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1.
Am J Drug Alcohol Abuse ; 50(2): 229-241, 2024 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-38407837

RESUMEN

Background: In 2016, California transitioned from legalized medical cannabis use to adult-use. Little is known about how this policy change affected medicinal cannabis use among young adults.Objectives: To identify longitudinal groups of medicinal cannabis users and concurrent changes in health- and cannabis use-related characteristics among young adults in Los Angeles between 2014 and 2021.Methods: Cannabis users (210 patients and 156 non-patients; 34% female; ages 18-26 at baseline) were surveyed annually across six waves. Longitudinal latent class analysis derived groups from two factors - cannabis patient status and self-reported medicinal use. Trajectories of health symptoms, cannabis use motives, and cannabis use (daily/near daily use, concentrate use, and problematic use) were estimated across groups.Results: Three longitudinal latent classes emerged: Recreational Users (39.3%) - low self-reported medicinal use and low-to-decreasing patient status; Recreational Patients (40.4%) - low self-reported medicinal use and high-to-decreasing patient status; Medicinal Patients (20.3%) - high self-reported medicinal use and high-to-decreasing patient status. At baseline, Medicinal Patients had higher levels of physical health symptoms and motives than recreational groups (p < .05); both patient groups reported higher level of daily/near daily and concentrate use (p < .01). Over time, mental health symptoms increased in recreational groups (p < .05) and problematic cannabis use increased among Recreational Patients (p < .01).Conclusions: During the transition to legalized adult-use, patterns of medicinal cannabis use varied among young adults. Clinicians should monitor increases in mental health symptoms and cannabis-related problems among young adults who report recreational - but not medicinal - cannabis use.


Asunto(s)
Marihuana Medicinal , Humanos , Femenino , Marihuana Medicinal/uso terapéutico , Adulto , Estudios Longitudinales , Masculino , Adulto Joven , Adolescente , California/epidemiología , Los Angeles/epidemiología , Legislación de Medicamentos , Motivación , Autoinforme , Fumar Marihuana/epidemiología , Fumar Marihuana/legislación & jurisprudencia
2.
Subst Use Misuse ; 59(2): 193-207, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37822106

RESUMEN

BACKGROUND: While growing evidence has identified mental and physical health-related cannabis use motives as significant mechanisms between childhood trauma and problematic cannabis use (PCU) for emerging adults (EA), there is a need to understand the longitudinal stability of these pathways and how they impact PCU as cannabis users age into later adulthood. METHODS: The current study extends an analysis examining the impact of childhood trauma (e.g., emotional abuse, sexual abuse) on multiple indicators of PCU through a range of cannabis use motives. 339 medical cannabis patient and non-patient EA users from the Los Angeles area were sampled at baseline (mean age = 21.23; SD = 2.48). The present analysis used four waves of follow-up data collected from 2016 to 2018 (W3, W4) and 2019-2020 (W5, W6). RESULTS: Use of cannabis to cope with nausea, sleep, pain, and emotional distress mediated the relationships between some types of childhood abuse and PCU at W4, though most associations attenuated by later adulthood (W6). Specifically, greater emotional distress and nausea motives were associated with greater PCU in models of emotional abuse and neglect and sexual abuse, with emotional distress continuing to mediate at W6. Conversely, sleep and pain motives were associated with lower PCU in models for emotional neglect. CONCLUSIONS: Mental and physical health-related motives reflect potential intervenable factors that predict PCU in emerging adulthood among EA cannabis users with histories of childhood trauma. Results highlight the importance of and value for assessing a wide range of motives and PCU outcomes to target and address areas for intervention.


Asunto(s)
Experiencias Adversas de la Infancia , Cannabis , Adulto , Humanos , Niño , Adulto Joven , Motivación , Dolor , Náusea
3.
Molecules ; 28(21)2023 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-37959778

RESUMEN

Nitric oxide (NO) production in injured and intact brain regions was compared by EPR spectroscopy in a model of brain and spinal cord injury in Wistar rats. The precentral gyrus of the brain was injured, followed by the spinal cord at the level of the first lumbar vertebra. Seven days after brain injury, a reduction in NO content of 84% in injured brain regions and 66% in intact brain regions was found. The difference in NO production in injured and uninjured brain regions persisted 7 days after injury. The copper content in the brain remained unchanged one week after modeling of brain and spinal cord injury. The data obtained in the experiments help to explain the problems in the therapy of patients with combined brain injury.


