Motivations for marijuana use: use and associated negative consequences.

Marijuana use has increased significantly among adolescents and young adults. It is important for prevention scientists to understand youth motivations for marijuana use in order to refine and/or create intervention to limit harm. The current study surveyed 114 marijuana using college students (67% women; 78% White) on their motivations for using marijuana, frequency of use and associated negative consequences, and theoretical and empirical influences on motivations and use. Results indicated that students most frequently endorsed enjoyment, sleep, and low-risk motivations for use. Variables associated with the Theory of Planned Behavior and Strain Theory were associated with a variety of motivations for use. Motivations, perceived behavioral control regarding marijuana, and parental active tracking were associated with frequency of use, while negative consequences were predicted by frequency of use and attitudes regarding marijuana. Researchers seeking to develop programs to prevent marijuana-related harm may benefit from focusing on the differential motivations for use observed.

The Association of Cannabis Use and Cigarette Smoking with Psychological Distress Among Adults in California.

BACKGROUND: In November 2016, California voters passed the Adult Use of Marijuana Act making recreational cannabis sales legal to adults aged 21and older starting January 1st, 2018. This study aims to understand the relationship of cannabis use and cigarette smoking with serious psychological distress (SPD) in California in light of the legalization of recreational cannabis sales. METHODS: This cross-sectional study included 42,313 adult participants from the 2017 to 2018 California Health Interview Surveys. We used the Kessler-6 (K6) scale to measure psychological distress in the past 30 days. Multiple logistic regression models were used to examine the association between cannabis/cigarette use and SPD. RESULTS: Cannabis use was positively associated with SPD (AOR = 2.48, 95% CI = 1.57, 3.91), but this association was not significantly different before and after recreational cannabis sales legalization in California (AOR = 0.82, 95% CI = 0.72, 2.05). Cigarette smoking was also positively associated with SPD (AOR = 2.76, 95% CI = 2.05, 3.71). Compared to those who used neither cannabis nor cigarettes, sole cannabis users (AOR = 2.51, 95% CI = 1.75, 3.60), sole cigarette smokers (AOR = 3.23, 95% CI = 2.28, 4.60), and dual users of cannabis and cigarettes (AOR = 5.65, 95% CI = 4.04, 7.89) were more likely to report SPD. Dual users were also more likely to report SPD than sole cannabis users (AOR = 2.25; 95% CI = 1.48, 3.43) and sole cigarette smokers (AOR = 1.75; 95% CI = 1.18, 2.59). CONCLUSIONS: These findings provide evidence for the need to develop effective cessation intervention strategies targeting individuals with SPD to reduce their cannabis use and dual-use of cannabis and cigarettes.

The Prospective Effects of Parents' and Friends' Approval of Drinking on Simultaneous Alcohol and Marijuana Use during College.

Background: Recent reports indicate that simultaneous alcohol and marijuana (SAM) use is a growing health concern among college students. As SAM use consists of both alcohol and marijuana, risk factors associated with either can serve as plausible targets by prevention efforts to reduce SAM use. Objectives: To explore this, the current study investigated the direct and indirect effects of two established risk factors for drinking on SAM use: perceived parental permissiveness toward drinking and friends' approval toward drinking (injunctive norms). Method: Incoming first-year students (N = 470) reported parental permissiveness, injunctive norms, alcohol use, and SAM use at baseline (T1) and 5 months later (T2). SAM use was assessed again 15 months post-baseline (T3). Path analysis was conducted to examine whether T2 variables mediated relationships between T1 variables and T3 SAM use. Results: Results revealed that T2 student alcohol use mediated the effects of T1 parental permissiveness, injunctive norms, and alcohol use on T3 SAM use. Conclusions/Importance: Findings from this study extend research on SAM use by identifying perceived parental permissiveness and injunctive drinking norms as risk factors for SAM use through their effects on alcohol use. Based on these findings, it is plausible that parent-based interventions and interventions targeting peer injunctive norms during the first year of college could be used to effectively prevent or reduce SAM use.

