Maternal Marijuana Exposure and Birth Weight: An Observational Study Surrounding Recreational Marijuana Legalization.

OBJECTIVE: This study aimed to study the relationship between prenatal marijuana and infant birth weight using natural cohorts established before, during and after the 20-month lapse between legalization and legal recreational sales in Washington State. STUDY DESIGN: Over 5 years, 5,343 pregnant women with documented urine drug screen (UDS) results delivered at Tacoma General Hospital or Good Samaritan Hospital. Maternal medical data were extracted for three delivery cohorts established based on before (T1), during (T2), and after legalization (T3) of recreational marijuana and legalized availability. Univariate and multivariate models were created to study marijuana exposure on infants' birth weight. RESULTS: Marijuana exposure increased the risk of low birth weight (LBW; odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.01-2.01). This was more pronounced in full-term babies (OR = 1.72, 95% CI: 1.10-2.69), and was independently associated with a higher risk for small for gestational age (SGA; OR = 1.51, 95% CI: 1.49-1.53). The associations between marijuana exposure and SGA were maintained in cohort-specific models (OR = 1.53, 95% CI: 1.01-2.32 for T2, and OR = 1.43, 95% CI: 1.01-2.02 for T3, respectively). CONCLUSION: Marijuana exposure verified by UDS was associated with LBW and SGA. However, recreational marijuana legalization and availability did not have direct impact on newborns' risk of LBW or SGA.

Prevalence of methamphetamine use among gay, bisexual and other men who have sex with men: A systematic review and meta-analysis.

BACKGROUND: International efforts have reduced the availability of methamphetamine precursors, but its distribution and use continue to rise. Methamphetamine use can lead to short- and long-term adverse effects, including addiction, physical and psychosocial health problems, socioeconomic troubles, incarceration, overdose, and death. Gay, bisexual, and other men who have sex with men (MSM) have been shown to have an elevated prevalence of methamphetamine use. METHODS: We conducted a systematic review and meta-analysis to estimate the prevalence of methamphetamine use among MSM. We searched electronic databases, such as PubMed, for peer-reviewed literature published between 2011 and 2022. Data on methamphetamine use were extracted, including study features, location, study design, sampling method, recruitment period, specific MSM subgroups, prevalence period, and demographics. Employing a random-effects model, we computed the pooled prevalence of methamphetamine use among MSM across two prevalence periods: recent use (i.e., one month, three months, six months, one year) and lifetime use. RESULTS: The systematic review included 56 studies with a total of 25,953 MSM who use methamphetamine. Most studies were conducted in Europe, with the highest prevalence reported in the United Kingdom. The studies primarily used cross-sectional or cohort study designs with convenience sampling. The pooled prevalence rates across recent use (i.e., past month, past three months, past six months, and past year) was 15% (95% CI [11-19%]). Additionally, we pooled lifetime use, which was 23% (95% CI [9-38%]). High heterogeneity (I2 > 99%) was observed, indicating significant variation. CONCLUSION: This systematic review and meta-analysis provide a pooled prevalence of methamphetamine use among MSM. The analysis accounts for study design, prevalence period, specific MSM subgroups, and geographical areas to estimate methamphetamine use in diverse settings and populations. The review highlights the need for targeted interventions and harm reduction strategies focused on prevention, education, healthcare access, and stakeholder collaboration to address the multifaceted challenges of methamphetamine use among MSM.

Recreational Cannabis Use Before and After Legalization in Women With Pelvic Pain.

OBJECTIVE: To evaluate the prevalence and characteristics of recreational cannabis use in women with pelvic pain, and to examine the influence of cannabis legalization on these parameters. METHODS: We conducted a retrospective analysis of a prospective registry of women with self-reported moderate-to-severe pelvic pain referred to a tertiary care clinic in Vancouver, Canada, 2013-2019. We excluded patients aged 18 years or younger and those with unknown data on cannabis use. Demographic, clinical, and validated questionnaire data were extracted for two main analyses: 1) comparison of current cannabis users with current nonusers, and 2) comparison of current cannabis users who entered the registry before cannabis legalization (October 17, 2018) with those who entered the registry on or after legalization. RESULTS: Overall, 14.9% (509/3,426) of patients were classified as current cannabis users. Compared with nonusers, cannabis users were younger (P<.001), had lower levels of education (P<.001) and lower household income (P<.001), were taking opioids (P<.001), antiinflammatories (P=.003), neuromodulators (P=.020), and herbal medications (P<.001) more frequently. They had worse questionnaire scores for depression, anxiety, pain catastrophizing, quality of life, and pelvic pain severity (P<.001 for all). After cannabis legalization, prevalence of current cannabis use increased from 13.3% (366/2,760) to 21.5% (143/666) (P<.001). Compared with prelegalization, postlegalization users were associated with higher levels of education (P<.001), worse anxiety (P=.036), and worse pain catastrophizing (P<.001) scores. They were taking fewer antiinflammatories (P<.001), neuroleptics (P=.027) and daily opioids or narcotics (P=.026), but more herbal medications (P=.010). CONCLUSION: Recreational cannabis use increased among patients with pelvic pain after legalization in Canada. Cannabis users had worse pain-related morbidities. Postlegalization, cannabis users were less likely to require daily opioids compared with cannabis users before legalization. The role, perceived benefits, and possible risks of cannabis for pelvic pain require further investigation. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02911090.

