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1.
Artigo em Inglês | MEDLINE | ID: mdl-34639657

RESUMO

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.


Assuntos
Cannabis , Abuso de Maconha , Fumar Maconha , Uso da Maconha , Adulto , Humanos , Aprendizado de Máquina , Abuso de Maconha/epidemiologia , Uso da Maconha/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
3.
Pediatr Clin North Am ; 68(5): 977-990, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34538307

RESUMO

Studies have yielded mixed findings regarding changes in adolescent substance use during the COVID-19 pandemic; some report increased alcohol and cannabis use, others show less binge drinking and vaping behaviors, and others no change. In 2019, only 8.3% of the 1.1 million adolescents with a substance use disorder received specialized treatment. Treatment rates for 2020 have not yet been published. Stay-at-home orders and social distancing guidelines put into place in March 2020 caused the partial closure of many outpatient substance use clinics. The implications of this treatment suspension and special considerations for working with adolescents during stay-at-home orders are discussed.


Assuntos
Comportamento do Adolescente/psicologia , COVID-19/psicologia , Isolamento Social/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Alcoolismo/epidemiologia , COVID-19/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Vaping/epidemiologia
4.
J Abnorm Psychol ; 130(7): 691-701, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34553951

RESUMO

Observational studies have repeatedly linked cannabis use and increased risk of psychosis. We sought to clarify whether this association reflects a causal effect of cannabis exposure or residual confounding. We analyzed data from two cohorts of twins who completed repeated, prospective measures of cannabis use (N = 1544) and cannabis use disorder symptoms (N = 1458) in adolescence and a dimensional measure of psychosis-proneness (the Personality Inventory for DSM-5 Psychoticism scale) in adulthood. Twins also provided molecular genetic data, which were used to estimate polygenic risk of schizophrenia. Both cumulative adolescent cannabis use and use disorder were associated with higher Psychoticism scores in adulthood. However, we found no evidence of an effect of cannabis on Psychoticism or any of its facets in co-twin control models that compared the greater-cannabis-using twin to the lesser-using co-twin. We also observed no evidence of a differential effect of cannabis on Psychoticism by polygenic risk of schizophrenia. Although cannabis use and disorder are consistently associated with increased risk of psychosis, the present results suggest this association is likely attributable to familial confounds rather than a causal effect of cannabis exposure. Efforts to reduce the prevalence and burden of psychotic illnesses thus may benefit from greater focus on other therapeutic targets. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Abuso de Maconha , Transtornos Psicóticos , Adolescente , Adulto , Humanos , Estudos Longitudinais , Abuso de Maconha/epidemiologia , Transtornos Psicóticos/epidemiologia , Gêmeos/psicologia , Gêmeos/estatística & dados numéricos
5.
PLoS One ; 16(8): e0255745, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34370775

RESUMO

BACKGROUND AND OBJECTIVES: Epidemiological studies show that the use of cannabis is related to the use of other illicit drugs, including stimulants such as cocaine and ecstasy. However, few studies have examined how patterns of cannabis use relate to the use of stimulants. In this research we determined relationships between patterns of cannabis use and recent stimulant use, drawing on data from two large nationally representative surveys. We also explored how frequency of cannabis use relates to stimulant use and whether subjects with a cannabis use disorder (CUD)-defined as cannabis abuse or dependence-are more likely to be recent users of cocaine or ecstasy. MATERIALS AND METHODS: We analysed data from Ireland's 2010/11 and 2014/15 National Drug Prevalence Surveys,which recruited 5,134 and 7,005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported some past cannabis use. Multivariable logistic regression analysis was used to examine associations between patterns of cannabis use and recent stimulant use. RESULTS: Among survey participants who had used cannabis in the last month, 17.9% reported recent cocaine use, while almost one-quarter (23.6%) reported recent ecstasy use. There was a significant linear relationship between patterns of cannabis use and recent use of cocaine, ecstasy or any stimulant, with last month cannabis users displaying greater odds (OR = 12.03, 95% CI: 8.15-17.78) of having recent stimulant use compared to last year (OR = 4.48, 95% CI: 2.91-6.91) and former (reference) cannabis users. Greater frequency of cannabis use in the last 30 days was also significantly related to the use of stimulants. In addition, results demonstrated an association between CUD and recent use of cocaine or ecstasy (OR = 2.28, 95% CI: 1.55-3.35). CONCLUSIONS: Findings from this study suggest a relationship between patterns and frequency of cannabis use and recent use of stimulants and an association between CUD and stimulant use. As the use of cannabis with stimulants may increase the risk of negative health consequences, education in community and medical settings about polydrug use and its increased risks may be warranted.


