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Ho BC, Barry AB, Koeppel JA, Macleod J, Boyd A, David A, O’Leary DS. Recreational Marijuana Use, Adolescent Cognitive Development, and Schizophrenia Susceptibility. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:222-232. [PMID: 37124347 PMCID: PMC10140454 DOI: 10.1016/j.bpsgos.2022.01.008] [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: 10/22/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background We investigated how low marijuana (MJ) use levels, the typical use pattern in most adolescent users, affect cognitive maturation and schizophrenia risk. Methods In two complementary adolescent samples where the majority reported minimal MJ use, we compared cognitive performances before and after MJ use initiation. The Iowa sample (40 first-degree relatives and 54 second-degree relatives of patients with schizophrenia and 117 control subjects with no schizophrenia family history) underwent a battery of standardized neuropsychological tests at 0, 18, and 36 months. Based on self-administered Timeline Followback interviews, 26.5% of adolescents had emergent MJ use (eMJ) during follow-up. The second sample (n = 3463), derived from a birth cohort, received substance use and sustained attention assessments between ages 10 and 15 years. Mixed linear models and regression analyses tested the effects of eMJ on longitudinal changes in cognitive performance. Results In the Iowa sample, longitudinal changes in 5 of 8 cognitive domains were significantly associated with eMJ. On sustained attention, visuospatial working memory, and executive sequencing, adolescents with eMJ showed less age-expected improved performance. In addition, first-degree relatives with eMJ were less improved on processing speed and executive reasoning than first-degree relatives without eMJ. In the birth cohort, greater intraindividual variability in reaction times (indicative of poorer sustained attention) was significantly associated with more frequent MJ use and with recreational use levels. Conclusions Nonheavy MJ use disrupts normal adolescent maturation and compounds aberrant adolescent maturation associated with familial schizophrenia risk. These findings underscore the importance of reducing adolescent MJ access in the context of increased availability to high-potency MJ.
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Affiliation(s)
- Beng-Choon Ho
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Amy B. Barry
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Julie A. Koeppel
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - John Macleod
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Andy Boyd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anthony David
- Division of Psychiatry, University College London, London, United Kingdom
| | - Daniel S. O’Leary
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Gorukanti AL, Kimminau KS, Tindle HA, Klein JD, Gorzkowski J, Kaseeska K, Ali R, Singh L, David SP, Halpern-Felsher B. Cross-sectional online survey of clinicians' knowledge, attitudes and challenges to screening and counselling adolescents and young adults for substance use. BMJ Open 2022; 12:e059019. [PMID: 36414284 PMCID: PMC9685226 DOI: 10.1136/bmjopen-2021-059019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine adolescent healthcare clinicians' self-reported screening practices as well as their knowledge, attitudes, comfort level and challenges with screening and counselling adolescents and young adults (AYA) for cigarette, e-cigarette, alcohol, marijuana, hookah and blunt use. DESIGN A 2016 cross-sectional survey. SETTING Academic departments and community-based internal medicine, family medicine and paediatrics practices. PARTICIPANTS Adolescent healthcare clinicians (N=771) from 12 US medical schools and respondents to national surveys. Of the participants, 36% indicated male, 64% female, mean age was 44 years (SD=12.3); 12.3% of participants identified as Asian, 73.7% as white, 4.8% as black, 4.2% as Hispanic and 3.8% as other. PRIMARY AND SECONDARY OUTCOME MEASURES Survey items queried clinicians about knowledge, attitudes, comfort level, self-efficacy and challenges with screening and counselling AYA patients about marijuana, blunts, cigarettes, e-cigarettes, hookah and alcohol. RESULTS Participants were asked what percentage of their 10-17 years old patients they screened for substance use. The median number of physicians reported screening 100% of their patients for cigarette (1st, 3rd quartiles; 80, 100) and alcohol use (75, 100) and 99.5% for marijuana use (50,100); for e-cigarettes, participants reported screening half of their patients and 0.0% (0, 50), (0, 75)) reported screening for hookah and blunts, respectively. On average (median), clinicians estimated that 15.0% of all 10-17 years old patients smoked cigarettes, 10.0% used e-cigarettes, 20.0% used marijuana, 25.0% drank alcohol and 5.0% used hookah or blunts, respectively; yet they estimated lower than national rates of use of each product for their own patients. Clinicians reported greater comfort discussing cigarettes and alcohol with patients and less comfort discussing e-cigarettes, hookah, marijuana and blunts. CONCLUSIONS This study identified low rates of screening and counselling AYA patients for use of e-cigarettes, hookahs and blunts by adolescent healthcare clinicians and points to potential missed opportunities to improve prevention efforts.
