The impact of cannabis use disorder on urologic oncologic surgery morbidity, length of stay, and inpatient cost: analysis of the National Inpatient Sample from 2003 to 2014.

PURPOSE: This study examined the impact of cannabis use disorder (CUD) on inpatient morbidity, length of stay (LOS), and inpatient cost (IC) of patients undergoing urologic oncologic surgery. METHODS: The National Inpatient Sample (NIS) from 2003 to 2014 was analyzed for patients undergoing prostatectomy, nephrectomy, or cystectomy (n = 1,612,743). CUD was identified using ICD-9 codes. Complex-survey procedures were used to compare patients with and without CUD. Inpatient major complications, high LOS (4th quartile), and high IC (4th quartile) were examined as endpoints. Univariable and multivariable analysis (MVA) were performed to compare groups. RESULTS: The incidence of CUD increased from 51 per 100,000 admissions in 2003 to 383 per 100,000 in 2014 (p < 0.001). Overall, 3,503 admissions had CUD. Patients with CUD were more frequently younger (50 vs. 61), male (86% vs. 78.4%), Black (21.7% vs. 9.2%), and had 1st quartile income (36.1% vs. 20.6%); all p < 0.001. CUD had no impact on any complication rates (all p > 0.05). However, CUD patients had higher LOS (3 vs. 2 days; p < 0.001) and IC ($15,609 vs. $12,415; p < 0.001). On MVA, CUD was not an independent predictor of major complications (p = 0.6). Conversely, CUD was associated with high LOS (odds ratio (OR) 1.31; 95% CI 1.08-1.59) and high IC (OR 1.33; 95% CI 1.12-1.59), both p < 0.01. CONCLUSION: The incidence of CUD at the time of urologic oncologic surgery is increasing. Future research should look into the cause of our observed phenomena and how to decrease LOS and IC in CUD patients.

The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective.

BACKGROUND: Gender-specific interventions are crucial in addressing substance use disorders -particularly cannabis use disorder - as they allow for tailored therapeutic approaches and increase the likelihood of successful outcomes. However, differences in therapeutic processes and outcomes between males and females are often not observed, making the prognosis and development of such interventions more difficult. OBJECTIVE: This study aimed to examine the moderating role of sex in the relationship between treatment admission profile characterized by indicators of cannabis use and sociodemographic sources of gender inequality (e.g., employment status) and adherence and outcome at discharge. METHOD: A multicentric retrospective observational study was conducted with a sample of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records were used for data analysis. RESULTS: The interaction between sex and the number of children, as well as pre-treatment cannabis use, predicted lower treatment adherence, particularly among females. Additionally, the interaction between sex and the number of children predicted outcomes at discharge, with females showing a higher likelihood of dropout compared to males. DISCUSSION AND CONCLUSION: Enhanced comprehensive treatment with intensified contingency management programs should be prioritized for females (especially those with children) who have consumed cannabis in the month before treatment. Adopting a treatment policy framework incorporating sex/gender-sensitive therapist training and evaluative measures is essential for optimizing treatment outcomes for all patients.

State Cannabis Legalization and Trends in Cannabis-Related Disorders in US Older Adults, 2017 to 2022.

This cross-sectional study examines trends in health care encounters with cannabis-related disorders among Medicare beneficiaries from 2017 to 2022.

Cocaine/crack and cannabis use among transgender women in Goiás, Central Brazil.

