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1.
Addict Behav ; 156: 108062, 2024 09.
Artigo em Inglês | MEDLINE | ID: mdl-38805771

RESUMO

OBJECTIVE: To characterize and compare transitions in blunt smoking behaviors among a diverse cohort of youth and young adults observed between Spring 2019 and Fall 2021. METHODS: We analyzed n = 14,152 observations (i.e., completed surveys) provided by n = 2,610 youth and young adults over six (6) waves from Spring 2019 to Fall 2021 via the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were recruited in age-cohorts, reflecting 16.5 years (0.5), 18.5 years (0.6), and 20.1 years (0.8) of age at baseline. We applied a three-state Markov model to estimate blunt initiation (never â†’ ever), onset (never â†’ current), continuation (ever â†’ current), and discontinuation (current â†’ ever). First, we compared transitions in blunt smoking by race/ethnicity, with non-Hispanic (NH) Whites as the referent. Second, we stratified the Markov models by race/ethnicity to identify common and unique predictors of blunt transitions, including sex, age, alcohol use, depression, anxiety, and tobacco cigar smoking. RESULTS: At baseline, 73% of participants had never smoked blunts, 15.3% had ever smoked blunts s, and 11.7% currently smoked blunts. NHB (HR: 2.15; 95% CI: 1.21-3.84) and Hispanic (HR: 1.72; 95% CI: 1.08-2.72) participants had significantly greater risk of blunt smoking initiation, relative to NHWs. Similarly, NHBs had great risk for continuation (HR: 1.65; 95% CI: 1.16-2.34) and lower risk of discontinuation (HR: 0.57; 95% CI: 0.42-0.77), relative to NHWs. Alcohol use predicted greater risk for onset among NHW (HR: 5.22; 95% CI: 1.40-19.45), NHB (HR: 3.14; 95% CI: 1.32-7.46), and Hispanic (HR: 2.99; 95% CI: 1.80-4.97) participants. CONCLUSIONS: Blunt smoking initiation was most common among NHB and Hispanic youth and young adults while risk for sustained blunt smoking was higher in NHB youth and young adults. Research and interventions should investigate the link between alcohol use and elevated blunt smoking among young people.


Assuntos
Fumar Charutos , Humanos , Texas/epidemiologia , Masculino , Feminino , Adolescente , Adulto Jovem , Fumar Charutos/epidemiologia , Estudos de Coortes , Fumar Maconha/epidemiologia , Cadeias de Markov , Hispânico ou Latino/estatística & dados numéricos
2.
Int J Drug Policy ; 126: 104363, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38401174

RESUMO

BACKGROUND: Despite thousands of licensed cannabis retail stores operating across Canada, there remains a significant illicit cannabis market. Some cannabis users continue to buy cannabis from dealers, illicit stores, and/or illicit online retailers. METHODS: Data are from the 2021 British Columbia Cannabis Use Survey. Respondents (n = 8473) were 19 years or older, lived in British Columbia at the time of the survey, and reported using cannabis in the past 12 months. RESULTS: Buying cannabis from all types of illicit sources was more common among younger cannabis users, those who use cannabis more frequently and started using cannabis before the age of 17 (vs. 19 or older), and among those who co-use cannabis with other drugs. Specifically, buying cannabis from a dealer was more common among men, those with lower educational attainment, and those who seek the lowest prices when buying cannabis. In contrast, those using cannabis for medical (vs. non-medical) purposes were more likely to report getting cannabis from illicit retail stores, while buying cannabis from illicit websites was more common among people who use edible cannabis products. CONCLUSION: Consistent with other studies, younger and more frequent cannabis users were more likely to report buying cannabis from illicit sources. However, these findings suggest there is significant heterogeneity among those who buy cannabis from different types of illicit sources, which should be carefully considered when developing policies and strategies aimed at encouraging consumers to transition to legal sources.


Assuntos
Comércio , Humanos , Colúmbia Britânica/epidemiologia , Masculino , Adulto , Estudos Transversais , Feminino , Adulto Jovem , Comércio/estatística & dados numéricos , Comércio/legislação & jurisprudência , Comércio/economia , Pessoa de Meia-Idade , Cannabis , Drogas Ilícitas/economia , Drogas Ilícitas/provisão & distribuição , Individualidade , Fatores Etários , Uso da Maconha/legislação & jurisprudência , Uso da Maconha/epidemiologia , Uso da Maconha/economia , Fumar Maconha/legislação & jurisprudência , Fumar Maconha/epidemiologia , Fumar Maconha/economia , Inquéritos e Questionários , Fatores Sexuais , Tráfico de Drogas/estatística & dados numéricos , Tráfico de Drogas/economia
3.
Int J Drug Policy ; 125: 104334, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38340482

