The Role of Documentation Status Concerns, Perceived Discrimination, and Social Support on Latinx Adults' Physical and Mental Health

There is a growing number of immigrants arriving in the USA, with the majority being of Latinx descent. Coupled with this increase, there has also been growing anti-immigration legislation which impacts the experiences this group faces and creates additional concerns for those who are residing in this country without documentation. Experiences of overt and covert discrimination and marginalization have been shown to relate to poorer mental and physical health outcomes. Drawing from Menjivar and Abrego's Legal Violence Framework, this paper explores the impact of perceived discrimination and social support on the mental and physical health of Latinx adults. We further observe whether these relationships differ based on participants' concerns about their documentation status. This data comes from a community-based participatory study conducted in a Midwestern County. Our analytic sample was comprised of 487 Latinx adults. We found social support to be related to fewer self-reported days of mental health symptoms for all participants regardless of documentation status concern. Perceived discrimination was found to be related to worse physical health for participants with concerns about their status. These findings point to the pernicious role of discrimination for Latinx's physical health and the importance of social support as an asset beneficial for their mental health.

Past-Year Use Prevalence of Cannabidiol, Cannabigerol, Cannabinol, and Δ8-Tetrahydrocannabinol Among US Adults

This survey study characterizes past-year use prevalence and factors associated with use of cannabidiol, cannabigerol, cannabinol, and Δ8-tetrahydrocannabinol among US adults.

Preferences and Support for Psychedelic Policies and Practices Among Those Using Psychedelics

Legal, scientific, and social landscapes for psychedelics are changing rapidly. Differences of opinion exist among key stakeholders regarding regulatory control, models of provisioning psychedelic therapy, and medicalization, decriminalization, and/or legalization policies. We assessed the policy preferences of people using psychedelics naturalistically (N = 1221) to understand how they aligned and differed with institutional entities and existing psychedelic policies. Three quarters of participants would support decriminalization and legalization. On average, participants strongly supported individuals being legally able to grow and possess psychedelic plants and/or fungi for personal consumption. Trends included more support for natural over synthetic substances, self-production and consumption over gifting, gifting over sales, and administration of psychedelics with therapeutic support than without therapeutic support. Participants were concerned about pharmaceutical-like policy models, including patents of natural and synthetic psychedelic compounds. Participants were mostly from the State of Michigan, though geographical differences were minor. Those who identified as a psychedelic guide, educator, or therapist had small yet extensive differences from those who did not. As psychedelic liberalization continues to advance, it is critical for policymakers to consider these preferences to ensure laws provide safe and equitable access to these substances and appropriate medical support for their use.

The Relationship Between Naturalistic Psychedelic Use and Clinical Care in Canada

Naturalistic psychedelic use among Canadians is common. However, interactions about psychedelic use between patients and clinicians in Canada remain unclear. Via an anonymous survey, we assessed health outcomes and integration of psychedelic use with health care providers (HCP) among Canadian adults reporting past use of a psychedelic. The survey included 2,384 participants, and most (81.2%) never discussed psychedelic use with their HCP. While 33.7% used psychedelics to self-treat a health condition, only 4.4% used psychedelics with a therapist and 3.6% in a clinical setting. Overall, 44.8% (n = 806) of participants were aware of substance testing services, but only 42.4% ever used them. Multivariate regressions revealed that therapeutic motivation, higher likelihood of seeking therapist guidance, and non-binary gender identification were significantly associated with higher odds of discussing psychedelics with one's primary HCP. Having used a greater number of psychedelics, lower age, non-female gender, higher education, and a therapeutic motivation were significantly associated with higher odds of awareness of substance testing. We conclude that naturalistic psychedelic use in Canada often includes therapeutic goals but is poorly connected to conventional healthcare, and substance testing is uncommon. Relevant training and education for HCPs is needed, along with more visible options for substance testing.

"How Do I Learn More About this?": Utilization and Trust of Psychedelic Information Sources Among People Naturalistically Using Psychedelics

There is a surge of interest in psychedelics, including new stakeholders and greater media attention. There is a need to examine the information-seeking behavior of people using psychedelics naturalistically, given the importance of preparation and harm-reduction. We examined sources of information for people using psychedelics naturalistically, and the degree to which they are trusted in a large, anonymous, online survey (N = 1221). The most common source of participants' information on psychedelics was their own experimentation and experiences (79.52%). Most also sought information from Internet websites (61.67%), friends (61.02%), Internet discussion forums (57.08%), books (57%), and articles in peer-reviewed scientific journals (54.55%). Few sought information from their primary health care provider (4.83%). Articles published in scientific journals, psychedelic nonprofits, and researchers based in colleges or universities were the most trusted sources of psychedelic information. Government agencies and pharmaceutical companies were the least trusted. Few participants thought that the popular media accurately stated the benefits and risks of psychedelics and most thought that the popular media failed to distinguish between different types of psychedelics. Our results indicate a high level of information seeking among psychedelic users, with a diverse array of information sources typically outside of mainstream health and medical care systems.

Therapeutic Potential of Psilocybin for Treating Psychological Distress among Survivors of Adverse Childhood Experiences: Evidence on Acceptability and Potential Efficacy of Psilocybin Use

Survivors of adverse childhood experience are at elevated risk for psychological distress. In recent years, renewed interest in psychedelic medicine has highlighted the therapeutic potential of psilocybin for those who have experienced childhood adversity. However, recreational psilocybin use remains illegal and access to approved therapies is difficult. Such use provides an opportunity to explore the therapeutic potential of psilocybin for psychological distress among people with adverse childhood experiences. Therefore, we conducted an online survey to assess interest in, acceptability of, and experiences with psilocybin. We further explored whether the association between Adverse Childhood Experiences Questionnaire (ACEQ) scores and psychological distress was lower among those who had used psilocybin in the past three months. Results showed high levels of interest in and acceptability of psilocybin that did not differ across ACEQ scores. Results also showed that the effect of adverse childhood experiences on psychological distress was lower for people who had recently used psilocybin (p = .019). Taken together, these findings suggest that psilocybin therapy may be potentially acceptable and may feasibly help in supporting survivors of adverse childhood experiences with particularly strong benefits to those with more severe childhood adversity.

