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2.
Psychol Addict Behav ; 33(8): 697-709, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31697091

RESUMO

Cannabis use has been rising despite recognition of the negative consequences associated with heavy use. The severity of these consequences has been shown to differ across racial/ethnic groups, even when controlling for consumption levels. The present study conducted an item response theory (IRT) analysis of the Cannabis Use Disorders Identification Test (CUDIT) to better understand the patterns of problematic cannabis use and their relation with other substance use across ethnic groups in the Healthy Life in an Urban Setting (HELIUS) study. CUDIT responses from 1,960 cannabis-using African Surinamese, South-Asian Surinamese, Dutch, Moroccan, and Turkish ethnic origin participants were used to test for differential item functioning (DIF) within an IRT framework. After restricting the sample to men because of low frequency of use among women, several instances of uniform DIF were identified. Multiple-group IRT analysis yielded a harmonized cannabis use phenotype that was used to estimate ethnic group differences in problematic cannabis use and its relation to alcohol and tobacco co-use. These analyses suggested that cannabis users from certain ethnic minority groups experienced higher rates of problematic use than the majority group despite lower rates of cannabis use. Further, cannabis and tobacco use were positively related across groups, whereas only ethnic minority groups showed a positive relation between cannabis and alcohol use. These results demonstrate the importance of accounting for DIF when examining group differences in problematic cannabis use, and support prior evidence suggesting that certain ethnic minority groups may be more likely to experience problematic cannabis use and alcohol co-use relative to the majority group. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Fumar Maconha/psicologia , Uso de Tabaco/psicologia , Adulto , Consumo de Bebidas Alcoólicas/etnologia , Grupos Étnicos , Humanos , Masculino , Fumar Maconha/etnologia , Pessoa de Meia-Idade , Grupos Minoritários , Países Baixos , Uso de Tabaco/etnologia , Adulto Jovem
3.
Medicina (Kaunas) ; 55(8)2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31387198

RESUMO

Background and objectives: Modern-day epidemiologic data on the risk and shifting landscape of occurrence of cardiovascular events in cannabis users remain inadequate and rather conflicting, especially amongst the young adult population. Furthermore, the problem of polysubstance use among youth is challenging for healthcare professionals and policy-makers. Previous studies report higher risk of concomitant use of tobacco, alcohol, cocaine, and amphetamine in young cannabis users. However, most of these studies did not eliminate the confounding effects of concomitant other substance abuse while assessing the incidence and outcome of cardiovascular events in cannabis users. Materials and methods: Using weighted discharge records from the National Inpatient Sample (NIS) from 2007-2014, we assessed the national trends in hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users (18-39 years), excluding cases with concomitant substance abuse with alcohol, tobacco, cocaine, and amphetamine. Results: Of 52.3 million hospitalizations without other substance abuse, 0.7 million (1.3%) young adults were current/former cannabis users. Among young adults without concomitant substance abuse, the frequency of admissions for AMI (0.23% vs. 0.14%), arrhythmia (4.02% vs. 2.84%), and stroke (0.33% vs. 0.26%) was higher in cannabis users as compared to non-users (p < 0.001). However, the frequency of admissions for VTE (0.53% vs. 0.84%) was lower among cannabis users as compared non-users. Between 2007 and 2014, we observed 50%, 79%, 300%, and 75% relative increases in hospitalizations for AMI, arrhythmias, stroke, and VTE, respectively, among young cannabis users as compared to non-users, showing relatively inferior or no ascent in the rates (ptrend < 0.001). Conclusions: The rising trends in hospitalizations for acute cardiovascular events among young cannabis users without concomitant other substance abuse call for future prospective well-designed studies to assess cannabis-related short-and long-term cardiovascular implications while simultaneously developing focused interventions towards raising awareness among the young population regarding the potential deleterious effects of cannabis use.


