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Chaliparambil RK, Mittal M, Gibson W, Ahuja C, Dahdaleh NS, El Tecle N. Association Between Preoperative Cannabis Use and Increased Rate of Revision Surgery Following Spinal Fusion: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e61828. [PMID: 38975423 PMCID: PMC11227316 DOI: 10.7759/cureus.61828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
The use of cannabis as a method of chronic pain relief has skyrocketed since its legalization in states across the United States. Clinicians currently have a limited scope regarding the effectiveness of marijuana on surgical procedures. This systematic review aims to determine the effect of current cannabis use on the rate of failure of spinal fusions and overall surgical outcomes. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. PubMed, Embase, and Scopus were searched, identifying studies assessing spinal fusion with reported preoperative cannabis use. Outcomes of interest included reoperation due to fusion failure or pseudoarthrosis with a follow-up time of at least six months. Subgroups of cervical fusions alone and lumbar fusions alone were also analyzed. Certainty in evidence and bias was assessed using the GRADE criteria and ROBINS-I tool (PROSPERO #CRD42023463548). Four studies met the inclusion criteria, with a total of 788 patients (188 in the cannabis user group and 600 in the non-user group). The rate of revision surgery among cannabis users was higher than that in non-users for all spinal fusions (RR: 3.58, 95% CI: 1.67 to 7.66, p = 0.001). For cervical fusions alone, there remained a higher rate of revision surgery for cannabis users compared to non-users (RR: 4.47, 95% CI: 1.93 to 10.36, p = 0.0005). For lumbar fusions alone, there was no difference in the rates of revision surgery between cannabis users and non-users (RR: 1.21, 95% CI: 0.28 to 7.73, p = 0.79). Cannabis use was shown to be associated with a higher rate of pseudoarthrosis revisions in spinal fusions on meta-analysis. On subgroup stratification by spine region, cannabis use remained associated with pseudoarthrosis revisions on cervical fusions alone but not lumbar fusions alone. Further research with larger, randomized studies is required to fully elucidate the relationship between cannabis use and fusion, both in general and by spinal region.
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Affiliation(s)
- Rahul K Chaliparambil
- Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Mehul Mittal
- Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - William Gibson
- Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Christopher Ahuja
- Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Nader S Dahdaleh
- Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Najib El Tecle
- Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
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Warnock CA, Ondrusek AR, Edelman EJ, Kershaw T, Muilenburg JL. Perspectives regarding cannabis use: Results from a qualitative study of individuals engaged in substance use treatment in Georgia and Connecticut. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100228. [PMID: 38585142 PMCID: PMC10997993 DOI: 10.1016/j.dadr.2024.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/08/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
Objective Cannabis use is increasingly pervasive throughout the U.S. People in treatment for substance use disorders (SUD) may be especially at-risk of harm due to this changing context of cannabis in the U.S. This study's objective was to qualitatively describe experiences and beliefs around cannabis among people who had entered treatment for any SUD in the past 12-months. Methods From May to November of 2022, we conducted 27 semi-structured interviews (n=16 in Georgia, n=11 in Connecticut) with individuals in treatment for SUD in Georgia and Connecticut. Interviews were recorded, transcribed, and thematically analyzed using an emergent approach. Results All participants had used cannabis in the past. Four themes emerged from the interviews. Participants: (1) perceived cannabis as an important contributor to non-cannabis substance use initiation in adolescence; (2) viewed cannabis as a substance with the potential to improve health with fewer side effects than prescription medications; (3) expressed conflicting opinions regarding cannabis as a trigger or tool to manage cravings for other non-cannabis substances currently; and 4) described concerns related to negative legal, social service, and treatment-related consequences as well as negative peer perception relating to the use of cannabis. Conclusion Although participants described cannabis's important role as an initiatory drug in adolescence and young adulthood, many felt that cannabis was a medicinal substance for a range of health challenges. These findings suggest SUD treatment clinicians should address medicinal beliefs related to cannabis among their clients and emphasizes the need for research on cannabis use and SUD treatment outcomes.
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Affiliation(s)
- Charles A. Warnock
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Ashlin R. Ondrusek
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - E. Jennifer Edelman
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, USA
| | - Trace Kershaw
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jessica L. Muilenburg
- Department of Health Promotion and Behavior, University of Georgia College of Public Health, Athens, GA, USA
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Dai HD, Idoate R, Mahroke A, Abresch C. Racial Disparities in Patterns and Modes of Current and Daily Marijuana Use among Adults Living with Children. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02008-x. [PMID: 38656451 DOI: 10.1007/s40615-024-02008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/28/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study sought to examine racial disparities in marijuana use among U.S. adults living with children. METHODS Data are drawn from the 2022 Behavioral Risk Factor Surveillance System to examine the prevalence of current (past month) and frequent (≥20 days in the last 30 days) marijuana use along with the mode of marijuana use by 7 racial and ethnic groups (non-Hispanic [NH] White, NH-Black, Hispanic, NH American Indian or Alaskan Native [AI/AN], NH-Asian, NH Native Hawaiian or other Pacific Islander only [NH/PI], and other/multiple races, n=22,659). RESULTS Compared to NH White adults with children, NH Black adults had a higher prevalence of current marijuana use (23.1% vs. 16.9%, p=0.003) and NH AI/AN adults had two times higher prevalence of frequent use (17.3% vs. 8.4%, p=0.0003). Adults living in recreational marijuana legal states (vs. no) were also more likely to report marijuana use, and there were significant age × race/ethnicity and education × race/ethnicity interactions (p<0.05) on marijuana use. Regarding the mode of use, racial minority users except Asians also reported a higher prevalence of smoking marijuana than their White counterparts. CONCLUSIONS AND RELEVANCE Substantial racial disparities in marijuana use patterns among adults who live with children highlight a potential risk for adolescents' health. Addressing these differences is essential for promoting equitable health outcomes in diverse communities.
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Affiliation(s)
- Hongying Daisy Dai
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Regina Idoate
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Avina Mahroke
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
- College of Osteopathic Medicine, Kansas City University, Kansas City, Kansas, USA
| | - Chad Abresch
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
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Forkus SR, Giff ST, Tomko R, Gex K, Flanagan JC. An examination of cannabis use motives among couples with intimate partner violence and alcohol use disorder. Am J Addict 2024. [PMID: 38591739 DOI: 10.1111/ajad.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/26/2024] [Accepted: 03/30/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Cannabis use is highly prevalent among individuals with a history of intimate partner violence (IPV) and among people who drink alcohol. Motives for cannabis use are important correlates of consumption and problem severity. However, no research has examined cannabis use motives among couples with IPV. The goals of the study were to examine (1) the associations between a person and their partner's cannabis use motives; and (2) examine the extent to which each partners' cannabis use motives are related to their own and their partner's cannabis consumption. METHODS Participants were 100 couples (n = 92 different-sex couples, n = 8 same-sex couples) who reported physical IPV in their current relationship. RESULTS Certain cannabis motives (coping and conformity) and behaviors (cannabis use frequency, quantity and drug-related problems) were positively associated between intimate partners. One's own higher coping motives were associated with greater frequency of cannabis consumption; higher conformity motives were associated with less quantity of consumption; higher social motives were associated with greater quantity of cannabis consumption; and one's partner's social motives were associated with less quantity of cannabis consumption. DISCUSSION AND CONCLUSIONS: Findings suggest that couples report similar motives for cannabis use, and that one's own and their partner's motives may differentially influence frequency and quantity of use. SCIENTIFIC SIGNIFICANCE This study provides novel information on congruency between cannabis use motives and behaviors between intimate partners, as well as how both an individual and their partner's motives for use can influence an individual's cannabis use behaviors.
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Affiliation(s)
- Shannon R Forkus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sarah T Giff
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
| | - Rachel Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kathryn Gex
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
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Chaaban S, Istvan M, Schreck B, Laigo P, Rousselet M, Grall-Bronnec M, Pain S, Victorri-Vigneau C. Cannabis use and dependence among festival attendees: results from the French OCTOPUS survey. BMC Public Health 2024; 24:992. [PMID: 38594675 PMCID: PMC11003156 DOI: 10.1186/s12889-024-18496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Chronic use of cannabis is associated with an increased risk of psychosocial, mental and physical health impairments. Sociohealth institutions reach a very limited proportion of cannabis users in need of treatment. Using data collected from festival attendees, this study aimed to estimate the prevalence of dependent cannabis users and to characterize cannabis dependence. METHODS We used data from the cross-sectional OCTOPUS survey carried out at 13 music events in the French department of Loire-Atlantique between July 2017 and July 2018. 383 participants aged 18 or older underwent a face-to-face interview about their basic sociodemographics, tobacco use, alcohol use and past-year substance use. Using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, we estimated the prevalence of dependent cannabis users and characterized their dependence. RESULTS More than two-thirds of participants reported that they had used cannabis in the past 12 months. Among 194 regular cannabis users (at least monthly), 63.4% were dependent. At least 40% of regular users reported health and/or social consequences of cannabis use. Compared to nondependent cannabis users, dependent cannabis users were more likely to be stimulant users and hallucinogen users. CONCLUSIONS Dependent cannabis use is common among festival attendees, especially among stimulant or hallucinogen users. Festival settings may be important arenas for i) implementing efficient harm reduction measures to prevent dependence and ii) providing information on care structures and promoting the use of care to dependent users. In addition, healthcare professionals should be aware of trends in polysubstance use among dependent cannabis users.
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Affiliation(s)
- Sarah Chaaban
- Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, Nantes Université, CHU Nantes, F-44000, Nantes, France
| | - Marion Istvan
- Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, Nantes Université, CHU Nantes, F-44000, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
| | - Benoit Schreck
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
- UIC Psychiatrie et Santé Mentale, Nantes Université, CHU Nantes, F-44000, Nantes, France
| | - Pauline Laigo
- Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, Nantes Université, CHU Nantes, F-44000, Nantes, France
| | - Morgane Rousselet
- Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, Nantes Université, CHU Nantes, F-44000, Nantes, France.
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France.
- UIC Psychiatrie et Santé Mentale, Nantes Université, CHU Nantes, F-44000, Nantes, France.
| | - Marie Grall-Bronnec
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
- UIC Psychiatrie et Santé Mentale, Nantes Université, CHU Nantes, F-44000, Nantes, France
| | - Stéphanie Pain
- Centre d'addictovigilance, Service de Pharmacologie Clinique, CHU de Poitiers, 86000, Poitiers, France
- Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U-1084, Université de Poitiers, 86000, Poitiers, France
| | - Caroline Victorri-Vigneau
- Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, Nantes Université, CHU Nantes, F-44000, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
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Murta JCD, Easpaig BNG, Hazell-Raine K, Byrne MK, Lertwatthanawilat W, Kritkitrat P, Bressington D. Recreational cannabis policy reform-What mental health nurses need to know about minimising harm and contributing to the reform debate. J Psychiatr Ment Health Nurs 2024; 31:270-282. [PMID: 37767750 DOI: 10.1111/jpm.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
The recently rapidly evolving legal status of recreational cannabis in various countries has triggered international debate, particularly around measures required to minimise resulting harms. The present article argues that mental health nurses should have a key role in promoting safe and appropriate use of recreational cannabis, and minimising harm based on the extant evidence. The article summarises the factors driving legalisation, outlines the evident medicinal benefits of cannabis, and appraises the evidence on the negative mental health impacts associated with use. We go on to discuss research findings on the potentially deleterious mental health effects resulting from legalising recreational cannabis and strategies to minimise these harms, including directions for future research and evaluation. Further, we consider the importance of the implementation of harm minimisation measures that are context-specific, using Thailand as an example. Finally, we present the key health promotion messages that mental health nurses should aim to convey to people who use or consider using recreational cannabis. Ultimately, we aim to provide a summary of the existing evidence that mental health nurses can draw upon to promote mental health and engage with the policy reform debate.
