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1.
BMC Psychiatry ; 24(1): 175, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38433233

RESUMO

BACKGROUND: Cannabis use disorder (CUD) is increasingly common and contributes to a range of health and social problems. Cannabidiol (CBD) is a non-intoxicating cannabinoid recognised for its anticonvulsant, anxiolytic and antipsychotic effects with no habit-forming qualities. Results from a Phase IIa randomised clinical trial suggest that treatment with CBD for four weeks reduced non-prescribed cannabis use in people with CUD. This study examines the efficacy, safety and quality of life of longer-term CBD treatment for patients with moderate-to-severe CUD. METHODS/DESIGN: A phase III multi-site, randomised, double-blinded, placebo controlled parallel design of a 12-week course of CBD to placebo, with follow-up at 24 weeks after enrolment. Two hundred and fifty adults with moderate-to-severe CUD (target 20% Aboriginal), with no significant medical, psychiatric or other substance use disorders from seven drug and alcohol clinics across NSW and VIC, Australia will be enrolled. Participants will be administered a daily dose of either 4 mL (100 mg/mL) of CBD or a placebo dispensed every 3-weeks. All participants will receive four-sessions of Cognitive Behavioural Therapy (CBT) based counselling. Primary endpoints are self-reported cannabis use days and analysis of cannabis metabolites in urine. Secondary endpoints include severity of CUD, withdrawal severity, cravings, quantity of use, motivation to stop and abstinence, medication safety, quality of life, physical/mental health, cognitive functioning, and patient treatment satisfaction. Qualitative research interviews will be conducted with Aboriginal participants to explore their perspectives on treatment. DISCUSSION: Current psychosocial and behavioural treatments for CUD indicate that over 80% of patients relapse within 1-6 months of treatment. Pharmacological treatments are highly effective with other substance use disorders but there are no approved pharmacological treatments for CUD. CBD is a promising candidate for CUD treatment due to its potential efficacy for this indication and excellent safety profile. The anxiolytic, antipsychotic and neuroprotective effects of CBD may have added benefits by reducing many of the mental health and cognitive impairments reported in people with regular cannabis use. TRIAL REGISTRATION: Australian and New Zealand Clinical Trial Registry: ACTRN12623000526673 (Registered 19 May 2023).


Assuntos
Ansiolíticos , Antipsicóticos , Canabidiol , Cannabis , Alucinógenos , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , Canabidiol/uso terapêutico , Qualidade de Vida , Austrália , Ensaios Clínicos Controlados Aleatórios como Assunto , Ensaios Clínicos Fase III como Assunto
2.
Int J Epidemiol ; 53(2)2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38503548

RESUMO

BACKGROUND: Gastroschisis is a congenital anomaly of the abdominal wall with an unknown aetiology. Recent trends in the prevalence of gastroschisis suggest that changing environmental or behavioural factors may contribute. We examined whether prenatal cannabis use disorder was associated with gastroschisis. METHODS: The Study of Outcomes of Mothers and Infants is a population-based cohort compiled of California birth records that have been linked to Department of Health Care Access and Information hospitalization, emergency department and ambulatory surgery records. We included 2007-19 singleton live births (n = 5 774 656). Cannabis use disorder was measured by diagnosis codes at any visit during pregnancy or at birth. Gastroschisis was measured by diagnosis or surgical repair procedure codes at birth or during the first year of life. RESULTS: The prevalence of cannabis use disorder was about 1%. The prevalence of gastroschisis was 0.14% and 0.06% among those with and without cannabis use disorder, respectively. There were positive associations between cannabis use disorder and gastroschisis when using a multivariable model [adjusted risk ratio (aRR) = 1.3, 95% confidence interval (CI) 1.0, 1.7) and a matched sample approach (aRR = 1.5, 95% CI 1.1, 2.1). The association varied by maternal age and was largest among people aged >34 years (aRR = 2.5, 95% CI 1.0, 5.8). CONCLUSIONS: We confirm findings of a positive association between cannabis exposure and gastroschisis and add that it is strongest when maternal age is greater than 34 years. More investigation into whether the association is causal, and why the association varies by maternal age, is encouraged.


