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Stampf A, Schwarzkopf L, Batalla A, Feingold D, Fischer B, Hoch E. Cannabis-related treatment demand at the eve of German cannabis legalization - a 20-years trend analysis. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01832-w. [PMID: 38951248 DOI: 10.1007/s00406-024-01832-w] [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] [Received: 01/19/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024]
Abstract
Post-2000, the prevalence of cannabis consumption has been rising internationally. This paper investigates whether cannabis-related treatment demand in German outpatient addiction care facilities (OACFs) has been following this trend. Treatment demand related to cannabis use disorder (CUD) for the period 2001 to 2021 was investigated using data from the nation-wide standardized German Addiction Care Statistical Service. Analyses covered all and first-time treatment admissions, demographics, and treatment outcomes. We identified years with significant changes in slope or direction of trends through joinpoint regression. Trends within the CUD client population were contrasted with trends among the entire OACF client population. CUD is the second-most common cause for OACF admissions in Germany. Between 2001 and 2021, the share of CUD-related cases among total OACF caseload increased from 7.1 to 19.9%, whereby the share of first-time treatment admissions declined from 79.6 to 55.6%. The share of CUD client population > 35 years almost tripled from 6.0 to 17.4%, that of female client population rose from 15.6 to 18.1%. From 2001 to 2007, the share of CUD-related treatments completed with improved symptomatology increased from 54.7 to 65.6%, followed by a marginal decline. CUD-related treatment demand is growing in Germany's OACFs, involving a client population that is increasingly older and more experienced with the addiction care system. As current intervention programmes mainly target adolescents and young adults who have been consuming cannabis only for a short time, adapting service offers to the changing client profiles appears paramount to improve treatment effectiveness.
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Affiliation(s)
- Alisa Stampf
- IFT Institut Für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstrasse 175, 80804, Munich, Germany
| | - Larissa Schwarzkopf
- IFT Institut Für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstrasse 175, 80804, Munich, Germany.
- Department of Psychiatry and Psychotherapy, University Clinic of the Ludwig Maximilians University Munich, Nussbaumstraße 7, 80336, Munich, Germany.
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 80336, Munich, Germany.
| | - Albert Batalla
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Daniel Feingold
- Psychology Department, Achva Academic College, 1 Achva, MP. Shikmim, 7980400, Arugot, Israel
| | - Benedikt Fischer
- Research & Graduate Studies, University of the Fraser Valley, 33844 King Road, Abbotsford, BC, Canada
- Department of Psychiatry, University of Toronto, 250 College St, Toronto, Canada
- Department of Psychiatry, Federal University of Sao Paulo, R. Sena Madureira, São Paulo, 1500, Brazil
- School of Population Health, University of Auckland, 85 Park Road, Auckland, New Zealand
| | - Eva Hoch
- IFT Institut Für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstrasse 175, 80804, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Clinic of the Ludwig Maximilians University Munich, Nussbaumstraße 7, 80336, Munich, Germany
- School of Population Health, University of Auckland, 85 Park Road, Auckland, New Zealand
- Department Psychologie, Professur Für Klinische Psychologie Und Psychotherapie, Charlotte-Fresenius-Universität, Infanteriestrasse 11a, 80797, Munich, Germany
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Harrison ME, Kanbur N, Canton K, Desai TS, Lim-Reinders S, Groulx C, Norris ML. Adolescents' Cannabis Knowledge and Risk Perception: A Systematic Review. J Adolesc Health 2024; 74:402-440. [PMID: 37966406 DOI: 10.1016/j.jadohealth.2023.09.014] [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: 02/12/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/16/2023]
Abstract
To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10-18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.
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Affiliation(s)
- Megan E Harrison
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Division of Adolescent Health, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada.
| | - Nuray Kanbur
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Division of Adolescent Health, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada
| | - Kyle Canton
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Tejas S Desai
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Chase Groulx
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Mark L Norris
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Division of Adolescent Health, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada
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Raitasalo K, Rossow I, Moan IS, Bye EK, Svensson J, Thor S, Ekholm O, Pisinger V, Arnarsson Á, Bloomfield K. Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study. Drug Alcohol Rev 2024; 43:616-624. [PMID: 37095643 DOI: 10.1111/dar.13672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a 'hardening' of users, implying that alcohol users increasingly use cannabis. METHODS Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003-2019. RESULTS The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%-0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. DISCUSSION AND CONCLUSIONS We found no support for the 'parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the 'substitution hypothesis', cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the 'hardening' hypothesis.
