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Baral A, Hanna F, Chimoriya R, Rana K. Cannabis Use and Its Impact on Mental Health in Youth in Australia and the United States: A Scoping Review. EPIDEMIOLOGIA 2024; 5:106-121. [PMID: 38534804 DOI: 10.3390/epidemiologia5010007] [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: 01/31/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Cannabis is a widely used substance among the youth population, with an estimated 2.8% currently smoking cannabis. Its popularity is growing due to the perception of its harmless nature and lack of dependence. However, this increase in use has been linked to mental health issues, especially since its partial decriminalisation in some part of the United States and Australia. The objective of this scoping review was to investigate the mental health impact of cannabis use among young people in Australia and the United States. A scoping review was conducted according to the Joanna Briggs Institute (JBI) protocol, and articles were searched from ProQuest Central and EBSCO Host (MEDLINE and CINAHL databases). A total of 24 articles were analysed, including systematic reviews, meta-analyses, and cohort, longitudinal, and cross-sectional studies. The findings indicate that cannabis use is associated with depression, psychosis, suicide, cannabis use disorder, dependence, decline in cognitive function, and the development of externalising behaviour, particularly attention deficit hyperactivity disorder. However, the relationship between cannabis use and anxiety is equivocal. Mental health issues were more prevalent with increased frequency, duration, intensity, and type of use. Female, minority, LGBTQI, African American, Aboriginal, and Torres Strait Islander youth and the age of onset of cannabis use were significant factors for the development of mental health problems. The increasing prevalence of cannabis use among high school and college students suggests the need for intervention by teachers, parents, and community health professionals to make them aware of its potential negative mental health outcomes. Moreover, policy-level interventions by the government are required to discourage young people from using cannabis.
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Affiliation(s)
- Aayush Baral
- Public Health Program, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
| | - Fahad Hanna
- Public Health Program, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia
| | - Ritesh Chimoriya
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Kritika Rana
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
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Single A, Alcolado G, Keough MT, Mota N. Cannabis use and social anxiety disorder in emerging adulthood: Results from a nationally representative sample. J Anxiety Disord 2024; 101:102808. [PMID: 38061325 DOI: 10.1016/j.janxdis.2023.102808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 01/17/2024]
Abstract
Cannabis use and social anxiety disorder (SAD) are prevalent during emerging adulthood. Previous work has demonstrated that SAD is related to cannabis use in adults; however, less is known about what correlates relate to this association in emerging adults. A subsample of individuals ages 18-25 years old from the NESARC-III (N = 5194) was used to (a) evaluate the association between cannabis use and SAD and (b) examine what correlates may be associated with cannabis use and SAD in emerging adulthood. Weighted cross-tabulations assessed sociodemographics and lifetime psychiatric disorder prevalence estimates among the emerging adult sample. Multinomial logistic regressions examined associations between sociodemographics and psychiatric disorders and four groups (i.e., no cannabis use or SAD; cannabis use only; SAD only; cannabis use + SAD). The prevalence of co-occurring cannabis use and SAD was 1.10%. Being White, a part-time student, or not a student were associated with increased odds of having co-occurring cannabis use + SAD (OR range: 2.26-3.09). Significant associations also emerged between major depressive disorder, bipolar I disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder and co-occurring cannabis use + SAD (AOR range: 3.03-19.05). Results of this study may have implications for better identifying and screening emerging adults who are at risk of co-occurring cannabis use and SAD.
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Affiliation(s)
- Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Gillian Alcolado
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St., North York, Ontario M3J 1P3, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada
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3
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Davis RE, Becnel J, Olatunde OE, Stokowski SE, Terrell A, Brown S, Bouza B, Nahar VK. Salient Beliefs Associated with Unsanctioned Adult Cannabis Use in an Evolving Socio-Political Environment. Subst Use Misuse 2023; 59:716-726. [PMID: 38115550 DOI: 10.1080/10826084.2023.2294980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Background: The changing cannabis legal climate in the United States has been associated with increased prevalence of use, more favorable general attitudes, and cultural norms toward its use among young adults. The purpose of this study was to conceptualize salient beliefs governing illicit cannabis use within a state where medical use is legal and adult use remains illegal. Methods: Following an initial qualitative pilot, a prospective study (baseline and a 30-day follow-up) that utilized an electronic survey design was conducted. Students at a large US university (N = 514) completed a baseline assessment of cannabis use and Theory of Planned Behavior (TPB) constructs, and 169 completed the follow-up assessing actual behavior. Results: Roughly 60% reported illicit cannabis use. Attitude and subjective norms accounted for 57% of the variation in intention for cannabis use in the next 30 days, while intention and perceived behavioral control (PBC) explained 51% of the variation in prospective use. The majority of salient beliefs identified exhibited moderate to strong correlations with intention and behavior among the larger sample. Close friends and partners were identified as important referents, outcome expectations of relaxation, improved social functioning, and more enjoyment, as well as environmental factors, such as proximity to use, safe utilization location, and continued illegality of adult use exhibited strong associations to intention and behavior. Conclusions: The practical utility of the salient belief measures identified herein presents a useful foundation for interventions aimed at reducing illicit cannabis utilization among young adults.
