Cannabis Consumption Research Articles

“I don’t need my kid to be high”: prioritizing harm reduction when using cannabis during pregnancy

BackgroundCannabis is the most common illicit substance used in pregnancy. As use continues to increase, understanding peoples’ behaviors surrounding cannabis use during pregnancy is needed to improve maternal and child health outcomes. The aim of this study was to better understand pregnant individuals' perceptions and knowledge of cannabis use and use patterns as well as the social and environmental factors that may influence their use.MethodsWe conducted interviews with 19 participants between December 2022 and March 2023. Individuals self-identified as BIPOC (Black, Indigenous, People of Color), were over 21 years of age, spoke English or Spanish, resided in California, and had used cannabis during pregnancy in the last 0–2 years. Using qualitative, constructivist grounded theory methods, we analyzed the contexts that contributed to participants’ lived experiences surrounding cannabis use behaviors during pregnancy.ResultsParticipants reported making conscious decisions to responsibly manage their cannabis use during pregnancy to minimize potential harm to the fetus. Participants prioritized making what they perceived to be safer adjustments to their use of cannabis: (1) changing the amount of cannabis used, (2) changing the types of cannabis products used, and (3) changing sources of cannabis procurement.DiscussionOur findings show that pregnant individuals are seeking information about safe cannabis use beyond medical supervision and are open to altering their cannabis consumption patterns. However, they are unable to find trustworthy and evidence-based harm reduction practices which can be implemented to mitigate harm to their unborn children. A harm reduction approach is needed in the field of maternal cannabis use to promote positive maternal and fetal health outcomes.ConclusionsMore data is needed on comprehensive harm reduction approaches to cannabis use during pregnancy. This requires implementation of education on these topics in healthcare settings presented by prenatal care clinicians.

Cannabis consumers’ preferences for legal and illegal cannabis: evidence from a discrete choice experiment

BackgroundIn U.S. states that legalized and commercialized recreational cannabis, cannabis sales in illegal markets are still sizable or even larger than those in legal markets. This study aimed to assess cannabis consumers’ preferences for purchasing cannabis from legal and illegal markets and estimate the trade-offs under various policy scenarios.Methods963 adults were recruited, who used cannabis in the past year and lived in a state with recreational cannabis legalization. In a discrete choice experiment, participants chose purchasing cannabis from a legal dispensary or an illegal dealer with varying levels in product attributes including quality, safety, accessibility, potency, and price. Mixed logit models were used to analyze preferences.ResultsThe likelihood of choosing legal cannabis increased with a higher quality, the presence of lab test, a shorter distance to seller, a higher tetrahydrocannabinol level, and a lower price. The likelihood of choosing illegal cannabis increased with a higher quality, a shorter distance to seller, and a lower price. Among product attributes, quality and accessibility were perceived to be the most important for legal cannabis and price was perceived to be the most important for illegal cannabis. Policy simulations predicted that improving quality, ensuring safety, allowing delivery services, increasing dispensary density, and lowering prices/taxes of legal cannabis may reduce illegal cannabis market share.ConclusionsIn the U.S., cannabis consumers’ preferences for illegal cannabis were associated with both legal and illegal cannabis product attributes. Policies regulating legal cannabis markets should consider potential spillover effects to illegal markets.

The Underrecognized Role of Cannabis in the Etiology of Acute Pancreatitis.