RESUMO

OBJECTIVES: To describe New Jersey residents' relative priorities for the allocation of tax revenue generated by recreational cannabis sales. We aim to assess preferences for public health initiatives, including drug treatment, compared to a range of alternatives, including traditional policing, especially within the social and demographic groupings of people generally most impacted by punitive drug enforcement policies. METHODS: We collected population-representative survey data four months post-implementation of recreational cannabis sales in New Jersey (N = 1,006). We gauge respondents' top preferences for the allocation of new revenue generated by the legal cannabis market. Using multinomial logistic regression, we assess how various demographic and political factors shape public support for devoting revenue toward public health initiatives. RESULTS: While priorities are mixed within the sample, we find more general support for funding community-based initiatives in public health, housing, and education than for funding police, courts, and prisons. Among Black residents, the largest proportion chose investments in affordable housing. Regression analysis reveals political orientation as having the most consistent association with expressed preferences, with Republicans favoring investments in traditional law enforcement priorities over other potential funding domains. CONCLUSIONS: Recreational cannabis legalization is occurring at a rapid pace, yet important context, including how the tax revenue could be invested in communities, remains unclear. Insight into current public opinion on funding priorities suggests a desire for investment in fundamental societal institutions, including education and public health, rather than the punitive enforcement mechanisms that have defined cannabis policy for many decades.


Assuntos
Cannabis , Alucinógenos , Fumar Maconha , Adulto , Humanos , Opinião Pública , New Jersey , Gastos em Saúde , Legislação de Medicamentos
4.
Am J Prev Med ; 66(6): 1035-1042, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38272242

RESUMO

INTRODUCTION: This study investigated the prevalence of past 30-day cannabis use among U.S. youth by cigarette use, alcohol use, demographics, and state-of-residence cannabis legal status in 2021 and examined whether changes in cannabis use prevalence were modified by these factors from 2013 to 2021. METHODS: Data were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System from 2013 to 2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced AORs by current cigarette, alcohol, and state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race, and ethnicity, to assess trends in prevalence from 2013 to 2021. RESULTS: In 2021, cannabis use was more common among female youth (16.75% vs 13.83% [AOR=1.26, 95% CI=1.16, 1.37]) and non-Hispanic Black and Hispanic youth than among non-Hispanic White youth (17.19%, 16.14% vs 14.60% [AOR=1.25, 95% CI=1.12, 1.39 and AOR=1.16, 95% CI=1.04, 1.29, respectively]). Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs 6.48% [AOR=11.80, 95% CI=10.57, 13.18]). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021, and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021. CONCLUSIONS: Public health officials should carefully consider the potential impact of expanding commercialization of cannabis as a wellness product on youth cannabis use, especially with regard to minoritized populations and co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue.


Assuntos
Consumo de Bebidas Alcoólicas , Humanos , Feminino , Masculino , Adolescente , Estados Unidos/epidemiologia , Prevalência , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Uso da Maconha/epidemiologia , Uso da Maconha/tendências , Uso de Tabaco/epidemiologia , Uso de Tabaco/tendências , Fumar Maconha/epidemiologia , Fumar Maconha/tendências
5.
Addict Behav ; 149: 107878, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37924581

RESUMO

BACKGROUND: In October 2021, a legal framework that regulates cannabis for recreational purposes in Spain was proposed, but research on its potential impacts on cannabis use is currently limited. This study examined the reliability and discriminant validity of two Marijuana Purchase Tasks (MPTs) for measuring hypothetical legal and illegal cannabis demand, and to examine differences in demand of both commodities in young adults at hazardous vs. non-hazardous cannabis use risk levels. METHODS: A total of 171 Spanish young adults [Mage = 19.82 (SD = 1.81)] with past-month cannabis use participated in a cross-sectional study from September to November 2021. Two 27-item MPTs were used to estimate hypothetical demand for legal and illegal cannabis independently. The Cannabis Use Disorder Identification Test (CUDIT-R) was used to assess hazardous cannabis use and test for discriminant validity of the MPTs. Reliability analyses were conducted using Classical Test Theory (Cronbach's alpha) and Item Response Theory (Item Information Functions). RESULTS: The MPT was reliable for measuring legal (α = 0.94) and illegal (α = 0.90) cannabis demand. Breakpoint (price at which demand ceases), and Pmax (price associated with maximum expenditure) were the most sensitive indicators to discriminate participants with different levels of the cannabis reinforcing trait. No significant differences between legal and illegal cannabis demand in the whole sample were observed, but hazardous vs. non-hazardous users showed higher legal and illegal demand, and decreased Breakpoint and Pmax if cannabis were legal vs illegal. CONCLUSION: The MPT exhibits robust psychometric validity and may be useful to inform on cannabis regulatory science in Spain.