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Affiliation(s)
- Robert E Davis
- Substance, Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | - Jennifer Becnel
- School of Human Environmental Sciences, University of Arkansas, Fayetteville, Arkansas, USA
| | - Oluwatoyin E Olatunde
- Substance, Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | - Sarah E Stokowski
- Department of Educational and Organizational Leadership Development, Clemson University, Clemson, South Carolina, USA
| | - Amanda Terrell
- School of Human Environmental Sciences, University of Arkansas, Fayetteville, Arkansas, USA
| | - Sarah Brown
- School of Human Environmental Sciences, University of Arkansas, Fayetteville, Arkansas, USA
| | - Brooke Bouza
- Caudex Medical Communication, An IGP Health Company, New York, New York, USA
| | - Vinayak K Nahar
- Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Coelho J, Montagni I, Micoulaud-Franchi JA, Plancoulaine S, Tzourio C. Study of the association between cannabis use and sleep disturbances in a large sample of University students. Psychiatry Res 2023; 322:115096. [PMID: 36842936 DOI: 10.1016/j.psychres.2023.115096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Sleep complaints and cannabis use are common among University students and are related to detrimental effects on health. The aim of this study was to explore their association. This cross-sectional study based on the i-Share e-cohort included French students between 18 and 30 years old (n = 14,787). Frequency of cannabis use was categorized into daily, weekly, monthly, and never/rarely use. Sleep complaints were defined using four items (i.e., insomnia, sleepiness, poor sleep quality, and sleep deprivation). In the whole sample (mean age: 20.4 years, 75.5% of females), 22.7% had insomnia, 18.3% had sleepiness, 22.4% had poor sleep quality, 52.5% had sleep deprivation, and 5.8% used cannabis weekly or daily. After adjustment, the likelihood of insomnia was significantly higher by 45% in cannabis users compared to non-users. The estimates steadily increased with frequency of use, reaching a 2.0-fold higher likelihood of insomnia in daily users compared to never/rarely users. Results were similar for the other sleep complaints. These findings provide support for an association between cannabis use and sleep complaints, particularly insomnia, among University students. Though direction and causality cannot be established in this setting, these results suggest warning students and health professionals about the association between cannabis use and sleep complaints.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France.
| | - Ilaria Montagni
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France
| | - Jean-Arthur Micoulaud-Franchi
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, Place Amélie Raba Léon, 33000, Bordeaux, Nouvelle-Aquitaine, France
| | - Sabine Plancoulaine
- Université Paris Cité, Inserm, INRAE, Centre de Recherche en Epidémiologie et StatistiquesS (CRESS), F-75004 Paris, France
| | - Christophe Tzourio
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France
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Grigsby TJ, Lopez A, Albers L, Rogers CJ, Forster M. A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences. Subst Abuse 2023; 17:11782218231166622. [PMID: 37056398 PMCID: PMC10087658 DOI: 10.1177/11782218231166622] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/13/2023] [Indexed: 04/15/2023]
Abstract
Objective Numerous reviews have examined risk and protective factors for alcohol-related negative consequences, but no equivalent review of risk and protective factors exists for cannabis-related negative consequences (CRNCs)-a gap filled by the present study. This scoping review examined survey-based research of risk and protective factors for CRNCs such as neglecting responsibilities, blacking out, or needing more cannabis. Methods Three databases (PubMed, PsycINFO, and Google Scholar) were searched for peer-reviewed manuscripts published between January 1, 1990, and December 31, 2021. A qualitative synthesis was performed using the matrix method and the results were organized using the socioecological model as a framework. Results Eighty-three studies were included in the review. There was considerable variation in measures and operationalizations of CRNCs across studies. Risk factors were identified in the intrapersonal (depression, social anxiety, PTSD, impulsivity, sensation seeking, motives, expectancies), interpersonal/community (trauma, victimization, family and peer substance use, social norms), and social/policy (education, employment, community attachment, legalization, availability of substances) domains of influence. Protective behavioral strategies were a robust protective factor for CRNCs. Males consistently reported more CRNCs than females, but there were no differences observed across race. Conclusions Future research should identify person- and product-specific patterns of CRNCs to refine theoretical models of cannabis misuse and addiction. Public health interventions to reduce the risk of negative consequences from cannabis should consider utilizing multilevel interventions to attenuate the cumulative risk from a combination of psychological, contextual, and social influences.
