Adolescent Δ8-THC and Marijuana Use in the US.

Importance: Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking. Objective: To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months. Design, Setting, and Participants: This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023. Exposures: Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated). Main Outcomes and Measures: The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used). Results: In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], -9.4% [95% CI, -15.2% to -3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, -8.6% [95% CI, -12.9% to -4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, -6.0% [95% CI, -10.8% to -1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, -7.2% [95% CI, -12.2% to -2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, -8.5% [95% CI, -14.9% to -2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education. Conclusions and Relevance: Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted.

Individual differences in legal and illicit cannabis purchasing behaviour in British Columbia, Canada: Findings from a 2021 cross-sectional survey.

BACKGROUND: Despite thousands of licensed cannabis retail stores operating across Canada, there remains a significant illicit cannabis market. Some cannabis users continue to buy cannabis from dealers, illicit stores, and/or illicit online retailers. METHODS: Data are from the 2021 British Columbia Cannabis Use Survey. Respondents (n = 8473) were 19 years or older, lived in British Columbia at the time of the survey, and reported using cannabis in the past 12 months. RESULTS: Buying cannabis from all types of illicit sources was more common among younger cannabis users, those who use cannabis more frequently and started using cannabis before the age of 17 (vs. 19 or older), and among those who co-use cannabis with other drugs. Specifically, buying cannabis from a dealer was more common among men, those with lower educational attainment, and those who seek the lowest prices when buying cannabis. In contrast, those using cannabis for medical (vs. non-medical) purposes were more likely to report getting cannabis from illicit retail stores, while buying cannabis from illicit websites was more common among people who use edible cannabis products. CONCLUSION: Consistent with other studies, younger and more frequent cannabis users were more likely to report buying cannabis from illicit sources. However, these findings suggest there is significant heterogeneity among those who buy cannabis from different types of illicit sources, which should be carefully considered when developing policies and strategies aimed at encouraging consumers to transition to legal sources.

Social Norms for Cannabis Use After Nonmedical Legalization in Canada.

INTRODUCTION: Social norms play an important role in cannabis use; however, there is little evidence on how social norms change in jurisdictions that legalize cannabis. This study examined trends in social norms before and after legalization of nonmedical cannabis in Canada in 2018. METHODS: Data are from the International Cannabis Policy Study, a series of cross-sectional surveys conducted annually with Canadian respondents aged 16-65 years. Analyses were conducted in 2023 and included data from 58,045 respondents across 4 waves: the year immediately before legalization (2018) and 3 post-legalization waves (2019-2021). Regression models examined trends in injunctive norms (perceived approval of cannabis) and comfort in using cannabis in six different social contexts, adjusting for cannabis use frequency, medical authorization, and sociodemographic covariates. RESULTS: Perceived social approval of cannabis use and comfort using cannabis in different social contexts was highest among males, frequent cannabis consumers, and those who reported medical authorization (p<0.05 in all cases). No changes in perceived approval were observed across years, except a temporary decrease in 2020 versus 2018 (OR=0.87, 95% CI=0.80, 0.95). Modest increases in comfort of using cannabis in 6 different social contexts were observed in 2019 (ß=0.10, p=0.001), 2020 (ß=0.10, p=0.001), and 2021 (ß=0.12, p<0.001) versus in 2018. CONCLUSIONS: Social norms have remained relatively stable after nonmedical legalization in Canada, with only modest increases in comfort of using cannabis in different social settings. The findings may reflect widespread cannabis use in Canada prior to nonmedical legalization in 2018 as well as comprehensive restrictions on promotion and advertising.

Legalización del consumo de cannabis recreativo en adultos y problemas de salud mentales / Legalization of recreational cannabis use in adults and mental health problems

