Frequency Of Cannabis Use Research Articles

Cannabis Use Increases the Risk of Sickness Absence: Longitudinal Analyses From the CONSTANCES Cohort.

AimsTo examine the longitudinal associations between cannabis use and risks of short (<7 days), medium (7-28 days), and long (>28 days) sickness absences at one-year follow-up.Methods87,273 participants aged 18-65 years from the French CONSTANCES cohort reported their frequency of cannabis use at inclusion between 2012 and 2018. Sickness absences occurring during one year of follow-up were collected from national medico-administrative registries. Multivariable generalized linear regressions were used to compute the Odds Ratios (OR) with their 95% Confidence Intervals (CI) of having at least one sickness absence at follow-up compared to no sickness absence, while controlling for sociodemographic factors, chronic conditions and occupational factors.ResultsCannabis use more than once a month was associated with an increased risk of short (OR, [95% CI]: 1.56 [1.32–1.83]) and medium (1.29 [1.07–1.54]) sickness absences at one-year follow-up, with dose-dependent relationships for short sickness absences (1.13 [1.08–1.18], p-for-trend <0.001). In stratified analyses, cannabis use was associated with an increased risk of sickness absences in older individuals, men, participants with good self-rated health, living or having lived as a couple, and having an open-ended contract.ConclusionsCannabis use prospectively increased the risk of short and medium sickness absences, even from once a month and with a dose-dependent relationship for short sickness absences. These findings should be considered in information and prevention public health campaigns to alert the general population and workers to this increased risk.

0686 Cognitive Behavioral Therapy for Insomnia to Reduce Cannabis Use: Results from a Pilot Randomized Controlled Trial

Abstract Introduction Cannabis use, including use for insomnia, has increased significantly in the United States over the past decade. Cannabis use disorders and/or heavy cannabis use have been linked to numerous negative outcomes, including poor work performance, other substance use, increased risk of psychosis, and neurocognitive deficits. In a pilot randomized controlled trial, we compared telemedicine-delivered CBT for insomnia tailored to individuals regularly using cannabis for sleep (CBT-CB-TM) to sleep hygiene education (SHE-TM) for improving sleep and daytime functioning and for reducing cannabis use. Methods Adults with chronic insomnia who reported using cannabis for sleep at least three times weekly were recruited through advertisements and at local cannabis dispensaries and screened for disqualifying sleep, medical, and mental health disorders. Fifty-seven eligible participants (43 women, mean age 37.6 ± 12.8 years) were randomized to 6 sessions of CBT-CB-TM (n=30) or SHE-TM (n=27). Participants completed self-reported measures of insomnia (Insomnia Severity Index, primary outcome), daytime functioning (sleep beliefs, depression, and overall functioning) and cannabis use before and after treatment and at 8-week follow-up. Results Mixed models showed that scores improved more on the Insomnia Severity Index (β=-2.83, se=0.62, p&amp;lt;.001) and Dysfunctional Beliefs and Attitudes about Sleep scale (β=-0.73, se=0.25, 9&amp;lt;.006) in the CBT-CB-TM compared to SHE-TM condition. Small pre- to post-treatment reductions in the daily frequency of cannabis use were evident for CBT-CB-TM compared to SHE-TM participants (pre-post change: 0.60 ± 0.94 vs. -0.04 ± 0.35, p&amp;lt;.007). Depression symptoms (PHQ-8: CBT-CB-TM 8.5 ± 0.7 to 6.8 ± 1.0 vs. SHE-TM 9.1 ± 0.7 to 7.0 ± 0.9, p&amp;lt;.004), and overall functioning (SF-12 MCS: CBT-CB-TM 43.3 ± 1.9 to 50.8 ± 2.9 vs. SHE-TM 39.8 ± 2.0 to 51.6 ± 2.5, p&amp;lt;.0005) improved in both conditions from pre-treatment through follow-up. Conclusion Telemedicine-delivered CBT for insomnia improved sleep and reduced cannabis use more than a matched behavioral placebo control in this pilot trial of adults using cannabis regularly for insomnia. These preliminary findings support the need for adequately-powered randomized controlled trials with longer follow-up periods to evaluate the efficacy of targeting insomnia to reduce problematic cannabis use. Support (If Any) R34 DA047466 (MPI: MA Ilgen, JT Arnedt)

