The Association of Frequency of Worry About Financial Debt With Substance Use Among Adults in Ontario, Canada.

BACKGROUND: Financial debt and associated stress might increase the risk of substance use problems or exacerbate existing ones. Little evidence is available about the degree of debt stress and its association with substance use. The objective of this study was to examine the associations of the frequency of worry about debt with heavy episodic drinking (HED), daily smoking, e-cigarette use, and cannabis use in the past 30 days. METHODS: Data were utilized from the 2020/2022 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The surveys employed a web-based panel survey of 6038 adults and collected data on debt-related stress, HED, tobacco smoking, e-cigarettes, and cannabis use in the past 30 days. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors. RESULTS: Overall, 18.4% of respondents reported that they were worried about their debt most or all of the time. Accounting for household income, educational status, employment status, and other factors, the results revealed that there was a dose-response relationship between the frequency of worry about debt and substance use including daily smoking, e-cigarette use, and cannabis use in the past 30 days compared to those who were not worried at all about their debt. Sex differences were also found in the association between worry about debt and e-cigarette use. CONCLUSIONS: The frequency of worry about debt might have an important role in substance use, which suggests that financial well-being is vital in substance use prevention and harm reduction.

Factors associated with stress about returning to pre-pandemic routines among Canadians.

The COVID-19 pandemic continues to be a public health concern, with important impacts on individuals' mental health. Many people have experienced significant changes to their daily routines due to the pandemic and for some, returning to pre-pandemic routines could create elevated stress. The present study explored factors associated with stress about returning to pre-pandemic routines (SRPR). A web-based, cross-sectional survey of 1,001 Canadian adults aged 18 years and older was conducted on July 9-13, 2021. SRPR was assessed by asking the respondents how much stress they have been feeling about returning to their pre-pandemic routines. Sociodemographic variables, anxiety, depression, loneliness, and COVID-19-related worry were examined in relation to SRPR. Overall, 28.8% of respondents reported moderate to extreme SRPR. After adjusting for covariates, factors associated with elevated SRPR included: younger age (AOR = 2.29, 95%CI 1.30-4.03), higher education (AOR = 2.08, 95%CI 1.14-3.79), being very worried about getting COVID-19 (AOR = 4.14, 95%CI 2.46-6.95), switching to working from home (AOR = 2.43, 95%CI 1.44-4.11), having anxiety (AOR = 5.02, 95%CI 3.19-7.89), feeling depressed (AOR = 1.93, 95%CI 1.14-3.25), and feeling lonely (AOR = 1.74, 95%CI 1.07-2.83). The findings of this study suggest that individuals experiencing mental health concerns (anxiety, feeling depressed, feeling lonely) may be especially likely to feel elevated SRPR and may therefore need additional support in making the transition back to prior routines.

Driving under the influence of cannabis risk perceptions and behaviour: A population-based study in Ontario, Canada.

Driving under the influence of cannabis (DUIC) is detrimental to road safety. Risk perception is a strong determinant of DUIC behaviour, yet little is known about the factors influencing DUIC risk perception in the general population. The objective of this study was to identify factors associated with risk perceptions of motor vehicle collision and legal consequences due to DUIC and examine whether these perceptions were associated with DUIC behaviour. Data were derived from the 2017 CAMH Monitor, a cross-sectional telephone survey of adults aged 18+ years in Ontario, Canada (n = 1813). Multivariable logistic regression analyses were performed. Approximately 90% of adults overall agreed that DUIC increases motor vehicle collision risk compared to 55% of those reporting past-year DUIC. Being male, less educated, and using cannabis at least monthly were associated with disagreeing that DUIC increases motor vehicle collision risk. Being male, young, and using cannabis at least monthly were associated with agreeing that DUIC is safer than driving under the influence of alcohol (DUIA). Being male and using cannabis less than monthly were associated with agreeing that the chances of getting caught for DUIC are higher than DUIA. Safety but not legal risk perceptions were associated with DUIC behaviour among cannabis-using drivers. Cannabis legalization provides a timely opportunity for DUIC prevention strategies. This study suggests that policymakers should target male cannabis users and highlight the safety risks of DUIC. Further research is needed to assess the effectiveness of prevention measures and the impact of cannabis legalization on DUIC perceptions and behaviour.

