Cannabis Use Disorder Identification Test Research Articles

15 Associations Among Subjective Cognitive Function and Cannabis Use in Older Adults

Objective:Cannabis use in older adults is becoming increasingly common as cannabis becomes both more socially acceptable and legally permissible, whether for medical or recreational purposes. While previous research has found harmful effects of cannabis use on cognition in adolescents and younger adults, few studies have explored cognition and cannabis use in older adults. This study aimed to examine the relationship between lifetime cannabis use patterns and subjective cognitive performance in older adults.Participants and Methods:The sample (N=51) consisted of adults ages 60 and older residing in the United States who endorsed cannabis use within the previous year. Participants completed online questionnaires on demographics, mental health [Geriatric Anxiety Scale (GAS) short form and Geriatric Depression Scale (GDS) short form], and measures of subjective cognitive function [Cognitive Failures Questionnaire (CFQ), the Cognitive Problems and Strategies Assessment (CPSA), and part IV of the Cognitive Self Efficacy Questionnaire (CSEQ)]. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQCU) and the Cannabis Use Disorder Identification Test (CUDIT) were used to assess cannabis use, and the Alcohol Use Disorders Identification Test Consumption items (AUD-C) were used to assess alcohol use. Partial Pearson’s correlations were used to examine relationships between scores of subjective cognitive functioning and cannabis use patterns while controlling for alcohol consumption.Results:Participants aged 60+ (M=68.06, SD=5.80, 49% women) had 15.39 (SD=2.21, range 12-18) years of education on average. Participants’ race/ethnicity was reported as 90.2% White (n=47), 5.9% Latinx or Hispanic (n=3), 2% Black or African American (n=1), and 1% Other (n=1). Most participants (59%) reported first using cannabis as a child or adolescent (range of ages 7-17 years), while 31% reported first using cannabis as an adult (ages 18-58 years), and only 8% endorsed initial use in older adulthood (62-84 years). On average, this sample reported using cannabis for 19.75 days (SD=11.14) in the last month with n=35 (69%) and having used cannabis for 20 or more years (range 1-60 years). The total CUDIT score was positively correlated with CFQ (rp=.47, p<.001), CPSA problems (rp=.46, p<.001), GAS (rp=.43, p=.002), and GDS (rp=.35, p=.014), and negatively correlated with the CSEQ (rp=-.33, p=.02), all while controlling for alcohol consumption. Days of use in the past month and total years of use were not significantly associated with subjective cognitive function.Conclusions:Among older adult cannabis users, symptoms of Cannabis Use Disorder (CUD) were significantly associated with greater self-reported cognitive failures/problems and worse self-efficacy for cognitive ability, as well as symptoms of anxiety and depression, when controlling for alcohol use. Notably, there was no relationship between subjective cognition and frequency of recent use or lifetime use. For patients who use cannabis, neuropsychologists may find it helpful to focus their clinical interview on CUD symptoms when discussing cognitive complaints rather than other measures of cannabis use. Additional research is needed to examine objective measures of cognitive functioning in older adult cannabis users.

Problematic Cannabis Use Is Associated with Reduced Rectal Microbial Species Richness and Diversity Among a Pilot Sample of Young Sexual and Gender Minorities.