Asunto(s)
Lesiones Encefálicas , Traumatismos de la Médula Espinal , Humanos , Ratas , Animales , Ratas Wistar , Óxido Nítrico , Médula Espinal , Encéfalo
4.
J Drug Issues ; 53(3): 422-430, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38603185

RESUMEN

It is crucial to understand COVID-19 vaccine uptake and attitudes among young adult cannabis users given the lowest vaccination rates among young adults and negative association between cannabis use and willingness to get vaccinated. 18-21-year-old and 26-33-year-old cohorts of cannabis users, recruited in California, were surveyed about the COVID-19 vaccine uptake/attitudes between March-August 2021. Cannabis use/demographic differences were investigated by vaccination status. Vaccine attitudes data were categorized and presented descriptively. 44.4% of the older and 71.8% of the younger cohorts were vaccinated. Non-Hispanic Black/African American race/ethnicity, lack of health insurance, and medicinal orientation towards cannabis use were negatively associated with vaccine receipt within the older cohort. For both cohorts, top reasons for vaccine hesitancy and rejection were concerns about speed of development, potential side effects, natural immunity, and lack of trust of vaccines. Our results highlight greater vaccine hesitance/rejection and need for targeted interventions among mid-20's-early-30's cannabis users.

5.
J Drug Issues ; 52(2): 207-224, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35382397

RESUMEN

Few qualitative studies have examined the impact of COVID-19 on cannabis and alcohol use, and overall well-being among cannabis users. Cannabis users (aged 26-32) were surveyed quantitatively (n=158) and interviewed qualitatively (n=29) in April 2020-May 2021 in Los Angeles. 63.3% of the quantitative sample reported increasing use of either cannabis (29.1%) or alcohol (15.2%) or both (19.0%) following the COVID-19 outbreak. Qualitative data revealed that increases in cannabis and alcohol use were largely attributed to changes in employment and staying at home resulting in fewer impediments and boredom. Themes of loneliness and utilization of various coping strategies were more pronounced among those who increased cannabis and/or alcohol use. For some, increases in cannabis/alcohol use were temporary until participants adjusted to "a new normal" or embraced more adaptive coping strategies. Results suggest monitoring cannabis/alcohol use trends and identifying coping strategies to reduce the pandemic's impact on substance use and mental health.

6.
Subst Use Misuse ; 56(8): 1144-1154, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33882778

RESUMEN

BACKGROUND: Pain is a primary reason for medical cannabis use among young adults, however little is known about the patterns of pain in this group. This study identified pain profiles among young adult cannabis users and examined related antecedents and distal outcomes. METHODS: Past 30-day cannabis users aged 18-26, both medical cannabis patients and non-patients, were enrolled in Los Angeles in 2014-2015. A latent class analysis was used to identify pain classes based on history of chronic pain conditions and recent non-minor pain. The study assessed the predictors of membership in pain classes and examined the association of classes with recent mental health characteristics, cannabis use motives and practices. RESULTS: Three classes were identified: Low pain (56.3%), Multiple pain (27.3%), and Nonspecific pain (16.4%). In adjusted models, lifetime insomnia was associated with membership in Multiple pain and Nonspecific pain classes versus the Low pain class. Medical cannabis patients and Hispanics/Latinos were more likely to belong to the Multiple pain class than the other classes. Regarding recent outcomes, the Multiple pain and Nonspecific pain classes were more likely than the Low pain class to use cannabis to relieve physical pain. Additionally, the Multiple pain class had a higher probability of psychological distress, self-reported medical cannabis use, consuming edibles, and using cannabis to sleep compared to one or both other classes. CONCLUSION: Findings suggest that young adult cannabis users can be separated into distinct groups with different pain profiles. The Multiple pain profile was associated with medically-oriented cannabis use motives and practices.


