Association of Cannabis Use With Intimate Partner Violence Among Couples With Substance Misuse

An examination of cannabis use motives among couples with intimate partner violence and alcohol use disorder

BACKGROUND AND OBJECTIVES

Cannabis use is highly prevalent among individuals with a history of intimate partner violence (IPV) and among people who drink alcohol. Motives for cannabis use are important correlates of consumption and problem severity. However, no research has examined cannabis use motives among couples with IPV. The goals of the study were to examine (1) the associations between a person and their partner's cannabis use motives; and (2) examine the extent to which each partners' cannabis use motives are related to their own and their partner's cannabis consumption.

METHODS

Participants were 100 couples (n = 92 different-sex couples, n = 8 same-sex couples) who reported physical IPV in their current relationship.

RESULTS

Certain cannabis motives (coping and conformity) and behaviors (cannabis use frequency, quantity and drug-related problems) were positively associated between intimate partners. One's own higher coping motives were associated with greater frequency of cannabis consumption; higher conformity motives were associated with less quantity of consumption; higher social motives were associated with greater quantity of cannabis consumption; and one's partner's social motives were associated with less quantity of cannabis consumption. DISCUSSION AND CONCLUSIONS: Findings suggest that couples report similar motives for cannabis use, and that one's own and their partner's motives may differentially influence frequency and quantity of use.

SCIENTIFIC SIGNIFICANCE

This study provides novel information on congruency between cannabis use motives and behaviors between intimate partners, as well as how both an individual and their partner's motives for use can influence an individual's cannabis use behaviors.

Measuring cannabis quantities in online surveys: A rapid review and proposals for ways forward

OBJECTIVES

Cannabis use quantities are relevant for determining cannabis-related harms. This research aims to provide an overview of the available methods to assess quantities through self-report.

METHODS

A rapid review of various strategies to collect information on cannabis use quantities through self-report. Two independent literature searches resulted in n = 38 studies included for review.

RESULTS

A total of n = 14 studies employed methods for collecting cannabis use quantities that are not suitable for online surveys (e.g., rolling a fake joint). Of the remaining n = 24 studies with items that are suitable for online surveys, the quantity assessment was performed in three different ways. The data collection was either carried out by asking (a) for the total number of joints (i.e., crude joint method), (b) for the total weight (i.e., crude weight method), or (c) for specific products separately, for example, for the amount of flower and resin (i.e., product-specific method). In only n = 8 studies, cannabis use quantities were ascertained by providing visual aids (e.g., illustration of various amounts of flower).

CONCLUSIONS

The crude joint method and the product-specific method are the two most promising methods to collect information on cannabis use quantities. Using visual aids may potentially improve the accuracy of those methods.

Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence

BACKGROUND

Women experiencing intimate partner violence (IPV) are at increased risk for developing hazardous patterns of cannabis use. Research suggests that women experiencing IPV use cannabis to cope with posttraumatic stress disorder (PTSD) symptoms. To advance research, we used experience sampling methods to explicate the within-day concurrent and proximal relations between PTSD symptom clusters and cannabis use among women experiencing IPV.

METHOD

Participants were 145 community women (M age = 40.66, 41.6% white, 31.4% Black, 10.9% Hispanic or Latina, 8% American Indian/Alaska Native, 5.8% Bi-/multi-racial) experiencing IPV and using substances who completed three surveys a day for 30 days.

RESULTS

Externalizing behavior (OR = 1.37, 95% CI [1.15, 1.65], p < 0.001) and dysphoric arousal (OR = 1.27, 95% CI [1.09, 1.49], p = 0.002) PTSD symptom clusters were associated with cannabis use reported in the same survey period. Results from the lagged models found no proximal associations between PTSD symptom clusters and cannabis use.

CONCLUSIONS

Results highlight the acute effects of externalizing behavior and dysphoric arousal PTSD symptoms on cannabis use among women experiencing IPV. These findings may inform prevention and intervention efforts for cannabis use in this population.

