Cannabis Consumption Research Articles

The impact of using cannabis during pregnancy on the infant and mother: An overview of systematic reviews, evidence map, targeted updates, and de novo synthesis.

Cannabis use during pregnancy is becoming more prevalent. While numerous studies have explored the relationship of cannabis use during pregnancy and outcomes for mothers and infants, uncertainty remains regarding the impact of cannabis use on pregnancy complications and later-life outcomes for offspring. To produce a summary of the short and long-term effects of prenatal cannabis exposure on fetal growth and development, neonatal conditions, later-life, and maternal outcomes. An overview of systematic reviews, an evidence and gap map, targeted updates of previous reviews, and de novo evidence synthesis was conducted. The databases searched include PubMed (National Center for Biotechnology Information); MEDLINE (Ovid); Embase (Ovid) and CINAHL with Full Text (EBSCO). Assessment of risk of bias was conducted in duplicate for all studies. Relevant studies were coded and are presented as an evidence and gap map. Where possible, meta-analyses were conducted with a narrative synthesis of the results. Primary studies and systematic reviews examining the relationship between cannabis consumption in pregnancy and the effect on fetal/child development, antenatal, and obstetric outcomes during pregnancy were eligible for inclusion. There were 89 studies/reviews eligible for inclusion in this review. There was a potentially harmful impact of prenatal cannabis exposure on all fetal growth and development outcomes, some neonatal outcomes, some later-life outcomes, and some maternal outcomes. The evidence regarding other neonatal conditions, later-life, and maternal outcomes was mixed. The evidence suggests cannabis should be avoided during pregnancy.

Quantitative analysis of cannabinoids and metabolites in oral fluid by volumetric absorptive microsampling combined with UHPLC-HRMS.

With recent evolution of cannabis legalization around the world and multiplication of cannabis derived products, identifying and qualifying cannabis consumption has a proven interest. Although blood, plasma, and urine are common matrices widely used in toxicology laboratories, oral fluid presents specific advantages. In the context of doping tests, addiction consultation or roadside checks, where other matrices are impractical to collect or can be adulterated, oral fluid is a promising matrix that allows a non-invasive, rapid, and monitored self-sampling. However, available devices required a consequent volume of oral fluid,more than 250 µL, sometimes difficult to collect. We present here a fully optimized quantitative method for seven cannabinoids, including four metabolites, in oral fluid, Δ9-tetrahydrocannabinol, 11-hydroxy-Δ9-tetrahydrocannabinol and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol; cannabidiol, 7-hydroxy and 7-carboxycannabidiol; and cannabinol. After self-collection of 20 µL using an accurate and precise volumetric absorptive microsampling device (VAMS®), cannabinoids were derivatized with 2-fluoro-1-methylpyridinium p-toluenesulfonate to increase sensitivity. The successive steps of the proposed method, including biosampling, 1 h sample preparation with derivatization, and acquisition by ultrahigh-performance liquid chromatography coupled to high-resolution mass spectrometry, were fully optimized. A limit of quantification of 0.5 ng/mL (≈10 pg per sampling) was thus targeted, adapted to the legal threshold required by the authorities and to clinical monitoring. Applied to six cannabis consumers, the proposed method made it possible to quantify in 20 µL oral fluid samples, Δ9-tetrahydrocannabinol ranging from 0.5 to 6236 ng/mL, cannabidiol from 0.6 to 190 ng/mL and cannabinol from 0.5 to 118 ng/mL.

Understanding Older Adults' Experiences with Cannabis for Medicinal Purposes: A Mixed Methods Study.

The aim of this study was to explore the perspectives of older medicinal cannabis consumers and those advising them on older Canadians' experiences accessing cannabis and information about it, as well as how stigma may influence their experiences. A concurrent triangulation mixed methods design was used. The design was qualitatively driven and involved conducting semi-structured interviews with older adults and advisors and developing a survey for older adults. We used a Qualitative Descriptive approach for the analysis of qualitative data and descriptive statistics for quantitative survey data. Findings demonstrate that many older adults are accessing information about cannabis for medical purposes from retailers, either because they are reticent to talk to their healthcare professionals or were rebuffed when bringing up the subject. We recommend cannabis education be required for healthcare professionals working with older persons and that future research examines their perspectives on medicinal cannabis and older adults.

