humulene and Marijuana-Use

As more jurisdictions legalize cannabis for non-medical use, the evidence on how legalization policies affect cannabis use and the use of other substances remains inconclusive and contradictory. This review aims to summarize recent research findings on the impact of recreational cannabis legalization (RCL) on cannabis and other substance use among different population groups, such as youth and adults.. Recent literature reports mixed findings regarding changes in the prevalence of cannabis use after the adoption of RCL. Most studies found no significant association between RCL and changes in cannabis use among youth in European countries, Uruguay, the US, and Canada. However, some studies have reported increases in cannabis use among youth and adults in the US and Canada, although these increases seem to predate RCL. Additionally, there has been a marked increase in unintentional pediatric ingestion of cannabis edibles postlegalization, and an association between RCL and increased alcohol, vaping, and e-cigarette use among adolescents and young adults.. Overall, the effects of cannabis legalization on cannabis use appear to be mixed. Further monitoring and evaluation research is needed to provide longer-term evidence and a more comprehensive understanding of the effects of RCL.

Topics: Adolescent; Canada; Cannabis; Child; Electronic Nicotine Delivery Systems; Humans; Legislation, Drug; Marijuana Use; Young Adult

Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use.. This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use.. This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded.. PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist.. A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use.. A total of 1,282 papers were identified through initial search terms. Through double-blind title/abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models.. The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention.

Topics: Adolescent; Adult; Alcohol Drinking; Cannabis; Cross-Sectional Studies; Ethanol; Humans; Marijuana Smoking; Marijuana Use; Prevalence; Randomized Controlled Trials as Topic; Substance-Related Disorders; Young Adult

In recent years, an increasing number of states have legalized marijuana, also known as cannabis, for recreational use. As marijuana becomes more accessible, adolescent use and accidental pediatric exposures are likely to become broad public health concerns. Edible marijuana products, which are consumable foods or beverages that contain cannabis extract, are particularly enticing to youth, as they come in appealing forms such as candies, cookies, and drinks. The purpose of this review is to provide pediatricians with an overview of the different types and potential dangers associated with edible marijuana products.. Edible marijuana products are often indistinguishable in appearance from normal food items and lack the smell and visible smoke associated with inhaled marijuana. Because they are inconspicuous, palatable, and easily accessible, they are increasingly popular among adolescents. Additionally, the packaging of edible baked goods, candies, and drinks is often purposefully very similar to that of mainstream foods, increasing the risk of accidental ingestion by children. An edible marijuana product must be digested before Δ9-tetrahydrocannabinol can enter the bloodstream, so there is a delayed onset of effects when consuming edibles compared with inhaling marijuana. This also predisposes users to accidental overconsumption.. Greater knowledge of edible marijuana product consumption by pediatric populations will allow pediatricians to more effectively help patients and advise caregivers in cases of overconsumption, dependence, or accidental ingestion. It is important for parents, guardians, and educators to be able to successfully identify edible marijuana products and recognize signs of cannabis use.

Topics: Adolescent; Cannabis; Child; Humans; Marijuana Use; Product Packaging

Different patterns of cannabis use can be traced directly back to different interactions between 2 types of variables: pharmacological and environmental. As legal cannabis expands in the U.S. and around the world, state and national regulatory agencies are gaining control over these variables. Specifically, regulatory agencies are increasingly capable of altering (a) the pharmacological properties of cannabis products and (b) the way these products are distributed to the population. Consequently, cannabis regulatory agencies are in a unique position to use evidence from psychological science to alter cannabis consumption patterns in ways that mitigate potential harm to public health. However, most state-level legal cannabis regulatory systems in the U.S. are not yet evidence-based or public health-oriented. This applied review and commentary draws on evidence from the psychological science literature to help regulators better understand the types of behaviors they must address and guide empirically supported regulation of THC-laden cannabis, whether used putatively for medical or recreational reasons. This review is organized into 3 parts that correspond to the 3 primary agents within the cannabis regulation ecosystem: (a) the cannabis consumer, (b) the cannabis industry, and (c) the cannabis regulatory agency. Within this structure, the review addresses critical psychological variables that drive cannabis consumer and industry behaviors and discusses how regulatory agencies can use this information to protect public health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Topics: Analgesics; Cannabis; Ecosystem; Hallucinogens; Humans; Marijuana Use; Public Health; United States

The legalization of medical and recreational marijuana has raised concerns about a potential increase in the availability and illegal use of marijuana by adolescent minors. To better understand the etiology, patterns, and consequences of adolescent marijuana use, this article reviews high quality, methodologically rigorous, longitudinal studies that focus on the role of personality factors such as sensation-seeking in the etiology of use, developmental trajectories of use and the effects of chronic use, potential gateway effects of marijuana on other illicit drugs, and its role in the onset of psychiatric disorders in adolescents and young adults. Implications are discussed in terms of mechanisms that account for initial and continued use of marijuana by adolescents, how use is associated with key developmental milestones and adult role socialization, and the potential of marijuana use during adolescence in furthering later drug involvement.

Topics: Adolescent; Cannabis; Causality; Humans; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

The goal of this systematic and umbrella review was to regroup all systematic reviews, non-systematic reviews and all original articles into one convenient publication that would facilitate the theoretical and applied scientific investigations directed on cannabis consumption and exercise performance, to update current findings on the matters, and assess evidence quality.. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method. A computer-based systematic search was conducted in September 2019 through the Pubmed, Scopus and SPORTDiscus databases. The reliability of the systematic search was assured by having the article selection process entirely repeated by a second author. Strength of evidence of the selected articles was assesses using a modified version of the Downs and Black Checklist.. The systematic search yielded a total of 8 peer-reviewed publications as well as 10 literature reviews. Results show that cannabis consumption prior to exercise induces decrements in performance (reduced ability to maintain effort, physical/maximal work capacity), undesired physiological responses (increased heart and breathing rate as well as myocardial oxygen demand) and neurological effects on balance (increased sway).. Based on the articles included in this review, the authors conclude that cannabis consumption has an ergolytic effect on exercise performance and therefore does not act as a sport performance enhancing agent as raised by popular beliefs. Thus, cannabis consumption prior to exercise should be avoided in order to maximize performance in sports. Further research should mimic modern THC dosage (150 mg).

Topics: Athletic Performance; Cannabinoids; Cannabis; Humans; Marijuana Use; Reproducibility of Results

Impulse control deficits are often found to co-occur with substance use disorders (SUDs). On the one hand, it is well known that chronic intake of drugs of abuse remodels the brain with significant consequences for a range of cognitive behaviors. On the other hand, individual variation in impulse control may contribute to differences in susceptibility to SUDs. Both of these relationships have been described, thus leading to a "chicken or the egg" debate which remains to be fully resolved. Does impulsivity precede drug use or does it manifest as a function of problematic drug usage? The link between impulsivity and SUDs has been most strongly established for cocaine and alcohol use disorders using both preclinical models and clinical data. Much less is known about the potential link between impulsivity and cannabis use disorder (CUD) or the directionality of this relationship. The initiation of cannabis use occurs most often during adolescence prior to the brain's maturation, which is recognized as a critical period of development. The long-term effects of chronic cannabis use on the brain and behavior have started to be explored. In this review we will summarize these observations, especially as they pertain to the relationship between impulsivity and CUD, from both a psychological and biological perspective. We will discuss impulsivity as a multi-dimensional construct and attempt to reconcile the results obtained across modalities. Finally, we will discuss possible avenues for future research with emerging longitudinal data.

Topics: Animals; Brain; Cannabis; Humans; Impulsive Behavior; Marijuana Abuse; Marijuana Use; Positron-Emission Tomography; Self-Control

To evaluate the association between cannabis use and testicular function (as assessed through semen quality and serum hormone levels) in different populations.. Systematic review and meta-analysis of population-based retrospective cohort studies. PRISMA guidelines were used for abstracting data and assessing data quality and validity. Data were pooled using a fixed-effects or random-effects model depending on the heterogeneity of studies included. Pooled risk ratio (RR) of having any sperm abnormality and testosterone, FSH, and LH standardized mean differences among male cannabis users and non-users, and meta-regression analysis according to age and year of publication.. Nine studies were evaluated which included 4014 men with semen data and 4787 with hormonal data. Overall among 1158 cannabis users, 44.9% had impaired semen parameters, compared with 24.5% of the 2856 non-users. The relative risk among cannabis users for any abnormal semen parameter was 1.159 (95% CI: 0.840; 1.599, P = 0.369). The standardized mean difference between user and non-user testosterone levels was -0.139 (95% CI: -0.413; 0.134, P = 0.318). For FSH, the standardized mean difference estimate was -0.142 (95% CI: -0.243; -0.0425, P = 0.005), while for LH the standardized mean difference estimate was -0.318 (95% CI: -0.810-0.175; P = 0.206).. The current evidence does not suggest clinically significant associations between cannabis use and testicular function. However, we cannot exclude an effect of cannabis because of the limited and heterogeneous studies. Additionally, well-designed studies will be needed to define the association between cannabis use and the male reproductive system.

Topics: Cannabis; Gonadotropins; Humans; Male; Marijuana Use; Semen Analysis; Testis; Testosterone

In the last few years, the attitude toward marijuana in many parts of the world has shifted from illicit to legalized for medical use and to decriminalized. In parallel, there has been a gradual increase in the consumption of this product in the general population, particularly among adolescents and young adults. Marijuana is generally perceived as a harmless drug. However, data obtained in observational studies and preclinical models have established associations between cannabis use and cardiovascular events. In addition, there is emerging evidence linking marijuana use to cerebrovascular complications. Here we provide a critical review of the literature with special emphasis on the association of cannabinoids with stroke and the possible pathogenic mechanisms involved.. Ischemic and hemorrhagic stroke have been described in association with cannabis use, particularly in young individuals. Cerebral infarction remains the most commonly reported stroke subtype seen in marijuana users. Several pathogenic mechanisms have been proposed to explain this association, including multifocal intracranial stenosis, reversible cerebral vasoconstriction syndrome, and coexisting vascular risk factors. Cannabis use is increasingly recognized in young individuals presenting with acute stroke. Our understanding of the pathogenic mechanisms associated with cannabis use and stroke is limited but rapidly evolving. Healthcare providers should educate patients about the potential cardiovascular and cerebrovascular complications related to marijuana or cannabinoids use.

Topics: Adolescent; Cannabinoids; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Stroke; Young Adult

Attentional bias, the automatic selective attentional orientation towards drug-related stimuli is well demonstrated in substance users. However, attentional bias studies of cannabis users specifically have thus far been inconclusive. Thus, the aim of this systematic review and meta-analysis was to synthesize the currently available literature regarding cannabis related attentional bias in cannabis users.. Literature search and selection was carried out, following the PRISMA guidelines, with all included studies investigating the relationship between cannabis use and attentional bias towards cannabis cues.. Fourteen manuscripts, reporting on 1271 participants (cannabis users n = 1044; controls n = 217), were considered for the systematic-review and majority were included in a meta-analysis. Studies reviewed used three types of attentional bias tasks: pictorial stimuli, word stimuli, and non-cannabis stimuli tasks. Greater attentional bias towards cannabis pictures (d = 0.42, P < 0.0001) and words (d = 0.63, P = 0.03) as well as both types of stimuli overall (d = 0.53, P < 0.0001) was observed in cannabis users compared to controls, though there was evidence of significant heterogeneity for both word stimuli and overall meta-analysis. Bigger effect sizes were associated with shorter durations of exposure to cannabis stimuli suggesting mainly automatic orientating rather than controlled attention processing.. These findings suggest that cannabis users display greater attentional bias towards cannabis cues, likely an automatic process, than control groups. Future studies employing shorter exposure durations may validate attentional bias as a treatment target for the development of interventions in people with cannabis use disorder.

Topics: Adult; Attentional Bias; Cannabis; Cues; Female; Humans; Male; Marijuana Abuse; Marijuana Use

The marijuana purchase task (MPT) is a behavioral economic measure of individualized cannabis value (i.e., demand). The MPT follows purchase tasks for other substances (e.g., alcohol, tobacco), though presents with unique caveats due to its mixed illicit status, non-uniform units of purchase and use, and substantial within substance variability in strain, potency, and quality. As the regulatory climate surrounding purchase and use of cannabis continues to evolve in the USA and globally, rigorous assessment of cannabis use and value are of the utmost importance. This study represents the first comprehensive review of investigations utilizing the MPT. Searches through PubMed and Web of Science databases by two independent coders identified 15 empirical articles referencing the use of an MPT and were published through the year 2019. Articles were coded for demographic and procedural characteristics, structural characteristics of the MPT itself, data analytic characteristics, and relationships with cannabis-related outcomes. Rigorous assessment of demand for cannabis is essential with respect to the broad public health issues surrounding cannabis legalization. We have synthesized the research presented herein and comment on vital considerations for subsequent MPT work, including recommendations for a unified approach to using the MPT in subsequent research.

Topics: Behavior Rating Scale; Cannabis; Economics, Behavioral; Humans; Marijuana Use; Reinforcement, Psychology

Currently, boys and men use cannabis at higher rates than girls and women, but the gender gap is narrowing. With the legalization of recreational cannabis use in Canada and in multiple US states, these trends call for urgent attention to the need to consider how gender norms, roles and relations influence patterns of cannabis use to inform health promotion and prevention responses. Based on a scoping review on sex, gender and cannabis use, this article consolidates existing evidence from the academic literature on how gender norms, roles and relations impact cannabis-use patterns. Evidence is reviewed on: adherence to dominant masculine and feminine norms and cannabis-use patterns among adolescents and young adults, and how prevailing norms can be both reinstated or reimagined through cannabis use; gendered social dynamics in cannabis-use settings; and the impact of gender roles and relations on cannabis use among young adults of diverse sexual orientations and gender identities. Findings from the review are compared and contrasted with evidence on gender norms, roles and relations in the context of alcohol and tobacco use. Recommendations for integrating gender transformative principles in health promotion and prevention responses to cannabis use are provided.

Topics: Adolescent; Cannabis; Female; Gender Identity; Humans; Male; Marijuana Smoking; Marijuana Use; Sexual Behavior; Young Adult

To help obstetric care providers, including family physicians, nurse practitioners, midwives, and obstetricians, educate patients on the risks of cannabis use in pregnancy and postpartum and its relationship to nausea and vomiting in pregnancy.. The Ovid MEDLINE database was searched using the MeSH terms. In utero exposure to cannabis has been associated with long-term neurodevelopmental outcomes that persist into young adulthood. Cannabis should not be used to treat nausea and vomiting in pregnancy and its chronic use might lead to the development of cannabinoid hyperemesis syndrome.. There is no known safe level of cannabis use during pregnancy or lactation. Pregnant women should be counseled regarding the risks of in utero exposure and encouraged to abstain from use in pregnancy and while breastfeeding.

Topics: Cannabis; Child; Child, Preschool; Dronabinol; Female; Humans; Hyperemesis Gravidarum; Infant; Infant, Newborn; Marijuana Use; Neurodevelopmental Disorders; Postpartum Period; Pregnancy; Prenatal Exposure Delayed Effects; Substance-Related Disorders; Young Adult

The concept of a cannabis 'entourage effect' was first coined as a hypothetical afterthought in 1998. Since then, multiple scientific reviews, lay articles, and marketing campaigns have promoted the effect as a wholly beneficial manifestation of polypharmacy expected to modulate the therapeutic effects of cannabis and its derivatives. There is reason to wonder at the authenticity of such claims.. A broad definition of the entourage effect is presented, followed by brief summaries of the nature of cannabis polypharmacy and the commonly cited contributing phytochemicals, with special attention to their attendant adverse effects. A critical analysis is then offered of the primary literature that is often portrayed as suggestive of the effect in existing reviews, with further studies being drawn from PubMed and Google Scholar searches. A final discussion questions the therapeutic value of the entourage effect and offers alternate perspectives on how it might be better interpreted.. Claims of a cannabis entourage effect invoke ill-defined and unsubstantiated pharmacological activities which are commonly leveraged toward the popularization and sale of ostensible therapeutic products. Overestimation of such claims in the scientific and lay literature has fostered their misrepresentation and abuse by a poorly regulated industry.

Topics: Animals; Cannabis; Humans; Marijuana Abuse; Marijuana Use; Phytochemicals

Non-medical cannabis policies are changing, including towards legalisation-with-regulation frameworks. New Zealand will hold a public referendum on cannabis legalisation in 2020. We reviewed data on cannabis use and health/social harms; policy reform options; experiences with and outcomes of reforms elsewhere; and other relevant considerations towards informing policy choices in the upcoming referendum.. Relevant epidemiological, health, social, criminal justice and policy studies and data were identified and comprehensively reviewed.. Cannabis use is common (including in New Zealand) and associated with risks for health and social harms, mainly concentrated in young users; key harms are attributable to criminalisation. 'Decriminalisation' reforms have produced ambivalent results. Existing cannabis legalisation frameworks vary considerably in main parameters. Legalisation offers some distinct advantages, for example regulated use, products and user education, yet outcomes depend on essential regulation parameters, including commercialisation, and policy ecologies. While major changes in use are not observed, legalisation experiences are inconclusive to date, including mixed health and social outcomes, with select harms increasing and resilient illegal markets. It is unclear whether legalisation reduces cannabis exposure or social harms (e.g. from enforcement) for youth.. No conclusive overall evidence on the outcomes of legalisation elsewhere exists, nor is evidence easily transferable to other settings. Legalisation offers direct social justice benefits for adults, yet overall public health impacts are uncertain. Legalisation may not categorically improve health or social outcomes for youth. Legalisation remains a well-intended, while experimental policy option towards more measured and sensible cannabis control and overall greater policy coherence, requiring close monitoring and possible adjustments depending on setting-specific outcomes.

Topics: Cannabis; Health Policy; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana; New Zealand; Public Health

The marijuana policy varies greatly worldwide. Marijuana use is illegal in most countries. Nevertheless, the medical potentials of marijuana have been increasingly uncovered, and its use by women is increasing.

Topics: Adolescent; Cannabis; Child; Female; Humans; Infant, Newborn; Lactation; Marijuana Smoking; Marijuana Use; Placenta; Pregnancy

Cannabinoids, the psychoactive compounds in marijuana, are one of the most commonly used substances in the United States. In this review, we summarize the impact of marijuana on child and adolescent health and discuss the implications of marijuana use for pediatric practice. We review the changing epidemiology of cannabis use and provide an update on medical use, routes of administration, synthetic marijuana and other novel products, the effect of cannabis on the developing brain, other health and social consequences of use, and issues related to marijuana legalization.

Topics: Adolescent; Adolescent Behavior; Animals; Brain; Cannabidiol; Cannabinoids; Cannabis; Child; Child Behavior; Drug Interactions; Endocannabinoids; Female; Fetus; Humans; Illicit Drugs; Male; Marijuana Abuse; Marijuana Use; Mass Media; Medical Marijuana; Milk, Human; Neurocognitive Disorders; Pregnancy; Prenatal Exposure Delayed Effects; Receptors, Cannabinoid; Tobacco Use

HIV infection and drug use intersect epidemiologically, and their combination can result in complex effects on brain and behavior. The extent to which drugs affect the health of persons with HIV (PWH) depends on many factors including drug characteristics, use patterns, stage of HIV disease and its treatment, comorbid factors, and age. To consider the range of drug effects, we have selected two that are in common use by PWH: methamphetamine and cannabis. We compare the effects of methamphetamine with those of cannabis, to illustrate how substances may potentiate, worsen, or even buffer the effects of HIV on the CNS. Data from human, animal, and ex vivo studies provide insights into how these drugs have differing effects on the persistent inflammatory state that characterizes HIV infection, including effects on viral replication, immune activation, mitochondrial function, gut permeability, blood brain barrier integrity, glia and neuronal signaling. Moving forward, we consider how these mechanistic insights may inform interventions to improve brain outcomes in PWH. This review summarizes literature from clinical and preclinical studies demonstrating the adverse effects of METH, as well as the potentially beneficial effects of cannabis, on the interacting systemic (e.g., gut barrier leakage/microbial translocation, immune activation, inflammation) and CNS-specific (e.g., glial activation/neuroinflammation, neural injury, mitochondrial toxicity/oxidative stress) mechanisms underlying HIV-associated neurocognitive disorders.

Topics: Amphetamine-Related Disorders; Animals; Blood-Brain Barrier; Brain; Cannabis; HIV Infections; Humans; Marijuana Use; Methamphetamine; Neurocognitive Disorders

Cannabis is one of the most widely used recreational drugs in the world. Tetrahydrocannabinol (THC) is the psychoactive principal constituent of the cannabis plant (Cannabis sativa). It is taken either orally or by inhalation, resulting in sedation, euphoria, relaxation and loss of social inhibition. Adverse effects from higher doses can include fear, distrust and a profound state of unease, hallucinations, ataxia, stupor and seizures. Long-term use can result in respiratory and cardiovascular toxicity and has been associated with a range of psychiatric conditions. Cannabinoid hyperemesis syndrome can occur with chronic use. Driving under the influence of THC is associated with approximately double the risk of motor vehicle crashes. The intensity and duration of symptoms is proportional to the concentration of THC in the blood. Following acute use, THC only remains in the blood for several hours before it is converted into a carboxylic derivative of THC and this partitions into the fat, from where it leaches out and can be detected in urine for weeks after use. Treatment of acute intoxication mainly consists of appropriate symptom-directed supportive care. Children are more susceptible to cannabis toxicity, particularly seizures and coma, and therefore may require additional supportive care for these potential symptoms. The aim of this narrative review is to provide a brief overview of the acute and chronic effects of cannabis, its pharmacokinetics, toxicity and the medical management of intoxication.

Topics: Adolescent; Adult; Cannabis; Dronabinol; Humans; Male; Marijuana Use; New Zealand; Young Adult

Cannabidiol (CBD) is an alkaloid present in

Topics: Animals; Cannabidiol; Cannabinoids; Cannabis; Dronabinol; Drug Approval; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana

The recent shift in sociopolitical debates and growing liberalization of cannabis use across the globe has raised concern regarding its impact on vulnerable populations, such as pregnant women and adolescents. Epidemiological studies have long demonstrated a relationship between developmental cannabis exposure and later mental health symptoms. This relationship is especially strong in people with particular genetic polymorphisms, suggesting that cannabis use interacts with genotype to increase mental health risk. Seminal animal research directly linked prenatal and adolescent exposure to delta-9-tetrahydrocannabinol, the major psychoactive component of cannabis, with protracted effects on adult neural systems relevant to psychiatric and substance use disorders. In this article, we discuss some recent advances in understanding the long-term molecular, epigenetic, electrophysiological, and behavioral consequences of prenatal, perinatal, and adolescent exposure to cannabis/delta-9-tetrahydrocannabinol. Insights are provided from both animal and human studies, including

Topics: Adolescent; Animals; Cannabis; Cognition; Female; Humans; Marijuana Use; Mental Disorders; Pregnancy; Prenatal Exposure Delayed Effects

We assess the current and describe possible future public health impacts of the legalisation of cannabis production, sale, and use in the Americas. First, we describe global patterns of cannabis use and their most probable adverse health effects. Second, we summarise evidence regarding the effectiveness of cannabinoids for medicinal use and describe approaches that have been used to regulate the use of medicinal cannabis and how these approaches might have affected medicinal and recreational use and harms (eg, road crashes). Third, we describe how jurisdictions that have legalised recreational use have regulated production and sale of cannabis. Fourth, we evaluate the effects of cannabis legalisation on cannabis use and harms and on the use of alcohol, tobacco, and other drugs. Fifth, we use alcohol and tobacco policy examples to identify possible long-term public health effects of cannabis legalisation. Finally, we outline policy approaches that could minimise harms to public health arising from the legalisation of a commercial cannabis industry.

Topics: Cannabis; Commerce; Female; Humans; Legislation, Drug; Male; Marijuana Use; Medical Marijuana; Public Health; Substance-Related Disorders

The change in legal status of cannabis (the botanical species Cannabis sativa, commonly known as marijuana) in the United States has had significant impact on pediatric drug exposures. In states with decriminalization of recreational and medicinal use of cannabis, emergency department visits and poison control center calls for unintentional pediatric cannabis intoxication are on the rise in the last few decades. Exploratory or unintentional ingestions of cannabis-containing products (as opposed to those derived from synthetic cannabinoids, which may mimic the structure and/or function of cannabis, but are not the focus of this article) can lead to significant pediatric toxicity, including encephalopathy, coma, and respiratory depression. With the increasing magnitude of the public health implications of widespread cannabis use, clinicians who care for pediatric patients routinely must be adept in the recognition, evaluation, management, and counseling of unintentional cannabis exposure.

Topics: Cannabinoids; Cannabis; Child; Female; Humans; Male; Marijuana Use; Receptors, Cannabinoid; United States

Whether the effects of cannabis use on brain function persist or recover following abstinence remains unclear. Therefore, using meta-analytic techniques, we examined whether functional alterations measured using fMRI persist in cannabis users abstinent for over 25 days (or 600 h) as evidence suggests that the effects on cognitive performance no longer persist beyond this period. Systematic literature search identified 20 studies, of which, 12 examined current cannabis users (CCU) (361 CCU versus 394 non-cannabis using controls (NU)) and 3 examined abstinent cannabis users (ACU) in 5 separate comparisons (98 ACU versus 106 NU). Studies in ACU were carried out in adolescents and suggest significantly greater activation in components of the central executive and default mode networks in adolescent ACU compared to NU. While this evidence is to be interpreted with caution because studies were carried out in overlapping samples, they indicate a pressing need for independent confirmation whether certain neurofunctional alterations in adolescent cannabis users may persist even after cannabis and its metabolites are likely to have left their bodies.

Topics: Adolescent; Brain; Cannabis; Executive Function; Humans; Magnetic Resonance Imaging; Marijuana Abuse; Marijuana Use; Neural Pathways

This article aims to provide an updated look at the use of marijuana in the United States and its impact on pregnancy. First, the prevalence of marijuana use is examined, including use both in and outside of pregnancy. The literature surrounding attitudes and beliefs with regard to use in pregnancy is reviewed. The impact on pregnancy outcomes is reviewed along with the evidence of marijuana's impact on neural development of the fetus. Finally, clinical considerations for providers are discussed.

Topics: Animals; Cannabis; Female; Humans; Marijuana Use; Pregnancy; Pregnancy Outcome; Prenatal Exposure Delayed Effects; Substance-Related Disorders

Cannabis is the most prevalent illicit drug used by adolescents worldwide. Over the past 40 years, changes in cannabis potency through rising concentrations of Δ-9-tetrahydrocannabiol (THC), decreases in cannabidiol, or both, have occurred. Epidemiological and experimental evidence demonstrates that cannabis with high THC concentrations and negligible cannabidiol concentrations is associated with an increased risk of psychotic outcomes, an effect on spatial working memory and prose recall, and increased reports of the severity of cannabis dependence. However, many studies have failed to address cannabis use in adolescence, the peak age at which individuals typically try cannabis and probably the most vulnerable age to experience its harmful effects. In this Review, we highlight the influence that changing cannabis products have on adolescent health and the implications they carry for policy and prevention measures as legal cannabis markets continue to emerge worldwide.

Topics: Adolescent; Adolescent Health; Cannabidiol; Cannabis; Humans; Marijuana Use

There is growing concern that increased use of medical and recreational cannabis may result in increased exposure to contaminants on the cannabis, such as pesticides. Several states are moving towards implementing robust regulation of the sales, cultivation, and manufacture of cannabis products. However, there are challenges with creating health-protective regulations in an industry that, to date, has been largely unregulated. The focus of this publication is a theoretical examination of what may happen when women are exposed pre-conceptually or during pregnancy to cannabis contaminated with pesticides. We propose an adverse outcome pathway of concomitant prenatal exposure to cannabinoids and the organophosphate pesticide chlorpyrifos by curating what we consider to be the key events at the molecular, cellular, and tissue levels that result in developmental neurotoxicity. The implications of this adverse outcome pathway underscore the need to elucidate the potential developmental neurotoxicity that may result from prenatal exposure to pesticide-contaminated cannabis.

Topics: Adverse Outcome Pathways; Cannabis; Female; Humans; Marijuana Use; Maternal-Fetal Exchange; Neurotoxicity Syndromes; Organophosphorus Compounds; Pesticide Residues; Pregnancy; Prenatal Exposure Delayed Effects

Cannabis has been cultivated by mankind for a multitude of uses over a period of thousands of years. This review explores how our relationship with the cannabis plant has evolved over this period of time, including the use of cannabis for recreational purposes and for its medicinal properties. The endocannabinoid system plays a complex role in the development of the fetal, infant and adolescent brain. Use of exogenous cannabinoids has the potential to result in supra-physiological stimulation and impact on normal central nervous system development. Cannabis is the most frequently used recreational drug in western societies and its use is common amongst pregnant women. This review summaries much of the evidence about what is known of the long term effects of in utero cannabis exposure. Further, the potential impact of use of medicinal cannabis products during pregnancy is considered and the implications to health professionals caring for pregnant women and their babies are explored.

Topics: Brain; Cannabinoids; Cannabis; Female; Humans; Marijuana Use; Pregnancy

Bipolar disorder (BD) is commonly associated with comorbidities, especially substance use disorders. In light of this, the present review aimed to investigate the prevalence and clinical correlates of cannabis use in BD. Studies evaluating the prevalence of cannabis use among patients with BD and studies reporting a dichotomous sample of patients with cannabis use compared to those without the use were included. Meta-analyses using random-effects models were performed, and sources of heterogeneity were explored using meta-regression. The search resulted in 2918 publications, of which 53 were included. The prevalence of cannabis use was 24% (95%CI:18-29; k = 35; n = 51,756). Cannabis use was significantly associated with being younger, male, and single; having fewer years of education and an earlier onset of affective symptoms; and lifetime psychotic symptoms, suicide attempts, and use of tobacco, alcohol, and other substances. In conclusion, cannabis use present in almost one-quarter of patients with BD and is associated with factors that are highly relevant for both clinical practice and public health.

Topics: Bipolar Disorder; Cannabis; Comorbidity; Humans; Marijuana Use; Prevalence

Studies testing the effect of single genetic variants on substance use have had modest success. This paper reviewed 39 studies using polygenic measures to test interaction with any type of environmental exposure (G×E) in alcohol, tobacco, and cannabis use. Studies using haplotype combinations, sum scores of candidate-gene risk alleles, and polygenic scores (PS) were included. Overall study quality was moderate, with lower ratings for the polygenic methods in the haplotype and candidate-gene score studies. Heterogeneity in investigated environmental exposures, genetic factors, and outcomes was substantial. Most studies (N = 30) reported at least one significant G×E interaction, but overall evidence was weak. The majority (N = 26) found results in line with differential susceptibility and diathesis-stress frameworks. Future studies should pay more attention to methodological and statistical rigor, and focus on replication efforts. Additional work is needed before firm conclusions can be drawn about the importance of G×E in the etiology of substance use.

Topics: Alcohol Drinking; Alleles; Cannabis; Ethanol; Gene Frequency; Gene-Environment Interaction; Genetic Predisposition to Disease; Haplotypes; Humans; Marijuana Use; Multifactorial Inheritance; Nicotiana; Risk Factors; Tobacco Use

Jurisdictions considering or implementing alternatives to cannabis supply prohibition will confront several decisions that will influence health, safety, and social equity outcomes. This essay highlights 14 of these design considerations, which all conveniently begin with the letter

Topics: Canada; Cannabis; Commerce; Costs and Cost Analysis; Humans; Law Enforcement; Legislation, Drug; Marijuana Abuse; Marijuana Use; Marketing; Public Policy; United States; Uruguay

Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. Increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries in preparation of drug concentrates have been documented. Cannabis dispensary workers ("budtenders") without medical training are giving medical advice that may be harmful to patients. Cannabis research may offer novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. Progress has been slow due to absent standards for chemical composition of cannabis products and limitations on research imposed by federal classification of cannabis as illegal. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use.

Topics: Accidents, Traffic; Behavioral Symptoms; Cannabis; Colorado; Driving Under the Influence; Drug Contamination; Drug Overdose; Emergency Service, Hospital; Hospitalization; Humans; Legislation, Drug; Marijuana Use; Mental Disorders; Mental Health Services; Poisoning; Vomiting

Cannabis use is common, and associated with adverse health outcomes. 'Routes of administration' (ROAs) for cannabis use have increasingly diversified, in part influenced by developments towards legalization. This paper sought to review data on prevalence and health outcomes associated with different ROAs.. This scoping review followed a structured approach. Electronic searches for English-language peer-reviewed publications were conducted in primary databases (i.e., MEDLINE, EMBASE, PsycINFO, Google Scholar) based on pertinent keywords. Studies were included if they contained information on prevalence and/or health outcomes related to cannabis use ROAs. Relevant data were screened, extracted and narratively summarized under distinct ROA categories.. Overall, there is a paucity of rigorous and high-quality data on health outcomes from cannabis ROAs, especially in direct and quantifiable comparison. Most data exist on smoking combusted cannabis, which is associated with various adverse respiratory system outcomes (e.g., bronchitis, lung function). Vaporizing natural cannabis and ingesting edibles appear to reduce respiratory system problems, but may come with other risks (e.g., delayed impairment, use 'normalization'). Vaporizing cannabis concentrates can result in distinct acute risks (e.g., excessive impairment, injuries). Other ROAs are uncommon and under-researched.. ROAs appear to distinctly influence health outcomes from cannabis use, yet systematic data for comparative assessments are largely lacking; these evidence gaps require filling. Especially in emerging legalization regimes, ROAs should be subject to evidence-based regulation towards improved public health outcomes. Concretely, vaporizers and edibles may offer potential for reduced health risks, especially concerning respiratory problems. Adequate cannabis product regulation (e.g., purity, labeling, THC-restrictions) is required to complement ROA-based effects.

Topics: Cannabis; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; Prevalence; Public Health

Recently, the world has seen examples of the legalization of cannabis for recreational purposes. Due to the diversity of experiences in progress, it is urgent to analyze the impacts of this legalization, from a public health perspective. Therefore, this article aims to review the accumulated knowledge in the states and countries where the use of cannabis is legal and to ponder over the relevance of starting a similar path towards legalization in Portugal, thus supporting political decisions to be properly informed and evidence-based.. An extensive literature review was performed using databases and scientific journals, such as PubMed, as well as the search of institutional documentation, including the EMCDDA and SICAD.. The gathered information provided insights and enabled assessment of (1) the acute and chronic effects of cannabis use on health, (2) the Portuguese situation related to cannabis and (3) the processes and lessons learned after the legalization of cannabis in other countries or states. Given the above, and according to the data presented, the authors argue for a safe and responsible strategy towards the legalization of cannabis use in Portugal. In accordance, a set of concrete proposals are presented.. From a public health perspective, it is assumed that the interest of this proposal is to reduce the problematic use of cannabis, to effectively fight against illicit drug trafficking and drug-related crime, as well as health promotion and prevention of addictions and other adverse health impacts. This article reveals that the effects of legalization might, contrary to general beliefs, generate positive results with respect to these aims, given that there will be greater control on the market, price, quality, and information - to name a few - if implementation occurs with proper consideration and definition.. The debate on the responsible and safe legalization of cannabis use in Portugal should be open and promoted, based on a public health perspective.. Introdução: Recentemente, o mundo assistiu a múltiplos exemplos de legalização do uso de cannabis para fins recreativos. Numa perspetiva de saúde pública, pela diversidade das experiências em curso, torna-se premente analisar os impactos desta legalização. Por conseguinte, este artigo tem por objetivo rever os conhecimentos acumulados nos estados e países onde o uso de cannabis é legal e ponderar sobre a pertinência de iniciar semelhante caminho para a legalização em Portugal. O objetivo é, não apenas promover a reflexão, mas também apoiar uma eventual tomada de decisão política para que possa ser devidamente informada e assente no mais avançado conhecimento científico, económico e jurídico. Material e Métodos: Foi realizada uma revisão extensa da literatura, tendo-se recorrido a bases de dados e revistas científicas, tais como PubMed, bem como pesquisas de documentação institucionais, nomeadamente do OEDT e SICAD. Resultados: A revisão da literatura permitiu sistematizar informação sobre o estado da arte sobre (1) os efeitos agudos e crónicos do consumo de cannabis na saúde, (2) a situação portuguesa relacionada com o uso de cannabis e, (3) os processos e lições aprendidas após a legalização de cannabis em outros países ou estados. Face ao exposto, e de acordo com os dados apresentados, os autores argumentam favoravelmente por uma estratégia de legalização responsável do uso de cannabis em Portugal e encadeiam um conjunto de propostas concretas nesse sentido. Discussão: Partindo de uma perspetiva de saúde pública, assume-se que o interesse da presente proposta reside na redução do consumo problemático de cannabis, no combate eficaz contra o tráfico de drogas ilícitas e crime relacionado, assim como a promoção da saúde, e a prevenção de dependências e outras consequências nefastas para a saúde. Este artigo revela que os efeitos de uma estratégia de legalização responsável podem, em contraste com as crenças comuns, gerar resultados positivos em relação a estes objetivos uma vez que passará a haver um maior controle sobre o mercado, preço, qualidade e informação - para citar alguns exemplos - se a implementação ocorrer de acordo com um programa devidamente desenhado e implementado com esses fins. Conclusão: Tendo por base uma perspetiva de saúde pública, o debate sobre a legalização responsável e segura do uso de cannabis em Portugal deve ser aberto e promovido.

Topics: Cannabis; Drug Approval; Humans; Marijuana Use; Portugal

The National Academies of Sciences, Engineering, and Medicine has found substantial evidence that cannabis (plant) is effective for the treatment of chronic pain in adults, and moderate evidence that oromucosal cannabinoids (extracts, especially nabiximols) improve short-term sleep disturbances in chronic pain. The paradoxical superiority of the cannabis plant over cannabinoid molecules represents a challenge for the medical community and the established processes that define modern pharmacy. The expanding and variable legalization of cannabis in multiple states nationwide represents an additional challenge for patients and the medical community because recreational and medicinal cannabis are irresponsibly overlapped. Cannabis designed for recreational use (containing high levels of active ingredients) is increasingly available to patients with chronic pain who do not find relief with current pharmacologic entities, which exposes patients to potential harm. This article analyzes the available scientific evidence to address controversial questions that the current state of cannabis poses for health care professionals and chronic pain patients and sets the basis for a more open discussion about the role of cannabis in modern medicine for pain management. A critical discussion on these points, the legal status of cannabis, and considerations for health care providers is presented.

Topics: Cannabinoids; Cannabis; Chronic Pain; Dronabinol; Humans; Marijuana Use; Medical Marijuana

With rising rates of cannabis use in the general population and an increasing number of US states legalizing both recreational and medical cannabis use, it is important to be informed about the adverse consequences of cannabinoids. This Commentary provides an overview of the psychiatric effects of plant-based and synthetic cannabinoids, differentiating acute effects from effects associated with persistent use. Cannabinoids produce multiphasic and dose-dependent effects on anxiety, mood, and perception, in addition to impairing cognition and psychomotor function. Generally, in healthy individuals, the acute negative psychiatric effects of cannabinoids are rated as milder in severity compared with those in individuals with pre-existing psychiatric disorders. With chronic exposure to cannabinoids, the probability of developing tolerance and dependence can increase. A problematic pattern of cannabis use can lead to clinically significant impairment and distress. Cessation of cannabis use in individuals who are tolerant and dependent can lead to a withdrawal syndrome. Studies report long-term cannabis exposure has been linked to psychiatric disorders, such as anxiety, psychotic and mood disorders. Limitations to the existing evidence notwithstanding, the plausibility of a causal relationship between cannabinoid exposure and persistent negative psychiatric outcomes, and the potential for long-term brain changes by regular exposure, especially for adolescents, are sufficient to warrant discussions with clinicians and the public. Implications for clinicians who certify, prescribe, or care for patients receiving cannabinoids are discussed, and a case is made for further research to better understand the impact of legalization on public mental health.

Topics: Affect; Brain; Cannabinoids; Cannabis; Cognition; Endocannabinoids; Humans; Marijuana Abuse; Marijuana Use; Memory; Psychomotor Performance; Psychotic Disorders

An increasing proportion of the world has legalized cannabis for medicinal or recreational use. The legalization trend appears to be continuing. These changes in the legislative landscape may have important health, treatment, and research implications. This review discusses public health outcomes that may be impacted by increases in cannabis availability and use. It additionally considers potential research and treatment priorities in the face of widespread cannabis legalization.

Topics: Cannabis; Humans; Legislation, Drug; Marijuana Use; Public Health

Reduced motivation is often noted as a consequence of cannabis use. However, prior studies examining this association have suboptimally operationalized motivation and have yielded mixed findings. This review discusses motivation and the closely related construct of reward sensitivity. We summarize the available literature examining associations between motivation and cannabis use, addressing the following questions: (a) Is there evidence for decreased motivation among cannabis users? (b) Is there evidence that lack of motivation among cannabis users is specific to their use of cannabis (rather than to use of other addictive drugs)? and (c) Is there evidence suggesting a causal relationship between cannabis use and motivation? Using PubMed, PsycINFO, and WebofScience, we conducted a literature search of studies examining nonacute effects of cannabis use on motivation, apathy, amotivation, effort, and reward sensitivity in humans. This search yielded 22 studies, which were reviewed in detail. We conclude that, although cross-sectional evidence of a cannabis-specific effect on motivation is equivocal, there is partial support from longitudinal studies for a causal link between cannabis use and reduced motivation. Additionally, we propose that reward sensitivity and motivation represent distinct yet related constructs and that reductions in one may not always lead to reductions in the other. Future work should longitudinally examine associations between cannabis use, motivation, and reward sensitivity; carefully define and operationalize these constructs; and control for the influence of potential confounding factors. (PsycINFO Database Record

Topics: Cannabis; Cross-Sectional Studies; Humans; Marijuana Abuse; Marijuana Use; Motivation; Reward; Substance-Related Disorders

Cannabis is the most commonly used illicit substance worldwide and the prevalence of users continues to increase. Over the last 2 decades, the world has seen significant changes regarding cannabis for recreational use as well as application in its use as a therapeutic medicine. This is likely to have influenced the decreasing perception of risks associated with the use of cannabis. Cannabis, however, is not benign and, depending on the pattern of its use, can incur a range of harmful effects, which have implications when prescribing medicinal cannabinoids for individuals. Based on research evidence from recreational use of cannabis as well as the emerging data from trials of medicinal cannabis, we propose some clinical domains that will need specific considerations when prescribing medicinal cannabis.

Topics: Cannabinoids; Cannabis; Humans; Marijuana Use; Medical Marijuana; Prevalence

Topics: Brain; Breast Feeding; Cannabinoids; Cannabis; Female; Humans; Internationality; Marijuana Use; Maternal-Fetal Exchange; Medical Marijuana; Pediatricians; Pregnancy; Societies, Medical

Previous studies have reported conflicting results in terms of acute effects of cannabis in man. Independently of other factors, such discrepancy may be attributable to the different cannabis use history of study volunteers. It is thought that regular cannabis users may develop tolerance to the effects of acute cannabis administration. Here we systematically review all studies examining the effects of single or repeated cannabinoid administration in man as a function of previous cannabis exposure. Research evidence tends to suggest that the acute effects of single cannabinoid administration are less prominent in regular cannabis users compared to non-regular users. Studies of repeated cannabinoid administration more consistently suggest less prominent effects upon repeated exposure. Cognitive function is the domain showing the highest degree of tolerance, with some evidence of complete absence of acute effect (full tolerance). The acute intoxicating, psychotomimetic, and cardiac effects are also blunted upon regular exposure, but to a lesser extent (partial tolerance). Limited research also suggests development of tolerance to other behavioral, physiological, and neural effects of cannabis.

