Cannabis (Albuquerque, N.M.)最新文献

Objective: Since the federal Canadian government legalized cannabis in 2018, cannabis use in the general population has slightly increased. However, little is known about the impact of cannabis legalization on pattens of cannabis use in psychiatric populations.

Method: We studied changes in daily/almost daily and average 30-day cannabis use amongst individuals currently using cannabis who reported past 12-month experiences of specific mental health disorders and among those without past 12-month experiences of any mental health disorder before and after Canadian legalization of recreational cannabis use (N = 13,527). Data came from Canadian respondents in Wave 1 (August-October 2018), Wave 2 (September-October 2019), and Wave 3 (September-November 2020) of the International Cannabis Policy Study (ICPS).

Results: After adjustment for covariates, among individuals currently using cannabis, the odds of using cannabis daily/almost daily increased only in individuals with schizophrenia between Wave 1 and Waves 3 (aOR = 9.19, 95% CI: 2.46 - 34.37). Similarly, significant increases in average 30-day cannabis use between Wave 1 (M = 12.80, SE = 1.65) and Wave 3 (M = 18.07, SE = 1.03) were observed only among individuals with schizophrenia, F (1,2) = 4.58, p < .05. No significant changes in daily/almost daily or average past 30-day cannabis use were observed in those without mental health problems or those reporting anxiety, depression, PTSD, bipolar disorder, or substance use disorders.

Conclusions: Since legalization, cannabis use has significantly increased only among people with schizophrenia, highlighting the need for targeted public health prevention programs.

Objective: People living with chronic pain increasingly use medical cannabis for symptom relief. We conducted a retrospective cohort study examining cannabis for chronic pain relief using anonymous archival data obtained from the medicinal cannabis tracking app, Strainprint®.

Method: We acquired cannabis utilization data from 741 adults with chronic pain and used multilevel modeling to examine the association of age, sex, type of pain (muscle, joint or nerve pain), cannabis formulation (high CBD, balanced CBD:THC, or high THC), route of administration (inhaled or ingested), cannabis use before vs. during the COVID-19 pandemic, and duration of cannabis use, with pain relief.

Results: Most patients were female (n = 464; 63%), with a mean age of 39 (SD = 11), and our cohort had completed a total of 83,622 tracked cannabis sessions through Strainprint. The majority of sessions reported use of inhaled cannabis products (78%), typically with high tetrahydrocannabinol (THC; 64%) versus high cannabidiol (CBD; 15%) or balanced THC:CBD (21%) products. The median change in pain scores across sessions was -3.0 points on a 10-point numeric rating scale (NRS; IQR -4.5 to -2.0). In our adjusted model, greater pain relief was associated with male vs. female sex (-0.69 points on a 10-point NRS; 95%CI -0.46 to -0.91). We found statistically significant, but trivial associations with joint pain (-0.05 points), balanced THC:CBD products in the long term (-0.003 points), and cannabis use during the pandemic (0.18 points).

Conclusions: We found that people living with chronic pain report important pain relief when using cannabis for medical purposes, and that men may achieve greater pain relief than women.

Objective: Cannabis has become more available in Canada since its legalization in 2018. Many individuals who use cannabis also use alcohol (co-use), which can be used either at the same time such that their effects overlap (simultaneous use) or at different times (concurrent use). Though studies have identified predictors of co-use relative to single-substance use, less is known about the predictors of specific types of co-use. The present study examined the mental health and dispositional predictors of simultaneous relative to concurrent use of the two legal substances (cannabis and alcohol) among adults in Canada.

Method: Canadian adults reporting past-year use of both cannabis and alcohol (N = 1,761) were recruited from Academic Prolific and six Canadian universities. Participants completed online self-report measures of demographic characteristics, cannabis and alcohol co-use, mental health symptoms, impulsivity, and personality traits.

Results: Binary logistic regression analyses revealed that when independent variables were each examined individually, greater severity of depression, anxiety, PTSD, and ADHD symptoms; greater negative urgency and lack of premeditation; and greater impulsivity each predicted an increased likelihood of reporting past-year simultaneous use relative to concurrent use. When independent variables were grouped into three separate models (mental health, impulsivity, and personality variables), greater anxiety symptom severity, ADHD symptom severity, negative urgency, and sensation seeking were each uniquely associated with an increased likelihood of simultaneous relative to concurrent use.

Conclusions: Individuals with elevated anxiety and ADHD symptoms, as well as negative urgency and sensation seeking, may be more inclined to engage in simultaneous use to self-medicate and achieve greater symptom reduction. Future studies may examine the directionality of these relations and motives (e.g., coping) that may differentiate simultaneous and concurrent use.