Assuntos
Cannabis , Fumar Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Adulto Jovem , Adulto , Economia Comportamental , Reprodutibilidade dos Testes , Estudos Transversais
6.
Clin Ther ; 45(6): 551-559, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37414506

RESUMO

There is ongoing debate about what policy approaches to cannabis use might best address health and social related harm. Profit-driven, adult-use cannabis markets have been introduced in the United States and Canada, where legalization reform has had mixed effects to date in terms of public health and has made limited progress in achieving social justice aims. Meanwhile, several jurisdictions have seen an organic evolution of alternative cannabis-supply regimes. Cannabis social clubs (CSCs), the focus of this commentary, are nonprofit cooperatives that supply cannabis to consumers with the goal of harm reduction. The peer and participatory aspects of CSCs may have positive effects on health-related outcomes of cannabis use, such as through encouraging the use of safer products and responsible use practices. The nonprofit objectives of CSCs may diminish the risk for increasing cannabis consumption in wider society. CSCs have recently made an important transition from grassroots organizations in Spain and elsewhere. In particular, they have become key players in top-down cannabis legalization reform in Uruguay and, most recently, Malta. The history of CSCs in reducing harm from cannabis use is an important advantage, but there might be concerns around the grassroots origins, low taxation opportunities, and capacity to sustain social objectives. Also, the CSC model might not seem unique, as contemporary cannabis entrepreneurs have absorbed some features of their community-based predecessors. CSCs can play an important role in future cannabis legalization reform due to their unique strengths as cannabis-consumption sites and can be effective in advancing social justice by giving people affected by cannabis prohibition agency and direct access to resources.


Assuntos
Cannabis , Fumar Maconha , Adulto , Humanos , Estados Unidos , Legislação de Medicamentos , Justiça Social , Espanha
7.
Clin Ther ; 45(6): 599-615, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37414510

RESUMO

PURPOSE: Despite the progression of recreational cannabis legalization, the legal system remains the largest source of referral to treatment for cannabis use. The legal system's continued practice of requiring participation in cannabis treatment programs raises questions regarding the extent to which individuals who interact with the legal system are monitored for cannabis use post-legalization. This article presents trends in justice-system referrals to treatment for cannabis use in legal and nonlegal states for 2007-2019. The relationship between legalization and justice system treatment referrals for black, Hispanic/Latino, and white adults and juveniles was explored. Given that minority and youth populations are subject to disproportionate levels of cannabis enforcement, legalization is expected to have a weaker relationship with justice-system referral rates in white juveniles and black and Hispanic/Latino adults and juveniles compared to white adults. METHODS: Using 2007-2019 data from the Treatment Episode Data Set-Admissions (TEDS-A), variables were created for state-level rates of legal system-referred treatment admissions for cannabis use in black, Hispanic/Latino, and white adults and juveniles. Rate trends were compared across populations and staggered difference-in-difference and event analyses were conducted to determine whether legalization is associated with a decline in justice-system referrals to treatment for cannabis use . FINDINGS: For the study period, the mean rate of legal system-referred admissions in the total population was 2.75 per 10,000 residents. Black juveniles had the highest mean rate (20.16), followed by Hispanic/Latino juveniles (12.35), black adults (9.18), white juveniles (7.58), Hispanic/Latino adults (3.42), and white adults (1.66). Legalization did not have a significant impact on treatment-referral rates in any population of study. Events analyses indicated significant rate increases in black juveniles in legalized states compared to controls at 2 and 6 years after policy change, and in black and Hispanic/Latino adults at 6 years after policy change (all, P < 0.05). While racial/ethnic disparities in referral rates declined in absolute terms, the relative size of these disparities increased in legalized states. IMPLICATIONS: TEDS-A captures only publicly funded treatment admissions and relies on the quality of individual-state reporting. Individual-level factors that may impact decisions regarding treatment referrals for cannabis use could not be controlled for. Despite limitations, the present findings suggest that for individuals who interact with the criminal legal system, cannabis use may still result in legal monitoring after reform. The upward trend in legal system referrals for black (but not white) adults and juveniles several years after states legalize cannabis warrants further examination and may reflect continued disparate treatment of these populations at multiple points along the legal-system continuum.


Assuntos
Cannabis , Fumar Maconha , Maconha Medicinal , Adolescente , Humanos , Adulto , Estados Unidos , Legislação de Medicamentos , Maconha Medicinal/uso terapêutico , Hospitalização
8.
Addict Behav ; 146: 107812, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37490827

RESUMO

OBJECTIVE: Rates of prenatal cannabis use are rising, yet little is known about modes of cannabis use during pregnancy. This focus group study with pregnant individuals aimed to examine use patterns and perceptions regarding common modes of prenatal cannabis use. METHOD: Kaiser Permanente Northern California pregnant adult patients who identified as White or Black and self-reported cannabis use during pregnancy were recruited to participate (N = 53; 40% Black, 60% White; Meanage = 30.3, SD = 5.2). Eighteen focus groups with race-concordant facilitators followed a semi-structured format that queried participants on their prenatal cannabis use, including preferred modes of use (e.g., vapes, blunts, dabs, joints, edibles, topicals, pipes). Focus group discussions were coded and analyzed using a general inductive approach. RESULTS: A range of modes were preferred, with no single mode predominant. Participants' preferences aligned with four themes: perceived effects and benefits of cannabis, health and safety, convenience and familiarity, and partner and friend influences. Participants sought modes that were accessible and familiar, provided consistent and quick relief for pregnancy-related symptoms, were aligned with partners or friends, and minimized perceived risks while also providing symptom relief. Participants desired evidence-based information about mode safety to better inform mode selection during pregnancy. CONCLUSIONS: A range of personal and social factors influenced mode preferences during pregnancy. Many participants desired to reduce harms and use cannabis more safely in pregnancy but received little mode-specific information to guide these preferences. Further research identifying mode-specific risks is needed to guide harm reduction approaches during pregnancy.


