Cannabis Use Research Articles

Association of Local Cannabis Policy and Retail Availability With Cannabis Use and Problematic Cannabis Use Among Adolescents in Northern California.

Objectives. To examine whether local cannabis policies and retail availability are associated with cannabis use and problematic cannabis use (PCU) among adolescents in Northern California. Methods. The sample comprised adolescents aged 13 to 17 years screened for past-year cannabis use during well-child visits in 2021. Exposures included local bans on cannabis storefront retailers, policy protectiveness, and retail proximity and density. Outcomes included self-reported past-year cannabis use and PCU diagnoses. Modified Poisson regression models adjusted for sociodemographics. Results. The sample (n = 103 134) was 51.1% male with a median age of 15 years (interquartile range [IQR] = 14-16 years); 5.5% self-reported cannabis use, and 0.3% had diagnosed PCU. Adolescents had a lower prevalence of cannabis use in jurisdictions that banned storefront retailers (adjusted prevalence rate [APR] = 0.857; 95% confidence interval [CI] = 0.814, 0.903 vs allowed), banned delivery (APR = 0.751; 95% CI = 0.710, 0.795 vs allowed), or had more policy protections (APR range = 0.705-0.800). Lower PCU prevalence was also found among those in jurisdictions that banned (vs allowed) storefront retailers (APR = 0.786; 95% CI = 0.629, 0.983) or delivery (APR = 0.783; 95% CI = 0.616, 0.996). Longer drive time and lower density of storefront retailers were associated with a lower cannabis use prevalence. Conclusions. More protective cannabis policies and less retail availability were associated with a lower prevalence of adolescent cannabis use and PCU. (Am J Public Health. 2024;114(S8):S654-S663. https://doi.org/10.2105/AJPH.2024.307787).

Longitudinal patterns of alcohol and cannabis use among US young adults: Correlates and implications for problematic health outcomes.

Alcohol and cannabis use are common during young adulthood. Less is known regarding correlates of alcohol-cannabis use patterns and related problematic health outcomes. Using longitudinal survey data (Fall 2018, 2019, 2020) from 2,194 young adults (YAs; ages 18-34), bivariate analyses and multivariable logistic regressions examined: (1) Wave 1 (W1) sociodemographics and psychosocial factors (i.e., adverse childhood experiences [ACEs], depressive symptoms, personality traits, parent and peer alcohol and cannabis use) in relation to W3 past-month use group (i.e., use of neither, alcohol only, cannabis only, both/co-use); and (2) W3 use group in relation to W5 problematic alcohol use (Alcohol Use Disorder Identification Test), problematic cannabis use (Cannabis Use Disorder Identification Test), and depressive/anxiety symptoms (Patient Health Questionnaire - 4 item). Overall, 42.3% reported W3 alcohol-only use, 34.9% co-use, 17.8% no use, and 5.0% cannabis-only use. Those reporting W3 co-use reported greater W1 extraversion, openness, friend alcohol/cannabis use, and were more likely to report parent cannabis use (vs. no use); reported less conscientiousness, greater friend cannabis use, and were more likely to report depressive symptoms and parent cannabis use (vs. alcohol-only use); and reported greater friend alcohol use, and were more likely to report parent alcohol use (vs. cannabis-only use). W3 co-use was associated with higher odds of W5 problematic alcohol use (vs. alcohol-only use) and problematic cannabis use (vs. cannabis-only use). Substance use messaging and interventions should consider YAs' alcohol-cannabis co-use and the unique correlates of such use.

Prevalence of Cannabis Use Among US Workers in 15 States, 2016-2020.

Objectives. To examine the prevalence of cannabis use among US workers using data from the US Behavioral Risk Factor Surveillance System (BRFSS) during 2016 to 2020. Methods. We analyzed past 30-day cannabis use among US workers. We calculated weighted prevalence and adjusted prevalence ratios (APRs) of cannabis use for working adults by industry groups, occupation groups, and sociodemographic characteristics (e.g., sex, education, age, race/ethnicity). Results. During the 5-year survey period, the weighted prevalence of past 30-day cannabis use among adult US workers from the 15 states included in the BRFSS was 10.7%. The industry group with the highest weighted prevalence of use was accommodation and food services (20.7%), and the highest-ranking occupation group was food preparation and service (21.9%). The industry group with the highest APR was accommodation and food services (APR = 1.31; 95% confidence interval [CI] = 1.10, 1.55), and the occupation group with the highest APR was arts, design, entertainment, sports, and media (APR = 1.91; 95% CI = 1.52, 2.41). Conclusions. Cannabis use among US workers varied widely by sex, age, race, education, industry groups, and occupation groups. A more accurate understanding of this variation can help guide research, focus policy discussions, and prioritize health messaging. (Am J Public Health. 2024;114(S8):S645-S653. https://doi.org/10.2105/AJPH.2024.307788).