Los problemas de salud mental hacen parte de las enfermedades no trasmisibles y se les atribuye, con otras enfermedades asociados al bienestar, hasta un 21 % de las muertes mundiales. Por ello, es necesario analizar y establecer la relación riesgo/beneficio de políticas relacionadas con la salud mental, caso de la legalización del consumo de cannabis recreativo en adultos. El cannabis es la droga “ilícita” de mayor consumo en los países occidentales, en esencia por incrementar la sociabilidad y la euforia. En la última década, varios países han promulgado normas orientadas a legalizar la comercialización de cannabis recreativo en adultos. En este sentido, existe controversia del efecto de este tipo de iniciativas, en el porcentaje de personas que consumen esta sustancia y en la salud de los mismos. Sin embargo, se podría esperar que este tipo de iniciativas favorezca un aumento en el porcentaje de personas que consumen esta sustancia. El aumento del consumo de marihuana puede favorecer una mayor prevalencia de problemas de salud mental, incluyendo psicosis y esquizofrenia. Se acepta la existencia de una asociación entre consumo de cannabis y psicosis (incluyendo esquizofrenia). En este marco, reconociendo los beneficios de las políticas de legalización del consumo de cannabis recreativo en adultos, orientadas a superar el enfoque prohibicionista y a buscar la reducción del daño, es conveniente evaluar y definir el efecto de las mismas. Además, estas iniciativas se deben acompañar de programas informativos y educativos, orientados a sintetizar los riesgos del consumo, incluyendo, la dependencia y problemas de salud mentales. (AU)

Mental health problems are included in the non-communicable diseases and together to other problems associated with well-being, they are attributed up to 21 % of global deaths. Therefore, it is necessary to analyze and establish the risk/benefit ratio of policy related to mental health, for example, in the case of the legalization of recreational cannabis use in adults. Cannabis is the most widely used “illicit” drug in Western countries, essentially because it increases sociability and euphoria. In the last decade, several countries have endorsed policies aimed at legalizing the commercialization of recreational cannabis in adults. In this sense, there is controversy about the effect of this type of policy on the percentage of people who consume this substance and on their health. However, it could be expected that this type of initiative will improve the percentage of people who consume this substance. Increased marijuana use may lead to a higher prevalence of mental health problems, including psychosis and schizophrenia. The existence of an association between cannabis use and psychosis (including schizophrenia) is accepted. In this framework, recognizing the benefits of policies to legalize the use of recreational cannabis in adults, advancing from a drug prohibition approach to one focused on harm reduction, it is convenient to evaluate and define the effect of this type of policies. Also, this kind of policies should be linked to informative and educational programs to clarify the risks of consumption, including, dependence and mental health problems. (AU)

Factors Associated with Initiating Cannabis Use After Legalization in Canada: A Cross-Sectional Study.

Background: Cannabis use has increased since the Government of Canada legalized nonmedical use in October 2018. We investigated demographic factors associated with initiating cannabis use after legalization. Materials and Methods: We used data from the 2018 and 2019 National Cannabis Survey and constructed multivariable regression models. Respondents' data were weighted and bootstrapped. We report relative measures of association as adjusted odds ratios (ORs) and absolute measures of association as adjusted risk increases (RIs). Results: Among the 58,195 households surveyed, 28,566 provided complete data (49%) and our weighted analysis represented 27,904,258 Canadians aged ≥ 15 years. Approximately one in five Canadians endorsed use of cannabis (19.8%), predominantly for nonmedical (9.5%) or combined medical and nonmedical (5.8%) reasons. Those who initiated cannabis use in the past 3 months (1.9%) were more likely to be younger (25-34 years vs. ≥ 65 years; adjusted OR 1.7, 95% confidence interval [CI] 1.1-2.8; adjusted RI 1.1%, 95% CI 0.1-2.0%), endorse poor to fair versus good to excellent physical health (adjusted OR 2.0, 95% CI 1.3-3.1; adjusted RI 1.7%, 95% CI 0.3-3.1%), and reside outside of Quebec (adjusted OR 1.4, 95% CI 1.1-2.0; adjusted RI 0.1%, 95% CI 0.6-1.1%). The 1% of Canadians who endorsed initiating use of cannabis due to legalization were more likely to reside outside of Quebec (adjusted OR 1.9, 95% CI 1.1-3.2; adjusted RI 0.5%, 95% CI 0.2-0.9%). Conclusion: Canadians initiating cannabis use after nonmedical legalization were likely to be younger and endorse worse physical health, and half of those using cannabis reported therapeutic use. Stricter policies, lower social acceptance, and less availability of cannabis in Quebec appear to have curtailed initiation of use after legalization.

