Neural reward sensitivity and longitudinal patterns of alcohol and cannabis use in college-aged youth.

The intersectionality of cannabis use and depression symptoms on functional brain topology in adults.

Gender Differences in Correlates of Cannabis Consumers Among Youth: Results From the 2023 Canadian Health Survey on Children and Youth.

Moderating Effect of Participation in Organized College Sports on Mental Health and Frequency of Cannabis Use in a National Cohort.

Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health problems such as depression and posttraumatic stress disorder (PTSD). Prior work has noted mixed results on the longitudinal associations between cannabis use and depression. Studying these associations at the daily level can lead to improved clarity. The present study examined the daily associations between cannabis use and depression in veterans using dynamic structural equation modeling (DSEM). We also explored these associations for those veterans who screened positive for posttraumatic stress disorder (PTSD) compared to those who did not. All participants were recruited using advertisements from BuildClinical, an NIH approved recruitment vendor. The sample consisted of 74 veterans who provided daily data for 87 consecutive days. Cannabis was assessed asking how many hours each individual spent high each day, depressed mood was assessed using a sliding scale from not depressed to very depressed each day, and PTSD was assessed using the PTSD checklist. Among the full veteran sample results revealed a bidirectional, negative, association. Specifically, on days when veterans reported greater depression, they reported fewer hours "high" the next day. Conversely, on days when veterans reported a greater number of hours high, they reported less depression the next day. Among veterans screening positive for PTSD, on days when they reported more depression, they reported fewer hours high the next day (no association was noted for cannabis use predicting depression). However, for those who did not screen positive for PTSD, on days when veterans reported greater number of hours high, they reported less depression the next day. These results highlight the need for further research on the effect of individual differences in cannabis use patterns among veterans with PTSD on health outcomes. Clinically, these results highlight the importance of targeting the pros and cons of cannabis use for depression symptom relief. Future research should incorporate daily objective measures of cannabis use to refine treatment strategies for veterans managing PTSD or depressive related distress.

The impact of cannabis co-use and cannabis use disorder on interest in and barriers to tobacco cessation.

Problematic cannabis use and attachment insecurities as Joint predictors of Depression: Cross-Sectional and longitudinal models.

The specific cognitive mechanisms that differentiate cannabis use disorder from recreational use remain unclear. Prior research has typically examined cognitive functions in isolation; here, we provide the first comprehensive assessment of both controlled and automatic processes and their dynamic interplay across the spectrum of cannabis use disorder. To address this gap, we compared three groups: non-users (n=43), recreational users (n=36) and problematic cannabis users (n=43), classified via the Cannabis Use Disorder Identification Test-Revised, on a comprehensive neuropsychological battery. Our results revealed a specific cognitive signature for cannabis use disorder severity, with the problematic user group showing a selective deficit only in complex working memory capacity compared to non-users. In contrast, performance in other executive domains-including inhibitory control and cognitive flexibility-as well as implicit learning, was preserved across all groups. While the overall balance between controlled and automatic systems was similar across groups, results indicated a potential alteration in the specific crosstalk between inhibitory control and implicit learning was altered in recreational users compared to non-users. This study highlights that cognitive alterations in cannabis users are not uniformly present but instead emerge selectively in relation to addiction severity, emphasizing the importance of distinguishing between recreational and problematic use in both research and clinical assessment.

Perceptions of negative reinforcement in the natural environment: Characterizing subjective alcohol- and cannabis-contingent relief.

Preparation of ZIF-8 grafted magnetic solid-phase extraction sorbent for sensitive determination of four cannabinoids in urine and oral fluid.

Latent profiles of maternal psychopathology and risk for lifetime/perinatal substance use: Findings from the HBCD study.