Attention Deficit Hyperactivity Disorder, Cannabis Use, and the Endocannabinoid System: A Scoping Review.

There is emerging evidence that the endocannabinoid system (ECS) plays a significant role in the pathophysiology of many psychiatric disorders, including attention deficit hyperactivity disorder (ADHD). Increasing evidence suggests that a number of neurobiological correlates between endogenous cannabinoid function and cognitive dysfunction are seen in ADHD, making the ECS a possible target for therapeutic interventions. Cannabis use and cannabis use disorder are more prevalent in individuals with ADHD, compared to the general population, and there is growing popular perception that cannabis is therapeutic for ADHD. However, the relationship between cannabis use and ADHD symptomology is poorly understood. Further understanding of the role of the ECS in ADHD pathophysiology and the molecular alterations that may be a target for treatment is needed. To further the science on this emerging area of research, this scoping review describes the preclinical and clinical evidence seeking to understand the relationship between the ECS and ADHD.

Trends in Driving Under the Influence of Alcohol and Cannabis Among Young Adults in Washington State From Before to During the COVID-19 Pandemic.

Objectives. To examine trends in young adult self-reported driving under the influence of alcohol (DUI-A), cannabis (DUI-C), and simultaneous alcohol and cannabis use (DUI-AC) in a state with legalized nonmedical cannabis use from before to during the COVID-19 pandemic. Methods. We used logistic regression and annual statewide data from the Washington Young Adult Health Survey to assess DUI behaviors from 2016 to 2021. Results. Both prepandemic yearly changes in prevalence and deviations from those trends during the pandemic years were small and not statistically significant. However, prevalence estimates were alarming: 12.0% of participants reported DUI-A, 12.5% reported DUI-C, and 2.7% reported DUI-AC. Exploratory moderation analyses indicated a relative increase in DUI-A during 2020 among 4-year college students relative to young adults not attending 4-year colleges. Conclusions. Young adults in Washington State continued to engage in risky DUI behaviors during the pandemic. College students may have increased their likelihood of DUI-A during COVID-19. Public Health Implications. Young adults, for whom vehicle crashes remain a leading cause of death, showed little change in DUI behaviors during the COVID-19 pandemic. There is continued need for young adult DUI prevention efforts. (Am J Public Health. 2024;114(S8):S698-S701. https://doi.org/10.2105/AJPH.2024.307767).

Self-Medication Paths: A Descriptive Study Unveiling the Interplay Between Medical and Non-medical Cannabis in Chronic Pain Management.

Cannabis is used by one-third of people living with chronic pain to alleviate their symptoms despite warnings from several organizations regarding its efficacy and safety. We currently know little about self-medication practices (use of cannabis for therapeutic purposes without guidance), mainly since the legalization of recreational cannabis in countries such as Canada has expanded the scope of this phenomenon. This study aimed to describe legal cannabis self-medication for pain relief in people living with chronic pain and to explore perceptions of the effectiveness and safety of cannabis. A cross-sectional descriptive study was performed among 73 individuals living with chronic pain and using cannabis (Quebec, Canada). Data collection using telephone interviews occurred in early 2023. Results indicated that 61.6% of participants reported using cannabis without the guidance of a healthcare professional (self-medication). Surprisingly, among those, 40.0% held a medical authorization. Overall, 20.6% of study participants were using both medical and legal non-medical cannabis. Different pathways to self-medication were revealed. Proportion of women vs. men participants self-medicating were 58.2% vs. 70.6% (P=0.284). In terms of perceptions, 90.4% of the sample perceived cannabis to be effective for pain management; 72.6% estimated that it posed no or minimal health risk. Cannabis research is often organized around medical vs. non-medical cannabis but in the real-world, those two vessels are connected. Interested parties, including researchers, healthcare professionals and funding agencies, need to consider this. Patients using cannabis feel confident in the safety of cannabis, and many of them self-medicate, which calls for action.