Cannabis-induced pancreatitis (CIP) is an emerging clinical entity that presents unique challenges in diagnosis and management. This narrative review explores the current understanding of CIP, synthesizing evidence from epidemiological, pathophysiological, and clinical studies. The rising prevalence of cannabis use worldwide has been paralleled by an increase in reported cases of CIP, particularly among younger populations. Pathophysiological mechanisms involve the interaction of exogenous cannabinoids with pancreatic cannabinoid receptors, potentially disrupting normal pancreatic function and triggering inflammation. Clinical presentation of CIP often mimics other forms of acute pancreatitis (AP), necessitating a high index of suspicion and thorough history-taking for accurate diagnosis. Management strategies align with established protocols for AP, with an emphasis on supportive care and cannabis cessation to prevent recurrence. While short-term outcomes are generally favorable, the risk of progression to chronic pancreatitis in cases of continued cannabis use underscores the importance of long-term follow-up and abstinence counseling. This review also highlights significant knowledge gaps, including the need for standardized diagnostic criteria, a better understanding of dose-response relationships, and potential interactions with other risk factors. Future research directions should focus on elucidating precise pathophysiological mechanisms, developing targeted therapies, and investigating the impact of different cannabis formulations and consumption methods on pancreatic health. As cannabis use continues to increase globally, a comprehensive understanding of its effects on pancreatic function is crucial for improving patient outcomes and informing public health policies.

Cannabinoid Hyperemesis Syndrome Presumed Secondary to CBD Use: A Case Report.

Cannabinoid hyperemesis syndrome is characterized by recurrent episodes of severe nausea and vomiting, often associated with prolonged and excessive cannabis use. With the recent legalization and rising consumption of cannabidiol (CBD) in Europe and the United States, concerns have emerged about its potential role in triggering similar symptoms. A 32-year-old male with a history of cannabis, tobacco and alcohol use disorder experienced multiple cyclic vomiting episodes after switching from cannabis to CBD. Initially, the patient presented with abdominal pain and vomiting after ceasing cannabis use, with symptoms alleviated by hot showers. Three months later, similar symptoms reappeared despite abstinence from cannabis but regular CBD consumption. Over the next 6 months, recurrent episodes of abdominal pain and vomiting persisted with daily CBD use but no cannabis consumption. Clinical data, laboratory results, and treatment responses were analyzed to investigate the connection between CBD consumption and symptom onset. The pathophysiology of cannabis-induced cyclic vomiting is poorly understood. Hypotheses include tetrahydrocannabinol accumulation in adipose tissue, pyrolytic conversion of CBD into tetrahydrocannabinol, and CBD's intrinsic effects, particularly its interaction with transient receptor potential vanilloid 1 receptors. Our analysis suggests that high doses of CBD may activate transient receptor potential vanilloid 1 receptors, inducing proemetic effects. Although the connection between CBD and cyclic vomiting remains uncertain, it warrants further investigation. The increasing use of CBD, perceived as a safe dietary supplement, underscores the need to understand its potential health impacts better.

Sexual experience under the influence of alcohol and cannabis consumption.

Substance use affects different areas of life, including the sexual sphere. Drugs and specifically the use of alcohol and cannabis, can influence sexual experience. However, there has been little research and to date none has been carried out in Spain that compares the effect of alcohol and cannabis consumption in the same people on their sexual experience. Therefore, the objective of the study was to analyze and compare the effect of alcohol and cannabis in the same people on their sexual experience. The sample consisted of 483 people who had ever consumed alcohol and cannabis. Participants answered an online questionnaire about alcohol and cannabis use and sexual experience. The results show that despite the fact that when people consume alcohol, they feel more attractive, they feel more attraction towards other people, they are more extroverted, their desire increases and they have longer sexual relations than when they consume cannabis, people who frequently consume when consume cannabis, they have more sensitivity and they are more sexually satisfied than when they consume alcohol. Regarding the sexual experience, although they prefer not to use drugs when they have sex, people who frequently consume prefer to consume more cannabis than alcohol. Therefore, it is concluded that, although alcohol facilitates the sexual encounter, with cannabis people feel more sexually satisfied.