Opioids are widely prescribed after colorectal surgery but may cause adverse events, misuse, and addiction. Despite growing interest in opioid-free analgesia, the rate and characteristics of patients undergoing colorectal surgery who consume no opioids postdischarge remain uncertain. This study aimed to (1) estimate the rate of patients who consume no opioids postdischarge after colorectal surgery and (2) identify patient and care characteristics associated with opioid-free analgesia. This prospective cohort study enrolled adults (aged ≥18 years) undergoing elective colorectal surgery at 2 academic hospitals. Self-reported analgesic consumption was assessed weekly for 1 month postdischarge. Rates of opioid-free analgesia were analyzed descriptively. Predictors were identified using Bayesian model averaging, with higher posterior effect probability reflecting stronger association. A total of 344 participants were included (mean age: 58 ± 15 years; 54% male; 65% laparoscopic surgery; 31% rectal procedure; median hospital stay: 3 days [interquartile range: 1-5 days]). Discharge prescriptions included nonopioids (92% acetaminophen, 38% nonsteroidal anti-inflammatory drugs, and 2% gabapentinoids) and opioids (92%). At 30 days, 51% used no opioids postdischarge (47% after open surgery, 51% after laparoscopic surgery, 52% after procedures via stoma [ie, loop ostomy reversal]). Opioid-free analgesia was associated with older age (odds ratio: 1.04, posterior effect probability = 100%), fewer opioid pills prescribed (odds ratio: 0.92, posterior effect probability = 100%), no postdischarge cannabis use (odds ratio: 0.09, posterior effect probability = 96%), and high patient activation (ie, confidence for self-managing care; odds ratio: 2.20, posterior effect probability = 67%). Approximately half of patients undergoing colorectal surgery do not use opioids postdischarge. Older patients, those with higher patient activation, those who did not use cannabis, and those with fewer opioids prescribed were more likely to rely on opioid-free analgesia. Opioid-free postdischarge analgesia may be feasible after colorectal surgery and should be further investigated.

Tobacco and cannabis co-use by route of administration in the United States, 2022/2023.

ABSTRACT While cannabis use is associated with subjective sleep improvements, studies employing objective sleep measures (e.g. actigraphy) demonstrate mixed relations. Based on social cognitive theory, it is possible that positive sleep-related cannabis expectancies (i.e. beliefs that cannabis will improve sleep) may modify self-reported sleep outcomes. This daily-level study examined agreement between subjective and objective sleep measures and evaluated whether positive sleep-related cannabis expectancies augmented discrepancies between subjective and objective sleep outcomes on cannabis use days. Individuals endorsing regular cannabis use and sleep motives (N = 23) completed baseline measures on cannabis use, sleep, and expectancies, followed by up to seven days of diaries and continuous actigraphy (n = 155 days). Diary and actigraphy agreement was poor for wake after sleep onset and sleep onset latency, moderate for total sleep time, and excellent for fall asleep time and wake-time. Expectancies were associated with overestimated diary total sleep time and this association was amplified on cannabis use days. Tendencies to self-report earlier diary fall asleep time on cannabis use days and later time on nonuse days were amplified as expectancies increased. Sleep-related cannabis expectancies may bias self-reported sleep, highlighting the need to account for such beliefs in future research examining cannabis-sleep relations with subjective measures.

Rates of recreational cannabis (ie, marijuana) use in the United States have increased in recent years as have rates of cannabis use disorder. The aim of this study was to assess theoretical correlates of intentions to initiate and sustain marijuana cessation among adult user-using domains of the Multi-Theory Model (MTM) of health behavior change. A cross-sectional survey was administered to a sample of adult cannabis users (n = 227; mean age = 40.9 years; 48.5% female; 85.5% non-Hispanic white). We assessed intention to quit cannabis using MTM constructs of initiation (participatory dialogue, behavioral confidence, changes in physical environment) and sustenance (emotional transformation, practice for change, changes in social environment). The structure of the MTM scale was assessed using confirmatory factor analysis. Hierarchical linear regression models were used to assess constructs of initiation and sustenance of cannabis use controlling for demographic characteristics and Cannabis Use Disorder Identification Test score (<12 and >12). The MTM scale evidenced good reliability (Cronbach's alphas > .7) and good model fit. Results indicated that only the change in physical environment construct was significantly associated with the intention of initiating cannabis cessation (B = 0.27, P < .001) while practice for change (B = 0.27, P < .001) and changes in social environment (B = 0.19, P = .001) was positively associated with the intentions of sustaining cannabis cessation. Results indicate that changes to physical and social environment are key features of initiating and sustaining cannabis use cessation, which aligns with research on tobacco cessation. Future research should explore how these factors interact and investigate additional influences on long-term cessation success.

Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are biomarkers for neuroaxonal damage and astroglial injury, respectively. The present study aimed to quantify NfL and GFAP as well as investigate their association with psychiatric symptoms in a sample of recreational cannabis users. Blood samples from 331 individuals with regular recreational cannabis use were collected. Serum NfL (sNfL) and GFAP (sGFAP) levels were quantified in duplicate by an ultrasensitive single-molecule array (Simoa) technology. Reference populations were used to calculate age-, BMI-, and (for GFAP) sex-adjusted Z scores. Participants completed validated psychometric instruments assessing symptoms of cannabis use disorder, alcohol use disorder, psychosis, depression, and anxiety. Mean GFAP levels were significantly lower than those in the reference population (t(330) = -6.718, p < 0.001), whereas NfL levels did not differ (t(330) = 1.3, p = 0.19). Participants with hazardous cannabis use and those screening positive for psychotic symptoms showed higher NfL levels. Psychotic symptoms were additionally associated with lower GFAP levels. NfL correlated positively with total Cannabis Use Disorder Identification Test-Revised (CUDIT-R) scores (ρ(329) = 0.12, p = 0.03) and specifically with the items "memory/concentration problems" (ρ(329) = 0.11, p = 0.04) and "time spent buying/using/recovering" (ρ(329) = 0.13, p = 0.02). In multiple regression analysis, psychotic and cannabis use disorder symptoms independently predicted higher NfL levels. No variables predicted GFAP levels. There was no association between self-reported cannabis use amount or frequency in the past 30days and GFAP or NfL. The results provide preliminary evidence of cannabis-related neuroaxonal alterations, warranting longitudinal studies to clarify the temporal relationship between these biomarkers and cannabis use.

Association Between Perceived Parent Attitudes and Teen Cannabis and Alcohol Use.

Although random assignment is the standard for drawing causal inferences within clinical trials, it is generally precluded in legal market cannabis research given its federal classification as a schedule 1 drug. Unfortunately, this may cause selection bias and compromise internal validity, and thus, alternative approaches are necessary. One such approach in this context, as well as more broadly, is quasi-random assignment whereby participants are randomly assigned to conditions but can accept or decline this assignment. This study explores whether those who accept or decline condition assignment differ in ways that impact study outcomes and informs best practices for other research areas where random assignment is not feasible or permitted. Data came from two studies examining cannabis, inflammation, and insulin sensitivity. The first included individuals who infrequently used cannabis; the second included regular users. Across studies, individuals were quasi-randomly assigned via dice roll to purchase and use either THC-dominant, CBD-dominant, or approximately equal THC:CBD ratio flower products for 1 (study 1) or 4weeks (study 2). Demographics, cannabis use, health behaviors (e.g., exercise), and anthropometrics (i.e., body mass index [BMI]) were compared across individuals who accepted versus declined their assigned condition. Most participants accepted their assignment (83% and 63% for studies 1 and 2, respectively). Those who accepted did not differ from those who declined on any variable (ps > 0.11). While findings cannot rule out a selection process outside the variables assessed, results support use of this methodology in situations where true random assignment is not possible. Clinical trials: The larger project from which the current paper draws data was pre-registered on Clinicaltrials.gov (NCT04114903) on 09-06-2019.

