1
|
Lees R, Lawn W, Petrilli K, Brown A, Trinci K, Borissova A, Ofori S, Mokrysz C, Curran HV, Hines LA, Freeman TP. Persistent increased severity of cannabis use disorder symptoms in adolescents compared to adults: a one-year longitudinal study. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01806-y. [PMID: 38709252 DOI: 10.1007/s00406-024-01806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/02/2024] [Indexed: 05/07/2024]
Abstract
Adolescence is a developmental period characterised by increased vulnerability to cannabis use disorder (CUD). However, previous investigations of this vulnerability have relied on cross-sectional comparisons and lack a detailed assessment of cannabis quantity, a potentially important confounding factor. Here, we aimed to investigate the one-year course of CUD in adolescents compared to adults who currently use cannabis, adjusting for a comprehensive measure of cannabis quantity. Data are from a one-year observational longitudinal study (CannTeen) of adolescents and adults who currently used cannabis regularly with five waves of assessment at 3-monthly intervals, based in London, UK. Participants were n = 70 adults (26-29, 45.7% female), who did not regularly use cannabis when they were under age 18, and n = 76 adolescents (16-17, 50.0% female). The exposure was adolescent (compared to adult) frequent cannabis use. The primary outcome was CUD symptoms measured using the cannabis use disorder identification test revised (CUDIT-R) at five time points. Models were adjusted for cannabis quantity using mean weekly standard THC units (one unit = 5 mg THC). Other covariates included gender, and whether each session occurred before or during the COVID-19 pandemic. In models adjusted for pre-registered covariates, adolescents scored 3.7 points higher on the CUDIT-R compared to the adult group across the 5 assessment waves (3.66 95% CIs 1.99, 5.34). There was also evidence of a linear reduction in symptoms over time in both groups (-0.47, 95%CIs -0.67, -0.27). Adolescents had persistently increased CUD symptoms compared to adults across the 12-month period. This association was robust after adjusting for the quantity of cannabis consumed and other covariates.
Collapse
Affiliation(s)
- Rachel Lees
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK.
| | - Will Lawn
- Department of Psychology, Kings College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| | - Amelia Brown
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, UCL, London, UK
| | - Anya Borissova
- Clinical Psychopharmacology Unit, UCL, London, UK
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, UCL, London, UK
| | | | | | - Lindsey A Hines
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| | - Tom P Freeman
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
2
|
Petrilli K, Lawn W, Lees R, Mokrysz C, Borissova A, Ofori S, Trinci K, Dos Santos R, Leitch H, Soni S, Hines LA, Lorenzetti V, Curran HV, Freeman TP. Enhanced cannabis timeline followback (EC-TLFB): Comprehensive assessment of cannabis use including standard THC units and validation through biological measures. Addiction 2024; 119:772-783. [PMID: 38105033 DOI: 10.1111/add.16405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/06/2023] [Indexed: 12/19/2023]
Abstract
AIMS The aims of this study were to present an enhanced cannabis timeline followback (EC-TLFB) enabling comprehensive assessment of cannabis use measures, including standard tetrahydrocannabinol (THC) units, and to validate these against objectively indexed urinary 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH) concentrations. DESIGN We used cross-sectional baseline data from the 'CannTeen' observational longitudinal study. SETTING The study was conducted in London, UK. PARTICIPANTS A total of 147 participants who used cannabis regularly took part in the study (n = 71 female, n = 76 male; mean age = 21.90, standard deviation = 5.32). MEASUREMENTS The EC-TLFB was used to calculate frequency of cannabis use, method of administration, including co-administration with tobacco, amount of cannabis used (measured with unaided self-report and also using pictorial aided self-report) and type of cannabis product (flower, hash) which was used to estimate THC concentration (both from published data on THC concentration of products and analysis of cannabis samples donated by participants in this study). We calculated total weekly standard THC units (i.e. 5 mg THC for all cannabis products and methods of administration) using the EC-TLFB. The outcome variable for validation of past week EC-TLFB assessments was creatinine-normalized carboxy-tetrahydrocannabinol (THC-COOH) in urine. FINDINGS All measures of cannabis exposure included in this analysis were positively correlated with levels of THC-COOH in urine (r = 0.41-0.52). Standard THC units, calculated with average concentrations of THC in cannabis in the UK and unaided self-report measures of amount of cannabis used in grams showed the strongest correlation with THC-COOH in urine (r = 0.52, 95% bias-corrected and accelerated = 0.26-0.70). CONCLUSIONS The enhanced cannabis timeline followback (EC-TLFB) can provide a valid assessment of a comprehensive set of cannabis use measures including standard tetrahydrocannabinol units as well as and traditional TLFB assessments (e.g. frequency of use and grams of cannabis use).
Collapse
Affiliation(s)
- Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Will Lawn
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rachel Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Anya Borissova
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Harry Leitch
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Shilpa Soni
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Lindsey A Hines
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Programme, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
3
|
Cousijn J, Kuhns L, Filbey F, Freeman TP, Kroon E. Cannabis research in context: The case for measuring and embracing regional similarities and differences. Addiction 2024. [PMID: 38454627 DOI: 10.1111/add.16460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Janna Cousijn
- Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Lauren Kuhns
- University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Emese Kroon
- Erasmus University Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
4
|
Constantinides C, Baltramonaityte V, Caramaschi D, Han LKM, Lancaster TM, Zammit S, Freeman TP, Walton E. Assessing the association between global structural brain age and polygenic risk for schizophrenia in early adulthood: A recall-by-genotype study. Cortex 2024; 172:1-13. [PMID: 38154374 DOI: 10.1016/j.cortex.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/22/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023]
Abstract
Neuroimaging studies consistently show advanced brain age in schizophrenia, suggesting that brain structure is often 'older' than expected at a given chronological age. Whether advanced brain age is linked to genetic liability for schizophrenia remains unclear. In this pre-registered secondary data analysis, we utilised a recall-by-genotype approach applied to a population-based subsample from the Avon Longitudinal Study of Parents and Children to assess brain age differences between young adults aged 21-24 years with relatively high (n = 96) and low (n = 93) polygenic risk for schizophrenia (SCZ-PRS). A global index of brain age (or brain-predicted age) was estimated using a publicly available machine learning model previously trained on a combination of region-wise gray-matter measures, including cortical thickness, surface area and subcortical volumes derived from T1-weighted magnetic resonance imaging (MRI) scans. We found no difference in mean brain-PAD (the difference between brain-predicted age and chronological age) between the high- and low-SCZ-PRS groups, controlling for the effects of sex and age at time of scanning (b = -.21; 95% CI -2.00, 1.58; p = .82; Cohen's d = -.034; partial R2 = .00029). These findings do not support an association between SCZ-PRS and brain-PAD based on global age-related structural brain patterns, suggesting that brain age may not be a vulnerability marker of common genetic risk for SCZ. Future studies with larger samples and multimodal brain age measures could further investigate global or localised effects of SCZ-PRS.
Collapse
Affiliation(s)
| | | | - Doretta Caramaschi
- Department of Psychology, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Laura K M Han
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Orygen, Parkville, Australia
| | | | - Stanley Zammit
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | | |
Collapse
|
5
|
Hall D, Lawn W, Ofori S, Trinci K, Borissova A, Mokrysz C, Petrilli K, Bloomfield MAP, Wall MB, Freeman TP, Curran HV. The acute effects of cannabis, with and without cannabidiol, on attentional bias to cannabis related cues: a randomised, double-blind, placebo-controlled, cross-over study. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06543-7. [PMID: 38416223 DOI: 10.1007/s00213-024-06543-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/20/2024] [Indexed: 02/29/2024]
Abstract
RATIONALE Attentional bias to drug-related stimuli is hypothesised to contribute towards addiction. However, the acute effects of Δ9-tetrahydrocannabinol (THC) on attentional bias to cannabis cues, the differential response in adults and adolescents, and the moderating effect of cannabidiol (CBD) are unknown. OBJECTIVES Our study investigated (1) the acute effects of vaporised cannabis on attentional bias to cannabis-related images in adults and adolescents and (2) the moderating influences of age and CBD. METHODS We conducted a randomised, double-blind, placebo-controlled, cross-over study where three weight-adjusted vaporised cannabis preparations: 'THC' (8 mg THC for a 75-kg person), 'THC + CBD' (8 mg THC and 24 mg CBD for a 75-kg person) and PLA (matched placebo). Cannabis was administered on 3 separate days to 48 participants, who used cannabis 0.5-3 days/week: 24 adolescents (12 females, aged 16-17) and 24 adults (12 females, aged 26-29). Participants completed a visual probe task with cannabis cues. Our primary outcome was attentional bias to cannabis stimuli, measured using the differential reaction time to a cannabis vs. neutral probe, on 200-ms trials. RESULTS In contrast to hypotheses, attention was directed away from cannabis cues on placebo, and there was a main effect of the drug (F(2,92) = 3.865, p = 0.024, η2p = 0.077), indicating THC administration eliminated this bias. There was no significant impact of CBD nor an age-by-drug interaction. CONCLUSIONS Acute THC intoxication eliminated attentional bias away from cannabis cues. There was no evidence of differential response in adolescents compared to adults and no evidence that a moderate vaporised dose of CBD altered the impact of cannabis on attentional bias. TRIAL REGISTRATION This study was listed with the US National Library of Medicine and registered on ClinicalTrials.gov, URL: Do Adolescents and Adults Differ in Their Acute Response to Cannabis?-Full Text View-ClinicalTrials.gov, registration number: NCT04851392.
Collapse
Affiliation(s)
- Daniel Hall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
- Daniel Hall, Springfield University Hospital, 15 Springfield Drive, London, SW17 0YF, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
- Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King's College, London, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - Anya Borissova
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, London, UK
| | - Michael A P Bloomfield
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
- Invicro London, Hammersmith Hospital, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK.
| |
Collapse
|
6
|
Wilson J, Mills KL, Sunderland M, Freeman TP, Teesson M, Haber PS, Marel C. The Long-Term Relationship Between Cannabis and Heroin Use: An 18- to 20-year Follow-Up of the Australian Treatment Outcome Study (ATOS). Am J Psychiatry 2024; 181:135-143. [PMID: 38018142 DOI: 10.1176/appi.ajp.20230088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Cannabis use is common among individuals with opioid use disorder, but it remains unclear whether cannabis use is associated with an increase or a reduction in illicit opioid use. To overcome limitations identified in previous longitudinal studies with limited follow-ups, the authors examined a within-person reciprocal relationship between cannabis and heroin use at several follow-ups over 18 to 20 years. METHODS The Australian Treatment Outcome Study (ATOS) recruited 615 people with heroin dependence in 2001 and 2002 and reinterviewed them at 3, 12, 24, and 36 months as well as 11 and 18-20 years after baseline. Heroin and cannabis use were assessed at each time point using the Opiate Treatment Index. A random-intercept cross-lagged panel model analysis was conducted to identify within-person relationships between cannabis use and heroin use at subsequent follow-ups. RESULTS After accounting for a range of demographic variables, other substance use, and mental and physical health measures, an increase in cannabis use 24 months after baseline was significantly associated with an increase in heroin use at 36 months (estimate=0.21, SE=0.10). Additionally, an increase in heroin use at 3 months and 24 months was significantly associated with a decrease in cannabis use at 12 months (estimate=-0.27, SE=0.09) and 36 months (estimate=-0.22, SE=0.08). All other cross-lagged associations were not significant. CONCLUSIONS Although there was some evidence of a significant relationship between cannabis and heroin use at earlier follow-ups, this was sparse and inconsistent across time points. Overall, there was insufficient evidence to suggest a unidirectional or bidirectional relationship between the use of these substances.
Collapse
Affiliation(s)
- Jack Wilson
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| | - Katherine L Mills
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| | - Tom P Freeman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| | - Paul S Haber
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| | - Christina Marel
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia (Wilson, Mills, Sunderland, Teesson, Marel); Addiction and Mental Health Group, University of Bath, Bath, U.K. (Freeman); Sydney Medical School, University of Sydney, Sydney, Australia (Haber); Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia (Haber)
| |
Collapse
|
7
|
Chester LA, Englund A, Chesney E, Oliver D, Wilson J, Sovi S, Dickens AM, Oresic M, Linderman T, Hodsoll J, Minichino A, Strang J, Murray RM, Freeman TP, McGuire P. Effects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Plasma Endocannabinoid Levels in Healthy Volunteers: A Randomized Double-Blind Four-Arm Crossover Study. Cannabis Cannabinoid Res 2024; 9:188-198. [PMID: 36493386 PMCID: PMC10874814 DOI: 10.1089/can.2022.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: The effects of cannabis are thought to be mediated by interactions between its constituents and the endocannabinoid system. Delta-9-tetrahydrocannabinol (THC) binds to central cannabinoid receptors, while cannabidiol (CBD) may influence endocannabinoid function without directly acting on cannabinoid receptors. We examined the effects of THC coadministered with different doses of CBD on plasma levels of endocannabinoids in healthy volunteers. Methods: In a randomized, double-blind, four-arm crossover study, healthy volunteers (n=46) inhaled cannabis vapor containing 10 mg THC plus either 0, 10, 20, or 30 mg CBD, in four experimental sessions. The median time between sessions was 14 days (IQR=20). Blood samples were taken precannabis inhalation and at 0-, 5-, 15-, and 90-min postinhalation. Plasma concentrations of THC, CBD, anandamide, 2-arachidonoylglycerol (2-AG), and related noncannabinoid lipids were measured using liquid chromatography-mass spectrometry. Results: Administration of cannabis induced acute increases in plasma concentrations of anandamide (+18.0%, 0.042 ng/mL [95%CI: 0.023-0.062]), and the noncannabinoid ethanolamides, docosatetraenylethanolamide (DEA; +35.8%, 0.012 ng/mL [95%CI: 0.008-0.016]), oleoylethanolamide (+16.1%, 0.184 ng/mL [95%CI: 0.076-0.293]), and N-arachidonoyl-L-serine (+25.1%, 0.011 ng/mL [95%CI: 0.004-0.017]) (p<0.05). CBD had no significant effect on the plasma concentration of anandamide, 2-AG or related noncannabinoid lipids at any of three doses used. Over the four sessions, there were progressive decreases in the preinhalation concentrations of anandamide and DEA, from 0.254 ng/mL [95%CI: 0.223-0.286] to 0.194 ng/mL [95%CI: 0.163-0.226], and from 0.039 ng/mL [95%CI: 0.032-0.045] to 0.027 ng/mL [95%CI: 0.020-0.034] (p<0.05), respectively. Discussion: THC induced acute increases in plasma levels of anandamide and noncannabinoid ethanolamides, but there was no evidence that these effects were influenced by the coadministration of CBD. It is possible that such effects may be evident with higher doses of CBD or after chronic administration. The progressive reduction in pretreatment anandamide and DEA levels across sessions may be related to repeated exposure to THC or participants becoming less anxious about the testing procedure and requires further investigation. The study was registered on clinicaltrials.gov (NCT05170217).