Relationship perceptions and conflict behavior among cannabis users

BackgroundCannabis use is increasingly common, yet few studies have examined its associations with couple functioning. To address this gap, we used actor-partner interdependence modeling to examine the associations between cannabis use, relationship perceptions, and observed conflict behavior in a community-based sample of cannabis users and their partners. MethodsCannabis users (N = 232; 96 males; 122 females; 14 undisclosed biological sex) and their partners completed self-reports of cannabis frequency and global relationship satisfaction and commitment. At a laboratory visit, couples engaged in a 10 min conflict discussion and a 5 min discussion of areas of agreement, and reported on their post-conflict perceptions. Each partner’s parasympathetic activity was assessed during the conflict task, and trained raters coded conflict and recovery behavior ResultsMore frequent actor cannabis use was associated with more negative engagement and avoidance behavior during conflict, less parasympathetic withdrawal during conflict, and less effective behavioral recovery immediately after conflict. More frequent cannabis use was also associated with greater satisfaction with conflict resolution following the conflict discussion, but was not associated with perceived overall relationship satisfaction or commitment. Cannabis effects were independent of alcohol use ConclusionsAmong cannabis users, there are discrepancies between perceived and objective measures of relationship functioning, such that cannabis users viewed their relationships as better functioning compared to independent raters’ reports. These findings highlight the need for a nuanced understanding of the associations between cannabis and relationship functioning, which appear to be distinct from alcohol, as well as an organizing theoretical framework to stimulate future research.

Frequency of adolescent cannabis smoking and vaping in the United States: Trends, disparities and concurrent substance use, 2017-19.

To quantify the trends in frequent and occasional cannabis vaping, demographic differences and concurrent nicotine and alcohol use. Observational study. Survey-weighted multinomial logistic regression models assessed trends and disparities in past 30-day cannabis use. Trends were assessed overall and by sex, race/ethnicity, parental education and urbanicity. Multinomial logistic regression models also estimated associations of cannabis use (none, use without vaping, use with vaping) with past 2-week binge drinking and past 30-day nicotine/tobacco use. United States, 2017-19. Participants in the national Monitoring the Future (n = 51 052) survey. Past 30-day frequent cannabis use (six or more times/30 days) and past 30-day occasional use (one to five times/30 days), with and without vaping. Past 30-day frequent cannabis use with vaping and occasional use with vaping rose from 2017 to 2019. Past 30-day frequent and occasional cannabis use without vaping declined. Certain groups, such as Hispanic/Latino or lower socio-economic status adolescents, experienced particularly notable increases in frequent cannabis use with vaping (e.g. prevalence among Hispanic/Latino adolescents). Adolescents who reported smoking and vaping nicotine, and 10+ occasions of binge drinking, were 42.28 [95% confidence interval (CI) = 33.14-53.93] and 10.09 (95% CI = 4.51-22.53) times more likely to report past 30-day cannabis use with vaping, respectively, compared with no use. Cannabis use without vaping appears to be declining among adolescents in the United States, while cannabis use with vaping is accelerating; frequent cannabis vaping is especially increasing, with consistent increases across almost all adolescent demographic groups. Cannabis use among US adolescents remains highly associated with other substance use.