Assuntos
Cannabis , Fumar Maconha , Adulto , Feminino , Gravidez , Humanos , Pesquisa Qualitativa , Grupos Focais , Autorrelato
9.
Subst Use Misuse ; 58(5): 657-665, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36786640

RESUMO

Background: This study aimed to examine the trend and factors associated with smoking marijuana from a hookah device among US adults. Methods: Data were drawn from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing nationally representative, longitudinal cohort study of the US population. Adult respondents who self-reported ever smoking marijuana from a hookah at Wave 5 (2018-19, N = 34,279 US adults) were included in the multivariable analysis. Trend analysis also was conducted using National Cancer Institute JoinPoint software from 2015 to 2019. Results: In 2018-19, an estimated 23.6 million (9.7%) US adults reported ever smoking marijuana from a hookah. Trend analysis showed the increasing prevalence of using marijuana from a hookah device from Wave 3 (8.9%) to Wave 5 (9.7%; time trend p = .007). Adults aged 25-44 years old (vs. 18-24; 13%, vs. 9%), whites (vs. Black; 11% vs. 9%), and lesbian, gay, or bisexual (LGB vs. straight; 17% vs. 9%) were more likely to report ever smoking marijuana from a hookah (ps < .05). Former and current users (vs. never users) of e-cigarettes (19% and 25% vs. 5%), cigarettes (11% and 21% vs. 2%), cigars (17% and 27% vs. 3%), and pipes (21% and 33% vs. 7%) and past 30-day blunt users (vs. non-users; 39% vs. 9%) were more likely to ever smoke marijuana from a hookah (ps < .05). Pregnant women (vs. non-pregnant; 12.8% vs. 8.6%; p = 0.03) were more likely to smoke marijuana from a hookah. Conclusions: Smoking marijuana from a hookah device is prevalent among young adults in the US, especially among vulnerable populations, and has increased significantly from 2015-2019.


Assuntos
Cannabis , Sistemas Eletrônicos de Liberação de Nicotina , Fumar Maconha , Cachimbos de Água , Produtos do Tabaco , Adulto Jovem , Humanos , Feminino , Gravidez , Estados Unidos/epidemiologia , Adulto , Nicotiana , Estudos Longitudinais , Fumar Maconha/epidemiologia , Uso de Tabaco/epidemiologia
10.
Exp Clin Psychopharmacol ; 31(2): 491-497, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36174147

RESUMO

Purchase tasks are used to measure the value, or demand, for various substances by assessing the amount of a substance individuals would purchase across a series of escalating prices. Marijuana purchase task (MPT) has been previously developed; however, cannabis can be consumed in various forms and measurements, thus raising questions about the applicability of the MPT across cannabis users. An adaptive MPT was developed to allow participants to select their preferred product (e.g., herbal, dabs) and division (e.g., hits, grams). Little research has been done to assess the temporal stability of these measures. Participants (N = 50, Mage = 35.3) who reported at least monthly cannabis use were recruited via Amazon's Mechanical Turk and completed a baseline and repeated original and adaptive MPT. Seventy-two percent (N = 36) of the sample reported the same preferred product and division. Results indicated that the baseline and repeated original MPT were significantly correlated across all indices (rrange = .37-.73), while the baseline and repeated adaptive MPT was significantly correlated with Pmax (r = .31, p = .029) and Omax (r = .57, p < .001). Permutation testing comparing the difference between the original and adaptive MPT on all indices demonstrated a difference for break point (rdifference = .52, p = .004) and elasticity (rdifference = .94, p = .005). Correlations were lower between participants who switched their preferences on the adaptive MPT. Only elasticity was significantly different (rdifference = .93, p = .012) between tasks among participants who did not switch their preferences. Results provide support that both the original and adaptive MPT are reliable across repeated measurement and demonstrate the importance of assessing cannabis product and division preferences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Cannabis , Alucinógenos , Fumar Maconha , Humanos , Adulto , Reprodutibilidade dos Testes , Economia Comportamental
11.
J Health Econ ; 87: 102700, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36455395

RESUMO

We exploit shocks to US federal enforcement policy to assess how legal medical marijuana market size affects youth marijuana use and consequences for youth traffic-related fatalities. Using hand-collected data on state medical marijuana patient rates to develop a novel measure of market size, we find that legal market growth increases youth marijuana use. Likely mechanisms are lower prices and easier access. Youth die more frequently from alcohol-involved car accidents, suggesting complementarities for youths. The consequences of marijuana legalization for youth are not immediate, but depend on how supply-side regulations affect production and prices.