Abstract P152: Association of Cannabis Use with Atherosclerotic Cardiovascular Diseases Outcomes: Insights from a Meta-Analysis of a Multinational Cohort of 1.9 Million Individuals

Background: Despite numerous reports suggesting a link between cannabis use and the risk of atherosclerotic cardiovascular diseases (ASCVD), the nature of this relationship—whether causal or not—remains uncertain. Objective: We aimed to consolidate data from observational studies to examine the association between cannabis use and ASCVD outcomes compared to non-users or controls. Methods: RevMan 5.4 was used for statistical analyses employing a random effects model, and outcomes were presented as risk ratios (RR) with corresponding 95% confidence intervals (CI). The study protocol has been registered with PROSPERO (CRD42024530366). Results: Our analysis integrated data from 17 studies, including 1,902,481 individuals aged 18 to 74, with a mean follow-up duration of 8.5 years. The pooled analysis revealed no statistically significant association between cannabis use and the risk of myocardial infarction compared to non-users, with an RR of 1.25 (95% CI: 0.91 to 1.71, p = 0.17). Similarly, the risk of stroke did not show a significant association with cannabis use (RR: 1.38, 95% CI: 0.88 to 2.16, p = 0.16). However, a statistically significant association was found between cannabis use and the composite outcome of any adverse cardiovascular events (RR: 1.48, 95% CI: 1.16 to 1.90, p = 0.002). Conclusion: The statistical correlations between cannabis use and composite adverse cardiovascular outcomes underscore its potential as a risk factor for cardiovascular disease. With rising trends in medical cannabis use and cannabis use disorder across age demographics, heightened risk awareness, CVD screening, and informed decision-making regarding cannabis consumption are critical priorities in healthcare and public health initiatives.

Changes in self-reported cannabis use in the United States from 1979 to 2022.

Multiple countries are considering revising cannabis policies. This study aimed to measure long-term trends in cannabis use in the United States and compare them with alcohol use. Secondary analysis of United States general population survey data. The national surveys had a total of 1 641 041 participants across 27 surveys from 1979 to 2022. Rates of use reported to the US National Survey on Drug Use and Health and its predecessors are described, as are trends in days of use reported. Four milepost years are contrasted: 1979 (first available data and end of relatively liberal policies of the 1970s), 1992 (end of 12 years of conservative Reagan-Bush era policies), 2008 (last year before the Justice Department signaled explicit federal non-interference with state-level legalizations) and 2022 (most recent data available). Reported cannabis use declined to a nadir in 1992, with partial recovery through 2008, and substantial increases since then, particularly for measures of more intensive use. Between 2008 and 2022, the per capita rate of reporting past-year use increased by 120%, and days of use reported per capita increased by 218% (in absolute terms from the annual equivalent of 2.3 to 8.1 billion days per year). From 1992 to 2022, there was a 15-fold increase in the per capita rate of reporting daily or near daily use. Whereas the 1992 survey recorded 10 times as many daily or near daily alcohol as cannabis users (8.9 vs. 0.9 M), the 2022 survey, for the first time, recorded more daily and near daily users of cannabis than alcohol (17.7 vs. 14.7 M). Far more people drink, but high-frequency drinking is less common. In 2022, the median drinker reported drinking on 4-5days in the past month, versus 15-16 days in the past month for cannabis. In 2022, past-month cannabis consumers were almost four times as likely to report daily or near daily use (42.3% vs. 10.9%) and 7.4 times more likely to report daily use (28.2% vs. 3.8%). Long-term trends in cannabis use in the United States parallel corresponding changes in cannabis policy, with declines during periods of greater restriction and growth during periods of policy liberalization. A growing share of cannabis consumers report daily or near daily use, and their numbers now exceed the number of daily and near daily drinkers.

