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Sharma P, Rao V, Chand PK, Murthy P. Quantification of Δ9-tetrahydrocannabinol in urine as a marker of cannabis abuse. Indian J Med Res 2023; 158:535-541. [PMID: 37929356 PMCID: PMC10878489 DOI: 10.4103/ijmr.ijmr_3899_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND OBJECTIVES Cannabis use has long been associated with celebration and hospitality, although abuse must be confirmed through testing. It has always been difficult to develop an accurate and reliable confirmatory method for the quantification of tetrahydrocannabinol carboxylic acid (THC-COOH) that meets local requirements. The goal was to develop a rapid, cost-effective analytical technique that can handle large batches. METHODS Because of the wide metabolite detection window and ease of collection, urine was preferable sample. The extraction of a pre-screened urine sample (adulteration and multidrug screening) was done on Bond Elut cartridges using a positive pressure vacuum manifold, followed by quantification using a gas chromatograph and mass spectrometer. RESULTS The assay was linear between 15 and 300 ng/ml ( r2 of 0.99). The intra-day precision was 8.69 per cent and the inter-day precision was 10.78 per cent, respectively with a 97.5 per cent recovery rate for the lowest concentration. A total of 939 urine samples were examined, with 213 detecting cannabis. Sixty per cent of the total individuals tested positive for simply cannabinoids, 33 per cent for cannabinoids and sedatives, five per cent for cannabinoids and morphine and one for cannabis, morphine and cocaine. INTERPRETATION CONCLUSIONS Assay characteristics included modest sample preparation, rapid chromatography, high specificity and small sample volume with a processing time of 12 h. The assay described here can be applied for diagnostic laboratories and in forensic settings as well.
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Affiliation(s)
- Priyamvada Sharma
- Department of Clinical Psychopharmacology & Neurotoxicology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Vijayashree Rao
- Department of Centre for Addicition Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Prabhat Kumar Chand
- Department of Centre for Addicition Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Clinical Psychopharmacology & Neurotoxicology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
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2
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Andersson F, Sundin E, Magnusson C, Ramstedt M, Galanti MR. Prevalence of cannabis use among young adults in Sweden comparing randomized response technique with a traditional survey. Addiction 2023; 118:1801-1810. [PMID: 37132063 DOI: 10.1111/add.16219] [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: 07/26/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND AND AIMS The prevalence of cannabis use based on self-reports is likely to be underestimated in population surveys, especially in contexts where its use is a criminal offence. Indirect survey methods ask sensitive questions ensuring that answers cannot be identified with an individual respondent, therefore potentially resulting in more reliable estimates. We aimed to measure whether the indirect survey method 'randomized response technique' (RRT) increased response rate and/or increased disclosure of cannabis use among young adults compared with a traditional survey. DESIGN We conducted two parallel nation-wide surveys during the spring and the summer of 2021. The first survey was a traditional questionnaire-based one (focusing on substance use and gambling). The second survey applied an indirect survey method known as 'the cross-wise model' to questions related to cannabis use. The two surveys employed identical procedures (e.g. invitations, reminders and wording of the questions) SETTING AND PARTICIPANTS: The participants were young adults (aged 18-29 years) living in Sweden. The traditional survey had 1200 respondents (56.9% women) and the indirect survey had 2951 respondents (53.6% women). MEASUREMENTS In both surveys, cannabis use was assessed according to three time-frames: life-time use; use during the past year; and use during the past 30 days. FINDINGS The estimated prevalence of cannabis use was two- to threefold higher on all measures when estimated using the indirect survey method compared with the traditional survey: use during life-time (43.2 versus 27.3%); during the past year (19.2 versus 10.4%); and during the past 30 days (13.2 versus 3.7%). The discrepancy was larger among males and individuals with an education shorter than 10 years, who were unemployed, and who were born in non-European countries. CONCLUSIONS Indirect survey methods may provide more accurate estimates than traditional surveys on prevalence of self-reported cannabis use.
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Affiliation(s)
- Filip Andersson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm, Sweden
| | - Erica Sundin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- The Swedish Council for Information on Alcohol and Other Drugs, Stockholm, Sweden
| | - Cecilia Magnusson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm, Sweden
| | - Mats Ramstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- The Swedish Council for Information on Alcohol and Other Drugs, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Maria Rosaria Galanti
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm, Sweden
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Ahuja M, Stamey J, Cimilluca J, Al Skir K, Herndon MK, Baggett K, Sathiyasaleen T, Fernandopulle P. Association between chronic disease and substance use among older adults in Tennessee. J Public Health Res 2023; 12:22799036231193070. [PMID: 37636292 PMCID: PMC10460272 DOI: 10.1177/22799036231193070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/16/2023] [Indexed: 08/29/2023] Open
Abstract
Background Substance use and misuse have a negative impact on health care outcomes, specifically in the older adult population. Older adults are at risk due to several factors occurring toward the end of life such as changing family dynamics, loss of friends and loved ones, and chronic diseases. Substance use in older adults with chronic diseases in rural areas remains poorly studied. This study examines older adults greater than 55 of age in the state of Tennessee, U.S.A. Design and methods Data was extracted from the 2019 National Behavioral Risk Factor Surveillance System (BRFSS) with a subsample for the State of Tennessee (N = 6242) and individuals over age 55 (N = 3389). Results At least 33.7% (N = 1143) of older adults have a chronic disease, and 24.4% (N = 828) have at least two or more chronic diseases. Alcohol use in the past month was reported in 29.4% of older adults; however, chronic disease status was not associated with alcohol use. Marijuana use and smoking in the past month were significant for older adults with two or more chronic diseases. Low income and less high school education were associated with chronic disease and smoking. Conclusions Marijuana use and smoking were found to be significant in older adults with chronic disease, but not with alcohol use. Preventative measures such as screening tools, education, and providing resources to patients should be targeted to populations at risk to promote overall health outcomes.