A mobile phone-based brief intervention with personalized feedback and interactive text messaging is associated with changes in driving after cannabis use cognitions in a proof-of-concept pilot trial.

Driving after cannabis use (DACU) is a significant public health concern and represents one of the riskiest cannabis-related behaviors. Though years of research has demonstrated that cannabis use impairs driving ability, many college students report believing that cannabis use does not impair their driving abilities. This perception of low danger may contribute to a permissive attitude toward DACU. The present proof-of-concept pilot study examined the preliminary efficacy of a mobile phone-based intervention with personalized feedback and text messaging to increase perceptions of dangerousness of DACU. Participants were 77 college cannabis users (65.8% women; average age = 21.2; 88.3% Caucasian) who endorsed DACU at least three times in the past 3 months. After completing baseline measures, participants were randomly assigned to one of three conditions: (a) personalized feedback plus interactive text messaging (PFT), (b) personalized feedback only (PF), or (c) informational control (IC). Participants completed outcome measures 3 months post intervention. Repeated measures mixed models revealed that compared to those in the IC condition, cannabis users in the PFT condition reported significantly greater increases over time in the perception of dangerousness of DACU. These findings provide initial support for the short-term efficacy of a mobile phone-based intervention for changing perceptions related to dangerousness of DACU among college cannabis users. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Relative Reduction in Prevalence (RRP): An Alternative to Cohen's Effect Size Statistics for Judging Alcohol, Cigarette, and Marijuana Use Prevention Outcomes.

Jacob Cohen developed two statistical measures for judging the magnitude of effects produced by an intervention, known as Cohen's d, appropriate for assessing scaled data, and Cohen's h, appropriate for assessing proportions. These have been widely employed in evaluating the effectiveness of alcohol, cigarette, marijuana, and other drug prevention efforts. I present two tests to consider the adequacy of using these statistics when applied to drug use prevention programs. I used student survey data from grades 6 through 12 (N = 1,963,964) collected by the Georgia Department of Education between 2015 and 2017 and aggregated at the school level (N = 1036). I calculated effect sizes for an imaginary drug prevention program that (1) reduced 30-day alcohol, cigarette, and marijuana prevalence by 50%; and (2) maintained 30-day prevalence at a pretest level for multiple years. While both approaches to estimating intervention effects represent ideal outcomes for prevention that surpass what is normally observed, Cohen's statistics failed to reflect the effectiveness of these approaches. I recommend including an alternative method for calculating effect size for judging program outcomes. This alternative method, Relative Reduction in Prevalence (RRP), calculates ratio differences between treatment and control group drug use prevalence at posttest and follow-up, adjusting for differences observed at pretest. RRP allows researchers to state the degree to which an intervention could be viewed as efficacious or effective that can be readily understood by practitioners.

Micro-level factors associated with alcohol use and binge drinking among youth in the COMPASS study (2012/13 to 2017/18). / Microfacteurs associés à la consommation d'alcool et à la consommation excessive d'alcool chez les jeunes dans l'étude COMPASS (2012-2013 à 2017-2018).

INTRODUCTION: This study examined the associations of micro-level factors with current alcohol use and binge drinking among a large sample of Canadian youth. METHODS: This descriptive-analytical study was conducted among high school students enrolled in the COMPASS study between 2012/13 and 2017/18. We used generalized estimating equations modelling to determine associations between micro-level factors and likelihood of current versus non-current alcohol use and binge drinking among respondents. RESULTS: Students reporting current cannabis use were more likely to report current alcohol use over never use (odds ratio [OR] = 4.46, 95% confidence interval [CI]: 4.33-4.60) compared to students reporting non-current cannabis use. Students reporting current smoking of tobacco products were more likely to report current binge drinking over never binge drinking (OR = 2.52, 95% CI: 2.45-2.58), compared to non-smoking students. Students reporting weekly disposable incomes of more than $100 were more likely to report current over never binge drinking (OR = 2.14, 95% CI: 2.09-2.19), compared to students reporting no weekly disposable income. CONCLUSION: Higher disposable incomes, smoking of tobacco products and use of cannabis were associated with current alcohol use and binge drinking among youth. Findings may inform design of polysubstance use prevention efforts in high schools.