Association of ADHD symptoms in adolescence and mortality in Northern Finland Birth Cohort 1986

Background Diagnosis of attention deficit hyperactive disorder (ADHD) has been associated with increased risk of mortality in large register samples. However, there is less known about the association between symptoms of ADHD in adolescents and risk of mortality in general population samples. Methods The Northern Finland Birth Cohort 1986 (n = 9432 at recruitment in early pregnancy) linked to nationwide register data for deaths was utilized to study the association between parent-rated ADHD symptoms assessed using Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire and mortality until age 33 years. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) was used to study the association between SWAN inattentive, hyperactive, and combined symptom scores and risk of death. Results Sixty-three (0.9%) of the 6685 participants died during the follow-up. Higher SWAN inattentive (crude HR = 2.30, 95% CI 1.46–3.63), SWAN hyperactive (crude HR = 2.43, 95% CI 1.29–4.56), and SWAN combined (crude HR = 2.69, 95% CI 1.57–4.61) scores were associated with increased risk of death. After adjustments for sex, family structure, and lifetime parental psychiatric disorder, these associations persisted. Further adjustment for frequent alcohol intoxication, cannabis, and other substance use in adolescence attenuated these to below statistical significance. Conclusions These results extend previous findings on the risk of mortality in adolescents who have symptoms of ADHD. Further research with larger samples are needed to determine whether the association between ADHD symptoms and mortality is independent of adolescent substance use.

Trends in Alcohol, Cigarette, E-Cigarette, and Nonprescribed Pain Reliever Use Among Young Adults in Washington State After Legalization of Nonmedical Cannabis

PurposeLiberalization of cannabis laws may be accompanied by changes in the use of substances other than cannabis and changes in associations of cannabis use with other types of substance use. This study assessed (1) trends in alcohol, nicotine, and nonprescribed pain reliever use and (2) changes in associations of cannabis use with these other substances among young adults in Washington State after nonmedical cannabis legalization. MethodsRegression models stratified by age (18–20 vs. 21–25) were used to analyze six annual waves of cross-sectional survey data from a statewide sample from 2014 through 2019 (N = 12,694). ResultsPrevalence of past-month alcohol use, heavy episodic drinking (HED), and cigarette use and prevalence of past-year pain reliever misuse decreased, while the prevalence of past-month e-cigarette use increased since 2016 (the first year assessed). Across years and age groups, the prevalence of substance use other than cannabis was higher among occasional and frequent cannabis users compared to cannabis nonusers. However, associations between both occasional (1–19 days in the prior month) and frequent (20+ days) cannabis use and pain reliever misuse and between frequent cannabis use and HED weakened over time among individuals ages 21–25. DiscussionContrary to concerns about spillover effects, implementation of legalized nonmedical cannabis coincided with decreases in alcohol and cigarette use and pain reliever misuse. The weakening association of cannabis use with the use of other substances among individuals ages 21–25 requires further research but may suggest increased importance of cannabis-specific prevention and treatment efforts.

A network approach to relationships between cannabis use characteristics and psychopathology in the general population

Cannabis use characteristics, such as earlier initiation and frequent use, have been associated with an increased risk for developing psychotic experiences and psychotic disorders. However, little is known how these characteristics relate to specific aspects of sub-clinical psychopathology in the general population. Here, we explore the relationships between cannabis use characteristics and psychopathology in a large general population sample (N = 2,544, mean age 29.2 years, 47% women) by employing a network approach. This allows for the identification of unique associations between two cannabis use characteristics (lifetime cumulative frequency of cannabis use, age of cannabis use initiation), and specific psychotic experiences and affective symptoms, while controlling for early risk factors (childhood trauma, urban upbringing). We found particularly pronounced unique positive associations between frequency of cannabis use and specific delusional experiences (persecutory delusions and thought broadcasting). Age of cannabis use initiation was negatively related to visual hallucinatory experiences and irritability, implying that these experiences become more likely the earlier use is initiated. Earlier initiation, but not lifetime frequency of cannabis use, was related to early risk factors. These findings suggest that cannabis use characteristics may contribute differentially to risk for specific psychotic experiences and affective symptoms in the general population.

The Relationship Between Circulating Endogenous Cannabinoids and the Effects of Smoked Cannabis.