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Affiliation(s)
| | | | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Mitchell K Byrne
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | | | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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Jiménez JH, Oña G, Alcázar-Córcoles MÁ, Bouso JC. Cannabis and Public Health: A Study Assessing Regular Cannabis Users Through Health Indicators. Cannabis Cannabinoid Res 2024; 9:659-668. [PMID: 36637397 DOI: 10.1089/can.2022.0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background and Objective: An increasing number of countries are deciding to regulate the medicinal and/or recreational use of cannabis (Cannabis sativa L.). However, there is a lack of information on the impact of regular consumption of this substance on public health. In this study, for the first time, regular cannabis consumers in Spain were assessed using health indicators, comparing these data with the general population. Methods: Various items of the Enquesta de Salut de Catalunya (ESCA) and other items related to cannabis use were selected to build a survey and administer it to a representative sample of regular cannabis users in Catalonia. Results: Most of the indicators did not show any deterioration in the health of regular cannabis users compared with the general population. It was observed that users suffered from more sleep problems and about 40% of the sample would like to discontinue cannabis use, suggesting a dependence pattern. About 30% of the sample was able to discontinue the use of prescription medications because of cannabis. Social support and sleep problems, and not cannabis use, were predictors of depression and well-being scores. Conclusions: It seems that regular cannabis use, despite contributing to problems related to sleep quality or dependence, does not have a negative impact on public health in a manner detectable using health indicators.
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Affiliation(s)
- Javier Hidalgo Jiménez
- International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, España
| | - Genís Oña
- International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, España
- Department of Anthropology, Philosophy and Social Work, Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, España
| | - Miguel Ángel Alcázar-Córcoles
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, España
- Department of Anthropology, Philosophy and Social Work, Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, España
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8
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Bleyer A, Barnes B, Finn K. United States marijuana legalization and opioid mortality trends before and during the first year of the COVID-19 pandemic. J Opioid Manag 2024; 20:119-132. [PMID: 38700393 DOI: 10.5055/jom.0829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
BACKGROUND To determine if marijuana legalization was associated with reduced opioid mortality. STUDY DESIGN The United States (US) opioid mortality trend during the 2010-2019 decade was compared in states and District of Columbia (jurisdictions) that had implemented marijuana legalization with states that had not. Acceleration of opioid mortality during 2020, the first year of the coronavirus disease 2019 (COVID-19) pandemic, was also compared in recreational and medicinal-only legalizing jurisdictions. METHODS Joinpoint methodology was applied to the Centers for Disease Control and Prevention WONDER data. Trends in legalizing jurisdictions were cumulative aggregates. RESULTS The overall opioid and fentanyl death rates and the percentage of opioid deaths due to fentanyl increased more during 2010-2019 in jurisdictions that legalized marijuana than in those that did not (pairwise comparison p = 0.007, 0.05, and 0.006, respectively). By 2019, the all-opioid and fentanyl death rates were 44 and 50 percent greater in the legalizing than in the nonlegalizing jurisdictions, respectively. When the COVID-19 pandemic hit in 2020, jurisdictions that implemented recreational marijuana legalization before 2019 had significantly greater increases in both overall opioid and fentanyl death rates than jurisdictions with medicinal-only legalization. For all-opioids, the mean (95 percent confidence interval) 2019-to-2020 increases were 46.5 percent (36.6, 56.3 percent) and 29.1 percent (20.2, 37.9 percent), respectively (p = 0.02). For fentanyl, they were 115.6 percent (80.2, 151.6 percent) and 55.4 percent (31.6, 79.2 percent), respectively (p = 0.01). CONCLUSIONS During the past decade, marijuana legalization in the US was associated at the jurisdiction level with a greater acceleration in opioid death rate. An even greater increase in opioid mortality occurred in recreational-legalizing jurisdictions with the onset of the COVID-19 pandemic. Marijuana legalization is correlated with worsening of the US opioid epidemic.
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Affiliation(s)
- Archie Bleyer
- Oregon Health and Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas. ORCID: https://orcid.org/0000-0001-7738-5146
| | - Brian Barnes
- St. Charles Healthcare System, Bend, Oregon; PhD Candidate, Integral and Transpersonal Psychology, California Institute of Integral Studies, San Francisco, California
| | - Kenneth Finn
- Springs Rehabilitation, Colorado Springs, Colorado
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Magno LAV, Tameirão DR, Alves LF, Guimarães NS. Effect of recreational cannabis use on bone mineral density: a systematic review. Osteoporos Int 2024; 35:391-399. [PMID: 38141142 DOI: 10.1007/s00198-023-06992-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
The recreational use of cannabis products has risen considerably worldwide over the past decade. As the cannabis legal market grows, a critical challenge has been to make substantiated claims about the benefits and adverse health problems triggered by cannabis exposure. Despite accumulating evidence from animal studies demonstrating the role of cannabinoids on bone metabolism, there are conflicting results in clinical literature regarding their effects on bone health outcomes.We undertook a systematic review to assess the evidence for the safety of cannabis use on bone health. We searched the databases MEDLINE, EMBASE, Cochrane Library, and Web of Science up to March 2023 for studies evaluating the effect of the recreational use of cannabis on the bone mineral density (BMD) of adults.Among the 2620 studies reviewed, three cross-sectional studies and one randomized controlled trial comprised 4032 participants from 18 to 60 years who met the inclusion criteria. Two studies showed that cannabis exposure decreased BMD, while the other 2 indicated no alteration. Despite the different study designs, the included studies showed a low risk of bias according to the Joanna Briggs Institute tool.Eligible studies present differences in cannabis products, administration routes, and exposure determination. Further longitudinal research is needed to establish multiple clinical predictors associated with potentially negative consequences of cannabis exposure, especially in vulnerable populations such as elderly individuals.
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Affiliation(s)
- Luiz Alexandre Viana Magno
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias, 275, Belo Horizonte, 30130-110, Brazil
| | - Diego Ribeiro Tameirão
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias, 275, Belo Horizonte, 30130-110, Brazil
- Observatório de Pesquisas E Extensão Em Nutrição E Saúde (OPeNS), Belo Horizonte, Brazil
| | - Lucas Ferreira Alves
- Curso de Medicina, Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Brazil
| | - Nathalia Sernizon Guimarães
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias, 275, Belo Horizonte, 30130-110, Brazil.
- Observatório de Pesquisas E Extensão Em Nutrição E Saúde (OPeNS), Belo Horizonte, Brazil.
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10
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Lo BD, Chen SY, Stem M, Papanikolaou A, Gabre-Kidan A, Safar B, Efron JE, Atallah C. Prevalence of cannabis use disorder and perioperative outcomes in adult colectomy patients: A propensity score-matched analysis. World J Surg 2024; 48:701-712. [PMID: 38342773 DOI: 10.1002/wjs.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/06/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND The decriminalization of cannabis across the United States has led to an increased number of patients reporting cannabis use prior to surgery. However, it is unknown whether preoperative cannabis use disorder (CUD) increases the risk of postoperative complications among adult colectomy patients. METHODS Adult patients undergoing an elective colectomy were retrospectively analyzed from the National Inpatient Sample database (2004-2018). To control for potential confounders, patients with CUD, defined using ICD-9/10 codes, were propensity score matched to patients without CUD in a 1:1 ratio. The association between preoperative CUD and composite morbidity, the primary outcome of interest, was assessed. Subgroup analyses were performed after stratification by age (≥50 years). RESULTS Among 432,018 adult colectomy patients, 816 (0.19%) reported preoperative CUD. The prevalence of CUD increased nearly three-fold during the study period from 0.8/1000 patients in 2004 to 2.0/1000 patients in 2018 (P-trend<0.001). After propensity score matching, patients with CUD exhibited similar rates of composite morbidity (140 of 816; 17.2%) as those without CUD (151 of 816; 18.5%) (p = 0.477). Patients with CUD also had similar anastomotic leak rates (CUD: 5.64% vs. No CUD: 6.25%; p = 0.601), hospital lengths of stay (CUD: 5 days, IQR 4-7 vs. No CUD: 5 days, IQR 4-7) (p = 0.415), and hospital charges as those without CUD. Similar findings were seen among patients aged ≥50 years in the subgroup analysis. CONCLUSIONS Though the prevalence of CUD has increased drastically over the past 15 years, preoperative CUD was not associated with an increased risk of composite morbidity among adult patients undergoing an elective colectomy.
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Affiliation(s)
- Brian D Lo
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sophia Y Chen
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Miloslawa Stem
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Angelos Papanikolaou
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alodia Gabre-Kidan
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bashar Safar
- Division of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA
| | - Jonathan E Efron
- Colorectal Research Unit, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Chady Atallah
- Division of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, New York City, New York, USA
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Ghandour L, Slim A, Abbas N, El-Khoury J. Patterns of cannabis use, perception of harm, and perceived impact of legislative change in an online sample of young adults from Lebanon: insight on recreational users versus dual motive users. Harm Reduct J 2024; 21:41. [PMID: 38360652 PMCID: PMC10868015 DOI: 10.1186/s12954-024-00958-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Lebanon remains as one of the major sources of cannabis worldwide. In 2020, its government passed a legislation enabling the cultivation of local medicinal cannabis. This first study following the legislative change examines the overlapping use of cannabis for recreational/medicinal purposes and characteristics of the distinct cannabis user types. METHODS A total of 1230 young adults (18-24 years) filled an anonymous online survey in early 2020. RESULTS Young adults in the sample were distributed as follows: 33% 18-20 years; 60% males; 94% Lebanese; 75% students; and 89% living with family. The older young adults (21-24), males, those employed, living with non-family members, and who perceived themselves as being a little/lot richer than most were statistically significantly more present in the cannabis user subtypes (recreational only or recreational/medicinal) than non-cannabis users. When dual recreational/medicinal users are compared to recreational users only, the latter seemed to have a more conservative profile of behaviours, attitudes, and perceptions and acts of harm. The prevalence ratio comparing the prevalence of users supporting consuming cannabis "once or twice" in dual motive users vs. recreational users only was 1.13 for "once or twice", 1.25 for "occasionally", 1.64 for "regularly", and 2.4 for "daily". Any other illicit drug use was reported by 1% of the non-cannabis users, 36% of the recreational users only, and 58% of the recreational/medicinal users (p-value < 0.01). Similarly, any prescription drug use was reported by 3% of the non-cannabis users, 16% of the recreational users only, and 28% of both recreational/medicinal users (p-value < 0.01). CONCLUSION The interface between recreational and medicinal cannabis use is complex. Dual motive users may warrant special attention as a subpopulation of cannabis users. This is relevant to contexts experiencing medicinal cannabis legislation changes, such as Lebanon, as policymakers and implementers should be sensitized to the emerging evidence for more data-informed policy changes.
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Affiliation(s)
- Lilian Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, P.O. Box 11-0236, Beirut, Lebanon
| | - Andre Slim
- Department of Epidemiology and Population Health, Faculty of Health Sciences, P.O. Box 11-0236, Beirut, Lebanon
| | - Nada Abbas
- Department of Epidemiology and Population Health, Faculty of Health Sciences, P.O. Box 11-0236, Beirut, Lebanon
| | - Joseph El-Khoury
- Department of Psychiatry, The Valens Clinic, Business Bay, Dubai, United Arab Emirates.
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12
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Adewale CA, Heffernan ME, Bendelow A, Rahmandar MH. What Parents Are Missing: Parental Knowledge of Adult-Use Cannabis Legislation and Health Effects, and Communication with Adolescents. Subst Use Misuse 2023; 59:154-157. [PMID: 37814444 DOI: 10.1080/10826084.2023.2267092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Background: The cannabis regulation landscape is ever evolving, and it may be difficult for parents to stay up to date. This study aimed to assess parental knowledge of recent cannabis legislation and cannabis health effects, as well as communication around cannabis use. Materials and Methods: Data were collected through the 2020 Voices of Child Health in Chicago Parent Panel Survey. Parents were asked about the veracity of statements on cannabis legislation and health effects, and about communication with their children. Descriptive statistics were calculated to characterize response frequencies. Rao-Scott chi-square test explored differences in the proportion of parents who answered all questions correctly or got at least one question wrong. Results: 75% and 74% of parents answered at least one legislation or health items incorrectly, respectively. Most parents reported talking to their children about legislation (56%), not using cannabis (75%) and rules around drug use (90%). Conclusions: While parents reported communicating with their children about cannabis, the majority had gaps in their knowledge. The results of this study indicate a need for effective cannabis education interventions.
