1
|
Dacosta-Sánchez D, Michelini Y, Pilatti A, Fernández-Calderón F, Lozano ÓM, González-Ponce BM. The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective. Addict Behav 2024; 157:108103. [PMID: 39018615 DOI: 10.1016/j.addbeh.2024.108103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Gender-specific interventions are crucial in addressing substance use disorders -particularly cannabis use disorder - as they allow for tailored therapeutic approaches and increase the likelihood of successful outcomes. However, differences in therapeutic processes and outcomes between males and females are often not observed, making the prognosis and development of such interventions more difficult. OBJECTIVE This study aimed to examine the moderating role of sex in the relationship between treatment admission profile characterized by indicators of cannabis use and sociodemographic sources of gender inequality (e.g., employment status) and adherence and outcome at discharge. METHOD A multicentric retrospective observational study was conducted with a sample of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records were used for data analysis. RESULTS The interaction between sex and the number of children, as well as pre-treatment cannabis use, predicted lower treatment adherence, particularly among females. Additionally, the interaction between sex and the number of children predicted outcomes at discharge, with females showing a higher likelihood of dropout compared to males. DISCUSSION AND CONCLUSION Enhanced comprehensive treatment with intensified contingency management programs should be prioritized for females (especially those with children) who have consumed cannabis in the month before treatment. Adopting a treatment policy framework incorporating sex/gender-sensitive therapist training and evaluative measures is essential for optimizing treatment outcomes for all patients.
Collapse
Affiliation(s)
- Daniel Dacosta-Sánchez
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| | - Yanina Michelini
- Faculty of Psychology, National University of Cordoba, Córdoba 5000, Argentina; Institute of Psychological Research, IIPsi-CONICET-UNC, National University of Córdoba, Córdoba 5000, Argentina.
| | - Angelina Pilatti
- Faculty of Psychology, National University of Cordoba, Córdoba 5000, Argentina; Institute of Psychological Research, IIPsi-CONICET-UNC, National University of Córdoba, Córdoba 5000, Argentina.
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| | - Óscar M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| | - Bella M González-Ponce
- Department of Clinical and Experimental Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071 Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva 21007, Spain.
| |
Collapse
|
2
|
Britton MK, DeFelice J, Porges EC, Cohen R, Li Y, Wang Y, Ibañez GE, Somboonwit C, Cook RL. Association between cannabis use disorder and greater apathy in adults with HIV. Drug Alcohol Depend 2024; 261:111354. [PMID: 38870567 DOI: 10.1016/j.drugalcdep.2024.111354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Apathy is prevalent among people with HIV (PWH) and is associated with poor clinical outcomes. Cannabis use and Cannabis Use Disorder (CUD) are also disproportionately prevalent among PWH. CUD and younger onset of cannabis use may be linked to apathy in the general population; however, patterns of use most strongly associated with apathy have not been firmly established, and it is unclear whether cannabis use is linked to apathy in PWH. METHODS We examined associations in 311 adult PWH between Apathy Evaluation Scale-Self (AES-S) scores and CUD history (current/past/no CUD/no cannabis use) and between AES-S scores and age of CUD onset (adolescent-onset/adult-onset). We also examined robustness of associations to adjustment for depressive symptoms (which may overlap with apathy symptoms) and alcohol use. RESULTS Current CUD was associated with greater AES-S scores relative to cannabis users with no CUD history (β = 2.13, 95 % CI = 0.37-3.90, p = 0.018). Adolescent-onset CUD was not associated with greater apathy relative to adult-onset CUD (β = 0.56, 95 % CI = -2.57 - 3.68, p = 0.7). Associations became nonsignificant after adjustment for depressive symptoms, but not after adjustment for alcohol use. Alcohol use was correlated with apathy (r = 0.19, 95 % CI: 0.076-0.29, p = 0.001). CONCLUSIONS Cannabis Use Disorder and at-risk alcohol use are associated with apathy among PWH; this finding highlights the need for substance use disorder prevention and treatment among PWH.
Collapse
Affiliation(s)
- Mark K Britton
- Center for Cognitive Aging and Memory, University of Florida, 1249 Center Drive, Gainesville, FL 32603, United States; Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL 32603, United States.
| | - Jason DeFelice
- Center for Cognitive Aging and Memory, University of Florida, 1249 Center Drive, Gainesville, FL 32603, United States
| | - Eric C Porges
- Center for Cognitive Aging and Memory, University of Florida, 1249 Center Drive, Gainesville, FL 32603, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, University of Florida, 1249 Center Drive, Gainesville, FL 32603, United States
| | - Yancheng Li
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL 32603, United States
| | - Yan Wang
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL 32603, United States
| | - Gladys E Ibañez
- Department of Epidemiology, Florida International University, 11200 SW 8th Street, Miami, FL 33199, United States
| | - Charurut Somboonwit
- Department of Internal Medicine, University of South Florida, 13330 USF Laurel Drive, Tampa, FL 33612, United States
| | - Robert L Cook
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL 32603, United States
| |
Collapse
|
3
|
Beyer E, Poudel G, Antonopoulos S, Thomson H, Lorenzetti V. Brain reward function in people who use cannabis: a systematic review. Front Behav Neurosci 2024; 17:1323609. [PMID: 38379938 PMCID: PMC10877725 DOI: 10.3389/fnbeh.2023.1323609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 02/22/2024] Open
Abstract
Rationale Cannabis is one of the most widely used psychoactive substances globally. Cannabis use can be associated with alterations of reward processing, including affective flattening, apathy, anhedonia, and lower sensitivity to natural rewards in conjunction with higher sensitivity to cannabis-related rewards. Such alterations have been posited to be driven by changes in underlying brain reward pathways, as per prominent neuroscientific theories of addiction. Functional neuroimaging (fMRI) studies have examined brain reward function in cannabis users via the monetary incentive delay (MID) fMRI task; however, this evidence is yet to be systematically synthesised. Objectives We aimed to systematically integrate the evidence on brain reward function in cannabis users examined by the MID fMRI task; and in relation to metrics of cannabis exposure (e.g., dosage, frequency) and other behavioural variables. Method We pre-registered the review in PROSPERO and reported it using PRISMA guidelines. Literature searches were conducted in PsycINFO, PubMed, Medline, CINAHL, and Scopus. Results Nine studies were included, comprising 534 people with mean ages 16-to-28 years, of which 255 were people who use cannabis daily or almost daily, and 279 were controls. The fMRI literature to date led to largely non-significant group differences. A few studies reported group differences in the ventral striatum while participants anticipated rewards and losses; and in the caudate while participants received neutral outcomes. A few studies examined correlations between brain function and withdrawal, dosage, and age of onset; and reported inconsistent findings. Conclusions There is emerging but inconsistent evidence of altered brain reward function in cannabis users examined with the MID fMRI task. Future fMRI studies are required to confirm if the brain reward system is altered in vulnerable cannabis users who experience a Cannabis Use Disorder, as postulated by prominent neuroscientific theories of addiction.