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Affiliation(s)
- Timothy J. Grigsby
- Department of Social and Behavioral
Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
- Timothy J. Grigsby, Department of Social
and Behavioral Health, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy,
Las Vegas, NV 89154, USA.
| | - Andrea Lopez
- Department of Social and Behavioral
Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Larisa Albers
- Department of Population and Public
Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Christopher J. Rogers
- Department of Health Sciences,
California State University, Northridge, Northridge, CA, USA
| | - Myriam Forster
- Department of Health Sciences,
California State University, Northridge, Northridge, CA, USA
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Single A, Bilevicius E, Ho V, Theule J, Buckner JD, Mota N, Keough MT. Cannabis use and social anxiety in young adulthood: A meta-analysis. Addict Behav 2022; 129:107275. [PMID: 35184002 DOI: 10.1016/j.addbeh.2022.107275] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 01/16/2023]
Abstract
Young adulthood (ages 18 to 30 years old), a developmental age of exploration, is marked by new experiences and transitions. Cannabis use frequency is highest in young adulthood compared to other age periods. Social anxiety (characterized by fear, shyness, and inhibition in social situations where scrutiny and judgment is possible) is also prevalent during young adulthood. Social anxiety may be a complex predictor of cannabis use frequency and problems (e.g., any negative physical, emotional, or social outcome from use). Social anxiety may act as a risk factor as individuals may use cannabis frequently to manage their fear of negative evaluation and associated unpleasant affective states. The purpose of this meta-analysis was to quantify the magnitude of the associations between social anxiety and two cannabis variables (frequency of use and problems) in young adulthood. A comprehensive literature review was conducted to identify studies that included measures of social anxiety and at least one cannabis-related variable of interest among young adults. Eighteen studies were included in the meta-analysis. Results revealed a small, statistically significant positive association between social anxiety and cannabis problems (r = 0.197, k = 16, p = <0.001), and a nonsignificant association between social anxiety and cannabis use frequency (r = 0.002, k = 16, p = 0.929). The association between social anxiety and cannabis use frequency was moderated by the mean age such that samples with older mean ages exhibited a stronger correlation. Additionally, the association between social anxiety and cannabis problems was moderated by clinically significant levels of social anxiety, such that samples with fewer participants who met clinical levels of social anxiety exhibit a stronger correlation. This meta-analysis supports the idea that there is a complex relation between social anxiety and cannabis outcomes during young adulthood.
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Affiliation(s)
- Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Victoria Ho
- University of Manitoba Libraries, University of Manitoba, 25 Chancellors Circle, Winnipeg, Manitoba R3T 5V5, Canada.
| | - Jennifer Theule
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge Louisiana 70803, United States.
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada.
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, Ontario M3J 1P3, Canada.
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Stiles-Shields C, Archer J, Zhang J, Burnside A, Draxler J, Potthoff LM, Reyes KM, Summersett Williams F, Westrick J, Karnik NS. A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults. Child Psychiatry Hum Dev 2021; 54:639-658. [PMID: 34724134 PMCID: PMC9310430 DOI: 10.1007/s10578-021-01280-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/22/2022]
Abstract
Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.