Collapse
Affiliation(s)
- Lucy A. Chester
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amir Englund
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Edward Chesney
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dominic Oliver
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, New South Wales, Australia
| | - Simina Sovi
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Alex M. Dickens
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- Department of Chemistry, University of Turku, Turku, Finland
| | - Matej Oresic
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Tuomas Linderman
- Turku Bioscience Center, University of Turku and Åbo Akademi University, Turku, Finland
| | - John Hodsoll
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amedeo Minichino
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| | - John Strang
- National Addiction Centre (NAC), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Robin M. Murray
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tom P. Freeman
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom
| |
Collapse
|
8
|
Oliver D, Englund A, Chesney E, Chester L, Wilson J, Sovi S, Wigroth S, Hodsoll J, Strang J, Murray RM, Freeman TP, Fusar‐Poli P, McGuire P. Cannabidiol does not attenuate acute delta-9-tetrahydrocannabinol-induced attentional bias in healthy volunteers: A randomised, double-blind, cross-over study. Addiction 2024; 119:322-333. [PMID: 37821096 PMCID: PMC10952555 DOI: 10.1111/add.16353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/30/2023] [Indexed: 10/13/2023]
Abstract
AIMS To test how attentional bias and explicit liking are influenced by delta-9-tetrahydrocannabinol (THC) and whether these effects are moderated by cannabidiol (CBD). DESIGN Double-blind, randomised, within-subjects cross-over study. SETTING NIHR Wellcome Trust Clinical Research Facility at King's College Hospital, London, United Kingdom. PARTICIPANTS/CASES Forty-six infrequent cannabis users (cannabis use <1 per week). INTERVENTION(S) Across four sessions, participants inhaled vaporised cannabis containing 10 mg of THC and either 0 mg (0:1 CBD:THC), 10 mg (1:1), 20 mg (2:1) or 30 mg (3:1) of CBD, administered in a randomised order and counter-balanced across participants (a total of 24 order groups). MEASUREMENTS Participants completed two tasks: (1) Attentional Bias (AB), comparing reaction times toward visual probes presented behind 28 target stimuli (cannabis/food) compared with probes behind corresponding non-target (neutral) stimuli. Participants responding more quickly to probes behind target than non-target stimuli would indicate greater attentional bias to cannabis/food; (2) Picture Rating (PR), where all AB stimuli were rated on a 7-point pleasantness scale, measuring explicit liking. FINDINGS During the AB task, participants were more biased toward cannabis stimuli in the 0:1 condition compared with baseline (mean difference = 12.2, 95% confidence intervals [CIs] = 1.20-23.3, d = 0.41, P = 0.03). No other significant AB or PR differences were found between cannabis and food stimuli between baseline and 0:1 condition (P > 0.05). No significant CBD effect was found on AB or PR task performance at any dose (P > 0.05). There was additionally no cumulative effect of THC exposure on AB or PR outcomes (P > 0.05). CONCLUSIONS A double-blind, randomised, cross-over study among infrequent cannabis users found that inhaled delta-9-tetrahydrocannabinol increased attentional bias toward cannabis in the absence of explicit liking, a marker of liability toward cannabis use disorder. At the concentrations normally found in legal and illegal cannabis, cannabidiol had no influence on this effect.
Collapse
Affiliation(s)
- Dominic Oliver
- Department of PsychiatryUniversity of OxfordOxfordUK
- NIHR Oxford Health Biomedical Research CentreOxfordUK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Amir Englund
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Addictions Department, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Lucy Chester
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Laboratoire Didier Jutras‐AswadCentre de Recherche du Centre hospitalier de l'Université de MontréalMontréalQCCanada
| | - Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02The University of SydneyNSWAustralia
| | - Simina Sovi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Stina Wigroth
- Addictions Department, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - John Hodsoll
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - John Strang
- Addictions Department, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and the Maudsley National Health Service Foundation TrustLondonUK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Tom P. Freeman
- Addictions Department, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of PsychologyUniversity of BathBathUK
| | - Paolo Fusar‐Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and the Maudsley National Health Service Foundation TrustLondonUK
- Department of Brain and Behavioural SciencesUniversity of PaviaPaviaItaly
- Department of Psychiatry and PsychotherapyLudwig‐Maximilian‐University MunichMunichGermany
| | - Philip McGuire
- Department of PsychiatryUniversity of OxfordOxfordUK
- NIHR Oxford Health Biomedical Research CentreOxfordUK
| |
Collapse
|
9
|
Austin A, Favril L, Craft S, Thliveri P, Freeman TP. Factors associated with drug use in prison: A systematic review of quantitative and qualitative evidence. Int J Drug Policy 2023; 122:104248. [PMID: 37952319 DOI: 10.1016/j.drugpo.2023.104248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND About a third of people use drugs during their incarceration, which is associated with multiple adverse health and criminal justice outcomes. Many studies have examined factors associated with in-prison drug use, but this evidence has not yet been systematically reviewed. We aimed to systematically review and synthesise the evidence on factors related to drug use in prison. METHODS Three databases (PubMed, PsycINFO and Embase) were systematically searched as well as grey literature, for quantitative, qualitative and mixed-methods studies examining factors related to drug use inside prison. We excluded studies that did not explicitly measure in prison drug use or only measured alcohol and/or tobacco use. Study quality was assessed using the Newcastle Ottawa Scale (NOS) for quantitative studies and Critical Appraisal Skills Programme (CASP) for qualitative studies. The review was prospectively registered on PROSPERO (CRD42021295898). RESULTS Fifty-four studies met the inclusion criteria, reporting data on 26,399 people in prison. Most studies were of low or moderate-quality, and all used self-report to assess drug use. In quantitative studies, studies found that previous criminal justice involvement, poor prison conditions, pre-prison drug use and psychiatric diagnosis were positively associated with drug use in prison. In qualitative studies, reasons for drug use were closely linked to the prison environment lacking purposeful activity and the social context of the prison whereby drug use was seen as acceptable, necessary for cohesion and pressurised. CONCLUSION In the first systematic review of factors associated with drug use in prison, key modifiable risk factors identified from quantitative and qualitative studies were psychiatric morbidity and poor prison conditions. Non-modifiable factors included previous drug use and criminal history linked to substance use. Our findings indicate an opportunity to intervene and improve the prison environment to reduce drug use and associated adverse outcomes.
Collapse
Affiliation(s)
- Alice Austin
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium
| | - Sam Craft
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Phoebe Thliveri
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK.
| |
Collapse
|
10
|
Craft S, Austin A, Tooth T, Glover C, Garrett T, Blagbrough IS, Sunderland P, Pudney CR, Freeman TP. Synthetic cannabinoid use in an adult male prison in the UK. Int J Drug Policy 2023; 122:104219. [PMID: 37813081 DOI: 10.1016/j.drugpo.2023.104219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION Synthetic cannabinoids (i.e. Spice) are a major public health problem in UK prisons, however, research in this area is limited. Here we aimed to draw comparisons between people with and without experience of using synthetic cannabinoids in prison, to characterise the features of, and motivations for use within this setting and evaluate support for different treatment interventions. METHOD Questionnaires were administered to 122 people in a category-B prison for adult males in England between July 2022 and March 2023. Participants were asked questions related to their sociodemographic and custodial characteristics, use of synthetic cannabinoids (and other drugs) inside and outside of prison and psychological distress was measured via the Brief Symptom Inventory (BSI-18). Those that had ever used synthetic cannabinoids in prison completed additional questions related to features of use, motivations for use and support for various interventions. RESULTS In total 46.7 % (n = 57) of participants reported use of synthetic cannabinoids in prison and this group experienced significantly greater levels of psychological distress compared to those reporting no use (mean (± standard deviation) BSI-18 scores = 23.7 (±16.7) vs 12.8 (±13.6), p < 0.001). Participants mostly reported using paper-based preparations (77.4 %) and use via e-cigarettes (75.9 %). The most strongly endorsed motivations for use included to alleviate boredom (91.1 % strongly agree/agree), to make the sentence pass faster (89.3 % strongly agree/agree) and to cope with stress (80.4 % strongly agree/agree). The interventions that received most support were strategies to better manage time and medication to manage withdrawal. CONCLUSIONS The use of synthetic cannabinoids in UK prisons typically involves the use of paper-based preparations via e-cigarettes, and use is associated with greater levels of psychological distress. Motivations for use were mostly pragmatic (e.g. to alleviate boredom or cope with stress) and interventions should prioritise increasing the time individuals spend out of cells and in meaningful activity.
Collapse
Affiliation(s)
- Sam Craft
- Addiction and Mental Health Group, Department of Psychology, University of Bath, UK.
| | - Alice Austin
- Addiction and Mental Health Group, Department of Psychology, University of Bath, UK
| | - Tom Tooth
- HM Prison and Probation Service (HMPPS), London, UK
| | - Catherine Glover
- Royal College of General Practitioners Secure Environments Group, London, UK
| | - Tina Garrett
- Office of Health Improvements and Disparities (OHID), London, UK
| | | | | | | | - Tom P Freeman
- Addiction and Mental Health Group, Department of Psychology, University of Bath, UK
| |
Collapse
|
11
|
Spinazzola E, Quattrone D, Rodriguez V, Trotta G, Alameda L, Tripoli G, Gayer-Anderson C, Freeman TP, Johnson EC, Jongsma HE, Stilo S, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Galatolo M, Tortelli A, Tagliabue I, Turco M, Pompili M, Selten JP, de Haan L, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, O'Donovan M, Rutten BP, Van Os J, Morgan C, Sham PC, Austin-Zimmerman I, Li Z, Vassos E, Murray RM, Di Forti M. The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study. Psychol Med 2023; 53:7418-7427. [PMID: 37129249 PMCID: PMC10719678 DOI: 10.1017/s0033291723001071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/23/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis. METHODS We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status. RESULTS Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status. CONCLUSIONS Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.
Collapse
Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- National Institute for Health Research, Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne, University Hospital (CHUV), Lausanne, Switzerland
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM); Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Michela Galatolo
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Institut Mondor de recherché biomedicale, Creteil, France
- Etablissement Public de Sante Maison Blanche, Paris, France
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Marco Turco
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Section, AmsterdamUMC, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- Reader; Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Department of Psychiatry, Centre for PanorOmic Sciences, and State Key Laboratory of Brain and Cognitive Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - EU-GEI WP2 Group
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
- Research Foundation, National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the NIHR BRC at University College London, London, UK
| |
Collapse
|
12
|
Trotta G, Rodriguez V, Quattrone D, Spinazzola E, Tripoli G, Gayer-Anderson C, Freeman TP, Jongsma HE, Sideli L, Aas M, Stilo SA, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Tortelli A, Schürhoff F, Szöke A, Pignon B, Selten JP, Velthorst E, de Haan L, Llorca PM, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, Richards A, Rutten BP, Van Os J, Austin-Zimmerman I, Li Z, Morgan C, Sham PC, Vassos E, Wong C, Bentall R, Fisher HL, Murray RM, Alameda L, Di Forti M. Cannabis use as a potential mediator between childhood adversity and first-episode psychosis: results from the EU-GEI case-control study. Psychol Med 2023; 53:7375-7384. [PMID: 38078747 PMCID: PMC10719680 DOI: 10.1017/s0033291723000995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/21/2023] [Accepted: 03/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis. METHODS Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0-11 years), and late (12-17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use. RESULTS The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord. CONCLUSIONS Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.
Collapse
Affiliation(s)
- Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- University of Bath Department of Pharmacy and Pharmacology: University of Bath Department of Life Sciences, Bath, UK
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Monica Aas
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simona A Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Caterina La Cascia
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Laura Ferraro
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Daniele La Barbera
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- University of Bologna Department of Medical and Surgical Sciences: Universita degli Studi di Bologna Dipartimento di Scienze Mediche e Chirurgiche, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Franck Schürhoff
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Baptiste Pignon
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
| | - Eva Velthorst
- Mount Sinai School of Medicine Department of Psychiatry: Icahn School of Medicine, New York, NY, USA
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigation Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Centro de Investigation Biomedica en Red de Salud Mental, School of Medicine, Universidad de Valencia, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Department of Medicine, Neuroscience Institute, University of Barcelona, Institute d'investigations Biomediques, August Pi I Sunyer, Centro de Investigation Biomedica en Red de Salud Mental, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - Alexander Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Hong Kong University: University of Hong Kong, Hong Kong
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chloe Wong
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard Bentall
- The University of Sheffield Department of Psychology, Sheffield, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - EU-GEI WP2 Group
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
13
|
Wilson J, Mills KL, Sunderland M, Freeman TP, Keaveny M, Haasnoot K, Teesson M, Haber PS, Marel C. Long-term patterns of treatment use for opioid use disorder (OUD): Findings from the 18-20-year Australian Treatment Outcome Study. Int J Drug Policy 2023; 120:104187. [PMID: 37713938 DOI: 10.1016/j.drugpo.2023.104187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Opioid-related deaths continue to increase to unprecedented rates in many regions of the world. While long-term stable treatment has been shown to reduce associated morbidity and mortality, discontinuation and numerous treatment episodes are common, limiting our understanding of the common course of treatment and associated characteristics. Therefore, using an 18-20-year follow-up of people with heroin dependence, we aimed to identify i) distinct trajectories of treatment use, ii) whether baseline characteristics predict treatment trajectory group membership, and ii) if group membership is associated with characteristics at 18-20-years post-baseline. METHODS A total of 615 people with heroin dependence were recruited from maintenance therapy, detoxification, residential rehabilitation, or needle and syringe programs as part of the Australian Treatment Outcome Study (ATOS), a longitudinal cohort followed up on seven occasions over 18-20-years between 2001 and 2021. Of those who had complete data (n = 393), group-based trajectory modelling and a series of multinomial logistical regressions were conducted. RESULTS Five trajectories of treatment use were identified: i) 'long-term low treatment' (17.2%), ii) 'rapid increase with gradual decrease' (13.9%), iii) 'late increase' (17.8%), (iv) 'long-term treatment' (27.7%), and (v) 'reduced treatment' (23.5%). Entering maintenance treatment at baseline predicted trajectory group membership, while trajectory group membership was associated with demographics and the use of heroin, methamphetamine, alcohol, and benzodiazepines at 18-20-years. CONCLUSIONS In one of the longest cohort studies of its kind, we characterised distinct trajectories of treatment use in people with heroin dependence over 18-20-years. Clinicians should be aware of the potential impact of demographics and substance use on long-term treatment use. Despite the well-documented benefits of long-term treatment, some patients may be able to achieve abstinence from opioids without engaging in treatment over the life-course.