Assuntos
Doenças Cardiovasculares/diagnóstico , Hospitalização/estatística & dados numéricos , Fumar Maconha/efeitos adversos , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Feminino , Hospitalização/tendências , Humanos , Incidência , Masculino , Fumar Maconha/epidemiologia , Fumar Maconha/psicologia , Fatores de Risco , Estados Unidos/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-31450730

RESUMO

Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Maconha/epidemiologia , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Europa (Continente)/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Amor , Masculino , Fumar Maconha/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
5.
Nord J Psychiatry ; 73(6): 323-330, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31240984

RESUMO

Background: Although cannabis use has been linked with schizophrenia in a dose-response pattern, to our knowledge, the relationship between cannabis and schizophrenia has rarely been reported in Asian population. Aim: We compared the clinical characteristics and psychotropic prescription patterns between cannabis users and non-users among Asian patients with schizophrenia. Moreover, we aimed to identify the independent correlates of cannabis use in these subjects. Methods: We performed the analysis of the data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP), a collaborative consortium survey used to collate the prescription patterns for antipsychotic and other psychotropic medications in patients with schizophrenia in Asia. We included 132 schizophrenia patients in the group of lifetime cannabis use and 1756 in the group that had never used cannabis. A binary logistic model was fitted to detect the clinical correlates of lifetime cannabis use. Results: Adjusting for the effects of age, sex, geographical region, income group, duration of untreated psychosis, and Charlson comordity index level, a binary logistic regression model revealed that lifetime cannabis use was independently associated with aggressive behavior [adjusted odds ratio (aOR) = 1.582, 95% confidence interval (CI) = 1.006-2.490, p = .047] and with long-acting injectable antipsychotic treatment (aOR = 1.796, 95% CI = 1.444-2.820, p = .001). Conclusion: Our findings indicate a close link between lifetime cannabis use and aggressive behavior. The use of long-acting, injectable antipsychotics preferentially treats the aggressive behavior cannabis users among patients with schizophrenia in Asia, especially, the South or Southeast Asia.


Assuntos
Agressão , Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Cannabis/efeitos adversos , Fumar Maconha/efeitos adversos , Esquizofrenia/tratamento farmacológico , Adulto , Ásia/epidemiologia , Grupo com Ancestrais do Continente Asiático/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Fumar Maconha/epidemiologia , Fumar Maconha/psicologia , Razão de Chances , Psicotrópicos/administração & dosagem , Psicotrópicos/uso terapêutico , Esquizofrenia/epidemiologia , Inquéritos e Questionários
6.
Psychopharmacology (Berl) ; 236(12): 3439-3450, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31250074

RESUMO

RATIONALE: Cannabis use is widespread and has previously been associated with memory impairments. However, the role of cannabis in relation to false memory production, i.e., memories of events that were not experienced, is less well-understood. OBJECTIVE: The aim of the current field study was to examine the impact of cannabis use on false memory production. METHODS: The Deese/Roediger-McDermott (DRM) paradigm was used to induce false memories. In this paradigm, participants study word lists that are associatively related to a non-presented word, termed the critical lure. In a later memory test, true recognition rates and false alarm rates toward critical lures and unrelated items are assessed. Memory performance was compared between three groups: regular cannabis consumers who were acutely intoxicated (n = 53), regular cannabis consumers who were sober (n = 50), and cannabis-naïve controls (n = 53). The participants were approached in Dutch coffee shops (cannabis outlets) and cafes and asked to participate in our study. After collecting general information on their cannabis use, they were subjected to the DRM procedure. RESULTS: Although false memory rates for critical lures did not statistically differ between groups, both intoxicated and sober cannabis consumers falsely recognized more unrelated items than control participants. Also, individuals without a history of cannabis use demonstrated higher memory accuracy compared with the intoxicated group. CONCLUSION: It is concluded that cannabis intoxication and history of cannabis use induce a liberal response criterion for newly presented words for which the level of association with previously learned words is low and uncertainty is high.