Collapse
Affiliation(s)
- Emillie Beyer
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Braincast Neurotechnologies, Melbourne, VIC, Australia
| | - Stephanie Antonopoulos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Hannah Thomson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| |
Collapse
|
4
|
Ney LJ, Akosile W, Davey C, Pitcher L, Felmingham KL, Mayo LM, Hill MN, Strodl E. Challenges and considerations for treating PTSD with medicinal cannabis: the Australian clinician's perspective. Expert Rev Clin Pharmacol 2023; 16:1093-1108. [PMID: 37885234 DOI: 10.1080/17512433.2023.2276309] [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: 06/29/2023] [Accepted: 10/24/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Preclinical and experimental research have provided promising evidence that medicinal cannabis may be efficacious in the treatment of posttraumatic stress disorder (PTSD). However, implementation of medicinal cannabis into routine clinical therapies may not be straightforward. AREAS COVERED In this review, we describe some of the clinical, practical, and safety challenges that must be addressed for cannabis-based treatment of PTSD to be feasible in a real-world setting. These issues are especially prevalent if medicinal cannabis is to be combined with trauma-focused psychotherapy. EXPERT OPINION Future consideration of the clinical and practical considerations of cannabis use in PTSD therapy will be essential to both the efficacy and safety of the treatment protocols that are being developed. These issues include dose timing and titration, potential for addiction, product formulation, windows of intervention, and route of administration. In particular, exposure therapy for PTSD involves recall of intense emotions, and the interaction between cannabis use and reliving of trauma memories must be explored in terms of patient safety and impact on therapeutic outcomes.
Collapse
Affiliation(s)
- Luke J Ney
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Wole Akosile
- Greater Brisbane Clinical School, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Chris Davey
- Department of Psychiatry, Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | | | - Kim L Felmingham
- School of Psychological Sciences, Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Leah M Mayo
- Department of Psychiatry, Mathison Centre for Mental Health Research, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Matthew N Hill
- Department of Psychiatry, Mathison Centre for Mental Health Research, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Esben Strodl
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
5
|
Abela N, Haywood K, Di Giovanni G. Alcohol and cannabinoid binges and daily exposure to nicotine in adolescent/young adult rats induce sex-dependent long-term appetitive instrumental learning impairment. Front Behav Neurosci 2023; 17:1129866. [PMID: 36815183 PMCID: PMC9939753 DOI: 10.3389/fnbeh.2023.1129866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 02/09/2023] Open
Abstract
Adolescence is a critical developmental period, concerning anatomical, neurochemical and behavioral changes. Moreover, adolescents are more sensitive to the long-term deleterious effects of drug abuse. Binge-like consumption of alcohol and marijuana, along with tobacco smoking, is a dangerous pattern often observed in adolescents during weekends. Nevertheless, the long-term effect of their adolescent co-exposure has not been yet experimentally investigated. Long-Evans adolescent male (n = 20) and female (n = 20) rats from postnatal day 30 (P30) until P60 were daily treated with nicotine (0.3 mg/kg, i.p.), and, on two consecutive 'binging days' per week (for a total of eight times), received an intragastric ethanol solution (3 g/kg) and an intraperitoneal (i.p.) dose of cannabinoid 1/2 receptor agonist WIN55,212-2 (1.2 mg/kg). These rats were tested after treatment discontinuation at > P90 for associative food-rewarded operant learning in the two-lever conditioning chambers for six consecutive days on a fixed ratio 1 (FR1) schedule followed by another six days of daily FR2 schedule testing, after 42 days rest. We found the main effects of sex x treatment interactions in FR1 but not in FR2 experiments. Treated females show attenuated operant responses for food pellets during all FR1 and the FR2 schedule, whilst the treated males show an impairment in FR2 but not in the FR1 schedule. Moreover, the treated females' percentage of learners was significantly lower than female controls in FR1 while treated males were lower than controls in FR2. Our findings suggest that intermittent adolescent abuse of common drugs, such as alcohol and marijuana, and chronic tobacco exposure can cause significant long-term effects on motivation for natural reinforcers later in adulthood in both sexes. Females appear to be sensitive earlier to the deleterious effects of adolescent polydrug abuse, with both sexes having an increased likelihood of developing lifelong brain alterations.
Collapse
Affiliation(s)
- Norbert Abela
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Katie Haywood
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta,Division of Neuroscience, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Giuseppe Di Giovanni
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta,Division of Neuroscience, School of Biosciences, Cardiff University, Cardiff, United Kingdom,*Correspondence: Giuseppe Di Giovanni, ;
| |
Collapse
|
6
|
Ince HY, Phan H, Nasr SZ, Pierce JM, Malas N. Clearing up the smoke: Physical and mental health considerations regarding cannabis use in adolescents with cystic fibrosis. Pediatr Pulmonol 2023; 58:398-407. [PMID: 36349504 PMCID: PMC10098788 DOI: 10.1002/ppul.26241] [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: 08/02/2022] [Revised: 10/11/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
The cannabis plant is the most used federally illegal drug in the United States and is widely used by adolescents. Cannabis has complex effects on the body and mind. All health professionals who take care of adolescents with cystic fibrosis (CF) should be aware of the factors impacting cannabis use in CF. Given limited evidence regarding the benefits of cannabis and the significant risks, clinicians have the responsibility to identify risk of cannabis use early, counsel patients about the risks, provide a safe space for ongoing conversations about cannabis use in the context of CF care, and deliver evidence-based interventions.