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Affiliation(s)
- Anu L Gorukanti
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Kim S Kimminau
- Department of Family and Community Medicine, University of Missouri Columbia, Columbia, Missouri, USA
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Medicine, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Jonathan D Klein
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Julie Gorzkowski
- Department of Healthy Resilient Children Youth and Families, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Kristen Kaseeska
- Department of Healthy Resilient Children Youth and Families, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Raabiah Ali
- Healthcare Settings Program, Chicago Department of Public Health, Chicago, Illinois, USA
| | - Lavisha Singh
- Department of Biostatistics, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Sean P David
- Department of Family Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA
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Goodhines PA, Wedel AV, Dobani F, Zaso MJ, Gellis LA, Park A. Cannabis use for sleep aid among high school students: Concurrent and prospective associations with substance use and sleep problems. Addict Behav 2022; 134:107427. [PMID: 35872526 PMCID: PMC9999445 DOI: 10.1016/j.addbeh.2022.107427] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Adolescents are at risk for both sleep problems and cannabis use. Despite emerging evidence for college students' self-medication with cannabis to help sleep, generalizability to earlier developmental stages remains unknown. This study remedied this literature gap by characterizing high school students' cannabis sleep aid use in terms of psychosocial correlates and prospective associations with substance use and sleep. METHODS Data were drawn froma longitudinal urban adolescent health behavior study, Project Teen, including 4079th-11thgraders(Year 1 Mage = 16.00 [SD = 1.08, range = 13-19]; 58% female; 41% Black, 22% White, 18% Asian, 17% multiracial,2% Native Hawaiian or other Pacific Islander, 1% American Indian or Alaska Native; 12% Hispanic/Latinx). Students completed two web-based surveys (Minterval = 388.89 days [SD = 27.34]) assessingsubstance use and sleep at Year 1 (Y1) and Year 2 (Y2). RESULTS Students reporting lifetime cannabis sleep aid use (8%) endorsed greater depression and anxiety symptoms at Y1, as well as greater cannabis, alcohol, and cigarette use (but not insomnia symptoms or sleep durations) at Y1 and Y2, compared to non-using peers. Over one year, cannabis sleep aid use was associated with increased cannabis dependence symptoms among students using cannabis, past-2-week binge drinking among students using alcohol, and lifetime cigarette use. However, cannabis sleep aid use was not prospectively associated with changes in insomnia symptoms or sleep durations. CONCLUSIONS Although replication is needed, cannabis sleep aid use among high school students may be associated with exacerbated cannabis dependence symptoms and increased binge drinking and cigarette use over time, without the intended sleep benefit.
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Affiliation(s)
| | - Amelia V Wedel
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Fatima Dobani
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Michelle J Zaso
- Clinical and Research Institute on Addictions, University at Buffalo - The State University of New York, Buffalo, NY, USA
| | - Les A Gellis
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA.
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Abstract
PURPOSE OF REVIEW In recent years, an increasing number of states have legalized marijuana, also known as cannabis, for recreational use. As marijuana becomes more accessible, adolescent use and accidental pediatric exposures are likely to become broad public health concerns. Edible marijuana products, which are consumable foods or beverages that contain cannabis extract, are particularly enticing to youth, as they come in appealing forms such as candies, cookies, and drinks. The purpose of this review is to provide pediatricians with an overview of the different types and potential dangers associated with edible marijuana products. RECENT FINDINGS Edible marijuana products are often indistinguishable in appearance from normal food items and lack the smell and visible smoke associated with inhaled marijuana. Because they are inconspicuous, palatable, and easily accessible, they are increasingly popular among adolescents. Additionally, the packaging of edible baked goods, candies, and drinks is often purposefully very similar to that of mainstream foods, increasing the risk of accidental ingestion by children. An edible marijuana product must be digested before Δ9-tetrahydrocannabinol can enter the bloodstream, so there is a delayed onset of effects when consuming edibles compared with inhaling marijuana. This also predisposes users to accidental overconsumption. SUMMARY Greater knowledge of edible marijuana product consumption by pediatric populations will allow pediatricians to more effectively help patients and advise caregivers in cases of overconsumption, dependence, or accidental ingestion. It is important for parents, guardians, and educators to be able to successfully identify edible marijuana products and recognize signs of cannabis use.