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Affiliation(s)
- Kirsimarja Raitasalo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Elin K Bye
- Norwegian Institute of Public Health, Oslo, Norway
| | - Johan Svensson
- Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Siri Thor
- Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Veronica Pisinger
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
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Casanova C, Ramier C, Fortin D, Carrieri P, Mancini J, Barré T. Cannabidiol use and perceptions in France: a national survey. BMC Public Health 2022; 22:1628. [PMID: 36038869 PMCID: PMC9421113 DOI: 10.1186/s12889-022-14057-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background Cannabidiol (CBD), a safe, non-intoxicating cannabis component, is growing in popularity in Europe and worldwide. However, CBD EU regulation is blurry, and consequent labelling and product quality issues may have implications for public health. There is therefore a need to assess the prevalence and perceived harmfulness of CBD use in EU countries, as well as to characterise CBD users. We aimed to do so in the French population. Methods In December 2021, an online survey was conducted in a sample respecting the French adult population structure for key demographic variables. Sociodemographic, behavioural and CBD perception data were collected. Three separate regressions were performed to identify correlates of i) having heard of CBD, ii) using CBD, iii) perceived harmfulness of CBD. A hierarchical classification was also performed to identify profiles of CBD users. Results The study sample comprised 1969 adults, of whom 69.2% had heard of CBD and 10.1% used it. Less than half (46.8%) of the former considered it harmful. Having heard of CBD was associated with younger age, being born in France, tobacco use, and cannabis use. CBD use was associated with younger age, tobacco use, cannabis use, poor self-reported general health status, and positive perception of alternative medicines. Cluster analysis revealed four different CBD user profiles based on socio-demographics and behavioural characteristics. Conclusion Ten percent of the adults in this French study used CBD, and several user profiles emerged. Our results indirectly advocate clearer European CBD regulations to ensure safe and high-quality products. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14057-0.
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Affiliation(s)
- Clémence Casanova
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
| | - Clémence Ramier
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
| | - Davide Fortin
- Sorbonne Economics Centre, University, Paris 1 Sorbonne, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France.
| | - Julien Mancini
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France.,Public Health Department, APHM, BIOSTIC, Marseille, France
| | - Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
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Wiedmann M, Kuitunen-Paul S, Basedow LA, Wolff M, DiDonato N, Franzen J, Wagner W, Roessner V, Golub Y. DNA methylation changes associated with cannabis use and verbal learning performance in adolescents: an exploratory whole genome methylation study. Transl Psychiatry 2022; 12:317. [PMID: 35933470 PMCID: PMC9357061 DOI: 10.1038/s41398-022-02025-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 11/09/2022] Open
Abstract
The association between extent of chronic cannabis use (CCU-extent) and cognitive impairment among adolescents has been the subject of controversial debate. Linking DNA methylation to CCU-extent could help to understand cannabis associated changes in cognitive performance. We analyzed cognitive task performances, CpG methylation in peripheral whole-blood samples and self-reported past-year CCU-extent of n = 18 adolescents (n = 9 psychiatric outpatients with chronic cannabis use (CCU), n = 9 without) who were matched for age, gender and psychiatric disorders. Patients with CCU were at least 24 h abstinent when cognitive tasks were performed. A Principal Component Analysis (PCA) was carried out to identify group differences in whole genome DNA methylation. Mediation analyses were performed between CCU-extent associated CpG sites and CCU-extent associated variables of cognitive tasks. PCA results indicated large differences in whole genome DNA methylation levels between the groups that did not reach statistical significance. Six CpG sites revealed reduced methylation associated with CCU-extent. Furthermore, CCU-extent was associated with lower scores in verbal learning. All six CpG sites mediated the effects between CCU-extent and verbal learning free recall. Our results indicate that CCU is associated with certain patterns in the methylome. Furthermore, CCU-extent associated impairments in memory function are mediated via differential methylation of the six CCU-associated CpG sits. Six identified CpG are located in genes previously described in the context of neurodegeneration, hippocampus-dependent learning and neurogenesis. However, these results have to be carefully interpreted due to a small sample size. Replication studies are warranted.