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Affiliation(s)
- Manik Ahuja
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Jessica Stamey
- College of Nursing, East Tennessee State University, Johnson City, TN, USA
| | - Johanna Cimilluca
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kawther Al Skir
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Mary K Herndon
- James H Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- University of Tennessee Medical Center, Knoxville, TN, USA
| | - Kathleen Baggett
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | | | - Praveen Fernandopulle
- James H Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
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Palamar JJ, Le A. Discordant report of vaping of cannabis among high school seniors in the United States. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:148-157. [PMID: 34266316 PMCID: PMC8760354 DOI: 10.1080/00952990.2021.1942030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Reliable responses on surveys are important to ensure accurate estimates of drug use. This study compared prevalence of self-reported vaping of cannabis based on two separate questions on the same survey.Methods: We examined combined data from the 2017-2019 Monitoring the Future nationally representative survey of high school seniors in the US (N = 6,982). Students were first asked whether they had used cannabis in the past year via vaporizer in a section about cannabis use. Later on, students were asked about vaping behaviors, including cannabis vaping. Prevalence of self-reported vaping of cannabis was compared and a multivariable model delineated correlates of providing a discordant response - defined as reporting vaporizer use but not reporting vaping.Results: Estimated prevalence of use based on the question in the cannabis section was 11.9% (95% CI: 11.0-12.9) and prevalence based on the question in the vaping section was 13.2% (95% CI: 12.3-14.2). Among those reporting vaping of cannabis, 17.3% provided a discordant response. The corrected prevalence was 16.5% (95% CI: 15.5-17.6). Black students were more likely to provide a discordant report (aPR = 1.82, 95% CI: 1.23-2.69) and those reporting past-year vaping of nicotine (aPR = 0.27, 95% CI: 0.19-0.38) and/or nonmedical use of prescription stimulants (aPR = 0.44, 95% CI: 0.21-0.91) were less likely to provide a discordant report.Conclusions: Self-report of vaping of cannabis varies depending on whether it is asked in a section about vaping practices or about overall cannabis use (use via vaporizer). Survey researchers need to consider how to best query cannabis vaping practices on surveys.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Austin Le
- Department of Population Health, New York University School of Medicine, New York, NY, USA,Department of Orthodontics and Dentofacial Orthopedics, New York University College of Dentistry, New York, NY, USA
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Le A, Han BH, Palamar JJ. Underreporting of past-year cannabis use on a national survey by people who smoke blunts. Subst Abus 2022; 43:349-355. [PMID: 34214396 PMCID: PMC8720324 DOI: 10.1080/08897077.2021.1941520] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Accurate prevalence estimates are critical to epidemiological research but discordant responses on self-report surveys can lead to over- or underestimation of drug use. We sought to examine the extent and nature of underreported cannabis use (among those later reporting blunt use) from a national drug survey in the US. Methods: We used data from the 2015-2019 National Survey on Drug Use and Health (N = 281,650), a nationally representative probability sample of non-institutionalized populations in the US. We compared self-reported prevalence of past-year cannabis use and blunt use and delineated correlates of underreporting cannabis use, defined as reporting blunt use but not overall cannabis use. Results: An estimated 4.8% (95% CI: 4.4-5.2) of people reported blunt use but not cannabis use. Although corrected prevalence, cannabis use recoded as use only increased from 15.2% (95% CI: 15.0-15.4) to 15.5% (95% CI: 15.3-15.7), individuals who are aged ≥50 (aOR = 1.81, 95% CI: 1.06-3.08), female (aOR = 1.35, 95% CI: 1.12-1.62), Non-Hispanic Black (aOR = 1.43, 95% CI: 1.16-1.76), or report lower English proficiency (aOR = 3.32, 95% CI: 1.40-7.83) are at increased odds for providing such a discordant response. Individuals with a college degree (aOR = 0.57, 95% CI: 0.39-0.84) and those reporting past-year use of tobacco (aOR = 0.75, 95% CI: 0.62-0.91), alcohol (aOR = 0.42, 95% CI: 0.33-0.54), cocaine (aOR = 0.50, 95% CI: 0.34-0.73), or LSD (aOR = 0.52, 95% CI: 0.31-0.87) were at lower odds of providing a discordant response. Conclusion: Although changes in prevalence are small when correcting for discordant responses, results provide insight into subgroups that may be more likely to underreport use on surveys.