Assuntos
Gastrosquise , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Gravidez , Recém-Nascido , Feminino , Lactente , Humanos , Gastrosquise/epidemiologia , Gastrosquise/diagnóstico , Fatores de Risco , Idade Materna , California/epidemiologia , Abuso de Maconha/epidemiologia , Prevalência
3.
Psychiatry Res ; 333: 115757, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38309009

RESUMO

Cannabis use has been increasing over the past decade, not only in the general US population, but particularly among military veterans. With this rise in use has come a concomitant increase in cannabis use disorder (CUD) among veterans. Here, we performed an epigenome-wide association study for lifetime CUD in an Iraq/Afghanistan era veteran cohort enriched for posttraumatic stress disorder (PTSD) comprising 2,310 total subjects (1,109 non-Hispanic black and 1,201 non-Hispanic white). We also investigated CUD interactions with current PTSD status and examined potential indirect effects of DNA methylation (DNAm) on the relationship between CUD and psychiatric diagnoses. Four CpGs were associated with lifetime CUD, even after controlling for the effects of current smoking (AHRR cg05575921, LINC00299 cg23079012, VWA7 cg22112841, and FAM70A cg08760398). Importantly, cg05575921, a CpG strongly linked to smoking, remained associated with lifetime CUD even when restricting the analysis to veterans who reported never smoking cigarettes. Moreover, CUD interacted with current PTSD to affect cg05575921 and cg23079012 such that those with both CUD and PTSD displayed significantly lower DNAm compared to the other groups. Finally, we provide preliminary evidence that AHRR cg05575921 helps explain the association between CUD and any psychiatric diagnoses, specifically mood disorders.


Assuntos
Cannabis , Abuso de Maconha , Transtornos de Estresse Pós-Traumáticos , Transtornos Relacionados ao Uso de Substâncias , Veteranos , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/genética , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Abuso de Maconha/psicologia , Metilação de DNA , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
4.
Drug Alcohol Depend ; 256: 111114, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38325066

RESUMO

BACKGROUND: Emerging research suggests morning cannabis use may be associated with using more cannabis and experiencing more cannabis-related consequences. This paper examined whether months when young adults reported morning cannabis use (use between 6:00AM and 12:00PM) were associated with cannabis use frequency, negative cannabis-related consequences, and changes in cannabis use disorder (CUD) symptoms. METHODS: Participants were 778 young adults (Mage=21.11 years, 58.5% female) enrolled in a longitudinal study on substance use and social role transitions. Eligible participants were 18-23 years old at screening and reported past-year alcohol use. Participants completed a baseline survey, 24 consecutive monthly surveys, and a follow-up survey 30 months after baseline. Aims were tested using multilevel models and multiple regression. RESULTS: Analyses were limited to cannabis use months (N=4719; 28.9% of sampled months) and participants who reported cannabis use at least once (N=542; 69.7% of all participants). Morning use was reported in 12.3% of cannabis use months and at least once by 23.6% of participants who reported using cannabis. Relative to non-morning use months, morning use months were associated with greater cannabis use frequency and more negative consequences. However, the association between morning use and negative consequences was not statistically significant after controlling for cannabis use frequency. The percentage of cannabis use months with morning use was positively associated with increased CUD symptoms at the 30-month follow-up, relative to baseline. CONCLUSIONS: Morning cannabis use may be a useful marker of high-risk cannabis use and may contribute to the maintenance and worsening of CUD over time.