Collapse
Affiliation(s)
- Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia.
| | - Katherine L Mills
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), University of Bath, BA2 7AY, United Kingdom
| | - Madeleine Keaveny
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia
| | - Katherine Haasnoot
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia
| | - Paul S Haber
- Sydney Medical School, The University of Sydney, 2006, NSW, Australia; Drug Health Services, Royal Prince Alfred Hospital, Camperdown, 2050, NSW, Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, 2006, NSW, Australia
| |
Collapse
|
14
|
Pelgrim TAD, Ramaekers JG, Wall MB, Freeman TP, Bossong MG. Acute effects of Δ9-tetrahydrocannabinol (THC) on resting state connectivity networks and impact of COMT genotype: A multi-site pharmacological fMRI study. Drug Alcohol Depend 2023; 251:110925. [PMID: 37598453 DOI: 10.1016/j.drugalcdep.2023.110925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Cannabis produces various acute psychotropic effects, with marked individual differences. Cannabis use is a risk factor for developing psychotic disorders. The main component responsible for these effects is Δ9-tetrahydrocannabinol (THC). Here we investigated the neural basis of acute THC effects and its modulation by catechol-methyl-transferase (COMT) Val158Met genotype. METHODS Resting state functional MRI data of healthy occasional cannabis users were combined and re-analyzed from three double-blind, placebo-controlled, within-subject pharmacological functional magnetic resonance imaging studies (total N=87). Functional connectivity after placebo and THC was compared in three functional networks (salience, executive and default mode network) and a network implicated in psychosis (the hippocampus-midbrain-striatum network). COMT genotype modulation of subjective effects and connectivity was examined. RESULTS THC reduced connectivity in the salience network, specifically from the right insula to both the left insula and anterior cingulate cortex. We found a trend towards decreased connectivity in the hippocampus-midbrain-striatum network after THC. COMT genotype modulated subjective effects of THC, with strongest dysphoric reactions in Met/Met individuals. In addition, reduced connectivity after THC was demonstrated in the hippocampus-midbrain-striatum network of Met/Met individuals only. CONCLUSIONS In this large multisite study we found that THC robustly decreases connectivity in the salience network, involved in processing awareness and salient information. Connectivity changes in the hippocampus-midbrain-striatum network may reflect the acute psychotic-like effects of THC. COMT genotype modulation of THC's impact on subjective effects and functional connectivity provides further evidence for involvement of prefrontal dopamine levels in the acute effects of cannabis.
Collapse
Affiliation(s)
- Teuntje A D Pelgrim
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Department of Psychiatry, Parnassia Psychiatric Institute, Amsterdam, the Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Matthew B Wall
- Invicro London, Hammersmith Hospital, London, UK; Faculty of Medicine, Imperial College London, London, UK; Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
| |
Collapse
|
15
|
Cozier G, Andrews RC, Frinculescu A, Kumar R, May B, Tooth T, Collins P, Costello A, Haines TSF, Freeman TP, Blagbrough IS, Scott J, Shine T, Sutcliffe OB, Husbands SM, Leach J, Bowman RW, Pudney CR. Instant Detection of Synthetic Cannabinoids on Physical Matrices, Implemented on a Low-Cost, Ultraportable Device. Anal Chem 2023; 95:13829-13837. [PMID: 37642957 PMCID: PMC10515102 DOI: 10.1021/acs.analchem.3c01844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
Synthetic cannabinoids (SCs) make up a class of novel psychoactive substances (NPS), used predominantly in prisons and homeless communities in the U.K. SCs can have severe side effects, including psychosis, stroke, and seizures, with numerous reported deaths associated with their use. The chemical diversity of SCs presents the major challenge to their detection since approaches relying on specific molecular recognition become outdated almost immediately. Ideally one would have a generic approach to detecting SCs in portable settings. The problem of SC detection is more challenging still because the majority of SCs enter the prison estate adsorbed onto physical matrices such as paper, fabric, or herb materials. That is, regardless of the detection modality used, the necessary extraction step reduces the effectiveness and ability to rapidly screen materials on-site. Herein, we demonstrate a truly instant generic test for SCs, tested against real-world drug seizures. The test is based on two advances. First, we identify a spectrally silent region in the emission spectrum of most physical matrices. Second, the finding that background signals (including from autofluorescence) can be accurately predicted is based on tracking the fraction of absorbed light from the irradiation source. Finally, we demonstrate that the intrinsic fluorescence of a large range of physical substrates can be leveraged to track the presence of other drugs of interest, including the most recent iterations of benzodiazepines and opioids. We demonstrate the implementation of our presumptive test in a portable, pocket-sized device that will find immediate utility in prisons and law enforcement agencies around the world.
Collapse
Affiliation(s)
- Gyles
E. Cozier
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
| | - Rachael C. Andrews
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
| | - Anca Frinculescu
- Department
of Analytical, Environmental and Forensic Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K.
- TICTAC
Communications Ltd., Room 1.159 Jenner Wing, St. George’s University of London, Cranmer Terrace, London SW17 0RE, U.K.
| | - Ranjeet Kumar
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
| | - Benedict May
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
| | - Tom Tooth
- HMP
Bristol, 19 Cambridge
Road, Horfield, Bristol BS7 8PS, U.K.
| | - Peter Collins
- Avon
and Somerset Police, Valley Road, Bristol BS20
8JJ, U.K.
| | - Andrew Costello
- MANchester
DRug Analysis & Knowledge Exchange (MANDRAKE), Department of Natural
Sciences, Manchester Metropolitan University, Manchester M1 5GD, U.K
- Greater
Manchester Police, Openshaw Complex, Lawton Street,
Openshaw, Manchester M11 2NS, U.K.
| | - Tom S. F. Haines
- Department of Computer Science and Department of
Psychology, University of Bath, Bath BA2 7AY, U.K.
| | - Tom P. Freeman
- Department of Computer Science and Department of
Psychology, University of Bath, Bath BA2 7AY, U.K.
| | - Ian S. Blagbrough
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
| | - Jennifer Scott
- Centre
for Academic Primary Care, Bristol Medical
School, Bristol BS8 2PN, U.K.
| | - Trevor Shine
- TICTAC
Communications Ltd., Room 1.159 Jenner Wing, St. George’s University of London, Cranmer Terrace, London SW17 0RE, U.K.
| | - Oliver B. Sutcliffe
- MANchester
DRug Analysis & Knowledge Exchange (MANDRAKE), Department of Natural
Sciences, Manchester Metropolitan University, Manchester M1 5GD, U.K
| | - Stephen M. Husbands
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
| | - Jonathan Leach
- Institute
of Chemical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K.
| | - Richard W. Bowman
- School
of Physics and Astronomy, University of
Glasgow, Glasgow G12 8QQ, U.K.
| | - Christopher R. Pudney
- Department
of Life Sciences, Department of Chemistry, and Centre for Sustainable and Circular
Technologies, University of Bath, Bath BA2 7AY, U.K.
- Centre
for Therapeutic Innovation, University of
Bath, Bath BA2 7AY, U.K.
| |
Collapse
|
16
|
Affiliation(s)
- Tom P Freeman
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| | - Wayne Hall
- National Centre for Youth Substance Use Research, University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
17
|
Ertl N, Lawn W, Mokrysz C, Freeman TP, Alnagger N, Borissova A, Fernandez-Vinson N, Lees R, Ofori S, Petrilli K, Trinci K, Viding E, Curran HV, Wall MB. Associations between regular cannabis use and brain resting-state functional connectivity in adolescents and adults. J Psychopharmacol 2023; 37:904-919. [PMID: 37515469 DOI: 10.1177/02698811231189441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND/AIM Cannabis use is highly prevalent in adolescents; however, little is known about its effects on adolescent brain function. METHOD Resting-state functional magnetic resonance imaging was used in matched groups of regular cannabis users (N = 70, 35 adolescents: 16-17 years old, 35 adults: 26-29 years old) and non-regular-using controls (N = 70, 35 adolescents/35 adults). Pre-registered analyses examined the connectivity of seven major cortical and sub-cortical brain networks (default mode network, executive control network (ECN), salience network, hippocampal network and three striatal networks) using seed-based analysis methods with cross-sectional comparisons between user groups and age groups. RESULTS The regular cannabis use group (across both age groups), relative to controls, showed localised increases in connectivity only in the ECN analysis. All networks showed localised connectivity differences based on age group, with the adolescents generally showing weaker connectivity than adults, consistent with the developmental effects. Mean connectivity across entire network regions of interest (ROIs) was also significantly decreased in the ECN in adolescents. However, there were no significant interactions found between age group and user group in any of the seed-based or ROI analyses. There were also no associations found between cannabis use frequency and any of the derived connectivity measures. CONCLUSION Regular cannabis use is associated with changes in connectivity of the ECN, which may reflect allostatic or compensatory changes in response to regular cannabis intoxication. However, these associations were not significantly different in adolescents compared to adults.
Collapse
Affiliation(s)
- Natalie Ertl
- Invicro London, Hammersmith Hospital, London, UK
- Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Will Lawn
- Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- Department of Addictions, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Naji Alnagger
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, University College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK
| | | | - Rachel Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Essi Viding
- Clinical, Educational, and Health Psychology Research Department, University College London, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Matthew B Wall
- Invicro London, Hammersmith Hospital, London, UK
- Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
18
|
Skumlien M, Craft S, Scott J, Freeman TP. Turning down the spice: tackling the problems of synthetic cannabinoids. BMJ 2023; 382:e076611. [PMID: 37604578 DOI: 10.1136/bmj-2023-076611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Affiliation(s)
- Martine Skumlien
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Sam Craft
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Jennifer Scott
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
19
|
Lorenzetti V, Freeman TP. Standardised cannabis metrics: Opportunities for tracking how cannabis use affects neurodevelopmental trajectories in youth cohorts worldwide. Addict Biol 2023; 28:e13309. [PMID: 37500491 DOI: 10.1111/adb.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/19/2023] [Accepted: 06/07/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, Melbourne, Australia
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
20
|
Lawn W, Trinci K, Mokrysz C, Borissova A, Ofori S, Petrilli K, Bloomfield M, Haniff ZR, Hall D, Fernandez‐Vinson N, Wang S, Englund A, Chesney E, Wall MB, Freeman TP, Curran HV. The acute effects of cannabis with and without cannabidiol in adults and adolescents: A randomised, double-blind, placebo-controlled, crossover experiment. Addiction 2023; 118:1282-1294. [PMID: 36750134 PMCID: PMC10481756 DOI: 10.1111/add.16154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND AIMS Long-term harms of cannabis may be exacerbated in adolescence, but little is known about the acute effects of cannabis in adolescents. We aimed to (i) compare the acute effects of cannabis in adolescent and adult cannabis users and (ii) determine if cannabidiol (CBD) acutely modulates the effects of delta-9-tetrahydocannabinol (THC). DESIGN Randomised, double-blind, placebo-controlled, crossover experiment. The experiment was registered on ClinicalTrials.gov (NCT04851392). SETTING Laboratory in London, United Kingdom. PARTICIPANTS Twenty-four adolescents (12 women, 16- to 17-year-olds) and 24 adults (12 women, 26- to 29-year-olds) who used cannabis 0.5-3 days/week and were matched on cannabis use frequency (mean = 1.5 days/week). INTERVENTION We administered three weight-adjusted vaporised cannabis flower preparations: 'THC' (8 mg THC for 75 kg person); 'THC + CBD' (8 mg THC and 24 mg CBD for 75 kg person); and 'PLA' (matched placebo). MEASUREMENTS Primary outcomes were (i) subjective 'feel drug effect'; (ii) verbal episodic memory (delayed prose recall); and (iii) psychotomimetic effect (Psychotomimetic States Inventory). FINDINGS Compared with 'PLA', 'THC' and 'THC + CBD' significantly (P < 0.001) increased 'feel drug effect' (mean difference [MD] = 6.3, 95% CI = 5.3-7.2; MD = 6.8, 95% CI = 6.0-7.7), impaired verbal episodic memory (MD = -2.7, 95% CI = -4.1 to -1.4; MD = -2.9, 95% CI = -4.1 to -1.7) and increased psychotomimetic effects (MD = 7.8, 95% CI = 2.8-12.7; MD = 10.8, 95% CI = 6.2-15.4). There was no evidence that adolescents differed from adults in their responses to cannabis (interaction P ≥ 0.4). Bayesian analyses supported equivalent effects of cannabis in adolescents and adults (Bayes factor [BF01 ] >3). There was no evidence that CBD significantly modulated the acute effects of THC. CONCLUSIONS Adolescent cannabis users are neither more resilient nor more vulnerable than adult cannabis users to the acute psychotomimetic, verbal memory-impairing or subjective effects of cannabis. Furthermore, in adolescents and adults, vaporised cannabidiol does not mitigate the acute harms caused by delta-9-tetrahydocannabinol.