The effects of alcohol and marijuana co-use patterns on intimate partner aggression perpetration

Alcohol and marijuana are two of the most widely used substances in the U.S, with rates of alcohol and marijuana co-use increasing in recent years. Despite this increase, little is known about the effects of alcohol and marijuana co-use patterns (e.g., simultaneous, concurrent) on intimate partner aggression (IPA) perpetration. The purpose of the current study was to examine differences in IPA among simultaneous and concurrent alcohol and marijuana use groups and an alcohol-only group. Participants were 496 individuals (57% identifying as a woman) recruited nationally in April 2020 via Qualtrics Research Services who reported being in a current relationship and recently consuming alcohol. Individuals completed an online survey that included demographics, measures of COVID-19 stress, alcohol and marijuana use, and physical and psychological IPA perpetration. Based on survey responses, individuals were categorized as belonging to the alcohol use only group (n = 300), the concurrent alcohol and marijuana use group (n = 129), or the regular simultaneous alcohol and marijuana use group (n = 67). Due to inclusion criteria, there was no marijuana use only group. Individuals with regular simultaneous or concurrent alcohol and marijuana co-use reported more frequent physical and psychological IPA perpetration compared to those who only used alcohol. Neither physical nor psychological IPA perpetration frequency differed between individuals who reported regular simultaneous versus concurrent alcohol and marijuana co-use. Results suggest that alcohol and marijuana co-use in general, and not the specific pattern of use, is associated with an increased likelihood of IPA perpetration.

"What a man can do, a woman can do better": women farmers, livelihood and drug abuse in Adamawa State, northeastern Nigeria

Drug and substance abuse among female population is on the rise but yet to be given adequate scholarly attention. This study examines how women farmers in Adamawa State are engaging in drug and substance abuse to enhance their farming livelihood practices and the implications of their action for health and social cohesion around their communities. Using data collected from interviews and observations, the study discovered that rising female-breadwinning in the study area put a lot of pressure on women to engage in farming as owners, hired or eclectic farmers. To be able to withstand the stress of farming, some engage in the use of psychotropic stimulant substances to enhance their performance. The study also discovered that the most abused substances are cannabis and tramadol due to affordability and availability. On the other hand however, the study found out that increasing indulgence of women in substance abuse is already impacting on spousal relationship between the women indulging in substance abuse and their husbands. The study recommended that government of Adamawa State should enforce in full, the Adamawa State Unclassified (Local Substances) Abuse Law 2015 by establishing a rehabilitation center for correction and reformation of addicts in the state. Furthermore, it is also recommended that all stakeholders should give empowerment of women in the state serious attention.

Relationship perceptions and conflict behavior among cannabis users

BACKGROUND

Cannabis use is increasingly common, yet few studies have examined its associations with couple functioning. To address this gap, we used actor-partner interdependence modeling to examine the associations between cannabis use, relationship perceptions, and observed conflict behavior in a community-based sample of cannabis users and their partners.

METHODS

Cannabis users (N = 232; 96 males; 122 females; 14 undisclosed biological sex) and their partners completed self-reports of cannabis frequency and global relationship satisfaction and commitment. At a laboratory visit, couples engaged in a 10 min conflict discussion and a 5 min discussion of areas of agreement, and reported on their post-conflict perceptions. Each partner's parasympathetic activity was assessed during the conflict task, and trained raters coded conflict and recovery behavior RESULTS: More frequent actor cannabis use was associated with more negative engagement and avoidance behavior during conflict, less parasympathetic withdrawal during conflict, and less effective behavioral recovery immediately after conflict. More frequent cannabis use was also associated with greater satisfaction with conflict resolution following the conflict discussion, but was not associated with perceived overall relationship satisfaction or commitment. Cannabis effects were independent of alcohol use CONCLUSIONS: Among cannabis users, there are discrepancies between perceived and objective measures of relationship functioning, such that cannabis users viewed their relationships as better functioning compared to independent raters' reports. These findings highlight the need for a nuanced understanding of the associations between cannabis and relationship functioning, which appear to be distinct from alcohol, as well as an organizing theoretical framework to stimulate future research.