Assuntos
Fumar Maconha/efeitos adversos , Fumar Maconha/psicologia , Transtornos da Memória/induzido quimicamente , Transtornos da Memória/psicologia , Memória/efeitos dos fármacos , Repressão Psicológica , Adolescente , Adulto , Cognição/efeitos dos fármacos , Cognição/fisiologia , Feminino , Humanos , Masculino , Memória/fisiologia , Rememoração Mental/efeitos dos fármacos , Rememoração Mental/fisiologia , Aprendizagem Verbal/efeitos dos fármacos , Aprendizagem Verbal/fisiologia , Adulto Jovem
7.
Drug Alcohol Depend ; 200: 139-144, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31129484

RESUMO

AIMS: The aim of this study was to examine the impact of vigorous intensity, high dose exercise (DEI) on cannabis use among stimulant users compared to a health education intervention (HEI) using data from the Stimulant Reduction Intervention using Dosed Exercise, National Institute of Drug Abuse National Drug Treatment Clinical Trials Network Protocol Number 0037 (STRIDE). METHODS: Adults (N = 302) enrolled in the STRIDE randomized clinical trial were randomized to either the DEI or the HEI. Interventions included supervised sessions three times a week during the Acute phase (12 weeks) and once a week during the Follow-up phase (6 months). Cannabis use was measured at each assessment via Timeline Follow Back and urine drug screens. Cannabis use was compared between the groups during the Acute and Follow-up phases using both the intent-to-treat sample and a complier average causal effects (CACE) analysis. FINDINGS: Approximately 43% of the sample reported cannabis use at baseline. The difference in cannabis use between the DEI and HEI groups during the Acute phase was not significant. During the Follow-up phase, the days of cannabis use was significantly lower among those in the DEI group (1.20 days) compared to the HEI group (2.15 days; p = 0.04). CONCLUSIONS: For those who adhered to the exercise intervention, vigorous intensity, high dose exercise resulted in less cannabis use. Results suggest that there were no significant short-term differences in cannabis use between the groups. Further study on the long-term impact of exercise as a treatment to reduce cannabis use should be considered.


Assuntos
Estimulantes do Sistema Nervoso Central/efeitos adversos , Exercício Físico/fisiologia , Fumar Maconha/terapia , Educação de Pacientes como Assunto/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Exercício Físico/psicologia , Feminino , Seguimentos , Educação em Saúde/métodos , Treinamento Intervalado de Alta Intensidade/métodos , Treinamento Intervalado de Alta Intensidade/psicologia , Humanos , Masculino , Fumar Maconha/psicologia , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
8.
Drug Alcohol Depend ; 200: 82-94, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31112834

RESUMO

BACKGROUND: Frequent Cannabis use has been linked to a variety of negative mental, physical, and social consequences. We assessed the effects of digital prevention and treatment interventions on Cannabis use reduction in comparison with control conditions. METHODS: Systematic review with two separate meta-analyses. Thirty randomized controlled trials met the inclusion criteria for the review, and 21 were included in the meta-analyses. Primary outcome was self-reported Cannabis use at post-treatment and follow-up. Hedges's g was calculated for all comparisons with non-active control. Risk of bias was examined with the Cochrane risk-of-bias tool. RESULTS: The systematic review included 10 prevention interventions targeting 8138 participants (aged 12 to 20) and 20 treatment interventions targeting 5195 Cannabis users (aged 16 to 40). The meta-analyses showed significantly reduced Cannabis use at post-treatment in the prevention interventions (6 studies, N = 2564, g = 0.33; 95% CI 0.13 to 0.54, p = 0.001) and in the treatment interventions (17 comparisons, N = 3813, g = 0.12; 95% CI 0.02 to 0.22, p = 0.02) as compared with controls. The effects of prevention interventions were maintained at follow-ups of up to 12 months (5 comparisons, N = 2445, g = 0.22; 95% CI 0.12 to 0.33, p < 0.001) but were no longer statistically significant for treatment interventions. CONCLUSIONS: Digital prevention and treatment interventions showed small, significant reduction effects on Cannabis use in diverse target populations at post-treatment compared to controls. For prevention interventions, the post-treatment effects were maintained at follow-up up to 12 months later.