Collapse
Affiliation(s)
- Will Lawn
- Department of Psychology, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Anna Borissova
- Department of Neuroimaging, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College HospitalLondonUK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - Michael Bloomfield
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
- NIHR University College London Hospitals Biomedical Research CentreUniversity College HospitalLondonUK
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of PsychiatryUniversity College LondonLondonUK
| | - Zarah R. Haniff
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Daniel Hall
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Natalia Fernandez‐Vinson
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Simiao Wang
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| | - Amir Englund
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Psychosis Studies, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Edward Chesney
- Department of Addictions, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Psychosis Studies, Institute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK
| | - Matthew B. Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
- Invicro LondonBurlington Danes Building, Hammersmith Hospital, Du Cane RoadLondonUK
| | - Tom P. Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - H. Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health PsychologyUniversity College LondonLondonUK
| |
Collapse
|
21
|
Hindson SA, Andrews RC, Danson MJ, van der Kamp MW, Manley AE, Sutcliffe OB, Haines TSF, Freeman TP, Scott J, Husbands SM, Blagbrough IS, Anderson JLR, Carbery DR, Pudney CR. Synthetic cannabinoid receptor agonists are monoamine oxidase-A selective inhibitors. FEBS J 2023; 290:3243-3257. [PMID: 36708234 PMCID: PMC10952593 DOI: 10.1111/febs.16741] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 01/29/2023]
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) are one of the fastest growing classes of recreational drugs. Despite their growth in use, their vast chemical diversity and rapidly changing landscape of structures make understanding their effects challenging. In particular, the side effects for SCRA use are extremely diverse, but notably include severe outcomes such as cardiac arrest. These side effects appear at odds with the main putative mode of action, as full agonists of cannabinoid receptors. We have hypothesized that SCRAs may act as MAO inhibitors, owing to their structural similarity to known monoamine oxidase inhibitors (MAOI's) as well as matching clinical outcomes (hypertensive crisis) of 'monoaminergic toxicity' for users of MAOIs and some SCRA use. We have studied the potential for SCRA-mediated inhibition of MAO-A and MAO-B via a range of SCRAs used commonly in the UK, as well as structural analogues to prove the atomistic determinants of inhibition. By combining in silico and experimental kinetic studies we demonstrate that SCRAs are MAO-A-specific inhibitors and their affinity can vary significantly between SCRAs, most notably affected by the nature of the SCRA 'head' group. Our data allow us to posit a putative mechanism of inhibition. Crucially our data demonstrate that SCRA activity is not limited to just cannabinoid receptor agonism and that alternative interactions might account for some of the diversity of the observed side effects and that these effects can be SCRA-specific.
Collapse
Affiliation(s)
- Sarah A. Hindson
- Department of Biology and BiochemistryUniversity of BathBA2 7AYBathUK
| | - Rachael C. Andrews
- Department of ChemistryUniversity of BathBA2 7AYBathUK
- Centre for Sustainable and Circular TechnologiesUniversity of BathBA2 7AYBathUK
| | - Michael J. Danson
- Department of Biology and BiochemistryUniversity of BathBA2 7AYBathUK
| | | | - Amy E. Manley
- Faculty of Health SciencesUniversity of BristolBS8 1THBristolUK
| | - Oliver B. Sutcliffe
- MANchester DRug Analysis & Knowledge Exchange (MANDRAKE), Department of Natural SciencesManchester Metropolitan UniversityM15 5GDManchesterUK
| | | | | | - Jennifer Scott
- Faculty of Health SciencesUniversity of BristolBS8 1THBristolUK
| | | | - Ian S. Blagbrough
- Department of Pharmacy and PharmacologyUniversity of BathBA2 7AYBathUK
| | | | - David R. Carbery
- Department of ChemistryUniversity of BathBA2 7AYBathUK
- Centre for Sustainable and Circular TechnologiesUniversity of BathBA2 7AYBathUK
| | - Christopher R. Pudney
- Department of Biology and BiochemistryUniversity of BathBA2 7AYBathUK
- Centre for Sustainable and Circular TechnologiesUniversity of BathBA2 7AYBathUK
- Centre for Therapeutic InnovationUniversity of BathBA2 7AYBathUK
| |
Collapse
|
22
|
Wilson J, Mills KL, Sunderland M, Freeman TP, Teesson M, Haber PS, Marel C. Different Tokes for Different Folks: Use of Cannabis Products Among a Longitudinal Cohort of People with Heroin Dependence. Int J Ment Health Addict 2023:1-17. [PMID: 37363767 PMCID: PMC10184640 DOI: 10.1007/s11469-023-01071-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/28/2023] Open
Abstract
Co-occurring cannabis use is common among those with opioid use disorder (OUD), but the extent to which it is harmful may be due to its preparation and concentration of various cannabinoids. The current study aimed to examine the prevalence of, and long-term associations with, the use of varying cannabis products among a naturalistic longitudinal cohort of people with heroin dependence. A total of 615 people, most of whom were entering treatment, were recruited to the Australian Treatment Outcome Study (ATOS) in 2001-2002. This analysis focuses on the 401 participants followed up at 18-20 years post baseline. Structured interviews assessed the use of cannabis products, as well as demographic and health covariates. High-potency/indoor-grown cannabis was the most common type ever used (68.8%), and in the past 12 months (80.4%), followed by low potency/outdoor grown (22.4%; 14.4%), and less so for other types of cannabis. After controlling for covariates, older age at baseline was associated with lower odds of high-potency cannabis being used as the primary type in the past 12 months. In contrast to studies of non-opioid dependent populations, common use of high-potency cannabis was not associated with more severe health outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-023-01071-5.
Collapse
Affiliation(s)
- Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, Sydney, NSW 2006 Australia
| | - Katherine L. Mills
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, Sydney, NSW 2006 Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, Sydney, NSW 2006 Australia
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY UK
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, Sydney, NSW 2006 Australia
| | - Paul S. Haber
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006 Australia
- Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building, G02, The University of Sydney, Sydney, NSW 2006 Australia
| |
Collapse
|
23
|
Petrilli K, Hines L, Adams S, Morgan CJ, Curran HV, Freeman TP. High potency cannabis use, mental health symptoms and cannabis dependence: Triangulating the evidence. Addict Behav 2023; 144:107740. [PMID: 37121087 DOI: 10.1016/j.addbeh.2023.107740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Cannabis potency (concentration of Δ-9-Tetrahydrocannabinol) has been associated with risks of adverse mental health outcomes and addiction but no studies have triangulated evidence from self-report and objective measures of cannabis potency. We hypothesised that users of high potency cannabis would have higher levels of (a) anxiety, (b) depression and (c) psychosis-like symptoms (d) cannabis dependence than users of lower potency cannabis. METHODS A cross-sectional study of 410 participants donated a sample of cannabis for analysis of THC concentration and reported their cannabis potency preference. These two exposure measures were investigated for their association with cannabis dependence, depression, anxiety, and psychosis-like symptoms in separate linear/logistic regression models. RESULTS High potency cannabis preference was associated with a slight increased risk of cannabis dependence after adjusting for confounding, with the exception of cannabis use frequency (OR = 1.16, 95% CI 1.04-1.28). No association was found between THC concentration in cannabis and cannabis dependence. There was weak evidence of a small association between cannabis potency and depression and anxiety. There was no association between high potency cannabis preference or THC concentration in cannabis and psychosis-like symptoms. CONCLUSIONS Users of cannabis who preferred high potency types might be at increased risk of problematic cannabis use. This should be considered with caution as we were not able to triangulate these results with an objective measure of cannabis potency. More research is needed to understand the association between high potency cannabis use and depression and anxiety.
Collapse
Affiliation(s)
- Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.
| | - Lindsey Hines
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK; Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sally Adams
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Celia J Morgan
- Washington Singer Laboratories, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
24
|
Hua DYH, Hindocha C, Baio G, Lees R, Shaban N, Morgan CJ, Mofeez A, Curran HV, Freeman TP. Effects of cannabidiol on anandamide levels in individuals with cannabis use disorder: findings from a randomised clinical trial for the treatment of cannabis use disorder. Transl Psychiatry 2023; 13:131. [PMID: 37085531 PMCID: PMC10121552 DOI: 10.1038/s41398-023-02410-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 04/23/2023] Open
Abstract
Cannabidiol (CBD) has shown promise in treating psychiatric disorders, including cannabis use disorder - a major public health burden with no approved pharmacotherapies. However, the mechanisms through which CBD acts are poorly understood. One potential mechanism of CBD is increasing levels of anandamide, which has been implicated in psychiatric disorders including depression and cannabis use disorder. However, there is a lack of placebo-controlled human trials investigating this in psychiatric disorders. We therefore assessed whether CBD affects plasma anandamide levels compared to placebo, within a randomised clinical trial of CBD for the treatment of cannabis use disorder. Individuals meeting criteria for cannabis use disorder and attempting cannabis cessation were randomised to 28-day administration with placebo (n = 23), 400 mg CBD/day (n = 24) or 800 mg CBD/day (n = 23). We estimated the effects of each CBD dose compared to placebo on anandamide levels from baseline to day 28. Analyses were conducted both unadjusted and adjusted for cannabis use during the trial to account for effects of cannabis on the endocannabinoid system. We also investigated whether changes in plasma anandamide levels were associated with clinical outcomes relevant for cannabis use disorder (cannabis use, withdrawal, anxiety, depression). There was an effect of 800 mg CBD compared to placebo on anandamide levels from baseline to day 28 after adjusting for cannabis use. Pairwise comparisons indicated that anandamide levels unexpectedly reduced from baseline to day 28 in the placebo group (-0.048, 95% CI [-0.089, -0.007]), but did not change in the 800 mg CBD group (0.005, 95% CI [-0.036, 0.047]). There was no evidence for an effect of 400 mg CBD compared to placebo. Changes in anandamide levels were not associated with clinical outcomes. In conclusion, this study found preliminary evidence that 28-day treatment with CBD modulates anandamide levels in individuals with cannabis use disorder at doses of 800 mg/day but not 400 mg/day compared to placebo.
Collapse
Affiliation(s)
- Daniel Ying-Heng Hua
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | | | | | - Rachel Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | | | - Celia J Morgan
- Washington Singer Labs, University of Exeter, Exeter, UK
| | - Ali Mofeez
- Pain Management Centre, National Hospital for Neurology and Neurosurgery, UCLH, London, UK
| | | | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.
| |
Collapse
|
25
|
Freeman TP, Lorenzetti V. Using the standard THC unit to regulate THC content in legal cannabis markets. Addiction 2023; 118:1007-1009. [PMID: 36987753 DOI: 10.1111/add.16183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023]
Affiliation(s)
- Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| |
Collapse
|
26
|
Wadsworth E, Rynard V, Driezen P, Freeman TP, Rychert M, Wilkins C, Hall W, Gabrys R, Hammond D. Legal sourcing of ten cannabis products in the Canadian cannabis market, 2019-2021: a repeat cross-sectional study. Harm Reduct J 2023; 20:19. [PMID: 36803833 PMCID: PMC9936931 DOI: 10.1186/s12954-023-00753-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND One of the objectives of cannabis legalization in Canada is to transition consumers from the illegal to the legal market. Little is known about how legal sourcing varies across different cannabis product types, provinces, and frequency of cannabis use. METHODS Data were analyzed from Canadian respondents in the International Cannabis Policy Study, a repeat cross-sectional survey conducted annually from 2019 to 2021. Respondents were 15,311 past 12-month cannabis consumers of legal age to purchase cannabis. Weighted logistic regression models estimated the association between legal sourcing ("all"/ "some"/ "none") of ten cannabis product types, province, and frequency of cannabis use over time. RESULTS The percentage of consumers who sourced "all" their cannabis products from legal sources in the past 12 months varied by product type, ranging from 49% of solid concentrate consumers to 82% of cannabis drink consumers in 2021. The percentage of consumers sourcing "all" their respective products legally was greater in 2021 than 2020 across all products. Legal sourcing varied by frequency of use: weekly or more frequent consumers were more likely to source "some" (versus "none") of their products legally versus less frequent consumers. Legal sourcing also varied by province, with a lower likelihood of legal sourcing in Québec of products whose legal sale was restricted (e.g., edibles). CONCLUSION Legal sourcing increased over time, demonstrating progress in the transition to the legal market for all products in the first three years of legalization in Canada. Legal sourcing was highest for drinks and oils and lowest for solid concentrates and hash.
Collapse
Affiliation(s)
- Elle Wadsworth
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada. .,Canadian Centre on Substance Use and Addiction, 75 Albert St, Suite 500, Ottawa, ON, K1P 5E7, Canada. .,RAND Europe, Westbrook Centre, Milton Road, Cambridge, CB4 1YG, UK.
| | - Vicki Rynard
- grid.46078.3d0000 0000 8644 1405School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1 Canada
| | - Pete Driezen
- grid.46078.3d0000 0000 8644 1405School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1 Canada ,grid.46078.3d0000 0000 8644 1405Department of Psychology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1 Canada
| | - Tom P. Freeman
- grid.7340.00000 0001 2162 1699Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Marta Rychert
- grid.148374.d0000 0001 0696 9806SHORE & Whāriki Research Centre, College of Health, Massey University, Palmerston North, New Zealand
| | - Chris Wilkins
- grid.148374.d0000 0001 0696 9806SHORE & Whāriki Research Centre, College of Health, Massey University, Palmerston North, New Zealand
| | - Wayne Hall
- grid.1003.20000 0000 9320 7537National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| | - Robert Gabrys
- Canadian Centre on Substance Use and Addiction, 75 Albert St, Suite 500, Ottawa, ON K1P 5E7 Canada
| | - David Hammond
- grid.46078.3d0000 0000 8644 1405School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1 Canada
| |
Collapse
|
27
|
Lorenzetti V, Gaillard A, Thomson D, Englund A, Freeman TP. Effects of cannabinoids on resting state functional brain connectivity: A systematic review. Neurosci Biobehav Rev 2023; 145:105014. [PMID: 36563921 DOI: 10.1016/j.neubiorev.2022.105014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/02/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Cannabis products are widely used for medical and non-medical reasons worldwide and vary in content of cannabinoids such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Resting state functional connectivity offers a powerful tool to investigate the effects of cannabinoids on the human brain. We systematically reviewed functional neuroimaging evidence of connectivity during acute cannabinoid administration. A pre-registered (PROSPERO ID: CRD42020184264) systematic review of 13 studies comprising 318 participants (mean age of 25 years) was conducted and reported using the PRISMA checklist. During THC and THCv exposure vs placebo reduced connectivity with the NAcc was widely reported. Limited evidence shows that such effects are offset by co-administration of CBD. NAcc-frontal region connectivity was associated with intoxication levels. Cannabis intoxication vs placebo was associated with lower striatal-ACC connectivity. CBD and CBDv vs placebo were associated with both higher and lower connectivity between striatal-prefrontal/other regions. Overall, cannabis and cannabinoids change functional connectivity in the human brain during resting state as a function of the type of cannabinoid examined.