Assuntos
Cannabis , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Adulto Jovem , Adolescente , Adulto , Masculino , Abuso de Maconha/complicações , Abuso de Maconha/epidemiologia , Estudos Longitudinais , Transtornos Relacionados ao Uso de Substâncias/complicações , Consumo de Bebidas Alcoólicas
5.
World J Surg ; 48(3): 701-712, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38342773

RESUMO

BACKGROUND: The decriminalization of cannabis across the United States has led to an increased number of patients reporting cannabis use prior to surgery. However, it is unknown whether preoperative cannabis use disorder (CUD) increases the risk of postoperative complications among adult colectomy patients. METHODS: Adult patients undergoing an elective colectomy were retrospectively analyzed from the National Inpatient Sample database (2004-2018). To control for potential confounders, patients with CUD, defined using ICD-9/10 codes, were propensity score matched to patients without CUD in a 1:1 ratio. The association between preoperative CUD and composite morbidity, the primary outcome of interest, was assessed. Subgroup analyses were performed after stratification by age (≥50 years). RESULTS: Among 432,018 adult colectomy patients, 816 (0.19%) reported preoperative CUD. The prevalence of CUD increased nearly three-fold during the study period from 0.8/1000 patients in 2004 to 2.0/1000 patients in 2018 (P-trend<0.001). After propensity score matching, patients with CUD exhibited similar rates of composite morbidity (140 of 816; 17.2%) as those without CUD (151 of 816; 18.5%) (p = 0.477). Patients with CUD also had similar anastomotic leak rates (CUD: 5.64% vs. No CUD: 6.25%; p = 0.601), hospital lengths of stay (CUD: 5 days, IQR 4-7 vs. No CUD: 5 days, IQR 4-7) (p = 0.415), and hospital charges as those without CUD. Similar findings were seen among patients aged ≥50 years in the subgroup analysis. CONCLUSIONS: Though the prevalence of CUD has increased drastically over the past 15 years, preoperative CUD was not associated with an increased risk of composite morbidity among adult patients undergoing an elective colectomy.


Assuntos
Colectomia , Abuso de Maconha , Adulto , Humanos , Estados Unidos/epidemiologia , Prevalência , Estudos Retrospectivos , Pontuação de Propensão , Colectomia/efeitos adversos , Abuso de Maconha/epidemiologia
6.
Child Abuse Negl ; 149: 106632, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38368781

RESUMO

BACKGROUND: Previous studies have shown the role of the interaction between the endocannabinoid system (ECS) and life's adversities in the formation of addiction, including alcohol abuse. OBJECTIVE: Our objective was to identify childhood maltreatment (CM) patterns with the strongest impact on the probability of heavy cannabis use (THCCOOH concentrations ≥150 ng/mL) in Iran. PARTICIPANTS AND SETTING: Using survivor sampling, 350 adult participants were selected, and they were then allocated to three categories based on an optimal algorithm: 1) Sexual abuse, 2) Physical abuse, and 3) Physical neglect. METHODS: From 1 September 2019 to 1 May 2023, we implemented a multicenter, matched-pairs, nested, case-control study based on the wave 3-wave 6 data of a longitudinal, multicenter, cohort study. The cases and controls (n = 350 men) were defined according to the severity of CM. The THC potency was evaluated with the delta-9 carboxy tetrahydrocannabinol (THC-COOH) levels in urine using gas chromatography/mass spectrometry (GC/MS). We calculated the population attributable fractions (PAFs) to identify the patterns of maltreatment associated with the highest odds of high-potency cannabis use. RESULTS: Accumulating CM, including sexual abuse, physical abuse, and physical neglect, carried more than three times the risk of heavy cannabis use (OR 3.4 95 % CI 2.9-4.1), and the combination of the three indicators of maltreatment and a high BMI (25-29.9) carried more than four times the risk of heavy cannabis use (OR 4.7 95 % CI 2.7-4.1) compared to the controls. We estimated that in the case of zero CM for each of the three indicators, over 20 % of new cases of heavy cannabis use can be prevented. CONCLUSIONS: The findings show the significance of CM as a predicator of heavy cannabis use in adulthood and in the abstinence phase.


