History of Cannabis Regulation and Medicinal Therapeutics: It's Complicated.

The genus Cannabis has a complex history, with great variations in the genus itself, as well as in its current uses worldwide. Today, it is the most commonly used psychoactive substance, with 209 million users in 2020. The legalization of cannabis for medicinal or adult use is complex. From its origins as a therapeutic agent in 2800 bc China, to the current knowledge on cannabinoids and the cannabinoid system, to the complex status of cannabis regulation across continents-knowledge gained from the history of cannabis use can inform research on cannabis-based treatments for patients with medical conditions that remain challenging in 21st century medicine, warranting research and evidence-based policy options. Changes in cannabis-related policymaking, scientific advances, and perceptions may result in increasing patient inquiries about its medicinal usage, regardless of personal opinions, thus meriting education and training of clinicians. This commentary outlines the long history of cannabis use, its current therapeutic potential from a regulatory research perspective, and the continued challenges in research and regulation in the ever-changing era of modern cannabis use. It is crucial to understand the history and complexity of cannabis use as medicine to better understand its potential for clinical therapeutics and the effects of modern-day legalization on other health- and society-related issues.

Medical Cannabis Program Sustainability in the Era of Recreational Cannabis.

PURPOSE: Since October 2022, a total of 21 states have enacted both medical-use and adult-use cannabis legalization, each with their own unique set of laws, regulations, implementation, structures, and enforcement ("policies"). Unlike adult-use programs, medical-use programs often represent a safer and affordable option for patients with diverse needs; however, current evidence suggests that medical-use program activity decreases after implementation of adult-use retail. The current study compares medical patient registration data and medical- and adult-use retail data from 3 distinct medical- and adult-use states (Colorado, Massachusetts, and Oregon) in the time after adult-use retail implementation in each state. METHODS: To investigate changes in medical cannabis programs with simultaneous adult-use legalization, correlation and linear regression analyses were used to assess outcome measures: (1) medical-use retail sales; (2) adult-use retail sales; and (3) number of registered medical patients in all fiscal quarters after adult-use retail sales were implemented in each state to September 2022. FINDINGS: Adult-use cannabis sales increased significantly over time in all 3 states. However, both medical-use sales and number of medical patients registered in the states increased only in Massachusetts. IMPLICATIONS: Results indicate that states' preexisting medical-use programs may undergo critical changes after adult-use cannabis legalization is enacted and implemented. Key policy and program differences, such as regulatory differences in the implementation of adult-use retail sales, may have differential impacts on medical-use programs. For continued patient access, it is critical that future research assess the differences within and between states' medical-use and adult-use programs that permit sustainability of medical-use programs alongside adult-use legalization and implementation.

Cannabis Retail Market Indicators in Five Legal States in the United States: A Public Health Perspective.

PURPOSE: Adult-use cannabis markets are operating in multiple US states and abroad. Sales and licensing data for alcohol and tobacco are often used to understand consumption patterns and evaluate policy changes. Cannabis market data may provide similar insights, although these newly legal markets are complex and evolving, and the state data structures can differ. This study describes variations in market indicators and discusses the utility of cannabis market metrics from a public health perspective. METHODS: We collected data from 5 early-adopting adult-use cannabis states: Alaska, Colorado, Massachusetts, Oregon, and Washington. Analyses focused on licensed retail outlets and retail sales revenues (pretax). Monthly data were collected from the opening of each state's adult-use market through June 2022. Joinpoint software was used to assess state trends and identify points of inflection in trends. Average sales per retailer for June 2019 and June 2022 were compared. Also described are retailers and revenue per population for 2022. FINDINGS: All states showed 4 distinct periods of growth in retail licensee numbers. The greatest increases typically occurred in the first 3 to 4 months. Growth rates slowed to <1% per month for Colorado, Oregon, and Washington at months 25, 24, and 34, respectively. The number of cannabis retailers per 100,000 residents in June 2022 ranged widely, from 16.8 in Oregon to 3.0 in Massachusetts. Colorado, Oregon, and Washington each showed 4 distinct trend periods in adult-use retail sales: early rapid growth lasting <1 year, subsequent varied growth periods, and then declining sales in the most recent months, following early coronavirus disease 2019 period increases. Sales in Alaska and Massachusetts displayed more stable, consistent growth patterns. Sales per state resident for July 2021 to June 2022 also ranged widely, from $382.97 in Alaska to $180.94 in Washington. IMPLICATIONS: We found some consistencies and some variations in both point-in-time measures and trends in states' adult-use cannabis markets. Differences may relate to varied state policies and general contexts (eg, economies). Market data can be useful for public health monitoring, including understanding the effects of policies intended to protect health and safety. States providing publicly accessible cannabis market data create opportunities for such use. Our results underscore the importance of considering individual state regulatory frameworks and implementation timelines in studies of cannabis legalization.