Background: The endogenous cannabinoid system (ECS), including the endocannabinoids (eCBs), anandamide (AEA), and 2-arachidonoylglycerol (2-AG), plays an integral role in psychophysiological functions. Although frequent cannabis use is associated with adaptations in the ECS, the impact of acute smoked cannabis administration on circulating eCBs, and the relationship between cannabis effects and circulating eCBs are poorly understood. Methods: This study measured the plasma levels of AEA, 2-AG, and Δ-9-tetrahydrocannabinol (THC), subjective drug-effects ratings, and cardiovascular measures at baseline and 15-180 min after cannabis users (n=26) smoked 70% of a cannabis cigarette (5.6% THC). Results: Cannabis administration increased the ratings of intoxication, heart rate, and plasma THC levels relative to baseline. Although cannabis administration did not affect eCB levels relative to baseline, there was a significant positive correlation between baseline AEA levels and peak ratings of "High" and "Good Drug Effect." Further, baseline 2-AG levels negatively correlated with frequency of cannabis use (mean days/week) and with baseline THC metabolite levels. Conclusions: In a subset of heavy cannabis smokers: (1) more frequent cannabis use was associated with lower baseline 2-AG, and (2) those with lower AEA got less intoxicated after smoking cannabis. These findings contribute to a sparse literature on the interaction between endo- and phyto-cannabinoids. Future studies in participants with varied cannabis use patterns are needed to clarify the association between circulating eCBs and the abuse-related effects of cannabis, and to test whether baseline eCBs predict the intoxicating effects of cannabis and are a potential biomarker of cannabis tolerance.

The relationship between anxious-depressive symptoms and harmful cannabis use: Multiple mediation models via rumination, negative urgency, protective behavioral strategies and refusal self-efficacy

BackgroundDistressful and negative affective states can be associated with limited self-regulation capacities, while emotion regulation processes (e.g., rumination, negative urgency) might contribute to further depletion of self-control capacities which in turn can lead to diminished control over cannabis use. AimsThe mediating functions of rumination (i.e., brooding and reflection), negative urgency (NU) and constructs of cannabis use regulation (i.e., cannabis protective behavioral strategies [CPBS] and cannabis refusal self-efficacy [CRSE]) were examined on the associations between anxious-depressive symptoms and cannabis use outcomes (i.e., frequency, harmful use). MethodsThe cross-sectional study used a sample of cannabis users showing signs of harmful consumption (N = 750; Males: 70.13% [N = 526]; Age: M = 29.11 [SD = 7.45]). Standardized questionnaires measured anxious-depressive symptoms, rumination, NU, CRSE, CPBS, frequency of cannabis use and harmful cannabis use. A linear regression-based, double-mediation model was performed. ResultsFive significant indirect effects were demonstrated in the mediation model. Single-mediation effects were shown between anxious-depressive symptoms and harmful cannabis use via CRSE and via CPBS. Double-mediation effects were presented between anxious-depressive symptoms and harmful cannabis use via reflection and CPBS, via reflection and CRSE, and via NU and CRSE. ConclusionsEmotion and cannabis use regulation pathways explained the associations between anxious-depressive symptoms and harmful cannabis use. The mediation model provided new details on how anxious-depressive symptoms, rumination and NU might lead to harmful cannabis use via regulation of cannabis use. Limited self-regulation capacities and similarities between emotion and cannabis use regulation processes might explain the identified indirect effects.