Help-Seeking Behaviours Among Cannabis Consumers in Canada and the United States: Findings from the International Cannabis Policy Study

Help-Seeking Behaviours Among Cannabis Consumers in Canada and the United States: Findings from the International Cannabis Policy Study

Intraperitoneal delivery of cannabidiol (CBD) and Δ9-tetrahydocannabinol (THC) promotes papillomavirus infections in athymic nude mice.

We used our mouse papillomavirus (MmuPV1) model to test the hypothesis that two primary psychoactive ingredients of marijuana, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), promote papillomavirus persistence in the oral mucosa of infected mice. We conducted intraperitoneal (ip) injections of a moderate dose (3 mg/kg) of either CBD and/or THC in both male and female athymic nude mice and followed the mice up to 20 weeks post-infection. These doses are comparable to what is estimated for human conventional cannabis consumption. All mice were infected with MmuPV1 in the oral cavity at week 4 post-ip delivery of CBD, THC, or a combination of THC and CBD (T+C). THC and CBD were detected in the blood of treated mice for up to 72 hours after ip injection. Significantly higher levels of viral DNA were detected in males from both CBD and T+C-treated groups compared to those in the control group at 9- 10-and 12-weeks post infection. A marginally increased viral RNA was also detected in the infected tongues of males in all tested groups compared to that in males in the vehicle control group; the opposite was observed in females. We detected significantly higher levels of dermal dendritic cells (CD205+CD11c+), granulocytes (Ly6G+), but macrophages (F4-80+) recruited to the infected tongues of CBD-treated females. Our findings suggest that CBD may play a role in promoting MmuPV1 persistence in the oral cavity.

Cannabis combined with oxycodone for pain relief in fibromyalgia pain: a randomized clinical self-titration trial with focus on adverse events.

We determined whether adding cannabis to oxycodone for chronic non-cancer pain management could reduce treatment-related adverse effects (AEs) while maintaining effective analgesia. In this open-label study, fibromyalgia patients aged ≥18 years were randomized to receive 5 mg oxycodone tablets (max. four times/day), 150 mg of inhaled cannabis containing 6.3% Δ9-tetrahydrocannabinol and 8% cannabidiol (max. times inhalation sessions/day), or a combination of both for 6 weeks. The primary endpoint was treatment-related adverse events, assessed using a 10-point composite adverse event (cAE) score; additionally, we recorded daily reported pain relief and daily tablet and cannabis consumption. In total, 23 patients were treated with oxycodone, 29 with cannabis, and 29 with the oxycodone/cannabis combination. Three patients from the oxycodone group (13%) and 18 patients from the cannabis groups (31%, 9 in each group) withdrew from the trial within 2-3 weeks because of the severity of AEs. There were no differences in treatment-related cAE scores among the three groups that completed the study (p = 0.70). The analgesic responder rate showed a ≥1- point reduction in pain in 50% and a ≥2-point reduction in 20% of patients, while 50% of patients experienced no treatment benefit. The combination treatment reduced oxycodone tablet consumption by 35% (p = 0.02), but it did not affect the number of cannabis inhalation sessions. Cannabis combined with oxycodone offered no advantage over either treatment alone, except for a reduction in opioid tablet intake; however, the overall drug load was the highest in the combination group. Moreover, cannabis was poorly tolerated and led to treatment discontinuation in one-third of participants treated with cannabis. The trial was registered at the WHO International Clinical Trials Registry Platform (trialsearch.who.int) on July 26, 2019, identifier NL7902.

A Comprehensive Review and Update on Cannabis Hyperemesis Syndrome.

Cannabis, derived from Cannabis sativa plants, is a prevalent illicit substance in the United States, containing over 400 chemicals, including 100 cannabinoids, each affecting the body's organs differently upon ingestion. Cannabis hyperemesis syndrome (CHS) is a gut-brain axis disorder characterized by recurring nausea and vomiting intensified by excessive cannabis consumption. CHS often goes undiagnosed due to inconsistent criteria, subjective symptoms, and similarity to cyclical vomiting syndrome (CVS). Understanding the endocannabinoid system (ECS) and its dual response (pro-emetic at higher doses and anti-emetic at lower doses) is crucial in the pathophysiology of CHS. Recent research noted that type 1 cannabinoid receptors in the intestinal nerve plexus exhibit an inhibitory effect on gastrointestinal motility. At the same time, the thermoregulatory function of endocannabinoids might explain compulsive hot bathing in CHS patients. The prevalence of cannabis CHS is expected to rise as legal restrictions on its recreational use decrease in several states. Education and awareness are vital in diagnosing and treating CHS as its prevalence increases. This comprehensive review explores the ECS's involvement, CHS management approaches, and knowledge gaps to enhance understanding of this syndrome.