Compared to young heterosexual men, young sexual and gender minorities (YSGM) have elevated systemic inflammation and unique intestinal microbial profiles, influenced by HIV infection and substance use. However, links between cannabis use and microbial dysbiosis in this population have not been well described. In this pilot study, we aimed to characterize the complex interrelationships between cannabis use and microbial community structure in YSGM in relationship to HIV status. Cannabis use was assessed by self-administered Cannabis Use Disorder Identification Test (CUDIT) questionnaires and rectal microbial community alpha-diversity metrics were assessed via 16S ribosomal ribonucleic acid (rRNA) sequencing in a subset of YSGM (n = 42) in the RADAR cohort (aged 16-29) in Chicago. Multivariable regression models were used to assess the relationship between cannabis use and microbiome alpha-diversity metrics, adjusting for HIV status and other risk characteristics, including inflammation, which was evaluated by plasma levels of C-reactive protein (CRP). Problematic cannabis use, but not general use, was significantly inversely associated with microbial community richness (Adj. Beta = -8.13; 95% confidence interval [CI]: -15.68 to -0.59) and Shannon diversity (Adj. Beta = -0.04; 95% CI: -0.07 to 0.009). No significant association was observed between CUDIT score and community evenness, nor was any significant moderation observed by HIV status. We observed that problematic cannabis use was associated with reduced microbial community richness and Shannon diversity, adjusting for within population differences in inflammation and HIV status. Future research should aim to assess how cannabis use contributes to microbiome-related health factors among YSGM and if decreasing cannabis use can restore gut microbial community structure.

Association of Dopamine Transporter Gene (DAT1) 40 bp 3' UTR VNTR Polymorphism (rs28363170) and Cannabis Use Disorder.

Cannabis remains the most widely used illicit drug among Nigerians, often associated with psychiatric disorders. Since genetic predisposition has been implicated in substance use disorders, we, therefore, aimed at finding out the relationship between dopamine transporter gene (DAT1) polymorphism and cannabis use disorder. We recruited 104 patients from a tertiary psychiatric facility in Lagos, Nigeria, who were diagnosed with cannabis use disorder according to ICD-10 and 96 non-smokers as a comparative group. The smokers were screened with Cannabis Use Disorder Identification Test (CUDIT), and cannabis dependence was assessed with the Severity of Dependence Scale (SDS). Genotyping was carried out for the 40 bp 3' UTR VNTR of the DAT1 (rs28363170). The frequencies of 9R/9R, 9R/10R, 10R/10R among non-smokers and smokers were 14 (14.3%), 25 (26.2%), 57 (59.5%) and 17 (16.3%), 54 (51.9%), 33 (31.7%) respectively. The genotype distribution was in Hardy Weinberg equilibrium (HWE) only in the smokers' population (χ² = 1.896, P = .166). Individuals with the 10R allele were almost twice as likely as the 9R carriers to smoke cannabis (OR = 1.915, 95% CI: 1.225-2.995). However, this polymorphism was not associated with the quantity of cannabis smoked, age at onset of smoking, CUDIT, and SDS scores. The DAT VNTR polymorphism was associated with cannabis smoking but not cannabis use disorder.

Salivary Microbiota is Associated with Cannabis Use in Adolescents

PurposeCannabis is now the second most commonly used substance during adolescence, with 35.7% of 18‐year‐olds reporting use in the past year and 6.4% reporting daily use. Accumulating evidence suggests that cannabis use affects the microbiome, however, this is still underexplored. Given that adolescence is a vital period of neural and microbial development, it is essential to investigate if cannabis use is associated with differences in microbiota as perturbations to microbial systems during this period of development may influence brain development.MethodsSaliva biospecimens were collected from adolescent (15‐19 years old) cannabis users (N=8) and control participants (N=9) in an ongoing clinical trial (K23 AA025399) at the Medical University of South Carolina. Bacterial quantification was performed by real‐time quantitative PCR (qPCR) using primers for representative oral phyla (Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria) and related species (Staphylococcus, Clostridium coccoides, Clostridium leptum, Lactobacillus, Escherichia coli, Bacteroides, and Prevotella). Standard t‐test was used to compare the relative abundances between the cannabis using group and control group. Correlations between levels of oral phyla and related species with cannabis use days reported on the Timeline Follow back (TLFB) and Cannabis Use Disorder Identification Test (CUDIT) scores were completed.ResultsAll saliva samples contained significant levels of bacterial gDNA (mean concentration: 96.9 ng/μl; ~10 ng/μl is sufficient). We observed significantly lower levels of Proteobacteria (p=0.031) and Bacteroides (p= 0.006) in the cannabis‐using group compared to the non‐cannabis‐using control group. Additionally, the number of cannabis use days reported on the TLFB and CUDIT scores were inversely correlated with Bacteroides levels (p= <0.001, p=0.011 respectively).ConclusionThese preliminary data suggest that cannabis use during adolescence may be associated with changes in the oral microbiota, specifically in Proteobacteria and Bacteroides. The lower abundance of Bacteroides in the cannabis using group is further strengthened by the inverse correlations between cannabis use days and CUDIT scores. Interestingly, Bacteroidesactively expresses GABA‐producing pathways, a type of inhibitory neurotransmitter pathway that studies have shown is inhibited by THC. In addition, ratios of Bacteroides from stool microbiota analyses have also been reported to be decreased in cannabis users. Therefore, saliva microbiota collection may serve as a favorable alternative to classic stool collection. Inclusion of more participants in future studies will allow for more power to detect microbial differences within adolescents who use cannabis.

