Association between affect and cannabis use varies by social context.

BACKGROUND: Cannabis use is rising globally, underscoring the importance of understanding contextual factors related to cannabis use. Although much work has retrospectively examined cannabis use patterns and effects, fewer studies have evaluated cannabis use in natural environments. METHODS: The present study used ecological momentary assessment (EMA) to examine the subjective experience of cannabis use (i.e., positive and negative affect) and how cannabis' mood effects are modified by the social context, defined as being alone or with others, in which use occurs. Associations between cannabis' mood effects and cannabis use disorder symptomatology were additionally examined. Participants (N = 200) completed baseline assessments and two 7-day waves of EMA data collection. Mixed-effects models examined between- and within-subject effects for positive and negative affect at cannabis use and nonuse times and interactions between cannabis use and social context. RESULTS: Positive affect was elevated at cannabis use times, compared to nonuse times, regardless of social context. The relationship between cannabis use and negative affect was moderated by social context, such that negative affect was elevated at cannabis use times when participants were alone and reduced at cannabis use times when participants were with others. Higher levels of cannabis use disorder symptomatology and cannabis use frequency were both associated with lower negative affect at cannabis use times. CONCLUSIONS: These results suggest that elevated positive affect is consistent across cannabis use times regardless of social context, but negative affect may vary more by the presence of others.

Effects of Cannabidiol in Adolescent and Young Adult Depressive and Anxiety Disorders: A Systematic Review of Clinical and Preclinical Research.

Background: Adolescents and young adults may use cannabidiol (CBD) products in an attempt to reduce depression and anxiety symptoms, despite little research examining this use. This systematic review evaluated preclinical and clinical research on the effects of CBD on depressive and anxiety disorders in adolescence and young adulthood. To provide context, we discuss CBD's mechanism of action and neurodevelopmental effects. Methods: PubMed was searched for articles published through June 2022. Preclinical or clinical CBD administration studies with N > 1 that examined depressive and/or anxiety disorders were eligible. Results: Initially, 224 publications were identified. After excluding duplicates and applying eligibility criteria, 6 preclinical (depression: n≈133; anxiety: n≈161) and 4 clinical (anxiety: n=113) articles remained. Due to the low number of studies, results were synthesized qualitatively. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence were used to rate each study's evidence. The preclinical effects of CBD on depression-like behavior appear to differ by sex, early life stress, and duration of use. Despite no evidence that CBD exerts anxiolytic effects in preclinical adolescent models, CBD may reduce anxiety symptoms in human adolescents and young adults with anxiety disorders. Conclusions: The existing evidence suggests that CBD may reduce symptoms of anxiety in adolescents and young adults. However, the evidence is sparse and limited by variations in samples and CBD dosing duration. Further research is needed to understand the potential benefits and/or harms of CBD for depression and anxiety disorders in this population. Implications for clinical practice and research are discussed.

Modafinil reduces smoked cocaine self-administration in humans: effects vary as a function of cocaine 'priming' and cost.

BACKGROUND: The absence of an FDA-approved medication for the treatment of cocaine use disorder (CUD) may, in part, reflect the varying conditions present when the decision to use cocaine is made, with one medication unlikely to work under all conditions. The objective of this double-blind, placebo-controlled, human laboratory study was to test the effects of modafinil, a medication with mixed efficacy for the treatment of CUD, using a novel self-administration procedure designed to model distinct clinical scenarios. METHODS: During modafinil maintenance (0, 300 mg/day), participants chose to self-administer up to 7 doses of smoked cocaine (25 mg) under 9 conditions: immediately after exposure to: (a) cues associated with cocaine and a non-contingent cocaine administration, i.e. 'prime' (25 mg), (b) only cocaine cues, and (c) neither cues nor cocaine. Each condition was tested when self-administered cocaine cost $5, $10 and $15/dose. RESULTS: Nontreatment-seeking cocaine smokers (3 F,13 M), spending $388 ± 218/week on cocaine and with no history of alcohol use disorder, completed the study. Relative to placebo, modafinil robustly attenuated self-administration when cocaine was expensive ($10,$15/dose) and when there was no 'prime.' Modafinil had no effect on self-administration when cocaine was inexpensive ($5/dose) or when participants received a 'prime.' CONCLUSIONS: Modafinil's effects on cocaine-taking varied substantially as a function of recent cocaine exposure and cost, which may help explain the mixed clinical findings. Modafinil may be most effective for preventing relapse in abstinent patients, particularly under conditions in which cocaine is costly, rather than initiating abstinence for those continuing to use cocaine.