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Affiliation(s)
- Chorine A Adewale
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Marie E Heffernan
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Anne Bendelow
- Data Analytics and Reporting, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Maria H Rahmandar
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Substance Use & Prevention Program, The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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13
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Sørensen JFL, Hansen JB. Childhood social capital and drug use disorder in adulthood: A retrospective study on antecedent determinants of the type of drug use. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:1673-1690. [PMID: 37260060 DOI: 10.1111/1467-9566.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/09/2023] [Indexed: 06/02/2023]
Abstract
Based on a sample of Danish adults who were enroled in treatment for drug use disorders as a prerequisite for qualifying for receiving unemployment benefits, we analyse the relationship between low social capital in childhood (LSCC) and the type of drug use in adulthood. The type of drug use is measured by distinguishing between those who were treated for using hard drugs (e.g., heroin and cocaine) and those who were treated for using soft drugs (cannabis). Extracting data from the initial treatment registration report, social capital is operationalised into seven different LSCC categories, and the total number of LSCC (the LSCC score) is recorded. Based on logistic regressions, the LSCC score shows a strong graded dose-response relationship with hard drug use. With each additional LSCC, the probability of being treated for hard drug use increases with 9%. Parental child abuse is the most important single predictor of being treated for hard drug use. Having been parentally abused as a child raises the probability by 32%. The results hold after controlling for age, initiation age, and number of years of drug use, all of which show a significant reversed U-shaped relationship with hard drug use.
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Affiliation(s)
- Jens Fyhn Lykke Sørensen
- Department of Sociology, Environmental and Business Economics, University of Southern Denmark, Esbjerg, Denmark
| | - Jens Baek Hansen
- Department of Sociology, Environmental and Business Economics, University of Southern Denmark, Esbjerg, Denmark
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14
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Yilin D, Bellerose M, Borbely C, Rowell-Cunsolo TL. Assessing the relationship between drug use initiation age and racial characteristics. J Ethn Subst Abuse 2023:1-15. [PMID: 37882363 DOI: 10.1080/15332640.2023.2271871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Initiating drug use in adolescence is associated with greater risk of drug misuse and dependence in adulthood and co-occurring mental health disorders. Initiating drug use in adulthood has been linked to higher-risk drug use networks and primary use of "harder drugs". The aim of our research is to examine racial/ethnic differences in age at drug use initiation and its relationship with adult outcomes. Based on data from the 2019 National Survey on Drug Use and Health (NSDUH), we used survey-weighted Poisson regression models with robust variance to identify associations between racial characteristics, age at drug use initiation, and three adult outcomes - past year polydrug use, substance use, and mental illness - adjusting for individual-level characteristics. Among 25,986 respondents who ever used drugs and reported their drug use initiation age, Asian-Americans reported the oldest drug use initiation age (19.5) on average, while Native Americans reported the youngest initiation age (16.6). While there were no significant differences in type of drug used during onset by race or ethnicity, generally, individuals start to use inhalants at the earliest age (17.4), while the misuse of sedatives is initiated at the oldest age (46.4). Initiation during late adolescence was associated with greater likelihood of a substance use disorder diagnosis, mental health diagnoses, and polydrug use in adulthood. Drug use prevention interventions should be tailored and accessible during adolescence to delay onset. Interventions that are culturally sensitive, screen for vulnerability to drug use, and offer age-appropriate services should be prioritized.
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Affiliation(s)
- Diandian Yilin
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Meghan Bellerose
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Carson Borbely
- School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
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15
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Pillay L, Thompson C, Tabane C, Kirby J, Hendricks S, Swart J, van Rensburg DCJ, Zondi P, Rotunno A, Bayever D. South African Institute of Drug-Free Sport Position Statement on CBD (Cannabidiol) and THC (Tetrahydrocannabinol). SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2023; 35:v35i1a16097. [PMID: 38249774 PMCID: PMC10798604 DOI: 10.17159/2078-516x/2023/v35i1a16097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Cannabidiol (CBD) and Tetrahydrocannabinol (THC) have become easily available to athletes over the years. Using these substances may inadvertently expose an athlete to the possibility of an adverse analytical finding (a "positive" test) and a sanction. Athletes need to understand the risk of an anti-doping rule violation or adverse analytical finding should these products be used, especially if no therapeutic use exemption exists. This position statement attempts to clarify the use of CBD and THC and their associated risks with Anti-Doping Rule Violations (ADRV) in the athletic population. The South African Sports Medicine Association supports this position statement.
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Affiliation(s)
- L Pillay
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria,
South Africa
- Faculty of Health, University of Witwatersrand, Johannesburg,
South Africa
| | - C Thompson
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine of Health Sciences, Stellenbosch University,
South Africa
| | - C Tabane
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
| | - J Kirby
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine of Health Sciences, Stellenbosch University,
South Africa
| | - S Hendricks
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- HPALS Research Center, Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town,
South Africa
| | - J Swart
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- International Federation of Sports Medicine (FIMS), Maison du Sport International, Av. de Rhodanie 54, Lausanne,
Switzerland
- HPALS Research Center, Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town,
South Africa
| | - DC Janse van Rensburg
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- International Federation of Sports Medicine (FIMS), Maison du Sport International, Av. de Rhodanie 54, Lausanne,
Switzerland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria,
South Africa
| | - P Zondi
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
| | - A Rotunno
- South African Sports Medicine Association (SASMA), 668 Corelli Street, Les Marais Pretoria,
South Africa
- HPALS Research Center, Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town,
South Africa
| | - D Bayever
- South African Institute for Drug-free Sport (SAIDS), Sport Science Institute of South Africa, 4th Floor, Newlands, Cape Town,
South Africa
- Faculty of Health, University of Witwatersrand, Johannesburg,
South Africa
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16
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Cook AC, Sirmans ET, Stype A. Medical cannabis laws lower individual market health insurance premiums. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104143. [PMID: 37572391 DOI: 10.1016/j.drugpo.2023.104143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND To evaluate the impact of medical cannabis laws (MCLs) on health insurance premiums. We study whether cannabis legalization significantly impacts aggregate health insurer premiums in the individual market. Increases in utilization could have spillover effects to patients in the form of higher health insurance premiums. METHODS We use 2010-2021 state-level U.S. private health insurer financial data from the National Association of Insurance Commissioners. We examined changes to individual market health insurance premiums after the implementation of medical cannabis laws. We employed a robust difference-in-differences estimator that accounted for variation in policy timing to exploit temporal and geographic variation in state-level medical cannabis legalization. RESULTS Seven years after the implementation of Medical Cannabis laws, we observe lower health insurer premiums in the individual market. Starting seven years post-MCL implementation, we find a reduction of $-1662.7 (95% confidence interval [CI -2650.1, -605.7]) for states which implemented MCLs compared to the control group, a reduction of -$1541.8 (95% confidence interval [CI 2602.1, -481.4]) in year 8, and a reduction of $-1625.8, (95% confidence interval [CI -2694.2, -557.5]) in year 9. Due to the nature of insurance pooling and community rating, these savings are appreciated by cannabis users and non-users alike in states that have implemented MCLs. CONCLUSIONS The implementation of MCLs lowers individual-market health insurance premiums. Health insurance spending, including premiums, comprises between 16% and 34% of household budgets in the United States. As healthcare costs continue to rise, our findings suggest that households that obtain their health insurance on the individual (i.e., not employer sponsored) market in states with MCLs appreciate significantly lower premiums.
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Affiliation(s)
- Amanda C Cook
- 356C Schmidthorst College of Business, Department of Economics, Bowling Green State University, Bowling Green, OH 43403, United States.
| | - E Tice Sirmans
- Department of Finance, Insurance and Law, Illinois State University and Katie School of Insurance and Risk Management, United States
| | - Amanda Stype
- Department of Economics, Eastern Michigan University, United States
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17
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Sedani AE, Campbell JE, Beebe LA. Cannabis use among cancer survivors in 22 states: Results from the Behavioral Risk Factor Surveillance System, 2020. Cancer 2023; 129:2499-2513. [PMID: 37029457 DOI: 10.1002/cncr.34793] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND This study identified factors associated with recent cannabis use and cannabis use for medical purposes among cancer survivors relative to individuals without a history of cancer. METHODS Data from the Behavioral Risk Factor Surveillance System were analyzed for the 22 states completing the optional cannabis module in 2020. Weighted multiple logistic regression was performed to explore variables associated with past 30-day cannabis use and cannabis use for medical purposes, stratified by history of cancer. Covariates included state-level cannabis policy, sociodemographic characteristics, health status indicators, and substance use. RESULTS Cannabis use was lower among cancer survivors compared to individuals with no history of cancer (7.57% vs. 10.83%). However, a higher proportion of cancer survivors reported use for medical purposes (82.23% vs. 62.58%). After adjusting for state-level policy, biological sex, age, educational attainment, self-reported race/ethnicity, home ownership, mental health status and physical health status, current smoking (odds ratio [OR], 5.14 vs. 3.74) and binge drinking (OR, 2.71 vs. 2.69) were associated with cannabis use in both groups. Characteristics associated with medical cannabis use varied for the two groups; however, daily use (20-30 days; OR, 1.72 vs. 2.43) was associated with cannabis use for medical purposes in both groups after adjusting for other variables in the model. CONCLUSIONS A high proportion of individuals report cannabis use for medical purposes with higher rates among cancer survivors. Findings support the urgent need for ongoing cannabis research to better understand and inform its use for medical purposes, as well as the development of high-quality standardized education materials and clinical practice guidelines.
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Affiliation(s)
- Ami E Sedani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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18
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Nannini DR, Zheng Y, Joyce BT, Kim K, Gao T, Wang J, Jacobs DR, Schreiner PJ, Yaffe K, Greenland P, Lloyd-Jones DM, Hou L. Genome-wide DNA methylation association study of recent and cumulative marijuana use in middle aged adults. Mol Psychiatry 2023; 28:2572-2582. [PMID: 37258616 PMCID: PMC10611566 DOI: 10.1038/s41380-023-02106-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023]
Abstract
Marijuana is a widely used psychoactive substance in the US and medical and recreational legalization has risen over the past decade. Despite the growing number of individuals using marijuana, studies investigating the association between epigenetic factors and recent and cumulative marijuana use remain limited. We therefore investigated the association between recent and cumulative marijuana use and DNA methylation levels. Participants from the Coronary Artery Risk Development in Young Adults Study with whole blood collected at examination years (Y) 15 and Y20 were randomly selected to undergo DNA methylation profiling at both timepoints using the Illumina MethylationEPIC BeadChip. Recent use of marijuana was queried at each examination and used to estimate cumulative marijuana use from Y0 to Y15 and Y20. At Y15 (n = 1023), we observed 22 and 31 methylation markers associated (FDR P ≤ 0.05) with recent and cumulative marijuana use and 132 and 16 methylation markers at Y20 (n = 883), respectively. We replicated 8 previously reported methylation markers associated with marijuana use. We further identified 640 cis-meQTLs and 198 DMRs associated with recent and cumulative use at Y15 and Y20. Differentially methylated genes were statistically overrepresented in pathways relating to cellular proliferation, hormone signaling, and infections as well as schizophrenia, bipolar disorder, and substance-related disorders. We identified numerous methylation markers, pathways, and diseases associated with recent and cumulative marijuana use in middle-aged adults, providing additional insight into the association between marijuana use and the epigenome. These results provide novel insights into the role marijuana has on the epigenome and related health conditions.