Interpersonal Violence, PTSD, and Substance Use Types among Women Receiving Substance Use Treatment

Objective: Many women receiving substance use treatment report histories of interpersonal violence (IV) victimization, including physical and sexual assault. IV is a risk factor for mental and behavioral health difficulties such as posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Consistent with the self-medication hypothesis, PTSD may explain elevated SUD among IV survivors. Yet, few studies have investigated whether PTSD may have differential mediating effects for different substances, which has significant treatment implications. Methods: In 124 women (M age = 35.37, SD = 11.90) in substance use treatment, we examined PTSD symptoms as a mediator between IV and severity of different types of substance use, including alcohol, cannabis, cocaine, and opioid use. Participants completed self-report measures including the ASSIST, PCL-5, and LEC-5. Data were analyzed using path analysis in Mplus 8.3. Both dichotomous and continuous outcomes of problematic substance use outcomes were examined. Results: Most women (53.3%) reported problematic substance use with at least one substance, including opioids (39.7%), cocaine (13.0%), alcohol (9.6%), and cannabis (5.6%). Most (83.2%) of the sample reported at least one IV incident. On average, women reported clinically significant PTSD symptom severity. When problematic substance use was examined dichotomously, findings revealed significant indirect effects from IV exposure to opioid (β = 0.10, p = .010) and cocaine use (β = 0.07, p = .039) via elevated PTSD symptoms. There were no significant indirect effects for problematic alcohol (β = 0.03, p = .260) or cannabis use (β = 0.02, p = .562). When substance use was examined continuously, results revealed significant indirect effects from IV exposure to opioid (β = 0.09, p = .017), cocaine use (β = 0.09, p = .015), and alcohol use (β = 0.08, p = .020) via elevated PTSD symptoms. Indirect effects for cannabis use remained nonsignificant (β = 0.05, p = .100). Conclusions: IV survivors may be particularly at risk for opioid and cocaine misuse because of elevated PTSD symptoms. Treatments that integrate PTSD and SUD are needed to simultaneously target traumatic stress and substance use. Women with opioid and cocaine misuse may particularly benefit from trauma-focused exposure-based psychotherapy to reduce symptoms of PTSD, and thus, decrease opioid and cocaine misuse.

Cannabis consumption and prosociality

The existing literature largely focuses on health risks and other pharmacodynamics of using cannabis, with fewer investigations of other normative psychological effects from consumption among otherwise healthy people. We measured several basic constructs of social psychology corresponding to the concept of prosociality among 146 healthy young adults between 18 and 25 years (M = 18.9, SD = 1.4) with varying detectable levels of tetrahydrocannabinol (THC) in their urine, controlling for participant’s sex, age, ethnicity, and childhood socio-economic status. Compared to THC-free individuals, cannabis users scored higher than non-users on validated measures of Prosocial Behaviors (d = .34, p = .04), the Empathy Quotient (d = .36, p < .01), Moral Harmlessness (d = .76, p < .01) and Moral Fairness (d = .49, p < .01), but exhibited a lower sense of Ingroup Loyalty (d = .33, p = .04). Relative to THC-free, same-sex individuals, female cannabis users scored significantly higher on measurements of Aggression (ds = .65 and .57, ps < .05) and male users scored higher on the Agreeableness dimension of personality (d = .91, p < .01).. Linear associations were found between the recency of last cannabis usage and the Prosocial Behaviors, Empathy Quotient, Moral Harmlessness, Moral Fairness and Agreeableness personality scores (rs from − .24 to .38, ps < .05). The findings suggest cannabis usage is associated with an increased sense of prosociality and prioritization of humanitarian behaviors that declines with time following cannabis consumption. Further research should focus on heterogeneity in the effects of cannabis consumption across users.

Technology-Facilitated Abuse Prevalence and Associations Among a Nationally Representative Sample of Young Men

PURPOSE

We undertook a study to determine the prevalence and associations of technology-facilitated abuse (TFA)-insults, harassment, coercion, or threats carried out using digital tools such as smartphones and computers-among a US nationally representative sample of young men.