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Affiliation(s)
- Austin Le
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA;,New York University College of Dentistry, New York, New York, USA
| | - Benjamin H. Han
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA;,Department of Medicine, Division of Geriatrics and Gerontology, University of California San Diego, San Diego, California, USA
| | - Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
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Shanahan L, Steinhoff A, Bechtiger L, Copeland WE, Ribeaud D, Eisner M, Quednow BB. Frequent teenage cannabis use: Prevalence across adolescence and associations with young adult psychopathology and functional well-being in an urban cohort. Drug Alcohol Depend 2021; 228:109063. [PMID: 34601277 DOI: 10.1016/j.drugalcdep.2021.109063] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Amidst cannabis legalization efforts and laws, we do not fully understand how the youngest frequent cannabis users fare during young adulthood. This study aims to 1) examine the prevalence of cannabis use during adolescence, and 2) investigate links of frequent (i.e., weekly or daily) teenage cannabis use with psychopathology and functional well-being at age 20-compared to no or occasional use. METHODS Data came from a prospective-longitudinal cohort study (assessments from 2004 to 2018, from ages 7-20) in an urban setting (N = 1482). Substance use was assessed with self-reports between ages 13 and 20. At age 20, participants reported on psychopathology (psychotic symptoms, problematic substance use, aggression, and internalizing symptoms) and functional well-being (delinquency, financial difficulties, social exclusion, general well-being, and not being in education, employment, or training). Covariates were based on self-, parent-, teacher-, and behavioral measures. FINDINGS Almost one in five adolescents had used cannabis frequently between ages 13 and 17 (26.6% of males, 9.8% of females). Adjusting nearly 20 potential confounders, frequent teenage cannabis use was associated with age 20 problematic substance use and poorer functional well-being compared to the no cannabis use and the occasional use groups. Frequent teenage cannabis use was more consistently associated with age 20 functional outcomes compared to frequent teenage nicotine or alcohol use. CONCLUSIONS Frequent teenage cannabis use was common and associated with problematic substance use, more delinquency, and poorer functional well-being at age 20. Accordingly, frequent teenage cannabis users could experience increased difficulties in mastering the transitions of young adulthood.
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Affiliation(s)
- Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland; Department of Psychology, University of Zurich, Binzmühlestrasse 14, Box 1, 8050 Zurich, Switzerland.
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - William E Copeland
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont College of Medicine, Box 3454, 1 South Prospect Street, MC 446AR6, Burlington VT 05401, USA
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland; Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge CB3 9DA, UK
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, PO Box 1931, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Winterthurerstr. 190, Y55 J04, 8057 Zurich, Switzerland
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Palamar JJ, Le A, Acosta P. Shifts in Drug Use Behavior Among Electronic Dance Music Partygoers in New York During COVID-19 Social Distancing. Subst Use Misuse 2021; 56:238-244. [PMID: 33317365 PMCID: PMC7935433 DOI: 10.1080/10826084.2020.1857408] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Little is known about how COVID-19-related social distancing has affected illegal drug use. We surveyed electronic dance music (EDM) partygoers-a population known for high levels of drug use-to determine whether their drug use patterns had changed during state-mandated social distancing in New York. Methods: Individuals were recruited online and screened for eligibility throughout April and May 2020. We surveyed 128 eligible adults and queried, retrospectively, whether their drug use behavior had changed during COVID-19-related social distancing. Results: Most participants reporting past-three-month use reported decreased frequency of use during COVID-19-related social distancing. Specifically, 78.6% reduced frequency of use of cocaine, 71.1% reduced frequency of use of ecstasy/MDMA/Molly, and 68.0% reduced frequency of use of LSD. Although some participants reported increased frequency of use of cocaine (7.1%), ecstasy (7.9%), or LSD (12.0%), 35.0% reported increased frequency of cannabis use. Most (66.7%) of those reporting cocaine use reduced the amount used. The majority of those reporting use of cannabis, ecstasy, cocaine, and/or LSD reported that drug cost (80.0-84.0%) and drug quality (84.2-92.0%) did not change during social distancing. Having a college degree was associated with higher odds for decreasing frequency of cannabis use. Older participants (ages ≥23) were at lower odds for decreasing frequency of cocaine use, as were those earning >$500 per week, and participants who attended EDM events biweekly or more often were at higher odds for decreasing frequency of LSD use. Conclusions: Participants in this sample tended to reduce party drug use during COVID-19-related social distancing.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Austin Le
- Department of Population Health, New York University Grossman School of Medicine, New York, NY.,New York University College of Dentistry, New York, NY
| | - Patricia Acosta
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
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Abstract
Most human subjects research involving contact with participants has been halted in the US due to the COVID-19 crisis. We have been testing an online method to recruit and survey participants as a temporary replacement for our street-intercept survey method. Online surveys already generate less generalizable findings than other surveys, but offering compensation for online survey completion further reduces generalizability because this increases mischievous submissions. In this letter we discuss methods to help detect invalid responses, such as utilizing a screener to test for eligibility and using flags to detect mischievous responses and repeat submissions. We recommend that researchers approach online recruitment and surveying with caution.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Patricia Acosta
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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