Assuntos
Abuso de Maconha/terapia , Fumar Maconha/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Terapia Assistida por Computador/métodos , Adolescente , Adulto , Terapia Comportamental/métodos , Criança , Humanos , Abuso de Maconha/diagnóstico , Abuso de Maconha/psicologia , Fumar Maconha/psicologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
9.
Drug Alcohol Depend ; 200: 145-152, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31132681

RESUMO

BACKGROUND: Cognitive Bias Modification (CBM) has garnered interest as a potential addiction treatment. CBM interventions such as Approach Avoidance Training (AAT) are designed to alter automatic tendencies to approach drugs or drug-related cues. In our previous work, the cannabis AAT (CAAT) reduced cannabis approach bias, which was related to reduced cannabis use, among 80 non-treatment-seeking cannabis-using youth (Jacobus et al., 2018). In this preliminary examination, a subsample of these youth underwent neuroimaging to explore CAAT's effect on cannabis cue-related neural activation. METHODS: Sub-study participants were 41 cannabis-using youth ages 17-21 (mean age = 18.83; 47.5% female). Participants completed a cannabis cue-reactivity task during a functional MRI scan pre- and post CAAT-training or CAAT-sham to examine CAAT-related neural changes. RESULTS: Thirty-seven youth completed all six CAAT (n = 19) or CAAT-sham (n = 18) training sessions and had usable neuroimaging data. The group*time interaction on cannabis approach bias reached trend-level significance (p = .055). Change in approach bias slopes from pre-to post-treatment was positive for CAAT-sham (increased approach bias) and negative for CAAT-training (change to avoidance bias), consistent with the larger study. No significant changes emerged for cannabis cue-induced activation following CAAT-training or CAAT-sham in whole brain or region of interest analyses. However, active CAAT-training was associated with small-to-medium decreases in amygdala (Cohen's dz = 0.36) and medial prefrontal cortex (Cohen's dz = 0.48) activation to cannabis cues. CONCLUSIONS: Despite reducing cannabis use in the larger sample, CAAT-training did not alter neural cannabis cue-reactivity in the sub-study compared to CAAT-sham. More research is needed to understand neural mechanisms underlying AAT-related changes in substance use.


Assuntos
Comportamento do Adolescente/psicologia , Aprendizagem da Esquiva , Encéfalo/diagnóstico por imagem , Imagem por Ressonância Magnética/tendências , Fumar Maconha/terapia , Terapia Assistida por Computador/tendências , Adolescente , Aprendizagem da Esquiva/fisiologia , Comportamento Aditivo/diagnóstico por imagem , Comportamento Aditivo/psicologia , Sinais (Psicologia) , Método Duplo-Cego , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Abuso de Maconha/diagnóstico por imagem , Abuso de Maconha/psicologia , Abuso de Maconha/terapia , Fumar Maconha/psicologia , Estimulação Luminosa/métodos , Projetos Piloto , Terapia Assistida por Computador/métodos , Adulto Jovem
10.
Psychopharmacology (Berl) ; 236(9): 2713-2724, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31044290

RESUMO

BACKGROUND: The main psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), can impair driving performance. Cannabidiol (CBD), a non-intoxicating cannabis component, is thought to mitigate certain adverse effects of THC. It is possible then that cannabis containing equivalent CBD and THC will differentially affect driving and cognition relative to THC-dominant cannabis. AIMS: The present study investigated and compared the effects of THC-dominant and THC/CBD equivalent cannabis on simulated driving and cognitive performance. METHODS: In a randomized, double-blind, within-subjects crossover design, healthy volunteers (n = 14) with a history of light cannabis use attended three outpatient experimental test sessions in which simulated driving and cognitive performance were assessed at two timepoints (20-60 min and 200-240 min) following vaporization of 125 mg THC-dominant (11% THC; < 1% CBD), THC/CBD equivalent (11% THC, 11% CBD), or placebo (< 1% THC/CBD) cannabis. RESULTS/OUTCOMES: Both active cannabis types increased lane weaving during a car-following task but had little effect on other driving performance measures. Active cannabis types impaired performance on the Digit Symbol Substitution Task (DSST), Divided Attention Task (DAT) and Paced Auditory Serial Addition Task (PASAT) with impairment on the latter two tasks worse with THC/CBD equivalent cannabis. Subjective drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content. Peak plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, suggesting a possible pharmacokinetic interaction. CONCLUSIONS/INTERPRETATION: Cannabis containing equivalent concentrations of CBD and THC appears no less impairing than THC-dominant cannabis, and in some circumstances, CBD may actually exacerbate THC-induced impairment.