Beyond School Climate: Validating the School as a Protective Factor-Brief Survey.

The conceptual framework for School as a Protective Factorapproach was presented in a companion article in this issue of the journal. The current article describes the validation of the School as a Protective Factor-Brief (SPF-Brief), a 13-item survey measuring the 3 core constructs and 13 defining characteristics of this framework. The SPF-Brief was validated through 2 studies. The developmental study used a longitudinal design including 1349 participants who completed surveys over 5 semesters, while the validation study used a cross-sectional design with 2775 participants. Both studies included middle and high school students. Factor analysis, growth model analysis, criterion-related validation, and outcome analysis were employed. Analyses provided strong evidence supporting the reliability and validity of the instrument and conceptual framework. Higher SPF-Brief scores were associated with higher math grades, English grades, and quality of life, as well as lower rates of anxiety, depression, conduct disorder, alcohol, e-cigarette, tobacco, and cannabis use. Effect size estimates ranged from moderate to strong. These findings suggest the utility of the SPF-Brief instrument and the School as a Protective Factor framework. Together, they may offer advantages to the traditional school climate approach.

Suicidal transition rates and their predictors in the adult general population: a repeated survey over 21years in France.

The "suicidal transition" from ideation to an act has become a specific topic of research. However, rates in the general population, variations across time and risk factors are unclear. Data were collected from the phone survey Baromètre Santé among 18-75-year-olds in France. Seven independent samples interviewed between 2000 and 2021 (total N=133,827 people; 51.3% females) were questioned about suicidal ideation and attempts over the previous 12months. Transition was calculated as the weighted ratio of attempt on ideation 12-month rates. Mean 12-month rates of suicidal ideation, attempts and transition were 4.7% (95% Confidence Interval (CI) (4.6-4.8)), 0.5% (95% CI (0.4-0.5)) and 7.7% (95% CI (6.8-8.6)), respectively. Transition rates varied between 4.5 and 11.9% across surveys. In multivariable analyses, higher transitions rates were associated with a previous suicide attempt (adjusted Odds Ratio (aOR)=11.1 95% CI (7.9-15.6)); 18-25 vs 26-55-year-olds (1.8 95% CI (1.2-2.8)); lower vs higher income (1.7 95% CI (1.0-2.7); and lower vs higher professional categories (aOR around 1.9). No significant association was found with gender, education level, employment status, living alone, urbanicity, current major depression, daily smoking, weekly heavy drinking, cannabis use, and body mass index. Most people with suicidal ideation do not attempt suicide. These findings emphasize the need to avoid generic terms such as "suicidality", and to increase research on suicidal transition to improve prevention and prediction. They may also inform the organization of suicide prevention in the general population.

Unequal cannabis use among European adolescents: the mediating role of perceived access and risk

Abstract Introduction Cannabis use among adolescents is a public health concern, because of its association with the use of other illicit drugs, mental health disorders, and social problems. Most studies show that adolescents from low socioeconomic status (SE) background are more likely to use cannabis, but the causes of SE inequalities remain to be understood. We test whether access and risk perceptions of cannabis use among disadvantaged adolescents explain the SE gradient. Objectives The aim of this study was to measure the mediating effect of access perception and risk perception on the association between SE status and cannabis use among European adolescents in 2019. Methods A cross-sectional, observational, analytical study was conducted, among 16-year-old students, based on data from the European School Survey Project on Alcohol and Drugs (ESPAD) in 2019. The outcome was cannabis use (experimental, regular, and problematic) and the exposure was SE status (parental education and subjective social status). Mediating variables were perceived accessibility and perceived risk of cannabis use. We used logistic regressions, where the odds ratio (OR) reduction measures the part of the association explained by the mediators. Results Regular and problematic cannabis use was significantly more prevalent among adolescents with a lower SE background (low parental education and low subjective social status, p < 0,001). This relationship remained significant after adjustment for perceived access and risk, and the modification of ORs was of a small magnitude (a non-significant reduction of the association). Conclusions Perceived accessibility and risk showed a weak mediating effect of the association between SE background and cannabis use. Consequently, these factors cannot be considered as major explanations for the higher use among worse-off adolescents. Reinforcing information or imposing stronger barriers in access may not help reduces SE inequalities in cannabis consumption. Key messages • Perceived accessibility and risk hardly explain the association between socioeconomic background and cannabis use among European adolescents. • Reinforcing information or imposing stronger barriers in access may not help reduces socioeconomic inequalities in cannabis use.

