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Shrier LA, McCaskill NH, Smith MC, O'Connell MM, Gluskin BS, Parker S, Everett V, Burke PJ, Harris SK. Telehealth counseling plus mHealth intervention for cannabis use in emerging adults: Development and a remote open pilot trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 166:209472. [PMID: 39111371 DOI: 10.1016/j.josat.2024.209472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 06/27/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION To improve treatment access for emerging adults with cannabis use disorder (CUD), we developed a telehealth counseling-plus-mHealth intervention and remotely conducted a single-arm open pilot study to preliminarily evaluate its feasibility in primary care. METHODS A multidisciplinary team including youth developed the intervention using the structure of the MOMENT intervention: two weekly counselor-delivered Motivational Enhancement Therapy (MET) sessions, then two weeks of smartphone surveys (4 prompted/day) querying socioemotional contexts and cannabis use, with pre-programmed messages on report of personal triggers for use (Ecological Momentary Intervention; EMI). The team adapted the MET for virtual delivery; created material to enhance self-reflection, plan behavior change, and anticipate withdrawal; shortened the sessions; and tested them with five youth actors. EMI messages were created to align with the MET and programmed to minimize repetition. Patients aged 18-25 using recreational cannabis ≥3 days/week were recruited from an urban medical practice. Participants received the intervention and responded to surveys on satisfaction and burden. At baseline, post-intervention, and two months, participants reported behavior change readiness/importance/confidence and cannabis use. EMI engagement was calculated as % days with ≥1 phone survey completed. RESULTS Fourteen eligible patients enrolled; 79 % used cannabis daily/near-daily and 100 % reported use problems. All completed both MET sessions and responded to EMI surveys. All agreed/strongly agreed that they felt respected by, comfortable with, and trust for the counselor and that the activities and discussion were helpful; all rated the MET sessions as very good/excellent. Technical issues were infrequent and minor. Median EMI engagement was 100 % (≥1 report/day) in each week. Behavior change confidence was higher post-intervention and importance and confidence were higher at two months vs. baseline. By two months, 11 participants had started to change cannabis use; median percent days of use in the past 30 days declined by 27 % and average times of use per use day declined by 28 %. All rated intervention quality as good, very good, or excellent. CONCLUSIONS Emerging adults were highly satisfied and engaged with a telehealth MET counseling-plus-mHealth EMI intervention for cannabis use and reported higher motivation to change cannabis use and less use post-intervention and at 2-month follow-up.
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Affiliation(s)
- Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Nicholas H McCaskill
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Madeline C Smith
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Madison M O'Connell
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Brittany S Gluskin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Sarah Parker
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Veronica Everett
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Pamela J Burke
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Sion Kim Harris
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Hashemi D, Gray K. Cannabis Use Disorder in Adolescents. Psychiatr Clin North Am 2023; 46:647-654. [PMID: 37879829 DOI: 10.1016/j.psc.2023.03.013] [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] [Indexed: 10/27/2023]
Abstract
With increasing cannabis potency, increasing variety of methods of cannabis use, and lower perceived risk of cannabis use, it is increasingly important clinicians who work with adolescents remain up-to-date on the latest literature regarding cannabis use and its associated outcomes. Adolescent cannabis use is associated with chronic cognitive, psychosocial, psychiatric, and physical outcomes. Clinicians working in this field should be able to recognize cannabis use disorder, understand how adolescent cannabis use can impact the developing mind, and have informed discussions with patients and families regarding risks of use.
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Affiliation(s)
- Daniel Hashemi
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, South Carolina 29425, USA.
| | - Kevin Gray
- Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC 29425, USA
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Oosten W, Vos E, Los L, Nelwan M, Pieters T. Towards a New Dynamic Interaction Model of Adolescent CUD Manifestation, Prevention, and Treatment: A Narrative Review. PSYCHOACTIVES 2023; 2:294-316. [PMID: 39280928 PMCID: PMC7616443 DOI: 10.3390/psychoactives2040019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
Background Cannabis is one of the most popular drugs of the 21st century, especially among adolescents and young adults. Evidence of a variety of lasting neuropsychological deficits as a result of chronic cannabis use has increased. Furthermore, regular cannabis use is found to be a predictor of mental health problems, less motivation in school, and school dropout. Aim Our goal is to propose a theoretical model of adolescent cannabis use disorder (CUD) based on Zinberg's drug, set, and setting model and explicated by a review of the literature on adolescent cannabis use to improve the prevention and treatment of CUD for adolescents. Methods PubMed and Web of Science were searched for relevant publications as part of a hypothesis-based and model-generating review. Results Individual (set) and environmental (setting) risk factors play important roles in the development of CUD in adolescents. School performance, motivation, and attendance can be negatively influenced by persistent cannabis use patterns and adolescent brain development can consequently be impaired. Thus, cannabis use can be understood as both being the cause of poor school performance but also the consequence of poor school performance. To prevent and reduce adolescent CUD the drug, set, and setting must all be considered. It is important to notice that the multiple feedback loops (indicated in our dynamic interaction model) are not mutually exclusive, but offer important intervention focus points for social workers, addiction professionals, parents, and other care takers. Conclusion We argue that the three dimensions of drug, set, and setting contribute significantly to the eventual manifestation of CUD. Based on our dynamic interaction model, recommendations are made for possible preventive and therapeutic interventions for the treatment of adolescents and young adults with CUD.
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Affiliation(s)
- Wesley Oosten
- Freudenthal Institute, Utrecht University, P.O. Box 85 170, 3508 AD Utrecht, The Netherlands
| | - Elena Vos
- Trimbos Institute, P.O. Box 80 125, 3500 AS Utrecht, The Netherlands
| | - Leontien Los
- Department of Adolescent Psychiatry and Addiction Prevention, Brijder-Jeugd, 2553 NZ The Hague, The Netherlands
| | - Michel Nelwan
- Department of Children and Adolescent Psychiatry, Erasmus Medical Center Sophia, P.O. Box 2060, 3015 CN Rotterdam, The Netherlands
| | - Toine Pieters
- Freudenthal Institute, Utrecht University, P.O. Box 85 170, 3508 AD Utrecht, The Netherlands
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80 082, 3508 TB Utrecht, The Netherlands
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Ross JA, Levy S. The Impact of Cannabis Use on Adolescent Neurodevelopment and Clinical Outcomes Amidst Changing State Policies. Clin Ther 2023; 45:535-540. [PMID: 37414504 DOI: 10.1016/j.clinthera.2023.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 07/08/2023]
Abstract
Cannabis is the most common illicit substance used by adolescents and the third most common psychoactive substance after alcohol and nicotine. Cannabis use during adolescence interrupts a critical period of brain development and leads to inappropriate activation of the reward pathway. Because the prefrontal cortex, which is responsible for impulse control and other executive functions, is not fully mature until the mid-twenties, the adolescent brain is especially vulnerable to damage from substance use. Although cannabis remains illegal at the federal level, recent changes in state policies have been associated with increased availability of a wide variety of cannabis products. As new products, formulations, and delivery devices that can deliver higher and faster peak doses of tetrahydrocannabinol enter the market, there is an even greater potential for cannabis to have negative clinical impacts on adolescent health. This article reviews the current literature on the impact of cannabis on adolescent health, including the neurobiology of the adolescent brain, potential clinical outcomes in adolescents who use cannabis, and the effects of changing state policies regarding cannabis on the increased availability of unregulated products.
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Affiliation(s)
- Jennifer A Ross
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
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Chronic exposure to a synthetic cannabinoid alters cerebral brain metabolism and causes long-lasting behavioral deficits in adult mice. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02607-8. [PMID: 36853560 PMCID: PMC10374737 DOI: 10.1007/s00702-023-02607-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/17/2023] [Indexed: 03/01/2023]
Abstract
In recent years, there has been growing evidence that cannabinoids have promising medicinal and pharmacological effects. However, the growing interest in medical cannabis highlights the need to better understand brain alterations linking phytocannabinoids or synthetic cannabinoids to clinical and behavioral phenotypes. Therefore, the aim of this study was to investigate the effects of long-term WIN 55,212-2 treatment-with and without prolonged abstinence-on cerebral metabolism and memory function in healthy wildtype mice. Adult C57BI/6J mice were divided into two treatment groups to study the acute effects of WIN 55,212-2 treatment as well the effects of WIN 55,212-2 treatment after an extended washout phase. We could demonstrate that 3 mg/kg WIN 55,212-2 treatment in early adulthood leads to a hypometabolism in several brain regions including the hippocampus, cerebellum, amygdala and midbrain, even after prolonged abstinence. Furthermore, prolonged acute WIN 55,212-2 treatment in 6-months-old mice reduced the glucose metabolism in the hippocampus and midbrain. In addition, Win 55,212-2 treatment during adulthood lead to spatial memory and recognition memory deficits without affecting anxiety behavior. Overall we could demonstrate that treatment with the synthetic CB1/CB2 receptor aganist Win 55,212-2 during adulthood causes persistent memory deficits, especially when mice were treated in early adulthood. Our findings highlight the risks of prolonged WIN 55,212-2 use and provide new insights into the mechanisms underlying the effects of chronic cannabinoid exposure on the brain and behavior.
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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.
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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
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Zellers SM, Ross JM, Saunders GRB, Ellingson JM, Walvig T, Anderson JE, Corley RP, Iacono W, Hewitt JK, Hopfer CJ, McGue MK, Vrieze S. Recreational cannabis legalization has had limited effects on a wide range of adult psychiatric and psychosocial outcomes. Psychol Med 2023; 53:1-10. [PMID: 36601811 PMCID: PMC10319916 DOI: 10.1017/s0033291722003762] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/15/2022] [Accepted: 11/28/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The causal impacts of recreational cannabis legalization are not well understood due to the number of potential confounds. We sought to quantify possible causal effects of recreational cannabis legalization on substance use, substance use disorder, and psychosocial functioning, and whether vulnerable individuals are more susceptible to the effects of cannabis legalization than others. METHODS We used a longitudinal, co-twin control design in 4043 twins (N = 240 pairs discordant on residence), first assessed in adolescence and now age 24-49, currently residing in states with different cannabis policies (40% resided in a recreationally legal state). We tested the effect of legalization on outcomes of interest and whether legalization interacts with established vulnerability factors (age, sex, or externalizing psychopathology). RESULTS In the co-twin control design accounting for earlier cannabis frequency and alcohol use disorder (AUD) symptoms respectively, the twin living in a recreational state used cannabis on average more often (βw = 0.11, p = 1.3 × 10-3), and had fewer AUD symptoms (βw = -0.11, p = 6.7 × 10-3) than their co-twin living in an non-recreational state. Cannabis legalization was associated with no other adverse outcome in the co-twin design, including cannabis use disorder. No risk factor significantly interacted with legalization status to predict any outcome. CONCLUSIONS Recreational legalization was associated with increased cannabis use and decreased AUD symptoms but was not associated with other maladaptations. These effects were maintained within twin pairs discordant for residence. Moreover, vulnerabilities to cannabis use were not exacerbated by the legal cannabis environment. Future research may investigate causal links between cannabis consumption and outcomes.