Collapse
Affiliation(s)
- H Yavuz Ince
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hanna Phan
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Samya Z Nasr
- Department of Pediatrics, Division of Pediatric Pulmonology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica M Pierce
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Nasuh Malas
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
7
|
Association Between Cannabis and Violence in Community-Dwelling Patients With Severe Mental Disorders: A Cross-sectional Study Using Machine Learning. J Nerv Ment Dis 2023; 211:88-94. [PMID: 36716062 DOI: 10.1097/nmd.0000000000001604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The objective of this cross-sectional study was to identify cannabis-related features and other characteristics predictive of violence using a data-driven approach in patients with severe mental disorders (SMDs). A Least Absolute Shrinkage and Selection Operator regularization regression model was used on the database consisting of 97 patients with SMD who completed questionnaires measuring substance use and violence. Cannabis use, particularly related to patients' decision to consume or time spent using, was a key predictor associated with violence. Other patterns of substance use and personality traits were identified as strong predictors. Regular patterns of cannabis use and interpersonal issues related to cannabis/stimulant abuse were inversely correlated to violence. This study identified the effect of several predictors correlated to violence in patients with SMD using a regularization regression model. Findings open the door to better identify the profiles of patients that may be more susceptible to perpetrate violent behaviors.
Collapse
|
8
|
Morissette SB, Blessing A, Russell P, Hale W. Cannabis use disorder uniquely predicts educational impairment in college students over and above other mental health disorders. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 36595591 DOI: 10.1080/07448481.2022.2155058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/20/2022] [Accepted: 09/25/2022] [Indexed: 06/17/2023]
Abstract
Objective: The impact of cannabis use disorder (CUD) on education functioning and GPA was examined within the context of co-occurring alcohol use disorder (AUD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Participants: Undergraduates (N = 210) who reported using cannabis within the past six months were recruited. Methods: Hierarchical multiple regression analyses were used to determine whether CUD symptom severity and presence of probable CUD diagnosis predicted educational impairment and current GPA, over and above other mental health conditions. Results: CUD symptom severity, but not probable CUD, significantly predicted greater educational impairment, over and above probable PTSD and MDD, which were also significant predictors. CUD symptom severity, but not probable CUD, significantly predicted lower GPA. Conclusion: In addition to other common mental health conditions, CUD may be an important area of assessment and intervention for university counseling centers to foster student academic success.
Collapse
Affiliation(s)
| | - Alexis Blessing
- The University of Texas at San Antonio, San Antonio, Texas, USA
| | | | - Willie Hale
- The University of Texas at San Antonio, San Antonio, Texas, USA
| |
Collapse
|
9
|
Bedard-Gilligan M, Lehinger E, Cornell-Maier S, Holloway A, Zoellner L. Effects of Cannabis on PTSD Recovery: Review of the Literature and Clinical Insights. CURRENT ADDICTION REPORTS 2022; 9:203-216. [PMID: 36385902 PMCID: PMC9648847 DOI: 10.1007/s40429-022-00414-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/27/2022]
Abstract
Purpose of Review Individuals with posttraumatic stress disorder (PTSD) may use cannabis to reduce symptoms yet are also at risk for developing problematic use. This review outlines theories, summarizes recent empirical studies, and discusses clinical implications of cannabis use and PTSD recovery. Recent Findings Although naturalistic studies and open trials find a relationship between cannabinoids and PTSD symptom reduction, methodological limitations preclude definitive conclusions. The only randomized controlled trial to date found cannabis had no greater effect on PTSD symptoms than placebo. Summary Rigorous studies of the long-term impact of cannabis use on PTSD recovery are needed. Clinicians and researchers must weigh the potential therapeutic effect against the costs and risks associated with long-term cannabis use. Clinicians should consider all available PTSD treatment options, along with client level factors such as the function of cannabis use, motivation to change use, and the potential impact of cannabis on treatment engagement when making clinical recommendations.
Collapse
Affiliation(s)
| | - Elizabeth Lehinger
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | - Ash Holloway
- Department of Psychology, University of Washington
| | | |
Collapse
|
10
|
Vele KC, Cavalli JM, Cservenka A. Effort-based decision making and self-reported apathy in frequent cannabis users and healthy controls: A replication and extension. J Clin Exp Neuropsychol 2022; 44:146-162. [PMID: 35767680 DOI: 10.1080/13803395.2022.2093335] [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: 10/17/2022]
Abstract
INTRODUCTION Amotivational syndrome is a term used to refer to lack of motivation and passive personality related to chronic cannabis use. Given mixed findings, the current study aimed to replicate and extend previous research on frequent cannabis use, motivated behavior, and self-reported apathy. METHOD Cannabis users (on average, ≥3 days/week of cannabis use over the past year), and healthy controls (≤1 day/month of cannabis use over the past year) completed the Apathy Evaluation Scale (AES), and the Effort Expenditure for Rewards Task (EEfRT). Repeated measures analysis of covariance was used to 1) examine the effects of group, reward magnitude, probability, and their interaction on hard task selections on the EEfRT, and 2) examine between-group differences on the AES, controlling for alcohol use and depressive symptoms. RESULTS There were significant main effects of reward magnitude, probability, and an interaction between reward magnitude and probability on hard task selection (p's < 0.05). Specifically, as reward magnitude and probability of winning the reward increased, participants were more likely to select hard tasks on the EEfRT. Relative to healthy controls, cannabis users were significantly more likely to select hard tasks on the EEfRT (F(1,56) = 6.49, p = 0.014, ηp2 = 0.10). When controlling for alcohol use and depressive symptoms, no significant group differences in self-reported apathy were present (p = 0.46). CONCLUSIONS Cannabis users exhibit a greater likelihood of exerting more effort for reward, suggesting enhanced motivation relative to healthy controls. Thus, the current results do not support amotivational syndrome in adult frequent cannabis users. Despite some harms of long-term cannabis use, amotivation may not be among them.