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Affiliation(s)
- Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Joseph Archer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA,School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Jim Zhang
- Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Amanda Burnside
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Janel Draxler
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Karen M. Reyes
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Jennifer Westrick
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
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Tetteh J, Ekem-Ferguson G, Quarshie ENB, Swaray SM, Ayanore MA, Seneadza NAH, Asante KO, Yawson AE. Marijuana use and suicidal behaviours among school-going adolescents in Africa: assessments of prevalence and risk factors from the Global School-Based Student Health Survey. Gen Psychiatr 2021; 34:e100558. [PMID: 34557644 PMCID: PMC8395261 DOI: 10.1136/gpsych-2021-100558] [Citation(s) in RCA: 6] [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: 04/22/2021] [Accepted: 07/13/2021] [Indexed: 11/05/2022] Open
Abstract
Background Marijuana use among adolescents, including high school students, has been consistently reported to be associated with a high incidence of suicidal behaviours. Little empirical research has been conducted on the propensity impact of marijuana use on suicidal behaviours in Africa. Aims To assess factors associated with marijuana use and further quantify marijuana use as an associated factor of suicidal behaviours, including repeated attempted suicide, suicidal ideation and suicide planning, among high school students in Africa. Methods A cross-sectional study was conducted among 32 802 school-going adolescents using the Global School-Based Student Health Survey data from 10 African countries grouped into West Africa, North Africa, South-East Africa, South Africa and East Africa subregions. Marijuana use and repeated attempted suicide were the main outcome variables. We employed double selection least absolute shrinkage and selection operator poisson regression model to assess risk factors associated with marijuana use and dominance analysis to establish ranked important and common risk factors. Inverse probability weighting poisson regression adjustment was applied to assess impact. Results The prevalence of marijuana use and repeated attempted suicide were 3.7% (95% CI: 3.1 to 4.3) and 6.6% (95% CI: 5.9 to 7.4), respectively. The most important risk factor for marijuana use generally across the countries and specifically in three subregions was alcohol consumption, which constituted approximately 40% of the impact. The average treatment effect on the treated (ATT) indicated that marijuana use significantly increased the risk of suicidal ideation, suicide planning and repeated attempted suicide by 12% (ATT=0.12 (95% CI: 0.02 to 0.22)), 18% (ATT=0.18 (95% CI: 0.13 to 0.22)) and 31% (ATT=0.31 (95% CI: 0.20 to 0.41)), respectively. Conclusions Marijuana use was significantly associated with suicidal behaviours (suicidal ideation, planning and repeated attempted suicide) among the students. To achieve Sustainable Development Goal 3.5 (to strengthen prevention and treatment of substance abuse), school-based psychosocial interventions should be streamlined to adequately assess and manage marijuana use. Targeting the most dominant risk factors in this population could translate into the reduction of suicidal behaviours in countries within Africa.
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Affiliation(s)
- John Tetteh
- Community Health, University of Ghana Medical School, Accra, Ghana
| | | | - Emmanuel Nii-Boye Quarshie
- Department of Psychology, School of Social Sciences, University of Ghana College of Humanities, Accra, Ghana
| | | | - Martin Amogre Ayanore
- Department of Family and Community Health, University of Health and Allied Sciences School of Public Health, Hohoe, Ghana
| | | | - Kwaku Oppong Asante
- Department of Psychology, School of Social Sciences, University of Ghana College of Humanities, Accra, Ghana
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Bartholomay EM, Stone BM, Lyons GA. Depression and social anxiety symptoms explain substance use problems beyond amount/frequency of substance use. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01984-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Park SY, Yun GW, Constantino N, Ryu SY. Gender differences in the risk and protective factors of marijuana use among U.S. College students. J Health Psychol 2021; 27:1710-1722. [PMID: 33832343 DOI: 10.1177/13591053211002248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Gender differences in the risk and protective factors of marijuana use among college students were explored by analyzing online survey responses from 464 undergraduates. Women perceived higher risk and used marijuana less than men, with no gender difference in peer disapproval. In addition, women had higher objective knowledge regarding the health effects of marijuana, although they exhibited lower confidence in their knowledge. In subsequent regression analyses, health knowledge, confidence in knowledge, perceived risk, and peer disapproval predicted women's marijuana use, whereas only confidence in knowledge and perceived risk predicted men's use. These findings can help devise effective intervention strategies.