Increases in Serious Psychological Distress among Ontario Students between 2013 and 2017: Assessing the Impact of Time Spent on Social Media.

OBJECTIVE: The objective of the current research was to examine the association between time spent on social media and serious psychological distress between 2013 and 2017, a period when the rates of both were trending upward. METHODS: The current study analyzed population-based data from 3 waves of the Ontario Student Drug Use and Health Survey (N = 15,398). Multivariate logistic regression models were used to examine the association between time spent on social media and serious psychological distress controlling for theoretically relevant covariates. Interactions were tested to assess whether the association changed over time. RESULTS: The prevalence of serious psychological distress increased from 10.9% in 2013 to 16.8% in 2017 concomitantly with substantial increases in social media usage, especially at the highest levels. In the multivariate context, we found a significant interaction between social media use and the survey year which indicates that the association between time spent on social media and psychological distress has decreased from 2013 to 2017. CONCLUSION: Although both social media use and psychological distress increased between 2013 and 2017, the interaction between these variables indicates that the strength of this association has decreased over time. This finding suggests that the higher rate of heavy social media use in 2017 compared to 2013 is not actually associated with the higher rate of serious psychological distress during the same time period. From a diffusion of innovation perspective, it is possible that more recent adopters of social media may be less prone to psychological distress. More research is needed to understand the complex and evolving association between social media use and psychological distress. Researchers attempting to isolate the factors associated with the recent increases in psychological distress could benefit from broadening their investigation to factors beyond time spent on social media.

Influence of Cannabinoid Receptor 1 Genetic Variants on the Subjective Effects of Smoked Cannabis.

As many jurisdictions consider relaxing cannabis legislation and usage is increasing in North America and other parts of the world, there is a need to explore the possible genetic differences underlying the subjective effects of cannabis. This pilot study investigated specific genetic variations within the cannabinoid receptor 1 (CNR1) gene for association with the subjective effects of smoked cannabis. Data were obtained from a double-blinded, placebo-controlled clinical trial studying the impact of cannabis intoxication on driving performance. Participants randomized to the active cannabis group who consented to secondary genetic analysis (n = 52) were genotyped at the CNR1 rs1049353 and rs2023239 polymorphic areas. Maximum value and area under the curve (AUC) analyses were performed on subjective measures data. Analysis of subjective effects by genotype uncovered a global trend towards greater subjective effects for rs1049353 T-allele- and rs2023239 C-allele-carrying subjects. However, significant differences attributed to allelic identity were only documented for a subset of subjective effects. Our findings suggest that rs1049353 and rs2023239 minor allele carriers experience augmented subjective effects during acute cannabis intoxication.

Ethnicity, Immigration Status, And Driving Under The Influence Of Alcohol.

BACKGROUND: Understanding risk factors for driving under the influence of alcohol (DUIA) informs development of effective interventions. This study examined the association between ethnicity, immigration status, and DUIA, exploring psychological distress and hazardous drinking as additional contributors. METHOD: Data were derived from the 2003-2011 cycles of the Centre for Addiction and Mental Health (CAMH) Monitor of 16,101 adults from Ontario, Canada. Hierarchical binary logistic regression analysis assessed self-identified ethnicity and immigration status as predictors of DUIA, adjusting for sociodemographics and driving exposure (Model 1), psychological distress (Model 2), and hazardous drinking (Model 3). RESULTS: In Model 1, respondents born outside of Canada had reduced odds of engaging in DUIA compared to those born in Canada (AOR = 0.72, 95%CI = 0.56 - 0.92). Relative to those identifying as Canadian, the odds of DUIA were significantly reduced for those identifying as East Asian (AOR = 0.28, 95%CI = 0.13 - 0.61) and South Asian (AOR = 0.52, 95%CI = 0.27 - 0.98). In Model 3, individuals who reported psychological distress (AOR = 1.69, 95%CI = 1.33 - 2.16) and those who reported hazardous drinking (AOR = 6.28, 95%CI= 5.13 - 7.69) were more likely to DUIA. Those identifying as East Asian continued to have reduced odds of DUIA compared to those identifying as Canadian (AOR = 0.38, 95%CI = 0.17 - 0.85). CONCLUSION: Individuals born outside of Canada were less likely to engage in DUIA than individuals born in Canada. Drivers who self-identified as East Asian were less likely to DUIA than those who self-identified as Canadian. Understanding ethnic differences underlying divergent risks for DUIA will improve prevention initiatives and remedial measures programming.