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Affiliation(s)
- Drew R Nannini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brian T Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kyeezu Kim
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tao Gao
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jun Wang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristine Yaffe
- University of California at San Francisco School of Medicine, San Francisco, CA, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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19
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García-Pérez Á, Aonso-Diego G, Weidberg S, Secades-Villa R. Testing the cannabis gateway hypothesis in a national sample of Spanish adolescents. Addict Behav 2023; 144:107751. [PMID: 37224582 DOI: 10.1016/j.addbeh.2023.107751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The gateway hypothesis holds that the use of legal substances (i.e., tobacco and alcohol) increases the risk of initiating in cannabis use which, in turn, increases the chances of using other illegal substances. The validity of this hypothesis has been the subject of intense debate in recent years, finding sequences with a different order. Moreover, this pattern has been scarcely studied in Spain, where characteristics related to cannabis use are meaningfully different to other countries. This study aims to examine the gateway effects of cannabis towards other legal and illegal substances in Spanish adolescents. MATERIAL AND METHODS Data were obtained from the Ministry of Health in Spain, through a representative survey of addictive behaviors of 36,984 Spanish adolescents (Mage = 15.7, SD = 1.2, 51.4% females). RESULTS Lifetime cannabis use increased the likelihood of later legal substance use, both tobacco (OR = 2.0; 95%CI 1.81, 2.22) and alcohol (OR = 1.93; 95%CI 1.61, 2.31), as well as illegal substances (OR = 5.36; 95%CI 4.80, 5.98) and polysubstance (OR = 18.24; 95%CI 14.63, 22.73). Early age of cannabis use onset significantly increased the likelihood of subsequent legal and illegal substance use (ORs between 1.82 and 2.65). CONCLUSIONS These findings confirm and expand the available evidence on cannabis as a gateway substance. These results can help to drive preventive strategies for substance use in Spanish adolescents.
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Affiliation(s)
- Ángel García-Pérez
- Department of Psychology, Sociology and Philosophy, University of Leon, Spain
| | | | - Sara Weidberg
- Department of Psychology, University of Oviedo, Spain
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20
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Hussain ZS, Khan A, Loya A, Shah K, Woreta FA, Riaz KM. Early Lifetime Substance Use and Development of Visual Impairment: Analysis of the National Survey on Drug Use and Health Data. Clin Ophthalmol 2023; 17:849-860. [PMID: 36968284 PMCID: PMC10030542 DOI: 10.2147/opth.s401167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
Purpose To investigate the association between early lifetime substance use on the development of severe visual acuity impairment or blindness on a national level. Methods National Survey of Drug Use and Health data was used to identify cases of substance use before 21* years of age, within the past year, and cases of self-reported blindness or visual impairment. Univariable and multivariable binary logistic regression with time-dependency was performed to evaluate odds of visual impairment influenced by 16 substances separated into three classes: prescription, non-prescription, and illicit drugs. Adjusted variables of interest included gender, marital status, race, level of education, total family income, poverty level, population density, and history of chronic disease. Results 55,824 total responses were analyzed with 2577 (4.6%) cases of self-reported blindness or significant visual impairment. All early-use substance categories, including prescription, non-prescription, and illegal substances, were significantly associated with self-reported VI (OR 2.068, CI 1.451-2.949, p<0.001; OR 1.352, CI 1.227-1.489, p<0.001); OR 1.211, CI 1.086-1.352, p<0.001), respectively). Non-prescription substances displayed parallel significances amongst all constituents (alcohol, cigarettes, inhalants, and marijuana) (OR=1.227, CI 1.12-1.344, p<0.001; OR 1.363, CI 1.243-1.495, p<0.001; OR 1.418, CI 1.134-1.774; OR 1.388, CI 1.27-1.518, p<0.001, respectively). Univariable and multivariable analysis revealed several significant demographical and clinical adjustors. Conclusion Early lifetime use of all three classes of substances is associated with enhanced odds of subsequent visual impairment or blindness. Several readily available and commonly used substances have a greater risk. These findings may help clinicians and public health agencies in mitigation ventures including education, prevention, and rehabilitation efforts.
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Affiliation(s)
- Zain S Hussain
- University of Medicine and Health Sciences, Basseterre, Saint Kitts and Nevis
- Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma City, OK, USA
| | - Asher Khan
- Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma City, OK, USA
- College of Medicine, University of Oklahoma, Oklahoma City, OK, USA
| | - Asad Loya
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Kaushal Shah
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University, Tulsa, OK, USA
| | - Fasika A Woreta
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Kamran M Riaz
- Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma City, OK, USA
- Correspondence: Kamran M Riaz, Dean McGee Eye Institute/University of Oklahoma, 608 Stanton L Young Blvd, Suite 313, Oklahoma City, OK, 73104, USA, Tel +1-405-271-1095, Fax +1-405-271-3680, Email
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21
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Patterns of Cannabis- and Substance-Related Congenital General Anomalies in Europe: A Geospatiotemporal and Causal Inferential Study. Pediatr Rep 2023; 15:69-118. [PMID: 36810339 PMCID: PMC9944887 DOI: 10.3390/pediatric15010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Recent series of congenital anomaly (CA) rates (CARs) have showed the close and epidemiologically causal relationship of cannabis exposure to many CARs. We investigated these trends in Europe where similar trends have occurred. METHODS CARs from EUROCAT. Drug use from European Monitoring Centre for Drugs and Drug Addiction. Income data from World Bank. RESULTS CARs were higher in countries with increasing daily use overall (p = 9.99 × 10-14, minimum E-value (mEV) = 2.09) and especially for maternal infections, situs inversus, teratogenic syndromes and VACTERL syndrome (p = 1.49 × 10-15, mEV = 3.04). In inverse probability weighted panel regression models the series of anomalies: all anomalies, VACTERL, foetal alcohol syndrome, situs inversus (SI), lateralization (L), and teratogenic syndromes (TS; AAVFASSILTS) had cannabis metric p-values from: p < 2.2 × 10-16, 1.52 × 10-12, 1.44 × 10-13, 1.88 × 10-7, 7.39 × 10-6 and <2.2 × 10-16. In a series of spatiotemporal models this anomaly series had cannabis metric p-values from: 8.96 × 10-6, 6.56 × 10-6, 0.0004, 0.0019, 0.0006, 5.65 × 10-5. Considering E-values, the cannabis effect size order was VACTERL > situs inversus > teratogenic syndromes > FAS > lateralization syndromes > all anomalies. 50/64 (78.1%) E-value estimates and 42/64 (65.6%) mEVs > 9. Daily cannabis use was the strongest predictor for all anomalies. CONCLUSION Data confirmed laboratory, preclinical and recent epidemiological studies from Canada, Australia, Hawaii, Colorado and USA for teratological links between cannabis exposure and AAVFASSILTS anomalies, fulfilled epidemiological criteria for causality and underscored importance of cannabis teratogenicity. VACTERL data are consistent with causation via cannabis-induced Sonic Hedgehog inhibition. TS data suggest cannabinoid contribution. SI&L data are consistent with results for cardiovascular CAs. Overall, these data show that cannabis is linked across space and time and in a manner which fulfills epidemiological criteria for causality not only with many CAs, but with several multiorgan teratologic syndromes. The major clinical implication of these results is that access to cannabinoids should be tightly restricted in the interests of safeguarding the community's genetic heritage to protect and preserve coming generations, as is done for all other major genotoxins.
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Hsieh TY, Simpkins SD, Vandell DL. Longitudinal associations between adolescent out-of-school time and adult substance use. J Adolesc 2023; 95:131-146. [PMID: 36250338 PMCID: PMC9822851 DOI: 10.1002/jad.12104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Based on Bronfenbrenner's bioecological theory and Bornstein's specificity principle, the purpose of this study was to examine adolescents' time in out-of-school settings as a precursor of three types of problematic substance use in adulthood (i.e., binge drinking, regular marijuana use, and use of illicit drugs). METHOD Adolescents (N = 978) reported the time they spent in four common out-of-school settings at ages 15 and 18: unsupervised time with peers, organized sports, other organized activities, and paid employment. At age 26, participants reported binge drinking, marijuana use, and illicit drug use. RESULTS AND CONCLUSIONS Adolescents' time in out-of-school settings during high school predicted age 26 substance use over and above family and adolescent factors, including adolescents' substance use during high school. Adolescents' unsupervised time with peers increased the odds and frequency of binge drinking and regular marijuana use at age 26. Time in high school organized sports increased the odds of binge drinking at age 26, but not marijuana or illicit drug use. Time spent in other organized activities, such as community service and the arts, lowered the odds of illicit drug use whereas paid employment in high school was not related to age 26 substance use. Aligned with Bornstein's specificity principle, time spent in specific out-of-school settings during adolescence were differentially related to substance use problems in early adulthood, with some activities serving as a risk factor and other activities serving as a protective factor for young adults.
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Reece AS, Hulse GK. Epigenomic and Other Evidence for Cannabis-Induced Aging Contextualized in a Synthetic Epidemiologic Overview of Cannabinoid-Related Teratogenesis and Cannabinoid-Related Carcinogenesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416721. [PMID: 36554603 PMCID: PMC9778714 DOI: 10.3390/ijerph192416721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND Twelve separate streams of empirical data make a strong case for cannabis-induced accelerated aging including hormonal, mitochondriopathic, cardiovascular, hepatotoxic, immunological, genotoxic, epigenotoxic, disruption of chromosomal physiology, congenital anomalies, cancers including inheritable tumorigenesis, telomerase inhibition and elevated mortality. METHODS Results from a recently published longitudinal epigenomic screen were analyzed with regard to the results of recent large epidemiological studies of the causal impacts of cannabis. We also integrate theoretical syntheses with prior studies into these combined epigenomic and epidemiological results. RESULTS Cannabis dependence not only recapitulates many of the key features of aging, but is characterized by both age-defining and age-generating illnesses including immunomodulation, hepatic inflammation, many psychiatric syndromes with a neuroinflammatory basis, genotoxicity and epigenotoxicity. DNA breaks, chromosomal breakage-fusion-bridge morphologies and likely cycles, and altered intergenerational DNA methylation and disruption of both the histone and tubulin codes in the context of increased clinical congenital anomalies, cancers and heritable tumors imply widespread disruption of the genome and epigenome. Modern epigenomic clocks indicate that, in cannabis-dependent patients, cannabis advances cellular DNA methylation age by 25-30% at age 30 years. Data have implications not only for somatic but also stem cell and germ line tissues including post-fertilization zygotes. This effect is likely increases with the square of chronological age. CONCLUSION Recent epigenomic studies of cannabis exposure provide many explanations for the broad spectrum of cannabis-related teratogenicity and carcinogenicity and appear to account for many epidemiologically observed findings. Further research is indicated on the role of cannabinoids in the aging process both developmentally and longitudinally, from stem cell to germ cell to blastocystoids to embryoid bodies and beyond.
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Affiliation(s)
- Albert Stuart Reece
- Division of Psychiatry, University of Western Australia, Crawley, WA 6009, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Correspondence:
| | - Gary Kenneth Hulse
- Division of Psychiatry, University of Western Australia, Crawley, WA 6009, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
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Wu G, Willits DW. The Impact of Recreational Marijuana Legalization on Simple Assault in Oregon. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP23180-NP23201. [PMID: 35229672 DOI: 10.1177/08862605221076169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There has been heightened public concern about the implications of recreational marijuana legalization to public safety. Prior research on this issue has primarily focused on Colorado and Washington State-the two states that first legalized recreational marijuana in the U.S.-and on legalization's impact on major crimes. This study extends this line of research to Oregon (OR, legalized in late 2014) and examines the impact of legalization on a less serious form of violent crime-simple assault. Using Uniform Crime Reporting (UCR) Program data from 2007 to 2017 and a quasi-experimental research design, this study found that counties in OR have experienced increases in simple assault rate following legalization, relative to rates in the 19 non-legalized states. Findings suggest the need for more scholarly efforts to explore the potential impact of marijuana legalization on different subtypes of violent crime in other legalized states.