Assuntos
Cannabis , Maus-Tratos Infantis , Abuso de Maconha , Masculino , Adulto , Humanos , Criança , Dronabinol/urina , Abuso de Maconha/epidemiologia , Abuso de Maconha/urina , Estudos de Casos e Controles , Incidência , Estudos de Coortes , Irã (Geográfico)/epidemiologia , Detecção do Abuso de Substâncias
7.
10.
Med Sci (Basel) ; 12(1)2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38390863

RESUMO

BACKGROUND: Tobacco use disorder (TUD) adversely impacts older patients with established cardiovascular disease (CVD) risk. However, CVD risk in chronic habitual cannabis users without the confounding impact of TUD hasn't been explored. We aimed to determine the risk of major adverse cardiac and cerebrovascular events (MACCE) in older non-tobacco smokers with established CVD risk with vs. without cannabis use disorder (CUD). METHODS: We queried the 2019 National Inpatient Sample for hospitalized non-tobacco smokers with established traditional CVD risk factors aged ≥65 years. Relevant ICD-10 codes were used to identify patients with vs. without CUD. Using multivariable logistic regression, we evaluated the odds of MACCE in CUD cohorts compared to non-CUD cohorts. RESULTS: Prevalence of CUD in the sample was 0.3% (28,535/10,708,815, median age 69), predominantly male, black, and non-electively admitted from urban teaching hospitals. Of the older patients with CVD risk with CUD, 13.9% reported MACCE. The CUD cohort reported higher odds of MACCE (OR 1.20, 95% CI 1.11-1.29, p < 0.001) compared to the non-CUD cohort. Comorbidities such as hypertension (OR 1.9) and hyperlipidemia (OR 1.3) predicted a higher risk of MACCE in the CUD cohort. The CUD cohort also had higher unadjusted rates of acute myocardial infarction (7.6% vs. 6%) and stroke (5.2% vs. 4.8%). CONCLUSIONS: Among older non tobacco smokers with known CVD risk, chronic cannabis use had a 20% higher likelihood of MACCE compared to those who did not use cannabis.


Assuntos
Cannabis , Alucinógenos , Hipertensão , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Tabagismo , Humanos , Masculino , Idoso , Feminino , Abuso de Maconha/complicações , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabagismo/epidemiologia
12.
Addict Behav ; 153: 107996, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38394959

RESUMO

Early positive subjective effects of cannabis predict the development of cannabis use disorder (CUD). Genetic factors, such as the presence of cytochrome P450 genetic variants that are associated with reduced Δ9-tetrahydrocannabinol (THC) metabolism, may contribute to individual differences in subjective effects of cannabis. Young adults (N = 54) with CUD or a non-CUD substance use disorder (control) provided a blood sample for DNA analysis and self-reported their early (i.e., effects upon initial uses) and past-year positive and negative subjective cannabis effects. Participants were classified as slow metabolizers if they had at least one CYP2C9 or CYP3A4 allele associated with reduced activity. Though the CUD group and control group did not differ in terms of metabolizer status, slow metabolizer status was more prevalent among females in the CUD group than females in the control group. Slow metabolizers reported greater past year negative THC effects compared to normal metabolizers; however, slow metabolizer status did not predict early subjective cannabis effects (positive or negative) or past year positive effects. Post-hoc analyses suggested males who were slow metabolizers reported more negative early subjective effects of cannabis than female slow metabolizers. Other sex-by-genotype interactions were not significant. These initial findings suggest that genetic variation in CYP2C9 and CYP3A4 may have sex-specific associations with cannabis-related outcomes. Slow metabolizer genes may serve as a risk factor for CUD for females independent of subjective effects. Male slow metabolizers may instead be particularly susceptible to the negative subjective effects of cannabis.


Assuntos
Cannabis , Abuso de Maconha , Adulto Jovem , Humanos , Masculino , Feminino , Abuso de Maconha/complicações , Caracteres Sexuais , Citocromo P-450 CYP3A/genética , Citocromo P-450 CYP2C9 , Genótipo
13.
Clin Toxicol (Phila) ; 62(1): 10-18, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38421358