Collapse
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Australia.
| | - Alexandra Gaillard
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Australia
| | - Diny Thomson
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Australia; Turner Institute for Brain and Mental Health, School of Psychological Science, Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group, Department of Psychology, Faculty of Humanities and Social Sciences, University of Bath, UK
| |
Collapse
|
28
|
Skumlien M, Freeman TP, Hall D, Mokrysz C, Wall MB, Ofori S, Petrilli K, Trinci K, Borissova A, Fernandez-Vinson N, Langley C, Sahakian BJ, Curran HV, Lawn W. The Effects of Acute Cannabis With and Without Cannabidiol on Neural Reward Anticipation in Adults and Adolescents. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:219-229. [PMID: 36642667 DOI: 10.1016/j.bpsc.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Adolescents may respond differently to cannabis than adults, yet no previous functional magnetic resonance imaging study has examined acute cannabis effects in this age group. In this study, we investigated the neural correlates of reward anticipation after acute exposure to cannabis in adolescents and adults. METHODS This was a double-blind, placebo-controlled, randomized, crossover experiment. Forty-seven adolescents (n = 24, 12 females, ages 16-17 years) and adults (n = 23, 11 females, ages 26-29 years) matched on cannabis use frequency (0.5-3 days/week) completed the Monetary Incentive Delay task during functional magnetic resonance imaging after inhaling cannabis with 0.107 mg/kg Δ⁹-tetrahydrocannabinol ("THC") (8 mg THC for a 75-kg person) or with THC plus 0.320 mg/kg cannabidiol ("THC+CBD") (24 mg CBD for a 75-kg person), or placebo cannabis. We investigated reward anticipation activity with whole-brain analyses and region of interest analyses in the right and left ventral striatum, right and left anterior cingulate cortex, and right insula. RESULTS THC reduced anticipation activity compared with placebo in the right (p = .005, d= 0.49) and left (p = .003, d = 0.50) ventral striatum and the right insula (p = .01, d = 0.42). THC+CBD reduced activity compared with placebo in the right ventral striatum (p = .01, d = 0.41) and right insula (p = .002, d = 0.49). There were no differences between "THC" and "THC+CBD" conditions and no significant drug by age group interaction effect, supported by Bayesian analyses. There were no significant effects in the whole-brain analyses. CONCLUSIONS In weekly cannabis users, cannabis suppresses the brain's anticipatory reward response to money, and CBD does not modulate this effect. Furthermore, the adolescent reward circuitry is not differentially sensitive to acute effects of cannabis on reward anticipation.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom.
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, United Kingdom
| | - Daniel Hall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Invicro, London, United Kingdom; Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, United Kingdom
| | - Katie Trinci
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Natalia Fernandez-Vinson
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
29
|
Skumlien M, Mokrysz C, Freeman TP, Valton V, Wall MB, Bloomfield M, Lees R, Borissova A, Petrilli K, Giugliano M, Clisu D, Langley C, Sahakian BJ, Curran HV, Lawn W. Anhedonia, Apathy, Pleasure, and Effort-Based Decision-Making in Adult and Adolescent Cannabis Users and Controls. Int J Neuropsychopharmacol 2023; 26:9-19. [PMID: 35999024 PMCID: PMC9850660 DOI: 10.1093/ijnp/pyac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cannabis use may be linked with anhedonia and apathy. However, previous studies have shown mixed results, and few have examined the association between cannabis use and specific reward sub-processes. Adolescents may be more vulnerable than adults to harmful effects of cannabis. This study investigated (1) the association between non-acute cannabis use and apathy, anhedonia, pleasure, and effort-based decision-making for reward; and (2) whether these relationships were moderated by age group. METHODS We used data from the "CannTeen" study. Participants were 274 adult (26-29 years) and adolescent (16-17 years) cannabis users (1-7 d/wk use in the past 3 months) and gender- and age-matched controls. Anhedonia was measured with the Snaith-Hamilton Pleasure Scale (n = 274), and apathy was measured with the Apathy Evaluation Scale (n = 215). Effort-based decision-making for reward was measured with the Physical Effort task (n = 139), and subjective wanting and liking of rewards was measured with the novel Real Reward Pleasure task (n = 137). RESULTS Controls had higher levels of anhedonia than cannabis users (F1,258 = 5.35, P = .02, η p2 = .02). There were no other significant effects of user-group and no significant user-group*age-group interactions. Null findings were supported by post hoc Bayesian analyses. CONCLUSION Our results suggest that cannabis use at a frequency of 3 to 4 d/wk is not associated with apathy, effort-based decision-making for reward, reward wanting, or reward liking in adults or adolescents. Cannabis users had lower anhedonia than controls, albeit at a small effect size. These findings are not consistent with the hypothesis that non-acute cannabis use is associated with amotivation.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Vincent Valton
- Institute of Cognitive Neuroscience, Division of Psychology and Language Sciences, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | | | - Rachel Lees
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Manuela Giugliano
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Denisa Clisu
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
- Department of Addictions, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| |
Collapse
|
30
|
Van Dyck E, Ponnet K, Van Havere T, Hauspie B, Dirkx N, Schrooten J, Waldron J, Grabski M, Freeman TP, Curran HV, De Neve J. Substance Use and Attendance Motives of Electronic Dance Music (EDM) Event Attendees: A Survey Study. Int J Environ Res Public Health 2023; 20:ijerph20031821. [PMID: 36767188 PMCID: PMC9914168 DOI: 10.3390/ijerph20031821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 06/01/2023]
Abstract
EDM event attendees are a high-risk population for substance use and associated adverse effects. The aim of this study was to examine substance use at EDM events, focusing on associations between attendance motives and substance use. Sociodemographic characteristics, event specifics, past-year use, and attendance motives were assessed through an online survey. Participants were 1345 Belgian EDM event attendees (69.44% male, Mage = 22.63, SDage = 4.03). Ecstasy/MDMA/Molly (52.28%), other synthetic hallucinogens (53.68%), ketamine (42.13%), amphetamines (40.45%), and alkyl nitrites (poppers) (32.76%) were most frequently used at festivals/outdoor parties/raves. In nightclubs, cocaine (32.29%) was shown to be prevalent as well, while other synthetic hallucinogens (15.79%) were less often consumed. At events with a more private character, cannabis (68.88%) and magic mushrooms (66.44%) were most frequently used. Aside from alcohol (47.76%), substance use in pubs/bars was negligible. Overall enjoyment was demonstrated to be the key attendance motive, which was succeeded by those relating to music and socialization. A wide range of motives proved to be more important to users (e.g., dance, exploration, escapism, excitement, alcohol, drugs) than non-users, while some were associated with the use of particular substances. The prevalence of substance use was shown to be dependent on the specifics of the setting. Moreover, the idea of a three-dimensional classification of the most principal motives for music event attendance was supported. Finally, correlations were estimated between attendance motives and substance use as well as specific substances. Results could enable more tailored approaches in prevention and harm reduction efforts as well as event management strategies.
Collapse
Affiliation(s)
- Edith Van Dyck
- Institute for Psychoacoustics and Electronic Music (IPEM), Department of Art History, Musicology and Theatre Studies, Ghent University, 9000 Ghent, Belgium
| | - Koen Ponnet
- Research Group for Media, Innovation and Communication Technologies, Department of Communication Sciences, IMEC-MICT, Ghent University, 9000 Ghent, Belgium
| | - Tina Van Havere
- Substance Use and Psychosocial Risk Behaviours (SUPR-B), University of Applied Sciences and Arts, 9000 Ghent, Belgium
| | - Bert Hauspie
- Research Group for Media, Innovation and Communication Technologies, Department of Communication Sciences, IMEC-MICT, Ghent University, 9000 Ghent, Belgium
- Substance Use and Psychosocial Risk Behaviours (SUPR-B), University of Applied Sciences and Arts, 9000 Ghent, Belgium
| | - Nicky Dirkx
- Substance Use and Psychosocial Risk Behaviours (SUPR-B), University of Applied Sciences and Arts, 9000 Ghent, Belgium
| | | | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
| | - Tom P. Freeman
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Helen Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London WC1E 7HB, UK
| | - Jan De Neve
- Department of Data-Analysis, Ghent University, 9000 Ghent, Belgium
| |
Collapse
|
31
|
Andrews R, May B, Hernández FJ, Cozier GE, Townsend PA, Sutcliffe OB, Haines TSF, Freeman TP, Scott J, Husbands SM, Blagbrough IS, Bowman RW, Lewis SE, Grayson MN, Crespo-Otero R, Carbery DR, Pudney CR. Photochemical Fingerprinting Is a Sensitive Probe for the Detection of Synthetic Cannabinoid Receptor Agonists; toward Robust Point-of-Care Detection. Anal Chem 2023; 95:703-713. [PMID: 36599091 PMCID: PMC9850351 DOI: 10.1021/acs.analchem.2c02529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
With synthetic cannabinoid receptor agonist (SCRA) use still prevalent across Europe and structurally advanced generations emerging, it is imperative that drug detection methods advance in parallel. SCRAs are a chemically diverse and evolving group, which makes rapid detection challenging. We have previously shown that fluorescence spectral fingerprinting (FSF) has the potential to provide rapid assessment of SCRA presence directly from street material with minimal processing and in saliva. Enhancing the sensitivity and discriminatory ability of this approach has high potential to accelerate the delivery of a point-of-care technology that can be used confidently by a range of stakeholders, from medical to prison staff. We demonstrate that a range of structurally distinct SCRAs are photochemically active and give rise to distinct FSFs after irradiation. To explore this in detail, we have synthesized a model series of compounds which mimic specific structural features of AM-694. Our data show that FSFs are sensitive to chemically conservative changes, with evidence that this relates to shifts in the electronic structure and cross-conjugation. Crucially, we find that the photochemical degradation rate is sensitive to individual structures and gives rise to a specific major product, the mechanism and identification of which we elucidate through density-functional theory (DFT) and time-dependent DFT. We test the potential of our hybrid "photochemical fingerprinting" approach to discriminate SCRAs by demonstrating SCRA detection from a simulated smoking apparatus in saliva. Our study shows the potential of tracking photochemical reactivity via FSFs for enhanced discrimination of SCRAs, with successful integration into a portable device.
Collapse
Affiliation(s)
- Rachael
C. Andrews
- Department
of Chemistry, University of Bath, BathBA2 7AY, U.K.,Centre
for Sustainable Chemical Technology, University
of Bath, BathBA2 7AY, U.K.
| | - Benedict May
- Department
of Biology and Biochemistry, University
of Bath, BathBA2 7AY, U.K.
| | | | - Gyles E. Cozier
- Department
of Biology and Biochemistry, University
of Bath, BathBA2 7AY, U.K.
| | - Piers A. Townsend
- School
of Applied Sciences, University of the West
of England, BristolBS16 1QY, U.K.
| | - Oliver B. Sutcliffe
- MANchester
DRug Analysis & Knowledge Exchange (MANDRAKE), Department of Natural
Sciences, Manchester Metropolitan University, ManchesterM15 5GD, U.K.
| | - Tom S. F. Haines
- Department
of Computer Science, University of Glasgow, GlasgowG12 8QQ, U.K.
| | - Tom P. Freeman
- Department
of Psychology. University of Glasgow, GlasgowG12 8QQ, U.K.
| | - Jennifer Scott
- Department
of Pharmacy and Pharmacology, University
of Glasgow, GlasgowG12 8QQ, U.K.
| | - Stephen M. Husbands
- Department
of Pharmacy and Pharmacology, University
of Glasgow, GlasgowG12 8QQ, U.K.
| | - Ian S. Blagbrough
- Department
of Pharmacy and Pharmacology, University
of Glasgow, GlasgowG12 8QQ, U.K.
| | - Richard W. Bowman
- School
of Physics and Astronomy, University of
Glasgow, GlasgowG12 8QQ, U.K.
| | - Simon E. Lewis
- Department
of Chemistry, University of Bath, BathBA2 7AY, U.K.
| | - Matthew N. Grayson
- Department
of Chemistry, University of Bath, BathBA2 7AY, U.K.,Centre
for Sustainable Chemical Technology, University
of Bath, BathBA2 7AY, U.K.,
| | - Rachel Crespo-Otero
- Department
of Chemistry, Queen Mary University of London, LondonE1 4NS, U.K.,
| | - David R. Carbery
- Department
of Chemistry, University of Bath, BathBA2 7AY, U.K.,
| | - Christopher R. Pudney
- Centre
for Sustainable Chemical Technology, University
of Bath, BathBA2 7AY, U.K.,Department
of Biology and Biochemistry, University
of Bath, BathBA2 7AY, U.K.,Centre for
Therapeutic Innovation, University
of Bath, BathBA2 7AY, U.K.,
| |
Collapse
|
32
|
Lawn W, Mokrysz C, Lees R, Trinci K, Petrilli K, Skumlien M, Borissova A, Ofori S, Bird C, Jones G, Bloomfield MAP, Das RK, Wall MB, Freeman TP, Curran HV. The CannTeen Study: Cannabis use disorder, depression, anxiety, and psychotic-like symptoms in adolescent and adult cannabis users and age-matched controls. J Psychopharmacol 2022; 36:1350-1361. [PMID: 35772419 PMCID: PMC9716489 DOI: 10.1177/02698811221108956] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Adolescence is characterised by psychological and neural development. Cannabis harms may be accentuated during adolescence. We hypothesised that adolescents would be more vulnerable to the associations between cannabis use and mental health and addiction problems than adults. METHOD As part of the 'CannTeen' study, we conducted a cross-sectional analysis. There were 274 participants: split into groups of adolescent users (n = 76; 16-17 years old) and controls (n = 63), and adult users (n = 71; 26-29 years old) and controls (n = 64). Among users, cannabis use frequency ranged from 1 to 7 days/week, while controls had 0-10 lifetime exposures to cannabis. Adolescent and adult cannabis users were matched on cannabis use frequency (mean=4 days/week). We measured Diagnostic and Statistical Manual (DSM-5) Cannabis Use Disorder (CUD), Beck Depression Inventory, Beck Anxiety Inventory and Psychotomimetic States Inventory-adapted. RESULTS After adjustment for covariates, adolescent users were more likely to have severe CUD than adult users (odd ratio = 3.474, 95% confidence interval (CI) = 1.501-8.036). Users reported greater psychotic-like symptoms than controls (b = 6.004, 95% CI = 1.211-10.796) and adolescents reported greater psychotic-like symptoms than adults (b = 5.509, 95% CI = 1.070-9.947). User-group was not associated with depression or anxiety. No significant interactions between age-group and user-group were identified. Exploratory analyses suggested that cannabis users with severe CUD had greater depression and anxiety levels than cannabis users without severe CUD. CONCLUSION Adolescent cannabis users are more likely than adult cannabis users to have severe CUD. Adolescent cannabis users have greater psychotic-like symptoms than adult cannabis users and adolescent controls, through an additive effect. There was no evidence of an amplified vulnerability to cannabis-related increases in subclinical depression, anxiety or psychotic-like symptoms in adolescence. However, poorer mental health was associated with the presence of severe CUD.
