannabis use among those with SPD, it may be important to consider potential consequences of this increased use for those with mental health vulnerabilities.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Yeshiva University Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, USA.
| | - Alan J Budney
- Geisel School of Medicine at Dartmouth, Center for Technology and Behavioral Health, Lebanon, NH, USA.
| | - Joun Lee
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Renee D Goodwin
- Institute for Implementation Science and Population Health, CUNY School of Public Health and Health Policy, New York, NY, USA; Department of Epidemiology and Biostatistics, CUNY School of Public Health, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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21
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Altered orbitofrontal activity and dorsal striatal connectivity during emotion processing in dependent marijuana users after 28 days of abstinence. Psychopharmacology (Berl) 2018; 235:849-859. [PMID: 29197984 DOI: 10.1007/s00213-017-4803-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/26/2017] [Indexed: 12/28/2022]
Abstract
RATIONALE Intact cognitive and emotional functioning is vital for the long-term success of addiction treatment strategies. Accumulating evidence suggests an association between chronic marijuana use and lasting alterations in cognitive brain function. Despite initial evidence for altered emotion processing in dependent marijuana users after short abstinence periods, adaptations in the domain of emotion processing after longer abstinence remain to be determined. OBJECTIVE AND METHODS Using task-based and resting state fMRI, the present study investigated emotion processing in 19 dependent marijuana users and 18 matched non-using controls after an abstinence period of > 28 days. RESULTS Relative to the control subjects, negative emotional stimuli elicited increased medial orbitofrontal cortex (mOFC) activity and stronger mOFC-dorsal striatal and mOFC-amygdala functional coupling in dependent marijuana users (p < 0.022, FWE-corrected). Furthermore, mOFC-dorsal striatal functional connectivity was increased at rest in marijuana users (p < 0.03, FWE-corrected). Yet, processing of positive stimuli and subjective ratings of valence and arousal were comparable in both groups. CONCLUSIONS Together, the present findings provide the first evidence for persisting emotion processing alterations in dependent marijuana users. Alterations might reflect long-term neural adaptations as a consequence of chronic marijuana use or predisposing risk factors for the development of marijuana dependence.
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