Asunto(s)
Cannabis , Marihuana Medicinal , Humanos , Los Angeles , Motivación , Dolor , Adulto Joven
7.
J Drug Issues ; 50(2): 157-172, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32655186

RESUMEN

This analysis examined the role of impactful life events/stressful contextual factors and cannabis use in the patterns of illicit drug use. It utilized semi-structured qualitative interviews with 40 young adult medical cannabis patients and 22 non-patient users collected in Los Angeles during 2014-2015. Three patterns of illicit drug use emerged based on participants' narratives: regular/problematic, recreational/occasional, and never users. Among regular/problematic users, a common theme was the lasting impact of traumatic life events or stressful contextual factors on transition to and away from problematic drug use, and using cannabis to cope with negative after effects of drug use. In contrast, most recreational/occasional and never users, who reported impactful life events or stressful contextual factors, used cannabis to cope with those experiences. Family history of addiction and acceptance of cannabis use within a family as protective factors against illicit drug use among some recreational/occasional and never users was an unexpected finding.

8.
Drugs (Abingdon Engl) ; 27(1): 69-78, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31949332

RESUMEN

While a range of sources exist for marijuana users to acquire marijuana for medical or personal use, prior research on marijuana sources primarily focused on single sources. In this analysis, we longitudinally examined characteristics of multiple sources selected by marijuana users, motivations to use sources, and how a blend of marijuana sources accommodated users' needs. Young adult marijuana users (n=60) in Los Angeles, CA, where marijuana has been legal for medical use since 1996, completed two annual qualitative interviews on marijuana use practices and sources between 2014 and 2016. Approximately two-thirds were medical marijuana patients and one-third were non-patient users. Participants reported acquiring marijuana from the following primary sources across two interviews: dispensaries and delivery services, private sellers in the illicit market, friends and family, and marijuana events/conferences. While patients with legal medical access to marijuana typically purchased marijuana from dispensaries or delivery services, they often supplemented from other illicit sources. Non-patients often accessed marijuana through dispensary diversion but also other sources. As patients became non-patients and vice versa during the study period, source type changed too. Broad access to marijuana via legal and illicit sources in this sample is indicative of societal trends towards normalization of marijuana use.

9.
BMC Health Serv Res ; 14: 261, 2014 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-24938376

RESUMEN

BACKGROUND: People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. METHODS: Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. RESULTS: Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. DISCUSSION: Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID.


Asunto(s)
Política de Salud , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Servicios Farmacéuticos/legislación & jurisprudencia , Abuso de Sustancias por Vía Intravenosa , China , Estudios de Factibilidad , Conocimientos, Actitudes y Práctica en Salud , Humanos , América del Norte , Investigación Cualitativa , Federación de Rusia , Vietnam
10.
BMC Public Health ; 13: 183, 2013 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-23452390

RESUMEN

BACKGROUND: The HIV epidemic in Russia is concentrated among injection drug users (IDUs). This is especially true for St. Petersburg where high HIV incidence persists among the city's estimated 80,000 IDUs. Although sterile syringes are legally available, access for IDUs may be hampered. To explore the feasibility of using pharmacies to expand syringe access and provide other prevention services to IDUs, we investigated the current access to sterile syringes at the pharmacies and the correlation between pharmacy density and HIV prevalence in St. Petersburg. METHODS: 965 pharmacies citywide were mapped, classified by ownership type, and the association between pharmacy density and HIV prevalence at the district level was tested. We selected two districts among the 18 districts--one central and one peripheral--that represented two major types of city districts and contacted all operating pharmacies by phone to inquire if they stocked syringes and obtained details about their stock. Qualitative interviews with 26 IDUs provided data regarding syringe access in pharmacies and were used to formulate hypotheses for the pharmacy syringe purchase test wherein research staff attempted to purchase syringes in all pharmacies in the two districts. RESULTS: No correlation was found between the density of pharmacies and HIV prevalence at the district level. Of 108 operating pharmacies, 38 (35%) did not sell syringes of the types used by IDUs; of these, half stocked but refused to sell syringes to research staff, and the other half did not stock syringes at all. Overall 70 (65%) of the pharmacies did sell syringes; of these, 49 pharmacies sold single syringes without any restrictions and 21 offered packages of ten. CONCLUSIONS: Trainings for pharmacists need to be conducted to reduce negative attitudes towards IDUs and increase pharmacists' willingness to sell syringes. At a structural level, access to safe injection supplies for IDUs could be increased by including syringes in the federal list of mandatory medical products sold by pharmacies.