Assuntos
Cannabis/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Abuso de Maconha/epidemiologia , Fumar Maconha/efeitos adversos , Adolescente , Adulto , Estimulantes do Sistema Nervoso Central/efeitos adversos , Cocaína/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/patologia , Feminino , Alucinógenos/efeitos adversos , Humanos , Irlanda/epidemiologia , Masculino , Abuso de Maconha/patologia , Adulto Jovem
6.
Am J Addict ; 30(6): 578-584, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34432919

RESUMO

BACKGROUND AND OBJECTIVES: Recent observations indicate that cannabis use can result in cardiovascular complications including arrhythmias. We studied the relationship between cannabis use disorder (CUD) and arrhythmia hospitalization. METHODS: We conducted a retrospective analysis of the Nationwide Inpatient Sample (2010-2014). Patients (age 15-54) with a primary diagnosis for arrhythmia (N = 570,556) were compared with non-arrhythmia (N = 67,662,082) inpatients for odds ratio (OR) of CUD by the logistic regression model, adjusted for demographics and comorbid risk factors. RESULTS: The incidence of CUD in arrhythmia inpatients was 2.6%. Among cannabis users, the most prevalent arrhythmia was atrial fibrillation (42%), followed by other arrhythmias (24%) and atrial flutter (8%). Patients with CUD were younger (15-24 years, OR: 4.23), male (OR: 1.70), and African American (OR: 2.70). CUD was associated with higher odds of arrhythmia hospitalization in the young population, 1.28 times in 15-24 years (95% confidence interval [CI]: 1.229-1.346) and 1.52 times in 25-34 years (95% CI: 1.469-1.578). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: With the growing legalization in the United States, there is an increased use of medicinal/recreational cannabis. This is the first national study to our knowledge that found that CUD is associated with a 47%-52% increased likelihood of arrhythmia hospitalization in the younger population and the risk of association was controlled for potential confounders including other substances. The fact that atrial fibrillation is the most prevalent arrhythmia is of special concern since it can result in stroke and other embolic events. Physicians need to familiarize themselves with cannabis abuse or dependence as a risk factor for arrhythmia.


Assuntos
Cannabis , Abuso de Maconha , Adolescente , Adulto , Arritmias Cardíacas/epidemiologia , Hospitalização , Humanos , Abuso de Maconha/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
7.
J Consult Clin Psychol ; 89(6): 483-498, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264697

RESUMO

OBJECTIVE: Justice-involved youth report high rates of adverse childhood experiences (ACEs; abuse, neglect, household dysfunction) and are at high risk for elevated behavioral health needs (i.e., substance use, psychiatric symptoms). Research with broad samples of adolescents shows ACEs predict behavioral health outcomes, yet most research on the impact of ACEs among justice-involved youth focuses on recidivism. The present study addresses this gap by examining the prospective association between ACEs and psychiatric symptoms, substance use, and substance-related problems (i.e., consequences of use) among first-time justice-involved youth. METHOD: First-time justice-involved youth (n = 271; 54.3% male; M age = 14.5 years; 43.5% Latinx; non-Latinx: 34.2% White, 8.6% Black, 7.1% Other, 6.7% Multiracial) and their caregivers were assessed at youth's first court contact and 4- and 12-month follow-ups. Youth and caregivers reported youth's exposure to ACEs through a series of instruments at baseline and 4-months (e.g., Childhood Trauma Questionnaire Short-Form; Traumatic Life Events Inventory). Primary outcomes included youth alcohol and cannabis use (Adolescent Risk Behavior Assessment), consequences of use (Brief Young Adult Alcohol Consequences Questionnaire; Brief Marijuana Consequences Scale), and psychiatric symptoms (Behavior Assessment System for Children; National Stressful Events Survey PTSD Short Scale). RESULTS: Youth were exposed to three ACEs, on average, prior to first justice contact (M = 3). Exposure to more ACEs, particularly abuse, predicted substance use and psychiatric outcomes. Gender differences emerged for cannabis use and internalizing symptoms. CONCLUSIONS: Implications for trauma-responsive juvenile justice reform are discussed, including screening for ACEs and their sequelae at first court contact and considering the role of masculine norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Cuidadores , Maus-Tratos Infantis/estatística & dados numéricos , Feminino , Humanos , Masculino , Abuso de Maconha/epidemiologia , Estudos Prospectivos , Inquéritos e Questionários
8.
Drug Alcohol Depend ; 226: 108887, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34216859

