1
|
MacQuarrie AL, Brunelle C. Profiles of cannabis users and impact on cannabis cessation. PLoS One 2024; 19:e0305088. [PMID: 38861510 PMCID: PMC11166302 DOI: 10.1371/journal.pone.0305088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/22/2024] [Indexed: 06/13/2024] Open
Abstract
Although cannabis was legalized in Canada in 2018 and is one of the most used substances in Canada, few studies have examined how individuals with different patterns of cannabis use differ in their attempts to decrease or abstain from cannabis. The current study examined how groups of cannabis users, which were formed on the basis of demographic characteristics, substance use patterns, mental health symptoms, and self-reported quality of life differed on their experiences with cannabis cessation. A sample of 147 Canadian adult participants who had attempted to decrease or quit cannabis were recruited from the community (n = 84, 57.14%) and crowdsourcing (n = 63, 42.86%). Four profiles of cannabis users emerged using a Latent Profile Analysis: low-risk (n = 62, 42.18%), rapidly escalating high-risk (n = 40, 27.21%), long-term high severity (n = 35, 23.81%), and long-term lower severity (n = 10, 6.80%). Individuals in the rapidly escalating profile had attempted to decrease their cannabis use more times compared to other profiles. More participants in the long-term high severity group found their use stayed the same or got worse after their last cessation attempt, compared to the low-risk group where more individuals indicated their use stopped. The results of the current study indicate that cannabis users differ in their attempts at reducing or ceasing cannabis use and that they may benefit from different intensity of cannabis interventions.
Collapse
Affiliation(s)
- Amy L. MacQuarrie
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - Caroline Brunelle
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| |
Collapse
|
2
|
Coelho SG, Hendershot CS, Aston ER, Ruocco AC, Quilty LC, Tyndale RF, Wardell JD. Executive functions and behavioral economic demand for cannabis among young adults: Indirect associations with cannabis consumption and cannabis use disorder. Exp Clin Psychopharmacol 2024; 32:305-315. [PMID: 37732960 PMCID: PMC10954585 DOI: 10.1037/pha0000678] [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: 09/22/2023]
Abstract
Behavioral economic demand for cannabis is robustly associated with cannabis consumption and cannabis use disorder (CUD). However, few studies have examined the processes underlying individual differences in the relative valuation of cannabis (i.e., demand). This study examined associations between executive functions and cannabis demand among young adults who use cannabis. We also examined indirect associations of executive functions with cannabis consumption and CUD symptoms through cannabis demand. Young adults (N = 113; 58.4% female; mean age 22 years) completed a Marijuana Purchase Task. Participants also completed cognitive tasks assessing executive functions (set shifting, inhibitory control, working memory) and semistructured interviews assessing past 90-day cannabis consumption (number of grams used) and number of CUD symptoms. Poorer inhibitory control was significantly associated with greater Omax (peak expenditure on cannabis) and greater intensity (cannabis consumption at zero cost). Poorer working memory was significantly associated with lower elasticity (sensitivity of consumption to escalating cost). Lower inhibitory control was indirectly associated with greater cannabis consumption and CUD symptoms through greater Omax and intensity, and poorer working memory was indirectly associated with greater cannabis consumption and CUD symptoms through reduced elasticity. This study provides novel evidence that executive functions are associated with individual differences in cannabis demand. Moreover, these results suggest that cannabis demand could be a mechanism linking poorer executive functioning with heavier cannabis use and CUD, which should be confirmed in future longitudinal studies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Christian S. Hendershot
- Bowles Center for Alcohol Studies, University of North Carolina–Chapel Hill, Chapel Hill, NC
- Department of Psychiatry, University of North Carolina–Chapel Hill, Chapel Hill, NC
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Anthony C. Ruocco
- Department of Psychological Clinical Science, University of Toronto
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
| | - Lena C. Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
| | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
- Department of Pharmacology and Toxicology, University of Toronto
| | - Jeffrey D. Wardell
- Department of Psychology, York University
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| |
Collapse
|
3
|
Piercey CJ, Mataczynski M, Stallsmith VT, Emery NN, Karoly HC. Examining Associations Between Cannabis Use Disorder and Measures of Weekly and Within-Day Cannabis Frequency, Quantity, and Potency in College Students. Cannabis Cannabinoid Res 2024; 9:e917-e923. [PMID: 37699241 DOI: 10.1089/can.2022.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Background: College student cannabis use has increased significantly in recent years, and individuals aged 18-25 are at elevated risk for development of cannabis use disorder (CUD). While weekly cannabis use frequency is a commonly used measure of cannabis consumption, there is increasing scientific interest in exploring more nuanced measures of cannabis use. Currently, limited research exists examining the clinical utility of cannabis quantity, within-day frequency, and potency variables. Methods: We used cross-sectional survey data from a sample of 617 undergraduate students in the state of Colorado. A two-part model-building approach was leveraged to examine whether within-session cannabis quantity and within-day cannabis use frequency were associated with odds of experiencing any CUD symptoms and total number of CUD symptoms endorsed. We also examined whether cannabis flower potency was associated with odds of experiencing any CUD symptoms and total number of CUD symptoms endorsed among a subset (N=288) of the sample who reported knowledge of the cannabinoid content of their most frequently used products. Results: Weekly flower use frequency (odds ratio [OR]=1.27, p<0.001) and weekly concentrate use frequency (OR=1.10, p=0.044) were positively associated with increased odds of experiencing any CUD symptoms, but cannabis quantity and within-day frequency variables were not. In addition, no association was found between flower potency and odds of endorsing any CUD symptoms. Among individuals endorsing at least one symptom, weekly flower use frequency (incident rate ratio [IRR]=1.06, p<0.001) was positively associated with total symptom count, but weekly concentrate use frequency, cannabis quantity variables, and within-day frequency variables were not. Among individuals endorsing symptoms, a positive association was found between flower potency and total symptom count (IRR=1.01, p=0.008). Conclusion: Current methods of assessing within-session cannabis quantity and within-day cannabis use frequency may lack clinical utility in examining college student CUD symptoms over and above weekly cannabis use frequency. Cannabis flower potency may prove useful in assessment of CUD symptom severity, but further research is warranted.
Collapse
Affiliation(s)
- Cianna J Piercey
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Maggie Mataczynski
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Vanessa T Stallsmith
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Noah N Emery
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Hollis C Karoly
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
4
|
Chang SC, Lin CW, Chen JC, Wu YH, Chen SG, Huang YY, Cheng NC, Cazzell SM, Chen HH, Huang KF, Tung KY, Huang HL, Perng CK, Shi B, Liu C, Ma Y, Cao Y, Li Y, Xue Y, Gao F, Cao Y, Yan L, Li Q, Armstrong DG, Ning G. Effects of ON101 for Hard-to-Heal Diabetic Foot Ulcers in A Randomized Phase III Trial: A Post hoc Analysis. Adv Wound Care (New Rochelle) 2024. [PMID: 38780901 DOI: 10.1089/wound.2023.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE Hard-to-heal diabetic foot ulcers (DFUs) are associated with higher mortality rates and an increased medical burden for patients. ON101, a new topical cream, exhibited better healing efficacy than the control dressing in a Phase III trial. In this post-hoc analysis, we further identify whether ON101 can improve the healing of ulcers with hard-to-heal risk factors in this cohort of DFU patients. APPROACH To compare the efficacy of ON101 with absorbent dressing among various hard-to-heal wounds in patients with DFU, a post hoc analysis of a randomized phase III trial included 276 DFU patients was performed by subgrouping those patients based on ulcer depth, location, size, duration, and patients' glycated hemoglobin (HbA1c) levels and body mass index (BMI). RESULTS In the full analysis set, the proportion of patients achieving healing was 61.7% in the ON101 group and 37.0% in the comparator (P =0.0001). In sub-group analysis according to risk factors, ON101 demonstrated superior healing capacity on Wagner grade 2 ulcers (P < 0.0001); plantar ulcers (P = 0.0016), ulcers size ≥5 cm² (P = 0.0122), ulcers duration ≥3 months (P = 0.0043); for patients with HbA1c ≥9% (P = 0.0285); and patients with BMI ≥25 (P = 0.0005). INNOVATION ON101, a novel therapeutic drug, can modulate the functions of macrophages and demonstrate superior healing rates to conventional absorbent dressing in patients with hard-to-heal DFUs. CONCLUSIONS The results of this post hoc study suggest that ON101 is a better therapeutic option than conventional dressing used in treatment for DFU patients with higher HbA1c, BMI, or ulcers with complex conditions such as longer duration, deeper wounds, larger size, and plantar location.
Collapse
Affiliation(s)
- Shun-Cheng Chang
- Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Department of Surgery, Taipei, Taiwan;
| | | | - Jui-Ching Chen
- Oneness Biotech Company Limited, Department of Medical Science, Taipei, Taiwan;
| | - Yi-Hsin Wu
- Oneness Biotech Company Limited, Taipei, Taiwan;
| | - Shyi-Gen Chen
- Tri-Service General Hospital, Division of Plastic and Reconstructive Surgery, Taipei, Taiwan
- National Defense Medical Center, Taipei, Taiwan;
| | - Yu-Yao Huang
- Chang Gung Memorial Hospital Linkou, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taoyuan City, Taiwan
- Chang Gung University College of Medicine, Taoyuan City, Taiwan;
| | - Nai-Chen Cheng
- National Taiwan University Hospital and College of Medicine, Division of Plastic Surgery, Department of Surgery, Taipei, Taiwan;
| | - Shawn M Cazzell
- Limb Preservation Platform, Inc., Fresno, California, United States;
| | - Hsin-Han Chen
- China Medical University Hospital, Plastic and Reconstruction Surgery, Taichung, Taiwan;
| | - Kuo-Feng Huang
- Chi Mei Medical Center, Division of Plastic Surgery, Department of Surgery, Tainan, Taiwan;
| | - Kwang-Yi Tung
- Mackay Memorial Hospital, Division of Plastic Surgery, Department of Surgery, Taipei, Taiwan;
| | - Hsuan-Li Huang
- Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, Division of Cardiology, New Taipei City, Taiwan
- School of Post-baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan;
| | - Cherng-Kang Perng
- Taipei Veterans General Hospital, Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei, Taiwan
- National Yang Ming Chiao Tung University School of Medicine, Department of Surgery, Taipei, Taiwan
- Chang Bing Show Chwan Memorial Hospital, Department of Surgery, Lukang, Taiwan;
| | - Bimin Shi
- First Affiliated Hospital of Soochow University, Department of Endocrinology, Suzhou, Jiangsu, China;
| | - Chang Liu
- Affiliated Hospital of Jiangsu University, Department of Burn and Plastic Surgery, Zhenjiang, Jiangsu, China;
| | - Yujin Ma
- Henan University of Science and Technology Affiliated First Hospital, Department of Endocrinology, Luoyang, Henan, China;
| | - Yemin Cao
- Shanghai Traditional Chinese Medicine Integrated Hospital, Department of Vascular Anomalies, Shanghai, China;
| | - Yanbing Li
- Sun Yat-sen University First Affiliated Hospital, Department of Endocrinology and Metabolism, Guangzhou, Guangdong, China;
| | - Yaoming Xue
- Southern Medical University Nanfang Hospital, Department of Endocrinology and Metabolism, Guangzhou, Guangdong, China;
| | - Fang Gao
- Southern Medical University Nanfang Hospital, Department of Endocrinology and Metabolism, Guangzhou, Guangdong, China;
| | - Ying Cao
- Southern Medical University Nanfang Hospital, Department of Endocrinology and Metabolism, Guangzhou, Guangdong, China;
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Department of Endocrinology, Guangdong Province, China;
| | - Qiu Li
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Department of Endocrinology,, Jinan, Shandong, China;
| | - David G Armstrong
- University of Southern California Keck School of Medicine, Department of Surgery, Los Angeles, California, United States;
| | - Guang Ning
- Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Department of Endocrine and Metabolic Diseases, Shanghai, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics,Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;
| |
Collapse
|
5
|
Farrelly KN, Keough MT, Wardell JD. Indirect Associations Between PTSD Symptoms and Cannabis Problems in Young Adults: The Unique Roles of Cannabis Coping Motives and Medicinal Use Orientation. Subst Use Misuse 2024; 59:1431-1439. [PMID: 38750663 DOI: 10.1080/10826084.2024.2352621] [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: 06/05/2024]
Abstract
Background: Cannabis use in young adulthood has been associated with exposure to traumatic events and posttraumatic stress disorder (PTSD). Coping motives for cannabis use represent one mechanism linking PTSD with cannabis problems, yet some individuals with PTSD consider their cannabis use to be medicinal in nature. While a medicinal orientation to cannabis overlaps conceptually with coping motives, it could be associated with unique cannabis outcomes. Objectives: This study examined trauma-related coping motives and medicinal cannabis orientation as mediators of the association between PTSD symptoms and cannabis outcomes in young adults. Method: Data came from an online survey of 212 university students (M age = 19.41; 70.3% Women; 43.4% White) who used cannabis in the past month and endorsed a traumatic life event. Path analyses examined associations of PTSD symptoms with past month cannabis frequency and problems through medicinal cannabis orientation (i.e., number of mental health symptoms that cannabis is used to manage) and trauma-related coping motives. Results: PTSD symptoms were associated with trauma-related coping motives but not with medicinal cannabis orientation. Both trauma-related coping motives and medicinal cannabis orientation were uniquely associated with greater cannabis use frequency, but only trauma-related coping motives were associated with greater cannabis problems. There were significant indirect relationships from PTSD symptoms to cannabis use frequency and problems through trauma-related coping motives but not through medicinal cannabis orientation. Conclusions: Results support unique contributions of trauma-related coping motives and medicinal cannabis orientation to cannabis outcomes and suggest that trauma-related coping motives are specifically implicated in the link between PTSD and cannabis problems.