Asunto(s)
Comercio/métodos , Infecciones por VIH/prevención & control , Accesibilidad a los Servicios de Salud , Farmacias/legislación & jurisprudencia , Abuso de Sustancias por Vía Intravenosa/epidemiología , Jeringas/economía , Adulto , Estudios de Cohortes , Femenino , Infecciones por VIH/etiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Farmacias/clasificación , Farmacias/estadística & datos numéricos , Farmacéuticos/psicología , Farmacéuticos/estadística & datos numéricos , Ubicación de la Práctica Profesional/estadística & datos numéricos , Investigación Cualitativa , Federación de Rusia , Abuso de Sustancias por Vía Intravenosa/complicaciones , Encuestas y Cuestionarios , Jeringas/provisión & distribución
11.
J Psychoactive Drugs ; : 1-11, 2023 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-37997888

RESUMEN

Cannabis was legalized for adult use in California in 2016 for individuals 21 and older. Among 18-20-years-olds, who can possess cannabis legally as medical cannabis patients (MCP) but not as non-patient cannabis users (NPU), the impact of adult use legalization (AUL) on cannabis and other substance use is unknown. Two cohorts of 18-20-year-old cannabis users (MCP and NPU) were surveyed, one in 2014-15 (n = 172 "pre-AUL") and another in 2019-20 (n = 139 "post-AUL"), using similar data collection methods in Los Angeles, California. Logistic and negative binomial regressions estimated cohort and MCP differences for cannabis and other drug use outcomes based on past 90-day use. In both pre- and post-AUL cohorts, MCP were more likely to self-report medical cannabis use (p < .001) while the post-AUL cohort reported greater use of edibles (p < .01), but fewer mean days of alcohol (p < .05) and cigarette (p < .01) use in multivariate models. Notably, frequency of cannabis use (days or hits per day) did not significantly differ between the pre- and post-AUL cohorts, except for greater use of edibles, despite potentially greater access to cannabis.

12.
Cannabis ; 6(1): 20-33, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37287728

RESUMEN

Introduction: As the COVID-19 pandemic has caused historic morbidity and mortality and disrupted young people's social relationships, little is known regarding change in young adults' social cannabis use following social distancing orders, or other factors associated with such changes before and during the pandemic. Methods: 108 young adult cannabis users in Los Angeles reported on their personal (egocentric) social network characteristics, cannabis use, and pandemic-related variables before (July 2019 - March 2020) and during the COVID-19 pandemic (August 2020 - August 2021). Multinomial logistic regression identified factors associated with increasing or maintaining the number of network members (alters) participants used cannabis with before and during the pandemic. Multilevel modeling identified ego- and alter-level factors associated with dyadic cannabis use between each ego and alter during the pandemic. Results: Most participants (61%) decreased the number of alters they used cannabis with, 14% maintained, and 25% increased. Larger networks were associated with a lower risk of increasing (vs. decreasing); more supportive cannabis-using alters was associated with a lower risk of maintaining (vs. decreasing); relationship duration was associated with a greater risk of maintaining and increasing (vs. decreasing). During the COVID-19 pandemic (August 2020 - August 2021), participants were more likely to use cannabis with alters they also used alcohol with and alters who were perceived to have more positive attitudes towards cannabis. Conclusions: The present study identifies significant factors associated with changes in young adults' social cannabis use following pandemic-related social distancing. These findings may inform social network interventions for young adults who use cannabis with their network members amid such social restrictions.

13.
J Psychoactive Drugs ; 54(2): 129-139, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34044753

RESUMEN

It is unknown how patterns of cannabis and other drug use changed among young adult cannabis users as they became, exited or stayed medical cannabis patients (MCPs) after California legalized cannabis for adult use in 2016. A cohort of 18-26 year-old cannabis users was recruited in Los Angeles in 2014-15 (64.8% male; 44.1% Hispanic/Latinx). Based on wave 1 (pre-legalization) and wave 4 (post-legalization) MCP status, four transition groups emerged: MCP, Into MCP, Out of MCP and NPU (non-patient user). Relationships between self-reported medical cannabis use, transition group membership, and cannabis/other drug use outcomes were examined. Changes in cannabis practices were consistent with changes in MCP status. Cannabis days, concentrate use, self-reported medical cannabis use and driving under influence of cannabis were highest among MCP, increased for Into MCP, and decreased for Out of MCP in wave 4. A majority of drug use outcomes decreased significantly by wave 4. Self-reported medical cannabis use was associated with more frequent cannabis use but less problematic cannabis and other drug use. Future studies should continue to monitor the impact of policies that legalize cannabis for medical or recreational use, and medical motivations for cannabis use on young adults' cannabis and other drug use.