A Double-Blind, Placebo-Controlled Study of Adjunctive Topiramate in Adolescents With Co-Occurring Bipolar and Cannabis Use Disorders

To evaluate the efficacy of adjunctive topiramate (TPM) for the treatment of cannabis use disorder in adolescents with bipolar I disorder. We conducted a 16-week, double-blind, randomized, placebo-controlled investigation of quetiapine plus TPM (median dose= 208 mg) vs quetiapine plus placebo in adolescents with bipolar I and cannabis use disorder. All subjects participated in a Motivational Interview and Compliance Enhancement Therapy. The primary outcome measure was change in weekly cannabis use over a 16-week treatment period using the Timeline Followback. The secondary outcome measure was the baseline-to-endpoint total score change in the Young Mania Rating Scale (YMRS). A total of 75 participants completed at least 1 post-baseline assessment (TPM= 38, placebo= 37). There was a significant time-by-treatment effect over the 16-week treatment period, with baseline-adjusted treatment differences in favor of the TPM group over time (p< .001). Although there was no difference in baseline-to-endpoint YMRS total score change between groups (p= .342), there was as significant decline in YMRS total score within both groups (p< .0001). There was a significant positive effect for alcohol use (p< .001) and nicotine use (p= .033) in the TPM group. More participants in the TPM group experienced appetite decrease (p= .032) and excitement (p= .025). Participants in the placebo group experienced greater weight gain (p= .010). Treatment with TPM adjunctive to quetiapine and a Motivational Interview and Compliance Enhancement Therapy is associated with a greater decrease in cannabis use and less weight gain. TPM is a well-tolerated and efficacious treatment for cannabis use disorder in adolescents with bipolar I disorder. Efficacy Study of Quetiapine Plus Topiramate for Reducing Cannabis Consumption and Bipolar Mania; https://clinicaltrials.gov/; NCT00393978. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science.

Lessons Learned in Developing a Behavioral Economic Measure of Cannabis Use Using a Predominantly White Sample.

Behavioral economic approaches to measuring cannabis demand represent a well-validated, low-cost method of assessing risk for hazardous cannabis use. One widely used measure of cannabis demand is the Marijuana Purchase Task (MPT), which has shown good psychometric properties across multiple samples. However, preliminary data suggest that changes could improve task ecological validity and acceptability. Using a predominantly White convenience sample, this study aimed to develop a revised MPT that uses a modern dispensary scenario to better reflect national trends in cannabis use (e.g., multiple forms of cannabis consumption). Participant inattentiveness due to increased task length and difficulty estimating purchases for the next month may have impacted demand measures. Lessons learned are discussed to inform future efforts to assess cannabis demand in a manner that is more reflective of naturalistic use: including minimizing participant burden, setting higher price ceilings to increase task utility, and considering person-level factors that may influence demand.

The mediating effects of minority stress experiences on cannabis consumption among 2SLGBTQ+ youth

Introduction Data suggest there are within-group variations in cannabis consumption among sexually diverse individuals. However, less is known about specific sexual orientations, such as Two-Spirit, asexual, pansexual, and queer (2SAPQ+), when compared with lesbian, gay, and bisexual people, as they often are not given an option to indicate their identities on surveys, leading them to be grouped with bisexuals. This study aimed to compare the relationship between LG and 2SAPBQ+ (including bisexual) identification and routine cannabis use, and whether it was mediated by minority stress. Methods Data were collected across two time points from 851 Two-Spirit, lesbian, gay, bisexual, queer, and questioning (2SLGBTQ+) youth participants. Structural equation modeling (SEM) was employed to analyze whether latent constructs within the minority stress framework mediated the relationship between sexual identity and cannabis use longitudinally. Results A preliminary logistic regression confirmed that 2SAPBQ + individuals were more likely to consume cannabis than LG individuals. The results suggest that the minority stress constructs accounted for a significant portion of the variance within the relationship between sexual orientation and cannabis use. Conclusion The pathway between sexual orientation and routine cannabis use was complex. Findings signal that not all sexual minority individuals should be grouped into one category and call for attention to careful measurement practices.

