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1.
N Engl J Med ; 386(2): 148-156, 2022 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-35020985

RESUMEN

BACKGROUND: The effect of cannabis legalization in Canada (in October 2018) on the prevalence of injured drivers testing positive for tetrahydrocannabinol (THC) is unclear. METHODS: We studied drivers treated after a motor vehicle collision in four British Columbia trauma centers, with data from January 2013 through March 2020. We included moderately injured drivers (those whose condition warranted blood tests as part of clinical assessment) for whom excess blood remained after clinical testing was complete. Blood was analyzed at the provincial toxicology center. The primary outcomes were a THC level greater than 0, a THC level of at least 2 ng per milliliter (Canadian legal limit), and a THC level of at least 5 ng per milliliter. The secondary outcomes were a THC level of at least 2.5 ng per milliliter plus a blood alcohol level of at least 0.05%; a blood alcohol level greater than 0; and a blood alcohol level of at least 0.08%. We calculated the prevalence of all outcomes before and after legalization. We obtained adjusted prevalence ratios using log-binomial regression to model the association between substance prevalence and legalization after adjustment for relevant covariates. RESULTS: During the study period, 4339 drivers (3550 before legalization and 789 after legalization) met the inclusion criteria. Before legalization, a THC level greater than 0 was detected in 9.2% of drivers, a THC level of at least 2 ng per milliliter in 3.8%, and a THC level of at least 5 ng per milliliter in 1.1%. After legalization, the values were 17.9%, 8.6%, and 3.5%, respectively. After legalization, there was an increased prevalence of drivers with a THC level greater than 0 (adjusted prevalence ratio, 1.33; 95% confidence interval [CI], 1.05 to 1.68), a THC level of at least 2 ng per milliliter (adjusted prevalence ratio, 2.29; 95% CI, 1.52 to 3.45), and a THC level of at least 5 ng per milliliter (adjusted prevalence ratio, 2.05; 95% CI, 1.00 to 4.18). The largest increases in a THC level of at least 2 ng per milliliter were among drivers 50 years of age or older (adjusted prevalence ratio, 5.18; 95% CI, 2.49 to 10.78) and among male drivers (adjusted prevalence ratio, 2.44; 95% CI, 1.60 to 3.74). There were no significant changes in the prevalence of drivers testing positive for alcohol. CONCLUSIONS: After cannabis legalization, the prevalence of moderately injured drivers with a THC level of at least 2 ng per milliliter in participating British Columbia trauma centers more than doubled. The increase was largest among older drivers and male drivers. (Funded by the Canadian Institutes of Health Research.).


Asunto(s)
Accidentes de Tránsito , Cannabis , Dronabinol/sangre , Etanol/sangre , Adulto , Distribución por Edad , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Colombia Británica , Dronabinol/efectos adversos , Femenino , Humanos , Legislación de Medicamentos , Masculino , Uso de la Marihuana/epidemiología , Persona de Mediana Edad
2.
Addict Behav ; 124: 107098, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34521066

RESUMEN

PURPOSE: This study estimated self-reported perceived negative marijuana use consequences among a national sample of U.S. young adults, examining consequence prevalence differences by use frequency, college attendance, living situation, employment, sex, and race/ethnicity; and use frequency/sociodemographic characteristic interactions. METHODS: A subsample of 1,212 respondents from the 2004-2018 class cohorts of 12th grade students participating in the nationally-representative Monitoring the Future study was surveyed up to two times from modal ages 19 through 22 (in 2008-2019). Respondents self-reported negative consequences related to their own past 12-month marijuana use. Bivariate and multivariable models examined subgroup differences in consequence prevalence. RESULTS: Approximately 60% of those using frequently (20+ use occasions in the past 30 days) and 35% of those using non-frequently reported negative consequences. Among all young adult marijuana users, 31.1% reported emotional/physical consequences, 12.9% performance/financial consequences, and 12.3% relational consequences. Use frequency was positively associated with consequence likelihood, excluding regret and unsafe driving. Among college students, frequent use was more strongly associated with any and performance/financial consequences. Controlling for use frequency, men reported more performance/financial consequences; relational consequences were higher among Hispanic (vs. White) respondents, and those living with parents, employed full-time, and not attending 4-year colleges. CONCLUSION: Young adults using marijuana reported a wide range of negative use consequences; likelihood of most consequences increased with higher use frequency. Perceived consequences varied by college attendance, living situation, employment, sex, and race/ethnicity. Efforts to reduce negative marijuana consequences may be strengthened by recognizing and addressing the different types of negative consequences users perceive.