Asunto(s)
Cannabis , Alucinógenos , Marihuana Medicinal , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Femenino , Humanos , Legislación de Medicamentos , Los Angeles/epidemiología , Masculino , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
14.
J Stud Alcohol Drugs ; 83(6): 802-811, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36484577

RESUMEN

OBJECTIVE: Social factors play an important role in young adults' substance use behaviors, but little is known about how egocentric social network factors are related to young adults' cannabis use. Young adults also report medicinal and recreational uses of cannabis, which may alter the strength of these relationships. Therefore, medical cannabis patient status and medicinal/recreational orientation toward cannabis were examined as moderators of these relationships. METHOD: Young adult medical cannabis patients (n = 182) and nonpatient users (n = 157) were surveyed in Los Angeles in 2015-2016 about their cannabis use, orientation (medicinal and/or recreational), and egocentric networks (cannabis use network size, social support network size, descriptive and injunctive norms). Regression models examined associations between network characteristics and past-90-day use and problematic use, and tested interactions between network characteristics and both patient status and cannabis use orientation. RESULTS: Only descriptive norms (adjusted incidence rate ratio [aIRR] = 1.19, 95% confidence interval [CI] [1.06, 1.33]) were associated with more frequent use, but not problematic use. Descriptive norms interacted with cannabis use orientation: descriptive norms were positively associated with cannabis use days among medicinally oriented users (aIRR = 1.22, 95% CI [1.02, 1.46]). However, this relationship was stronger for recreationally oriented users (aIRR = 1.62, 95% CI [1.31, 2.01]). No interactions were found predicting problematic use. CONCLUSIONS: Descriptive cannabis use norms among one's personal network members are an important variable predicting young adults' cannabis use, but not problematic use. Perceived descriptive norms may be a stronger motivator to use for recreational users than medicinal users.


Asunto(s)
Cannabis , Alucinógenos , Marihuana Medicinal , Humanos , Adulto Joven , Marihuana Medicinal/uso terapéutico , Encuestas y Cuestionarios , Red Social
15.
Drug Alcohol Depend ; 221: 108648, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33676073

RESUMEN

INTRODUCTION: Cannabidiol (CBD) is purportedly a promising therapeutic agent to provide relief for a variety of medical conditions with mild or no psychoactive effects. However, little is known about young adults who use cannabis and CBD-dominant products, and associations between CBD use and other drug use. METHODS: Young adults (aged 24-32) who currently used cannabis (n = 239) were surveyed in Los Angeles in March 2019 through March 2020. The sample was divided into CBD-dominant (at least 1:1 CBD:THC ratio) and THC-dominant product users. We described CBD forms, reasons and conditions for CBD use and examined between-group differences in sociodemographic characteristics, cannabis practices, health and other drug use. RESULTS: CBD-dominant users were more likely to be female, use cannabis at lower frequency and amount (except for edible/drinkable/oral products), self-report medical motivation for cannabis use, use cannabis for pain and report more health problems. Oil, flower, topicals and sprays/drops/tinctures were the most prevalent CBD forms. Psychological problems and pain were commonly reported conditions and medical reasons for CBD use. CBD-dominant users were more likely to report illicit drug use, where psilocybin use was markedly different between the two groups. CONCLUSIONS: CBD use was associated with health histories and motivations linked to pain and psychological problems. Positive association between CBD use and illicit drug use may indicate self-medication for psychological conditions. Future studies should evaluate the effectiveness of various CBD forms and dose regimens for treatment of pain and psychological problems, and as a potential intervention for decreasing other drug use and associated harms.