An Assessment of Psychedelic Knowledge Among People Using Psychedelics Naturalistically

Identifying gaps and strengths in psychedelic-related knowledge is key to developing effective, evidence-based education to inform appropriate use of and harm reduction practices for psychedelics in the naturalistic use landscape. The current study piloted an assessment instrument with questions on legal status, therapeutic potential, and side effects of psychedelics among people reporting current psychedelic use. We recruited participants (N = 1435) at a psychedelic advocacy event and through psychedelic interest groups on social media. Respondents completed a brief survey of psychedelic use and psychedelic knowledge. Items assessed basic knowledge of various topics surrounding psychedelics, such as legal status, active compounds, and known therapeutic efficacy based on the clinical trial literature. Respondents who had used greater numbers of different psychedelics, with higher levels of education, lower age, greater frequency of psychedelic use, identifying as male, used high doses (vs. microdosing only), identifying as Caucasian/White, and with greater annual household income answered more questions correctly. Most respondents exhibited high knowledge of psychedelics, though there is also a demonstrated need for education and outreach, especially in under-represented communities.

Medicinal Cannabis Use for Rheumatic Conditions in the US Versus Canada: Rationale for Use and Patient-Health Care Provider Interactions

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.

Naturalistic Psychedelic Use: A World Apart from Clinical Care

Interest in and availability of psychedelics for therapeutic purposes has increased in recent decades. In a large, anonymous, online survey, we investigated patterns of communication with healthcare providers and awareness and utilization of substance testing kits or services among people using psychedelics naturalistically. The sample population included attendees of a psychedelic activism event and users of psychedelic social media forums. Among 1,435 participants, 72.5% never discussed psychedelic use with their primary care provider (PCP). Only 4.4% reported using psychedelics with a therapist and 3% in clinical settings, although 77.8% were very or extremely likely to take psychedelics with a therapist if one were legally available. While 62.6% of participants were aware of substance testing services, 42.6% of these indicated never using them. Regression analyses identified several variables associated with disclosure to PCP and utilization of substance testing services including age, gender, frequency and number of psychedelics used, and likelihood of consuming psychedelics under the guidance of a therapist if one were legally available. Further research is necessary to investigate these findings among other groups. Our findings suggest that relevant training and education for healthcare providers is needed, along with more visible options for substance identity testing.

Slouching towards engagement: interactions between people using psychedelics naturalistically and their healthcare providers

Introduction

There is substantial public interest in psychedelics as potential treatments for psychiatric conditions. However, most psychedelics are criminalized under federal law in the USA, so it is unclear whether use occurs with clinical support. Our objective was to assess whether naturalistic psychedelic use occurs with clinical support, interactions between those using psychedelics and healthcare providers (psychiatrist, therapist, or primary physicians), and use characteristics.

Methods

We conducted an online, anonymous, confidential, cross-sectional survey of adults reporting psychedelic use (N = 1221) through a psychedelics advocacy event and social media between 9/18/2022 and 11/5/2022. We assessed participant disclosure of psychedelic use with their psychiatric care provider (PsyCP) and/or primary care provider (PCP), desire for provider support, access to support, and rate of taking prescribed psychoactive medications alongside psychedelics.

Results

Among participants with such care providers, 22% disclosed psychedelic use to their PCP vs. 58% to their PsyCP. Participants were less confident in PCP vs. PsyCP ability to integrate psychedelics into treatment. Common reasons for nondisclosure included stigma, inadequate provider knowledge, and legal concerns. 23% reported taking psychedelics on the same day as potentially interacting psychiatric medications (e.g., anxiolytics, antidepressants). Despite 81% of participants desiring therapist support during psychedelic experiences, only 15% had received such support.

Discussion

Our results show that psychedelic use is generally disconnected from primary and psychiatric clinical care. This disconnection may result in safety issues, including inadequate screening for contraindicated conditions, lack of support during emergent adverse events, and drug interactions. Enhanced clinical education and orienting drug policy towards known harms and benefits of psychedelics is needed.

Individual Differences in How Desirable People Think They Are as a Mate

Mate value is an important concept in mate choice research although its operationalization and understanding are limited. Here, we reviewed and evaluated previously established conceptual and methodological approaches measuring mate value and presented original research using individual differences in how people view themselves as a face-valid proxy for mate value in long- and short-term contexts. In data from 41 nations (N = 3895, Mage = 24.71, 63% women, 47% single), we tested sex, age, and relationship status effects on self-perceived mate desirability, along with individual differences in the Dark Triad traits, life history strategies, peer-based comparison of desirability, and self-reported mating success. Both sexes indicated more short-term than long-term mate desirability; however, men reported more long-term mate desirability than women, whereas women reported more short-term mate desirability than men. Further, individuals who were in a committed relationship felt more desirable than those who were not. Concerning the cross-sectional stability of mate desirability across the lifespan, in men, short- and long-term desirability rose to the age of 40 and 50, respectively, and decreased afterward. In women, short-term desirability rose to the age of 38 and decreased afterward, whereas long-term desirability remained stable over time. Our results suggest that measuring long- and short-term self-perceived mate desirability reveals predictable correlates.

Reviewing the Risk of Ketene Formation in Dabbing and Vaping Tetrahydrocannabinol-O-Acetate

Introduction: In the wake of continued consumer demand despite increasing regulatory scrutiny, there is a need to develop systematic methods for identifying the harm profile of new psychoactive substances derived from hemp. Tetrahydrocannabinol-O (THC-O)-acetate, colloquially known as THCO, is the acetate ester of the principal psychoactive compound in cannabis. The heating of THCO can create ketene gas, which is harmful to the lungs. Materials and Methods: The research team used a multidisciplinary, iterative process to develop a survey to incorporate consumers' perspectives of semisynthetic cannabinoids. The survey was then distributed across the social media platform Reddit to learn about delivery device preferences and associated use styles when consuming THCO. Results: Most participants (74.9%) vaped THCO and one-quarter of participants (24.3%) dabbed THCO and tended to report higher temperatures for dabbing than vaping THCO. A small portion (12.0%) of participants reported concerns regarding ketene risk. Conclusion: As there are multiple variables associated with the formation of ketene, and consumer responses indicate temperatures use that might enable ketene formation, more research is needed to understand the risk profile of hemp-derived substances like THCO. Further studies are needed to understand the how various routes of administration and delivery devices used with THCO may exacerbate the risk of ketene formation and other potential harms.