Assuntos
Condução de Veículo , Canabidiol/efeitos adversos , Cognição/efeitos dos fármacos , Dronabinol/efeitos adversos , Fumar Maconha/efeitos adversos , Vaping/efeitos adversos , Adulto , Condução de Veículo/psicologia , Canabidiol/administração & dosagem , Cognição/fisiologia , Estudos Cross-Over , Método Duplo-Cego , Dronabinol/administração & dosagem , Feminino , Alucinógenos/administração & dosagem , Alucinógenos/efeitos adversos , Humanos , Masculino , Fumar Maconha/psicologia , Psicotrópicos/efeitos adversos , Vaping/psicologia , Adulto Jovem
11.
Psychopharmacology (Berl) ; 236(9): 2773-2784, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31044291

RESUMO

RATIONALE: Cannabis use is common among adolescents and some research suggests that adolescent cannabis use increases the risk for depression, anxiety, and cognitive impairments in adulthood. In human studies, however, confounds may affect the association between cannabis use and the development of brain disorders. OBJECTIVES: These experiments investigated the effects of adolescent exposure to either cannabis smoke or THC on anxiety- and depressive-like behavior and cognitive performance in adulthood in Long-Evans rats. METHODS: Adolescent rats of both sexes were exposed to either cannabis smoke from postnatal days (P) 29-49 or ascending doses of THC from P35-45. When the rats reached adulthood (P70), anxiety-like behavior was investigated in the large open field and elevated plus maze, depressive-like behavior in the sucrose preference and forced swim tests, and cognitive function in the novel object recognition test. RESULTS: Despite sex differences on some measures in the open field, elevated plus maze, forced swim, and novel object recognition tests, there were no effects of either adolescent cannabis smoke or THC exposure, and only relatively subtle interactions between exposure conditions and sex, such that sex differences on some performance measures were slightly attenuated. CONCLUSION: Neither cannabis smoke nor THC exposure during adolescence produced robust alterations in adult behavior after a period of abstinence, suggesting that adverse effects associated with adolescent cannabis use might be due to non-cannabinoid concomitants of cannabis use.


Assuntos
Cognição/efeitos dos fármacos , Dronabinol/efeitos adversos , Emoções/efeitos dos fármacos , Fumar Maconha/efeitos adversos , Fumar Maconha/psicologia , Fatores Etários , Animais , Cannabis/efeitos adversos , Cognição/fisiologia , Dronabinol/administração & dosagem , Emoções/fisiologia , Feminino , Exposição por Inalação/efeitos adversos , Masculino , Ratos , Ratos Long-Evans , Caracteres Sexuais
12.
Psychopharmacology (Berl) ; 236(9): 2677-2685, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30968175

RESUMO

BACKGROUND: Synthetic cannabinoids (SCs) are a class of new psychoactive substances that have been rapidly evolving around the world throughout recent years. Many different synthetic cannabinoid analogues are on the consumer market and sold under misleading names, like "spice" or "incense." A limited number of studies have reported serious health effects associated with SC use. In this study, we compared clinical and subclinical psychopathological symptoms associated with SC use and natural cannabis (NC) use. METHODS: A convenience sample of 367 NC and SC users was recruited online, including four validated psychometric questionnaires: The Drug Use Disorders Identification Test (DUDIT), Insomnia Severity Index (ISI), Altman Mania Scale (Altman), and Brief Symptom Inventory (BSI). The two groups were compared with analysis of variance (ANOVA) and covariance (ANCOVA), chi2 tests, and logistic regression when appropriate. RESULTS: The SC user group did not differ in age from the NC user group (27.7 years), but contained less females (21% and 30%, respectively). SC users scored higher than NC users on all used psychometric measures, indicating a higher likelihood of drug abuse, sleep problems, (hypo)manic symptoms, and the nine dimensions comprising the BSI, somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Odds ratios (95% CI) for the SC user group vs NC user group were, respectively, drug dependence 3.56 (1.77-7.16), (severe) insomnia 5.01 (2.10-11.92), (hypo-)mania 5.18 (2.04-13.14), and BSI psychopathology 5.21 (2.96-9.17). DISCUSSION: This study shows that SC use is associated with increased mental health symptomatology compared to NC use.