Knowledge, opinions and experiences of nurses and nursing students in Portugal regarding the use of medical Cannabis

BackgroundThe opening up of the laws to medicinal cannabis in recent years is a key factor in the growth of this therapy, but there is little information about what nurses know and think about it. The present paper seeks to analyze the knowledge, opinions, and experiences of nurses and nursing students in Portugal regarding the use of cannabis and to understand gender differences.MethodsA self-completion questionnaire was drawn up and published online. It received face and content validity and was approved by the Ethics Committee. The instrument includes socio-demographic data, questions about knowledge, opinions, experiences, and training in cannabis. The data was collected and processed by applying descriptive and inferential statistics using the chi-square test and Fisher’s exact test on the SPSS platform.ResultsThe majority of the 610 participants were women. The therapeutic benefits of medical cannabis were appreciated by 79,6% of nurses and 84,3% of students. When asked about the functions of the endocannabinoid system, 71,7% of nurses and 79,5% of students had never heard of it. There is a statistically significant gender difference concerning personal experience of cannabis use to treat symptoms or illnesses.ConclusionsAs the levels of knowledge were low and a minority had education on medical cannabis, there is a need for further education of nurses and for this emerging area to be included in the curricula.

Socioeconomic inequalities in substance use among Norwegian adolescents between 2014 and 2022

Abstract Background Increasing use of substances is observed among adolescents in recent years. Early onset of substance use dramatically increases the risk of substance use disorder, dependence, and poorer psychological, social, and physical health, and is thus a public health concern. We explore trends in socioeconomic inequalities in past year use of cannabis and other illicit drugs between 2014 and 2022 among Norwegian adolescents. Methods This study is based on data retrieved from five waves of the nationwide Norwegian Ungdata survey (2014-2022) among adolescents attending upper secondary education (N = 282,259; 51 % girls). Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results The use of cannabis and other illicit drugs increased among boys (from 13% to 19%, and from 2% to 5%, respectively) and girls (from 8% to 14%, and from 1% to 3%, respectively) between 2014 and 2022. Higher prevalence’s was observed among the least affluence girls between 2020 and 2022, both in absolute and relative terms (SII: 0.01 to 0.06, RII: 0.97 to 1.52, p < 0.001). No inequalities were observed among boys during this time. While relative and absolute inequalities in use of other illicit drugs decreased in boys, absolute inequalities increased in girls. Boys were more likely than girls to have used cannabis and other illicit drugs, although the gender gap in cannabis use narrowed slightly during the study period. Conclusions Our data suggest increasing use of cannabis and other illicit drugs among Norwegian adolescent boys and girls between 2014 and 2022. Future studies should examine the potential causes of increasing substance use as a basis for understanding, and distinguishing between, the many intertwining factors that influence adolescent drug use behaviors. Key messages • The use of cannabis and other illicit drugs increased between 2014 and 2022 among Norwegian boys and girls. • While inequalities in the use of cannabis and ither illicit drug use increased in girls, small or no inequalities was observed among boys.

Loneliness and cannabis use among older adults: findings from a Canada national survey during the COVID-19 pandemic

BackgroundCannabis use has been increasing among older adults in Canada, particularly during the COVID-19 pandemic. This study aims to examine the association between loneliness and cannabis use among older Canadians during the pandemic.MethodsQuantitative data analyses were performed based on 2,020 participants aged 55 years and older from the Canadian Perspectives Survey Series 6, 2021: Substance Use and Stigma During the Pandemic.ResultsThis study found that participants who used cannabis in the 30 days before the survey reported significantly higher loneliness scores than those who never used cannabis after adjusting social-demographic, social interaction, and pandemic-related factors. Participants who kept using cannabis during the pandemic also reported significantly higher loneliness scores than those who never used cannabis.ConclusionThe findings about the correlation between cannabis use and greater loneliness contribute to the discourse on potential health and wellbeing harms of cannabis use among older adults.