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Affiliation(s)
- Guangzhen Wu
- Department of Sociology, 7060The University of Utah, Salt Lake City, USA
| | - Dale W Willits
- Department of Criminal Justice and Criminology, 6760Washington State University, Pullman, USA
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Machado do Vale TC, da Silva Chagas L, de Souza Pereira H, Giestal-de-Araujo E, Arévalo A, Oliveira-Silva Bomfim P. Neuroscience Outside the Box: From the Laboratory to Discussing Drug Abuse at Schools. Front Hum Neurosci 2022; 16:782205. [PMID: 35634202 PMCID: PMC9133440 DOI: 10.3389/fnhum.2022.782205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
One of the effects of the current COVID-19 pandemic is that low-income countries were pushed further into extreme poverty, exacerbating social inequalities and increasing susceptibility to drug use/abuse in people of all ages. The risks of drug abuse may not be fully understood by all members of society, partly because of the taboo nature of the subject, and partly because of the considerable gap between scientific production/understanding and communication of such knowledge to the public at large. Drug use is a major challenge to social development and a leading cause of school dropout rates worldwide. Some public policies adopted in several countries in recent decades failed to prevent drug use, especially because they focused on imposing combative or coercive measures, investing little or nothing in education and prevention. Here we highlight the role of neuroscience education as a valid approach in drug use education and prevention. We propose building a bridge between schools and scientists by promoting information, student engagement and honest dialogue, and show evidence that public policy regulators should be persuaded to support such science-based education programs in their efforts to effect important positive changes in society.
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Affiliation(s)
- Thereza Cristina Machado do Vale
- NuPEDEN, Nucleus for Research, Education, Dissemination and Neurosciences Popularization, Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Luana da Silva Chagas
- NuPEDEN, Nucleus for Research, Education, Dissemination and Neurosciences Popularization, Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Helena de Souza Pereira
- Department of Molecular and Cell Biology, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Elizabeth Giestal-de-Araujo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Analía Arévalo
- Department of Experimental Surgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Priscilla Oliveira-Silva Bomfim
- NuPEDEN, Nucleus for Research, Education, Dissemination and Neurosciences Popularization, Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
- *Correspondence: Priscilla Oliveira-Silva Bomfim,
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A Framework for Online Public Health Debates: Some Design Elements for Visual Analytics Systems. INFORMATION 2022. [DOI: 10.3390/info13040201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Nowadays, many people are deeply concerned about their physical well-being; as a result, they invest much time and effort investigating health-related topics. In response to this, many online websites and social media profiles have been created, resulting in a plethora of information on such topics. In a given topic, oftentimes, much of the information is conflicting, resulting in online camps that have different positions and arguments. We refer to the collection of all such positionings and entrenched camps on a topic such as an online public health debate. The information people encounter regarding such debates can ultimately influence how they make decisions, what they believe, and how they act. Therefore, there is a need for public health stakeholders (i.e., people with a vested interest in public health issues) to be able to make sense of online debates quickly and accurately. In this paper, we present a framework-based approach for investigating online public health debates—a preliminary work that can be expanded upon. We first introduce the concept of online debate entities (ODEs), which is a generalization for those who participate in online debates (e.g., websites and Twitter profiles). We then present the framework ODIN (Online Debate entIty aNalyzer), in which we identify, define, and justify ODE attributes that we consider important for making sense of online debates. Next, we provide an overview of four online public health debates (vaccines, statins, cannabis, and dieting plans) using ODIN. Finally, we showcase four prototype visual analytics systems whose design elements are informed by the ODIN framework.
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United States marijuana legalization and opioid mortality epidemic during 2010–2020 and pandemic implications. J Natl Med Assoc 2022; 114:412-425. [DOI: 10.1016/j.jnma.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 11/23/2022]
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Abdelmoneim WM, Ghandour NM, Fawzy M, Mohammed MK, Ramadan AG, Abdellah NZ. Clinical pattern of synthetic cannabinoids users in Upper Egypt: cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2022. [PMCID: PMC8964025 DOI: 10.1186/s43045-022-00188-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background There is an expanding use of new psychoactive substances containing synthetic cannabinoids in the last years. This study was conducted to identify the epidemiologic data of acute and chronic toxicity by synthetic cannabinoids in Upper Egypt patients. Results All cases included in the presenting study were fifty males. Most users of synthetic cannabinoids were in the adolescence and middle age group (15–< 35) representing 68%. Curiosity was the most common motivator for using synthetic cannabinoids. Alteration of perception was reported in 68% of subjects after synthetic cannabinoids use. Additionally, dizziness, loss of consciousness, convulsion, and panic attacks were also reported. Cardiovascular adverse effects experienced by users were palpitations (76%) and chest pain (12%). Half of included subjects (50%) reported financial problems and about one-third (32%) got involved in domestic violence. Abnormal routine laboratory findings that were found in included cases were in the form of 12% anemia, 10% leukocytosis, and 6% leucopenia. Also, liver and kidney functions were elevated in 8% and 4% of the cases, respectively. While 22% and 4% of cases were positive for hepatitis C and HIV respectively. Conclusions This study can be concluded that adolescence are the most common users of SCs; neuro-psychiatric and cardiovascular side effects were the most experienced by subjects. Violence in many forms, especially domestic violence, was associated with synthetic cannabinoids abuse. Trial registration Registered in clinical trial under name syntheticcannabinoidsAssiut and ID NCT03866941 and URL.
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Hill KP, Gold MS, Nemeroff CB, McDonald W, Grzenda A, Widge AS, Rodriguez C, Kraguljac NV, Krystal JH, Carpenter LL. Risks and Benefits of Cannabis and Cannabinoids in Psychiatry. Am J Psychiatry 2022; 179:98-109. [PMID: 34875873 DOI: 10.1176/appi.ajp.2021.21030320] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The United States is in the midst of rapidly changing laws regarding cannabis. The increasing availability of cannabis for recreational and medical use requires that mental health clinicians be knowledgeable about evidence to be considered when counseling both patients and colleagues. In this review, the authors outline the evidence from randomized double-blind placebo-controlled trials for therapeutic use of cannabinoids for specific medical conditions and the potential side effects associated with acute and chronic cannabis use. METHODS Searches of PubMed and PsycInfo were conducted for articles published through July 2021 reporting on "cannabis" or "cannabinoids" or "medicinal cannabis." Additional articles were identified from the reference lists of published reviews. Articles that did not contain the terms "clinical trial" or "therapy" in the title or abstract were not reviewed. A total of 4,431 articles were screened, and 841 articles that met criteria for inclusion were reviewed by two or more authors. RESULTS There are currently no psychiatric indications approved by the U.S. Food and Drug Administration (FDA) for cannabinoids, and there is limited evidence supporting the therapeutic use of cannabinoids for treatment of psychiatric disorders. To date, evidence supporting cannabinoid prescription beyond the FDA indications is strongest for the management of pain and spasticity. CONCLUSIONS As cannabinoids become more available, the need for an evidence base adequately evaluating their safety and efficacy is increasingly important. There is considerable evidence that cannabinoids have a potential for harm in vulnerable populations such as adolescents and those with psychotic disorders. The current evidence base is insufficient to support the prescription of cannabinoids for the treatment of psychiatric disorders.
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Affiliation(s)
- Kevin P Hill
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Mark S Gold
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Charles B Nemeroff
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - William McDonald
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Adrienne Grzenda
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Alik S Widge
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Carolyn Rodriguez
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Nina V Kraguljac
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - John H Krystal
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
| | - Linda L Carpenter
- Department of Psychiatry, Harvard Medical School, Boston, andBeth Israel Deaconess Medical Center, Boston (Hill);Department of Psychiatry, School of Medicine, Washington University in St. Louis (Gold);Department of Psychiatry, Dell Medical School, University of Texas at Austin (Nemeroff);Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (McDonald);Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles (Grzenda);Department of Psychiatry, University of Minnesota, Minneapolis (Widge);Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., andVeterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez);Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham (Kraguljac);Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal);Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, andButler Hospital, Providence, R.I. (Carpenter)
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Schleimer JP, Smith N, Zaninovic V, Keyes KM, Castillo-Carniglia A, Rivera-Aguirre A, Cerdá M. Trends in the sequence of initiation of alcohol, tobacco, and marijuana use among adolescents in Argentina and Chile from 2001 to 2017. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103494. [PMID: 34666217 DOI: 10.1016/j.drugpo.2021.103494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/08/2021] [Accepted: 10/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Variation in drug policies, norms, and substance use over time and across countries may affect the normative sequences of adolescent substance use initiation. We estimated relative and absolute time-varying associations between prior alcohol and tobacco use and adolescent marijuana initiation in Argentina and Chile. Relative measures quantify the magnitude of the associations, whereas absolute measures quantify excess risk. METHODS We analyzed repeated, cross-sectional survey data from the National Surveys on Drug Use Among Secondary School Students in Argentina (2001-2014) and Chile (2001-2017). Participants included 8th, 10th, and 12th grade students (N = 680,156). Linear regression models described trends over time in the average age of first use of alcohol, tobacco, and marijuana. Logistic regression models were used to estimate time-varying risk ratios and risk differences of the associations between prior alcohol and tobacco use and current-year marijuana initiation. RESULTS Average age of marijuana initiation increased and then decreased in Argentina and declined in Chile. In both countries, the relative associations between prior tobacco use and marijuana initiation weakened amid declining rates of tobacco use; e.g., in Argentina, the risk ratio was 19.9 (95% CI: 9.0-30.8) in 2001 and 11.6 (95% CI: 9.0-13.2) in 2014. The relative association between prior alcohol use and marijuana initiation weakened Chile, but not in Argentina. On the contrary, risk differences (RD) increased substantially across both relationships and countries, e.g., in Argentina, the RD for tobacco was 3% (95% CI: 0.02-0.03) in 2001 and 12% (95% CI: 0.11-0.13) in 2014. CONCLUSION Diverging trends in risk ratios and risk differences highlight the utility of examining multiple measures of association. Variation in the strength of the associations over time and place suggests the influence of environmental factors. Increasing risk differences indicate alcohol and tobacco use may be important targets for interventions to reduce adolescent marijuana use.
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Affiliation(s)
- Julia P Schleimer
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine, 2315 Stockton Blvd., Sacramento, CA 95817, USA.
| | - Nathan Smith
- Department of Psychology, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
| | - ViniNatalie Zaninovic
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St. NY, NY 10032, New York, NY, USA
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Badajoz 130, Las Condes, Santiago, Chile; School of Public Health, Universidad Mayor, Jose Toribio Medina #38, Santiago, Chile; Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Ariadne Rivera-Aguirre
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
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Obadeji A, Oluwole LO, Kumolalo BF, Dada MU. Patterns of Substance Use Disorders and Associated Co-occurring Psychiatric Morbidity among Patients Seen at the Psychiatric Unit of a Tertiary Health Center. ADDICTION & HEALTH 2022; 14:35-43. [PMID: 35573761 PMCID: PMC9057648 DOI: 10.22122/ahj.v14i1.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Understanding the pattern of co-occurring mental illness in patients with substance use disorders (SUDs) is essential in improving the prevention and treatment of substance use-related problems. This study examined the pattern of SUDs, the associated co-occurring psychiatric morbidities, and associated factors among patients with SUDs managed at a tertiary health center. METHODS The records of patients who presented with SUDs between 2010 and 2019 were examined. Socio-demographics of interest were extracted from case files. Substance use diagnoses, as well as associated co-occurring mental illness, were extracted and entered into SPSS software. Bivariate analyses including the risk of developing co-occurring mental disorder were calculated. FINDINGS For most patients, the initiation of substance use was before the age of 21 years, while the onset of SUDs was between 21-30 years. Cannabis use disorders (CUDs), alcohol use disorders (AUDs), and nicotine use disorders (NUDs) were the commonest SUDs. Compared with those with CUDs, non-users of cannabis were significantly less likely to develop co-occurring mental illness [odds ratio (OR) = 0.25, 95% confidence interval (CI) =0.13-0.42, P = 0.001]. Those with tramadol use disorders (OR = 2.13, 95% CI = 1.03-4.41, P = 0.040) and those without pentazocine use disorders (P = 0.003) were more likely to have a comorbid mental illness. Patients with AUDs (P = 0.001), CUDs (P = 0.001), NUDs (P = 0.001), and tramadol use disorders (P = 0.045) were significantly more likely to be multiple substance users. CONCLUSION Results suggest an association between SUDs and co-occurring mental illness, though differences in these associations were noticed across the categories of substances. This emphasizes a holistic approach to prevention and care of patients presenting with SUDs.