Assuntos
Cannabis , Fumar Maconha , Maconha Medicinal , Adolescente , Humanos , Maconha Medicinal/uso terapêutico , Políticas , Impostos , Legislação de Medicamentos
12.
Subst Use Misuse ; 57(12): 1873-1881, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36083235

RESUMO

Introduction: Prevalence of alcohol and marijuana use is highest in young adulthood and an increasing number of young adults report simultaneous alcohol and marijuana (SAM) use, which is consistently linked with numerous negative consequences. To better understand reasons for engaging in SAM use and to refine measurement of subjective effects of SAM use, this study aimed to identify (1) how young adults describe subjective experiences during a SAM use occasion and (2) how language describing subjective effects changes as a function of level of alcohol and marijuana use. Methods: Using Amazon's Mechanical Turk (MTurk), 323 participants (53.6% women, 68.4% White, M age = 23.0 years) who reported past-month heavy episodic drinking and past-month SAM use were asked to list words to describe how they feel when using only alcohol, only marijuana, and various combinations of alcohol and marijuana. Results: SAM use language varied as a function of age and substance use behavior but was not associated with sex or race. Large differences in the terms used to describe subjective effects were observed when comparing different combinations of alcohol and marijuana use; most notably the term "cross-faded" appeared primarily when engaging at the heaviest combinations of alcohol and marijuana. Conclusion: Young adults have a wide range of vocabulary for describing subjective effects of SAM use, and subjective effects vary as a function of the level of each substance used. Future research should consider integrating such contemporary language when measuring subjective effects of SAM use.


Assuntos
Cannabis , Fumar Maconha , Uso da Maconha , Transtornos Relacionados ao Uso de Substâncias , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol , Feminino , Humanos , Idioma , Masculino , Fumar Maconha/epidemiologia , Uso da Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
13.
Drug Alcohol Depend ; 238: 109531, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35809475

RESUMO

BACKGROUND: Adolescence is a period of psychological and neural development in which harms associated with cannabis use may be heightened. We hypothesised that adolescent who use cannabis (adolescentsWUC) would have steeper delay discounting (preference for immediate over future rewards) and greater demand (relative valuation) for cannabis than adults who use cannabis (adultsWUC). METHODS: This cross-sectional study, part of the 'CannTeen' project, compared adultsWUC (n = 71, 26-29 years old) and adolescentsWUC (n = 76, 16-17 years old), and gender- and age-matched adolescent (n = 63) and adult (n = 64) controls. AdolescentsWUC and adultsWUC used cannabis 1-7 days/week and were matched on cannabis use frequency (4 days/week). The Monetary Choice Questionnaire assessed delay discounting. A modified Marijuana Purchase Task (MPT) assessed cannabis demand in adolescentsWUC and adultsWUC. The MPT yielded five indices: intensity (amount of cannabis used at zero cost), Omax (total peak expenditure), Pmax (price at peak expenditure), breakpoint (cost at which cannabis demand is suppressed to zero) and elasticity (degree to which cannabis use decreases with increasing price). Analyses were adjusted for covariates of gender, socioeconomic status, other illicit drug use. RESULTS: Both adolescentsWUC and adultsWUC had steeper delay discounting than controls (F, (1,254)= 9.13, p = 0.003, ηp2= 0.04), with no significant age effect or interaction. AdolescentsWUC showed higher intensity (F, (1,138)= 9.76, p = 0.002, ηp2= 0.07) and lower elasticity (F, (1,138)= 15.25, p < 0.001, ηp2= 0.10) than adultsWUC. There were no significant differences in Pmax, Omax or breakpoint. CONCLUSION: Individuals who use cannabis prefer immediate rewards more than controls. AdolescentsWUC, compared to adultsWUC, may be in a high-risk category with diminished sensitivity to cannabis price increases and a greater consumption of cannabis when it is free.


Assuntos
Cannabis , Desvalorização pelo Atraso , Fumar Maconha , Adolescente , Adulto , Analgésicos , Estudos Transversais , Economia Comportamental , Humanos , Fumar Maconha/psicologia , Recompensa
14.
Int J Methods Psychiatr Res ; 31(3): e1912, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35684977

RESUMO

OBJECTIVE: While polysubstance use is highly prevalent among people who use drugs, the field lacks a reliable assessment that can detect detailed temporal patterns of polysubstance use. This study assessed the test-retest reliability of the newly developed Polysubstance Use-Temporal Patterns Section (PSU-TPS). METHODS: Participants who used cocaine plus alcohol and/or marijuana at least once in the past 30 days (n = 48) were interviewed at baseline and approximately 7 days later (retest) using the Substance Abuse Module and the PSU-TPS. Reliability of PSU-TPS measures of quantity, frequency, and duration of polysubstance use was examined using intra-class correlation coefficients (ICCs) and kappa tests. RESULTS: Excellent reliability was observed for frequencies of concurrent polysubstance use patterns in the past 30 days (ICC range: 0.90-0.94) and quantity of alcohol use (ICC = 0.83), and fair to good reliability was observed for duration of substance use (ICC range: 0.52-0.73). CONCLUSION: Detailed information regarding cocaine, alcohol, and marijuana polysubstance use in the past 30 days can be reliably measured with the PSU-TPS. Data on the order and timing of polysubstance use at the hourly level will improve our understanding of the implications of sequential and simultaneous use patterns, which can help inform treatment and prevention efforts.