Asunto(s)
Fumar Marihuana , Uso de la Marihuana , Trastornos Relacionados con Sustancias , Adulto , Humanos , Masculino , Fumar Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Autoinforme , Estudiantes , Adulto Joven
3.
Addict Behav ; 124: 107115, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34543868

RESUMEN

BACKGROUND: Loneliness is a widespread problem, with demonstrated negative health effects. However, prospective data on the relationship between loneliness and problematic substance use are lacking, and few studies have examined specific commonplace substances, such as alcohol and cannabis. This study used prospective data from a community sample of US adults with problematic alcohol or cannabis use to examine whether loneliness was a predictor of subsequent increased substance use. METHODS: Participants (N = 210) were recruited between 05/2016-06/2019 from a New York City medical center. At baseline, 3-month, and 6-month follow-ups, participants completed identical computerized questionnaires. We used generalized estimating equations to assess the average effect of past 2-week loneliness on subsequent number of days of alcohol or cannabis use, controlling for baseline days of use, demographic characteristics, and past 2-week DSM-5 depression. RESULTS: Compared with individuals who were never lonely, participants with moderate or severe loneliness had a significantly higher frequency of alcohol or cannabis use at the subsequent assessment (ß = 0.25 95% CI: 0.08-0.42). CONCLUSION: Individuals experiencing loneliness at least a few times in the past 2 weeks reported more days of subsequent alcohol or cannabis use compared with individuals who were not lonely. This is cause for concern, as national surveys of US adults indicate increasing rates of loneliness, depression and substance use during the COVID-19 pandemic. These results suggest the need for health care providers to screen for feelings of loneliness and potentially harmful coping behaviors such as substance use, and to offer healthier alternative coping strategies.


Asunto(s)
COVID-19 , Uso de la Marihuana , Trastornos Relacionados con Sustancias , Adulto , Humanos , Soledad , Uso de la Marihuana/epidemiología , Pandemias , SARS-CoV-2
4.
Addict Behav ; 124: 107120, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34560423

RESUMEN

BACKGROUND: Pre-gaming, or drinking before going out, is common among young adults and associated with heavier drinking and negative consequences. However, findings have been mixed as to whether a unique, day-level association between pre-gaming and negative consequences exists independent of alcohol intake. It is also unknown whether young adults experience more positive consequences of alcohol use on days they engage in pre-gaming. This study tested day-level associations between pre-gaming and positive and negative consequences, controlling for same-day alcohol intake, as well as whether these associations were moderated by person- and day-level variables. METHODS: Participants were 148 young adult heavy drinkers (Mage = 20.30, SDage = 1.45, 57.4% female) who reported past-month simultaneous alcohol and marijuana use. For up to 14 consecutive days, participants completed electronic surveys asking about their drinking behaviors and consequences the previous day. RESULTS: Prior to adjusting for alcohol intake, Poisson multilevel models showed that participants reported more negative and positive consequences on days they pre-gamed and those who reported pre-gaming more often throughout the study also experienced more negative and positive consequences overall. After controlling for alcohol intake, a positive, day-level association between pre-gaming and positive consequences remained. There was no evidence of moderation of study associations by person- or day-level variables. CONCLUSION: The unique association between pre-gaming and positive consequences may help explain why pre-gaming is linked with heavy drinking and other risky behaviors as positive consequences have been shown to reinforce such behaviors. Findings suggest pre-gaming may be a useful intervention point for alcohol reduction programs.


Asunto(s)
Intoxicación Alcohólica , Fumar Marihuana , Uso de la Marihuana , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Etanol , Femenino , Humanos , Lactante , Masculino , Uso de la Marihuana/epidemiología , Adulto Joven
5.
Addict Behav ; 124: 107118, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34583272