Objective: Recent studies found that recreational legalization of cannabis consumption for Canadian adults has increased presentation to the emergency department (ED) among children. In this descriptive study, our objectives were to (1) understand Canadian pediatric emergency medicine (PEM) providers' training and knowledge of clinical presentations associated with cannabis exposure in children and (2) describe pediatric ED presentations related to cannabis exposure across Canada following legalization in 2018.

Method: In 2021, following ethics board approval, 230 Pediatric Emergency Research Canada (PERC) network pediatric emergency medicine (PEM) physicians were invited to share about their knowledge, training, and experience with patients presenting with cannabis-associated emergencies using an anonymized survey administered through REDCap.

Results: In total, 84/230 (36.5%) invited physicians completed the survey. Almost 70% of the PEM physicians reported an increase in the number of cannabis-associated ED presentations they have seen since legalization, while only 15% reported no increase in presentations. More than 90% of the respondents reported an average or higher level of knowledge of cannabis-associated pediatric emergencies. More than half (n = 48, 57%) were interested in pursuing further training, preferring formal training opportunities. The main presentations to the ED were decreased level of consciousness, known unintentional (accidental) ingestion and vomiting. Significantly more tests were ordered when cannabis consumption was unknown at the beginning of the assessment, compared to when it was known, however, treatment plans were the same (mainly supportive measures).

Conclusions: Most PEM providers are managing an increasing number of cannabis-associated ED presentations. PEM providers should improve communication with caregivers around household cannabis use. When caregivers feel comfortable disclosing cannabis presence at home, it can help prevent unnecessary tests and interventions for their children if they present to the ED.

Objective: In October 2018, the Government of Canada legalized cannabis for recreational use nationwide. The effects of legalization on cannabis use have been primarily assessed through cross-sectional surveys.

Method: In the present study, a two-wave longitudinal design was used to explore potential demographic, substance use and behavioral addiction, and mental health predictors of change in cannabis use status following legalization. Canadian online panelists (18+) were initially surveyed about their gambling and substance use in 2018 (i.e., before cannabis legalization). From the original sample, 4,707 (46.2%) were retained in the follow-up survey one year later, post-cannabis legalization. These respondents were the focus of the present study.

Results: When queried about how legalization would impact their use, 61.8% said, 'I'll never use it', 21.1% stated "I'll use it about the same as I do now," 10.3% indicated, "I may try it for the first time," 5.0% answered, "I'll use it more," and 1.9% responded that, "I'll use it less." Consistent with these sentiments, within the retained sample there was a modest but significant increase in cannabis use from baseline (18.4%) to follow-up (26.1%). Regressions established that younger age, being male, substance use, tobacco or e-cigarette use, problematic gambling, and stated intention to use cannabis were predictors of later cannabis use.

Conclusions: This national cohort design indicates that cannabis use appears to have increased in Canada following legalization. The present study makes a unique contribution by also identifying variables that statistically forecast movement toward and away from cannabis use.

Objective: The present research evaluated the impact of legalizing recreational cannabis among individuals with substance use disorders (SUDs) who may already use cannabis at high rates.

Method: Using an interrupted time series study design, we evaluated the potential impact of legalizing recreational cannabis among individuals seeking treatment for SUD within a hospital-based treatment setting in Guelph, Ontario. We examined 2,925 individuals who entered an inpatient SUD treatment program between April 2017 and December 2021. We performed segmented regression analyses using both the date of cannabis legalization and the date of edibles legalization as the interruption time point. We also performed stratified analyses to examine potential sex differences.

Results: We found no significant changes in the frequency of cannabis use using either of the interruption time points. However, among the subsample who had used cannabis, there was evidence of increasing CUD severity post-legalization of edibles, as well as an overall decreasing trend in readiness to quit over time. Stratified analyses also suggested possible sex differences in frequency of cannabis use, CUD severity, and readiness to quit.

Conclusions: Results point to some small but potentially important impacts of recreational cannabis legalization that may only continue with time. Nevertheless, there is a need to continue to monitor cannabis use trends over time to understand any potential lagged effects.

Objective: The relationship between cannabis use and mental health has garnered significant attention in recent decades. However, studies have largely been in general populations or in countries in which recreational cannabis use is illegal.

Method: The current cross-sectional study examines the relationship between cannabis use, mood disorders, anxiety, and psychosis in an inpatient psychiatric population with severe concurrent mental health and substance use disorders, exploring the potential moderating effect of the legalization of recreational cannabis in Canada.

Results: Cannabis use compared to non-use was associated with higher self-reported depression, anxiety, and psychotic symptoms but was not associated with diagnosis of a mood, anxiety, or psychotic disorder. Frequency of cannabis use was unrelated to mental health outcomes, but age of first use was negatively associated with self-reported psychoticism symptoms. There were some significant associations between recreational cannabis legalization and mental health, but legalization was largely unrelated to outcomes. There were also some significant differences by demographics.