Collapse
Affiliation(s)
- Kyra N Farrelly
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Matthew T Keough
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Carter-Rogers K, Al-Hamdani M, Kearney CPM, Smith SM. Risk-Taking, Social Support, and Belongingness Contribute to the Risk for Cannabis Use Frequency in University Students. Subst Use Misuse 2024; 59:1357-1366. [PMID: 38711241 DOI: 10.1080/10826084.2024.2341998] [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: 05/08/2024]
Abstract
Background: Cannabis use and misuse is known to be associated with a variety of negative health, academic, and work-related outcomes; therefore, it is important to study the factors that contribute to or moderate its use. Objectives: The aim of this study was to determine whether risky behavior, belongingness and social support as clustering variables play a role in cannabis use frequency. Method: In a university student sample, participant data on risky behavior, belongingness and social support were used to generate vulnerability profiles through cluster analysis (low vulnerability with low risk, low vulnerability with high belonging, moderate vulnerability, and high vulnerability). Using an analysis of variance, the vulnerability profiles were compared with respect to cannabis use frequency and quantity. Through chi-square tests we assessed whether these profiles are overrepresented in certain demographics. Results: The cluster analysis yielded four groups, which differed in their vulnerability for cannabis use. The most vulnerable cluster group had higher cannabis use frequency relative to the two least vulnerable groups. Low income vs. high income was also associated with high vulnerability group membership. International students were overrepresented in the low vulnerability with high belonging group relative to the low vulnerability with low-risk group. The opposite was observed for domestic students. Conclusions: This research adds to the expanding body of literature on cannabis use and misuse in Canada, which may contribute to public health policy and the prevention and treatment of cannabis addiction by providing new insight on who may be at risk.
Collapse
Affiliation(s)
| | - Mohammed Al-Hamdani
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | |
Collapse
|
7
|
Hinckley JD, Ferland JMN, Hurd YL. The Developmental Trajectory to Cannabis Use Disorder. Am J Psychiatry 2024; 181:353-358. [PMID: 38706340 DOI: 10.1176/appi.ajp.20231006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Jesse D Hinckley
- Division of Addiction Science, Treatment & Prevention, Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colo. (Hinckley); Department of Psychiatry, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, Addiction Institute at Mount Sinai, New York (Ferland, Hurd)
| | - Jacqueline-Marie N Ferland
- Division of Addiction Science, Treatment & Prevention, Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colo. (Hinckley); Department of Psychiatry, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, Addiction Institute at Mount Sinai, New York (Ferland, Hurd)
| | - Yasmin L Hurd
- Division of Addiction Science, Treatment & Prevention, Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colo. (Hinckley); Department of Psychiatry, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, Addiction Institute at Mount Sinai, New York (Ferland, Hurd)
| |
Collapse
|
8
|
Wardell JD, Coelho SG, Farrelly KN, Fox N, Cunningham JA, O'Connor RM, Hendershot CS. Interactive effects of alcohol and cannabis quantities in the prediction of same-day negative consequences among young adults. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:967-979. [PMID: 38575530 DOI: 10.1111/acer.15309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Simultaneous alcohol and cannabis use is common, but observational studies examining negative consequences of simultaneous use have rarely considered dose-related interactions between alcohol and cannabis. This study examined interactions between quantities of cannabis and alcohol consumed in predicting negative consequences on simultaneous use days. METHODS Young adults (N = 151; 64% female; 62% White) reporting recent simultaneous use and at least weekly alcohol and cannabis use completed 21 daily, smartphone-based surveys assessing previous day quantities of cannabis and alcohol used, types of cannabis used (flower, concentrates, edibles), and negative substance-related consequences. Multilevel models examined: (1) whether negative consequences differed within-person across simultaneous use days and single-substance use days; and (2) whether quantities of alcohol and cannabis consumed on simultaneous use days interacted, within-person, to predict negative consequences. We focused on quantities of cannabis flower (grams) in primary analyses and explored quantities of other forms of cannabis (concentrates, edibles) in supplementary analyses. RESULTS Participants reported fewer negative consequences on alcohol-only (243 observations) and cannabis-only (713 observations) days than they did on simultaneous use days (429 observations). On simultaneous use days involving cannabis flower use (313 observations across 81 participants), the within-person association between number of standard drinks and negative consequences was weaker on days during which larger (vs. smaller) amounts of cannabis flower were consumed. Inspection of simple slopes revealed that decreased alcohol use was associated with less of a decline in negative consequences when combined with relatively greater amounts of cannabis flower. CONCLUSIONS Although simultaneous use was associated with more negative consequences than alcohol-only and cannabis-only use, negative consequences on simultaneous use days varied as a function of the interaction between alcohol and cannabis quantities. As findings suggest that using larger amounts of cannabis may attenuate declines in negative consequences associated with lighter drinking, interventions for higher-risk simultaneous use patterns may benefit from a focus on quantities of both alcohol and cannabis.
Collapse
Affiliation(s)
- Jeffrey D Wardell
- Department of Psychology, York University, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sophie G Coelho
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Kyra N Farrelly
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Nicolle Fox
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - John A Cunningham
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Addictions, Kings College London, London, UK
| | - Roisin M O'Connor
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
9
|
Wightman RS, Metrik J, Lin TR, Collins AB, Beaudoin FL. Cannabinoid hyperemesis syndrome: Clinical trajectories and patterns of use three months following a visit to the emergency department. Acad Emerg Med 2024; 31:463-470. [PMID: 37387520 DOI: 10.1111/acem.14773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Cannabinoid hyperemesis syndrome (CHS) is a clinical condition of cyclic vomiting, nausea, and abdominal pain associated with chronic cannabis use. Despite increased recognition of CHS, there are limited details on cannabis use practices and symptoms over time. Understanding what happens in the period surrounding the emergency department (ED) visit, including any changes in symptoms and cannabis use practices following the visit, can help inform the development of patient-centered interventions around cannabis use disorder for patients with CHS. METHODS A prospective observational cohort (n = 39) of patients with suspected CHS recruited from the ED at the time of a symptomatic cyclic vomiting episode was followed for 3 months. Disease progression, cannabis use practices, and health care utilization were monitored. RESULTS Participants reported high rates of persistent CHS symptoms (abdominal pain, nausea, or cyclic vomiting) in the 2-week period immediately following an ED visit with a median duration of 7 days. Cannabis use frequency and quantity were reduced immediately after the ED visit, but most participants returned to pre-ED visit cannabis use patterns within a few days. Recurrent ED visits for cyclic vomiting were reported by 25% of participants who completed follow-up during the 3-month follow-up period. CONCLUSIONS Participants continued to have ongoing symptoms after the ED visit, but most managed symptoms on their own and did not return to the ED. Longitudinal studies beyond 3 months are needed to better understand the clinical course of patients with suspected CHS.
Collapse
Affiliation(s)
- Rachel S Wightman
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA
- Providence VA Medical Center, Providence, Rhode Island, USA
| | - Timmy R Lin
- Brown Emergency Medicine, Providence, Rhode Island, USA
| | - Alexandra B Collins
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| |
Collapse
|
10
|
Threeton EM, Morris PE, Buckner JD. Sexual orientation-based microaggressions and cannabis use outcomes among sexual minority individuals: The impact of negative affect and coping-motivated cannabis use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209293. [PMID: 38272122 PMCID: PMC11060912 DOI: 10.1016/j.josat.2024.209293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/02/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Sexual minority individuals report significantly more cannabis use and problems than their heterosexual peers, possibly due to their frequent experiences with sexual orientation-based microaggressions. As a result, sexual minority individuals may turn to cannabis use to cope with the negative affect associated with these experiences. No known studies have tested this hypothesis; therefore, the current study tested if sexual orientation microaggressions are positively associated with negative affect (anxiety and depression), cannabis coping motives, and cannabis-related outcomes (frequency, problems); if coping motives are positively associated with cannabis-related outcomes; and if negative affect and cannabis use to cope with negative affect serially mediate the relation between sexual orientation microaggressions and cannabis-related outcomes. METHODS Sexual minority undergraduate students who reported cannabis use in the past three months (N = 328; 71.3 % cis-female) completed an online survey. RESULTS Microaggressions were significantly positively correlated with anxiety, depression, coping-motivated cannabis use, cannabis-related problems, non-sexual orientation-related stress, and overt sexual orientation-based discrimination. Additionally, after controlling for non-sexual orientation-related stress and overt sexual orientation-based discrimination, microaggressions were indirectly positively related to cannabis use frequency and problems via the sequential effects of negative affect and coping motives. This relation remained significant when examining negative affect specific to sexual orientation microaggressions and cannabis use to cope with this microaggressions-specific negative affect. CONCLUSIONS Results highlight the adverse impact of sexual orientation microaggressions in terms of negative affect and negative cannabis-related outcomes.
Collapse
Affiliation(s)
- Evan M Threeton
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Paige E Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Julia D Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
| |
Collapse
|
11
|
Wichaidit W, Chapakiya I, Waeuseng A, Chumchuen K, Assanangkornchai S. Density of cannabis outlets vs. cannabis use behaviors and prevalent cannabis use disorder: findings from a nationally-representative survey. PeerJ 2024; 12:e17317. [PMID: 38699183 PMCID: PMC11064851 DOI: 10.7717/peerj.17317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/09/2024] [Indexed: 05/05/2024] Open
Abstract
Background Thailand recently decriminalized (de facto legalized) cannabis use and sales. However, nationally representative data are scarce with regard to cannabis use behaviors and its association with cannabis outlet density. The objectives of this study are: (1) to describe the prevalence of cannabis use behaviors and cannabis use disorder among the general adult population of Thailand; (2) to describe the extent that the density of cannabis outlets is associated with cannabis use behaviors, cannabis use disorder, and the amount of cannabis smoked per day. Methods We conducted a community-based cross-sectional study in 11 provinces and the Bangkok Metropolitan Area. Participants were residents of sampled communities aged 20 years or older. We requested literate participants to self-administer the questionnaire and interviewed participants who could not read. We analyzed data using descriptive statistics with sampling weight adjustments and multivariate logistic regression analyses. Results The prevalence of current cannabis use was 15 percent. At a 400-m radius, participants who reported three cannabis outlets had 4.2 times higher odds of being current users than participants who reported no outlet (Adjusted OR = 4.82; 95% CI [3.04-7.63]). We found no association between outlet density and hazardous cannabis use or cannabis use disorder, nor association with the amount of cannabis use among cannabis smokers. Discussion and Conclusion The patterns of association between outlet density and cannabis use behaviors were inconsistent. Furthermore, limitations regarding outlet density measurement and lack of temporality should be considered as caveats in the interpretation of the study findings.
Collapse
Affiliation(s)
- Wit Wichaidit
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Province, Thailand
- Centre for Alcohol Studies, Hat Yai, Songkhla Province, Thailand
| | - Ilham Chapakiya
- Division of Computational Science (Statistics), Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla Province, Thailand
| | - Aneesah Waeuseng
- Division of Computational Science (Statistics), Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla Province, Thailand
| | - Kemmapon Chumchuen
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Province, Thailand
| | - Sawitri Assanangkornchai
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Province, Thailand
- Centre for Alcohol Studies, Hat Yai, Songkhla Province, Thailand
| |
Collapse
|
12
|
Willoughby JF, Hust SJT, Li J, Couto L. Exposure to Pro and Anti-Cannabis Social Media Messages and Teens' and College Students' Intentions to Use Cannabis. HEALTH COMMUNICATION 2024; 39:183-194. [PMID: 36628502 DOI: 10.1080/10410236.2022.2162707] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Content analyses have documented that posts about cannabis are increasingly common on social media. The relationship between the cannabis-related content to which teens and college students are exposed on social media and how such content may be associated with intentions to use and use of cannabis is less known, however. We conducted an online survey with teens (N = 350) who lived in Washington state using online survey panel participants in June 2018 and with college students (N = 966) in a Washington state-wide university system in February and March 2019. Participants in both samples reported seeing both pro-cannabis and anti-cannabis messages on social media platforms. Exposure to pro-cannabis messages on social media was associated with an increased intention to use cannabis. Exposure to anti-cannabis messages on social media was indirectly associated with decreased intentions to use cannabis through negative outcome beliefs of cannabis use and, among college students, through perceived norms. Among college students specifically, exposure to pro-cannabis messages on social media was also associated with more frequent cannabis use. Health communicators could focus anti-cannabis messaging on negative outcome beliefs among teens and college students as well as norms among college students to potentially influence constructs associated with intentions and use.
