Project description:BACKGROUND:Correlates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative. METHODS:This study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25?years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition. RESULTS:Of the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ?.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90?days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability. CONCLUSIONS:Cannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.
Project description:PURPOSE:We evaluate if cigarette smoking and/or nicotine dependence predicts cannabis use disorder symptoms among adolescent and young adult cannabis users and whether the relationships differ based on frequency of cannabis use. METHODS:Data were drawn from seven annual surveys of the NSDUH to include adolescents and young adults (age 12-21) who reported using cannabis at least once in the past 30?days (n?=?21,928). Cannabis use frequency trends in the association between cigarette smoking, nicotine dependence and cannabis use disorder symptoms were assessed using Varying Coefficient Models (VCM's). RESULTS:Over half of current cannabis users also smoked cigarettes in the past 30?days (54.7% SE 0.48). Cigarette smoking in the past 30?days was associated with earlier onset of cannabis use, more frequent cannabis use and a larger number of cannabis use disorder symptoms compared to those who did not smoke cigarettes. After statistical control for socio-demographic characteristics and other substance use behaviors, nicotine dependence but not cigarette smoking quantity or frequency was positively and significantly associated with each of the cannabis use disorder symptoms as well as the total number of cannabis symptoms endorsed. Higher nicotine dependence scores were consistently associated with the cannabis use disorder symptoms across all levels of cannabis use from 1?day used (past month) to daily cannabis use, though the relationship was strongest among infrequent cannabis users. CONCLUSION:Prevention and treatment efforts should consider cigarette smoking comorbidity when addressing the increasing proportion of the US population that uses cannabis.
Project description:Contemporary models of substance use disorders emphasize the role of cognitive control, which has been linked to difficulties in resisting the use of substances. In the present study, we measured two aspects of cognitive control, response inhibition (operationalized by a Go/NoGo Task) and performance monitoring (operationalized by an Eriksen Flanker Task), in a group of young cannabis-use disorder (CUD) patients and compared these functions with two control groups (i.e. a group of cigarette smokers and a group of non-smokers). We employed both behavioural and electrophysiological measures. The results indicate that CUD patients displayed reduced NoGo-P3 event-related potentials compared with non-smoking controls, but not compared with smoking controls. In addition, CUD patients were slower on Go trials than both control groups. No other between-group electrophysiological or behavioural differences were observed. These results seem to suggest that CUD patients have problems related to response inhibition, but performance monitoring seems relatively unaffected.
Project description:OBJECTIVES:Daily cannabis use can portend problematic use or dependence. We aimed to identify early risk factors for daily cannabis use in young adults. METHODS:Data were available in a longitudinal investigation of 1294 grade 7 students age 12 to 13 years at inception recruited in 10 secondary schools in Montreal, Canada, in 1999. Data on daily cannabis use were collected in mailed self-report questionnaires from 878 participants (67.9% of 1294) at age 20. The associations between each of 23 potential risk factors measured in grade 7 and daily cannabis use at age 20 were modeled using logistic regression. RESULTS:At age 20, 44% of participants reported past-year cannabis use; 10% reported daily use. Older age; male sex; higher levels of family stress and other stress; use of alcohol, cigarettes, and other tobacco products; parent(s), sibling(s), and friend(s) smoke cigarettes; higher body mass index; higher impulsivity and novelty seeking; and lower self-esteem increased the odds of daily cannabis use. CONCLUSIONS:Children at risk of daily cannabis use as young adults can be identified early. They may benefit from early intervention to prevent problematic cannabis use.