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Affiliation(s)
- Adetunji Obadeji
- Department of Psychiatry, College of Medicine AND Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria,Correspondence to: Adetunji
| | - Lateef Olutoyin Oluwole
- Department of Psychiatry, College of Medicine AND Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Banji Ferdinand Kumolalo
- Department of Psychiatry, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Mobolaji Usman Dada
- Department of Psychiatry, College of Medicine AND Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
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Datta S, Ramamurthy PC, Anand U, Singh S, Singh A, Dhanjal DS, Dhaka V, Kumar S, Kapoor D, Nandy S, Kumar M, Koshy EP, Dey A, Proćków J, Singh J. Wonder or evil?: Multifaceted health hazards and health benefits of Cannabis sativa and its phytochemicals. Saudi J Biol Sci 2021; 28:7290-7313. [PMID: 34867033 PMCID: PMC8626265 DOI: 10.1016/j.sjbs.2021.08.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022] Open
Abstract
Cannabis sativa, widely known as 'Marijuana' poses a dilemma for being a blend of both good and bad medicinal effects. The historical use of Cannabis for both medicinal and recreational purposes suggests it to be a friendly plant. However, whether the misuse of Cannabis and the cannabinoids derived from it can hamper normal body physiology is a focus of ongoing research. On the one hand, there is enough evidence to suggest that misuse of marijuana can cause deleterious effects on various organs like the lungs, immune system, cardiovascular system, etc. and also influence fertility and cause teratogenic effects. However, on the other hand, marijuana has been found to offer a magical cure for anorexia, chronic pain, muscle spasticity, nausea, and disturbed sleep. Indeed, most recently, the United Nations has given its verdict in favour of Cannabis declaring it as a non-dangerous narcotic. This review provides insights into the various health effects of Cannabis and its specialized metabolites and indicates how wise steps can be taken to promote good use and prevent misuse of the metabolites derived from this plant.
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Affiliation(s)
- Shivika Datta
- Department of Zoology, Doaba College, Jalandhar, Punjab 144001, India
| | - Praveen C. Ramamurthy
- Interdisciplinary Centre for Water Research (ICWaR), Indian Institute of Sciences, Bangalore 560012, Karnataka, India
| | - Uttpal Anand
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Simranjeet Singh
- Interdisciplinary Centre for Water Research (ICWaR), Indian Institute of Sciences, Bangalore 560012, Karnataka, India
| | - Amritpal Singh
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College and Hospital, Amphala, Jammu 180012, India
| | - Daljeet Singh Dhanjal
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Vaishali Dhaka
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Sanjay Kumar
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Miyagi 980-8577, Japan
| | - Dhriti Kapoor
- Department of Botany, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Samapika Nandy
- Department of Life Sciences, Presidency University, Kolkata 700073, West Bengal, India
| | - Manoj Kumar
- Department of Life Sciences, School of Natural Science, Central University of Jharkhand, Brambe, Ratu-Lohardaga Road Ranchi, Jharkhand 835205, India
| | - Eapen P. Koshy
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata 700073, West Bengal, India
| | - Jarosław Proćków
- Department of Plant Biology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Kożuchowska 5b, 51-631 Wrocław, Poland
| | - Joginder Singh
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
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Borst JM, Costantini TW, Reilly L, Smith AM, Stabley R, Steele J, Wintz D, Bansal V, Biffl WL, Godat LN. Driving under the influence: a multi-center evaluation of vehicular crashes in the era of cannabis legalization. Trauma Surg Acute Care Open 2021; 6:e000736. [PMID: 34786487 PMCID: PMC8587622 DOI: 10.1136/tsaco-2021-000736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background Eleven states have instituted laws allowing recreational cannabis use leading to growing public health concerns surrounding the effects of cannabis intoxication on driving safety. We hypothesized that after the 2016 legalization of cannabis in California, the use among vehicular injury patients would increase and be associated with increased injury severity. Methods San Diego County’s five adult trauma center registries in were queried from January 2010 to June 2018 for motor vehicle or motorcycle crash patients with completed toxicology screens. Patients were stratified as toxicology negative (TOX−), positive for only THC (THC+), only blood alcohol >0.08% (ETOH+), THC+ETOH, or THC+ with any combination with methamphetamine or cocaine (M/C). County medical examiner data were reviewed to characterize THC use in those with deaths at the scene of injury. Results Of the 11,491 patients identified, there were 61.6% TOX−, 11.7% THC+, 13.7% ETOH+, 5.0% THC+ETOH, and 7.9% M/C. THC+ increased from 7.3% to 14.8% over the study period and peaked at 14.9% post-legalization in 2017. Compared with TOX− patients, THC+ patients were more likely to be male and younger. THC+ patients were also less likely to wear seatbelts (8.5% vs 14.3%, p<0.001) and had increased mean Injury Severity Score (8.4±9.4 vs 9.0±9.9, p<0.001) when compared with TOX− patients. There was no difference in in-hospital mortality between groups. From the medical examiner data of the 777 deaths on scene, 27% were THC+. Discussion THC+ toxicology screens in vehicular injury patients peaked after the 2016 legalization of cannabis. Public education on the risks of driving under the influence of cannabis should be a component of injury prevention initiatives. Level of evidence III, Prognostic
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Affiliation(s)
- Johanna Marie Borst
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Todd W Costantini
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Lindsay Reilly
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Alan M Smith
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, UC San Diego School of Medicine, San Diego, California, USA
| | - Robert Stabley
- Examiner's Office, San Diego County Medical Examiner's Office, San Diego, California, USA
| | - John Steele
- Trauma, Palomar Medical Center, Escondido, California, USA
| | - Diane Wintz
- Trauma, Sharp Memorial Medical Center, San Diego, California, USA
| | - Vishal Bansal
- Trauma, Scripps Mercy Hospital, San Diego, California, USA
| | - Walter L Biffl
- Trauma, Scripps Memorial Hospital, La Jolla, California, USA
| | - Laura N Godat
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery, University of California San Diego School of Medicine, San Diego, California, USA
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Vijapur SM, Levy NS, Martins SS. Cannabis use outcomes by past-month binge drinking status in the general United States population. Drug Alcohol Depend 2021; 228:108997. [PMID: 34508962 PMCID: PMC8595626 DOI: 10.1016/j.drugalcdep.2021.108997] [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: 04/26/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
Cannabis use and binge drinking are increasingly common in the United States, yet little is known about cannabis use patterns among people who engage in binge drinking. This study explored the relationship between several cannabis use outcomes and past-month binge drinking status. Pooled 2015-2018 National Surveys on Drug Use and Health data (N = 226,632) were used to explore the hypothesis that binge drinking is associated with higher prevalence of cannabis outcomes. Cannabis outcomes included past-month and past-year use, daily/almost daily use, and past-year DSM-IV/DSM-5 cannabis use disorder (CUD). Covariates included age, gender, race, total income, and study year. Separate weighted multivariable logistic regressions assessed associations between binge drinking and each cannabis outcome and provided adjusted prevalences of cannabis outcomes by binge drinking status. Past-month binge drinking was positively associated with past-month (OR: 3.72, 95 %CI: 3.56-3.93) and past-year (OR: 3.90, 95 %CI: 3.74-4.06) cannabis use in adjusted regressions. The adjusted odds of DSM-IV and DSM-5 CUD among people who used cannabis were 15 % and 12 % higher among people who engaged in binge drinking than those who did not, respectively (OR: 1.15, 95 %CI: 1.05, 1.26 and OR: 1.12, 95 %CI: 1.03, 1.21). Conversely, the odds of past-month daily cannabis use among people who used cannabis and reported binge drinking was 18 % lower than those who did not (OR: 0.82, 95 %CI: 0.74, 0.91). Our findings provide evidence of associations between binge drinking and cannabis use. Future studies should explore associations between cannabis and other alcohol use behaviors, including heavy drinking, and simultaneous alcohol and cannabis use.
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Affiliation(s)
- Sushupta M. Vijapur
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, 10032, USA
| | - Natalie S. Levy
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, 10032, USA
| | - Silvia S. Martins
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, 10032, USA
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Kuźnicki P, Neubauer K. Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse. J Clin Med 2021; 10:4623. [PMID: 34640641 PMCID: PMC8509435 DOI: 10.3390/jcm10194623] [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] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/26/2021] [Accepted: 10/04/2021] [Indexed: 12/16/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic and potentially devastating condition of the digestive tract which is exemplified by increasing prevalence worldwide, byzantine pathogenesis with a poorly defined role of the environmental factors, and complex clinical demonstration. As a systemic disease, IBD may progress with a wide spectrum of extraintestinal manifestations (EMs) and comorbidities affecting different organs and systems, from anaemia, undernutrition, and cancer to those which are often neglected like anxiety and depression. Evolving IBD epidemiology and changing environment are reflected by an expanding list of IBD-related comorbidities. In contrast to the well-established role of smoking the connection between alcohol and IBD is still debatable on many levels, from pathogenesis to complications. Furthermore, little is known about narcotics use in IBD patients, even if there are obvious factors that may predispose them to narcotics as well as alcohol misuse. Last but not least, the question arises what is the prevalence of eating disorders in IBD. In our paper, we aimed to discuss the current knowledge on alcohol and drugs misuse and eating disorders as emerging extraintestinal comorbidities in IBD.
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Affiliation(s)
- Paweł Kuźnicki
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland;
| | - Katarzyna Neubauer
- Department of Gastroenterology and Hepatology, Division of Dietetics, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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36
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Petersen M, Koller K, Straley C, Reed E. Effect of cannabis use on PTSD treatment outcomes in veterans. Ment Health Clin 2021; 11:238-242. [PMID: 34316419 PMCID: PMC8287864 DOI: 10.9740/mhc.2021.07.238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 05/27/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction Researchers have found anandamide (an endocannabinoid) and cannabinoid type 1 receptor activation encourages extinction of aversive memories. Some theorize cannabinoids such as those in cannabis may provide a new treatment approach for PTSD, while others suggest it may worsen symptomology. The objective of the current study was to determine if cannabis use impacts the success of evidence-based intensive outpatient PTSD treatment in a veteran population. Methods A list of veterans enrolled in the Battle Creek Veterans' Affairs Medical Center outpatient PTSD Clinical Team Clinic between October 1st, 2008 and October 1st, 2016 was obtained, and a random sample was identified. Study participants were veterans aged 18 to 85 years, with at least 2 PTSD Checklist scores, and a diagnosis of PTSD. Data collected included mental health medications, type and number of evidence-based psychotherapy used, and presence of co-occurring behavioral health diagnoses. The cannabis use group was compared to the no-cannabis-use group, and differences in variables pertaining to the relative number of treatment successes and failures was evaluated for statistical and clinical significance. Results The majority of patients were white (87.1%) and male (95%). The success rate was similar between the cannabis and no-cannabis-use groups (51.9% and 51.4%, respectively). Discussion The current study did not show that a predominantly white male veteran sample diagnosed with PTSD differed in intensive PTSD treatment success or failure based on cannabis use.