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Affiliation(s)
- Stephanie M. Zellers
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - J. Megan Ross
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Jarrod M. Ellingson
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Tasha Walvig
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jacob E. Anderson
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - William Iacono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - John K. Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Christian J. Hopfer
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Matt K. McGue
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
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Hashemi D, Gray K. Cannabis Use Disorder in Adolescents. Child Adolesc Psychiatr Clin N Am 2023; 32:13-20. [PMID: 36410900 DOI: 10.1016/j.chc.2022.06.001] [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] [Indexed: 11/03/2022]
Abstract
With increasing cannabis potency, increasing variety of methods of cannabis use, and lower perceived risk of cannabis use, it is increasingly important clinicians who work with adolescents remain up-to-date on the latest literature regarding cannabis use and its associated outcomes. Adolescent cannabis use is associated with chronic cognitive, psychosocial, psychiatric, and physical outcomes. Clinicians working in this field should be able to recognize cannabis use disorder, understand how adolescent cannabis use can impact the developing mind, and have informed discussions with patients and families regarding risks of use.
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Affiliation(s)
- Daniel Hashemi
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, South Carolina 29425, USA.
| | - Kevin Gray
- Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC 29425, USA
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Muacevic A, Adler JR, Oxner A. A Case of Panic Attacks Developing After 10 Years of Chronic Cannabis Use in a Patient With No Prior Psychiatric History. Cureus 2023; 15:e34197. [PMID: 36843769 PMCID: PMC9954761 DOI: 10.7759/cureus.34197] [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: 12/05/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
Cannabis use for medical and recreational purposes is increasing. Inhibitory activity of cannabinoids (CB) at the CB1 and CB2 receptors centrally and peripherally mediate the therapeutic effects that are wielded for palliation of pain, anxiety, inflammation, and nausea in indicated conditions. Cannabis dependence is also associated with anxiety; however, the direction of causality is unknown, such as whether anxiety disorders lead to cannabis use, or whether cannabis contributes to the development of anxiety disorder. The evidence hints that both may have validity. Here we present a case of cannabis-associated panic attacks following 10 years of chronic cannabis dependence in an individual with no prior psychiatric history. The patient is a 32-year-old male with no significant past medical history who presented complaining of five-minute episodes of palpitations, dyspnea, upper extremity paresthesia, subjective tachycardia, and cold diaphoresis occurring in a variety of circumstances for the past two years. His social history was significant for 10 years of smoking marijuana multiple times daily, which he had quit over two years ago. The patient denied past psychiatric history or known anxiety problems. Symptoms were unrelated to activity and only relieved with deep breathing. The episodes were not associated with chest pain, syncope, headache, or emotional triggers. The patient had no family history of cardiac disease or sudden death. The episodes were refractory to the elimination of caffeine, alcohol, or other sugary beverages. The patient had already stopped smoking marijuana when the episodes began. Due to the unpredictable nature of the episodes, the patient reported a growing fear of being in public. On laboratory workup, metabolic and blood panels were within normal limits, as well as thyroid studies. Electrocardiogram showed normal sinus rhythm, and continuous cardiac monitoring revealed no arrhythmias or abnormalities despite the patient indicating multiple triggered events within the duration of monitoring. Echocardiography also showed no abnormalities. With organic cardiac causes of the subjective palpitation episodes ruled out, a psychogenic etiology of the episodes was presumed, and the patient was referred to behavioral health services. In conclusion, cannabis-induced anxiety or panic disorders should be considered in patients with no prior psychiatric history presenting with anxiety-like attacks following a period of cannabis dependence or current use. These patients should be advised to cease cannabis use and referred to behavioral medicine.
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Dennen CA, Blum K, Bowirrat A, Khalsa J, Thanos PK, Baron D, Badgaiyan RD, Gupta A, Braverman ER, Gold MS. Neurogenetic and Epigenetic Aspects of Cannabinoids. EPIGENOMES 2022; 6:27. [PMID: 36135314 PMCID: PMC9498086 DOI: 10.3390/epigenomes6030027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 12/04/2022] Open
Abstract
Cannabis is one of the most commonly used and abused illicit drugs in the world today. The United States (US) currently has the highest annual prevalence rate of cannabis consumption in the world, 17.9% in individuals aged 12 or older, and it is on the rise. With increasing cannabis use comes the potential for an increase in abuse, and according to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 5.1% of Americans had Cannabis Use Disorder (CUD) in 2020. Research has shown that genetics and epigenetics play a significant role in cannabis use and CUD. In fact, approximately 50-70% of liability to CUD and 40-48% of cannabis use initiation have been found to be the result of genetic factors. Cannabis usage and CUD have also been linked to an increased risk of psychiatric disorders and Reward Deficiency Syndrome (RDS) subsets like schizophrenia, depression, anxiety, and substance use disorder. Comprehension of the genetic and epigenetic aspects of cannabinoids is necessary for future research, treatment plans, and the production of pure cannabinoid compounds, which will be essential for FDA approval. In conclusion, having a better understanding of the epigenetic and genetic underpinnings of cannabis use, CUD, and the endocannabinoid system as a whole will aid in the development of effective FDA-approved treatment therapies and the advancement of personalized medicine.
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Affiliation(s)
- Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19114, USA
| | - Kenneth Blum
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, Austin, TX 78701, USA
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of the Provost), Graduate College, Western University of Health Sciences, Pomona, CA 91766, USA
- Institute of Psychology, ELTE Eötvös Loránd University, 1075 Budapest, Hungary
- Department of Psychiatry, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright University Boonshoft School of Medicine, Dayton, OH 45324, USA
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20037, USA
- Medical Consequences of Drug Abuse and Infections Branch, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20852, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of the Provost), Graduate College, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, Icahn School of Medicine Mt Sinai, New York, NY 10029, USA
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX 78229, USA
- Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - Eric R. Braverman
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, Austin, TX 78701, USA
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Rup J, Freeman TP, Perlman C, Hammond D. Cannabis and Mental Health: Adverse Outcomes and Self-Reported Impact of Cannabis Use by Mental Health Status. Subst Use Misuse 2022; 57:719-729. [PMID: 35170396 DOI: 10.1080/10826084.2022.2034872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Cannabis can induce negative outcomes among consumers with mental health conditions. This study examined medical help-seeking behavior, patterns of adverse effects, and perceived impacts of cannabis among consumers with and without mental health conditions. Methods: Data came from the International Cannabis Policy Study, via online surveys conducted in 2018. Respondents included 6,413 past 12-month cannabis consumers aged 16-65, recruited from commercial panels in Canada and the US. Regression models examined differences in adverse health effects and perceived impact of cannabis among those with and without self-reported past 12-month experience of anxiety, depression, PTSD, bipolar disorder, psychosis. Results: Overall, 7% of past 12-month consumers reported seeking medical help for adverse effects of cannabis, including panic, dizziness, nausea. Help-seeking was greater for those with psychosis (13.8%: AOR = 1.78; 1.11-2.87), depression (8.9%: AOR = 1.57; 1.28-1.93), and bipolar disorder (10.1%: AOR = 1.53; 1.44-2.74). Additionally, 54.1% reported using cannabis to manage symptoms of mental health, with higher rates among those with bipolar (90.8%) and PTSD (90.7%). Consumers reporting >1 condition were more likely to perceive positive impacts on friendships, physical/mental health, family life, work, studies, quality of life (all p < .001). Consumers with psychosis were most likely to perceive negative effects across categories. Conclusion: For conditions with substantial evidence suggesting cannabis is harmful, greater help-seeking behaviors and self-perceived negative effects were observed. Consumers with mental health conditions generally perceive cannabis to have a positive impact on their lives. The relationship between cannabis and mental health is disorder specific and may include a combination of perceived benefits and harms.
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Affiliation(s)
- Jennifer Rup
- School of Public Health Sciences, University of Waterloo, ON, Canada
| | - Tom P Freeman
- Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Chris Perlman
- School of Public Health Sciences, University of Waterloo, ON, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, ON, Canada
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12
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Barry KM, Gomajee R, Kousignian I, Bustamante JJH, Lakrout P, Mary-Krause M, Melchior M. Adolescent cannabis experimentation and unemployment in young to mid-adulthood: Results from the French TEMPO Cohort study. Drug Alcohol Depend 2022; 230:109201. [PMID: 34864566 DOI: 10.1016/j.drugalcdep.2021.109201] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND France accounts for one of the highest levels of recreational cannabis use, with almost 40% of youth aged 17 reporting having experimented with cannabis. We investigated the impact of early cannabis experimentation (defined as first-time use ≤ 16 years) on future probability of unemployment in young to mid-adulthood using a longitudinal, community sample over the span of 9 years. METHODS Data were obtained from the French TEMPO Cohort study, set up in 2009 among young adults aged 22-25 years old. Participants who reported information on age of cannabis experimentation and employment status in at least one study wave (2009, 2011, 2015 and 2018) were included in the statistical analyses (N = 1487, 61.2% female). RESULTS In A-IPW-adjusted analyses, early cannabis experimenters (≤ 16 years) had 1.71 (95% CI: 1.46-2.02) times higher odds of experiencing unemployment compared to late cannabis experimenters (> 16 years) and 2.40 (95% CI: 2.00 - 2.88) times higher odds of experiencing unemployment compared to non-experimenters. Late cannabis experimenters experienced 1.39 (95% CI: 1.17-1.68) times higher odds of being unemployed compared to non-experimenters, and early cannabis experimenters experienced 3.84 (95%CI: 2.73-5.42) times higher odds of experiencing long-term unemployment (defined as unemployed at least twice) compared to non-experimenters. CONCLUSIONS Participants who ever used cannabis, especially at or before the age of 16, had higher odds of experiencing unemployment, even when accounting for many psychological, academic and family characteristics which preceded cannabis initiation.