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Affiliation(s)
- Melina Wiedmann
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307, Dresden, Germany.
| | - Sören Kuitunen-Paul
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany ,grid.6810.f0000 0001 2294 5505Technische Universität Chemnitz, Chair for Clinical Psychology and Psychotherapy, Chemnitz, Germany
| | - Lukas Andreas Basedow
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany
| | - Max Wolff
- grid.6363.00000 0001 2218 4662Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - Nataliya DiDonato
- grid.4488.00000 0001 2111 7257Technische Universität Dresden, University Hospital, Institute for Clinical Genetics, Dresden, Germany
| | - Julia Franzen
- grid.1957.a0000 0001 0728 696XHelmholtz-Institute for Biomedical Engineering, Stem Cell Biology and Cellular Engineering, RWTH Aachen University Medical School, Aachen, Germany
| | - Wolfgang Wagner
- grid.1957.a0000 0001 0728 696XHelmholtz-Institute for Biomedical Engineering, Stem Cell Biology and Cellular Engineering, RWTH Aachen University Medical School, Aachen, Germany
| | - Veit Roessner
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany
| | - Yulia Golub
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany
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Alcohol Consumption Patterns: A Systematic Review of Demographic and Sociocultural Influencing Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138103. [PMID: 35805782 PMCID: PMC9265892 DOI: 10.3390/ijerph19138103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
Background: Excessive alcohol consumption has negative effects not only on the drinkers’ health but also on others around them. Previous studies suggest that excessive alcohol consumption can be related to a combination of factors such as age, family background, religiosity, etc. Investigating and clarifying these roots of alcohol consumption is crucial so that the right type of interventions can be designed in a specific and targeted manner. Objectives: This work was conducted as a systematic review to reveal the factors associated with alcohol consumption and to heighten the understanding of the differences among various communities and segments of the population regarding their usage of alcohol. Data sources: A systematic search of Web of Science, PubMed, ScienceDirect, and Google Scholar was performed. Results: Forty-five studies were included in the review after excluding irrelevant records and duplicates. Conclusions: Alcohol consumption patterns can be associated with several factors related to communities and individuals, and our review revealed demographic factors, including age and proximity to alcohol outlets, as well as social factors, including family background, socioeconomic background, and religious influence. These findings can be used to establish a guideline for further studies in understanding alcohol consumption patterns among individuals according to their personal characteristics and sociocultural backgrounds.
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Dahl SL, Bretteville-Jensen AL, Andreas JB. Exploring the onto-politics of cannabis: Shifting drug policies and understandings in Norway. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 38:394-396. [PMID: 35308113 PMCID: PMC8899050 DOI: 10.1177/14550725211030741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
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Wiedmann M, Atzendorf J, Basedow LA, Roessner V, Golub Y, Kuitunen-Paul S. [Substance Use, Resulting Disorders, and Collateral Mental Disorders Among Adolescents in a Special Outpatient Institutions for Addictions]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:105-119. [PMID: 35005989 DOI: 10.1024/1422-4917/a000846] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Substance Use, Resulting Disorders, and Collateral Mental Disorders Among Adolescents in a Special Outpatient Institutions for Addictions Abstract. Objective: Only few clinics offer the outpatient treatment of substance use disorders (SUDs) among adolescents. Therefore, only limited data describe substance use patterns, SUDs, and co-occurring psychiatric disorders characteristic of adolescents who present in such outpatient clinics specialized in the treatment of SUDs. Method: Via interview we collected data from n = 201 patients between 12 and 19 years concerning their substance use, SUDs, and current co-occurring psychiatric disorders. We created descriptive presentation of data regarding use patterns, SUDs, and co-occurring disorders divided by sex and current age. Results: Tobacco (88 %) and cannabis (86 %) were the most frequently used substances. 67 % of all patients presented with more than one SUD, cannabis use disorder being the most prevalent one (84 %). 72 % presented with at least one co-occurring disorder, with conduct disorders (40 %), attention deficit (hyperactivity) disorders (21 %), and depressive disorders (18 %) being the most frequent ones. Conclusions: Adolescent SUD patients often present with co-occurring psychiatric disorders. Institutions for adolescent SUD treatment should also focus on treating co-occurring conduct disorders, depression, and attention deficit disorders.
