University students' attributions for abstinence from synthetic cannabinoids and synthetic cathinones.

BACKGROUND: Synthetic cannabinoids and synthetic cathinones are two increasingly available and potentially dangerous classes of substances. OBJECTIVE: We designed this study to test whether university students rated the influence of different types of reasons for abstaining differently as a function of type of drug (synthetic cannabinoids vs. synthetic cathinones) and gender (male vs. female). METHOD: Using a web-based survey, 176 male and 437 female undergraduate university students rated the degree to which each of 42 reasons for not taking drugs influenced their abstinence from those two classes of substances. RESULTS: Exploratory factor analyses suggested four subscales of reasons applicable to both substances: (1) psychological and behavioral impairment, (2) somatic and physiological concerns, (3) social approval and self-image concerns, and (4) insufficient knowledge and limited access. Both men and women rated all four subscales of reasons as having more influence on their abstinence from synthetic cathinones than synthetic cannabinoids, and women rated each subscale except somatic and physiological concerns as having more influence than did men. CONCLUSIONS: Although there were main effects for type of drug, because students typically reported the same types of reasons as being more or less influential for both classes of substances, prevention interventions could focus simultaneously on reasons to avoid or delay use of both types of substances.

Comparison of outcome expectancies for synthetic cannabinoids and botanical marijuana.

BACKGROUND: Although initially developed for medical purposes, synthetic cannabinoids have also been consumed for recreational purposes. OBJECTIVE: To evaluate whether agreement with positive and negative outcome expectancies differed for synthetic cannabinoids versus botanical marijuana, and assess reported reasons for using synthetic cannabinoids. METHOD: Using a web-based recruitment and data collection procedure, 186 adults who had used both synthetic cannabinoids and botanical marijuana and 181 adults who had used botanical marijuana but not synthetic cannabinoids, completed measures of outcome expectancies and other relevant questionnaires. RESULTS: A significant interaction revealed that participants who had used both synthetic cannabinoids and botanical marijuana indicated lower agreement with positive expectancies for synthetic cannabinoids, and higher agreement with positive expectancies for botanical marijuana, than did those participants who used only botanical marijuana. There was no interaction between type of drug and use history on agreement with negative expectancies, and participants agreed more strongly with negative outcome expectancies for synthetic cannabinoids than for botanical marijuana whether they had used one or both types of these drugs. The most frequently provided reasons for using synthetic cannabinoids included availability, perceived legality, cost, curiosity, and social interaction. CONCLUSION: Given growing public acceptance of recreational and medical marijuana, coupled with negative perceptions and increasing regulation of synthetic cannabinoid compounds, botanical marijuana is likely to remain more available and more popular than synthetic cannabinoids.

Acceptability of non-abstinence goals among students enrolled in addiction studies programs across the United States.

BACKGROUND: Previous studies of acceptability of non-abstinence recruited older, experienced addiction professionals; it's possible that younger, emerging addiction professionals may be more accepting of non-abstinence, perhaps due to training in harm reduction. METHODS: One hundred seventy graduate and undergraduate students enrolled in college/university-based programs offering training in addiction studies across the United States were recruited to complete a Web-based questionnaire assessing whether acceptability of non-abstinence outcome goals varied depending on the specific substance a client consumes, severity of diagnosis, and finality of outcome goal. RESULTS: More respondents rated non-abstinence an acceptable Intermediate goal for clients diagnosed with a Moderate cannabis use disorder (57%) or Moderate alcohol use disorder (45%) than for clients diagnosed with any other listed Moderate substance use disorder (32% to 36%). Similarly, larger proportions of respondents rated non-abstinence an acceptable Final goal for clients diagnosed with a Moderate cannabis use disorder (37%) or Moderate alcohol use disorder (31%) than for clients diagnosed with any other listed Moderate substance use disorder (19% to 23%). Only 14% to 26% of respondents rated non-abstinence an acceptable Final goal for clients diagnosed with a Severe substance use disorder, but 28% to 42% rated non-abstinence acceptable for clients diagnosed with a Severe substance use disorder when non-abstinence was an Intermediate goal. CONCLUSIONS: Compared with previous research examining the acceptability of non-abstinence, these results suggest that students enrolled in addiction studies training programs may be more accepting of clients who decide to pursue non-abstinence either as an intermediate step on the way to abstinence or as a final goal.

Self-Medication of Somatic and Psychiatric Conditions Using Botanical Marijuana.

