Baseline Marijuana Use Research Articles

Interpersonal Consequences Predicting Adolescent Substance Use: Examining the Role of Temptation Coping, Motivation, and Impulsivity

Background: Adolescent substance use is highly prevalent and problematic; it has been reported as one of the most pertinent leading health concerns in the United States. The current longitudinal study examined the presence of peer and parental interpersonal relationship consequences (IP) as a motivating factor in activating coping skills to decrease the frequency of adolescent substance use, while further evaluating the role of impulsivity within that process. Objectives: Two main hypotheses were proposed: (1) IP will decrease substance use frequency mediated by increases in motivation and temptation coping; and (2) impulsivity will moderate the link between coping and substance use frequency. Participants included 343 adolescents between the ages of 13-19 (M = 16.23) referred to Project READY, a school-based substance use intervention. Assessments were completed during Sessions 1 and 4 of the intervention. Results: Serial mediation analyses indicated temptation coping, baseline alcohol use, and Time 2 marijuana use were the only statistically significant predictors of Time 2 alcohol use. Temptation coping and baseline marijuana use were the only statistically significant predictors of Time 2 marijuana use. Conclusions: Once adolescents’ baseline and concurrent substance use were incorporated into the model, there was no statistical significance of the indirect effects. Results provided a stronger examination of the factors related to long-term substance use among adolescents. Knowing that temptation coping and baseline substance use levels were significant predictors of time 2 substance use independent of interpersonal consequences and motivation to change provides a structural frame and highlights need for early intervention.

Is E-cigarette use a gateway to marijuana use? Longitudinal examinations of initiation, reinitiation, and persistence of e-cigarette and marijuana use

BackgroundConcerns have been raised regarding e-cigarette use as a potential stepping-stone to marijuana use. Based on Kandel’s gateway hypothesis, this study investigated if e-cigarette use could lead to marijuana use by testing two hypotheses with a longitudinal national U.S. adult sample, including (1) primary hypothesis: e-cigarette use is a gateway to marijuana use; and (2) falsification hypothesis: marijuana use is not a gateway to e-cigarette use. MethodsAdults were extracted from the Population Assessment of Tobacco and Health Study Waves 1–3 (2013–2016). For primary hypotheses, based on baseline e-cigarette use statuses, three study groups were defined, and three logistic regressions were conducted to examine associations between baseline e-cigarette use and follow-up marijuana use initiation, reinitiation, and persistence, respectively. Similarly, for falsification hypotheses, three additional study groups were defined, and three logistic regressions were conducted to examine associations between baseline marijuana use and follow-up e-cigarette use behaviors. ResultsBaseline e-cigarette use was associated with marijuana use initiation and reinitiation (ORs = 2.08, 1.37, respectively, both ps < .05) but not persistence at follow-up. Additionally, baseline marijuana use was associated with only e-cigarette use initiation (OR = 2.23, p < .01) but not reinitiation or persistence at follow-up. ConclusionsFindings partially support the gateway hypothesis that e-cigarette use could be a steppingstone to marijuana use reinitiation among the U.S. adults. The mechanisms and behavioral characteristics, such as etiological and psychosocial factors, that may pertain to the progression from e-cigarette use to reinitiation of other substance use should be further investigated to inform effective behavioral, educational, and policy interventions.

Caffeinated energy drink consumption and predictors of use among secondary school students over time in the COMPASS cohort study.