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Rinehart L, Spencer S. Which came first: Cannabis use or deficits in impulse control? Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110066. [PMID: 32795592 PMCID: PMC7750254 DOI: 10.1016/j.pnpbp.2020.110066] [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: 04/30/2020] [Revised: 07/12/2020] [Accepted: 08/05/2020] [Indexed: 12/16/2022]
Abstract
Impulse control deficits are often found to co-occur with substance use disorders (SUDs). On the one hand, it is well known that chronic intake of drugs of abuse remodels the brain with significant consequences for a range of cognitive behaviors. On the other hand, individual variation in impulse control may contribute to differences in susceptibility to SUDs. Both of these relationships have been described, thus leading to a "chicken or the egg" debate which remains to be fully resolved. Does impulsivity precede drug use or does it manifest as a function of problematic drug usage? The link between impulsivity and SUDs has been most strongly established for cocaine and alcohol use disorders using both preclinical models and clinical data. Much less is known about the potential link between impulsivity and cannabis use disorder (CUD) or the directionality of this relationship. The initiation of cannabis use occurs most often during adolescence prior to the brain's maturation, which is recognized as a critical period of development. The long-term effects of chronic cannabis use on the brain and behavior have started to be explored. In this review we will summarize these observations, especially as they pertain to the relationship between impulsivity and CUD, from both a psychological and biological perspective. We will discuss impulsivity as a multi-dimensional construct and attempt to reconcile the results obtained across modalities. Finally, we will discuss possible avenues for future research with emerging longitudinal data.
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Affiliation(s)
- Linda Rinehart
- University of Minnesota, Department of Psychiatry and Behavioral Sciences
| | - Sade Spencer
- University of Minnesota, Department of Pharmacology, Minneapolis, MN, USA.
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12
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Interplay between personality and antisocial peer affiliation as prospective predictors of marijuana use and academic achievement in the transition into and out of college. Addict Behav 2021; 114:106736. [PMID: 33279342 DOI: 10.1016/j.addbeh.2020.106736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
Marijuana use has increased in recent cohorts and is associated with several negative outcomes, including poorer academic achievement. Less is known about how personality and peer factors in the first two years of college work together to predict problematic marijuana use and potentially co-occurring academic problems three years later. The longitudinal College Experiences Study (N = 209) was used to address this (N = 209, ~90% white, ~40% male); this study collected data from students in their first year of college, as well as ~1 year later (retention = 85%), and again ~4 years after the initial data collection (retention = 80%). Longitudinal data were analyzed via the traditional cross-lagged panel (CLPM) and the random-intercept CLPM approach. Results were consistent in that there was strong stability in problematic marijuana use, constraint, and antisocial peer affiliation across time, which were predominately influenced by stable, trait-like influences. These factors were also highly correlated but there was less evidence that one predicted the other over time. Nonetheless, greater constraint at Wave 1 was associated with significantly greater cumulative GPA in the transition out of college (βs = 0.43-0.44). Results support the importance of early prevention and intervention of problematic marijuana use, as well as the possibility of using personality-targeted approaches in the first year of college to promote growth in behaviors related to constraint (e.g., staying organized, risk avoidant) in an effort to improve academic success and correlated substance use outcomes by the transition out of college.
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13
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Drazdowski TK, Kliewer WL, Marzell M. College students' using marijuana to sleep relates to frequency, problematic use, and sleep problems. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:103-112. [PMID: 31498749 PMCID: PMC7061072 DOI: 10.1080/07448481.2019.1656634] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/01/2019] [Accepted: 08/11/2019] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Given the rising rates of insufficient sleep and the popularity of marijuana, we investigated using marijuana as a sleep aid, marijuana use frequency, problematic marijuana use, and sleep problems. Participants: Participants included a convenience sample of college students who endorsed using marijuana in the past year from May to December 2013 (N = 354; 68% female, 57% White). Methods: Path analyses investigated if using marijuana to sleep predicted: (1) marijuana use outcomes and (2) sleep problems; and if sleep problems predicted marijuana use outcomes. Results: Using marijuana to sleep was related to increased use and problematic use, as well as worse sleep efficiency. Daytime dysfunction related to sleepiness was associated with elevated levels of marijuana use and problematic use. Similar associations were found across sex and race. Conclusions: College students should be informed of the potential misconceptions between marijuana and improved sleep and provided with evidence-based alternatives to improve their sleep.
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Affiliation(s)
- Tess K. Drazdowski
- UCLA Integrated Substance Abuse Programs, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA 90025
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401
| | - Wendy L. Kliewer
- Virginia Commonwealth University, Department of Psychology, PO Box 842018, Richmond VA 23284
| | - Miesha Marzell
- Binghamton University, Department of Social Work, PO Box 6000, Binghamton, NY 13902-6000
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14
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Patterson A, Vu M, Haardörfer R, Windle M, Berg CJ. Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students. JOURNAL OF DRUG ISSUES 2020; 50:359-377. [PMID: 34290453 PMCID: PMC8291292 DOI: 10.1177/0022042620917101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined (a) differences between alcohol-only users and alcohol-marijuana co-users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Correlates of co-use (n = 345; vs. alcohol-only use, n = 1,525) included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and alcohol use motives (p's < .05). Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives (p's < .001); greater Coping and Self-enhancement alcohol use motives (p's < .01) predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives (p's < .05); greater Expansion marijuana use motives (p = .005) predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives.