Collapse
Affiliation(s)
- Kimberly C Vele
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| | - Jessica M Cavalli
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| | - Anita Cservenka
- School of Psychological Science, Oregon State University, Corvallis, OR, United States
| |
Collapse
|
11
|
Camchong J, Haynos AF, Hendrickson T, Fiecas MB, Gilmore CS, Mueller BA, Kushner MG, Lim KO. Resting Hypoconnectivity of Theoretically Defined Addiction Networks during Early Abstinence Predicts Subsequent Relapse in Alcohol Use Disorder. Cereb Cortex 2022; 32:2688-2702. [PMID: 34671808 PMCID: PMC9393062 DOI: 10.1093/cercor/bhab374] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
Theoretical models of addiction suggest that alterations in addiction domains including incentive salience, negative emotionality, and executive control lead to relapse in alcohol use disorder (AUD). To determine whether the functional organization of neural networks underlying these domains predict subsequent relapse, we generated theoretically defined addiction networks. We collected resting functional magnetic resonance imaging data from 45 individuals with AUD during early abstinence (number of days abstinent M = 25.40, SD = 16.51) and calculated the degree of resting-state functional connectivity (RSFC) within these networks. Regression analyses determined whether the RSFC strength in domain-defined addiction networks measured during early abstinence predicted subsequent relapse (dichotomous or continuous relapse metrics). RSFC within each addiction network measured during early abstinence was significantly lower in those that relapsed (vs. abstained) and predicted subsequent time to relapse. Lower incentive salience RSFC during early abstinence increased the odds of relapsing. Neither RSFC in a control network nor clinical self-report measures predicted relapse. The association between low incentive salience RSFC and faster relapse highlights the need to design timely interventions that enhance RSFC in AUD individuals at risk of relapsing faster.
Collapse
Affiliation(s)
- J Camchong
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - A F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - T Hendrickson
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, MN 55455, USA
| | - M B Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - C S Gilmore
- Geriatric Research, Education, and Clinical Center (GRECC), Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - B A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - M G Kushner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - K O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
- Geriatric Research, Education, and Clinical Center (GRECC), Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| |
Collapse
|
12
|
Hazle MC, Hill KP, Westreich LM. Workplace Cannabis Policies: A Moving Target. Cannabis Cannabinoid Res 2022; 7:16-23. [PMID: 33998870 PMCID: PMC8864412 DOI: 10.1089/can.2020.0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: This article proposes a workplace cannabis policy paradigm that encompasses rapidly changing laws and regulations, legally defensible drug testing policies, and the needs of particular workplaces. Numerous states have now decriminalized medical or recreational use of cannabis, although U.S. federal law still defines cannabis as a Schedule I substance with no currently accepted medical use and a high potential for abuse. For employers and employees, the confusion generated by this contradiction is exacerbated by the widely varying effects of the available cannabis delivery systems, the primitive and cumbersome drug testing protocols often used in workplace settings, difficulties in measuring cannabis-related workplace impairment, and a rapidly changing cultural ethos regarding cannabis. Although other articles have addressed many of the broad theoretical constructs, there exists little practical guidance on how workplace drug programs should address cannabis use by employees, both on the job and during off-hours. Materials and Methods: Research for this review was performed in the PubMed/National Library of Medicine database. Discussion: Cannabis use is associated with cognitive deficits, motivation problems, and perceptual distortions, so employers have a legitimate interest in preventing on-the-job impairment related to cannabis use. Similarly, employees have a legitimate interest in behaving as they wish outside of the workplace, as long as that behavior does not affect their job performance. Relevant statues and case law on the subject of cannabis in the workplace reflect different legal models across jurisdictions, in addition to legislators and judges' attempts to manage this tension between employer and employees. Conclusion: An effective workplace cannabis policy must fit into a larger workplace drug and alcohol policy. It should be constructed with a collaborative effort of addiction professionals, labor attorneys, and human resource professionals. Only then can the ultimate workplace cannabis policy comply with relevant laws, protect workplace safety and productivity, and support employees while remaining flexible enough to adapt to changes in the legal environment.
Collapse
Affiliation(s)
- Mia C. Hazle
- Division of Addiction Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,*Address correspondence to: Mia C. Hazle, MD, Division of Addiction Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA,
| | - Kevin P. Hill
- Division of Addiction Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Laurence M. Westreich
- Division of Alcoholism and Drug Abuse, Department of Psychiatry, New York University School of Medicine, New York, New York, USA
| |
Collapse
|
13
|
de Water E, Curtin P, Gennings C, Chelonis JJ, Paule M, Bixby M, McRae N, Svensson K, Schnaas L, Pantic I, Téllez-Rojo MM, Wright RO, Horton MK. Prenatal metal mixture concentrations and reward motivation in children. Neurotoxicology 2022; 88:124-133. [PMID: 34793781 PMCID: PMC8748386 DOI: 10.1016/j.neuro.2021.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 01/03/2023]
Abstract
Reward motivation is a complex umbrella term encompassing the cognitions, emotions, and behaviors involved in the activation, execution, and persistence of goal-directed behavior. Altered reward motivation in children is characteristic of many neurodevelopmental and psychiatric disorders. Previously difficult to operationalize, the Progressive Ratio (PR) task has been widely used to assess reward motivation in animal and human studies, including children. Because the neural circuitry supporting reward motivation starts developing during pregnancy, and is sensitive to disruption by environmental toxicants, including metals, the goal of this study was to examine the association between prenatal concentrations of a mixture of neurotoxic metals and reward motivation in children. We measured reward motivation by administering a PR test to 373 children ages 6-8 years enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) Study in Mexico City. Children were asked to press a response lever for a token reward; one press on the response lever was required to earn the first token and each subsequent token required an additional 10 lever presses. Maternal blood concentrations of lead, manganese, zinc, arsenic, cadmium, and selenium were measured using inductively-coupled plasma mass spectrometry during the 2nd and 3rd trimesters of pregnancy. We performed generalized Weighted Quantile Sum (gWQS) regression analyses to examine associations between the prenatal metal mixture and reward motivation; adjusting for child sex, birthweight and age; and maternal IQ, education, and socioeconomic status. The prenatal metal mixture was significantly associated with higher motivation as indicated by more lever presses (ß = 0.02, p < 0.001) and a shorter time between receiving the reinforcer and the first press (ß = 0.23, p = 0.01), and between subsequent presses (ß = 0.07, p = 0.005). Contributions of different metals to this association differed by trimester and child sex. These findings suggest that children with increased exposure to metal during the 2nd and 3rd trimesters of gestation demonstrate increased reward motivation, which may reflect a tendency to perseverate or hypersensitivity to positive reinforcement.