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Affiliation(s)
- Meagan Petersen
- Mental Health Clinical Pharmacy Specialist, Battle Creek Veteran Affairs Medical Center, Battle Creek, Michigan.,Professor, Pharmacy Practice Department, College of Pharmacy, Ferris State University, Big Rapids, Michigan.,Mental Health Clinical Pharmacy Specialist, Battle Creek Veteran Affairs Medical Center, Battle Creek, Michigan
| | - Katherine Koller
- Mental Health Clinical Pharmacy Specialist, Battle Creek Veteran Affairs Medical Center, Battle Creek, Michigan
| | - Craig Straley
- Professor, Pharmacy Practice Department, College of Pharmacy, Ferris State University, Big Rapids, Michigan
| | - Ellen Reed
- Mental Health Clinical Pharmacy Specialist, Battle Creek Veteran Affairs Medical Center, Battle Creek, Michigan
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Ganson KT, Murray SB, Nagata JM. Associations between eating disorders and illicit drug use among college students. Int J Eat Disord 2021; 54:1127-1134. [PMID: 33638571 DOI: 10.1002/eat.23493] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To estimate the associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among a large, diverse sample of college students. METHOD We analyzed data from the national (United States), cross-sectional 2018-2019 Healthy Minds Study (HMS; n = 42,618; response rate: 16%). HMS collects information on the physical, mental, and social health of college students. Multiple logistic regression analyses were used to estimate the association between a positive eating disorder screen (measured using the SCOFF) and any self-reported lifetime eating disorder diagnosis and self-reported illicit drug use in the past 30 days (any illicit drug use and use of marijuana, cocaine, heroin, methamphetamines, stimulants, ecstasy, opioids, benzodiazepines), while adjusting for potential confounders. RESULTS Among the sample, 54.34% (n = 28,608) were female and the mean age of participants was 23.30 (SE ± 0.05) years. Logistic regression analyses revealed unique associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among the sample of college student participants. A positive eating disorder screen was most strongly associated with methamphetamine use (adjusted odds ratio [AOR] 3.93, 95% confidence interval [CI] 1.43-10.78), and any lifetime eating disorder diagnosis was most strongly associated with benzodiazepine use (AOR 3.42, 95% CI 2.28-5.13). DISCUSSION Illicit drug use is common among college students who screen positive for an eating disorder and report any lifetime eating disorder diagnosis. The co-occurring nature of eating disorders and illicit drug use may complicate treatment and lead to compounded adverse health outcomes.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Karakasi MV, Kevrekidis DP, Voultsos P, Trypsiannis G, Manolopoulos VG, Raikos N, Pavlidis P. Investigation of patterns and dynamics of substance users: A long-term toxicology study on a sample of the Greek population between 2005 and 2019. J Forensic Sci 2021; 66:1841-1854. [PMID: 34128547 DOI: 10.1111/1556-4029.14776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
The purpose of the present study is to investigate dynamics underlying drug abuse and identify statistical correlations/patterns of forensic findings and sociodemographic factors in a population of illicit substance users. The following long-term studies were conducted: (a) a retrospective autopsy cohort study on autopsy incidents with available toxicological screening results (N = 482) in investigation of any possible forensic associations of exposure to illicit drugs; and (b) a cross-sectional study on a sample of arrested drug law offenders with available toxicological screening results (N = 195) as well as cluster analysis in order to possibly identify user profiles. Although outside the scope of the present study, ethanol was generally considered to be the main substance of abuse, as more than half of the premature deaths reported tested positive on the ethanol toxicology screen. Cannabis and opioid use was associated with unintentional causes of death, while an association of deliberate self-harm was noted with opioid and benzodiazepine use. Both cannabis and opioid use correlated with significantly younger ages (more than a decade) of premature death. Most frequently, an onset of substance use was reported in the early 20s with cannabis use. Although 65.3% of the subjects were diagnosed as dependent and unable to eliminate substance use on their own, only 7.7% of the subjects in the users' population had ever accessed appropriate support through rehabilitation programs.
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Affiliation(s)
- Maria-Valeria Karakasi
- Laboratory of Forensic Sciences, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece.,Third University Department of Psychiatry, AHEPA University General Hospital - Department of Mental Health, Aristotle University - Faculty of Medicine, Thessaloniki, Greece
| | | | - Polichronis Voultsos
- Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigorios Trypsiannis
- Laboratory of Medical Statistics, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece
| | - Vangelis G Manolopoulos
- Laboratory of Pharmacology, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece
| | - Nikolaos Raikos
- Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pavlos Pavlidis
- Laboratory of Forensic Sciences, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece
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Voth EA. Physicians Warn Cannabis Can Cause Serious Health Hazards. MISSOURI MEDICINE 2021; 118:203-205. [PMID: 34149074 PMCID: PMC8210996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Eric A Voth
- FACP practiced Internal Medicine and Pain & Addiction Medicine for 36 years. He is President and Chairman of the Board of Directors of the International Academy on the Science & Impact of Cannabis (IASIC)
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Morie KP, Potenza MN. A Mini-Review of Relationships Between Cannabis Use and Neural Foundations of Reward Processing, Inhibitory Control and Working Memory. Front Psychiatry 2021; 12:657371. [PMID: 33967859 PMCID: PMC8100188 DOI: 10.3389/fpsyt.2021.657371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 01/26/2023] Open
Abstract
Cannabis is commonly used, and use may be increasing in the setting of increasing legalization and social acceptance. The scope of the effects of cannabis products, including varieties with higher or lower levels of Δ9-tetrahydrocannabinol (THC) or cannabidiol (CBD), on domains related to addictive behavior deserves attention, particularly as legalization continues. Cannabis use may impact neural underpinnings of cognitive functions linked to propensities to engage in addictive behaviors. Here we consider these neurocognitive processes within the framework of the dual-process model of addictions. In this mini-review, we describe data on the relationships between two main constituents of cannabis (THC and CBD) and neural correlates of reward processing, inhibitory control and working memory.
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Affiliation(s)
- Kristen P. Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
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Tsai DH, Foster S, Baggio S, Gmel G, Mohler-Kuo M. Comparison of Water Pipes vs Other Modes of Cannabis Consumption and Subsequent Illicit Drug Use in a Longitudinal Cohort of Young Swiss Men. JAMA Netw Open 2021; 4:e213220. [PMID: 33822068 PMCID: PMC8025106 DOI: 10.1001/jamanetworkopen.2021.3220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE There are concerns that the use of water pipes to consume cannabis is associated with increased risks of engaging in more addictive behaviors. OBJECTIVE To examine whether consuming cannabis with a water pipe was associated with later consumption of other illicit drugs compared with not using a water pipe. DESIGN, SETTING, AND PARTICIPANTS The Cohort Study on Substance Use Risk Factors (C-SURF) was a population-based study, recruiting 5987 Swiss men aged 18 to 25 years from 3 of 6 Swiss Armed Forces recruitment centers (response rate: 79.2%). The baseline assessment (t0) was done from 2010 to 2012, first follow-up (t1) from 2012 to 2014, and second follow-up (t2) from 2016 to 2018. Our sample included men who participated in both t0 and t2 assessments and used cannabis but no other illicit drugs at t0. Data analysis was performed from July 2020 to January 2021. EXPOSURES Cannabis use frequency and route of administration from self-administered questionnaires completed at t0 and t2. MAIN OUTCOMES AND MEASURES Outcome measures were initiation of illicit drug use and cannabis use disorder, identified by the Cannabis Use Disorder Identification Test. To examine whether water pipe use at t0 was associated with illicit drug use at t2, multivariable logistic regression analysis was performed. RESULTS Among 1108 Swiss male cannabis users who did not use other illicit drugs at t0, the mean (SD) age was 20 (1.2) years, 617 (55.7%) were from Switzerland's French-speaking region, and 343 (30%) used water pipes to consume cannabis. Water pipe users at t0 were more likely to use other illicit drugs at t2 compared with water pipe nonusers (adjusted odds ratio [aOR], 1.54; 95% CI, 1.10-2.16). The odds of using middle-stage drugs (including stimulants, hallucinogens, and inhaled drugs) at t2 were increased for water pipe users (aOR, 1.61; 95% CI, 1.13-2.29). Water pipe use at t0 was not associated with cannabis use disorder at t2 after adjusting for cannabis use frequency. CONCLUSIONS AND RELEVANCE This cohort study's results suggest that, among Swiss young men, water pipe use is associated with other illicit drug use later in life, particularly middle-stage illicit drugs. Preventive programs must focus on the potential of later harm to cannabis users who use water pipes but have not yet started taking other illicit drugs.
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Affiliation(s)
- Dai-Hua Tsai
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
- Office of Correction, Department of Justice and Home Affairs of the Canton of Zurich, Zurich, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Addiction Switzerland, Lausanne, Switzerland
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Faculty of Health and Social Sciences, University of the West of England, Frenchay Campus, Bristol, United Kingdom
| | - Meichun Mohler-Kuo
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
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42
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Mennis J, Stahler GJ, Mason MJ. Treatment admissions for opioids, cocaine, and methamphetamines among adolescents and emerging adults after legalization of recreational marijuana. J Subst Abuse Treat 2021; 122:108228. [DOI: 10.1016/j.jsat.2020.108228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 10/21/2020] [Accepted: 11/26/2020] [Indexed: 12/17/2022]
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Trangenstein PJ, Whitehill JM, Jenkins MC, Jernigan DH, Moreno MA. Cannabis Marketing and Problematic Cannabis Use Among Adolescents. J Stud Alcohol Drugs 2021; 82:288-296. [PMID: 33823976 PMCID: PMC8864622 DOI: 10.15288/jsad.2021.82.288] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/26/2020] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Health consequences of commercializing nonmedical cannabis remain unclear, but data suggest that youth may encounter unintended risks. This study examined whether cannabis marketing exposure and engagement are associated with problematic cannabis use among adolescents. METHOD The analytic sample included 172 lifetime cannabis users (15-19 years old) who lived in one of six states with legalized nonmedical cannabis in 2018. Predictors included having exposure to or engagement with cannabis marketing on Facebook or Instagram, seeing cannabis billboards, owning/likely to own cannabis-branded merchandise, and reporting a favorite cannabis brand. Logistic regression assessed whether these predictors were associated with weekly cannabis use, high-intensity cannabis use, and cannabis use disorder (CUD). RESULTS Adolescents who saw billboards rarely/sometimes had 5 times the odds of CUD, whereas youth who saw them most/all of the time had 7 times the odds of weekly use and 6 times the odds of CUD. Adolescents who owned/were likely to own branded merchandise had nearly 23 times the odds of weekly use, and those with a favorite brand had 3 times the odds of weekly use and CUD. Adolescents who reported seeing promotions on Instagram rarely/sometimes had 85% lower odds of weekly use, and those who saw them most/all of the time had 93% lower odds. CONCLUSIONS The ways cannabis businesses market their products, especially branding, may affect patterns of underage cannabis use. Future research should test whether these associations persist in longitudinal designs. In the interim, states should consider an approach that offers youth additional means to protect them from cannabis marketing.
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Affiliation(s)
- Pamela J. Trangenstein
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer M. Whitehill
- Department of Health Promotion and Policy, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, Massachusetts
| | - Marina C. Jenkins
- Department of Pediatrics, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin
| | - David H. Jernigan
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Megan A. Moreno
- Department of Pediatrics, University of Wisconsin – Madison School of Medicine and Public Health, Madison, Wisconsin
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44
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Keethakumar A, Mehra VM, Khanlou N, Tamim H. Cannabis use and patterns among middle and older aged Canadians prior to legalization: a sex-specific analysis of the Canadian Tobacco, Alcohol and Drugs Survey. BMC Public Health 2021; 21:26. [PMID: 33407292 PMCID: PMC7786462 DOI: 10.1186/s12889-020-10074-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The recreational use of cannabis was legalized across Canada in October 2018. While many people use cannabis without harm, adverse outcomes have been noted in a few populations, including middle-aged and older adults. Given that the current literature has neglected to study cannabis use among this population and between sexes, the objective of our study was to identify the prevalence, characteristics, and patterns of cannabis use among middle and older aged males and females prior to legalization in Canada. METHODS Secondary analysis was conducted on the Canadian Tobacco, Alcohol and Drugs Survey 2017, with the sample restricted to adults ages 40 and above. The main outcome was defined as past-year cannabis use and statistical analysis was conducted separately for males and females. Bivariate and multivariable logistic regression was performed to identify associations between the main outcome and various sociodemographic, health, and substance use variables. Explanatory supplementary variables were also explored. RESULTS In 2017, 5.9% of females and 9.0% of males over the age of 40 reported past-year cannabis use. Almost 62% of males who used cannabis in the past-year reported a failed attempt at reducing or stopping their cannabis use. Over half (56%) of older females, self-reported using cannabis for medical purposes. Additionally, over one in five older adults reported using a vaporizer or e-cigarette as a delivery method for cannabis. Significant characteristics of male cannabis use included having no marital partner, cigarette smoking, and illegal drug use. Furthermore, significant predictors of past-year cannabis use in females included residing in an urban community, Eastern- Atlantic provinces or British Columbia, having fair/poor mental health, smoking cigarettes, use of other tobacco products, and illegal drugs. CONCLUSION To our such knowledge, this is the first nationally representative study to outline the prevalence, characteristics, and patterns of past-year cannabis use prior to Canadian legalization, among middle and older aged Canadians. Results from this study are expected to be used to reliably to track changes in usage, behaviours, and related disorders in the years to come.