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Sorensen JL, Draanen J, Shingle M. Legalization of cannabis in Canada—Local media analysis. Am J Addict 2022; 31:148-151. [DOI: 10.1111/ajad.13263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 01/05/2022] [Accepted: 01/16/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- James L. Sorensen
- Department of Psychiatry and Behavioral Sciences, School of Medicine University of California San Francisco San Francisco California USA
- Zuckerberg San Francisco General Hospital & Medical Center San Francisco California USA
| | - Jenna Draanen
- Family and Population Health Nursing; and Health Systems and Population Health University of Washington Child Seattle Washington USA
| | - Mallory Shingle
- Department of Psychiatry and Behavioral Sciences, School of Medicine University of California San Francisco San Francisco California USA
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Ahuja M, Awasthi M, Gim S, Records K, Cimilluca J, Al-Ksir K, Tremblay J, Doshi RP, Sathiyasaleen T, Fernandopulle P. Early Age of Cannabis Initiation and Its Association With Suicidal Behaviors. Subst Abuse 2022; 16:11782218221116731. [PMID: 35966616 PMCID: PMC9373116 DOI: 10.1177/11782218221116731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
Background: Suicide rates in the U.S. have continued to rise over the last 2 decades. The increased availability and broader legalization of cannabis is a public health concern, particularly among adolescents. The objective of this study was to examine the association between the age of cannabis initiation and lifetime suicidal ideations and attempts in a sample of adults aged 18 or older. Methods: Data are from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001 to 2003 (N = 15 238). The primary objective of the CPES was to collect data about the prevalence of mental disorders, impairments associated with these disorders, and their treatment patterns from representative samples of majority and minority adult populations in the U.S. Logistic regression analyses were conducted to test the association between cannabis initiation age (early ⩽14 years old; later >14 years old) and outcomes of lifetime suicide ideation and attempts. Cigarette use, cannabis use, gender, income, race, education, and age were controlled for the analyses. Results: Overall, 12.5% of participants reported suicide ideation, while 4.2% reported attempt. Early cannabis use was associated with a higher risk of suicide ideation (AOR = 3.32, 95% CI [2.75, 3.80]) than later cannabis use (AOR = 2.15, 95% CI [1.92, 2.39]). Early cannabis use was associated with a higher risk of suicide attempt (AOR = 4.38, 95% CI [3.48, 5.52]) than later cannabis use (AOR = 2.56, 95% CI [2.14, 3.06]). Wald chi-squared tests revealed significant differences between the early and late initiation for both ideation (χ2 = 26.99; P < .001) and attempts (χ2 = 26.02; P < .001). Conclusions: Significant associations were found between early initiation of cannabis and suicide behaviors. As suicide rates continue to rise, it is recommended that clinicians, treatment providers, and other professionals consider the use of cannabis at an early age as a risk for subsequent suicide behaviors.
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Affiliation(s)
- Manik Ahuja
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Manul Awasthi
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Suzanna Gim
- LUI Pharmacy, Long Island University, Brooklyn, NY, USA
| | - Kathie Records
- School of Nursing, College of Natural and Health Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Johanna Cimilluca
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kawther Al-Ksir
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Johnathan Tremblay
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Riddhi P Doshi
- Center for Population Health, UConn Health, Farmington, CT, USA
| | | | - Praveen Fernandopulle
- Department of Psychiatry and Behavioral Sciences, East Tennessee State University, Johnson City, TN, USA
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Stiles-Shields C, Archer J, Zhang J, Burnside A, Draxler J, Potthoff LM, Reyes KM, Summersett Williams F, Westrick J, Karnik NS. A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults. Child Psychiatry Hum Dev 2021; 54:639-658. [PMID: 34724134 PMCID: PMC9310430 DOI: 10.1007/s10578-021-01280-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/22/2022]
Abstract
Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.