The highs and lows of cannabis stigma: a vignette study of factors that influence stigma toward cannabis consumers

Background Cannabis consumption has increased across all demographics following legalization in Canada. While cannabis is becoming increasingly more prevalent, prevailing stigma in the community has been highlighted as a concern. The purpose of this study was to determine the context in which Canadians stigmatize cannabis use to inform policy and harm-reduction campaigns. Methods An experimental vignette design aimed to quantify cannabis-related stigma and explore the impact of the following items on stigma (1) reason for use (recreational/medical/self-medication); (2) method of consumption (smoking joints/edibles); (3) frequency (monthly/almost daily/multiple times daily); and (4) source (unregulated/regulated market). Canadian citizens 18 years and older were recruited through public opinion agency (N = 1118). Participants were randomly assigned two vignettes altering the independent variables and completed the Social Distance Questionnaire following each vignette as the dependent measure of stigma. Results 2x3 ANOVAs revealed that stigma toward cannabis consumption increased when cannabis was used recreationally, by smoking joints, more frequently, and purchased from the neighborhood. Conclusions Stigma may be a barrier to help-seeking for consumers who use riskier methods of administration. Stigmatization may also impact purchasing from regulated suppliers. Findings can help inform cannabis policies and education strategies to reduce stigma and barriers regarding consumption behaviors.

Cannabis use in endometriosis: the patients have their say—an online survey for German-speaking countries

PurposeEndometriosis is a chronic inflammatory disease that can cause various pain symptoms. Current therapy options do not always provide sufficient pain relief and often cause unpleasant side effects. Recent studies have shown that the endocannabinoid system is involved in the endometriosis pathophysiology, and using Cannabinoids may be a potential therapeutic option. We aimed to determine for the first time, the Cannabis use prevalence, self-rated effectiveness, and the possible reduction in medication in German-speaking countries.MethodsA cross-sectional online survey was distributed through endometriosis support and advocacy groups on social media. German-speaking endometriosis patients aged ≤ 18, residing in Germany, Austria, and Switzerland were eligible to participate.ResultsOut of 912 participants who provided valid answers, 114 reported using cannabis for self-management. Cannabis was rated as the most effective self-management strategy to reduce symptom intensity (self-rated efficacy 7.6 out of 10). Additionally, ~ 90% of the participants were able to decrease their pain medication intake. The greatest improvement was observed in sleep (91%), menstrual pain (90%), and non-cyclic pain (80%). Apart from increased fatigue (17%), side effects were infrequent (≤ 5%).ConclusionAt the time of the study, Cannabis consumption was still illegal in Germany, Austria, and Switzerland, with medical cannabis being rarely prescribed due to complex requirements. Results suggest that Cannabis has become a popular self-management method for treating endometriosis-related symptoms, leading to substantial symptom improvement. Further studies are needed to investigate the best administration methods, dosage, THC/CBD ratio, potential side effects, and long-term effects to provide official recommendations to patients and healthcare providers.

Beyond Frequency and Quantity of Cannabis Consumption among College Students: Context of Using Cannabis Relates to Cannabis-Related Outcomes

Objective: Due to little knowledge regarding the contextual factors related to cannabis use, we aimed to provide descriptive statistics regarding contextual factors related to use and examine the predictive ability of contextual factors. Method: We included college student participants (n = 5700; male = 2893, female = 3702, other gender identity = 48, missing = 57) from three multi-site studies in our analyses. We examined the means and standard deviations of contextual factors related to cannabis use (social context/setting, form of cannabis, route of administration, source of purchase, and proxies of use). Additionally, we tested the predictive ability of the contextual factors on cannabis use consequences, protective behavioral strategies, and severity of cannabis use disorder, via an exploratory machine learning model (random forest). Results: Descriptive statistics and the correlations between the contextual factors and the three outcomes are provided. Exploratory random forests indicated that contextual factors may be helpful in predicting consequences and protective behavioral strategies and especially useful in predicting the severity of cannabis use disorder. Conclusions: Contextual factors of cannabis use warrants further exploration, especially considering the difficulty in assessing dosage when individuals are likely to consume in a group context. We propose considering measuring contextual factors along with use in the past 30 days and consequences of use.

Marijuana's Impact On Implant-based Breast Reconstruction: A Retrospective Cohort Study.