Consumption of caffeinated energy drinks (CED) by youth is a public health priority, given the lack of regulation and evidence for both short and long-term health effects of CED use. Considering the potential risks associated with excessive caffeine consumption, this paper examined CED consumption and predictors of CED use over time in a large sample of Canadian secondary school students participating in the COMPASS study.Using linked longitudinal data (n = 4949) from the first three years of the COMPASS study (2012/13 to 2014/15), three logistic Generalized Estimated Equation models were performed to examine predictors of weekday CED use, weekend CED use, and weekly CED use.The prevalence of weekly CED use remained fairly consistent across the three years of follow-up; 12.5% in year-1, 11.3% in year-2, and 11.4% in year-3. Smokers and marijuana users at follow-up were all at greater odds of weekday or weekly CED use, regardless of baseline use. Binge drinkers at baseline were at greater odds for weekday or weekly CED use, but not if they started binge drinking after their baseline year. Marijuana users at follow-up were all at greater odds of weekend CED use, regardless of baseline marijuana use.>1 in 10 youth reported consuming CEDs one or more times per week, where specific subpopulations of youth, such as marijuana users, appear to be more frequent CED users. Although CED use remained relatively constant over the three-year period examined, prevalence of CED use remains problematic among secondary school students.

The Development of Marijuana Dealing Behavior During Adolescence and Early Adulthood Among Juvenile Offenders: Risk Factors for Development

ABSTRACT Despite the amount of attention paid to marijuana use, there has yet to be any research that examines heterogeneity in the development of marijuana dealing behavior across time. This research used group-based trajectory modeling to elucidate developmental trends in this behavior and examines how risk factors may predict heterogeneity in marijuana dealing among a sample of juvenile offenders. The Pathways to Desistance data set, a sample of 1,354 juvenile offenders followed across 84 months during adolescence and early adulthood following a recent adjudication, was utilized in analyses. Results indicate that a five-group model best fits the data. Results indicate that higher baseline resistance to peer influence was associated with increased risk of assignment to the Accelerating and High Chronic groups, whereas baseline marijuana use was associated with assignment to the Accelerating, Desisting, and High Chronic groups when all covariates were included in estimation. This indicates that juvenile offenders may be at risk for dealing marijuana during adolescence and use of the drug and low susceptibility to peer influence may indicate higher risk for engagement.

Marijuana Use and Depressive Symptoms; Gender Differences in African American Adolescents.

Introduction: This study aimed to examine gender differences in the bidirectional associations between marijuana use and depressive symptoms among African American adolescents. The study also tested gender differences in the effects of socioeconomic status, maternal support, and friends’ drug use on adolescents’ depressive symptoms and marijuana use.Methods: This is a secondary analysis of the Flint Adolescent Study (FAS). Six hundred and eighty one African American adolescents (335 males and 346 females) were followed for 3 years, from 1995 (mean age 16) to 1997 (mean age 19). Depressive symptoms (Brief Symptom Inventory) and marijuana use were measured annually during the follow up. We used multi-group latent growth curve modeling to explore the reciprocal associations between depressive symptoms and marijuana use over time based on gender.Results: Baseline marijuana use was predictive of an increase in depressive symptoms over time among male but not female African American adolescents. Baseline depressive symptoms were not predictive of an increase in marijuana use among male or female adolescents.Conclusion: Study findings suggest that male African American adolescents who use marijuana are at an increased risk of subsequent depressive symptoms. Interventions that combine screening and treatment for marijuana use and depression may be indicated for African American male adolescents.

Associations between anhedonia and marijuana use escalation across mid-adolescence.