RESUMEN

Simultaneous alcohol and marijuana use (SAM) such that their effects overlap has emerged as a behavior that is riskier than using either substance separately. It has been associated with high-risk binge drinking and driving while intoxicated during young adulthood, and it has been demonstrated to cause greater physical and mental impairment than use of alcohol or marijuana separately. To identify intervention and prevention targets specific to SAM, we examined the relationships between alcohol- and marijuana-specific beliefs and attitudes (risk factors) and self-reported SAM compared to non-simultaneous co-use (CAM) and alcohol use only in the past 30 days in a sample of young adults (n = 1,023, mean age = 23.17; SD = 0.43). Of those who reported drinking alcohol in the past 30 days, 20.7% reported SAM, 12.6% reported CAM, and 66.6% reported using only alcohol. Results from multinomial logistic regression analyses indicated that some marijuana-specific risk factors (e.g., belief that it is not at all wrong for someone their age to use marijuana) differentiated SAM or CAM from alcohol use only, but alcohol-specific risk factors generally did not. However, the perceptions that parents approved of their using marijuana or frequently drinking heavily were associated with a greater likelihood of SAM compared to CAM (OR ranged from 2.25 to 3.53). Findings point to the salience of individuals' attitudes and beliefs around marijuana use and their perception of parental approval of heavy drinking and marijuana use as potential targets for prevention programs targeting risk reduction among young adults.


Asunto(s)
Cannabis , Fumar Marihuana , Uso de la Marihuana , Adulto , Consumo de Bebidas Alcohólicas , Etanol , Humanos , Uso de la Marihuana/epidemiología , Adulto Joven
6.
Addict Behav ; 124: 107087, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34464915

RESUMEN

BACKGROUND: Marijuana is the most frequently used illicit drug among college students, and there is a need to understand the social processes that contribute to young adults' marijuana use. Substance use behaviors tend to be more similar (homophilous) among individuals with social ties to one another. However, little is known about whether marijuana use homophily within young adult relationships is due to social selection (seeking out ties with similar marijuana use to one's own) or social influence (adopting similar marijuana use behaviors as one's ties), or both. METHODS: Students (N = 1,489; 54.6% female; Mage = 18.6 years) at one University completed online surveys in their first three semesters of college. Surveys assessed participant characteristics, marijuana use, and ties to up to 10 other students in the whole (sociocentric) network of first-year college students. Stochastic-actor oriented models (SAOMs) were used to analyze the co-evolution of marijuana use and social ties over time. RESULTS: Participants were more likely to select peers with similar past 30-day marijuana use as themselves. Concurrently, students' past 30-day marijuana use became more similar to their peers' use over time. DISCUSSION: Evidence for selection and influence effects were highly significant after controlling for network structure and other covariates indicating these processes may work in tandem to increase marijuana use homophily over the first year of college. This highlights the importance of relationships made early in the first-year of college, as these initial peer ties are likely to reinforce marijuana use behaviors that occur within these relationships.


Asunto(s)
Fumar Marihuana , Uso de la Marihuana , Trastornos Relacionados con Sustancias , Adolescente , Femenino , Humanos , Masculino , Fumar Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Grupo Paritario , Estudiantes , Universidades , Adulto Joven
8.
Dev Psychol ; 57(12): 2250-2264, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34928672

RESUMEN

Adolescent marijuana use has become increasingly more problematic compared with the past; thus, understanding developmental processes that increase the liability of marijuana use is essential. Two developmental pathways to adolescent substance use have been proposed: an externalizing pathway that emphasizes the expression of aggressive and delinquent behavior, and an internalizing pathway that emphasizes the role of depressive symptoms and negative affect. In this study, we aimed to examine the synergistic role of impulsiveness and sensation seeking in the two risk pathways to determine whether both high and low levels of the traits are risk factors for marijuana use. Our study included 343 adolescents (52% were girls, 78% identified as Hispanic) that oversampled high-risk youth (78% had a family history of substance use disorder), assessed biannually between the ages of 13-16 years old. Moderated mediation analyses revealed that high levels of sensation seeking indirectly predicted marijuana use through higher mean levels of externalizing behavior. The positive relationship between sensation seeking and externalizing behavior was only significant at high levels of impulsiveness. Conversely, low levels of sensation seeking indirectly predicted marijuana use through higher mean levels of internalizing behavior. The negative relationship between sensation seeking and internalizing behavior was only significant at low levels of impulsiveness. Collectively, these results demonstrate that high and low levels of both impulsiveness and sensation seeking confer increased risk of marijuana use, albeit through different mechanisms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Fumar Marihuana , Uso de la Marihuana , Trastornos Relacionados con Sustancias , Adolescente , Cognición , Femenino , Humanos , Sensación
10.
MMWR Morb Mortal Wkly Rep ; 70(43): 1505-1508, 2021 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-34710079