Topics: Cannabinoid Receptor Agonists; Cannabis; Dronabinol; Drug Tolerance; Humans; Marijuana Abuse; Marijuana Use

Although cannabis is often used for the purposes of relieving negative affective states such as anxiety and depression, the associations between cannabis use and affect in daily life are unclear. Ecological momentary assessment (EMA) has been used to study these associations in individuals' natural environments, providing more ecological validity, minimizing retrospective bias, and allowing for the analysis of within-individual processes over time. This review focuses on studies that utilized EMA to examine daily-life associations of cannabis use and negative and positive affective states.. We review the findings of the 19 articles that met inclusion criteria, including clinical and community samples.. Results provide equivocal evidence regarding relations between cannabis use and affect for community samples. Findings are mixed for clinical samples as well, but more consistent patterns emerge for general negative affect (NA) and anger/hostility at the momentary level; cannabis use may be more likely following increased NA and lead to decreases in NA and anger/hostility in psychiatric populations.. Findings support a negative reinforcement hypothesis for clinical samples in terms of general NA and anger/hostility. However, discrepancies among studies point to a need to thoroughly characterize samples, consider motives for and expectancies of use, improve quantification of cannabis use, and consider co-use with other substances. Additional design recommendations are also offered for future studies.

Topics: Affect; Anger; Biomedical Research; Cannabis; Female; Forecasting; Humans; Male; Marijuana Abuse; Marijuana Use; Medical Records; Motivation; Retrospective Studies

This review presents a comprehensive picture of research studies about marijuana-related content in news, social media, and advertisements. Studies that examined the extent of people's exposure to the messages and its effects were also included. A total of 27 peer-reviewed journal articles and one thesis were located, of which 16 analyzed the content, four contained information about people's exposure to the messages, and ten examined the effects. Over time, news coverage shifted from negative to slightly positive toward marijuana use. Social media and advertisements were overwhelmingly favorable toward marijuana use and legalization by claiming social, romantic, and health benefits of marijuana use while completely downplaying risks. A majority of social media accounts were also run by advocacy groups and industry interests, rather than individuals who were simply sharing opinions or experiences. Furthermore, absence of health authorities among the highly popular social media accounts about marijuana was notable. The news, social media, and advertising messages about marijuana were widely used by the members of public, which in turn generated some demonstrable effects on the audience's marijuana-related perceptions and behaviors. The public and policymakers need to become aware of this information environment for potential marijuana users and take more proactive measures to protect vulnerable populations.

Topics: Advertising; Cannabis; Humans; Marijuana Use; Mass Media; Public Opinion; Social Media

Topics: Biomedical Research; Cannabis; Humans; Legislation, Drug; Marijuana Use; Recreation; United States

In the United States, federal and state laws regarding the medical use of cannabis and cannabinoids are in conflict and have led to confusion among patients, caregivers, and healthcare providers. Currently, cannabis is legal for medical purposes in 50% of the states, and another seventeen states allow products that are high in cannabidiol (CBD) and low in THC (tetrahydrocannabinol) for medical use. Many of these artisanal products are sold in dispensaries or over the internet. However, none of these products has been approved by the Food and Drug Administration (FDA). Understanding how federal laws apply to clinical research and practice can be challenging, and the complexity of these laws has resulted in particular confusion regarding the legal status of CBD. This paper provides an up-to-date overview (as of August 2016) of the legal aspects of cannabis and cannabidiol, including cultivation, manufacture, distribution, and use for medical purposes. This article is part of a Special Issue title, Cannabinoids and Epilepsy.

Topics: Cannabidiol; Cannabinoids; Cannabis; Dronabinol; Epilepsy; Federal Government; Humans; Marijuana Use; Medical Marijuana; State Government; United States

Justice-involved youth (JIY) are at elevated risk for substance use and for substance use-related harm compared to non-JIY. Marijuana use is of significant concern in this population, as it is tied to reoffending. Motivational enhancement therapy (MET) and electronic interventions show promise in reducing youth substance use; the degree to which these findings extend to JIY requires additional research attention. Thus, the purpose of this study was to test the preliminary feasibility and effectiveness of a combined brief electronic parenting intervention plus a brief MET-based electronic intervention for JIY adolescents, followed by feedback and development of a change plan with a court worker, on marijuana use.. Participants were 83 parent-youth dyads recruited from a diversionary family court program who screened positive for past-year marijuana use. At baseline and 3- and 6-month follow-ups, youth self-reported on their substance use, parental monitoring, peer substance use, and dyads completed a discussion task querying parental monitoring, limit setting, and substance use. The study randomized dyads to psychoeducation or the experimental intervention condition post-baseline. The MET-based intervention involved the self-administered e-TOKE (an electronic, marijuana-specific assessment and feedback tool) and a brief follow-up meeting with court staff counselors to review feedback and create a marijuana use change plan. Caregivers completed a computer program aimed at improving parenting and communication with their adolescents. The study administered feasibility and acceptability measures for both conditions.. Feasibility of study procedures was demonstrated through recruitment and retention (∼75 % success). Acceptability ratings from youth, parents, and court staff were high and positive. While levels of parental monitoring, as assessed by an observational task, improved over the course of the study, the intervention did not result in a significant change in any of the outcomes tested.. Despite high acceptability and feasibility ratings for the use of an electronic plus in-person MET intervention, reduction of marijuana and other substances was limited for most youth. This suggests that a more intensive intervention, such as stepped care, may be necessary for JIY who are not specifically referred for court proceedings due to marijuana use or those with already well-established use patterns.

Topics: Adolescent; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Motivational Interviewing; Substance-Related Disorders

We examined central nervous system [CNS] stress responses among deprived and continuing heavy marijuana users and nonusers.. Participants (. Deprivation did not affect startle potentiation overall (timing task:. A history of marijuana use or acute deprivation did not alter central stress responses despite prominent theoretical expectations. This study adds to growing research on central stress responses in individuals with a history of drug use and begins to parse moderating roles of individual differences and stressor characteristics. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Topics: Adult; Cannabis; Female; Humans; Male; Marijuana Use; Reflex, Startle; Substance-Related Disorders; Young Adult

This study examined approaches to delivering brief interventions (BI) for risky substance use and sexual behaviors in school-based health centers (SBHCs).. 300 Adolescents (ages 14-18; 54 % female) with risky marijuana and/or alcohol use identified via CRAFFT screening (scores >1) were recruited from two SBHCs and randomized to computer-delivered BI (CBI) or nurse practitioner-delivered BI (NBI). Both BIs included motivational and didactic content targeting marijuana, alcohol, and risky sexual behaviors. Assessments at baseline, 3-month, and 6-month follow-up included past 30-day frequency of marijuana use, alcohol use, binge drinking, unprotected sex, and sex while intoxicated; marijuana and alcohol problems; and health-related quality-of-life (HRQoL). A focused cost-effectiveness analysis was conducted. An historical 'assessment-only' cohort (N=50) formed a supplementary quasi-experimental comparison group.. There were no significant differences between NBI and CBI on any outcomes considered (e.g., days of marijuana use; p=.26). From a cost-effectiveness perspective, CBI was 'dominant' for HRQoL and marijuana use. Participants' satisfaction with BI was significantly higher for NBI than CBI. Compared to the assessment-only cohort, participants who received a BI had lower frequency of marijuana (3-months: Incidence Rate Ratio [IRR] = .74 [.57, .97], p=.03), alcohol (3-months: IRR = .43 [.29, .64], p<.001; 6-months: IRR = .58 [.34, .98], p = .04), alcohol-specific problems (3-months: IRR = .63 [.45, .89], p=.008; 6-months: IRR = .63 [.41, .97], p = .04), and sex while intoxicated (6-months: IRR = .42 [.21, .83], p = .013).. CBI and NBI did not yield different risk behavior outcomes in this randomized trial. Supplementary quasi-experimental comparisons suggested potential superiority over assessment-only. Both NBI and CBI could be useful in SBHCs.

Topics: Adolescent; Alcohol Drinking; Alcohol-Related Disorders; Cannabis; Computers; Crisis Intervention; Female; Health Risk Behaviors; Humans; Male; Marijuana Smoking; Marijuana Use; Mass Screening; Nurse Practitioners; Risk-Taking; School Health Services; Schools; Sexual Behavior; Substance-Related Disorders

Marijuana use may increase schizophrenia risk, and this effect may be genetically moderated. We investigated how hypothetical genetic test results indicating the presence or absence of heightened schizophrenia risk in reaction to marijuana use would affect attitudes toward marijuana use. In two experiments, participants were randomized to hypothetical scenarios in which genetic testing showed the presence or absence of a predisposition for marijuana use to increase their schizophrenia risk, or to a control condition with no mention of genetic testing. Experiment 1 used a sample of 801 U.S. young adults recruited via Amazon.com's Mechanical Turk platform. Experiment 2 replicated the same procedures with a nationally representative sample of 800 U.S. adults aged 18-30. In Experiment 1, those in the predisposition condition, compared to the control condition, rated the likelihood and importance of their avoiding marijuana as significantly higher, whereas those in the no-predisposition condition rated both as significantly lower. In experiment 2, these findings were largely replicated for the predisposition condition but not the no-predisposition condition, and prior marijuana use was a significant moderator, with the effects of the predisposition condition confined to participants who reported having used marijuana. If these results are predictive of responses to actual genetic testing, they suggest that genetic test results indicating that marijuana use will increase one's schizophrenia risk may incentivize abstinence, especially for those with prior marijuana use. Future research could further investigate whether genetic test results indicating the absence of such a predisposition might disincentivize abstinence from marijuana use.

Topics: Cannabis; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Schizophrenia; Substance-Related Disorders; Young Adult

No medications are approved for cannabis use disorder (CUD). Gamma-aminobutyric acid (GABA) reuptake is modulated by cannabinoid (CB) receptor agonists, and there are shared effects between CB agonists and the GABA reuptake inhibitor tiagabine. This overlapping neuropharmacology suggested that tiagabine might be useful for CUD. The study determined the ability of tiagabine maintenance to reduce cannabis self-administration using a placebo-controlled, double-blind, counterbalanced, within-subjects design. Nontreatment-seeking daily cannabis users (N = 12; 3 female, 9 male) completed two 12-day outpatient maintenance phases (0 or 12 mg of tiagabine/day). Each phase consisted of a safety session, 7 maintenance days, and 4 experimental sessions. During experimental sessions, maintenance continued and participants completed two 2-day blocks of sampling and self-administration sessions to determine the reinforcing effects of smoked cannabis (0% and 5.9% Δ9-tetrahydrocannabinol). Naturalistic cannabis use, the subjective, performance and physiological response to cannabis, as well as side effects, sleep quality, craving, other self-reported substance use, and observer ratings were also measured. Cannabis functioned as a reinforcer and produced prototypical effects (e.g., increased heart rate and ratings of "high"), but tiagabine generally did not impact the effects of cannabis, or alter naturalistic use. Furthermore, tiagabine produced small, but significant, increases on 2 subscales of a Marijuana Craving Questionnaire, and reductions in both the amount of time slept in the past 24 hr and ratings of positive mood upon awakening. These human laboratory results from a sample of nontreatment-seeking cannabis users do not support the potential efficacy of 12 mg of tiagabine as a stand-alone pharmacotherapy for CUD. (PsycINFO Database Record

Topics: Adult; Affect; Cannabinoid Receptor Agonists; Cannabis; Craving; Double-Blind Method; Dronabinol; Female; GABA Uptake Inhibitors; Hallucinogens; Humans; Male; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Reinforcement, Psychology; Self Administration; Sleep; Surveys and Questionnaires; Tiagabine

Morning cannabis use is associated with heavier, frequent cannabis use and more cannabis-related negative consequences, yet little empirical research has examined its predictors. Using 24 months of longitudinal data, the present study tested demographic, psychosocial, and behavioral predictors of morning cannabis use among young adults at the monthly- and person-levels. Young adults (N = 778) were part of a larger study on substance use and social role transitions; participants completed a baseline survey and up to 24 consecutive monthly surveys. Hypotheses were tested using logistic multilevel models to estimate odds ratios for any vs. no morning use in a given month. At the monthly level, social anxiety motives and cannabis use frequency on a given month were positively associated with morning cannabis use. At the person level, typical coping motives, average cannabis use frequency, and male sex were positively associated with morning cannabis use. Findings advance our understanding of individual and psychosocial predictors of morning cannabis use among young adults. Notably, social anxiety motives may represent a malleable target for intervention efforts that could reduce risky use patterns associated with morning use. Such efforts may be especially prudent for young men, as our findings indicated morning cannabis use probabilities were much higher for men than women.

Topics: Adaptation, Psychological; Cannabis; Female; Humans; Male; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Motivation; Young Adult

Topics: Cannabis; Health Knowledge, Attitudes, Practice; Humans; Marijuana Use; Students, Pharmacy; Substance-Related Disorders; Surveys and Questionnaires

To measure longitudinal trajectories of marijuana use in four tobacco/nicotine products (hand-rolled cigarettes/spliffs, cigars/blunts, hookah, and e-cigarettes) among young adult Texas college students from 2015 to 2019.. This study used six consecutive waves of data from the marketing and promotions across colleges in Texas project (Project M-PACT), a longitudinal study of the tobacco behaviors of young adult college students. The first four waves were collected every 6 months (fall 2015-spring 2017), and the final two waves were conducted yearly (spring 2018 and 2019). Growth curve models measured trajectories of marijuana use in tobacco products across the 3.5-year period.. A total of 4857 young adults from 24 colleges in the largest metropolitan areas of Texas, United States (Austin, Dallas, Houston, and San Antonio): mean age = 21.0, SD = 2.3; 64.2% assigned female; 36.1% non-Hispanic white, 31.0% Hispanic, and 33.0% other or combination race/ethnicity.. Participants completed online surveys assessing their past 6-month use of marijuana in four tobacco products of interest (spliffs, blunts, hookah, and e-cigarettes) and socio-demographic variables (sex, race/ethnicity, age, 2-year/4-year college attendance, and sexual and gender minority identity).. Observed vaping marijuana in e-cigarettes approximately doubled between the spring of 2015 and the spring of 2019, from 11.8% to 23.9% following a quadratic time trend (linear OR = 0.84, 95% CI = 0.73-0.97, quadratic OR = 1.18, CI = 1.13-1.22). This same time period saw a quadratic decline in using marijuana in hookah (P < 0.001) and no changes in using hand-rolled cigarettes/spliffs or cigars/blunts for marijuana delivery.. The popularity of nicotine e-cigarettes appears to be expanding the avenues for marijuana delivery among young adults in Texas, United States.

Topics: Adult; Cannabis; Child, Preschool; Electronic Nicotine Delivery Systems; Female; Humans; Longitudinal Studies; Marijuana Use; Nicotiana; Nicotine; Students; Texas; Tobacco Products; Tobacco Use; Young Adult

To estimate the effect of recreational legalization on cannabis use frequency and sources of variance across legal environments.. Longitudinal discordant twin and gene-environment interaction models in twins recruited from birth records and assessed prospectively.. The United States, including states with different recreational cannabis policies before and after 2014, when recreational cannabis was first legalized.. Two longitudinal, prospectively assessed samples of American twins aged 24-47 (n = 1425 in legal states, n = 1996 in illegal states), including 111 monozygotic pairs discordant for residence.. Current cannabis use frequency (measured continuously and ordinally) was the primary outcome, and the predictor was recreational status of cannabis (legal/illegal) in the participant's state of residence at the time of assessment. Covariates include age, sex and cannabis use frequency prior to 2014.. In the United States, there appears to be a ~ 20% average increase in cannabis use frequency attributable to recreational legalization, consistent across increasingly rigorous designs. In addition, the heritability of cannabis use frequency appears to be moderated by legalization.

Topics: Cannabis; Humans; Legislation, Drug; Longitudinal Studies; Marijuana Smoking; Marijuana Use; United States

Most adults report beliefs that cannabis has at least one benefit (e.g., stress relief, chronic pain management); however, the benefits are not well established. Beliefs about cannabis benefits are associated with the initiation of use, whereas beliefs about the risks of cannabis are protective factors against its use. Little is known about how health-related beliefs impact cannabis use among American Indians/Alaska Natives (AIAN).. This exploratory study examined beliefs about perceived benefits (i.e., stress relief, pain management) of cannabis, how beliefs vary as a function of use, and associations between health worry and benefits of cannabis among AIAN adults.. Participants (n = 182) were on average 41.4 (SD = 16.3) years old, 63.9% female, and identified as AIAN. Participants were asked questions about general demographics, health-related worry and perceptions, and cannabis use. Linear regressions were conducted to examine associations.. Those who used cannabis in the past year were more likely to agree that cannabis relieves stress and less likely to believe that those who use cannabis should be very worried about their health. Participants who agreed that those who use cannabis should be worried about their health were less likely to report beliefs that cannabis relieves stress or helps with chronic pain.. Our study confirms the role of health-related perceptions and worry about cannabis products with cannabis use among this population that may be at risk for higher cannabis use. Findings may have implications for cannabis policy at the tribal, state, and federal levels and the need for the development of targeted communications about the true health risks of cannabis.

Topics: Adult; American Indian or Alaska Native; Anxiety; Cannabis; Chronic Pain; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Marijuana Use; Middle Aged; Stress, Psychological

Public support for the legalization of marijuana (cannabis) for medical or recreational use by adults has grown rapidly over the past two decades. Given the growing prevalence and concerns about potential harms, a better understanding is needed of disparities in marijuana use among adults by disability status.. Using 2015-2019 data from the National Survey on Drug Use and Health (NSDUH), we obtained a national sample of 195,130 working-age (18-64 year) adults. Descriptive and multivariable analyses were conducted to assess the prevalence and risk factors associated with marijuana use among adults by disability status and type.. We found the prevalence of marijuana use was higher among adults with disabilities (16.6% vs 10.9%) compared to those without disabilities, and this disparity widened from 2015 to 2019. Furthermore, the odds of marijuana use varied by disability type. Specifically, adults with vision disability only (OR 1.28; 95% CI 1.14-1.44), cognitive disability only (OR 1.24; 95% CI 1.13-1.35), and those with multiple disabilities (OR 1.22; 95% CI 1.11-1.34) had higher odds of marijuana use compared to adults without any disability.. Adults with disabilities have a higher prevalence of marijuana use compared to those without disabilities. Living in a state with legalized medical marijuana also increased the odds of marijuana use. These findings can help to inform policy and public health surveillance of marijuana use in the U.S. Further studies are needed to monitor the rising prevalence of marijuana use and examine how intensity of marijuana use affects health outcomes in adults with and without disabilities.

Topics: Adult; Cannabis; Disabled Persons; Hallucinogens; Humans; Marijuana Smoking; Marijuana Use; Medical Marijuana; Prevalence; Risk Factors; Substance-Related Disorders; United States

Within-person studies are lacking regarding how recreational cannabis legalization (RCL) and the numbers of neighborhood cannabis retailers relate to adolescents' cannabis use. Study participants were 146 offspring (55% girls; 77% White non-Latinx) of men recruited in childhood from neighborhoods with high delinquency rates. Youth were assessed for past-year cannabis and alcohol use one or more times from ages 13 to 20 years (age M[SD] = 16.4 [2.1] years across 422 observations), while they were living in Oregon or Washington from 2005 to 2019 (where cannabis retail stores opened to adults ages 21 years and older in 2014 and 2015, respectively). We calculated distances between addresses of licensed cannabis retailers and participants' homes. Multilevel models that accounted for effects of age on cannabis use did not support that the number of retail stores within 2-, 5-, 10-, or 20-mile radii of adolescents' homes increased likelihood of past-year cannabis use at the within- or between-subjects levels. Likewise, primary models did not support a greater likelihood of cannabis use among youth whose adolescence coincided more fully with the post-RCL period. A secondary model suggested that after adjusting for adolescents' concurrent alcohol use as a marker of general substance use risk, RCL was associated with cannabis use (between-subjects B [95% CI] = .35 [.05-.66], p = .024). Further research is needed with larger prospective samples, at-risk subgroups, and as cannabis markets mature.

Topics: Adolescent; Adult; Alcohol Drinking; Cannabis; Child, Preschool; Female; Humans; Male; Marijuana Use; Prospective Studies; Risk Factors

Topics: Adolescent; Adolescent Behavior; Adult; Alcoholism; Cannabis; Female; Goals; Humans; Male; Marijuana Use; Protective Factors; Risk Factors; Substance-Related Disorders; Surveys and Questionnaires; Young Adult

It is important to examine normative age-related change in substance use risk factors across the lifespan, with research focusing on middle adulthood particularly needed. The current study examined time-varying associations between depressive symptoms and alcohol, cigarette, and marijuana use from modal ages 35 to 55 in a national sample of US adults, overall and by sex. Data were obtained from 11,147 individuals in the longitudinal Monitoring the Future study. Participants were in 12

Topics: Adolescent; Adult; Alcohol Drinking; Binge Drinking; Cannabis; Depression; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Substance-Related Disorders

Topics: Cannabis; Dronabinol; Hallucinogens; Humans; Legislation, Drug; Marijuana Use; Virtues

The purpose of this study was to examine attitudes toward legalization of cannabis use and openness to legal use among Norwegian partygoers.. We examined a combined sample (. Although 46.1% of participants reported having used cannabis at least once, only 1/3 (32.6%) favored legalization and 1/4 (25.6%) stated they would themselves use cannabis if legalized. Yet, even among never-users, we observed non-opposition to legalization (16.4% in favor; 14.9% don't know) and openness to legal use (8.2% would use; 12.4% don't know). Histories of cannabis, tobacco, or any other drug use, sex (male), and age younger than 21 years (vs. 30 or older) were consistently associated with affirmative responses to both questions. Openness to legal use was strongly associated with favorable legalization attitudes and age younger than 21, even after accounting for lifetime cannabis use history.. Favoring cannabis legalization and openness to legal use were relatively low in this sample of young Norwegian partygoers. Yet, prevalence of cannabis use may increase after legalization among its supporters and among those younger than 21, especially if "don't know" responses are considered.

Topics: Adult; Attitude; Cannabis; Female; Hallucinogens; Humans; Male; Marijuana Use; Medical Marijuana; Norway; Young Adult

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.. 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.. 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).. 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.

Topics: Canada; Cannabis; Cross-Sectional Studies; Humans; Legislation, Drug; Marijuana Use

Growing cannabis legalization has coincided with an increased focus on use of both alcohol and cannabis (AC co-use) among younger people; however, little is known about AC co-use among adults over age 30. This study examines the prevalence of different types of AC co-use among adults, as well as compares AC co-users and alcohol-only users on individual, social network, and neighborhood characteristics.. Data come from three annual surveys of a nationally representative sample of 1,770 U.S. adults, initially between the ages of 30-80, conducted between 2019 and 2021. The baseline sample is 52.8 years old on average, 51.8 % female, and 60.1 % non-Hispanic White.. Past month co-use at baseline was reported by 8.4% of adults, and mostly consisted of simultaneous use, with less than 5% of the sample initiating co-use over the two-year follow-up period. Multivariable models indicate AC co-use was cross-sectionally associated with respondents being male, younger, Hispanic (vs White), and having more alcohol use and related problems, and with their social network composition (e.g., having more drinking buddies and cannabis users in the network). However, co-use status was not associated with mental health, physical ailments, or neighborhood quality. Longitudinal analyses indicated that AC co-use at baseline predicted more alcohol use one year later and alcohol related problems two years later among men only.. AC co-use among adults over age 30 deserves further attention given its prevalence and associations with heavier drinking and related problems. Network-focused interventions may be a promising approach for reducing AC co-use.

Topics: Adult; Aged; Aged, 80 and over; Alcohol Drinking; Cannabis; Female; Hispanic or Latino; Humans; Male; Marijuana Use; Middle Aged; Surveys and Questionnaires

The use of marijuana for the treatment of glaucoma has been widely debated amongst ophthalmologists and glaucoma specialists. Recent evidence suggests the majority of ophthalmologists do not support the use of marijuana as active treatment for glaucoma. However, there has been no investigation into understanding the public's direct perception of the efficacy of marijuana in glaucoma treatment. By using Twitter as a tool to understand the public's thoughts, tweets were analyzed over the last 2 years. Of the 700 tweets analyzed, 72% (n=503) of tweets were in favor of cannabis use in the treatment of glaucoma, whereas 18% (n=124) were evidently opposed. The majority of those in favor came from accounts of individual users (n=391; 56%) whereas those that opposed marijuana as a treatment came from accounts of health care media, ophthalmologists, and other health care workers. The discrepancy between the public and ophthalmologists and other health care professionals requires recognition and further action to better educate the public on the role of marijuana in glaucoma treatment.

Topics: Cannabis; Glaucoma; Humans; Intraocular Pressure; Marijuana Use; Public Opinion; Social Media

Topics: Cannabis; Humans; Marijuana Smoking; Marijuana Use; Medical Marijuana; United States; Veterans

American Indian (AI) adolescents report higher rates of cannabis use than national US adolescents. Previous study examined interactive relationships between depressed affect and family factors on AI adolescent alcohol use. These factors have not been investigated for cannabis use. We examined whether parental monitoring dampened risk for cannabis use due to depressed affect, and potential moderation by sex.. We measured cannabis use, depressed affect, parental monitoring, and sex among reservation area AI youth among students in grades 7-12 attending 45 schools. We used censor-inflated regression models to identify parental monitoring as a moderator of the relationship between depressed affect and cannabis use.. In the logistic portion of censor-inflated models, level of depressed affect and parental monitoring significantly related to last 30-day cannabis use. Higher levels of parental monitoring at lower levels of depressed affect related to lower likelihood of cannabis use. Female students had greater likelihood of endorsing cannabis use at higher levels of depressed affect. In the linear portion of the censor-inflated regression models, sex and level of parental monitoring significantly related to cannabis use frequency. Male students endorsed more frequent cannabis use while higher levels of parental monitoring related to lower frequency of use.. Parental monitoring may dampen the effect of depressed affect on cannabis use among AI youth on reservations.. Future interventions should foster skill-building prevention efforts directed at coping with depression, along with parental training for effective monitoring. Special attention to AI female adolescents may be indicated.

Topics: Adolescent; American Indian or Alaska Native; Cannabis; Depression; Female; Humans; Indians, North American; Male; Marijuana Use; Parenting; Parents; Schools; Sex Factors; United States

Simultaneous alcohol and marijuana (SAM) use is reported to be associated with heavier alcohol and marijuana use and more negative consequences, but less is known about the social, physical, and temporal contexts of SAM use.. The social context of alone only (vs. with others only) was associated with consuming fewer drinks. Physical contexts that included using both at home and outside the home (vs. only at home) were associated with greater alcohol and marijuana quantity and negative consequences (but not after controlling for alcohol quantity); use outside the home only (vs. only at home) was associated with more alcohol use, more alcohol consequences (but not after controlling for alcohol quantity), and fewer marijuana consequences (even after controlling for marijuana quantity). The temporal context of first engaging in SAM use before 6 P.M. (vs. after 9 P.M.) was associated with greater alcohol and marijuana quantity and more marijuana consequences (but not after controlling for number of hours high), and first engaging in SAM use between 6 and 9 P.M. was associated with more hours high.. SAM use contexts such as using with others, using outside the home, and using earlier in the evening are typically associated with greater alcohol/marijuana quantity and consequences.

Topics: Alcohol Drinking; Cannabis; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

Public health experts caution that legalization of recreational marijuana may normalize smoking and undermine the decades-long achievements of tobacco control policy. However, very little is known about the impact of recreational marijuana laws (RMLs) on adult tobacco use. Using newly available data from the Population Assessment of Tobacco and Health (PATH) and dynamic difference-in-differences and discrete-time hazard approaches, we find that RML adoption increases prior-month marijuana use among adults ages 18-and-older by 2-percentage-points, driven by an increase in marijuana initiation among prior non-users. However, this increase in adult marijuana use does not extend to tobacco use. Rather, we find that RML adoption is associated with a lagged reduction in electronic nicotine delivery systems (ENDS) use, consistent with the hypothesis that ENDS and marijuana are substitutes. Moreover, auxiliary analyses from the National Survey on Drug Use and Health (NSDUH) show that RML adoption is associated with a reduction in adult cigarette smoking. We conclude that RMLs may generate tobacco-related health benefits.

Topics: Adult; Cannabis; Electronic Nicotine Delivery Systems; Humans; Marijuana Smoking; Marijuana Use; Public Health; Tobacco Products; Tobacco Use

This study examined whether recreational marijuana legalization (RML) and local retail availability were associated with marijuana and alcohol use and co-use among adolescents.. We investigated associations between RML and past-30-day marijuana and alcohol use and co-use, and moderating effects of retail availability of marijuana and alcohol, using data from the 2010-2011 to 2018-2019 California Healthy Kids Surveys (CHKS) of 9th and 11th grade students in 38 California cities. Multilevel mixed-effects logistic regression analyses were conducted, controlling for secular trends and student and city demographics. Additional analyses examined associations of RML and retail availability with co-use among subgroups of drinkers and marijuana users.. For the full sample, RML was inversely associated with alcohol use but was not significantly associated with marijuana use or co-use with alcohol. However, significant interactions between RML and marijuana outlet density showed that there were increases in marijuana and alcohol co-use and alcohol following legalization in cities with higher densities of marijuana outlets. RML was positively associated with co-use among non-heavy and heavy drinkers, but inversely related to co-use among occasional and frequent marijuana users. A significant positive interaction between RML and marijuana outlet density indicated that RML was associated with increases in co-use for occasional marijuana users in cities with higher densities of marijuana outlets.. RML was associated with increases in marijuana and alcohol co-use and alcohol use among California high school students, particularly those in cities with higher densities of retail cannabis stores, although this varied across alcohol and marijuana use subgroups.

Topics: Adolescent; California; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Students

Marijuana is a widely used psychoactive substance in the US and medical and recreational legalization has risen over the past decade. Despite the growing number of individuals using marijuana, studies investigating the association between epigenetic factors and recent and cumulative marijuana use remain limited. We therefore investigated the association between recent and cumulative marijuana use and DNA methylation levels. Participants from the Coronary Artery Risk Development in Young Adults Study with whole blood collected at examination years (Y) 15 and Y20 were randomly selected to undergo DNA methylation profiling at both timepoints using the Illumina MethylationEPIC BeadChip. Recent use of marijuana was queried at each examination and used to estimate cumulative marijuana use from Y0 to Y15 and Y20. At Y15 (n = 1023), we observed 22 and 31 methylation markers associated (FDR P ≤ 0.05) with recent and cumulative marijuana use and 132 and 16 methylation markers at Y20 (n = 883), respectively. We replicated 8 previously reported methylation markers associated with marijuana use. We further identified 640 cis-meQTLs and 198 DMRs associated with recent and cumulative use at Y15 and Y20. Differentially methylated genes were statistically overrepresented in pathways relating to cellular proliferation, hormone signaling, and infections as well as schizophrenia, bipolar disorder, and substance-related disorders. We identified numerous methylation markers, pathways, and diseases associated with recent and cumulative marijuana use in middle-aged adults, providing additional insight into the association between marijuana use and the epigenome. These results provide novel insights into the role marijuana has on the epigenome and related health conditions.

Topics: Cannabis; DNA Methylation; Epigenesis, Genetic; Epigenome; Genome-Wide Association Study; Humans; Marijuana Use; Middle Aged; Young Adult

Simultaneous alcohol and marijuana (SAM) use is associated with adverse consequences for youth. While SAM use is overall declining among youth, prior studies indicate increasing marijuana use among US adolescents who ever used cigarettes, suggesting possible moderation of the alcohol-marijuana relationship by cigarette use.. We included 43,845 12-th grade students participating in Monitoring the Future data (2000-2020). A 5-level alcohol/marijuana measure was used, including past-year SAM, alcohol-only, marijuana-only, non-simultaneous alcohol and marijuana, or no use. Multinomial logistic regressions estimated associations between time periods (categorized based on sample size: 2000-2005, 2006-2009, 2010-2014, 2015-2020) and the 5-level alcohol/marijuana measure. Models adjusted for sex, race, parental education and survey mode and included interactions of time periods and lifetime cigarette or vaped nicotine use.. While overall SAM among 12th graders decreased from 23.65% to 18.31% between 2000 and 2020, SAM increased among students who never used cigarettes or vaped nicotine (from 5.42% to 7.03%). Among students who ever used cigarettes or vaped nicotine, SAM increased from 39.2% in 2000-2005-44.1% in 2010-2014 then declined to 37.8% in 2015-2020. Adjusted models controlling for demographics indicated that among students with no lifetime cigarette or vaped nicotine use, students in 2015-2020 had 1.40 (95% C.I. 1.15-1.71) times the odds of SAM, and 5.43 (95% C.I. 3.63-8.12) times the odds of marijuana-only (i.e., no alcohol use) compared to students who used neither in 2000-2005. Alcohol-only declined over time in both students who ever and never used cigarettes or nicotine vape products.. Paradoxically, while SAM declined in the overall adolescent US population, the prevalence of SAM increased among students who have never smoked cigarettes or vaped nicotine. This effect arises because of a substantial decline in the prevalence of cigarette smoking; smoking is a risk factor for SAM, and fewer students smoke. Increases in vaping are offsetting these changes, however. Preventing adolescent use of cigarettes and nicotine vaped products could have extended benefits for other substance use, including SAM.

Topics: Adolescent; Cannabis; Electronic Nicotine Delivery Systems; Ethanol; Hallucinogens; Humans; Marijuana Use; Nicotine; Substance-Related Disorders; Tobacco Products; Vaping

Nations wrestle with whether to prohibit products that can harm consumers and third parties but whose prohibition creates illegal markets. For example, cannabis is banned in most of the world, but supply for non-medical use has been legalized in Uruguay, Canada, and much of the United States and possession restrictions have been liberalized in other countries. Likewise, supply and possession of fireworks have been subject to varying degrees of prohibition in multiple countries, with those bans prompting significant evasion.. Current and past history of fireworks regulations, sales, and harms are reviewed and contrasted with those for cannabis. The focus is on the United States, but literature from other countries is incorporated when possible and appropriate. This extends the insightful literature comparing drugs to other vices (such as gambling and prostitution) by comparing a drug to a risky pleasure that is not seen as a vice but which has been subject to prohibition.. There are many parallels between fireworks and cannabis in legal approaches, harms to "users", harms to others, and other externalities. In the U.S. the timing of prohibitions were similar, with prohibitions on fireworks being imposed a little later and repealed a little sooner. Internationally, the countries that are strictest with fireworks are not always those that are strictest with drugs. By some measures, harms are of roughly similar magnitude. During the last years of U.S. cannabis prohibition, there were about 10 emergency department (ED) events per million dollars spent on both fireworks and illegal cannabis, but fireworks generated very roughly three times as many ED events per hour of use/enjoyment. There are also differences, e.g., punishments were less harsh for violating fireworks prohibitions, fireworks consumption is heavily concentrated in just a few days or weeks per year, and illegal distribution is primarily of diverted legal products, not of illegally produced materials.. The absence of hysteria over fireworks problems and policies suggests that societies can address complex tradeoffs involving risky pleasures without excessive acrimony or divisiveness when that product or activity is not construed as a vice. However, the conflicted and time-varying history of fireworks bans also show that difficulty balancing freedoms and pleasure with harms to users and others is not restricted to drugs or other vices. Use-related harms fell when fireworks were banned and rose when those bans were repealed, so fireworks prohibitions can be seen as "working" from a public health perspective, but not well enough for bans to be employed in all times or places.

Topics: Canada; Cannabis; Commerce; Humans; Legislation, Drug; Marijuana Use; Public Policy; United States

Washington State was among the first states in the US to legalize recreational consumption and retail sales of marijuana. Recreational use of cannabis was legalized December 6, 2012, following the passage of Initiative 502 30 days prior. Roughly 19 months later the first retail cannabis stores opened their doors for public sales ("commercialization"). I measure the impact of cannabis legalization and commercialization on traffic collisions in Washington State.. With county-level vehicle crash data from the Washington State Department of Transportation collected monthly, I utilize an interrupted time-series framework with Poisson estimation to compare traffic collisions with recreational retail cannabis sales revenue from 2011 (three years pre-commercialization) through 2017 (three years post-commercialization). First, I measure the shift in collisions brought about by Washington's 2012 cannabis legalization. Then, I compare retail cannabis sales-a measure of commercialization-to traffic collisions based on severity of injury (fatal, severe injury, minor injury, non-injury, and all).. After controlling for confounding factors, evidence suggests that recreational cannabis legalization led to fewer fatal and serious injury collisions. Retail cannabis sales generally correlate with more traffic collisions, particularly for less severe (minor injury) crashes. These findings are robust to the inclusion of additional control variables pertaining to county-level cannabis usage and driving behavior while intoxicated.. Cannabis legalization led to fewer fatal, serious, and minor injury collisions. Commercialization (cannabis sales) correlated with an increase in less severe crashes. Although cannabis use generally increased in Washington State following legalization/commercialization, survey data suggest that driving behavior while under the influence of cannabis did not change significantly over the post-commercialization period. Future research should focus on measuring the dose-dependent impact of cannabis consumption on traffic collisions. This should include recognition of the importance of cannabis dosing, timing, and route of consumption. Lastly, the dangers of poly-drug driving-particularly cannabis and alcohol-are well established and should be high priority for further research.

Topics: Accidents, Traffic; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Washington

This study tested how individuals anticipate they will respond to opportunities to engage in simultaneous alcohol and marijuana (SAM) use.. Two studies utilizing a within-subjects design were conducted. Study 1 was conducted in Spring 2021 and a replication (Study 2) was conducted in Fall 2021. Participants were presented with pairs of scenarios. One scenario pair compared how willing participants expected to be to get drunk if they were sober. In Study 1 participants reported greater willingness to get drunk when sober than when high. This was qualified by a statistically significant interaction whereby differences were greater among those who had more experience with past 30-day heavy drinking. Similar findings emerged for willingness to use marijuana. Participants anticipated greater willingness to use marijuana when sober than when drunk. This was also qualified by a statistically significant interaction whereby differences were greater among experimental or established users of marijuana than among abstainers. Study 2 findings replicated those from Study 1.. College attending young adults state greater willingness to remain under the influence of one substance than to engage in SAM use when opportunities arise. Simultaneous use of alcohol and marijuana among college students is likely an exception, not the rule. Implications for prevention are discussed.

Topics: Alcohol Drinking; Alcoholic Intoxication; Alcoholism; Cannabis; Ethanol; Female; Hallucinogens; Humans; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

Adult-use cannabis markets are operating in multiple US states and abroad. Sales and licensing data for alcohol and tobacco are often used to understand consumption patterns and evaluate policy changes. Cannabis market data may provide similar insights, although these newly legal markets are complex and evolving, and the state data structures can differ. This study describes variations in market indicators and discusses the utility of cannabis market metrics from a public health perspective.. We collected data from 5 early-adopting adult-use cannabis states: Alaska, Colorado, Massachusetts, Oregon, and Washington. Analyses focused on licensed retail outlets and retail sales revenues (pretax). Monthly data were collected from the opening of each state's adult-use market through June 2022. Joinpoint software was used to assess state trends and identify points of inflection in trends. Average sales per retailer for June 2019 and June 2022 were compared. Also described are retailers and revenue per population for 2022.. All states showed 4 distinct periods of growth in retail licensee numbers. The greatest increases typically occurred in the first 3 to 4 months. Growth rates slowed to <1% per month for Colorado, Oregon, and Washington at months 25, 24, and 34, respectively. The number of cannabis retailers per 100,000 residents in June 2022 ranged widely, from 16.8 in Oregon to 3.0 in Massachusetts. Colorado, Oregon, and Washington each showed 4 distinct trend periods in adult-use retail sales: early rapid growth lasting <1 year, subsequent varied growth periods, and then declining sales in the most recent months, following early coronavirus disease 2019 period increases. Sales in Alaska and Massachusetts displayed more stable, consistent growth patterns. Sales per state resident for July 2021 to June 2022 also ranged widely, from $382.97 in Alaska to $180.94 in Washington.. We found some consistencies and some variations in both point-in-time measures and trends in states' adult-use cannabis markets. Differences may relate to varied state policies and general contexts (eg, economies). Market data can be useful for public health monitoring, including understanding the effects of policies intended to protect health and safety. States providing publicly accessible cannabis market data create opportunities for such use. Our results underscore the importance of considering individual state regulatory frameworks and implementation timelines in studies of cannabis legalization.

Topics: Adult; Cannabis; Commerce; COVID-19; Humans; Legislation, Drug; Marijuana Use; Public Health; United States; Washington

We aimed to identify distinct trajectories of tobacco, cannabis, and their co-use among African Americans, and to investigate whether these patterns were associated with polygenic risk scores (PRS) for tobacco and cannabis use.. Participants (N=428 participants; 50.9% male) were initially recruited for an elementary school-based prevention in a Mid-Atlantic city when they were in first grade. From ages 14-26, participants reported on their frequency of tobacco and cannabis use in the past year during annual assessments. DNA was collected from participants at age 21. PRS for smoking heaviness (i.e., cigarettes per day) and lifetime cannabis use were created based on genome-wide association study results derived from Liu et al. (2019) and Pasman et al. (2018), respectively.. We identified five distinct trajectories of tobacco and cannabis co-use, including (1) Low Tobacco and Cannabis Use, (2) Adolescent Limited Tobacco and Cannabis Use, (3) Experimental Cannabis, Young Adult Increasing Tobacco, (4) Experimental Tobacco, Young Adult Increasing Cannabis, and (5) High, Chronic Tobacco and Cannabis Use. Compared to the Low Tobacco and Cannabis Use subgroup, individuals in the High, Chronic Tobacco and Cannabis Use subgroup had greater PRS for smoking heaviness, and individuals in the Experimental Cannabis, Young Adult Increasing Tobacco subgroup had higher PRS for lifetime cannabis use.. Polygenic risk for lifetime cannabis use and smoking heaviness is associated with the developmental progression of tobacco and cannabis co-use among African Americans, furthering knowledge on the etiology of co-use in this population.

Topics: Adolescent; Adult; Black or African American; Cannabis; Cigarette Smoking; Female; Genome-Wide Association Study; Humans; Male; Marijuana Use; Multifactorial Inheritance; Nicotiana; Risk Factors; Smoking; Young Adult

Cumulative exposure to adverse childhood experiences (ACEs) and antenatal stressful life events (ASLEs) are independently associated with marijuana use during pregnancy. However, research has not explored how both exposures may influence marijuana use jointly. Assessing the joint associations of ACEs and recent ASLEs on marijuana use can identify people who may benefit from early intervention. Data come from the Nevada Pregnancy Risk Assessment Monitoring System, 2017-2020 (N = 2483). We assessed eight measures of ACEs before age 18 and fourteen measures of ASLEs twelve months before giving birth. Generalized estimating equations estimated the direct and joint associations (additive and multiplicative interaction) of ACEs and ASLEs on marijuana use during pregnancy. 9.8% used marijuana during the most recent pregnancy. Compared to people who reported no ACEs, those reporting 1 ACE (adjusted prevalence ratio[aPR] = 1.96, 95% confidence interval [CI] = 1.30-2.94), 3 ACEs (aPR = 3.58, 95%CI = 2.69-4.77), and 4+ ACEs (aPR = 3.67, 95%CI = 2.36-5.72) were more likely to use marijuana. Compared to people reporting no ASLEs, those reporting 4+ ASLEs (aPR = 3.12, 95% CI = 1.64-5.92) were more likely to use marijuana. There was evidence of interaction for high ACE and ASLE exposure on an additive scale. ACEs and ASLEs were independently associated with marijuana use during pregnancy, and there was evidence of additive interaction. Screening for ACEs and ASLEs during pregnancy, referrals to appropriate behavioral health services, and trauma-informed approaches are important to address marijuana use during pregnancy.