Examining the effect of social bonds on the relationship between ADHD and past arrest in a representative sample of adults.

BACKGROUND: Several studies have found a connection between attentional deficit hyperactivity disorder (ADHD) and criminal behaviour in clinical and prison samples of adults, but there is a lack of representative general population data on this. AIM: To test relationships between histories of ADHD and arrest. Our main research question was whether any such relationship is direct or best explained by co-occurring variables, especially indicators of social bonds. METHOD: Data were from a sample of 5,376 adults (18+) representative of the general population of Ontario, Canada. Logistic regression analysis was used to explore the relationship between self-reported arrest on criminal charges and ADHD as measured by the Adult Self Report Scale (ASRS-v1.1). Indicators of strong social bonds (post secondary education, household size) and weak bonds (drug use, antisocial behaviours, alcohol dependence) were also obtained at interview and included in the statistical models. RESULTS: In a main effects model, screening positive for ADHD was twice as likely (OR 2.05 CI 1.30, 3.14) and past use of medications for ADHD three times as likely (OR 3.94 CI 2.46, 6.22) to be associated with ever having been arrested. These associations were no longer significant after controls for weak and strong social bonds were added to the models. In the best fitting statistical model, ever having been arrested was not associated with ADHD, but it was significantly associated with indicators of strong and weak social bonds. CONCLUSIONS: The observed connection between ADHD and criminality may be better understood through their shared relationships with indicators of poor social bonds. These include antisocial behaviour more generally, but also drug use and failure to progress to any form of tertiary education, including vocational training. Copyright © 2017 John Wiley & Sons, Ltd.

Roadway Aggression Among Drivers and Passengers With or Without a History of Traumatic Brain Injury.

OBJECTIVE: This study examined the association between roadway aggression and traumatic brain injury (TBI) among drivers and passengers who reside in the province of Ontario, Canada. METHODS: Data were based on a 3-year cumulated cross-sectional sample of 6,048 adults aged 18 years and older who were surveyed by telephone. The outcome in this study was road rage in the form of verbal/gestural or physical aggression toward other road users and/or their vehicle. RESULTS: Driving status, history of TBI, age, gender, education, and the interaction between history of TBI and education significantly predicted roadway aggression. Odds ratios (ORs) for roadway aggression were significantly higher among drivers ( OR= 2.65) compared to passengers, between 2 and 4.5 times higher among individuals aged 18-64 years old compared to those older than 65 years, higher among adults with TBI (OR = 2.05) than without, and men (OR = 1.54) than women. Among respondents with lowest, but not highest, levels of education, roadway aggression was predicted by a history of TBI. CONCLUSION: This is the first population-based study to compare rates of roadway aggression between drivers and passengers with and without TBI. Research to understand these differences will be important for roadway aggression prevention efforts and policy.

Personality predictors of driver vengeance.

