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Incremental validity of estimated cannabis grams as a predictor of problems and cannabinoid biomarkers: Evidence from a clinical trial.

ABSTRACT: BACKGROUND:Quantifying cannabis use is complex due to a lack of a standardized packaging system that contains specified amounts of constituents. A laboratory procedure has been developed for estimating physical quantity of cannabis use by utilizing a surrogate substance to represent cannabis, and weighing the amount of the surrogate to determine typical use in grams. METHOD:This secondary analysis utilized data from a multi-site, randomized, controlled pharmacological trial for adult cannabis use disorder (N=300), sponsored by the National Drug Abuse Treatment Clinical Trials Network, to test the incremental validity of this procedure. In conjunction with the Timeline Followback, this physical scale-based procedure was used to determine whether average grams per cannabis administration predicted urine cannabinoid levels (11-nor-9-carboxy-?9-tetrahydrocannabinol) and problems due to use, after accounting for self-reported number of days used (in the past 30 days) and number of administrations per day in a 12-week clinical trial for cannabis use disorder. RESULTS:Likelihood ratio tests suggest that model fit was significantly improved when grams per administration and relevant interactions were included in the model predicting urine cannabinoid level (X2=98.3; p<0.05) and in the model predicting problems due to cannabis use (X2=6.4; p<0.05), relative to a model that contained only simpler measures of quantity and frequency. CONCLUSIONS:This study provides support for the use of a scale-based method for quantifying cannabis use in grams. This methodology may be useful when precise quantification is necessary (e.g., measuring reduction in use in a clinical trial).

SUBMITTER: Tomko RL

PROVIDER: S-EPMC5742553 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Incremental validity of estimated cannabis grams as a predictor of problems and cannabinoid biomarkers: Evidence from a clinical trial.

Tomko Rachel L RL Baker Nathaniel L NL McClure Erin A EA Sonne Susan C SC McRae-Clark Aimee L AL Sherman Brian J BJ Gray Kevin M KM

Drug and alcohol dependence 20171102

<h4>Background</h4>Quantifying cannabis use is complex due to a lack of a standardized packaging system that contains specified amounts of constituents. A laboratory procedure has been developed for estimating physical quantity of cannabis use by utilizing a surrogate substance to represent cannabis, and weighing the amount of the surrogate to determine typical use in grams.<h4>Method</h4>This secondary analysis utilized data from a multi-site, randomized, controlled pharmacological trial for ad ...[more]

PMID: 29112827

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Project description:BackgroundEpidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs.MethodsData are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426), Colombia (n = 5,782) and the United States (USA; n = 8,228). The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO) users across these surveyed populations.ResultsThe experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004) and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001).ConclusionsThis study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that might make cannabis-related social and legal problems more frequent in Colombia than in the USA.

Project description:The discovery of phytocannabinoid synthesizing enzymes, tetrahydrocannabinolic acid synthase (THCAs) and cannabidiolic acid synthase (CBDAs) was a breakthrough in Cannabis research. However, their evolutionary aspects and distribution across organisms has not been adequately studied. We searched for THCAs and CBDAs genes in organisms other than Cannabis plants using the database available in NCBI. Both cannabinoid synthases seem to be widely distributed in the plant kingdom. Of several complete or partial sequences of cannabinoid synthases-likes, CBDAs-like from Morus notabilis matched closely to CsCBDAs and CsTHCAs. When amino acid sequences of CsTHCAs, CsCBDAs and MnCBDAs-like were compared to each other, and to the motif database stored in Expasy, all three proteins contained the FAD_PCMH (PCMH-type FAD-binding) domain indicating the conservation of this domain in cannabinoid synthases. Apart from FAD binding, Berberine Bridge Enzyme (BBE-likes), which catalyzes the synthesis of isoquinoline alkaloids in many plants such as mulberry, poplas and citrus, were the other most closely related enzymes to CsTHCAs and CsCBDAs. We also searched for THCAs and CBDAs in fungal and bacterial kingdom but could not find any notably similar sequence. However, partial mRNA from FAD binding enzyme from Trametes versicolor and 6-hydroxy D nicotine oxidase from Aspergillus saccharolyticus matched the CsTHCA sequence and a partial mRNA from a hypothetical protein in Pneumocystis carinii was the most closely matched fungal enzyme to the CsCBDA. Our database search showed that Morus notabilis from mulberry family could be the candidate plant for further studies. Comparative transcriptomic and metabolomic studies for mulberry and Cannabis plants could provide a much clear concepts on the co-evolution of these syanthases. Moreover, the understanding of cannabinoid synthesis pathway is still evolving, in-depth bioinformatics and functional analysis of the enzymes involved are required for pharmaceutical research and industrial advancement.

Dataset Information

Incremental validity of estimated cannabis grams as a predictor of problems and cannabinoid biomarkers: Evidence from a clinical trial.

Publications

Incremental validity of estimated cannabis grams as a predictor of problems and cannabinoid biomarkers: Evidence from a clinical trial.

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