[Why and how keep in mind cannabis in our smoking outpatients?] / ¿Por qué y cómo tener en cuenta al cannabis en nuestros pacientes fumadores?

EVICT project has noted the increase in cannabis use in the Spanish youth population, and has studied its association with tobacco, concluding that: It has an influence in the learning to smoke process: The beginning can be combined and with bi-directional influence. It has an influence on dependence the development of dependence Their interaction is relevant in the development of dependence. It has an influence on toxicity: Smoking tobacco and cannabis generates greater problems than smoking tobacco alone. And, therefore, the EVICT team issues some considerations: Prevention considerations. Differentiate between therapeutic and recreational use. Smoking cannabis is not therapeutic nor innocuous, and can affect the development of nicotine dependence, or, less frequently, cannabis dependence. Approach and treatment considerations. In A first option of cessation of both must be proposed in people who consume tobacco and cannabis Harm Reduction. To those that only consume tobacco/cannabis: Harm Reduction programs should be more applicable to those in whom consumption is considered more problematic.

Brief interventions for cannabis use in emerging adults: A systematic review, meta-analysis, and evidence map.

PURPOSE: This systematic review summarizes and critically appraises the existing literature on brief interventions (BIs) for cannabis use among emerging adults. METHODS: Eligible BIs were operationalized as 1-2 sessions focused exclusively on cannabis use for samples with mean ages between 15 and 30. Outcomes related to cannabis use, other substance use, mental health, help-seeking, or functional status were included. Two independent reviewers screened a total of 3638 records, identifying 244 studies for full-text screening. In total, 32 BIs in 26 primary studies with 6318 participants were included. RESULTS: Participants were typically not seeking treatment and using cannabis at least once a month. Most interventions were motivational, single sessions, and delivered in person. Few discussed concurrent psychiatric conditions. Pooling results at 1-3 months post-intervention, BIs compared to passive control slightly reduced symptoms of cannabis use disorder (SMD -0.14 [95% CI -0.26 to -0.01]) and increased the odds of abstinence (OR 1.73 [95% CI 1.13-2.66]). Other outcome results often favored BIs but were not significant. Results of studies comparing types of BIs (k = 8) or BIs to longer interventions (k = 1) are discussed narratively. Quality assessment suggested low to very low-quality evidence. CONCLUSIONS: This review indicates that BIs targeting non-treatment seeking emerging adults result in significant reductions in symptoms of cannabis use disorder and an increased likelihood of cannabis abstinence, however evidence is of low quality.

Self-reported Daily, Weekly, and Monthly Cannabis Use Among Women Before and During Pregnancy.