Collapse
Affiliation(s)
- Erik de Water
- Icahn School of Medicine at Mount Sinai, New York, NY, USA,Corresponding author: Erik de Water, PhD, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, United States, , T: 212-824-7301
| | - Paul Curtin
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chris Gennings
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John J. Chelonis
- U.S. Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | - Merle Paule
- U.S. Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | - Moira Bixby
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nia McRae
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Lourdes Schnaas
- National Institute of Perinatology (INPer), Mexico City, Mexico
| | - Ivan Pantic
- National Institute of Perinatology (INPer), Mexico City, Mexico
| | | | | | | |
Collapse
|
14
|
Wardle MC, Pabon E, Webber HE, de Wit H. Delta-9-tetrahydrocannabinol reduces willingness to exert effort in women. Psychopharmacology (Berl) 2022; 239:1487-1497. [PMID: 35102424 PMCID: PMC8803458 DOI: 10.1007/s00213-021-06032-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of cannabis has been clinically associated with decreased motivation to engage in normally rewarding activities. However, evidence from previous controlled studies is mixed. METHOD In this study, we examined the effects of acute delta-9-tetrahydrocannabinol (THC) versus placebo on a task measuring willingness to exert effort for rewards. This is a secondary analysis of a larger study examining interactions between ovarian hormones and THC. In this within-subjects study, oral THC and placebo were administered under double-blind conditions in counterbalanced order to healthy young adult (M age = 24 years) women with previous cannabis experience who were not regular users. Forty subjects completed three 4-h sessions with PL, 7.5 and 15 mg THC, while an additional 18 completed only PL and 15 mg THC sessions (design abridged due to pandemic). At each session, they completed a task consisting of making repeated choices between a hard and an easy task, which were worth varying amounts of money at varying probabilities. RESULTS THC dose-dependently decreased hard task choices (drug effect, b = - 0.79, SE = 0.29, z = - 2.67, p < 0.01), especially at moderate to high expected values of reward (drug × probability × amount interaction, b = 0.77, SE = 0.38, z = 1.99, p = 0.04). THC also slowed task performance (drug effect, b = 0.01, SE = 0.005, t(5.24) = 2.11, p = 0.04), but the effect of THC on choice was still significant after controlling for this psychomotor slowing. CONCLUSIONS These findings support the idea that cannabis acutely reduces motivation to earn non-drug rewards. Still to be determined are the neurochemical mechanisms underlying this effect.
Collapse
Affiliation(s)
- Margaret C. Wardle
- Department of Psychology, University of Illinois Chicago, 1007 W. Harrison St, Chicago, IL 60607 USA
| | - Elisa Pabon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| | - Heather E. Webber
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX 77054 USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| |
Collapse
|
15
|
Skumlien M, Langley C, Lawn W, Voon V, Sahakian BJ. Apathy and Anhedonia in Adult and Adolescent Cannabis Users and Controls Before and During the COVID-19 Pandemic Lockdown. Int J Neuropsychopharmacol 2021; 24:859-866. [PMID: 34077523 PMCID: PMC8244616 DOI: 10.1093/ijnp/pyab033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/18/2021] [Accepted: 06/01/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND COVID-19 lockdown measures have caused severe disruptions to work and education and prevented people from engaging in many rewarding activities. Cannabis users may be especially vulnerable, having been previously shown to have higher levels of apathy and anhedonia than non-users. METHODS In this survey study, we measured apathy and anhedonia, before and after lockdown measures were implemented, in n = 256 adult and n = 200 adolescent cannabis users and n = 170 adult and n = 172 adolescent controls. Scores on the Apathy Evaluation Scale (AES) and Snaith-Hamilton Pleasure Scale (SHAPS) were investigated with mixed-measures ANCOVA, with factors user group, age group, and time, controlling for depression, anxiety, and other drug use. RESULTS Adolescent cannabis users had significantly higher SHAPS scores before lockdown, indicative of greater anhedonia, compared with adolescent controls (P = .03, η p2 = .013). Contrastingly, adult users had significantly lower scores on both the SHAPS (P < .001, η p2 = .030) and AES (P < .001, η p2 = .048) after lockdown compared with adult controls. Scores on both scales increased during lockdown across groups, and this increase was significantly smaller for cannabis users (AES: P = .001, η p2 = .014; SHAPS: P = .01, η p2 = .008). Exploratory analyses revealed that dependent cannabis users had significantly higher scores overall (AES: P < .001, η p2 = .037; SHAPS: P < .001, η p2 = .029) and a larger increase in scores (AES: P = .04, η p2 =.010; SHAPS: P = .04, η p2 = .010), compared with non-dependent users. CONCLUSIONS Our results suggest that adolescents and adults have differential associations between cannabis use as well as apathy and anhedonia. Within users, dependence may be associated with higher levels of apathy and anhedonia regardless of age and a greater increase in levels during the COVID-19 lockdown.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neurosciences Institute, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Trust, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
16
|
Skumlien M, Langley C, Lawn W, Voon V, Curran HV, Roiser JP, Sahakian BJ. The acute and non-acute effects of cannabis on reward processing: A systematic review. Neurosci Biobehav Rev 2021; 130:512-528. [PMID: 34509513 DOI: 10.1016/j.neubiorev.2021.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/11/2021] [Accepted: 09/05/2021] [Indexed: 12/14/2022]
Abstract
Cannabis use has historically been thought to cause amotivation, but the relationship between cannabis and apathy, anhedonia, and reward processing remains poorly characterised. In this systematic review, we evaluated whether cannabis exposure acutely and/or non-acutely was associated with altered reward processing using questionnaire, behavioural, or functional neuroimaging measures. Questionnaire studies demonstrated greater anhedonia in adolescent cannabis users, and some indication of greater apathy in young adult cannabis users. Behavioural studies yielded some evidence of reduced reward learning in adolescent cannabis users, though there were too few studies in this category for reliable conclusions. Finally, longitudinal and acute functional neuroimaging studies showed an association between cannabis and blunted neural responses to reward, which did not emerge consistently in cross-sectional studies. The current results suggest that cannabis use is associated with specific impairments in reward and motivation. Future large-scale, longitudinal studies which use multiple behavioural and neuroimaging measures of reward processing may further clarify the impact of cannabis use on motivational and reward processes, and neural networks.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | | | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, Cambridge, UK; Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | | |