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Affiliation(s)
- Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Joseph Archer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA,School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Jim Zhang
- Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Amanda Burnside
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Janel Draxler
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Karen M. Reyes
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Jennifer Westrick
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
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Simoneau T, Hollenbach JP, Langton CR, Kuo CL, Cloutier MM. Smoking cessation and counseling: A mixed methods study of pediatricians and parents. PLoS One 2021; 16:e0246231. [PMID: 33561136 PMCID: PMC7872228 DOI: 10.1371/journal.pone.0246231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/02/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Pediatric providers play an important role in parental and youth smoking cessation. The goal of this study was to understand smoking cessation attitudes of parents and the behaviors, confidence and self-efficacy of pediatricians related to providing smoking cessation counseling to parents and youth. METHODS A mixed methods study was conducted in a convenience sample of families (n = 1,549) and pediatric primary care clinicians (n = 95) in Connecticut using surveys and focus groups from April, 2016 to January, 2017. RESULTS The smoking rate (cigarettes or electronic cigarettes) among all households surveyed was 21%. Interest in quitting smoking was high (71%) and did not differ based on smoking amount, duration, type of community of residence (urban, rural, etc), or race/ethnicity. For example, compared to participants who smoked for <10 years, those who smoked ≥20 years had a similar interest in quitting (OR = 1.12; 95% CI: 0.85-1.48). Ninety percent of clinicians surveyed asked parents about their smoking behavior at least annually but 36% offered no smoking cessation counseling services or referral. Clinicians almost always reported counseling youth about the dangers of nicotine and tobacco use (99%), were more confident about counseling youth than parents (p<0.01) and reported low self-efficacy about smoking cessation and prevention counseling of parents and youth. Ninety-three percent of clinicians opined that electronic cigarettes were equally or more dangerous than cigarettes but 34% never counseled youth about the dangers of electronic cigarettes. CONCLUSIONS Clinicians frequently screen parents about their smoking behaviors, but rarely provide smoking cessation counseling and express low confidence in this activity. Clinicians are more confident counseling youth than parents. Clinicians also recognize the dangers of electronic cigarettes, yet they infrequently counsel youth about these dangers.
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Affiliation(s)
- Tregony Simoneau
- Department of Pediatrics, Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Jessica P. Hollenbach
- Department of Pediatrics, UConn Health, Farmington, Connecticut, United States of America
- Asthma Center, Connecticut Children’s Medical Center, Hartford, Connecticut, United States of America
| | - Christine R. Langton
- Asthma Center, Connecticut Children’s Medical Center, Hartford, Connecticut, United States of America
| | - Chia-Ling Kuo
- Department of Community Medicine and Health Care, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, United States of America
| | - Michelle M. Cloutier
- Department of Pediatrics, UConn Health, Farmington, Connecticut, United States of America
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Starks TJ, Jones SS, Kyre K, Robles G, Cain D, Jimenez R, Stephenson R, Sullivan PS. Testing the drug use and condomless anal sex link among sexual minority men: The predictive utility of marijuana and interactions with relationship status. Drug Alcohol Depend 2020; 216:108318. [PMID: 33022531 PMCID: PMC7959658 DOI: 10.1016/j.drugalcdep.2020.108318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND The association between drug use and condomless anal sex (CAS) is well documented among sexual minority men (SMM). Less is known about whether this association generalizes to marijuana and across relationship status and sexual agreements groups (single, partnered monogamous, partnered open -outside partners permitted, and partnered monogamish -outside partners permitted when main partners are together). METHODS A nationwide sample of SMM (N = 65,707) were recruited through a geosocial networking app between November 2017 and November 2019. Participants reported on drug use and instances of CAS with casual partners in the previous 30 days. RESULTS Both marijuana and club drug use were associated with the occurrence of CAS with casual partners among single men. Only club drug use was associated with CAS frequency in this group. The association between marijuana and the occurrence of CAS did not differ significantly among monogamous men, while the associations between club drug use and the occurrence as well as frequency of CAS were significantly weaker. Meanwhile, the associations between club drug use and the occurrence as well as frequency of CAS did not differ significantly between single and non-monogamous (open and monogamish) subgroups; however, the association between marijuana and the occurrence of CAS was significantly weaker. CONCLUSIONS Findings largely replicated the robust association between club drug use and CAS with casual partners. They support the assertion that marijuana use predicts sexual risk for some SMM subgroups. Finally, they illustrate the potential for relationship status - and sexual agreements - to contextualize associations between drug use and CAS.