INTRODUCTION: Illicit drug use is a significant public health problem. Studies have shown a high prevalence of cocaine and cannabis use in transgender women (TGW). OBJECTIVE: To describe the consumption patterns of cannabis and cocaine/crack use and variables associated with their use in TGW in Central Brazil. METHODS: A cross-sectional study was conducted on TGW in Goiás, Brazil. Participants were recruited using a respondent-driven sampling method and were interviewed face-to-face about cannabis and crack-cocaine and the variables associated with them. The Alcohol Smoking and Substance Involvement Screening Test was used to assess substance use. Unweighted logistic regression was used to identify variables associated with cannabis and crack cocaine use. P-values < 0.05 were considered statistically significant. RESULTS: A total of 440 transgender women participated in the study. Their median age was 25 years (interquartile range: 20.5-29.5 years). Most participants were single (85.5%) and had engaged in sex work in their lifetime (58.6%). Cannabis was reported by 68.9% and 53.4% of participants in their lifetime and in the past three months, respectively, and cocaine/crack use was reported by 59.8% and 44.1% of participants in their lifetime and the past three months, respectively. Of the participants, 10.2% reported high-risk cannabis use, and 9.1% reported high-risk cocaine/crack use. Furthermore, 35% of participants reported using both drugs. Previous physical violence (Adjusted Odds Ratio (AOR): 2.37), inconsistent condom uses during anal sex (AOR: 2.17), and moderate-/high-risk cocaine/crack use (AOR: 3.14) were associated with high-risk cannabis use. Previous sexual violence (AOR: 2.84), previous STI (AOR: 2.90), moderate-/high-risk cannabis (AOR: 3.82), and binge drinking (AOR; 3.28) were associated with high-risk cocaine/crack use. CONCLUSION: Our study found a high frequency, significant overlap in the use of cannabis and cocaine/crack use and violence associated with these drugs consumption among TGW, highlighting the urgent need for health policies for drug disorders among this socially marginalized group.

Cannabis use, mental health, and problematic Internet use in Quebec: A study protocol.

BACKGROUND: Problematic Internet use is characterized by excessive use of online platforms that can result in social isolation, family problems, psychological distress, and even suicide. Problematic Internet use has been associated with cannabis use disorder, however knowledge on the adult population remains limited. In Quebec, cannabis use has significatively increased since 2018, and it is associated with various risks in public safety, public health, and mental health. This study aims to identify factors associated with problematic Internet use among adult cannabis users and to better understand their experiences. METHOD: This project is a mixed explanatory sequential study consisting of two phases. Phase 1 (n = 1500) will be a cross-sectional correlational study using probability sampling to examine variables that predispose individuals to problematic Internet use, characteristics associated with cannabis use, Internet use, and the mental health profile of adult cannabis users in Quebec. Descriptive analyses and regression models will be used to determine the relationship between cannabis use and Internet use. Phase 2 (n = 45) will be a descriptive qualitative study in the form of semi-structured interviews aimed at better understanding the experience and background of cannabis users with probable problematic Internet use. DISCUSSION: The results of this study will support the development of public policies and interventions for the targeted population, by formulating courses of action that contribute to the prevention and reduction of harms associated with cannabis use and problematic Internet use. Furthermore, an integrated knowledge mobilization plan will aid in the large-scale dissemination of information that can result useful to decision-makers, practitioners, members of the scientific community, and the general population regarding the use of cannabis and the Internet.

Association between cannabis use disorder and greater apathy in adults with HIV.

BACKGROUND: Apathy is prevalent among people with HIV (PWH) and is associated with poor clinical outcomes. Cannabis use and Cannabis Use Disorder (CUD) are also disproportionately prevalent among PWH. CUD and younger onset of cannabis use may be linked to apathy in the general population; however, patterns of use most strongly associated with apathy have not been firmly established, and it is unclear whether cannabis use is linked to apathy in PWH. METHODS: We examined associations in 311 adult PWH between Apathy Evaluation Scale-Self (AES-S) scores and CUD history (current/past/no CUD/no cannabis use) and between AES-S scores and age of CUD onset (adolescent-onset/adult-onset). We also examined robustness of associations to adjustment for depressive symptoms (which may overlap with apathy symptoms) and alcohol use. RESULTS: Current CUD was associated with greater AES-S scores relative to cannabis users with no CUD history (ß = 2.13, 95 % CI = 0.37-3.90, p = 0.018). Adolescent-onset CUD was not associated with greater apathy relative to adult-onset CUD (ß = 0.56, 95 % CI = -2.57 - 3.68, p = 0.7). Associations became nonsignificant after adjustment for depressive symptoms, but not after adjustment for alcohol use. Alcohol use was correlated with apathy (r = 0.19, 95 % CI: 0.076-0.29, p = 0.001). CONCLUSIONS: Cannabis Use Disorder and at-risk alcohol use are associated with apathy among PWH; this finding highlights the need for substance use disorder prevention and treatment among PWH.