Perceived Group Identity Alters Task-Unrelated Thought and Attentional Divergence During Conversations.

Task-unrelated thought (TUT) occurs frequently in our daily lives and across a range of tasks, but we know little about how this phenomenon arises during and influences the way we communicate. Conversations also provide a novel opportunity to assess the alignment (or divergence) in TUT during dyadic interactions. We conducted a study to determine: (a) the frequency of TUT during conversation as well as how partners align/diverge in their rates of TUT, (b) the subjective and behavioral correlates of TUT and TUT divergence during conversation, and (c) if perceived social group identity impacts TUT and TUT divergence during conversation. We used a minimal groups induction procedure to assign participants (N = 126) to either an ingroup, outgroup, or control condition. We then asked them to converse with one another via a computer-mediated text chat application for 10 min while self-reporting TUTs. On average, participants reported TUT about once every 2 min; however, this rate was lower for participants in the ingroup condition, compared to the control condition. Conversational pairs in the ingroup condition were also aligned more in their rates of TUT compared to the outgroup condition. Finally, we discuss subjective and behavioral correlates of TUT and TUT divergence in conversations, such as valence, turn-taking ratios, and topic shifts.

Automatically detecting task-unrelated thoughts during conversations using keystroke analysis.

Task-unrelated thought (TUT), commonly referred to as mind wandering, is a mental state where a person's attention moves away from the task-at-hand. This state is extremely common, yet not much is known about how to measure it, especially during dyadic interactions. We thus built a model to detect when a person experiences TUTs while talking to another person through a computer-mediated conversation, using their keystroke patterns. The best model was able to differentiate between task-unrelated thoughts and task-related thoughts with a kappa of 0.363, using features extracted from a 15 second window. We also present a feature analysis to provide additional insights into how various typing behaviors can be linked to our ongoing mental states.

How task-unrelated and freely moving thought relate to affect: Evidence for dissociable patterns in everyday life.

Much of our knowledge about the correlates of mind-wandering comes from assessing task-unrelated thought. Less is known about the correlates of freely moving thought, a dimension that assesses the degree to which thoughts arise and unfold with low levels of guidance or constraints. Task-unrelated thought is consistently associated with more negative affective valence compared with being on task; however, it is unclear whether freely moving thought shares the same relationship with affect. We conducted two ecological momentary assessment studies in the context of everyday life and found that the two dimensions have different affective correlates. In Study 1, task-unrelated thought was associated with less positive concurrent valence than being on-task. However, freely moving thought was associated with more positive concurrent valence and was predictive of more positive valence at a subsequent timepoint. Freely moving thought, but not task-unrelated thought, also positively predicted concurrent arousal. Computational sentiment analyses of participants' thought descriptions offered convergent evidence of differential relationships between the two thought dimensions and affect. Study 2 used different measurement scales to assess whether (a) the pattern of findings replicated and (b) if the effects were robust to changes in measurement. The main findings were replicated: task-unrelated thought was negatively associated with concurrent valence, whereas freely moving thought was positively associated with concurrent valence. However, freely moving thought did not predict subsequent valence and was not related to concurrent arousal. The most robust findings related to concurrent valence. Although mind-wandering has acquired a relatively negative reputation to date, our findings suggest that there might be positive aspects that remain unexplored. (PsycInfo Database Record (c) 2021 APA, all rights reserved).