RESUMO

BACKGROUND: Regular cannabis use, even without cannabis use disorder (CUD), is associated with numerous biopsychosocial problems. Biopsychosocial risk factors that precede regular use and CUD might reflect broader pre-existing risk factors rather than the consequence of cannabis use. We aimed to (1) replicate prior work differentiating psychosocial problems associated with regular cannabis use with or without CUD relative to no-use in adulthood, and (2) test if these use groups differed in biopsychosocial functioning in early and middle childhood. METHODS: Biopsychosocial characteristics of individuals at-risk for substance use problems (n = 402) reporting no-use, regular use without CUD, and regular use with CUD by young adulthood were prospectively compared during early childhood (ages 3-5), middle childhood (ages 9-11) and young adulthood (ages 18-25). RESULTS: Regular use (vs. no-use) was associated with more health problems (mean d = |0.57|), psychopathology (mean d = |0.72|), social and family environment risk (mean d = |0.88|) in childhood and adulthood and comorbid substance use in adulthood (mean d = |1.25|). Regular use with and without CUD was linked to similar, developmentally-persistent patterns of problems across domains. CONCLUSIONS: We found that childhood risk factors present many years prior to cannabis initiation (as early as age 3) differentiated patterns of adult cannabis use and CUD status in adulthood. Therefore, biopsychosocial impairments associated with regular cannabis use in adulthood is not solely attributable to cannabis exposure but can be traced back to early and persistent biopsychosocial risk that may benefit from early behavioral intervention, irrespective of CUD diagnosis.


Assuntos
Cannabis , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Criança , Pré-Escolar , Família , Humanos , Relações Interpessoais , Abuso de Maconha/epidemiologia , Adulto Jovem
9.
Drug Alcohol Depend ; 226: 108834, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34216857

RESUMO

BACKGROUND: Persons with severe opioid or cocaine use disorders are particularly vulnerable to morbidity and mortality. Heaviest use of mu-opioid receptor agonists and cocaine typically commences in early adulthood and is preceded by substantial adolescent exposure to cannabis and/or alcohol. Little information exists on the age trajectories of exposure to cannabis or alcohol in persons diagnosed with severe opioid or cocaine use disorders, compared to persons diagnosed with other substance use disorders (unrelated to opioids or cocaine). METHOD: This observational study had n = 854 volunteers (male = 581, female = 273; ≥18 years of age at the time of interview) and examined the ages of onset of heaviest use of cannabis and alcohol in persons diagnosed by DSM-IV criteria with opioid dependence (OD), both opioid and cocaine dependence (OD + CD) and cocaine dependence (CD). These age trajectory measures were compared to persons with other substance use disorders (primarily cannabis and alcohol use disorders, termed "Any Other Diagnoses"). RESULTS: Unadjusted survival analyses showed persons diagnosed with either OD + CD or CD had earlier onset of heaviest use of cannabis (mean ages of 16.2 and 17.8, respectively) compared to the "Any Other Diagnoses" reference group (mean age = 19.5). A multivariate logistic regression showed that later onset of heaviest use of cannabis was associated with lower odds of being in the OD + CD or CD groups, when compared to the reference group. CONCLUSIONS: Persons diagnosed with severe cocaine use disorders or dual opioid and cocaine use disorders exhibit a pattern of heavy and especially early adolescent exposure to cannabis, compared to persons with other substance use disorders.