The Effect of Cannabis Consumption During Lactation on the Macronutrient Concentrations in Breast Milk.

Introduction: Human breast milk macronutrients play a vital role in the development of breastfed infants and are known to be influenced by several factors. There is limited information on the influence of cannabis use during lactation on these macronutrients. Given the rising use of cannabis among lactating women with its widespread legalization, this study aimed to examine the association of cannabis use during lactation on breast milk macronutrients. Materials and Methods: A cross-sectional study design was used and 637 breast milk samples with measured macronutrients were utilized. Of these, 165 samples that had detectable cannabis metabolites were defined as the study group, and 472 samples from mothers who did not report cannabis use and from mothers who reported cannabis use but did not have measurable metabolites of cannabis in their milk samples were defined as the control group. Multivariable linear regression models were used to assess the association of presence of cannabis metabolites with protein, carbohydrates, fat, and calories in breast milk. Results: Greater protein levels (95% confidence interval [CI]: 0.112-0.376; p < 0.001) and lower fat levels (95% CI: -0.217, -0.018; p = 0.020) were found in the milk exposed to cannabis compared with reported nonexposure. The presence of cannabis was associated with an increase of 0.244 mg/dL in protein and a reduction of 11% in fats in breast milk. The levels of energy and carbohydrates were not significantly different among the two groups. Conclusions: This study demonstrated a statistically significant association between the presence of metabolites of cannabis in breast milk and protein and fat concentrations in breath milk. Further studies are required toward building the body of evidence to determine safety of cannabis use during lactation.

Quantity of delta-9-tetrahydrocannabinol consumption and cannabis use disorder among daily cannabis consumers.

Amid escalating cannabis legalization and daily consumption in the United States (US), determining the risk of cannabis use disorder (CUD) and relevant consequences among daily consumers has become a public health priority. Understanding these risks requires valid assessment of the daily quantity of delta-9-tetrahydrocannabinol (THC) consumed and its relation to consequences. This study characterized daily cannabis consumption using a new method for estimating milligrams of THC (mgTHC), and examined the relationship between daily mgTHC and CUD severity in a large national sample of daily consumers. US adult (aged 18+ years) daily cannabis consumers (n = 4134) completed a comprehensive online survey of cannabis consumption patterns (e.g. frequency, quantity, product types, potencies, administration methods) and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) CUD criteria. The primary exposure was past-week daily mgTHC consumption, calculated from survey responses to queries about product type, amount and potency consumed and including adjustments for puff size and loss of THC from specific methods of administration. The primary outcomes were (1) number of CUD criteria (range = 0-11) and (2) CUD severity categories: none, mild, moderate, severe. Median daily consumption was ~130 mgTHC, with substantial variability (25% ≤ 50 mg and 25% ≥ 290 mg). On average, participants endorsed 2.5 CUD criteria, and 65% met criteria for CUD (39% mild, 18% moderate, 8% severe). Greater daily mgTHC predicted higher CUD criteria count [betalog(mgTHC) = 0.50, 95% confidence interval (CI) = 0.267-0.734] and higher odds of mild [log odds ratio (logOR) = 0.238, 95% CI = 0.184-0.292], moderate (logOR = 0.303, 95% CI = 0.232-0.374) or severe (logOR = 0.335, 95% CI = 0.236-0.435) CUD. Among daily consumers of cannabis, there appears to be a positive relationship between the daily quantity of cannabis consumed (measured in milligrams of delta-9-tetrahydrocannabinol) and both the risk and severity of cannabis use disorder.

Cannabinoids and General Anesthetics: Revisiting Molecular Mechanisms of Their Pharmacological Interactions.