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Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA,Doctoral Program in Health Psychology and Clinical Science, Graduate Center of CUNY, New York, NY, USA
| | - S. Scott Jones
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Kory Kyre
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Ruben Jimenez
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Rob Stephenson
- Department of Systems, Populations and Leadership, and The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Bélanger RE, Grant CN. Le counseling auprès des adolescents et des parents au sujet du cannabis : une introduction pour les professionnels de la santé. Paediatr Child Health 2020; 25:S41-S48. [DOI: 10.1093/pch/pxaa049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/12/2020] [Indexed: 11/14/2022] Open
Abstract
Résumé
L’usage de cannabis est fréquent chez les adolescents du Canada, mais les jeunes en reconnaissent les dangers potentiels et s’attendent de plus en plus à ce que des dispensateurs de soins bien informés leur parlent d’usage de substances psychoactives dans leur pratique quotidienne. Le présent point de pratique propose de solides outils fondés sur des données probantes pour aider les professionnels de la santé à parler d’usage de cannabis à des fins non médicales (récréatives) et des risques qui s’y associent. Les auteurs expliquent comment rendre le milieu clinique sécuritaire pour parler de substances psychoactives avec les jeunes et suggèrent des stratégies précises pour leur parler d’usage de cannabis de manière efficace et adaptée à leur développement. Conformément aux publications scientifiques récentes, ils recommandent des questionnaires de dépistage pour contribuer à structurer les échanges et déterminer quels adolescents pourraient profiter d’interventions plus spécialisées. Puisqu’un adolescent sur six qui expérimente le cannabis finit par en faire un usage abusif, l’évaluation de la volonté des adolescents à modifier leurs comportements à risque représente un aspect essentiel des soins, conjointement avec l’établissement d’objectifs complémentaires et l’aide aux familles. Enfin, des ressources pour les praticiens et les parents sont recommandées.
Tant les parents que les adolescents se préoccupent des effets et des dommages potentiels du cannabis et des autres substances psychoactives (1,2). De nombreux adolescents considèrent les professionnels de la santé comme des sources d’information fiables sur les substances psychoactives et s’attendent à ce qu’ils abordent l’usage ou les risques qui s’y associent lors des rendez-vous de santé (3). Dans le rôle de facilitateurs et de courtiers du savoir, les dispensateurs de soins (DdS) peuvent entretenir un dialogue efficace avec les jeunes et leur famille.
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Affiliation(s)
- Richard E Bélanger
- Société canadienne de pédiatrie, groupe consultatif du projet sur le cannabis, Ottawa (Ontario)
| | - Christina N Grant
- Société canadienne de pédiatrie, groupe consultatif du projet sur le cannabis, Ottawa (Ontario)
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Bélanger RE, Grant CN. Counselling adolescents and parents about cannabis: A primer for health professionals. Paediatr Child Health 2020; 25:S34-S40. [PMID: 34136052 DOI: 10.1093/pch/pxaa048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/12/2020] [Indexed: 11/13/2022] Open
Abstract
While cannabis use among adolescents is frequent in Canada, youth do recognize the potential harms, and increasingly expect knowledgeable health care providers to discuss substance use in everyday practice. This practice point provides sound, evidence-based tools to help health professionals address nonmedical (recreational) cannabis use and its related risks. After highlighting how to make the clinical setting a safe space for youth to talk about psychoactive substances, specific strategies for approaching cannabis use in effective, developmentally appropriate ways are described. Consistent with current literature, screening questionnaires to help structure discussion and identify adolescents who may benefit from more specialized interventions are recommended. Because one in six adolescents who experiments with cannabis goes on to misuse it, appraising their willingness to change risky behaviours is a key aspect of care, along with supportive goal-setting and helping families. Recommended resources for practitioners and parents are included.