Profiles of cannabis users and impact on cannabis cessation.

Although cannabis was legalized in Canada in 2018 and is one of the most used substances in Canada, few studies have examined how individuals with different patterns of cannabis use differ in their attempts to decrease or abstain from cannabis. The current study examined how groups of cannabis users, which were formed on the basis of demographic characteristics, substance use patterns, mental health symptoms, and self-reported quality of life differed on their experiences with cannabis cessation. A sample of 147 Canadian adult participants who had attempted to decrease or quit cannabis were recruited from the community (n = 84, 57.14%) and crowdsourcing (n = 63, 42.86%). Four profiles of cannabis users emerged using a Latent Profile Analysis: low-risk (n = 62, 42.18%), rapidly escalating high-risk (n = 40, 27.21%), long-term high severity (n = 35, 23.81%), and long-term lower severity (n = 10, 6.80%). Individuals in the rapidly escalating profile had attempted to decrease their cannabis use more times compared to other profiles. More participants in the long-term high severity group found their use stayed the same or got worse after their last cessation attempt, compared to the low-risk group where more individuals indicated their use stopped. The results of the current study indicate that cannabis users differ in their attempts at reducing or ceasing cannabis use and that they may benefit from different intensity of cannabis interventions.

Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in-Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis.

BACKGROUND: With the increase in popularity of cannabis and its use and the lack of large-scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used a nationally representative cohort of young adults (aged 18-44 years) to compare the odds of admissions and in-hospital mortality of PE with and without cannabis use disorder (CUD). METHODS AND RESULTS: Identified patients with PE using the National Inpatient Sample (2018) were compared for baseline, comorbidities, and outcomes. Multivariable regression analysis, adjusted for covariates, was used to compare the odds of PE in young patients with CUD (CUD+) versus those without (CUD-) and those with prior venous thromboembolism. Propensity score-matched analysis (1:6) was also performed to assess in-hospital outcomes. A total of 61 965 (0.7%) of 8 438 858 young adult admissions in 2018 were PE related, of which 1705 (0.6%) had CUD+. On both unadjusted (odds ratio, 0.80 [95% CI, 0.71-0.90]; P<0.001) and adjusted regression analyses, the CUD+ cohort had a lower risk of PE admission. The CUD+ cohort had fewer routine discharges (58.3% versus 68.3%) and higher transfers to short-term (7.9% versus 4.8%) and nursing/intermediate care (12.6% versus 9.5%) (P<0.001). The PE-CUD+ cohort of in-hospital mortality did not differ from the CUD- cohort. Propensity score-matched (1:6) analysis revealed comparable mortality odds with higher median hospital stay and cost in the CUD+ cohort. CONCLUSIONS: Young adults with CUD demonstrated lower odds of PE hospitalizations without any association with subsequent in-hospital mortality. The median hospital stay of the CUD+ cohort was longer, they were often transferred to other facilities, and they had a higher cost.

Cannabis use and its association with psychopathological symptoms in a Swiss adult population: a cross-sectional analysis.