Topics: Adolescent; Adverse Childhood Experiences; Cannabis; Female; Humans; Marijuana Smoking; Marijuana Use; Pregnancy; Risk Assessment; Substance-Related Disorders

This Viewpoint examines the significant gap in knowledge regarding the effects of cannabis use on perinatal health outcomes.

Topics: Biomedical Research; Cannabis; Female; Hallucinogens; Humans; Marijuana Use; Pregnancy

Experiencing negative substance use consequences may deter future use, alter patterns of substance use (e.g., substituting one substance for another, combining substances), or point to a sustained pattern of engaging in heavy or frequent use. We used monthly data to examine relationships between negative alcohol and cannabis use consequences experienced in one month and changes in use the following month.. Data were from 508 individuals (59% female; ages 18-23 years at enrollment) who were surveyed monthly for 2 years and used both alcohol and cannabis during the study period. Multilevel models assessed within-person associations between monthly fluctuations in substance-related negative consequences and the next month's substance use (i.e., typical drinks per week, cannabis use frequency, and simultaneous alcohol and cannabis/marijuana [SAM] use), controlling for the prior month's substance use.. Positive associations were found between alcohol consequences and the following month's alcohol use and between cannabis consequences and subsequent cannabis use, although only the cannabis association was statistically significant. There was little evidence of effects of cannabis consequences on the next month's alcohol use or alcohol consequences on the next month's cannabis use. Cannabis consequences had a positive and statistically significant association with the next month's SAM use. Within-substance positive associations were strongest for physical alcohol consequences and cannabis consequences of low motivation, memory problems, and trouble breathing.. Experiencing negative cannabis use consequences predicted more frequent cannabis use and greater chance of SAM use 1 month later. Results point to negative consequences, along with prior use, indicating risk for future use.

Topics: Alcohol Drinking; Cannabis; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

Topics: Cannabis; Humans; Marijuana Use

Topics: Breast Feeding; Cannabis; Cross-Sectional Studies; Female; Hospitals; Humans; Infant; Infant, Newborn; Lactation; Marijuana Use; Mothers; Pregnancy; Substance-Related Disorders

Studies have demonstrated important associations between depressive symptoms and tobacco and marijuana use. However, to date, it is unknown if depressive symptoms predispose youth to tobacco and marijuana use at earlier ages over time.. Data from the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) for the years 2019-2021 (Waves 9-14) were used. Eligible samples include individuals who had never used cigarette (n=1776), e-cigarette (n=1353), or marijuana (n=1505) at basline and had complete data on covariates. Interval-censoring survival analysis was used to examine the differences in the estimated age of first use of cigarettes, e-cigarettes, and marijuana by depressive symptoms.. 10th-grade cohort participants with depressive symptoms had increased risk of earlier age of first use of cigarette [AHR=1.45; 95% CI=1.02-2.04)], e-cigarette [AHR=1.65(1.27-2.15)], and marijuana [AHR=1.56(1.20-2.01)]. 12th-grade cohort participants with depressive symptoms had increased risk of earlier age of first use of cigarette [AHR=1.41(1.11-1.82), e-cigarette [AHR=1.35(1.10-1.87)] and marijuana [AHR=1.25(1.01-1.55)]. However, among the two-year post-high school cohort, depressive symptoms predicted the age of first use of marijuana only [AHR=1.34(1.13-1.60)]. Between ages 18-to-20 years, the estimated cumulative incidence of initiation almost doubled for all three products among depressive participants in 10th and 12th-grade cohorts.. Among 10th-grade, 12th-grade, and 2-year post-HS students, those with depressive symptoms initiate tobacco and marijuana use at earlier ages than peers without depressive symptoms. Early screening and management of depressive symptoms among adolescents and young adults may be a promising target for preventing or delaying the age of first use of substance use.

Topics: Adolescent; Cannabis; Depression; Electronic Nicotine Delivery Systems; Humans; Marijuana Use; Nicotiana; Substance-Related Disorders; Tobacco Products; Tobacco Use; Vaping; Young Adult

Topics: Cannabis; Humans; Marijuana Use; Perioperative Care

Topics: Alcohol Drinking; Alcohol Drinking in College; Cannabis; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Students; Substance-Related Disorders; Universities

Alaska and Hawaii, the only two noncontiguous states in the United States, have different marijuana policy environments. Alaska enacted recreational marijuana legalization (RML) in 2014, whereas recreational marijuana is still illegal in Hawaii. This study analyzed how RML affects adolescents' marijuana use (MU) by comparing two states. We used data from 2 states (Alaska and Hawaii) from the Youth Risk Behavior Survey, 2009 to 2019 years (N = 35 467). The trends of lifetime MU and current MU were examined. Using difference-in-differences analysis models, this study investigated whether RML increased lifetime and current MU in Alaska compared with Hawaii after adjusting for socioeconomic characteristics. Both lifetime and current MU prevalence among adolescents in Alaska increased after RML, while both rates in Hawaii gradually decreased. The rate of lifetime MU in Alaska was significantly increased after RML (odds ratio [OR] = 1.29) compared with Hawaii. Similarly, the current MU among adolescents in Alaska was significantly increased compared with that in Hawaii (OR = 1.34). Both lifetime and current MU were increased following RML in Alaska, suggesting that RML may affect the increase of MU among adolescents.

Topics: Adolescent; Alaska; Cannabis; Hawaii; Humans; Legislation, Drug; Marijuana Use; United States

Simultaneous alcohol and marijuana use (SAM) such that their effects overlap has emerged as a behavior that is riskier than using either substance separately. It has been associated with high-risk binge drinking and driving while intoxicated during young adulthood, and it has been demonstrated to cause greater physical and mental impairment than use of alcohol or marijuana separately. To identify intervention and prevention targets specific to SAM, we examined the relationships between alcohol- and marijuana-specific beliefs and attitudes (risk factors) and self-reported SAM compared to non-simultaneous co-use (CAM) and alcohol use only in the past 30 days in a sample of young adults (n = 1,023, mean age = 23.17; SD = 0.43). Of those who reported drinking alcohol in the past 30 days, 20.7% reported SAM, 12.6% reported CAM, and 66.6% reported using only alcohol. Results from multinomial logistic regression analyses indicated that some marijuana-specific risk factors (e.g., belief that it is not at all wrong for someone their age to use marijuana) differentiated SAM or CAM from alcohol use only, but alcohol-specific risk factors generally did not. However, the perceptions that parents approved of their using marijuana or frequently drinking heavily were associated with a greater likelihood of SAM compared to CAM (OR ranged from 2.25 to 3.53). Findings point to the salience of individuals' attitudes and beliefs around marijuana use and their perception of parental approval of heavy drinking and marijuana use as potential targets for prevention programs targeting risk reduction among young adults.

Topics: Adult; Alcohol Drinking; Cannabis; Ethanol; Humans; Marijuana Smoking; Marijuana Use; Young Adult

Variation in drug policies, norms, and substance use over time and across countries may affect the normative sequences of adolescent substance use initiation. We estimated relative and absolute time-varying associations between prior alcohol and tobacco use and adolescent marijuana initiation in Argentina and Chile. Relative measures quantify the magnitude of the associations, whereas absolute measures quantify excess risk.. We analyzed repeated, cross-sectional survey data from the National Surveys on Drug Use Among Secondary School Students in Argentina (2001-2014) and Chile (2001-2017). Participants included 8th, 10th, and 12th grade students (N = 680,156). Linear regression models described trends over time in the average age of first use of alcohol, tobacco, and marijuana. Logistic regression models were used to estimate time-varying risk ratios and risk differences of the associations between prior alcohol and tobacco use and current-year marijuana initiation.. Average age of marijuana initiation increased and then decreased in Argentina and declined in Chile. In both countries, the relative associations between prior tobacco use and marijuana initiation weakened amid declining rates of tobacco use; e.g., in Argentina, the risk ratio was 19.9 (95% CI: 9.0-30.8) in 2001 and 11.6 (95% CI: 9.0-13.2) in 2014. The relative association between prior alcohol use and marijuana initiation weakened Chile, but not in Argentina. On the contrary, risk differences (RD) increased substantially across both relationships and countries, e.g., in Argentina, the RD for tobacco was 3% (95% CI: 0.02-0.03) in 2001 and 12% (95% CI: 0.11-0.13) in 2014.. Diverging trends in risk ratios and risk differences highlight the utility of examining multiple measures of association. Variation in the strength of the associations over time and place suggests the influence of environmental factors. Increasing risk differences indicate alcohol and tobacco use may be important targets for interventions to reduce adolescent marijuana use.

Topics: Adolescent; Adolescent Behavior; Alcohol Drinking; Argentina; Cannabis; Chile; Cross-Sectional Studies; Humans; Marijuana Use; Nicotiana; Substance-Related Disorders; Tobacco Use

Colorado legalized marijuana use for recreational purposes by adults over 21 in 2012. Our goal is to examine the first major communication campaign (called Good-To-Know) mounted by the state government with the objective of informing the public regarding regulatory and safety precautions surrounding newly legal use.

Topics: Adult; Analgesics; Cannabis; Colorado; Communication; Hallucinogens; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use

The present study examined daily associations between mental health symptoms (i.e., depression and anxiety symptoms) and simultaneous alcohol and marijuana (SAM) use and use-related negative consequences among young adults.. Daily mental health symptoms were not associated with SAM use likelihood. However, baseline SAM coping motives moderated the association between mental health symptoms and use such that young adults with stronger coping motives showed a stronger positive association between mental health symptoms and SAM use. Further, on SAM use days, reporting more mental health symptoms relative to one's average was associated with experiencing more use-related negative consequences, even after controlling for daily levels of alcohol and marijuana use (RR = 1.03, 95% CI = 1.01-1.05,. The association between daily mental health symptoms and SAM use depended on whether the young adults had coping motives for use. Daily fluctuations in mental health were associated with negative use-related consequences experienced on SAM use days regardless of motives. These findings highlight the potential importance of prevention and intervention strategies particularly on days when young adults are experiencing increased mental health symptoms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Topics: Adolescent; Adult; Alcohol Drinking; Analgesics; Cannabis; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Mental Health; Motivation; Substance-Related Disorders; Young Adult

Cannabis-derived products containing cannabidiol with no or minimal levels of delta 9-tetrahydrocannabinol (CBD products) are widely available in the United States and use of these products is common among young adults and those who use marijuana. The purpose of this study was to examine patterns and correlates of CBD product use and co-use with marijuana in a sample of young adults.. The study used cross-sectional survey data collected in 2019-2020 from a cohort of young adults (n = 2534; mean age 23) based primarily in California. The survey assessed lifetime, past-year, and past-month frequency and type of CBD products used, frequency and amount of marijuana consumption and indicators of marijuana use-related problems. Linear, Poisson, and logistic regression models compared individuals reporting past month CBD-only use, marijuana-only use, concurrent CBD + marijuana use (co-use), and use of neither product. Among those reporting co-use, we examined associations between CBD use frequency and marijuana use frequency and heaviness of use (occasions per day) and indicators of problem marijuana use (e.g., Cannabis Use Disorder Identification Test Short-Form, solitary use, marijuana consequences).. Approximately 13% of respondents endorsed past-month CBD use; of these, over three-quarters (79%) indicated past-month co-use of marijuana. Among individuals reporting co-use, more frequent CBD use was associated with more frequent and heavier marijuana use but was not associated with marijuana use-related problems.. CBD use was common and associated with higher levels of marijuana consumption in this sample. Routinely assessing CBD use may provide a more comprehensive understanding of individuals' cannabis product consumption.

Topics: Adult; Cannabidiol; Cannabis; Cross-Sectional Studies; Dronabinol; Humans; Marijuana Smoking; Marijuana Use; United States; Young Adult

Topics: Canada; Cannabis; Child; Child, Preschool; Cross-Sectional Studies; Emergency Service, Hospital; Environmental Exposure; Female; Humans; Infant; Legislation, Drug; Male; Marijuana Use

The effect of cannabis legalization in Canada (in October 2018) on the prevalence of injured drivers testing positive for tetrahydrocannabinol (THC) is unclear.. We studied drivers treated after a motor vehicle collision in four British Columbia trauma centers, with data from January 2013 through March 2020. We included moderately injured drivers (those whose condition warranted blood tests as part of clinical assessment) for whom excess blood remained after clinical testing was complete. Blood was analyzed at the provincial toxicology center. The primary outcomes were a THC level greater than 0, a THC level of at least 2 ng per milliliter (Canadian legal limit), and a THC level of at least 5 ng per milliliter. The secondary outcomes were a THC level of at least 2.5 ng per milliliter plus a blood alcohol level of at least 0.05%; a blood alcohol level greater than 0; and a blood alcohol level of at least 0.08%. We calculated the prevalence of all outcomes before and after legalization. We obtained adjusted prevalence ratios using log-binomial regression to model the association between substance prevalence and legalization after adjustment for relevant covariates.. During the study period, 4339 drivers (3550 before legalization and 789 after legalization) met the inclusion criteria. Before legalization, a THC level greater than 0 was detected in 9.2% of drivers, a THC level of at least 2 ng per milliliter in 3.8%, and a THC level of at least 5 ng per milliliter in 1.1%. After legalization, the values were 17.9%, 8.6%, and 3.5%, respectively. After legalization, there was an increased prevalence of drivers with a THC level greater than 0 (adjusted prevalence ratio, 1.33; 95% confidence interval [CI], 1.05 to 1.68), a THC level of at least 2 ng per milliliter (adjusted prevalence ratio, 2.29; 95% CI, 1.52 to 3.45), and a THC level of at least 5 ng per milliliter (adjusted prevalence ratio, 2.05; 95% CI, 1.00 to 4.18). The largest increases in a THC level of at least 2 ng per milliliter were among drivers 50 years of age or older (adjusted prevalence ratio, 5.18; 95% CI, 2.49 to 10.78) and among male drivers (adjusted prevalence ratio, 2.44; 95% CI, 1.60 to 3.74). There were no significant changes in the prevalence of drivers testing positive for alcohol.. After cannabis legalization, the prevalence of moderately injured drivers with a THC level of at least 2 ng per milliliter in participating British Columbia trauma centers more than doubled. The increase was largest among older drivers and male drivers. (Funded by the Canadian Institutes of Health Research.).

Topics: Accidents, Traffic; Adult; Age Distribution; Alcohol Drinking; British Columbia; Cannabis; Dronabinol; Ethanol; Female; Humans; Legislation, Drug; Male; Marijuana Use; Middle Aged

Topics: Biomarkers; Bronchoalveolar Lavage Fluid; Cannabis; Case-Control Studies; Gene Expression Regulation; Humans; Marijuana Use; RNA-Seq

Topics: Adolescent; Adult; Cannabis; Cross-Sectional Studies; Humans; Legislation, Drug; Marijuana Use; Washington; Young Adult

Topics: Alcohol Drinking; Analgesics; Argentina; Cannabis; Ethanol; Hallucinogens; Humans; Marijuana Smoking; Marijuana Use; Substance-Related Disorders

Cigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among youth experiencing homelessness who use combustible tobacco in a Midwestern city to inform smoking cessation intervention.. This study included 96 youth (ages 14-24 years; 52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana, other product use characteristics (e.g., frequency, brand and flavor), and psychosocial predictors of more frequent (i.e., daily) use of combustible tobacco and marijuana.. Most youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (n = 85, 88.5%), cigars (n = 89, 92.7%), and marijuana (n = 82, 85.4%) in the past month. One-third (n = 34) used electronic vapor products (EVPs), 19.8% (n = 19) smoked hookah, and 11.5% (n = 11) used smokeless tobacco (ST). Most marijuana users co-administered with tobacco (n = 67, 69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one's housing situation. Newport (n = 66, 72.5%) and Black & Mild (n = 48, 51.1%) were the most popular brands of cigarettes and cigars among ever users. Most non-combustible tobacco ever users reported not having a usual brand (EVPs: n = 51, 73.9%; ST: n = 16, 57.1%). Cigar smokers reported the most varied selection of flavors.. Young combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support smoking cessation in this population.

Topics: Adolescent; Cannabis; Female; Humans; Ill-Housed Persons; Male; Marijuana Use; Nicotiana; Substance-Related Disorders; Tobacco Products; Tobacco Use; Young Adult

The present study evaluated the two-factor structure of the Protective Behavioral Strategies for Marijuana Scale (PBSM-SF) Short-Form, a 13-item measure of harm reduction behaviors related to cannabis use. Additionally, the PBSM was evaluated for measurement invariance based on sex and state cannabis legalization status.. Participants were 1,048 college students (M. The two-factor structure (i.e., Quantity and Context) of the PBSM-SF identified in Mian et al. (2021) was supported in the present study. Additionally, analyses demonstrated evidence of convergent and concurrent validity. Finally, the two-factor PBSM-SF demonstrated some degree of invariance by sex and state legalization status.. This study provides additional support for a two-factor model of PBSM-SF (i.e., Quantity and Context) that functions similarly for men and women college students as well as for students from states without legalized cannabis use and states with legalized cannabis use.

Topics: Adult; Cannabis; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Students; Substance-Related Disorders; United States; Universities; Young Adult

Little research has examined psychosocial influences differentially associated with driving under the influence of alcohol and marijuana (DUIA/DUIM) or of being a passenger in a vehicle driven by someone under the influence of alcohol or marijuana (PVA/PVM).. Using 2019 survey data among 2,375 young adults (. A total of 22.6% reported past-month DUIA, 24.1% DUIM, 29.7% PVA, and 27.7% PVM. Of those reporting DUIA, 41.4% reported DUIM, 71.8% PVA, and 40.7% PVM. Of those reporting DUIM, 47.7% reported DUIA, 49.6% PVA, and 83.8% PVM. LCA indicated four classes: alcohol and marijuana risk takers (5.9%), all of whom reported DUIA and DUIM, 81.2% PVA, and 89.2% PVM; marijuana risk takers (14.2%), 45.1% DUIM, 100% PVM, 7.8% PVA, and 0% DUIA; alcohol risk takers (24.1%), 40.1% DUIA, 98.6% PVA, 2.6% DUIM, and 33.8% PVM; and low risk takers (55.8%), 8.7% DUIA, 4.5% DUIM, and 0% PVA/PVM. Relative to the other classes, alcohol and marijuana risk takers were more likely male, heterosexual, and White, and alcohol and marijuana risk takers reported greater depressive symptoms. Influences of parent/peer alcohol versus marijuana use were specific to the respective DUI risk behaviors. No differences emerged for legal marijuana retail.. Findings regarding those at particular risk, social influences, and situations under which DUI-related behaviors occur should inform future interventions and research.

Topics: Alcohol Drinking; Cannabis; Driving Under the Influence; Ethanol; Female; Hallucinogens; Humans; Longitudinal Studies; Male; Marijuana Use; Risk Factors; Young Adult

Simultaneous use of alcohol and marijuana (SAM) is common among U.S. college students, but little research has examined specific substance use behaviors during SAM use episodes. This study identified latent classes of SAM users based on their SAM, alcohol-only, and marijuana-only use episodes.. College student SAM users (. Five unique classes emerged: Frequent Marijuana-Focused SAM users (21%); Frequent Alcohol-Initiating SAM users (29%); Heavy-Drinking Infrequent SAM users (12%); Moderate SAM users (29%); and Light Infrequent SAM users (9%). These groups were differentiated primarily by their frequency of SAM use, form of marijuana, whether marijuana was used on non-SAM occasions, and whether consequences were experienced. Groups differed significantly by sex.. College student SAM users are heterogeneous with respect not only to their degree of SAM use but also in their pattern of drinking, type of marijuana use, relative focus on alcohol versus marijuana, and risk of experiencing acute negative consequences. Describing this heterogeneity is an important step toward developing interventions for different types of users.

Topics: Alcohol Drinking; Cannabis; Diaries as Topic; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Young Adult

Topics: Cannabis; Child; Humans; Marijuana Use; Surveys and Questionnaires

The objective of this study was to estimate the effects of marijuana legalization and the subsequent onset of retail sales on injury and fatal traffic crash rates in the United States during the period 2009-2019.. State-by-state quarterly crash rates per mile of travel were modeled as a function of time, unemployment rate, maximum posted speed limit, seat belt use rate, alcohol use rate, percent of miles driven on rural roads, and indicators of legalized recreational marijuana use and sales.. Legalization of the recreational use of marijuana was associated with a 6.5% increase in injury crash rates and a 2.3% increase in fatal crash rates, but the subsequent onset of retail marijuana sales did not elicit additional substantial changes. Thus, the combined effect of legalization and retail sales was a 5.8% increase in injury crash rates and a 4.1% increase in fatal crash rates. Across states, the effects on injury crash rates ranged from a 7% decrease to an 18% increase. The effects on fatal crash rates ranged from a 10% decrease to a 4% increase.. The estimated increases in injury and fatal crash rates after recreational marijuana legalization are consistent with earlier studies, but the effects varied across states. Because this is an early look at the time trends, researchers and policymakers need to continue monitoring the data.

Topics: Accidents, Traffic; Alcohol Drinking; Cannabis; Humans; Legislation, Drug; Marijuana Use; United States

Topics: Adult; Alcohol Drinking; Cannabis; Ethanol; Female; Humans; Language; Male; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

Pediatric specialty care provides an opportunity to screen for and address patient substance use; however, little is known about providers' screening rates, their opinions regarding substance use harms, or the potential marijuana to be used as a medication.. We surveyed national convenience samples of pediatric endocrinologists (N = 142) and rheumatologists (N = 83) and used descriptive statistics and multivariate logistic regression to examine alcohol screening rates, barriers, and for medical use of marijuana, differences between subspecialist concerns.. In all, 36.4% of providers reported screening adolescent patients annually or more, and a majority expressed concerns about impacts on disease management (80.0%/80.0%) and symptom management (69.3%/53.3%) from alcohol and marijuana, respectively. Nearly equal proportions disagreed (30.2%), were neutral (34.7%), or agreed (35.1%) that some patients would benefit from medical marijuana, although majorities were not comfortable recommending marijuana (62.7%) and did not believe marijuana is standardized enough to be used as medication (57.8%).. Fewer than half of the subspecialists in our study routinely screen their adolescent patients for substance use, although many have concerns regarding the impacts of alcohol and marijuana use on their patients. Education and training on best practice could help to increase screening rates. There is agreement that marijuana is not standardized enough to be used as a medication. There is also a broad range of opinions regarding the pharmaceutical potential of marijuana and concerns about the impact of marijuana on underlying chronic medical conditions, which should be considered as marijuana policy continues to evolve.

Topics: Adolescent; Cannabis; Child; Ethanol; Humans; Marijuana Smoking; Marijuana Use; Medical Marijuana; Substance-Related Disorders

Measuring marijuana use quantity in survey research is complicated due to wide variation in the types (e.g., flower, edibles) and potency of marijuana products and in the modes (e.g., smoking, dabbing) used to consume products. There is currently no gold standard marijuana use quantity measure for survey research. This study examined whether number of hours high can be used as a proxy for marijuana use quantity in survey research, particularly in intensive longitudinal designs.. Participants came from a community sample of young adults participating in a longitudinal study on simultaneous alcohol and marijuana use that used a longitudinal measurement-burst design in which participants completed surveys on up to 14 consecutive days in up to five bursts across nearly two calendar years. Those who reported using marijuana on at least one sampled day were included in present analyses (N = 379; M. Within persons, mode-specific marijuana use quantity variables predicted same-day number of hours high indicating evidence of initial criterion validity. In turn, hours high predicted same-day negative marijuana-related consequences indicating evidence of proximal predictive validity. Between persons, participants' average number of hours high was positively associated with their odds of possible cannabis use disorder following the last burst demonstrating distal predictive validity.. Number of hours high may be a parsimonious proxy for measuring marijuana use quantity (regardless of mode of use) in survey research, particularly in intensive longitudinal designs.

Topics: Adult; Cannabis; Female; Hallucinogens; Humans; Longitudinal Studies; Male; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; Young Adult

The prevention of youth marijuana use has become a national priority in the United States. This study examined the influence of parent and peer disapproval on youth marijuana use, mediated by youth risk perception. Because the legal status of marijuana use can influence individual perceptions of the drug, this study investigated differences in the mediating mechanism between youth living in states with medical marijuana legalization (MML) and those living in non-MML states.. The 2019 National Survey of Drug Use and Health was used with a youth population aged 12-17 years (N = 2293). Structural equation modeling and bias-corrected bootstrapping were used to examine hypothesized path models and to evaluate the mediating effect of youth risk perception.. Findings demonstrated that parent and peer disapproval significantly increased youth risk perception of marijuana and reduced youth marijuana use. Second, youth risk perception significantly mediated the association between parent and peer disapproval and youth marijuana use. Third, parent disapproval had a more significant direct effect on youth marijuana use, while peer disapproval had a more significant indirect effect on youth marijuana use via youth risk perception. Finally, the results showed a similar pattern in the mechanism between youths living in MML states compared with those in non-MML states in terms of significance and direction.. The findings suggested a need for improvements in marijuana related policies for both MML and non-MML states. Moreover, parent and peer focused strategies for education and prevention concerning marijuana use among youth are emphasized.

Topics: Adolescent; Cannabis; Hallucinogens; Humans; Marijuana Smoking; Marijuana Use; Medical Marijuana; Parents; Perception; United States

This Viewpoint discusses the critical need for research regarding perceptions of edible cannabis, effective methods to educate and screen caregivers, and innovative approaches to safe storage, considering the increase in unintentional ingestion of cannabis edibles among children.

Topics: Cannabis; Child, Preschool; Eating; Humans; Marijuana Use; Public Health

On October 6, 2022, President Biden announced that he is taking steps to pardon those convicted of simple marijuana possession at the federal level and reconsider the classification of cannabis as a Schedule I substance. At the same time, Congress is working to pass legislation to streamline research in the cannabis space. These efforts signal that federal marijuana laws that have been in place for the past 85 years have created a multitude of problems, including barriers to research, and the federal government is finally considering decisions to create change.

Topics: Biomedical Research; Cannabis; Federal Government; Marijuana Use

Topics: Adult; Analgesics; Cannabis; Drug Evaluation, Preclinical; Female; Humans; Marijuana Smoking; Marijuana Use; Pregnancy

There is an association between recreational marijuana use in pregnancy and legalization. As more states legalize marijuana, its use in pregnancy may increase. The objective of this study was to evaluate pregnant women's knowledge and opinions about marijuana use, potential risks, and legalization.. A cross-sectional survey of pregnant women at a regional perinatal center in New Jersey was performed from January-December 2019. Pregnant subjects were invited to complete a voluntary, anonymous 23-question survey about marijuana use in pregnancy, potential risks, and legalization. Subjects were excluded if they could not read in English or Spanish. Survey questions were based on a 5-point Likert scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). Likelihood of agreeing or disagreeing with potential risks, with neutral responses as the reference, were estimated based on the relative risk (RR) (95% confidence interval [CI]). Associations were examined with prior tobacco/marijuana use and education level.. During the study period, approximately 1133 consecutive patients were approached and 843 completed the study (74.4% response rate). The majority of participants were English-speaking, college educated, and employed. 204 (25.2%) reported prior marijuana use and 36 (4.5%) reported marijuana use during pregnancy. Overall, pregnant women had poor knowledge about potential risks of marijuana use in pregnancy. Although 234 (29.0%) patients were opposed to legalization, more than 90% of pregnant subjects indicated that they would be more likely to use marijuana in pregnancy if it were legalized. Associations of marijuana risks by prior tobacco use showed that nonsmokers had more awareness about risks. Nonsmokers had higher likelihood of agreeing that marijuana use may be harmful to a pregnancy (RR 1.41, 95% CI 1.12-1.76), may hurt the growth of a baby (RR 1.36, 95% CI 1.07-1.74), may cause preterm birth (RR 1.18, 95% CI 1.00-1.40), and may hurt a child's ability to learn (RR 1.20, 95% CI 0.95-1.51). Similar trends were observed for subjects who reported no prior marijuana use and for subjects with more than high school education.. The majority of surveyed pregnant women demonstrated poor knowledge about the possible risks of marijuana in pregnancy and indicated that they would be more likely to use marijuana in pregnancy if it were legalized. As the use of marijuana increases, providers should focus on educating their patients about potential risks associated with marijuana use in pregnancy while additional research is needed to clarify associated risks.

Topics: Cannabis; Child; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Marijuana Smoking; Marijuana Use; Pregnancy; Pregnant Women; Premature Birth

Many American and Dutch adolescents use marijuana regularly. There is concern that such use may impair cognitive function more in adolescents than adults. We examined effects of regular marijuana use on long-term memory and perseveration among American and Dutch adolescents. We administered Buschke's Selective Reminding Test (BSRT) to assess long-term memory and the Wisconsin Card Sorting Test (WCST) to assess perseveration in male teenagers. Usable test data were obtained for 12 American marijuana users, 13 American controls, 9 Dutch marijuana users, and 12 Dutch controls. In BSRT, users showed lower overall long-term storage than controls (adjusted means ± SE's for numbers of words per trial of 9.4 ± 0.2, 13.4 ± 0.3, 11.7 ± 0.2, and 12.4 ± 0.2 for American users, Dutch users, American controls, and Dutch controls, respectively). Marijuana was associated with memory effects only in American, not Dutch, users. Bivariate Pearson correlations for American and Dutch users combined showed associations of lower total recall with more uses in the previous year and lifetime (r = -0.61 and r = -0.53, respectively); and more perseverative errors with more uses in the previous year (r = 0.55). Some findings were consistent with the possibility that regular adolescent marijuana use causes deficits in cognition, especially memory. However, a causal interpretation cannot be inferred from our findings and is challenging to reconcile with the observation of memory deficits only in American users. Our study was novel in examining the influence of nationality on marijuana's cognitive effects. More studies of this topic should compare effects across nationalities or cultures.

Topics: Adolescent; Adult; Cannabis; Cognition; Humans; Male; Marijuana Use; Memory; Neuropsychological Tests; Substance-Related Disorders

Gender differences in the risk and protective factors of marijuana use among college students were explored by analyzing online survey responses from 464 undergraduates. Women perceived higher risk and used marijuana less than men, with no gender difference in peer disapproval. In addition, women had higher objective knowledge regarding the health effects of marijuana, although they exhibited lower confidence in their knowledge. In subsequent regression analyses, health knowledge, confidence in knowledge, perceived risk, and peer disapproval predicted women's marijuana use, whereas only confidence in knowledge and perceived risk predicted men's use. These findings can help devise effective intervention strategies.

Topics: Cannabis; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Protective Factors; Sex Factors; Students; Universities

This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Topics: Cannabis; Discrimination, Psychological; Electronic Nicotine Delivery Systems; Female; Humans; Illicit Drugs; Male; Marijuana Use; Substance-Related Disorders; Young Adult

Little is known about the possible impacts of recreational marijuana legalization on alcohol and marijuana co-use among underage youth. This study examines the association between recreational marijuana legalization in California in 2016 and alcohol and marijuana co-use among adolescents. Additional analyses investigate the associations between recreational marijuana legalization and co-use among past 30-day drinkers and marijuana users and the frequency of alcohol and marijuana use among co-users.. This study used annual cross-sectional data from 7th, 9th, and 11th graders (N=3,319,329) who participated in the California Healthy Kids Survey from 2010-2011 to 2018-2019. Measures included past 30-day alcohol and marijuana use and student demographic characteristics, survey year, pre-post recreational marijuana legalization, and urbanicity. Multilevel regression analyses were conducted in 2021.. Recreational marijuana legalization was associated with greater odds of past 30-day alcohol and marijuana co-use in the total sample (OR=1.06, 95% CI=1.05, 1.07). Recreational marijuana legalization was more strongly associated with co-use among adolescents who reported past 30-day alcohol use (OR=1.58, 95% CI=1.52, 1.62) and heavy drinking (OR=1.25, 95% CI=1.21, 1.29) but was inversely related to co-use among past 30-day marijuana users (OR=0.76, 95% CI=0.74, 0.78). Among past 30-day co-users, there was a positive association with the frequency of marijuana use (β=0.36, SE=0.07).. Recreational marijuana legalization may increase the risk of alcohol and marijuana co-use among adolescents. Greater restrictions on the numbers of alcohol and marijuana retail outlets and hours of operation and advertising and higher taxes on alcohol and marijuana products may help reduce the availability of these substances to adolescents.

Topics: Adolescent; Alcohol Drinking; Cannabis; Cross-Sectional Studies; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana

Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects.. Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects.. The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Topics: Adolescent; Adult; Alcohol Drinking; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Motivation; Young Adult

Cannabis use is increasing among young adults, but its effects on cardiovascular health are poorly understood. We aimed to assess the association between recent cannabis use and history of myocardial infarction (MI) in young adults (aged 18-44 yr).. We performed a cross-sectional study using pooled data from the 2017 and 2018 cohorts of the American Behavioral Risk Factor Surveillance System survey of US adults. We analyzed the association between any recent cannabis use and history of MI using a weighted logistic regression model that adjusted for demographic factors, socioeconomic factors, health-related behaviours, concomitant substance use and other comorbidities. We also assessed this association after stratifying by frequency of use and by primary method of consumption.. Among 33 173 young adults (18.5 million weighted), 4610 respondents (3.2 million weighted) reported recent cannabis use (17.5%, 95% confidence interval [CI] 16.8%-18.2%). A history of MI was more frequent among recent cannabis users (. Our study provides evidence supporting an association between recent cannabis use and history of MI in young adults. Increasing cannabis use in an at-risk population could have negative implications for cardiovascular health.

Topics: Adolescent; Adult; Cannabis; Comorbidity; Cross-Sectional Studies; Female; Health Behavior; Humans; Logistic Models; Male; Marijuana Smoking; Marijuana Use; Myocardial Infarction; Odds Ratio; Prevalence; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; United States; Young Adult

As marijuana is legalized in more states, modes of administration that facilitate co-use with tobacco are growing in popularity among young adults. This study examines the prevalence, patterns, correlates, and reasons for co-use so that targeted interventions can be developed to prevent negative consequences associated with tobacco use and co-use.. In Fall 2019, 1887 young adults, originally recruited in 2010 from 11 colleges in North Carolina and Virginia to participate in a cohort study, completed an online survey. Co-use was defined as self-reported use of marijuana and tobacco in the past month. Tobacco-only, marijuana-only and co-users were compared using regression modeling.. Overall, 9.3% of the sample were co-users, 7.1% tobacco-only, and 15.8% marijuana-only users. Tobacco use was associated with an increased likelihood of marijuana use and vice-versa. Co-users were more likely to use e-cigarettes and blunts to administer marijuana and less likely to use smokeless tobacco products. They were more likely to use cocaine, have less anxiety, and be heavier marijuana users than marijuana-only users. Co-users of e-cigarettes and marijuana were less likely to be daily e-cigarette users and make quit attempts than e-cigarette users that did not use marijuana. Experimentation was the primary reason for co-use of tobacco and marijuana.. Co-users were more likely to use modes of administration that facilitate use of both substances and have patterns of use that may impact cessation efforts. These findings highlight the importance of surveillance of co-use and the development of interventions targeting experimentation with these substances by young adults.

Topics: Cannabis; Cohort Studies; Electronic Nicotine Delivery Systems; Humans; Marijuana Use; Nicotiana; Tobacco Products; Tobacco Use; Young Adult

This study examined past-2-week driving after marijuana use (DMU) and driving after having five or more drinks (D5D) during young adulthood, specifically focusing on associations between within-person change in social roles (living situation, marriage, parenthood, education, employment) and mediators (perceived risk, evenings out, and religiosity) from modal ages 19 to 30.. Multilevel analyses were conducted using survey data collected from 2013 to 2019 from 1,873 adults (1,060 women; total number of data collection waves = 7,037) participating in the longitudinal Monitoring the Future study.. Change across waves from not being married to married was associated with lower DMU likelihood at any particular wave both directly and via mediation through wave-level change in evenings out. Change in employment (not employed to employed full time) was associated with higher D5D likelihood at any particular wave both directly and via mediation through change in evenings out. Wave-level change in other social roles was indirectly associated with DMU/D5D likelihood via wave-level change in evenings out.. Change in all social roles examined was associated with change in evenings out, which appears to be a primary, proximal predictor of young adult DMU/D5D. Improved understanding of how socialization change is associated with driving after substance use may strengthen efforts to reduce the harms associated with such driving behaviors.

Topics: Adult; Alcohol Drinking; Automobile Driving; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Surveys and Questionnaires; Young Adult

Adolescents with bipolar disorder have high rates of cannabis use, and cannabis use is associated with increased symptom severity and treatment resistance in bipolar disorder. Studies have identified anomalous resting-state functional connectivity among reward networks in bipolar disorder and cannabis use independently, but have yet to examine their convergence.. Participants included 134 adolescents, aged 13 to 20 years: 40 with bipolar disorder and lifetime cannabis use, 31 with bipolar disorder and no history of cannabis use, and 63 healthy controls without lifetime cannabis use. We used a seed-to-voxel analysis to assess the restingstate functional connectivity of the amygdala, the nucleus accumbens and the orbitofrontal cortex, regions implicated in bipolar disorder and cannabis use. We used a generalized linear model to explore bivariate correlations for each seed, controlling for age and sex.. We found 3 significant clusters. Resting-state functional connectivity between the left nucleus accumbens seed and the left superior parietal lobe was negative in adolescents with bipolar disorder and no history of cannabis use, and positive in healthy controls. Resting-state functional connectivity between the right orbitofrontal cortex seed and the right lateral occipital cortex was positive in adolescents with bipolar disorder and lifetime cannabis use, and negative in healthy controls and adolescents with bipolar disorder and no history of cannabis use. Resting-state functional connectivity between the right orbitofrontal cortex seed and right occipital pole was positive in adolescents with bipolar disorder and lifetime cannabis use, and negative in adolescents with bipolar disorder and no history of cannabis use.. The study did not include a cannabis-using control group.. This study provides preliminary evidence of cannabis-related differences in functional reward circuits in adolescents with bipolar disorder. Further studies are necessary to evaluate whether the present findings reflect consequences of or predisposition to cannabis use.

Topics: Adolescent; Amygdala; Bipolar Disorder; Cannabis; Female; Humans; Male; Marijuana Use; Neural Pathways; Nucleus Accumbens; Prefrontal Cortex; Rest; Reward

Marijuana is the most common illicit substance globally. The rate of marijuana use is increasing in young adults in the US. The current environment of legalizing marijuana use is further contributing to an increase of users. The purpose of this study was to explore the characteristics of adults who abuse marijuana (20-49 years old) and analyze behavior and social relation variables related to depression and suicide risk using machine-learning algorithms. A total of 698 participants were identified from the 2019 National Survey on Drug Use and Health survey as marijuana dependent in the previous year. Principal Component Analysis and Chi-square were used to select features (variables) and mean imputation method was applied for missing data. Logistic regression, Random Forest, and K-Nearest Neighbor machine-learning algorithms were used to build depression and suicide risk prediction models. The results showed unique characteristics of the group and well-performing prediction models with influential risk variables. Identified risk variables were aligned with previous studies and suggested the development of marijuana abuse prevention programs targeting 20-29 year olds with a regular depression and suicide screening. Further study is suggested for identifying specific barriers to receiving timely treatment for depression and suicide risk.

Topics: Adult; Cannabis; Humans; Machine Learning; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Middle Aged; Young Adult

Topics: Alcohol Drinking; Alcoholic Beverages; Canada; Cannabis; Commerce; COVID-19; Humans; Marijuana Use; Pandemics; SARS-CoV-2

There is mixed evidence that individuals who use cannabis have reduced hippocampal and amygdalar gray matter volume, potentially because of small sample sizes and imprecise morphological characterization. New automated segmentation procedures have improved the measurement of these structures and allow better examination of their subfields, which have been linked to distinct aspects of memory and emotion. The current study applies this new segmentation procedure to the Human Connectome Project Young Adult dataset (N = 1080) to investigate associations of cannabis use with gray matter volume in the hippocampus and amygdala. Results revealed significant bilateral inverse associations of hippocampal volume with recent cannabis use (THC+ urine drug screen; P < .005). Hippocampal subfield analyses indicated these associations were primarily driven by the head of the hippocampus, the first section of the cornu amonis (CA1), the subicular complex, and the molecular layer of the hippocampus. No associations were detected for age of cannabis initiation, the frequency of cannabis use across the lifespan, or the lifetime presence of cannabis use disorder. In one of the largest studies to date, these results support the hypothesis that recent cannabis use is linked to reduced hippocampal volume, but that this effect may dissipate following prolonged abstinence. Furthermore, these results clarify the specific subfields which may be most associated with recent cannabis use.

Topics: Adult; Amygdala; Cannabis; Female; Hippocampus; Humans; Magnetic Resonance Imaging; Male; Marijuana Use; Organ Size; Young Adult

Co-administration of tobacco/nicotine and marijuana (e.g., using both products on the same occasion by mixing them in the same delivery device) is a risky, yet common, form of co-use among young adults. Understanding motivations for co-administration co-use, and how these are associated with subsequent use and related problems, is needed to inform policy, prevention, and intervention efforts. We conducted a latent class analysis on 342 young adults with past-year co-administration of tobacco/nicotine and marijuana to determine how emergent classes of 16 co-use motives were associated with use and co-administration co-use of tobacco/nicotine and marijuana one year later. Four classes emerged: (1) a high all class that reported high endorsement of all motives, (2) a high coping class that reported high endorsement of co-use due to coping with stress and bad moods, (3) a high social/physiological reinforcement class that reported low endorsement of coping but high probability of social and relaxation motives and motives to even out effects of each substance, and (4) a low all class that reported low endorsement of all motives. The high all and high coping classes reported greater frequency and quantity of single substance use and co-administration. The high coping class reported more marijuana consequences than the low all class. The high all and high coping classes reported younger age of initiation of each individual substance and co-administration. Considering co-use motives may be useful in identifying those at highest risk for future use and consequences and tailoring interventions to the distinct needs of co-use subgroups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Topics: Adaptation, Psychological; Adolescent; Cannabis; Female; Humans; Male; Marijuana Use; Motivation; Nicotiana; Nicotine; Smoking; Substance-Related Disorders; Time Factors; Young Adult

Few countries have developed detailed legislative proposals for legalizing cannabis. New Zealand recently released the Cannabis Legalization and Control Bill (CLCB) that will be the subject of a referendum in September 2020.. To assess the CLCB, drawing on emerging evidence from cannabis legalization overseas, public health research on alcohol and tobacco and the attempt to establish a regulated market for 'legal highs' in New Zealand.. The CLCB proposes a strictly regulated commercial cannabis market that resembles the Canadian approach, but notably without on-line sales or regional heterogeneity in retail distribution. The objective of the CLCB of lowering cannabis use over time appears at odds with the largely commercial cannabis sector that will focus on expanding sales. The CLCB includes provision for home cultivation and social benefit operators, but it is not clear what priority these operators will receive. A potency cap of 15% tetrahydrocannabinol (THC) for cannabis plants is included, and this is at the high end of black-market cannabis. The proposed progressive product tax based on THC will be challenging to implement. There is no formal minimum price, but rather discretionary powers to raise the excise if the price drops too much. The CLCB includes a comprehensive ban on advertising, but non-conventional on-line promotion will be difficult to suppress. The central government cannabis authority is tasked with developing local retail outlet policies. We caution against the temptation to employ an interim regulatory regime following a positive referendum result, because a partially regulated market will expose users to health risks and undermine public support.. New Zealand's Cannabis Legalization and Control Bill's objective of reducing cannabis use via a commercial market will be challenging to achieve. The bill could be strengthened with formal minimum pricing, lower potency cap and greater clarity concerning social benefit operators and the role of local government.