Frequent Cannabis Use Moderates the Relationship Between Sexual Dysfunction and Depression Among Female German Adults

BackgroundSexual dysfunction and heavy substance use (alcohol, tobacco, and cannabis) play an important role in the development of depression, while frequent substance use affects sexual dysfunction. AimThis study aimed to investigate the association between sexual dysfunction and depression among German adults in a nationally representative sample and the effect of alcohol, tobacco, and cannabis use on this association using moderator analysis. MethodsData come from the German Health and Sexuality Survey (GeSiD) with N = 4,955 men and women aged between 18 and 75 years. We used multiple logistic regression analysis to examine the moderation effect of substance use between sexual dysfunction and depression by including an interaction term. OutcomesSelf-reported diagnosed and treated depression within the last 12 months and the moderation effect of substance use on the association between sexual dysfunction and depression. ResultsMen and women with at least 1 sexual dysfunction were more likely to be affected by depression as compared to those without sexual dysfunction. A moderation effect of frequent cannabis use was found between sexual dysfunction and depression among women. Clinical ImplicationsClinicians and therapists addressing addiction, depression, and dysfunction should keep the complex interactions in mind. Strengths & LimitationsThis study provides new data on the association between sexual dysfunction and depression among German adults in a nationally representative sample and the moderation effect of substance use on this association. Further studies should disentangle the pathways between sexual dysfunction, cannabis use, and depression through moderated mediation analyses. ConclusionFrequent cannabis use plays a moderating role in the association between sexual dysfunction and depression among German adult women. Belau MH, Wiessner C, Becher H, et al. Frequent Cannabis use Moderates the Relationship between Sexual Dysfunction and Depression Among Female German Adults. J Sex Med 2022;19:940–949.

Psychometric properties of the French and English short form of the Protective Behavioural Strategies for Marijuana Scale in Canadian university students

BackgroundThe Protective Behavioural Strategies for Marijuana (PBSM-17) scale serves to identify and measure strategies employed by young adults before, during or after cannabis use. After the adaptation and translation of...

Cannabis Use Is Associated With Lower COVID-19 Susceptibility but Poorer Survival.

ObjectivesTo investigate the impact of cannabis use on the infection and survival outcomes of COVID-19.Study DesignCross-sectional study based on the UK Biobank (UKB) dataset.MethodsWe identified 13,099 individuals with cannabis smoking history in the UKB COVID-19 Serology Study. The Charlson-Quan Comorbidity Index was estimated using inpatient ICD-10 records. Multivariable logistic regression characterized features associated with COVID-19 infection. Cox models determined the hazard ratios (HR) for COVID-19-related survival.ResultsCannabis users were more likely to getting COVID-19 (odds ratio: 1.22, P = 0.001) but multivariable analysis showed that cannabis use was a protective factor of COVID-19 infection (adjusted odds ratio: 0.81, P = 0.001). Regular cannabis users, who smoked more than once per month, had a significantly poorer COVID-19-related survival, after adjusting for known risk factors including age, gender, smoking history, and comorbidity (adjusted hazard ratio: 2.81, P = 0.041).ConclusionsThe frequency of cannabis use could be considered as a candidate predictor for mortality risk of COVID-19.

Adaptive Treatment for Youth With Substance Use and Depression: Early Depression Response and Short-term Outcomes.