Assuntos
Canabinoides/efeitos adversos , Abuso de Maconha/epidemiologia , Abuso de Maconha/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Medicamentos Sintéticos/efeitos adversos , Adolescente , Adulto , Idoso , Canabinoides/administração & dosagem , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Fumar Maconha/epidemiologia , Fumar Maconha/psicologia , Transtornos Mentais/induzido quimicamente , Pessoa de Meia-Idade , Psicopatologia , Inquéritos e Questionários , Medicamentos Sintéticos/administração & dosagem , Adulto Jovem
13.
Drug Alcohol Depend ; 199: 59-67, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30999251

RESUMO

BACKGROUND: Given a rapidly changing policy landscape, we sought to characterize the effects of state marijuana laws on parents' views of marijuana use by their teenage children. METHODS: Data are from 595 respondents to a nationally administered, web-based survey of parents of adolescents (ages 13-18 years) with any of three chronic conditions (type 1 diabetes, rheumatic disease, attention-deficit/hyperactivity disorder). Multivariate ordinal logistic regression was used to model the effects of parents' reports of state cannabis laws on their views toward marijuana use by their child. RESULTS: While 89.9% said any marijuana use was risky for their child, 27.9% would approve of its use if prescribed as medicine. Parents reporting marijuana decriminalization (11.1%) were more amenable to teenage use, less concerned about how marijuana might impact their child's condition, more accepting of the safety of marijuana as medicine, and approved its use with a prescription. Parents reporting legal medical (35.6%) or recreational (5.7%) use were more likely to report that their child has tried or used marijuana regularly. Parents reporting legal recreational use were less likely to agree that marijuana has medical benefits for their child. CONCLUSIONS: Among parents of medically vulnerable children, perceiving state marijuana policies as more permissive is strongly associated with lower perceived riskiness of marijuana use for their children. State marijuana policies are changing with implications for how parents of medically vulnerable youth view and potentially govern marijuana use by their medically vulnerable children.


Assuntos
Doença Crônica/psicologia , Legislação de Medicamentos , Uso da Maconha/legislação & jurisprudência , Uso da Maconha/psicologia , Pais/psicologia , Populações Vulneráveis/psicologia , Adolescente , Adulto , Cannabis , Doença Crônica/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Fumar Maconha/efeitos adversos , Fumar Maconha/legislação & jurisprudência , Fumar Maconha/psicologia , Uso da Maconha/efeitos adversos , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Psychol Addict Behav ; 33(4): 412-419, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30869920

RESUMO

Separately, research has identified use of marijuana protective behavioral strategies and marijuana refusal self-efficacy to be protective factors associated with less marijuana use and associated harms. To date, these factors have not been examined together. Using a large sample of college students recruited from 10 U.S. universities (n = 1,123), we examined the extent to which use of marijuana protective behavioral strategies and marijuana refusal self-efficacy have redundant, independent, or interactive effects on a wide range of marijuana-related outcomes using cross-sectional data. Across 9 marijuana-related outcomes, we found 1 significant buffering interaction (length of typical intoxication), 1 significant synergistic interaction (peak subjective intoxication), and 7 nonsignificant interactions (past month frequency, typical frequency, typical quantity, typical subjective intoxication, frequency of peak intoxication, negative consequences, and cannabis use disorder symptoms). Despite variability across distinct outcomes, on 8 of 9 of these outcomes, we found that individuals who reported high use of marijuana protective behavioral strategies and high levels of marijuana refusal self-efficacy demonstrated the lowest rates of marijuana use/harms. Our findings suggest that both of these factors are promising intervention targets, and future studies should examine distinct intervention strategies to modify use of marijuana protective behavioral strategies and marijuana refusal self-efficacy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Abuso de Maconha/psicologia , Fumar Maconha/psicologia , Autoeficácia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Proteção , Estudantes , Universidades , Adulto Jovem
17.
Exp Clin Psychopharmacol ; 27(6): 578-587, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30907601