RESUMEN

In Colorado, excessive alcohol use* contributed to $5 billion in economic costs in 2010 (1) and >1,800 deaths annually during 2011-2015 (2). The most common pattern of excessive drinking is binge drinking (consumption of four or more drinks on an occasion for women or five or more drinks for men) (3), which is associated with increased likelihood of using other substances, including marijuana (4). Retail (i.e., nonmedical) marijuana sales began in Colorado on January 1, 2014. The Colorado Department of Public Health and Environment (CDPHE) and CDC used data from Colorado's 2015-2019 Behavioral Risk Factor Surveillance System (BRFSS) to examine current use of marijuana (including hashish) by drinking patterns among 45,991 persons aged ≥18 years who responded to questions about alcohol and marijuana use. The age-standardized, weighted prevalence of current marijuana use among persons who reported binge drinking (34.4%) was significantly higher than the prevalence among current non-binge drinkers (14.8%) and nondrinkers (9.9%). Evidence-based strategies recommended by the Community Preventive Services Task Force to reduce excessive alcohol use and tobacco use (e.g., increasing prices or reducing access) can reduce alcohol- and tobacco-related harms. Similar strategies might be effective in reducing marijuana use and its potential harms as well.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Comercio/legislación & jurisprudencia , Legislación de Medicamentos , Uso de la Marihuana/epidemiología , Adolescente , Adulto , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Colorado/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-34639657

RESUMEN

Marijuana is the most common illicit substance globally. The rate of marijuana use is increasing in young adults in the US. The current environment of legalizing marijuana use is further contributing to an increase of users. The purpose of this study was to explore the characteristics of adults who abuse marijuana (20-49 years old) and analyze behavior and social relation variables related to depression and suicide risk using machine-learning algorithms. A total of 698 participants were identified from the 2019 National Survey on Drug Use and Health survey as marijuana dependent in the previous year. Principal Component Analysis and Chi-square were used to select features (variables) and mean imputation method was applied for missing data. Logistic regression, Random Forest, and K-Nearest Neighbor machine-learning algorithms were used to build depression and suicide risk prediction models. The results showed unique characteristics of the group and well-performing prediction models with influential risk variables. Identified risk variables were aligned with previous studies and suggested the development of marijuana abuse prevention programs targeting 20-29 year olds with a regular depression and suicide screening. Further study is suggested for identifying specific barriers to receiving timely treatment for depression and suicide risk.


Asunto(s)
Cannabis , Abuso de Marihuana , Fumar Marihuana , Uso de la Marihuana , Adulto , Humanos , Aprendizaje Automático , Abuso de Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Persona de Mediana Edad , Adulto Joven
13.
Psychol Addict Behav ; 35(6): 712-722, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34591512

RESUMEN

Objective: The current study expands the literature on simultaneous alcohol and marijuana (SAM) use by focusing on the distinction between unplanned and planned SAM use to identify potential intervention targets. This study explored whether unplanned or planned SAM use was associated with differences in alcohol and/or marijuana use and consequences. Method: A community sample of young adults (aged 18-25) with recent alcohol and SAM use was recruited [N = 409; mean (SD) = 21.61 (2.17) years; 50.9% female; 48.2% non-Hispanic/Latinx White]. Participants completed five 2-week bursts of online daily surveys (2 ×/day; 81.99% of morning and 82.23% of afternoon surveys completed) and reported on substance use intentions and behavior. Results: Descriptive findings showed that among days on which participants reported SAM use, 41.85% of the days were unplanned SAM use days. Based on daily-level results from multilevel models, on days with unplanned SAM use, young adults reported consuming fewer drinks, fewer hours high from marijuana, and lower subjective intoxication/high, compared to planned SAM use days, thus indicating that planned SAM use was riskier. Unplanned SAM use was not significantly associated with positive or negative consequences related to alcohol or marijuana, after accounting for the number of drinks or hours high from marijuana. Conclusions: Current findings suggest that interventions should target days on which young adults are planning to engage in SAM use. Future work is needed to identify factors that predict planned SAM use on specific occasions and also to disentangle the potential role of unplanned heavy use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Cannabis , Fumar Marihuana , Uso de la Marihuana , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Humanos , Uso de la Marihuana/epidemiología , Adulto Joven
14.
Psychol Addict Behav ; 35(6): 682-690, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34591517