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Affiliation(s)
- Melina Wiedmann
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Josefine Atzendorf
- Munich Center for the Economics of Aging (MEA), Max-Plank-Institut für Sozialrecht und Sozialpolitik, München
| | - Lukas Andreas Basedow
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Yulia Golub
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Sören Kuitunen-Paul
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
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Barry DT, Oberleitner DE, Beitel M, Oberleitner LMS, Gazzola MG, Eller A, Madden LM, Zheng X, Bergman E, Tamberelli JF. A Student Walks into Class … Vignettes to Identify Substance Use Disorder Models of Illness among College Students. Subst Use Misuse 2022; 57:1523-1533. [PMID: 35787230 DOI: 10.1080/10826084.2022.2091787] [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: 10/17/2022]
Abstract
INTRODUCTION Illness models, including illness recognition, perceived severity, and perceived nature can affect treatment-seeking behaviors. Vignettes are a leading approach to examine models of illness but are understudied for substance use disorders (SUDs). We created vignettes for multiple common DSM-5 SUDs and assessed SUD illness models among college students. METHODS Seven vignettes in which the protagonist meets DSM-5 diagnostic criteria for SUDs involving tobacco, alcohol, cannabis, Adderall, cocaine, Vicodin, and heroin were pilot tested and randomly assigned to 216 college students who completed measures related to illness recognition, perceived severity, and perceived nature. MANOVAs with Scheffe post-hoc tests were conducted to examine vignette group differences on models of illness. RESULTS Vignettes met acceptable levels of clarity and plausibility. Participants characterized the protagonist's substance use as a problem, a SUD, or an addiction most frequently with Vicodin, heroin, and cocaine and least frequently with tobacco and cannabis. Participants assigned to the Vicodin, heroin, and cocaine vignettes were the most likely to view the protagonist's situation as serious and life-threatening, whereas those assigned to the cannabis vignette were the least likely. Numerically more participants characterized the pattern of substance use as a problem (91%) or an addiction (90%) than a SUD (76%), while only 15% characterized it as a chronic medical condition. CONCLUSIONS Illness recognition and perceived severity varied across substances and were lowest for cannabis. Few participants conceptualized SUDs as chronic medical conditions. College students may benefit from psychoeducation regarding cannabis use disorder and the chronic medical condition model of SUDs.
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Affiliation(s)
- Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - David E Oberleitner
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Psychology, University of Bridgeport, Bridgeport, Connecticut, USA
| | - Mark Beitel
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - Lindsay M S Oberleitner
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA.,Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Marina Gaeta Gazzola
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - Anthony Eller
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lynn M Madden
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xiaoying Zheng
- APT Foundation, Inc, New Haven, Connecticut, USA.,Yale University, New Haven, Connecticut, USA
| | - Emma Bergman
- APT Foundation, Inc, New Haven, Connecticut, USA.,Quinnipiac School of Medicine, Hamden, Connecticut, USA
| | - Joseph F Tamberelli
- APT Foundation, Inc, New Haven, Connecticut, USA.,Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
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Borodovsky JT, Krueger RF, Agrawal A, Elbanna B, de Looze M, Grucza RA. U.S. Trends in Adolescent Substance Use and Conduct Problems and Their Relation to Trends in Unstructured In-Person Socializing With Peers. J Adolesc Health 2021; 69:432-439. [PMID: 33814281 PMCID: PMC8403622 DOI: 10.1016/j.jadohealth.2020.12.144] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/24/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE This study examined whether national trends in unstructured in-person socializing with peers (i.e., socializing without goals or supervision) among adolescents could help explain recent declines in adolescent risk behaviors (e.g., substance use, fighting, theft). METHODS The sample contained of 44,842 U.S. 12th-grade students (aged 17-18 years) from the Monitoring the Future survey (years 1999-2017). Analyses examined (1) prevalence trends, (2) latent factor structure of risk behaviors and unstructured in-person socializing, and (3) whether trends in the unstructured in-person socializing factor accounted for the relationship between time (i.e., survey year) and the risk behavior factor. RESULTS Adolescent risk behaviors and unstructured in-person socializing declined by approximately 30% in the U.S., and both formed coherent latent factors. After adjusting for sociodemographics, declines in unstructured in-person socializing accounted for approximately 86% of declines in risk behaviors. CONCLUSIONS The prevalence of risk behaviors and unstructured in-person socializing behaviors declined among U.S. 12th graders from 1999 to 2017. It is unknown whether such effects are directly causal and/or influenced by unmeasured variables. However, the results provide evidence that national declines in unstructured in-person socializing are a likely component of the explanation for national declines in adolescent risk behaviors.
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Affiliation(s)
- Jacob T Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire.