A Content Analysis of Social Media Discussions on THC-O-Acetate

Novel cannabinoids require systematic research to inform policies and practices. There is a growing interest in semi-synthetic cannabinoids by consumers, manufacturers, and regulators. However, there is a scarcity of research on these substances. Online discussion forums can provide guidance for research questions when current knowledge is scarce. The current project investigates the topics and issues covered in a social media forum devoted to THC-O-acetate (THCO), a semi-synthetic cannabinoid with rapidly rising popularity. Reddit comments posted on the THCO subreddit from June 2021 through November 2021 were coded for major and minor themes by a team of five coders and a supervisor. Major themes were established and clarified through group discussions. A second round of coding confirmed major themes and identified minor themes. The analysis identified several future research topics for THC-O-acetate, including the extent of variation in product composition, the characteristics of user experiences and comparisons with other substances, whether THC-O-acetate produces psychedelic effects, concerns and adverse experiences, and user harm reduction practices. As an acetate ester, THC-O-acetate may break down when heated and release toxic ketene gas. Although several users expressed safety concerns regarding THC-O-acetate, some explicitly mentioning ketene risk, the most common administration method reported was heated inhalation.

THC-O-Acetate: Scarce Evidence for a Psychedelic Cannabinoid

There is a growing interest in semi-synthetic cannabinoids, including THC-O-acetate (THC-Oac). Some cannabis marketers and users have claimed that THC-Oac produces psychedelic effects; the current study is the first to examine this claim. Researchers developed an online survey for THC-Oac consumers based on previous cannabis and psychedelic use surveys and in consultation with the moderator of an online forum. The survey assessed the experiential profile of THC-Oac and included items from the Mystical Experience Questionnaire (MEQ), an instrument for assessing psychedelic experiences. Participants reported a low to moderate level of cognitive distortions (altered sense of time, difficulties concentrating, difficulties with short-term memory) and few visuals or hallucinations. Participants' responses were significantly below the threshold for a complete mystical experience on all four MEQ dimensions. Participants who had used classic (5-HT_2A agonist) psychedelics had lower scores on all MEQ dimensions. When asked directly, 79% responded that using THC-Oac is "not at all" or "a little" of a psychedelic experience. Some reports of psychedelic experiences may be due to expectations or contaminants. Those having prior experience with classic psychedelics had lower ratings of mystical experiences.

Physicians' Attitudes and Practices Regarding Cannabis and Recommending Medical Cannabis Use

Introduction: Medical cannabis users tend not to trust or rely on health care providers regarding cannabis advice. Previous surveys of physicians have focused on favorability toward medical cannabis. The current study assesses how physicians interact with patients regarding cannabis in their day-to-day practice, and whether and how they address important topics such as use patterns and substituting cannabis for medications. We predicted that physicians would generally perceive cannabis dispensary staff and caretakers as not competent in addressing patient health needs and would not be likely to use their recommendations. Methods: Physicians in a university-affiliated health system completed an anonymous online survey. The survey assessed physicians' cannabis related education experiences, perceptions of their knowledge of and competence regarding medical cannabis, and the content of cannabis related discussions with patients. We also examined perceptions of the sources of influence on patients regarding cannabis and physicians' attitudes toward medical cannabis dispensary staff and medical cannabis caregivers (MCCs). Results: A few physicians (10%) had ever signed a medical cannabis authorization form for their patients, consistent with their perceptions of low knowledge and competence in this area. Discussions on cannabis primarily focus on risks (63%) rather than dosage (6%) and harm reduction (25%). Physicians see their influence on patients as weak compared with other information sources and have generally unfavorable attitudes toward medical cannabis dispensary staff and MCCs. Conclusion: Greater integration of medical cannabis knowledge is needed at all levels of medical and clinical education to address the potential harm to patients if they receive no guidance. Continued research is needed to provide a strong scientific basis for developing treatment guidelines and standardized medical education for medical cannabis use.

Validation of the Interprofessional Collaborative Competency Attainment Survey (ICCAS) retrospective pre-test measures

Establishing the effectiveness of IPE experiences is essential, and current assessment measures may be subject to various types of bias. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) is administered after the learning experience as retrospective pretest and posttest measures of perceived collaborative practice skills. Because the ICCAS does not have an actual pretest, there are potential risks of recall bias and social desirability bias. To address these concerns, Jackson (2017) proposed conducting a true ICCAS pretest before the learning experience and examining the differences between the true and retrospective pretest scores and the differences between these pretest and posttest scores. This study design was implemented for two in-person Interprofessional forums conducted in the Fall (N = 745) and following Spring (N = 599) semesters. Students from 11 (Fall) and 12 (Spring) health professions education programs were included. True ICCAS pretest scores did not significantly differ from the retrospective pretest scores in either sample, although the effect sizes for pretest to posttest gains were slightly smaller for the true pretest scores. These results support and provide confidence for using the standard ICCAS administration methodology by demonstrating the administration methodology is not adversely impacted by recall or social desirability biases.