Collapse
|
17
|
Exploring the relationship between recency and frequency of cannabis use and diminished expression and apathy as two dimensions of negative symptoms in first episode psychosis. A one-year follow-up study. Schizophr Res 2021; 236:89-96. [PMID: 34454305 DOI: 10.1016/j.schres.2021.08.004] [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] [Received: 03/30/2021] [Revised: 06/18/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022]
Abstract
The association between cannabis use and negative symptoms remains unclear because of inconsistent results in existing studies. In this study we aimed to investigate the association between different aspects of cannabis use and 1) diminished expression and 2) apathy as a two-dimensional model of negative symptoms in a sample of 460 participants with first-episode psychosis. Data were collected on relevant clinical and demographic factors including diagnostics and habits of drug use at baseline, with a follow-up assessment after 12-months. We found an association between the frequency of cannabis use two years prior to baseline and the severity of diminished expression and apathy at baseline, while only the association to diminished expression held after controlling for potential clinical and demographic confounders. Frequency of cannabis use at baseline also had a significant effect on the development of diminished expression over the 12-month follow-up period. In conclusion, this study suggests that the frequency of cannabis use contributes to the severity of diminished expression at baseline, and to the progression of diminished expression after 12-months follow-up. Our findings also imply a dose-response relationship between frequency of use and severity of symptoms and add evidence to an association between cannabis use and negative symptoms.
Collapse
|
18
|
Evidence Lacking for Cannabis Users Slacking: A Longitudinal Analysis of Escalating Cannabis Use and Motivation among Adolescents. J Int Neuropsychol Soc 2021; 27:637-647. [PMID: 34261556 PMCID: PMC8289119 DOI: 10.1017/s135561772000096x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Reduced motivation is often noted as a consequence of cannabis use. However, previous work has yielded mixed results and focused largely on adults. To address these limitations, this study examined longitudinal associations between cannabis use and self-reported motivation in a large adolescent sample. METHOD Participants were 401 adolescents aged 14-17 at baseline who completed five bi-annual assessments. We assessed motivation at three timepoints using two self-report questionnaires: the Apathy Evaluation Scale and the Motivation and Engagement Scale (disengagement, persistence, planning, self-efficacy, and valuing school subscales). Controlling for relevant covariates, we used latent growth curve modeling to characterize patterns of cannabis use and motivation over time, examining bidirectional influences between these processes. RESULTS On average, adolescent cannabis use frequency increased significantly over time. The disengagement and planning facets of motivation also increased significantly over time, whereas other aspects of motivation remained stable. At baseline, greater cannabis use was associated with greater disengagement, lower planning, and lower valuing of school. Greater baseline cannabis use also predicted lesser increases in disengagement over time. After controlling for the effect of sex, age, depression, and use of alcohol and nicotine, only the baseline association between cannabis use and valuing school remained significant. CONCLUSIONS Our results do not support a prospective link between cannabis use and reduced motivation among adolescents. Although most observed associations were accounted for by covariates, greater cannabis use was cross-sectionally associated with lower perceived value of school, which may contribute to poorer educational and later life outcomes.
Collapse
|
19
|
Langlois C, Potvin S, Khullar A, Tourjman SV. Down and High: Reflections Regarding Depression and Cannabis. Front Psychiatry 2021; 12:625158. [PMID: 34054594 PMCID: PMC8160288 DOI: 10.3389/fpsyt.2021.625158] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/15/2021] [Indexed: 12/20/2022] Open
Abstract
In light of the recent changes in the legal status of cannabis in Canada, the understanding of the potential impact of the use of cannabis by individuals suffering from depression is increasingly considered as being important. It is fundamental that we look into the existing literature to examine the influence of cannabis on psychiatric conditions, including mood disorders. In this article, we will explore the relationship that exists between depression and cannabis. We will examine the impact of cannabis on the onset and course of depression, and its treatment. We have undertaken a wide-ranging review of the literature in order to address these questions. The evidence from longitudinal studies suggest that there is a bidirectional relationship between cannabis use and depression, such that cannabis use increases the risk for depression and vice-versa. This risk is possibly higher in heavy users having initiated their consumption in early adolescence. Clinical evidence also suggests that cannabis use is associated with a worse prognosis in individuals with major depressive disorder. The link with suicide remains controversial. Moreover, there is insufficient data to determine the impact of cannabis use on cognition in individuals with major depression disorder. Preliminary evidence suggesting that the endogenous cannabinoid system is involved in the pathophysiology of depression. This will need to be confirmed in future positron emission tomography studies. Randomized controlled trials are needed to investigate the potential efficacy of motivational interviewing and/or cognitive behavioral therapy for the treatment of cannabis use disorder in individuals with major depressive major disorder. Finally, although there is preclinical evidence suggesting that cannabidiol has antidepressant properties, randomized controlled trials will need to properly investigate this possibility in humans.
Collapse
Affiliation(s)
| | - Stéphane Potvin
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Atul Khullar
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Smadar Valérie Tourjman
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| |
Collapse
|
20
|
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: 7] [Impact Index Per Article: 2.3] [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.