Impacto de la legalización del consumo recreativo del cannabis / Impact of the legalisation of recreational cannabis use

En los últimos años se han producido importantes cambios legislativos en numerosos países respecto al consumo de cannabis con fines medicinales y/o recreativos, que han facilitado su accesibilidad. Actualmente, Uruguay, Canadá y algunos estados de EE.UU. han legalizado el consumo recreativo, aplicando distintos modelos legislativos. El objetivo de la presente revisión es analizar los efectos que ha tenido la legalización del cannabis recreativo sobre su consumo y sus consecuencias. En general, las evidencias indican que la legalización se ha asociado a un descenso en el precio, mayor concentración de THC (potencia), mayor diversidad de presentaciones para su consumo, una menor percepción de riesgo y un incremento en el consumo en adultos y de forma moderada en adolescentes (aunque sea ilegal el consumo para ellos), así como un aumento de las consecuencias adversas derivadas del consumo en la salud pública. Se ha producido un descenso en los arrestos relacionados con el consumo, pero el mercado ilegal sigue utilizándose de forma habitual. No se ha detectado un incremento de la demanda de tratamiento por este consumo. Por el momento, estos cambios legislativos no han conseguido alcanzar sus objetivos principales que eran suprimir el mercado ilegal y proteger a los grupos más vulnerables, mientras que, por el contrario, parecen implicar un incremento de algunos aspectos negativos asociados al consumo de cannabis. Sin embargo, teniendo en cuenta que la mayoría de estos cambios legislativos han entrado en vigor hace relativamente poco tiempo, se requiere un periodo de seguimiento mayor para poder extraer conclusiones definitivas. (AU)

In recent years, there have been important legislative changes in many countries regarding the use of cannabis for medicinal and/or recreational purposes, which have facilitated access to it. Uruguay, Canada and some of the US states are the only jurisdictions that have legalised recreational consumption, applying different legislative models. The aim of this review is to analyse the effects that the legalisation of recreational cannabis has had on its use and its consequences. In general, the evidence accumulated to date indicates that the legalisation of cannabis has been associated with a decrease in the price of the substance, higher concentration of THC (potency), greater diversity of presentations for consumption, lower risk perception and an increase in consumption in adults and moderately in adolescents (even though it is illegal for them to consume), as well as an increase in the adverse consequences derived from cannabis consumption on public health. There has been a decrease in drug-related arrests, but the illegal market continues to be frequently used. No increase in the demand for treatment due to cannabis consumption has been detected. Therefore, these legislative changes have so far failed to achieve their main objectives, which were to suppress the illegal market and protect the most vulnerable groups, while on the contrary, they seem to imply an increase in some of the negative aspects associated with cannabis consumption. However, taking into account that most of these legislative changes have entered into force relatively recently, a longer follow-up period is required to be able to draw definitive conclusions. (AU)

A Decision 85 Years in the Making.

On October 6, 2022, President Biden announced that he is taking steps to pardon those convicted of simple marijuana possession at the federal level and reconsider the classification of cannabis as a Schedule I substance. At the same time, Congress is working to pass legislation to streamline research in the cannabis space. These efforts signal that federal marijuana laws that have been in place for the past 85 years have created a multitude of problems, including barriers to research, and the federal government is finally considering decisions to create change.

Visibilización de las estrategias de rebranding y captura corporativa de la salud pública por la industria del cannabis / Visibility of rebranding and corporate capture strategies of public health by the cannabis industry

Cuando las políticas afectan a los determinantes comerciales de la salud, como el alcohol, el tabaco y el cannabis se conoce como captura corporativa de la salud pública. El objetivo del estudio fue visibilizar las estrategias promotoras del cultivo, consumo y regulación del cannabis orientadas hacia una regulación conveniente para la industria, en detrimento de la salud pública. Se siguió un diseño exploratorio cualitativo utilizando un muestro intencional a partir de los diversos canales de información utilizados por la industria del cannabis. Las estrategias de rebranding y captura corporativa halladas se fundamentan en: a) argumentos de desarrollo económico en los que justificar su expansión y una regulación laxa; b) fomento de una imagen positiva del cannabis asociando su consumo a fines de salud y bienestar; c) fomento de una imagen social más aceptable del consumidor, del autocultivador e, incluso, del vendedor; d) la captación y fidelización de consumidores a través de productos derivados del cine, la televisión o los videojuegos, y de manera especial a través de influencers; e) los regalos publicitarios y de patrocinio de eventos dirigidos al “tarjet” de los potenciales consumidores; f) la difusión de fake news que sugieren que el cannabis cura enfermedades; y, g) procesos distorsionadores que afectan a la investigación sobre el cannabis, cuando la financiación proviene de la industria del cannabis. Estos hallazgos ponen de manifiesto las acciones de captura corporativa de la industria del cannabis, orientadas a bloquear o retrasar lasmedidas de salud pública que son contrarias a sus intereses económicos (AU)