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Affiliation(s)
- Richard E Bélanger
- Canadian Paediatric Society, Cannabis Project Advisory Group, Ottawa, Ontario
| | - Christina N Grant
- Canadian Paediatric Society, Cannabis Project Advisory Group, Ottawa, Ontario
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Santaella-Tenorio J, Levy NS, Segura LE, Mauro PM, Martins SS. Cannabis use disorder among people using cannabis daily/almost daily in the United States, 2002-2016. Drug Alcohol Depend 2019; 205:107621. [PMID: 31698323 PMCID: PMC7359630 DOI: 10.1016/j.drugalcdep.2019.107621] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cannabis use disorder (CUD) prevalence among people reporting past-year cannabis use declined from 2002-2016. We examined whether similar reductions in CUD were observed among people reporting daily/almost daily cannabis use. We expected that CUD prevalence among people reporting daily/almost daily use would not decrease. METHODS We used 2002-2016 National Survey on Drug Use and Health (NSDUH) data, including 22,651 individuals using cannabis 300+ days in the past year. CUD was defined using DSM-IV criteria for cannabis abuse and/or dependence. Age categories included: 12-17, 18-25, and 26 + . Annual prevalence of CUD, cannabis dependence, cannabis abuse, and each individual abuse/dependence items accounted for the complex survey design. Differences in trends over time were examined by age group. RESULTS From 2002-2016, the prevalence of CUD among people reporting daily/almost daily cannabis use decreased by 26.8% in adolescents, by 29.7% in ages 18-25, and by 37.5% in ages 26 + . Prevalence of DSM-IV cannabis dependence decreased significantly among adolescents (-43.9%) and young adults (-26.8%) but remained stable in adults 26 + . Reductions in most dependence items were observed in young adults, with less consistent patterns in adolescents and adults 26 + . Prevalence of DSM-IV cannabis abuse decreased overall and for each abuse item across all age groups. CONCLUSIONS Contrary to expectations, CUD prevalence decreased significantly across all ages reporting daily/almost daily cannabis use between 2002-2016. Cannabis dependence prevalence decreased for adolescents and young adults and was stable only among adults ages 26+ reporting daily/almost daily cannabis use. Potential drivers of this decrease should be further explored.
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Affiliation(s)
- Julian Santaella-Tenorio
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA.
| | - Natalie S. Levy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Luis E. Segura
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Pia M. Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
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Brooks-Russell A, Hall K, Peterson A, Graves J, Van Dyke M. Cannabis in homes with children: use and storage practices in a legalised state. Inj Prev 2019; 26:89-92. [PMID: 31371385 DOI: 10.1136/injuryprev-2019-043318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 11/04/2022]
Abstract
Our objective was to examine the prevalence of cannabis in homes with children and temporal trends in storage practices among caregivers. Caregivers of children ages 1-14 in Colorado, identified through a representative population-based telephone survey, participated in a repeated telephone survey from 2014 to 2017. Representing 79 805 households in Colorado with children, 8.6% (95% CI 7.3 to 10.0) of caregivers reported cannabis in the home. From 2014 to 2017, the prevalence of reporting cannabis in the home increased significantly from 6.9% to 11.2% (p=0.02). Among caregivers who reported cannabis in the home, 91.4% reported storage locations inaccessible to children, such as 'out of reach'. Fewer, 67.0%, caregivers reported storage in a locked container, such as a cabinet, drawer or safe. In a state with recreational cannabis, an increasing number of children live in homes where cannabis is present. Public health practitioners should promote messages to caregivers about safe cannabis storage practices.
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Affiliation(s)
- Ashley Brooks-Russell
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Katelyn Hall
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Anne Peterson
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Janessa Graves
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Mike Van Dyke
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
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Pecker LH, Darbari DS. Psychosocial and affective comorbidities in sickle cell disease. Neurosci Lett 2019; 705:1-6. [DOI: 10.1016/j.neulet.2019.04.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/11/2019] [Accepted: 04/05/2019] [Indexed: 12/31/2022]
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Abstract
OBJECTIVES The aim of the study was to describe use of oral or sublingual cannabis oil (CO) by adolescent and young adult patients with inflammatory bowel disease (IBD). METHODS A descriptive study of IBD patients 13 to 23 years of age seen between January 2015 through December 2017 at Children's Hospital Colorado. Information obtained included chart abstraction, electronic and interview self-report, and serum cannabinoid levels. We compared CO users and cannabis non-users for clinical characteristics and perceptions of risk. Users of CO provided information on routes, patterns, motivations, and perceived benefits and problems with use. RESULTS The 15 users and 67 non-users were similar for clinical characteristics and pain and appetite scores. 9 of 15 (60%) CO users had used in the past 30 days, an average of 22 ± 9 times; and 4 used daily. A variety of strengths and CBD:THC ratios were reported. Most common perceived effect of use was on sleep quality, nausea, and increase in appetite. Of the 15 users, 6 used only CO and no additional forms of cannabis. Of these 6 CO only users, 5 reported a medical reason for use, most commonly to relieve pain. CONCLUSIONS Adolescent and young adults with IBD used oral CO and many used other cannabis products as well. Users perceived some medical benefit. Care teams should strive for open communication about use until further information on safety and efficacy becomes available.