Consumer Experiences with Delta-8-THC: Medical Use, Pharmaceutical Substitution, and Comparisons with Delta-9-THC

Introduction: Cannabis products containing delta-8-THC became widely available in most of the United States in late 2020 and rapidly became a significant source of revenue for hemp processing companies, especially in states where use of delta-9-THC remains illegal or requires professional authorization for medical use. Scientific research on the use of delta-8-THC is scarce, previous clinical studies included a combined total of 14 participants, leading some state governments to prohibit it until its properties and effects are better understood. Methods: Researchers developed an online survey for delta-8-THC consumers addressing a broad range of issues regarding delta-8-THC, including use for the treatment of health and medical conditions. Previous survey studies on the medical use of cannabis and cannabis products informed survey components. Results: Patterns of delta-8-THC use had both similarities with and differences from the use of delta-9-THC cannabis and products. Administration methods were primarily edibles (64%) and vaping concentrates (48%). About half of the participants (51%) used delta-8-THC to treat a range of health and medical conditions, primarily anxiety or panic attacks (69%), stress (52%), depression or bipolar disorder (46%), and chronic pain (41%). Participants compared delta-8-THC very favorably with both delta-9-THC and pharmaceutical drugs and reported substantial levels of substitution for both. Most participants did not inform their primary care provider of their delta-8-THC use (78%) and were not confident of their primary care provider's ability to integrate medical cannabis into their treatment (70%). Knowledge of effective dosages was low, and participants' knowledge of delta-8-THC was primarily from the Internet and their own experiences. Conclusion: Harm reduction is a central component of public health. Although the legal environment is becoming more restrictive for delta-8-THC in comparison to delta-9-THC, results suggest that delta-8-THC may be equally effective for desired purposes of cannabis use and lower in undesirable or adverse effects. All policies and practices should be informed by empirical evidence. Considerable research will be needed to systematically verify the patterns reported by participants, and collaborations among academic researchers, government, and the cannabis industry may be valuable in developing the knowledge base for delta-8-THC and other cannabinoids.

Healthcare provider and medical cannabis patient communication regarding referral and medication substitution: the Canadian context

Background

Patients use medical cannabis for a wide array of illnesses and symptoms, and many substitute cannabis for pharmaceuticals. This substitution often occurs without physician oversight, raising patient safety concerns. We aimed to characterize substitution and doctor-patient communication patterns in Canada, where there is a mature market and national regulatory system for medical cannabis.

Methods

We conducted an anonymous, cross-sectional online survey in May 2021 for seven days with adult Canadian federally-authorized medical cannabis patients (N = 2697) registered with two global cannabis companies to evaluate patient perceptions of Primary Care Provider (PCP) knowledge of medical cannabis and communication regarding medical cannabis with PCPs, including PCP authorization of licensure and substitution of cannabis for other medications.

Results

Most participants (62.7%, n = 1390) obtained medical cannabis authorization from their PCP. Of those who spoke with their PCP about medical cannabis (82.2%, n = 2217), 38.6% (n = 857) reported that their PCP had “very good” or “excellent” knowledge of medical cannabis and, on average, were moderately confident in their PCP’s ability to integrate medical cannabis into treatment. Participants generally reported higher ratings for secondary care providers, with 82.8% (n = 808) of participants rating their secondary care provider’s knowledge about medical cannabis as “very good” or “excellent.” Overall, 47.1% (n = 1269) of participants reported substituting cannabis for pharmaceuticals or other substances (e.g., alcohol, tobacco/nicotine). Of these, 31.3% (n = 397) reported a delay in informing their PCP of up to 6 months or more, and 34.8% (n = 441) reported that their PCP was still not aware of their substitution. Older, female participants had higher odds of disclosing cannabis substitution to their PCPs.

Conclusion

Most of the surveyed Canadian medical cannabis patients considered their PCPs knowledgeable about cannabis and were confident in their PCPs’ ability to integrate cannabis into treatment plans. However, many surveyed patients substituted cannabis for other medications without consulting their PCPs. These results suggest a lack of integration between mainstream healthcare and medical cannabis that may be improved through physician education and clinical experience.

Supplementary Information

The online version contains supplementary material available at 10.1186/s42238-022-00141-0.

Assessing Health Care Providers' Knowledge of Medical Cannabis

Introduction: Many health care providers would benefit from greater knowledge and awareness of medical cannabis, even if they choose not to integrate it into their medical practice. Unfortunately, health care providers generally report low knowledge of medical cannabis and cite this lack of knowledge as a barrier to making patient recommendations. It is important to understand health care providers' medical cannabis knowledge and its correlates. However, few studies have rigorously assessed clinically relevant cannabis-related knowledge, instead typically focusing on attitudes toward cannabis and perceived knowledge. Methods: Physicians in a university-affiliated health system completed an anonymous online survey. The survey assessed participants' basic demographics and medical experience, experiences with cannabis education, beliefs about their knowledge of and competency regarding medical cannabis, and knowledge of medical cannabis in relation to the current scientific evidence. Results: The average level of medical cannabis knowledge was 58% correct, with scores ranging from 39% to 78% correct. Perceived cannabis knowledge predicted actual knowledge, and those who pursued self-initiated study or attended a lecture on medical cannabis had higher knowledge levels. Conclusion: Levels of factual knowledge about medical cannabis among physicians were moderate. Our results highlight the mismatch between physician knowledge and cannabis policy. We offer our brief, 10-min assessment as a baseline for characterizing cannabis knowledge, acknowledging that the content and interpretation may change as knowledge advances.

Delta-8-THC: Delta-9-THC's nicer younger sibling?

BACKGROUND

Products containing delta-8-THC became widely available in most of the USA following the 2018 Farm Bill and by late 2020 were core products of hemp processing companies, especially where delta-9-THC use remained illegal or required medical authorization. Research on experiences with delta-8-THC is scarce, some state governments have prohibited it because of this lack of knowledge.

OBJECTIVE

We conducted an exploratory study addressing a broad range of issues regarding delta-8-THC to inform policy discussions and provide directions for future systematic research.

METHODS

We developed an online survey for delta-8-THC consumers, including qualities of delta-8-THC experiences, comparisons with delta-9-THC, and open-ended feedback. The survey included quantitative and qualitative aspects to provide a rich description and content for future hypothesis testing. Invitations to participate were distributed by a manufacturer of delta-8-THC products via social media accounts, email contact list, and the Delta8 Reddit.com discussion board. Participants (N = 521) mostly identified as White/European American (90%) and male (57%). Pairwise t tests compared delta-8-THC effect rating items; one-sample t tests examined responses to delta-9-THC comparison items.