Importance: As the overall prevalence of prenatal cannabis use rises, it is vital to also monitor trends in the frequency of cannabis use in the period leading up to and during pregnancy because more frequent use may confer greater health risks for mothers and their children. Objective: To examine trends in the frequency of self-reported cannabis use among pregnant women in the year before and during pregnancy. Design, Setting, and Participants: Cross-sectional study using data from 367 403 pregnancies among 276 991 women 11 years or older who completed a self-administered questionnaire on cannabis use during standard prenatal care in Kaiser Permanente Northern California from January 1, 2009, to December 31, 2017. The annual prevalence of self-reported daily, weekly, and monthly cannabis use among women before and during pregnancy was estimated using Poisson regression with a log link function, adjusting for sociodemographics. Data analyses were conducted from February to May 2019. Exposures: Calendar year. Main Outcomes and Measures: Self-reported frequency of cannabis use in the year before pregnancy and during pregnancy assessed as part of standard prenatal care (at approximately 8 weeks' gestation). Results: Among the overall sample of 367 403 pregnancies among 276 991 women, 35.9% of the women self-reported white race/ethnicity; 28.0%, Hispanic; 16.6%, Asian; 6.0%, African American; and 13.5%, other. In the sample, 1.2% of the women were aged 11 to 17 years; 15.3%, 18 to 24 years; 61.4%, 25 to 34 years; and 22.0%, older than 34 years. Median (interquartile range) neighborhood household income was $70 472 ($51 583-$92 643). From 2009 to 2017, the adjusted prevalence of cannabis use in the year before pregnancy increased from 6.80% (95% CI, 6.42%-7.18%) to 12.50% (95% CI, 12.01%-12.99%), and the adjusted prevalence of cannabis use during pregnancy increased from 1.95% (95% CI, 1.78%-2.13%) to 3.38% (95% CI, 3.15%-3.60%). Annual relative rates of change in self-reported daily cannabis use (1.115; 95% CI, 1.103-1.128), weekly cannabis use (1.083; 95% CI, 1.071-1.095), and monthly or less cannabis use (1.050; 95% CI, 1.043-1.057) in the year before pregnancy increased significantly, with daily use increasing most rapidly (from 1.17% to 3.05%). Similarly, annual relative rates of change in self-reported daily cannabis use (1.110; 95% CI, 1.089-1.132), weekly cannabis use (1.075; 95% CI, 1.059-1.092) and monthly or less cannabis use (1.044; 95% CI, 1.032-1.057) during pregnancy increased significantly from 2009 to 2017, with daily use increasing most rapidly (from 0.28% to 0.69%). Conclusions and Relevance: Results of this study demonstrate that frequency of cannabis use in the year before pregnancy and during pregnancy has increased in recent years among pregnant women in Northern California, potentially associated with increasing acceptance of cannabis use and decreasing perceptions of cannabis-associated harms.

Selective invalidation of ambivalent pro-marijuana attitude components.

INTRODUCTION: Attitudes of drug-abstinent youth considering marijuana initiation can be highly ambivalent. Invalidating pro-usage elements (i.e., opinions) of ambivalent marijuana attitudes, while leaving anti-marijuana elements intact, may create stronger, less ambivalent marijuana-resistant attitudes and lower usage intentions, while concurrently elucidating the role of ambivalence in persuasive prevention. METHOD: From an initial pool of marijuana-abstinent middle-school students (N = 538), the quintile expressing the most negative attitudes toward a marijuana prevention appeal (N = 101) were randomly assigned to one of three conditions designed to invalidate pro-marijuana opinions. Analyses then tested their susceptibility to a second marijuana prevention appeal. RESULTS: Personally threatening messages were found ineffective, but appeals contesting resistant responses significantly decreased ambivalence (p < .01). Mediational analyses showed that this decreased ambivalence was associated with less favorable attitudes and lower marijuana usage intentions (both p < .001). An attribution-based manipulation increased ambivalence (p < .05), which was associated with positive usage intentions mediated through positive attitudes (both p < .001). CONCLUSION: Analyses elucidated the role of attitude ambivalence in prevention, providing a more complete understanding of potential facilitative use of ambivalence in prevention models based on prevention. Results support the further examination and use of methods that invalidate pro-marijuana opinions, thereby leading to greater susceptibility to subsequent prevention appeals.

Primary versus secondary prevention messages: College students' perceptions of effectiveness by marijuana user status.

Objective: With medical and recreational marijuana legislation expanding throughout the country, the need to educate high-risk populations is evident. The purpose of this study was to assess college students' perceptions of health communication messages comparing primary and secondary prevention messages concerning marijuana. Participants: Participants (n = 487) included college students, ages 18-25, enrolled in a Midwestern University. Methods: Participants assessed messages based on likeability, creativity, believability, persuasiveness, relevance, and usefulness using an online questionnaire that also included open-end comments. Results: Rasch analyses indicate that nonmarijuana users rated primary prevention messages higher than secondary prevention messages, whereas marijuana users ranked secondary prevention messages more favorably than primary prevention messages. Conclusion: Interventions designed to address marijuana use among college students may be more effective if tailored toward user status. Specifically, primary prevention materials should be designed for abstainers, while secondary prevention messages that focus on harm reduction strategies should be used with marijuana users.