Anhedonia-a transdiagnostic psychopathological trait indicative of inability to experience pleasure-could lead to and result from adolescent marijuana use, yet this notion has not been tested. This study aimed to estimate the association of: (1) anhedonia at age 14 with rate of change in marijuana use over an 18-month follow-up, and (2) marijuana use at age 14 with rate of change in anhedonia over follow-up. Secondary aims were to test whether gender, baseline marijuana use history and peer marijuana use moderated these associations. Observational longitudinal cohort repeated-measures design, with baseline (age 14years), 6-month, 12-month and 18-month follow-up assessments. Ten public high schools in Los Angeles, CA, USA, 2013-15. Students [n=3394; 53.5% female, mean (standard deviation) age at baseline=14.1 (0.42)]. Self-report level of anhedonia on the Snaith-Hamilton Pleasure Scale and frequency of marijuana use in the past 30days. Parallel process latent growth curve models adjusting for confounders showed that baseline anhedonia level was associated positively with the rate of increase in marijuana use frequency across follow-ups [β, 95% confidence interval (CI)=0.115 (0.022, 0.252), P=0.03]. Baseline marijuana use frequency was not related significantly to the rate of change in anhedonia across follow-ups [β, 95% CI=-0.015 (-0.350, 0.321), P=0.93]. The association of baseline anhedonia with faster marijuana use escalation was amplified among adolescents with (versus without) friends who used marijuana at baseline [β, 95% CI=0.179 (0.043, 0.334) versus 0.064 (-0.071, 0.187), interaction P=0.04], but did not differ by gender or baseline ever marijuana use. In mid-adolescence, anhedonia is associated with subsequent marijuana use escalation, but marijuana use escalation does not appear to be associated with subsequent anhedonia.

The academic consequences of marijuana use during college.

Although several studies have shown that marijuana use can adversely affect academic achievement among adolescents, less research has focused on its impact on postsecondary educational outcomes. This study utilized data from a large longitudinal cohort study of college students to test the direct and indirect effects of marijuana use on college grade point average (GPA) and time to graduation, with skipping class as a mediator of these outcomes. A structural equation model was evaluated taking into account a variety of baseline risk and protective factors (i.e., demographics, college engagement, psychological functioning, alcohol and other drug use) thought to contribute to college academic outcomes. The results showed a significant path from baseline marijuana use frequency to skipping more classes at baseline to lower first-semester GPA to longer time to graduation. Baseline measures of other drug use and alcohol quantity exhibited similar indirect effects on GPA and graduation time. Over time, the rate of change in marijuana use was negatively associated with rate of change in GPA, but did not account for any additional variance in graduation time. Percentage of classes skipped was negatively associated with GPA at baseline and over time. Thus, even accounting for demographics and other factors, marijuana use adversely affected college academic outcomes, both directly and indirectly through poorer class attendance. Results extend prior research by showing that marijuana use during college can be a barrier to academic achievement. Prevention and early intervention might be important components of a comprehensive strategy for promoting postsecondary academic achievement.

Can marijuana make it better? Prospective effects of marijuana and temperament on risk for anxiety and depression.

Increases in marijuana use in recent years highlight the importance of understanding how marijuana affects mental health. Of particular relevance is the effect of marijuana use on anxiety and depression given that marijuana use is highest among late adolescents/early adults, the same age range in which risk for anxiety and depression is the highest. Here we examine how marijuana use moderates the effects of temperament on level of anxiety and depression in a prospective design in which baseline marijuana use and temperament predict anxiety and depression 1 year later. We found that harm avoidance (HA) is associated with higher anxiety and depression a year later, but only among those low in marijuana use. Those higher in marijuana use show no relation between HA and symptoms of anxiety and depression. Marijuana use also moderated the effect of novelty seeking (NS), with symptoms of anxiety and depression increasing with NS only among those with high marijuana use. NS was unrelated to symptoms of anxiety and depression among those low in marijuana use. The temperament dimension of reward dependence was unrelated to anxiety and depression symptoms. Our results suggest that marijuana use does not have an invariant relationship with anxiety and depression, and that the effects of relatively stable temperament dimensions can be moderated by other contextual factors.