RESULTS

Most delta-8-THC users experienced a lot or a great deal of relaxation (71%); euphoria (68%) and pain relief (55%); a moderate amount or a lot of cognitive distortions such as difficulty concentrating (81%), difficulties with short-term memory (80%), and alerted sense of time (74%); and did not experience anxiety (74%) or paranoia (83%). Participants generally compared delta-8-THC favorably with both delta-9-THC and pharmaceutical drugs, with most participants reporting substitution for delta-9-THC (57%) and pharmaceutical drugs (59%). Participant concerns regarding delta-8-THC were generally focused on continued legal access.

CONCLUSIONS

Delta-8-THC may provide much of the experiential benefits of delta-9-THC with lesser adverse effects. Future systematic research is needed to confirm participant reports, although these studies are hindered by the legal statuses of both delta-8-THC and delta-9-THC. Cross-sector collaborations among academics, government officials, and representatives from the cannabis industry may accelerate the generation of knowledge regarding delta-8-THC and other cannabinoids. A strength of this study is that it is the first large survey of delta-8 users, limitations include self-report data from a self-selected convenience sample.

Evaluating the impact of interprofessional forums on dental medicine students' collaborative practice skill perception

PURPOSE

This study evaluates third-year dental medicine students' perceived competencies related to interprofessional collaborative practice (IPCP) after completing two exposure level experiences with students from other professions across a large academic health center.

METHODS

Two cohorts of D3 dental medicine students (2018-2019 and 2019-2020) completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) after participating in in-person 2.5-h Interprofessional (IP) Forums in the Fall and Spring semesters. Self-reported competencies were compared between pre-and post-IP Forum ratings and between Fall and Spring.

RESULTS

Prior to the IP Forums, dental medicine students (n = 185) reported perceived skill in the interprofessional competencies to be from Good to Very Good using the ICCAS. After participation in the Fall IP Forum, students' ICCAS scores increased in all ICCAS subscales with large effect sizes. Students reported a perceived decline in these skills in the four months between Fall and Spring IP Forums and restoration of IP skill levels after participating in a second IP Forum (Spring).

CONCLUSIONS

Participation in IP Forums has a positive impact on students' IPCP skill perception. Our data suggest that perceived skill level requires repeated IP learning experiences. If dental medicine students are expected to embrace collaborative practice to enhance patient outcomes, then dental school educators must provide opportunities for students to engage in collaborative practice experiences at all levels of their training.

Phenotypic Mimicry Distinguishes Cues of Mating Competition From Paternal Investment in Men's Conspicuous Consumption

Evolutionary psychologists propose that men's conspicuous consumption facilitates mate attraction because it predicts resource investment in offspring. This article elaborates on the ultimate functions of men's luxury displays based on Life History Theory. Three studies provide evidence for phenotypic mimicry, in which consumer product features mimicking male secondary sex characteristics indicate investment in mating competition, at the expense of paternal investment. Men owning shirts with larger luxury brand logos were rated higher on mating effort, lower on parental investment, higher on interest in brief sexual affairs, lower on interest in long-term committed romantic relationships, higher in attractiveness to women for brief sexual affairs, lower in attractiveness to women for long-term committed relationships, and higher in developmental environment unpredictability compared with men owning shirts displaying a smaller logo. Participants recognized the strategic use of luxury display properties across social contexts but did not consistently associate product properties with owners' physiological characteristics.

Belief in an Afterlife Influences Altruistic Helping Intentions in Alignment With Adaptive Tendencies

Evolutionary definitions of altruism are only concerned with reproductive consequences and not motives or other psychological mechanisms, making them ideal for generalization to all forms of organisms. Hamilton's inclusive fitness theory explains altruistic behavior toward genetic relatives and has generated extensive empirical support. Trivers' theory of reciprocal altruism helps explain patterns of helping among non-kin, and other research has demonstrated that human helping intentions follow fitness consequences from age-based reproductive value on altruism. The current study examines a novel psychological factor, belief in the afterlife, which may influence altruistic helping intentions. Belief in the afterlife was incorporated into a previous study design assessing the effects of a target's genetic relatedness and age-based reproductive value. The influences of inclusive fitness and target age were reproduced in a non-Western sample of participants (N = 300) in Iran. Belief in the afterlife predicted the overall confidence of risking one's life to save another across all targets, and also moderated the effects of genetic relatedness and target age. Rather than promoting altruism equitably or advantaging those favored by adaptive tendencies, higher belief in an afterlife aligned with these tendencies in promoting further favoritism toward close kin and younger targets with higher reproductive value.

Communication between healthcare providers and medical cannabis patients regarding referral and medication substitution

BACKGROUND

People report using cannabis as a substitute for prescription medications but may be doing so without the knowledge of their primary health care providers (PCPs). This lack of integration creates serious concerns, e.g., using cannabis to treat medical conditions that have established treatment options.

METHODS

We conducted an anonymous, cross-sectional online survey among patrons of a medical cannabis dispensary in Michigan (n = 275) to examine aspects of their relationship with their PCP and their perceptions of PCP knowledge related to cannabis.

RESULTS

Overall, 64% of participants initiated medical cannabis use based on their own experiences vs. 24% citing advice from their PCP. Although 80% reported that their PCP knew they currently used medical cannabis, 41% reported that their PCP had not always known. Only 14% obtained their medical cannabis authorization from their PCP. Only 18% of participants rated their PCP's knowledge about medical cannabis as very good or excellent and only 21% were very or completely confident in their PCP's ability to integrate medical cannabis into their treatment. Although 86% had substituted cannabis for pharmaceutical medications, 69% (n = 134) of those who substituted reported some gap in their PCP's knowledge of their substitution, and 44% (n = 86) reported that their PCP was currently unaware of their substitution.

CONCLUSIONS

Patients frequently substitute cannabis for prescription drugs, often without PCP knowledge. Although most participants disclosed cannabis use to their PCP, their perceptions of PCP knowledge ranged widely and many obtained medical cannabis licensure from an outside physician. Our results highlight the need for standardized physician education around appropriate medical cannabis use.