When policies affect commercial determinants of health, such as alcohol, tobacco and cannabis, it is known as corporate capture of public health. The aim of the study was to make visible the strategies promoting cannabis cultivation, consumption and regulation oriented towards industry-friendly regulation, to the detriment of public health. An exploratory qualitative design was followed using a purposive sample from the various information channels used by the cannabis industry. The rebranding and corporate capture strategies found are based on: (a) economic development arguments to justify its expansion and lax regulation; (b) promotion of a positive image of cannabis by associating its use with health and wellbeing purposes; (c) promotion of a more acceptable social image of the consumer, the self-cultivator and even the seller; (d) consumer recruitment and loyalty through products derived from film, television or video games, and especially through influencers; e) advertising and event sponsorship gifts aimed at the “tarjet” of potential consumers; f) the dissemination of fake news suggesting that cannabis cures diseases; and, g) distorting processes affecting cannabis research, when funding comes from the cannabis industry. These findings highlight the cannabis industry’s corporate capture actions aimed at blocking or delaying public health measures that are contrary to its economic interests. (AU)

Consecuencias jurídico-penales de los comportamientos relacionados con el cannabis: posicionamientos doctrinales y criterios jurisprudenciales / Legal-criminal consequences of behaviors related to cannabis: doctrinal positions and jurisprudential criteria

Los comportamientos relacionados con el cannabis, incluyendo su consumo, posesión y cultivo, deben ajustarse a lo dispuesto en el ordenamiento jurídico pues, de lo contario, podrían llegar a ser constitutivos de una infracción de carácter administrativo o, incluso, de un delito. La confusión entre la regulación administrativa y penal, junto con una actitud social tolerante hacia el cannabis, podría explicar, en parte, la creencia errónea de que estas conductas son siempre plenamente legítimas. En este artículo se abordará la regulación jurídico penal de los comportamientos relacionados con esta sustancia -que la jurisprudencia del Tribunal Supremo considera como una droga que no causa grave daño a la salud-, examinando algunas de las cuestiones más controvertidas que se plantean en la práctica judicial, especialmente en relación con las asociaciones y clubes sociales de cannabis, como es la posible aplicación de la doctrina del consumo compartido o el error de prohibición, teniendo en cuenta los criterios jurisprudenciales más recientes en esta materia. (AU)

Behaviours related to cannabis, including its consumption, possession and cultivation, must comply with the provisions of the legal system, otherwise they could constitute an administrative offence or even a criminal offence. The confusion between administrative and criminal regulation, together with a tolerant social attitude towards cannabis, could partly explain the erroneous belief that these behaviours are always fully legitimate. This article will address the criminal legal regulation of behaviours related to this substance - which the jurisprudence of the Supreme Court considers to be a drug that does not cause serious harm to health -, examining some of the most controversial issues that arise in judicial practice, especially in relation to cannabis associations and social clubs, such as the possible application of the doctrine of shared consumption or the error of prohibition, taking into account the most recent jurisprudential criteria in this area. (AU)

Legal / criminal consequences of behaviours related to cannabis: doctrinal positions and jurisprudential criteria / Consecuencias jurídico-penales de los comportamientos relacionados con el cannabis: posicionamientos doctrinales y criterios jurisprudenciales

Behaviours related to cannabis, including its consumption, possession and cultivation, must comply with the provisions of the legal system, otherwise they could constitute an administrative offence or even a criminal offence. The confusion between administrative and criminal regulation, together with a tolerant social attitude towards cannabis, could partly explain the erroneous belief that these behaviours are always fully legitimate. This article will address the criminal legal regulation of behaviours related to this substance - which the jurisprudence of the Supreme Court considers to be a drug that does not cause serious harm to health -, examining some of the most controversial issues that arise in judicial practice, especially in relation to cannabis associations and social clubs, such as the possible application of the doctrine of shared consumption or the error of prohibition, taking into account the most recent jurisprudential criteria in this area. (AU)

Los comportamientos relacionados con el cannabis, incluyendo su consumo, posesión y cultivo, deben ajustarse a lo dispuesto en el ordenamiento jurídico pues, de lo contario, podrían llegar a ser constitutivos de una infracción de carácter administrativo o, incluso, de un delito. La confusión entre la regulación administrativa y penal, junto con una actitud social tolerante hacia el cannabis, podría explicar, en parte, la creencia errónea de que estas conductas son siempre plenamente legítimas. En este artículo se abordará la regulación jurídico penal de los comportamientos relacionados con esta sustancia -que la jurisprudencia del Tribunal Supremo considera como una droga que no causa grave daño a la salud-, examinando algunas de las cuestiones más controvertidas que se plantean en la práctica judicial, especialmente en relación con las asociaciones y clubes sociales de cannabis, como es la posible aplicación de la doctrina del consumo compartido o el error de prohibición, teniendo en cuenta los criterios jurisprudenciales más recientes en esta materia. (AU)