Relationship Between Recency and Frequency of Youth Cannabis Use on Other Substance Use.

PURPOSE: To assess the relationship between lifetime, past-year, and frequent past-year cannabis use on use of other substances among youth in order to inform prevention initiatives. METHODS: Data are from 27,900 youth aged 12-17 participating in the 2015-2016 National Surveys on Drug Use and Health. Multivariable multinomial logistic regression assessed the relationship between levels of youth cannabis use and past-year use of other substances compared to youth with no lifetime cannabis use. RESULTS: Prevalence of lifetime cannabis use among youth was 15.4%; 3.0% reported lifetime but not past-year use, 10.3% reported past-year use <200 days, and 2.1% reported past-year use ≥200 days. Past-year tobacco and alcohol use, and past-year misuse of prescription sedatives or tranquilizers, stimulants, and opioids were associated with increased adjusted relative risk ratios across all levels of cannabis use compared to youth reporting no lifetime cannabis use. Increased adjusted relative risk ratios across all levels of cannabis use were seen among youth aged 14-15 and 16-17 compared to 12-17 and among non-Hispanic blacks and Hispanics compared to non-Hispanic whites. CONCLUSIONS: Cannabis use is prevalent among youth and associated with other substance use. Efforts to scale up prevention programming and science-based messaging on risks of substance use are needed.

'Parents are the best prevention'? Troubling assumptions in cannabis policy and prevention discourses in the context of legalization in Canada.

BACKGROUND: Canada has announced that it will legalize cannabis on October 17, 2018, and as a result of this impending drug law reform the need to develop prevention resources and drug education - in schools, in public health, and for parents - has emerged as a public concern and a policy priority. Set against this context, the aim of our paper is to amplify the parent perspective on preventing problematic adolescent cannabis use, but also to interrogate the idea of 'parents as the best prevention' that has taken hold in discussions about the potential consequences of legalization for youth. METHODS: In 2016 we undertook an exploratory, qualitative interview study in Vancouver, British Columbia (n = 16) with parents of adolescents who had used cannabis. Building on our past research developing educator-led resources to support an open dialogue about cannabis in the classroom, in this study we asked parents about the supports and resources they needed to inform their discussions about cannabis with their adolescent children, as well the challenges they faced in responding to cannabis use when they believed it had become problematic. FINDINGS: Across the interviews, parents mobilized discourses of risk and responsibility for preventing problematic cannabis use that appeared to reinstate individualizing accounts of substance use. Many echoed normative ideas about health, the risks of cannabis use, and 'good' parenting, sidestepping social inequities around drug use, and thus implicating parents and families as solely responsible for preventing adolescent drug use. CONCLUSION: Our analysis suggests how parents have been largely disempowered and unsupported when it comes to addressing adolescent drug use in the family context. Even as they expressed their awareness that formal supports and resources to assist them were lacking, parents also assigned blame to themselves - or to other parents - for 'failing' to prevent problematic cannabis use.

Effects of state education requirements for substance use prevention.

We provide the first evidence on the effects of state laws requiring students to receive education about alcohol, tobacco, and other drugs using data on over a million youths from the 1976-2010 Monitoring the Future study. In difference-in-differences and event-study models, we find robust evidence that these laws significantly reduced recent alcohol and marijuana use among high school seniors by 1.6-2.8 percentage points, or about 8-10% of the overall decline over this period. Our results suggest that information interventions can reduce youth substance use.

Universal cannabis outcomes from the Climate and Preventure (CAP) study: a cluster randomised controlled trial.