Assuntos
Alcoolismo , Cannabis , Cocaína , Abuso de Maconha , Transtornos Relacionados ao Uso de Opioides , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Idade de Início , Alcoolismo/epidemiologia , Analgésicos Opioides , Cannabis/efeitos adversos , Humanos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Adulto Jovem
10.
Drug Alcohol Depend ; 226: 108865, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34216861

RESUMO

Research exploring patterns and predictors of problematic cannabis use behaviors among young adults is limited. This knowledge is essential for intervening to prevent abuse and dependence outcomes. METHODS: Young adult cannabis users (Mage = 19.2[SD = 0.8]) in Southern California (N = 1007) were classified by patterns of problematic cannabis use from the Cannabis Abuse Screening Test, using Latent Class Analysis. Multinomial regression evaluated the association of frequency of use (no past 30 day use, infrequent [use on 1-2 of past 30 days], semi-frequent [use on 3-9 of the past 30 days], and frequent [use on 10 or more of the past 30 days]) for each cannabis product type (combustible, edible, vaporized, concentrate, blunt) with class membership. RESULTS: Four distinct classes of cannabis-related problems were identified: "non-symptomatic" (no problems; 33.8 %), "non-recreational use" (before noon and when alone; 34.5 %), "moderate use problems" (before noon, alone, and memory problems; 8.0 %), and "severe cannabis problems" (all 6 problems; 23.7 %). Semi-frequent (AOR range: 1.85-4.63;ps<0.05) and frequent (AOR range: 9.18-24.2;ps<0.05) use of combustible and vaporized cannabis, frequent blunt use (AORs range: 4.03-10.3;ps<0.05), and semi-frequent, but not frequent edible use (AOR range: 2.57-2.73;ps<0.05) was associated with higher odds of classification in any problematic use class (vs. non-symptomatic). CONCLUSIONS: Differences in cannabis use problems across these classes and their predictors reveal the heterogeneity in cannabis-related problems experienced by young people. Combustible cannabis, vaporized cannabis, and blunt cannabis use may confer the most risk for cannabis abuse and dependency outcomes, with more frequent days of use contributing to increased patterns of risk.


Assuntos
Cannabis , Abuso de Maconha , Adolescente , Humanos , Análise de Classes Latentes , Abuso de Maconha/epidemiologia , Adulto Jovem
11.
Addict Behav ; 123: 107049, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34303941

RESUMO

OBJECTIVE: This short communication reports on the association of annual measures of young adult (age 18-24) past month cannabis use with cannabis use disorder (CUD) treatment admissions by state in the U.S. from 2008 to 2017. METHODS: Annual data on percentage of past month cannabis use and the total number of CUD treatment admissions among young adults were acquired for each state from SAMHSA NSDUH and TEDS-A data sets. For each state, the correlation over time between cannabis use and treatment admissions rate was calculated and visualized in a choropleth map. Fixed-effects regression, where effects are fixed by state, was used to investigate the association of cannabis use with treatment admissions rate. RESULTS: In 38 out of 50 states, including seven out of the eight states legalizing recreational cannabis during the study period, as young adult cannabis use increased, treatment admissions declined. Cannabis use is significantly and negatively associated with treatment admissions (ß = -7.21, 95% CI = -11.88, -2.54), even after controlling for health insurance coverage, criminal justice referral, treatment center availability, and cannabis legalization status. CONCLUSIONS: While it is possible that across the U.S. more young adults are using cannabis without developing CUD, we speculate that increasing social acceptance of cannabis use, and declining perception of harm, may influence treatment seeking behavior, potentially resulting in growing unmet need for CUD treatment among young adults. Monitoring state-level trends in cannabis use, CUD prevalence, and treatment admissions is key to developing CUD prevention and treatment policies targeted to timely, state-specific conditions.