Background: As the most commonly used illicit substance, cannabis is gaining global acceptance through increasing legalization efforts. This shift intensifies the need for research to guide policymakers and healthcare providers in harm reduction and treatment strategies. Nonetheless, the relationship between psychopathological symptoms and cannabis use remains inadequately understood. Methods: A sample of regular cannabis consumers completed self-reported assessments for depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), Attention-Deficit/Hyperactivity Disorder (ADHD; Adult ADHD Self-Report Scale V1.1), and psychosis (Early Recognition Inventory based on IRAOS) as well as previous black-market cannabis use patterns. Cannabis Use Disorder Identification Test Revised (CUDIT-R) was used to identify cannabis use disorder (CUD). To understand psychopathological symptom load related to cannabis consumption as well as cannabis use motives, multiple regression models were performed to identify psychopathological variables predicting cannabis use frequency and quantity. Linear regression and correlation analyses were conducted, adjusting for relevant covariates (age, gender, education, alcohol, other substance use). Results: Three-hundred-sixty regular cannabis users interested in a study on regulated cannabis access in Basel, Switzerland were examined. In bivariate analysis, cannabis use frequency correlated with depressive (r(358) = 0.16, p = 0.003) and anxiety symptom load (r(358) = 0.11, p = 0.034). Cannabis quantity correlated with depressive (r(358) = 0.15, p = 0.005), ADHD (r(358) = 0.14, p = 0.008), and psychosis symptom load (r(358) = 0.16, p = 0.002). However, in the adjusted regression models only depressive and ADHD symptom loads were significantly associated with cannabis use frequency (p = 0.006 and p = 0.034, respectively) and quantity (p = 0.037 and p = 0.019, respectively). No significant correlations between cannabis consumption and anxiety or psychosis remained after adjustment. Conclusion: ADHD and depressive symptoms correlate with increased cannabis use in a cohort of regular users, suggesting potential self-medication in nonclinical populations. With the rising availability of cannabis worldwide, these results highlight the necessity for longitudinal studies to disentangle the complex dynamics between cannabis consumption and mental health symptoms.

Evaluation of the immune system status and hematological dyscrasias, among amphetamine and cannabis abusers at Eradah Hospital in Qassim, Saudi Arabia.

This cross-sectional study aims to evaluate the immune system status and hematological disturbances among individuals who abuse amphetamines and cannabis. Substance abuse, particularly of amphetamines and cannabis, has been associated with various adverse effects on the body, including potential impacts on the immune system and hematological parameters. However, limited research has been conducted to comprehensively assess these effects in a cross-sectional design. Additionally, fungal infections are on the rise internationally, and immune-compromised people are particularly susceptible. The study will recruit a sample of amphetamine and cannabis abusers (n = 50) at the Eradah Hospital in the Qassim Region of Buraydah and assess their sociodemographic and biochemical variables, including blood indices and differential WBC indices, liver, and kidney profiles. Additionally, 50 sputum samples in total were cultured for testing for fungus infections. To obtain the descriptive statistics, the data was imported into Microsoft Excel and subjected to statistical analysis using SPSS 22.0. Amphetamine and cannabis abuser's sociodemographic variables analysis observed that the majority (52%) were aged 18-30, with 56% in secondary school. Unemployment was a significant issue, and most had no other health issues. The majority (50%) had 5-10 years of abuse, while 32% had less than 5 years, and only 18% had been drug abusers for more than 10 years. There were significant changes (p < 0.001) in all different leukocyte blood cells, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Furthermore, a microscopic examination of blood films from individuals who misuse the combination of the medications "amphetamine and cannabis" reveals hazardous alterations in Neutrophils. Out of 50, 35 sputum samples showed positive growth on Sabouraud dextrose agar (SDA) with chloramphenicol antibiotic, indicating a unicellular fungal growth. The present study explores the immune system and hematological disturbances linked to amphetamine and cannabis abuse, providing insights into health risks and targeted interventions. The findings complement previous research on drug users' hematological abnormalities, particularly in white blood cells. Routine hematological tests help identify alterations in homeostatic conditions, improving patient knowledge and preventing major issues. Further research is needed on multi-drug abuse prevention, early detection, and intervention. The cross-sectional design allows for a snapshot of the immune system and hematological status among abusers, laying the groundwork for future longitudinal studies. Key Words: Drug Effect, Immunity, Epidemiology, Oxidative Stress, Inflammation.

Exposure to maternal cannabis use disorder and risk of autism spectrum disorder in offspring: A data linkage cohort study.