Collapse
Affiliation(s)
| | - Stacey J T Hust
- The Edward R. Murrow College of Communication, Washington State University
| | - Jiayu Li
- The Edward R. Murrow College of Communication, Washington State University
| | - Leticia Couto
- The Edward R. Murrow College of Communication, Washington State University
| |
Collapse
|
13
|
Borodovsky JT, Hasin DS, Shmulewitz D, Walsh C, Livne O, Aharonovich E, Struble CA, Habib MI, Budney AJ. Typical Hits, Grams, or Joints: Evaluating Cannabis Survey Measurement Strategies for Quantifying Consumption. Cannabis Cannabinoid Res 2024; 9:646-658. [PMID: 36577020 PMCID: PMC10998027 DOI: 10.1089/can.2022.0237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: Standardized survey measures that capture diverse cannabis consumption patterns are needed to inform public health and policy. Our team is developing a flexible, personalized, low-burden survey item inventory to measure cannabis use patterns and estimate milligrams of THC (mgTHC) consumption in large samples. This study aimed to identify measurement gaps and analysis implications associated with an initial pool of candidate items that assessed use of cannabis flower and concentrate products (smoked and/or vaporized). Methods: Adult cannabis consumers (n=4247) completed an online survey assessing cannabis use frequency, quantity, product types, product potencies (%THC), and methods of administration. Participants chose to report their consumption quantities using one of three units: "hits per day," "grams per week," or "joints per week." Respondents also indicated whether their past 7-day consumption pattern represented their typical pattern. Results: Eighty-one percent had used cannabis daily in the past week. Thirty-two percent, 53%, and 15% chose to report flower and concentrate consumption quantity in hits, grams, and joints, respectively. Approximately 80-90% of responses for the number of hits, grams, and joints consumed were less than the maximum response option-suggesting that response options captured the full range of potential cannabis consumption behaviors. Those who chose grams or joints units were generally more likely to endorse higher risk cannabis use (e.g., morning use, high %THC products) in the past week than those who chose the hits unit (adjusted Odds Ratio range: 1.2-3.9). Among those who reported that the past week represented their typical behavior (83%), past 30-day and past 7-day frequencies were highly correlated (Spearman's Rho=0.77)-supporting the feasibility of using lower burden "typical week" items to extrapolate patterns beyond a 1-week time frame. Conclusion: Results from this online convenience sample of frequent cannabis consumers suggest that the current items yield coherent and expected response patterns. Although additional testing is required, a standardized, flexible survey instrument for large-scale assessment of cannabis patterns and calculation of mgTHC seems within reach.
Collapse
Affiliation(s)
- Jacob T. Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, New York, USA
| | - Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Cara A. Struble
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Mohammad I. Habib
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Alan J. Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| |
Collapse
|
14
|
Budney AJ, Borodovsky JT, Struble CA, Habib MI, Shmulewitz D, Livne O, Aharonovich E, Walsh C, Cuttler C, Hasin DS. Estimating THC Consumption from Smoked and Vaped Cannabis Products in an Online Survey of Adults Who Use Cannabis. Cannabis Cannabinoid Res 2024; 9:688-698. [PMID: 36521175 PMCID: PMC10998014 DOI: 10.1089/can.2022.0238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: Quantification of consumption patterns of the primary psychoactive compounds in cannabis, which cause euphoria or intoxication, is sorely needed to identify potential risks and benefits of use and to provide meaningful safety information to the public. The diversity of products available, multiple methods of administration, and lack of labeling of products have made such quantification challenging. Our group is developing a survey instrument for estimating the quantity of delta 9-tetrahydrocannabinol (THC) consumed in population samples, which is flexible and incorporates individualized reports of patterns of consumption. This study provides an illustration of a procedure for translating self-reported consumption into milligrams of THC (mgTHC), which may serve as a working model for future quantification efforts. Methods: Social media advertising was leveraged to enroll 5627 adults who use cannabis into an online, anonymous survey study. Only those who used cannabis in the past 7 days, used flower or concentrate products, and who chose to report their quantity of use in hits per day or grams per week (n=3211) were included in this report. Formulas were used to estimate mgTHC used per day, in hits per day or grams per week; potency (%THC); constants for estimating the amount of material consumed for each hit; and a method of administration efficiency constant to account for THC loss due to the administration method. Results: The estimate for mgTHC used per day was M=92.8 mg/day (SD=97.2 mg; 1st-3rd quartile range=25-132 mg). The estimated quantity of use was much lower for those reporting in hits (M=43.7 mg, SD=43.8) than for those reporting in grams (M=115.1 mg, SD=107.0). The estimated rate of binge use in the past week, arbitrarily defined as more than 50 mgTHC within any one daily time quadrant, was 6.8%, which increased to 29.3% if 25 mgTHC was used. Conclusions: The approach illustrated in this study goes beyond existing cannabis measures by asking participants to provide highly detailed estimates of their past 7-day use patterns and then applying a logical formula to translate this information into mgTHC. This initial procedure has limitations and lacks generalization; however, we hope this demonstration stimulates testing of similar approaches and relevant laboratory experiments that will enhance the validity of cannabis consumption estimation procedures.
Collapse
Affiliation(s)
- Alan J. Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Jacob T. Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Cara A. Struble
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Mohammad I. Habib
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, USA
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| |
Collapse
|
15
|
Pellicane MJ, Quinn ME, Bean CAL, Bartek ME, Heggeness LF, Ciesla JA. Delta-8- and Delta-9-THC Use Frequency, Use Motives, and Mental Health Outcomes. J Psychoactive Drugs 2024; 56:199-205. [PMID: 37031429 DOI: 10.1080/02791072.2023.2200211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/02/2023] [Indexed: 04/10/2023]
Abstract
Use of delta-8-THC ("delta-8") has proliferated after the passage of the 2018 Farm Bill. Yet, research on the mental health effects of this increasingly popular cannabinoid is scant. The current study sought to examine mental health correlates of delta-8 use frequency and motives, investigate whether delta-8 use motives predict use frequency, and compare use motives and problems between delta-8 and traditional cannabis. Participants consisted of 363 self-reported delta-8 users who completed measures of delta-8 use frequency, motives, and problems that were adapted from comparable measures for cannabis, as well as measures of mental health outcomes. Delta-8 use frequency was unrelated to use problems and other mental health outcomes. Delta-8 use frequency was positively associated with social and coping motives, but negatively associated with enhancement and conformity motives. Coping and conformity motives were associated with greater depression, anxiety, insomnia, and delta-8 use problems. Participants were more likely to report coping and enhancement motives for delta-8 use compared to cannabis use, but less likely to report conformity motives. Further longitudinal research is needed to assess causality for associations between delta-8 use frequency, use motives, and mental health outcomes.
Collapse
Affiliation(s)
| | - Madison E Quinn
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Christian A L Bean
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Madeline E Bartek
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Luke F Heggeness
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jeffrey A Ciesla
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| |
Collapse
|
16
|
Martin-Willett R, Elmore JS, Phillips PX, Bidwell LC. Meaningfully Characterizing Cannabis Use for Research and Clinical Settings: A Comprehensive Review of Existing Measures and Proposed Future Directions. PSYCHIAT CLIN PSYCH 2024; 34:82-93. [PMID: 38883882 PMCID: PMC11177636 DOI: 10.5152/pcp.2024.23645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/30/2023] [Indexed: 06/18/2024] Open
Abstract
Cannabis use is increasingly common. There is a need for validated tools to meaningfully assess recreational, medical, and disordered cannabis use in both research and clinical contexts. Cannabis assessments were considered against pre-determined inclusion criteria within a comprehensive review. Measures were categorized as either (i) evaluating use frequency or quantity, (ii) measuring symptoms of disordered use and withdrawal, or (iii) assessing use motives, effects, and perceptions. The applications and validations for each assessment are summarized. Finally, recommendations for refining of existing measures or development of new measures are presented. The literature review resulted in 289 publications that were reviewed in detail, yielding 21 assessments that met inclusion criteria. The applications of these assessments are described here, in addition to the information about the validation studies of each assessment. Based on the complication of these tools, 5 areas of potential development are highlighted to guide future research, including (i) sensitivity to the mode of cannabis administration as well as sensitivity to (ii) potency of cannabis products alongside frequency and quantity, (iii) unit equivalence, (iv) aligning clinical measures consistently with cannabis use disorder (CUD) diagnostic criteria, and (v) creating measures specific to medical users, their motives for use, and their perceptions of therapeutic benefits or side effects. Clinicians and researchers can pragmatically benefit from this summary of validated measures of cannabis use, and future work could improve the study of and clinical care for cannabis use and CUD by pursuing one or more key areas of development described here.
Collapse
Affiliation(s)
- Renee Martin-Willett
- Department of Psychology and Neuroscience, University of Colorado Boulder, Colorado, USA
| | - Joshua S Elmore
- Department of Psychology and Neuroscience, University of Colorado Boulder, Colorado, USA
| | - Paige X Phillips
- Institute of Cognitive Science, University of Colorado Boulder, Colorado, USA
| | - L Cinnamon Bidwell
- Department of Psychology and Neuroscience, University of Colorado Boulder, Colorado, USA
- Institute of Cognitive Science, University of Colorado Boulder, Colorado, USA
| |
Collapse
|
17
|
Trinh CD, Girard R, Schick MR, Spillane NS. Positive psychological interventions on alcohol use and consequences: Pilot randomized trial in a young adult cannabis-using sample. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 158:209241. [PMID: 38056630 DOI: 10.1016/j.josat.2023.209241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/18/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Young adults exhibit high rates of concurrent alcohol and cannabis use, which is associated with more negative alcohol-related consequences. Positive psychological interventions have successfully been leveraged to target alcohol, cannabis, and nicotine use, as well as substance use disorders, and may be a useful harm reduction approach to reduce alcohol-related consequences. This pilot study sought to generate effect sizes for two positive psychological interventions, Savoring and Three Good Things, on frequency of alcohol use, quantity of alcohol use, and alcohol-related consequences. METHODS The current study used data from a pilot study testing positive psychological interventions to reduce cannabis use and cannabis-related consequences in young adults (ages 18 to 25) who used cannabis at least once per week within the prior month (N = 50, Mage = 22.72, 72 % men, 40 % White). Participants reported baseline alcohol and cannabis use and alcohol-related consequences, then the study randomized them to complete a daily Savoring intervention, Three Good Things, or a control exercise, and completed daily text message surveys for two weeks (i.e., the intervention period) and a follow-up survey. RESULTS Analyses revealed no significant differences across experimental conditions on alcohol use frequency, alcohol use quantity, or alcohol-related consequences at baseline or follow-up. Paired samples t-tests demonstrated that participants in the Savoring group showed large, significant decreases in alcohol-related consequences (t[16] = 2.28, p = .04, gav = 0.54); no decreases occurred in frequency or quantity of alcohol use. The Three Good Things group showed no significant decreases in alcohol-related consequences, frequency of alcohol use, or quantity of alcohol use. CONCLUSIONS Results suggest that a larger scale clinical trial is warranted to determine whether Savoring and Three Good Things might function as harm reduction interventions to reduce alcohol-related consequences in young adults who concurrently use alcohol and cannabis. Future research should use a larger sample, a longer intervention administration period, and a longer follow-up period to examine these positive psychological interventions more rigorously.
Collapse
Affiliation(s)
- Catherine D Trinh
- University of Rhode Island, Department of Psychology, Kingston, RI 02881, USA
| | - Rachel Girard
- University of Rhode Island, Department of Psychology, Kingston, RI 02881, USA
| | - Melissa R Schick
- Yale School of Medicine, Division of Prevention and Community Research, New Haven, CT 06511, USA
| | - Nichea S Spillane
- University of Rhode Island, Department of Psychology, Kingston, RI 02881, USA.
| |
Collapse
|
18
|
Smith CB, Schmidt J, Holdsworth EA, Caffé B, Brooks O, Williams JE, Gang DR, McGuire MA, McGuire MK, Barbosa-Leiker C, Meehan CL. Cannabis use, decision making, and perceptions of risk among breastfeeding individuals: the Lactation and Cannabis (LAC) Study. J Cannabis Res 2024; 6:6. [PMID: 38365778 PMCID: PMC10870434 DOI: 10.1186/s42238-023-00212-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/13/2023] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE Our primary objective was to understand breastfeeding individuals' decisions to use cannabis. Specifically, we investigated reasons for cannabis use, experiences with healthcare providers regarding use, and potential concerns about cannabis use. METHODS We collected survey data from twenty breastfeeding participants from Washington and Oregon who used cannabis at least once weekly. We documented individuals' cannabis use and analyzed factors associated with their decisions to use cannabis during lactation. Qualitative description was used to assess responses to an open-ended question about potential concerns. RESULTS Fifty-five percent of participants (n = 11) reported using cannabis to treat or manage health conditions, mostly related to mental health. Eighty percent of participants (n = 16) reported very few or no concerns about using cannabis while breastfeeding, although participants who used cannabis for medical purposes had significantly more concerns. Most participants (n = 18, 90%) reported receiving either no or unhelpful advice from healthcare providers. Four themes arose through qualitative analysis, indicating that breastfeeding individuals are: 1) identifying research gaps and collecting evidence; 2) monitoring their child's health and development; 3) monitoring and titrating their cannabis use; and 4) comparing risks between cannabis and other controlled substances. CONCLUSIONS Breastfeeding individuals reported cannabis for medical and non-medical reasons and few had concerns about cannabis use during breastfeeding. Breastfeeding individuals reported using a variety of strategies and resources in their assessment of risk or lack thereof when deciding to use cannabis. Most participants reported receiving no helpful guidance from healthcare providers.