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Affiliation(s)
- Katharine M Barry
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France.
| | - Ramchandar Gomajee
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Isabelle Kousignian
- Université de Paris, Unité de Recherche " Biostatistique, Traitement et Modélisation des données biologiques ", BioSTM - 4 avenue de l'Observatoire, 75006 Paris, France
| | - Joel José Herranz Bustamante
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Paula Lakrout
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Murielle Mary-Krause
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, 27 rue de Chaligny, 75571 Cedex 12 Paris, France
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13
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Rubin-Kahana DS, Crépault JF, Matheson J, Le Foll B. The impact of cannabis legalization for recreational purposes on youth: A narrative review of the Canadian experience. Front Psychiatry 2022; 13:984485. [PMID: 36213917 PMCID: PMC9539831 DOI: 10.3389/fpsyt.2022.984485] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/30/2022] [Indexed: 12/02/2022] Open
Abstract
Cannabis legalization for non-medical purposes (subsequently referred to as "cannabis legalization" or "legalization") took place in Canada in October 2018. One of the federal government's stated goals with cannabis legalization was to protect Canadian youth from cannabis-related harms. The main objective of this narrative review is to describe the impact of cannabis legalization on Canadian youth. To that end, we discuss the regulation of the Canadian cannabis market, outline changes in the epidemiology and parameters of cannabis use (modes of use, potency of cannabis) among youth, and discuss prevention and education initiatives related to cannabis. The Canadian model differs from other jurisdictions that legalized recreational cannabis use, especially with regard to a higher degree of government regulation of the cannabis market. Another difference is the development and endorsement of lower-risk cannabis use guidelines to educate the public and health professionals. The results available for this review cover only 3 years post-legalization. Cannabis legalization in Canada brought an apparent increase in use among Canadian older than 25. However, results for youth are mixed, with the majority of studies showing no pronounced increase. Notably, the trend of a decrease in adolescents' cannabis use seen pre-legalization may have reversed. Emerging evidence also suggests that cannabis-related hospitalizations and emergency department visits among Canadian youth may have increased due to cannabis legalization. Data about changes in the age of initiation, the influence of legalization on sex and gender, and race/ethnicity are limited, with evidence suggesting that the age of initiation slightly increased. So far, there is limited data about the impact of cannabis legalization on Canadian youth. Further long-term monitoring and research to assess the effects of cannabis legalization on Canadian youth.
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Affiliation(s)
- Dafna Sara Rubin-Kahana
- Child and Youth Mental Health Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jean-François Crépault
- Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Justin Matheson
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Bernard Le Foll
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Departments of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Waypoint Centre for Mental Health Care, Waypoint Research Institute, Penetanguishene, ON, Canada
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14
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Abate SM, Chekol YA, Minaye SY. Prevalence and risk factors of psychoactive substance abuse among students in Ethiopia: A systematic review and meta-analysis. Ann Med Surg (Lond) 2021; 70:102790. [PMID: 34540211 PMCID: PMC8437783 DOI: 10.1016/j.amsu.2021.102790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/24/2021] [Accepted: 09/02/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Substance uses were seen in 18-25 years old age groups who are more than 40% world population, from which Africa was the region with the highest proportion accounting 60% in 2016. This review aimed to assess the burden of substance abuse among students in Ethiopia. METHODS A comprehensive search was conducted in PubMed/Medline; Science direct and African Online Journal without language and date restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All cross-sectional studies reporting rate of prevalence of psychoactive substance among students were included and the rest were excluded. RESULT A total of 545 articles were identified from different databases and 42 articles were selected for evaluation. Twenty-nine Articles with 22, 012 participants were included. The overall prevalence of psychoactive substance abuse was 32.28% (95% confidence interval (CI): 26.74 to 37.82). CONCLUSION The review revealed that one-third of the high school and higher education students used different psychoactive substances in Ethiopia. REGISTRATION This Systematic Review and Meta-Analysis was registered in Prospero international prospective register of systemic reviews (CRD42020146656) on April 28/2020.
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Affiliation(s)
- Semagn Mekonnen Abate
- Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Yigrem Ali Chekol
- Department of Psychiatry, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Solomon Yimer Minaye
- Department of Psychiatry, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
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15
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Guttmannova K, Fleming CB, Rhew IC, Abdallah DA, Patrick ME, Duckworth JC, Lee CM. Dual trajectories of cannabis and alcohol use among young adults in a state with legal nonmedical cannabis. Alcohol Clin Exp Res 2021; 45:1458-1467. [PMID: 34089527 PMCID: PMC8357031 DOI: 10.1111/acer.14629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/18/2021] [Accepted: 04/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding the nature of the association between cannabis and alcohol use within individuals over time in the era of legalized cannabis is of crucial importance for assessing the public health consequences of increasing cannabis use. An important unanswered question is whether cannabis and alcohol use substitute for one another. Specifically, is greater use of one substance associated with less use of the other substance (i.e., a negative association) or are the substances complementary and their association positive? METHODS We used 24 consecutive months of data on a young adult sample (n = 774; 56% female, age 18-25 during the study) who drank alcohol in the year prior to enrollment. The sample was recruited in Washington State in 2015/2016 (after legalization of nonmedical cannabis) using media advertisements and community flyers and outreach. Using parallel process latent growth curve models, we assessed three types of association between cannabis and alcohol use across the 24-month period: (1) an association between average levels of cannabis and alcohol use; (2) an association between rates of change in cannabis and alcohol use; and (3) correlations between shorter-term deviations/fluctuations off of longer-term trajectories of level and change in cannabis and alcohol use. RESULTS We found a positive association between the average frequency of cannabis and alcohol use; individuals who used cannabis more frequently on average also drank alcohol more frequently on average. Change over time in cannabis use was positively associated with change in alcohol use. There was also a contemporaneous positive association between fluctuations in cannabis and alcohol use. CONCLUSIONS Overall, we found no evidence of substitution. Rather, the results suggest a complementary relationship between cannabis and alcohol use, such that the use of cannabis and alcohol rises and falls together.
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Affiliation(s)
- Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Charles B. Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Devon Alisa Abdallah
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Christine M. Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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16
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Villanueva VJ, Herrera-Gutiérrez E, Redondo-Martín S, Isorna M, Lozano-Polo A. Proyecto piloto de promoción de la salud en consumo dual de cannabis y tabaco en universitarios: ÉVICT-Universidad. Glob Health Promot 2021. [PMID: 34015999 DOI: 10.1177/17579759211007454] [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: 11/15/2022]
Abstract
INTRODUCCIÓN La universidad es el lugar de formación de los futuros profesionales de los ámbitos educativo, sanitario y social. La implementación de programas de formación, prevención de adicciones y promoción de la salud con universitarios provoca un doble impacto, sobre el propio individuo y, dado su papel mediador, sobre la comunidad universitaria en general. El objetivo del trabajo es, partiendo de un proyecto piloto de investigación-acción, establecer un marco de promoción de la salud en contraposición al consumo dual de cannabis y tabaco en el contexto universitario, involucrando a la comunidad universitaria como agente de cambio. METODOLOGÍA Estudio descriptivo de la implementación, cobertura y resultados preliminares del Proyecto piloto ÉVICT-Universidad. RESULTADOS Entre el 2018 y el 2020 se implementó el Proyecto ÉVICT-Universidad en 11 universidades. Se formó a estudiantes universitarios como mediadores y se realizaron actividades comunitarias de sensibilización e información orientadas a la promoción de la salud y la prevención del uso de cannabis y tabaco, con especial foco en el consumo dual de estas sustancias, alcanzando a un total de 1471 beneficiarios en los tres años de implementación. CONCLUSIONES La experiencia piloto permite detectar fortalezas, aspectos de mejora y resultados prometedores sobre el nivel de conocimientos, contribuyendo a la adopción de estilos de vida saludables en el ámbito universitario. En especial, se destaca la contribución a la formación como agentes promotores de salud de estudiantes y, por tanto, el empoderamiento en salud desde la propia comunidad universitaria.
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Affiliation(s)
- Víctor J Villanueva
- Facultad de Ciencias de la Salud, Universidad Internacional de Valencia, Valencia, España.,Proyecto ÉVICT, Comité Nacional para la Prevención del Tabaquismo, Madrid, España
| | - Eva Herrera-Gutiérrez
- Proyecto ÉVICT, Comité Nacional para la Prevención del Tabaquismo, Madrid, España.,Facultad de Psicología, Universidad de Murcia, Murcia, España
| | - Susana Redondo-Martín
- Proyecto ÉVICT, Comité Nacional para la Prevención del Tabaquismo, Madrid, España.,Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Manuel Isorna
- Proyecto ÉVICT, Comité Nacional para la Prevención del Tabaquismo, Madrid, España.,Facultad de Educación y Trabajo Social, Universidad de Vigo, Orense, España
| | - Adelaida Lozano-Polo
- Proyecto ÉVICT, Comité Nacional para la Prevención del Tabaquismo, Madrid, España.,Facultad de Medicina, Universidad de Murcia, Murcia, España
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17
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Shah S, Patel S, Paulraj S, Chaudhuri D. Association of Marijuana Use and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Data Analysis of 133,706 US Adults. Am J Med 2021; 134:614-620.e1. [PMID: 33181103 DOI: 10.1016/j.amjmed.2020.10.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Marijuana is the most commonly used psychoactive drug, while its effects on cardiovascular health are not well known and remain a subject of interest. METHODS We used the pooled 2016-2018 data from the Behavioral Risk Factor Surveillance System to perform a cross-sectional analysis evaluating the association of marijuana and cardiovascular disease among US adults who never smoked cigarettes. RESULTS Among US adults ages 18-74 years, when compared with nonusers, frequent marijuana use was associated with 88% higher odds of myocardial infarction or coronary artery disease (adjusted odds ratio [aOR] 1.88; 95% confidence interval [CI], 1.15-3.08), and 81% higher odds of stroke (aOR 1.81; 95% CI, 1.14-2.89). Among the premature cardiovascular disease group, frequent marijuana users had 2.3 times higher odds of myocardial infarction or coronary artery disease (aOR 2.27; 95% CI, 1.20-4.30), and 1.9 times higher odds of stroke (aOR 1.92; 95% CI, 1.07-3.43). In terms of the modality of marijuana use, frequent marijuana smoking had 2.1 times higher odds of myocardial infarction or coronary artery disease (aOR 2.07; 95% CI, 1.21-3.56), and 1.8 times higher odds of stroke (aOR 1.84; 95% CI, 1.09-3.10). A similar association was observed in the premature cardiovascular disease group who smoked marijuana (aOR [for myocardial infarction or coronary artery disease] 2.64; 95% CI, 1.37-5.09; aOR [for stroke] 2.00; 95% CI, 1.05-3.79). No association was observed between marijuana use in any form other than smoking and cardiovascular disease, across all age groups. CONCLUSION Frequent marijuana smoking is associated with significantly higher odds of stroke and myocardial infarction or coronary artery disease, with a possible role in premature cardiovascular disease.