Um estudo sobre o paradigma proibicionista e a (des)criminalização da maconha no Brasil / A study of the prohibitionist paradigm and the (de)criminalization of marihuana in Brasil / Un estudio sobre el paradigma prohibicionista y la (des)criminalización de la marihuana em Brasil

A maconha atualmente figura entre as substâncias consideradas ilícitas no Brasil. No entanto, nem sempre foi assim. O processo histórico que culminou com a proibição da maconha no Brasil é datado do início do século XX, perpassado por concepções eugenistas e higienistas que consolidaria o paradigma proibicionista.Todavia, ainda que paulatinamente, o proibicionismo vem sendo questionado em âmbito internacional e já há registros de outros modelos de relação de Estados com as drogas e dos indivíduos com as substâncias psicoativas. Sendo assim, o presente artigo, através da realização de entrevistas semiestruturadas, buscou identificar as diferentes maneiras pelas quais a proibição da maconha exerce seus efeitos nas subjetividades de indivíduos militantes, usuários ou não da planta. Dessa maneira, pretende-se demostrar a possibilidade de se pensar novas formas de se relacionar com a maconha, tanto em âmbito individual quanto em âmbito social, e ampliar o conhecimento da população acerca dos efeitos da proibição. (AU)

Marijuana currently ranks among the substances considered illegal in Brazil. However, it was not always like this. The historical process that culminated inthe prohibition of marijuana in Brazil is dated to the beginning of the 20th century, when eugenicist and hygienist ideas helped to consolidated the prohibitionist paradigm. However, even if gradually, prohibitionism has been questioned at the international level and there are already records of other models of relationship between States and drugs and between individuals and psychoactive substances. Therefore, this article, through semi-structured interviews, sought to identify the different ways in which the prohibition of marijuana exerts its effects on the subjectivities of individuals, users or not users of the plant. In this way, it is intended to demonstrate the possibility of thinking about new ways of relating to marijuana, both individually and socially and to broaden the population's knowledge about the effects of the ban. (AU)

La marihuana, en la actualidad, se encuentra como las substancias ilegales en Brasil. Pero no siempre fue así. El proceso histórico que culminó con la prohibición de marihuana en Brasil data del principio del siglo XX, influenciado por concepciones eugénicas e higienistas que consolidarían el paradigma prohibicionista. Aunque gradualmente, el prohibicionismo ha sido cuestionado y ya existen otros modos de relación entre los Estados con las drogas y también de las personas con las substancias. Por ello, este artículo, a través de entrevistas, buscó identificar las diferentes formas que la prohibición de la marihuana ejerce sus efectos sobre la subjetividad. Por lo tanto, tiene la intención de demonstrar la posibilidad de pensar en diferentes modos de relacionarse con la marihuana, tanto individual como socialmente, así como aumentar el conocimiento acerca de los efectos de la criminalización. (AU)

Cannabis legalisation: should doctors be concerned?

A referendum on the Cannabis Legalisation and Control Bill was held in New Zealand. The Bill was meant to oversee government control over the production, supply and use of cannabis and reduce cannabis-related harm. Public health control was proposed over cannabis market by imposing licenses and cultivation, the quality and strength of marketed cannabis, and sale restrictions. Under this Bill, cannabis was only meant to be available to adults aged over 20 years through licenced stores. The potency of cannabis was to be limited. Cannabis use and was going to be permitted in private homes and specifically licensed premises. The Electoral Commission announced on 6 November 2020 that 50.7% of voters opposed the Bill and 48.4% supported it. Despite the outcome of the referendum, legalisation of cannabis may remain a live issue for many people, and doctors need to have an informed view about the impact of legalisation on mental health conditions. Experience from other countries shows that access to and potency of cannabis increased with legalisation. Despite the intent to prevent harm, cannabis legislation has been associated with adverse effects on mental health, emergency hospital presentations and crime. Public health strategies, including educating public about harm associated with cannabis, surveillance of potency and labelling, increasing minimal age for legal recreational cannabis use and bolstering treatment capacity for problematic cannabis use, including those with psychiatric disorders, should be funded by revenue generated from cannabis legislation.