Assuntos
Cocaína , Fumar Maconha , Transtornos Relacionados ao Uso de Substâncias , Consumo de Bebidas Alcoólicas , Humanos , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
15.
Addiction ; 117(8): 2351-2358, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35293047

RESUMO

AIMS: To evaluate the feasibility and validity of a new method of quantifying cannabis flower use, integrating the amount of cannabis flower smoked, and the potency of the cannabis flower. DESIGN: Ecological momentary assessment (EMA) for 14 days. SETTING: Participants' daily lives in Columbia, Missouri, USA. PARTICIPANTS: A total of 50 community participants, who were regular cannabis flower smokers (48% female). MEASUREMENTS: Momentary subjective intoxication ratings following cannabis flower smoking; momentary quantity of cannabis flower smoked; potency of cannabis flower smoked in terms of percentage of tetrahydrocannabinol (THC) concentration assessed with a portable device, the Purpl Pro; and time since finished smoking. FINDINGS: Participants completed our field testing of their cannabis flower (96.2%) and were compliant with our 2-week EMA protocol (73% for random prompts and 91% for morning reports). Momentary subjective intoxication ratings trended down as a function of time since smoking (r = -0.10, P = 0.004, 95% CI, [-0.17, -0.03]). Multi-level model (MLM) results indicated the momentary standard THC units (mg THC) were positively associated with momentary subjective intoxication ratings (b = 0.01, P = 0.03, 95% CI, [0.01, 0.012]). CONCLUSIONS: There is evidence to support the feasibility and initial validity of a new method of quantifying cannabis flower use into standard tetrahydrocannabinol units. Researchers investigating the effects of cannabis flower use on a range of outcomes (e.g. neurobehavioral effects, emotional sequelae, and driving impairment) as well as in clinical treatment trials might adopt this method to provide estimates of cannabis flower use.


Assuntos
Cannabis , Alucinógenos , Fumar Maconha , Agonistas de Receptores de Canabinoides , Dronabinol , Avaliação Momentânea Ecológica , Feminino , Flores , Humanos , Masculino , Fumar Maconha/psicologia
16.
SMAD, Rev. eletrônica saúde mental alcool drog ; 17(4): 23-32, out.-dez. 2021. ilus
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1347838

RESUMO

OBJETIVO: conhecer as influências da regulamentação do consumo da Cannabis no Uruguai sobre o consumo desta substância psicoativa na região de fronteira com o Brasil. MÉTODO: estudo qualitativo, exploratório e descritivo. Participaram 14 pessoas que usam Cannabis, residentes em uma cidade da fronteira Brasil/Uruguai. Dados coletados por entrevista semiestruturada, analisados através da Análise de Conteúdo. RESULTADO: as transformações sociais estão relacionadas com a aceitação social do consumo; visualização de pessoas idosas que utilizam a substância e maior interação entre pessoas que usam Cannabis dos países envolvidos. As transformações no consumo estão relacionadas com a possibilidade de se adquirir Cannabis in natura, disponibilidade de variados tipos e subespécies da planta e o fluxo de brasileiros para realizar o consumo no lado uruguaio da fronteira. CONCLUSÃO: investigar espaços de fusão social, cultural e política, pode servir para reflexão acerca do atual cenário brasileiro, e implementação de ações que busquem salvaguardar os direitos humanos, respeitando a autonomia, e cuidando sobre a perspectiva de saúde.


OBJECTIVE: to know the influences of the regulation of Cannabis use in Uruguay on the consumption of this psychoactive substance in the border region with Brazil. METHOD: a qualitative, exploratory and descriptive study. The participants were 14 individuals who use Cannabis, living in a city on the Brazil/Uruguay border. Data was collected by semi-structured interviews and analyzed through Content Analysis. RESULT: social transformations are related to the social acceptance of consumption; visualization of older adults who use the substance and greater interaction between individuals who use Cannabis from the countries involved. The changes in consumption are related to the possibility of acquiring Cannabis in natura, to the availability of various types and subspecies of the plant, and to the flow of Brazilians to carry out consumption on the Uruguayan side of the border. CONCLUSION: investigating spaces of social, cultural and political fusion can serve to reflect on the current Brazilian scenario, and to implement actions that seek to safeguard human rights, respecting autonomy, and taking care about the health perspective.