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Affiliation(s)
- Siddharth Shah
- Division of Cardiology, State University of New York Upstate Medical University, Syracuse.
| | - Siddharth Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham
| | | | - Debanik Chaudhuri
- Division of Cardiology, State University of New York Upstate Medical University, Syracuse
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18
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The impact of state cannabis legislation, county-level socioeconomic and dog-level characteristics on reported cannabis poisonings of companion dogs in the USA (2009-2014). PLoS One 2021; 16:e0250323. [PMID: 33861797 PMCID: PMC8051783 DOI: 10.1371/journal.pone.0250323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/05/2021] [Indexed: 11/19/2022] Open
Abstract
With current trends in cannabis legalization, large efforts are being made to understand the effects of less restricted legislation on human consumption, health, and abuse of these products. Little is known about the effects of cannabis legalization and increased cannabis use on vulnerable populations, such as dogs. The objective of this study was to examine the effects of different state-level cannabis legislation, county-level socioeconomic factors, and dog-level characteristics on dog cannabis poisoning reports to an animal poison control center (APCC). Data were obtained concerning reports of dog poisoning events, county characteristics, and state cannabis legislation from the American Society for the Prevention of Cruelty to Animals’ (ASPCA) APCC, the US Census Bureau, and various public policy-oriented and government websites, respectively. A multilevel logistic regression model with random intercepts for county and state was fitted to investigate the associations between the odds of a call to the APCC being related to a dog being poisoned by a cannabis product and the following types of variables: dog characteristics, county-level socioeconomic characteristics, and the type of state-level cannabis legislation. There were significantly higher odds of a call being related to cannabis in states with lower penalties for cannabis use and possession. The odds of these calls were higher in counties with higher income variability, higher percentage of urban population, and among smaller, male, and intact dogs. These calls increased throughout the study period (2009–2014). Reporting of cannabis poisonings were more likely to come from veterinarians than dog owners. Reported dog poisonings due to cannabis appear to be influenced by dog-level and community-level factors. This study may increase awareness to the public, public health, and veterinary communities of the effects of recreational drug use on dog populations. This study highlights the need to educate dog owners about safeguarding cannabis products from vulnerable populations.
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19
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Hasin D, Walsh C. Trends over time in adult cannabis use: A review of recent findings. Curr Opin Psychol 2021; 38:80-85. [PMID: 33873044 PMCID: PMC8905582 DOI: 10.1016/j.copsyc.2021.03.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 01/06/2023]
Abstract
In the United States, policies regarding the medical and nonmedical use of cannabis are changing rapidly. In 2021, a total of 34 US states have legalized cannabis for adult medical use, and 15 of these states have legalized adult non-medical use. These changing policies have raised questions about increasing prevalences of cannabis use, changing perceptions regarding frequent use, and potentially related outcomes such as comorbid psychiatric illness or driving under the influence of cannabis. Research regarding the correlates of any and frequent cannabis use is also developing quickly. This article reviews recent empirical studies concerning (1) adult trends in cannabis use, (2) state cannabis laws and related outcomes, and (3) emerging evidence regarding how the global coronavirus 19 pandemic may impact cannabis use patterns. We summarize recent findings and conclude with suggestions to address unanticipated effects of rapidly changing cannabis laws and policies.
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Affiliation(s)
- Deborah Hasin
- New York State Psychiatric Institute, New York, NY, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Claire Walsh
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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20
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Bruins J, Pijnenborg GHM, Visser E, Castelein S. The association of cannabis use with quality of life and psychosocial functioning in psychosis. Schizophr Res 2021; 228:229-234. [PMID: 33461022 DOI: 10.1016/j.schres.2020.11.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/31/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cannabis use is highly prevalent among people with a psychotic disorder. They often report sociality, coping with unpleasant affect and having positive experiences as important reasons for cannabis use, suggesting that cannabis improves their quality of life (QoL) and psychosocial functioning. However, based on previous studies we hypothesize that cannabis use is negatively associated with long-term subjective QoL and psychosocial functioning in people with a psychotic disorder. METHODS We included 2994 people with a psychotic disorder (36.4% female), mean age 44.4 (SD 11.9), mean illness duration 17.2 years (SD 11.1), who participated in two yearly routine outcome assessments between 2014 and 2018 (interval 9-15 months) from the naturalistic PHAMOUS cohort study. Linear regression analyses were used to examine whether first assessment cannabis use was associated with QoL (ManSA) and psychosocial functioning (HoNOS). Changes in outcomes between assessments were analyzed with AN(C)OVA, to examine differences between continuers (n = 255), discontinuers (n = 85), starters (n = 83) and non-users (n = 2571). RESULTS At first assessment, 11.4% was using cannabis. They had lower QoL (B = -2.93, p < 0.001) and worse psychosocial functioning (B = 1.03, p = 0.002) than non-users. After one year, changes in QoL and psychosocial functioning were not significantly different between continuers, starters, discontinuers and non-users. CONCLUSIONS Cannabis users were less satisfied with their family relations and financial situation and showed more aggressive and disruptive behavior and self-harm than non-users. These differences are likely the result of patients having used cannabis for many years. Starting or discontinuing cannabis did not lead to changes in QoL and psychosocial functioning within one year.
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Affiliation(s)
- J Bruins
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands.
| | - G H M Pijnenborg
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands; GGZ Drenthe Mental Health Institution, Assen, the Netherlands.
| | | | - E Visser
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands.
| | - S Castelein
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands.
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21
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Abstract
Objectives: This paper reviews research on the topic of cannabis use and mental health harms in older adults and illustrates potential contributing factors and special clinical considerations for working with this population. Known risk factors for cannabis-related mental disorders and mental health problems are outlined, first for the general population and then specifically for older adults. Methods: Studies were identified through online databases using a variety of search words. Articles were included in the review if they were peer-reviewed or published by a reputable national organization, published in English, and were pertinent to the topic of mental health harms of cannabis use. Results: Risk factors that emerged from the literature review aligned with the following categories: (1) patterns of use (i.e., potency of product, frequency of use), (2) personal characteristics (i.e., age, sex, social demographics), (3) psychosocial constructs (motivations, perceptions), and (4) morbidities (mental health, medication interactions). Conclusions: Frequent use was associated with increased risk for mental health consequences related to cannabis use. Certain motives for use (i.e., using to cope, using as a sleep aid) may increase susceptibility to cannabis-related harms, although more empirical work is required. Mental health conditions may predispose to cannabis-related harms through a variety of mechanisms, including increased vulnerability for cannabis-related psychiatric disorders, poorer prognosis for preexisting psychiatric disorders, and possibility of cannabis-medication interactions. Personal characteristics (younger age, being male, lower socioeconomic status) predict more frequent cannabis use, which may dispose to adverse outcomes. Clinical Implications: Predictors of cannabis-related harms hold relevance for public health messaging, as well as clinical interventions. Understanding how cannabis interacts with sociodemographic factors, mental health morbidities, and medications is crucial in providing accurate guidance to patients about their recreational cannabis use and in informing prescriber decisions about medicinal cannabis.
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Affiliation(s)
- Amanda Hudson
- Mental Health and Addictions, Health PEI , Charlottetown, Canada.,Department of Health Management, University of Prince Edward Island , Charlottetown, Canada
| | - Pamela Hudson
- Mental Health and Addictions, Health PEI , Charlottetown, Canada.,Family Medicine, Health PEI , Charlottetown, Canada.,Department of Medicine, Dalhousie University , Halifax, Canada
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22
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La funcionalidad política de la “ciencia” prohibicionista: El caso del cannabis y los psicodélicos. Salud Colect 2020; 16:e2493. [DOI: 10.18294/sc.2020.2493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 08/06/2020] [Indexed: 11/24/2022] Open
Abstract
Se analiza, desde una perspectiva externalista, el uso de la ciencia como herramienta política por parte de la lógica prohibicionista. El prohibicionismo trabaja para que sus preceptos político-morales sean considerados científicos, es decir, como el resultado de un proceso de investigación neutro a nivel ideológico. El artículo analiza el caso del cannabis y de los psicodélicos para mostrar cómo el prohibicionismo solo ha recurrido a la “ciencia” para ocultar su agenda político-moral, mientras ha ignorado todos los resultados de las investigaciones científicas que no se ajustaban a sus apriorismos. Finalmente planteamos que las políticas de drogas deben fundamentarse en la evidencia científica y en ciertos valores básicos –defensa de la salud pública, de la cohesión social, de los Derechos Humanos–, por lo que un análisis en términos de relaciones de poder permitiría entender mejor las contradictorias relaciones entre ciencia y políticas de drogas.
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23
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Bears Augustyn M, Loughran T, Larroulet P, Henry KL. Economic Effects of Adolescent to Adult Patterns of Cannabis Use: Full-Time Employment and Employment Stability. JOURNAL OF DRUG ISSUES 2020. [DOI: 10.1177/0022042620943538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Research has yet to examine stability in employment as a function of cannabis use once an individual transitions into full-time work. Using data from the Rochester Youth Development Study, trajectories of cannabis use spanning ages 14 to 30 were identified among a sample of predominantly minorities (>80%; 68% African American). After hard-classifying individuals by patterns of cannabis use, probabilities of full-time employment and conditional probabilities of full-time employment were calculated and compared across patterns of use. Abstention or rare cannabis use was associated with a higher likelihood of full-time employment compared with other cannabis use patterns. Full-time employment stability was high for each pattern of cannabis use (>89%) and differences decreased with age and prior periods of employment. The results indicate that patterns of cannabis use spanning adolescence to adulthood have limited impact on the ability to retain full-time employment once employed and are interpreted in light of growing legalization of cannabis use.
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Affiliation(s)
| | | | - Pilar Larroulet
- University of Maryland, College Park, USA
- Pontificia Universidad Católica de Chile, Santiago, Chile
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24
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Scheier LM, Griffin KW. Youth marijuana use: a review of causes and consequences. Curr Opin Psychol 2020; 38:11-18. [PMID: 32653770 DOI: 10.1016/j.copsyc.2020.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
The legalization of medical and recreational marijuana has raised concerns about a potential increase in the availability and illegal use of marijuana by adolescent minors. To better understand the etiology, patterns, and consequences of adolescent marijuana use, this article reviews high quality, methodologically rigorous, longitudinal studies that focus on the role of personality factors such as sensation-seeking in the etiology of use, developmental trajectories of use and the effects of chronic use, potential gateway effects of marijuana on other illicit drugs, and its role in the onset of psychiatric disorders in adolescents and young adults. Implications are discussed in terms of mechanisms that account for initial and continued use of marijuana by adolescents, how use is associated with key developmental milestones and adult role socialization, and the potential of marijuana use during adolescence in furthering later drug involvement.
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Affiliation(s)
- Lawrence M Scheier
- LARS Research Institute, Inc., Scottsdale, AZ, USA; Prevention Strategies, Greensboro, NC, USA.
| | - Kenneth W Griffin
- George Mason University, Department of Global and Community Health, College of Health & Human Services, USA
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Thompson K, Leadbeater B, Ames M, Merrin GJ. Associations Between Marijuana Use Trajectories and Educational and Occupational Success in Young Adulthood. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:257-269. [PMID: 29704147 PMCID: PMC6414467 DOI: 10.1007/s11121-018-0904-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Adolescence and young adulthood is a critical stage when the economic foundations for life-long health are established. To date, there is little consensus as to whether marijuana use is associated with poor educational and occupational success in adulthood. We investigated associations between trajectories of marijuana use from ages 15 to 28 and multiple indicators of economic well-being in young adulthood including achievement levels (i.e., educational attainment and occupational prestige), work characteristics (i.e., full vs part-time employment, hours worked, annual income), financial strain (i.e., debt, trouble paying for necessities, delaying medical attention), and perceived workplace stress. Data were from the Victoria Healthy Youth Survey, a 10-year prospective study of a randomly recruited community sample of 662 youth (48% male; Mage = 15.5), followed biennially for six assessments. Models adjusted for baseline age, sex, SES, high school grades, heavy drinking, smoking, and internalizing and oppositional defiant disorder symptoms. Chronic users (our highest risk class) reported lower levels of educational attainment, lower occupational prestige, lower income, greater debt, and more difficulty paying for medical necessities in young adulthood compared to abstainers. Similarly, increasers also reported lower educational attainment, occupational prestige, and income. Decreasers, who had high early use but quit over time, showed resilience in economic well-being, performing similar to abstainers. Groups did not differ on employment status or perceived workplace stress. The findings indicate that early onset and persistent high or increasingly frequent use of marijuana in the transition from adolescent to young adulthood is associated with risks for achieving educational and occupational success, and subsequently health, in young adulthood.