This study aimed to investigate the association between pre-pregnancy, prenatal and perinatal exposures to cannabis use disorder (CUD) and the risk of autism spectrum disoder (ASD) in offspring. Data were drawn from the New South Wales (NSW) Perinatal Data Collection (PDC), population-based, linked administrative health data encompassing all-live birth cohort from January 2003 to December 2005. This study involved 222 534 mother-offspring pairs. . The exposure variable (CUD) and the outcome of interest (ASD) were identified using the 10th international disease classification criteria, Australian Modified (ICD-10-AM). We found a three-fold increased risk of ASD in the offspring of mothers with maternal CUD compared to non-exposed offspring. In our sensitivity analyses, male offspring have a higher risk of ASD associated with maternal CUD than their female counterparts. In conclusion, exposure to maternal CUD is linked to a higher risk of ASD in offspring, with a stronger risk in male offspring. Further research is needed to understand these gender-specific effects and the relationship between maternal CUD and ASD risk in children.

Trends in Adolescent Comorbid Cannabis Use Disorder and Postoperative Complications.

BACKGROUND: Increasing legalization and widespread misinformation about the dangers of cannabis use have contributed to the rising prevalence of cannabis use disorder (CUD) among adolescents. Our objective was to determine the prevalence of CUD in adolescent surgical patients and evaluate its association with postoperative complications. METHODS: We performed a retrospective, 1:1 propensity-matched cohort study of adolescents (aged 10-17 years) with and without CUD who underwent inpatient operations at US hospitals participating in the Pediatric Health Information System from 2009 to 2022. The primary outcome was the trend in prevalence of CUD. Secondary outcomes included postoperative complications. Using a Bonferroni correction, we considered a P value < .008 to be significant. RESULTS: Of 558 721 adolescents undergoing inpatient surgery from 2009 to 2022, 2604 (0.5%) were diagnosed with CUD (2483 were propensity matched). The prevalence of CUD increased from 0.4% in 2009 to 0.6% in 2022 (P < .001). The adjusted odds of respiratory complications, ICU admission, mechanical ventilation, and extended hospital stay were significantly higher in adolescents with CUD (respiratory complications: odds ratio [OR], 1.52; 95% confidence interval [CI], 1.16-2.00; P = .002; ICU admission: OR, 1.78; 95% CI, 1.61-1.98; P < .001; mechanical ventilation: OR, 2.41; 95% CI, 2.10-2.77; P < .001; extended hospital stay: OR, 1.96; 95% CI, 1.74-2.20; P < .001). The propensity score-adjusted odds of postoperative mortality or stroke for adolescents with CUD were not significantly increased (mortality: OR, 1.40; 95% CI, 0.87-2.25; P = .168; stroke: OR, 2.46; 95% CI, 1.13-5.36; P = .024). CONCLUSIONS: CUD is increasing among adolescents scheduled for surgery. Given its association with postoperative complications, it is crucial to screen adolescents for cannabis use to allow timely counseling and perioperative risk mitigation.

Cumulative lifetime violence, social determinants of health, and cannabis use disorder post-cannabis legalization in a community sample of men: An intersectional perspective.

Despite Canada having the highest disease burden globally for cannabis use disorder (CUD) and violence being ubiquitous in men's lives, little is known about how intersections among social determinants of health (SDOH) and cumulative lifetime violence severity (CLVS) influence CUD in men post-cannabis legalization. Using data collected in a survey with a national community sample of 597 men who self-identified as having experienced violence, we conducted a latent profile analysis using 11 subscales of the CLVS-44 scale and explored differential associations between CLVS profiles and CUD considering SDOH covariates. Four profiles were distinguished by intersections among CLVS-44 subscale severity and roles as target and perpetrator. CLVS profiles were significantly associated with CUD in the unadjusted model and in the adjusted model where age, adverse housing, and education were significant covariate controls. In the adjusted model, CUD was differentially associated with CLVS profiles and significantly higher in Profile 4 (highest severity target and perpetrator) than in Profile 1 (lowest severity target, no perpetration). Chi-square tests showed significant intersection between adverse housing, younger age, Profile 4 CLVS, and moderate to severe CUD among cannabis users. These results reveal the importance of understanding simultaneous intersections among indicators of CLVS in determining profiles of lifetime violence. Also critical are intersections among CLVS profiles and significant covariates as a basis for trauma- and violence-informed care for CUD that prioritizes men most disadvantaged by this convergence and attends to individual and structural health disparities at practice and policy levels.