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Basant Elbanna
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Margaretha de Looze
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Richard A Grucza
- Departments of Family and Community Medicine and Health and Clinical Outcomes Research, Saint Louis University, Saint Louis, Missouri
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Brunborg GS, von Soest T, Burdzovic Andreas J. Adolescent income and binge drinking initiation: prospective evidence from the MyLife study. Addiction 2021; 116:1389-1398. [PMID: 33009694 DOI: 10.1111/add.15279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/20/2020] [Accepted: 09/25/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS No previous studies have examined the prospective association between disposable income and binge-drinking initiation among adolescents. We aimed to examine whether there is such an association and, if so, whether it is robust to confounders, uniform across individual characteristics and linear versus non-linear. DESIGN Prospective study of adolescents from 32 middle schools, stratified according to geographic location, urban and rural locations and standard of living. Adolescents were assessed in 2017 (T1) and 1 year later (T2). SETTING Norway. PARTICIPANTS A nation-wide sample of 1845 adolescents (mean age 13.5 years, 44% boys) with no binge-drinking experience at T1. MEASUREMENTS Data were collected on binge drinking at T1 and T2. Data on disposable income and on a range of demographic, individual and family factors were collected at T1. FINDINGS Overall, 7.2% initiated binge drinking between T1 and T2. Logistic regression showed that the crude linear effect of disposable income on binge drinking initiation was substantial, and only slightly attenuated in the fully adjusted model including all putative confounders [odds ratio (OR) = 1.19, 95% confidence interval (CI) = 1.08, 1.31, P < 0.001]. However, interaction analyses showed disposable income to be negatively related to binge drinking initiation for adolescents who had experienced light drinking at T1 (OR = 0.66, 95% CI = 0.49, 0.89, P = 0.006) or who had seen their mothers intoxicated [OR = 0.62, 95% CI = 0.39, 0.99, P = 0.043). CONCLUSION Norwegian adolescents with higher disposable income have a greater risk of subsequent binge drinking initiation than those with lower disposable income. Each additional 100 NOK (≈ €10) of weekly income increased the risk of binge drinking initiation in the following year by approximately 20%.
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Affiliation(s)
- Geir Scott Brunborg
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Mynttinen MA, Mishina KE, Kangasniemi MK. Adolescents' Perceptions and Experiences of Their Responsibilities for Their Alcohol Use-A Group Interview Study. CHILDREN-BASEL 2021; 8:children8030214. [PMID: 33799621 PMCID: PMC7998918 DOI: 10.3390/children8030214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/15/2021] [Accepted: 03/09/2021] [Indexed: 11/27/2022]
Abstract
Young people often experiment with alcohol during adolescence, which is a period of their life that is characterized by increasing responsibility. Knowing how adolescents perceive responsibilities with regard to their alcohol use could prevent their alcohol consumption and help them to take responsibility for this aspect of their lives. This study describes adolescents’ perceptions and experiences of their responsibilities for alcohol use. We used a qualitative descriptive method that focused on 87 adolescents aged 14–16 years, from two schools. They took part in semi-structured interviews in 19 groups in Finland in 2017. The data were analyzed using inductive content analysis. The adolescents described alcohol as harmful, but tempting, and said that they were developing a sense of responsibility for their alcohol use. They were responsible for their own wellbeing, behaving responsibly if they drank and intervening in peers’ alcohol use. They talked about how their parents had unquestionable responsibilities to care about whether adolescents drank alcohol. Their parents’ responsibilities related to the guidance they gave, how strict they were and how they responded to adolescents using alcohol. Anonymous and intense support from authorities encouraged adolescents to learn to take responsibility. Identifying and focusing on their responsibilities could help adolescents to develop into healthy individuals and increase their awareness of the need to avoid alcohol. Parents may also need support to meet their responsibilities.
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Affiliation(s)
- Mari A. Mynttinen
- Department of Nursing Science, Faculty of Medicine, University of Turku, 20014 Turku, Finland; (M.A.M.); (M.K.K.)
| | - Kaisa E. Mishina
- Department of Nursing Science, Faculty of Medicine, University of Turku, 20014 Turku, Finland; (M.A.M.); (M.K.K.)
- Department of Child Psychiatry, Faculty of Medicine, University of Turku, 20014 Turku, Finland
- INVEST Research Flagship Center, University of Turku, 20014 Turku, Finland
- Correspondence: ; Tel.: +358-40-5338798
| | - Mari K. Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, 20014 Turku, Finland; (M.A.M.); (M.K.K.)