Assuntos
Cannabis , Alucinógenos , Abuso de Maconha , Maconha Medicinal , Adolescente , Adulto , Humanos , Legislação de Medicamentos , Abuso de Maconha/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
12.
J Clin Psychiatry ; 82(4)2021 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-34232581

RESUMO

Objective: The current study prospectively investigated the relationship between cigarette use and the onset of, persistence of, and relapse to cannabis use disorder (CUD) 3 years later among adults in the United States.Methods: Analyses included respondents who completed Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002 and 2004-2005, respectively) and responded to questions about cigarette use, cannabis use, and CUD (n = 34,653). CUDs were defined by DSM-IV criteria using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic Version IV. Multivariable logistic regression models were used to calculate the odds of CUD onset, persistence, and relapse at Wave 2 by Wave 1 cigarette use status. Analyses were adjusted for sociodemographics, psychiatric disorders, nicotine dependence, and alcohol and other substance use disorders.Results: Cigarette use at Wave 1 was associated with onset of CUD at Wave 2 among those without Wave 1 cannabis use (adjusted odds ratio [AOR] = 1.62; 95% CI, 1.35-1.94) but not among those with Wave 1 cannabis use (AOR = 1.00; 95% CI, 0.83-1.19). Cigarette use at Wave 1 was also associated with persistence of CUD at Wave 2 among those with CUD at Wave 1 (AOR = 1.63; 95% CI, 1.30-2.00) and relapse to CUD at Wave 2 among those with remitted CUD at Wave 1 (AOR = 1.23; 95% CI, 1.09-1.45).Conclusions: Among adults, cigarette use is associated with increased onset and persistence of and relapse to CUD 3 years later. Additional attention to cigarette use in community prevention and clinical treatment efforts aimed at reducing CUD may be warranted.


Assuntos
Fumar Cigarros/epidemiologia , Abuso de Maconha/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Uso da Maconha/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
13.
J Int Neuropsychol Soc ; 27(6): 520-532, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34261554

RESUMO

Attention allows us to select relevant information from the background. Although several studies have described that cannabis use induces deleterious effects on attention, it remains unclear if cannabis dependence affects the attention network systems differently. OBJECTIVES: To evaluate whether customary consumption of cannabis or cannabis dependence impacts the alerting, orienting, and executive control systems in young adults; to find out whether it is related to tobacco or alcohol dependence and if cannabis use characteristics are associated with the attention network systems. METHOD: One-hundred and fifty-four healthy adults and 102 cannabis users performed the Attention Network Test (ANT) to evaluate the alerting, orienting, and executive control systems. RESULTS: Cannabis use enhanced the alerting system but decreased the orienting system. Moreover, those effects seem to be associated with cannabis dependence. Out of all the cannabis-using variables, only the age of onset of cannabis use significantly predicted the efficiency of the orienting and executive control systems. CONCLUSION: Cannabis dependence favors tonic alertness but reduces selective attention ability; earlier use of cannabis worsens the efficiency of selective attention and resolution of conflicts.


Assuntos
Alcoolismo , Abuso de Maconha , Função Executiva , Humanos , Abuso de Maconha/complicações , Abuso de Maconha/epidemiologia , Orientação , Tempo de Reação , Adulto Jovem
14.
Am J Drug Alcohol Abuse ; 47(5): 535-547, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34280058

RESUMO

BACKGROUND: While males are more likely diagnosed with cannabis use disorder (CUD), females are more susceptible to developing and maintaining CUD. Yet, for both sexes, CUD is associated with high rates of comorbid mental illness (MI). OBJECTIVES: To identify and compare sex differences in the prevalence of comorbid CUD amongst individuals with/without MIs. METHODS: This systematic review generated pooled odds ratios (OR) and 95% confidence intervals (CI) from 37 studies (including clinical trials, cohort, and case-control studies) among individuals with and without MIs, quantifying sex differences in rates of comorbid CUD. A meta-analysis was also completed. RESULTS: In the CUD-only group, males were twice as likely to have CUD than females (OR = 2.0, CI = 1.9-2.1). Among MIs, males were more likely than females to have CUD comorbid with schizophrenia (OR ~2.6, CI = 2.5-2.7) and other psychotic, mood, and substance use disorders (1> OR <2.2, CI = 0.7-2.6). The reverse association (females > males) was observed for anxiety disorders and antisocial personality disorder (OR = 0.8, CI = 0.7-1.0). Among females, MIs increased the likelihood of having CUD, except for psychotic disorders and depression. A meta-analysis was inconclusive due to high heterogeneity across studies. Thus, comparisons across MI groups were not possible. CONCLUSION: While males are more likely to be diagnosed with CUD, there are important sex differences in the prevalence of CUD across MI diagnoses that should be taken into account when approaching CUD prevention and determining treatment efficacy.