Topics: Cannabis; Commerce; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; New Zealand; Public Health; Taxes

Results from previous research are inconsistent regarding the association between socioeconomic status (SES) and cannabis use among adolescents. Since there are risks associated with cannabis use, a social gradient in cannabis use may contribute to reproducing socioeconomic differences in life opportunities. The aim of this study was to assess the association between childhood SES and cannabis use among youth in Sweden.. We used repeated cross-sectional data from three waves (2014-2016) of the Swedish national school survey among 11th graders. The analysis encompassed 9497 individuals in 668 school classes. Childhood SES was measured through parents' highest education, as reported by the students. Cannabis use was measured in terms of lifetime use and frequency of use. Data were analysed using multi-level mixed-effects Poisson regression.. Adolescents with at least 1 parent with university/college education had 17% (incidence rate ratio 1.17, confidence interval 1.05, 1.30) higher risk of lifetime use of cannabis compared with those whose parents had no university/college education, adjusting for sex, SES of the school environment, academic orientation, truancy, risk assessment and parental permissiveness. Among life-time users of cannabis, risk for frequent cannabis use was 28% (incidence rate ratio 0.72, confidence interval 0.53, 0.97) lower for those with at least 1 parent with university or college education.. Childhood SES, in terms of parental education, was associated with cannabis use among Swedish adolescents. Adolescents from families with lower SES were less likely to ever try cannabis, but at higher risk for frequent use.

Topics: Adolescent; Cannabis; Cross-Sectional Studies; Humans; Marijuana Use; Schools; Social Class; Sweden

Sexual minority (SM) young adults have higher rates of substance use than heterosexuals, but little is known about daily use of multiple substances, which confer numerous health risks for this population. Using daily diary data from a smartphone-based study, we examined the associations between sexual identity (i.e., SM vs. heterosexual) and patterns of same-day multiple substance use (i.e., cigarettes and alcohol, cigarettes and cannabis, alcohol and cannabis, and all 3 substances).. Young adult smokers (N = 147, aged 18-26, 51.7% female, 41.5% SM, 40.8% White) reported consecutive daily assessments on substance use over 30 days. We used generalized estimating equations to examine associations between sexual identity and patterns of same-day multiple substance use, controlling for demographic factors and psychological distress.. Of 2,891 daily assessments, 16.7% reported same-day use of cigarettes and alcohol, 18.1% cigarettes and cannabis, 1.5% alcohol and cannabis, and 15.0% use of all 3 substances. SM participants (vs. heterosexuals) had significantly greater odds of reporting days with use of cigarettes and cannabis [Adjusted Odds Ratio (AOR) = 2.05, 95% Confidence Interval (CI) [1.04, 4.01]] and use of all three substances (AOR = 2.79, 95% CI [1.51, 5.14]) than days with single substance use or no use.. These findings warrant tailored interventions addressing multiple substance use among SM young adults and temporally accurate measures of multiple substance use patterns. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Topics: Alcohol Drinking; Cannabis; Ethanol; Female; Gender Identity; Heterosexuality; Humans; Male; Marijuana Use; Sexual and Gender Minorities; Smokers; Smoking; Tobacco Products; Young Adult

Adolescent drinking and cannabis use in Norway declined in the 2000s, and we tested the assumption that psychosocial problems were more strongly related to substance use when the prevalence was quite low (2012/2013) than when it was considerably higher (2002).. Data stemmed from school surveys of almost 20 000 students aged 14-17 years in 2002 and 2012/2013 in the four largest cities in Norway. We assessed how various deviant behaviours and depressive mood were related to past-year measures on any alcohol intoxication, frequent intoxication (6+ times) and any cannabis use, and tested whether the associations varied significantly by survey year.. The prevalence of any intoxication episodes dropped markedly from 2002 (50%) to 2012/2013 (28%), as did the prevalence of frequent intoxication (29% vs. 10%) and any cannabis use (15% vs. 7%). Deviant behaviours and depressive mood were either more closely related to the drinking outcomes in 2012/2013 than in 2002, or the associations showed no temporal change. None of the associations with cannabis use varied significantly by survey year.. The assumption that psychosocial problems correlated more strongly with alcohol and cannabis use in a low-prevalence period (2012/2013) as compared to a high-prevalence period (2002) was partly supported, but only with respect to drinking. The strength of the associations with cannabis use was stable, which may reflect that the proportion reporting any use of the drug was low even in the relatively 'high-prevalence' period.

Topics: Adolescent; Adolescent Behavior; Alcohol Drinking; Alcoholic Intoxication; Cannabis; Humans; Marijuana Use; Norway; Prevalence; Underage Drinking

Policy changes have increased access to cannabis for individuals with little or no prior exposure. Few studies have examined sex differences in cannabis effects among individuals with sporadic cannabis use or for nonsmoked routes of cannabis administration. Data from four double-blind, placebo-controlled studies were pooled to compare the acute pharmacodynamic effects of vaporized and oral cannabis in male (n = 27) and female (n = 23) participants who used cannabis infrequently (no use ≥30 days prior to randomization). Analyses compared peak change-from-baseline scores between male and female participants for subjective drug effects, cognitive/psychomotor performance, cardiovascular effects, and blood concentrations of Δ9-tetrahydrocannabinol (THC) and its primary metabolites (11-OH-THC, THC-COOH) after exposure to placebo cannabis or cannabis containing low-dose (5 or 10 mg) or high-dose THC (20 or 25 mg). Overall, cannabis elicited dose-orderly increases in subjective effects, impairment of cognitive/psychomotor performance, heart rate, and blood cannabinoid concentrations. Females exhibited greater peak blood 11-OH-THC concentrations and reported greater peak subjective ratings of "drug effect" that remained when controlling for body weight. When controlling for both body weight and peak blood cannabinoid concentrations, ratings of "anxious/nervous," "heart racing," and "restless" were significantly higher for females than males. Although additional research is needed to elucidate sex differences in responses to cannabis at a wider range of THC doses, other routes of administration, and products with diverse chemical composition, the current data indicate that public health messaging and clinical decision making around the use of cannabinoids should recommend lower starting doses for females and warnings about acute anxiogenic reactions.

Topics: Administration, Oral; Adolescent; Adult; Cannabinoids; Cannabis; Dose-Response Relationship, Drug; Double-Blind Method; Dronabinol; Female; Heart Rate; Humans; Male; Marijuana Use; Middle Aged; Psychomotor Performance; Sex Characteristics; Volatilization; Young Adult

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Cannabis; Child; Child, Preschool; Emergency Service, Hospital; Food; Humans; Infant; Marijuana Smoking; Marijuana Use; Michigan; Middle Aged; Retrospective Studies; Young Adult

Research indicates a link between adolescent e-cigarette use and combustible tobacco cigarette (CTC) initiation, and recent studies suggest their connection with marijuana uptake. Our 3-year longitudinal cohort study investigated the implications of adolescent, peer, and family e-cigarette use with adolescents' expectations and willingness to initiate CTC use, and subsequent CTC and marijuana use.. Relationships were examined in a secondary analysis of a 3-year longitudinal cohort subsample involving adolescents enrolled in alternative California high schools (N = 1025). Analyses examined responses over three yearly observations. Family, peer, and respondents' e-cigarette use, respondents' positive cigarette expectancies and willingness to use CTCs were assessed in the study's first year (T1). CTC use in the survey's second year (T2) and marijuana use in the third year (T3) were assessed via path analysis.. Respondents reporting at least one family member or peer using e-cigarettes were more likely to use e-cigarettes at T1 than those whose peers/family members did not. They reported more positive expectancies about CTCs and greater willingness to initiate use. These variables predicted CTC use at T2, which directly anticipated marijuana use in the survey's third year (T3), as did adolescents' use of e-cigarettes at T1. All model relations were statistically significant.. Analysis demonstrated the strong association of family members' and peers' behaviors with adolescent e-cigarette use, and the temporal precedence of e-cigarette use with subsequent CTC and marijuana uptake. The predictive implications of e-cigarettes for other dangerous substance use should be examined in future prevention campaigns.. The presented study expands upon existing literature connecting adolescent e-cigarette use and later CTC and marijuana use. The findings indicate the significant implications of exposure to e-cigarette use by parents and peers and demonstrate in a longitudinal 4-year panel survey the direct and indirect predictive implications of e-cigarette use for CTC and marijuana uptake. The research illustrates the utility of programs and campaigns that target peer and family groups to maximize impacts on adolescent willingness to try CTCs, positive expectancies, and possible onset of CTC and marijuana use.

Topics: Adolescent; Adolescent Behavior; Cannabis; Cigarette Smoking; Electronic Nicotine Delivery Systems; Female; Humans; Longitudinal Studies; Male; Marijuana Smoking; Marijuana Use; Nicotiana; Nicotine; Parents; Peer Group; Schools; Substance-Related Disorders; Tobacco Products; Tobacco Use; Vaping

Topics: Alcohol Drinking; Alcoholic Beverages; Cannabis; COVID-19; Humans; Marijuana Use; Public Health; SARS-CoV-2

Measures assessing marijuana-related consequences or problems experienced by young adults have typically been adapted from measures assessing alcohol consequences. These measures may not fully reflect the specific unwanted or perceived "not so good" effects of marijuana that are experienced by young adults. Thus, using these measures may present a gap, which needs to be addressed, given that reports of consequences are often utilized in brief motivational personalized feedback interventions. Data from three different studies of young adults were used to (1) examine self-reported "not so good" effects or consequences of marijuana use among frequent marijuana-using college students (Study 1), (2) create a new version of a marijuana consequences list and compare it to an existing marijuana consequences measure (Study 2), and (3) assess convergent and divergent validity between a finalized Marijuana Consequences Checklist (MCC, 26-items) and marijuana use and risk for cannabis use disorder (Study 3). The most frequently endorsed self-reported effects of marijuana included the impact on eating (the "munchies"), dry mouth, trouble concentrating, and acting foolish or goofy. Higher scores on the MCC were associated with more frequent use and a higher probability of meeting criteria for cannabis use disorder. The MCC represents a range of negative consequences of marijuana use derived from frequent users' own accounts and includes consequences not assessed by other measures. The MCC captures marijuana-specific negative consequences relevant for young adults, which can be incorporated in brief motivational personalized feedback interventions.

Topics: Cannabis; Checklist; Humans; Marijuana Smoking; Marijuana Use; Motivation; Young Adult

In many countries, liberalisation of the legislation regulating the use of cannabis has outpaced rigorous scientific studies, and a growing number of patients presenting for surgery consume cannabis regularly. Research to date suggests that cannabis can impact perioperative outcomes. We present recommendations obtained using a modified Delphi method for the perioperative care of cannabis-using patients. A steering committee was formed and a review of medical literature with respect to perioperative cannabis use was conducted. This was followed by the recruitment of a panel of 17 experts on the care of cannabis-consuming patients. Panellists were blinded to each other's participation and were provided with rater forms exploring the appropriateness of specific perioperative care elements. The completed rater forms were analysed for consensus. The expert panel was then unblinded and met to discuss the rater form analyses. Draft recommendations were then created and returned to the expert panel for further comment. The draft recommendations were also sent to four independent reviewers (a surgeon, a nurse practitioner, and two patients). The collected feedback was used to finalise the recommendations. The major recommendations obtained included emphasising the importance of eliciting a history of cannabis use, quantifying it, and ensuring contact with a cannabis authoriser (if one exists). Recommendations also included the consideration of perioperative cannabis weaning, additional postoperative nausea and vomiting prophylaxis, and additional attention to monitoring and maintaining anaesthetic depth. Postoperative recommendations included anticipating increased postoperative analgesic requirements and maintaining vigilance for cannabis withdrawal syndrome.

Topics: Cannabinoids; Cannabis; Consensus; Delphi Technique; Humans; Intraoperative Complications; Marijuana Use; Perioperative Care; Postoperative Complications; Substance Withdrawal Syndrome

The association between cannabis exposure and working memory impairment and its neural substrates remain unclear. In this cross-sectional observational study, we investigated this by examining the relationship between frequency of exposure to cannabis, working memory performance and regional brain volumes and tested whether lower volumes of cortical and subcortical structures mediate the association between cannabis exposure and working memory deficit using the Human Connectome Project data from 234 individuals with self-reported cannabis exposure and 174 individuals unexposed to cannabis. We tested the relationship between self-reported frequency of cannabis exposure and list-sorting working memory task performance (total number of correct responses), between T1 weighted MRI-derived regional grey-matter volumes and working memory task performance as well as between frequency of cannabis exposure and brain volumes after controlling for potential confounders. Finally, mediation analysis was carried out to test whether deficit in working memory performance associated with cannabis use was mediated by its association with lower grey-matter volume. Participants who reported higher frequency of cannabis use tended to have lower number of correct responses in the list-sorting working memory task and lower bilateral hippocampal volumes. Association between severity of cannabis exposure as indexed by frequency of cannabis use and impairment in working memory was mediated by lower left hippocampal volume in cannabis users. We report evidence in support of the left hippocampus volume-mediated working memory impairment associated with recreational cannabis exposure. Future studies employing prospective longitudinal design are necessary to examine the cause-effect relationships of cannabis exposure on working memory and brain volumes.

Topics: Adolescent; Adult; Cannabis; Cross-Sectional Studies; Female; Gray Matter; Hippocampus; Humans; Magnetic Resonance Imaging; Male; Marijuana Use; Mediation Analysis; Memory Disorders; Memory, Short-Term; Young Adult

We study the effect of recent legalization of recreational marijuana use laws (RMLs) in the United States on new applications and allowances for Social Security Disability Insurance and Supplemental Security Income over the period 2001-2019. We combine administrative caseload data from the Social Security Administration with state policy changes using two-way fixed-effects methods. We find that RML adoption increases applications for both benefits. However, there is no change in allowances post-RML. We provide suggestive evidence that the observed changes in applications post-RML are driven by increases in marijuana misuse and selective migration, and decreases in unemployment.

Topics: Cannabis; Cross-Sectional Studies; Humans; Legislation, Drug; Marijuana Use; Unemployment; United States

Alcohol and marijuana/cannabis are frequently used simultaneously (i.e., SAM use). SAM use is complex, and the ways in which alcohol and cannabis are simultaneously used may reveal differential effects. The purpose of this study was to examine day-level effects of distinct alcohol and cannabis product combinations on simultaneous use and consequences on that day.. College student SAM users (N = 274; 50% women; M. Using multiple products (≥2) of alcohol was consistently linked to higher odds of experiencing a negative consequence. Combining beer with only one cannabis product (leaf or concentrate) was consistently associated with lower odds of a consequence. Combining cannabis with multiple alcohol products was associated with heavier alcohol consumption. Using dual cannabis products also was associated with heavier cannabis consumption, but this pattern was not significantly different than using concentrate only on a given day.. This is the first study to examine day-level influences of distinct alcohol and cannabis product combinations on consumption and consequences among young adult SAM users. Findings suggest that mixing alcohol products confers greater risk for negative consequences and heavier consumption, whereas there is little difference in cannabis consumption when using concentrate only vs. 2 cannabis products on a given day, except for concentrate + beer. Our findings support existing protective strategies of not mixing alcohol products and avoiding use of cannabis concentrate for SAM use as well.

Topics: Adolescent; Alcohol Drinking in College; Beer; Cannabis; Female; Humans; Male; Marijuana Use; Surveys and Questionnaires; Underage Drinking; Young Adult

To assess whether frequency of marijuana and alcohol use are cross-sectionally associated with indicators of social and emotional well-being including loneliness, psychological distress, and flourishing across important life domains among young adults.. The study sample included 562 participants ages 22-29 who were originally recruited from an urban Pacific Northwest region in the US as part of a longitudinal study of social role transitions and alcohol use. At one assessment, participants completed an online survey that included a 3-item measure of loneliness, a 4-item measure of depression and anxiety symptoms, and a 12-item measure of flourishing as well as measures of marijuana and alcohol use frequency. Linear and generalized linear models were used to estimate associations of marijuana and alcohol use frequency with indicators of well-being.. Greater frequency of marijuana use was associated with higher levels of loneliness, higher levels of psychological distress, and lower levels of flourishing, with the greatest difference observed for daily marijuana users compared to non-users. However, these indicators of well-being did not significantly differ by levels of alcohol use frequency.. Study findings suggest that frequent users of marijuana, but not alcohol, may experience more loneliness, more psychological distress, and less flourishing. Intervention approaches for frequent marijuana users may be warranted to reduce impacts of loneliness and psychological distress and improve overall well-being.

Topics: Adolescent; Adult; Alcohol Drinking; Anxiety; Cannabis; Emotions; Female; Humans; Loneliness; Longitudinal Studies; Male; Marijuana Smoking; Marijuana Use; Mental Health; Northwestern United States; Psychological Distress; Surveys and Questionnaires; Young Adult

A common concern surrounding increasingly permissive marijuana policies in the US is that they will lead to more dangerous behavior, including driving after marijuana use. Although there is considerable research on the effects of marijuana policies on behaviours, few studies have examined self-reported driving after marijuana use. In this study, we use data from the Traffic Safety Culture Index (TSCI) to model self-reported past-year driving after marijuana use in association with medical and recreational marijuana policies.. We analysed individual responses to annual administrations of TSCI from years 2013-2017 using a multiple logistic regression model. Our outcome variable was self-reported past-year driving after marijuana use (at least once vs. never), and our primary explanatory variable was the respondents' state medical marijuana (MM) and recreational marijuana (RM) policy. Additional explanatory variables include policies that specify thresholds for marijuana-intoxicated driving, year, and demographic factors.. Drivers in states that legalized MM but not RM had marginally higher odds of self-reporting driving after marijuana use compared to drivers in states where both RM and MM were illegal (adjusted OR 1.29; 95% CI 0.98, 1.70; p = 0.075). However, we found little evidence that drivers in states that legalized both RM and MM had higher odds of driving after marijuana use compared to drivers in states where both RM and MM were illegal (adjusted OR 1.06; 95% CI 0.71, 1.56; p = 0.784). Per-se or THC threshold laws were associated with lower self-reported driving after marijuana use (adjusted OR 0.74; 95% CI 0.57, 0.95; p = 0.018).. Although we found some evidence of an association between MM legalization and self-reported driving after marijuana use, our results provide only mixed support for the hypothesis that permissive marijuana policies are associated with higher odds of self-reported driving after marijuana use.

Topics: Cannabis; Humans; Marijuana Smoking; Marijuana Use; Medical Marijuana; Policy; Self Report; United States

Vaping has become an increasingly common mode of administration for marijuana among youth, but there are limited data on its prevalence. There is a need to better understand youth prevalence of past 30-day marijuana vaping and its predictors.. Data were from a nationally representative sample of students from the Monitoring the Future survey in 2018 (N=9,131). This study examined past 30-day prevalence of marijuana vaping, and for a subset with complete data (n=5,755), the predictors of marijuana vaping among respondents asked about that behavior. Bivariate chi-square tests and multivariable logistic regression estimated the extent to which various factors were associated with marijuana vaping. These factors included the current use of various substances, school-related risk behaviors, attitude and risk behaviors related to substance use, and selected sociodemographic variables.. Past 30-day prevalence of marijuana vaping was higher among 10th graders, male youth, and those in the Other race/ethnicity category. Students who engaged in current past 30-day alcohol use, cigarette use, binge drinking, and nonmedical use of prescription drugs had significantly greater odds of past 30-day marijuana vaping. Past 30-day use was more common among students with a lower perceived risk of marijuana use, those who claimed that it was easy to obtain a vaporizer or marijuana, students with a lower grade point average, and those with recent truancy.. Past 30-day marijuana vaping is prevalent among U.S. students, and there are robust associations between use and school- and substance-related risk behaviors. These results suggest that the emergence of vaping products might redefine populations at risk, which should be taken into account by marijuana regulatory policies or prevention programs.

Topics: Adolescent; Adolescent Behavior; Cannabis; Humans; Male; Marijuana Smoking; Marijuana Use; Prevalence; Vaping

Since conduct problems (CP) vary distinctly across youths, better subtyping CP may be an important vehicle to study specific risk factors associated to differential patterns of CP. In a sample of 63,196 adolescents, we employed a two-step method to the identify such CP patterns and to help classify youths based on several sociodemographic and psychopathological risk factors associated with CP.. K-means clustering methods were first used to reduce the heterogeneity of CP by analyzing patterns of aggressive (AGG) and rule-breaking (RB) behaviors. A multi-class Classification and Regression Tree approach was further employed to examine the hierarchical interactions between risk factors specific to the emergence of different CP patterns.. Results revealed a three-cluster solution: (i) Low AGG-RB, (ii) High AGG and low RB, and (iii) High AGG-RB. The frequency of cannabis use, level of victimization and hyperactivity symptoms were the three factors best discriminating youths' membership to distinct patterns of CP. The model displayed a moderate to strong discriminatory capacity.. Although this study provides evidence of key factors that may increase the risk of youths following specific patterns of disruptive behavior, additional research is necessary to clarify the etiology, longitudinal trajectories and outcomes related to these patterns.

Topics: Adolescent; Aggression; Bullying; Cannabis; Crime Victims; Humans; Juvenile Delinquency; Male; Marijuana Use; Schools; Students; Substance-Related Disorders

Previous research links cigarette use and marijuana use in adolescence with the use of other illicit substances. Limited research, however, has explored whether vaping nicotine and marijuana, along with using these substances through multiple modes of delivery (traditional cigarette/marijuana use and vaping) is associated with the use of other illicit substances in adolescence.. This study addresses this gap in the literature by employing negative binomial regression to examine the relationships between three categories of nicotine users (traditional cigarettes only, nicotine vaping only, and dual mode nicotine use), three categories of marijuana users (traditional marijuana use only, marijuana vaping only, and dual mode marijuana use), and the use of other illicit substances in a sample of Florida middle school and high school students.. Our findings reveal that nicotine vaping and dual mode use of both nicotine and marijuana are associated with the use of a greater variety of illicit substances compared to non-users.. In conclusion, our findings suggest that dual mode use of nicotine and marijuana are associated with greater likelihood of using other illicit substances. The implications of these findings for future research are discussed.

Topics: Adolescent; Cannabis; Electronic Nicotine Delivery Systems; Female; Florida; Hallucinogens; Humans; Male; Marijuana Smoking; Marijuana Use; Nicotine; Schools; Students; Substance-Related Disorders; Tobacco Use; Vaping

American Indian (AI) adolescents report high rates of marijuana use and related consequences and availability of marijuana has a robust relationship with marijuana use. The purpose of the present study was to examine the role of perceptions of approval (i.e., injunctive norms), and acceptability (i.e., descriptive norms and perceived harm) in the relationship between marijuana availability and marijuana use.. Data collected from 2009 to 2013 included 3498 AI 7th-12th graders residing on or near a reservation (47.8 % female). Multilevel mediation analyses were conducted using the MLmed macro in IBM SPSS v26.0 to account for the nesting of data within schools.. The associations between marijuana availability and perceived risks (b=-.38, p < .001), descriptive norms (b = .80, p < .001), and injunctive norms related to marijuana use (b=-.24, p < .001), were significant. The associations between perceived risks (b=-.27, p < .001), descriptive norms (b = .14, p < .001), and injunctive norms (b=-.18, p < .001) and marijuana use were also significant. The indirect effects of marijuana availability on marijuana use through the pathways of perceived risks (b = .10, p < .001, 95 %CI[.08, .12]), descriptive norms (b = .11, p < .001, 95 %CI[.09, .14]), and injunctive norms related to marijuana use (b = .04, p < .001, 95 %CI[.03, .06]) were significant. The direct effect linking marijuana availability to marijuana use remained significant (b = .28, p < .001) but decreased by 37.8 %. when controlling for perceived risks, descriptive norms, and injunctive norms related to marijuana use.. Interventions aiming to reduce AI adolescent marijuana use should focus on availability and may also be well served by targeting descriptive and injunctive norms, as well as perceived risks of marijuana use.

Topics: Adolescent; American Indian or Alaska Native; Cannabis; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Schools; Social Norms; Students; Substance-Related Disorders

Topics: Administration, Inhalation; Adolescent; Cannabinoids; Cannabis; Cross-Sectional Studies; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Prevalence; Substance-Related Disorders; Surveys and Questionnaires; United States; Vaping

Topics: Adolescent; Cannabis; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; Oregon

While no European country has legalized recreational use of cannabis, several countries, but not Sweden, have decriminalized it. Although we hitherto have a relatively low prevalence of users compared to other countries, Swedish policy is criticized. Strong voices advocate legalization. It is hypothesized that a legalization would minimize adolescent access, ensure quality control, make consumption safer and raise tax revenue. Furthermore, it is assumed to diminish the illicit drug market and drug related crimes. However, the legalization in the US and Canada has instead made cannabis more available to users by innovative marketing and product development, while the illegal market persists. Meanwhile the price of cannabis decreases and potency, which are related to many of the risks, increases. Cannabis-related harms include e.g. cognitive impairment, psychosis and psychosocial problems. The long-term effects from legalization is yet to be seen.

Topics: Adolescent; Canada; Cannabis; Europe; Humans; Legislation, Drug; Marijuana Use; Sweden

Despite medicalization and legalization of marijuana use, factors influencing demand for marijuana among persons living with HIV (PLWH) are incompletely understood. This knowledge gap undermines effective clinical management and policies. This study used demand curve simulation methods to address these issues.. Marijuana-using PLWH (N = 119) completed experimental tasks to simulate amount of marijuana purchasing/use across different costs (money or time), and likelihood of reselling marijuana or marijuana therapeutic-use registration card in relation to profits. Additional simulations assessed purchasing of marijuana relative to other drug and non-drug goods.. Simulated marijuana use decreased as money and time costs increased. Consumption was greater for participants with more severe Cannabis Use Disorder (CUD) and anxiety, intermediate pain levels, and past 90-day opioid use. Whereas few participants chose to sell their registration card, marijuana resale (diversion) steeply increased with profit. Likelihood of seeking marijuana therapeutic-use certification decreased in relation to registration card money cost, having to visit more physicians to get a signature, and delay to receiving the card, and increased with duration of certification. Participants who reported recent opioid use were more likely to seek certification. Consumption of several commodities assessed was independent of marijuana.. Simulated marijuana use was related to participants' clinical profile (CUD, anxiety and pain symptoms, recent opioid use), and unrelated to purchasing other goods. Likelihood of seeking marijuana therapeutic-use registration was affected by several types of costs and recent opioid use. Participants were unlikely to divert registration cards. We discuss clinical and policy implications of these findings.

Topics: Adult; Anxiety; Cannabis; Female; Hallucinogens; HIV Infections; Humans; Male; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Medical Marijuana; Opioid-Related Disorders; Pain; Surveys and Questionnaires

Research on prenatal cannabis use and adverse infant outcomes is inconsistent, and findings vary by frequency of use or cigarette use. We assess (1) the prevalence of high frequency (≥once/week), low frequency (

Topics: Adult; Cannabis; Cigarette Smoking; Cross-Sectional Studies; Female; Health Behavior; Humans; Infant, Newborn; Infant, Small for Gestational Age; Marijuana Use; Pregnancy; Premature Birth; Prevalence; Risk Assessment; Tobacco Products; United States; Young Adult

The treatment of myotonic dystrophy type 1 (DM1) focuses on reducing symptom burden. However, since medication often fails to produce satisfying symptom relief, some patients seek alternatives, such as cannabis, to help reduce some of these symptoms. The aim of this study was to provide an accurate profile of cannabis use among DM1 patients. Phone interviews were conducted to identify current and former users, and to assess reasons for cannabis use. Characteristics of cannabis use were also investigated. Briefly, among the 72 study participants, 22.2% currently used cannabis and a majority of them (56.9%) reported using it to relieve symptoms associated with DM1. These users, classified as therapeutic users, reported poorer health status (EQ-5D index scores: 0.532±0.230 vs. 0.823±0.208, p = 0.020; EQ-VAS scale 50.56±10.74 vs. 75.57±21.50, p = 0.009) than non-therapeutic users. Finally, differences among sex were also highlighted. While the therapeutic effects of cannabis were not explored in our study, our results support the potential role of cannabis and cannabinoids in the treatment of DM1-associated symptoms which will need to be thoroughly investigated.

Topics: Adult; Canada; Cannabis; Female; Humans; Male; Marijuana Use; Middle Aged; Myotonic Dystrophy; Pilot Projects; Surveys and Questionnaires

Topics: Adult; Cannabis; Female; Humans; Marijuana Use; Pregnancy; Pregnancy Complications; United States

Research suggests African American men use cannabis to cope with racial discrimination. This conjecture may also be true for incarcerated African American men, who report high rates of cannabis use prior to and after incarceration. However, no studies to date have examined the association between race-related stress and chronic cannabis use among incarcerated African American men. As this population encounters pervasive negative cultural stereotypes and devaluation from larger society, cultural race-related stress may predict cannabis use among this population. Therefore, the purpose of this brief report was to examine the relationship between cultural race-related stress and years of regular cannabis use among a sample of incarcerated African American men.. Study staff completed interviews with N = 177 African American men nearing release from four prisons in Kentucky. The interviews focused on mental health, drug use, and HIV risk behaviors. Participants provided their demographics (e.g., age, years of education, and length of incarceration), self-reported their years of regular cannabis use (3 times or more per week), and completed the Brief Index of Race-Related Stress (IRRS-B; Utsey, Measurement & Evaluation in Counseling & Development, 1999, 32, 149).. Multivariate regression analyses demonstrated cultural race-related stress was significant and positively associated with the number of years of regular cannabis use (p = .003) among this population.. This finding has implications for culturally tailored substance abuse treatment, specifically for cannabis use, with African American men upon their community re-entry from prison. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Topics: Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Black or African American; Cannabis; HIV Infections; Humans; Kentucky; Male; Marijuana Use; Mental Health; Middle Aged; Prisoners; Prisons; Racism; Young Adult

Legal limits on the amount of cannabis sold per transaction in states with recreational cannabis may promote moderate use and limit diversion. However, state sales limits are heterogeneous and difficult to interpret in terms of tetrahydrocannabinol dose equivalents.. This cross-sectional study examined how transaction sales limits on recreational cannabis translate to tetrahydrocannabinol doses among U.S. states allowing commercial cannabis sales as of January 1, 2020. Weight-based quantity limits by cannabis type (flower/bud, concentrates, and edibles) were converted into grams of tetrahydrocannabinol content per transaction using known potency values in 2020.. Weight-based sales limits for flower and concentrate vary considerably across states (range=1.0-2.5 oz for flower and 3.5-15.0 g for concentrate), whereas limits for edible cannabis are heterogeneous. A total of 4 states have independent limits for each product category, and 6 states place limits across all products sold in the transaction. Because no states impose limits on the potency of flower or concentrates, the small differences in the weight-based limits translate into large differences in grams of tetrahydrocannabinol allowed to be sold. Assuming a typical dose of 10 mg of tetrahydrocannabinol, current laws allow for sales of up to 560 (Alaska) to 2,283 (Michigan) doses per transaction on the basis of median product potencies.. All states allow a large number of tetrahydrocannabinol doses per transaction, larger than what is typically consumed by daily users over a month. States concerned about public health and diversion should consider reducing sales limits and basing them on total tetrahydrocannabinol content across all purchased products.

Topics: Alaska; Cannabis; Cross-Sectional Studies; Humans; Marijuana Use; Michigan

Using data from Truven Health MarketScan Commercial Claims and Encounters Database between 2009 and 2015, we studied the effects of medical and recreational marijuana laws on opioid prescribing in employer-sponsored health insurance. We used a differences-in-differences (DD) approach and found that the implementation of medical marijuana laws (MMLs) and recreational marijuana laws (RMLs) reduced morphine milligram equivalents per enrollee by 7% and 13%, respectively. The reduction associated with MMLs was predominately in people aged 55-64, whereas the reduction associated with RMLs was largely in people aged 35-44 and aged 45-54. Our findings suggest that both MMLs and RMLs have the potential to reduce opioid prescribing in the privately insured population, especially for the middle-aged population.

Topics: Adult; Analgesics, Opioid; Cannabis; Humans; Insurance, Health; Marijuana Use; Medical Marijuana; Middle Aged; Practice Patterns, Physicians'; United States

Topics: Adult; California; Cannabis; Female; Humans; Legislation, Drug; Marijuana Use; Pregnancy

Cannabidiol (CBD) is purportedly a promising therapeutic agent to provide relief for a variety of medical conditions with mild or no psychoactive effects. However, little is known about young adults who use cannabis and CBD-dominant products, and associations between CBD use and other drug use.. Young adults (aged 24-32) who currently used cannabis (n = 239) were surveyed in Los Angeles in March 2019 through March 2020. The sample was divided into CBD-dominant (at least 1:1 CBD:THC ratio) and THC-dominant product users. We described CBD forms, reasons and conditions for CBD use and examined between-group differences in sociodemographic characteristics, cannabis practices, health and other drug use.. CBD-dominant users were more likely to be female, use cannabis at lower frequency and amount (except for edible/drinkable/oral products), self-report medical motivation for cannabis use, use cannabis for pain and report more health problems. Oil, flower, topicals and sprays/drops/tinctures were the most prevalent CBD forms. Psychological problems and pain were commonly reported conditions and medical reasons for CBD use. CBD-dominant users were more likely to report illicit drug use, where psilocybin use was markedly different between the two groups.. CBD use was associated with health histories and motivations linked to pain and psychological problems. Positive association between CBD use and illicit drug use may indicate self-medication for psychological conditions. Future studies should evaluate the effectiveness of various CBD forms and dose regimens for treatment of pain and psychological problems, and as a potential intervention for decreasing other drug use and associated harms.

Topics: Adolescent; Adult; Cannabidiol; Cannabis; Cohort Studies; Dronabinol; Female; Hallucinogens; Humans; Longitudinal Studies; Los Angeles; Male; Marijuana Use; Pain; Self Report; Substance-Related Disorders; Young Adult

Several studies have investigated the relationship between personality and psychoactive substance use. Researches of personality and marijuana use suggests that certain personality traits differentiate between occasional and regular marijuana consumers. Understanding the relationship between individual persona - lity traits and marijuana use is a key step in the development of prevention and treatment methods. In the current study, we present the development of emotion regulation difficulties, coping with stress, impulsivity, external-internal control and sensation seeking in occasional and regular marijuana users.. 322 people participated in our study, within this 51 occasional and 56 regular marijuana users and 215 non-marijuana users who formed the control group. The examined personality traits were measured with the Diffi - culties in Emotion Regulation Scale, the Coping Inventory for Stressful Situations, the Barratt Impulsiveness Scale, the Internal-External Locus of Control Scale and the Sensation Seeking Scale.. Varying levels of marijuana use increased difficulty in emotion regulation as well as impulsivity. Addi tio nally, the use of emotion-oriented coping strategies were most common in occasional and regular marijuana use. Regular marijuana users were more likely to have external control than occasional users. Non-marijuana users were less sen - sation seekers that the two groups of marijuana users, however, we did not find significant difference between occasio nal and regular users.

Topics: Adaptation, Psychological; Cannabis; Emotional Regulation; Humans; Impulsive Behavior; Internal-External Control; Marijuana Use; Personality; Sensation; Stress, Psychological

As decriminalization, increased access, and decreased perception of risk spurs the popularity of medical and recreational marijuana, more information is needed on possible links between marijuana use and social determinants of health. The goal of this study was to assess the relationships between marijuana use and exercise. Data sources included the two most recent waves of the National Longitudinal Study of Adolescent to Adult Health (Wave IV, 2008-2009; N = 14,784 and Wave V, 2016-2018; N = 12,043). The exercise variables included any form of exercise/sport during the past 7 days and the number of days participating in each of 7 types of exercise/sport. Marijuana-use variables comprised any current use and frequency of use during the past 30 days. Both fixed-effects and random-effects models were estimated with numerous control variables, along with binary and count measures of exercise. Results show that, particularly for fixed-effects models, marijuana use is not significantly related to exercise, counter to conventional wisdom that marijuana users are less likely to be active. Indeed, the only significant estimates suggest a positive relationship, even among heavier users during the past 30 days. These findings are at odds with much of the existing literature, which generally shows a negative relationship between marijuana use and exercise. As additional states legalize the medicinal and recreational use of marijuana, perhaps its impact on exercise, one of the leading social determinants of health, is not necessarily a primary concern.

Topics: Adolescent; Adult; Cannabis; Humans; Longitudinal Studies; Marijuana Smoking; Marijuana Use; Middle Aged; Substance-Related Disorders; United States

State cannabis laws are changing rapidly. Research is inconclusive about their association with rates of self-harm and assault. Existing studies have not considered variations in cannabis commercialization across states over time.. To evaluate the association of state medical and recreational cannabis laws with self-harm and assault, overall and by age and sex, while considering varying degrees of commercialization.. Using a cohort design with panel fixed-effects analysis, within-state changes in claims for self-harm and assault injuries before and after changes in cannabis laws were quantified in all 50 US states and the District of Columbia. Comprehensive claims data on commercial and Medicare Advantage health plan beneficiaries from January 1, 2003, to December 31, 2017, grouped by state and month, were evaluated. Data analysis was conducted from January 31, 2020, to January 21, 2021.. Categorical variable that indexed the degree of cannabis legalization in each state and month based on law type (medical or recreational) and operational status of dispensaries (commercialization).. Claims for self-harm and assault injuries based on International Classification of Diseases codes.. The analysis included 75 395 344 beneficiaries (mean [SD] age, 47 [22] years; 50% female; and median follow-up, 17 months [interquartile range, 8-36 months]). During the study period, 29 states permitted use of medical cannabis and 11 permitted recreational cannabis. Point estimates for populationwide rates of self-harm and assault injuries were higher in states legalizing recreational cannabis compared with states with no cannabis laws, but these results were not statistically significant (adjusted rate ratio [aRR] assault, recreational dispensaries: 1.27; 95% CI, 0.79-2.03;self-harm, recreational dispensaries aRR: 1.15; 95% CI, 0.89-1.50). Results varied by age and sex with no associations found except for states with recreational policies and self-harm among males younger than 40 years (aRR <21 years, recreational without dispensaries: 1.70; 95% CI, 1.11-2.61; aRR aged 21-39 years, recreational dispensaries: 1.46; 95% CI, 1.01-2.12). Medical cannabis was generally not associated with self-harm or assault injuries populationwide or among age and sex subgroups.. Recreational cannabis legalization appears to be associated with relative increases in rates of claims for self-harm among male health plan beneficiaries younger than 40 years. There was no association between cannabis legalization and self-harm or assault, for any other age and sex group or for medical cannabis. States that legalize but still constrain commercialization may be better positioned to protect younger male populations from unintended harms.

Topics: Cannabis; Female; Follow-Up Studies; Humans; Incidence; Legislation, Drug; Male; Marijuana Use; Middle Aged; Retrospective Studies; Self-Injurious Behavior; United States

The objective of this study was to test indirect effects of the Marijuana e-CHECKUP TO GO program on college students' frequent marijuana use through decreased use in specific social and academic activities. This study randomly assigned college students who reported frequent marijuana use (i.e., approximately five times per week) in fall 2016 to receive Marijuana e-CHECKUP TO GO or healthy stress management (HSM) strategies. The final baseline sample included 298 participants. Path analyses tested direct program effects on marijuana use at six-week posttest, as well as the indirect effect via use within four activities frequently participated in by college students: socializing, being physically active, studying, and being in class. Direct Marijuana e-CHECKUP TO GO effects on reductions in frequent use were transmitted by decreased marijuana use while studying and no use while socializing, being physically active, or in class. Marijuana e-CHECKUP TO GO may be most effective at reducing use of marijuana among college students while studying.

Topics: Cannabis; Humans; Marijuana Smoking; Marijuana Use; Students; Universities

Observational studies have linked cannabis use to an array of negative outcomes, including psychiatric symptoms, cognitive impairment, and educational and occupational underachievement. These associations are particularly strong when cannabis use occurs in adolescence. Nevertheless, causality remains unclear. The purpose of the present study was thus to examine associations between prospectively assessed adolescent cannabis use and young-adult outcomes (psychiatric, cognitive, and socioeconomic) in three longitudinal studies of twins (

Topics: Adolescent; Adult; Cannabis; Child; Cognition; Educational Status; Employment; Humans; Longitudinal Studies; Marijuana Use; Mental Disorders; Minnesota; Young Adult

Topics: Adult; Cannabidiol; Cannabinoids; Cannabis; Cohort Studies; Dronabinol; Female; Humans; Male; Marijuana Use; Massachusetts; Medical Marijuana; Middle Aged

Utilizing the Consumer Expenditure Interview Survey from 2005 to 2019, I study spending on food and alcohol following recreational marijuana law (RML). Exploiting differences in the timing of the passage of RMLs and employing two-way fixed-effects methods, I find that households located in states adopting these laws increase their quarterly spending on food, which is driven mainly by spending on food consumed away from home. Legalization of recreational marijuana also leads to increased quarterly spending on alcohol. These findings suggest a complementarity between food, alcohol, and marijuana.

Topics: Cannabis; Family Characteristics; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use

Topics: Cannabis; Chicago; Humans; Marijuana Smoking; Marijuana Use; Sexual and Gender Minorities

Topics: Aged; Cannabis; Consumer Behavior; Facilities and Services Utilization; Female; Health Status; Health Surveys; Humans; Male; Marijuana Use; Medical Marijuana; Middle Aged; United States

Young adults who engage in simultaneous alcohol and marijuana (SAM) use may be more likely to engage in unsafe behaviors including riding with impaired drivers and driving after alcohol and/or marijuana use.. Young adult SAM users (N = 408) self-reported their behavior for five 14-day bursts, yielding daily-level responses on a total of 14,675 substance use days. Adjusted odds ratios (AOR) estimated the likelihood of riding with an impaired driver and of driving after use on SAM use days compared to alcohol- or marijuana-only use days.. More frequent SAM users were more likely to ride with an impaired driver and to drive after use than less frequent SAM users (between-persons). On SAM use days, there were greater odds of riding with an impaired driver, compared to alcohol-only days (AOR = 1.28) and marijuana-only days (AOR = 2.22), and of driving after use, compared to marijuana-only days (AOR = 1.25). Driving after use was more likely on days with non-simultaneous alcohol and marijuana use compared to SAM use (AOR = 1.59).. Riding with an impaired driver is common among young adult substance users, and more likely following simultaneous use of alcohol and marijuana compared to other types of alcohol and marijuana use. Driving after use is more likely after SAM use than marijuana-only use days, but most likely on days when both alcohol and marijuana were used but not simultaneously. Future research on situation-level predictors of riding and driving-related risks among young adults is warranted.

Topics: Alcohol Drinking; Automobile Driving; Cannabis; Ethanol; Humans; Marijuana Use; Young Adult

Understanding the nature of the association between cannabis and alcohol use within individuals over time in the era of legalized cannabis is of crucial importance for assessing the public health consequences of increasing cannabis use. An important unanswered question is whether cannabis and alcohol use substitute for one another. Specifically, is greater use of one substance associated with less use of the other substance (i.e., a negative association) or are the substances complementary and their association positive?. We used 24 consecutive months of data on a young adult sample (n = 774; 56% female, age 18-25 during the study) who drank alcohol in the year prior to enrollment. The sample was recruited in Washington State in 2015/2016 (after legalization of nonmedical cannabis) using media advertisements and community flyers and outreach. Using parallel process latent growth curve models, we assessed three types of association between cannabis and alcohol use across the 24-month period: (1) an association between average levels of cannabis and alcohol use; (2) an association between rates of change in cannabis and alcohol use; and (3) correlations between shorter-term deviations/fluctuations off of longer-term trajectories of level and change in cannabis and alcohol use.. We found a positive association between the average frequency of cannabis and alcohol use; individuals who used cannabis more frequently on average also drank alcohol more frequently on average. Change over time in cannabis use was positively associated with change in alcohol use. There was also a contemporaneous positive association between fluctuations in cannabis and alcohol use.. Overall, we found no evidence of substitution. Rather, the results suggest a complementary relationship between cannabis and alcohol use, such that the use of cannabis and alcohol rises and falls together.