Density of cannabis outlets vs. cannabis use behaviors and prevalent cannabis use disorder: findings from a nationally-representative survey.

Background: Thailand recently decriminalized (de facto legalized) cannabis use and sales. However, nationally representative data are scarce with regard to cannabis use behaviors and its association with cannabis outlet density. The objectives of this study are: (1) to describe the prevalence of cannabis use behaviors and cannabis use disorder among the general adult population of Thailand; (2) to describe the extent that the density of cannabis outlets is associated with cannabis use behaviors, cannabis use disorder, and the amount of cannabis smoked per day. Methods: We conducted a community-based cross-sectional study in 11 provinces and the Bangkok Metropolitan Area. Participants were residents of sampled communities aged 20 years or older. We requested literate participants to self-administer the questionnaire and interviewed participants who could not read. We analyzed data using descriptive statistics with sampling weight adjustments and multivariate logistic regression analyses. Results: The prevalence of current cannabis use was 15 percent. At a 400-m radius, participants who reported three cannabis outlets had 4.2 times higher odds of being current users than participants who reported no outlet (Adjusted OR = 4.82; 95% CI [3.04-7.63]). We found no association between outlet density and hazardous cannabis use or cannabis use disorder, nor association with the amount of cannabis use among cannabis smokers. Discussion and Conclusion: The patterns of association between outlet density and cannabis use behaviors were inconsistent. Furthermore, limitations regarding outlet density measurement and lack of temporality should be considered as caveats in the interpretation of the study findings.

Cannabis use and mood disorders: a systematic review.

Background: Problematic cannabis use is highly prevalent among people with mood disorders. This underscores the need to understand the effects of cannabis and cannabinoids in this population, especially considering legalization of recreational cannabis use. Objectives: We aimed to (1) systematically evaluate cross-sectional and longitudinal studies investigating the interplay between cannabis use, cannabis use disorder (CUD), and the occurrence of mood disorders and symptoms, with a focus on major depressive disorder (MDD) and bipolar disorder (BD) and; (2) examine the effects of cannabis on the prognosis and treatment outcomes of MDD and BD. Methods: Following PRISMA guidelines, we conducted an extensive search for English-language studies investigating the potential impact of cannabis on the development and prognosis of mood disorders published from inception through November 2023, using EMBASE, PsycINFO, PubMed, and MEDLINE databases. Results: Our literature search identified 3,262 studies, with 78 meeting inclusion criteria. We found that cannabis use is associated with increased depressive and manic symptoms in the general population in addition to an elevated likelihood of developing MDD and BD. Furthermore, we observed that cannabis use is linked to an unfavorable prognosis in both MDD or BD. Discussion: Our findings suggest that cannabis use may negatively influence the development, course, and prognosis of MDD and BD. Future well-designed studies, considering type, amount, and frequency of cannabis use while addressing confounding factors, are imperative for a comprehensive understanding of this relationship. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023481634.

Cannabis Use Characteristics Associated with Self-Reported Cognitive Function in a Nationally Representative U.S. sample.

BACKGROUND: With increases in cannabis use and potency, there is a need to improve our understanding of the impact of use on cognitive function. Previous research indicates long-term cannabis use may have a negative effect on executive function. Few studies have examined persistence of it in protracted abstinence, and there is limited evidence of predictors of worse cognitive function in current and former users. In this study, we aim to evaluate the associations between cannabis use status (current, former, and never use) and self-report cognition. Further, we investigate if cannabis use characteristics predict self-report cognitive function. METHODS: Cross-sectional cannabis use data from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III), a national survey (N = 36,309) conducted in the USA between 2012 and 2013 were used alongside the Executive Function Index scales. The data were analyzed by using Ordinary Least Squares regression. RESULTS: Current (N = 3,681, Female = 37.7%) and former users (N = 7,448, Female = 45.4%) reported poorer cognition than never users (N = 24,956, Female = 56.6%). Self-reported cognition of former users was in-between that of current and never users. Several cannabis use characteristics were associated with self-reported cognition in current and former users. CONCLUSION: While prospective studies are required to confirm, findings suggest cannabis use is linked to worse cognition. There may be some limited recovery of cognition in former users and some cannabis use characteristics predict impairment. These findings add to our understanding of the cognitive impact of cannabis use. As worse cognitive function may impact relapse, findings have implications for personalization of cannabis use disorder treatment.

Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States.

BACKGROUND: Most violent crimes (52 %) are committed by adults aged 18-34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use disorder (CUD). We examined whether and how associations of cannabis use, use frequency, and CUD with violent behavior (i.e., attacking someone with the intent to harm seriously) vary by sex in U.S. young adults. METHODS: Data were from 113,454 participants aged 18-34 in the 2015-2019 US National Surveys on Drug Use and Health, providing nationally representative data on cannabis use, CUD (using DSM-IV criteria), and violent behavior. Descriptive analyses and bivariate and multivariable logistic regression analyses were conducted. RESULTS: Among U.S. adults aged 18-34, 28.9 % (95 % CI = 28.5-29.2 %) reported past-year cannabis use (with/without CUD), including 20.5 % (95 % CI = 20.2-20.8 %) with non-daily cannabis without CUD, 4.7 % (95 % CI = 4.5-4.8 %) with daily cannabis use without CUD, 2.1 % (95 % CI = 1.9-2.2 %) with non-daily cannabis use and CUD, and 1.7 % (95 % CI = 1.5-1.8 %) with daily cannabis use and CUD. Past-year adjusted prevalence of violent behavior was higher among males with daily cannabis use but without CUD (2.9 %, 95 % CI = 2.4-2.7 %; adjusted prevalence ratio (PR) = 1.7, 95 % CI = 1.3-2.2) and males with daily cannabis use and CUD (3.1 %, 95 % CI = 2.3-4.0 %; adjusted PR = 1.8, 95 % CI = 1.3-2.4) than males without past-year cannabis use (1.7 %, 95 % CI = 1.6-1.9 %). Adjusted prevalence of violent behavior was higher among females with cannabis use regardless of daily cannabis use/CUD status (adjusted prevalence = 1.6-2.4 %, 95 % CIs = 0.9-3.2 %; adjusted PRs = 1.6-2.4, 95 % CI = 1.3-3.2) than females without past-year cannabis use (1.0 %, 95 % CI = 0.9-1.1 %). CONCLUSIONS: Research is needed to ascertain the directionality of the associations between cannabis use and violent behavior and underlying sex-specific mechanism(s). Our results point to complex sex-specific relationships between cannabis use frequency, CUD, and violent behavior and highlight the importance of early screening for and treatment of CUD and of preventive interventions addressing cannabis misuse.

Cannabis use and dependence among festival attendees: results from the French OCTOPUS survey.

BACKGROUND: Chronic use of cannabis is associated with an increased risk of psychosocial, mental and physical health impairments. Sociohealth institutions reach a very limited proportion of cannabis users in need of treatment. Using data collected from festival attendees, this study aimed to estimate the prevalence of dependent cannabis users and to characterize cannabis dependence. METHODS: We used data from the cross-sectional OCTOPUS survey carried out at 13 music events in the French department of Loire-Atlantique between July 2017 and July 2018. 383 participants aged 18 or older underwent a face-to-face interview about their basic sociodemographics, tobacco use, alcohol use and past-year substance use. Using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, we estimated the prevalence of dependent cannabis users and characterized their dependence. RESULTS: More than two-thirds of participants reported that they had used cannabis in the past 12 months. Among 194 regular cannabis users (at least monthly), 63.4% were dependent. At least 40% of regular users reported health and/or social consequences of cannabis use. Compared to nondependent cannabis users, dependent cannabis users were more likely to be stimulant users and hallucinogen users. CONCLUSIONS: Dependent cannabis use is common among festival attendees, especially among stimulant or hallucinogen users. Festival settings may be important arenas for i) implementing efficient harm reduction measures to prevent dependence and ii) providing information on care structures and promoting the use of care to dependent users. In addition, healthcare professionals should be aware of trends in polysubstance use among dependent cannabis users.