Cannabis (Albuquerque, N.M.)最新文献

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: 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: 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.

Objective: Trauma survivors are more likely than others to use cannabis, and post-traumatic stress disorder (PTSD) commonly co-occurs with cannabis use disorder (CUD). Automatic memory associations between trauma reminders and cannabis use have been suggested as contributing mechanisms. These associations can be studied experimentally by manipulating trauma cue exposure in a cue-reactivity paradigm (CRP) and examining effects on the accessibility of cannabis information in memory in trauma survivors with and without PTSD.

Method: Cannabis users with trauma histories (N = 202) completed a PTSD measure (PTSD Checklist-5) and were randomized to a trauma or neutral expressive writing task as an online CRP. Next, participants completed a cue-behavior word association task, which involved presentation of a series of ambiguous cue words to which participants provided the first word that came to mind. Some of these ambiguous cues pertained to cannabis (e.g., weed, pot) and some to other substances (e.g., blow, shot). This task was scored by two independent raters. Linear regression models tested the hypothesized main and interactive effects of CRP condition (trauma, neutral) and PTSD group (probable PTSD, no PTSD) on the number of cannabis and other substance responses generated.

Results: Main effects of CRP condition were found for cannabis responses (b = 0.41, p = .048; trauma > neutral) but not other substance responses. Unexpectedly, no main effects or interactions of PTSD group were observed for either outcome.

Conclusions: In cannabis users with trauma histories, writing about one's trauma specifically activates greater accessibility of cannabis-related information in memory, regardless of PTSD.

Objective: An increase in medical cannabis and prescribed cannabinoids use for chronic pain management has been observed in Canada in the past years. This study aimed to: 1) Describe clinicians' perceived risk associated with the use of medical cannabis and prescribed cannabinoids for the management of chronic pain; and 2) Identify sociodemographic and professional factors associated with perceived risk of adverse effects.

Method: A web-based cross-sectional study was conducted in Quebec, Canada in 2022. A convenience sample of 207 clinicians was recruited (physicians/pharmacists/nurse practitioners). They were asked to rate the risk of adverse effects associated with medical cannabis (e.g., smoke, or oil) and prescribed cannabinoids (e.g., nabilone) on a scale of 0 to 10 (0: no risk, 10: very high risk), respectively. Multiple linear regression was performed to identify factors associated with perceived risk.

Results: Average perceived risk associated with medical cannabis and prescribed cannabinoids were 5.93 ± 2.08 (median:6/10) and 5.76 ± 1.81 (median:6/10). Factors associated with higher medical cannabis perceived risk were working in primary care (β = 1.38, p = .0034) or in another care setting (β = 1.21, p = .0368) as compared to a hospital setting. As for prescribed cannabinoids, being a pharmacist (β = 1.14, p = .0452), working in a primary care setting (β = 0.83, p = .0408) and reporting more continuing education about chronic pain (β = 0.02, p = .0416) were associated with higher perceived risk. No sex differences were found in terms of perceived risk.

Conclusions: Considering the clinician's experience provide insights on cannabis risk as these professionals are at the forefront of patient care when they encounter adverse effects.

Although Canada legalized cannabis beverages in 2019, most available research on acute cannabis intoxication derives from dried flower and edible products. The distinct bioavailability and pharmacokinetic properties of phytocannabinoids ingested from beverages, however, contribute to significantly different acute and long-term effects that need to be better understood to ensure consumer safety.

Objective: This review investigates existing cannabis beverage literature, with a particular focus on acute intoxication effects.

Method: PubMed, PsycINFO and Web of Science databases were systematically searched. A structured search generated 29 eligible studies, comprising studies of consumption patterns and beliefs, advertisements and marketing, acute effects in human models, and drink composition.

Results: Human studies report aversive acute subjective and physiological effects induced by cannabis beverages in healthy, infrequent users. Beverages also showed inaccurate cannabinoid labeling, posing potential risks to consumers. This review highlights the paucity and inconsistency of available research, further exacerbated by the sheer diversity of formulations investigated, while beginning to address some questions surrounding the safety and risks associated with cannabis beverages.

Conclusions: Given the extensive differences in effects across cannabis-infused beverages, and the growing 'drinkables' market, it is essential that more studies directly examine both acute and long-term impacts of cannabis beverage consumption.

Objective: Little is known about the population-level impact of recreational cannabis legalization on trends in opioid-related mortality. Increased access to cannabis due to legalization has been hypothesized to reduce opioid-related deaths because of the potential opioid-sparing effects of cannabis. The objective of this study was to examine the relations between national retail sales of recreational (non-medical) cannabis and opioid overdose deaths in the 5 years following legalization in Canada.

Method: Using time-series data, we applied Granger causality methods to evaluate the association between trends in legal recreational cannabis sales and opioid-related deaths over time. Both sales and opioid deaths grew over time, with the latter exhibiting significant increases following the onset of the COVID-19 pandemic.

Results: We found no support for the hypothesis that increasing post-legalization sales Granger caused changes in opioid-related deaths in British Columbia, Ontario, or at the national level.

Conclusions: These findings suggest that increases in legal recreational cannabis sales following legalization were not meaningfully associated with changes in opioid-related mortality. Further examination with longer follow-up periods will be needed as the legal cannabis market becomes more entrenched in Canada, but these findings converge with previous work suggesting legalization is not related to opioid overdose mortality and further undermine that hypothesized link as a basis for legalization in other jurisdictions.