17.3 ASSOCIATIONS BETWEEN CHILDHOOD MALTREATMENT, ALCOHOL USE DISORDER, AND NEURO-COMPUTATIONAL IMPAIRMENTS IN REWARD PREDICTION ERROR (RPE) REPRESENTATION

This part of the Symposium will focus on a series of novel studies that investigate gaps in the current literature on neurocomputational impairments in childhood maltreatment, substance use, and conduct disorder (CD). Prior work has found that trauma exposure is associated with impairments in reward prediction error (RPE) representation in adolescents. Despite the association between trauma and CD, the impact of maltreatment on RPE representation in individuals with CD is unclear. Further, the extent to which maltreatment-related dysfunction in RPE representation relates to alcohol use disorder (AUD) vs cannabis use disorder (CUD) is unclear. A total of 156 adolescents participated in a 3-armed bandit instrumental learning task in which they learn to select novel or nonnovel stimuli associated with a certain monetary value. A mixed reinforcement learning/logistic regression method was used to calculate individual novelty propensity (NP) during the task. Functional MRI data were analyzed within the general linear model framework. In Study 1, maltreatment was measured with the Childhood Trauma Questionnaire (CTQ) in a subsample of adolescents with CD (N = 89). In Study 2, AUD severity was measured with the Alcohol Use Disorders Identification Test (AUDIT), and CUD severity was measured with the Cannabis Use Disorder Identification Test (CUDIT) within the full sample (N = 156). In Study 1, there was CTQ-by-NP interaction on RPE representation during selection of novel stimuli within dorsolateral prefrontal cortex (dlPFC) and inferior frontal gyrus (iFG) (p < 0.05, corrected). In Study 2, AUD severity was associated with alterations in RPE representation within striatum, anterior insular cortex, iFG, dlPFC, and anterior cingulate cortex (ACC), particularly when exploring novel stimuli (p < 0.05, corrected) and with behavioral impairments on the task (p < 0.05). Our findings show that trauma is related to neural representation of RPE within dlPFC and iFG in individuals with CD. These regions also overlap with regions associated with impaired RPE representation in individuals with high AUD severity. Future work should investigate the relationships between maltreatment and AUD in individuals with and without CD.

Alcohol and Cannabis Use Disorder Symptom Severity, Conduct Disorder, and Callous-Unemotional Traits and Impairment in Expression Recognition.

Background: Alcohol and cannabis are commonly used by adolescents in the United States. Both alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with reduced emotion expression recognition ability. However, this work has primarily occurred in adults and has not considered neuro-cognitive risk factors associated with conduct problems that commonly co-occur with, and precede, substance use. Yet, conduct problems are also associated with reduced emotion expression recognition ability. The current study investigated the extent of negative association between AUD and CUD symptom severity and expression recognition ability over and above any association of expression recognition ability with conduct problems [conduct disorder (CD) diagnostic status].Methods: In this study, 152 youths aged 12.5–18 years (56 female; 60 diagnosed with CD) completed a rapid presentation morphed intensity facial expression task to investigate the association between relative severity of AUD/CUD and expression recognition ability.Results: Cannabis use disorder identification test (CUDIT) scores were negatively associated with recognition accuracy for higher intensity (particularly sad and fearful) expressions while CD diagnostic status was independently negatively associated with recognition of sad expressions. Alcohol use disorder identification test (AUDIT) scores were not significantly associated with expression recognition ability.Conclusions: These data indicate that relative severity of CUD and CD diagnostic status are statistically independently associated with reduced expression recognition ability. On the basis of these data, we speculate that increased cannabis use during adolescence may exacerbate a neuro-cognitive risk factor for the emergence of aggression and antisocial behavior.