To investigate prevalence and predictors of early depression response (EDR) in adolescents with substance use and depression receiving cognitive-behavioral therapy (CBT) for substance use and to test the efficacy of supplemental CBT targeting depression (CBT-D) for non-EDR adolescents in an adaptive treatment approach. At 2 sites, 95 youths (ages 14-21, mean [SD]= 17.4 [1.8]) with alcohol or cannabis use and depressive symptoms received up to 12 sessions of CBT for substance use over 14 weeks. Assessments were at baseline and weeks 4, 9, and 14. The Children's Depression Rating Scale-Revised was the primary depression measure, with a reduction of 50% or more on this scale at week 4 defining EDR. The primary substance use outcomes of alcohol use, heavy alcohol use, and cannabis use frequency were assessed via interview report on the Alcohol Consumption Questionnaire and the Drug Checklist. Urinalysis provided a secondary measure of cannabis use. Non-EDR adolescents were randomly assigned to supplemental CBT-D or enhanced treatment as usual (ETAU). Thirty-five adolescents (37%; 95% CI, 27%-47%) demonstrated EDR. Fewer days of cannabis use (odds ratio 0.977; 95% CI, 0.961-0.992) and absence of conduct disorder (odds ratio 0.149; 95% CI, 0.031-0.716) predicted EDR. Frequency of drinking (F1,82= 11.09, η2= 0.119, p= .001), heavy drinking (F1,82= 19.91, η2= 0.195, p< .0001), and cannabis use (F1,220= 35.01, η2= 0.137, p< .001) decreased over time for EDR, CBT-D, and ETAU adolescents, with EDR adolescents evidencing earlier lower cannabis use (F2,220= 4.16, η2= 0.036, p= .0169). Negative (clean) urine screens increased over time (F1,219= 5.10, η2= 0.023, p= .0249). Comparison of CBT-D and ETAU indicated that depression significantly decreased over time in both groups (F1,48= 64.20, η2= 0.572, p< .001), with no advantage for CBT-D. Approximately one-third of adolescents with substance use and depression attain EDR during substance use treatment. Less frequent cannabis use facilitates depression response. The relatively small sample may have precluded identification of additional EDR predictors. Treatment for Teens With Alcohol Abuse and Depression; https://clinicaltrials.gov/; NCT02227589.

Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis.

Epidemiological studies show a dose-response association between cannabis use and the risk of psychosis. This review aimed to determine whether there are identifiable risk-thresholds between the frequency of cannabis use and psychosis development. Systematic search of Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science for relevant studies (1 January 2010-26 April 2021). Case-control or cohort studies that investigated the relationship between cannabis use and the risk of psychosis development that reported effect estimates [odds ratios (OR), hazard ratios (HR), risk ratios (RR)] or the raw data to calculate them, with information on the frequency of cannabis consumption were included. Effect estimates were extracted from individual studies and converted to RR. Two-stage dose-response multivariable meta-analytic models were utilized and sensitivity analyses conducted. The Newcastle Ottawa Scale was used to assess the risk of bias of included studies. Ten original (three cohorts, seven case-control) studies were included, including 7390 participants with an age range of 12-65 years. Random-effect model meta-analyses showed a significant log-linear dose-response association between cannabis use frequency and psychosis development. A restricted cubic-splines model provided the best fit for the data, with the risk of psychosis significantly increasing for weekly or more frequent cannabis use [RR = 1.01, 95% confidence interval (CI) 0.93-1.11 yearly; RR = 1.10, 95% CI 0.97-1.25 monthly; RR = 1.35, 95% CI 1.19-1.52 weekly; RR = 1.76, 95% CI 1.47-2.12 daily]. Individuals using cannabis frequently are at increased risk of psychosis, with no significant risk associated with less frequent use. Public health prevention messages should convey these risk-thresholds, which should be refined through further work.

Comparing a mindfulness- and CBT-based guided self-help Internet- and mobile-based intervention against a waiting list control condition as treatment for adults with frequent cannabis use: a randomized controlled trial of CANreduce 3.0

BackgroundThough Internet- and mobile-based interventions (IMIs) and mindfulness-based interventions (generally delivered in-situ) appear effective for people with substance use disorders, IMIs incorporating mindfulness are largely missing, including those targeting frequent cannabis use.MethodsThis paper details the protocol for a three-arm randomized controlled trial comparing a mindfulness-based self-help IMI (arm 1) and cognitive-behavioral therapy (CBT)-based self-help IMI (arm 2) versus being on a waiting list (arm 3) in their effectiveness reducing cannabis use in frequent cannabis users. Predictors of retention, adherence and treatment outcomes will be identified and similarities between the two active intervention arms explored. Both active interventions last six weeks and consist of eight modules designed to reduce cannabis use and common mental health symptoms. With a targeted sample size of n = 210 per treatment arm, data will be collected at baseline immediately before program use is initiated; at six weeks, immediately after program completion; and at three and six months post baseline assessment to assess the retention of any gains achieved during treatment.The primary outcome will be number of days of cannabis use over the preceding 30 days. Secondary outcomes will include further measures of cannabis use and use of other substances, changes in mental health symptoms and mindfulness, client satisfaction, intervention retention and adherence, and adverse effects. Data analysis will follow ITT principles and primarily employ (generalized) linear mixed models.DiscussionThis RCT will provide important insights into the effectiveness of an IMI integrating mindfulness to reduce cannabis use in frequent cannabis users.Trial registrationInternational Standard Randomized Controlled Trial Number Registry: ISRCTN14971662; date of registration: 09/09/2021.