Collapse
Affiliation(s)
- Caroline B Smith
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | - Jenna Schmidt
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | | | - Beatrice Caffé
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | - Olivia Brooks
- College of Nursing, Washington State University Health Sciences Spokane, Spokane, WA, USA
| | - Janet E Williams
- Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, ID, USA
| | - David R Gang
- Institute of Biological Chemistry, Washington State University, Pullman, WA, USA
| | - Mark A McGuire
- Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, ID, USA
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
| | | | - Courtney L Meehan
- Department of Anthropology, Washington State University, Pullman, WA, USA.
| |
Collapse
|
19
|
Salinas KZ, Saran S, Saulnier K, Hoglen B, Houser KR, Krebs NM, Kaynak Ö, Bordner CR, Yingst JM, Foulds J, Allen SI, Hobkirk AL. A Comparison of Mental Health Symptoms among Adults Who Vape Nicotine, Cannabis, or Both. Subst Use Misuse 2024; 59:601-607. [PMID: 38115560 DOI: 10.1080/10826084.2023.2294956] [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: 12/21/2023]
Abstract
OBJECTIVES Dual use of combustible cannabis and nicotine is related to worse mental health symptoms (MHS); however, little is known about MHS among those who vape cannabis and nicotine. The current study aimed to determine if dual use of cannabis and nicotine vapes is associated with worse MHS compared to single use and to identify correlates of MHS for dual users. METHODS We used Amazon Mechanical Turk to survey adults (N = 492) who used nicotine or cannabis vapes in the past 30 days on stress, anxiety, depression, vape use behaviors and sociodemographic information. We conducted hierarchical linear regressions to compare MHS between dual vs. single substance vape use and to identify correlates of MHS, including sociodemographic variables and vape use characteristics. RESULTS The final sample was 37.6% female, 87.6% White, and 11% Hispanic/Latinx with a mean age of 34.15 years. After controlling for sociodemographic characteristics and combustible product use, dual users had significantly higher mean MHS severity than single users. For dual users, younger age and being married were associated with higher symptoms of depression and stress. Holding a medical cannabis card was associated with higher anxiety symptoms. CONCLUSION The findings suggest that dual use of cannabis and nicotine vapes is associated with worse MHS severity compared to single substance use.
Collapse
Affiliation(s)
- Kalin Z Salinas
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Savreen Saran
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kevin Saulnier
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Brianna Hoglen
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kenneth R Houser
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Nicolle M Krebs
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Övgϋ Kaynak
- School of Behavioral Sciences & Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | - Candace R Bordner
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jessica M Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jonathan Foulds
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Sophia I Allen
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Andrea L Hobkirk
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
20
|
Chesney E, Lawn W, McGuire P. Assessing Cannabis Use in People with Psychosis. Cannabis Cannabinoid Res 2024; 9:49-58. [PMID: 37971872 PMCID: PMC10874830 DOI: 10.1089/can.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Introduction: Cannabis use is common in people with psychotic disorders and is associated with the exacerbation of symptoms, poor treatment adherence, and an increased risk of relapse. Accurate assessment of cannabis use is thus critical to the clinical management of psychosis. Discussion: Cannabis use is usually assessed with self-report questionnaires that were originally developed for healthy individuals or people with a cannabis use disorder. Compared to these groups, the pattern of cannabis use and the associated harms in patients with psychosis are quite different. Moreover, in people with psychosis, the accuracy of self-reported use may be impaired by psychotic symptoms, cognitive deficits, and a desire to conceal use when clinicians have advised against it. Although urinary screening for delta-9-tetrahydrocannabinol is sometimes used in the assessment of acute psychotic episodes, it is not used in routinely. Cannabis use could be assessed by measuring the concentration of cannabinoids in urine and blood, but this is rarely done in either clinical settings or research. Conclusion: Using quantitative biological measures could provide a more accurate guide to the effects of use on the disorder than asking patients or using questionnaires.
Collapse
Affiliation(s)
- Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Will Lawn
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Philip McGuire
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| |
Collapse
|
21
|
Buckner JD, Shepherd J, Stoneking FR, Zvolensky MJ. Dual Electronic and Combustible Cigarette Use: Understanding the Relation of Cannabis Use with E-Cigarette Outcomes. Subst Use Misuse 2024; 59:432-438. [PMID: 37932873 PMCID: PMC10842333 DOI: 10.1080/10826084.2023.2275570] [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: 11/08/2023]
Abstract
Background: E-cigarette use is on the rise and many who use e-cigarettes also smoke combustible cigarettes. Dual use (i.e., use of both electronic and combustible cigarettes) is associated with greater rates of cannabis use and cannabis use among individuals who engage in dual use is related to more severe ecigarette-related problems. Yet, no known studies have tested whether cannabis use is related to more severe e-cigarette problems via negative affect and the expectation that e-cigarettes can help manage negative affect. Objectives: The current study tested this hypothesis among 400 adults who endorsed dual use, 33% of whom endorsed current (past three month) cannabis use. Results: Results indicated that participants with cannabis use reported more anxiety, depression, e-cigarette problems, and the following e-cigarette use expectancies: negative consequences, negative reinforcement, and weight concerns. Multiple mediator models found that the relation between cannabis use status and e-cigarette problem severity was mediated by anxiety (but not depression) and by negative reinforcement and weight concerns (but not negative consequences) expectancies. Serial mediator models indicated that the relation between cannabis use and e-cigarette problems occurred via the serial effects of anxiety and negative reinforcement (but not weight concerns) expectancies. Conclusions: These results highlight several clinical correlates of cannabis use among adults who smoke combustible and e-cigarettes, and suggest that anxiety and the expectation that e-cigarettes may help manage such negative emotions play important roles in e-cigarette-related problems among these individuals.
Collapse
Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Justin Shepherd
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Faith R Stoneking
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas Maryland Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
22
|
Miller-Matero LR, Ross K, Arellano C, Zelenak L, DePascale E, Gavrilova L, Braciszewski JM, Hecht LM, Haley EN, Brescacin C, Carlin AM. Cannabis use following bariatric surgery is associated with anxiety and maladaptive eating. Surg Obes Relat Dis 2024; 20:91-97. [PMID: 37863791 DOI: 10.1016/j.soard.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND There are limited data regarding the association of cannabis use with outcomes after bariatric surgery. As such, it is challenging to know how to counsel patients using cannabis. OBJECTIVES The purpose of this study was to examine whether postsurgical cannabis use was associated with psychiatric symptoms and maladaptive eating among individuals up to 4 years after bariatric surgery. SETTING Single health system. METHODS All patients who underwent bariatric surgery over a 4-year period were invited to participate. Participants (N = 765) completed questionnaires online regarding postsurgical cannabis use, psychiatric symptoms, and maladaptive eating. RESULTS Any cannabis use after bariatric surgery was associated with increased likelihood of having elevated symptoms of anxiety (odds ratio [OR] = 1.88, P = .003; 37.8% versus 24.4%), increased likelihood of grazing behaviors (OR = 1.77, P = .01; 71.2% versus 58.2%), and higher scores for eating in response to depression (P = .01; 12.13 versus 10.75). Weekly cannabis use was associated with loss of control eating (OR = 1.81, P = .04; 37.2% versus 24.7%), binge eating (OR = 2.16, P = .03; 20.0% versus 10.4%), and night eating behaviors (OR = 2.11, P = .01; 40.0% versus 24.0%). Cannabis use was not associated with depression (P > .05). CONCLUSIONS Cannabis use after bariatric surgery was associated with anxiety symptoms and engaging in maladaptive eating behaviors. Frequent cannabis use (i.e., ≥1 per week) was associated with additional types of maladaptive eating. Clinicians involved in presurgical and postsurgical care may want to counsel patients currently using cannabis, especially those who are engaging in frequent use.
Collapse
Affiliation(s)
- Lisa R Miller-Matero
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan.
| | - Kaitlin Ross
- Wayne State University School of Medicine, Detroit, Michigan
| | - Camila Arellano
- Wayne State University School of Medicine, Detroit, Michigan
| | - Logan Zelenak
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Eve DePascale
- Henry Ford Health, Behavioral Health, Detroit, Michigan
| | - Lyubov Gavrilova
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Jordan M Braciszewski
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Leah M Hecht
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Erin N Haley
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Carly Brescacin
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
| | - Arthur M Carlin
- Wayne State University School of Medicine, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
| |
Collapse
|
23
|
Porche S, Gardner B. Reflective and non-reflective influences on cannabis use among undergraduate students: A qualitative study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:328-334. [PMID: 35157557 DOI: 10.1080/07448481.2022.2034835] [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: 03/30/2021] [Revised: 10/19/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Around 40% of US university students use cannabis, 25% of whom present with cannabis use disorder, which endangers health. We investigated the concurrent contribution of reflective processes, which generate action via conscious deliberation, and non-reflective processes, which prompt behavior automatically, to undergraduates' cannabis consumption. PARTICIPANTS Eighteen UK undergraduates who regularly consume cannabis (11 female, 7 male; mean age 20 y). METHODS Semi-structured interviews explored cannabis motives, routines, cues, and decision points. Thematic analysis identified themes, in each of which reflective and non-reflective dimensions were coded. RESULTS Four themes were identified: cannabis use for relaxation, social bonding, and symbolic-affective significance, and contexts and triggers. Some influences guided cannabis use reflectively in some settings, and non-reflectively in others. Even when cannabis use was consciously driven, non-reflective processes were deployed to execute subservient acts, such as rolling joints. CONCLUSIONS Findings highlight specific processes and pathways that might be targeted to reduce cannabis-related harm.
Collapse
Affiliation(s)
- Samuele Porche
- Department of Psychology, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Benjamin Gardner
- Department of Psychology, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| |
Collapse
|
24
|
Zhekova RM, Perry RN, Spinella TC, Dockrill K, Stewart SH, Barrett SP. The impact of cannabidiol placebo on responses to an acute stressor: A replication and proof of concept study. J Psychopharmacol 2024; 38:116-124. [PMID: 38214314 PMCID: PMC10851629 DOI: 10.1177/02698811231219060] [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: 01/13/2024]
Abstract
BACKGROUND Our group has previously reported that cannabidiol (CBD) expectancy alone blunts markers of stress, particularly during anticipation, but it is not clear the extent to which such findings were specific to the methods utilized. AIMS To examine CBD-related placebo effects on stress reactivity and anticipation and to validate a protocol to be used in a neuroimaging study. METHODS Forty-eight healthy adults (24 female) were randomly assigned to be informed that they ingested a CBD-containing oil or a CBD-free oil despite receiving the same oil (CBD-free). Following oil administration, participants engaged in a laboratory stressor and were then incorrectly informed that they would engage in a second more difficult task following a waiting period. Subjective state (sedation, energy, stress, anxiety) and heart rate were assessed at baseline, post-oil administration, immediately following the first stressor, and while anticipating the second stressor. RESULTS Subjective stress and anxiety were significantly elevated immediately following the stressor (p-values < 0.001). CBD expectancy was associated with increased subjective sedation (p < 0.01) and tended to be associated with blunted subjective stress (p = 0.053). Post hoc within-condition pairwise compassions suggested a return to pre-stressor levels during the anticipation period in the CBD condition for subjective stress and anxiety (p = 0.784, 0.845), but not the CBD-free condition (p = 0.025, 0.045). CONCLUSION Results replicate and extend previous findings that CBD expectancy alone can impact stress- and anxiety-relevant responses in the laboratory context.
Collapse
Affiliation(s)
- Radostina M Zhekova
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Robin N Perry
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Toni C Spinella
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Kayley Dockrill
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sean P Barrett
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
25
|
Coelho SG, Hendershot CS, Quilty LC, Wardell JD. Screening for cannabis use disorder among young adults: Sensitivity, specificity, and item-level performance of the Cannabis Use Disorders Identification Test - Revised. Addict Behav 2024; 148:107859. [PMID: 37717499 DOI: 10.1016/j.addbeh.2023.107859] [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: 07/15/2023] [Revised: 08/15/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
The Cannabis Use Disorders Identification Test Revised (CUDIT-R) is a widely used screening tool. However, its utility in screening for cannabis use disorder (CUD) among young adults requires further investigation. The current study evaluated the accuracy of the CUDIT-R in distinguishing between young adults with and without CUD. We also examined the individual item properties of the CUDIT-R in this sample. A community sample of young adults (N = 153, ages 19-26 years) who reported at least one lifetime period of regular cannabis use (i.e., twice or more per month for at least six months) completed the CUDIT-R and the Structured Clinical Interview for DSM-5 (SCID-5) Substance Use Module. The CUDIT-R showed good accuracy in distinguishing between young adults with and without CUD as determined by the SCID-5 (area under the receiver operating characteristic curve = 0.84). A cut-point of nine yielded 87.80 % sensitivity and 70.42 % specificity, with positive and negative predictive values of 77.42 % and 83.33 %, respectively. Item response theory analyses revealed that CUDIT-R items assessing impaired control, failure to meet expectations, time devoted to use, and memory and concentration problems displayed high discrimination and were relatively difficult, whereas items assessing frequency of use and attempts to reduce use showed moderate discrimination and relatively low difficulty. Items assessing hours high and use with potential for physical hazard displayed poor discrimination. The CUDIT-R appears to validly distinguish between young adults with and without CUD and may be useful in screening for CUD in this high-risk population. Further research considering individual item properties is needed to refine the CUDIT-R for use among young adults.