Using an Optimized Marijuana Purchase Task to Examine Cannabis Demand in Relation to Cannabis Misuse in Heavy Drinking Emerging Adults

A behavioral economic approach to cannabis misuse emphasizes a crucial role of high drug demand (i.e., reinforcing value), which may be measured using a marijuana purchase task (MPT). The multiple indices from this measure have been associated with cannabis misuse, but somewhat inconsistently, possibly because of task variability across studies. Based on recent qualitative research, the current study implemented an optimized MPT to examine the underlying factor structure and the relationship between cannabis demand and both cannabis misuse and motivation to change. Participants were two independent samples of emerging adults who reported cannabis use and heavy episodic drinking in the last month, one Canadian (n = 396) and the other American (n = 275). Both were assessed using an MPT, the Cannabis Use Disorder Identification Test (CUDIT), the Marijuana Adverse Consequences Questionnaire (MACQ), and readiness to change items. Principal component analyses of the MPT indices revealed the same two-factor latent structure in both samples, interpreted as Amplitude (intensity, Omax, elasticity) and Persistence (breakpoint, Pmax). Regressions revealed that Amplitude was significantly associated with CUDIT and MACQ in both samples. In the Canadian sample, Persistence was also significantly associated with CUDIT and MACQ, and both factors were associated with motivation to change. The optimized MPT generated a two-factor latent structure that was parallel across samples, and the Amplitude factor was consistently associated with cannabis misuse. The current findings indicate the robust relevance of behavioral economic demand for cannabis in relation to cannabis misuse but suggest that links to motivation may be sample-specific.

Reduction in hippocampal volumes subsequent to heavy cannabis use: a 3-year longitudinal study

Cannabis exposure is related to neuroanatomical changes in brain regions rich in cannabinoid receptors, such as the hippocampus. However, researchers have not clearly determined whether persistent heavy cannabis use leads to morphological changes in the hippocampus or whether an earlier age of onset of first cannabis use and/or higher doses of cannabis exposure exacerbate these alterations. In this longitudinal study, we investigated whether continued heavy cannabis use in young adults is associated with an altered hippocampal volume. Twenty heavy cannabis users (CBs) and 22 healthy controls (HCs) underwent a comprehensive psychological assessment and a T1 structural scan at baseline and at a 3-year follow-up visit. Volumes of the hippocampus and its subregions were estimated using volBrain software. Except for the cornu ammonis 2 (CA2)/CA3 subregions, age had significant effects on all hippocampal subregions in both the CB and HC groups. The relative right hippocampal volume and absolute and relative right CA1 volumes displayed a greater rate of decrease in CBs compared to HCs. In addition, we explored the relationship between alterations in hippocampal volume and cannabis use characteristics. Changes in the relative right hippocampal volume and the relative right CA1 volume were related to age at first cannabis use but not to age at onset of frequent cannabis use. Alterations in the relative right hippocampal volume and absolute and relative right CA1 volumes were associated with Cannabis Use Disorder Identification Test (CUDIT) scores. Based on these results, heavy cannabis use in early adulthood is a risk factor for a greater rate of decrease in the volume of the right hippocampus (particularly the right CA1).