Perceptions of the health risks of cannabis: estimates from national surveys in Canada and the United States, 2018-2019.

Few studies have compared knowledge of the specific health risks of cannabis across jurisdictions. This study aimed to examine perceptions of the health risks of cannabis in Canada and US states with and without legal non-medical cannabis. Cross-sectional data were collected from the 2018 and 2019 International Cannabis Policy Study online surveys. Respondents aged 16-65 (n = 72 459) were recruited from Nielsen panels using non-probability methods. Respondents completed questions on nine health effects of cannabis (including two 'false' control items). Socio-demographic data were collected. Regression models tested differences in outcomes between jurisdictions and by frequency of cannabis use, adjusting for socio-demographic factors. Across jurisdictions, agreement with statements on the health risks of cannabis was highest for questions on driving after cannabis use (66-80%), use during pregnancy/breastfeeding (61-71%) and addiction (51-62%) and lowest for risk of psychosis and schizophrenia (23-37%). Additionally, 12-18% and 6-7% of respondents agreed with the 'false' assertions that cannabis could cure/prevent cancer and cause diabetes, respectively. Health knowledge was highest among Canadian respondents, followed by US states that had legalized non-medical cannabis and lowest in states that had not legalized non-medical cannabis (P < 0.001). Overall, the findings demonstrate a substantial deficit in knowledge of the health risks of cannabis, particularly among frequent consumers.

Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms.

Cannabis use is common among individuals with posttraumatic stress disorder (PTSD) symptoms, but its impact on psychiatric symptoms and functioning in this population is unclear. To clarify the clinical and functional correlates of cannabis use in individuals with PTSD symptoms, we analyzed data from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative survey of U.S. military veterans. Participants with current subthreshold or full PTSD (N = 608) reported on their past-6-month cannabis use and current psychiatric symptoms, functioning, treatment utilization, and PTSD symptom management strategies. Veterans with subthreshold/full PTSD who used cannabis more than weekly were more likely to screen positive for co-occurring depression, anxiety, and suicidal ideation than those who did not use cannabis, ORs = 3.4-3.8, or used cannabis less than weekly, ORs = 2.7-3.7. Veterans who used cannabis more than weekly also scored lower in cognitive functioning than veterans with no use, d = 0.25, or infrequent use, d = 0.71, and were substantially more likely to endorse avoidance coping strategies, ORs = 8.2-12.2, including substance use, OR = 4.4, and behavioral disengagement, ORs = 2.7-9.1, to manage PTSD symptoms. Despite more psychiatric and functional problems, veterans with frequent cannabis use were not more likely to engage in mental health treatment, ORs = 0.87-0.99. The results suggest enhanced cannabis use screening, interventions targeting risky use, and strategies promoting treatment engagement may help ameliorate more severe clinical presentations associated with frequent cannabis use among veterans with subthreshold/full PTSD.