RESUMO

INTRODUCTION: Cannabis intoxication may increase the risk of motor vehicle crashes. However, reliable methods of assessing cannabis intoxication are limited. The presence of eyelid tremors is among the signs of cannabis use identified under the Drug Evaluation and Classification Program of the International Association of Chiefs of Police. Our objectives were to assess the accuracy and replicability of identifying eyelid tremor as an indicator of recent cannabis smoking using a blinded, controlled study design. METHODS: Adult subjects (N = 103) were recruited into three groups based on their cannabis use history: daily, occasional, and no current cannabis use. Participants' closed eyelids were video recorded for 30 seconds by infrared videography goggles before and at a mean ± standard deviation time of 71.4 ± 4.6 minutes after the onset of a 15-minute interval of ad libitum cannabis flower smoking or vaping. Three observers with expertise in neuro-ophthalmology and medical toxicology were trained on exemplar videos of eyelids to reach a consensus on how to grade eyelid tremor. Without knowledge of subjects' cannabis use history or time point (pre- or post-smoking), observers reviewed each video for eyelid tremor graded as absent, slight, moderate, or severe. During subsequent data analysis, this score was further dichotomized as a consensus score of absent (absent/slight) or present (moderate/severe). RESULTS: Kappa and intraclass correlation coefficient statistics demonstrated moderate agreement among the coders, which ranged from 0.44-0.45 and 0.58-0.61, respectively. There was no significant association between recent cannabis use and the observers' consensus assessment that eyelid tremor was present, and cannabis users were less likely to have tremors (odds ratio: 0.75; 95 percent confidence interval: 0.25, 2.40). The assessment of eyelid tremor as an indicator of recent cannabis smoking had a sensitivity of 0.86, specificity of 0.18, and accuracy of 0.64. DISCUSSION: Eyelid tremor has fair sensitivity but poor specificity and accuracy for identification of recent cannabis use. Inter-rater reliability for assessment of eyelid tremor was moderate for the presence and degree of tremor. The weak association between recent cannabis use and eyelid tremor does not support its utility in identifying recent cannabis use. LIMITATIONS: Videos were recorded at only one time point after cannabis use. Adherence to abstinence could not be strictly supervised. Due to regulatory restrictions, we were unable to control the cannabis product used or administer a fixed Δ9-tetrahydrocannabinol dose. Participants were predominately non-Hispanic and White. CONCLUSIONS: In a cohort of participants with a range of cannabis use histories, acute cannabis smoking was not associated with the presence of eyelid tremor, regardless of cannabis use history, at 70 minutes post-smoking. Additional research is needed to identify the presence of eyelid tremor accurately, determine the relationship between cannabis dose and timeline in relation to last cannabis use to eyelid tremor, and determine how it should be, if at all, utilized for cannabis Drug Recognition Evaluator examinations.


Assuntos
Pálpebras , Alucinógenos , Abuso de Maconha , Detecção do Abuso de Substâncias , Adulto , Humanos , Cannabis , Pálpebras/efeitos dos fármacos , Fumar Maconha , Reprodutibilidade dos Testes , Tremor/induzido quimicamente , Tremor/diagnóstico , Abuso de Maconha/diagnóstico , Detecção do Abuso de Substâncias/métodos
16.
Drug Alcohol Depend ; 256: 111096, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38277735

RESUMO

BACKGROUND: It is important to identify interventions that reduce harm in youth not motivated to change their cannabis use. This study evaluated how short-duration contingency management (CM) impacts cannabis use attitudes and behavior after abstinence incentives are discontinued among non-treatment seeking youth. METHODS: Participants (N=220) were randomized to 4 weeks of abstinence-based CM (CB-Abst; n=126) or monitoring (CB-Mon; n=94). Participants completed self-report and provided biochemical measures of cannabis exposure at baseline, end-of-intervention, and 4-week follow-up. Changes in self-reported cannabis use frequency (days/week; times/week) and biochemically verified creatinine-adjusted 11-nor-9-carboxy-tetrahydrocannabinol concentrations (CN-THCCOOH) were analyzed between groups from baseline to follow-up. In CB-Abst, cannabis use goals at end-of-intervention were described and changes in cannabis use at follow-up were explored by goals and cannabis use disorder (CUD) diagnosis. RESULTS: There was a group by visit interaction on cannabis use (days: beta=0.93, p=0.005; times: beta=0.71, p<0.001; CN-THCCOOH: beta=0.26, p=0.004), with reductions at follow-up detected only in CB-Abst. Following 4 weeks of abstinence, 68.4% of CB-Abst participants wanted to reduce or abstain from cannabis use following completion of CM. Those in CB-Abst who set end-of-intervention reduction goals and were without CUD had greater decreases in cannabis use frequency at follow-up (Goals*time on days/week: beta=-2.27, p<0.001; CUD*time on times/week: beta=0.48, SE=0.24, t=2.01, p=0.048). CONCLUSIONS: Findings support the utility of brief incentivized abstinence for generating motivation to reduce cannabis use and behavior change even after incentives end. This study supports CM as a potentially viable harm reduction strategy for those not yet ready to quit.