Collapse
Affiliation(s)
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States; Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, Canada; Department of Psychiatry, University of Toronto, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
| |
Collapse
|
26
|
Callender L, Lai T, Driver S, Ketchum JM, Ochoa C, Corrigan JD, Hammond FM, Harrison-Felix C, Martin AM, Rabinowitz AR, Starosta AJ, Dubiel R. The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset. J Head Trauma Rehabil 2024; 39:82-93. [PMID: 38167717 PMCID: PMC10947995 DOI: 10.1097/htr.0000000000000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To determine if the interaction of opiate misuse and marijuana use frequency is associated with behavioral health outcomes. SETTING Community. PARTICIPANTS Three thousand seven hundred fifty participants enrolled in the Traumatic Brain Injury Model Systems who completed the Pain Survey and had complete opioid use and marijuana use information. DESIGN Cross-sectional, secondary analysis from a multisite observational cohort. MAIN OUTCOME MEASURES Clinically significant behavioral health symptoms for posttraumatic stress disorder (PTSD), depression, anxiety, and sleep quality. RESULTS Three thousand five hundred thirty-five (94.3%) participants did not misuse opiates, 215 (5.7%) did misuse opiates (taking more opioid pain medication than prescribed and/or using nonprescription opioid pain medication); 2683 (70.5%) participants did not use marijuana, 353 (9.3%) occasionally used marijuana (less than once a week), and 714 (18.8%) regularly used marijuana (once a week or more frequently). There was a statistically significant relationship (P < .05) between the interaction of opiate misuse and marijuana use frequency and all behavioral health outcomes and several covariates (age, sex, cause of injury, severity of injury, and pain group category). Pairwise comparisons confirm that statistically significant associations on behavioral health outcomes are driven by endorsing opiate misuse and/or regular marijuana use, but occasional marijuana use was not associated. CONCLUSIONS Higher odds of clinically significant PTSD, depression, anxiety, and poor sleep quality are present in people with traumatic brain injury (TBI) who misuse opiates and/or who use marijuana regularly. In the absence of opiate misuse, regular marijuana use had higher odds of worse behavioral health outcomes than occasional and no use. The interaction of opiate misuse and regular marijuana use yielded the highest odds. Individuals with TBI should be informed of the relationship of substance use and behavioral health outcomes and that current chronic pain may mediate the association.
Collapse
Affiliation(s)
- Librada Callender
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas (Mss Callender and Ochoa, Drs Lai, Driver, and Dubiel); Research Department, Craig Hospital, Englewood, Colorado (Drs Ketchum and Harrison-Felix); College of Medicine, The Ohio State University, Columbus (Dr Corrigan); Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine & Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Mental Health and Behavioral Science Service, James A. Haley Veterans Hospital, Tampa, Florida (Dr Martin); Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa (Dr Martin); Department of Physical Medicine and Rehabilitation, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Rabinowitz); and Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle (Dr Starosta)
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
McInnes AN, Sullivan CRP, MacDonald AW, Widge AS. Psychometric validation and clinical correlates of an experiential foraging task. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.28.573439. [PMID: 38234810 PMCID: PMC10793407 DOI: 10.1101/2023.12.28.573439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Measuring the function of decision-making systems is a central goal of computational psychiatry. Individual measures of decisional function could be used to describe neurocognitive profiles that underpin psychopathology and offer insights into deficits that are shared across traditional diagnostic classes. However, there are few demonstrably reliable and mechanistically relevant metrics of decision making that can accurately capture the complex overlapping domains of cognition whilst also quantifying the heterogeneity of function between individuals. The WebSurf task is a reverse-translational human experiential foraging paradigm which indexes naturalistic and clinically relevant decision-making. To determine its potential clinical utility, we examined the psychometric properties and clinical correlates of behavioural parameters extracted from WebSurf in an initial exploratory experiment and a pre-registered validation experiment. Behaviour was stable over repeated administrations of the task, as were individual differences. The ability to measure decision making consistently supports the potential utility of the task in predicting an individual's propensity for response to psychiatric treatment, in evaluating clinical change during treatment, and in defining neurocognitive profiles that relate to psychopathology. Specific aspects of WebSurf behaviour also correlate with anhedonic and externalising symptoms. Importantly, these behavioural parameters may measure dimensions of psychological variance that are not captured by traditional rating scales. WebSurf and related paradigms might therefore be useful platforms for computational approaches to precision psychiatry.
Collapse
Affiliation(s)
- Aaron N. McInnes
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Christi R. P. Sullivan
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | | | - Alik S. Widge
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
28
|
Kinnunen K, Robayo LE, Cherup NP, Frank SI, Widerström-Noga E. A preliminary study evaluating self-reported effects of cannabis and cannabinoids on neuropathic pain and pain medication use in people with spinal cord injury. FRONTIERS IN PAIN RESEARCH 2023; 4:1297223. [PMID: 38188193 PMCID: PMC10767995 DOI: 10.3389/fpain.2023.1297223] [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: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Approximately 60% of individuals with a spinal cord injury (SCI) experience neuropathic pain, which often persists despite the use of various pharmacological treatments. Increasingly, the potential analgesic effects of cannabis and cannabinoid products have been studied; however, little research has been conducted among those with SCI-related neuropathic pain. Therefore, the primary objective of the study was to investigate the perceived effects of cannabis and cannabinoid use on neuropathic pain among those who were currently or had previously used these approaches. Additionally, the study aimed to determine if common pain medications are being substituted by cannabis and cannabinoids. Participants (N = 342) were recruited from existing opt-in listserv sources within the United States. Of those, 227 met the inclusion criteria and were enrolled in the study. The participants took part in an anonymous online survey regarding past and current use of cannabis and their perceived effects on neuropathic pain, including the use of pain medication. Those in the sample reported average neuropathic pain intensity scores over the past week of 6.8 ± 2.1 (0 to 10 scale), reflecting a high moderate to severe level of pain. Additionally, 87.9% noted that cannabis reduced their neuropathic pain intensity by more than 30%, and 92.3% reported that cannabis helped them to better deal with their neuropathic pain symptoms. Most participants (83.3%) also reported substituting their pain medications with cannabis, with the most substituted medication categories being opioids (47.0%), gabapentinoids (42.8%) and over-the-counter pain medications (42.2%). These preliminary results suggest that cannabis and cannabinoids may be effective in reducing neuropathic pain among those with SCI and may help to limit the need for certain pain medications.
Collapse
Affiliation(s)
- Kristiina Kinnunen
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States
| | - Linda E. Robayo
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States
| | - Nicholas P. Cherup
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States
| | - Scott I. Frank
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States
- Neuroscience Graduate Program, University of Miami, Miami, FL, United States
| | - Eva Widerström-Noga
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States
- Neuroscience Graduate Program, University of Miami, Miami, FL, United States
- Department of Neurological Surgery, University of Miami, Miami, FL, United States
| |
Collapse
|
29
|
Macatee RJ, Schermitzler BS, Minieri JB, Moeller SJ, Afshar K, Preston TJ. Neurophysiological error processing and addiction self-awareness correlates of reduced insight in cannabis use disorder. Addiction 2023; 118:2397-2412. [PMID: 37612599 PMCID: PMC10730014 DOI: 10.1111/add.16321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND AND AIMS Cannabis use disorder (CUD) prevalence has increased, while perceived risks of cannabis use and CUD treatment need have decreased. Chronic cannabis use may also impair the neural and behavioral mechanisms of insight, further hampering treatment-seeking. This study aimed to measure whether CUD is characterized by reduced self-monitoring in drug-related contexts (objectively-assessed insight), subserved by functional neural abnormalities in error-processing and manifested clinically as decreased awareness of the need to change. DESIGN Case-control laboratory study was used. SETTING University setting was in Alabama, USA. PARTICIPANTS There were 42 CUD participants and 47 age-, sex-, and nicotine use-matched controls. MEASUREMENTS Participants completed a probabilistic choice task, adapted for the first time for CUD, in which they selected pleasant, unpleasant, neutral, and cannabis-related images according to their preference. Reduced versus accurate insight was operationalized as the correspondence between self-reported and actual most chosen image type. Neurophysiological error-processing during an inhibitory control task was recorded using electroencephalography. Participants with CUD completed measures of cannabis problem recognition and motivation to change. FINDINGS Compared with controls, the CUD group made significantly more cannabis selections on the choice task (mean difference [MD] = 8.11, 95% confidence interval [CI] [4.88 11.35], p < 0.001) and had significantly reduced insight into cannabis choice (odds ratio [OR] = 9.69, 95% CI [1.06 88.65], p = 0.04). CUD participants with reduced insight on the choice task had significantly decreased neurophysiological reactivity to errors on the inhibitory control task (error-related negativity) compared with CUD participants with accurate insight (MD = 2.64 μV, 95% CI [0.74 μV 4.54 μV], p = 0.008) and controls (MD = 4.05 μV, 95% CI [1.29 μV 6.80 μV], p = 0.005). Compared with CUD participants with accurate insight on the choice task, CUD participants with reduced insight reported significantly less agreement that they had a cannabis problem (MD = -5.06, 95% CI [-8.49-1.62], p = 0.003). CONCLUSIONS People with CUD who show reduced insight on a drug-related choice task may also have decreased early neural error-processing and less cannabis problem recognition.
Collapse
Affiliation(s)
| | | | | | | | - Kaveh Afshar
- Auburn University, Department of Psychological Sciences
| | | |
Collapse
|
30
|
Knox JR, Dolotina B, Moline T, Matthews I, Durrell M, Hanson H, Almirol E, Hotton A, Pagkas-Bather J, Chen YT, English D, Manuzak J, Rower JE, Miles C, Millar B, Jean-Louis G, Rendina HJ, Martins SS, Grov C, Hasin DS, Carrico AW, Shoptaw S, Schneider JA, Duncan DT. HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach. JMIR Res Protoc 2023; 12:e48548. [PMID: 38039075 PMCID: PMC10724817 DOI: 10.2196/48548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. OBJECTIVE This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. METHODS Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). RESULTS The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. CONCLUSIONS The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48548.
Collapse
Affiliation(s)
- Justin R Knox
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Dolotina
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Tyrone Moline
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Isabella Matthews
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Mainza Durrell
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Ellen Almirol
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Anna Hotton
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Yen-Tyng Chen
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Devin English
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Jennifer Manuzak
- Division of Immunology, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Joseph E Rower
- Center for Human Toxicology, University of Utah, Salt Lake City, UT, United States
| | - Caleb Miles
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Millar
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Silvia S Martins
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Grov
- Einstein-CUNY-Rockefeller Center for AIDS Research, School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Deborah S Hasin
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Adam W Carrico
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Dustin T Duncan
- Mailman School of Public Health, Columbia University, New York, NY, United States
| |
Collapse
|
31
|
Trinh CD, Schick MR, Lynch-Gadaleta B, Martz A, Nalven T, Spillane NS. The Role of Savoring in Young Adult Cannabis Use and Associated Consequences: A Replication Study. J Psychoactive Drugs 2023:1-8. [PMID: 37947346 PMCID: PMC11082068 DOI: 10.1080/02791072.2023.2278583] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/29/2023] [Indexed: 11/12/2023]
Abstract
Young adults exhibit high rates of cannabis use and are at heightened risk of experiencing negative cannabis-associated consequences. The purpose of the present study was to replicate and extend to prior work on savoring, the ability to experience positive experiences/emotions, and cannabis use frequency on cannabis-associated consequences. Young adults (18-25 years old, N = 122, 36.1% women) who reported weekly cannabis use completed self-report surveys. Savoring was significantly associated with cannabis use frequency (r = .28, p < .01) and cannabis-associated consequences (r = -.20, p < .05). Cannabis use frequency was significantly and negatively associated with cannabis-associated consequences (r = -.24, p < .01). However, the interaction between cannabis use frequency and savoring on cannabis-associated consequences was not significant (b = 0.0004, p = .91, 95% CI [-0.007, 0.008]). When the interaction was removed, neither cannabis use frequency (b = -0.14, p = .08, CI [-0.29, -0.02]) nor savoring (b = -0.05, p = .16, CI [-0.13, 0.02]) were associated with cannabis-associated consequences. Results did not replicate previous findings regarding the moderating role of savoring in the relationship between cannabis use frequency and cannabis-associated consequences. Future research may explore why findings did not replicate by using more fine-grained assessment methods and comprehensive measures of cannabis use.
Collapse
Affiliation(s)
- Catherine D. Trinh
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Melissa R. Schick
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Anika Martz
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Tessa Nalven
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Nichea S. Spillane
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| |
Collapse
|
32
|
Gette JA, Littlefield AK, Victor SE, Schmidt AT, Garos S. Evaluation of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Questionnaire and its Relations to Cannabis-Related Problems. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:64-86. [PMID: 38035173 PMCID: PMC10683753 DOI: 10.26828/cannabis/2023/000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Cannabis use and the prevalence of cannabis use disorder (CUD) among emerging adults are on the rise. Several indicators of cannabis use (e.g., quantity, frequency) as they relate to negative outcomes have been posited in the extant literature. Despite research examining links between indicators and cannabis outcomes, few assessments of cannabis use indicators exist. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU) was developed to assess cannabis use across a range of factors. However, the factor structure of the DFAQ-CU has not been replicated. Further, the DFAQ-CU was modeled using reflective strategies despite formative strategies being conceptually appropriate. The present study utilized principal components analyses (PCA) and principal axis factoring (PAF) to evaluate the structure of the DFAQ-CU. PCA yielded a four-component solution; PAF resulted in a five-factor solution. Linear regression found significant relations between PCA components and PAF factors with CUD symptoms and cannabis-related problems; however, effect sizes were larger for the PAF suggesting possible misdisattenuation. The PCA components demonstrated evidence of discriminant and convergent validity with measures of cannabis and alcohol behavior. The study informs research and clinical work through the refinement of cannabis use assessment and enhancing our understanding of the importance of model selection.