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Affiliation(s)
- Kara Thompson
- Department of Psychology, St. Francis Xavier University, 2323 Notre Dame Ave., Antigonish, NS, B2G 2W5, Canada.
| | | | - Megan Ames
- University of Victoria, Victoria, BC, V8P 5C2, Canada
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Abstract
An important advance in understanding and defining mental disorders has been the development of empirical approaches to mapping dimensions of dysfunction and their interrelatedness. Such empirical approaches have consistently observed intercorrelations among the many forms of psychopathology, leading to the identification of a general factor of psychopathology (the p factor). In this article, we review empirical support for p, including evidence for the stability and criterion validity of p. Further, we discuss the strong relationship between p and both the general factor of personality and the general factor of personality disorder, substantive interpretations of p, and the potential clinical utility of p. We posit that proposed substantive interpretations of p do not explain the full range of symptomatology typically included in p. The most plausible explanation is that p represents an index of impairment that has the potential to inform the duration and intensity of a client's mental health treatment.
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Affiliation(s)
- Gregory T Smith
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506, USA; , , , ,
| | - Emily A Atkinson
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506, USA; , , , ,
| | - Heather A Davis
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506, USA; , , , ,
| | - Elizabeth N Riley
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506, USA; , , , ,
| | - Joshua R Oltmanns
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506, USA; , , , ,
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Bears Augustyn M, Loughran T, Larroulet P, Fulco CJ, Henry KL. Intergenerational marijuana use: A life course examination of the relationship between parental trajectories of marijuana use and the onset of marijuana use by offspring. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:818-829. [PMID: 31750702 DOI: 10.1037/adb0000530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Prior research documents intergenerational (IG) continuity in marijuana use, with most work adopting a life course perspective. Incorporating a methodology that allows for the measurement of "patterns of behavior" instead of singular aspects of parent marijuana use (e.g., age of onset or frequency at any one age or ages), we investigated the simultaneous effects of parental age of onset, frequency, and duration of marijuana use across 3 periods of the life course (i.e., adolescence, emerging adulthood, and adulthood) on the timing of first marijuana use among offspring. Using prospective data from 2 companion studies, the Rochester Youth Development Study and the Rochester Intergenerational Study, we used group-based trajectory models to estimate trajectories (or patterns) of parental marijuana use spanning ages 14 to 31 among a birth cohort of 462 parents. We then examined the relationship between parental trajectories of marijuana use and the timing of the onset of marijuana use through age 25 among firstborn offspring. Both late-onset persistent use by parents and increasing chronic use spanning adolescence to adulthood by parents were associated with an increased likelihood of onset of marijuana use among offspring. The results underscore the importance of patterns of marijuana use for IG continuity in contrast to singular measures (e.g., age of onset among parents), which can obfuscate important IG patterns of continuity. Prevention and intervention programs should consider the entire history of parent use to better identify children most at risk for the onset of marijuana use in adolescence and emerging adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Megan Bears Augustyn
- Department of Criminology and Criminal Justice, The University of Texas at San Antonio
| | - Thomas Loughran
- Department of Sociology and Criminology, Pennsylvania State University
| | - Pilar Larroulet
- Department of Criminology and Criminal Justice, University of Maryland
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Ates N, Unubol B, Bestepe EE, Bilici R. The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder. J Ethn Subst Abuse 2019; 22:316-336. [PMID: 31686619 DOI: 10.1080/15332640.2019.1685051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of perceived social support on the quality of life of male patients with alcohol, opiate and synthetic cannabinoid use disorders by considering sociodemographic factors and mood, and to compare these three groups in terms of social support and quality of life. METHOD One hundred and thirtyone (131) patients who were hospitalized at Addiction Clinic of Istanbul Erenkoy Psychiatric and Neurological Diseases Training and Research Hospital in Turkey and diagnosed as alcohol, opiate and synthetic cannabinoid use disorder were included in the study. Sociodemographic Data Form, Turkish version of the World Health Organization Quality of Life Questionnaire Scale (WHOQOL-BREF-TR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), API (Addiction Profile Index) were applied to the participants. RESULTS A total of 131 male patients were 32 synthetic cannabinoids, 51 opiates and 48 alcohol use disorders diagnosed. The mean age of alcohol users was higher than the other groups. Separation/divorce rate was higher in alcohol users and single rate in opiate users. Alcohol use was higher in living alone and opiate users lived with first degree relatives. The crime history was higher in the cannabis group. Prison experience, probation and self-injury were higher among opiate users. Family history of substance use was higher in opiate users. Crime was found to be less in alcohol users. In the comparison of alcohol and substance (opiate, cannabis) groups, the rate of self-injury (93.8%) was found to be significantly higher in the substance user' group. There was no statistically significant difference between the groups in terms of depression and anxiety scores. When the alcohol and substance (opiate, cannabis) comparisons were made between the groups, the mean depression (21.02 ± 11.6) and anxiety (20.09 ± 17.49) of the alcohol group was significantly higher. The "effect on life" (31.8 ± 6.13) and "motivation" subscales (10.38 ± 2.39) of API was found to be significantly higher in patients with substance use. In the opioid group, physical, environmental and psychological subscales of the WHOQOL-BREF-TR did not show significant correlation with MSPSS, and the family, friend' subscales and total perceived social support were significantly correlated with the social subscale of WHOQOL-BREF-TR. In the alcohol group, the environmental and social subscales of WHOQOL-BREF-TR showed a significant correlation with perceived social support from the family and private person and total perceived support. CONCLUSION Addiction is a recurrent and chronic disease and inevitably reduces quality of life. Social support has an important role on the quality of life. Improving the quality of life seems to be one of the main goals during the addiction treatment. For this purpose, it is very important to provide psychosocial support with pharmacological treatment by evaluating the medical, mental and social needs of the dependent patient as a whole.
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Affiliation(s)
- Nazli Ates
- Darica Farabi Training and Research Hospital, Kocaeli, Turkey
| | - Basak Unubol
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Engin Emrem Bestepe
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Rabia Bilici
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
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Marshall N, Mushquash AR, Mushquash CJ, Mazmanian D, McGrath DS. Marijuana use in undergraduate students: the short-term relationship between motives and frequency of use. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1683906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Nicole Marshall
- Department of Psychology, Lakehead University, Thunder Bay, Canada
| | | | | | - Dwight Mazmanian
- Department of Psychology, Lakehead University, Thunder Bay, Canada
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Maher DP, Carr DB, Hill K, McGeeney B, Weed V, Jackson WC, DiBenedetto DJ, Moriarty EM, Kulich RJ. Cannabis for the Treatment of Chronic Pain in the Era of an Opioid Epidemic: A Symposium-Based Review of Sociomedical Science. PAIN MEDICINE (MALDEN, MASS.) 2019; 20:2311-2323. [PMID: 29016917 PMCID: PMC7963205 DOI: 10.1093/pm/pnx143] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Abstract
OBJECTIVE This manuscript reviews medical literature published pertaining to the management of chronic pain with medical marijuana therapy (MMJ), with an emphasis on the social, medical, and legal aspects of therapy. DESIGN Narrative review of peer-reviewed literature. METHODS The 3rd Symposium on Controlled Substances and Their Alternatives for the Treatment of Pain was held in Boston on February 27, 2016, with a focus on MMJ for the treatment of chronic pain. Invited speakers had diverse backgrounds, including pain management, addiction psychiatry, neurology, and legal authorities. The purpose of this conference and this subsequent narrative review is to provide a medical, legal, and logistical framework for physicians and other health care providers to refer to when considering the initiation of medical marijuana therapy. RESULTS The invited speakers each covered a unique aspect of MMJ therapy for the treatment of chronic pain. These presentations highlighted the current data for and against the use of MMJ as a pain therapy. Optimal patient selection and screening, in addition to policy developments, were discussed. CONCLUSIONS Increasing interest in MMJ for chronic pain underscores a need for primary care and pain physicians to better understand the indications and evidence for its use free from cultural bias. Given a lack of full conclusive clinical utility, continued research is needed to better understand how to best utilize MMJ therapy for the treatment of chronic pain. Policy initiatives, such as enumerated indications, should follow medical science in order to prevent another abused substance epidemic.
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Affiliation(s)
- Dermot P Maher
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel B Carr
- Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Kevin Hill
- McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Brian McGeeney
- Boston University School of Medicine, Boston, Massachusetts
| | | | - William C Jackson
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Craniofacial Pain and Headache Center, Tufts University, Boston, Massachusetts
| | | | | | - Ronald J Kulich
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Craniofacial Pain and Headache Center, Tufts University, Boston, Massachusetts
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The efficacy of spiritual/religious interventions for substance use problems: A systematic review and meta-analysis of randomized controlled trials. Drug Alcohol Depend 2019; 202:134-148. [PMID: 31349206 DOI: 10.1016/j.drugalcdep.2019.04.045] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Spiritual/religious (S/R) interventions are commonly used to treat substance use problems, but this is the first systematic review and meta-analysis to examine their efficacy for these problems. METHODS Ten electronic databases were searched to identify eligible studies (i.e., randomized controlled trials) published between January 1990 and February 2018 that examined S/R interventions' efficacy for substance use or psycho-social-spiritual outcomes. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analysis. RESULTS Twenty studies comprising 3700 participants met inclusion criteria. Four studies used inactive controls, 14 used active controls, and two used both inactive and active controls and were therefore included in estimating both absolute and relative effect sizes. The absolute effect of S/R interventions (compared with inactive controls such as no treatment) was moderate but non-significant (six studies, d = .537, 95% confidence interval [CI] = -.316, 1.390), possibly due to low power. The relative effect of S/R interventions (compared with other interventions) was statistically significant (16 studies, d = .176, 95% CI = .001, .358). Because only 12-step-oriented interventions were compared with other interventions, this finding does not apply to the relative effect of non-12-step-oriented S/R interventions. Moderator analysis showed that relative effect sizes differ significantly by country. CONCLUSION We found evidence of S/R interventions' efficacy in helping people with substance use problems. More high-quality efficacy studies of non-12-step-oriented S/R interventions for substance use problems are needed.