Collapse
Affiliation(s)
- Will Lawn
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Clinical Psychopharmacology Unit, University College London, London, UK,Will Lawn, Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, Guy’s Campus, King’s College London, London, SE1 1UL, UK.
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rachel Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Katie Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anna Borissova
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Catherine Bird
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Grace Jones
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Michael AP Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, UK,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK,Translational Psychiatry Research Group, Division of Psychiatry, Mental Health Neuroscience Department, University College London, London, UK,Invicro London, London, UK
| | - Ravi K Das
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK,Invicro London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK,Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
33
|
Craft S, Dunn M, Vidler D, Officer J, Blagbrough IS, Pudney CR, Henderson G, Abouzeid A, Dargan PI, Eddleston M, Cooper J, Hill SL, Roper C, Freeman TP, Thomas SHL. Trends in hospital presentations following analytically confirmed synthetic cannabinoid receptor agonist exposure before and after implementation of the 2016 UK Psychoactive Substances Act. Addiction 2022; 117:2899-2906. [PMID: 35665553 PMCID: PMC9796520 DOI: 10.1111/add.15967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/23/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS The United Kingdom (UK) Psychoactive Substances Act (PSA), implemented on the 26th May 2016, made the production, supply and sale of all non-exempted psychoactive substances illegal. The aim of this study was to measure trends in hospital presentations for severe toxicity following analytically confirmed synthetic cannabinoid receptor agonist (SCRA) exposure before and after implementation of the PSA. DESIGN Observational study. SETTING Thirty-four hospitals across the UK participating in the Identification of Novel Psychoactive Substances (IONA) study. PARTICIPANTS A total of 627 (79.9% male) consenting individuals who presented to participating hospitals between July 2015 and December 2019 with severe acute toxicity and suspected novel psychoactive substances exposure. MEASUREMENTS Toxicological analyses of patient samples were conducted using liquid-chromatography tandem mass-spectrometry. Time-series analysis was conducted on the monthly number of patients with and without analytically confirmed SCRA exposure using Poisson segmented regression. FINDINGS SCRAs were detected in 35.7% (n = 224) of patients. After adjusting for seasonality and the number of active sites, models showed no clear evidence of an upward or downward trend in the number of SCRA exposure cases in the period before (incidence rate ratio [IRR], 1.12; 95% CI, 0.99-1.26; P = 0.068) or after (IRR, 0.97; 95% CI, 0.94-1.01; P = 0.202) the implementation of the PSA. There was also no clear evidence of an upward or downward trend in non-SCRA exposure cases before (IRR, 1.12; 95% CI, 0.98-1.27; P = 0.105) or after (IRR, 1.01; 95% CI, 0.98-1.04; P = 0.478) implementation of the PSA. CONCLUSIONS There is no clear evidence of an upward or downward trend in the number of patients presenting to UK hospitals with severe acute toxicity following analytically confirmed synthetic cannabinoid receptor agonist exposure since the implementation of the Psychoactive Substances Act.
Collapse
Affiliation(s)
- Sam Craft
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - Michael Dunn
- Translational and Clinical Research InstituteNewcastle UniversityNewcastleUK
| | - Dan Vidler
- Translational and Clinical Research InstituteNewcastle UniversityNewcastleUK
| | - Jane Officer
- Scottish Police Authority Forensic ServicesEdinburghUK
| | | | | | - Graeme Henderson
- School of Physiology, Pharmacology and NeuroscienceUniversity of BristolBristolUK
| | - Ahmed Abouzeid
- Blackpool Teaching Hospitals NHS Foundation TrustBlackpoolBlackpoolUK
| | | | | | | | - Simon L. Hill
- Newcastle Hospitals NHS Foundation Trust, Royal Victoria InfirmaryNewcastleUK
| | - Clair Roper
- Translational and Clinical Research InstituteNewcastle UniversityNewcastleUK
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - Simon H. L. Thomas
- Translational and Clinical Research InstituteNewcastle UniversityNewcastleUK
| |
Collapse
|
34
|
Sawyer K, Fredman Stein K, Jacobsen P, Freeman TP, Blackwell AKM, Metcalfe C, Kessler D, Munafò MR, Aveyard P, Taylor GMJ. Acceptability of integrating smoking cessation treatment into routine care for people with mental illness: A qualitative study. Health Expect 2022; 26:108-118. [PMID: 36222067 PMCID: PMC9854288 DOI: 10.1111/hex.13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Improving Access to Psychological Therapies (IAPTs) Services could offer smoking cessation treatment to improve physical and psychological outcomes for service users, but it currently does not. This study aimed to understand participants' views and experiences of receiving a novel smoking cessation intervention as part of the ESCAPE trial (intEgrating Smoking Cessation treatment As part of usual Psychological care for dEpression and anxiety). We used the Capability, Opportunity and Motivation Model of Behaviour (COM-B) to understand the (i) acceptability of the integrated smoking cessation treatment, (ii) views of psychological well-being practitioners' (PWPs) ability to deliver the smoking cessation treatment and (iii) positive and negative impacts of smoking cessation treatment. METHODS This was a qualitative study embedded within a feasibility randomized-controlled trial (ESCAPE) in primary care services in the United Kingdom (IAPT). Thirty-six participants (53% female) from both usual care and intervention arms of the ESCAPE trial, including both quitters and nonquitters, were interviewed using semi-structured interviews. Data were analysed using a framework approach to thematic analysis, using the COM-B as a theoretical frame. RESULTS Psychological Capability: Integrated smoking cessation treatment was acceptable and encouraged participants to reflect on their mental health. Some participants found it difficult to understand nicotine withdrawal symptoms. MOTIVATION Participants were open to change during the event of presenting to IAPT. Some described being motivated to take part in the intervention by curiosity, to see whether quitting smoking would help their mental health. Physical Opportunity: IAPT has a natural infrastructure for supporting integrated treatment, but there were some barriers such as session duration and interventions feeling segmented. Social Opportunity: Participants viewed PWPs as having good interpersonal skills to deliver a smoking cessation intervention. CONCLUSION People with common mental illness generally accepted integrated smoking cessation and mental health treatment. Smoking cessation treatment fits well within IAPT's structure; however, there are barriers to implementation. PATIENT OR PUBLIC CONTRIBUTION Before data collection, we consulted with people with lived experience of smoking and/or mental illness and lay public members regarding the aims, design and interview schedules. After analysis, two people with lived experience of smoking and mental illness individually gave feedback on the final themes and quotes.
Collapse
Affiliation(s)
- Katherine Sawyer
- Department of Psychology, Addiction and Mental Health GroupUniversity of BathBathUK
| | - Kim Fredman Stein
- Department of Psychology, Addiction and Mental Health GroupUniversity of BathBathUK
| | - Pamela Jacobsen
- Department of Psychology, Addiction and Mental Health Group, Bath Centre for Mindfulness and CompassionUniversity of BathBathUK
| | - Tom P. Freeman
- Department of Psychology, Addiction and Mental Health GroupUniversity of BathBathUK
| | - Anna K. M. Blackwell
- Department of Psychology, Addiction and Mental Health GroupUniversity of BathBathUK
| | - Chris Metcalfe
- Bristol Randomised Trials Collaboration, Population Health SciencesBristol Medical SchoolBristolUK
| | - David Kessler
- Department of Population Health Sciences, Bristol Medical School, Centre for Academic Primary CareUniversity of BristolBristolUK
| | - Marcus R. Munafò
- MRC Integrative Epidemiology Unit, School of Psychological ScienceUniversity of BristolBristolUK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Gemma M. J. Taylor
- Department of Psychology, Addiction and Mental Health GroupUniversity of BathBathUK
| |
Collapse
|
35
|
Wilson J, Mills KL, Freeman TP, Sunderland M, Visontay R, Marel C. Response to Bahji et al.: Limitations of the available evidence that restrict our interpretation of the transition from cannabis to opioid use. Addiction 2022; 117:2754-2755. [PMID: 35792056 DOI: 10.1111/add.15993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Katherine L Mills
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Rachel Visontay
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
36
|
Skumlien M, Mokrysz C, Freeman TP, Wall MB, Bloomfield M, Lees R, Borissova A, Petrilli K, Carson J, Coughlan T, Ofori S, Langley C, Sahakian BJ, Curran HV, Lawn W. Neural responses to reward anticipation and feedback in adult and adolescent cannabis users and controls. Neuropsychopharmacology 2022; 47:1976-1983. [PMID: 35388175 PMCID: PMC9485226 DOI: 10.1038/s41386-022-01316-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022]
Abstract
Chronic use of drugs may alter the brain's reward system, though the extant literature concerning long-term cannabis use and neural correlates of reward processing has shown mixed results. Adolescents may be more vulnerable to the adverse effects of cannabis than adults; however, this has not been investigated for reward processing. As part of the 'CannTeen' study, in the largest functional magnetic resonance imaging study of reward processing and cannabis use to date, we investigated reward anticipation and feedback in 125 adult (26-29 years) and adolescent (16-17 years) cannabis users (1-7 days/week cannabis use) and gender- and age-matched controls, using the Monetary Incentive Delay task. Blood-oxygen-level-dependent responses were examined using region of interest (ROI) analyses in the bilateral ventral striatum for reward anticipation and right ventral striatum and left ventromedial prefrontal cortex for feedback, and exploratory whole-brain analyses. Results showed no User-Group or User-Group × Age-Group effects during reward anticipation or feedback in pre-defined ROIs. These null findings were supported by post hoc Bayesian analyses. However, in the whole-brain analysis, cannabis users had greater feedback activity in the prefrontal and inferior parietal cortex compared to controls. In conclusion, cannabis users and controls had similar neural responses during reward anticipation and in hypothesised reward-related regions during reward feedback. The whole-brain analysis revealed tentative evidence of greater fronto-parietal activity in cannabis users during feedback. Adolescents showed no increased vulnerability compared with adults. Overall, reward anticipation and feedback processing appear spared in adolescent and adult cannabis users, but future longitudinal studies are needed to corroborate this.
Collapse
Affiliation(s)
- Martine Skumlien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK.
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Invicro, London, UK
- Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | | | - Rachel Lees
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Anna Borissova
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Kat Petrilli
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - James Carson
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Tiernan Coughlan
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology Department, University College London, London, UK
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
37
|
Lorenzetti V, Hindocha C, Petrilli K, Griffiths P, Brown J, Castillo-Carniglia Á, Caulkins JP, Englund A, El Sohly MA, Gage SH, Groshkova T, Gual A, Hammond D, Lawn W, López-Pelayo H, Manthey J, Mokrysz C, Liccardo Pacula R, van Laar M, Vandrey R, Wadsworth E, Winstock A, Hall W, Curran HV, Freeman TP. The iCannTookit: a consensus-based, flexible framework for measuring contemporary cannabis use. Addiction 2022; 117:2558-2560. [PMID: 35603918 DOI: 10.1111/add.15956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health, Australian Catholic University, Melbourne, Australia
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Portugal
| | - Jamie Brown
- Behavioural Science and Health Institute of Epidemiology and Health, University College London, London, UK
| | - Álvaro Castillo-Carniglia
- Society and Health Research Center and School of Public Health, Universidad Mayor, Chile.,Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mahmoud A El Sohly
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Suzanne H Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Teodora Groshkova
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Portugal
| | - Antoni Gual
- Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, RTA, Barcelona, Spain
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Hugo López-Pelayo
- Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, RTA, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rosalie Liccardo Pacula
- USC Sol Price School of Public Policy, USC Leonard D. Schaeffer Center for Health Policy and Economics, Los Angeles, CA, USA
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elle Wadsworth
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Adam Winstock
- Behavioural Science and Health Institute of Epidemiology and Health, University College London, London, UK.,Global Drug Survey, London, UK
| | - Wayne Hall
- National Addiction Centre, King's College London, London, UK.,National Centre for Youth Substance Use Research, The University of Queensland, Australia
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
38
|
Borissova A, Soni S, Aston ER, Lees R, Petrilli K, Wall MB, Bloomfield MAP, Mertzani E, Paksina A, Freeman TP, Mokrysz C, Lawn W, Curran HV. Age differences in the behavioural economics of cannabis use: Do adolescents and adults differ on demand for cannabis and discounting of future reward? Drug Alcohol Depend 2022; 238:109531. [PMID: 35809475 DOI: 10.1016/j.drugalcdep.2022.109531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Adolescence is a period of psychological and neural development in which harms associated with cannabis use may be heightened. We hypothesised that adolescent who use cannabis (adolescentsWUC) would have steeper delay discounting (preference for immediate over future rewards) and greater demand (relative valuation) for cannabis than adults who use cannabis (adultsWUC). METHODS This cross-sectional study, part of the 'CannTeen' project, compared adultsWUC (n = 71, 26-29 years old) and adolescentsWUC (n = 76, 16-17 years old), and gender- and age-matched adolescent (n = 63) and adult (n = 64) controls. AdolescentsWUC and adultsWUC used cannabis 1-7 days/week and were matched on cannabis use frequency (4 days/week). The Monetary Choice Questionnaire assessed delay discounting. A modified Marijuana Purchase Task (MPT) assessed cannabis demand in adolescentsWUC and adultsWUC. The MPT yielded five indices: intensity (amount of cannabis used at zero cost), Omax (total peak expenditure), Pmax (price at peak expenditure), breakpoint (cost at which cannabis demand is suppressed to zero) and elasticity (degree to which cannabis use decreases with increasing price). Analyses were adjusted for covariates of gender, socioeconomic status, other illicit drug use. RESULTS Both adolescentsWUC and adultsWUC had steeper delay discounting than controls (F, (1,254)= 9.13, p = 0.003, ηp2= 0.04), with no significant age effect or interaction. AdolescentsWUC showed higher intensity (F, (1,138)= 9.76, p = 0.002, ηp2= 0.07) and lower elasticity (F, (1,138)= 15.25, p < 0.001, ηp2= 0.10) than adultsWUC. There were no significant differences in Pmax, Omax or breakpoint. CONCLUSION Individuals who use cannabis prefer immediate rewards more than controls. AdolescentsWUC, compared to adultsWUC, may be in a high-risk category with diminished sensitivity to cannabis price increases and a greater consumption of cannabis when it is free.
