Cannabis (Albuquerque, N.M.)最新文献

Objective: Increasingly, cannabis is being prescribed/used to help manage posttraumatic stress symptoms (PTSS) or chronic pain, as cannabis has been argued to be beneficial for both types of symptoms. However, the evidence on efficacy is conflicting with evidence of risks mounting, leading some to caution against the use of cannabis for the management of PTSS and/or chronic pain. We examined the main and interactive effects of PTSS and chronic pain interference on adverse cannabis outcomes (a composite of cannabis use levels and cannabis use disorder, CUD, symptoms). We hypothesized that chronic pain interference and PTSS would each significantly predict adverse cannabis outcomes, and that chronic pain interference effects on adverse cannabis outcomes would be strongest among those with greater PTSS.

Method: Forty-seven current cannabis users with trauma histories and chronic pain (34% male; mean age = 32.45 years) were assessed for current PTSS, daily chronic pain interference, past month cannabis use levels (grams), and CUD symptom count.

Results: Moderator regression analyses demonstrated chronic pain interference significantly predicted the adverse cannabis outcomes composite, but only at high levels of PTSS.

Conclusions: Cannabis users with trauma histories may be at greatest risk for heavier/more problematic cannabis use if they are experiencing both chronic pain interference and PTSS.

Objective: This study investigated young adults' (YAs) experiences with tolerance breaks (temporary abstinence from cannabis; T-breaks).

Method: In Study 1, 15 YAs who used cannabis completed a qualitative interview. In Study 2, 66 YAs who used cannabis at least 2x/week completed online survey items assessing T-break familiarity, definitions, motivations, and experiences. Data were analyzed using qualitative thematic analysis.

Results: In Study 1, five themes were identified: (1) time frames for T-breaks were variable but brief and temporary, (2) T-breaks were motivated by tolerance reduction (3) and other motives, (4) withdrawal is an early barrier; positive outcomes occurred with longer breaks, (5) some YAs viewed T-breaks as unnecessary/unachievable. Study 2 findings demonstrated that YAs were familiar with T-breaks and most had attempted a T-break in the past year; greater variability in T-break motivations was apparent in Study 2.

Conclusions: Results suggest that YAs define T-breaks as an intentional and temporary period of abstinence from cannabis, regardless of motivation.

Objective: Due to little knowledge regarding the contextual factors related to cannabis use, we aimed to provide descriptive statistics regarding contextual factors related to use and examine the predictive ability of contextual factors.

Method: We included college student participants (n = 5,700; male = 2,893, female = 3,702, other gender identity = 48, missing = 57) from three multi-site studies in our analyses. We examined the means and standard deviations of contextual factors related to cannabis use (social context/setting, form of cannabis, route of administration, source of purchase, and proxies of use). Additionally, we tested the predictive ability of the contextual factors on cannabis use consequences, protective behavioral strategies, and severity of cannabis use disorder, via an exploratory machine learning model (random forest).

Results: Descriptive statistics and the correlations between the contextual factors and the three outcomes are provided. Exploratory random forests indicated that contextual factors may be helpful in predicting consequences and protective behavioral strategies and especially useful in predicting the severity of cannabis use disorder.

Conclusions: Contextual factors of cannabis use warrants further exploration, especially considering the difficulty in assessing dosage when individuals are likely to consume in a group context. We propose considering measuring contextual factors along with use in the past 30 days and consequences of use.

Objective: Driving after cannabis use (DACU) has become an increasing public health concern nationwide. Although previous research has linked perceived peer approval, perceptions of dangerousness, and negative effect expectancies to DACU, no previous work has examined whether these constructs can be successfully targeted in an intervention or whether changes in these variables lead to changes in DACU. The present study is a secondary data analysis to investigate within-subject change and potential mechanisms of change in a pilot trial for a mobile phone-based intervention shown to significantly reduce DACU over time.

Method: Participants were 66 emerging adults who completed the mobile-based intervention and provided 3-month follow-up data. Participants completed measures that assessed rates of DACU, negative cannabis expectancies, perceptions of dangerousness, and perceived peer-approval.

Results: Results indicated that negative effect expectancies significantly increased from baseline to three-month follow-up, while perceived peer approval for DACU significantly decreased from baseline to three-month follow-up. Though significant within-subject change was found for all variables of interest, none of the variables of interest significantly mediated changes in instances of DACU over time. The results of the current study suggest that key variables associated with DACU-perceived peer approval and negative cannabis expectancies can be successfully targeted in a mobile-based brief intervention.

Conclusions: Continued research investigating moderators and mediators of intervention outcomes is warranted.

Objective: Limited research examines the effect of stress on behavioral economic constructs among individuals using cannabis. This study examined whether the effects of acute stress on delay discounting differed in terms of cannabis use status and whether cannabis demand changed after stress induction.