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Stormshak EA, Caruthers AS, Gau JM, Winter C. The impact of recreational marijuana legalization on rates of use and behavior: A 10-year comparison of two cohorts from high school to young adulthood. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:595-602. [PMID: 31424245 DOI: 10.1037/adb0000508] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although many states' policies and laws concerning marijuana use have recently become more permissive, little is known about the impact of recreational marijuana legalization (RML) on rates of use, risk factors associated with use, and patterns of use over time. We compared samples from 2 longitudinal studies focused on understanding risk and protective factors related to substance use from adolescence to young adulthood (N = 1,468). The samples were collected 10 years apart from the same neighborhoods in an urban area, and the same measures, research design, and data collection procedures were used in each study. As such, the samples are matched on many demographic variables and provide a unique opportunity to compare rates of use and other associated risk factors before and after RML in Oregon. Our results suggest increased marijuana use in a 30-day time frame among Sample 2 during the young adult years, the time at which RML went into effect in Oregon. In Sample 2, young adults had 2.12 times the odds in Sample 1 of using marijuana at age 24, and they were more likely than those in Sample 1 to report use over multiple time points in young adulthood. Overall, our results suggest that young adults after RML are more likely to use marijuana than young adults were before RML 10 years earlier. Implications for prevention and education are discussed in light of rising rates of daily and 30-day use patterns among this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Kumar N, Puljević C, Ferris J, Winstock A, Barratt MJ. Cannabis use patterns at the dawn of US cannabis reform. J Cannabis Res 2019; 1:5. [PMID: 33526080 PMCID: PMC7815050 DOI: 10.1186/s42238-019-0003-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/07/2019] [Indexed: 02/02/2023] Open
Abstract
In the United States (US), three in 10 cannabis users develop cannabis use disorder (CUD). Usage patterns in line with CUD may be associated with socio-economic disadvantage, and other negative effects. Thus, research on CUD is paramount. To provide understanding around CUD, it is necessary to detail granular cannabis usage preferences, as some risk from cannabis use may be mitigated through informed behavioral choices by users. We describe cannabis usage preferences among US Global Drug Survey (GDS) respondents, primarily young men. The cross-sectional web-based GDS (2017) was completed by 8345 US-resident respondents (median age = 23, Interquartile Range 19–32; % male = 75.48) who reported cannabis use. Of those who reported cannabis use in the past year, most (78%) reported consuming their first joint more than an hour after waking, and about half the sample (49%) had their last joint 1–2 h before bed. Cannabis was used for a median of 250 days in the last year (almost daily). Respondents spent a median of four hours a day stoned when cannabis was used. High potency herbal cannabis was the preferred variant by 62% of participants. We suggest that frequent use of cannabis may increase risk of health harms, and highlight the need to mitigate problematic use. With the rapidly developing US cannabis market, possibly problematic usage patterns may indicate potential for CUD especially within young men.
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Affiliation(s)
- Navin Kumar
- Yale Institute for Network Science, Yale University, New Haven, CT, USA. .,Center for Empirical Research on Stratification and Inequality (CERSI), Yale University, New Haven, CT, USA. .,Department of Sociology, Yale University, New Haven, CT, USA.
| | - Cheneal Puljević
- Centre for Health Service Research, University of Queensland, QLD, Brisbane, Australia
| | - Jason Ferris
- Centre for Health Service Research, University of Queensland, QLD, Brisbane, Australia
| | - Adam Winstock
- University College London, London, UK.,Global Drug Survey Ltd, London, UK
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
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Isralowitz R, Reznik A. Cannabis Use in Israel: a Cross Sectional Overview of Multiple Study Groups. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-9911-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Shrier LA, Burke PJ, Kells M, Scherer EA, Sarda V, Jonestrask C, Xuan Z, Harris SK. Pilot randomized trial of MOMENT, a motivational counseling-plus-ecological momentary intervention to reduce marijuana use in youth. Mhealth 2018; 4:29. [PMID: 30148142 PMCID: PMC6087802 DOI: 10.21037/mhealth.2018.07.04] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/16/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Ecological momentary interventions (EMIs) influence behavior in real time, in real life. We evaluated trial feasibility and preliminary efficacy of MOMENT, a counseling-plus-EMI to reduce frequent marijuana use in youth in primary care. METHODS Primary care patients age 15-24 years using marijuana at least 3 times/week were randomized to MOMENT [motivational enhancement therapy (MET)/smartphone-based momentary assessment/responsive motivational messaging] vs. No-messages (MET/momentary assessment) vs. MET-only. In MOMENT, two MET sessions were followed by 2 weeks of momentary assessment of marijuana use and factors related to use, with motivational messaging displayed after report of marijuana triggers, desire, use, and effort to avoid use. We evaluated study feasibility (recruitment, retention, and response rates; feedback survey responses) and explored intervention effects on marijuana desire and use at three months with linear mixed effects modeling. RESULTS Seventy youth [mean (M) =20.7 years, 60% female] were assigned to MOMENT (n=27), No-messages (n=15; assignment suspended to enrich other arms), or MET-only (n=28). Most attrition occurred during baseline, before MET. Of those completing MET session 1, 82% completed their assigned treatment and 79% provided 3-month data. Participants highly rated acceptability; comments reflected changing motivation and behavior. Across arms, participants reported significantly lower marijuana use, desire, and problems at follow-up vs. baseline. Momentary marijuana desire declined more in MOMENT vs. MET-only. Marijuana use following a targeted context or behavior was less likely in MOMENT and No-messages, vs. MET-only. CONCLUSIONS The MOMENT intervention is feasible to deliver, acceptable, and potentially efficacious in reducing marijuana desire and use among adolescent and young adults in primary care. A larger randomized trial to evaluate efficacy is warranted.
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Affiliation(s)
- Lydia A. Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Pamela J. Burke
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Meredith Kells
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Emily A. Scherer
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Cassandra Jonestrask
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, USA
| | - Sion Kim Harris
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Krauss MJ, Rajbhandari B, Sowles SJ, Spitznagel EL, Cavazos-Rehg P. A latent class analysis of poly-marijuana use among young adults. Addict Behav 2017; 75:159-165. [PMID: 28756354 DOI: 10.1016/j.addbeh.2017.07.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/27/2017] [Accepted: 07/13/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION With more states legalizing marijuana use, the marijuana industry has grown, introducing a variety of marijuana products. Our study explores the use of multiple marijuana products (poly-marijuana use) and the characteristics associated with this behavior. METHODS Past-month marijuana users aged 18-34years were surveyed online via an existing online panel (n=2444). Participants answered questions about past-month use of three types of marijuana (plant-based, concentrates, edibles), marijuana use patterns, and driving after use. Latent class analysis was used to identify subgroups of marijuana users. RESULTS Four classes of marijuana users were identified: Light plant users, who used only plant-based products infrequently and were unlikely to drive after use (32%); Heavy plant users, who used mainly plant-based products frequently, multiple times per day, and were likely to drive after use (37%); Plant and concentrates users, who used plant-based products heavily and concentrates at least infrequently, used multiple times per day, and were likely to drive after use (20%); Light plant and edibles users, who used both products infrequently and were unlikely to drive after use (10%). Those in legal marijuana states were more likely to belong to the poly-marijuana groups. DISCUSSION Our findings reflect the increase in popularity of new marijuana products in legal states and suggest that heavy user groups, including concentrates users, are associated with driving after use. As various forms of marijuana use increases, monitoring and surveillance of the use of multiple types of marijuana will be important for determining potential varying impacts on physiological and social consequences.
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Affiliation(s)
- Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
| | - Biva Rajbhandari
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Shaina J Sowles
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Edward L Spitznagel
- Department of Mathematics, Washington University School of Medicine, St. Louis, MO, United States
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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Lee JY, Brook JS, Finch SJ, Brook DW. Trajectories of cannabis use beginning in adolescence associated with symptoms of posttraumatic stress disorder in the mid-thirties. Subst Abus 2017; 39:39-45. [PMID: 28771096 DOI: 10.1080/08897077.2017.1363121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) symptoms are related to a number of adverse consequences such as substance use and general medical conditions. The present longitudinal study seeks to find the longitudinal patterns of cannabis use as precursors of PTSD symptoms. Such information will serve as a guide for intervention programs for PTSD. METHODS Growth mixture modeling was conducted to identify the cannabis use trajectory groups using a community sample of 674 participants (53% African Americans, 47% Hispanics of Puerto Rican decent; 60% females) from the Harlem Longitudinal Development Study. Logistic regression analyses were performed to examine the association between earlier trajectories of cannabis use (ages 14 to 36) and later symptoms of PTSD (at age 36) for the full model including the entire sample (N = 674) as well as the reduced model including only participants who had experienced a traumatic event (n = 205). RESULTS Five trajectory groups of cannabis use were obtained. The chronic use group (full model: adjusted odds ratio [AOR] = 4.68, P < .01; reduced model: AOR = 4.27, P < .05), the late quitting group (full model: AOR = 6.18, P < .01; reduced model: AOR = 6.67, P < .01), and the moderate use group (full model: AOR = 3.97, P < .01; reduced model: AOR = 3.32, P < .05) were all associated with an increased likelihood of having PTSD symptoms at age 36 compared with the no use group. CONCLUSIONS The findings provide information that PTSD symptoms in the mid-30s can possibly be reduced by decreasing membership in the chronic cannabis use trajectory group, the late quitting trajectory group, and the moderate cannabis use trajectory group.
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Affiliation(s)
- Jung Yeon Lee
- a Department of Psychiatry , New York University School of Medicine , New York, New York , USA
| | - Judith S Brook
- a Department of Psychiatry , New York University School of Medicine , New York, New York , USA
| | - Stephen J Finch
- b Department of Applied Mathematics and Statistics , Stony Brook University , Stony Brook, New York , USA
| | - David W Brook
- a Department of Psychiatry , New York University School of Medicine , New York, New York , USA
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Mason MJ, Sabo R, Zaharakis NM. Peer Network Counseling as Brief Treatment for Urban Adolescent Heavy Cannabis Users. J Stud Alcohol Drugs 2017; 78:152-157. [PMID: 27936376 DOI: 10.15288/jsad.2017.78.152] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE A small body of evidence supports targeting adolescents who are heavy users of cannabis with brief interventions, yet more research is needed to confirm the effectiveness of these studies. We conducted a secondary analysis of our Peer Network Counseling (PNC) study (Mason et al., 2015), focusing on 46 adolescents of the sample of 119 who reported heavy cannabis use at baseline. METHOD Urban adolescents (91% African American) presenting for primary health care were randomized to intervention or control conditions and followed for 6 months. We selected cases (n = 46) to analyze based on heavy cannabis use reported at baseline (≥10 times in past month). The ordinal response data (cannabis use) were modeled using a mixed-effects proportional odds model, including fixed effects for treatment, time, and their interaction, and a subject-level random effect. RESULTS In the subsample of adolescents with heavy cannabis use, those assigned to PNC had a 35.9% probability of being abstinent at 6 months, compared with a 13.2% probability in the control condition. Adolescents in the PNC condition had a 16.6% probability of using cannabis 10 or more times per month, compared with a 38.1% probability in the control condition. This differs from results of the full sample (N = 119), where no significant effects on cannabis use were found. CONCLUSIONS PNC increased the probability of abstinence and reduced heavy cannabis use. These results provide initial support for PNC as a model for brief treatment with non-treatment seeking adolescents who are heavy users of cannabis.