Cannabis has been used for recreation and medical purposes for more than a millennium across the world; however, its use's consequences remain poorly understood. Although a growing number of surgical patients are regular cannabis consumers, little is known regarding the pharmacological interactions between cannabis and general anesthetics; consequently, there is not a solid consensus among anesthesiologists on the perioperative management of these patients. The existing evidence about the molecular mechanisms underlying pharmacological interactions between cannabinoids and anesthetic agents, both in animal models and in humans, shows divergent results. While some animal studies have demonstrated that phytocannabinoids (tetrahydrocannabinol [THC], cannabidiol [CBD], and cannabinol [CBN]) potentiate the anesthetic effects of inhalation and intravenous anesthetics, while others have found effects comparable with what has been described in humans so far. Clinical studies and case reports have consistently shown increased requirements of GABAergic anesthetic drugs (isoflurane, sevoflurane, propofol, midazolam) to achieve adequate levels of clinical anesthesia. Several potential molecular mechanisms have been proposed to explain the effects of these interactions. However, it is interesting to mention that in humans, it has been observed that the ingestion of THC enhances the hypnotic effect of ketamine. Animal studies have reported that cannabinoids enhance the analgesic effect of opioids due to a synergistic interaction of the endogenous cannabinoid system (ECS) with the endogenous opioid system (EOS) at the spinal cord level and in the central nervous system. However, human data reveals that cannabis users show higher scores of postoperative pain intensity as well as increased requirements of opioid medication for analgesia. This review aims to improve understanding of the molecular mechanisms and pharmacological interactions between cannabis and anesthetic drugs and the clinical outcomes that occur when these substances are used together.

Right iliac deep vein thrombosis and pulmonary embolism associated with recreational nitrous oxide: a case report

BackgroundThe recreational use of nitrous oxide is becoming increasingly common among teenagers and young adults. Since 2018, the use of nitrous oxide has increased exponentially and has become a public health problem.Case presentationA 23-year-old patient was referred to accident and emergency (A&E) by his general practitioner for deterioration in general condition, vomiting, diarrhea and febrile headache at 39 °C.He reported that he had been partying for a month and consuming alcohol, cannabis and nitrous oxide. Three days before the consultation, he reported increased abdominal pain in the right iliac fossa. His homocysteine concentration was 51.9 μmol/L, and his plasma methyl malonate concentration increased to 4.45 μmol/L. A thoracic and abdominal CT scan revealed right iliac venous thrombosis associated with bilateral pulmonary embolism.ConclusionNitrous oxide inhibits the activity of methionine synthetase. We therefore observed an increase in plasma homocysteine and 5-methyl-THF. The increase in homocysteine could be responsible for the pro-thrombotic activity resulting from nitrous oxide intoxication. At present, no threshold or duration of exposure has been identified as being particularly likely to cause complications. It is likely that other factors coexist, such as coagulation disorders and polymorphisms of the MHTFR gene, which can lead to hyperhomocysteinaemia, cannabis consumption, inflammatory conditions and others. Treatment is based on vitamin B12 supplementation and curative anticoagulation. Some authors also recommend folate supplementation.Consumption of nitrous oxide could be associated with arterial and venous thromboembolic disease.

Bridging the gap: Exploring consumer experiences and motivations for transitioning between illicit and regulated cannabis markets

BackgroundCanada pioneered the non-medical legalization of cannabis production and sales, witnessing substantial growth in the regulated market over the last five years, post-legalization. However, persistent barriers hinder many consumers from transitioning to the legal market, necessitating a nuanced understanding of their behaviors for targeted policy interventions. This study aims to improve understanding of cannabis consumers’ unregulated purchase decisions in British Columbia (B.C.), and to explore motivational factors for transitioning to the legal market. MethodsWe conducted semi-structured interviews with cannabis consumers in B.C., who were at least 19 years old and purchased some or all of their cannabis through unregulated sources. Interviews were transcribed and an inductive thematic analysis was conducted using NVivo. Through coding iterations, we moved from descriptive to analytic codes, and finally mapped the codes to themes aligned with the Five Stages of Consumer Decision Making model. ResultsParticipants (N = 31) represented a broad range of demographic characteristics (i.e., gender, age, education, income). Four themes were identified: seeking information, evaluation of alternatives, purchase decision, and post purchase evaluation. Despite purchasing all or some of their cannabis from the unregulated market, most participants were supportive of legalization and felt that legal cannabis is safe, accessible, and of reasonable quality. However, several barriers prevent consumers from regularly accessing the regulated market, including: price, lack of sales and promotions, potency, limited product variety, and inadequate product interaction. ConclusionThis study delineates barriers that obstruct consumers' transition to the regulated market. These findings, aligned with considerations for public health and safety, offer valuable insights to inform cannabis policy and promote a more effective and consumer-oriented regulatory framework.