Collapse
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
| |
Collapse
|
21
|
McGehee R. The Effect of Marijuana Use on Personality Development in Adolescence and Young Adulthood. PSYCHOANALYTIC STUDY OF THE CHILD 2021. [DOI: 10.1080/00797308.2020.1859284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Rex McGehee
- Training and Supervising Analyst Denver Institute for Psychoanalysis, Associate Clinical Professor of Psychiatry, University of Colorado Health Sciences Center
| |
Collapse
|
22
|
Cannabis use and psychosocial functioning: evidence from prospective longitudinal studies. Curr Opin Psychol 2021; 38:19-24. [DOI: 10.1016/j.copsyc.2020.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/31/2023]
|
23
|
Aloi J, Crum KI, Blair KS, Zhang R, Bashford-Largo J, Bajaj S, Schwartz A, Carollo E, Hwang S, Leiker E, Filbey FM, Averbeck BB, Dobbertin M, Blair RJR. Individual associations of adolescent alcohol use disorder versus cannabis use disorder symptoms in neural prediction error signaling and the response to novelty. Dev Cogn Neurosci 2021; 48:100944. [PMID: 33773241 PMCID: PMC8024914 DOI: 10.1016/j.dcn.2021.100944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/13/2021] [Accepted: 03/14/2021] [Indexed: 12/20/2022] Open
Abstract
Two of the most commonly used illegal substances by adolescents are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with poorer decision-making in adolescents. In adolescents, level of AUD symptomatology has been negatively associated with striatal reward responsivity. However, little work has explored the relationship with striatal reward prediction error (RPE) representation and the extent to which any augmentation of RPE by novel stimuli is impacted. One-hundred fifty-one adolescents participated in the Novelty Task while undergoing functional magnetic resonance imaging (fMRI). In this task, participants learn to choose novel or non-novel stimuli to gain monetary reward. Level of AUD symptomatology was negatively associated with both optimal decision-making and BOLD response modulation by RPE within striatum and regions of prefrontal cortex. The neural alterations in RPE representation were particularly pronounced when participants were exploring novel stimuli. Level of CUD symptomatology moderated the relationship between novelty propensity and RPE representation within inferior parietal lobule and dorsomedial prefrontal cortex. These data expand on an emerging literature investigating individual associations of AUD symptomatology levels versus CUD symptomatology levels and RPE representation during reinforcement processing and provide insight on the role of neuro-computational processes underlying reinforcement learning/decision-making in adolescents.
Collapse
Affiliation(s)
- Joseph Aloi
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States; College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Kathleen I Crum
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Karina S Blair
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Ru Zhang
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Sahil Bajaj
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Amanda Schwartz
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Erin Carollo
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Emily Leiker
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States
| | - Bruno B Averbeck
- Section on Learning and Decision Making, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, United States
| | - Matthew Dobbertin
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| | - R James R Blair
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE, United States
| |
Collapse
|
24
|
Hergert DC, Robertson-Benta C, Sicard V, Schwotzer D, Hutchison K, Covey DP, Quinn DK, Sadek JR, McDonald J, Mayer AR. Use of Medical Cannabis to Treat Traumatic Brain Injury. J Neurotrauma 2021; 38:1904-1917. [PMID: 33256496 DOI: 10.1089/neu.2020.7148] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is not a single pharmacological agent with demonstrated therapeutic efficacy for traumatic brain injury (TBI). With recent legalization efforts and the growing popularity of medical cannabis, patients with TBI will inevitably consider medical cannabis as a treatment option. Pre-clinical TBI research suggests that cannabinoids have neuroprotective and psychotherapeutic properties. In contrast, recreational cannabis use has consistently shown to have detrimental effects. Our review identified a paucity of high-quality studies examining the beneficial and adverse effects of medical cannabis on TBI, with only a single phase III randomized control trial. However, observational studies demonstrate that TBI patients are using medical and recreational cannabis to treat their symptoms, highlighting inconsistencies between public policy, perception of potential efficacy, and the dearth of empirical evidence. We conclude that randomized controlled trials and prospective studies with appropriate control groups are necessary to fully understand the efficacy and potential adverse effects of medical cannabis for TBI.
Collapse
Affiliation(s)
- Danielle C Hergert
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, Albuquerque, New Mexico, USA
| | - Cidney Robertson-Benta
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, Albuquerque, New Mexico, USA
| | - Veronik Sicard
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, Albuquerque, New Mexico, USA
| | - Daniela Schwotzer
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado, USA
| | - Dan P Covey
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
| | - Davin K Quinn
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Joseph R Sadek
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.,Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.,New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Jacob McDonald
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
| | - Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, Albuquerque, New Mexico, USA.,Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.,Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.,Psychology Department, University of New Mexico, Albuquerque, New Mexico, USA
| |
Collapse
|
25
|
Graczyk M, Łukowicz M, Dzierzanowski T. Prospects for the Use of Cannabinoids in Psychiatric Disorders. Front Psychiatry 2021; 12:620073. [PMID: 33776815 PMCID: PMC7994770 DOI: 10.3389/fpsyt.2021.620073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/17/2021] [Indexed: 12/26/2022] Open
Abstract
Increasing evidence suggests an essential role of the endocannabinoid system in modulating cognitive abilities, mood, stress, and sleep. The psychoactive effects of cannabis are described as euphoric, calming, anxiolytic, and sleep-inducing and positively affect the mood, but can also adversely affect therapy. The responses to cannabinoid medications depend on the patient's endocannabinoid system activity, the proportion of phytocannabinoids, the terpenoid composition, and the dose used. There is some evidence for a therapeutic use of phytocannabinoids in psychiatric conditions. THC and CBD may have opposing effects on anxiety. Current guidelines recommend caution in using THC in patients with anxiety or mood disorders. In a small number of clinical trials, cannabinoids used to treat cancer, HIV, multiple sclerosis, hepatitis C, Crohn's disease, and chronic neuropathic pain report decreases in anxiety or depression symptoms and presented sedative and anxiolytic effects. Several studies have investigated the influence of potential genetic factors on psychosis and schizophrenia development after cannabis use. THC may increase the risk of psychosis, especially in young patients with an immature central nervous system. There is limited evidence from clinical trials that cannabinoids are effective therapy for sleep disorders associated with concomitant conditions. There is evidence for a possible role of cannabis as a substitute for alcohol and drugs, also in the context of the risks of opioid use (e.g., opioid-related mortality). In this narrative review of the recent evidence, we discuss the prospects of using the psychoactive effects of cannabinoids in treating mental and psychiatric disorders. However, this evidence is weak for some clinical conditions and well-designed randomized controlled trials are currently lacking. Furthermore, some disorders may be worsened by cannabis use.