METHODS

Analyses were based on 1,079 men aged 18 to 35 years who completed questionnaires during August and September of 2014 and reported ever having been in a romantic relationship. We used validated measures to assess demographics, health service use, mental health and substance use, and TFA delivered to and received from partners in the past year. We calculated survey-weighted descriptive statistics and conducted multinomial logistic regression analysis.

RESULTS

Overall, 4.1% of men reported delivering TFA only, 8.0% receiving TFA only, and 25.6% both delivering and receiving TFA. Men were more likely to report only delivering TFA if they identified as Hispanic (adjusted odds ratio [AOR] = 2.72; 95% CI, 1.13 to 6.57), used marijuana (AOR = 1.31; 95% CI, 1.02 to 1.68), and used prescription opioids for nonmedical reasons (AOR 2.86; 95% CI, 1.48 to 5.54). Men were more likely to report only receiving TFA if they identified as Hispanic (AOR = 2.55; 95% CI, 1.01 to 6.43) and used prescription opioids for nonmedical reasons (AOR = 2.43; 95% CI, 1.34 to 4.39), whereas a primary care connection appeared protective (AOR = 0.43; 95% CI, 0.22 to 0.86). Men were more likely to report both delivering and receiving TFA if they identified as non-Hispanic Black (AOR = 2.83; 95% CI, 1.44 to 5.58), owned a smartphone (AOR = 1.80; 95% CI, 1.05 to 3.09), had ever had mental health care visits (AOR = 1.86; 95% CI, 1.16 to 2.98), misused alcohol (AOR = 1.10; 95% CI, 1.04 to 1.17), and used prescription opioids for nonmedical reasons (AOR = 1.79; 95% CI, 1.04 to 3.08).

CONCLUSIONS

We found that TFA was prevalent among young men, with 1 in 25 reporting delivery only, 1 in 12 reporting receipt only, and 1 in 4 reporting both. Primary care physicians can consider assessing TFA among male patients and developing interventions to mitigate this behavior.VISUAL ABSTRACT.

Factors associated with violence against women by an intimate partner in Northeast Brazil

This study examined the prevalence, and associated factors, of violence against women by an intimate partner amongst 369 women who attended nursing consultations at primary care centres in Northeast Brazil. Socio-demographic variables, substance use, mental health and the forms of violence were analysed. IPV was a reality for 65.4% of the women of reproductive age seen in the centres. IPV, including psychological violence, is associated with age, education and religion, particularly amongst female cannabis users whose partners were also substance users. Primary care providers are in a position to detect, screen, counsel and treat women who experience IPV.

Violence and Cannabis Use: A Focused Review of a Forgotten Aspect in the Era of Liberalizing Cannabis

There has been a shift surrounding societal and legal perspectives on cannabis reflecting changing public attitudes towards the perceived safety and social acceptability of cannabis use. With cannabis liberalization internationally, the focus of most cannabis-related harms has been on effects with users themselves. Harm-to-others including injuries from violence have nevertheless been unfortunately largely overlooked. While studies remain heterogeneous, there is meta-analytical evidence pointing towards an association. The aims of this focused review are two-fold: (I) review the evidence from meta-analyses on the association between cannabis and violence; and (II) provide an overview of possible mechanisms relating cannabis use to violence. First, evidence from meta-analytical studies in youths, intimate partners, and individuals with severe mental disorders have shown that there is a global moderate association between cannabis use and violence, which is stronger in the latter more at-risk population. Preliminary data has even highlighted a potential dose-response relationship with larger effects in more frequent users. Although of importance, this subject has remained essentially forgotten as a public health concern. While literature remains inconclusive, data has suggested potential increases in cannabis use following liberalization policies. This may increase violent outcomes if the effect is directly related to the use of cannabis by means of its psychophysiological modifications. However, for the moment, the mechanisms associating cannabis use and violence remain to be clearly resolved. Considering the recency of policy changes on cannabis, further methodologically sound research using longitudinal designs should examine the effects that cannabis use may have on different forms of violence and the trends that emerge, while evaluating the effects of possible confounding factors (e.g. other substance use). In addition, as evidence-based research from meta-analyses have shown that cannabis use is associated with violence, measures must be taken to mitigate the risks.