Studies have shown that chronic marijuana use is associated with increased vascular inflammation, endothelial damage, myocardial infarctions, strokes, arteritis, and cardiomyopathies; however, cannabis's effect on wound healing in immediate direct-to-implant (DTI) breast reconstruction is unknown. With the increasing prevalence of marijuana use, it is imperative to understand its effects on surgical outcomes. We performed a retrospective cohort study of consecutive patients in a quaternary-care breast cancer center undergoing immediate DTI reconstruction. Patient demographics, operative details, and surgical complications were extracted through chart review. Active cannabis use was defined as use within 12 weeks of operation. Univariate and multivariable analyses were performed. In total, 243 consecutive patients underwent immediate DTI reconstruction, and 12 reported active cannabis use. There were no significant differences in patient demographics, cancer treatment, or operative details. Active marijuana users demonstrated higher rates of cellulitis treated with IV antibiotics (P = 0.004), explantation for infection (P = 0.004), emergency department visits (P = 0.028), readmission (P = 0.037), takeback to the operating room in 90 days (P < 0.001), and overall major complications (P < 0.001). Multivariable analysis demonstrated that active marijuana users were more likely to experience cellulitis treated with IV antibiotics [odds ratio (OR) = 3.55, P = 0.024], takeback to the OR within 90 days of operation (OR = 4.75, P = 0.001), and major complications (OR = 2.26, P = 0.048). The consumption of cannabis in the perioperative setting is associated with increased rates of complications in patients undergoing immediate DTI reconstruction; however, an analysis with a larger patient population is needed to conclude that abstinence from its use should be highly encouraged.

Outcomes after open repair of aortic aneurysms and dissections in cannabis consumers

ObjectiveTo investigate the influence of cannabis consumption on the mid- and long-term surgical outcomes of patients with aortic aneurysms or dissections. MethodsAll individuals aged 18 years and older with more than 6 months of cannabis use at the time of surgical repair for cardiovascular disease (aortic aneurysms or aortic dissection) between 2007 and 2023 were eligible. Patients were stratified into 2 groups based on their preoperative history of cannabis use: cannabis users and noncannabis users. The primary end point was complications or death within 30 days of intervention. Secondary outcomes included late complications and reinterventions. Data were combined from our institution and inpatient hospital records. ResultsWe identified 134 patients who met the inclusion criteria out of 1543 treated patients (9%). Compared with the nonusing cannabis group, individuals in the cannabis group were significantly younger (cannabis: 48.3 ± 11.8 years vs noncannabis: 58.5 ± 14.9 years; P < .001). The cannabis group included significantly higher patients with Marfan syndrome (cannabis: 11.2% vs noncannabis: 4.4%; P < .001). Furthermore, the cannabis group showed significantly higher history of recreational drug use, including cocaine (25.4% vs 1.6%; P < .001), amphetamines (3.7% vs 0.6%; P < .001), opioids (8.2% vs 0.5%; P < .001), and intravenous drugs (6.7% vs 0.6%; P < .001). Emergency surgeries were significantly more frequent in the cannabis group (cannabis: 56.7% vs noncannabis: 36.2%; P < .001). Surgical mortality was comparable between both groups (cannabis: 9.7% vs noncannabis: 8.6%; P = .662). Postoperative stroke was significantly higher in the cannabis group (cannabis: 14.9% vs noncannabis: 8.2%; P = .009), and the rate of postoperative respiratory complications was also significantly higher in the cannabis group (cannabis: 32.1% vs noncannabis: 19.0%; P < .001). ConclusionsThe increased rates of postoperative cerebrovascular accidents and respiratory complications suggest that cannabis use is a significant risk factor in aortic surgery. Our study showed that young, healthy patients with prolonged cannabis use might be at a higher risk of requiring more emergency surgeries due to their background.

Chronic Cannabis users exhibit altered oscillatory dynamics and functional connectivity serving visuospatial processing.