Renal infarction by cannabis consumption

Renal infarction is a rare cause for an acute renal failure. At the time being, there is no sufficient correlation to the consumption of cannabis described. A 40-year-old male patient presented to our emergency room because of pain in the right renal bed. The duplex ultrasound showed no ectasia, but the computed tomography confirmed a renal infraction on the right side. The further diagnostics gave no indication of a classical pathogenesis, but there was a constant consumption of cannabis documented. We decided for a conservative treatment with analgesia, diagnostic laboratory controls and anticoagulants because of the prolonged process. The complaints decreased. The correlation between thrombo-embolic events and the consumption of cannabis has to be more explored because of its recent legalization in Germany. It should be considered as a cardiovascular risk factor. Until today there are no recommendations for the anticoagulants.

Divergence in Cannabis and Alcohol Use Disorder Prevalence Trends from 2002-2019

IntroductionDespite increases in availability, potency, and consumption of cannabis, epidemiological data suggest decreases in prevalence of cannabis use disorder (CUD) in some groups. Understanding mechanisms for these changes may help improve diagnostic tools for identifying disordered use. This analysis evaluates changes in CUD compared to a substance with comparably stable social and environmental context (alcohol use disorder [AUD]) as well as treatment engagement and need from 2002 to 2019. MethodsData were from the National Survey on Drug Use and Health. Outcomes included CUD and AUD symptoms, treatment engagement, and perceived need. Temporal trends and average annual rate of change [AARC] were computed. ResultsBetween 2002 and 2019, daily cannabis use prevalence increased by 94% (AARC=11.68%), whereas CUD prevalence among those using cannabis daily reduced by 47.9% (AARC=-10.30%). Daily alcohol use prevalence decreased by 10.86% (AARC=-1.90%), and AUD prevalence among those using alcohol daily reduced by 3.9% (AARC=-0.67%). Prevalence of individual 12-month CUD criteria among those using cannabis daily decreased (-13.4 to -59.6% change; AARC = -2.4% to -14%). Among those using cannabis daily, trends in prevalence of individual AUD criteria varied, with some criteria increasing in prevalence and others decreasing (-30.2% to 24.6% change; AARC = -5.82% to 3.7%). Treatment engagement and perceived need reduced for cannabis, whereas treatment engagement increased and perceived need decreased for alcohol. ConclusionThese results suggest that CUD and AUD criteria may be determined within the cultural context dictating the definition of harm which has changed for cannabis, but not alcohol, from 2002-2019.

Latent transition analysis of time-varying cannabis use motives to inform adaptive interventions.

The rising prevalence of daily cannabis use among older adolescents and young adults in the United States has significant public health implications. As a result, more individuals may be seeking or in need of treatment for adverse outcomes (e.g., cannabis use disorder) arising from excessive cannabis use. Our objective was to explore the potential of self-reported motives for cannabis use as a foundation for developing adaptive interventions tailored to reduce cannabis consumption over time or in certain circumstances. We aimed to understand how transitions in these motives, which can be collected with varying frequencies (yearly, monthly, daily), predict the frequency and adverse outcomes of cannabis use. We conducted secondary analyses on data collected at different frequencies from four studies: the Medical Cannabis Certification Cohort Study (n = 801, biannually), the Cannabis, Health, and Young Adults Project (n = 359, annually), the Monitoring the Future Panel Study (n = 7,851, biennially), and the Text Messaging Study (n = 87, daily). These studies collected time-varying motives for cannabis use and distal measures of cannabis use from adolescents, young adults, and adults. We applied latent transition analysis with random intercepts to analyze the data. We identified the types of transitions in latent motive classes that are predictive of adverse outcomes in the future, specifically transitions into or staying in classes characterized by multiple motives. The identification of such transitions has direct implications for the development of adaptive interventions designed to prevent adverse health outcomes related to cannabis use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development, Content Validation and Usability of a Chatbot for Disseminating Scientific Information About Cannabis Among Young Adults