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Affiliation(s)
- Michael J Mason
- Department of Psychiatry, Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Roy Sabo
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
| | - Nikola M Zaharakis
- Department of Psychiatry, Commonwealth Institute for Child & Family Studies, Virginia Commonwealth University, Richmond, Virginia
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Peiper NC, Gourdet C, Meinhofer A, Reiman A, Reggente N. Medical Decision-Making Processes and Online Behaviors Among Cannabis Dispensary Staff. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2017; 11:1178221817725515. [PMID: 28855796 PMCID: PMC5570116 DOI: 10.1177/1178221817725515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 07/10/2017] [Indexed: 01/12/2023]
Abstract
Background: Most cannabis patients engage with dispensary staff, like budtenders, for medical advice on cannabis. Yet, little is known about these interactions and how the characteristics of budtenders affect these interactions. This study investigated demographics, workplace characteristics, medical decision-making, and online behaviors among a sample of budtenders. Methods: Between June and September 2016, a cross-sectional Internet survey was administered to budtenders in the San Francisco Bay Area and Greater Los Angeles. A total of 158 budtenders fully responded to the survey. A series of comparisons were conducted to determine differences between trained and untrained budtenders. Results: Among the 158 budtenders, 56% had received formal training to become a budtender. Several demographic differences were found between trained and untrained budtenders. For workplace characteristics, trained budtenders were more likely to report budtender as their primary job (74% vs 53%), practice more than 5 years (34% vs 11%), and receive sales commission (57% vs 16%). Trained budtenders were significantly less likely to perceive medical decision-making as very important (47% vs 68%) and have a patient-centered philosophy (77% vs 89%). Although trained budtenders had significantly lower Internet usage, they were significantly more likely to exchange information with patients through e-mail (58% vs 39%), text message (46% vs 30%), mobile app (33% vs 11%), video call (26% vs 3%), and social media (51% vs 23%). Conclusions: Budtenders who are formally trained exhibit significantly different patterns of interaction with medical cannabis patients. Future studies will use multivariate methods to better determine which factors independently influence interactions and how budtenders operate after the introduction of regulations under the newly passed Proposition 64 that permits recreational cannabis use in California.
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Affiliation(s)
- Nicholas C Peiper
- Behavioral Health and Criminal Justice Research Division, RTI International, Research Triangle Park, NC, USA
| | - Camille Gourdet
- Public Health Research Division, RTI International, Research Triangle Park, NC, USA
| | - Angélica Meinhofer
- Behavioral Health and Criminal Justice Research Division, RTI International, Research Triangle Park, NC, USA
| | - Amanda Reiman
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Nicco Reggente
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Boccio CM, Beaver KM. Examining the influence of adolescent marijuana use on adult intelligence: Further evidence in the causation versus spuriousness debate. Drug Alcohol Depend 2017; 177:199-206. [PMID: 28609722 DOI: 10.1016/j.drugalcdep.2017.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/04/2017] [Accepted: 04/06/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES There is conflicting evidence regarding the association between adolescent marijuana use and adult intelligence, with some studies suggesting adolescent marijuana use can lead to declines in intelligence. The purpose of this study is to shed additional light on the potential link between marijuana use and changes in intelligence. METHODS We employed change scores and ordinary least squares (OLS) analysis to test for associations between marijuana use and changes in intelligence scores from adolescence (ages 12-21) to adulthood (ages 18-26) using data drawn from the National Longitudinal Study of Adolescent to Adult Health. RESULTS The findings revealed that while a binary measure of marijuana use (ever/never) maintains a statistically significant association with changes in intelligence scores, the effect sizes are relatively small (β=0.043-0.051). Additionally, our findings did not reveal a significant association between cumulative marijuana use and changes in intelligence scores. CONCLUSIONS Taken together, the results suggest that while the binary measure of marijuana use (ever/never) has a statistically significant association with changes in intelligence scores, the binary measure accounts for at most a 1-2 point change in intelligence scores.
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Affiliation(s)
- Cashen M Boccio
- College of Criminology and Criminal Justice, Florida State University, 145 Convocation Way, Eppes Hall, Tallahassee, FL 32306-1127, United States.
| | - Kevin M Beaver
- College of Criminology and Criminal Justice, Florida State University, 145 Convocation Way, Eppes Hall, Tallahassee, FL 32306-1127, United States; Center for Social and Humanities Research, King Abdulaziz University, Jeddah, Saudi Arabia.
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41
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The Moderating Role of Spirituality in the Association between Stress and Substance Use among Adolescents: Differences by Gender. J Youth Adolesc 2017; 47:818-828. [PMID: 28493184 DOI: 10.1007/s10964-017-0687-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/02/2017] [Indexed: 10/19/2022]
Abstract
Adolescents are exposed to various stressors that may increase the risk for substance use. Due to the detrimental, and potentially long-lasting, effects related to substance use, it is necessary to explore more optimal coping strategies. This study explored the association between substance use and stress among male and female high school students in relation to spirituality as a moderator. To examine these relationships, the study used cross-sectional data collected from 27,874 high school students (Male = 50.7%, Female = 49.3%) across 58 high schools in Maryland that included an ethnically diverse sample (49% Caucasian, 30% African American) with an average age of 16 years old. Bivariate results showed differences in substance use, stress, and spirituality between male and female students. Higher rates of substance use were generally found among male students compared to female students; rates tended to be higher among female students for stress and spirituality compared to their male counterparts. Multilevel analyses indicated a positive association between stress and substance use among male and female students after adjusting for demographic and school-level factors. Both male and female students who reported turning to spiritual beliefs when experiencing problems were less likely to use substances. However, the interaction between stress and spirituality was significant for males only. These findings suggest that stress may increase the propensity for substance use and that spirituality might be a viable coping mechanism useful for helping high school students adapt to stressful circumstances and situations.
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42
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Cerdá M, Wall M, Feng T, Keyes KM, Sarvet A, Schulenberg J, O’Malley PM, Pacula RL, Galea S, Hasin DS. Association of State Recreational Marijuana Laws With Adolescent Marijuana Use. JAMA Pediatr 2017; 171:142-149. [PMID: 28027345 PMCID: PMC5365078 DOI: 10.1001/jamapediatrics.2016.3624] [Citation(s) in RCA: 260] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Historical shifts are occurring in marijuana policy. The effect of legalizing marijuana for recreational use on rates of adolescent marijuana use is a topic of considerable debate. OBJECTIVE To examine the association between the legalization of recreational marijuana use in Washington and Colorado in 2012 and the subsequent perceived harmfulness and use of marijuana by adolescents. DESIGN, SETTING, AND PARTICIPANTS We used data of 253 902 students in eighth, 10th, and 12th grades from 2010 to 2015 from Monitoring the Future, a national, annual, cross-sectional survey of students in secondary schools in the contiguous United States. Difference-in-difference estimates compared changes in perceived harmfulness of marijuana use and in past-month marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010-2012) with postlegalization (2013-2015) vs the contemporaneous trends in other states that did not legalize recreational marijuana use in this period. MAIN OUTCOMES AND MEASURES Perceived harmfulness of marijuana use (great or moderate risk to health from smoking marijuana occasionally) and marijuana use (past 30 days). RESULTS Of the 253 902 participants, 120 590 of 245 065(49.2%) were male, and the mean (SD) age was 15.6 (1.7) years. In Washington, perceived harmfulness declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015. In contrast, among states that did not legalize recreational marijuana use, perceived harmfulness decreased by 4.9% and 7.2% among eighth and 10th graders, respectively, and marijuana use decreased by 1.3% and 0.9% over the same period. Difference-in-difference estimates comparing Washington vs states that did not legalize recreational drug use indicated that these differences were significant for perceived harmfulness (eighth graders: % [SD], -9.3 [3.5]; P = .01; 10th graders: % [SD], -9.0 [3.8]; P = .02) and marijuana use (eighth graders: % [SD], 5.0 [1.9]; P = .03; 10th graders: % [SD], 3.2 [1.5]; P = .007). No significant differences were found in perceived harmfulness or marijuana use among 12th graders in Washington or for any of the 3 grades in Colorado. CONCLUSIONS AND RELEVANCE Among eighth and 10th graders in Washington, perceived harmfulness of marijuana use decreased and marijuana use increased following legalization of recreational marijuana use. In contrast, Colorado did not exhibit any differential change in perceived harmfulness or past-month adolescent marijuana use following legalization. A cautious interpretation of the findings suggests investment in evidence-based adolescent substance use prevention programs in any additional states that may legalize recreational marijuana use.
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Affiliation(s)
- Magdalena Cerdá
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento
| | - Melanie Wall
- Department of Psychiatry, Columbia University Medical Center, New York, New York3New York State Psychiatric Institute, New York4Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Tianshu Feng
- Department of Psychiatry, Columbia University Medical Center, New York, New York5Research Foundation of Mental Hygiene, New York, New York
| | - Katherine M. Keyes
- Department of Psychiatry, Columbia University Medical Center, New York, New York6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Aaron Sarvet
- Department of Psychiatry, Columbia University Medical Center, New York, New York3New York State Psychiatric Institute, New York6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Schulenberg
- Department of Psychology, University of Michigan, Ann Arbor8Institute for Social Research, University of Michigan, Ann Arbor
| | | | | | - Sandro Galea
- Boston School of Public Health, Boston University, Boston, Massachusetts
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Medical Center, New York, New York3New York State Psychiatric Institute, New York6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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43
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Green KM, Doherty EE, Ensminger ME. Long-term consequences of adolescent cannabis use: Examining intermediary processes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:567-575. [PMID: 27929672 DOI: 10.1080/00952990.2016.1258706] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND In the United States, perceptions of marijuana's acceptability are at an all-time high, risk perceptions among youth are low, and rates are rising among Black youth. Thus, it is imperative to increase the understanding of long-term effects of adolescent marijuana use and ways to mitigate adverse consequences. OBJECTIVES To identify the midlife consequences of heavy adolescent marijuana use and the mechanisms driving effects among a Black, urban population. METHODS This study analyzed the propensity score-matched prospective data from the Woodlawn Study, a community cohort study of urban Black youth followed from ages 6-42. After matching the 165 adolescents who used marijuana heavily to 165 non-heavy/nonusers on background confounders to reduce selection effects (64.5% male), we tested the association of heavy marijuana use by age 16 with social, economic, and physical and psychological health outcomes in midlife and the ability of adult drug trajectories (marijuana, cocaine, and heroin use from ages 17-42) and school dropout to mediate effects. RESULTS Heavy adolescent marijuana use was associated with an increased risk of being poor and of being unmarried in midlife. Marijuana use also predicted lower income and greater anxious mood in midlife. Both adult drug use trajectories and school dropout significantly mediated socioeconomic effects but not marital or anxious mood outcomes. CONCLUSION Heavy adolescent marijuana use seems to set Black, urban youth on a long-term trajectory of disadvantage that persists into midlife. It is critical to interrupt this long-term disadvantage through the prevention of heavy adolescent marijuana use, long-term marijuana and other drug use, and school dropout.