The purpose of this study was to identify personality and individual difference measures related to driver vengeance, as measured by the Driver Vengeance Questionnaire (DVQ; Wiesenthal, Hennessy, & Gibson, 2000). There were 170 undergraduate students who completed paper-and-pencil questionnaires including the DVQ and measures of narcissism, impulsivity, and trait driver stress. A hierarchical linear regressidn predicting DVQ score revealed that being male (ß = .25), narcissism (ß = .19), and trait driver stress (ß = .41) were significantly associated with vengeance. Impulsivity was significant in the third block of the regression but was not a significant predictor of vengeance in the final block. Interactions between gender and the individual difference measures were not significant. The final model accounted for 34% of the variance. Implications of the results and directions for future research are discussed.

Exploring the Behaviour Change Wheel and the Theoretical Domains Framework in interventions for mobile phone driver distraction: A scoping review.

Mobile phone use while driving remains a significant traffic safety concern. Although numerous interventions have been developed to address it, there is a gap in the synthesis of relevant information through a comprehensive behaviour change lens. This scoping review uses the Behaviour Change Wheel (BCW) and the Theoretical Domains Framework (TDF) to examine the literature to (a) identify behavioural constructs targeted in interventions for mobile phone use while driving, (b) determine if the intervention success varied by sociodemographic group (e.g., age, gender, driving experience), and (c) map interventions to TDF domains to highlight areas for future research. Following the PRISMA extension for scoping reviews, we searched seven databases and identified 5,202 articles. After screening, 50 articles detailing 56 studies met the following inclusion criteria: (a) intervention studies, (b) providing details on methods and results, (c) written in English, and (d) targeting any driver behaviour related to mobile phone use while driving with a bottom-up approach, using not regulation or law enforcement, but individuals' psychological processes, such as cognitive, behavioural, and emotional. Findings show that most interventions targeted young drivers and were typically effective. Except for a few studies, the effectiveness of interventions targeting different sociodemographic groups either remained untested or revealed nonsignificant differences. This finding points to a gap in the literature, indicating a need for further investigation into the efficacy of interventions for different groups, and for tailoring and testing them accordingly. The interventions also often targeted multiple TDF domains, complicating the interpretation of the relative efficacy of specific domains. Most frequently targeted domains included beliefs and consequences, emotions, knowledge, social influence, social/professional role and identity, and behavioural regulation. Physical skills and optimism domains were not targeted in any intervention. Further, almost all interventions addressed deliberate engagement in mobile phone distractions, while the automatic and fast processes involved in such behaviours were often overlooked. Mobile phone distractions are in part habitual behaviours, yet the existing mitigation efforts mostly assumed intentional engagement. More focus on the habitual nature of mobile phone distractions is needed.

Work-related and non-work-related mild traumatic brain injury: Associations with mental health and substance use challenges in a Canadian population-level survey.

BACKGROUND: Mild traumatic brain injury (mTBI) can profoundly impact overall health, employment, and family life. Incidence of mTBI in the workplace represents an important subgroup with poorer outcomes. Mental health (MH) and substance use (SU) challenges are a primary correlate of TBI, but are rarely assessed among individuals with a work-related (wr)-mTBI, particularly at a population-level. OBJECTIVE: This study aimed to assess the association between lifetime wr-mTBI and non-wr-mTBI and the experience of MH and SU challenges. METHODS: The 2019 Centre for Addiction and Mental Health (CAMH) Monitor is a cross-sectional telephone survey of adults aged≥18 years in Ontario, Canada, employing a stratified (six regions) two-stage (telephone number, respondent) list-assisted random digit dialing probability selection procedure (N = 1792). Adjusting for sociodemographic variables, binary logistic regression was conducted to assess the association between lifetime wr-mTBI and non-wr-mTBI (relative to no TBI) and four outcomes: hazardous use of alcohol and of cannabis, psychological distress, and fair/poor mental health. RESULTS: Adjusting for sociodemographic variables, non-wr-mTBI demonstrated increased odds of hazardous alcohol (AOR = 2.12, 95% CI = 1.41, 3.19) and cannabis use (AOR = 1.61, 95% CI = 1.05, 2.45), psychological distress (AOR = 1.68, 95% CI = 1.14, 2.49), and fair/poor mental health (AOR = 1.70, 95% CI = 1.11, 2.59). Lifetime wr-mTBI demonstrated increased odds of reporting psychological distress (AOR = 3.40, 95% CI = 1.93, 5.97) and fair/poor mental health (AOR = 2.16, 95% CI = 1.12, 4.19) only. CONCLUSIONS: Non-wr-mTBI was associated with both MH and SU, whereas wr-mTBI was associated with MH only. MH outcomes were more strongly associated with wr-mTBI than non-wr-mTBI. Physicians, employers, and insurers need to consider the potential association between wr-mTBI and MH, and provide care accordingly.