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Abstract
As the number of states legalizing marijuana for medical and/or recreational use continues to grow, there are an increasing number of children exposed to marijuana-containing products in homes and communities. Increased exposure leads to a greater probability of accidental ingestion and toxicity. Because marijuana ingestion can cause a dangerous and potentially life-threatening toxicity for children, pediatric health care providers need an increased awareness of the danger. This article describes the growing problem and outlines clinical management as well as prevention. [Pediatr Ann. 2018;47(12):e474-e476.].
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Adolescent electric cigarette use is associated with subsequent marijuana use. J Pediatr 2018; 200:291-294. [PMID: 30144923 DOI: 10.1016/j.jpeds.2018.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Weeding Out the Justification for Marijuana Treatment in Patients with Developmental and Behavioral Conditions. J Dev Behav Pediatr 2018. [PMID: 28622159 DOI: 10.1097/dbp.0000000000000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alex is a 13-year-old adolescent with high-functioning autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD)-combined type, anxiety, and depression. He has been resistant to engaging in therapy and treatment with various medications has been unsuccessful. Alex's parents are concerned about his anxiety, isolation, oppositional behaviors, academic underachievement, truancy, and substance use. A recent altercation with his stepfather led to a police intervention and a brief removal of Alex from the home. Alex previously used alcohol and other drugs; at present, he reports that his current drug use consists of frequently smoking pot. Alex states that he uses marijuana to relieve his anxiety and does not understand why this is problematic as marijuana is now legal in his state.Kevin is a 24-year-old adult man with diagnoses of autism spectrum disorder, mild intellectual disability, and schizoaffective disorder. He has a long history of challenging and problematic behaviors including aggression toward self and others, property destruction, inappropriate sexual behaviors, elopement, emotional outbursts, anxiety, and suicidal ideation. Past diagnoses include bipolar affective disorder, depression, and intermittent explosive disorder. Kevin is notably obese and somnolent. His current medications include 8 psychotropic medications, 3 antiallergy medications, levothyroxine, and a fish oil supplement. His father reports that medications have gradually been added and dosages increased over time. Two weeks ago, his new psychiatrist initiated a trial of medical marijuana. His father hopes that the marijuana will allow Kevin's other medications to be decreased or discontinued.Linda is an 11-year-old girl with high-functioning autism spectrum disorder, anxiety, and ADHD-inattentive subtype. Anxiety has been her most impairing condition, and Linda has been responding well to a treatment with cognitive behavioral therapy and a selective serotonin reuptake inhibitor. She is also working with her therapist on strategies to address her symptoms of ADHD. Linda has had no side effects from her medication and she and her family have been pleased with her progress. At a follow-up appointment, her mother brings an article from the lay press authored by a parent who claims that marijuana "saved" her autistic son. Linda's mother asks if marijuana should be considered for her daughter.
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Regular Marijuana Use is Associated with Poor Viral Suppression in HIV-Infected Adolescents and Young Adults. AIDS Behav 2018; 22:1363-1372. [PMID: 29094229 DOI: 10.1007/s10461-017-1961-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is a paucity of data regarding the impact of drug use on HIV suppression and care retention among adolescents and young adults (AYAs). We recruited a clinic-based sample of HIV infected AYAs to assess the prevalence of self-reported drug use. Clinical data, including retention and viral suppression, were abstracted from the electronic medical record. Logistic regression was used to evaluate marijuana and illicit drug use associations and to identify other risk factors. Of 200 participants (mean age 21, 2.4 years, 69% horizontally infected), 46% reported current drug use, with marijuana as the most commonly used drug. Any illicit drug use (aOR 1.99, 95% CI 1.06-3.73, p = 0.032) and lower education (aOR 2.11, 95% CI 1.09-4.08, p = 0.046) were associated with poor viral suppression in multivariable analyses. Considering marijuana use only, an association with poor viral suppression was more pronounced (aOR 2.10, 95% CI 1.12-3.94, p = 0.021). Drug use did not have a significant association with retention in care, but AYAs who were retained in HIV care were less likely to have poorly suppressed HIV (aOR 0.22, 95% CI 0.10-0.49, p < 0.001). High prevalence of marijuana use among HIV infected AYAs, and its association with poorly suppressed HIV, demonstrates the need for intervention strategies to decrease its consumption.
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