Conclusions: While findings are relatively consistent with prior literature, some significant associations differed, suggesting the importance of examining concurrent disorder patients as a unique population when examining relationships between cannabis use and mental health.

Introduction: Increasing reinforcement received from cannabis-free activities, relative to reinforcement from cannabis-related activities, is one way to reduce harmful cannabis use. Thus, accurate measurement of cannabis reinforcement is important. Using convergent mixed methods, we developed the Adolescent Reinforcement Survey Schedule-Cannabis Use Version (ARSS-CUV). ARSS-CUV, adapted from the alcohol use version, measures cannabis reinforcement by asking individuals how frequently they engaged in, and how much they enjoyed, different activities when using and not using cannabis.

Method: Young adults (N = 65; M _age = 20.4 years [SD = 1.8]) completed measures of cannabis use, the ARSS-CUV, and provided feedback on included activities, via focus groups. Following Standards for Educational and Psychological Testing framework, this study examined evidence of measurement validity based on item content.

Results: Quantitative findings revealed that peer interactions were the most reinforcing activities, whereas activities related to family were least reinforcing. Qualitative findings indicated some confusion with question wording. Participants also indicated the importance of environmental context when using cannabis and noted who they use cannabis with may be more important than the activity they are doing. Changes were made to survey flow and response choices after participant feedback.

Conclusions: ARSS-CUV includes revisions in activities solicited and response format. The revised ARSS-CUV provides opportunities to advance measurement of an important construct (i.e., reinforcement) in the study of cannabis use. Psychometric properties of the ARSS-CUV across different populations and contexts of use (e.g., polysubstance use) should be examined.

Background: Sexual minority young adults (SMYAs) experience discrimination and have high cannabis use prevalence. Discrimination may be associated with cannabis use, including hazardous use and co-use with tobacco, depending on emotion regulation and gender.

Methods: Fall 2020 survey data assessed discrimination, use frequency of emotion regulation strategies (i.e., cognitive reappraisal, expressive suppression), current cannabis use, hazardous use, and cannabis-tobacco dual use among SMYAs (age 18-34) in 6 United States metropolitan areas (women: n=450, M _age =24.1, SD=4.7, 69.6% bisexual, 18.2% lesbian/gay, 12.2% other; men: n=254, M _age=24.7, SD=4.5, 33.5% bisexual, 54.3% gay, 12.2% other). Multivariable logistic regression examined the moderating roles of cognitive reappraisal and expressive suppression on associations of discrimination with cannabis use outcomes, stratified by gender and adjusted for age, race and ethnicity, and employment.

Results: Among SMYA women, 89.5% experienced any discrimination; 53.1% reported current cannabis use, of whom 49.4% and 47.7% reported hazardous use and cannabis-tobacco dual use, respectively. Adjusting for sociodemographics, experiencing greater discrimination was associated with greater odds of hazardous cannabis use (aOR=1.08, 95% CI [1.02, 1.15]) and cannabis-tobacco dual use (aOR=1.04, 95% CI [1.01, 1.08]) among SMYA women with greater use of expressive suppression. Among SMYA men, 83.9% experienced any discrimination; 49.2% reported current cannabis use, of whom 55.2% and 44.0% reported hazardous use and cannabis-tobacco dual use. Discrimination and emotion regulation were unrelated to cannabis use outcomes among men. Conclusions: Given high rates of discrimination experiences among SMYAs, emotion regulation skills training may empower SMYAs, particularly women, to cope with discrimination without using cannabis.

Objective: Perseverative cognitive processes, such as rumination, may indirectly influence effects of personality traits on cannabis use and related problems. Understanding relations among personality, rumination, and cannabis use motives may lead to better understanding of problematic cannabis use. The present study examined personality traits' influence on negative cannabis-related consequences via rumination and cannabis use coping motives.

Methods: We tested a sequential path model across two independent samples such that the model was tested in one sample and replicated in the second sample. Participants were U.S. undergraduate students from multiple universities who reported using cannabis at least once in the prior thirty days.

Results: Results partially supported hypotheses such negative urgency and distress tolerance were indirectly related to negative cannabis-related consequences via rumination and coping motives. Specifically, higher negative urgency and lower distress tolerance were related to higher rumination. Higher rumination was related to higher coping motives; which in turn was related to more negative cannabis-related consequences. Results indicate that rumination is a risk factor belying associations between personality and cannabis use to cope and negative consequences of use.

Conclusions: Implementing techniques that attenuate rumination for individuals high in negative urgency or low in distress tolerance may reduce or prevent problematic cannabis and unintended outcomes.