Cannabis legalization and driving under the influence of cannabis and driving under the influence of alcohol among adult and adolescent drivers in Ontario, Canada (2001-2019).

BACKGROUND: The impacts of cannabis legalization on driving under the influence of cannabis and driving under the influence of alcohol among adults and adolescents were examined in Ontario, Canada. METHODS: Data were sourced from adult (N=38,479) and adolescent (N=23,216) populations-based surveys (2001-2019). The associations between cannabis legalization and driving within an hour of using cannabis and driving within an hour of drinking two or more drinks of alcohol were quantified using logistic regression, with testing of multiplicative interactions between cannabis legalization and age and sex. All analyses were conducted separately for adults and adolescents and restricted to participants with a valid driver's license. RESULTS: Cannabis legalization was not associated with driving within an hour of using cannabis among adults (OR, 95% CI: 1.21, 0.69-2.11). However, a multiplicative interaction indicated that there was an increased likelihood of driving within an hour of using cannabis among adults ≥55 years of age (4.23, 1.85-9.71) pre-post cannabis legalization. Cannabis legalization was not associated with driving within an hour of using cannabis among adolescents (0.92, 0.72-1.16), or with driving within an hour of consuming two or more drinks of alcohol among adults (0.78, 0.51-1.20) or adolescents (0.87, 0.42-1.82). CONCLUSIONS: An increased likelihood of driving under the influence of cannabis among adults ≥55 years of age was detected in the year following cannabis legalization, suggesting the need for greater public awareness and education and police monitoring and enforcement concerning driving under the influence of cannabis, particularly among older adults.

Cannabis and Driving in Older Adults.

Importance: Epidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of the association between cannabis and driving in people aged older than 65 years are lacking. Objective: To investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults. Design, Setting, and Participants: Using an ecologically valid counterbalanced design, in this cohort study, regular cannabis users operated a driving simulator before, 30 minutes after, and 180 minutes after smoking their preferred legal cannabis or after resting. This study was conducted in Toronto, Canada, between March and November 2022 with no follow-up period. Data were analyzed from December 2022 to February 2023. Exposures: Most participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD). Main outcomes and measures: The primary end point was SD of lateral position (SDLP, or weaving). Secondary outcomes were mean speed (MS), maximum speed, SD of speed, and reaction time. Driving was assessed under both single-task and dual-task (distracted) conditions. Blood THC and metabolites of THC and CBD were also measured at the time of the drives. Results: A total of 31 participants (21 male [68%]; 29 White [94%], 1 Latin American [3%], and 1 mixed race [3%]; mean [SD] age, 68.7 [3.5] years), completed all study procedures. SDLP was increased and MS was decreased at 30 but not 180 minutes after smoking cannabis compared with the control condition in both the single-task (SDLP effect size [ES], 0.30; b = 1.65; 95% CI, 0.37 to 2.93; MS ES, -0.58; b = -2.46; 95% CI, -3.56 to -1.36) and dual-task (SDLP ES, 0.27; b = 1.75; 95% CI, 0.21 to 3.28; MS ES, -0.47; b = -3.15; 95% CI, -5.05 to -1.24) conditions. Blood THC levels were significantly increased at 30 minutes but not 180 minutes. Blood THC was not correlated with SDLP or MS at 30 minutes, and SDLP was not correlated with MS. Subjective ratings remained elevated for 5 hours and participants reported that they were less willing to drive at 3 hours after smoking. Conclusions and relevance: In this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.