Topics: Adolescent; Alcohol Drinking; Cannabis; Ethnicity; Female; Humans; Legislation, Drug; Longitudinal Studies; Male; Marijuana Use; Washington; Young Adult

Topics: Adolescent; Adult; Cannabis; Emergency Service, Hospital; Female; Humans; Male; Marijuana Abuse; Marijuana Use; Michigan; Retrospective Studies; Syndrome; Vomiting; Young Adult

Perceptions of risk of using marijuana have decreased significantly in the US over the last decade, while marijuana use has increased. In order to educate people on the risks associated with marijuana use, large-scale health messaging campaigns have been deployed to educate the public about the risks associated with marijuana use, particularly in states where medical or recreational marijuana is legal. Few studies have examined how messages about marijuana affect the audiences' cognitive and emotional responsivity to these messages.. To address this knowledge gap, this study used psychophysiological assessment (heart rate, skin conductance, facial action coding) and self-report measures to explore the impact of different marijuana risk messages on real-time cognitive and affective responses and self-reported message receptivity, likeability, and intentions to use marijuana in a sample of 50 young adult marijuana users and non-users. Each participant saw six messages. Three messages were used from each of two campaigns, representing one of three risks (cognitive ability, driving, health harms).. Psychophysiological responses showed that the driving-themed messages for both campaigns had the greatest cognitive resource allocation to encoding the message, the greatest arousal, and the most positive emotional response, regardless of user status. Self-reports showed a less consistent pattern.. Overall, psychophysiological measures provided a more consistent picture of message processing and effects than self-report measures. Findings from this study provide immediately useful data for improving the development and effectiveness of marijuana health-risk prevention campaigns by elucidating cognitive and emotional processes that could be targeted in future programs.

Topics: Cannabis; Cognition; Health Promotion; Humans; Marijuana Smoking; Marijuana Use; Text Messaging; Young Adult

Topics: Cannabis; Humans; Marijuana Use; Time Perception

Brain activity linked with error processing has rarely been examined among persons living with HIV (PLWH) despite importance for monitoring and modifying behaviors that could lead to adverse health outcomes (e.g., medication non-adherence, drug use, risky sexual practices). Given that cannabis (CB) use is prevalent among PLWH and impacts error processing, we assessed the influence of HIV serostatus and chronic CB use on error-related brain activity while also considering associated implications for everyday functioning and clinically-relevant disease management behaviors.. A sample of 109 participants, stratified into four groups by HIV and CB (HIV+/CB+, n = 32; HIV+/CB-, n = 27; HIV-/CB+, n = 28; HIV-/CB-, n = 22), underwent fMRI scanning while completing a modified Go/NoGo paradigm called the Error Awareness Task (EAT). Participants also completed a battery of well-validated instruments including a subjective report of everyday cognitive failures and an objective measure of medication management abilities.. Across all participants, we observed expected error-related anterior insula (aI) activation which correlated with better task performance (i.e., less errors) and, among HIV- participants, fewer self-reported cognitive failures. Regarding awareness, greater insula activation as well as greater posterior cingulate cortex (PCC) deactivation were notably linked with aware (vs. unaware) errors. Regarding group effects, unlike HIV- participants, PLWH displayed a lack of error-related deactivation in two default mode network (DMN) regions (i.e., PCC, medial prefrontal cortex [mPFC]). No CB main or interaction effects were detected. Across all participants, reduced error-related PCC deactivation correlated with reduced medication management abilities and PCC deactivation mediated the effect of HIV on such abilities. More lifetime CB use was linked with reduced error-related mPFC deactivation among HIV- participants and poorer medication management across CB users.. These results demonstrate that insufficient error-related DMN suppression linked with HIV infection, as well as chronic CB use among HIV- participants, has real-world consequences for medication management behaviors. We speculate that insufficient DMN suppression may reflect an inability to disengage task irrelevant mental operations, ultimately hindering error monitoring and behavior modification.

Topics: Adult; Awareness; Brain; Cannabis; Default Mode Network; Disease Management; Female; Gyrus Cinguli; HIV Infections; Humans; Magnetic Resonance Imaging; Male; Marijuana Use; Medication Adherence; Neuropsychological Tests; Prefrontal Cortex; Task Performance and Analysis

A referendum on the Cannabis Legalisation and Control Bill was held in New Zealand. The Bill was meant to oversee government control over the production, supply and use of cannabis and reduce cannabis-related harm. Public health control was proposed over cannabis market by imposing licenses and cultivation, the quality and strength of marketed cannabis, and sale restrictions. Under this Bill, cannabis was only meant to be available to adults aged over 20 years through licenced stores. The potency of cannabis was to be limited. Cannabis use and was going to be permitted in private homes and specifically licensed premises. The Electoral Commission announced on 6 November 2020 that 50.7% of voters opposed the Bill and 48.4% supported it. Despite the outcome of the referendum, legalisation of cannabis may remain a live issue for many people, and doctors need to have an informed view about the impact of legalisation on mental health conditions. Experience from other countries shows that access to and potency of cannabis increased with legalisation. Despite the intent to prevent harm, cannabis legislation has been associated with adverse effects on mental health, emergency hospital presentations and crime. Public health strategies, including educating public about harm associated with cannabis, surveillance of potency and labelling, increasing minimal age for legal recreational cannabis use and bolstering treatment capacity for problematic cannabis use, including those with psychiatric disorders, should be funded by revenue generated from cannabis legislation.

Topics: Attitude of Health Personnel; Cannabis; Commerce; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; Mental Health; New Zealand; Public Health

Marijuana is the most commonly used illicit drug in the United States; yet, little is known about why adults use it. We examined the prevalence of past-month marijuana use by users' reasons for use-medical, recreational, and both-and identified correlates of each group.. Data from 20 states, which participated in the 2017-2019 Behavioral Risk Factor Surveillance System and fielded the marijuana use module, and multinomial logistic regression analysis were used to identify risk factors for past-month marijuana use by reason for use. User profiles were developed to illustrate how states' policy environments influenced reported reasons for use.. The average predicted probabilities of past-month marijuana use for medical, recreational, and both reasons were 28.6 %, 38.2 %, and 33.1 %, respectively. Age, gender, marital and employment status, income, mode and frequency of administration, and health status were associated with reasons for use. The reasons that young adult males who were infrequent marijuana users and binge drinkers gave for their marijuana use varied by state policy environment-in legal states, the average predicted probabilities were 5.3 % lower for recreational reasons and 5.0 % higher for both reasons. Reported reasons for past-month marijuana use did not significantly differ by state policy environment among daily users who were older women in poor mental and physical health.. Significant differences existed in the characteristics of past-month marijuana users by reasons for use. Our estimates can serve as a baseline against which post-legalization marijuana users' reasons for use can be compared as state policy environments shift.

Topics: Aged; Cannabis; Hallucinogens; Humans; Illicit Drugs; Marijuana Smoking; Marijuana Use; Medical Marijuana; United States; Young Adult

Simultaneous alcohol and marijuana (SAM) use is increasingly prevalent among young adults but has adverse health consequences. The current study examined daily-level associations between perceived sleep health and SAM use, relative to non-substance-use days and alcohol- or marijuana-only days. We also estimated linear associations between alcohol/marijuana use and perceived sleep health and explored whether effects were moderated by combined use of alcohol and marijuana.. A community sample of SAM-using young adults (N = 409; Mage = 21.61, SD = 2.17; 50.9% female; 48.2% White; 48.9% college students) completed twice-daily surveys for five 14-day sampling bursts. Daily measurements assessed substance use and perceived sleep health in terms of subjective sleep quality, negative impact of sleep on functioning, and symptoms of insomnia.. Multilevel models indicated that, relative to non-substance-use days, participants reported poorer perceived sleep health on alcohol-only days, better perceived sleep health on marijuana-only days, and mixed evidence regarding SAM use (i.e. fewer perceived symptoms of insomnia, but poorer perceived next day functioning attributed to sleep). Daily-level estimates showed increased alcohol use was associated with poorer perceived sleep health, while stronger effects from marijuana were associated with better perceived sleep health. Across all indices of sleep health, only one linear association was moderated by combined use: The adverse association between alcohol and next day functioning was weaker on days alcohol was combined with marijuana.. Findings provide additional evidence for daily-level effects of alcohol and marijuana use on perceived sleep health and address an important literature gap regarding potential adverse effects of SAM use.

Topics: Alcohol Drinking; Cannabis; Ethanol; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Sleep; Young Adult

Topics: Adolescent; Adult; Alcohol Drinking; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Students; Substance-Related Disorders

Cannabis use in pregnancy is common, as are mental health disorders, but the association between the two is not well established. This study is a single-site retrospective cohort. Urine testing for cannabis was evaluated at two-time points to categorize women as having never used, quit or continued to use. Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder (GAD) screen results were compared across groups using multinomial logistic regression. In addition, EPDS and GAD change scores between initiation of care and delivery were analyzed. 604 women were included, 221 (36.3%) with positive toxicology testing for cannabis at the initiation of care. Women who continued cannabis use were significantly more likely to have elevated GAD and EPDS scores (2.55 [1.31, 4.99]) and EPDS score (2.75 [1.43, 5.28]), respectively as compared to those with no use. No significant differences were found between groups in GAD or EPDS change scores t women with higher depression scores on the EPDS had 2.70 times the odds of being in the continuous use group compared to the quit using group (aOR = 2.70, 95% CI = [1.30, 5.88]). Both anxiety and depression symptoms were found to be associated with cannabis use and continued use during pregnancy.

Topics: Adult; Anxiety; Anxiety Disorders; Cannabis; Depression; Female; Humans; Marijuana Use; Pregnancy; Psychiatric Status Rating Scales; Retrospective Studies; Smoking Cessation

The simultaneous use of alcohol and cannabis ("simultaneous alcohol and marijuana [SAM] use") is common among young adults and associated with negative substance-related consequences. SAM use may be tied to fluctuating mood states such as negative affect and individual characteristics including trait level of anxiety and sex. However, little is understood about their collective role. In this study, we sought to understand the daily link between SAM use and negative affect and whether this link might differ by both trait anxiety and sex.. Participants were 154 young adults (57.8% female, 72.7% White, M age = 20.2) who completed baseline surveys on trait anxiety symptoms and up to 14 consecutive daily surveys on their substance use and affective states.. Multilevel models tested for associations of type of substance use day (i.e., alcohol-only days, cannabis-only days, and no use days relative to SAM use days) with next-day negative affect. Three-way and lower order interactions were tested for substance use day type, anxiety, and sex. Two three-way interactions between cannabis-only days, anxiety, and sex and between alcohol-only days, anxiety, and sex emerged such that SAM use was associated with greater next-day negative affect relative to single substance use days particularly among female participants with elevated anxiety.. Anxiety and sex are salient factors in the link between SAM use relative to single-substance use and daily negative affect. Study findings reinforce the need to account for all of these factors in order to develop maximally efficacious substance use interventions.

Topics: Adult; Alcohol Drinking; Anxiety; Cannabis; Ethanol; Humans; Marijuana Use; Young Adult

Little is known about how cannabis use over the life-course relates to harms in adulthood. The present study aimed to identify trajectories of cannabis use from adolescence to adulthood and examine both the predictors of these trajectories and adverse adult outcomes associated with those trajectories.. A latent trajectory analysis of a longitudinal birth cohort (from birth to age 35 years).. General community sample (n = 1065) from New Zealand.. Annual frequency of cannabis use (ages 15-35 years); childhood family and individual characteristics (birth to age 16 years); measures of adult outcomes (substance use disorders, ages 30-35 years; mental health disorders, ages 30-35 years; socio-economic outcomes at age 35 years; social/family outcomes at age 35 years).. A six-class solution was the best fit to the data. Individuals assigned to trajectories with higher levels of cannabis use were more likely to have experienced adverse childhood family and individual circumstances. Membership of trajectories with higher levels of use was associated with increased risk of adverse outcomes at ages 30-35 years. Adjustment of these associations for the childhood family and individual predictors largely did not reduce the magnitude of the associations.. In New Zealand, long-term frequent cannabis use, or transition to such use, appears to be robustly associated with diverse harms in adulthood.

Topics: Adolescent; Adult; Cannabis; Child; Child, Preschool; Cohort Studies; Family Relations; Female; Humans; Infant; Latent Class Analysis; Longitudinal Studies; Male; Marijuana Use; Mental Disorders; New Zealand; Socioeconomic Factors; Substance-Related Disorders; Young Adult

Topics: Adult; Cannabis; Female; Humans; Male; Marijuana Abuse; Marijuana Use; Mindfulness; Young Adult

The objective was to evaluate trends in marijuana exposures reported to the Colorado regional poison centre (RPC). Human exposures cases from the Colorado RPC obtained from 1 January 2000 through 31 December 2018 using generic marijuana exposure codes. There were 2221 marijuana exposures, with an increase in exposures by 11.2 cases per year (p<0.0001). Annual cases remained steady since 2014 (p=0.22), with a 19.4% increase in 2018 compared with 2017. Since 2014, the largest increase was in children age 0-8 years (p<0.0001). Edible marijuana exposures increased by 9.6 exposures per year from 2015 to 2018 (p=0.04). After observing an increase in Colorado RPC marijuana exposure cases in 2010 and 2014, annual exposures have been stable through 2017, with the first increase in legalised recreational sales era in 2018. There are specific concerns for the paediatric population and exposures involving edibles, as these cases continue to increase.

Topics: Adolescent; Adult; Cannabis; Child; Child, Preschool; Colorado; Female; Humans; Male; Marijuana Use; Middle Aged; Poison Control Centers

Data from controlled laboratory experiments in adults indicate that the subjective effects of cannabis vary by administration method (e.g., combustible, vaporized). Whether the subjective effects of cannabis experienced in the natural ecology and among adolescents differ by cannabis administration method is unknown. In this observational study, adolescents' retrospective reports of subjective effects after combustible, edible, and vaporized cannabis use were examined.. Students from ten public schools in Los Angeles, CA, USA (M[SD] age = 16.1 [.43] years) who reported past 6-month use of combustible, edible, or vaporized cannabis (N = 584) were surveyed on subjective effects experienced after use (yes/no). They were provided with a 12 item self-report checklist of six positive (e.g., relaxed, energetic) and six negative (e.g., drowsy, lazy) subjective effects. For each method of administration, affirmative responses were summed in positive (range: 0-6) and negative (range: 0-6) effect composite scores.. Generalized estimating equations adjusted for demographics and recent cannabis use revealed a graded pattern of differences in positive subjective effects across products, with highest scores for combustible (M[SD] = 3.98[1.76]), followed by edible (M[SD] = 3.58 [2.04]) and vaporized (M[SD] = 3.11 [2.21]) cannabis (all pairwise cross-product contrasts p < .01). Mean negative effect score was highest for edible (M[SD] = 2.27 [1.95]), followed by combustible (M[SD] = 1.94 [1.66]), and vaporized (M[SD] = 1.34 [1.73]) cannabis, respectively (all pairwise contrasts p < .02).. Adolescents' reports of subjective effects varied across cannabis administration methods. Combustible cannabis' more desirable subjective effects profile might be indicative of higher abuse liability.

Topics: Adolescent; Adolescent Health; Cannabis; Female; Humans; Los Angeles; Male; Marijuana Use; Nebulizers and Vaporizers; Plants, Edible; Retrospective Studies; Self Report; Students; Surveys and Questionnaires

Topics: Cannabis; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; Substance-Related Disorders; United States

Concomitant use of cannabis and other psychoactive substances is common and it is often difficult to differentiate its acute effects from those of other substances. This study aimed to characterize the acute toxicity of cannabis with and without co-use of other substances.. Retrospective analysis of cases presenting at the emergency departments of three large hospitals in Switzerland due to acute toxicity related to cannabis recreational use.. Among 717 attendances related to acute cannabis toxicity, 186 (26 %) were due to use of cannabis alone. The median patient age was 26 years (range 14-68), and 73 % were male. Commonly reported symptoms/signs in lone-cannabis cases included nausea/vomiting (26 %), palpitations (25 %), anxiety (23 %), and chest pain (15 %); there were no fatalities and most intoxications were of minor severity (61 %). Most patients (83 %) using cannabis alone were discharged from the emergency department, 8 % were referred to psychiatric, and two (1 %) to the intensive care; severe complications included psychosis (7 %), coma (6 %), and seizures (5 %) and one patient (<1 %) required intubation. Lone-cannabis patients presented more often with palpitations, anxiety, panic attacks, and chest pain than patients in the co-use group, whereas the latter presented more often with impaired consciousness, agitation, respiratory depression and hallucinations, and were more often admitted to psychiatric or intensive care.. Intoxication with cannabis alone was mostly associated with minor toxicity. Nevertheless, severe complications and cases requiring admission to intensive or psychiatric care were also reported, which indicates that intoxication with cannabis alone does not exclude considerable health risks.

Topics: Adolescent; Adult; Aged; Cannabis; Emergency Service, Hospital; Female; Hospitalization; Humans; Male; Marijuana Use; Middle Aged; Retrospective Studies; Switzerland; Young Adult

This analysis of county-level voting on 22 state referenda that sought to legalize marijuana for medical purposes or recreational use is driven by hypotheses from post-materialism theory. Separate regression models for each type of policy largely, though not entirely, support our expectations. Voting to legalize both medical and recreational marijuana was greater in counties with larger college-educated populations, a partisan preference for Democratic presidential candidates, and smaller percentages of Catholic, Protestant, and Evangelical adherents. The findings for age, the other primary driver of post-materialist values, are counter-intuitive, but holding these referenda during a U.S. presidential election year had statistically significant though different impacts on the outcome. The higher turnout during presidential elections seemingly facilitated voting in favor of recreational marijuana while lower turnouts during non-presidential elections aided voting for medical marijuana. Finally, population density was not statistically significant in either model.

Topics: Cannabis; Health Policy; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana; Politics; United States

The use of cannabis has previously been linked to both depression and self-harm; however, the role of genetics in this relationship is unclear. This study aimed to estimate the phenotypic and genetic associations between cannabis use and depression and self-harm.. Cross-sectional data collected through UK Biobank were used to test the phenotypic association between cannabis use, depression and self-harm. UK Biobank genetic data were then combined with consortia genome-wide association study summary statistics to further test the genetic relationships between these traits using LD score regression, polygenic risk scoring and Mendelian randomization methods.. United Kingdom, with additional international consortia data.. A total of 126 291 British adults aged between 40 and 70 years, recruited into UK Biobank.. Phenotypic outcomes were life-time history of cannabis use (including initial and continued cannabis use), depression (including single-episode and recurrent depression) and self-harm. Genome-wide genetic data were used and assessment centre, batch and the first six principal components were included as key covariates when handling genetic data.. In UK Biobank, cannabis use is associated with an increased likelihood of depression [odds ratio (OR) = 1.64, 95% confidence interval (CI) = 1.59-1.70] and self-harm (OR = 2.85, 95% CI = 2.69-3.01). The strength of this phenotypic association is stronger when more severe trait definitions of cannabis use and depression are considered. Using consortia genome-wide summary statistics, significant genetic correlations are seen between cannabis use and depression [rg = 0.289, standard error (SE) = 0.036]. Polygenic risk scores for cannabis use and depression explain a small but significant proportion of variance in cannabis use, depression and self-harm within a UK Biobank target sample. However, two-sample Mendelian randomization analyses were not significant.. Cannabis use appeared to be both phenotypically and genetically associated with depression and self-harm. Limitations in statistical power mean that conclusions could not be made on the direction of causality between these traits.

Topics: Adult; Aged; Biological Specimen Banks; Cannabis; Cross-Sectional Studies; Depression; Female; Genome-Wide Association Study; Humans; Lod Score; Male; Marijuana Use; Mendelian Randomization Analysis; Middle Aged; Multifactorial Inheritance; Phenotype; Self-Injurious Behavior; United Kingdom

This population-based study showed that maternal opioid plus marijuana use during pregnancy was associated with increased odds of prematurity and low birth weight but lower odds of neonatal abstinence syndrome and prolonged hospitalization compared with opioid exposure without marijuana use. Further research should evaluate the biologic mechanisms responsible for these outcomes.

Topics: Adolescent; Adult; Analgesics, Opioid; Cannabis; Child; Data Collection; Databases, Factual; Female; Hospitalization; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Male; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Massachusetts; Neonatal Abstinence Syndrome; Opioid-Related Disorders; Outcome Assessment, Health Care; Pregnancy; Pregnancy Complications; Young Adult

Topics: Cannabis; Female; Humans; Male; Marijuana Use; Sexual Behavior; Surveys and Questionnaires

Topics: Aged; Canada; Cannabis; Child; Food; Government Regulation; Humans; Legislation, Drug; Marijuana Use

To develop a tool to assess current (past 30 days) and lifetime marijuana use in older Veterans.. US Veteran's Affairs Healthcare System.. 704 older Veterans were screened, 339 completed the initial survey, 100 completed the follow-up.. Pearson's correlation coefficient to assess strength of association between initial and follow-up survey on measures of current and lifetime marijuana use.. Both a 'gram-month' measure of marijuana smoked in the past 30 days (r=0.83) and a frequency-based measure assessing total number of times smoked in the past 30 days were reliable (r=0.89). Both a simple categorical measure of lifetime use (agreement=85%) and a continuous measure of lifetime use (r=0.82) were reliable.. The Cannabis Assessment Tool offers a reliable assessment of past 30 days and lifetime assessments of smoking cannabis in older adults.

Topics: Aged; Cannabis; Female; Follow-Up Studies; Humans; Incidence; Male; Marijuana Smoking; Marijuana Use; United States; Veterans

This study theorizes and tests moderators (perceived availability of marijuana and age-group) of the association between adolescents' frequency of marijuana ad exposure and past-year marijuana use. To test this model, I analyzed national survey data from 9,024 American adolescents with hierarchical regression techniques. Results showed that being a male (95% confidence interval [CI] for unstandardized regression coefficient [0.06, 0.16]) and peer pressure (95% CI [0.04, 0.14]) were positively associated with past-year marijuana use, and father education (95% CI [-0.11, -0.06]) was negatively associated with it. Perceived ease of access (95% CI [0.18, 0.22]), ad exposure (95% CI [0.03, 0.14]), and age (95% CI [0.16, 0.27]) were positively associated with past-year marijuana use. Importantly, the associations of perceived ease of access and age with past-year marijuana use were significantly larger than that of ad exposure. Age (95% CI [0.00, 0.15]) and perceived ease of access (95% CI [0.01, 0.07]) independently strengthened the ad exposure to use association. There was a significant three-way interaction (95% CI [0.01, 0.12]) showing that age increases the positive influence of perceived ease of access on the marijuana ad exposure to past-year marijuana use association. An exploratory analysis further revealed that male adolescents are more strongly influenced by perceived ease of access compared to females. Based on the findings, I suggest that approaches for reducing perceived marijuana availability and for implementing age-specific interventions are promising avenues for prevention programs aimed at decreasing marijuana use in adolescents.

Topics: Adolescent; Cannabis; Female; Humans; Male; Marijuana Use; Substance-Related Disorders; United States

While cannabis use has been found to impair motor vehicle driving, the association between cannabis legalization and motor vehicle fatalities is unclear. In Uruguay in December 2013, cannabis for recreational purposes was legalized. This study assessed the association between implementation of this law and changes in traffic fatality rates.. Interrupted time-series analysis of traffic fatality rates of light motor vehicle drivers and motorcyclists in urban and rural settings. Changes are reported as step and trend effects against modeled trends in the absence of legalization.. Uruguay, Montevideo and four rural provinces (Colonia, Florida, Río Negro and San José) from 1 January 2012 to 31 December 2017. Cases and measurement Weekly traffic fatalities of light motor vehicle drivers and motorcyclists per type of vehicle. Data were gathered from the National Road Safety Agency of Uruguay and the Ministry of Transport and Public Works, respectively.. Cannabis legalization was associated with a 52.4% immediate increase [95% confidence interval (CI) = 11.6, 93.3, P = 0.012] in the light motor vehicle driver's fatality rate. However, no significant change in the motorcyclists' fatality rate was observed. In Montevideo the legislation was associated with an absolute increase in its light motor vehicle driver's fatality rate by 0.06 (95% CI = 0.01, 0.11, P = 0.025), but no significant associations were observed in rural settings.. In Uruguay, the 2013 legislation legalizing recreational cannabis consumption may have been associated with an increase in fatal motor vehicle crashes, particularly in light motor-vehicle drivers and urban settings.

Topics: Accidents, Traffic; Cannabis; Humans; Interrupted Time Series Analysis; Legislation, Drug; Marijuana Use; Uruguay

Topics: Cannabis; Female; Humans; Infant, Newborn; Marijuana Smoking; Marijuana Use; Pregnancy; Pregnancy Complications; Premature Birth; United States

Historically, cannabis researchers have assumed a single mode and product of cannabis (e.g., smoking plant). However, patterns of use, products (e.g., concentrates, edibles), and modes (e.g. blunts, vaporizers) are diversifying. This study sought to: 1) classify cannabis users into groups based on their use of the full range of cannabis products, and 2) examine user group differences on demographics, cannabis consequences and cannabis use disorder (CUD) symptomatology.. In a sample of college students (data collected in Fall 2017), who used cannabis in the past year (N = 1390), latent class analysis (LCA) was used to characterize cannabis users. We then added demographic characteristics, cannabis consequences, and CUD symptomatology scores separately to LCA models to examine class differences.. Five unique classes emerged: high-frequency all-product users, high-frequency plant/moderate-frequency edible and concentrate users, low-frequency plant users, moderate-frequency plant and edible users, and low-frequency edible users. Demographic characteristics, cannabis consequences, and CUD symptomatology differed across classes characterized by frequency as well as product.. Results reflect the increasing variety of cannabis products, modes, and use patterns among college students. In this sample, frequency of use remains a strong predictor of cannabis-related consequences, in addition to type of product. As variation in cannabis use patterns continue to evolve, it is essential for researchers to conduct comprehensive assessments.

Topics: Adolescent; Cannabis; Drug Users; Female; Humans; Latent Class Analysis; Male; Marijuana Abuse; Marijuana Use; Students; United States; Universities; Young Adult

The experiences of crime and policing from the perspective of adolescent cannabis users before treatment entry are not often understood by practitioners.. A qualitative design within an interpretivist paradigm was used. Data were collected using one-to-one semi-structured interviews. A convenience sample was recruited through two treatment centers in Dublin, Ireland in 2015. A deductive thematic analysis was used.. In-depth interviews with eight young people were conducted. At the individual level, there was a common theme of naïve crimes with the introduction of debt and developing violence. Young people often stole from their families and obtained credit from dealers. Policing was initially viewed as benign. Families suffered as a result of the drug debts but young people also spoke of intergenerational drug use. As the young person's use progressed, the oppressed became the oppressor, young people were entrapped, violence escalated and real fear of incarceration and remorse was expressed.. Findings highlight the commonality of fear and the seriousness of personal and familial violent harms. The need for targeted developmental preventions in vulnerable settings is proposed. Parents and professionals need to have an awareness of money in the home and the role of intergenerational substance use.

Topics: Adolescent; Cannabis; Crime; Fear; Female; Humans; Ireland; Male; Marijuana Use; Parents; Qualitative Research; Violence

Topics: Administration, Oral; Anxiety; Cannabis; Cardiovascular Diseases; Dose-Response Relationship, Drug; Dronabinol; Drug Labeling; Drug Packaging; Humans; Marijuana Use; Psychoses, Substance-Induced

Recreational cannabis has been legalized in 11 states and District of Columbia (DC) in the United States. Among these, 10 states further permitted retail sale to provide a legal supply to adults. This study examined the associations of cannabis exposures with recreational cannabis legalization and commercialization.. Secondary data analysis of state-quarter level cannabis exposures during 2010-17 in the United States. Linear regressions with a difference-in-differences design were used to compare pre- and post-legalization trends in states that legalized recreational cannabis to contemporaneous trends in states that did not legalize recreational cannabis.. United States, including all 50 states and DC.. Cannabis exposures reported to the US National Poison Data System.. The primary outcome was state age-adjusted cannabis exposures reported to the US National Poison Data System per 1 000 000 population per quarter. The two policy variables of interest included (1) the enactment of recreational cannabis legalization (i.e. removing penalties for adults' possession of cannabis in a small amount for recreational use) and (2) the initiation of recreational cannabis commercialization (i.e. providing a legal supply of cannabis to adults through licensed dispensaries).. The association between a state's enactment of recreational cannabis legalization and its changes in cannabis exposures was statistically non-significant overall. After controlling for recreational cannabis legalization, however, the initiation of recreational cannabis commercialization was associated with 5.06-5.80 more exposures per 1 000 000 population per quarter (67-77% increase relative to the pre-legalization average), depending on the composition of comparison states. The increase associated with commercialization was higher among minors than adults (7.97-9.53 versus 3.83-4.21 more exposures), higher among males than females (6.16-7.56 versus 3.76-3.91 more exposures) and higher among exposures with medical consequences than those without medical consequences (4.09-4.79 versus 0.97-1.01 more exposures).. An increase in cannabis exposures reported to the US National Poison Data System was observed following recreational cannabis commercialization in the United States.

Topics: Adult; Cannabis; Female; Humans; Legislation, Drug; Male; Marijuana Use; United States; Young Adult

Topics: Cannabis; Humans; Legislation, Drug; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Students

Topics: Adult; Cannabis; Child; Female; Humans; Marijuana Use; Pregnancy; Prenatal Exposure Delayed Effects

To examine associations between in utero marijuana exposure and birth outcomes.. In two separate cohorts (Appalachian, Rocky Mountain), data were collected from medical records. Marijuana exposure was positive based on urine drug screening at delivery, with nonexposed controls matched on multiple factors including other substance exposure.. Marijuana-exposed newborns (n = 531) had significantly worse birth outcomes than controls (n = 531), weighing 218 g less, 82%, 79%, and 43% more likely to be low birth weight, preterm, or admitted to the NICU, respectively, and significantly lower Apgar scores.. Marijuana exposure in utero predicted newborn factors linked to longer-term health and development issues. Effects were not attributable to other comorbidities in this study due to rigorous matching and biochemical verification of marijuana and other drug use. Findings add to growing evidence linking marijuana exposure to adverse birth and longer-term outcomes. Women should be encouraged to avoid marijuana use during pregnancy.

Topics: Apgar Score; Cannabis; Humans; Infant, Low Birth Weight; Infant, Newborn; Marijuana Smoking; Marijuana Use; Pregnancy

Cannabis use is increasing in the United States. Prior work suggests tobacco use in pregnancy is much more common among those with depression. It is not known whether cannabis use is also more common among this especially vulnerable group. Identifying those at highest risk for cannabis use is required to direct prevention and intervention efforts.. Data were drawn from the 2005-2018 National Survey on Drug Use and Health (NSDUH), an annual, cross-sectional sample of persons ages 12 and older representative of the US. The prevalence of past-30-day cannabis use by depression status (past-12-month) and by sociodemographic factors and perception of risk associated with cannabis use was estimated among pregnant women.. Cannabis use was significantly more common among pregnant women with, compared to without, depression (12.7 % vs. 3.7 %; odds ratio (OR) = 3.8 (95 % confidence interval 2.8, 5.0)). This was the case across all sociodemographic subgroups. The relationship between depression and cannabis use was significantly stronger among those who perceived moderate-great risk (OR = 6.9 (3.7, 13.0)) compared with no risk (OR = 1.6 (1.1, 2.4); P. Women with depression are more than three times more likely to use cannabis during pregnancy. Disparities in cannabis use among pregnant women by depression status appear to be echoing trends in tobacco use. Education about risks associated with cannabis use in pregnancy and prevention, akin to those for prenatal tobacco use, may be needed among pregnant women who are depressed to stem this increase and potentially growing disparity.

Topics: Adolescent; Adult; Cannabis; Child; Cross-Sectional Studies; Depression; Female; Health Surveys; Humans; Marijuana Use; Pregnancy; Pregnancy Complications; Pregnant Women; United States; Young Adult

This study tested whether increases in recent and cumulative cannabis use were each associated with increases in internalizing problems from adolescence to young adulthood. Participants were boys from a community sample that was assessed annually from ~age 15-26 (N = 506). Boys reported on their cannabis use, depression symptoms, and anxiety/depression problems each year. Exposures were frequency of cannabis use in a given year (no use, < weekly use, weekly or more frequent use) and cumulative prior years of weekly cannabis use. Outcomes were depression symptoms and anxiety/depression problems in a given year. Analyses examined within-person associations between changes in exposures and outcomes over time, which eliminated "fixed" (unchanging) individual differences as potential confounds. Analyses also accounted for time-varying factors as potential confounds (other substance use, externalizing problems, subclinical psychotic symptoms). Results showed that increases in recent cannabis use and cumulative prior years of weekly cannabis use were each associated with increases in depression symptoms and anxiety/depression problems. After controlling for time-varying covariates, increases in cumulative prior years of weekly cannabis use, but not recent cannabis use, remained associated with increases in depression symptoms and anxiety/depression problems. Specifically, each additional year of prior weekly cannabis use was associated with a small increase in depression symptoms (b = 0.012, p = .005) and anxiety/depression problems (b = 0.009, p = .001). Associations did not vary systematically across time. There was also no evidence of reverse causation. As boys engaged in weekly cannabis use for more years, they showed increases in internalizing problems, suggesting the importance of preventing chronic weekly cannabis use.

Topics: Adolescent; Adult; Anxiety; Cannabis; Depression; Humans; Longitudinal Studies; Male; Marijuana Use; Young Adult

There is concern that recreational marijuana legalization (RML) may lead to increased cannabis use disorder (CUD) among youth due to increased marijuana use. This study investigates whether adolescent substance use disorder treatment admissions for marijuana use increased in Colorado and Washington following RML.. Annual data on 2008-2017 treatment admissions for marijuana use from the SAMHSA TEDS-A dataset for adolescents age 12-17 were used to model state treatment admissions trends. Difference-in-differences models were used to investigate whether treatment admissions increased following RML in Colorado/Washington compared to non-RML states, after adjusting for socioeconomic characteristics and treatment availability.. Over all states in the analysis, the rate of adolescent treatment admissions for marijuana use declined significantly over the study period (β=-3.375, 95 % CI=-4.842, -1.907), with the mean rate falling nearly in half. The decline in admissions rate was greater in Colorado and Washington compared to non-RML states following RML, though this difference was not significant (β=-7.671, 95 % CI=-38.798, 23.456).. Adolescent treatment admissions for marijuana use did not increase in Colorado and Washington following RML. This may be because youth marijuana use did not increase, CUD did not increase (even if use did increase), or treatment seeking behaviors changed due to shifts in attitudes and perceptions of risk towards marijuana use.

Topics: Adolescent; Adolescent Behavior; Cannabis; Child; Colorado; Female; Hospitalization; Humans; Legislation, Drug; Male; Marijuana Abuse; Marijuana Use; Patient Admission; United States; United States Substance Abuse and Mental Health Services Administration; Washington

Topics: Cannabis; Dose-Response Relationship, Drug; Humans; Incidence; Legislation, Drug; Marijuana Use; Prevalence; Psychoses, Substance-Induced; Schizophrenia

Caffeine, alcohol, nicotine and cannabis are commonly used psychoactive substances. While the use of these substances has been previously shown to be genetically correlated, causality between these substance use traits remains unclear. We aimed to revisit the genetic relationships among different measures of SU using genome-wide association study (GWAS) summary statistics from the UK Biobank, International Cannabis Consortium, and GWAS & Sequencing Consortium of Alcohol and Nicotine use.. We obtained GWAS summary statistics from the aforementioned consortia for ten substance use traits including various measures of alcohol consumption, caffeine consumption, cannabis initiation and smoking behaviours. We then conducted SNP-heritability (h. SNP h. Most of the substance traits were genetically correlated but there is little evidence to establish causality apart from the relationship between smoking initiation and caffeine consumption.

Topics: Alcohol Drinking; Caffeine; Cannabis; Cigarette Smoking; Cognition; Cohort Studies; Female; Genome-Wide Association Study; Humans; Male; Marijuana Use; Mendelian Randomization Analysis; Nicotine

Cannabis-infused "edibles" are a popular means of cannabis use, and the variety of edible food products available to consumers continues to grow. Although there has been much discussion on dose standardization, childproof packaging, and the prevention of overconsumption, the important topic of food safety has received less attention.We discuss potential food safety hazards associated with cannabis-infused edible food products, drawing on examples from Colorado, and describe edible-associated foodborne illness outbreaks and other contamination events.It is important for public health agencies, particularly environmental health and enteric disease programs, to be familiar with the cannabis industry, including regulatory partners, signs and symptoms of cannabis ingestion, the scope of edible products sold and consumed, and the food safety risks unique to cannabis products.

Topics: Candy; Cannabis; Colorado; Food; Food Safety; Humans; Marijuana Use; Medical Marijuana; Public Health

Topics: Cannabis; Hallucinogens; Humans; Legislation, Drug; Marijuana Use; Poisons

Edible cannabis products have increased in popularity, particularly in jurisdictions that have legalized nonmedical cannabis. Rates of adverse events from cannabis edibles have also increased, in part because of difficulties identifying and titrating tetrahydrocannabinol (THC) levels. The current study tested whether packaging cannabis in separate units enhances consumer understanding of serving sizes.. An experimental task was conducted as part of the 2018 International Cannabis Policy Study online survey. Participants were recruited from the Nielsen Global Insights Consumer Panel. A total of 26,894 participants (61.5% female) ages 16-65 years from Canada and the United States were randomly assigned to view a cannabis brownie packaged according to one of three conditions: (a) multiserving edible ("control condition"), (b) single-serving edible, and (c) single-serving edible packaged separately ("unit-dose packaging"). Participants were asked to identify a standard serving based on information on the product label. Logistic regression was used to test the influence of packaging condition on the likelihood of a correct response, adjusting for key covariates.. Compared with the multiserving edible control (50.6%), participants were significantly more likely to correctly identify the serving size in the single-serving edible condition (55.3%; adjusted odds ratio = 1.22, CI [1.15, 1.29], p < .001) and the unit-dose packaging condition (54.3%; adjusted odds ratio = 1.17, CI [1.10, 1.24], p < .001).. Packaging in which each product unit contained one dose of THC enhanced consumers' ability to identify how much of a product constitutes a standard serving or dose. Packaging products as individual doses eliminates the need for mental math and could reduce the risk of accidental overconsumption of cannabis.

Topics: Adolescent; Adult; Aged; Canada; Cannabis; Comprehension; Dronabinol; Female; Hallucinogens; Humans; Male; Marijuana Use; Middle Aged; Product Packaging; Serving Size; Surveys and Questionnaires; United States; Young Adult

The most commonly used illicit substance worldwide is cannabis. To date, no national level study of cannabis-related death has been undertaken in Australia. The current study aimed to investigate the rates, characteristics and manner of cannabis-related deaths recorded in Australia (2000-2018).. A retrospective case review of medicolegal files was undertaken through the National Coronial Information System (NCIS) (1/07/2000-31/12/2018).. A total of 559 cases were identified, with a mean age of 35.8 years, 81.2% were male. The crude mortality rate per 100,000 people ranged between 0.10 (CI = 0.06-0.15) and 0.23 (CI = 0.17-0.30). The manner of deaths were: accidental injury (29.9%), suicide (25.0%), polysubstance toxicity (17.0%), natural disease (16.1 %), natural disease and drug effect/toxicity (7.9%), assault (3.0%) and unascertained (1.1%). No deaths were solely due to cannabis toxicity. Men were over-represented in this group and were three times as likely to die of accidental injury than women who died from cannabis-related deaths. Motor vehicle accidents were the leading cause of accidental injury. Cardiovascular (14.3%) and respiratory conditions (9.7%) were the most common disease types recorded in cause of death. The median Δ-9-tetrahydrocannabinol blood concentration was 0.008 mg/L (range 0.0005-19.00 mg/L). Other drugs were cited in the cause of death alongside cannabis (81.4%), the most common being alcohol (47.2%).. Low all-cause crude mortality rates remained relatively stable over the study period. No deaths were due to direct cannabis toxicity, but death due to accidental injury was prominent.

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Australia; Cannabis; Cause of Death; Female; Habits; Humans; Male; Marijuana Use; Middle Aged; Mortality; Retrospective Studies; Suicide; Young Adult

While using most drugs of abuse is associated with higher than control rates of delay discounting, cannabis use may be the exception. As such, between-commodity differences in delay discounting (i.e., money vs. cannabis) have not been thoroughly examined. We examined these between-commodity differences using modern analytic techniques to disentangle effects of subjects' sensitivity to magnitude and delay as potential drivers of any obtained delay discounting rate differences.. ; Fifty-eight college students (n = 33 cannabis users, n = 25 non-users) completed a monetary delay discounting task - with the cannabis users completing the cannabis problems questionnaire as well a delay discounting of cannabis task- in an on-campus laboratory.. Responding between groups differed on the cannabis problems questionnaire, but not on delay discounting of monetary outcomes. Cannabis users, however, discounted cannabis at higher rates than money. Multilevel logistic regression revealed that these between-commodity delay discounting differences were due to subjects' differential sensitivity to the magnitude of these two commodities, rather than sensitivity to delay to receiving these commodities.. Although differences in delay discounting rate were not obtained between students that did and did not use cannabis, cannabis users did discount cannabis at higher rates than they did money - suggesting considerable generality of the between commodity differences in delay discounting obtained elsewhere. The current between-commodity delay discounting differences appear to be driven by differential sensitivity to the reinforcer magnitudes presented in each task - a finding that awaits replication across other comparisons before statements about generality can be made.

Topics: Adult; Cannabis; Delay Discounting; Female; Humans; Impulsive Behavior; Male; Marijuana Use; Reward; Students; Universities; Young Adult

Topics: Cannabis; Commerce; Crop Production; Dronabinol; Drug Labeling; Government Agencies; Humans; Law Enforcement; Marijuana Use; New Zealand

Marijuana decriminalization holds potential to reduce health inequities. However, limited attention has focused on assessing the impact of decriminalization policies across different populations. This study aims to determine the differential effect of a marijuana decriminalization policy change in Philadelphia, PA on marijuana arrests by demographic characteristics.. Using a comparative interrupted time series design, we assessed whether the onset of marijuana decriminalization in Philadelphia County was associated with reduction in arrests rates from 2009 to 2018 compared to Dauphin County. Stratified models were used to describe the differential impact of decriminalization across different demographic populations.. Compared to Dauphin, the mean arrest rate for all marijuana-related crimes in Philadelphia declined by 19.9 per 100,000 residents (34.9% reduction), 17.1 per 100,000 residents (43.1% reduction) for possession, and 2.8 per 100,000 resident (15.9% reduction) for sales/manufacturing. Arrest rates also differed by demographic characteristics post-decriminalization. Notably, African Americans had a greater absolute/relative reduction in possession-based arrests than Whites. However, relative reductions for sales/manufacturing-based arrests was nearly 3 times lower for African Americans. Males had greater absolute/relative reduction for possession-based arrests, but lower relative reduction for sales/manufacturing-based arrests compared to females. There were no substantial absolute differences by age; however, youths (vs. adults) experienced higher relative reduction in arrest rates.. Findings suggest an absolute/relative reduction for possession-based arrests post-decriminalization; however, relative disparities in sales/manufacturing-based arrests, specifically for African Americans, increased. More consideration towards the heterogeneous effect of marijuana decriminalization are needed given the unintended harmful effects of arrest on already vulnerable populations.