ABSTRACT Despite the high prevalence of cannabis consumption, there is limited information about cannabis based on scientific evidence available and targeted toward young adults, especially considering accessible language and ease of access. The present study aimed to develop the proof of concept of a chatbot for the dissemination of evidence and scientific information about cannabis, focused on a young adult audience. The proof of concept involved stages of literature review, conversation flow development, content evaluation through a panel of experts (n = 10) and usability analysis using a sample of potential users (young adults, n = 10). The chatbot developed presents information on epidemiology, toxicology, acute and chronic effects of cannabis use, information on cannabis use disorder, and the use of cannabinoids for medicinal purposes. The content evaluation through the Health Education Content Validation Instrument concluded that the tool was considered to have a good structure and content (Content Validity Index > 0,78; overall score = 9.0/10.0). The tool also proved to be functional and highly usable according to the analysis with the System Usability Scale (overall usability score = 9.2/10.0). Digital strategies such as chatbots can help in health education and scientific communication within stigmatized areas, such as the consumption of psychoactive substances.

Fear of COVID-19 Diagnosis and Cannabis Use Patterns Among Adults with Chronic Health Conditions: Results from COVID-19 Cannabis Health Study

ABSTRACT Given the scarcity of literature regarding COVID-19 impacts on cannabis consumers with chronic illnesses who widely use cannabis to manage their health conditions, we aim to assess the effect of COVID-19 on cannabis use patterns among adults living with chronic diseases. Cannabis consumers with a chronic disease (N = 1,466) from COVID-19 Cannabis Health Study were included in this analysis. The primary outcomes were change in cannabis dosage, past 30-day cannabis usage, and change in route of cannabis administration, with the main exposure being self-reported fear of COVID-19 diagnosis. Significant differences were found between changes in cannabis dose by fear of COVID-19 diagnosis (p = .03) where 41.5% of adults fearing diagnosis reported an increase in their cannabis dosage since the pandemic. Multinomial logistic regression showed that individuals who feared COVID-19 diagnosis had 50% greater odds [aOR = 1.50, 95% CI: 1.02–2.24 of decreasing their cannabis in reference to their dose staying the same, than those without fear of COVID-19, adjusting for socio-demographics. Our findings highlight the significant association between fear of COVID-19 diagnosis and changes in cannabis usage patterns among adults with chronic diseases. This underscores the pandemic’s impact on health-related behaviors and the role of cannabis as a coping mechanism during uncertain times.

&lt;b&gt;Perspectiva de la Población Frente al Consumo de Cannabis Medicinal y Recreativo&lt;/b&gt;

The objective of this paper is to determine various groups' perspectives on medicinal and recreational cannabis consumption in Costa Rica through a qualitative and cross- sectional methodology, which has a descriptive scope. This study was conducted at the University of Iberoamerica (UNIBE) from September 2023 to May 2024. The sample for the study consisted of 17 individuals who met the inclusion and exclusion criteria. Among the results, the negative repercussions of recreational consumption stand out. Regarding the medical use of cannabis, it was evident that it can be used as an alternative to deal with various illnesses. Regarding the perspective on legalization, there is a noticeable division, with one part of the population considering it harmful and the other part considering it potentially beneficial.

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 &amp;lt; 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.

Cultivating Choice: Determinants of Home Cannabis Growing Among Legal Users in the United States

As cannabis legalization evolves in the United States, policies regarding home cultivation vary significantly across states. This study examines factors influencing the decision to grow cannabis at home by cannabis‐consuming residents in legal states. Using data from a large online survey (n = 4,823) of recent cannabis users in cannabis‐legal states, we explore four potential explanations for home cultivation: legal access, needs‐based motivations, resource‐based factors, and identity‐based reasons. Our analysis reveals that home growers differ significantly from non‐growers across multiple dimensions. The stance of state policies on home cultivation plays a role in determining who will grow their own. Notably, a strong sense of cannabis identity is the most powerful predictor for home cultivation. While some aspects of needs‐based and resource‐based motivations play a role, multivariate analyses demonstrate that the most compelling explanation includes a mix of variables, demonstrating the complexity of cannabis consumption and choices to cultivate.