Exploring the intersection of brain injury and mental health in survivors of intimate partner violence: A scoping review.

Rationale: Intimate partner violence (IPV) is the most commonly occurring form of violence against women. The most common site of injury in IPV is the head, face, and neck, resulting in possible brain injury (BI). Independently, mental health (MH) concerns are highly prevalent among both IPV survivors and individuals with BI; however, no systematic review exists on the combined experience of BI and MH in IPV. Objective: The aim of this review was to describe the identification of and relationships between BI, MH, and IPV in the literature and the implications for health policy and practice. Methods: A search strategy including text words and subject headings related to BI, IPV, and MH was developed for MEDLINE and translated to EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science. Two reviewers independently assessed articles for inclusion. Articles discussing MH, BI, and IPV in relation to one another were included in the review. Results: Twenty-eight articles were identified for inclusion. Methods for identifying IPV, BI, and MH were highly variable across studies. Fourteen studies reported significantly higher MH scores in IPV survivors with BI than in those without BI. Articles predominantly focused on cis gender women in heterosexual relationships and the impact of race and ethnicity were largely overlooked. Healthcare access was explored by eight articles, though none discussed the implications of co-occurring BI and MH. Conclusion: Brain injury and MH are highly prevalent among IPV survivors; however, little research discusses the implication for healthcare. Future research should explore healthcare-related needs and experiences to inform policy and practice and better represent the diversity of IPV survivors.

Barriers to Accessing Mental Health Support Services in Undergraduate Medical Training: A Multicenter, Qualitative Study.

PURPOSE: Medical students report higher levels of burnout, anxiety, and depression compared with age-matched peers. These mental health challenges have been linked to reduced workplace productivity, empathy, and professionalism. Yet, students experiencing mental health issues often decide not to access mental health resources, citing limited time and concerns about confidentiality, stigma, and the cost of private therapy. This study aimed to provide a framework for understanding barriers medical students face regarding access to mental health resources. METHOD: A constructivist grounded theory approach was employed, with 24 students from 6 medical schools in Ontario, Canada, participating in semistructured telephone interviews between May 2019 and February 2020. Participants were purposively sampled to capture a broad range of experiences, institutional contexts, and training levels. The authors then developed a framework to conceptualize the barriers that medical students face while accessing mental health resources. RESULTS: The information obtained from the interviews revealed that the barriers were both overt and covert. Overt barriers were primarily administrative challenges, including restrictive leave of absence policies and sick days, mandatory reporting of extended sick leave time during the residency selection process, time-restricted academic and clinical schedules, and difficulty in accessing mental health supports during distance education. Covert barriers to accessing mental health supports included a medical culture not conducive to mental health, felt stigma (i.e., fear of stigma and being labeled as weak), and the hidden curriculum (i.e., the unofficial or unintended rules and mannerisms propagated within medical education systems). CONCLUSIONS: Better understanding the overt and covert barriers that medical students to face while accessing mental health supports may help guide and inspire new advocacy efforts to enhance medical student well-being.

The Utility of THC Cutoff Levels in Blood and Saliva for Detection of Impaired Driving.

Background: Δ9-Tetrahydrocannabinol (THC) is the psychoactive component in cannabis and a relationship of THC to driving impairment is expected. Despite this, there are discrepant findings with respect to the relationship of blood THC to driving. This study investigated the relationship of blood, urine, and saliva THC/THC-COOH levels to "weaving," as measured by a driving simulator. Methods: Participants smoked cannabis alone or with alcohol. THC/THC-COOH levels in blood, urine, and saliva were correlated with standard deviation of lateral position (SDLP), measuring "weaving." In addition, SDLP after cannabis and/or alcohol were compared with SDLP after placebo when THC/THC-COOH levels were above or below specified thresholds in blood (5 ng/mL), urine (50 ng/mL), or saliva (25 ng/mL). Results: A clear linear relationship between blood THC concentration and SDLP was not observed based on calculation of Spearman coefficients. When compared with placebo, SDLP was significantly increased after cannabis and cannabis combined with alcohol when THC in the blood was above the legal limit. SDLP was increased in drug conditions when saliva cutoffs were above the legal limit. Conclusions: The findings of this study suggest that specified thresholds for THC in blood and saliva may be able to detect driving impairment, but future studies are needed. ClinicalTrials.gov ID: NCT03106363.