BACKGROUND: The Climate and Preventure (CAP) study was the first trial to assess and demonstrate the effectiveness of a combined universal and selective approach for preventing alcohol use and related harms among adolescents. The current paper reports universal effects from the CAP study on cannabis-related outcomes over three years. METHODS: A cluster randomized controlled trial was conducted with 2190 students from twenty-six Australian high schools (mean age: 13.3 yrs., SD 0.48). Participants were randomised to one of four conditions; universal prevention for all students (Climate); selective prevention for high-risk students (Preventure); combined universal and selective prevention (Climate and Preventure; CAP); or health education as usual (Control). Participants were assessed at baseline, post intervention (6-9 months post baseline), and at 12-, 24- and 36-months, on measures of cannabis use, knowledge and related harms. This paper compares cannabis-related knowledge, harms and cannabis use in the Control, Climate and CAP groups as specified in the protocol, using multilevel mixed linear models to assess outcomes. RESULTS: Compared to Control, the Climate and CAP groups showed significantly greater increases in cannabis-related knowledge initially (p <  0.001), and had higher knowledge at the 6, 12 and 24-month follow-ups. There was no significant difference between the Climate and CAP groups. While no differences were detected between Control and the CAP and Climate groups on cannabis use or cannabis-related harms, the prevalence of these outcomes was lower than anticipated, possibly limiting power to detect intervention effects. Additional Bayesian analyses exploring confidence in accepting the null hypothesis showed there was insufficient evidence to conclude that the interventions had no effect, or to conclude that they had a meaningfully large effect. CONCLUSIONS: Both the universal Climate and the combined CAP programs were effective in increasing cannabis-related knowledge for up to 2 years. The evidence was inconclusive regarding whether the interventions reduced cannabis use and cannabis-related harms. A longer-term follow-up will ascertain whether the interventions become effective in reducing these outcomes as adolescents transition into early adulthood. TRIAL REGISTRATION: This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000026820) on the 6th of January 2012, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347906&isReview=true.

Young adults' perceptions of acceptability and effectiveness of a text message-delivered treatment for cannabis use disorder.

OBJECTIVE: This study collected in-depth treatment satisfaction and effectiveness data to provide insight into the mechanisms of behavior change and to identify aspects of a text message- delivered treatment for cannabis use disorder that could be improved. METHODS: Data were collected via a web-based survey from 30 young adults (ages 18-25) who were recent participants in a randomized controlled trial of Peer Network Counseling-txt (PNC- txt), a text message treatment for cannabis use disorder. The survey assessed reactions to the text-delivered treatment, changes in cannabis use, reactions to the peer-focused components, and feedback about improvements to the treatment. RESULTS: Nearly all (93%) respondents found PNC-txt to be helpful to their treatment. The majority of the sample (63%) reported that PNC-txt heightened awareness of their cannabis use, and 40% reported a better understanding of problematic use. Fifty percent reported that they use less cannabis than they did prior to the intervention. Seventy percent of respondents stated that it was helpful to answer questions about their close friend group and nearly one- quarter of participants decreased the amount of time spent with "unhealthy" friends. Approximately 85% indicated that thinking about their peer network helped them meet goals of stopping, reducing, or better managing their cannabis use. CONCLUSIONS: These findings provide insight into the acceptability of the text-delivered treatment platform and potential mechanisms of behavior change for PNC-txt. The participants provided positive feedback about the treatment and indicated that it helped reduce their cannabis use. Given the acceptability and promising efficacy of PNC-txt, continued research is warranted, particularly with adolescents and with larger samples.

Effectiveness evaluation of the school-based drug prevention program #Tamojunto in Brazil: 21-month follow-up of a randomized controlled trial.