OBJETIVO: conocer la influencia de la regulación del consumo de Cannabis en Uruguay sobre el consumo de esa sustancia psicoactiva en la región fronteriza con Brasil. MÉTODO: estudio cualitativo, exploratorio y descriptivo. Participaron 14 personas que consumen Cannabis y viven en una ciudad de la frontera entre Brasil y Uruguay. Los datos fueron recopilados por medio de entrevista semiestructurada, analizados mediante Análisis de Contenido. RESULTADO: las transformaciones sociales están relacionadas con la aceptación social del consumo; visualización de personas mayores que consumen la sustancia y mayor interacción entre personas que consumen Cannabis en los países involucrados. Los cambios en el consumo están relacionados con la posibilidad de adquirir Cannabis in natura, la disponibilidad de varios tipos y subespecies de la planta y el flujo de brasileños para realizar el consumo en el lado uruguayo de la frontera. CONCLUSIÓN: investigar espacios de fusión social, cultural y política, puede servir para reflexionar sobre el escenario brasileño actual e implementar acciones que busquen salvaguardar los derechos humanos, respetando la autonomía y cuidando la perspectiva de la salud.


Assuntos
Humanos , Uruguai , Áreas de Fronteira , Brasil , Fumar Maconha , Abuso de Maconha , Saúde na Fronteira
17.
JAMA Netw Open ; 4(11): e2136571, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34846523

RESUMO

Importance: Cannabis use has increased, but there are few studies on frequent and daily cannabis use among US adults. Individuals who engage in higher frequency use may suffer more health consequences. Objective: To examine frequency of cannabis use and associated factors among US adults. Design, Setting, and Participants: This survey study included data from 21 US states and 2 US territories reported in the Behavioral Risk Factor Surveillance System surveys from 2016 to 2019. Cross-sectional data on US adults ages 18 years and older were used to estimate demographic, socioeconomic, and behavioral risk factors for cannabis use, taking into account the survey strata and sampling weights for the 4 years of combined data. Using a multivariable ordinal logistic analysis, the association of demographic, socioeconomic status, and behavioral risk factors with past month cannabis frequency were examined. Exposures: Sociodemographic characteristic, ie, age, gender, race and ethnicity, educational attainment, employment status, and annual household income. Main Outcomes and Measures: Ordinal categorization of number of days of cannabis use in the past 30 days in terms of nonuse, infrequent use (1-5 days), frequent use (6-29 days), and daily use. Results: Among the 387 179 respondents, 58 009 (27.9%) were ages 18 to 34 years, 186 923 (50.3%) were ages 35 to 64 years, and 142 225 (21.8%) were age 65 years or older (mean [SD] age, 48.3 [0.1] years). The sample included 28 345 (9.8%) Black, 36 697 (22.6%) Hispanic, and 292 210 (57.3%) White respondents. Smoking was the most common form of cannabis use. The frequency of cannabis use varied significantly by age, gender, race, marital status, education, and employment. Higher frequency cannabis use was associated with younger age (ages 18-34 years: adjusted odds ratio [aOR],4.12; 95% CI, 3.63-4.68; ages 35-64 years: aOR,2.22; 95% CI, 1.98-2.49), Black (aOR, 1.46; 95% CI, 1.33-1.71) and Native American (aOR, 1.25; 95% CI, 1.04-1.52) race, and less educational attainment (high school or less: aOR,1.09; 95% CI, 1.02-1.17; some college: aOR,1.27; 95% CI, 1.19-1.35). Being married (aOR, 0.54; 95% CI, 0.51-0.58) or identifying as Asian (aOR, 0.60; 95% CI, 0.51-0.71) or Hispanic (aOR, 0.71; 95% CI, 0.65-0.77) was associated with lower-frequency cannabis use after accounting for other baseline factors. Conclusions and Relevance: This nationally based study found that higher-frequency cannabis use is more common among young and racial minority populations, as well as respondents with low socioeconomic status. Given the known and emerging negative health effects of cannabis use, more attention may need to be paid to high-frequency use among underserved populations in the form of screening, risk stratification, and treatment.


Assuntos
Fatores Etários , Fumar Maconha/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários/estatística & dados numéricos , Fatores de Tempo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
18.
Drug Alcohol Depend ; 227: 108920, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34399137