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15
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Abstract
PURPOSE OF REVIEW The goal was to review recent (1/2015-2/2020) evidence of impulsivity as a feature of substance use disorders or use of substances (alcohol, cannabis, nicotine, opioids, stimulants) in males compared to females in terms of: a) impulsivity in substance-using groups (or substance-using compared to control groups), and b) relationship between impulsivity and substance use behavior, clinical severity, or treatment outcomes. RECENT FINDINGS Of 361 papers identified by the searches, 69 met inclusion criteria, and 39 were highlighted for considering sex/gender in relation to impulsivity in substance-using populations. Taken together, findings supported higher impulsivity in males and females who use substances, relative to controls; and higher impulsivity was linked with more substance use/severity in both sex/genders. There were mixed findings regarding male versus female differences in impulsivity among individuals who use substances, or in the magnitude of the relationship between impulsivity and substance use severity. SUMMARY The current body of evidence does not point to a consistent sex/gender difference in the role of impulsivity within and across substance use disorders. Impulsivity is a clinically-relevant construct for male and female individuals who use substances, across a range of substances.
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Pellegrino AJ, Duck KD, Kriescher DPJ, Shrake ME, Phillips MM, Lalonde TL, Phillips KT. Characterizing symptoms of cannabis use disorder in a sample of college students. JOURNAL OF DRUG ISSUES 2020; 50:524-537. [PMID: 34305171 DOI: 10.1177/0022042620936655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Since legalization of marijuana in several U.S. states in 2012, there has been concern about increases in the development of cannabis use disorder (CUD). The current study examined rates of CUD in Colorado college students who reported regular marijuana use and assessed a range of factors associated with CUD symptoms, including coping motives, concentrate/dab use, mental health concerns (depression, anxiety), age of regular marijuana use, and alcohol use. College students were recruited from a mid-sized university and completed a baseline assessment that included a marijuana urine screen. Participants reported a median of five CUD symptoms and 90% met criteria for CUD. After adjusting for covariates, age of regular marijuana use was negatively associated with number of CUD symptoms, while average daily alcohol drinks was positively associated with number of symptoms. Prevention and intervention efforts at the university level should be increased to reduce negative outcomes associated with problem marijuana use.
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Affiliation(s)
- Alexa J Pellegrino
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Kerry D Duck
- School of Education, University of Delaware, 113 Willard Hall Education Building, Newark, DE 19716
| | - Dylan P J Kriescher
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Mackenzie E Shrake
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Michael M Phillips
- School of Psychological Sciences, Campus Box 94, University of Northern Colorado, Greeley, CO 80639
| | - Trent L Lalonde
- Department of Applied Statistics and Research Methods, Campus Box 124, University of Northern Colorado, Greeley, CO 80639
| | - Kristina T Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente, 501 Alakawa St., Suite 201, Honolulu, HI 96817
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17
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Goodness TM, Palfai TP. Electronic screening and brief intervention to reduce cannabis use and consequences among graduate students presenting to a student health center: A pilot study. Addict Behav 2020; 106:106362. [PMID: 32120198 DOI: 10.1016/j.addbeh.2020.106362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 10/25/2022]
Abstract
This pilot study sought to test the feasibility of screening and delivering a web-based intervention to reduce marijuana use and consequences among graduate student presenting to a Student Health Center (SHC). Graduate students completed a 9-item electronic health screening instrument during their visit to the SHC. Those who reported monthly or greater marijuana use were eligible for participation in the pilot trial. Forty-nine students completed baseline assessments and were randomly assigned to an electronic screening and brief intervention (eSBI) for marijuana (eCHECKUPTOGO-marijuana; [BI]) or a control condition (CTL) that consisted of minimal general health information. Participants completed measures of marijuana use frequency and negative consequences at baseline, 3- and 6-months. Latent growth modeling was used to provide effect size estimates for the influence of the intervention on 6-month outcomes. Effect size estimates showed a small-to-medium effect of BI on marijuana use frequency at 6-months; there was no evidence of the BI on consequences. Results suggest that BI may hold promise as a method to reduce marijuana use among graduate students who present to primary care settings. Future research should test the efficacy of this approach in a full-scale randomized controlled trial.