Collapse
Affiliation(s)
- Jordan A Gette
- The Center of Alcohol and Substance Use Studies, Rutgers University
| | | | - Sarah E Victor
- Department of Psychological Sciences, Texas Tech University
| | - Adam T Schmidt
- Department of Psychological Sciences, Texas Tech University
| | - Sheila Garos
- Department of Psychological Sciences, Texas Tech University
| |
Collapse
|
33
|
Espinoza S, Lagunas MA, Claudia R, Lovell JL. Perceived Risks and Therapeutic Benefits of Cannabis Among College Students Amidst the COVID-19 Pandemic. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:18-33. [PMID: 38035168 PMCID: PMC10683751 DOI: 10.26828/cannabis/2023/000157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
More than half of the United States has legalized medicinal and/or recreational cannabis. The purpose of the study is to understand cannabis use and perceptions among college students with cannabis experience - 21 years and older - in a legalized cannabis state. Participants included 170 college students, the majority identified as female (72.9%, n = 124) and Latinx/Hispanic (55.9%, n = 95). The online survey included demographic questions and questionnaires measuring cannabis consumption, cannabis use disorder, and quality of life. Participants answered open-ended questions about the negative, positive, and spiritual impact/s of cannabis on their life and health, and how the COVID-19 pandemic impacted their cannabis use. A paired-sample t-test indicated participants significantly found more relief using cannabis compared to non-cannabis treatments or medications. There was no significant correlation between quality of life and cannabis use disorder symptoms. Inductive content analysis of 112 written responses revealed perceived negative effects (e.g., anxiety/mental health issues) and positive effects (e.g., relaxation/stress reduction) from using cannabis. Most participants reported no spiritual benefits; however, some participants discussed cannabis use improving connection to self and self-awareness. Regarding the impact of the COVID-19 pandemic on use, most participants (27.8%) reported increased cannabis use, while some reported decreased cannabis use. These findings reflect the importance of understanding the wide-range of benefits and risks perceived by college students who consume cannabis and how these results can inform the development of university prevention and wellness strategies within states that have legalized recreational and medical cannabis.
Collapse
|
34
|
Davis AK, Arterberry BJ, Xin Y, Hubbard SM, Schwarting CM, Bonar EE. Incremental Predictive Validity of the Dualistic Model of Passion for Cannabis Use Among College Undergraduate Students With and Without a Cannabis Use Disorder. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:105-126. [PMID: 38035170 PMCID: PMC10683744 DOI: 10.26828/cannabis/2023/000180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Introduction We examined whether the Dualistic Model of Passion (DMP; i.e., obsessive passion [OP] and harmonious passion [HP]) for cannabis use was prospectively associated with cannabis use and use-related outcomes, and with academic performance, relationship attachment style, and social connectedness among college students. We also explored whether the DMP was associated with outcomes when included in a model using established constructs (e.g., coping motives, refusal self-efficacy, cannabis use disorder [CUD] symptoms) as predictors of cannabis use and outcomes. Methods Using a longitudinal cohort design (baseline, 5-month, 10-month [timepoints chosen to better correspond to 9-month academic year]), 513 undergraduate students from two universities who reported using cannabis at least four times in the past month completed a baseline survey (308 meeting criteria for CUD). We used Generalized Estimating Equations to assess longitudinal associations between OP/HP and cannabis use and academic/social outcomes at 5-month and 10-month. Results At baseline, participants were young adults (Mean age = 20.57, SD = 2.51), 78.8% non-Hispanic, 83.8% White, 55.0% female, and 72.3% heterosexual. Greater HP was not associated with greater past month cannabis use or cannabis-related problems. Greater OP was associated with greater past month cannabis use and more cannabis-related problems. There were no significant passion by time interactions. Greater HP was associated with more anxious attachment. OP was associated with less social connection. Conclusion This research suggests that the DMP provides novel information about factors associated with cannabis use and use-related consequences, which can aid in our understanding of cannabis use, misuse, and CUD among college students.
Collapse
Affiliation(s)
- Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University. Columbus, OH USA
- Institute for Population Research, University of Michigan, Ann Arbor, MI USA
| | - Brooke J Arterberry
- Institute for Population Research, University of Michigan, Ann Arbor, MI USA
- Department of Psychology, Iowa State University, Ames, IA USA
| | - Yitong Xin
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University. Columbus, OH USA
| | | | | | - Erin E Bonar
- University of Michigan - Department of Psychiatry; Ann Arbor, MI, USA
- University of Michigan - Addiction Center; Ann Arbor, MI, USA
- University of Michigan - Injury Prevention Center; Ann Arbor, MI, USA
| |
Collapse
|
35
|
Borodovsky JT, Struble CA, Habib MI, Hasin DS, Shmulewitz D, Walsh C, Livne O, Aharonovich E, Budney AJ. Exploring survey methods for measuring consumption quantities of cannabis flower and concentrate products. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:733-745. [PMID: 37774316 PMCID: PMC10795727 DOI: 10.1080/00952990.2023.2246635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/06/2023] [Indexed: 10/01/2023]
Abstract
Background: Researchers need accurate measurements of cannabis consumption quantities to assess risks and benefits. Survey methods for measuring cannabis flower and concentrate quantities remain underdeveloped.Objective: We examined "grams" and "hits" units for measuring flower and concentrate quantities, and calculating milligrams of THC (mgTHC).Methods: Online survey participants (n = 2,381) reported preferred unit (hits or grams), past-week hits and grams for each product, and product %THC. Quantile regression compared mgTHC between unit-preference subgroups. Hits-based mgTHC calculations assumed a universal grams-per-hit ratio (GPHR). To examine individualized GPHRs, we tested a "two-item approach," which divided total grams by total hits, and "one-item approach," which divided 0.5 grams by responses to the question: "How many total hits would it take you to finish 1/2 g of your [product] by [administration method]?"Results: Participants were primarily daily consumers (77%), 50% female sex, mean age 39.0 (SD 16.4), 85% White, 49% employed full-time. Compared to those who preferred the hits unit, those who preferred the grams unit reported consuming more hits and grams, higher %THC products, and consequently, larger median mgTHC (flower-hits mgTHC: 32 vs. 91 (95%CI: 52-67); flower-grams mgTHC: 27 vs. 113 (95%CI: 73-95); concentrate-hits mgTHC: 29 vs. 59 (95%CI: 15-43); concentrate-grams mgTHC: 61 vs. 129 (95%CI: 43-94)). "Two-item" and "one-item" approach GPHRs were similar and frequently 50% larger or smaller than the universal GPHR.Conclusion: Allowing respondents to choose "hits" or "grams" when reporting cannabis quantities does not compromise mgTHC estimates. A low-burden, one-item approach yields individualized "hit sizes" that may improve mgTHC estimates.
Collapse
Affiliation(s)
- Jacob T. Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH 03766, USA
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755, USA
| | - Cara A. Struble
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH 03766, USA
| | - Mohammad I. Habib
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH 03766, USA
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168 St, New York, NY 10032, USA
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Claire Walsh
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Alan J. Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, 46 Centerra Pkwy, Lebanon, NH 03766, USA
| |
Collapse
|
36
|
Larsen SF, Johnson AJ, Larimer ME, Dager SR, Kleinhans NM. Self-report methodology for quantifying standardized cannabis consumption in milligrams delta-9-tetrahydrocannabinol. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:723-732. [PMID: 37506343 DOI: 10.1080/00952990.2023.2232525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
Background: There is currently no format-independent method to determine delta-9-tetrahydrocannabinol (THC) in milligrams for self-report studies.Objectives: Validate self-report method for quantifying mg THC from commercially available cannabis products using product labeling, which includes both net weight and product potency.Methods: 53 adult cannabis users (24 M, 29F), 21-39 years of age (M = 28.38, SD = 4.15), were instructed to report daily use via a weekly survey for two consecutive weeks, provide product label photographs, abstain from use for 24 h, submit a urine sample and complete the Cannabis Use Disorder Identification Test - Revised (CUDIT-R) and the Marijuana Craving Questionnaire - Short Form (MCQ-SF). Milligrams of THC were determined by multiplying quantity of product used by its THC concentration. Urine was analyzed for the urine metabolite 11-nor-carboxy-THC (THC-COOH) via liquid chromatography mass spectroscopy. THC and THC-COOH values were log10 transformed prior to correlational analyses.Results: Median daily THC consumption was 102.53 mg (M = 203.68, SD = 268.13). Thirty-three (62%) of the 53 participants reported using two or more formats over the 2-week period. There was a significant positive correlation between log10 THC-COOH and log10 THC mg (r(41) = .59, p < .001), log10 THC mg and MCQ-SF score (r(41) = .59, p < .001), and log10 THC mg dose and CUDIT-R score, (r(41) = .39, p = .010).Conclusion: Our label-based methodology provides consumption information across all modalities of cannabis use in standard units that can be combined across products for calculation of dose. It is a viable and valid method for quantifying mg of THC consumed and can be utilized in any region where cannabis is legal, and labeling is regulated.
Collapse
Affiliation(s)
- Sarah F Larsen
- Department of Radiology, University of Washington, Seattle, WA, USA
- Integrated Brain Imaging Center, University of Washington, Seattle, WA, USA
| | - Allegra J Johnson
- Department of Radiology, University of Washington, Seattle, WA, USA
- Integrated Brain Imaging Center, University of Washington, Seattle, WA, USA
| | - Mary E Larimer
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA, USA
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
- Department of Biomedical Engineering, University of Washington, Seattle, WA, USA
| | - Natalia M Kleinhans
- Department of Radiology, University of Washington, Seattle, WA, USA
- Integrated Brain Imaging Center, University of Washington, Seattle, WA, USA
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
| |
Collapse
|
37
|
Balneaves LG, Watling CZ, Strus JA, Boscow M, Davis L, Graveline K, Harrigan T, Henriquez N, Mitchell K, Thompson G. Baccalaureate nursing students' knowledge, attitudes, educational needs, and use of medical and non-medical cannabis at five institutions in Manitoba, Canada: A cross-sectional analysis. NURSE EDUCATION TODAY 2023; 130:105955. [PMID: 37677985 DOI: 10.1016/j.nedt.2023.105955] [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: 05/20/2023] [Revised: 08/15/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND With the legalization of non-medical cannabis in Canada, cannabis is commonly used in the community and nurses and nursing students are likely to engage in clinical practice discussions around cannabis use for both medical and non-medical purposes. However, whether having previous experience using cannabis influences nursing students' knowledge and attitudes towards cannabis remains unclear. OBJECTIVE The aim of this study was to describe nursing students' knowledge, attitudes, educational needs, and use of cannabis. DESIGN Cross-sectional survey. SETTING Five academic undergraduate nursing programs in Manitoba, Canada. PARTICIPANTS Nursing students in Manitoba. METHODS Students were asked about their use of cannabis, knowledge and attitudes regarding cannabis, clinical experiences and educational needs related to cannabis. Students' current knowledge was compared to their desired knowledge using paired t-tests. Using t-tests, attitudes towards cannabis were compared between students who had ever taken cannabis versus those with no experience. Descriptive statistics were utilized for all other questions. RESULTS A total of 327 nursing students participated in the survey with 220 students (67.3 %) reporting they had used cannabis in the past, and 123 students (37.6 %) reporting monthly use of cannabis. Students who previously used cannabis held more positive attitudes towards both medical and non-medical cannabis use in comparison to those with no experience. Students recognised that their current knowledge around cannabis was insufficient and indicated the need for greater knowledge on both medical and non-medical cannabis-related topics. Only 37.7 % of students reported receiving any education on cannabis in their nursing program. Nearly all students (92.2 %) agreed if they had more education on medical cannabis use that they would feel more comfortable discussing this in their clinical practice. CONCLUSION Education on both medical and non-medical cannabis is needed to support future nurses addressing cannabis use in their clinical practice. Nursing institutions must implement and evaluate curricula to ensure nursing students are adequately prepared to address cannabis use in their clinical practice and their own fitness to practice.
Collapse
Affiliation(s)
- Lynda G Balneaves
- 89 Curry Place, College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Cody Z Watling
- 89 Curry Place, College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | | | - Megan Boscow
- 436 7 St E, Faculty of Nursing, University College of the North, Thompson and The Pas, MB R9A 1T4, Canada.
| | - Lori Davis
- 89 Curry Place, College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Kellie Graveline
- 436 7 St E, Faculty of Nursing, University College of the North, Thompson and The Pas, MB R9A 1T4, Canada.
| | - Tom Harrigan
- 2055 Notre Dame Avenue, Nursing Department, Red River College Polytechnic, Winnipeg, MB R3H 0J9, Canada.
| | - Nadine Henriquez
- 270-18th Street, Faculty of Health Studies, Brandon University, Brandon, MB R7A 6A9, Canada.
| | - Kimberley Mitchell
- 89 Curry Place, College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; 2055 Notre Dame Avenue, Nursing Department, Red River College Polytechnic, Winnipeg, MB R3H 0J9, Canada.
| | - Genevieve Thompson
- 89 Curry Place, College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| |
Collapse
|
38
|
Cooke JT, Schmidt AT, Garos S, Littlefield AK. The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes. Arch Clin Neuropsychol 2023; 38:1068-1081. [PMID: 37001549 DOI: 10.1093/arclin/acad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment. METHOD The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university. RESULTS The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P. CONCLUSIONS Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.