Collapse
Affiliation(s)
- A Borissova
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom.
| | - S Soni
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - E R Aston
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - R Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - K Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - M B Wall
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom; Invicro London, Burlington Danes Building, Hammersmith Hospital, Du Cane Road, London, United Kingdom
| | - M A P Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, United Kingdom; Psychiatric Imaging Group, Medical Research Council London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - E Mertzani
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - A Paksina
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - T P Freeman
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom; Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - C Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - W Lawn
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - H V Curran
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| |
Collapse
|
39
|
Petrilli K, Ofori S, Hines L, Taylor G, Adams S, Freeman TP. Association of cannabis potency with mental ill health and addiction: a systematic review. Lancet Psychiatry 2022; 9:736-750. [PMID: 35901795 DOI: 10.1016/s2215-0366(22)00161-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/11/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022]
Abstract
Cannabis potency, defined as the concentration of Δ9-tetrahydrocannabinol (THC), has increased internationally, which could increase the risk of adverse health outcomes for cannabis users. We present, to our knowledge, the first systematic review of the association of cannabis potency with mental health and addiction (PROSPERO, CRD42021226447). We searched Embase, PsycINFO, and MEDLINE (from database inception to Jan 14, 2021). Included studies were observational studies of human participants comparing the association of high-potency cannabis (products with a higher concentration of THC) and low-potency cannabis (products with a lower concentration of THC), as defined by the studies included, with depression, anxiety, psychosis, or cannabis use disorder (CUD). Of 4171 articles screened, 20 met the eligibility criteria: eight studies focused on psychosis, eight on anxiety, seven on depression, and six on CUD. Overall, use of higher potency cannabis, relative to lower potency cannabis, was associated with an increased risk of psychosis and CUD. Evidence varied for depression and anxiety. The association of cannabis potency with CUD and psychosis highlights its relevance in health-care settings, and for public health guidelines and policies on cannabis sales. Standardisation of exposure measures and longitudinal designs are needed to strengthen the evidence of this association.
Collapse
Affiliation(s)
- Kat Petrilli
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK.
| | - Shelan Ofori
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology Department, University College London, London, UK
| | - Lindsey Hines
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma Taylor
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| | - Sally Adams
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Tom P Freeman
- Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, UK
| |
Collapse
|
40
|
Freeman TP, Scott J, Taylor GMJ. Evidence from naturalistic studies can be strengthened by triangulation. Addiction 2022; 117:2141-2142. [PMID: 35434879 PMCID: PMC9545303 DOI: 10.1111/add.15891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Tom P. Freeman
- Addiction and Mental Health Group (AIM)University of BathBathUK
| | - Jenny Scott
- Addiction and Mental Health Group (AIM)University of BathBathUK
| | | |
Collapse
|
41
|
Sawyer K, Burke C, Ng RLY, Freeman TP, Adams S, Taylor G. Effectiveness of Mental Health Warnings on Tobacco Packaging in People With and Without Common Mental Health Conditions: An Online Randomised Experiment. Front Psychiatry 2022; 13:869158. [PMID: 35911223 PMCID: PMC9331922 DOI: 10.3389/fpsyt.2022.869158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health warning labels on tobacco packaging are a cost-effective means of health risk communication. However, while an extensive range of physical health risks are well-portrayed via current tobacco health warnings in the UK, there are none that currently portray the negative impact of smoking on mental health. Aims (i) develop novel mental health warning labels for tobacco packaging and (ii) test perceptions of these warnings in smokers and non-smokers, with and without mental health problems. Methods Six mental health warning labels were developed with a consultancy focus group. These warning labels were tested in an online randomised experiment, where respondents (N = 687) rated six Mental Health Warning Labels (MHWLs) and six Physical Health Warning Labels (PHWLs) on measures of perceived effectiveness, believability, arousal, valence, acceptability, reactance and novelty of information. Results MHWLs were perceived as low to moderately effective (mean = 4.02, SD = 2.40), but less effective than PHWLs (mean = 5.78, SD = 2.55, p < 0.001, η p 2 = 0.63). MHWLs were perceived as less believable, arousing, unpleasant, and acceptable than PHWLs. MHWLs evoked more reactance and were rated as more novel. Perceptions of MHWLs did not differ in people with and without mental health problems except for reactance and acceptability, but consistent with the PHWL literature, perceptions of MHWLs differed between non-smokers and smokers. Conclusion MHWLs could be an effective means to communicate novel information about the effects of smoking on mental health. MHWLs are perceived as less effective, believable, arousing, unpleasant, and acceptable than PHWLs, but MHWLs evoke more reactance and are rated as more novel.
Collapse
Affiliation(s)
- Katherine Sawyer
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Chloe Burke
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Ronnie Long Yee Ng
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Sally Adams
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Gemma Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| |
Collapse
|
42
|
Svenson MRE, Freeman TP, Maynard OM. The Effect of Conflicting Public Health Guidance on Smokers' and Vapers' E-cigarette Harm Perceptions. Nicotine Tob Res 2022; 24:1945-1950. [PMID: 35793536 PMCID: PMC9653072 DOI: 10.1093/ntr/ntac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/06/2022] [Accepted: 06/30/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND E-cigarettes are increasingly being viewed, incorrectly, as more harmful than cigarettes. This may discourage smokers from switching to e-cigarettes. One potential explanation for these increasingly harmful attitudes is conflicting information presented in the media and online, and from public health bodies. AIMS AND METHODS In this prospectively registered online study, we aimed to examine the impact of conflicting public health information on smokers' and vapers' e-cigarette harm perceptions. Daily UK smokers who do not vape (n = 334) and daily UK vapers (n = 368) were randomized to receive either: (1) a consistent harm reduction statement from two different public health bodies (Harm Reduction), (2) a consistent negative statement about e-cigarette harms from two different public health bodies (Negative), (3) a harm reduction statement from one public health body and a negative statement from another (Conflict), and (4) a statement of the risks of smoking followed by a harm reduction statement from one public health body and a negative statement from another (Smoking Risk + Conflict). Participants then answered questions regarding their perceptions of e-cigarette harm. RESULTS The Negative condition had the highest e-cigarette harm perceptions, significantly higher than the Smoking Risk + Conflict condition (MD = 5.4, SE = 1.8, p < .016, d = 0.3 [CI 0.73 to 10.04]), which did not differ from the Conflict condition (MD = 1.5, SE = 1.8, p = .836, d = 0.1 [CI -3.14 to 6.17]). The Conflict condition differed from the Harm Reduction condition, where harm perceptions were lowest (MD = 5.4, SE = 1.8, p = .016, d = 0.3 [CI 0.74 to 10.07]). CONCLUSIONS These findings are the first to demonstrate that, compared to harm reduction information, conflicting information increases e-cigarette harm perceptions amongst vapers, and smokers who do not vape. IMPLICATIONS This research provides the first empirical evidence that conflicting information increases smokers' and vapers' e-cigarette harm perceptions, compared to harm reduction information. This may have a meaningful impact on public health as e-cigarette harm perceptions can influence subsequent smoking and vaping behavior. Conflicting information may dissuade smokers, who have the most to gain from accurate e-cigarette harm perceptions, from switching to e-cigarettes. These findings indicate that public health communications that are consensus-based can lower harm perceptions of e-cigarettes, and have the potential to reduce morbidity and mortality attributable to tobacco smoking.
Collapse
Affiliation(s)
- Madeleine R E Svenson
- Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Tom P Freeman
- Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Olivia M Maynard
- Corresponding Author: Olivia M. Maynard, PhD, MRC Integrative Epidemiology Unit (IEU), University of Bristol, School of Psychological Science, 12a Priory Road, Bristol, BS81TU, UK. Telephone: +44 117 928 9000; Fax: +44 117 928 8588; E-mail:
| |
Collapse
|
43
|
Lawn W, Fernandez-Vinson N, Mokrysz C, Hogg G, Lees R, Trinci K, Petrilli K, Borissova A, Ofori S, Waters S, Michór P, Wall MB, Freeman TP, Curran HV. Correction to: The CannTeen study: verbal episodic memory, spatial working memory, and response inhibition in adolescent and adult cannabis users and age‑matched controls. Psychopharmacology (Berl) 2022; 239:2371. [PMID: 35648202 PMCID: PMC9205827 DOI: 10.1007/s00213-022-06169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- W Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK. .,Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - N Fernandez-Vinson
- Clinical Psychopharmacology Unit, University College London, London, UK.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - G Hogg
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - R Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - K Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - K Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - A Borissova
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - S Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - S Waters
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - P Michór
- School of Life Sciences, University of Warwick, Coventry, UK
| | - M B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK.,Invicro London, Hammersmith Hospital, Burlington Danes Building, Du Cane Road, London, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK.,Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
44
|
Wall MB, Freeman TP, Hindocha C, Demetriou L, Ertl N, Freeman AM, Jones AP, Lawn W, Pope R, Mokrysz C, Solomons D, Statton B, Walker HR, Yamamori Y, Yang Z, Yim JL, Nutt DJ, Howes OD, Curran HV, Bloomfield MA. Individual and combined effects of cannabidiol and Δ 9-tetrahydrocannabinol on striato-cortical connectivity in the human brain. J Psychopharmacol 2022; 36:732-744. [PMID: 35596578 PMCID: PMC9150138 DOI: 10.1177/02698811221092506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are the two major constituents of cannabis with contrasting mechanisms of action. THC is the major psychoactive, addiction-promoting, and psychotomimetic compound, while CBD may have opposite effects. The brain effects of these drugs alone and in combination are poorly understood. In particular, the striatum is implicated in the pathophysiology of several psychiatric disorders, but it is unclear how THC and CBD influence striato-cortical connectivity. AIMS To examine effects of THC, CBD, and THC + CBD on functional connectivity of striatal sub-divisions (associative, limbic and sensorimotor). METHOD Resting-state functional Magnetic Resonance Imaging (fMRI) was used across two within-subjects, placebo-controlled, double-blind studies, with a unified analysis approach. RESULTS Study 1 (N = 17; inhaled cannabis containing 8 mg THC, 8 mg THC + 10 mg CBD or placebo) showed strong disruptive effects of both THC and THC + CBD on connectivity in the associative and sensorimotor networks, but a specific effect of THC in the limbic striatum network which was not present in the THC + CBD condition. In Study 2 (N = 23, oral 600 mg CBD, placebo), CBD increased connectivity in the associative network, but produced only relatively minor disruptions in the limbic and sensorimotor networks. OUTCOMES THC strongly disrupts striato-cortical networks, but this effect is mitigated by co-administration of CBD in the limbic striatum network. Oral CBD administered has a more complex effect profile of relative increases and decreases in connectivity. The insula emerges as a key region affected by cannabinoid-induced changes in functional connectivity, with potential implications for understanding cannabis-related disorders, and the development of cannabinoid therapeutics.
Collapse
Affiliation(s)
- Matthew B Wall
- Invicro London, London, UK.,Clinical Psychopharmacology Unit, University College London, London, UK.,Faculty of Medicine, Imperial College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK.,Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Lysia Demetriou
- Invicro London, London, UK.,Faculty of Medicine, Imperial College London, London, UK.,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Natalie Ertl
- Invicro London, London, UK.,Faculty of Medicine, Imperial College London, London, UK
| | - Abigail M Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rebecca Pope
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Ben Statton
- MRC London Institute of Medical Sciences, London, UK
| | - Hannah R Walker
- Division of Psychiatry, University College London, London, UK
| | - Yumeya Yamamori
- Division of Psychiatry, University College London, London, UK
| | - Zixu Yang
- Faculty of Medicine, Imperial College London, London, UK
| | - Jocelyn Ll Yim
- Division of Psychiatry, University College London, London, UK
| | - David J Nutt
- Faculty of Medicine, Imperial College London, London, UK
| | - Oliver D Howes
- MRC London Institute of Medical Sciences, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | |
Collapse
|
45
|
Lorenzetti V, Hindocha C, Petrilli K, Griffiths P, Brown J, Castillo‐Carniglia Á, Caulkins JP, Englund A, ElSohly MA, Gage SH, Groshkova T, Gual A, Hammond D, Lawn W, López‐Pelayo H, Manthey J, Mokrysz C, Pacula RL, van Laar M, Vandrey R, Wadsworth E, Winstock A, Hall W, Curran HV, Freeman TP. The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use. Addiction 2022; 117:1510-1517. [PMID: 34590359 PMCID: PMC9298052 DOI: 10.1111/add.15702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. METHODS A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. RESULTS The expert-based consensus agreed upon a three-layered hierarchical framework. Each layer-universal measures, detailed self-report and biological measures-reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. CONCLUSIONS Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation.