RESUMO

Individuals with cannabis use disorders (CUD) show inhibitory control deficits and differential attention toward marijuana (MJ) stimuli. The robustness and utility of these measures in the CUD literature are somewhat equivocal. The present study was designed to increase measurement sensitivity by capitalizing on (a) individually calibrated stimulus selection based on cue reactivity patterns and (2) eye-tracking based measurement. CUD (n = 42) and non-CUD controls (n = 11) served as subjects. Subjects were first exposed to MJ and neutral pictures while measuring physiological and subjective responses on a trial by trial basis. A single reactivity index was created for each stimulus (L2 vector norm). Subject-unique high-reactivity MJ and low-reactivity neutral stimuli were then used in an eye-tracking task (pro-/antisaccade). The stimulus calibration procedure produced large reactivity differences between high/MJ and low/neutral stimuli (p < .001, effect size >7). CUD subjects made more overall antisaccade errors than controls (inhibitory control, p < .02, effect size >1), and CUD subjects (but not controls) made more errors on MJ trials versus neutral trials (attentional bias, p < .002, effect size >1). Within CUD subjects, L2 vector norm scores were associated with antisaccade errors (p < .04), and antisaccade errors were correlated with the Perceived Stress Scale (p < .03) and marginally with CUD severity (p < .07). Because of precise understanding of the neural circuitry governing antisaccades (a marker in several neuro/psychiatric disorders), eye movement-based measures combined with individually determined stimuli may provide an efficient and robust marker in CUD research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Atenção/fisiologia , Viés de Atenção , Movimentos Oculares , Abuso de Maconha/psicologia , Fumar Maconha/psicologia , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
18.
Drug Alcohol Depend ; 198: 105-111, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30901744

RESUMO

BACKGROUND: Despite the high prevalence of blunt smoking among cannabis users, very few studies examine the clinical profile of blunt smokers relative to those using more common methods of cannabis use, such as joints. METHODS: The current study uses baseline data from the ACCENT (Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment) study, a multi-site randomized pharmacotherapy clinical trial within the National Drug Abuse Treatment Clinical Trials Network, to predict the association between blunt and joint use frequency and cannabis use characteristics (e.g., grams of cannabis used) and consequences (e.g., withdrawal) among past-month cannabis users (N = 377) who were screened for study participation. RESULTS: After controlling for race, age, gender, other forms of cannabis use (including joint use) and nicotine dependence, multivariable linear regression models indicated that the number of days of blunt use in the past month was a significant predictor of the average amount of cannabis per using day (t = 3.04, p < .01), the estimated average cost of cannabis (t = 2.28, p < .05) and Cannabis Withdrawal Scale scores (t = 1.94, p < .05). Frequency of joint use did not significantly predict any of the cannabis use characteristics or consequences. CONCLUSIONS: Blunt smokers may present to treatment with greater amounts of cannabis smoked and more intense withdrawal symptoms, which may adversely impact their likelihood of successful abstinence. Cannabis-dependent blunt smokers may be more likely to benefit from treatment that targets physiological and mood-related withdrawal symptoms.


Assuntos
Cannabis/efeitos adversos , Fumar Maconha/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fumar/epidemiologia , Síndrome de Abstinência a Substâncias/epidemiologia , Tabagismo/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Modelos Lineares , Masculino , Fumar Maconha/psicologia , Fumar Maconha/terapia , Pessoa de Meia-Idade , Prevalência , Fumar/psicologia , Fumar/terapia , Síndrome de Abstinência a Substâncias/psicologia , Síndrome de Abstinência a Substâncias/terapia , Tabagismo/psicologia , Tabagismo/terapia
19.
Psychopharmacology (Berl) ; 236(9): 2641-2652, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30927021