Asunto(s)
Cannabidiol/administración & dosificación , Alucinógenos/administración & dosificación , Uso de la Marihuana/epidemiología , Uso de la Marihuana/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Cannabidiol/efectos adversos , Cannabis/efectos adversos , Estudios de Cohortes , Dronabinol/administración & dosificación , Dronabinol/efectos adversos , Femenino , Alucinógenos/efectos adversos , Humanos , Estudios Longitudinales , Los Angeles/epidemiología , Masculino , Dolor/tratamiento farmacológico , Dolor/epidemiología , Dolor/psicología , Autoinforme , Adulto Joven
16.
Drug Alcohol Rev ; 39(6): 743-752, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32390280

RESUMEN

INTRODUCTION AND AIMS: Young adults have the highest rates of drug use and contribute significantly to the growing population of medical cannabis patients (MCP). This study examined relationships between longitudinal patterns of illicit/prescription drug use/misuse and cannabis practices among young adult cannabis users. DESIGN AND METHODS: In 2014-2015, 210 young adult MCP and 156 nonpatient users were recruited in Los Angeles and surveyed annually over four waves. The analytical sample was limited to completers of all four waves (n = 301). Distinct developmental trajectories of illicit drug use and prescription drug misuse were identified. Fixed effects regression analysis evaluated changes in cannabis practices by trajectory groups. RESULTS: Results supported two-trajectory solutions (high/low) for illicit drug use and prescription drug misuse. Decreases in use within all four trajectories occurred by wave 4. Low illicit drug use trajectory members were more likely to self-report medical cannabis use. Membership in both types of high-use trajectories was associated with use of concentrates and edibles. The prevalence of MCP, edibles use and cannabis days decreased significantly by wave 4. DISCUSSION AND CONCLUSIONS: While alternative cannabis forms use was associated with membership in high drug use trajectories, self-reported medical cannabis use (not MCP) was negatively associated with high illicit drug use trajectory membership. Reductions in the prevalence of MCP, cannabis days, edibles use and other drug use by wave 4 alongside stable levels of self-reported medical cannabis use might reflect the changing legal status of cannabis in California, maturing out phenomenon and safer patterns of cannabis use.


Asunto(s)
Cannabis , Drogas Ilícitas , Marihuana Medicinal , Mal Uso de Medicamentos de Venta con Receta , Trastornos Relacionados con Sustancias , Femenino , Humanos , Los Angeles/epidemiología , Masculino , Mal Uso de Medicamentos de Venta con Receta/tendencias , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
17.
Drug Alcohol Depend ; 198: 21-27, 2019 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-30861391

RESUMEN

INTRODUCTION: Young adults have the highest rates of cannabis and other drug use, as compared to other age groups, and contribute a significant proportion to the total population of medical cannabis patients (MCP). However, little is known about the relationships between various cannabis practices and illicit drug use/prescription drug misuse among young adult cannabis users with and without legal access to medical cannabis. METHODS: 210 MCP and 156 non-patient cannabis users (NPU) aged 18-26 were recruited in Los Angeles in 2014-15 for a longitudinal study assessing the impact of medical cannabis on health and substance use among emerging adults. For the present analysis, only quantitative baseline survey data were used. Logistic regression was used to examine the associations between past 90-day cannabis practices and other drug use, including illicit drug use and prescription drug misuse. RESULTS: Illicit drug use was associated with being non-Hispanic white (AOR = 3.0, 95% CI 1.8-5.1), use of cannabis concentrates (AOR = 2.8, 95% CI 1.6-4.9), while self-reported medical cannabis use was associated with lower probability of illicit drug use (AOR = 0.5, 95% CI 0.3-0.9). The odds of prescription drug misuse were increased for participants who reported use of cannabis edibles (AOR = 2.0, 95% CI 1.1-3.5), and decreased with age (AOR = 0.9, 95% CI 0.8-1.0) and for those who used cannabis alone (AOR = 0.5, 95% CI 0.3-0.9). CONCLUSION: Use of alternative cannabis forms, but not cannabis use frequency, were associated with greater odds of other drug use. Self-reported medical cannabis use, but not MCP status, decreased probability of illicit drug use.