Prevalence and Correlates of Cannabis Use among Cancer Survivors

Abstract Background Delaware has legalized marijuana use for both medical and recreational use. This study identified factors associated with cannabis use among adults with chronic relative to individuals without a history of cancer in the First State. Methods Combined data (2020, 2021 and 2022) from the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed for Delaware. Multivariable logistic regression examined individual-level demographic, socio-economic, clinical, and behavioral predictors associated with marijuana use stratified by history of cancer. Results Cannabis use was lower among cancer survivors compared to individuals with no history of cancer (6.76% vs. 13.43%). However, a higher proportion of cancer survivors reported use for medical purposes (75.13% vs. 64.28%). Marijuana use prevalence decreased with age among cancer survivors. After adjusting for sex, age, educational attainment, self-reported race/ethnicity, mental health status and physical health status, current smoking (odds ratio [OR], 4.24 vs. 2.74) and binge drinking (OR, 2.45 vs. 1.75) were associated with cannabis use in both groups. Conclusions Adults with cancer were more likely to use marijuana. Marijuana use prevalence decreased with age. Public perceptions of marijuana is becoming more acceptable. Risk of medical conditions such as cancer increase with age. As such, older adults might also become consumers of marijuana. Clinicians should screen for marijuana use among patients and initiate open discussions with patients about the benefits and risks associated with marijuana. Key messages • Need for ongoing cannabis research to better understand and inform its use for medical purposes. • Development of high-quality standardized education materials and clinical practice guidelines for marijuana use.

Cannabis use, mental health and suicide attempts among adolescents in Puerto Rico

Abstract Cannabis is the most widely used illicit substance worldwide, with recent reports estimating an 11.6% annual prevalence of use in North America. Mental health, suicidal ideation, suicide attempts and completed suicides, has been the focus of several studies exploring its association with frequent cannabis use. The purpose of this study is to evaluate the association between cannabis use, mental health symptoms and suicide attempts among adolescent students in Puerto Rico. Consulta Juvenil X is a monitoring program that aims to study the prevalence of substance use, mental health and violent behavior as well as the risk factors associated with those practices. The survey was conducted during the 2018-20 academic year. The study utilizes a self-administered questionnaire. The sample included 4,668 (54%) females and 3,977 (46%) males. Half of the sample was between seventh and ninth grade with a median age of 15 years old. The majority of the sample was recruited from the public school system in Puerto Rico (70.3%). The prevalence of marihuana use in the public and private schools participating in the study was 9.4% and the suicide attempts was 7.6%. Multiple logistic regression analyses revealed that students who use marihuana during the last year were significantly more likely to report depressive and anxiety symptoms after controlling for sociodemographic variables. Moreover, adolescents who use marihuana were significantly more likely to report suicide attempts after controlling for depression symptoms (OR = 3.07; 95%CI: 2.53-3.72). Findings of this study suggest that adolescents who report marihuana use seem to be at higher risk for mental health problems and suicide attempts. Understanding who is most likely to report marihuana use is important in developing interventions to prevent mental health problems and suicidal behaviors. Key messages • Findings of this study suggest that adolescents who report marihuana use seem to be at higher risk for mental health problems and suicide attempts. • Understanding who is most likely to report marihuana use is important in developing interventions to prevent mental health problems and suicidal behaviors.

Clinical Evaluation of the Cannabis-UsingPatient: A Moving Target.

The prevalence of cannabis use has been increasing among both adolescents and adults worldwide. New trends in cannabis legalization and enhanced social media marketing have led to the availability of multiple high-potency cannabis products with hundreds of new and powerful delivery systems. Over the last decade, there have been drastic changes in cannabis formulations, potency, routes of consumption, and device technology, with increased complexity and sophistication among growers, suppliers, and consumers. Patterns of cannabis use among patients can have important clinical implications, including acute neurocognitive effects, chronic multiorgan toxicity, psychiatric, behavioral, social, and economic impact. However, assessment of medical or surgical patients who use cannabis either recreationally or problematically has become challenging for the clinician due to the changing patterns of cannabis consumption. This review provides information on the clinical evaluation of patients who use cannabis in a problematic fashion, with the focus on tetrahydrocannabinol. It provides the clinician with knowledge regarding cannabis terminology, sources, pharmacology, routes of administration, formulations, dosing, and toxicities. Using these components, an assessment approach for diagnosing cannabis use disorder is synthesized at the conclusion of the article.