Topics: Adolescent; Adult; Cannabis; Crime; Female; Humans; Interrupted Time Series Analysis; Law Enforcement; Male; Marijuana Use; Philadelphia; Vulnerable Populations

Opioid overdose death rates have continued to spike exponentially from the start of the 21st century, creating what is known to be one of the worst public health crises in the United States. Simultaneously, as more states began passing medical cannabis laws (MCLs), the idea that marijuana was the solution to the opioid crisis began to spread nationwide. As some states have maintained strict medical marijuana policies, others-such as Colorado-have expanded their statutes to allow recreational marijuana sales within their state. Researchers have been able to provide sense of the public health implications resulting from MCLs, but little is known about the effects of this marijuana policy expansion. This preliminary study will focus on exploring the statewide effects of Colorado's recreational marijuana policy on the state's opioid overdose death rates.. Because Colorado has existing panel data for opioid overdose death rates, we can use statistical software to define and create an optimal control group to adequately resemble Colorado's outcome variable of interest. This process known as the synthetic control method can provide a valid counterfactual for Colorado's opioid overdose outcomes in the absence of this policy-a Colorado that did not expand marijuana policy to the point recreational dispensaries were established.. Opioid overdose death rate data from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (WONDER) will be used to construct a synthetic control unit composed of a donor pool of states resembling Colorado's regulatory environment pertaining to marijuana before legalization. The synthetic control unit allows for a comparative observation of overdose rate trends in Colorado and its synthetic counterpart for the years 1999-2017, all while including a set of predictor variables for robustness checks. A difference-in-difference estimate will then help us observe the effects of the treatment given to Colorado. Inference tests will be conducted to evaluate the method's predictive power and significance of the results.. The results of the synthetic control model and its outcomes showed that the estimated negative 5% drop in overdose death rates was deemed insignificant on conducting a placebo in-space analysis, meaning there is not enough evidence to prove that opening recreational dispensaries as a result of recreational marijuana legislation was instrumental in reducing Colorado's ongoing opioid crisis depicted through opioid overdose deaths.. Owing to the lack of additional post-treatment data and captured lagged effects, it is too soon to dismiss this policy as inadequate in combating the opioid epidemic. Once additional post-treatment data become available, the study can be reproduced to obtain more robust results and achieve a clearer understanding of the policy implications shown.

Topics: Adult; Analgesics, Opioid; Cannabis; Centers for Disease Control and Prevention, U.S.; Colorado; Drug Overdose; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana; Middle Aged; Opioid Epidemic; Public Health; Public Policy; Spatial Analysis; United States

Cannabis contains over a hundred of different cannabinoids, of which Δ

Topics: Adolescent; Adult; Cannabidiol; Cannabis; Commerce; Dronabinol; Female; Health Status; Humans; Male; Marijuana Abuse; Marijuana Use; Prevalence; United States; Vulnerable Populations; Young Adult

Topics: Biomedical Research; Cannabis; Humans; Marijuana Use; Medical Marijuana; Risk Factors

Cannabis use in some individuals can meaningfully introduce

Topics: Adolescent; Adolescent Development; Animals; Behavior, Addictive; Brain; Cannabis; Comorbidity; Disease Models, Animal; Executive Function; Gene Expression; Humans; Long-Term Potentiation; Marijuana Use; Mental Disorders; Mice; Opioid-Related Disorders; Young Adult

The Government of Manitoba created a cannabis public health surveillance system in 2018 in preparation for nonmedical cannabis legalization on 17 October, 2018. An initial evaluation was conducted to assess the usefulness, flexibility and simplicity attributes of the system, using an online stakeholder survey, website metrics, system analysis and interviews. Resulting recommendations included creating a detailed communication plan for surveillance products, changing the format and frequency of reporting, maintaining strong relationships with partners and building towards a centralized provincial substance use surveillance database and surveillance system.. En 2018, le gouvernement du Manitoba a créé un système de surveillance de santé publique en matière de cannabis en prévision de la légalisation du cannabis à des fins non médicales le 17 octobre 2018. Une première évaluation a été menée pour déterminer les caractéristiques d’utilité, de flexibilité et de simplicité du système, au moyen d’une enquête en ligne auprès d’intervenants, de paramètres du site Internet, d’une analyse du système et d’entrevues. Les recommandations qui ont pu en être tirées sont la création d’un plan de communication détaillé pour les rapports de surveillance, la modification du format et de la fréquence des rapports, le maintien de relations solides avec les partenaires et la mise en place d’une base de données provinciale centralisée de surveillance de la consommation de substances et d’un système de surveillance.. Evaluating public health surveillance systems is essential for understanding system performance and providing guidance for improvement. An initial evaluation of Manitoba’s cannabis surveillance system showed that the system was moderately useful, highly flexible and moderately simple. Recommendations included creating a detailed communications plan prior to surveillance product release to increase the audience reach; producing a shorter infographicstyle product that sets cannabis in context of other substances once or twice a year; and leveraging the existing provincial opioid misuse and overdose surveillance system to include cannabis and other substances.. L’évaluation des systèmes de surveillance en santé publique est essentielle pour comprendre le rendement de ces systèmes et fournir des conseils pour les améliorer. Une évaluation initiale du système de surveillance du cannabis du Manitoba a montré que le système était modérément utile, très souple et modérément simple. Les recommandations ont été la création d’un plan de communication détaillé avant la diffusion des rapports de surveillance afin d’en accroître la portée, la production une ou deux fois par année d’un rapport plus bref de type infographique mettant le cannabis en contexte avec d’autres substances et enfin l’utilisation du système de surveillance provincial déjà en place pour les cas de consommation abusive et de surdose d’opioïdes afin d’y inclure le cannabis et d’autres substances.

Topics: Adolescent; Adult; Cannabis; Humans; Manitoba; Marijuana Use; Public Health Surveillance; Young Adult

To examine post-retail marijuana legalization (RML) change in marijuana use frequency and pro-marijuana norms among parents.. The Intergenerational Study, a longitudinal panel of parents (N = 668) and children, followed participants from 2002 to 2018, when parents were 27 and 43 years old, respectively. Three quarters of participants (74%) lived in an RML state and 142 (21%) had used marijuana in the 8 years prior to RML. Piecewise growth modelling compared pre- and post-RML slopes of use frequency and pro-marijuana norms.. Frequency of use and pro-marijuana norms increased following legalization in both RML and non-RML states, though norms rose significantly faster in RML states. Growth in use was primarily driven by new users of marijuana. There were no differences in frequency of marijuana use or pro-marijuana norms by race/ethnicity, gender, or education.. An increase in marijuana use frequency associated with RML among parents poses risk to both parents' well-being and the health of their children. A faster pace of increase in pro-marijuana norms in RML states may signal continued increases in use in the future.

Topics: Adult; Cannabis; Child; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; Parents

Schools are increasingly concerned about student cannabis use with the recent legalization in Canada; however, little is known about how to effectively intervene when students violate school substance use policies. The purpose of this study is to assess the disciplinary approaches present in secondary schools prior to cannabis legalization and examine associations with youth cannabis use. This study used Year 6 (2017/2018) data from the COMPASS (Cannabis use, Obesity, Mental Health, Physical Activity, Alcohol use, Smoking, Sedentary behavior) study including 66,434 students in grades 9 through 12 and the 122 secondary schools they attend in British Columbia, Alberta, Ontario, and Quebec. Student questionnaires assessed youth cannabis use and school administrator surveys assessed potential use of 14 cannabis use policy violation disciplinary consequences through a ("check all that apply") question. Regression models tested the association between school disciplinary approaches and student cannabis use with student- (grade, sex, ethnicity, tobacco use, binge drinking) and school-level covariates (province, school area household median income). For first-offence violations of school cannabis policies, the vast majority of schools selected confiscating the product (93%), informing parents (93%), alerting police (80%), and suspending students from school (85%), among their disciplinary response options. Few schools indicated requiring students to help around the school (5%), issuing a fine (7%), or assigning additional class work (8%) as potential consequences. The mean number of total first-offence consequences selected by schools was 7.23 (SD = 2.14). Overall, 92% of schools reported always using a progressive disciplinary approach in which sanctions get stronger with subsequent violations. Students were less likely to report current cannabis use if they attended schools that indicated assigning additional class work (OR 0.57, 95% CI (0.38, 0.84)) or alerting the police (OR 0.81, 95% CI (0.67, 0.98)) among their potential first-offence consequences, or reported always using the progressive discipline approach (OR 0.77, 95% CI (0.62, 0.96)) for subsequent cannabis policy violations. In conclusion, results reveal the school disciplinary context in regard to cannabis policy violations in the year immediately preceding legalization. Various consequences for cannabis policy violations were being used by schools, yet negligible association resulted between the typ

Topics: Adolescent; Alberta; British Columbia; Cannabis; Female; Humans; Male; Marijuana Use; Ontario; Organizational Policy; Punishment; Quebec; Schools; Students

New Zealand will hold a public referendum in 2020 on the possible replacement of current cannabis prohibition with legalisation of use and supply policy. Cannabis legalisation policies have been implemented-albeit with heterogeneous regulatory frameworks-in several (eg, North/South America) jurisdictions, with yet inconclusive evidence on main health and social outcomes. The New Zealand government has recently presented the final draft of its Cannabis Legalisation and Regulation Bill, including main regulatory parameters and provisions of the legalisation framework. As regulation elements are known to determine feasibility and outcomes of legalisation policy, we have undertaken a critical review and assessment of 10 of the Bill's main regulation components, based on evidence from and experiences with cannabis policy elsewhere as well as other substance policy areas. The reviewed components include: "political promises; age of use/access; places of use; penalties for underage use; 'home-growing'; retail distribution; licensed production; products available; new/remaining offenses; research and monitoring". New Zealand's cannabis legalisation plan is embedded within an overall public health-oriented framework. However, multiple essential regulatory provisions appear questionable for feasibility, consistency with public health principles or practice, or may lead to-possibly un-intended-adverse outcomes. These regulatory elements should be re-considered and adjusted, ideally before possible implementation of legalisation if supported by the referendum.

Topics: Cannabis; Health Policy; Humans; Legislation, Drug; Marijuana Use; New Zealand; Public Health

Topics: Adolescent; California; Cannabis; Humans; Legislation, Drug; Marijuana Smoking; Marijuana Use; Prevalence; Social Justice

Topics: Adolescent; California; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Social Justice

Topics: Cannabis; Dronabinol; Germany; Humans; Marijuana Use; Medical Marijuana; Recreational Drug Use

Topics: Adolescent; Canada; Cannabis; Child; Humans; Marijuana Use; Pediatrics; Surveys and Questionnaires; Vaping

Topics: Biomedical Research; Canada; Cannabis; England; Humans; Illicit Drugs; Marijuana Abuse; Marijuana Use; National Institute on Drug Abuse (U.S.); Recreational Drug Use; United States

There is a well-established relationship between cannabis use and psychosis, although the exact nature of this relationship is not fully understood. Recent studies have observed significant genetic overlap between a diagnosis of schizophrenia and lifetime cannabis use. Expanding on this work, the current study aimed to examine whether genetic overlap also occurs for subclinical psychosis (schizotypy) and cannabis use, as well as examining the phenotypic association between the traits. Phenotypic correlations were calculated for a variety of schizotypy and cannabis phenotypes in the UK Biobank (UKB), and single nucleotide polymorphism (SNP)-based heritability estimates and genetic correlations were calculated for these UKB phenotypes as well as for several other variables taken from recent genomewide association studies. Positive phenotypic correlations were observed between 11 out of 12 pairs of the cannabis use and schizotypy phenotypes (correlation range .05-.18), indicating a robust association between increased symptoms of schizotypy and cannabis use. SNP-based heritability estimates for two schizotypy phenotypes remained significant after multiple testing correction: social anhedonia (h2SNP = .08, SE = .02, N = 4025) and ever seen an unreal vision (h2SNP = .35, SE = .10, N = 150,717). Finally, one significant genetic correlation was observed between schizotypy and cannabis use, a negative correlation between social anhedonia and number of times used cannabis (rg = -.30, p = .012). The current study suggests the relationship between cannabis use and psychosis is also seen in subclinical symptoms of psychosis, but further research with larger samples is needed to determine the biological mechanisms underlying this association.

Topics: Cannabis; Humans; Marijuana Use; Phenotype; Polymorphism, Single Nucleotide; Psychotic Disorders; Schizotypal Personality Disorder

Boys use cannabis at a younger age and more frequently than girls. It has been suggested these sex differences might vary according to students' relationship to school. We explored whether the association between sex and adolescents' cannabis use varies among schools and according to students' school connectedness.. The study population consisted of all students from 11 secondary schools in the greater Québec City area. The sample included 6185 respondents in years 1 to 5 at the secondary level (equivalent to grades 7-11). Study outcomes were monthly cannabis use and early cannabis use.. The association between sex and monthly cannabis use varied significantly among schools after controlling for students' main characteristics and school socioeconomic environment. We found a statistically significant modifying effect of school connectedness on the association between sex and monthly cannabis use. For early cannabis use, we found no modifying effect of school connectedness nor any association with sex.. Measures to reduce adolescents' cannabis use could be better adapted to local context and more tailored to specific higher-risk groups. School connectedness is a protective factor for cannabis use, although this effect appears stronger for girls than boys.

Topics: Adolescent; Adolescent Behavior; Cannabis; Humans; Marijuana Use; Schools; Sex Factors; Students

Cannabis warning labels can communicate risks, but there is little research on warning perceptions and differences by product type.. In a 2019 online survey, 1,000 U.S. adults (500 cannabis users and 500 cannabis non-users who used tobacco) were randomly assigned to view no warning or one of four U.S. or Canadian warnings displayed on images of packaging for dried flower or edible cannabis. The warnings described cannabis risks related to psychosis, addiction, lack of FDA oversight, and impaired driving. We used linear regression to examine perceptions of warnings and product harm as a function of product type (dried or edible) and warning. We examined which warning participants selected as most effective for discouraging youth use and impaired driving.. Participants found the addiction warning (cannabis users: B = -1.04, p < 0.001; cannabis non-users: B = 1.17, p < 0.001) and psychosis warning (users: B = -0.65, p < 0.05; non-users: B = -0.71, p < 0.05) less believable than the driving warning but indicated that they learned more from the psychosis warning than the driving warning (users: B = 0.88, p < 0.01; non-users (B = 1.60, p < 0.001). Participants viewing any warning considered smoking cannabis to be more harmful than those viewing no warning (all p < 0.05). The psychosis warning was most frequently selected as the best warning for discouraging youth use.. Warnings have the potential to educate consumers and impact cannabis harm perceptions. Warnings have similar effects across product types, potentially eliminating the need for product type-specific warnings. The association of cannabis use with risk for psychosis, a topic addressed in Canadian warnings, could be a useful topic of focus in U.S. warnings.

Topics: Adolescent; Adult; Behavior, Addictive; Canada; Cannabis; Female; Humans; Male; Marijuana Use; Middle Aged; Perception; Product Labeling; Product Packaging; Surveys and Questionnaires; United States; Young Adult

We use retail scanner data on purchases of high calorie food to study the causal relationship between recreational marijuana laws (RMLs) and consumption of high calorie food. To do this we exploit differences in the timing of introduction of recreational marijuana laws among states and find that they are complements. Specifically, in counties located in RML states monthly sales of high calorie food increased by 3.2 percent when measured by sales and 4.5 percent when measured by volume when using our preferred identification strategy. Results are robust to including placebo effective dates for RMLs in treated states and products as well as when using Synthetic Control Methods as an alternative methodology.

Topics: Cannabis; Commerce; Humans; Marijuana Use; Snacks

Diversion programs are considered alternatives to the arrest and incarceration of non-violent drug offenders, including those found in possession of smaller amounts of cannabis in states with prohibitive laws. Despite the progressive nature of such programs, the inability to complete diversion program requirements can often result in greater involvement with the criminal justice system than traditional case adjudication. Few studies have evaluated racial group differences in cannabis diversion program completion.. The current study examined a sample of 8323 adult participants in Harris County, Texas' Marijuana Misdemeanor Diversion Program (MMDP) between March 2017 and July 2019. Gender, age, and race/ethnicity were examined as predictors of program completion and time to completion using Chi square, Kruskal Wallis tests, and Cox proportional hazard regression models.. Both males and African Americans were over-represented (80 % and 50 %, respectively) among participants of Harris County's MMDP. African American (HR = 0.782, 95 % CI [.735-.832], p < .001) and Latino American MMDP participants (HR = .822, 95 % CI [.720-.937], p = .003) had significantly lower odds of MMDP completion and a longer interval to program completion as compared to non-Latino White participants.. The current study identified racial/ethnic and gender disparities in a large county's cannabis diversion program. These findings may be related to law enforcement disparities which disproportionately target males and people of color. Findings may serve to inform the continued reform of the criminal justice system, particularly laws relating to cannabis.

Topics: Adult; Cannabis; Criminal Law; Ethnicity; Female; Humans; Law Enforcement; Male; Marijuana Use; Middle Aged; Racial Groups; Sex Factors; Socioeconomic Factors; Texas; United States; Urban Population

Topics: Adolescent; Adult; Cannabis; Humans; Marijuana Use; Medical Marijuana; New Zealand; Public Health; Young Adult

Recent structural MRI studies on gray matter (GM) volumes using group-level mass-univariate statistical analysis suggest that chronic and heavy cannabis exposure may affect brain region-based morphology. In this prospective study, we use a multivariate pattern analysis approach to investigate the voxel-level change of GM densities in chronic heavy cannabis users. Principal component analysis and linear support vector machine are used in this study, resulting in an 88.1% separation between chronic heavy cannabis users (N = 20) and non-cannabis healthy controls (HCs, N = 22) through leave-one-out cross-validation. The model's discriminative pattern showed that GM density decreases in the part of middle frontal gyrus, inferior frontal gyrus, middle temporal gyrus, inferior temporal gyrus and left occipital lobe in heavy cannabis users with respect to HCs and increases in the part of lentiform nucleus, left cerebellum and right parietal lobe. These results suggest that GM densities alteration has taken place on chronic heavy cannabis users compared with HCs at voxel level.

Topics: Adult; Cannabis; Cerebral Cortex; Female; Gray Matter; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Marijuana Use; Multivariate Analysis; Prospective Studies; Young Adult

As states continue to legalize the sale of recreational cannabis, there is a need to study attitudes and behaviors regarding driving after cannabis use. The purpose of this study was to describe US adults' attitudes and behaviors regarding driving after cannabis use by state-level legal sale of recreational cannabis, and to determine whether these associations differ by frequency of cannabis use.. Data were collected from a national sample of 17,112 adults in the United States. Weighted adjusted prevalence ratios and 95% confidence intervals were used to compare the prevalence of behaviors and attitudes by state-level legal sale of recreational cannabis. Analyses were repeated among recent cannabis users, stratifying by cannabis use status.. Driving after cannabis use was more prevalent in legal cannabis sales states; however, so were potentially protective attitudes related to cannabis use and driving. After stratifying by frequency of use, daily/almost daily, weekly/monthly, and past 12-month users from states with legal recreational cannabis sales had significantly lower prevalence of driving after cannabis use and higher prevalence of protective attitudes compared to those from states without legal recreational sales. Risk perceptions were lower for cannabis than alcohol.. Public health messaging campaigns to reduce driving and riding after cannabis use and to improve attitudes regarding driving after cannabis use are warranted across all U.S. states, regardless of legalization status.

Topics: Adult; Attitude; Automobile Driving; Cannabis; Driving Under the Influence; Humans; Marijuana Use; United States

Sexual and gender minorities (SGM) are at increased risk for substance use and depression. However, little research has examined the directionality of associations between substance use and depression in this high-risk population, and we are not aware of any to parse associations between depression and changes in the frequency of substance use versus substance use cessation. Such research can help to inform the development of future interventions to address health disparities affecting SGM.. We used data from two longitudinal cohorts of SGM assigned male at birth (SGM-AMAB; N = 1,418) to examine associations between changes in frequency of alcohol, cannabis, and stimulant use and depressive symptoms. Multilevel models tested whether changes in substance use predicted changes in depressive symptoms and vice versa.. Results indicate that when SGM-AMAB decreased their alcohol use or ceased alcohol, cannabis, or stimulant use, they experienced concurrent decreases in depressive symptoms. Only reducing stimulant use (not alcohol or cannabis use) was associated with decreases in depressive symptoms over the subsequent 6 months. Depressive symptoms did not prospectively predict cessation or reduction in the use of any substance.. These findings suggest that clinical interventions targeting substance use may simultaneously reduce depressive symptoms and that reductions in alcohol use (even in the absence of cessation) may simultaneously benefit mental health among SGM-AMAB. The limited evidence of prospective effects over 6 months suggests that studies with shorter lags may be better equipped to examine the directionality of the association between depressive symptoms and substance use/reduction.

Topics: Adolescent; Adult; Alcohol Drinking; Cannabis; Cohort Studies; Depression; Female; Humans; Longitudinal Studies; Male; Marijuana Use; Prospective Studies; Sexual and Gender Minorities; Sexual Behavior; Substance-Related Disorders; Young Adult

Perhaps the best way to understand early-Twenty-First Century state and federal cannabis law in the United States is to examine the relevant history. Justice Oliver Wendell Holmes, Jr.'s statement is apropos: "[A] page of history is worth a volume of logic." This article begins by discussing the early history of cannabis and its uses. Next, the article examines the first state and federal marijuana laws. After a brief comparison of alcohol prohibition to cannabis prohibition, this article addresses cannabis laws from the 1920s to the early 1950s. Then, the article takes up the reorganization of the federal drug regulatory bureaucracy since its inception. Addressing the current era of cannabis laws and regulations, this article recounts how marijuana became a Schedule I drug. The discussion then turns to changing social attitudes towards cannabis as reflected in presidential politics and popular culture. Starting with the late-1990s, this article describes the development of state and federal cannabis laws and policies up to the present day.

Topics: Cannabis; Drug and Narcotic Control; History, 20th Century; Humans; Legislation, Drug; Marijuana Use; Policy Making; Politics; Popular Culture; United States

Cannabis use among older adults is on the rise. Despite growing interest in the topic, there exists a paucity of standardized measures capturing cannabis-specific attitudes among older adults. Using data from a survey of older Coloradans, we create two scales that separately measure medical and recreational cannabis attitudes. We also examine how these two attitudes relate to individual-level characteristics.. We assess reliability using Cronbach's alpha and item-rest correlations and perform confirmatory factor analyses to test the two attitude models. We conduct a seemingly unrelated regression estimation to assess how individual characteristics predict medical and recreational cannabis attitude scores.. Twelve indicators combined into two valid and reliable scales. Both scales had a three-factor structure with affect, cognition and social perception as latent dimensions. For both scales, fit indices for the three-factor model were statistically superior when compared with other models. The three-factor structure for both scales was invariant across age groups. Age, physical health, and being a caregiver differentially predicted medical and recreational cannabis attitude scores.. Medical and recreational cannabis attitude scales can inform the development and evaluation of tailored interventions targeting older adult attitudes that aim to influence cannabis use behaviors. These scales also enable researchers to measure cannabis-specific attitudes among older adults more accurately and parsimoniously, which in turn can facilitate a better understanding of the complex interplay between cannabis policy, use, and attitudes.

Topics: Aged; Cannabis; Colorado; Factor Analysis, Statistical; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Marijuana Use; Medical Marijuana; Reproducibility of Results; Surveys and Questionnaires

In nineteenth-century British India, concern regarding large numbers of asylum patients with 'Indian Hemp Insanity' led to establishment of the Indian Hemp Drugs Commission. The exotic cannabis plant was widely used in pharmacopeia and a source of government revenue. The Commission was tasked with determining the public health risks of cannabis use, particularly mental illness. This analysis of the Commission report seeks to highlight the status of 1892 cannabis research and compare it with current evidence for medical and recreational cannabis use.. Detailed historiographic review of the Indian Hemp Drugs Commission Report (1892).. In 1892, heavy cannabis use was considered to have been associated with severe mental illness (7.3% of asylum patients; 12.6% of patients with diagnoses). About two-thirds were children and young adults with higher relapse rates. Risk increased with early cannabis use and a family history of mental illness. Cannabis psychosis was found to have a shorter trajectory and better prognosis than other mental illnesses in the asylums. Different cannabis potency and modes of consumption had different effects. Occasional cannabis use was felt to have medicinal benefits for some. Appendices provided symptoms and demographic characteristics of cannabis-induced mental illness.. This important nineteenth-century study observed frequency and dose-related effects of cannabis on mental health, particularly psychotic symptoms in young people with a previous or hereditary risk of mental illness. Pathophysiological observations were consistent with current knowledge. As one of the most systematic and detailed studies of the effects of cannabis of the time it foreshadowed contemporary cannabis issues.

Topics: Adolescent; Cannabis; Child; Female; History, 19th Century; Hospitals, Psychiatric; Humans; India; Male; Marijuana Use; Mental Health; Psychotic Disorders; Young Adult

Topics: Accidents, Traffic; Canada; Cannabis; Humans; Marijuana Use; Psychoses, Substance-Induced

Topics: Cannabis; Crop Production; Horticulture; Humans; Marijuana Use; Medical Marijuana; Quality Control

Topics: Adult; Arachidonic Acids; Athletic Performance; Cannabidiol; Cannabis; Doping in Sports; Dronabinol; Endocannabinoids; Exercise; Female; Humans; Inflammation; Male; Marijuana Use; Motivation; Performance-Enhancing Substances; Polyunsaturated Alkamides; Reproducibility of Results; Young Adult

Problem-solving courts have developed across the United states to offer specific offenders, including those with substance use or mental disorders, alternatives to incarceration that often involve community-based treatment services and judicial supervision. At the same time, dozens of states have legalized the use of cannabis for medical or recreational purposes, even as cannabis use remains illegal under federal law. State legalization of cannabis use has introduced legal and medical complexities for problem-solving courts, particularly concerning the management of offenders who use cannabis. This article reviews implications of cannabis use for defendants' eligibility and participation in problem-solving courts, with a focus on adult drug courts and mental health courts. This article also examines a range of policies, such as abstinence-based, tolerance-based, and adaptive approaches, that problem-solving courts may consider implementing. Further research is needed to characterize existing problem-solving court policies toward cannabis use and to develop evidence-based practices that courts may follow.

Topics: Cannabis; Criminals; Humans; Judicial Role; Marijuana Use; Problem Solving; Social Control Policies; United States

Topics: Cannabis; Humans; Marijuana Use; Smoking; Substance-Related Disorders; Tobacco Use; Vaping

To establish whether the population-level pattern of cannabis use by quantity is similar to the distributions previously reported for alcohol, in which a small subset of drinkers accounts for a majority of total population alcohol consumption.. The current study pooled Waves 1-3 of the 2018 National Cannabis Survey (n = 18,900; 2584 past-three-month cannabis users), a set of stratified, population-based surveys designed to assess cannabis consumption and related behaviors in Canada. Each survey systematically measured self-reported cannabis consumption by quantity across seven of the major cannabis-product types. In order to enable the conversion of self-reported consumption of non-flower cannabis products into a standard joint equivalent (SJE: equal to 0.5 g of dried cannabis), we created conversion metrics for physical production equivalencies across cannabis products.. Similar to the findings in the alcohol literature, study results show that cannabis consumption is highly concentrated in a small subset of users: the upper 10% of cannabis users accounted for approximately two-thirds of all cannabis consumed in the country. Males reported consuming more cannabis by volume than females (approximately 60% versus 40%), with young males (15-34 years old) being disproportionately represented in the heaviest-using subgroups.. Most of the cannabis used in Canada is consumed by a relatively small population of very heavy cannabis users. Future research should attempt to identify the characteristics of the heaviest-using groups, as well as how population-level cannabis consumption patterns relate to the calculus of cannabis-related harms in society.

Topics: Adolescent; Adult; Age Distribution; Alcohol Drinking; Canada; Cannabis; Female; Humans; Male; Marijuana Use; Middle Aged; Self Report; Sex Distribution; Surveys and Questionnaires; Young Adult

Cannabis use and disorders (CUD) are influenced by multiple genetic variants of small effect and by the psychosocial environment. However, this information has not been effectively incorporated into studies of gene-environment interaction (GxE). Polygenic risk scores (PRS) that aggregate the effects of genetic variants can aid in identifying the links between genetic risk and psychosocial factors. Using data from the Pasman et al. GWAS of cannabis use (meta-analysis of data from the International Cannabis Consortium and UK Biobank), we constructed PRS in the Collaborative Study on the Genetics of Alcoholism (COGA) participants of European (N: 7591) and African (N: 3359) ancestry. The primary analyses included only individuals of European ancestry, reflecting the ancestral composition of the discovery GWAS from which the PRS was derived. Secondary analyses included the African ancestry sample. Associations of PRS with cannabis use and DSM-5 CUD symptom count (CUDsx) and interactions with trauma exposure and frequency of religious service attendance were examined. Models were adjusted for sex, birth cohort, genotype array, and ancestry. Robustness models were adjusted for cross-term interactions. Higher PRS were associated with a greater likelihood of cannabis use and with CUDsx among participants of European ancestry (p < 0.05 and p < 0.1 thresholds, respectively). PRS only influenced cannabis use among those exposed to trauma (R

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Black People; Cannabis; Child; Female; Gene-Environment Interaction; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Male; Marijuana Use; Middle Aged; Multifactorial Inheritance; Peer Influence; Risk Factors; Spirituality; Violence; White People; Young Adult

Using a nationally representative longitudinal cohort, we examine how cognitive aptitude in early adolescence is associated with heterogeneous pathways of marijuana use from age sixteen through young adulthood. We also examine whether this relationship can be explained by the role of cognitive aptitude in the social organization of peer group deviance.. Using the National Longitudinal Survey of Youth 1997, we identified 5 latent trajectories of frequency of marijuana use between ages 16 and 26: abstainers, dabblers, early heavy quitters, consistent users, and persistent heavy users. Multinomial regression assessed the relationship of cognitive aptitude in early adolescence with these latent trajectories, including the role of peer group substance use in this relationship.. A one decile increase in cognitive aptitude in early adolescence is associated with greater relative risk of the dabbler trajectory (RR = 1.048; p < .001) and consistent user trajectory (RR = 1.126; p < .001), but lower relative risk of the early heavy quitter trajectory (RR = 0.917; p < .05) in comparison with the abstainer trajectory. There was no effect for the persistent heavy user trajectory. The inclusion of peer group substance use-either via illegal drugs or smoking-had no effect on these relationships.. Adolescents who rate higher in cognitive aptitude during early adolescence may be more likely to enter into consistent but not extreme trajectories of marijuana use as they age into young adulthood. Cognition may not influence patterns of marijuana use over time via the organization of peer groups.

Topics: Adolescent; Adult; Aptitude; Cannabis; Cognition; Female; Humans; Male; Marijuana Abuse; Marijuana Use; Peer Group; Risk Factors; Substance-Related Disorders; Young Adult

Cannabis use is frequent among individuals with cocaine use disorder. Despite recent non-controlled studies advocating a therapeutic role of smoked cannabis, there is a paucity of evidence-based data on potential therapeutic and cognitive side-effects of this association.. We examined 63 cocaine-addicted subjects who used cannabis more than 50 times in lifetime (COC + CAN), 24 cocaine-addicted patients who use cannabis less than 50 times (COC), and 36 controls (CON). Participants were evaluated with an extensive battery of neurocognitive tests after two weeks of supervised detoxification in an inpatient treatment program. Patients were followed up in one, three, and six months after discharge.. Both groups of patients performed worse than CON on working memory, processing speed, inhibitory control, mental flexibility, and decision making. COC + CAN performed worse than COC on speed processing, inhibitory control and sustained attention, while COC performed worse than COC + CAN on mental flexibility. Concomitant cannabis use did not decrease relapses to cocaine use after one, three and six months. Among COC + CAN, earlier cocaine and cannabis use, and impaired executive functioning were predictive of relapse on cocaine after six months.. Our results did not support the recommendation of smoked cannabis as a safe therapeutic approach for cocaine-addicted patients due to significant negative cognitive side-effects and absence of efficacy. Further studies investigating frontal brain morphology, neuromaturation, and prescription of the non-psychoactive constituent of cannabis sativa cannabidiol among cocaine-addicted patients who use cannabis are warranted.

Topics: Adult; Analgesics; Attention; Cannabis; Case-Control Studies; Cocaine; Cocaine-Related Disorders; Decision Making; Female; Follow-Up Studies; Hallucinogens; Humans; Inhibition, Psychological; Male; Marijuana Use; Memory, Short-Term; Neuropsychological Tests; Reaction Time; Young Adult

Cannabis legalization and use are increasing globally, however, little is known about associations between cannabis use and other health behaviors, such as physical activity (PA). Importantly, the extent to which cannabis use is associated with PA in adolescents is yet to be explored in low- and middle-income countries (LMICs), where there may be unique sociodemographic and environmental characteristics compared with high-income countries. Therefore, this study examined the association between PA and cannabis use among adolescents in 21 LMICs using data from the 2010-2016 Global School-based Student Health Survey.. A multivariable logistic regression analysis was performed among a final sample of 89,777 adolescents (49.2% females) aged 12-15 years with a mean (SD) age of 13.7 (0.9) years.. The overall prevalence of past (i.e., in lifetime but not in past 30 days) and current (in past 30 days) cannabis use were 1.0% and 2.9% respectively, while the prevalence of adequate PA in the past week (7 days/week of 60 min of PA) was 16.6%. The prevalence of adequate levels of PA in past and current cannabis use was 7.3% and 6.9%, respectively. Current and past cannabis use (vs. never) were associated with a significant 0.62 (95% CI = 0.41-0.94) and 0.43 (95%CI = 0.30-0.63) times lower odds for achieving adequate levels of PA, respectively.. The results underscore the high prevalence of low PA among adolescents in LMICs, and emphasize the need to understand behavioral factors that may affect PA levels, such as cannabis use, when designing interventions to improve health.

Topics: Adolescent; Cannabis; Child; Cross-Sectional Studies; Developing Countries; Exercise; Female; Health Behavior; Health Surveys; Humans; Male; Marijuana Use; Poverty

Topics: Cannabis; Colorado; Emergency Medicine; Emergency Service, Hospital; Humans; Marijuana Use

Topics: Cannabis; Humans; Marijuana Use; Medical Marijuana; Motivation; Research

Topics: Adolescent; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Nicotiana; Parents

This study seeks to understand whether people substitute between recreational cannabis and conventional over-the-counter (OTC) sleep medications. UPC-level grocery store scanner data in a multivariable panel regression design were used to compare the change in the monthly market share of sleep aids with varying dispensary-based recreational cannabis access (existence, sales, and count) in Colorado counties between 12/2013 and 12/2014. We measured annually-differenced market shares for sleep aids as a portion of the overall OTC medication market, thus accounting for store-level demand shifts in OTC medication markets and seasonality, and used the monthly changes in stores' sleep aid market share to control for short-term trends. Relative to the overall OTC medication market, sleep aid market shares were growing prior to recreational cannabis availability. The trend reverses (a 236% decrease) with dispensary entry (-0.33 percentage points, 95% CI -0.43 to -0.24, p < 0.01) from a mean market share growth of 0.14 ± 0.97. The magnitude of the market share decline increases as more dispensaries enter a county and with higher county-level cannabis sales. The negative associations are driven by diphenhydramine- and doxylamine-based sleep aids rather than herbal sleep aids and melatonin. These findings support survey evidence that many individuals use cannabis to treat insomnia, although sleep disturbances are not a specific qualifying condition under any U.S. state-level medical cannabis law. Investigations designed to measure the relative effectiveness and side effect profiles of conventional OTC sleep aids and cannabis-based products are urgently needed to improve treatment of sleep disturbances while minimizing potentially serious negative side effects.

Topics: Cannabis; Colorado; Humans; Illicit Drugs; Marijuana Use; Nonprescription Drugs; Sleep Aids, Pharmaceutical; Sleep Initiation and Maintenance Disorders

Topics: Advisory Committees; Cannabis; Conflict of Interest; Drug and Narcotic Control; Expert Testimony; History, 19th Century; Humans; India; Marijuana Use; Psychoses, Substance-Induced; Taxes

At the present time there are continuing debates on the legal status of cannabis in New Zealand. Many of these debates have not given sufficient consideration to evidence concerning cannabis-related harm, much of which has been gathered here in New Zealand by the Christchurch Health and Development Study (CHDS) and the Dunedin Multidisciplinary Health and Development Study (DMHDS). We present a summary of this evidence, and recommendations for a cautious path forward for changing cannabis laws in New Zealand that aims at reducing cannabis-related harm.

Topics: Accidents; Cannabis; Depression; Humans; Marijuana Use; New Zealand; Risk Management

Given that risk perception has been found to be both a vulnerability and a protective factor with respect to consumption, the objectives of this study were to find out whether there exist specific patterns of risk perception associated with cannabis use and, if so, how they relate to cannabis consumption and to the sources of information on drugs accessed by young people. An ex post facto study was carried out with 1851 young Andalusians aged 18 to 29, using an adaptation of the Andalusian Government "Andalusian Population versus Drugs" survey. For the first objective, a cluster analysis was carried out in which three perceptual style groups were formed: "Strict", "Permissive-Awareness" and "Lax". Cannabis use in the "lax" group was found to be 14.31 times more frequent than in the "strict" group and 2.75 times more frequent than in the "permissive-awareness" group. A logistic regression analysis was also performed, which correctly predicted 80.4% of users and non-consumers. Correlation was found between perceptual styles and the sources of information used about drugs. This study identified three different risk perception styles that heavily correlated to cannabis consumption and to the type of sources young Andalusians use to obtain information about drugs, suggesting the need for a change in preventive policy.

Topics: Adolescent; Adolescent Behavior; Adult; Cannabis; Consumer Health Information; Female; Health Knowledge, Attitudes, Practice; Humans; Logistic Models; Male; Marijuana Use; Perception; Prospective Studies; Psychology, Adolescent; Risk-Taking; Surveys and Questionnaires; Young Adult

Topics: Cannabis; Hallucinogens; Humans; Marijuana Use; Obsessive-Compulsive Disorder

Topics: Arthroplasty; Cannabis; Humans; Marijuana Smoking; Marijuana Use; Self Report

The ZNF804A gene and cannabis use are risk factors for psychosis and both have also been associated with schizotypal traits. This study aimed to investigate: i) the association of lifetime cannabis use (and its dose effect) with schizotypal personality traits, and ii) whether the genetic variability at ZNF804A gene modulates that association. Our sample consisted of 385 Spanish non-clinical subjects (43.1% males, mean age = 21.11(2.19)). Schizotypy was evaluated using the three factors of the Schizotypal Personality Questionnaire-Brief (SPQ-B): Cognitive-Perceptual (SPQ-CP), Interpersonal (SPQ-I) and Disorganized (SPQ-D). Subjects were classified according to their frequency of cannabis consumption, and dichotomized as users or non-users. The effects of a genetic variant of ZNF804A (rs1344706) and cannabis use, as well as their interaction, on each of the three SPQ-B factors were assessed using linear models and permutation tests. Sex, SCL anxiety scores and use of other drugs were included as covariates. Our analysis showed a significant relationship between ZNF804A and SPQ-I: AA genotype was associated with higher scores (β = 0.885 p

Topics: Cannabis; Female; Gene-Environment Interaction; Genetic Association Studies; Genetic Predisposition to Disease; Humans; Kruppel-Like Transcription Factors; Male; Marijuana Use; Polymorphism, Single Nucleotide; Psychiatric Status Rating Scales; Psychotic Disorders; Schizotypal Personality Disorder; Young Adult

Research concerning the spatial orientation in patients with schizophrenia has demonstrated a state independent deficit in inhibition of return (IOR), which has been discussed as a vulnerability marker for schizophrenia. Other recent investigations on brain structure and cognitive processing have revealed less deficits in schizophrenia patients with comorbid cannabis use (SCH + CUD) compared to abstinent schizophrenia patients (SCH). It was hypothesized that these results may reflect a premorbid lower vulnerability in at least a subgroup of comorbid patients. The aim of the present study is to extend previous work by investigating IOR functioning in patients with schizophrenia and cannabis use. This in turn should supplement the existing studies on the vulnerability of this patient group. Therefore, we compared IOR functioning in four groups: 62 patients with schizophrenia and 46 healthy controls, both with and without cannabis use. Participants underwent a covert orienting of attention task (COVAT) with peripheral cues and three stimulus onset asynchronies (SOAs: 200 ms, 400 ms and 800 ms). Both schizophrenia groups displayed delayed IOR with a more pronounced IOR effect in SCH + CUD compared to SCH. In healthy controls, IOR did not seem to be significantly affected by cannabis use. Significant IOR-differences between groups were only seen between SCH patients without cannabis use and both healthy groups at SOA 400 ms. Patterns of cannabis use as well as clinical parameters of psychoses did not affect IOR. Our results may support the hypothesis of IOR as a vulnerability marker for schizophrenia and of a lower biological vulnerability in at least a subgroup of SCH + CUD.

Topics: Adult; Attention; Cannabis; Comorbidity; Female; Humans; Inhibition, Psychological; Male; Marijuana Use; Schizophrenia; Schizophrenic Psychology

The evolving legal status of cannabis world-wide necessitates evidence-based regulatory policies to minimize risks associated with cannabis misuse. A prominent concern is the impact legalization may have on the illegal cannabis market, including whether illegal cannabis will serve as a substitute for legal cannabis. Empirical data on this issue are virtually non-existent. This study used behavioral economics to investigate substitutability of legal and illegal cannabis in legalized catchment areas in the United States.. A substitution-based marijuana purchase task assessed estimated cannabis consumption from concurrently available legal (a dispensary) and illegal (a dealer) sources. Prices of the two options were reciprocally either held constant ($10/gram) or escalated ($0-$60/gram).. US states with legalized recreational cannabis.. Adult cannabis users who were at least 21 years old (n = 724; mean age = 34.13; 52% female; 74% Caucasian) were recruited using online crowdsourcing.. Mean consumption values were used in demand curve modeling to generate indices of price sensitivity and elasticity. Differences in demand indices were compared using extra sums-of-squares F-tests.. Both legal and illegal fixed-price cannabis options had significant positive cross-price elasticities (Ps < 0.001), indicating that higher prices motivate substitution irrespective of legality. However, the presence of a legal alternative had a substantially greater effect on consumption and elasticity of illegal cannabis (∆. Cannabis users treat legal cannabis as a superior commodity compared with illegal cannabis and exhibit asymmetric substitutability favoring legal product. Cannabis price policies that include somewhat higher consumer costs for legal cannabis relative to contraband (but not excessively higher costs) would not be expected to incentivize and expand the illegal market.