Causal inference multiple imputation investigation of the impact of cannabinoids and other substances on ethnic differentials in US testicular cancer incidence.

BACKGROUND: Ethnic differences in testicular cancer rates (TCRs) are recognized internationally. Cannabis is a known risk factor for testicular cancer (TC) in multiple studies with dose-response effects demonstrated, however the interaction between ancestral and environmental mutagenic effects has not been characterized. We examined the effects of this presumed gene-environment interaction across US states. METHODS: State based TCR was downloaded from the Surveillance Epidemiology and End Results (SEER) website via SEERStat. Drug use data for cigarettes, alcohol use disorder, analgesics, cannabis and cocaine was taken from the National Survey of Drug Use and Health a nationally representative study conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) with a 74.1% response rate. Cannabinoid concentrations derived from Drug Enforcement Agency publications. Median household income and ethnicity data (Caucasian-American, African-American, Hispanic-American, Asian-American, American-Indian-Alaska-Native-American, Native-Hawaiian-Pacific-Islander-American) was from the US Census Bureau. Data were processed in R using instrumental regression, causal inference and multiple imputation. RESULTS: 1975-2017 TCR rose 41% in African-Americans and 78.1% in Caucasian-Americans; 2003-2017 TCR rose 36.1% in Hispanic-Americans and 102.9% in Asian-Pacific-Islander-Americans. Ethnicity-based scatterplot-time and boxplots for cannabis use and TCR closely mirrored each other. At inverse probability-weighted interactive robust regression including drugs, income and ethnicity, ethnic THC exposure was the most significant factor and was independently significant (ß-estimate = 4.72 (2.04, 7.41), P = 0.0018). In a similar model THC, and cannabigerol were also significant (both ß-estimate = 13.87 (6.33, 21.41), P = 0.0017). In additive instrumental models the interaction of ethnic THC exposure with Asian-American, Hispanic-American, and Native-Hawaiian-Pacific-Islander-American ethnicities was significant (ß-estimate = - 0.63 (- 0.74, - 0.52), P = 3.6 × 10- 29, ß-estimate = - 0.25 (- 0.32, - 0.18), P = 4.2 × 10- 13, ß-estimate = - 0.19 (- 0.25, - 0.13), P = 3.4 × 10- 9). After multiple imputation, ethnic THC exposure became more significant (ß-estimate = 0.68 (0.62, 0.74), P = 1.80 × 10- 92). 25/33 e-Values > 1.25 ranging up to 1.07 × 105. Liberalization of cannabis laws was linked with higher TCR's in Caucasian-Americans (ß-estimate = 0.09 (0.06, 0.12), P = 6.5 × 10- 10) and African-Americans (ß-estimate = 0.22 (0.12, 0.32), P = 4.4 × 10- 5) and when dichotomized to illegal v. others (t = 6.195, P = 1.18 × 10- 9 and t = 4.50, P = 3.33 × 10- 5). CONCLUSION: Cannabis is shown to be a TC risk factor for all ethnicities including Caucasian-American and African-American ancestries, albeit at different rates. For both ancestries cannabis legalization elevated TCR. Dose-response and causal relationships are demonstrated.

Public health impacts to date of the legalisation of medical and recreational cannabis use in the USA.