RESUMO

BACKGROUND: Dopaminergic mechanisms that may underlie cannabis' reinforcing effects are not well elucidated in humans. This positron emission tomography (PET) imaging study used the dopamine D2/3 receptor antagonist [11C]raclopride and kinetic modelling testing for transient changes in radiotracer uptake to assess the striatal dopamine response to smoked cannabis in a preliminary sample. METHODS: PET emission data were acquired from regular cannabis users (n = 14; 7 M/7 F; 19-32 years old) over 90 min immediately after [11C]raclopride administration (584 ± 95 MBq) as bolus followed by constant infusion (Kbol = 105 min). Participants smoked a cannabis cigarette, using a paced puff protocol, 35 min after scan start. Plasma concentrations of Δ9-THC and metabolites and ratings of subjective "high" were collected during imaging. Striatal dopamine responses were assessed voxelwise with a kinetic model testing for transient reductions in [11C]raclopride binding, linear-parametric neurotransmitter PET (lp-ntPET) (cerebellum as a reference region). RESULTS: Cannabis smoking increased plasma Δ9-THC levels (peak: 0-10 min) and subjective high (peak: 0-30 min). Significant clusters (>16 voxels) modeled by transient reductions in [11C]raclopride binding were identified for all 12 analyzed scans. In total, 26 clusters of significant responses to cannabis were detected, of which 16 were located in the ventral striatum, including at least one ventral striatum cluster in 11 of the 12 analyzed scans. CONCLUSIONS: These preliminary data support the sensitivity of [11C]raclopride PET with analysis of transient changes in radiotracer uptake to detect cannabis smoking-induced dopamine responses. This approach shows future promise to further elucidate roles of mesolimbic dopaminergic signaling in chronic cannabis use. ClinicalTrials.gov Identifier: NCT02817698.


Assuntos
Cannabis , Fumar Maconha , Estriado Ventral , Adulto , Corpo Estriado/diagnóstico por imagem , Dopamina , Humanos , Tomografia por Emissão de Pósitrons , Racloprida , Adulto Jovem
19.
Pancreas ; 50(5): 766-772, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34016899

RESUMO

OBJECTIVES: Cannabis legalization has increased its use. The incidence of acute pancreatitis (AP) and severe acute pancreatitis (SAP) has also increased. In this study, data on pancreatitis were obtained from 2 states before and after cannabis legalization and compared with 2 states without legalized cannabis. METHODS: Data were extracted from State Inpatient Databases from the states of Colorado and Washington before recreational cannabis legalization (2011) and after legalization (2015). Arizona and Florida were used as the nonlegalized cannabis states. Multivariable logistic regression models were fit for AP and SAP to determine a trend difference between legalized and nonlegalized cannabis states. RESULTS: Cannabis use, AP, and SAP increased in all states. The increase in AP and SAP was not significantly different between the states that legalized cannabis use and those that did not. Legalized cannabis states had lower charges for AP and SAP and shorter length of hospitalizations. CONCLUSIONS: The trend of AP and SAP increased during the study period, but this was not correlated to cannabis use. Cannabis users had lower hospitalization costs and hospital stay. The effects of other confounders such as cannabis dose and delivery methods, alcohol, tobacco, and others need to be studied further as use increases.


Assuntos
Cannabis/efeitos adversos , Fumar Maconha/efeitos adversos , Pancreatite/epidemiologia , Uso Recreativo de Drogas , Adolescente , Adulto , Idoso , Bases de Dados Factuais , Feminino , Regulamentação Governamental , Custos Hospitalares , Humanos , Incidência , Legislação de Medicamentos , Tempo de Internação , Masculino , Fumar Maconha/legislação & jurisprudência , Fumar Maconha/tendências , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Pancreatite/economia , Pancreatite/terapia , Uso Recreativo de Drogas/legislação & jurisprudência , Uso Recreativo de Drogas/tendências , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Governo Estadual , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto Jovem
20.
Health Rep ; 32(4): 3-14, 2021 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-33881274

RESUMO

BACKGROUND: The Canadian government legalized non-medical cannabis use by adults in October 2018 to minimize associated harms and redirect profits from criminals. In October 2019, a wider array of products, including edibles, was legalized, with entry into the legal market beginning in December. DATA AND METHODS: Three quarters (the first quarters of 2018 and 2019 and the fourth quarter of 2020) of the National Cannabis Survey were used to examine changes in cannabis use (overall use and daily or almost daily (DAD) use), consumption methods, products and sources. RESULTS: Cannabis use in the past three months was higher in late 2020 (20.0%) than in 2019 (17.5%) and 2018 (14.0%), and this was particularly the case among: females (for whom rates rose to equal male rates for the first time), adults aged 25 and older, and some provinces. Similarly, DAD use, at 7.9% also increased. Higher percentages of Canadians reported getting at least some of their cannabis from legal sources or growing it, and fewer were relying on friends and family or illegal sources in 2020. DISCUSSION: This study spans three years-from before legalization to about two years after. It provides a more complete picture of the law's impact on cannabis use and related behaviours, given the more established legal cannabis industry better equipped to compete with the black market on price, convenience and selection. Findings demonstrate that change is continuing, and, as before, some cautions and assurances remain. The impact of the COVID-19 pandemic on cannabis use continues to be difficult to measure. Monitoring remains important, given the ever-changing provincial retail landscapes; the introduction of new products; and the pressure by the industry to remove or adjust potency limits, and allow widespread delivery, farm-gate sales and cannabis lounges.


Assuntos
Cannabis , Legislação de Medicamentos , Fumar Maconha , Adulto , COVID-19 , Canadá , Feminino , Humanos , Legislação de Medicamentos/estatística & dados numéricos , Legislação de Medicamentos/tendências , Masculino , Fumar Maconha/economia , Fumar Maconha/legislação & jurisprudência , Inquéritos e Questionários
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