Assuntos
Abuso de Maconha/epidemiologia , Transtornos Mentais/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Razão de Chances , Prevalência , Distribuição por Sexo , Fatores Sexuais
15.
J Psychiatr Res ; 140: 316-322, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34126426

RESUMO

Marijuana use may increase schizophrenia risk, and this effect may be genetically moderated. We investigated how hypothetical genetic test results indicating the presence or absence of heightened schizophrenia risk in reaction to marijuana use would affect attitudes toward marijuana use. In two experiments, participants were randomized to hypothetical scenarios in which genetic testing showed the presence or absence of a predisposition for marijuana use to increase their schizophrenia risk, or to a control condition with no mention of genetic testing. Experiment 1 used a sample of 801 U.S. young adults recruited via Amazon.com's Mechanical Turk platform. Experiment 2 replicated the same procedures with a nationally representative sample of 800 U.S. adults aged 18-30. In Experiment 1, those in the predisposition condition, compared to the control condition, rated the likelihood and importance of their avoiding marijuana as significantly higher, whereas those in the no-predisposition condition rated both as significantly lower. In experiment 2, these findings were largely replicated for the predisposition condition but not the no-predisposition condition, and prior marijuana use was a significant moderator, with the effects of the predisposition condition confined to participants who reported having used marijuana. If these results are predictive of responses to actual genetic testing, they suggest that genetic test results indicating that marijuana use will increase one's schizophrenia risk may incentivize abstinence, especially for those with prior marijuana use. Future research could further investigate whether genetic test results indicating the absence of such a predisposition might disincentivize abstinence from marijuana use.


Assuntos
Cannabis , Abuso de Maconha , Fumar Maconha , Uso da Maconha , Esquizofrenia , Transtornos Relacionados ao Uso de Substâncias , Humanos , Abuso de Maconha/epidemiologia , Abuso de Maconha/genética , Fumar Maconha/genética , Uso da Maconha/epidemiologia , Uso da Maconha/genética , Esquizofrenia/genética , Adulto Jovem
16.
Am J Addict ; 30(5): 485-495, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34143567

RESUMO

BACKGROUND AND OBJECTIVES: Screening, brief intervention, and referral to treatment (SBIRT) can reduce substance use, but receipt of these services by those who use cannabis frequently and have cannabis use disorder (CUD) remains unexplored. We examined cannabis use frequency and CUD's associations with the odds of receiving a substance use screening and a healthcare professional discussion among those who used healthcare services. METHODS: Data came from the 2015-2019 National Survey on Drug Use and Health (N = 214,505 aged 18+). Among adults who used cannabis and attended healthcare settings in the past year (N = 36,374), multivariable logistic regression analysis was used to examine associations of cannabis use frequency and CUD with receiving a substance use screen and substance use discussion by a healthcare professional. RESULTS: Cannabis use frequency was associated with higher odds of receiving a screen (adjusted odds ratio [AOR] = 1.27, 95% confidence interval [CI] = 1.14-1.41 for 300+ days of use) and a discussion among those screened (AOR = 1.83, 95% CI = 1.60-2.09 for 300+ days of use). CUD was not associated with receiving a screen, but it was positively associated with receiving a discussion among those screened (AOR = 1.22, 95% CI = 1.08-1.39). Nonmedical users were less likely to have a discussion among those screened and not screened. DISCUSSION AND CONCLUSIONS: Findings indicate disparities in screening and discussion of substance use with patients, especially between medical and nonmedical users. SCIENTIFIC SIGNIFICANCE: Study findings provide novel insight into differences in the reach of SBIRT services among adult cannabis users.