Method: Participants were two groups (n = 39 endorsing high-frequency cannabis use and n = 48 not endorsing cannabis use) of young adults (75.86% female, 67.82% White, M _age = 21.64 years). During an online Zoom session, participants completed a prestress assessment, the Trier Mental Challenge Test (TMCT) stress induction, and then a poststress assessment.

Results: Subjective stress increased significantly across groups after stress induction (p < .001, ηp² = .23); no group X time interaction was observed. There were no differences in delay discounting across time or groups. For the use group only, cannabis demand intensity (p = .006, d = .50), but not other demand indices, significantly increased following the acute stress induction. Coping motives did not moderate the association between the change in subjective stress and the change in delay discounting or the change in any cannabis demand indices among the use group.

Conclusions: Cannabis demand might exert a more influential role than delay discounting in shaping decisions related to cannabis use while experiencing acute stress. However, the practical implications of this finding warrant further research due to the relatively small difference in hypothetical cannabis use observed. Study design limitations that could impact the findings or lead to null results are discussed to inform future research.

Objective: Despite increasing use of medical cannabis to manage cancer-related symptoms, U.S. payers do not reimburse medical cannabis, leaving patients responsible for all associated costs. We assessed how self-reported financial well-being is associated with patterns of cannabis consumption, out-of-pocket costs, and impact on symptoms in patients with cancer.

Method: From December 2021 to January 2022, we surveyed patients with cancer enrolled in the Minnesota Medical Cannabis Program. The mailed survey included cancer history, cannabis use history, symptom changes and sociodemographic questions including income and perceived financial wellness. We conducted descriptive analyses.

Results: Of 797 eligible adults, 220 (28%) responded to the survey. Two hundred eleven answered a question about current household income as living comfortably (LC, 45%; n = 95) or not living comfortably (NLC, 55%; n = 116). The NLC group reported lower incomes (47% vs 8% with annual incomes <$50,000) and were typically younger, unmarried, unemployed, or disabled. NLC group purchased more vaporizers (48% vs 27%), used products high in THC (92% vs 82%), and reported higher cannabis costs (40% vs 21% spending $200+/month). The NLC group more often stopped or used cannabis less frequently than they would like (54% versus 32%), frequently citing costs as a reason (85% vs 39%). Both NLC and LC groups typically used cannabis daily and reported a high degree of symptom improvement.

Conclusions: Patients with cancer using cannabis report significant improvements in cancer-related symptoms. High out-of-pocket costs for cannabis may be especially burdensome among those already financially struggling, raising questions about affordability of and equitable access to this therapy.

Objective: Sexual minority women (SMW) have higher rates of cannabis use compared to heterosexual women, which may be partially attributed to lower harm perceptions. However, no study has examined if the association between harm perceptions and cannabis use is stronger for SMW than heterosexual women. This study examined if sexual identity (SMW vs. heterosexual woman) moderated the association between harm perceptions and past 30-day cannabis use among a sample of female young adults (18-25 years old).

Method: Participants were 949 (29.8% SMW; Mean age = 24.33; 92.1% non-Hispanic White) females (99.3% cisgender) recruited from Amazon Mechanical Turk who reported weekly cannabis use. Participants reported how many days they used cannabis in the past 30-days and how harmful they perceived cannabis to be to their health (not at all/slightly/somewhat harmful vs. very/extremely harmful). An Analysis of Covariance examined the study aim.

Results: A significantly larger percentage of heterosexual women perceived cannabis to be very/extremely harmful to their health than SMW (45.2% vs. 22.6%). Those who perceived cannabis to be very/extremely harmful reported more frequent cannabis use in the past-30 days. SMW who perceived cannabis to be very/extremely harmful reported more frequent cannabis use relative to those who held lower harm perceptions; there were no significant differences for heterosexual women.

Conclusions: SMW may perceive cannabis as harmful because they may be experiencing health consequences from frequent use. It may be important for interventions and public health campaigns to be tailored specifically to SMW and include information about the potential harms of cannabis use.

Objective: Almost half of U.S. states have passed recreational cannabis laws as of May 2024. While considerable evidence to date indicates cannabis may be a substitute for prescription opioids in the treatment of pain, it remains unclear if patients are treating pain with cannabis alone or concomitantly with other medications.

Method: Using data from a national sample of commercially insured adults, we examine the effect of recreational cannabis legalization (through two sequential policies) on prescribing of opioids, NSAIDS, and other pain medications by implementing synthetic control estimations and constructing case-study level counterfactuals for the years 2007-2020.