INTRODUCTION: A school-based randomized controlled trial was conducted in 2014/2015 with students in 7th and 8th grades in 72 public schools in 6 Brazilian cities. A total of 5028 students were linked (75, 7%) in at least one of the two waves of follow-up (9 months and 21 months later). The principal research question was whether this 12-lesson program delays the initiation of alcohol, tobacco, inhalants and binge drinking among early adolescents when compared to usual care, that is, no prevention program in Brazilian schools, after 21 months of follow up. METHODS: Cox regression models were adjusted to evaluate the incidence of drug use. Generalized linear latent mixed models (GLLAMM) were used to evaluate changes in the prevalence of each drug over time and between groups. Findings The incidence analysis showed a negative effect of the program for alcohol initiation (aHR = 1.13, 95%CI 1.01; 127) but an opposite protective effect for the initiation of inhalant use (aHR = 0.79, 95%CI 0.66; 0.95). After 21 months, the prevalence of past-year use of alcohol changed from 30.1% to 49.8% in the intervention group and from 29.9% to 45.8% in the control group. Adolescents in the intervention group were 30% more likely to have reported past-year use of alcohol than students in the control group at 21 months (aOR = 1.30, 95%CI 1.02; 1.65). No effects of the program on past-month drug use were found. The Brazilian version of the Unplugged program may be misinterpreted by public school students, perhaps arousing their curiosity regarding alcohol use.

Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care.

OBJECTIVE: The primary care (PC) setting provides a unique opportunity to address adolescent alcohol and other drug (AOD) use. METHOD: We conducted a randomized controlled trial in 4 PC clinics from April 2013 to November 2015 to determine whether a 15-min brief motivational interviewing (MI) AOD intervention, delivered in PC, reduced alcohol and marijuana use and consequences. Adolescents ages 12-18 who came for an appointment during the 2.5-year study period were asked to be in the study and screened using the National Institute of Alcohol Abuse and Alcoholism Screening Guide. Those identified as at risk were randomized to the CHAT intervention or usual care (UC). Adolescents completed 4 web-based surveys at baseline and 3, 6, and 12 months postbaseline. RESULTS: The sample (n = 294) was 58% female and 66% Hispanic, 17% Black, 12% White, 5% multiethnic or other, with an average age of 16 years. Compared to UC adolescents, CHAT adolescents reported significantly less perceived peer use of alcohol and marijuana at 3 months (alcohol: p < .0001; marijuana p = .01) and 6 months (alcohol: p = .04; marijuana p = .04). CHAT adolescents also reported marginally fewer negative alcohol consequences experienced at 6 months (p = .08). At 12 months, compared to UC, CHAT adolescents reported less perceived peer alcohol (p = .04) and marijuana (p < .01) use and fewer negative consequences from alcohol (p = .03) and marijuana (p = .04) use. CONCLUSIONS: A brief MI intervention delivered in PC reduced negative consequences from alcohol and marijuana use 1 year later. Findings emphasize that adolescents can benefit from PC interventions that briefly and effectively address both alcohol and marijuana use. (PsycINFO Database Record

The Legalization of Medical/Recreational Marijuana: Implications for School Health Drug Education Programs.

BACKGROUND: More than half of US states have legalized medical marijuana. Several states have also legalized it for recreational use. In spite of states' actions, marijuana remains illegal under federal law. It remains to be seen, however, if the Trump administration will enforce federal law in states that have legalized marijuana. For now, it appears the move toward state legalization of marijuana will increase. Because of its legal status, research concerning the medical benefits of marijuana has been limited. METHODS: We reviewed the literature pertaining to medical use and legalization of marijuana. RESULTS: Available research shows that marijuana can benefit some conditions. There are also concerns about harmful effects on both individual and public health and whether legalization will lead to increased marijuana use among youth. Each of these elements has implications for school-based drug education programs. Researchers have shown that the 10 states with the highest rate of past month marijuana use by youth all have legalized recreational and/or medical use of marijuana, whereas none of the 10 states with the lowest rate of past month marijuana use by youth, has legalized marijuana. In the debate over legalization schools can potentially serve as a community resource, providing accurate information concerning marijuana. CONCLUSIONS: Teachers and parents should continue to discourage young people from using marijuana (as well as alcohol, tobacco, and other drugs).