Assuntos
Cannabis , Alucinógenos , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Adulto , Atenção à Saúde , Humanos , Abuso de Maconha/diagnóstico , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
17.
J Psychiatr Res ; 138: 375-379, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33933928

RESUMO

An association has been found between cannabis use disorder (CUD) and violence in several clinical populations, including veterans with posttraumatic stress disorder (PTSD), and there is evidence that CUD has been increasing among veterans since September 11, 2001. There is also evidence that some veterans may be attempting to self-medicate psychological problems including PTSD and aggression with cannabis, despite the lack of safety and efficacy data supporting this use. To date, however, the association between CUD and aggression has yet to be examined in a large, non-clinic sample of veterans. The present study examined the association between cannabis use disorder, anger, aggressive urges, and difficulty controlling violence in a large sample of Iraq/Afghanistan-era veterans (N = 3028). Results of multivariate logistic regressions indicated that current CUD was significantly positively associated with difficulty managing anger (OR = 2.93, p < .05), aggressive impulses/urges (OR = 2.74, p < .05), and problems controlling violence in past 30 days (OR = 2.71, p < .05) even accounting for demographic variables, comorbid symptoms of depression and PTSD, and co-morbid alcohol and substance use disorders. Lifetime CUD was also uniquely associated with problems controlling violence in the past 30 days (OR = 1.64, p < .05), but was not significantly associated with difficulty managing anger or aggressive impulses/urges. Findings indicated that the association between CUD and aggression needs to be considered in treatment planning for both CUD and problems managing anger and aggressive urges, and point to a critical need to disentangle the mechanism of the association between CUD and violence in veterans.


Assuntos
Cannabis , Abuso de Maconha , Transtornos de Estresse Pós-Traumáticos , Veteranos , Afeganistão , Ira , Humanos , Iraque , Guerra do Iraque 2003-2011 , Abuso de Maconha/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Violência
18.
Subst Abus ; 42(2): 220-226, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34010118

RESUMO

Background: We sought to understand the association between heavy alcohol and frequent drug use and non-adherence to recommended social distancing and personal hygiene guidelines for preventing the spread of COVID-19 early in the US pandemic. Methods: A survey was offered on the crowdsourcing platform, Amazon Mechanical Turk (MTurk) during April 2020 (the early days of strict, social distancing restrictions). The study included 1,521 adults ages 18 years and older who resided in the US and were enrolled as MTurk workers, i.e., workers who are qualified by Amazon to complete a range of human interaction tasks, including surveys through the MTurk worker platform. Main predictors included measures of heavy drinking, marijuana, and polysubstance use. The dependent measures were measures of social distancing and personal hygiene, based on guidelines recommended at the time of the survey by the US Centers for Disease Control to prevent the spread of COVID-19. Results: We found consistent negative associations between heavy drinking and drug use and adherence to social distancing and personal hygiene. Additionally, three control variables, age, gender, and race/ethnicity, were significant correlates of adherence to these measures. Conclusions: The findings here are consistent with previous research exploring links between substance use and other adverse health behaviors. Further, the negative association between heavy drinking (five or more drinks in one sitting) and adherence underscore the public health risks entailed with the unrestricted reopening of public drinking establishments.


Assuntos
Alcoolismo/epidemiologia , COVID-19/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Higiene , Abuso de Maconha/epidemiologia , Distanciamento Físico , Saúde Pública , Política Pública , Adolescente , Adulto , Controle de Doenças Transmissíveis , Feminino , Higiene das Mãos/estatística & dados numéricos , Humanos , Masculino , SARS-CoV-2 , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos , Adulto Jovem
19.
BMC Public Health ; 21(1): 997, 2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044802