Project description:IntroductionBinge drinking (BD) and cannabis use are prevalent in European adolescents and students. BD has been shown to have a negative impact on neuropsychological functioning, but little is known about the additive effect when it is combined with cannabis consumption. We therefore investigated the neuropsychological profiles of students who engage in combined BD and cannabis use, in order to explore the potentially harmful additive effects of cannabis use and BD on cognition.Material and methodsA sample of college students (N = 298) completed questionnaires on alcohol and cannabis use, and were screened for neuropsychological impairments using the Brief Evaluation of Alcohol-Related Neuropsychological Impairments (BEARNI). First, after dividing students into three groups according to their alcohol and cannabis use (i.e., light drinkers, binge drinkers, and binge drinkers consuming cannabis), we ran a linear mixed model based on the BEARNI z scores to test the performances of the three groups. Information yielded by the mixed model was supplemented by individual analyses. Second, to explore the heterogeneity of binge drinkers' profiles, we ran a cluster analysis to characterize the alcohol users at higher risk of more severe neuropsychological impairment.ResultsOverall, poorer neuropsychological performances were observed among binge drinkers compared with light drinkers, whether they used cannabis or not. However, flexibility, episodic memory and working memory were particularly affected among binge drinkers who used cannabis.ConclusionsResults emphasize the importance of asking binge drinkers if they smoke cannabis, in order to adapt care and prevention strategies to their consumption and neuropsychological profile.
Project description:BackgroundHistorically, cannabis researchers have assumed a single mode and product of cannabis (e.g., smoking plant). However, patterns of use, products (e.g., concentrates, edibles), and modes (e.g. blunts, vaporizers) are diversifying. This study sought to: 1) classify cannabis users into groups based on their use of the full range of cannabis products, and 2) examine user group differences on demographics, cannabis consequences and cannabis use disorder (CUD) symptomatology.MethodsIn a sample of college students (data collected in Fall 2017), who used cannabis in the past year (N = 1390), latent class analysis (LCA) was used to characterize cannabis users. We then added demographic characteristics, cannabis consequences, and CUD symptomatology scores separately to LCA models to examine class differences.ResultsFive unique classes emerged: high-frequency all-product users, high-frequency plant/moderate-frequency edible and concentrate users, low-frequency plant users, moderate-frequency plant and edible users, and low-frequency edible users. Demographic characteristics, cannabis consequences, and CUD symptomatology differed across classes characterized by frequency as well as product.ConclusionsResults reflect the increasing variety of cannabis products, modes, and use patterns among college students. In this sample, frequency of use remains a strong predictor of cannabis-related consequences, in addition to type of product. As variation in cannabis use patterns continue to evolve, it is essential for researchers to conduct comprehensive assessments.
Project description:BackgroundThe persistence of cannabis use disorder (CUD) in young adults with first-episode psychosis (FEP) is associated with poor clinical and functional outcomes. Face-to-face psychological interventions are effective in treating CUD. However, their use in early intervention services (EISs) for psychosis is inconsistent because of barriers, including high workload and heterogeneity in training of clinicians and lack of motivation for treatment among patients. Tailoring new technology-based psychological interventions (TBPIs) to overcome these barriers is necessary to ensure their optimal acceptability.ObjectiveThe aim of this study is twofold: to explore psychological intervention practices and intervention targets that are relevant for treating CUD in individuals with early psychosis and to explore factors related to the development and implementation of a technology-assisted psychological intervention.MethodsA total of 10 patients undergoing treatment for FEP and CUD in EISs participated in a focus group in June 2019. Semistructured individual interviews were conducted with 10 clinicians working in first-episode clinics in the province of Québec, Canada. A hybrid inductive-deductive approach was used to analyze data. For the deductive analysis, we used categories of promoting strategies found in the literature shown to increase adherence to web-based interventions for substance use (ie, tailoring, reminders, delivery strategies, social support, and incentives). For the inductive analysis, we identified new themes through an iterative process of reviewing the data multiple times by two independent reviewers.ResultsData were synthesized into five categories of factors that emerged from data collection, and a narrative synthesis of commonalities and differences between patient and clinician perspectives was produced. The categories included attitudes and beliefs related to psychological interventions (eg, behavioral stage of change), strategies for psychological interventions (eg, motivational interviewing, cognitive behavioral therapy, psychoeducation, stress management), incentives (eg, contingency management), general interest in TBPIs (eg, facilitators and barriers of TBPIs), and tailoring of TBPIs (eg, application needs and preferences, outcome measures of interest for clinicians).ConclusionsThis study provides a comprehensive portrait of the multifaceted needs and preferences of patients and clinicians related to TBPIs. Our results can inform the development of smartphone- or web-based psychological interventions for CUD in young adults with early psychosis.