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Affiliation(s)
- Kerry M Green
- a Department of Behavioral and Community Health , University of Maryland, College Park , MD , USA
| | - Elaine E Doherty
- b Department of Criminology and Criminal Justice , University of Missouri Saint Louis , Saint Louis , MO , USA
| | - Margaret E Ensminger
- c Johns Hopkins Bloomberg School of Public Health , Department of Health, Behavior & Society , Baltimore , MD , USA
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44
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Roditis ML, Delucchi K, Chang A, Halpern-Felsher B. Perceptions of social norms and exposure to pro-marijuana messages are associated with adolescent marijuana use. Prev Med 2016; 93:171-176. [PMID: 27746339 PMCID: PMC5268762 DOI: 10.1016/j.ypmed.2016.10.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 09/19/2016] [Accepted: 10/13/2016] [Indexed: 11/27/2022]
Abstract
Despite consistent declines in rates of cigarette use among adolescents in the last five years, rates of marijuana use have remained constant, with marijuana being the most widely used illegal drug among adolescents. More work is needed to understand how social norms, perceived risks and benefits, and social media messaging impact use of marijuana. This study compared perceptions and social norms related to marijuana, blunts and cigarettes. Additionally, we assessed how perceptions related to social norms, risks and benefits, and exposure to pro- versus anti-marijuana messaging is related to use. Participants were 786 adolescents from Southern and Northern California (36.7% male, 63.21% females; mean age=16.1years; SD=1.6). Participants came from diverse ethnic backgrounds, with 207 (26.61%) White, 171 (21.98%) Asian/Pacific Islander, 232 (29.82%) Hispanic, and 168 (21.59%) other. Results indicated that marijuana and blunts were consistently perceived as more socially acceptable and less risky than cigarettes (p<0.01). Participants who reported that their friends used marijuana had a 27% greater odds of using marijuana themselves. Further, seeing messages about the good things or benefits of marijuana use was associated with a 6% greater odds of use [OR 1.06 (CI 1.00, 1.12)]. This study's findings offer a number of important public health implications, particularly as states move towards legalization of marijuana for recreational use. As this occurs, states need to take adolescents' perceptions of risks, benefits, social norms, and peer influences into account as they implement strategies to reduce youth use of marijuana and blunts.
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Affiliation(s)
- Maria L Roditis
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA
| | - Kevin Delucchi
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - Audrey Chang
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA.
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45
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Greenan G, Ahmad SB, Anders MG, Leeser A, Bromberg JS, Niederhaus SV. Recreational marijuana use is not associated with worse outcomes after renal transplantation. Clin Transplant 2016; 30:1340-1346. [DOI: 10.1111/ctr.12828] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Garrett Greenan
- Department of Surgery; University of Maryland School of Medicine; Baltimore MD USA
| | - Sarwat B. Ahmad
- Department of Surgery; University of Maryland School of Medicine; Baltimore MD USA
| | - Megan G. Anders
- Department of Anesthesiology; University of Maryland School of Medicine; Baltimore MD USA
| | - Alexia Leeser
- Department of Surgery; University of Maryland School of Medicine; Baltimore MD USA
| | - Jonathan S. Bromberg
- Department of Surgery; University of Maryland School of Medicine; Baltimore MD USA
| | - Silke V. Niederhaus
- Department of Surgery; University of Maryland School of Medicine; Baltimore MD USA
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46
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Lee JY, Brook JS, Finch SJ, Brook DW. Pathways from victimization to substance use: Post traumatic stress disorder as a mediator. Psychiatry Res 2016; 237:153-8. [PMID: 26832837 PMCID: PMC4769948 DOI: 10.1016/j.psychres.2016.01.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/11/2015] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
Abstract
Traumatic events are linked with an array of adverse consequences such as substance use. Only a few individuals exposed to traumatic events, however, suffer from post traumatic stress disorder (PTSD) or substance use. The present longitudinal study examined the inter-relationship among victimization, PTSD, and substance use. 674 participants (53% African Americans, 47% Puerto Ricans) were surveyed over five time waves at mean ages 14, 19, 24, 29, and 36. Of the 674, 60% were females. We used Mplus to perform structural equation modeling. Victimization at ages 19, 24, and 29 was directly associated with substance use at age 36 and was also related to PTSD at age 36. PTSD, in turn, was related to substance use at age 36. This study indicates the importance of intervention for those who have been victimized with a focus on PTSD treatment. From a public health perspective, health providers should consider treatment and prevention programs for helping individuals cope with some of the consequences of victimization. This might ultimately reduce substance use.
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Affiliation(s)
- Jung Yeon Lee
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Judith S Brook
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
| | - Stephen J Finch
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - David W Brook
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
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47
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Cerdá M, Moffitt TE, Meier MH, Harrington H, Houts R, Ramrakha S, Hogan S, Poulton R, Caspi A. Persistent cannabis dependence and alcohol dependence represent risks for midlife economic and social problems: A longitudinal cohort study. Clin Psychol Sci 2016; 4:1028-1046. [PMID: 28008372 DOI: 10.1177/2167702616630958] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18-38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (n=1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence.
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Affiliation(s)
- Magdalena Cerdá
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY; Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom
| | | | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Renate Houts
- Department of Psychology and Neuroscience, Duke University, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sean Hogan
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom
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48
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Why young people's substance use matters for global health. Lancet Psychiatry 2016; 3:265-79. [PMID: 26905482 DOI: 10.1016/s2215-0366(16)00013-4] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 01/16/2023]
Abstract
During puberty, when young people are completing their education, transitioning into employment, and forming longer-term intimate relationships, a shift in emotional regulation and an increase in risky behaviour, including substance use, is seen. This Series paper considers the potential effects of alcohol, tobacco, and illicit drug use during this period on: social, psychological, and health outcomes in adolescence and young adulthood; role transitions, and later health and social outcomes of regular substance use initiated in adolescence; and the offspring of young people who use substances. We sourced consistent support for causal relations between substance use and outcomes and evidence of biological plausibility from different but complementary research designs. Many adverse health and social outcomes have been associated with different types of substance use. The major challenge lies in deciding which are causal. Furthermore, qualitatively different harms are associated with different substances, differences in life stage when these harms occur, and the quality of evidence for different substances and health outcomes varies substantially. The preponderance of evidence comes from a few high-income countries, thus whether the same social and health outcomes would occur in other countries and cultures is unclear. Nonetheless, the number of harms that are causally related to substance use in young people warrant high-quality research design interventions to prevent or ameliorate these harms.
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49
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Maslowsky J, Schulenberg J, Chiodo LM, Hannigan JH, Greenwald MK, Janisse J, Sokol RJ, Delaney-Black V. Parental Support, Mental Health, and Alcohol and Marijuana Use in National and High-Risk African-American Adolescent Samples. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 9:11-20. [PMID: 26843811 PMCID: PMC4736548 DOI: 10.4137/sart.s22441] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/21/2015] [Accepted: 09/23/2015] [Indexed: 11/05/2022]
Abstract
African-American adolescents experience disproportionate rates of negative consequences of substance use despite using substances at average or below-average rates. Due to underrepresentation of African-American adolescents in etiological literature, risk and protective processes associated with their substance use require further study. This study examines the role of parental support in adolescents' conduct problems (CPs), depressive symptoms (DSs), and alcohol and marijuana use in a national sample and a high-risk sample of African-American adolescents. In both samples, parental support was inversely related to adolescent CPs, DSs, and alcohol and marijuana use. CPs, but not DSs, partially mediated the relation of parental support to substance use. Results were consistent across the national and high-risk samples, suggesting that the protective effect of parental support applies to African-American adolescents from a range of demographic backgrounds.
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Affiliation(s)
- Julie Maslowsky
- Department of Kinesiology and Health Education, Population Research Center, University of Texas, Austin, TX, USA
| | - John Schulenberg
- Department of Psychology, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Lisa M Chiodo
- College of Nursing, University of Massachusetts, Amherst, MA, USA
| | - John H Hannigan
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.; Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA
| | - Mark K Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.; Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - James Janisse
- Department of Family Medicine, Wayne State University, Detroit, MI, USA
| | - Robert J Sokol
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA
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50
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Arria AM, Caldeira KM, Bugbee BA, Vincent KB, O’Grady KE. Marijuana use trajectories during college predict health outcomes nine years post-matriculation. Drug Alcohol Depend 2016; 159:158-65. [PMID: 26778758 PMCID: PMC4724514 DOI: 10.1016/j.drugalcdep.2015.12.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/25/2015] [Accepted: 12/11/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Several studies have linked marijuana use with a variety of health outcomes among young adults. Information about marijuana's long-term health effects is critically needed. METHODS Data are from a ten-year study of 1253 young adults originally recruited as first-year college students and assessed annually thereafter. Six trajectories of marijuana use during college (Non-Use, Low-Stable, Early-Decline, College-Peak, Late-Increase, Chronic) were previously derived using latent variable growth mixture modeling. Nine health outcomes assessed in Year 10 (modal age 27) were regressed on a group membership variable for the six group trajectories, holding constant demographics, baseline health status, and alcohol and tobacco trajectory group membership. RESULTS Marijuana trajectory groups differed significantly on seven of the nine outcomes (functional impairment due to injury, illness, or emotional problems; psychological distress; subjective well-being; and mental and physical health service utilization; all ps<.001), but not on general health rating or body mass index. Non-users fared better than the Late-Increase and Chronic groups on most physical and mental health outcomes. The declining groups (Early-Decline, College-Peak) fared better than the Chronic group on mental health outcomes. The Late-Increase group fared significantly worse than the stable groups (Non-Use, Low-Stable, Chronic) on both physical and mental health outcomes. CONCLUSIONS Even occasional or time-limited marijuana use might have adverse effects on physical and mental health, perhaps enduring after several years of moderation or abstinence. Reducing marijuana use frequency might mitigate such effects. Individuals who escalate their marijuana use in their early twenties might be at especially high risk for adverse outcomes.
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Affiliation(s)
- Amelia M. Arria
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. , ,
| | - Kimberly M. Caldeira
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. , ,
| | - Brittany A. Bugbee
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. , ,
| | - Kathryn B. Vincent
- Center on Young Adult Health and Development, University of Maryland School of Public Health, Department of Behavioral and Community Health, 2387 School of Public Health Building, College Park, MD 20742, USA. , ,
| | - Kevin E. O’Grady
- Department of Psychology, University of Maryland, 3109 Biology-Psychology Building, College Park, MD 20742, USA.
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