Self-Medication of Somatic and Psychiatric Conditions Using Botanical Marijuana.

As a complement to research evaluating botanical marijuana as a medical therapy for various somatic and psychiatric conditions, there is a growing body of research assessing marijuana users' self-reports of the symptoms and conditions for which they use marijuana without a physician's recommendation. As part of two larger web-based surveys and one in-situ survey at an outdoor marijuana festival, we asked regular marijuana users if they consumed the drug without a physician's recommendation and, if so, to describe (or select from a checklist) the conditions for which they used marijuana as a medication. Participants reported using marijuana to self-medicate a wide variety of both somatic conditions (such as pain, diabetes, and irritable bowel syndrome) and psychiatric conditions (such as depression, anxiety, and insomnia). Because fewer than half of the American states, and only a few countries, allow physicians to recommend medicinal marijuana, these findings may be of interest to clinicians as they treat patients, to lawmakers and policymakers as they consider legislation allowing physicians to recommend botanical marijuana for somatic and psychiatric conditions, and to researchers evaluating conditions that individuals elect to self-medicate using botanical marijuana.

The pornography craving questionnaire: psychometric properties.

Despite the prevalence of pornography use, and recent conceptualization of problematic use as an addiction, we could find no published scale to measure craving for pornography. Therefore, we conducted three studies employing young male pornography users to develop and evaluate such a questionnaire. In Study 1, we had participants rate their agreement with 20 potential craving items after reading a control script or a script designed to induce craving to watch pornography. We dropped eight items because of low endorsement. In Study 2, we revised both the questionnaire and cue exposure stimuli and then evaluated several psychometric properties of the modified questionnaire. Item loadings from a principal components analysis, a high internal consistency reliability coefficient, and a moderate mean inter-item correlation supported interpreting the 12 revised items as a single scale. Correlations of craving scores with preoccupation with pornography, sexual history, compulsive internet use, and sensation seeking provided support for convergent validity, criterion validity, and discriminant validity, respectively. The enhanced imagery script did not impact reported craving; however, more frequent users of pornography reported higher craving than less frequent users regardless of script condition. In Study 3, craving scores demonstrated good one-week test-retest reliability and predicted the number of times participants used pornography during the following week. This questionnaire could be applied in clinical settings to plan and evaluate therapy for problematic users of pornography and as a research tool to assess the prevalence and contextual triggers of craving among different types of pornography users.

Further evaluation of the construct, convergent and criterion validity of the Gambling Urge Scale with university-student gamblers.

BACKGROUND: Research has documented the prevalence of problem gambling among university students, and craving is one factor that may provoke and maintain episodes of gambling. OBJECTIVES: We designed this study to assess elements of construct, convergent and criterion validity of the Gambling Urge Scale (GUS) when administered to regularly gambling university students. METHODS: Students (n = 250) recruited from three universities during the spring semester, 2012, were randomly assigned to one of four conditions to test the impact of cue exposure to one of two types of stimuli (gambling versus non-gambling activity), and two types of presentation format (photographic versus imagery scripts), on current craving to gamble. RESULTS: Self-reported craving increased significantly following exposure to gambling cues, but not following exposure to engaging non-gambling cues, regardless of the format by which cues were presented. Among those exposed to gambling cues, GUS craving scores were significantly correlated with all three subscales of another measure of craving to gamble, gambling-related problems, passionate attachment to gambling, distorted gambling beliefs and gambling refusal self-efficacy. CONCLUSIONS: These findings provide further support for the construct, convergent and criterion validity of the GUS as a measure of subjective craving in university student gamblers.

Assessing the impact of cue exposure on craving to gamble in university students.

We recruited a sample of university student gamblers (n = 48) to complete a web-based battery of instruments in a study designed to assess the impact of imagery-based versus photographic cue exposure on acute craving to gamble using the multi-item Gambling Urge Scale (GUS; Raylu and Oei 2004). Although self-reported craving increased following both forms of cue exposure, the imagery script had a more pronounced impact than did examination of photographs of gambling-related stimuli. We also evaluated the association of the post-cue exposure GUS with other relevant measures, and found it correlated highly both with other questionnaires assessing craving to gamble and with other gambling-relevant characteristics (e.g., gambling-related problems, preoccupation with gambling, distorted gambling beliefs, gambling refusal self-efficacy, sensation seeking), but was not associated with social desirability bias. These findings support the use of the GUS-a brief multi-item scale that shows several key elements of construct, convergent, criterion and discriminant validity-to study the experience of craving in university student gamblers.

Nonpharmacological harm-reduction interventions in British substance-misuse services.

The present study was designed to assess the acceptability and availability of harm-reduction interventions, including needle exchange, education regarding safer drug-ingestion methods, complementary/alternative therapies, and safe places where problem drinkers and drug takers may stay after consumption or may consume substances on the premises. We surveyed a nationwide sample of agencies listed in directories of substance-abuse services in England, Wales, and Scotland. Seventy percent (436 of 623 eligible agencies) returned questionnaires. Except for the provision of a safe place where clients could consume their own alcohol and drugs, large majorities of responding agencies rated these harm-reduction options as somewhat or completely acceptable, but only harm-reduction education and alternative therapies were available from a majority of responding agencies.

Acceptability and availability of harm-reduction interventions for drug abuse in American substance abuse treatment agencies.

This study assessed acceptability, availability, and reasons for nonavailability of interventions designed to prevent drug use related harm by substituting pharmaceuticals for illicit drugs; facilitating detoxification; and reducing the occurrence of HIV transmission, relapse, and opiate overdose. A survey was mailed to a sample of 500 randomly selected American substance abuse treatment agencies. Of 435 potentially eligible respondents, 222 (51%) returned usable data. A subset of interventions--including harm reduction education, cue exposure therapy, needle exchange, substitute opiate prescribing, various detoxification regimes, and complementary therapies--were rated as somewhat or completely acceptable by 50% or more of the respondents. Regardless of their acceptability, listed interventions were generally not available from responding agencies; respondents typically attributed unavailability to lack of resources and inconsistency of an intervention with agency philosophy.