Requirements for Cannabis Product Labeling by U.S. State

Introduction: As more states allow for medical and nonregistered adult cannabis (i.e., marijuana) use, ensuring proper utilization should be a priority. Standardized labeling for foods and pharmaceutical drugs promotes consumer safety. This study investigated cannabis product labeling requirements in the United States. Materials and Methods: Researchers compiled the requirements for cannabis product labeling across 31 U.S. states with medical cannabis programs from state regulatory publications. Results: Information requirements ranged considerably by U.S. state. All states required delta-9-tetrahydrocannabinol content and manufacturer contact information, >80% of states required the batch number, health risks, production tracking, a cannabis symbol, cannabidiol content, children disclaimer, and an impairment disclaimer. There appeared to be a random pattern in requirements for other specific items. The relationships between the extent of cannabis product labeling requirements and the number of years that a state had a medical cannabis program or whether states allowed nonregistered adult use cannabis were not significant, although there was a trend for nonregistered adult use states to require more recommended label attributes. Conclusion: A comprehensive framework for cannabis use is needed to protect the public, maximize benefits, and minimize harms and risks. Standardization of cannabis product labeling requirements would benefit consumers and promote safer and more effective usage of cannabis products.

Medication and substance use increases among people using cannabis medically during the COVID-19 pandemic

Background

The ongoing COVID-19 pandemic strains the medical system, limiting access to healthcare services. Many people use cannabis medically for chronic health conditions and as a substitute for other medications. As such, changes in cannabis access associated with COVID-19 may result in increased non-cannabis drug use.

Methods

We recruited N = 353 individuals through Amazon Mechanical Turk who reported current medical cannabis use in April and May of 2020. We assessed the effects of the COVID-19 pandemic on patterns of medication and substance use, as well as on cannabis use patterns.

Results

Over half of participants either started using or increased use of medications or substances because of the COVID-19 pandemic, most commonly alcohol and sleep aids. Over a third of participants increased cannabis use while 25% decreased cannabis use. Approximately 40% of participants who increased or started use of medications/substances (other than cannabis) reported doing so because of changed access to medical cannabis.

Conclusion

The reported increase in drug use among people using medical cannabis is concerning. Because the pandemic will likely continue for months (or even years), having a better understanding of why this is occurring is critical for developing effective harm-reduction strategies in this population.

A content analysis of internet information sources on medical cannabis

BACKGROUND

Medical cannabis users report that their knowledge regarding cannabis is predominantly from their own personal experiences and the Internet.

OBJECTIVE

We summarize and describe information found through Internet searches on medical cannabis in English language websites.

METHODS

We used terms related to medical cannabis in the Google search engine between November and December 2019. Resulting websites were catalogued and coded for content, including mentions of health and medical conditions, pharmacology, dosage, harmful or adverse effects, harm reduction techniques, cautions or warnings, products for sale, and credentials.

RESULTS

We coded 344 web pages on 179 unique websites. Cannabis was mentioned for the treatment of 151 different medical and health conditions, only four of the twenty most frequently mentioned conditions have received substantial empirical support for cannabis or cannabinoid treatment. Information content varied widely across sites, only a small proportion of sites included information on pharmacology, dosage, risks, and other aspects that are requirements for pharmaceutical drugs. Information provided was only moderately related to conclusions in the emerging scientific literature.

CONCLUSIONS

Given the rise in cannabis use within the U.S. and the reliance on the Internet as a source of information, considerable efforts are needed to provide accurate on-line cannabis education to minimize harms and maximize benefits for individuals and society.

Cannabis Enthusiasts’ Knowledge of Medical Treatment Effectiveness and Increased Risks From Cannabis Use

Purpose:

To compare cannabis enthusiasts’ knowledge about cannabis risks and effectiveness in treating medical conditions with existing empirical evidence.

Design:

A brief survey assessed cannabis use, information sources, and knowledge about risks and effectiveness.

Setting:

A cannabis advocacy event in April 2019 in a state with legal medical and recreational cannabis.

Participants:

Demographically diverse adults (N = 472) who frequently used cannabis; 85% used cannabis for health or medical purposes.

Measures:

Participants reported the sources of their cannabis information, health conditions they thought cannabis was effective in treating (n = 10), and health risks increased by cannabis (n = 6). Conditions and risks were based on ratings of evidence (ie, from substantial to insufficient) for therapeutic effects and risks identified in a review by The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017).

Analyses:

Chi-square tests examined the correspondence between participants’ knowledge and NASEM conclusions.

Results:

Most participants’ (95% confidence interval [CI]: 74%-81%) knowledge of cannabis was from their own experiences; 18% (95% CI: 14%-21%) received information from primary care providers. On average, participants’ beliefs matched NASEM conclusions for half of effectiveness (95% CI: 50%-53%) and risk items (95% CI: 55%-57%). Many (95% CI: 38%-42%) thought that cannabis use did not increase any risk. Contrary to NASEM conclusions, many thought cannabis was effective in treating cancer (76%), depressive symptoms (72%), and epilepsy (68%). Those who received cannabis information from their primary care providers had better knowledge of medical effectiveness. Medicinal cannabis use frequency inversely predicted knowledge of medical effectiveness and increased risks of adverse events.

Conclusion:

There were considerable discrepancies between cannabis users’ knowledge and available evidence, highlighting the need for more research and education (by physicians, caregivers, and dispensaries) on effectiveness and health risks, especially for users with specific health issues such as pregnant women and people with depression.

Social Integration may Moderate the Relationship between Neighborhood Vacancy and Mental Health Outcomes: Initial Evidence from Flint, Michigan

Long-term residence in neighborhoods is thought to promote the development and maintenance of supportive relationships and trust. These strong social ties may, however, be limited in communities in post-industrial cities characterized by high levels of vacant properties. This study aimed to examine the relationship between neighborhood vacancy and mental health with adjustment for length of residence and possible moderation by social (dis)integration in a sample of Flint, MI, residents. We found that short-term (but not long-term) increases in neighborhood vacancy were associated with poorer mental health, after adjustment for individual covariates. When considering neighborhood vacancy, length of residence and individual covariates, however, the only significant association detected was between higher social disintegration and lower wellbeing. This effect was direct and not mediated by other factors. In this way, it appears that the social conditions of neighborhoods may be important, particularly in places that have experienced declines in the built environment. In addition, we identified evidence that social integration moderates the relationship between neighborhood vacancy and mental health outcomes. The level of neighborhood vacancies had a weaker relationship to wellbeing among those with higher levels of social ties. But none of the independent variables in our study were able to predict social integration, highlighting some potential areas for future research. From these findings, we posit that establishing strong social connections can buffer residents against negative mental health outcomes, and health promotion efforts could usefully assist in maintaining social ties among neighbors.