Asunto(s)
Marihuana Medicinal/uso terapéutico , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Femenino , Humanos , Drogas Ilícitas , Modelos Logísticos , Estudios Longitudinales , Los Angeles/epidemiología , Masculino , Autoinforme , Encuestas y Cuestionarios , Adulto Joven
18.
Drug Alcohol Depend ; 170: 181-188, 2017 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-27987475

RESUMEN

BACKGROUND: Little is known about young adult medical marijuana patients (MMP) and their marijuana using patterns and practices, which includes frequency of use, sourcing of marijuana products, forms/modes of administration, and patterns of illicit/prescription drug misuse, compared to non-patient marijuana users (NPU). METHODS: Young adults (N=366) aged 18-26 years old were sampled in Los Angeles in 2014-15 and segmented into NPU (n=156), marijuana users who never had a medical marijuana (MM) recommendation, and MMP (n=210), marijuana users with a current, verified MM recommendation. Differences regarding self-reported marijuana and other drug use during the past 90days are expressed as unadjusted risk ratios or differences in means. RESULTS: MMP reported significantly greater mean days of use (76.4 vs. 59.2, p<0.001) and mean dollars spent on marijuana products (564.5 vs. 266.9, p<0.001) than NPU. Approximately one-quarter (22.6%) of both MMP and NPU report selling marijuana obtained from a dispensary to someone else in the past 90days. MMP were more likely to report vaporization modalities for concentrates (URR=1.5, 95% C.I.=1.2, 2.0) and for marijuana (URR=1.5, 95% C.I.=1.1, 2.1) than NPU. Though not significant, trends toward lower misuse of prescription drugs in the past 90days were observed among MMP compared to NPU. CONCLUSION: MMP reported greater access to marijuana via dispensaries, more frequent and intensive use of marijuana, and greater use of non-combustible forms of marijuana compared to NPU. MMP reported less recent misuse of prescription drugs compared to NPU.


Asunto(s)
Cannabis , Fumar Marihuana/psicología , Marihuana Medicinal , Adolescente , Adulto , Femenino , Humanos , Los Angeles , Masculino , Mal Uso de Medicamentos de Venta con Receta/psicología , Adulto Joven
19.
Int J Rheum Dis ; 20(5): 597-608, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28464513

RESUMEN

AIM: To detect faults in phagocytosis in peripheral blood cells of pregnant women with systemic lupus erythematosus (SLE) and in cord blood of their newborns. METHODS: Pregnant women fulfilled ≥ 4 American College of Rheumatology criteria for SLE and their newborns were recruited. Pregnant women without SLE and their newborns constituted controls. Phagocytosis and respiratory burst were measured using PHAGOTEST and BURSTTEST kits (Biotechnology GmbH, Germany) on FACSCalibur™ flow cytometer. Expression of CD11b was estimated with antibodies (BD Biosciences, San Jose, CA, USA). Mann-Whitney rank-sum test was used to compare SLE group and controls. RESULTS: Phagocytosis and respiratory burst were estimated in blood of 31 SLE women (29.5 ± 3.3 years) and in cord blood of 26 newborns. Controls were 21 health women (29.8 ± 2.8 years) and their 21 babies. Median reactive oxygen species (ROS) production was reduced in the SLE group versus controls (arbitrary units): women, 2315 versus 3316 (P = 0.034); babies, 1051 versus 1791 (P = 0.041), respectively. Proportion of ROS-producing granulocytes decreased in the SLE group: women, 72.5% versus 94.0% (P = 0.025); babies, 46.8% versus 90.7% (P = 0.008). Proportion of phagocytes which engulfed Escherichia coli and bacteria number per phagocyte also decreased in SLE women. Monocyte activity was suppressed in newborns from the SLE group (RLU): 224 versus 507 (P = 0.022). CD11b expression was reduced in SLE women (RLU): granulocytes, 588 versus 1448.5 (P < 0.001); monocytes, 1017 versus 1619 (P = 0.002). CONCLUSION: Pregnant SLE women have low ingesting capacity of phagocytes. Suppression of phagocytosis in their newborns is mainly due to reduced number of cells producing ROS.


Asunto(s)
Sangre Fetal/inmunología , Lupus Eritematoso Sistémico/sangre , Fagocitos/inmunología , Fagocitosis , Complicaciones del Embarazo/sangre , Adulto , Biomarcadores/sangre , Antígeno CD11b/sangre , Estudios de Casos y Controles , Escherichia coli/fisiología , Femenino , Humanos , Recién Nacido , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/inmunología , Fagocitos/microbiología , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/inmunología , Especies Reactivas de Oxígeno/sangre , Estallido Respiratorio , Adulto Joven
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