Collapse
Affiliation(s)
- Jeffrey T Cooke
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Adam T Schmidt
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Sheila Garos
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| |
Collapse
|
39
|
Coelho SG, Rueda S, Costiniuk CT, Jenabian MA, Margolese S, Mandarino E, Shuper PA, Hendershot CS, Cunningham JA, Arbess G, Singer J, Wardell JD. Knowledge of Cannabinoid Content Among People Living with HIV Who Use Cannabis: a Daily Diary Study. Int J Behav Med 2023:10.1007/s12529-023-10221-x. [PMID: 37794278 DOI: 10.1007/s12529-023-10221-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Many people living with HIV (PLWH) use cannabis for medicinal reasons. Patients' knowledge of the tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations of the cannabis products they use may be important in helping patients achieve symptom relief while guarding against potential risks of cannabis use. However, no studies have examined cannabinoid concentration knowledge among PLWH. METHOD PLWH (N = 29; 76% men, mean age 47 years) reporting cannabis use for both medicinal and nonmedicinal reasons completed daily surveys over 14 days assessing cannabis products used, knowledge of cannabinoid concentrations of cannabis products used, cannabis use motives (medicinal, nonmedicinal, both), and positive and negative cannabis-related consequences. Across the 361 cannabis use days captured on the daily surveys, at least some knowledge of cannabinoid concentrations was reported on an average of 43.1% (for THC) and 26.6% (for CBD) of the days. RESULTS Generalized linear mixed models revealed that participants were more likely to report knowing THC and CBD concentrations on days when they used non-flower forms of cannabis relative to days when they used cannabis flower only. Participants who used cannabis for medicinal reasons on a greater proportion of days had greater knowledge of cannabinoid concentration overall across days. Further, greater overall knowledge of cannabinoid concentrations was associated with fewer reported negative cannabis-related consequences. CONCLUSIONS Findings suggest that among PLWH, knowledge of cannabinoid concentrations may be higher when using non-flower cannabis products and among those reporting primarily medicinal cannabis use. Moreover, knowledge of cannabinoid concentration may protect against negative cannabis-related consequences in this population.
Collapse
Affiliation(s)
- Sophie G Coelho
- Department of Psychology, York University, 277 Behavioural Sciences Building, 4700 Keele St., Toronto, ON, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Cecilia T Costiniuk
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
- Chronic Viral Illness Service and Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
- Infection and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Mohammad-Ali Jenabian
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
- Department of Biological Sciences, Université du Québec á Montréal, Montreal, QC, Canada
| | | | | | - Paul A Shuper
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Christian S Hendershot
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
- Bowles Centre for Alcohol Studies, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - John A Cunningham
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Addictions, Kings College London, London, UK
| | - Gordon Arbess
- Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Joel Singer
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, 277 Behavioural Sciences Building, 4700 Keele St., Toronto, ON, Canada.
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada.
| |
Collapse
|
40
|
Schofield K, Cuttler C, Conner BT, Prince MA. Pot at the End of the Rainbow: Cannabis Use Among Sexual Minorities. Cannabis Cannabinoid Res 2023; 8:942-948. [PMID: 36595520 DOI: 10.1089/can.2022.0240] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction: Gay, lesbian, and bisexual individuals (i.e., sexual minorities) use cannabis more frequently than heterosexuals; however, little research has directly compared sexual minorities' patterns of cannabis use (e.g., quantity, age of onset, forms of cannabis used) with heterosexuals. Some research has identified motivations for cannabis use in sexual minorities, but much of this research has been qualitative and/or narrow in scope (e.g., focused on sexual motivations). To the best of our knowledge, no previous research has used a validated measure to examine motives for cannabis use among sexual minorities. Additionally, cannabis use is known to be associated with mental health symptoms, but little research has examined relationships between cannabis use and mental health in this population. Materials and Methods: Data analyses were performed on archival survey data collected from 10 undergraduate psychology subject pools across the United States (N=4,669) as a part of Project ART (Addictions Research Team). Participants indicated their sexual orientation using a 5-point scale, and responses were used to classify participants into three groups: the majority of the sample (n=3,483) were classified into the heterosexual group, about one quarter were classified into the bisexual group (n=1,081), and a small number were classified into the gay group (n=105). Results: The bisexual group was more likely to report using cannabis. They also reported using cannabis more frequently, were more likely to report use of all product types (i.e., flower, concentrates, and edibles), and reported more severe symptoms of cannabis use disorder (CUD) than the heterosexual group. The bisexual group also reported higher levels of coping and enhancement motives for using cannabis and reported higher levels of all measured mental health symptoms (e.g., depression, suicidality, generalized anxiety, and social anxiety) compared with the heterosexual group. Conclusions: Increased frequency of cannabis use, use of a broad range of different products, and use of cannabis to cope with mental health concerns may be placing bisexual individuals at greater risk of CUD. Findings from this study can be used to guide future research and help target mental health interventions among bisexual individuals.
Collapse
Affiliation(s)
- Kyle Schofield
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
41
|
Okey SA, Waddell JT, Shah RV, Kennedy GM, Frangos MP, Corbin WR. An Ecological Examination of Indica Versus Sativa and Primary Terpenes on the Subjective Effects of Smoked Cannabis: A Preliminary Investigation. Cannabis Cannabinoid Res 2023; 8:857-866. [PMID: 36648357 DOI: 10.1089/can.2022.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The legal cannabis landscape has greatly outpaced scientific knowledge. Many popular cannabis claims, such as cultivar (colloquially referred to as strain) classification and terpene content producing different subjective effects, are unsubstantiated. This study examined, for the first time, whether cultivar classification (sativa/indica) and terpene content (caryophyllene, limonene, myrcene, pinene, and terpinolene) were associated with subjective cannabis effects (i.e., pain levels, low-arousal ["indica-like"] effects, high-arousal ["sativa-like"] effects, and negative effects). Methods: Regular cannabis users (n=101) took part in a 2-week long ecological momentary assessment study in which they responded to questions about their cannabis use, stated their preference for sativa versus indica, and reported their in-the-moment subjective effects within 30 min of smoking cannabis. Cultivars were coded for sativa versus indica classification and primary terpene content using Leafly, a popular search engine. Linear mixed-effect models then examined subjective response by sativa/indica and primary terpene. Covariates included demographics (age, sex, race, income), cannabis use (medical use, cannabis use frequency, stated preference for sativa/indica, global expected cannabis effects), morning pain ratings, and specific smoked cannabis occasions (hour of day, minutes since use, context, number of hits, and tetrahydrocannabinol). Results: The majority of participants (78.3%) had a preference for either sativa or indica and reported reasons for their preference that aligned with industry claims. After controlling for covariates, findings revealed that cultivars classified as indica dominant were associated with greater low-arousal (e.g., sluggish, slow) effects relative to the unweighted mean of all cannabis cultivars (b = 0.44, SE=0.16, p=0.01). Cultivars with primary caryophyllene were associated with greater pain ratings (b = 0.53, SE=0.24, p=0.03) and negative effects (b = 0.22, SE=0.08, p=0.01) relative to the mean of all other terpene types. Cultivars with primary pinene were associated with less negative effects (b = -0.35, SE=0.18, p=0.04). Conclusions: Cultivars classified as indica dominant were associated with greater low-arousal effects in models that accounted for both within- and between-person variation, despite the scientific challenges distinguishing between sativa and indica. Preliminary findings also suggest terpenes may play a role in subjective effects. These results emphasize the need for further research, particularly controlled lab studies.
Collapse
Affiliation(s)
- Sarah A Okey
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Jack T Waddell
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Rishika V Shah
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Gillian M Kennedy
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Maria P Frangos
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - William R Corbin
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| |
Collapse
|
42
|
St Pierre M, Daniels S, Sanchez TA, Holtzman S, Russo EB, Walsh Z. The Naturalistic Cannabis Administration Protocol (NCAP): A Proof-of-Concept Study. J Psychoactive Drugs 2023; 55:389-401. [PMID: 36130915 DOI: 10.1080/02791072.2022.2125466] [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: 01/25/2022] [Revised: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 10/14/2022]
Abstract
Lab-based studies examining the effects of cannabis administration on human behavior compromise ecological validity due to the influence of set and setting. Contextual factors of clinical settings have long been recognized as producing measurable changes in physiology, emotionality, and cognition. Among people who use drugs, these settings may be associated with higher levels of perceived stigma and stereotype threat which may meaningfully confound the effects of cannabis on outcomes of interest. Recent liberalization of cannabis regulation may allow novel and more ecologically valid approaches to assessing the acute effects of cannabis. The Naturalistic Cannabis Administration Protocol (NCAP) is a novel paradigm for the study of acute cannabis effects in an ecologically valid manner. Two independent studies demonstrated the safety and feasibility of the NCAP. Participants (N= 79; Mage = 25.44, SD = 5.67) self-administered the cannabis of their choice in their home and then (Study 1; n= 47) engaged in a leisure activity or (Study 2; n= 32) underwent cognitive assessment remotely via videoconference following cannabis administration. The NCAP was well tolerated across samples with no reported adverse events. These findings provide a rationale for the adoption of the NCAP to reduce research barriers and develop our research capabilities to fit the landscape of cannabis use today.
Collapse
Affiliation(s)
- Michelle St Pierre
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Sarah Daniels
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Tatiana A Sanchez
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | - Susan Holtzman
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| | | | - Zach Walsh
- Department of Psychology, the University of British Columbia, Kelowna, BC, Canada
| |
Collapse
|
43
|
Boehnke KF, Martel MO, Smith T, He Y, Bergmans RS, Kruger DJ, Andwele M, Bevan S, Williams DA, Fitzcharles M. Medicinal Cannabis Use for Rheumatic Conditions in the US Versus Canada: Rationale for Use and Patient-Health Care Provider Interactions. ACR Open Rheumatol 2023; 5:443-453. [PMID: 37519131 PMCID: PMC10502834 DOI: 10.1002/acr2.11592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE Understanding how medical cannabis (MC) use is integrated into medical practice for rheumatic disease management is essential. We characterized rationale for MC use, patient-physician interactions around MC, and MC use patterns among people with rheumatic conditions in the US and Canada. METHODS We surveyed 3406 participants with rheumatic conditions in the US and Canada, with 1727 completing the survey (50.7% response rate). We assessed disclosure of MC use to health care providers, MC authorization by health care providers, and MC use patterns and investigated factors associated with MC disclosure to health care providers in the US versus Canada. RESULTS Overall, 54.9% of US respondents and 78.0% of Canadians reported past or current MC use, typically because of inadequate symptom relief from other medications. Compared to those in Canada, fewer US participants obtained MC licenses, disclosed MC use to their health care providers, or asked advice on how to use MC (all P values <0.001). Overall, 47.4% of Canadian versus 28.2% of US participants rated their medical professionals as their most trusted information source. MC legality in state of residence was associated with 2.49 greater odds of disclosing MC use to health care providers (95% confidence interval: 1.49-4.16, P < 0.001) in the US, whereas there were no factors associated with MC disclosure in Canada. Our study is limited by our convenience sampling strategy and cross-sectional design. CONCLUSION Despite widespread availability, MC is poorly integrated into rheumatic disease care, with most patients self-directing use with minimal or no clinical oversight. Concerted efforts to integrate MC into education and clinical policy is critical.
Collapse
Affiliation(s)
| | | | | | - Ying He
- University of MichiganAnn Arbor
| | | | | | | | - Sian Bevan
- Arthritis Society CanadaTorontoOntarioCanada
| | | | | |
Collapse
|
44
|
Manthey J, Pons‐Cabrera MT, Rosenkranz M, Lopez‐Pelayo H. Measuring cannabis quantities in online surveys: A rapid review and proposals for ways forward. Int J Methods Psychiatr Res 2023; 32:e1971. [PMID: 37089041 PMCID: PMC10485338 DOI: 10.1002/mpr.1971] [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: 12/09/2022] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 04/25/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Jakob Manthey
- Department of Psychiatry and PsychotherapyCenter for Interdisciplinary Addiction Research (ZIS)University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
- Department of PsychiatryMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Maria Teresa Pons‐Cabrera
- Grup de Recerca en Addicions ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Unitat de Conductes AddictivesServei de Psiquiatria Psicologia (ICN)Hospital Clínic de BarcelonaBarcelonaSpain
| | - Moritz Rosenkranz
- Department of Psychiatry and PsychotherapyCenter for Interdisciplinary Addiction Research (ZIS)University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - Hugo Lopez‐Pelayo
- Grup de Recerca en Addicions ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Unitat de Conductes AddictivesServei de Psiquiatria Psicologia (ICN)Hospital Clínic de BarcelonaBarcelonaSpain
- Red de Investigación en Atención Primaria de Adicciones (RIAPAd)BarcelonaSpain
| |
Collapse
|
45
|
Buckner JD, Morris PE, Threeton EM, Zvolensky MJ. Cannabis and Nicotine Dual Use among Sexual Minority Individuals: Relations to Cannabis Use and Negative Affect. Subst Use Misuse 2023; 58:1813-1817. [PMID: 37622481 PMCID: PMC10786340 DOI: 10.1080/10826084.2023.2250427] [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: 08/26/2023]
Abstract
Background: Sexual minority individuals report significantly more cannabis use and use-related problems than their heterosexual peers, and emerging data indicate sexual minority individuals who use cannabis are at greater risk for dual use of nicotine products (combustible smoking, e-cigarette use) than heterosexual individuals. Although cannabis-nicotine dual use is related to worse cannabis outcomes and negative affect, little work has identified factors related to dual use among sexual minority individuals or tested if sexual orientation-based discrimination (microaggressions, overt discrimination) is related to dual use. Objectives: The current study tested if cannabis-nicotine dual use is related to more frequent cannabis use, more cannabis-related problems, negative affect, and discrimination among sexual minority undergraduate students who endorsed current (past three-month) cannabis use (N = 328), 43.6% of whom endorsed dual nicotine use. Cannabis-nicotine dual use was related to more frequent cannabis use, more cannabis-related problems, more anxiety (but not depression), and more sexual orientation-based microaggressions and microaggressions-related negative affect (but not overt discrimination or non-sexual orientation-based daily stressors). Conclusions/Importance: Overall, this is the first known study to identify that sexual orientation-based discrimination is related to cannabis-nicotine dual use and that dual use is related to more frequent cannabis use, use-related problems, and negative affect (especially anxiety) among this underrepresented group.