Results: Overall, we find recreational cannabis legalization is associated with a decrease in opioid fills among commercially insured adults in the U.S., and we find evidence of a compositional change in prescriptions of pain medications more broadly. Specifically, we find marginally significant increases in prescribing of non-opioid pain medications after recreational cannabis becomes legal in some states. Once recreational cannabis dispensaries open, we find statistically significant decreases in the rate of opioid prescriptions (13% reduction from baseline, p < .05) and marginally significant decreases in the average daily supply of opioids (6.3% decrease, p < .10) and number of opioid prescriptions per patient (3.5% decrease, p < .10).

Conclusions: These results suggest that substitution of cannabis for traditional pain medications increases as the availability of recreational cannabis increases. There appears to be a small shift once recreational cannabis becomes legal, but we see stronger results once users can purchase cannabis at recreational dispensaries. The decrease in opioids and marginal increase in non-opioid pain medication may reflect patients substituting opioids with cannabis and non-opioid pain medications, either separately or concomitantly. Reductions in opioid prescription fills stemming from recreational cannabis legalization may prevent exposure to opioids in patients with pain and lead to decreases in the number of new opioid users, rates of opioid use disorder, and related harms.

Objective: The study investigated whether California storefront and non-storefront cannabis retailers are adhering to online age-gating requirements and whether differences in website marketing practices exist.

Methods: Websites of 134 storefront and 115 non-storefront licensed retailers were randomly selected. Bivariate associations were tested between retailer type and website marketing, age-gating methods, and presence of age-gating at various purchase stages.

Results: Among the 200 (80.3%) websites with age-gating when entering, 182 (91%) employed an ineffective method where users click either "Yes" or "No" to confirm their age. Moreover, 49 (19.68%) websites lacked age-gating when entering. Amongst those requiring photo identification during checkout (n = 100, 40.16%), 97% allowed users to proceed after uploading an irrelevant image. Significantly more storefront retailers employed combined age-gating at entry, mandatory account registration, and age-gating during checkout than non-storefront retailers, X ² (1, N = 249) = 7.69, p < .01. Retailer websites frequently displayed "clean" labels (n = 200, 80.32%), followed by positive state claims (n = 198, 79.52%), physical health claims (n = 166, 66.67%), and mental health claims (n = 146, 58.63%). Significantly more storefront retailers displayed physical health claims, X ² (1, N = 249) = 7.52, p < .01, and health warnings than non-storefront retailers, X ² (1, N = 249) = 4.13, p = .04.

Conclusions: Most cannabis retailers comply with age-gating requirements; however, methods employed are easily circumvented. Youths' easy and unrestricted access to cannabis retailer websites may increase positive attitudes about cannabis and encourage use.

Objective: While cannabis use is common among people with HIV (PWH), there have been few studies examining the association of use with health outcomes among PWH. We aimed to evaluate the association between cannabis use and bothersome physical and mental health symptoms using both self-report and a direct biomarker for cannabis use.

Method: The Medications, Alcohol and Substance use in HIV Study (MASH) is a cross-cohort study focused on polypharmacy and substance use among PWH. Participants were enrolled from October 2018 to May 2022 in the Swiss HIV Cohort Study (SHCS), Kaiser Permanente Northern California (KPNC) HIV Cohort, and 7 sites (Atlanta, GA; Bronx, NY; Washington, DC; Houston, TX; Los Angeles, CA; New York, NY; and Nashville, TN) in the Veterans Aging Cohort Study - HIV (VACS-HIV). Participants submitted self-reported information on the presence/absence of symptoms in the prior 4 weeks, along with bothersome level, using the HIV Symptom Index, which is comprised of 20 symptoms commonly reported in PWH, including fatigue, diarrhea, fever, anxiety, and weight loss, among others. Concurrent self-reported substance use information was also collected, and participants provided nail clippings to be tested for cannabis use. We used logistic regression models, adjusted for age, sex, race/ethnicity, and cohort, to examine associations of self-report and biomarker-identified cannabis use with self-reported bothersome symptoms.

Results: The analytic sample included 1,226 PWH who were predominantly male (85%), non-white (64%), with an average age of 57 years; 20% tested positive for cannabis use, and 23% reported recent cannabis use. Agreement between self-report and biomarker cannabis use was substantial (agreement 89%, kappa = 0.67). Put together, 27% either reported cannabis use or tested positive. Of the 20 symptoms included in the HIV Symptom Index, 19 were more prevalent at a bothersome level among those with cannabis use compared to those without. In adjusted models, the patterns of association remained for both self-reported and biomarker-confirmed cannabis use, and they were particularly substantial for memory, depression, anxiety, and nausea.

Conclusions: Cannabis use was common among PWH and was associated with a number of bothersome symptoms. While cannabis use may be used to treat loss of appetite, nausea/vomiting, and weight loss, the associations of cannabis use with depression, anxiety, and memory loss are concerning and deserve investigation.