'I'm going to look for you and take your kids': Reproductive justice in the context of immigration enforcement

Prior research has shown that immigration law enforcement contributes to poor health outcomes—including reproductive health outcomes—among Latinos. Yet no prior research has examined how immigration enforcement might inhibit reproductive justice and limit individual’s reproductive autonomy. We utilized data from an existing study that consisted of a partnership with a Latino community in Michigan in which an immigration raid resulted in multiple arrests and deportations midway through data collection. Using cross-sectional survey data (n = 192) where no one was re-interviewed, we used ordinal logistic regression to compare desired pregnancy timing of individuals surveyed prior to and after the raid to determine the impact of an immigration raid on desired timing of next pregnancy. We then used qualitative data—including 21 in-depth interviews and participant observation—collected in the community after the raid to contextualize our findings. Controlling for socio-demographic characteristics, we found that Latinos surveyed in the aftermath of the raid were more likely to report a greater desire to delay childbearing than Latinos surveyed before the raid occurred. Our qualitative data showed that an immigration raid has financial and psychological effects on immigrant families and that a raid may impact reproductive autonomy because people are fearful of these impacts. These finding suggest that current immigration enforcement efforts may influence reproductive decision-making, impede Latinos reproductive autonomy, and that family-friendly immigration policy reform is needed.

University Sports Rivalries Provide Insights on Coalitional Psychology : Territorial Context Influences Reactions to Vocal Signals of Allegiance

Sports are an excellent venue for demonstrating evolutionary principles to audiences not familiar with academic research. Team sports and sports fandom feature dynamics of in-group loyalty and intergroup competition, influenced by our evolved coalitional psychology. We predicted that reactions to expressions signaling mutual team/group allegiance would vary as a function of the territorial context. Reactions should become more prevalent, positive, and enthusiastic as one moves from the home territory to a contested area, and from a contested area to a rival's territory during active rival engagement. We also predicted that men would be more responsive than women based on sex differences in evolved coalitional psychology. The research team visited public places immediately prior to 2016-2017 collegiate football and basketball games. A male research confederate wore a sweatshirt displaying the logo of one of the competing university teams and vocalized the team's most popular slogan when he saw a fan displaying similar logos. Observers followed 5 m behind, recording reactions (N = 597) and response positivity/enthusiasm. Reaction tone was most positive in the rival territory, least positive in the home territory, and intermediate in the periphery and contested territory. Rates of "no reaction" were lowest in the rival territory but were highest in the periphery. Men had higher reaction rates and more positive and enthusiastic reaction tones than women. Reactions generally followed predictions based on expected signal value. This project provides evidence that coalitional psychology influences dynamics related to university sports team rivalries and that context matters for expressions of alliance.

Medical Cannabis Users' Comparisons between Medical Cannabis and Mainstream Medicine

An evidence-based approach is needed to shape policies and practices regarding medical cannabis, thereby reducing harm and maximizing benefits to individuals and society. This project assesses attitudes towards and utilization of medical cannabis and the mainstream healthcare system among medical cannabis users. The research team administered brief hard copy surveys to 450 adults attending an annual public event advocating for cannabis law reform. Among usable responses (N = 392), the majority (78%) reported using cannabis to help treat a medical or health condition. Medical cannabis users reported a greater degree of use of medical cannabis and a greater degree of trust in medical cannabis compared to mainstream healthcare. In comparison to pharmaceutical drugs, medical cannabis users rated cannabis better on effectiveness, side effects, safety, addictiveness, availability, and cost. Due to the medical use of cannabis, 42% stopped taking a pharmaceutical drug and 38% used less of a pharmaceutical drug. A substantial proportion (30%) reported that their mainstream healthcare provider did not know that they used medical cannabis. Other issues identified included lack of access to mainstream healthcare, self-initiated treatment of health issues, little knowledge of psychoactive content, and heavy cannabis use.

Drunchies Hangover

Background and Purpose: Alcohol intoxication affects college students' eating patterns. Yet, little is known about dietary habits on the day after heavy alcohol consumption. The purpose of this study was to examine college students’ dietary choices during alcohol consumption and on the following day by gender and level of alcohol consumption (including none). Methods: Ethnically diverse undergraduates (N = 286; 52% male, 48% female, M age = 19, SD age = 1) at a public university in the Midwest completed an anonymous on-line survey. The survey included Behavioral Risk Factor Surveillance System nutrition items, items on consumption of "empty calorie foods," and open-ended response items on dietary choices that were coded by a nutritionist. Results: Participants reported differences in the likelihoods of consuming non-nutrient dense foods after drinking alcohol both before sleeping and the next day compared to at other times when they were not consuming alcohol. Conclusion: College students are more likely to eat after drinking alcohol and tend to consume less healthy foods. These dietary practices necessitate the need for customized interventions focusing on the dietary influences of alcohol consumption.

The Role of Present Time Perspective in Predicting Early Adolescent Violence

This study investigated the role of present and future time perspectives, and their relationships with subjective norms and beliefs regarding violence, in predicting violent behaviors among urban middle school students in the Midwestern United States. Although present time perspective covaried with subjective norms and beliefs, each made a unique prediction of self-reported violent behaviors. Future time perspective was not a significant predictor when accounting for these relationships. In addition, present orientation moderated the relationship between subjective norms and beliefs and rates of violent behaviors; those with higher present orientations exhibited stronger associations. We replicated this pattern of results in data from new participants in a subsequent wave of the study. Interventions that explicitly address issues related to time perspective may be effective in reducing early adolescent violence.