The legality of cannabis use has been changing in a number of jurisdictions around the world. In the U.S., it has been legalised for medicinal and/or recreational uses in 34 jurisdictions and counting. This study leverages the decades-long experience of legalisation in the U.S. to provide an overview of the associated changes in public attitudes, cannabis markets and adverse health effects. We found a broad-based warming of public attitudes toward legalisation, potentially influenced by the increasingly positive portrayal of cannabis in media and declines in cannabis risk perceptions. Potency of cannabis products increased significantly while prices fell sharply. Although adults were less responsive to price changes than adolescents, adults who use cannabis regularly were sensitive to prices, with an estimated 10% price reduction leading to about 2.5% increase in the rate of use. Overall, past-year cannabis use has increased in adults since 2002, and adults over 26 years old who resided in states with medicinal cannabis laws were more likely to have used cannabis in the past 30 days, to have used daily, and to have higher rates of cannabis use disorders than adults who resided in states without legalised medicinal cannabis. Traffic fatalities involving cannabis temporarily increased in some states post-legalisation, and there were more presentations to medical services related to chronic regular cannabis use. There is suggestive evidence that adverse health consequences have increased among people who use cannabis regularly since legalisation. More robust research is needed to determine whether these effects of legalisation are temporary or long-term.

Acute and Severe Acute Pancreatitis and the Effect of Cannabis in States Before and After Legalization Compared With States Without Legalized Cannabis.

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.

[Qualitative study on risk and care practices in nightlife settings with massive presence of people in Buenos Aires City]. / Estudio cualitativo sobre prácticas de riesgo y de cuidado en escenarios nocturnos de presencia masiva de la Ciudad Autónoma de Buenos Aires.

The aim of the present study was to investigate care and risk practices carried out in nightlife settings with massive presence of people in the Autonomous City of Buenos Aires. In addition to this, the perceived reasons behind the consumption of psychoactive substances were investigated. For this purpose, 16 young people between 21 and 35 years of age were interviewed. The data was analyzed following the approach proposed in the grounded theory and using the Atlas.Ti program. Practices were studied at individual, group and environmental levels. Among the risk practices, substance availability, excessive intake and substance mixing were frequently mentioned. Regarding care practices, the value of the group was highlighted by keeping together and providing help to its members. Practical implications of these results are discussed, and limitations and future lines of research are presented.

El objetivo del presente estudio fue indagar las prácticas de cuidado y de riesgo que se despliegan en escenarios nocturnos de presencia masiva de la Ciudad Autónoma de Buenos Aires. Asimismo, se indagaron los motivos percibidos para el consumo de sustancias psicoactivas. Para ello se entrevistó a 16 jóvenes de entre 21 a 35 años de edad. Los datos fueron analizados siguiendo la propuesta de la teoría fundamentada y con el soporte del programa Atlas.Ti. Se analizaron prácticas individuales, prácticas grupales, y a nivel del entorno. Entre las prácticas de riesgo se mencionaron con frecuencia la disponibilidad de las sustancias, la ingesta excesiva y las mezclas. Respecto de las prácticas de cuidado, se destacó el valor del grupo al mantenerse todos juntos y brindar ayuda a sus miembros. Se discuten las implicancias prácticas de estos resultados, y se presentan las limitaciones y líneas futuras de investigación.

Estudio cualitativo sobre prácticas de riesgo y de cuidado en escenarios nocturnos de presencia masiva de la Ciudad Autónoma de Buenos Aires / Qualitative study on risk and care practices in nightlife settings with massive presence of people in Buenos Aires City

RESUMEN El objetivo del presente estudio fue indagar las prácticas de cuidado y de riesgo que se despliegan en escenarios nocturnos de presencia masiva de la Ciudad Autónoma de Buenos Aires. Asimismo, se indagaron los motivos percibidos para el consumo de sustancias psicoactivas. Para ello se entrevistó a 16 jóvenes de entre 21 a 35 años de edad. Los datos fueron analizados siguiendo la propuesta de la teoría fundamentada y con el soporte del programa Atlas.Ti. Se analizaron prácticas individuales, prácticas grupales, y a nivel del entorno. Entre las prácticas de riesgo se mencionaron con frecuencia la disponibilidad de las sustancias, la ingesta excesiva y las mezclas. Respecto de las prácticas de cuidado, se destacó el valor del grupo al mantenerse todos juntos y brindar ayuda a sus miembros. Se discuten las implicancias prácticas de estos resultados, y se presentan las limitaciones y líneas futuras de investigación.

ABSTRACT The aim of the present study was to investigate care and risk practices carried out in nightlife settings with massive presence of people in the Autonomous City of Buenos Aires. In addition to this, the perceived reasons behind the consumption of psychoactive substances were investigated. For this purpose, 16 young people between 21 and 35 years of age were interviewed. The data was analyzed following the approach proposed in the grounded theory and using the Atlas.Ti program. Practices were studied at individual, group and environmental levels. Among the risk practices, substance availability, excessive intake and substance mixing were frequently mentioned. Regarding care practices, the value of the group was highlighted by keeping together and providing help to its members. Practical implications of these results are discussed, and limitations and future lines of research are presented.