Collapse
Affiliation(s)
- Julia D. Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Paige E. Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Evan M. Threeton
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| |
Collapse
|
46
|
Najera MS, Cavalli JM, Cservenka A. Distress tolerance and problematic cannabis use: does the form of cannabis matter? J Addict Dis 2023:1-11. [PMID: 37565482 DOI: 10.1080/10550887.2023.2244378] [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: 08/12/2023]
Abstract
BACKGROUND Low distress tolerance may result in greater vulnerability to problematic cannabis use. However, the role of the primary form of cannabis used has not been examined as a moderator of this association. While marijuana flower remains the preferred form of cannabis, the popularity of other forms of cannabis, including concentrates and edibles, is on the rise. OBJECTIVES We examined the association between distress tolerance and problematic cannabis use and whether the primary form of cannabis used moderates this relationship. METHODS Participants were 695 (67.6% male) past-month cannabis users who completed an online survey. Multiple linear regressions assessed whether distress tolerance, the primary form of cannabis used, and their interaction were related to problematic cannabis use while controlling for demographic variables and past 30-day alcohol and cannabis use frequency. RESULTS Lower tolerance for distress was associated with more problematic cannabis use. Endorsing concentrates as the primary form of cannabis used vs. marijuana flower was related to more problematic cannabis use while reporting edibles as the primary form of cannabis used vs. marijuana flower or concentrates was related to less problematic cannabis use. Individuals preferring marijuana flower or concentrates reported more problematic cannabis use at lower levels of distress tolerance. CONCLUSIONS Cannabis users exhibiting low distress tolerance or a preference for concentrates may be at greatest risk for experiencing negative consequences related to their cannabis use. Additionally, building tolerance for stressful situations, among both concentrates and marijuana flower users, may aid in minimizing problematic cannabis use.
Collapse
Affiliation(s)
- Melissa S Najera
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Jessica M Cavalli
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Anita Cservenka
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| |
Collapse
|
47
|
Wightman RS, Metrik J, Lin TR, Li Y, Badea A, Almeida R, Collins AB, Beaudoin FL. Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome. Ann Emerg Med 2023; 82:121-130. [PMID: 37479395 PMCID: PMC10363750 DOI: 10.1016/j.annemergmed.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/17/2023] [Accepted: 03/03/2023] [Indexed: 07/23/2023]
Abstract
STUDY OBJECTIVES The objectives of this study were to characterize the detailed cannabis use patterns (eg, frequency, mode, and product) and determine the differences in the whole-blood cannabinoid profiles during symptomatic versus asymptomatic periods of participants with suspected cannabinoid hyperemesis syndrome recruited from the emergency department (ED) during a symptomatic episode. METHODS This is a prospective observational cohort study of participants with symptomatic cyclic vomiting onset after chronic cannabis use. Standardized assessments were conducted to evaluate for lifetime and recent cannabis use, cannabis use disorder, and cannabis withdrawal symptoms. Quantitative whole-blood cannabinoid testing was performed at 2 times, first when symptomatic (ie, baseline) and at least 2 weeks after the ED visit when asymptomatic. The differences in cannabinoid concentrations were compared between symptomatic and asymptomatic testing. The study was conducted from September 2021 to August 2022. RESULTS There was a difference observed between delta-9-tetrahydrocannabinol metabolites, but not the parent compound during symptomatic episodes and asymptomatic periods. Most participants (84%) reported using cannabis > once per day (median 3 times per day on weekdays, 4 times per day on weekends). Hazardous cannabis use was universal among participants; the mean cannabis withdrawal discomfort score was 13, indicating clinically significant rates of cannabis withdrawal symptoms with cessation of use. Most participants (79%) previously tried to stop cannabis use, but a few (13%) of them had sought treatment. CONCLUSION Patients presenting to the ED with cannabinoid hyperemesis syndrome have high cannabis use disorder scores. Further studies are needed to better understand the influence of THC metabolism and concentrations on symptomatic cyclic vomiting.
Collapse
Affiliation(s)
- Rachel S Wightman
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI; Department of Epidemiology, School of Public Health at Brown University, Providence, RI.
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University, School of Public Health, Providence, RI; Providence VA Medical Center, Providence, RI
| | | | - Yu Li
- Department of Epidemiology, School of Public Health at Brown University, Providence, RI
| | - Adina Badea
- Department of Pathology and Laboratory Medicine, Lifespan Academic Medical Center, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Robert Almeida
- Forensic Toxicology Laboratory, Department of Health, Rhode Island, Providence, RI
| | - Alexandra B Collins
- Department of Epidemiology, School of Public Health at Brown University, Providence, RI
| | - Francesca L Beaudoin
- Department of Epidemiology, School of Public Health at Brown University, Providence, RI
| |
Collapse
|
48
|
Spillane NS, Schick MR, Hostetler KL, Trinh CD, Kahler CW. Results of a pilot study examining the effect of positive psychology interventions on cannabis use and related consequences. Contemp Clin Trials 2023; 131:107247. [PMID: 37263491 PMCID: PMC10875633 DOI: 10.1016/j.cct.2023.107247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/24/2023] [Accepted: 05/26/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Young adults experience high rates of cannabis use and consequences. Cross-sectional work has linked positive psychological constructs (e.g., savoring) to less cannabis use and consequences, and positive psychological interventions (PPIs) have shown promise in targeting other substance use behaviors. This pilot study sought to provide an initial test of PPIs to reduce young adult cannabis use and consequences. METHODS Adults (18-25 years old) who endorsed at least weekly past-month cannabis use (N = 59, 69.6% men, 41.1% White) reported their baseline cannabis use and consequences. Participants were randomized to complete one of three daily exercises (Savoring, Three Good Things, or a control) along with daily text message surveys for two weeks, then completed a follow-up survey at the end of the two weeks. RESULTS Paired samples t-tests indicated that participants in the Three Good Things group showed medium to large reductions in frequency of weekly cannabis use (p = .08, gav = -0.57) and cannabis-associated consequences (p = .08, gav = -0.57) from baseline to follow-up. In the Savoring and control groups, there were not significant changes in frequency of weekly cannabis use (Savoring: p = .39, gav = 0.20; Control: p = .96, gav = 0.01) nor cannabis-associated consequences (Savoring: p = .84, gav = 0.05; Control: p = .45, gav = -0.18). Participants in both positive psychology conditions reported the exercises were easy to complete, providing evidence for acceptability. DISCUSSION Results provide initial support for the feasibility and potential promise of a text-message based PPI as a harm reduction approach for cannabis users. A larger clinical trial is warranted to test the effects of such interventions with adequate statistical power.
Collapse
Affiliation(s)
- Nichea S Spillane
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI 02881, United States of America.
| | - Melissa R Schick
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI 02881, United States of America; Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Katherine L Hostetler
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI 02881, United States of America; Health Services Research & Development, Providence VA Medical Center, Providence, RI 02908, United States of America
| | - Catherine D Trinh
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI 02881, United States of America
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02903, United States of America
| |
Collapse
|
49
|
Jäckel D, Willert A, Brose A, Leopold K, Nischk D, Senner S, Pogarell O, Sachenbacher S, Lambert M, Rohenkohl A, Kling-Lourenco P, Rüsch N, Bermpohl F, Schouler-Ocak M, Disselhoff V, Skorupa U, Bechdolf A. Enhancing educational and vocational recovery in adolescents and young adults with early psychosis through Supported Employment and Education (SEEearly): study protocol for a multicenter randomized controlled trial. Trials 2023; 24:440. [PMID: 37400899 PMCID: PMC10316586 DOI: 10.1186/s13063-023-07462-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Psychotic disorders often develop a chronic course with devastating consequences for individuals, families, and societies. Early intervention programs for people in the first 5 years after the initial psychotic episode (early psychosis) can significantly improve the outcome and are therefore strongly recommended in national and international guidelines. However, most early intervention programs still focus on improving symptoms and relapse prevention, rather than targeting educational and vocational recovery. The aim of the present study is to explore the effects of Supported Employment and Education (SEE) following the Individual Placement and Support (IPS) model in people with early psychosis. METHODS The SEEearly trial compares treatment as usual (TAU) plus SEE to TAU alone in outpatient psychiatric settings. The study is a six-site, two-arm, single-blinded, superiority randomized controlled trial (RCT). Participants are randomly assigned (1:1) to the intervention or control group. Aiming to recruit 184 participants, with an assumed drop-out rate of 22%, we will be able to detect a 24% difference in the main outcome of employment/education with 90% power. We make assessments at baseline and at 6- and 12-month follow-ups. Outcome data on employment/education, medication, and current psychiatric treatment is obtained monthly through phone based short assessments. The primary outcome is steady participation for at least 50% of the 12-month follow-up in competitive employment and/or mainstream education. Secondary employment outcomes capture length of employment/education, time to first employment/education, monthly wages/educational attainment, and social return on investment (SROI). Secondary non-employment outcomes include subjective quality of life, psychopathology, substance use, relapse, hospitalization, and functional impairment. To be eligible, participants must be between 16 and 35 years, fulfill diagnostic criteria for early psychosis, and be interested in competitive employment and/or mainstream education. DISCUSSION In SEEearly, we hypothesize that participants with psychosis, who receive TAU plus SEE, present with better primary and secondary outcomes than participants, who receive TAU alone. Positive results of this study will justify SEE as an evidence-based strategy for clinical routine treatment in people with early psychosis. TRIAL REGISTRATION SEEearly was registered nationally and internationally in the German Clinical Trials Register (DRKS; identifier: DRKS00029660) on October 14, 2022.
Collapse
Affiliation(s)
- D Jäckel
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - A Willert
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany.
| | - A Brose
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - K Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - D Nischk
- Department of Social Psychiatry, Zentrum für Psychiatrie, Reichenau, Germany
| | - S Senner
- Department of Social Psychiatry, Zentrum für Psychiatrie, Reichenau, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - S Sachenbacher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Rohenkohl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Kling-Lourenco
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - N Rüsch
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - F Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - M Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - V Disselhoff
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - U Skorupa
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - A Bechdolf
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| |
Collapse
|
50
|
Phillips KT, Phillips MM, Lalonde TL, Stein MD. Momentary Craving, Craving Variability, and Cannabis Use: Associations With THC Concentrates and Sex. J Stud Alcohol Drugs 2023; 84:530-534. [PMID: 37014655 PMCID: PMC10488307 DOI: 10.15288/jsad.22-00330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/15/2022] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE Ecological momentary assessment (EMA) studies are well positioned to assess the impact of craving on cannabis use in real time and may better capture its time-varying nature. The goal of this exploratory study was to examine whether momentary craving and craving variability predict subsequent use of cannabis and how baseline concentrate use status and male sex might affect these relationships. METHOD College students residing in a state with legal recreational cannabis use who used cannabis twice a week or more completed a baseline interview and signal-contingent EMA for 2 weeks using a smartphone application. Hierarchical (multi-level) regression was used to examine time-lagged associations between craving, craving variability, and subsequent cannabis use. Baseline concentrate use and male sex were examined as moderators. RESULTS Participants (N = 109) included 59% women, with an average age of 20.2 years, and most using cannabis near-daily or daily. A main effect for craving (within-level effect) on the likelihood of cannabis use at the next EMA instance was found (odds ratio = 1.292, p < .001), although this effect was moderated by concentrate use status. For men, between-level increases in craving led to a greater likelihood of cannabis use at the next instance, but greater craving variability led to a lower likelihood of use. Greater variability in craving was associated with a greater likelihood of cannabis use among those using concentrates. CONCLUSIONS The experience of craving may differ based on important participant characteristics. More research examining the fluctuating nature of craving and the role of cannabis potency on craving is warranted.
Collapse
Affiliation(s)
- Kristina T. Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente Hawai’i, Honolulu, Hawaii
| | - Michael M. Phillips
- Office of Public Health Studies, University of Hawai’i–Manoa, Honolulu, Hawaii
| | | | - Michael D. Stein
- School of Public Health, Boston University, Boston, Massachusetts
| |
Collapse
|