Cell phone-induced ostracism threatens fundamental needs

Cell phones are useful tools with both practical and social benefits. However, using them in the context of face-to-face conversations may be problematic. We consider this behavior a form of ostracism and test its effects on the satisfaction of basic psychological needs for belonging, self-esteem, control, and meaningful existence. In Study 1 participants who recalled a time in which a friend was checking a cell phone during a serious conversation reported feeling more ostracized (ignored and excluded), greater pain, and threat to basic needs than participants recalling a conversation without a cell phone interruption or a control event. Study 2 replicated and extended this effect: Cell phone-induced ostracism's effects were partially mediated by decreased feelings of relational evaluation, and threatened basic needs both in serious and casual conversation contexts. Findings from both studies also indicated that cell phone-induced ostracism hurts women more so than men.

Risk for Unintended Pregnancy Among Latino Men and Women in a Nonmetropolitan County in Michigan

INTRODUCTION

This study characterizes the risk for unintended pregnancy among Latino men and women within a racially and ethnically diverse county in Michigan.

METHODS

Latino respondents aged 18 to 50 years who reported no intention to become pregnant in the next year and no contraception use were defined as "at risk" for unintended pregnancy. Any associations between risk for unintended pregnancy and sociodemographic factors was determined through multivariate logistic regression.

RESULTS

Risk for unintended pregnancy was higher among men (67%) than women (59%; P=0.046; n=341). In multivariate logistic regression analysis, English speaking ability was associated with lower odds for risk of unintended pregnancy (OR=0.73; P=0.004). Having a high school degree or less was associated with higher odds for risk of unintended pregnancy (OR=4.15, P<0.001 and OR=2.74, P=0.026, respectively).

CONCLUSION

Among Latinos in a nonmetropolitan community, both men and women were at high risk for unintended pregnancy. Future studies that address the reasons behind this elevated risk may inform potential interventions among this at-risk group.

Neighborhood Influences and BMI in Urban Older Adults

OBJECTIVE

Increases in body weight and declining physical activity that may accompany aging are linked to a range of problems affecting daily life (i.e., decreased mobility and overall quality of life). This study investigates the actual and perceived neighborhood environment on overweight and obese urban older adults.

METHOD

We selected 217 individuals aged 65+ who answered questions about their neighborhood on the 2009 Speak to Your Health survey. Using multinomial regression models and geospatial models, we examined relationships between neighborhood environment and BMI.

RESULTS

We found that obese older adults were 63% less likely to have a park within their neighborhood ( p = .04). Our results also show that older adults who perceive their neighborhood crime as very high are 12 times more likely to be overweight ( p = .04).

DISCUSSION

Findings suggest that parks may affect BMI in older adults; however, neighborhood perceptions play a greater role.

Perceived Water Quality and Reported Health among Adults during the Flint, MI Water Crisis

Background and Purpose: In April 2014, the municipal water source for Flint, Michigan was changed from Lake Huron to the Flint River. Although residents reported concerns about the quality of tap water and resulting health problems, officials insisted that the water was safe. This study examined relationships between self-reported tap water quality during the water crisis and health conditions among Flint residents. Methods: Participants from each residential Census Tract in the City of Flint were recruited via address lists, online social media, and community-based events. The survey included mental and physical health items from the CDC’s Behavioral Risk Factor Surveillance System and an item on tap water quarter quality experiences. Analyses were weighted to be demographically representative. Results: Participants (N = 277) rated their tap water quality (taste, smell, appearance) as Poor (57%), Fair (20%), Good (13%), Very Good (6%), and Excellent (3%). Controlling for age, gender, years of education, whether respondents were African American or Hispanic/Latino/a, and population demographics, lower perceived tap water quality was associated with worse mental and physical health across all indicators. Conclusion: This study demonstrates associations of tap water quality experiences with reported poor physical and mental health among adults in Flint during the Flint Water Crisis.

Brief Self-Report Scales Assessing Life History Dimensions of Mating and Parenting Effort

Life history theory (LHT) is a powerful evolutionary framework for understanding physiological, psychological, and behavioral variation both between and within species. Researchers and theorists are increasingly integrating LHT into evolutionary psychology, as it provides a strong foundation for research across many topical areas. Human life history variation has been represented in psychological and behavioral research in several ways, including indicators of conditions in the developmental environment, indicators of conditions in the current environment, and indicators of maturation and life milestones (e.g., menarche, initial sexual activity, first pregnancy), and in self-report survey scale measures. Survey scale measures have included constructs such as time perspective and future discounting, although the most widely used index is a constellation of indicators assessing the K-factor, thought to index general life history speed (from fast to slow). The current project examined the utility of two brief self-report survey measures assessing the life history dimensions of mating effort and parenting effort with a large undergraduate sample in the United States. Consistent with the theory, items reflected two inversely related dimensions. In regressions including the K-factor, the Mating Effort Scale proved to be a powerful predictor of other constructs and indicators related to life history variation. The Parenting Effort Scale had less predictive power overall, although it explained unique variance across several constructs and was the only unique predictor of the number of long-term (serious and committed) relationships. These scales may be valuable additions to self-report survey research projects examining life history variation.

On the Psychometric Study of Human Life History Strategies

This article attends to recent discussions of validity in psychometric research on human life history strategy (LHS), provides a constructive critique of the extant literature, and describes strategies for improving construct validity. To place the psychometric study of human LHS on more solid ground, our review indicates that researchers should (a) use approaches to psychometric modeling that are consistent with their philosophies of measurement, (b) confirm the dimensionality of life history indicators, and (c) establish measurement invariance for at least a subset of indicators. Because we see confirming the dimensionality of life history indicators as the next step toward placing the psychometrics of human LHS on more solid ground, we use nationally representative data and structural equation modeling to test the structure of middle adult life history indicators. We found statistically independent mating competition and Super-K dimensions and the effects of parental harshness and childhood unpredictability on Super-K were consistent with past research. However, childhood socioeconomic status had a moderate positive effect on mating competition and no effect on Super-K, while unpredictability did not predict mating competition. We conclude that human LHS is more complex than previously suggested-there does not seem to be a single dimension of human LHS among Western adults and the effects of environmental components seem to vary between mating competition and Super-K.