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Burdzovic Andreas J, Sivertsen B, Lønning KJ, Skogen JC. Cannabis use among Norwegian university students: Gender differences, legalization support and use intentions, risk perceptions, and use disorder. Addict Behav Rep 2021; 13:100339. [PMID: 33604449 PMCID: PMC7873627 DOI: 10.1016/j.abrep.2021.100339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/16/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022] Open
Abstract
Past year cannabis use was fairly common in a sample of Norwegian college students. About 6% of users possibly met criteria for use disorder, function of use frequency. Legalization attitudes and risk perceptions were associated with cannabis use risk. Intentions to use cannabis if legal were evident even among some current non-users. Many non-users expressed uncertainty in legalization attitudes and risk perceptions.
Aims We explored past-year cannabis use and associated characteristics, focusing on legalization attitudes, use intentions, risk perceptions, and possible dependence among Norwegian university/college students. Methods We examined a nation-wide sample of Norwegian university/college students (N = 49,688; 67% female) who participated in the Students’ Health and Wellbeing Study (SHoT-study) in 2018. Participants reported past-year substance use, support for cannabis legalization, intent to use cannabis if legal, and perceived risks of weekly use. Past-year cannabis use (including use frequency) was examined in relation to these indicators. Legalization support, use intentions, and risk perceptions were examined in relation to use and gender. Potential cannabis use disorder was assessed with the Cannabis Abuse Screening Test (CAST) and examined in relation to use frequency and gender. Findings Past-year use was reported by 15.3% (11.8% women; 22.9% men). Majority of current users (roughly 90%) used no more than 50 times past year, and 6% (3.8% women; 8.5% men) met CAST use disorder criteria. Legalization support, use intentions, and no/low risk perceptions were significantly associated with greater odds of use, and greater use frequency among current users in both crude and adjusted models. Legalization support (23.0%), use intentions (14.0%), and perceptions of no/low risk (29.2%) were also relatively common even among current non-users, especially men. Male gender and more frequent use were associated with greater CAST scores and greater odds of use disorder. Conclusions Cannabis use was relatively common in this student sample. In addition to targeting frequent use, interventions may focus on cannabis-related attitudes and risk perceptions among uncertain/uninformed students.
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Affiliation(s)
- Jasmina Burdzovic Andreas
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Jussie Lønning
- The Norwegian Medical Association, Oslo, Norway.,The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Brunborg GS, Scheffels J, Tokle R, Buvik K, Kvaavik E, Burdzovic Andreas J. Monitoring young lifestyles (MyLife) - a prospective longitudinal quantitative and qualitative study of youth development and substance use in Norway. BMJ Open 2019; 9:e031084. [PMID: 31662382 PMCID: PMC6830719 DOI: 10.1136/bmjopen-2019-031084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/29/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The Monitoring Young Lifestyles (MyLife) project was initiated as an integrated quantitative and qualitative prospective investigation of correlates, causes, and consequences of adolescent substance use and other addictive behaviours in Norway. PARTICIPANTS The MyLife cohort was recruited from middle schools in Norway, which were selected from low, medium and high standard of living areas in both rural and urban regions of the country. A total of 3512 eighth, ninth and tenth graders (55% girls) from 33 schools were enrolled in the quantitative project arm (QT), while a total of 120 eighth graders (52% girls) from six schools were enrolled in the qualitative project arm (QL). FINDINGS TO DATE QT baseline was conducted in the fall of 2017, when 2975 adolescents completed an online questionnaire at school during a regular class time. A total of 2857 adolescents participated in the first QT follow-up 1 year later. QL baseline was conducted across the fall semesters of 2014 (one class) and 2015 (five classes), when a total of 118 eighth graders completed face-to-face interviews. QL follow-ups were conducted in the spring of 2015 and fall of 2017 (n=98) for group interviews, and in the spring of 2017 and 2018 (n=95) for individual interviews. In terms of additional data sources, a total of 3035 parents consented to own participation, of which 1899 completed a brief online questionnaire at QT baseline in late 2017. School principals completed brief surveys at the same time. FUTURE PLANS Both QT and QL arms have planned follow-ups through 2021. Consents were obtained for individual-level linkages of adolescent and parental quantitative surveys to each other, as well as to the information available in multiple national registries and databases. These supplemental data sources will provide key information on additional putative exposures as well as on the long-term health, educational, and social outcomes of the MyLife participants.
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Affiliation(s)
- Geir Scott Brunborg
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Janne Scheffels
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Rikke Tokle
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Buvik
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Elisabeth Kvaavik
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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