Assuntos
Cannabis , Alucinógenos , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Adolescente , Motivação , Abuso de Maconha/terapia , Terapia Comportamental , Dronabinol , Agonistas de Receptores de Canabinoides
17.
Behav Ther ; 55(1): 1-13, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38216224

RESUMO

Many interventions for cannabis use disorder (CUD) are associated with decreases in frequency and quantity of use but fail to increase overall rates of sustained abstinence. It is currently unknown whether reductions in use (in the absence of sustained abstinence) result in clinically significant improvements in functioning. The objective of this study was to refine a mobile contingency management approach to reduce cannabis use to ultimately evaluate whether reductions in frequency and quantity of cannabis are related to improvements in functional and mental health status. Three cohorts of participants (n = 18 total, n = 10 women) were enrolled and completed 2 weeks of ecological momentary assessment (EMA) during a baseline ad lib cannabis use period, followed by a 6-week reduction period. Participants completed EMA assessments multiple times per day and were prompted to provide videotaped saliva cannabis testing 2-3 times daily. Data from participants who were at least 80% adherent to all EMA prompts were analyzed (13 out of 18). During the ad lib phase, participants were using cannabis on 94% of the days and reported using a mean of 1.42 grams daily. The intervention was a mobile application that participants used to record cannabis use by saliva tests to bioverify abstinence and participants completed electronic diaries to report their grams used. During the 6-week intervention phase, participants reported reducing their use days to 47% of the days with a reported mean of .61 grams daily. In the last cohort, at least 50% of the heavy users were able to reduce their cannabis use by at least 50%. The effect of cannabis reduction (versus abstinence) is largely unknown. Observations suggest that it is possible to develop a mobile intervention to reduce cannabis use among heavy users, and this paradigm can be utilized in future work to evaluate whether reductions in cannabis use among heavy users will result in improvements in functional and mental health status.


Assuntos
Cannabis , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Abuso de Maconha/terapia , Abuso de Maconha/psicologia , Resultado do Tratamento , Terapia Comportamental
18.
Toxins (Basel) ; 16(1)2024 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-38251258

RESUMO

Stingless bee honeys (SBHs) from Australian and Malaysian species were analysed using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) for the presence of pyrrolizidine alkaloids (PAs) and the corresponding N-oxides (PANOs) due to the potential for such hepatotoxic alkaloids to contaminate honey as a result of bees foraging on plants containing these alkaloids. Low levels of alkaloids were found in these SBHs when assessed against certified PA standards in targeted analysis. However, certain isomers were identified using untargeted analysis in a subset of honeys of Heterotrigona itama which resulted in the identification of a PA weed species (Ageratum conyzoides) near the hives. The evaluation of this weed provided a PA profile matching that of the SBH of H. itama produced nearby, and included supinine, supinine N-oxide (or isomers) and acetylated derivatives. These PAs lacking a hydroxyl group at C7 are thought to be less hepatoxic. However, high levels were also observed in SBH (and in A. conyzoides) of a potentially more toxic diester PA corresponding to an echimidine isomer. Intermedine, the C7 hydroxy equivalent of supinine, was also observed. Species differences in nectar collection were evident as the same alkaloids were not identified in SBH of G. thoracica from the same location. This study highlights that not all PAs and PANOs are identified using available standards in targeted analyses and confirms the need for producers of all types of honey to be aware of nearby potential PA sources, particularly weeds.