Young Adult Outcomes Associated With Teen Pregnancy Among High-Risk Girls in a Randomized Controlled Trial of Multidimensional Treatment Foster Care

Teen pregnancy is associated with a host of deleterious outcomes for girls, such as drug use and poor parenting. Thus, reducing teen pregnancy rates could improve long-term developmental outcomes for girls, including adjustment during young adulthood. Based on the positive effects of Multidimensional Treatment Foster Care (MTFC) relative to group care (GC) in a study of adolescent girls (significantly fewer pregnancies reported in the 2-year follow-up for MTFC girls), the present study followed this sample into young adulthood (approximately 7 years post-baseline) to examine the effects of adolescent pregnancy on young adult substance use and pregnancy-related outcomes. All participants were randomly assigned to MTFC (N = 81) or GC (N = 85) as adolescents as part of a randomized controlled trial (RCT). Results from logistic regression analyses indicated that becoming pregnant during the 2-year follow-up was significantly related to illicit drug use, miscarriage from a new pregnancy, and child welfare involvement 7 years post-baseline. In addition, baseline marijuana use predicted marijuana use at 7 years post-baseline.

Predictors of alcohol use among rural drug users after disclosure of hepatitis C virus status.

Alcohol consumption dramatically increases the risk of liver damage among those with hepatitis C virus (HCV) infection, yet the impact of HCV status disclosure and standard informational counseling on alcohol use among rural drug users remains poorly understood. In this prospective study, 503 rural Appalachian drug users were recruited using respondent-driven sampling. Participants were tested for HCV antibodies, and data on sociodemographic characteristics, lifetime and past-30-day drug and alcohol use, and psychiatric disorders were collected by interviewer-administered questionnaires. A total of 470 participants returned after 6 months for follow-up; however,4 of those had no history of alcohol use, thus leaving a final sample size of 466. Multivariate negative binomial regression was used to determine the effect of disclosure of HCV status and posttest counseling on alcohol consumption at follow-up. Despite an overall decrease in drinking frequency in the cohort, those who were HCV-positive were drinking at a frequency similar to their HCV-negative counterparts at follow-up, despite posttest counseling informing them of the risks of alcohol use with an HCV diagnosis (adjusted incidence rate ratio = 1.07, 95% CI [0.72, 1.61]). Significant predictors of increased days of alcohol use after 6 months included baseline alcohol use, baseline marijuana use, and meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for antisocial personality disorder. Those using OxyContin at baseline had significantly fewer days of alcohol use at follow-up. HCV status disclosure and standard informational counseling alone do not curtail drinking among HCV-positive drug users in the rural setting. Targeted interventions with regard to alcohol use are warranted in order to mitigate the damage of the HCV epidemic.

Predicting Self-Initiated Marijuana Use Cessation among Youth at Continuation High Schools

The current article reports a large scale study of the prediction of marijuana use cessation among individuals attending alternative high schools who were regular users at baseline. Based on the Triadic Influence Theory, predictors of marijuana use cessation at 1-year follow-up were organized by type of influence (e.g., interpersonal, cultural and attitudinal, and intrapersonal) and level of influence (e.g., distal and ultimate). Among the 522 students who were past 30-day marijuana users at baseline, quitting was defined as having not used marijuana in the last 30 days at 1-year follow-up (43% of baseline users). To account for the level of influence we employed a theory-based analytic strategy, hierarchical regression. In the final multivariate model, lower level of baseline marijuana use and less of a likelihood to endorse pro-drug-use myths remained predictors of marijuana use cessation 1-year later. Implications of these findings include the need to develop cessation programs that reduce psychological dependence on marijuana use, and correct cognitive misperceptions about drug use in order to help adolescents make decisions that lead to health-promoting behaviors.

The influence of baseline marijuana use on treatment of cocaine dependence: application of an informative-priors bayesian approach.