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Affiliation(s)
- Asvini Keethakumar
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada.
| | - Vrati M Mehra
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
| | - Nazilla Khanlou
- School of Nursing, Faculty of Health, York University, Toronto, Canada
| | - Hala Tamim
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
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Preadult polytoxicomania-strong environmental underpinnings and first genetic hints. Mol Psychiatry 2021; 26:3211-3222. [PMID: 33824432 PMCID: PMC8505259 DOI: 10.1038/s41380-021-01069-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 11/09/2022]
Abstract
Considering the immense societal and personal costs and suffering associated with multiple drug use or "polytoxicomania", better understanding of environmental and genetic causes is crucial. While previous studies focused on single risk factors and selected drugs, effects of early-accumulated environmental risks on polytoxicomania were never addressed. Similarly, evidence of genetic susceptibility to particular drugs is abundant, while genetic predisposition to polytoxicomania is unexplored. We exploited the GRAS data collection, comprising information on N~2000 deep-phenotyped schizophrenia patients, to investigate effects of early-life environmental risk accumulation on polytoxicomania and additionally provide first genetic insight. Preadult accumulation of environmental risks (physical or sexual abuse, urbanicity, migration, cannabis, alcohol) was strongly associated with lifetime polytoxicomania (p = 1.5 × 10-45; OR = 31.4), preadult polytoxicomania with OR = 226.6 (p = 1.0 × 10-33) and adult polytoxicomania with OR = 17.5 (p = 3.4 × 10-24). Parallel accessibility of genetic data from GRAS patients and N~2100 controls for genome-wide association (GWAS) and phenotype-based genetic association studies (PGAS) permitted the creation of a novel multiple GWAS-PGAS approach. This approach yielded 41 intuitively interesting SNPs, potentially conferring liability to preadult polytoxicomania, which await replication upon availability of suitable deep-phenotyped cohorts anywhere world-wide. Concisely, juvenile environmental risk accumulation, including cannabis and alcohol as starter/gateway drugs, strongly predicts polytoxicomania during adolescence and adulthood. This pivotal message should launch more effective sociopolitical measures to prevent this deleterious psychiatric condition.
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Liu Y, Cheong J, Setlow B, Cottler LB. Cocaine and Marijuana Polysubstance Use and Cocaine Use Disorder: Investigating Mediated Effects through Patterns of Cocaine Use. J Dual Diagn 2021; 17:23-33. [PMID: 33300839 PMCID: PMC7902454 DOI: 10.1080/15504263.2020.1849887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cocaine use is on the rise and it is comorbid with marijuana use. We examined the association between lifetime cocaine + marijuana polysubstance use (CM PSU) versus cocaine only and lifetime cocaine use disorder (CocUD) and examined the potential mediation by cocaine use patterns. Methods: A total of 2,968 lifetime cocaine users were identified from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Mediation analysis was utilized to examine cocaine use quantity, frequency, and duration as potential mediators in the association between CM PSU and CocUD. A parallel multiple mediator model and a structural equation model were used, respectively, to examine: (1) the individual contribution of cocaine use quantity, frequency, and duration, and (2) combined contribution as a set specified by a latent variable. Results: Cocaine users were divided into 2,782 (93.7%) CM polysubstance users and 186 (6.3%) cocaine only users. CM PSU was associated with decreased risk of CocUD, but after including the mediators, the association was no longer significant. Examined separately, only quantity was found to be a significant mediator over and above frequency and duration, while the latent variable with three cocaine use pattern indicators explained 56.6% of the total association between CM PSU and CocUD. Conclusions: Compared to cocaine only users, CM polysubstance users were less likely to use cocaine heavily; this lower intensity of cocaine use was in turn associated with decreased risk of CocUD. Future research is warranted to determine the nature of the association between CM PSU and reduced CocUD.
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Affiliation(s)
- Yiyang Liu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA
| | - JeeWon Cheong
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Barry Setlow
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA
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Hasin D, Walsh C. Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review. J Clin Med 2020; 10:E15. [PMID: 33374666 PMCID: PMC7793504 DOI: 10.3390/jcm10010015] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/10/2020] [Accepted: 12/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. METHODS A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. RESULTS A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. CONCLUSIONS Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.
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Affiliation(s)
- Deborah Hasin
- New York State Psychiatric Institute, New York, NY 10032, USA;
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY 10032, USA;
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Gottschling S, Ayonrinde O, Bhaskar A, Blockman M, D’Agnone O, Schecter D, Suárez Rodríguez LD, Yafai S, Cyr C. Safety Considerations in Cannabinoid-Based Medicine. Int J Gen Med 2020; 13:1317-1333. [PMID: 33299341 PMCID: PMC7720894 DOI: 10.2147/ijgm.s275049] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
Cannabinoids are a diverse class of chemical compounds that are increasingly recognized as potential therapeutic options for a range of conditions. While many studies and reviews of cannabinoids focus on efficacy, safety is much less well reported. Overall assessment of the safety of cannabinoid-based medicines is confounded by confusion with recreational cannabis use as well as different study designs, indications, dosing, and administration methods. However, clinical studies in registered products are increasingly available, and this article aims to discuss and clarify what is known regarding the safety profiles of cannabinoid-based medicines, focusing on the medical and clinical safety evidence and identifying areas for future research. The two most well-studied cannabinoids are Δ9-tetrahydrocannabinol (THC), or its synthetic variants (dronabinol, nabilone), and cannabidiol (CBD). Across diverse indications, dizziness and fatigue are generally the most common adverse events experienced by patients receiving THC or combined THC and CBD. Patients receiving THC may experience adverse cognitive effects and impairment in psychomotor skills, with implications for driving and some occupations, while CBD may help to lower the psychotropic effects of THC when used in combination. Studies on dependency and addiction in a medical context are limited, but have shown inconsistent findings regarding misuse potential. Generally, the recommended route of administration is oral ingestion, as smoking medicinal cannabinoid products potentially releases mutagenic and carcinogenic by-products. There are several potential drug-drug interactions and contraindications for cannabinoid-based medicines, which physicians should account for when making prescribing decisions. The available evidence shows that, as with any other class of pharmaceuticals, cannabinoid-based medicines are associated with safety risks which should be assessed in the context of potential therapeutic benefits. Each patient should be assessed on an individual basis and physicians must rely on informed, evidence-based decision-making when determining whether a cannabinoid-based medicine could be an appropriate treatment option.
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Affiliation(s)
| | | | - Arun Bhaskar
- Imperial College Healthcare NHS Trust, London, UK
| | - Marc Blockman
- University of Cape Town and Groot Schuur Hospital, Cape Town, South Africa
| | | | | | | | | | - Claude Cyr
- McGill University, Montreal, Quebec, Canada
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Patel RS, Sreeram V, Vadukapuram R, Baweja R. Do cannabis use disorders increase medication non-compliance in schizophrenia?: United States Nationwide inpatient cross-sectional study. Schizophr Res 2020; 224:40-44. [PMID: 33183946 DOI: 10.1016/j.schres.2020.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/19/2020] [Accepted: 11/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aims to find the prevalence of medication non-compliance among schizophrenia inpatients and to compare the relative risks of medication non-compliance with cannabis use disorders (CUDs) versus without CUDs. In addition, this study also examines the odds of medication non-compliance in schizophrenia inpatients with CUDs. METHODS This is a retrospective cross-sectional analysis of the nationwide inpatient sample. This sample includes 1,030,949 inpatients (age 18 to 65 years) from 2010 to 2014 with primary ICD-9 diagnoses of schizophrenia and other psychotic disorders, that were further sub grouped based on medication non-compliance. CUDs were recognized using the ICD-9 codes. RESULTS The prevalence of medication non-compliance was 26% among schizophrenia inpatients. Multivariable analysis revealed that CUD comorbidity was a significant risk factor for medication non-compliance among schizophrenia patients when unadjusted (OR 1.49, 95%CI 1.469-1.503), and association remained significant even after adjusting for covariates (adjusted OR 1.38, 95%CI 1.268-1.489). Comorbid CUD was seen in young adults (18-35 years, 62.4%), males (80.5%), African Americans (54.1%) and low-income families below 25th percentile (48.6%) with personality disorders (10.5%). CONCLUSION Medication compliance is a challenge among schizophrenia patients, which has a significant adverse impact on the course of illness. CUD Comorbidity increases the risk of medication non-compliance significantly among schizophrenia patients. In addition to case management, an integrated treatment model to address both substance use disorders and psychosis will translate into better long-term outcomes in schizophrenia patients.
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Affiliation(s)
- Rikinkumar S Patel
- Department of Psychiatry, Griffin Memorial Hospital, Norman, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University, Tulsa, OK, USA.
| | | | - Ramu Vadukapuram
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
| | - Raman Baweja
- Department of Psychiatry and Behavioral Health, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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50
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Hansen TM, Sabourin BC, Oketola B, Bernstein CN, Singh H, Targownik LE. Cannabis Use in Persons With Inflammatory Bowel Disease and Vulnerability to Substance Misuse. Inflamm Bowel Dis 2020; 26:1401-1406. [PMID: 31725152 DOI: 10.1093/ibd/izz272] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is unknown whether cannabis users self-medicating their inflammatory bowel disease (IBD) symptoms are more likely to have comorbid mental health or personality risk factors associated with an increased potential for substance misuse compared with recreational cannabis users. METHODS We surveyed individuals with IBD about their cannabis use, their mental health symptoms, and personality risk factors associated with substance misuse. We compared risk factors for substance misuse between individuals using cannabis to manage IBD symptoms and those using cannabis recreationally. RESULTS Of 201 persons with IBD who completed the questionnaire, 108 reported lifetime cannabis use. Of those, a larger proportion of Crohn's disease patients used cannabis to manage IBD symptoms (53% [34/64] vs 28% [12/43]; P = 0.010). Individuals self-medicating with cannabis were more likely to use cannabis for coping reasons (P = 0.016) and demonstrated higher levels of impulsivity (P = 0.004) and depressive symptoms (P = 0.012) when compared with individuals using cannabis recreationally. Logistic regression revealed that cannabis was 4.1 times (P = 0.05) and 3.7 times (P = 0.05) more likely to be used for IBD symptoms by smokers and individuals with moderate-severe depressive symptoms, respectively. Individuals high in impulsivity were 4.1 times more likely to use cannabis for their IBD symptoms than those low in impulsivity (P = 0.005). CONCLUSIONS Persons with IBD self-medicating with cannabis have characteristics associated with increased vulnerability to substance misuse when compared with those using cannabis recreationally. Screening for mental health comorbidities and vulnerability to substance misuse should be undertaken if cannabis is to be used to treat IBD symptoms.
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Affiliation(s)
- Tawnya M Hansen
- Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brigitte C Sabourin
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Banke Oketola
- Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Charles N Bernstein
- Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - Harminder Singh
- Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura E Targownik
- Division of Gastroenterology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
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