RESUMEN

Objective: Co-use of alcohol and marijuana has increased among college students, though comparisons among simultaneous (i.e., use of both substances such that effects overlap), dual (i.e., use of both substances within a similar time period but without overlapping effects), and marijuana-only use are limited. This study aimed to understand differences between simultaneous, dual, and marijuana-only users on marijuana use rates, consequences, and context of use in a multi-university study. Method: College students (N = 4,764; Mage = 19.9 years) who were mainly female (70.6%) and White (67.9%) completed an online survey. The Marijuana Use Grid captured marijuana use quantity/frequency, and the Brief Marijuana Consequences Questionnaire and the Cannabis Use Disorders Identification Test-Revised assessed problem use. Location, method of consumption, and social context of use also were assessed. Results: Fifty-five percent of the sample endorsed lifetime use of alcohol and marijuana. Of these students, 36.1% endorsed past-month simultaneous use, 10.8% endorsed past-month dual use, and 6.4% endorsed past-month marijuana-only use. Simultaneous users reported more marijuana use and problems than dual users. Marijuana-only users did not differ from simultaneous users on marijuana use indices, though they reported greater use than dual users as well. Simultaneous users used marijuana in plant form, at parties, and with unknown others a greater percentage of the time than dual users, while dual users used edibles and ingested marijuana a greater percentage of the time. Conclusions: Given their greater levels of marijuana use and marijuana-related problems, screening and interventions for simultaneous alcohol-marijuana use are needed in college students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Cannabis , Fumar Marihuana , Uso de la Marihuana , Trastornos Relacionados con Sustancias , Adulto , Consumo de Bebidas Alcohólicas , Humanos , Fumar Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Universidades , Adulto Joven
15.
Drug Alcohol Depend ; 227: 109000, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34507062

RESUMEN

BACKGROUND: As marijuana is legalized in more states, modes of administration that facilitate co-use with tobacco are growing in popularity among young adults. This study examines the prevalence, patterns, correlates, and reasons for co-use so that targeted interventions can be developed to prevent negative consequences associated with tobacco use and co-use. METHODS: In Fall 2019, 1887 young adults, originally recruited in 2010 from 11 colleges in North Carolina and Virginia to participate in a cohort study, completed an online survey. Co-use was defined as self-reported use of marijuana and tobacco in the past month. Tobacco-only, marijuana-only and co-users were compared using regression modeling. RESULTS: Overall, 9.3% of the sample were co-users, 7.1% tobacco-only, and 15.8% marijuana-only users. Tobacco use was associated with an increased likelihood of marijuana use and vice-versa. Co-users were more likely to use e-cigarettes and blunts to administer marijuana and less likely to use smokeless tobacco products. They were more likely to use cocaine, have less anxiety, and be heavier marijuana users than marijuana-only users. Co-users of e-cigarettes and marijuana were less likely to be daily e-cigarette users and make quit attempts than e-cigarette users that did not use marijuana. Experimentation was the primary reason for co-use of tobacco and marijuana. CONCLUSIONS: Co-users were more likely to use modes of administration that facilitate use of both substances and have patterns of use that may impact cessation efforts. These findings highlight the importance of surveillance of co-use and the development of interventions targeting experimentation with these substances by young adults.


Asunto(s)
Cannabis , Sistemas Electrónicos de Liberación de Nicotina , Uso de la Marihuana , Productos de Tabaco , Estudios de Cohortes , Humanos , Uso de la Marihuana/epidemiología , Tabaco , Uso de Tabaco/epidemiología , Adulto Joven
16.
J Stud Alcohol Drugs ; 82(5): 584-594, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34546904

RESUMEN

OBJECTIVE: This study examined past-2-week driving after marijuana use (DMU) and driving after having five or more drinks (D5D) during young adulthood, specifically focusing on associations between within-person change in social roles (living situation, marriage, parenthood, education, employment) and mediators (perceived risk, evenings out, and religiosity) from modal ages 19 to 30. METHOD: Multilevel analyses were conducted using survey data collected from 2013 to 2019 from 1,873 adults (1,060 women; total number of data collection waves = 7,037) participating in the longitudinal Monitoring the Future study. RESULTS: Change across waves from not being married to married was associated with lower DMU likelihood at any particular wave both directly and via mediation through wave-level change in evenings out. Change in employment (not employed to employed full time) was associated with higher D5D likelihood at any particular wave both directly and via mediation through change in evenings out. Wave-level change in other social roles was indirectly associated with DMU/D5D likelihood via wave-level change in evenings out. CONCLUSIONS: Change in all social roles examined was associated with change in evenings out, which appears to be a primary, proximal predictor of young adult DMU/D5D. Improved understanding of how socialization change is associated with driving after substance use may strengthen efforts to reduce the harms associated with such driving behaviors.