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18
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Bravo AJ, Sotelo M, Pilatti A, Mezquita L, Read JP. Depressive symptoms, ruminative thinking, marijuana use motives, and marijuana outcomes: A multiple mediation model among college students in five countries. Drug Alcohol Depend 2019; 204:107558. [PMID: 31586807 PMCID: PMC6878192 DOI: 10.1016/j.drugalcdep.2019.107558] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/19/2019] [Accepted: 07/14/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have evidenced that rumination and drinking motives may mediate the association between depressive symptoms and alcohol outcomes. The present study cross-culturally examined whether a similar mediation model may extend to marijuana. Specifically, we tested distinct rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and marijuana use motives (social, coping, expansion, conformity, enhancement) as double-mediators of the paths from depressive symptoms to marijuana outcomes (use and consequences). METHOD A comprehensive mediation path model was tested in a cross-sectional sample of college student marijuana users (n = 1175) from five countries (U.S., Argentina, Uruguay, Spain, Netherlands). Multi-group models were tested to determine if the proposed mediational model was invariant across sex and different cultures/countries. RESULTS Depressive symptoms and marijuana outcomes were indirectly associated through ruminative thinking and marijuana motives. Specifically, higher depressive symptoms were associated with higher problem-focused thoughts; which in turn were associated with: a) higher endorsement of coping motives which in turn was associated with higher marijuana use and related consequences and b) lower endorsement of enhancement motives which in turn was associated with lower marijuana use and related consequences. The multi-group analyses showed that the model was invariant across sex and the five countries. CONCLUSIONS The present research supports the existence of a universal (i.e., cross-national invariant) negative affect regulation pathway to marijuana use/misuse similar to those previously found with alcohol. Additional research is needed to confirm the role of enhancement motives in the associations of depression, rumination and marijuana outcomes.
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Affiliation(s)
- Adrian J Bravo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM 87106, USA.
| | - Melissa Sotelo
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM 87106, USA.
| | - Angelina Pilatti
- Universidad Nacional de Córdoba. Facultad de Psicología. Bv. de la Reforma esq. Enfermera Gordillo s/n. Córdoba, Argentina; Instituto de Investigaciones Psicológicas, IIPSI, Unidad Ejecutora CONICET-UNC. Córdoba, Argentina.
| | - Laura Mezquita
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, av. de Vicente Sos Baynat, s/n, 12071, Castelló, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, av. de Vicente Sos Baynat, s/n, 12071, Castelló, Spain.
| | - Jennifer P Read
- Department of Psychology, University at Buffalo, 12 Capen Hall, Buffalo, New York 14260-1660, USA.
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Alcohol and Cannabis Intake in Nursing Students. ACTA ACUST UNITED AC 2019; 55:medicina55100628. [PMID: 31554263 PMCID: PMC6843613 DOI: 10.3390/medicina55100628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 11/20/2022]
Abstract
Background and objectives: Drug misuse among young people has become a major worldwide health concern. The present study analyzes substance misuse and its social and personal consequences in young university students. Materials and Methods: Screening of alcohol misuse was based on the Alcohol Use Disorder Identification Test (AUDIT), while screening of substance-related risks and problems was performed with the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) score. Results: The population was composed of nursing students at the University of Valencia (Valencia, Spain) (n = 185). More than 50% of the surveyed students reported alcohol intake based on the CRAFFT scale; 31.4% were classified as having “risky alcohol use”, and 19.5% met the criterion for hazardous drinking based on the AUDIT score. In turn, 34.1% of the sample reported marijuana/hashish intake based on the CRAFFT scale. A gender effect was only observed for marijuana/hashish use, which was significantly (p < 0.001) higher in male students. No other gender differences were observed. In the logistic regression analysis, only age was identified as a protective factor for obtaining a reduced risk score with both the AUDIT and the CRAFFT. Among the social and personal consequences of drug misuse, the inability to “stop drinking once you have started” or the inability to “remember what happened while consuming” was significantly associated with an increased frequency of alcohol consumption (OR 20.93, p < 0.0001 and OR 13.68, p < 0.05, respectively). Conclusions: Our findings are consistent with emerging social concerns about drug misuse in the university population, including nursing students as future healthcare professionals.
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