RESUMO

RATIONALE: Non-medical prescription opioid use and opioid use disorder (OUD) present a significant public health concern. Identifying behavioral mechanisms underlying OUD will assist in developing improved prevention and intervention approaches. Behavioral economic demand has been extensively evaluated as a measure of reinforcer valuation for alcohol and cigarettes, whereas prescription opioids have received comparatively little attention. OBJECTIVES: Utilize a purchase task procedure to measure the incremental validity and test-retest reliability of opioid demand. METHODS: Individuals reporting past year non-medical prescription opioid use were recruited using the crowdsourcing platform Amazon Mechanical Turk (mTurk). Participants completed an opioid purchase task as well as measures of cannabis demand, delay discounting, and self-reported pain. A 1-month follow-up was used to evaluate test-retest reliability. RESULTS: More intense and inelastic opioid demand was associated with OUD and more intense cannabis demand was associated with cannabis use disorder. Multivariable models indicated that higher opioid intensity and steeper opioid delay discounting rates each significantly and uniquely predicted OUD. Increased opioid demand intensity, but not elasticity, was associated with higher self-reported pain, and no relationship was observed with perceived pain relief from opioids. Opioid demand showed acceptable-to-good test-retest reliability (e.g., intensity rxx = .75; elasticity rxx = .63). Temporal reliability was lower for cannabis demand (e.g., intensity rxx = .53; elasticity rxx = .58) and discounting rates (rxx = .42-.61). CONCLUSIONS: Opioid demand was incrementally valid and test-retest reliable as measured by purchase tasks. These findings support behavioral economic demand as a clinically useful measure of drug valuation that is sensitive to individual difference variables.


Assuntos
Analgésicos Opioides/administração & dosagem , Mercantilização , Desvalorização pelo Atraso/efeitos dos fármacos , Economia Comportamental , Medição da Dor/efeitos dos fármacos , Adulto , Analgésicos Opioides/economia , Desvalorização pelo Atraso/fisiologia , Prescrições de Medicamentos/economia , Feminino , Humanos , Masculino , Fumar Maconha/economia , Fumar Maconha/psicologia , Transtornos Relacionados ao Uso de Opioides/economia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Transtornos Relacionados ao Uso de Opioides/psicologia , Medição da Dor/economia , Medição da Dor/psicologia , Reprodutibilidade dos Testes , Fatores de Risco , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
20.
Drug Alcohol Depend ; 197: 134-140, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30825793

RESUMO

BACKGROUND: Daily cannabis use is increasing in the United States (US). Yet, it is not known whether daily cannabis use is disproportionately common, or whether it has increased differentially over time, by mental health status. This study estimated the prevalence of daily cannabis use among adults in the US with and without past-month serious psychological distress (SPD; measured by the Kessler Psychological Distress Scale (K6)) in 2016 and estimated trends in daily cannabis use by past-30-day SPD status from 2008 to 2016. METHODS: Data were drawn from adults age 18 and older in the 2008-2016 National Survey on Drug Use and Health (combined total analytic sample n = 356,413). Linear time trends of daily cannabis use, stratified by SPD status, were assessed using logistic regression models with continuous year as the predictor. RESULTS: In 2016, past-month daily cannabis use was significantly more common among those with past-month SPD (8.07%), compared to those without past-month SPD (2.66%). Daily cannabis use increased significantly from 2008 to 2016 among those both with and without SPD although use among those with SPD was persistently higher than use among those without SPD over the time period studied. CONCLUSIONS: Daily cannabis use is significantly more common among persons with serious psychological distress and is increasing in this group, as well as among those without. Given this increase and the high prevalence of cannabis use among those with SPD, it may be important to consider potential consequences of this increased use for those with mental health vulnerabilities.


Assuntos
Inquéritos Epidemiológicos , Fumar Maconha/epidemiologia , Fumar Maconha/psicologia , Saúde Mental , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Cannabis , Feminino , Inquéritos Epidemiológicos/tendências , Humanos , Masculino , Fumar Maconha/efeitos adversos , Fumar Maconha/tendências , Saúde Mental/tendências , Pessoa de Meia-Idade , Prevalência , Estresse Psicológico/diagnóstico , Estados Unidos/epidemiologia
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