Cannabis is the most widely used psychoactive drug in the United States. While multiple studies have associated acute cannabis consumption with alterations in cognitive function (e.g., visual and spatial attention), far less is known regarding the effects of chronic consumption on the neural dynamics supporting these cognitive functions. We used magnetoencephalography (MEG) and an established visuospatial processing task to elicit multi-spectral neuronal responses in 44 regular cannabis users and 53 demographically matched non-user controls. To examine the effects of chronic cannabis use on the oscillatory dynamics underlying visuospatial processing, neural responses were imaged using a time-frequency resolved beamformer and compared across groups. Neuronal oscillations serving visuospatial processing were identified in the theta (4-8 Hz), alpha (8-14 Hz), and gamma range (56-76 Hz), and these were imaged and examined for group differences. Our key results indicated that users exhibited weaker theta oscillations in occipital and cerebellar regions and weaker gamma responses in the left temporal cortices compared to non-users. Lastly, alpha oscillations did not differ, but alpha connectivity among higher-order attention areas was weaker in cannabis users relative to non-users and correlated with performance. Overall, these results suggest that chronic cannabis users have alterations in the oscillatory dynamics and neural connectivity serving visuospatial attention. Such alterations were observed across multiple cortical areas critical for higher-order processing and may reflect compensatory activity and/or the initial emergence of aberrant dynamics. Future work is needed to fully understand the implications of altered multispectral oscillations and neural connectivity in cannabis users.

A Bivariate Twin Study of Lifetime cannabis Initiation and Lifetime Regular Tobacco Smoking Across Three Different Countries

Regular cigarette smoking and cannabis consumption are strongly positively related to each other, yet few studies explore their underlying variation and covariation. We evaluated the genetic and environmental decomposition of variance and covariance of these two traits in twin data from three countries with different social norms and legislation. Data from the Netherlands Twin Register, FinnTwin12/16, and the Minnesota Center for Twin Family Research (total N = 21,617) were analyzed in bivariate threshold models of lifetime regular smoking initiation (RSI) and lifetime cannabis initiation (CI). We ran unstratified models and models stratified by sex and country. Prevalence of RSI was lowest in the Netherlands and prevalence of CI was highest in Minnesota. In the unstratified model, genetic (A) and common environmental factors (C) contributed substantially to the liabilities of RSI (A = 0.47, C = 0.34) and CI (A = 0.28, C = 0.51). The two liabilities were significantly phenotypically (rP = 0.56), genetically (rA = 0.74), and environmentally correlated in the unstratified model (rC = 0.47and rE = 0.48, representing correlations between common and unique environmental factors). The magnitude of phenotypic correlation between liabilities varied by country but not sex (Minnesota rP ~ 0.70, Netherlands rP ~ 0.59, Finland rP ~ 0.45). Comparisons of decomposed correlations could not be reliably tested in the stratified models. The prevalence and association of RSI and CI vary by sex and country. These two behaviors are correlated because there is genetic and environmental overlap between their underlying latent liabilities. There is heterogeneity in the genetic architecture of these traits across country.

Acceptability, feasibility and fidelity of the culturally adapted version of Unplugged (“Yo Se Lo Que Quiero”), a substance use preventive program among adolescents in Chile: a pilot randomized controlled study