The mental health impacts of the COVID-19 pandemic among individuals with depressive, anxiety, and stressor-related disorders: A scoping review.

OBJECTIVE: A scoping review of studies published in the first year of the COVID-19 pandemic focused on individuals with pre-existing symptoms of depression, anxiety, and specified stressor-related disorders, with the objective of mapping the research conducted. ELIGIBILITY CRITERIA: (1) direct study of individuals with pre-existing depressive, anxiety, and/or specified stressor-related (i.e., posttraumatic stress, acute stress) disorders/issues; (2) focus on mental health-related pandemic effects, and; (3) direct study of mental health symptoms related to depression, anxiety, or psychological distress. SOURCES OF EVIDENCE: Database-specific subject headings and natural language keywords were searched in Medline, Embase, APA PsycInfo, and Cumulative Index to Nursing & Allied Health Literature (CINAHL) up to March 3, 2021. Review of potentially relevant studies was conducted by two independent reviewers and proceeded in two stages: (1) title and abstract review, and; (2) full paper review. DATA CHARTING: Study details (i.e., location, design and methodology, sample or population, outcome measures, and key findings) were extracted from included studies by one reviewer and confirmed by the Principal Investigator. RESULTS: 66 relevant articles from 26 countries were identified. Most studies adopted a cross-sectional design and were conducted via online survey. About half relied on general population samples, with the remainder assessing special populations, primarily mental health patients. The most commonly reported pre-existing category of disorders or symptoms was depression, followed closely by anxiety. Most studies included depressive and anxiety symptoms as outcome measures and demonstrated increased vulnerability to mental health symptoms among individuals with a pre-existing mental health issue. CONCLUSION: These findings suggest that improved mental health supports are needed during the pandemic and point to future research needs, including reviews of other diagnostic categories and reviews of research published in subsequent years of the pandemic.

Association between ABCB1 rs2235048 Polymorphism and THC Pharmacokinetics and Subjective Effects following Smoked Cannabis in Young Adults.

Genetic influences on acute responses to psychoactive drugs may contribute to individual variability in addiction risk. ABCB1 is a human gene that encodes P-glycoprotein, an ATP-dependent efflux pump that may influence the pharmacokinetics of delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis. Using data from 48 young adults (aged 19-25 years) reporting 1-4 days of cannabis use per week who completed a placebo-controlled human laboratory experiment, we tested the hypothesis that the rs2235048 polymorphism of ABCB1 would influence acute responses to smoked cannabis. C-allele carriers reported on average greater frequency of weekly cannabis use compared to the TT genotype carriers (TC/CC mean ± SEM = 2.74 ± 0.14, TT = 1.85 ± 0.24, p = 0.004). After smoking a single cannabis cigarette to their desired high, C-allele carriers had higher area-under-the-curve (AUC) of both THC metabolites (11-OH-THC TC/CC = 7.18 ± 9.64, TT = 3.28 ± 3.40, p = 0.05; THC-COOH TC/CC = 95.21 ± 116.12, TT = 45.92 ± 42.38, p = 0.043), and these results were impact by self-reported ethnicity. There were no significant differences in self-reported subjective drug effects except for a greater AUC of visual analogue scale rating of drug liking (TC/CC = 35,398.33 ± 37,233.72, TT = 15,895.56 ± 13,200.68, p = 0.017). Our preliminary findings suggest that further work in a larger sample should investigate whether human ABCB1 influences cannabis-related phenotypes and plays a role in the risk of developing a cannabis use disorder.