As a complement to research evaluating botanical marijuana as a medical therapy for various somatic and psychiatric conditions, there is a growing body of research assessing marijuana users' self-reports of the symptoms and conditions for which they use marijuana without a physician's recommendation. As part of two larger web-based surveys and one in-situ survey at an outdoor marijuana festival, we asked regular marijuana users if they consumed the drug without a physician's recommendation and, if so, to describe (or select from a checklist) the conditions for which they used marijuana as a medication. Participants reported using marijuana to self-medicate a wide variety of both somatic conditions (such as pain, diabetes, and irritable bowel syndrome) and psychiatric conditions (such as depression, anxiety, and insomnia). Because fewer than half of the American states, and only a few countries, allow physicians to recommend medicinal marijuana, these findings may be of interest to clinicians as they treat patients, to lawmakers and policymakers as they consider legislation allowing physicians to recommend botanical marijuana for somatic and psychiatric conditions, and to researchers evaluating conditions that individuals elect to self-medicate using botanical marijuana.

Substance use consequences, mental health problems, and readiness to change among Veterans seeking substance use treatment.

Individuals seeking substance use treatment who have one or more co-occurring mental health problems tend to have lower treatment engagement, higher rates of attrition, and poorer treatment outcomes. Readiness to change (RTC) is an integral construct in the recovery process, with higher RTC associated with improved treatment outcomes. However, the impact of psychiatric symptoms on RTC is not fully understood, especially among specialty subpopulations, such as military Veterans. Therefore, the aim of the present study was to examine the associations of mental health problems with RTC in a sample of Veterans initiating outpatient substance use treatment. The present sample was comprised of 278 Veterans (12% women, Mage = 48.22, SD = 14.06) who completed self-report intake measures assessing past month substance use frequency, substance-related consequences, symptoms of insomnia, depression, and anxiety, and importance and confidence to change one's substance use. Four separate canonical correlation analyses focusing on RTC alcohol, opioid, cannabis, and nicotine use were conducted. Veterans' inclusion in each analysis was not mutually exclusive. Results indicated that greater depression, anxiety, consequences, and frequency of alcohol use corresponded with greater importance to change alcohol use. Likewise, greater depression, anxiety, and insomnia symptoms along with frequency of use and consequences related to greater importance and confidence to change one's opioid use. In contrast, greater anxiety, depression, insomnia, and frequency of use were associated with less confidence in one's ability to change cannabis use. None of these variables were related to one's RTC nicotine use. Findings highlight the importance of assessing mental health problems at outset of substance use treatment, as they may be an indication of RTC and could be used as a catalyst to advance Veterans forward in the process of behavior change.

Patterns of Use, Acute Subjective Experiences, and Motivations for Using Synthetic Cathinones ("Bath Salts") in Recreational Users.

Given the variety and potential toxicity of synthetic cathinones, clinicians and educators would benefit from information about patterns of and motivations for use, frequency of psychosocial consequences, and experience of acute subjective effects. We administered a comprehensive, web-based survey to 104 recreational users of synthetic cathinones. Sixty percent of respondents consumed synthetic cathinones once or more per month, usually snorting or swallowing these drugs, typically at home, usually with others, customarily during the evening and nighttime hours, and often in combination with another drug such as alcohol or marijuana. Acute subjective effects attributed to synthetic cathinones were similar to those of other psychostimulants, including increased energy, rapid heartbeat, racing thoughts, difficulty sleeping, euphoria, decreased appetite, open-mindedness, and increased sex drive. Reported reasons for using synthetic cathinones included its stimulating effects, curiosity, substitution for another drug, and being at a party/music event. Respondents had experienced an average of six negative consequences of using synthetic cathinones during the previous year (e.g., tolerance, neglecting responsibilities, personality change). In combination with previously published investigations, these findings increase our understanding of the reported rationales and outcomes of recreational use of synthetic cathinones.

Psychometric evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale with young recreational marijuana users.

INTRODUCTION: This study evaluated the cue-reactivity and several psychometric properties of a questionnaire designed to assess marijuana users' self-efficacy to employ 21 specific cognitive-behavioral strategies to reduce their marijuana use. METHOD: Using a web-based recruitment and data-collection procedure, 513 regular marijuana users completed dependent measures following marijuana-related or control cue exposure. RESULTS: Although exposure to marijuana-related stimuli significantly increased reported craving, mean reduction-strategy self-efficacy scores did not differ as a function of cue exposure. Reliability analyses supported retaining all 21 items as a single scale. Reduction-strategy self-efficacy was positively associated with marijuana-refusal self-efficacy and with recent past use of reduction strategies, was negatively associated with quantity and frequency of marijuana use and marijuana-related problems, and was positively but weakly associated with general self-efficacy. The most frequently reported strategies that were employed reflected restricting marijuana use to once per day, not keeping a large stash available, turning down unwanted hits, and not obtaining more marijuana right away if one's supply runs out. CONCLUSIONS: These findings further support the reliability and validity of the questionnaire when administered to a diverse sample of regular marijuana users.