IntroductionThe consumption of alcohol, tobacco, and cannabis is a public health problem that impacts the cognitive, social, and emotional development of adolescents. Prevention strategies such as the “Unplugged” program are effective in delaying the progression of daily smoking and episodes of drunkenness among adolescents. “Yo Se Lo Que Quiero” (YSLQQ) corresponds to the adaptation of this program to the Chilean context. This study assesses the acceptability and feasibility of implementing this program to the local reality.Material and methodsThis was a cluster-randomized controlled pilot study conducted on six public schools. All consented students attending 6th, 7th, and 8th grades (n = 1,180) participated in the study. The schools were randomly assigned to one of two conditions in a 1:1 ratio: (1) the “YSLQQ” intervention group (n = 526), and (2) the Control group (n = 654). The program consisted of a 12-hour class-based curriculum based on a comprehensive social-influence approach delivered by a trained facilitator. The acceptability and feasibility were assessed in the intervention group at the end of the intervention using questionnaires answered by students and facilitators. The quality and fidelity of the program were evaluated during the implementation using self-ported surveys answered by the facilitators and the assessment of video-recorded sessions rated by external observers. Finally, a pre-test and a post-test survey assessing past and current substance use and risk and protective factors were conducted before and immediately after the program’s implementation.ResultsA high proportion of students (49.6%) liked the sessions. 79.2% reported that the YSLQQ helped them learn about the dangers of substances, while 65.8% reported having more skills to avoid substance use in the future. Regarding students’ satisfaction with YSLQQ, 62.9% reported being happy or very happy with the program. Facilitators reported implementing the intervention according to the manual in 73.9% of sessions. Regarding substance use, students who participated in the intervention groups reported a significant reduction in drunkenness in the last year and last 30-day prevalence and also a significant reduction in a lifetime and 30-day prevalence of cannabis use when compared with those students in the control group.ConclusionsOur results suggest that YSLQQ has adequate acceptability and feasibility to be implemented in the Chilean context, and there were promising results in reducing drunkenness and cannabis use. Future research should confirm these results in a larger RCT study.Trial registrationThe trial was registered in ClinicalTrials.gov, NCT04566627; registration date: 01/03/2019

From mood to use: Using ecological momentary assessments to examine how anhedonia and depressed mood impact cannabis use in a depressed sample

Anhedonia and depressed mood are two cardinal symptoms of major depressive disorder (MDD). Prior work has demonstrated that cannabis consumers often endorse anhedonia and depressed mood, which may contribute to greater cannabis use (CU) over time. However, it is unclear (1) how the unique influence of anhedonia and depressed mood affect CU and (2) how these symptoms predict CU over more proximal periods of time, including the next day or week (rather than proceeding weeks or months). The current study used data collected from ecological momentary assessment (EMA) in a sample with MDD (N = 55) and employed mixed effects models to detect and predict weekly and daily CU from anhedonia and depressed mood over 90 days. Results indicated that anhedonia and depressed mood were significantly associated with CU, yet varied at daily and weekly scales. Moreover, these associations varied in both strength and directionality. In weekly models, less anhedonia and greater depressed mood were associated with greater CU, and directionality of associations were reversed in the models looking at any CU (compared to none). Findings provide evidence that anhedonia and depressed mood demonstrate complex associations with CU and emphasize leveraging EMA-based studies to understand these associations with more fine-grained detail.

Associations between Cannabis Consumption Methods and Cannabis Risk Perception.

Given diversified cannabis products, we examined associations between cannabis consumption methods and cannabis risk perception of smoking cannabis 1-2 times a week. Using the 2022 U.S. National Survey on Drug Use and Health data (N = 12,796 past-year adult cannabis users; M = 6127 and F = 6669), we used multinomial and binary logistic regression models. Smoking was the most prevalent method, followed by eating/drinking, vaping, and dabbing. One-half of cannabis users reported no perceived risk of smoking cannabis 1-2 times a week, 37.5% perceived slight risk, 9.2% moderate risk, and 2.9% great risk. Those with moderate or great risk perception had a lower likelihood of using 4+ methods of consumption (e.g., RRR = 0.40, 95% CI = 0.20, 0.77 for great risk perception). Any perceived risk was associated with higher odds of edibles/drinks only (e.g., aOR = 2.81, 95% CI = 1.43, 5.54 for great risk perception). Along with medical use and CUD, sociodemographic factors, mental illness, and other substance use were also significant correlates of cannabis consumption methods. Understanding the varying risk perceptions associated with different consumption methods is needed for harm reduction initiatives. More research is needed on cannabis products, particularly edibles/drinks and dabs/concentrates, to better understand the potential risks associated with them.