Knowledge and perspectives about medicinal cannabis in nurses and nursing students in Portugal

Abstract Background The opening up of legislation on medicinal cannabis in recent years has been a determining factor in the growth of this therapy. In Europe, regulation of medicinal use is a reality in several countries. Nurses can play a leading role in its administration, helping to ensure that it is carried out more effectively and assuming a fundamental role in the success of the therapy. It is therefore pertinent to analyze the knowledge of nurses and nursing students in Portugal about medicinal cannabis. Methods Quantitative descriptive study. A self-completion questionnaire was drawn up and made available on the google forms platform. It was face-validated, content-validated and approved by the Ethics Committee. The instrument included sociodemographic data, questions about cannabis knowledge and perspectives. Descriptive statistics were analyzed. Results Out of a total of 610 responses, 318 were nurses and 292 nursing students. Medical cannabis is considered legitimate by 79.6% of nurses and 84.3% of students. When asked about the functions of the endocannabinoid system, 71.7% of nurses and 79.5% of students said they had no knowledge. 88.7% of nurses and 79.5% of students disagreed that they had sufficient knowledge to advise users on the use of medicinal cannabis. Also, 38.4% believe that their patients use cannabis illegally to manage the symptoms of illnesses. Conclusions There is a need for continuing training for nurses and for the undergraduate and postgraduate nursing curricula to include this emerging area. Key messages • The results show that this issue is a public health problem. It reinforces the need to formulate public policies in this area and to implement training for nurses and nursing students. • These measures will be fundamental in preventing the use of illegal cannabis and promoting the safe use of medicinal cannabis.

Prenatal Cannabis Exposure and Executive Function and Aggressive Behavior at Age 5 Years.

Cannabis use during pregnancy is increasingly common in the US and may affect the development and behavior of preschool-aged children. To prospectively investigate the association of prenatal cannabis exposure with executive function and aggressive behavior at age 5 years. This cohort study was conducted from 2016 through 2020. Data analysis was conducted from 2022 through 2024. Patients aged 16 through 50 years who were able to communicate in English and intended to deliver at the Ohio State University Wexner Medical Center were enrolled in a pregnancy research repository. Participants (n = 355) who gave consent for future contact and whose child(ren) was presumed to be alive were invited to participate again at child age 5 years (children born May 25, 2010, through February 7, 2016) and 250 children participated (70%). Cannabis exposure was measured prospectively by urine toxicology, maternal self-report, and obstetric record abstraction. Executive function and aggressive behavior, measured via multimodal assessment by staff masked to exposure status. Outcomes were chosen a priori. Of 250 children, 80 were exposed to cannabis (32%). Use of tobacco, other drugs, and alcohol during pregnancy was common (22% to 39% each). Most families were living in poverty. There were 155 children who were Black/African American, non-Hispanic (62%); 11 were Hispanic (4%); 34 indicated more than one race or another race, non-Hispanic (14%); and 50 were White, non-Hispanic (20%). Age-corrected standard scores for children's attention and inhibitory control (National Institutes of Health Toolbox) were about 0.4 SDs lower for those exposed to cannabis compared with unexposed (β = -6.1 points; 95% CI, -10.8 to -1.4), following propensity score weighting and adjustment for confounders. Exposed children also exhibited poorer task-based planning ability and more observed aggression. Caregiver ratings of executive function and behavior and laboratory assessments of other aspects of executive functioning showed no differences by exposure status. Results from this contemporary US cohort where prenatal cannabis exposure was common and indicated that exposed children exhibited some differences in aspects of executive function and behavior relevant to long-term academic success and adaptive functioning. These results may be considered in refining clinical recommendations regarding cannabis use during pregnancy.

The annual trend of suicide rates from 2010 to 2021 in patients with cannabis use disorder – a national registry study