Topics: Adult; Cannabis; Commerce; Drug Trafficking; Economics, Behavioral; Female; Humans; Illicit Drugs; Male; Marijuana Use; Medical Marijuana; Young Adult

Topics: Cannabis; Child; Child, Preschool; Colorado; Emergency Service, Hospital; Female; Hospitals, Pediatric; Humans; Infant; Male; Marijuana Use; Poison Control Centers; Retrospective Studies

Cannabis consumption is widespread across the world, and the co-occurrence of cannabis use and alcohol consumption is common. The study of background noise - resting-state neural activity, in the absence of stimulation - is an approach that could enable the neurotoxicity of these substances to be explored. Preliminary results have shown that delta-9-tetrahydrocannabinol (Δ9-THC) causes an increase in neural noise in the brain. Neurons in the brain and the retina share a neurotransmission system and have similar anatomical and functional properties. Retinal function, evaluated using an electroretinogram (ERG), may therefore reflect central neurochemistry. This study analyses retinal background noise in a population of regular co-occurrent cannabis and alcohol consumers.. We recorded the flash ERGs of 26 healthy controls and 45 regular cannabis consumers, separated into two groups based on their alcohol consumption: less than or equal to 4 glasses per week (CU ≤ 4) or strictly >4 glasses per week (CU >4). In order to extract the background noise, the Fourier transform of the pseudo-periodic and sinusoidal signals of the 3.0 flicker-response sequence was calculated. This sequence represents the vertical transmission of the signal from cones to bipolar cells. The magnitude of the background noise is defined as the average of the magnitudes of the two neighbouring harmonics: harmonic -1 (low frequency noise) and harmonic +1 (high frequency noise).. The magnitude of harmonic -1 was significantly increased between the groups CU > 4 (6.78 (±1.24)) and CU ≤ 4 (5.69 (±1.80)) among regular users of cannabis and alcohol. A significant increase in the average magnitude of the two harmonics was found between the groups CU > 4 (5.12 (±0.92)) and CU ≤ 4 (4.36 (±1.14)). No significant difference was observed with regard to the magnitude of the harmonic +1.. The increase in background noise may reflect the neurotoxicity of cannabis, potentiated by alcohol consumption, on retinal neurons dynamic. This neural disruption of the response generated by retinal stimulation may be attributable to altered neurotransmitter release.

Topics: Adult; Alcohol Drinking; Cannabis; Electroretinography; Female; Humans; Male; Marijuana Use; Photic Stimulation; Retina; Vision, Ocular

There is a rapidly evolving legal and medical culture around cannabis, with corresponding changes in the demographics of users. For instance, the percentage of the aging population accessing cannabis is growing substantially, outpacing other age groups. The goals of this study were to describe the acute effects of cannabis, subjective experiences of withdrawal, and beliefs around the addictiveness of cannabis, as well as to determine whether these effects differ as a function of age or reason for use (medical vs. recreational use). It was hypothesized that medical users and younger users would report fewer adverse effects.. Survey responses from 2905 cannabis users were analyzed.. Hierarchical logistic regression analyses were used to compare group percentages after statistically controlling for confounding differences in their demographic and cannabis use characteristics. The most commonly endorsed acute effects were improved sleep, more calm/peaceful, desire to eat, more creative, and dry mouth; while the most commonly endorsed withdrawal symptoms were irritability, insomnia, and anxiety. Relative to recreational users, medical users were less likely to report undesirable acute effects but were more likely to report undesirable withdrawal symptoms. Older (50+) individuals reported fewer undesirable acute effects and withdrawal symptoms compared with younger users (18-29). Only 17% of the total sample reported believing that cannabis is addictive, and this did not vary as a function of reason for use.. Older people and medical users appear to experience acute and withdrawal effects of cannabis differently than recreational and younger users, perhaps because these groups benefit more from the medicinal properties of cannabis. These data can provide descriptive information to help inform health care providers and potential consumers about effects of cannabis use.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Behavior; Cannabis; Cognition; Cross-Sectional Studies; Female; Humans; Male; Marijuana Use; Medical Marijuana; Middle Aged; Plant Extracts; Substance Withdrawal Syndrome; Young Adult

To assess, before legalization in Canada, whether parental cannabis use is associated with initiation of use in adolescent offspring or with use in young-adult offspring.. Data were available in 2 longitudinal studies in Montréal, Canada. In AdoQuest, 1048 parents with children in grade 6 reported past-year cannabis use. Cannabis initiation among offspring was measured in grade 7, 9, and/or 11. In the Nicotine Dependence in Teens study, cannabis use data were available for 584 participants (mean age 24 years) and their parents (ie, 542 offspring-mother pairs, 438 offspring-father pairs). The association between parental and offspring cannabis use was estimated using multivariable logistic regression in both studies.. In AdoQuest, grade 6 never-users were 1.8 times more likely to initiate cannabis during high school if their parents reported past-year use. In the Nicotine Dependence in Teens study, the aORs (95% CI) for past-year cannabis use among adult offspring were not different for "mother uses cannabis" (2.8 [1.4-5.8]) or "father uses cannabis" (2.1 [1.2-3.8]). Participants with 1 or 2 cannabis-using parents were 1.7 and 7.1 times more likely to use cannabis, respectively, than participants with non-using parents.. To enable informed decision-making about their own cannabis use, parents need to be aware that children of cannabis users are more likely to use cannabis in adolescence and young adulthood.

Topics: Adolescent; Adolescent Behavior; Adult; Canada; Cannabis; Female; Humans; Logistic Models; Male; Marijuana Use; Parents; Risk Factors; Surveys and Questionnaires; Young Adult

Few studies have explored how polygenic propensity to cannabis use unfolds across development, and no studies have yet examined this question in the context of environmental contributions such as peer cannabis use. Outlining the factors that contribute to progression from cannabis initiation to problem use over time may ultimately provide insights into mechanisms for targeted interventions. We sought to examine the relationships between polygenic liability for cannabis use, cannabis use trajectories from ages 12-30 years and perceived peer cannabis use at ages 12-17 years.. Mixed-effect logistic and linear regressions were used to examine associations between polygenic risk scores, cannabis use trajectory membership and perceived peer cannabis use.. United States.. From the Collaborative Study on the Genetics of Alcoholism (COGA) study, a cohort of 1167 individuals aged 12-26 years at their baseline (i.e. first) interview.. Key measurements included life-time cannabis use (yes/no), frequency of past 12-month cannabis use, maximum life-time frequency of cannabis use, cannabis use disorder (using DSM-5 criteria) and perceived peer cannabis use. Polygenic risk scores (PRS) were created using summary statistics from a large (n = 162 082) genome-wide association study (GWAS) of cannabis use.. Genetic propensity to cannabis use derived from heterogeneous samples appears to correlate with longitudinal increases in cannabis use frequency in young adults.

Topics: Adolescent; Alcoholics; Cannabis; Child; Cohort Studies; Female; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Male; Marijuana Use; Multifactorial Inheritance; Peer Influence; Risk Factors; United States; White People; Young Adult

Cannabis use is associated with unwanted health outcomes, including anxiety, depression, poor sleep hygiene, and disrupted cognitive functioning. However, research to date has not been able to disentangle the complexities of these relations, leaving behavioral health service providers lacking clear direction for treatment. A limiting factor may be the common practices for cannabis use assessment. Cannabis use is typically assessed by frequency, even though to estimate the amount of psychoactive compounds ingested potency, quantity, and route of administration should also be assessed. This study, one of the first of its kind, takes an important step in assessing cannabis use by studying the link between cannabis potency and behavioral health (i.e., physical and mental health) outcomes. Self-reported data were analyzed using the New Statistics, which focuses on effect sizes and confidence intervals, rather than null hypothesis significance testing. Findings were inconsistent, with some positive, some negative, and some trivial associations across four domains (i.e., demographic variables, cannabis use variables, mental health, and physical health). The most valuable discovery was the importance of method of administration in understanding the link between potency and health. We observed a "potency valley" (i.e., a range of potencies for which products were not available) between flower potencies and concentrate potencies. Further, collapsing potency data across flower and concentrated cannabis obscured important relations between cannabis potency and behavioral health outcomes. Findings suggest that to more fully understand the relation between cannabis potency and behavioral health outcomes, researchers should examine potency separately across routes of administration.

Topics: Adult; Anxiety; Cannabis; Depression; Female; Health Status; Humans; Male; Marijuana Use; Mental Health; Self Report; Young Adult

In the context of cannabis legalization, an important question among clinicians, policymakers, and the public is whether availability of legal cannabis will significantly reduce consumption (demand) of illegal cannabis. Using paradigms from behavioural economics, we tested the prediction that legal cannabis would be an asymmetrical substitute for illegal cannabis, with legal cannabis operating as a superior commodity based on its regulated status. In a sample of 289 adult cannabis users in Ontario, we found evidence of substitutability for both legal and illegal cannabis, but significantly lower substitutability of illegal for legal cannabis, a pattern that was also present for price elasticity (α) and P

Topics: Adult; Cannabis; Commerce; Economics, Behavioral; Female; Humans; Illicit Drugs; Legislation, Drug; Male; Marijuana Use; Ontario

Introduction State legalization of marijuana for medical purposes could increase illicit marijuana use among young people. Medical marijuana laws may boost the availability of marijuana and reduce perceptions of its harmfulness, leading more young people to try it. Prior studies report little evidence that these laws are impacting marijuana consumption by young Americans, and none have systematically compared developmentally distinct age groups. Methods We performed multilevel, serial cross-sectional analyses on ten annual waves of U.S. National Survey on Drug Use and Health, from 2004 to 2013, comparing young people in states with and without medical marijuana laws. Disaggregated analyses compared multiple measures of marijuana use across approximately 450,300 individuals in early adolescence (12-14 years), late adolescence (15-17 years) and young adulthood (18-25 years). Results Dwelling in a state that had legalized medical marijuana was not associated with marijuana consumption in the past month among early adolescents, late adolescents or young adults. However, young adults living in medical marijuana states were significantly more likely to have initiated first use in the past year. Conclusions Medical marijuana laws increase the likelihood that young adults will start using marijuana but do not affect more vulnerable developmental groups in early and late adolescence. Delaying the age of first use into young adulthood can reduce the risk of a drug use disorder later in life. Young adults are in the peak years of engagement with illicit drugs and state medical marijuana laws appear to be leading larger numbers to try the drug.

Topics: Adolescent; Adult; Cannabis; Child; Child Development; Criminal Law; Cross-Sectional Studies; Female; Humans; Male; Marijuana Use; Regression Analysis; Surveys and Questionnaires; United States

Topics: Cannabis; Female; Humans; Marijuana Smoking; Marijuana Use; Nausea; Pregnancy; Vomiting

Topics: Cannabis; Female; Humans; Marijuana Smoking; Marijuana Use; Nausea; Pregnancy; Vomiting

Topics: Canada; Cannabis; Consumer Product Safety; Emergency Service, Hospital; Food; Food Additives; Health Knowledge, Attitudes, Practice; Humans; Legislation, Drug; Marijuana Use; Needs Assessment; Public Health

The purpose of the study was to describe associations between employment and marijuana use among adolescents 2 years before passage of 2012 ballot initiative and 2 years after the implementation of retail recreational marijuana sales took place in Washington.. We used 2010 and 2016 data from Washington's statewide school-based Healthy Youth Survey, which is completed by more than 76,000 youth annually and representative of 8th, 10th, and 12th graders in public schools. We used "difference-in-differences" regression to estimate the odds of current, past 30-day marijuana use by working status and hours worked per week compared with nonworking youth.. Working adolescents in all grades had higher prevalence of recent marijuana use compared with nonworking adolescents. Youth working in formal settings, such as retail and service sectors, were more likely to use marijuana than nonworking and youth working in informal settings, such as babysitting. Between 2010 and 2016, marijuana use decreased significantly among working and nonworking 8th and 10th graders. Among working 12th graders, marijuana use increased significantly over time relative to nonworking youth (adjusted odds ratio: 1.34, 95% confidence interval: 1.22-1.48). Associations were stronger for youth who worked more hours per week.. Working youth were more likely to use marijuana before and after Washington's legalization of retail marijuana. Legalization was associated with increases in marijuana use specifically among 12th-grade working youth. States legalizing marijuana may consider implementing interventions to support healthy behaviors among working youth.

Topics: Adolescent; Age Factors; Cannabis; Child; Commerce; Employment; Female; Health Surveys; Humans; Male; Marijuana Use; Prevalence; Schools; Students; Washington

Topics: Cannabis; Humans; Liver Transplantation; Marijuana Smoking; Marijuana Use

Although the rate of cannabis use by older adults is increasing more quickly than all other age groups, little is known about the reasons why older adults use cannabis and the outcomes they experience.. The objective of this study was to identify the most salient themes concerning the use of medical and recreational cannabis by older adults living in Colorado. Specifically, we sought to (1) characterize perceptions of cannabis use by users and non-users, (2) determine how older adults access cannabis, and (3) explicate both positive and negative outcomes associated with cannabis use.. Between June and November 2017, we conducted 17 focus groups in senior centers, health clinics, and cannabis dispensaries in 15 Colorado cities. Participants included 136 persons aged over 60 years who were both users and non-users of cannabis. We coded and analyzed session transcripts using thematic analysis with NVivo software.. We identified 16 codes from which five main themes emerged. These themes included: a lack of education and research about cannabis, a lack of provider communication, access to medical cannabis, the outcomes of cannabis use, and a reluctance to discuss cannabis use.. Older adults want more information about cannabis and desire to communicate with their healthcare providers. Older adults who used cannabis for medical purposes reported positive outcomes but highlighted difficulties in accessing medical cannabis. Older adults in Colorado also revealed how a stigma continues to be attached to using cannabis.

Topics: Aged; Cannabis; Colorado; Female; Humans; Male; Marijuana Use; Medical Marijuana; Middle Aged; Pain Management; Senior Centers

Some research suggests that marijuana use facilitates an anti-inflammatory response, yet the relationship between marijuana use and inflammation, as measured by C-reactive protein (CRP), remains poorly understood. The present study examined the association between recency of marijuana use and serum C-reactive protein levels in a nationally representative sample of adults.. Data from Waves III and IV (N = 13,166) of the National Longitudinal Study of Adolescent to Adult Health was utilized. Past 30 day marijuana use was assessed in Waves III and IV, and past year marijuana use was also assessed at Wave IV. CRP was dichotomized with a cutpoint of 3 mg/L. Logistic regression analyses examined the association between marijuana use and CRP levels at Wave IV.. Past 30 day marijuana use was reported by 23.5% and 17.7% of participants at Wave III and Wave IV respectively, and 23.6% of participants reported past year marijuana use during Wave IV. Marijuana use was associated with lower CRP levels in bivariate analyses. However, these associations attenuated after adjusting for sociodemographic and health-related covariates.. Though marijuana and lower CRP levels were initially associated, the effect of marijuana use on CRP was later explained by gender, BMI, and anti-inflammatory medication use. This suggests that marijuana use does not confer an anti-inflammatory effect and recency of use is not relevant. Given expanding marijuana use legislation and discourse surrounding the consequences of marijuana for health, continued research is needed to elucidate the effect of marijuana on inflammation and subsequent risk of chronic disease.

Topics: Adolescent; Adult; Anti-Inflammatory Agents; C-Reactive Protein; Cannabis; Chronic Disease; Female; Humans; Inflammation; Longitudinal Studies; Male; Marijuana Use; Medical Marijuana; Young Adult

Topics: Cannabis; Female; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Pregnancy; Public Health

Topics: Cannabis; Female; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Pregnancy; Public Health

Given a rapidly changing policy landscape, we sought to characterize the effects of state marijuana laws on parents' views of marijuana use by their teenage children.. Data are from 595 respondents to a nationally administered, web-based survey of parents of adolescents (ages 13-18 years) with any of three chronic conditions (type 1 diabetes, rheumatic disease, attention-deficit/hyperactivity disorder). Multivariate ordinal logistic regression was used to model the effects of parents' reports of state cannabis laws on their views toward marijuana use by their child.. While 89.9% said any marijuana use was risky for their child, 27.9% would approve of its use if prescribed as medicine. Parents reporting marijuana decriminalization (11.1%) were more amenable to teenage use, less concerned about how marijuana might impact their child's condition, more accepting of the safety of marijuana as medicine, and approved its use with a prescription. Parents reporting legal medical (35.6%) or recreational (5.7%) use were more likely to report that their child has tried or used marijuana regularly. Parents reporting legal recreational use were less likely to agree that marijuana has medical benefits for their child.. Among parents of medically vulnerable children, perceiving state marijuana policies as more permissive is strongly associated with lower perceived riskiness of marijuana use for their children. State marijuana policies are changing with implications for how parents of medically vulnerable youth view and potentially govern marijuana use by their medically vulnerable children.

Topics: Adolescent; Adult; Cannabis; Chronic Disease; Cross-Sectional Studies; Female; Humans; Legislation, Drug; Male; Marijuana Smoking; Marijuana Use; Middle Aged; Parents; Surveys and Questionnaires; Vulnerable Populations

Topics: Adolescent; Cannabis; Humans; Latent Class Analysis; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Young Adult

Drug-related cues play a critical role in the development and persistence of substance use disorder. Few human laboratory studies have evaluated how these cues contribute to decisions between concurrently presented reinforcers, and none have examined the specific role of cannabis cues. This study evaluated the contribution of cannabis-related cues to concurrent monetary reinforcer choice in humans.. Participants with a cannabis use history (i.e., use in the past two weeks and 50 or more lifetime uses; n = 71) and controls without this history (i.e., 5 or less lifetime uses; n = 79) were recruited using Amazon Mechanical Turk. A cued concurrent choice task was used in which cannabis trials presented two cues (one cannabis and one neutral) side-by-side followed by concurrent monetary offers below each image. The primary dependent measure was choice for cannabis-cued monetary reinforcers on equal value trials. Secondary analyses evaluated individual difference variables related to choice bias.. Participants in the cannabis group showed a significant bias for cannabis-cued choices (mean 76.0%) whereas participants in the control group showed a significant bias against cannabis-cued choices (mean 30.3%). Reaction times on cannabis trials were faster than neutral filler trials and did not differ by group. Cannabis-cued choice was significantly associated with more frequent cannabis use (r = .44), higher cannabis demand intensity (r = .28), and lower cannabis elasticity (r = -.30).. These findings suggest that cannabis-related cues can influence reinforcer choice and potentially promote disadvantageous decision-making related to non-drug reinforcers.

Topics: Adult; Attention; Cannabis; Choice Behavior; Cues; Female; Humans; Male; Marijuana Use; Photic Stimulation; Random Allocation; Reaction Time; Reinforcement, Psychology; Young Adult

As the legal status of cannabis changes across the United States and modes of administration expand, it is important to examine the potential impact on adolescent cannabis use. This study aimed to assess changes in prevalence of frequent cannabis use in adolescents in the United States and how far this varies by age and cohort.. Analysis of Monitoring the Future, a nationally representative annual survey of 8th-, 10th- and 12th-grade students in the United States conducted from 1991 to 2018.. In-school surveys completed by US adolescents.. A total of 1 236 159 8th-, 10th- and 12th-graders; 51.5% female, 59.6% non-Hispanic white, 12.3% non-Hispanic black, 13.4% Hispanic and 14.7% other race/ethnicity.. Frequent cannabis use (FCU), defined as six or more occasions in the past 30 days, stratified by sex, race/ethnicity and parental education.. FCU among US adolescents increased over the study period; the peak in 2010-18 was 11.4% among 18-year-old students. This increase was best explained by both period and cohort effects. Compared with respondents in 2005, adolescents surveyed in 2018 had period effects in FCU that were 1.6 times greater. Adolescents in younger birth cohorts (those born > 1988) had a lower increase in FCU than those born prior to 1988. Results were consistent across sex, parent education and race/ethnicity, with period effects indicating increasing FCU after 2005 and cohort effects indicating a lower magnitude of increase in more recent birth cohorts. Age and parental education disparities in FCU have increased over time, whereas race/ethnicity differences have converged over time; black students were 0.67 [95% confidence interval (CI) = 0.64-0.70] times as likely to use cannabis frequently as white students from 1991 to 2000, and 1.03 (95% CI = 0.98-1.09) times as likely from 2011 to 2018 (P-value for time interaction < 0.001).. The prevalence of frequent cannabis use (FCU) increased from 1991 to 2018 among older adolescents in the United States. Racial/ethnic differences in FCU converged, whereas parental education differences have diverged.

Topics: Adolescent; Age Factors; Cannabis; Cohort Effect; Cohort Studies; Ethnicity; Female; Humans; Male; Marijuana Use; Prevalence; Students; Surveys and Questionnaires; United States

Previous research suggests that some adolescents are using e-cigarette devices to vaporise ('vaping') cannabis in the form of hash oil, tetrahydrocannabinol (THC) wax or oil, or dried cannabis buds or leaves. However, it is unclear how adolescents who vape cannabis use other tobacco products. This study examined the extent to which adolescents reported ever vaping cannabis and investigated how demographic variables and tobacco behaviours were associated with use.. We used cross-sectional data from adolescents (total response rate 64.5%) who participated in the 2017 North Carolina Youth Tobacco Survey. SAS logistic regression survey procedures were used to account for the complex survey design and sampling weights.. North Carolina, USA.. Adolescents in high school (n=2835).. Adolescents were asked to indicate whether they had ever used an e-cigarette device with marijuana, THC or hash oil, or THC wax.. Approximately 1 in 10 high school students reported ever vaping cannabis in the overall sample (9.6%). In multivariable models, adolescents who reported using cigars (adjusted OR (aOR) 3.76, 95% CI 2.33 to 6.07), waterpipe (aOR 2.32, 95% CI 1.37 to 3.93) or e-cigarettes (aOR 3.18, 95% CI 2.38 to 4.25) in the past 30 days had higher odds of reporting ever vaping cannabis compared with their counterparts. There was no significant association between use of smokeless tobacco (aOR 0.89, 95% CI 0.42 to 1.91) or use of cigarettes (aOR 1.27, 95% CI 0.71 to 2.29) in the past 30 days and odds of reporting ever vaping cannabis.. These findings provide evidence that large numbers of high school students who use tobacco products have vaped cannabis. As tobacco control policies-such as communication campaigns or smoke-free laws-increasingly focus on e-cigarettes, attention to understanding how adolescents use e-cigarettes to vape substances other than nicotine is essential.

Topics: Adolescent; Adolescent Behavior; Cannabis; Cluster Analysis; Comorbidity; Cross-Sectional Studies; Female; Humans; Male; Marijuana Use; North Carolina; Prevalence; Tobacco Use; Vaping

Topics: Asia, Central; Cannabis; History, Ancient; Humans; Marijuana Use

Cannabis policies should be relevant to communities most impacted by them. Home cultivation policies can engage people who grow cannabis and build on their motivation to supply a safe product. This paper aims to examine the laws pertaining to "home" (i.e. personal, small-scale) cannabis cultivation internationally and their different aspects, and to discuss the potential of these policies to be expanded into community-level cannabis supply models.. We reviewed relevant laws and regulations in states/countries that legalised, decriminalised or applied other non-prohibitive approaches to home cannabis cultivation.. Non-prohibitive approaches to home cannabis cultivation have been adopted in at least 27 jurisdictions. Twelve jurisdictions "de jure" legalised home cultivation (three U.S. states and Antigua and Barbuda legalised only home cultivation; six U.S. states, Uruguay and Canada legalised commercial sales as well). Eight states/countries "de facto" (Belgium, the Netherlands) or "de jure" decriminalised it (Czech Republic, Spain, Jamaica, and three Australian states). "De jure" depenalisation was in place in Chile and Brazil and recent court rulings yielded "de facto" depenalisation or "de facto" legalisation in five other jurisdictions (South Africa, Mexico, Colombia, Costa Rica and Georgia). Varying number of plants (per person and per property) and the circumstances of cultivation were in place. The key limitations of the regulations included (i) possession thresholds for the produce from home cultivations, (ii) rules about sharing the produce, and (iii) potentially disproportionate sanctions for non-authorised behaviours. Despite currently being limited, home cultivation policies might have the capacity to engage cannabis networks that already exist in the community and like that, enhance their participation in legitimate policy schemes.. Rules around pooled cultivation and sharing could be made fit for purpose to accommodate community supply of cannabis. Home cultivation policies could serve as a basis for community-level cannabis supply models and as such, for more inclusive cannabis policies.

Topics: Cannabis; Commerce; Humans; Legislation, Drug; Marijuana Use; Public Policy

Amid changing marijuana policies in the Southern Cone, we examined relationships between marijuana-related risk factors and marijuana use among adolescents in Argentina, Chile, and Uruguay from 2001 to 2016.. In all countries, marijuana use increased over time and adolescents who perceived no/low risk and easy availability had higher odds of use. In Argentina, the bivariate risk/use association weakened from 2001 (OR = 15.24, 95%CI = 9.63, 24.12) to 2004 [OR = 3.86 (2.72, 5.48)] and strengthened until 2011 [OR = 8.22 (7.56, 10.30)]; the availability/use association strengthened from 2005 [OR = 5.32 (4.05, 6.98)] to 2009 [OR = 20.77 (15.57, 27.70)] and weakened until 2014 [OR = 11.00 (9.11, 13.27)]. In Chile, the risk/use association weakened from 2001 [OR = 7.22 (6.57, 7.95)] to 2015 [OR = 5.58 (4.82, 6.48)]; the availability/use association weakened from 2001 [OR = 5.92 (4.96, 7.06)] to 2015 [OR = 4.10 (3.15, 5.34)]. In Uruguay, the risk/use association weakened from 2003 [OR = 34.22 (22.76, 51.46)] to 2016 [OR = 6.23 (4.96, 7.83)]; the availability/use association weakened from 2005 [OR = 29.13 (13.39, 63.39) to 2007 [OR = 9.42 (3.85, 23.07)], and strengthened until 2016 [OR = 22.68 (12.03, 42.76)].. Overall, the association between risk and use weakened in all countries, suggesting risk perceptions became a weaker determinant of marijuana use. Perceived availability remained strongly associated with use and may become an increasingly important driver of use (particularly in Uruguay and Argentina).

Topics: Adolescent; Adolescent Behavior; Argentina; Cannabis; Chile; Cross-Sectional Studies; Female; Health Surveys; Humans; Male; Marijuana Use; Risk Factors; Uruguay; Young Adult

Topics: Adolescent; Cannabis; Employment; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Socioeconomic Factors; Washington

Topics: Cannabis; Humans; Marijuana Use; Medical Marijuana; United States

This paper combines complementary attributes of web and general population surveys to estimate cannabis consumption and spending in Washington State. It compares those estimates to legal sales recorded by the state's seed-to-sale tracking system, and thus exploits a rare opportunity to contrast two independent estimates for the same cannabis market. This sheds light on the question of whether nontrivial amounts of black market sales continue even after a state allows licensed production and sale.. Prevalence of past-month use is estimated from the 2015/16 U.S. National Survey on Drug Use and Health, adjusted for under-reporting. Estimates of consumption and spending per user broken down by age, gender, and frequency of use are developed from RAND's 2013 survey of cannabis users in Washington State. Supply side estimates come from the Washington State Liquor and Cannabis Board's seed-to-sale tracking system. They are expressed in terms of spending, equivalent-weight of flowers, and THC, with THC for edibles imputed using a machine learning technique called random forests.. For the period July 1, 2016 to June 30, 2017, Washington's seed-to-sale data record sales from licensed cannabis stores of $1.17B and across all products an amount of THC that is equivalent to roughly 120-150 MT of flower. Survey responses suggest that amounts spent and quantities consumed are larger than that, perhaps on the order of $1.66B and over 200 MT, respectively.. A perfect match is not expected because of sales to tourists, residual black market activity, production for medical purposes, and diversion across state lines. Nonetheless, the results suggest that three years after state-licensed stores opened, there remained considerable consumption of cannabis supplied outside of the licensed system.

Topics: Adult; Cannabis; Commerce; Data Interpretation, Statistical; Female; Humans; Internet; Legislation, Drug; Male; Marijuana Smoking; Marijuana Use; Marketing; Surveys and Questionnaires; Washington; Young Adult

Topics: Adult; Cannabis; Child; Dronabinol; Humans; Marijuana Use; Marketing

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cannabis; Female; Humans; Legislation, Drug; Male; Marijuana Use; Middle Aged; Risk Factors; Washington; Young Adult

Topics: Cannabis; Female; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Pregnancy; Self Report

In 2013 Uruguay regulated three models for the supply of cannabis for recreational use (Law 19.172), including Cannabis Social Clubs (CSCs). According to the Cannabis Regulation and Control Institute, 110 CSCs are active at the time of writing.. This paper has a twofold goal. Firstly, it aims to take stock of how the CSC model has continued to be implemented in practice, drawing on the first-hand accounts of those involved in its management. Secondly, our analysis seeks to contribute to the understanding of the CSC model by considering the different variants of the model that have emerged in Uruguay.. Our analysis draws on qualitative research conducted in Uruguay between June and October of 2018. We conducted 15 semi-structured and face-to-face interviews with representatives of registered Uruguayan CSCs and with 13 other stakeholders.. CSCs' role as cannabis suppliers is perceived positively in terms of the type of cannabis produced and the means of distribution. We found that truly social CSCs co-exist with, and may be losing ground to, quasi-dispensary clubs. A number of factors may have contributed to this, including the Uruguayan regulatory framework, institutional context, and disengagement of members and/or CSC managers. This raises potential new challenges as to the contribution of the CSC model from a harm reduction perspective.

Topics: Cannabis; Commerce; Humans; Interviews as Topic; Marijuana Use; Models, Organizational; Uruguay

Topics: Adolescent; Brain; Brain Chemistry; Cannabis; Humans; Marijuana Use; Substance-Related Disorders

Topics: Cannabis; Health Knowledge, Attitudes, Practice; Humans; Marijuana Abuse; Marijuana Use; New Zealand; Psychotic Disorders; Violence

Marijuana use is disproportionately prevalent among HIV-infected individuals. The strongest neurocognitive effect of marijuana use is impairment in the domain of memory. Memory impairment is also high among HIV-infected persons. The present study examined 69 HIV-infected individuals who were stratified by age of regular marijuana initiation to investigate how marijuana use impacts neurocognitive functioning. A comprehensive battery assessed substance use and neurocognitive functioning. Findings indicated early onset marijuana users (regular use prior to age 18), compared to non-marijuana users and late onset marijuana users (regular use at age 18 or later), were over 8 times more likely to have learning impairment and nearly 4 times more likely to have memory impairment. A similar pattern of early onset marijuana users performing worse in learning emerged when examining domain deficit scores. The potential for early onset of regular marijuana use to exacerbate already high levels of memory impairment among HIV-infected persons has important clinical implications, including increased potential for medication non-adherence and difficulty with independent living.

Topics: Adolescent; Adult; Cannabis; Cognition; Cognitive Dysfunction; Female; HIV Infections; Humans; Learning; Male; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Memory Disorders; Memory, Short-Term; Middle Aged; Neuropsychological Tests; Substance-Related Disorders

Topics: Cannabis; Cooking; Humans; Information Dissemination; Marijuana Use; Social Media; Video Recording

Topics: Cannabinoids; Cannabis; Evidence-Based Medicine; Humans; Legislation, Drug; Marijuana Use; Medical Marijuana

Although recent Cannabis use is widely reported to be associated with drug-related traffic accidents, the evidence that Cannabis users show an increased risk of being involved in road crashes is still not unequivocally proved. The purpose of the present work is to provide an objective assessment of this hypothesis, by comparing the frequency of occurrence of positive urine analyses in drivers involved in traffic accidents (n = 1406) with that observed in a control population undergoing mandatory urine drug testing (n = 1953). Urine analyses for drugs of abuse were performed by screening immunometric techniques followed by confirmation with UHPLC-QQQ MS, adopting a cut-off concentration for THC-COOH of 15 ng/mL. A case was classified as "positive" when a driver admitted to hospital for road traffic injuries showed urine concentrations of THC-COOH higher than the cut-off. All samples showing positive results for any other controlled drug in urine or blood alcohol concentrations >0.5 mg/mL were excluded from the study. Subjects positive to THC-COOH, and negative to all the other tested substances were 116 in Group 1 (8.2%) and 16 in Group 2 (0.8%). Subjects resulting negative to any tested substances were 1290 in Group 1 and 1937 in Group 2. The frequency of THC-COOH detection in the two groups was compared by using the "chi square" test, which resulted = 119.57, i.e. highly significant (P <<< 0.01). The Odds Ratio of the two groups was =10.88, showing a high degree of association between the presence of THC-COOH in urine and the occurrence of traffic accidents (P < 0.0001). The presented data, proving a high degree of association between Cannabis use and the occurrence of traffic accidents with injuries of the driver, support the use of urine testing for Cannabis in the procedures for the issuing of the driving licence, particularly in the case of subjects formerly or presently using Cannabis. This finding looks even more relevant in the present times, because of the increasing success of the policies of legalization of Cannabis for medical and non-medical purposes.

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Automobile Driving; Cannabis; Dronabinol; Female; Humans; Italy; Male; Marijuana Use; Middle Aged; Substance Abuse Detection; Young Adult

Topics: Cannabis; Cohort Effect; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Mental Health; Prevalence; Surveys and Questionnaires; United States

Topics: Accidents, Traffic; Age Factors; Cannabis; Driving Under the Influence; Holidays; Humans; Marijuana Use; Risk Factors; United States

Drug policy, whether for legal or illegal substances, is a controversial field that encompasses many complex issues. Policies can have effects on a myriad of outcomes and stakeholders differ in the outcomes they consider and value, while relevant knowledge on policy effects is dispersed across multiple research disciplines making integrated judgements difficult.. Experts on drug harms, addiction, criminology and drug policy were invited to a decision conference to develop a multi-criterion decision analysis (MCDA) model for appraising alternative regulatory regimes. Participants collectively defined regulatory regimes and identified outcome criteria reflecting ethical and normative concerns. For cannabis and alcohol separately, participants evaluated each regulatory regime on each criterion and weighted the criteria to provide summary scores for comparing different regimes.. Four generic regulatory regimes were defined: absolute prohibition, decriminalisation, state control and free market. Participants also identified 27 relevant criteria which were organised into seven thematically related clusters. State control was the preferred regime for both alcohol and cannabis. The ranking of the regimes was robust to variations in the criterion-specific weights.. The MCDA process allowed the participants to deconstruct complex drug policy issues into a set of simpler judgements that led to consensus about the results.

Topics: Alcohol Drinking; Cannabis; Consensus; Decision Support Techniques; Delivery of Health Care; Drug and Narcotic Control; Humans; Legislation, Drug; Marijuana Use; Public Policy

Topics: Cannabis; Humans; Liver; Liver Transplantation; Marijuana Use; Waiting Lists

Cannabis legalization in Colorado resulted in increased cannabis-associated health care utilization. Our objective was to examine cooccurrence of cannabis and mental health diagnostic coding in Colorado emergency department (ED) discharges and replicate the study in a subpopulation of ED visits where cannabis involvement and psychiatric diagnosis were confirmed through medical review.. We collected statewide ED International Classification of Diseases, 9th Revision, Clinical Modification diagnoses from the Colorado Hospital Association and a subpopulation of ED visits from a large, academic hospital from 2012 to 2014. Diagnosis codes identified visits associated with mental health and cannabis. Codes for mental health conditions and cannabis were confirmed by manual records review in the academic hospital subpopulation. Prevalence ratios (PRs) of mental health ED discharges were calculated to compare cannabis-associated visits to those without cannabis. Rates of mental health and cannabis-associated ED discharges were examined over time.. Statewide data demonstrated a fivefold higher prevalence of mental health diagnoses in cannabis-associated ED visits (PR = 5.35, 95% confidence interval [CI], 5.27-5.43) compared to visits without cannabis. The hospital subpopulation supported this finding with a fourfold higher prevalence of psychiatric complaints in cannabis attributable ED visits (PR = 4.87, 95% CI = 4.36-5.44) compared to visits not attributable to cannabis. Statewide rates of ED visits associated with both cannabis and mental health significantly increased from 2012 to 2014 from 224.5 to 268.4 per 100,000 (p < 0.0001).. In Colorado, the prevalence of mental health conditions in ED visits with cannabis-associated diagnostic codes is higher than in those without cannabis. There is a need for further research determining if these findings are truly attributed to cannabis or merely coincident with concurrent increased use and availability.

Topics: Adult; Cannabis; Colorado; Cross-Sectional Studies; Emergency Service, Hospital; Female; Humans; Male; Marijuana Abuse; Marijuana Use; Middle Aged; Patient Discharge; Prevalence; Retrospective Studies

Topics: Canada; Cannabis; Humans; Legislation, Drug; Marijuana Use; Recreation

The US has seen an increase in the popularity of highly concentrated forms of cannabis (hereafter concentrates) and too little is known about the potential risks associated with their use.. The present study aims to better understand the patterns and outcomes of concentrates use through the perspectives of young adult users.. Participants (N = 234, 27.9% female) aged 18-35 years were recruited using SurveyMonkey Audience® and had ingested concentrates at least once in the past 6 months. They were queried on concentrates use patterns (e.g., frequency, medical/recreational) and the effects experienced after using concentrates (e.g., physiological/psychological, strength/duration).. A total of 27.8% of participants reported frequent use of concentrates (≥10 days in past month). Those who used for medical purposes or lived in states where use is legal were more likely to use concentrates frequently. While most (64.2%) did not report experiencing potentially serious side effects, some reported a sense of altered reality/confusion (23.3%), rapid heartbeat (11.2%), lung pain (9.9%) and severe paranoia (6.9%). Among those who used concentrates in the past month (N = 168), 72.6% used concentrates with other cannabis forms, 57.7% used along with alcohol, and 22.6% used with other drugs.. Continued research on concentrates use in the US is needed. Research-informed policies that foster safe and responsible use of concentrates are necessary to protect users, especially those who use concentrates frequently, from potential negative side effects.

Topics: Adolescent; Adult; Cannabis; Drug Compounding; Female; Humans; Male; Marijuana Use; Medical Marijuana; Young Adult

Topics: Cannabis; Cocaine; Heart Diseases; Humans; Marijuana Use; Myocardial Infarction; Young Adult

Cannabis is among the most widely used psychoactive substances in the United States, and rates of cannabis use and cannabis-related problems are increasing. Anxiety sensitivity, or the fear of aversive interoceptive sensations, may be relevant to better understanding cannabis use problems and other significant cannabis use processes (e.g., beliefs about quitting). Previous research has primarily focused on the global anxiety sensitivity construct; however, anxiety sensitivity lower-order facets (Cognitive Concerns, Physical Concerns, and Social Concerns) tend to be differentially related to substance use processes in non-cannabis specific studies. The current study therefore explored anxiety sensitivity lower-order facets in relation to cannabis use problems, perceived barriers for cannabis cessation, and abstinence phobia (fear of not using cannabis) among a community sample of 203 cannabis-using adults. Results indicated that anxiety sensitivity Cognitive Concerns were significantly associated with each of the dependent measures and these effects were not explained by shared variance with the other lower-order factors or a range of other covariates (e.g., tobacco use). The present findings suggest future work may benefit from focusing on the role of anxiety sensitivity Cognitive Concerns in the maintenance of cannabis use.

Topics: Adult; Anxiety; Cannabis; Cross-Sectional Studies; Fear; Female; Humans; Male; Marijuana Smoking; Marijuana Use; Middle Aged; Perception; Phobic Disorders

To determine if regular use of marijuana has an impact on time to pregnancy.. Retrospective review of cross-sectional survey data from male and female respondents aged 15-44 years who participated in the 2002, 2006-2010, and 2011-2015 National Survey of Family Growth.. Not applicable.. The National Survey of Family Growth is a nationally representative population-based sample derived from stratified multistage area probability sampling of 121 geographic areas in the U.S. Our analytic sample was participants who were actively trying to conceive.. Exposure status was based on the respondents' answers regarding their marijuana use in the preceding 12 months.. The main outcome was estimated time to pregnancy, which was hypothesized before analysis to be delayed by regular marijuana use.. A total of 758 male and 1,076 female participants responded that they were actively trying to conceive. Overall, 16.5% of men reported using any marijuana while attempting to conceive, versus 11.5% of women. The time ratio to pregnancy for never smokers versus daily users of marijuana in men was 1.08 (95% confidence interval 0.79-1.47) and in women 0.92 (0.43-1.95), demonstrating no statistically significant impact of marijuana use on time to pregnancy.. Our study suggests that neither marijuana use nor frequency of marijuana use was associated with time to pregnancy for men and women.

Topics: Adolescent; Adult; Cannabis; Cross-Sectional Studies; Female; Fertilization; Humans; Male; Marijuana Use; Pregnancy; Retrospective Studies; Surveys and Questionnaires; Time-to-Pregnancy; United States; Young Adult

To evaluate state-level prevalence estimates of prenatal and early postnatal cannabis use in a state with legalized medical and recreational marijuana and the association with adverse neonatal outcomes.. We conducted a cross-sectional study on 3,207 respondents from the 2014-2015 Colorado Pregnancy Risk Assessment Monitoring System with state-developed questions on cannabis use. Differences in perinatal cannabis use were evaluated according to maternal characteristics, breastfeeding patterns, and pregnancy intendedness. Multiple logistic regression models evaluated the relationship between prenatal cannabis use and adverse neonatal outcomes including low birth weight, small for gestational age, preterm birth, and admission to the neonatal intensive care unit.. The self-reported prevalence of cannabis use at any time during pregnancy was 5.7 ± 0.5% and the prevalence of early postnatal cannabis use among women who breastfed was 5.0% (95% CI, 4.1%-6.2%). Prenatal cannabis use was associated with a 50% increased likelihood of low birth weight, independent of maternal age, race/ethnicity, level of education, and tobacco use during pregnancy (OR, 1.5; 95% CI, 1.1-2.1; P = .02). Small for gestational age, preterm birth, and neonatal intensive care unit admission were not associated with prenatal cannabis use, independent of prenatal tobacco use.. Our findings underscore the importance of screening for cannabis use during prenatal care and the need for provider counselling about the adverse health consequences of continued use during pregnancy and lactation.

Topics: Adolescent; Adult; Breast Feeding; Cannabis; Colorado; Cross-Sectional Studies; Female; Humans; Infant, Newborn; Marijuana Use; Medical Marijuana; Pregnancy; Pregnancy Outcome; Prenatal Exposure Delayed Effects; Prevalence; Risk Factors; Young Adult

Approximately 6%-8% of U.S. adolescents are daily/past-month users of marijuana. However, survey data may not reliably reflect the impact of legalization on adolescents. The objective was to evaluate the impact of marijuana legalization on adolescent emergency department and urgent cares visits to a children's hospital in Colorado, a state that has allowed both medical and recreational marijuana.. Retrospective review of marijuana-related visits by International Classification of Diseases codes and urine drug screens, from 2005 through 2015, for patients ≥ 13 and < 21 years old.. From 2005 to 2015, 4,202 marijuana-related visits were identified. Behavioral health evaluation was obtained for 2,813 (67%); a psychiatric diagnosis was made for the majority (71%) of these visits. Coingestants were common; the most common was ethanol (12%). Marijuana-related visits increased from 1.8 per 1,000 visits in 2009 to 4.9 in 2015. (p = < .0001) CONCLUSIONS: Despite national survey data suggesting no appreciable difference in adolescent marijuana use, our data demonstrate a significant increase in adolescent marijuana-associated emergency department and urgent cares visits in Colorado.

Topics: Adolescent; Adult; Ambulatory Care; Cannabis; Colorado; Emergency Service, Hospital; Female; Humans; Male; Marijuana Abuse; Marijuana Use; Retrospective Studies; Young Adult

Trade-offs are central to the cannabis policy debate. Prohibition and strict regulation may help reduce the physical, mental and social harms of cannabis consumption, but at the cost of increasing the harms from illegal markets and reducing consumption benefits. An economic model clarifies how these costs and benefits relate to policy and connects them to observable prices and tax-levels given the assumptions of the analysis. These model- based arguments are related to the ongoing academic policy debate. While some arguments from this literature modify the interpretation of the model (e.g., due to dependence, cognitive biases and market structure), the literature often fails to appropriately account for the magnitude of the policy costs and benefits identified. Taking various caveats into account, the framework indicates that a strict regulation would likely be preferable to prohibition given current estimates of excess harms (externalities and internalities) from cannabis use. While cannabis prohibition appears difficult to justify within an economic regulatory framework, risks from industry influence, policy ratchet effects, and human "decision-making flaws" speak to the need for caution and strong regulation when implementing legal regimes.