Assuntos
Ageratum , Mel , Abuso de Maconha , Alcaloides de Pirrolizidina , Abelhas , Animais , Espectrometria de Massas em Tandem , Austrália , Alcaloides de Pirrolizidina/toxicidade , Óxidos
19.
BMJ Open ; 14(1): e078437, 2024 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-38262644

RESUMO

OBJECTIVES: To determine cannabis use patterns, the predictive sociodemographic correlates of driving under the influence of cannabis (DUIC) and the association between risk perception and cannabis dependence among vehicle drivers in Jamaica. DESIGN: Secondary data analysis. SETTING: Used the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: 1060 vehicle drivers extracted from the population sample of 4623. PRIMARY AND SECONDARY OUTCOME MEASURES: Analysis used Pearson's χ2 test and logistic regression. ORs and 95% CIs were recorded. A p<0.05 was considered statistically significant. RESULTS: More than 10% of Jamaican drivers admitted to DUIC in the past year. Approximately 43.3% of drivers who currently use cannabis reported DUIC only. Evidently, 86.8% of drivers who DUIC were heavy cannabis users. Approximately 30% of drivers with moderate to high-risk perception of smoking cannabis sometimes or often were dependent on cannabis. Notwithstanding, drivers with no to low-risk perception of smoking cannabis sometimes or often were significantly likelier to be dependent (p<0.001 and p<0.001, respectively). Logistic regression highlighted male drivers (OR 4.14, 95% CI 1.59 to 14.20, p=0.009) that were 34 years and under (OR 2.97, 95% CI 1.71 to 5.29, p<0.001) and were the head of the household (OR 2.22, 95% CI 1.10 to 4.75, p=0.031) and operated a machine as part of their job (OR 1.87, 95% CI 1.09 to 3.24, p=0.023) were more likely to DUIC, while those who were married (OR 0.42, 95% CI 0.22 to 0.74, p=0.004) and had achieved a tertiary-level education (OR 0.26, 95% CI 0.06 to 0.76, p=0.031) were less likely. CONCLUSIONS: Two in five Jamaican drivers, who currently smoke cannabis, drive under its influence, with over 85% engaging in heavy use. Public health implications necessitate policy-makers consider mobile roadside drug testing and amending drug-driving laws to meet international standards.


Assuntos
Cannabis , Dirigir sob a Influência , Abuso de Maconha , Fumar Maconha , Masculino , Humanos , Jamaica , Agonistas de Receptores de Canabinoides
20.
Soc Psychiatry Psychiatr Epidemiol ; 59(1): 77-85, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37093229

RESUMO

BACKGROUND: Various forms of interpersonal abuse (e.g., physical, emotional, sexual) and cannabis use across the lifespan have both been known to increase odds of psychotic experiences; however, there have been few studies examining their separate and joint effects in the United States. METHODS: We analyzed data from the Healthy Minds Study (2020-2021) and used multivariable logistic regression and interaction contrast ratios to assess separate and joint effects of interpersonal abuse (past 12 months) and cannabis use (past 30 days) on psychotic experiences (past 12 months). RESULTS: Students who only used cannabis had significantly greater odds of psychotic experiences (aOR: 1.70; 95% CI 1.58-1.82), as well as those who only experienced interpersonal abuse (aOR: 2.40; 95% CI 2.25-2.56). However, those who reported both cannabis use and interpersonal abuse had the greatest odds, exceeding the sum of these individual effects (the combined effect aOR: 3.46; 95% CI 3.19-3.76). CONCLUSIONS: Recent interpersonal abuse and recent cannabis use both separately and jointly increase odds of having recent psychotic experiences. Future research should continue to examine the potential interactive and additive impact of multiple known exposures to better inform primary and secondary prevention efforts.


Assuntos
Cannabis , Abuso de Maconha , Transtornos Psicóticos , Humanos , Estados Unidos/epidemiologia , Transtornos Psicóticos/psicologia , Abuso de Maconha/epidemiologia , Abuso de Maconha/complicações , Estudantes
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