Background: Marijuana use is prevalent among patients with cocaine dependence and often non-exclusionary in clinical trials of potential cocaine medications. The dual-focus of this study was to (1) examine the moderating effect of baseline marijuana use on response to treatment with levodopa/carbidopa for cocaine dependence; and (2) apply an informative-priors, Bayesian approach for estimating the probability of a subgroup-by-treatment interaction effect. Method: A secondary data analysis of two previously published, double-blind, randomized controlled trials provided complete data for the historical (Study 1: N = 64 placebo), and current (Study 2: N = 113) data sets. Negative binomial regression evaluated Treatment Effectiveness Scores (TES) as a function of medication condition (levodopa/carbidopa, placebo), baseline marijuana use (days in past 30), and their interaction. Results: Bayesian analysis indicated that there was a 96% chance that baseline marijuana use predicts differential response to treatment with levodopa/carbidopa. Simple effects indicated that among participants receiving levodopa/carbidopa the probability that baseline marijuana confers harm in terms of reducing TES was 0.981; whereas the probability that marijuana confers harm within the placebo condition was 0.163. For every additional day of marijuana use reported at baseline, participants in the levodopa/carbidopa condition demonstrated a 5.4% decrease in TES; while participants in the placebo condition demonstrated a 4.9% increase in TES. Conclusion: The potential moderating effect of marijuana on cocaine treatment response should be considered in future trial designs. Applying Bayesian subgroup analysis proved informative in characterizing this patient-treatment interaction effect.

Cocaine use trajectories of club drug-using young adults recruited using time-space sampling

Cocaine is the most widely used club drug. Yet, little is known about how patterns of cocaine use vary over time among young adults of diverse gender and sexual identities. This study used latent class growth analysis to identify trajectories of cocaine use over a year and explored individual and substance use factors associated with these trajectories. A sample of 400 young adults (mean age = 23.9 years) with recent club drug use were recruited from New York City bars and nightclubs using time-space sampling. Participants completed quantitative measures at baseline, 4-, 8- and 12-months follow-up. A 4-class model fit the data best. Patterns were: Consistent use (48%), Inconsistent use (14%), Decreasing Likelihood of use (28%), and Consistent non-use (11%). Those most likely to be in the Consistent use class had the highest frequency of baseline club drug dependence ( χ 2 (3, 397) = 15.1, p < .01), cocaine dependence ( χ 2 (3, 397) = 18.9, p < .01), recent alcohol use ( χ 2 (3, 397) = 12.48, p < .01), and drug sensation-seeking ( χ 2 (3, 397) = 9.03, p < .01). Those most likely to be in the Consistent Non-use class had the highest frequency of baseline marijuana use ( χ 2 (3, 397) = 2.71, p < .05). Contrary to hypotheses, there were no differences in most-likely trajectory class by gender/sexual-orientation, age, ethnicity, education, employment status, or income. Findings highlight the diversity of cocaine use patterns over time among young adults, and the personal and substance use characteristics that are associated with each.

Effects of research setting on observed depressive symptoms in marijuana users

A post hoc analysis examined depressive symptoms in regular marijuana smokers interested in nontreatment, laboratory studies, and marijuana-dependent treatment-seekers considering clinical trial participation. Among marijuana-dependent treatment-seeking patients screened for a clinical trial, the mean Beck Depression Inventory Score (BDI) was significantly higher than for marijuana-using volunteers screened for nontreatment laboratory studies. Mean self-reported baseline marijuana use was not significantly different between groups, and BDI score was not correlated with use. Although the methods by which the two groups were selected influenced their characteristics (i.e., treatment-seekers are more likely to be experiencing some degree of clinical distress), it is notable that treatment-seeking, and not marijuana use per se, is associated with significantly higher rates of depression.

Impact of Victimization on Substance Abuse Treatment Outcomes for Adolescents in Outpatient and Residential Substance Abuse Treatment

This paper considers whether victimization moderates adolescents' outcomes in substance abuse treatment. Adolescents (N=975) in outpatient and residential settings were assessed at intake, three, six, nine, and 12 months. Differential outcomes by gender and degree of victimization were analyzed. Dependent variables were marijuana use and substance-related problems. The residential sample reported higher baseline marijuana use and victimization. Both samples significantly reduced marijuana use and associated problems during treatment. Victimization was significantly related to more substance-related problems at intake and follow-up. More severe trauma histories in residential females were associated with significantly greater persistence in substance-related problems post-discharge.