Topics: Cannabis; Cost-Benefit Analysis; Drug and Narcotic Control; Humans; Marijuana Use; Models, Economic; Policy Making; Public Policy

The study aimed to investigate the prevalence of cannabis use among undergraduate medical students of the University of the Free State (UFS), and the extent of their knowledge about the substance.. This cross-sectional study included five year groups of undergraduate medical students. A self-administered, anonymous questionnaire was used.. Of the 643 medical students, 541 (84.1%) completed the questionnaire. In total, 161 (30.9%) students reported that they had ever used cannabis. The percentage of males who had ever used cannabis was twice that of females (relative risk 2.04; 95% CI 1.56; 2.67). Of the cannabis users, less than 12% used it monthly or more often. A fifth (19.5%) of all students stated that they did not know the side effects of cannabis use. Nearly half (45.4%) indicated that they could not name any medicinal (medical) uses. The median knowledge score of students who used cannabis tended to be higher than that of students who did not use cannabis; this was statistically significant only in the third-year group.. Medical students generally have a low level of knowledge about cannabis. The reported lifetime prevalence and pattern of cannabis use are similar to those reported in other South African studies published over the past 35 years.

Topics: Cannabis; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Marijuana Use; Prevalence; South Africa; Students, Medical; Surveys and Questionnaires; Universities

The purpose of this paper is to analyze characteristics of marijuana concentrate users, describe patterns and reasons of use, and identify factors associated with daily use of concentrates among U.S.-based cannabis users recruited via a Twitter-based online survey.. An anonymous Web-based survey was conducted in June 2017 with 687 U.S.-based cannabis users recruited via Twitter-based ads. The survey included questions about state of residence, socio-demographic characteristics, and cannabis use including marijuana concentrates. Multiple logistic regression analyses were conducted to identify characteristics associated with lifetime and daily use of marijuana concentrates.. Almost 60% of respondents were male, 86% were white, and the mean age was 43.0 years. About 48% reported marijuana concentrate use. After adjusting for multiple testing, significant predictors of concentrate use included: living in "recreational" (AOR = 2.04; adj. p = .042) or "medical, less restrictive" (AOR = 1.74; adj. p = .030) states, being younger (AOR = 0.97, adj. p = .008), and daily herbal cannabis use (AOR = 2.57, adj. p = .008). Out of 329 marijuana concentrate users, about 13% (n = 44) reported daily/near daily use. Significant predictors of daily concentrate use included: living in recreational states (AOR = 3.59, adj. p = .020) and using concentrates for therapeutic purposes (AOR = 4.34, adj. p = .020).. Living in states with more liberal marijuana policies is associated with greater likelihood of marijuana concentrate use and with more frequent use. Characteristics of daily users, in particular, patterns of therapeutic use warrant further research with community-recruited samples.

Topics: Adult; Cannabis; Female; Humans; Internet; Male; Marijuana Smoking; Marijuana Use; Medical Marijuana; Social Media; Surveys and Questionnaires; United States; Young Adult

A prevailing epidemiological theory about drug use occurrence among secondary school students is that trends in perceived risk of drug-related harms can drive use. If so, cannabis risk perceptions during one school year should predict newly incident cannabis use in the same school the following year. We aimed to study trends in incidence and epidemiological clustering of cannabis use among United States (US) 12th-graders, and a novel prediction that incidence in school-year 't' is influenced by school-specific cannabis risk perceptions (CRP) of 12th-graders a year prior at 't-1'.. US schools sampled each year from 1976 to 2013 (∼130 schools per year) yielded an annual nationally representative sample of ∼15-16,000 12th-graders with questionnaire assessments. Analyses involved Alternating Logistic Regressions (ALR) to study trends in school-level clustering and slopes that estimate the degree to which CRP levels at 't-1' might predict newly incident cannabis use at 't'.. School-level CRP levels at 't-1' predict newly incident cannabis use in the next year's 12th-grade class. For each unit CRP increment, the next year's class shows tangibly reduced incidence of starting to use cannabis (overall odds ratio, OR = 0.10; 95% CI: 0.03, 0.33). Within-school clustering of newly incident cannabis smoking also can be seen (e.g., pairwise odds ratio, PWOR = 1.11; 95% CI: 1.07, 1.15).. Programmatic manipulation of perceived risk in one year's senior class via public health/school alliances might dampen the subsequent risk of newly incident cannabis use in the next year's class.

Topics: Adolescent; Adolescent Behavior; Cannabis; Cluster Analysis; Female; Humans; Incidence; Logistic Models; Male; Marijuana Use; Odds Ratio; Perception; Prospective Studies; Risk Assessment; Risk-Taking; Schools; Students; Surveys and Questionnaires; United States

Topics: Adolescent; Cannabis; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Medical Marijuana; United States

There is a lack of studies investigating the dose-response effect of childhood trauma, recent events and cannabis use on recent psychosis. This study aims to determine the relationship between the level of exposure to stress factors and cannabis use with psychosis and to determine the combination effect among these factors in predicting a psychotic disorder.. 146 recent onset psychotic (ROP) patients and 61 healthy controls were included. Childhood trauma was evaluated using the childhood trauma questionnaire (CTQ) and recent events using the Holmes-Rahe social readjustment scale. The pattern of cannabis use was assessed by a detailed interview. A hierarchical multiple regression was run in order to determine both the cumulative and independent contribution of each factor in predicting a psychotic disorder.. The highest levels of exposure to childhood trauma and cannabis were associated with psychosis while neither low nor high recent event exposure was associated. The combined effect of risk factors yielded a significant association with psychosis (×. Our study provides evidence for a cumulative and a dose-response effect of environmental factors on recent psychosis. Considering that cannabis use and stress are highly prevalent in the population with psychosis, investigations of their relationships are needed to implement targeted prevention and treatment strategies.

Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Cannabis; Cross-Sectional Studies; Female; Humans; Male; Marijuana Abuse; Marijuana Use; Psychotic Disorders; Retrospective Studies; Risk Factors; Stress, Psychological; Young Adult

The assessment of marijuana use quantity poses unique challenges. These challenges have limited research efforts on quantity assessments. However, quantity estimates are critical to detecting associations between marijuana use and outcomes. We examined accuracy of marijuana users' estimations of quantities of marijuana they prepared to ingest and predictors of both how much was prepared for a single dose and the degree of (in)accuracy of participants' estimates. We recruited a sample of 128 regular-to-heavy marijuana users for a field study wherein they prepared and estimated quantities of marijuana flower in a joint or a bowl as well as marijuana concentrate using a dab tool. The vast majority of participants overestimated the quantity of marijuana that they used in their preparations. We failed to find robust predictors of estimation accuracy. Self-reported quantity estimates are inaccurate, which has implications for studying the link between quantity and marijuana use outcomes. (PsycINFO Database Record

Topics: Adult; Cannabis; Eating; Female; Humans; Male; Marijuana Use; Middle Aged; Self Report; Young Adult

Substance abuse is a public health priority in the context of the HIV epidemic, especially in military communities. This cross-sectional study quantified alcohol and cannabis use in the Malawi Defence Force and investigated its associations with condom use, transactional sex, multiple sexual partners, and sexual violence. Participants were 944 male and female service members ≥ 18 years old. Data were collected in 2013 using a computer-assisted self-interview. Twenty-four percent of men and women screened positive for hazardous and harmful drinking [Alcohol Use Disorders Identification Test (AUDIT) score ≥ 8]. About 6% reported using cannabis in the past year and 10% reported using cannabis prior to 1 year ago. Multivariable models found elevated adjusted odds of transactional sex and multiple sexual partners for men with an AUDIT score ≥ 8, and men who reported ever using cannabis. The adjusted odds of experiencing sexual violence were also elevated for men who reported ever using cannabis. These findings add to the growing concern that substance use may perpetuate the HIV epidemic in Sub-Saharan Africa by increasing risky sexual behaviors. A comprehensive military HIV prevention response should include substance use education and appropriate care and treatment for individuals screening positive for hazardous and harmful drinking.

Topics: Adult; Alcohol Drinking; Cannabis; Cross-Sectional Studies; Female; Humans; Malawi; Male; Marijuana Use; Military Personnel; Risk-Taking; Unsafe Sex; Violence

With the State of California legalizing recreational cannabis sales on January 1, 2018, the regulatory process is once more in the forefront of cannabis research. Colorado, often held up as a model of legalization policy, was the first state to implement retail sale of recreational cannabis on January 1

Topics: California; Cannabis; Colorado; Commerce; Data Science; Drug and Narcotic Control; Humans; Industry; Marijuana Use; Policy Making; Public Health; Social Control, Formal

Prevalence of marijuana (MJ) use among adolescents has been on the rise. MJ use has been reported to impact several brain regions, including frontal regions such as the orbitofrontal cortex (OFC). The OFC is involved in emotion regulation and processing and has been associated with symptoms of depression and anxiety. Therefore, we hypothesized that adolescent MJ users would show disruptions in OFC connectivity compared with healthy adolescents (HC) which would be associated with symptoms of mood and anxiety.. 43 MJ-using and 31 HC adolescents completed clinical measures including the Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Resting-state functional magnetic resonance imaging data was also acquired for all participants.. In MJ users, increased depressive symptoms were associated with increased connectivity between the left OFC and left parietal regions. In contrast, lower ratings of anxiety were associated with increased connectivity between right and left OFC and right occipital and temporal regions. These findings indicate significant differences in OFC connectivity in MJ-using adolescents, which correlated with mood/anxiety.. Future studies with an increased number of female participants is required to address potential sex differences in connectivity patterns related to symptoms of depression and anxiety.. This study highlights the association between OFC connectivity, MJ use, and symptoms of depression and anxiety in adolescents. These findings provide further insight into understanding the neural correlates that modulate the relationship between comorbid MJ use and mood disorders and could potentially help us better develop preventive and treatment measures.

Topics: Adolescent; Anxiety; Cannabis; Case-Control Studies; Comorbidity; Depression; Emotions; Female; Functional Neuroimaging; Humans; Magnetic Resonance Imaging; Male; Marijuana Smoking; Marijuana Use; Mood Disorders; Neural Pathways; Occipital Lobe; Parietal Lobe; Prefrontal Cortex; Sex Characteristics; Temporal Lobe; Young Adult

Topics: Adolescent; Cannabis; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Medical Marijuana

In 2017, the annual prevalence of marijuana use rose to 24% among 8

Topics: Adolescent; Adolescent Psychiatry; Cannabis; Health Personnel; Health Policy; Humans; Marijuana Use; Psychotic Disorders; United States

The cannabis academic literature is informed by dominant deficit, public health and harm reduction frameworks. However, a large majority of cannabis consumption appears to place outside the scope of these models that prioritise the identification and limitation of negative impacts. As such there are apparent analytical blind spots pertaining to: non-problematic use of cannabis (as defined by Global Commission on Drug Policy); the intersection of medical and recreational intents of use; and pleasure. This paper explores the academic and grey literature relating to the spectrum of wellness to assess its suitability as a framework for cannabis scholars. For millennia cannabis use has been associated with wellness models, particularly at the nexus of mind, body, and spirit. Despite this seemingly obvious match, the academic literature that incorporates cannabis consumption patterns into wellness conceptions is thin. The spectrum of wellness has both advantages and disadvantages compared to existing models and may be useful as a complementary framework that allows for broader examination of cannabis consumer activity.

Topics: Cannabis; Drug and Narcotic Control; Harm Reduction; Health Promotion; Humans; Marijuana Abuse; Marijuana Use; Pleasure; Public Health; Public Policy

Topics: Adolescent; Ambulatory Care; Cannabis; Colorado; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use

Topics: Animals; Breast Feeding; Cannabinoids; Cannabis; Female; Humans; Marijuana Use; Milk, Human; Mothers; Pediatricians

Previous research shows that between individuals there is a positive association between medically motivated use and cannabis use frequency and quantity. While between-subjects' analyses are useful for understanding shared vulnerabilities, research has so far not examined within-subjects' relationships which are closer to evaluating functional relationships (i.e., do individuals tend to use cannabis more heavily subsequent to elevations in pain experiences?). To better understand the association between experiences of pain and cannabis use, the current paper examines whether there is a functional within-subjects association between experiences of pain and heavy cannabis use.. 182 regular cannabis users without a medical cannabis license were asked to report momentary experiences of physical pain, whether they had used cannabis, and if so, quantity consumed five times per day over a five-day period on their smartphones. Mixed effects models examined the relations between within- and between-subjects experiences of pain and cannabis use and quantity consumed.. Elevated experiences of pain were not associated with cannabis use occasions at the within- or between-subjects level. Experiences of pain were associated with greater amount of cannabis consumed at the within-subjects level, but not at the between-subjects level.. Experiences of pain are not associated with decisions about whether or not to use cannabis. Once cannabis users are in cannabis-using situations, they tend to use larger amounts when they are experiencing elevated levels of pain. This may have implications for cannabis abuse treatment as pain may make it more difficult for users to reduce their consumption.

Topics: Adult; Cannabinoids; Cannabis; Ecological Momentary Assessment; Female; Habits; Humans; Male; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Medical Marijuana; Motivation; Pain; Young Adult

Topics: Adult; Analgesics, Opioid; Cannabis; Humans; Marijuana Use; Medicaid; Practice Patterns, Physicians'

Topics: Aged; Analgesics, Opioid; Cannabis; Humans; Marijuana Use; Medical Marijuana; Practice Patterns, Physicians'; United States

Topics: Adult; Analgesics, Opioid; Cannabis; Humans; Marijuana Use; Medicaid; Practice Patterns, Physicians'

Topics: Adolescent; Adult; Cannabis; Directive Counseling; Humans; Marijuana Use; Medical Marijuana; Parents; Patient Education as Topic

Topics: Adolescent; Cannabis; Child; Female; Humans; Male; Marijuana Use; Parent-Child Relations; Parents

Cannabis use has increased since legalization in various states within the United States of America. Although much of the research on the neurological and psychological effects of cannabis has been on non-human animals, the current research suggests that it can have anxiolytic effects and also decrease some cognitive functioning (e.g. memory, emotional processing, etc.). Individuals with high anxiety have been suggested to have increased attentional bias towards threat-related stimuli. The current study measured event-related potential (ERP) during a dot-probe task with fearful and neutral facial expression to examine the residual effects of cannabis use on attentional bias. The results indicated that there was reduced attentional bias, as measured by the P1 component in cannabis users, which is similar to low anxious individuals. Additionally, there was no difference between users and non-users in N170, indicating that the residual effects of cannabis did not interfere with face processing. However, an exploratory correlation indicated that higher cannabis use was associated with reduced N170 towards fearful faces. Cannabis use was associated with enhanced N2pc, which would indicate greater spatial orientation of attention. These results suggest that cannabis use did have an effect on attentional bias towards fearful faces.

Topics: Adolescent; Adult; Anti-Anxiety Agents; Attentional Bias; Brain; Cannabinoid Receptor Modulators; Cannabis; Electroencephalography; Evoked Potentials; Facial Expression; Facial Recognition; Fear; Female; Humans; Male; Marijuana Use; Young Adult

Topics: Adult; Cannabis; Female; Health Policy; Humans; Marijuana Use; Nurse's Role; Pregnancy; Pregnancy Outcome; Women's Health

Topics: Adolescent; Attitude; Cannabis; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use

Recreational cannabis is being legalized in states across the USA. The public relies on popular media for health information about cannabis. We assessed the accuracy of reporting on health effects of cannabis use in GreenState, a specialty publication on cannabis published by the San Francisco Chronicle and the main newspaper using the Index of Scientific Quality for Health Related News Reports. Results were compared using t-tests. Seventeen GreenState articles and four San Francisco Chronicle articles were identified for analysis. Health articles in GreenState scored 2.9 (±1.1 [SD]) Global, with the highest scoring category Applicability (4.5 ± 0.4) and the lowest Precision (2.4 ± 1.0) on a scale of 1-5. In contrast, the San Francisco Chronicle articles received a Global rating of 4.6 (±0.2), ranging from Applicability (5.0 ± 0) to Benefits (3.8 ± 0.9). Articles in the San Francisco Chronicle scored significantly higher in all categories but Benefits which was not significantly different for the San Francisco Chronicle compared with GreenState (3.8 vs. 3.6, p = 0.77). The public, clinicians, and policymakers need to be aware of this pattern and treat information in publications like GreenState with an appropriate level of skepticism until the quality of reporting improves to general journalistic standards.

Topics: Cannabis; Humans; Marijuana Use; Medical Marijuana; Newspapers as Topic; San Francisco

Recreational marijuana use was legalized in the state of Washington in 2012, and the Washington Administrative Code (WAC) 314-55-155 was implemented to limit the exposure of youths to marijuana advertisements.. To evaluate the content of social media posts by marijuana companies and to assess the compliance of these posts with WAC regulations.. In a cross-sectional study, a content analysis of 1027 social media posts was conducted to identify and assess compliance of WAC regulations with the business pages of recreational marijuana companies located on Facebook and Twitter platforms in the state of Washington from December 1, 2015, through November 30, 2016.. Application of coding based on WAC regulations to focus on the prohibition of language that promoted the overconsumption of marijuana, that described its curative or therapeutic benefits, or that was designed to appeal to youths; and the requirements for warnings about intoxication, driving, health risks, and age restrictions for marijuana.. Of the 1027 posts on Facebook and Twitter from business pages of 6 marijuana companies, Facebook followers ranged from 342 to 1592 persons and Twitter followers ranged from 374 to 2915 persons per company. Findings for WAC regulations included 17 posts (1.7%) that encouraged overconsumption; 137 posts (13.3%) that promoted therapeutic benefits; and 9 posts (0.01%) that appealed to youths. Requirements for warnings addressing intoxication, driving, health risks, and age restrictions were present on 110 posts (10.7%). Some businesses repeatedly violated particular regulations; 7 of 17 (41.2%) posts encouraging overconsumption derived from 1 marijuana company.. Most social media posts by marijuana companies were consistent with WAC regulations that prohibit particular messages, but few companies provided required warning messages. Findings can be used toward implementation strategies for marijuana prevention to address these influential media messages.

Topics: Adolescent; Adult; Advertising; Cannabis; Communication; Cross-Sectional Studies; Female; Government Regulation; Humans; Illicit Drugs; Industry; Male; Marijuana Use; Plant Preparations; Social Media; State Government; Washington; Young Adult

Despite growing research, it remains unclear if cannabis use is associated with additive cognitive impairment in people with psychotic illness and whether exposure in early adolescence is associated with poorer cognitive performance in adulthood.. This cross-sectional study of a nationally representative sample of 1199 adults with psychotic illness compared current cognition (digit symbol coding) of 297 current users of cannabis (used in the past year), 460 past users (used previously but not in the past year) and 442 non-users (never used). Multiple logistic regression was used to examine whether cognitive performance of cannabis-user groups varied by exposure age and diagnosis (non-affective/affective psychoses).. Unadjusted analysis showed current cannabis users had significantly higher odds of impaired cognitive function compared to non-users (odds ratio=1.52, 95%CI=1.04-2.22). After adjusting for potential confounders, differences between the three groups were not significant. Exposure age was not significant in adjusted analysis. In participants with nonaffective psychoses, cognitive ability of current cannabis users did not differ from non-users. However, in participants with affective psychoses, using cannabis in the last year was a significant predictor of impaired cognitive function (odds ratio=2.25, 95%CI=1.05-4.84).. Among people with psychotic illness, there was no significant difference in cognitive function between current, past and non-users of cannabis. However, when we compared cognitive performance of the three cannabis groups by diagnostic grouping, current cannabis use had a significant negative relationship with cognitive function in people with affective psychoses, but not in those with non-affective psychoses. This finding requires replication and further investigation.

Topics: Adult; Age Factors; Cannabis; Cognition; Cognition Disorders; Cross-Sectional Studies; Female; Humans; Male; Marijuana Use; Neuropsychological Tests; Odds Ratio; Psychotic Disorders

Topics: Biomedical Research; Cannabinoids; Cannabis; Chronic Pain; Humans; Marijuana Use; Medical Marijuana; Muscular Dystrophies; Nausea; United States; Vomiting

Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.

Topics: Adolescent; Adult; Anti-HIV Agents; Anxiety; Cannabis; Case-Control Studies; Cohort Studies; Depression; Female; HIV Infections; Humans; Male; Marijuana Use; Medication Adherence; Middle Aged; Self Administration; Self Report; Young Adult

Topics: Analgesics; Cannabis; Female; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Pregnancy

The National Institute on Alcohol Abuse and Alcoholism's Alcohol Policy Information System (APIS) is, for the first time, adding legal data pertaining to recreational cannabis use to its current offerings on alcohol policy. Now that Colorado, Washington, Oregon, Alaska, and the District of Columbia have legalized aspects of recreational cannabis, and more states are considering it, there is an urgency to provide high-quality, multi-dimensional legal data to the public health community. This article introduces the Cannabis Policy Taxonomy recently posted on APIS, and explores its theoretical and empirical contributions to the substance abuse literature and its potential for use in policy research. We also present results of interviews with public health experts in alcohol and cannabis policy, which sought to determine the most important variables to address in the initial release of cannabis policy data. From this process, we found that pricing controls emerged as the variable singled out by the largest number of experts. This analysis points to a host of vital policies that are of increasing importance to public health policy scholars and their current and future research.

Topics: Cannabis; Health Policy; Humans; Legislation, Drug; Marijuana Use

Marijuana is the most commonly used illicit drug in pregnancy, and the prevalence of use during pregnancy is increasing in the United States. Although much of the existing research investigating marijuana use in pregnancy is limited by study design and confounding factors, a growing accumulation of data suggests adverse outcomes. Studies have identified associations with decreased birth weight, increased spontaneous preterm birth, and impaired neurodevelopment among children and adults with in utero exposure. Moderate concentrations of marijuana have also been identified in breast milk. Due to these findings, multiple professional societies have issued clear statements against marijuana use during pregnancy and lactation.

Topics: Adult; Birth Weight; Breast Feeding; Cannabis; Child; Female; Fetus; Humans; Infant, Low Birth Weight; Infant, Newborn; Lactation; Marijuana Smoking; Marijuana Use; Maternal Exposure; Milk, Human; Neurodevelopmental Disorders; Pregnancy; Pregnancy Complications; Pregnant Women; Premature Birth; Prenatal Exposure Delayed Effects; United States

To (1) assess trends and variation in the market share of product types and potency sold in a legal cannabis retail market and (2) estimate how potency and purchase quantity influence price variation for cannabis flower.. Secondary analysis of publicly available data from Washington State's cannabis traceability system spanning 7 July 2014 to 30 September 2016. Descriptive statistics and linear regressions assessed variation and trends in cannabis product variety and potency. Hedonic regressions estimated how purchase quantity and potency influence cannabis flower price variation.. Washington State, USA.. (1) A total of 44 482 176 million cannabis purchases, including (2) 31 052 123 cannabis flower purchases after trimming price and quantity outliers.. Primary outcome measures were (1) monthly expenditures on cannabis, total delta-9-tetrahydrocannabinol (THC) concentration and cannabidiol (CBD) concentration by product type and (2) excise tax-inclusive price per gram of cannabis flower. Key covariates for the hedonic price regressions included quantity purchased, THC and CBD.. Traditional cannabis flowers still account for the majority of spending (66.6%), but the market share of extracts for inhalation increased by 145.8% between October 2014 and September 2016, now comprising 21.2% of sales. The average THC-level for cannabis extracts is more than triple that for cannabis flowers (68.7% compared to 20.6%). For flower products, there is a statistically significant relationship between price per gram and both THC [coefficient = 0.012; 95% confidence interval (CI) = 0.011-0.013] and CBD (coefficient = 0.017; CI = 0.015-0.019). The estimated discount elasticity is -0.06 (CI = -0.07 to -0.05).. In the state of Washington, USA, the legal cannabis market is currently dominated by high-THC cannabis flower, and features growing expenditures on extracts. For cannabis flower, both THC and CBD are associated with higher per-gram prices, and there are small but significant quantity discounts.

Topics: Cannabis; Commerce; Humans; Legislation, Drug; Marijuana Use; Washington

Sexual minority women have elevated trauma exposure and prevalence of posttraumatic stress disorder (PTSD) compared to heterosexual women and they are also more likely to use cannabis, although no research has examined relationships between PTSD and cannabis use in this population. Daily-level methodologies are necessary to examine proximal associations between PTSD and use.. This study included 90 trauma-exposed young adult women who identified as sexual minorities (34.4% identified as lesbian and 48.9% identified as bisexual) and evaluated daily-level associations between their PTSD symptoms and cannabis use. Participants were assessed at two measurement waves, one year apart, each consisting of 14 consecutive daily assessments.. Cannabis use occurred on 22.8% of the days. Results from generalized linear mixed effects models showed that a person's mean level of PTSD symptom severity across days was strongly associated with same-day likelihood of cannabis use (OR=2.67 for 1 SD increase in PTSD score; p<0.001). However, daily deviation from one's average PTSD score was not associated with cannabis use on the same day.. Findings suggest that PTSD severity may confer general risk for cannabis use, rather than being a state-dependent risk factor.

Topics: Adolescent; Adult; Cannabis; Female; Humans; Longitudinal Studies; Marijuana Use; Risk Factors; Severity of Illness Index; Sexual and Gender Minorities; Stress Disorders, Post-Traumatic; United States; Young Adult

A quarter of people living with human immunodeficiency virus (HIV) infection in the United States are women. Furthermore, African American and Hispanic/Latina women continue to be disproportionately affected by HIV, compared with women of other races/ethnicities. Cannabis use prior to intercourse may be associated with increased risky sexual behaviors which are highly related to HIV. The ultimate goal of this research is to better understand the relationships between unconventional personal attributes (e.g., risk-taking behaviors) in the late 20s, substance use (e.g., alcohol) in the mid 30s, and cannabis use prior to intercourse in the late 30s using a community sample; such an understanding may inform interventions. This study employing data from the Harlem Longitudinal Development Study includes 343 female participants (50% African Americans, 50% Puerto Ricans). Structural equation modeling indicated that unconventional personal attributes in the late 20s were associated with substance use in the mid 30s (β=0.32, p<0.001), which in turn, was associated with cannabis use prior to sexual intercourse in the late 30s (β=0.64, p<0.001). Unconventional personal attributes in the late 20s were also directly related to cannabis use prior to sexual intercourse in the late 30s (β=0.39, p<0.01). The findings of this study suggest that interventions focused on decreasing unconventional personal attributes as well as substance use may reduce sexual risk behaviors among urban African American and Puerto Rican women. Also, the implications of this study for health care providers and researchers working in HIV prevention are that these precursors may be useful as patient screening tools.

Topics: Adult; Age Factors; Black or African American; Cannabis; Female; Hispanic or Latino; Humans; Longitudinal Studies; Marijuana Use; New York City; Puerto Rico; Risk-Taking; Sexual Behavior; Substance-Related Disorders; Surveys and Questionnaires; Urban Population; Young Adult

Alternative methods for consuming cannabis (e.g., vaping and edibles) have become more popular in the wake of U.S. cannabis legalization. Specific provisions of legal cannabis laws (LCL) (e.g., dispensary regulations) may impact the likelihood that youth will use alternative methods and the age at which they first try the method - potentially magnifying or mitigating the developmental harms of cannabis use.. This study examined associations between LCL provisions and how youth consume cannabis. An online cannabis use survey was distributed using Facebook advertising, and data were collected from 2630 cannabis-using youth (ages 14-18). U.S. states were coded for LCL status and various LCL provisions. Regression analyses tested associations among lifetime use and age of onset of cannabis vaping and edibles and LCL provisions.. Longer LCL duration (OR. Specific provisions of LCL appear to impact the likelihood, and age at which, youth use alternative methods to consume cannabis. These methods may carry differential risks for initiation and escalation of cannabis use. Understanding associations between LCL provisions and methods of administration can inform the design of effective cannabis regulatory strategies.

Topics: Adolescent; Cannabis; Humans; Legislation, Drug; Licensure; Male; Marijuana Smoking; Marijuana Use; Surveys and Questionnaires; United States; Vaping

There is a growing interest in how extensively the use of marijuana by drivers relates to crash involvement. While cognitive, lab-based studies are consistent in showing that the use of cannabis impairs driving tasks, epidemiological, field-based studies have been inconclusive regarding whether cannabis use causes an increased risk of accidents. There is ample evidence that the presence of cannabis among drivers with a BAC≥0.08g/dL highly increases the likelihood of a motor vehicle crash. Less clear, however, is the contribution of cannabis to crash risk when drivers have consumed very little or no alcohol. This effort addresses this gap in knowledge. We took advantage of a unique database that merged fatal crashes in the California Statewide Integrated Traffic Records System (SWITRS) and the Fatality Analysis Reporting System (FARS), which allows for a precise identification of crash responsibility. To account for recent increase in lab testing, we restricted our sample to cover only the years 1993-2009. A total of 4294 drivers were included in the analyses. Descriptive analyses and logistic regressions were run to model the contribution of alcohol and drugs to the likelihood of being responsible in a fatal crash. We found evidence that compared with drivers negative for alcohol and cannabis, the presence of cannabis elevates crash responsibility in fatal crashes among drivers at zero BACs (OR=1.89) and with 0

Topics: Accidents, Traffic; Adult; Alcohol Drinking; Automobile Driving; California; Cannabis; Humans; Logistic Models; Male; Marijuana Use; Probability; Social Behavior

Although there are serious negative harms associated with simultaneous alcohol and marijuana (SAM) use, little is known about the self-reported acute effects of SAM use and how they may be similar to or different than effects experienced when using alcohol or marijuana only. The current study examines the perceived acute effects of SAM use, compared to using alcohol or marijuana only, as well as demographic and substance use predictors of overall SAM effects.. Participants were a community sample of young adults ages 18-23 participating in a longitudinal study on social role transitions and substance use during young adulthood. Young adults who reported SAM use at least once in their lifetime were selected for the present analyses (N=315; mean age=21.42; 58% female) and reported the effects they experienced from typical alcohol use, marijuana use, and SAM use.. There were significant differences in the extent to which young adults perceived the effects depending on the substances used. Most effects (i.e., clumsy, confused, dizzy, difficulty concentrating) were rated strongest when engaging in SAM use, compared to typical alcohol or marijuana use alone. Feeling high and feeling marijuana effects were rated strongest when engaging in marijuana use alone compared to SAM use, but feeling drunk was greater during SAM use compared to alcohol use alone. Greater alcohol use and increased time spent high during typical SAM use were associated with greater overall SAM effects.. When young adults engage in SAM use they report experiencing greater negative physiological and cognitive effects.

Topics: Alcohol Drinking; Cannabis; Emotions; Ethanol; Female; Humans; Longitudinal Studies; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Perception; Self Report; Substance-Related Disorders; Young Adult

Long term change in diagnosis of patients having Cannabis induced psychosis (CIP) at the index evaluation is well recognised. Some patients are known to achieve complete remission while others go on to develop independent schizophrenia or mood disorders.. To study the long-term course of CIP and factors influencing it.. Patients diagnosed as CIP (ICD 10: F12.5), admitted at NIMHANS, a tertiary neuropsychiatry centre at Bangalore, over the past 10 years were identified from medical records. 200 case records were identified and screened in detail. 57 met inclusion criteria and 35 patients could be followed up. Mean follow up duration was 5.75 years.. Patients who completely abstained from cannabis after the 1. Abstaining from cannabis early in the course of illness is critical for good recovery. The course of CIP is variable and categorising CIP into affective vs. non-affective psychosis can be useful in clinical practice.

Topics: Adolescent; Adult; Affective Disorders, Psychotic; Age Factors; Aged; Bipolar Disorder; Cannabis; Disease Progression; Follow-Up Studies; Humans; Male; Marijuana Use; Middle Aged; Mood Disorders; Psychoses, Substance-Induced; Recurrence; Social Class; Young Adult

Over half of U.S. states have enacted legal cannabis laws (LCL). In parallel, edible cannabis products (i.e., edibles) have presented new regulatory challenges. LCL provisions that dictate access to cannabis (e.g., home cultivation (HC) or dispensaries (DSP)) may impact edible production and use. This study examined relationships among HC and DSP provisions, cannabis cultivation, and edible use.. An online cannabis use survey was distributed using Facebook. Data were collected from 1813 cannabis-using adults. U.S. states were classified as states without LCL (Non-LCL) or LCL states that: (1) only permit DSP (LCL DSP-only), (2) only permit HC (LCL HC-only), or (3) permit HC and DSP (LCL HC+DSP). Analyses tested associations among these classifications, cannabis growing, and edible use and procurement.. Individuals in LCL HC-only and LCL HC+DSP states were more likely to report currently growing cannabis at home (OR: 3.3, 95% CI: 1.7, 6.2; OR: 3.9, 95% CI: 2.4, 6.3, respectively) and past-month edible use (OR: 2.1, 95% CI: 1.4, 3.4; OR: 2.9, 95% CI: 2.2, 3.9, respectively) than individuals in LCL DSP-only states. Regardless of state, those who had grown cannabis were more likely to have made edibles than those who had never grown cannabis (OR: 2.2, 95% CI: 1.8, 2.6). Individuals in LCL HC-only states were more likely to have made edibles in the past month than individuals from Non-LCL (OR: 2.75, 95% CI: 1.5, 5.3) and DSP-only states (OR: 2.1, 95% CI: 1.0, 4.4). Individuals in LCL HC+DSP states were more likely to have purchased edibles in the past month than individuals from Non-LCL (OR: 3.7, 95% CI: 2.4, 5.6) and DSP-only states (OR: 3.2, 95% CI: 1.8, 5.5).. Specific LCL provisions may differentially affect individuals' propensity to grow cannabis and make, buy, and use edible cannabis products. Permitting home cultivation contributes to a greater likelihood of growing cannabis. Those who grow cannabis economize the plant by creating homemade edible cannabis products. Conversely, permitting dispensaries increases the likelihood of purchasing edibles. The psychoactive effects of edibles with unknown and variable cannabinoid content will be unpredictable. Policymakers should carefully consider how specific LCL provisions can affect patterns of cannabis edible product access and quality.

Topics: Adolescent; Adult; Agriculture; Cannabis; Commerce; Female; Humans; Legislation, Drug; Male; Marijuana Use; Middle Aged; Plants, Edible; Surveys and Questionnaires; Young Adult

Topics: Cannabis; Child, Preschool; Consciousness Disorders; Dronabinol; Female; Food; Humans; Marijuana Abuse; Marijuana Use; Substance Abuse Detection

Topics: Adolescent; Cannabis; Humans; Legislation, Drug; Marijuana Abuse; Marijuana Smoking; Marijuana Use

Interest in marijuana edibles has increased as perceptions of harm from marijuana have decreased. Media and peer influences impact youth substance use, and YouTube is the most popular video-sharing website. No studies have examined the content and accessibility of YouTube videos related to marijuana edibles.. To describe the messages conveyed to viewers in YouTube videos about edibles and determine their accessibility to youth.. On June 12, 2015, we searched YouTube for videos about marijuana/cannabis/weed edibles. A total of 51 videos were coded for presence of an age restriction, purpose(s) of the videos, consumption of edibles during the video, effects, and safety concerns.. Total views across all 51 videos were >9 million. Only 14% (7/51) were restricted to viewers over the age of 18 years. Over half (27/51, 53%) were informative videos, most (20/27, 74%) teaching how to make edibles, and 37% (19/51) were entertaining videos. Someone consumed an edible in 31% (16/51) of the videos, and the type of high was mentioned in 51% (26/51) of the videos, including delayed (18/26, 69%) or intense high (13/26, 50%). Fifty-five percent (28/51) mentioned delta-9-tetrahydrocannabinol potency or dosage. Only 10 of these (36%) presented this information specifically as a warning to prevent adverse effects. Conclusions/Importance: Edibles-related videos are easily found on YouTube, often instructing how to bake your own edibles and lacking information needed for safe consumption, and most are not age-restricted. Videos showing how to make edibles or presenting edibles use in an entertaining way that could influence youth to initiate use.

Topics: Cannabis; Food; Humans; Marijuana Use; Social Media; Video Recording

Cannabis Social Clubs (CSCs) are a model of non-profit production and distribution of cannabis among a closed circuit of adult cannabis users. CSCs are now operating in several countries around the world, albeit under very different legal regimes and in different socio-political contexts.. In this paper we describe and compare the legal framework and the self-regulatory practices of Cannabis Social Clubs in three countries (Spain, Belgium, and Uruguay). The objective of our comparative analysis is to investigate how CSCs operate in each of these countries. To foster discussions about how one might regulate CSCs to promote public health objectives, we conclude this paper with a discussion on the balance between adequate governmental control and self-regulatory competences of CSCs.. The data used for this analysis stem from independently conducted local studies by the authors in their countries. Although the particular designs of the studies differ, the data in all three countries was collected through similar data collection methods: analysis of (legal and other documents), field visits to the clubs, interviews with staff members, media content analysis.. We identified a number of similarities and differences among the CSCs' practices in the three countries. Formal registration as non-profit association seems to be a common standard among CSCs. We found nevertheless great variation in terms of the size of these organisations. Generally, only adult nationals and/or residents are able to join the CSCs, upon the payment of a membership fee. While production seems to be guided by consumption estimates of the members (Spain and Belgium) or by the legal framework (Uruguay), the thresholds applied by the clubs vary significantly across countries. Quality control practices remain an issue in the three settings studied here. The CSCs have developed different arrangements with regards to the distribution of cannabis to their members.. By uncovering the current practices of CSCs in three key settings, this paper contributes to the understanding of the model, which has to some extent been shaped by the self-regulatory efforts of those involved on the ground. We suggest that some of these self-regulatory practices could be accommodated in future regulation in this area, while other aspects of the functioning of the CSCs may require more formal regulation and monitoring. Decisions on this model should also take into account the local context where the clubs have emerged. Finally, the integration of medical supply within this model warrants further attention.

Topics: Adult; Belgium; Cannabis; Commerce; Humans; Legislation, Drug; Marijuana Use; Models, Theoretical; Public Health; Quality Control; Spain; Uruguay

The therapeutic and recreational use of cannabis and its derived products has been known since ancient times. The debate regarding its properties and legal status, which has recently changed in several states, has grown in recent years. However, scientifc evidence for or against its use, as well as for potential toxic effects in the short or long term, is scarce. In spite of the promising perspectives for its therapeutic use, in particular for neurological diseases such as refractory epilepsy or multiple sclerosis, which certainly aim for a controlled administration, this opinion article advocates for a greater incidence of basic and clinical scientifc research that may take this debate further away from matters of belief or prejudice and put it where it belongs, together with evidence and rationality.

Topics: Cannabinoids; Cannabis; Humans; Marijuana Use; Medical Marijuana

Recent research indicates that marijuana-infused food product (i.e., edible) use is becoming nearly as common as smoking marijuana where medical marijuana is available. This study explores edible use among teens. We conducted four focus groups in the San Francisco Bay Area with youth, ages 15-17. The focus groups were divided by gender and whether they used marijuana. Some teens mentioned edible use at school. Youth reported that teens consume edibles, primarily to reduce the likelihood of getting caught. Edibles are also attractive to those who do not like to smoke or have concerns about smoking. Both male and female respondents suggested that females are more likely than males to prefer edibles over smoking, one reason for which may be to avoid smelling like marijuana smoke. For some young women, edibles may be a way to avoid publicly presenting themselves as marijuana users. Findings also suggest that youth have access to edibles through multiple sources. Youth reported that they can purchase edibles at school from other students who either make the edibles themselves or are reselling edibles obtained from dispensaries. Both users and non-users were aware of potentially negative consequences related to edible use. Some youth mentioned that they have heard of youth dying from edibles, and several reported being concerned about the high produced by edibles. Female non-users appeared to be more concerned than others about edibles and compared them to drinks that could be spiked with drugs. However, sentiment among some male marijuana users was that if you cannot handle edibles you should not be using them. These findings suggest that strategies to curb access to edibles and use among youth, such as restricting sales of edibles with strong youth appeal and educating youth on the risks of edibles, will need to be developed.

Topics: Adolescent; Adolescent Behavior; Cannabis; Feeding Behavior; Female; Focus Groups; Humans; Male; Marijuana Smoking; Marijuana Use; San Francisco; Smoking

As marijuana laws have become more permissive, survey data on adolescents in the United States have shown an increase in marijuana-specific risk factors, particularly in the proportion of youth who do not perceive marijuana use as harmful. Prevalence of marijuana use among youth, however, has changed little. Using representative data from Washington State, which has legalized medical and nonmedical marijuana for adults, we examined two competing hypotheses to account for this divergence in population trends.. Data were from 2000 to 2014 biennial Washington State surveys of 10th-grade students. First, we assessed whether associations between marijuana use and marijuana-specific risk factors have weakened over time. Second, we examined whether decreases in alcohol and cigarette use can account for the lack of expected increase in marijuana use prevalence.. Despite stability in marijuana use prevalence, there were increases in marijuana-specific risk factors of low perceived harm, youth favorable attitudes about use, and perceived community attitudes favorable to use. Associations between marijuana use and marijuana use predictors varied little across time; if anything, the positive association between low perceived harm and marijuana use grew stronger. Decreases in prevalence of alcohol and cigarette use largely accounted for stability in marijuana use during a period when marijuana risk factors increased.. Decreases in other types of substance use or in the underlying, common risk for substance use may have mitigated effects of increases in marijuana-specific risk factors.

Topics: Adolescent; Adolescent Behavior; Alcohol Drinking; Cannabis; Cigarette Smoking; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Marijuana Use; Prevalence; Risk Factors; Surveys and Questionnaires; United States; Washington

Cannabis use has been associated with favorable outcomes on metabolic risk factors. The cause of this relation is still unknown. In this study we investigated whether this effect is mediated by the AKT1 gene, as activation of the related enzyme by cannabis may cause metabolic changes. Six Single Nucleotide Polymorphisms (SNPs) of the AKT1 gene (rs1130214, rs1130233, rs2494732, rs2498784, rs3730358, and rs3803300) of patients with psychotic disorders (n=623) were related to Body Mass Index (BMI), levels of glycosylated hemoglobin (HBA1c) and total metabolic risk. Next, mediation analysis was performed with BMI as outcome, cannabis as predictor, and AKT1 as mediator. Cannabis use was inversely related to BMI but not with levels of HBA1c and total metabolic risk. Moreover, out of 6 AKT1 SNPs, rs2494732 was associated with cannabis use, but AKT1 did not mediate the effect of cannabis on BMI. In conclusion, cannabis use is likely to be associated with a lower BMI in patients with a psychotic disorder. Moreover, AKT1 risk alleles may increase the incidence of cannabis use in patients with a psychotic disorder, but AKT1 does not appear to mediate the effect of cannabis on BMI.

Topics: Adolescent; Adult; Alleles; Body Mass Index; Cannabis; Female; Genetic Predisposition to Disease; Glycated Hemoglobin; Humans; Longitudinal Studies; Male; Marijuana Use; Middle Aged; Polymorphism, Single Nucleotide; Proto-Oncogene Proteins c-akt; Psychotic Disorders; Regression Analysis; Risk Factors; Young Adult

Topics: Adult; Cannabis; Cross-Sectional Studies; Humans; Marijuana Abuse; Marijuana Smoking; Marijuana Use; Surveys and Questionnaires