Project description:OBJECTIVE:Given changes in U.S. marijuana laws, attitudes, and use patterns, individuals with pain may be an emerging group at risk for nonmedical cannabis use and cannabis use disorder. The authors examined differences in the prevalence of nonmedical cannabis use and cannabis use disorder among U.S. adults with and without pain, as well as whether these differences widened over time. METHODS:Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2002; N=43,093) and NESARC-III (2012-2013; N=36,309) were analyzed using logistic regression. Risk differences of past-year nonmedical cannabis use, frequent (at least three times a week) nonmedical use, and DSM-IV cannabis use disorder were estimated for groups with and without moderate to severe pain, and these risk differences were tested for change over time. RESULTS:Any nonmedical cannabis use was more prevalent in respondents with than without pain (2001-2002: 5.15% compared with 3.74%; 2012-2013: 12.42% compared with 9.02%), a risk difference significantly greater in the 2012-2013 data than in the 2001-2002 data. The prevalence of frequent nonmedical cannabis use did not differ by pain status in the 2001-2002 survey, but was significantly more prevalent in those with than without pain in the 2012-2013 survey (5.03% compared with 3.45%). Cannabis use disorder was more prevalent in respondents with than without pain (2001-2002: 1.77% compared with 1.35%; 2012-2013: 4.18% compared with 2.74%), a significantly greater risk difference in the data from 2012-2013 than from 2001-2002. CONCLUSIONS:The results suggest that adults with pain are a group increasingly vulnerable to adverse cannabis use outcomes, warranting clinical and public health attention to this risk. Psychiatrists and other health care providers treating patients with pain should monitor such patients for signs and symptoms of cannabis use disorder.
Project description:In people with mental health issues, approximately 20% have co-occurring substance use, often involving cannabis. Although emotion regulation can be affected both by major depressive disorder (MDD) and by cannabis use, the relationship among all three factors is unknown. In this study, we used fMRI to evaluate the effect that cannabis use and MDD have on brain activation during an emotion regulation task. Differences were assessed in 74 emerging adults aged 16-23 with and without MDD who either used or did not use cannabis. Severity of depressive symptoms, emotion regulation style, and age of cannabis use onset were also measured. Both MDD and cannabis use interacted with the emotion regulation task in the left temporal lobe, however the location of the interaction differed for each factor. Specifically, MDD showed an interaction with emotion regulation in the middle temporal gyrus, whereas cannabis use showed an interaction in the superior temporal gyrus. Emotion regulation style predicted activity in the right superior frontal gyrus, however, this did not interact with MDD or cannabis use. Severity of depressive symptoms interacted with the emotion regulation task in the left middle temporal gyrus. The results highlight the influence of cannabis use and MDD on emotion regulation processing, suggesting that both may have a broader impact on the brain than previously thought.
Project description:The increase in cannabis potency may have treatment implications for cannabis use disorder (CUD). Given the reported increase in prevalence of cannabis use among adults, there is a need to understand substance use treatment needs for CUD.We examined demographics and behavioral health indicators of adults aged ?18 years that met criteria for past-year CUD (n=10,943) in the 2005-2013 National Surveys on Drug Use and Health. We determined prevalence and correlates of past-year treatment use for alcohol/drug, any drug, and cannabis use related problems, to inform treatment efforts for CUD.The majority of adults with past-year CUD were young adults aged 18-25 or men, had low income, and did not attend college. Two-thirds of adults with CUD met criteria for cannabis dependence, which was comparatively common among younger adults, women, low-income or publicly insured adults, and college-educated adults. Nicotine dependence (40.92%) and alcohol (44.07%) or other drug use disorder (19.70%) were prevalent among adults with CUD. Overall, less than 13% of adults with CUD had received alcohol/drug use treatment the past year; only 7.8% received cannabis-specific treatment. There was no significant yearly variation in treatment use prevalence over 9 years. In particular, Asian-Americans, women, and college-educated adults underutilized cannabis-specific treatment.This large sample of adults with CUD reveals pervasive underutilization of cannabis-related treatment, especially in women, married adults, and those with college education, despite a high proportion of comorbid behavioral health problems.