Association of Plasma Dopamine and Norepinephrine Levels and Cannabis Use among Male Cannabis Smokers

Background: Many studies have employed both direct and indirect methods of measuring the brain dopaminergic activity in relation to drug dependence, internet addiction and other disorders in which dopamine signalling has been implicated. However, only a few scientific reports have found a relationship between plasma dopamine and/or norepinephrine levels and addiction. Objective: The present work was aimed at determining the association between plasma dopamine level and consumption of cannabis as the most widely used illicit drug in the world. Methods: One hundred and six participants with cannabis use disorder based on International Classification of Diseases version 10 (ICD-10) were recruited for the study. Screening for current cannabis use disorder was done using Cannabis Use Disorder Identification Test (CUDIT). Cannabis dependence was assessed using the Severity of Dependence Scale (SDS). Venous blood samples were taken from the subjects to assay for the plasma dopamine by enzyme-linked immunosorbent assay (ELISA) method. Results: There was a high correlation between plasma dopamine and SDS scores with plasma dopamine accounting for more than 31% of the variance in SDS scores. However, the relationship between plasma dopamine and current cannabis use disorder was not strong as it accounts for just more than 9% of the variance in CUDIT scores. There was a relationship found between plasma norepinephrine and SDS scores. Plasma norepinephrine only accounts for about 5% of the variance in SDS score while there was virtually no association between plasma norepinephrine and CUDIT scores. Conclusion: Higher plasma dopamine level was found to be significantly associated with cannabis use and dependence as measured by SDS but less associated with current cannabis use disorder as measured by CUDIT.

Association of dopamine receptor D2 TaqI A polymorphism and cannabis use disorder in Lagos, Nigeria.

TaqI A polymorphism (rs1800497) has been linked to many substance use disorders but there is a shortage of data on cannabis use disorder. Nigeria has a huge burden of cannabis use disorder, prompting our investigation of the relation between cannabis use disorder and the TaqI A polymorphism among males in Lagos, Nigeria. We recruited 106 males with cannabis use disorder based on International Classification of Diseases, version 10 (ICD-10) and 98 cannabis-naive males for the study. Cannabis use disorder was assessed using the Severity of Dependence Scale (SDS) and Cannabis Use Disorder Identification Test (CUDIT). Genotyping was done using the Restriction Fragment Length Polymorphism (RFLP). The frequency of the A1 allele was higher among the cannabis users (57.8%) compared with the nonusers (42.2%). The genotype distribution was found to be in Hardy-Weinberg equilibrium in both populations. The homozygous A1 genotype alone contributed 11.8% to the variance in the SDS scores. However, both A1/A1 and A1/A2 genotypes contributed to the variance in the CUDIT scores (10.2% and 5.1%, respectively). In conclusion, the distribution of the A1 allele among the general population in this study correlates with the previously reported findings in a southwestern Nigerian population. We also found that carrying an A1 allele appears to be a significant predictor of cannabis use disorder. The result suggests that carrying just a single allele of the A1 is enough to predict cannabis abuse, as shown by the allele association with CUDIT scores. However, double A1 alleles seem to be necessary for the prediction of dependence.

Risky Cannabis Use is Associated with Alexithymia, Frontal Lobe Dysfunction, and Impulsivity in Young Adult Cannabis Users

Risky or problematic alcohol use by young adults has been found to be associated with factors such as alexithymia, frontal lobe dysfunction, reward sensitivity, and impulsivity. One interpretation is that these factors reflect inherent traits that predispose to risky substance use in general, a notion examined in the present study. Alexithymia, everyday frontal lobe functioning, sensitivity to reward and punishment, and impulsivity were examined in 138 young adult cannabis users who were divided into Low Risk (n = 99) and Risky (n = 39) users according to their Cannabis Use Disorder Identification Test (CUDIT) scores. Risky cannabis use was significantly positively associated with alexithymia, multiple signs of frontal lobe dysfunction in everyday life, and impulsivity. A broader pattern of dysfunction was indicated for risky cannabis use than for risky alcohol use in this sample. Findings are interpreted as likely reflecting not only inherent traits that predispose to risky substance use in general, but also perhaps residual effects of recent heavy cannabis use in the Risky user group. Longitudinal research is needed to disentangle these competing possibilities.