Abstract Purpose The temporal trend of suicide in patients with cannabis use disorder (CUD) is important to investigate, considering the recent increases in THC concentration in cannabis products. This study describes the annual suicide rates in patients with CUD from 2010 to 2021. To investigate if any change in suicide rate was specific to CUD, we compared these suicide rates with corresponding data for patients with alcohol use disorders (AUD) and other substance use disorders (SUDs). Method The study used a time series design. We used a national registry linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry from 2010 to 2021, including patients with CUD (ICD-10 code F12), AUD (F10), or other SUDs (F11; F13-F16; F18-F19) who died by suicide, supplemented with the total number of patients treated with specific disorders to estimate the suicide rates. The trend was analyzed by comparing the annual suicide rate to 2010 and using Poisson regression, adjusting for gender, age, and mental disorders. Results We found increased annual incidence rate ratios for patients with CUD in 2018 (IRR = 2.14 (95% CI 1.14–3.99)) and onwards and an increasing time trend over the study period (IRR = 1.08 (1.05–1.12)). No increases in trends were found for AUD or other SUDs. The time trend for CUD was attenuated when adjusting for depressive or anxiety disorders (aIRR = 1.00 (0.92–1.08)) or other SUDs (aIRR = 0.96 (0.87–1.06)). Conclusions Increasing suicide rates were found in patients with CUD. Comorbid anxiety and depression or other SUDs, but not other mental disorders, could partly explain these results.

Eco-anxiety: an additional burden for university students?

Abstract Background Eco-anxiety encompasses climate change anxiety, including global warming, as well as anxiety about a multiplicity of environmental disasters, which not be directly caused by climate change The objective is to assess eco-anxiety in healthcare and non healthcare students and investigate a relationship with health behaviour, mental health, and environmental opinion. Methods A cross-sectional study was conducted among voluntary university students in the Rouen University in Normandy, France. Volunteer healthcare students aged 18 years and older were included. Eco-anxiety was assessed with the Hogg Eco-Anxiety Scale (HEAS-13). Socio-demographics, health behavior, mental health and healthcare data were also collected. Results A total of 1,887 students were included with 74.3% of women and a mean age of 21.1 years (SD = 6.8). The HEAS-13 mean was 13.2 (SD = 2.6): affective symptoms 4.1 (SD = 2.7), eco-rumination 3.7 (SD = 2.4), behaviour 1.0 (SD = 1.5), and anxiety about one’s personal impact on the planet 4.4 (SD = 2.5). Respectively, 59.6% and 31.4% of students are moderately and very much involved in pro environmental-behaviour. 84.6% of students will consider environmental issues in their career choices. Eco-anxiety was associated with being a woman, being in curricula other than health, accommodation with roommates or in couple, use of cannabis, eating disorders, insomnia, emotional exhaustion, cynicism, depression, quality of life, and visiting a general practitioner for stress. Conclusions An high eco-anxiety was associated with impaired mental health and could be an additional burden for university students. Intervention options for those that do experience eco-anxiety and suffering can be as prescribing environmental action, mental health skills, and climate change resolution without imposing the burden of change solely on young people Key messages • A high eco-anxiety is prevalent among university. • The eco-anxiety impaired mental health that could be an additional burden for university students.

CANNABIS: USO TERAPÊUTICO E DESAFIOS PARA SUA APLICABILIDADE MEDICINAL NO BRASIL

Introduction: The legalization of medicinal marijuana use has been a controversial and constantly debated topic in recent years worldwide. Marijuana, also known as cannabis, is a plant that contains various chemical components, including THC (tetrahydrocannabinol) and CBD (cannabidiol), which are the main compounds responsible for its medicinal effects. Although many countries have already established regulations for the therapeutic use of cannabis, there are still many barriers to overcome. Objective: To explore the methodology of therapeutic use and the challenges for the application of cannabis, focusing on its medicinal use, identifying notable challenges and the regulatory aspects involved. Methodology: This study is based on a bibliographic review with a qualitative methodology, centered on the subjective nature of the verified bibliography through literary studies. The works reviewed were published between 2020 and 2023, collected from three main sources: LILACS and PUBMED databases. Results: The review identified significant evidence pointing to the therapeutic potential of Cannabis sativa L., particularly in the treatment of neurological conditions such as epilepsy, multiple sclerosis, and anxiety disorders. However, it also highlighted the major regulatory challenges faced in countries like Brazil, where the cultivation of cannabis for medicinal purposes remains prohibited. This prohibition increases treatment costs and limits accessibility for patients. Additionally, the results revealed a growing acceptance among healthcare professionals and patients, suggesting a likely increase in the demand for medicinal cannabis in the coming years. Conclusion: Although there is robust evidence supporting the efficacy of cannabis for medicinal purposes, significant regulatory and legal barriers remain, particularly in countries with restrictive policies. A reformulation of regulatory frameworks is urgently needed to expand patient access and promote the development of local medicinal cannabis industries. Further investment in scientific research is also essential to ensure that regulatory decisions are based on comprehensive and context-specific data.