RESUMO

BACKGROUND: From a secondary prevention perspective, it is useful to know who is at greatest risk of progressing from substance initiation to riskier patterns of future use. Therefore, the aim of this study was to determine relationships between age at first use of alcohol, tobacco and cannabis and patterns of cannabis use, frequency of use and whether age of substance use onset is related to having a cannabis use disorder (CUD). METHODS: We analysed data from Ireland's 2010/11 and 2014/15 National Drug Prevalence Surveys, which recruited 5134 and 7005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported lifetime cannabis use. Multinomial, linear and binary logistic regression analyses were used to determine relationships between age of substance use onset and patterns of cannabis use, frequency of use and having a CUD. RESULTS: When compared to former users, the odds of being a current cannabis user were found to be reduced by 11% (OR = 0.89; 95% CI: 0.83, 0.95) and 4% (OR = 0.96; 95% CI: 0.92, 1.00) for each year of delayed alcohol and cannabis use onset, respectively. Among current users, significant inverse linear relationships were noted, with increasing age of first use of tobacco (ß = - 0.547; P < .001) and cannabis (ß = - 0.634; P < .001) being associated with a decreased frequency of cannabis use within the last 30 days. The odds of having a CUD were found to be reduced by 14% (OR = 0.86; 95% CI: 0.78, 0.94) and 11% (OR = 0.89; 95% CI: 0.82, 0.98) for each year of delayed tobacco and cannabis use onset respectively in analyses which examined survey participants aged 15-34 years. CONCLUSIONS: Among people who report past cannabis use, it is those with a more precocious pattern of early use of substances, including alcohol, and especially tobacco and cannabis, who are more likely to report ongoing, heavy and problematic cannabis use. Secondary prevention initiatives should prioritise people with a pattern of very early onset substance use.


Assuntos
Cannabis , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estudos Longitudinais , Abuso de Maconha/epidemiologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
20.
ScientificWorldJournal ; 2021: 6622363, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33986635

RESUMO

Introduction: Injuries are of public health concern and the leading cause of residual disability and death among teenagers, especially in low- and middle-income countries (LMICs). In Ghana, the burden of injury among adolescents is under-reported. Hence, the study sought to determine the prevalence of serious injuries (SI) and the potential factors influencing these injuries among school children in Ghana. Methods: This study was conducted in Ghana among Junior High School (JHS) and senior high school students (SHS) using the 2012 Global School-Based Student Health Survey (GSHS) data. The GSHS employed two-stage cluster sampling method. Serious injuries (SI) and independent factors were measured via self-administered questionnaires. Pearson chi-square test between each explanatory variable and serious injuries was conducted and the level of statistical significance was set at 5%. The significant variables from the chi-square test were selected for multiple logistic regression analysis. Multiple logistic regression was performed to estimate the adjusted odds ratio (AOR) at 95% confidence interval (CI). Results: The prevalence of SI in the past 12 months was 66% [CI=61.8-70.2] . The most common cause of SI was fall, 36%. The common types of injuries were cut/stab wounds and broken/dislocated bone. In the multiple logistic regression analysis, after controlling for other variables, educational level (AOR = 0.64, CI = 0.44-0.90, p < 0.015), suicidal ideation (AOR = 1.58, CI = 1.00-2.48, p < 0.002), suicidal attempt (AOR = 1.88, CI = 1.29-2.72, p < 0.001), having at least one close friend (AOR = 1.49, CI = 1.17-1.89, p < 0.002), school truancy (AOR = 1.66, CI = 1.31-2.09, p < 0.000), smoking marijuana (AOR = 2.64, CI = 1.22-5.69), and amphetamine use (AOR = 2.95, CI = 1.46-5.69) were independently associated with SI. Conclusion: The findings of the study established a high prevalence of SI among adolescents in Ghana, with cut/stab wound and broken/dislocated bone being the most reported type of injuries. This study also revealed that factors such as educational level, suicidal ideation, suicidal attempt, at least one close friend, school truancy, smoking marijuana, and amphetamine use are associated with SI among the adolescents. Therefore, pragmatic interventional programs should be targeted at these factors to curb the rate of SI among junior and senior school students.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Fraturas Ósseas/epidemiologia , Abuso de Maconha/epidemiologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Ferimentos Penetrantes/epidemiologia , Absenteísmo , Adolescente , Criança , Escolaridade , Feminino , Fraturas Ósseas/patologia , Amigos/psicologia , Gana/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Razão de Chances , Prevalência , Instituições Acadêmicas , Estudantes/psicologia , Ferimentos Penetrantes/patologia , Adulto Jovem
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