Collapse
Affiliation(s)
- Michał Graczyk
- Department of Palliative Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Małgorzata Łukowicz
- Department of Rehabilitation, Center of Postgraduate Medical Education, Gruca Orthopedic and Trauma Teaching Hospital in Otwock, Otwock, Poland
| | - Tomasz Dzierzanowski
- Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
26
|
Subramaniam P, Yurgelun-Todd D. Neural and behavioral correlates associated with adolescent marijuana use. CURRENT ADDICTION REPORTS 2020; 7:475-485. [PMID: 33777643 DOI: 10.1007/s40429-020-00335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose of Review Marijuana (MJ) is one of the most commonly used drugs among adolescents. Exposure to MJ during adolescence can lead to alterations in brain development, and, subsequently to the behavioral correlates regulated by the affected brain regions. In this review, we discuss findings from preclinical and human studies examining the relationship between adolescent MJ use and the neurobiological and behavioral correlates associated with it. Recent Findings Current findings indicate that adolescent MJ use is associated with alterations in brain structure and function, especially in regions that express high levels of the cannabinoid 1 receptor such as the prefrontal cortex, hippocampus, cerebellum and limbic regions. These alterations are correlated with changes in affective, cognitive and reward-seeking behavior. Furthermore, evidence suggests that exposure to MJ during adolescence can have long-lasting and pronounced neural and behavioral effects into adulthood. Summary The wide ranging neural and behavioral correlates associated with MJ use during adolescence highlight the need for further studies to better understand the potential risk factors and/or neurotoxic effects of adolescent MJ use.
Collapse
Affiliation(s)
- Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT
| | - Deborah Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA.,Diagnostic Neuroimaging Lab, University of Utah, Salt Lake City, UT USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT.,VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City VA Health Care System, Salt Lake City, UT, USA
| |
Collapse
|
27
|
Cannabis, nicotine and the negative symptoms of schizophrenia: Systematic review and meta-analysis of observational studies. Neurosci Biobehav Rev 2020; 116:415-425. [DOI: 10.1016/j.neubiorev.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
|
28
|
Pacheco-Colón I, Ramirez AR, Gonzalez R. Effects of Adolescent Cannabis Use on Motivation and Depression: A Systematic Review. CURRENT ADDICTION REPORTS 2019; 6:532-546. [PMID: 34079688 DOI: 10.1007/s40429-019-00274-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose of review This article reviews recent behavioral and neuroimaging studies to elucidate whether adolescent cannabis use is related to reduced motivation and increased risk of depression. Recent findings Recent work suggests that heavy adolescent cannabis use predicts poorer educational outcomes, often presumed to reflect reduced academic motivation, as well as increased levels of depressive symptoms. However, evidence of a link between cannabis use and general motivation was lacking. Factors such as concurrent alcohol and tobacco use, trajectories of cannabis use during adolescence, and cannabis-related changes in underlying neurocircuitry may impact associations among cannabis use, motivation, and depression. Summary Heavy adolescent cannabis use is associated with poorer educational outcomes and increased levels of depressive symptoms. The role of depression in how cannabis may affect motivation, broadly, is not yet clear, as most studies have not examined associations among all three constructs. Future work should explore possible overlap between cannabis effects on motivation and depression, and clarify the temporality of these associations.
Collapse
Affiliation(s)
- Ileana Pacheco-Colón
- Center for Children and Families, Department of Psychology, Florida International University
| | - Ana Regina Ramirez
- Center for Children and Families, Department of Psychology, Florida International University
| | - Raul Gonzalez
- Center for Children and Families, Department of Psychology, Florida International University
| |
Collapse
|
29
|
Norris C, Szkudlarek HJ, Pereira B, Rushlow W, Laviolette SR. The Bivalent Rewarding and Aversive properties of Δ 9-tetrahydrocannabinol are Mediated Through Dissociable Opioid Receptor Substrates and Neuronal Modulation Mechanisms in Distinct Striatal Sub-Regions. Sci Rep 2019; 9:9760. [PMID: 31278333 PMCID: PMC6611878 DOI: 10.1038/s41598-019-46215-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/17/2019] [Indexed: 11/09/2022] Open
Abstract
The primary psychoactive compound in cannabis, Δ9-tetrahydrocannabinol (THC), is capable of producing bivalent rewarding and aversive affective states through interactions with the mesolimbic system. However, the precise mechanisms underlying the dissociable effects of THC are not currently understood. In the present study, we identify anatomically dissociable effects of THC within the rat nucleus accumbens (NAc), using an integrative combination of behavioral pharmacology and in vivo neuronal electrophysiology. We report that the rewarding vs. aversive stimulus properties of THC are both anatomically and pharmacologically dissociable within distinct anterior vs. posterior sub-regions of the NAc. While the rewarding effects of THC were dependent upon local μ-opioid receptor signaling, the aversive effects of THC were processed via a κ-opioid receptor substrate. Behaviorally, THC in the posterior NASh induced deficits in social reward and cognition whereas THC in the anterior NAc, potentiated opioid-related reward salience. In vivo neuronal recordings demonstrated that THC decreased medium spiny neuron (MSN) activity in the anterior NAc and increased the power of gamma (γ) oscillations. In contrast, THC increased MSN activity states in the posterior NASh and decreased γ-oscillation power. These findings reveal critical new insights into the bi-directional neuronal and pharmacological mechanisms controlling the dissociable effects of THC in mesolimbic-mediated affective processing.
Collapse
Affiliation(s)
- Christopher Norris
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada.
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada.
| | - Hanna J Szkudlarek
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Brian Pereira
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Walter Rushlow
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Steven R Laviolette
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| |
Collapse
|