Collapse
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health SciencesAustralian Catholic UniversityMelbourneAustralia
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)LisbonPortugal
| | - Jamie Brown
- Behavioural Science and Health Institute of Epidemiology and HealthUniversity College LondonLondonUK
| | - Álvaro Castillo‐Carniglia
- Society and Health Research Center and School of Public HealthUniversidad MayorSantiagoChile
- Department of Population HealthNYU Grossman School of MedicineNew YorkNYUSA
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Mahmoud A. ElSohly
- National Center for Natural Products Research, School of PharmacyUniversity of MississippiUniversityMSUSA
- Department Pharmaceutics and Drug Delivery, School of PharmacyUniversity of Mississippi, UniversityMSUSA
| | - Suzanne H. Gage
- Department of Psychology, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
| | - Teodora Groshkova
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)LisbonPortugal
| | - Antoni Gual
- Psychiatry DepartmentNeurosciences Institute, Hospital Clínic, IDIBAPS, RTABarcelonaSpain
| | - David Hammond
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
| | - Will Lawn
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
- Addictions Department, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
| | - Hugo López‐Pelayo
- Psychiatry DepartmentNeurosciences Institute, Hospital Clínic, IDIBAPS, RTABarcelonaSpain
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
- Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
| | - Rosalie Liccardo Pacula
- USC Sol Price School of Public PolicyUSC Leonard D. Schaeffer Center for Health Policy & EconomicsLos AngelesCAUSA
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Elle Wadsworth
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
| | - Adam Winstock
- Behavioural Science and Health Institute of Epidemiology and HealthUniversity College LondonLondonUK
- Global Drug SurveyLondonUK
| | - Wayne Hall
- National Addiction Centre, King's College LondonLondonUK
- National Centre for Youth Substance Use ResearchThe University of QueenslandBrisbaneAustralia
| | - H. Valerie Curran
- Clinical Psychopharmacology Unit (CPU)University College LondonLondonUK
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathUK
| |
Collapse
|
46
|
Lorenzetti V, Hindocha C, Petrilli K, Griffiths P, Brown J, Castillo‐Carniglia Á, Caulkins JP, Englund A, ElSohly MA, Gage SH, Groshkova T, Gual A, Hammond D, Lawn W, López‐Pelayo H, Manthey J, Mokrysz C, Liccardo Pacula R, van Laar M, Vandrey R, Wadsworth E, Winstock A, Hall W, Curran HV, Freeman TP. The iCannToolkit: a tool to embrace measurement of medicinal and non-medicinal cannabis use across licit, illicit and cross-cultural settings. Addiction 2022; 117:1523-1525. [PMID: 35289010 PMCID: PMC9314823 DOI: 10.1111/add.15855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, the Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of HealthAustralian Catholic UniversityMelbourneAustralia
| | - Chandni Hindocha
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Kat Petrilli
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathSomersetUK
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)Portugal
| | - Jamie Brown
- Department of Behavioural Science and Health, Institute of Epidemiology & Health CareUniversity College LondonLondonUK
| | - Álvaro Castillo‐Carniglia
- Society and Health Research CenterUniversidad Mayor, Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), and Millennium Nucleus on Sociomedicine (SocioMed)Chile
- Department of Population HealthNYU Grossman School of MedicineNew YorkNYUSA
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
- Department of Psychosis StudiesInstitute of Psychiatry, Psychology & Neuroscience, King'’s College LondonLondonUK
| | - Mahmoud A. ElSohly
- National Center for Natural Products Research, School of PharmacyUniversity of Mississippi, UniversityMississippiUSA
- Department Pharmaceutics and Drug Delivery, School of PharmacyUniversity of Mississippi, UniversityMSUSA
| | - Suzanne H. Gage
- Department of Psychology, Institute of Population HealthUniversity of LiverpoolLiverpoolUK
| | - Teodora Groshkova
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)Portugal
| | - Antoni Gual
- Addictions Research Group. Psychiatry DepartmentNeurosciences Institute. Hospital Clínic. IDIBAPS. RTA. BarcelonaSpain
| | - David Hammond
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Will Lawn
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Hugo López‐Pelayo
- Addictions Research Group. Psychiatry DepartmentNeurosciences Institute. Hospital Clínic. IDIBAPS. RTA. BarcelonaSpain
| | - Jakob Manthey
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- Department of Psychiatry, Medical FacultyUniversity of LeipzigLeipzigGermany
| | - Claire Mokrysz
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Rosalie Liccardo Pacula
- USC Sol Price School of Public PolicyUSC Leonard D. Schaeffer Center for Health Policy & EconomicsCaliforniaLos AngelesUSA
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Elle Wadsworth
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Adam Winstock
- Department of Behavioural Science and Health, Institute of Epidemiology & Health CareUniversity College LondonLondonUK
- Global Drug SurveyLondonUK
| | - Wayne Hall
- Queensland Alliance for Environmental Health Sciences, The University of QueenslandAustralia
- National Centre for Youth Substance Use ResearchThe University of QueenslandAustralia
| | | | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of PsychologyUniversity of BathBathSomersetUK
| |
Collapse
|
47
|
Lawn W, Fernandez-Vinson N, Mokrysz C, Hogg G, Lees R, Trinci K, Petrilli K, Borissova A, Ofori S, Waters S, Michór P, Wall MB, Freeman TP, Curran HV. The CannTeen study: verbal episodic memory, spatial working memory, and response inhibition in adolescent and adult cannabis users and age-matched controls. Psychopharmacology (Berl) 2022; 239:1629-1641. [PMID: 35486121 PMCID: PMC9110435 DOI: 10.1007/s00213-022-06143-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/07/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND Preclinical and human studies suggest that adolescent cannabis use may be associated with worse cognitive outcomes than adult cannabis use. We investigated the associations between chronic cannabis use and cognitive function in adolescent and adult cannabis users and controls. We hypothesised user-status would be negatively associated with cognitive function and this relationship would be stronger in adolescents than adults. METHODS As part of the 'CannTeen' project, this cross-sectional study assessed cognitive performance in adolescent cannabis users (n = 76; 16-17-year-olds), adolescent controls (n = 63), adult cannabis users (n = 71; 26-29-year-olds) and adult controls (n = 64). Users used cannabis 1-7 days/week. Adolescent and adult cannabis users were matched on cannabis use frequency (4 days/week) and time since last use (2.5 days). Verbal episodic memory (VEM) was assessed using the prose recall task, spatial working memory (SWM) was assessed using the spatial n-back task, and response inhibition was assessed with the stop-signal task. Primary outcome variables were: delayed recall, 3-back discriminability, and stop signal reaction time, respectively. RESULTS Users had worse VEM than controls (F(1,268) = 7.423, p = 0.007). There were no significant differences between user-groups on SWM or response inhibition. Null differences were supported by Bayesian analyses. No significant interactions between age-group and user-group were found for VEM, SWM, or response inhibition. CONCLUSIONS Consistent with previous research, there was an association between chronic cannabis use and poorer VEM, but chronic cannabis use was not associated with SWM or response inhibition. We did not find evidence for heightened adolescent vulnerability to cannabis-related cognitive impairment.
Collapse
Affiliation(s)
- W Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK.
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - N Fernandez-Vinson
- Clinical Psychopharmacology Unit, University College London, London, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - G Hogg
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - R Lees
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - K Trinci
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - K Petrilli
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - A Borissova
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK
| | - S Ofori
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - S Waters
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - P Michór
- School of Life Sciences, University of Warwick, Coventry, UK
| | - M B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK
- Invicro London, Hammersmith Hospital, Burlington Danes Building, Du Cane Road, London, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
48
|
Grabski M, Waldron J, Freeman TP, van Laar M, Curran HV. Is approving esketamine as an antidepressant for treatment resistant depression associated with recreational use and risk perception of ketamine? Results from a longitudinal and cross-sectional survey in nightlife attendees. Int J Drug Policy 2022; 102:103612. [PMID: 35151083 DOI: 10.1016/j.drugpo.2022.103612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Esketamine was licensed for use in treatment resistant depression by the European Medicines Agency in December 2019. It is unclear whether this new approval has lowered the risk perception of recreational ketamine use. This is important given a recent increase in recreational ketamine use. METHODS This study expanded on an existing longitudinal online study of the nightlife scene, by adding an additional longitudinal assessment as well as a new cross-sectional sample. Participants had to be aged 18-34 years, reside in the UK and have attended at least 6 electronic music events in the past year. The likelihood of increasing recreational ketamine use due to the approval, attitudes towards and risk perception of medical ketamine use and experiences resulting from recreational ketamine use were collected after the approval. Changes in ketamine use and frequency were assessed longitudinally before and after the approval. RESULTS The overall sample size was 2415: 414 longitudinal (57% retention rate) and 2001 new cross-sectional participants. The majority indicated no change in their likelihood of using recreational ketamine due to the approval of esketamine (87%). Longitudinal participants did not indicate an increase in past 12 month use or frequency after the approval. Only one-third of participants reported being aware of the approval. Participants previously aware showed greater overall support for medical use of ketamine than participants previously unaware of the change. However, an equally high risk was assigned to the recreational use of ketamine in both groups. Ketamine users indicated both increases as well as decreases in depression and anxiety as a result of ketamine use. CONCLUSION The introduction of esketamine as an antidepressant was not associated with a change in the risk perception of recreational ketamine use in most participants, nor was it longitudinally associated with increased use. Potential negative effects of recreational ketamine use on mental health, as users in this sample reported, should be clearly communicated when discussing the benefits of (es-) ketamine in a therapeutic context.
Collapse
Affiliation(s)
- Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom; Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, United Kingdom
| | - Margriet van Laar
- Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521VS, Utrecht, the Netherlands
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| |
Collapse
|
49
|
Wilson J, Mills K, Freeman TP, Sunderland M, Visontay R, Marel C. Weeding out the truth: a systematic review and meta-analysis on the transition from cannabis use to opioid use and opioid use disorders, abuse or dependence. Addiction 2022; 117:284-298. [PMID: 34264545 DOI: 10.1111/add.15581] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/18/2021] [Accepted: 05/12/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS The idea that cannabis is a 'gateway drug' to more harmful substances such as opioids is highly controversial, yet has substantially impacted policy, education and how we conceptualize substance use. Given a rise in access to cannabis products and opioid-related harm, the current study aimed to conduct the first systematic review and meta-analysis on the likelihood of transitioning from cannabis use to subsequent first-time opioid use, opioid use disorders (OUD), dependence or abuse. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, pubMed/MEDLINE, Scopus, EMBASE, PsychINFO, Cochrane Central Register of Controlled Trials and Informit Health Collection were searched for full-text articles assessing the likelihood of transitioning from cannabis to subsequent opioid use, and from opioid use to OUD, abuse or dependence given prior cannabis use. Analysis of subpopulations within studies were discussed narratively, and E-values were calculated to assess the potential influence of unmeasured confounding. FINDINGS Six studies provided relevant data from the United States, Australia and New Zealand between 1977 and 2017, a total sample of 102 461 participants. Random-effects analysis of the adjusted pooled effect size indicates that the likelihood of transitioning from cannabis to opioid use, relative to non-cannabis users, is odds ratio (OR) = 2.76, 95% confidence interval (CI) = 2.26-3.36, whereas the likelihood of transitioning from opioid use to OUD, abuse or dependence given prior cannabis use is OR = 2.52, 95% CI = 1.65-3.84. While the evidence was determined to be of low quality with moderate risk of bias, E-values suggest that these findings are robust against unmeasured confounding. CONCLUSION A systematic review and meta-analysis found that while people who use cannabis are disproportionately more likely to initiate opioid use and engage in problematic patterns of use than people who do not use cannabis, the low quality of the evidence must be considered when interpreting these findings.
Collapse
Affiliation(s)
- Jack Wilson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Rachel Visontay
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
50
|
Rup J, Freeman TP, Perlman C, Hammond D. Cannabis and Mental Health: Adverse Outcomes and Self-Reported Impact of Cannabis Use by Mental Health Status. Subst Use Misuse 2022; 57:719-729. [PMID: 35170396 DOI: 10.1080/10826084.2022.2034872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Cannabis can induce negative outcomes among consumers with mental health conditions. This study examined medical help-seeking behavior, patterns of adverse effects, and perceived impacts of cannabis among consumers with and without mental health conditions. Methods: Data came from the International Cannabis Policy Study, via online surveys conducted in 2018. Respondents included 6,413 past 12-month cannabis consumers aged 16-65, recruited from commercial panels in Canada and the US. Regression models examined differences in adverse health effects and perceived impact of cannabis among those with and without self-reported past 12-month experience of anxiety, depression, PTSD, bipolar disorder, psychosis. Results: Overall, 7% of past 12-month consumers reported seeking medical help for adverse effects of cannabis, including panic, dizziness, nausea. Help-seeking was greater for those with psychosis (13.8%: AOR = 1.78; 1.11-2.87), depression (8.9%: AOR = 1.57; 1.28-1.93), and bipolar disorder (10.1%: AOR = 1.53; 1.44-2.74). Additionally, 54.1% reported using cannabis to manage symptoms of mental health, with higher rates among those with bipolar (90.8%) and PTSD (90.7%). Consumers reporting >1 condition were more likely to perceive positive impacts on friendships, physical/mental health, family life, work, studies, quality of life (all p < .001). Consumers with psychosis were most likely to perceive negative effects across categories. Conclusion: For conditions with substantial evidence suggesting cannabis is harmful, greater help-seeking behaviors and self-perceived negative effects were observed. Consumers with mental health conditions generally perceive cannabis to have a positive impact on their lives. The relationship between cannabis and mental health is disorder specific and may include a combination of perceived benefits and harms.
Collapse
Affiliation(s)
- Jennifer Rup
- School of Public Health Sciences, University of Waterloo, ON, Canada
| | - Tom P Freeman
- Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Chris Perlman
- School of Public Health Sciences, University of Waterloo, ON, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, ON, Canada
| |
Collapse
|