Asunto(s)
Conducción de Automóvil , Cannabis , Fumar Marihuana , Uso de la Marihuana , Adulto , Consumo de Bebidas Alcohólicas , Humanos , Uso de la Marihuana/epidemiología , Encuestas y Cuestionarios , Adulto Joven
17.
Psychol Addict Behav ; 35(6): 698-711, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34472880

RESUMEN

OBJECTIVE: Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects. METHOD: Past-month SAM users (n = 341; 52% female; 75% White; 10% Latinx/Hispanic; age 18-24) from three U.S. college campuses completed 8 weeks of surveys up to five times a day. Three-level generalized linear mixed-effects models tested the effects of situational motives and social and physical contexts on occasion type (SAM vs. cannabis-only), cannabis use, and subjective effects. RESULTS: Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects. CONCLUSIONS: The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Cannabis , Fumar Marihuana , Uso de la Marihuana , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Humanos , Fumar Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Motivación , Adulto Joven
19.
Eur J Obstet Gynecol Reprod Biol ; 266: 36-41, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34562806

RESUMEN

OBJECTIVE: To characterize the association between antepartum marijuana exposure and maternal and neonatal outcomes at our institution. STUDY DESIGN: Retrospective chart review identified an obstetric cohort of singleton gestations. Women with self-reported marijuana use were compared with non-users. Demographic characteristics, risk factors, and maternal-fetal outcomes were evaluated. Associations between outcomes and marijuana use were assessed with regression analysis. RESULTS: Of 2792 deliveries, 5.4% reported marijuana use. Compared to non-users, marijuana users entered prenatal care later, were younger, non-Hispanic, and used other illicit substances. Marijuana users had a higher rate of cesarean delivery (p = 0.01). After adjusting for confounders, marijuana use remained associated with 4.1-fold risk of delivering a small for gestational age (SGA) infant and 2.89-fold risk of neonatal oxygen use. CONCLUSION: At a safety net hospital, antepartum marijuana use is significantly associated with cesarean delivery, SGA and supplemental oxygen use at birth. Healthcare disparities associated with marijuana use make this a population of critical interest.


Asunto(s)
Uso de la Marihuana , Cesárea , Femenino , Humanos , Lactante , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Uso de la Marihuana/epidemiología , Embarazo , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , Proveedores de Redes de Seguridad
20.
Am J Case Rep ; 22: e932479, 2021 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-34388145

RESUMEN

BACKGROUND Intussusception is a common phenomenon in children, but it is rare in adults. In the pediatric population, the presentation is commonly primary, without a lead point. However, up to 90% of intussusception cases arise due to a secondary cause - a pathological lead point - which the most common etiology in adults being malignancy. Herein, we present a case report of adult intussusception without a known cause. CASE REPORT A 26-year-old woman presented to the hospital with severe abdominal pain. She admitted to not passing stool or gas for 2 days. The patient's social history was significant for chronic marijuana use. A computed tomography (CT) scan of the abdomen revealed a 6-cm in length intussuscepted segment of bowel in the descending colon distal to the splenic flexure with no obvious inciting mass. The patient was sent for emergent open abdominal surgery. Upon surgical exploration, the surgeons discovered that the intussusception had self-resolved. Aside from a small ball of stool, an intraoperative colonoscopy revealed no masses or polyps. CONCLUSIONS Marijuana use is known to disrupt gastrointestinal (GI) mobility through receptors in the GI tract nerve plexuses. The incidence of chronic marijuana use and adult intussusception is documented in the literature. Conservative management with bowel rest is confirmed to be a suitable treatment option with a favorable outcome. Therefore, we present this case to increase awareness of the potential adverse effects of chronic marijuana use, and to prevent invasive treatment.


Asunto(s)
Intususcepción , Uso de la Marihuana , Dolor Abdominal , Adulto , Niño , Colonoscopía , Femenino , Humanos , Intususcepción/inducido químicamente , Intususcepción/cirugía , Tomografía Computarizada por Rayos X , Adulto Joven
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