Emergency medical services (EMS) clinicians are first responders who experience recurrent occupational stressors. Cross-sectional research suggests that higher self-regulation of emotions may be related to lower stress, especially in individuals with regular substance use. However, temporal dynamics are unclear. Our objective was to identify real-time dynamics between perceived stress and emotion regulation in EMS clinicians who regularly use substances. Participants were full-time EMS clinicians reporting alcohol and/or cannabis use ≥2x/week. Participants completed five daily ecological momentary assessments (EMAs) at semi-random times for 28 days. We used a continuous-time structural equation model with Bayesian estimation to identify dynamics between perceived stress and emotion regulation (both within-person centered and standardized). The 110 participants completed 12,234 EMAs (81.3% adherence). Higher perceived stress predicted lower future emotion regulation (standardized estimate = -0.68 [-1.05, -0.31]). Inversely, higher emotion regulation predicted lower future perceived stress (standardized estimate = -2.25 [-3.38, -1.15]). We identified bidirectional relationships between perceived stress and emotion regulation in the daily lives of EMS clinicians with regular substance use. While results may not be generalizable to EMS clinicians who do not regularly use substances, we identified emotion regulation as a future interventional target to reduce real-time stress in this highest-risk group.

Tobacco-cannabis co-use is associated with increased psychosocial and health harms; however, the treatment literature assessing the impact of co-use has been mixed and suffers from critical limitations. To date, no prospective studies have evaluated the degree to which cannabis co-use affects tobacco cessation, nor are there treatment recommendations for those who co-use. The goal of this study was to evaluate and quantify the impact of cannabis co-use on tobacco cessation through a 12-week prospective tobacco cessation trial. This was a multi-site, non-randomized trial. Inverse probability weighted modified Poisson regression models were used to assess the probability of tobacco abstinence between tobacco-only and tobacco-cannabis co-use cohorts. Enrollment occurred at three sites across South Carolina, USA: The Medical University of South Carolina (MUSC) Charleston, Behavioral Health Services of Pickens County and MUSC Florence. Enrolled participants were adults (n = 181; ages 18-40) who (1) smoked tobacco cigarettes and used cannabis regularly (co-use cohort; oversampled) or (2) smoked tobacco cigarettes daily (tobacco-only cohort). Across 3 sites, 181 adults (110 co-using cannabis; 71 tobacco-only) were enrolled (49% female; 19% Black/African American; 6% Hispanic/LatinX). All participants received 12 weeks of first-line tobacco treatment (varenicline, incentives for tobacco abstinence, counseling), while cannabis use was not addressed as part of treatment. The primary outcome was biochemically confirmed 7-day point prevalence tobacco abstinence (PPA) at end of treatment (EOT; Week 12 post-enrollment). Average baseline reported cigarettes per day were not different between tobacco-only or cannabis co-use cohorts [14.9, (standard deviation, SD =7.2) versus 13.4 (SD =7.8); P = 0.25]. Among the co-use cohort, days of cannabis use in the past month at baseline was 23.7 (SD =9.5). In imputed analyses, EOT 7-day PPA tobacco abstinence was achieved in 59% of tobacco-only participants and 33% of the cannabis co-use cohort [Imputed data: relative risk (RR) =1.63, 95% confidence interval (CI) = 1.14-2.33]. Neither baseline daily cannabis use [adjusted relative risk (RRadj) =1.05, 95% CI= 0.63-1.77] nor within-treatment cannabis use frequency (RRadj=0.51, 95% CI = 0.25, 1.06) was associated with EOT PPA for tobacco in the cannabis co-use cohort. This is the first prospective study designed to compare tobacco cessation outcomes by cannabis co-use status. Regular cannabis co-use had a negative impact on tobacco abstinence among younger to middle-aged adults. Addressing cannabis use should be incorporated into standard tobacco treatment to improve cessation outcomes.