Socio-demographic, health and drug use characteristics among people with different frequency patterns of cannabis use in Brazil

Data on cannabis use patterns and health outcome indicators for Brazil are limited. We undertook a cross-sectional internet-based survey assessing socio-demographics, cannabis use frequency, other drug use, quality-of-life (QOL), affective states (i.e. anxiety and depression), and cannabis use disorder among adult respondents in Brazil. A multinomial logistic regression was conducted using cannabis frequency status as the dependent variable. A total of 6876 responders were identified as people with occasional (n = 1088), regular (n = 1062), and frequent (n = 4726) cannabis use. Groups differed greatly on sociodemographic characteristics and other drug use rates. Cannabis use disorder (p < 0.001), early-onset of cannabis use (aOR:1.71), and other substance use (aOR: from 1.53 to 2.59) were associated with a higher frequency of cannabis use. We did not find major differences in psychosocial and mental health outcomes as related to the frequency of cannabis use. Our results suggest that early initiation of cannabis, high use frequency, and using cannabis with other substances may elevate the risk for cannabis use disorder. Given the generally liberalizing trends for cannabis use, it is timely and appropriate to further study cannabis use and related outcomes in Brazil, considering that available indicators for this country are limited.

Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition.

Prior research has examined the prevalence and correlates of cannabis use disorder (CUD) in people who use cannabis; however, these are poorly described for people using cannabis for medical reasons. Data came from a 2018 to 2019 online, anonymous, cross-sectional survey of Australians reporting using either illicit or licit cannabis for medical reasons within the past year. Included were questions on demographics, current and lifetime patterns of cannabis use, clinical conditions for which medical cannabis was used, and individual criteria for CUD and cannabis withdrawal syndrome. Bayesian Horseshoe logistic regression models were used to identify covariates associated with meeting CUD DSM-5 conditions for any-CUD (≥2/11 criteria) and moderate-severe-CUD (≥4/11). A total of 905 participants were included in the analysis. The majority (98%) used illicit cannabis products. Criteria for any-CUD criteria were met by 290 (32.0%), and 117 (12.9%) met criteria for moderate-severe-CUD. Tolerance (21%) and withdrawal (35%) were the most commonly met criteria. Correlates with the strongest association with CUD were inhaled route of administration [odds ratio (OR)=2.96, 95% credible interval 1.11, 7.06], frequency of cannabis use (OR=1.24, 1.11-1.35), proportion of cannabis for medical reasons (OR=0.83, 0.74, 0.94), frequency of tobacco use (OR=1.10, 1.03, 1.17), age (OR=0.75, 0.64, 0.90) and pain as main clinical indication (OR=0.58, 0.36, 1.00). Prevalence of CUD in medical cannabis users appears comparable to 'recreational' users, with many similar correlates. CUD was associated with using cannabis to treat mental health rather than pain conditions and inhaled over other routes of administration.

Impact of early intervention on the population prevalence of common mental disorders: 20-year prospective study.

The potential for early interventions to reduce the later prevalence of common mental disorders (CMD) first experienced in adolescence is unclear. To examine the course of CMD and evaluate the extent to which the prevalence of CMD could be reduced by preventing adolescent CMD, or by intervening to change four young adult processes, between the ages of 20 and 29 years, that could be mediating the link between adolescent and adult disorder. This was a prospective cohort study of 1923 Australian participants assessed repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). Causal mediation analysis was undertaken to evaluate the extent to which the prevalence of CMD at age 35 years in those with adolescent CMD could be reduced by either preventing adolescent CMD, or by intervening on four young adult mediating processes: the occurrence of young adult CMD, frequent cannabis use, parenting a child by age 24 years, and engagement in higher education and employment. At age 35, 19.2% of participants reported CMD; a quarter of these participants experienced CMD during both adolescence and young adulthood. In total, 49% of those with CMD during both adolescence and young adulthood went on to report CMD at age 35 years. Preventing adolescent CMD reduced the population prevalence at age 35 years by 3.9%. Intervening on all four young adult processes among those with adolescent CMD, reduced this prevalence by 1.6%. In this Australian cohort, a large proportion of adolescent CMD resolved by adulthood, and by age 35 years, the largest proportion of CMD emerged among individuals without prior CMD. Time-limited, early intervention in those with earlier adolescent disorder is unlikely to substantially reduce the prevalence of CMD in midlife.