Frequency Of Cannabis Use Research Articles

Young Adult Medical Cannabis Patients in Florida: Gender Differences in Characteristics of use, Experiences at Dispensaries, and Association With Health-Related Problems

In recent years there has been an increase in cannabis use among adults in the U.S., which corresponds with changes in state-level laws making cannabis available for medical/recreational use. While cannabis became available for medical use in Florida in 2014, it was not until a ban on smoking cannabis was lifted in 2019 that the number of patients began to increase. The data for the current study are the Florida Young Adult Cannabis Study and focus on 415 medical cannabis patients (MCP). We identified several significant differences between male and female MCP. Female MCP initiated regular cannabis use at a younger age and reported more frequent cannabis use. Female MCP were more likely to endorse self-treatment motives while male MCP were more likely to endorse recreational motives. As Florida is one of the largest and most diverse states in the U.S., research on MCP is needed to inform policy.

Cannabis Use Frequency is Associated with PrEP Cessation and Self-reported HIV Diagnosis.

To achieve stated targets in the United States of Ending the HIV Epidemic by 2030, it is necessary to decrease rates of pre-exposure prophylaxis use (PrEP) cessation. In particular, it is key to assess PrEP use and cannabis use frequency given the recent wave of cannabis decriminalization across the U.S., particularly among sexual minority men and gender diverse (SMMGD) individuals. We used data from the baseline visit of a national study of Black and Hispanic/Latino SMMGD. Among participants reporting any lifetime cannabis use, we further assessed the association between frequency of cannabis use in the past 3 months and: (1) self-reported PrEP use, (2) recency of last PrEP dose, and (3) HIV status using adjusted regression models. Compared to those who never used cannabis, odds of PrEP cessation were higher among those who used it once or twice (aOR 3.27; 95% CI 1.38, 7.78), those who used it monthly (aOR 3.41; 95% CI 1.06, 11.01), and those who used it weekly or more frequently (aOR 2.34; 95% CI 1.06, 5.16). Similarly, those reporting cannabis use 1-2 times in the past 3 months (aOR 0.11; 95% CI 0.02, 0.58) and those reporting weekly or more frequent use (aOR 0.14; 95% CI 0.03, 0.68) were each more likely to report more recent PrEP cessation. These results suggest that cannabis users in general may be a population at elevated risk of HIV diagnosis although more research regarding these findings is needed with nationally representative populations.

Co-occurring mental health and drug use experiences among Black and Hispanic/Latino sexual and gender diverse individuals.

Black and Hispanic/Latino sexual and gender diverse individuals disproportionately experience overlapping health disparities, such as drug use and elevated depressive symptoms, which are often driven by minority stressors. We sought to better understand the interaction between drug use and mental health, as it may be fruitful in developing effective interventions to address co-occurring health disparities. In a longitudinal, 5-wave sample of 300 Black and Hispanic/Latino sexual and gender diverse (SGD) individuals collected between March 2020 and March 2022, we found a within-person association between greater than average levels of psychological distress (depression and anxiety) and more frequent extra-medical use of cannabis, inhalants, methamphetamines, and opioids over the span of two years. These associations held after adjusting for the direct, within-person association of internalized homonegativity with drug use frequency. These results suggest that psychological distress explains at least some variance in drug use among Black and Hispanic/Latino SGD individuals. This highlights the importance of interventions that focus on mental health among Black and Hispanic/Latino SGD individuals who report drug use.

An exploratory follow-up study of cannabis use and decision-making under various risk conditions within adolescence.

Studies examining the associations between decision-making (DM) and cannabis use (CU) often use cross-sectional, adult samples, and composite scores or single tasks to assess DM. The present study explored differential associations between tasks assessing DM under various risk conditions (i.e., ambiguous vs. explicit; gain vs. loss) and CU frequency, CU-related problems, and CU disorder (CUD) onset across a 2-year period within adolescence. Adolescents (n = 401, 90% Hispanic) aged 14-17 at baseline participated in five biannual assessments. CU frequency, CU-related problems, and CUD were assessed using the Drug Use History Questionnaire, Marijuana Problems Scale, and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition, respectively. DM was assessed using the Iowa gambling task (IGT), Game of Dice Task (GDT), and Cups Task. We used latent growth curve modeling to examine bidirectional associations between DM and escalation in CU frequency and CU-related problems, and discrete time survival analyses to determine whether baseline performance across DM tasks predicted CUD onset. Baseline performance on the GDT predicted greater escalation in CU (β = .200, p = .008) and CU-related problems (β = .388, p = .035). No other significant associations were found. DM under explicit risk may be a more salient risk factor for escalating CU and CU-related problems than DM under ambiguous risk. Deficits in executive functioning could partially explain the results. Findings suggest that neurocognitive development should inform prevention and intervention efforts focused on reducing CU. Given the exploratory nature of the present study, replication of findings is needed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Attention-deficit/hyperactivity disorder (ADHD) symptoms and their relation to diagnosed ADHD, sociodemographic characteristics, and substance use among patients receiving opioid agonist therapy: a Norwegian cohort study

BackgroundAttention-deficit/hyperactivity disorder (ADHD) symptoms may challenge sufficient treatment of substance use and mental disorders. The literature on the extent of such symptoms among patients receiving opioid agonist therapy (OAT) is scarce. This study examined ADHD symptoms using the ADHD self-report scale (ASRS) and the association between the ‘ASRS–memory’ and ‘ASRS–attention’ scores and substance use and sociodemographic characteristics among patients receiving OAT.MethodsWe used data from assessment visits of a cohort of patients in Norway. In total, 701 patients were included from May 2017 to March 2022. All patients responded at least once to two ASRS questions assessing memory and attention, respectively. Ordinal regression analyses were performed to investigate whether the two obtained scores were associated with age, sex, frequent substance use, injecting use, housing status, and educational attainment at baseline, i.e., the first assessment, and over time. The results are presented as odds ratios (OR) with 95% confidence intervals (CI). Additionally, a subsample of 225 patients completed an extended interview, including the ASRS–screener and collection of registered mental disorder diagnoses from the medical records. Standard cutoffs were used to define the presence of each ASRS symptom or a positive ASRS–screener (‘ASRS–positive’).ResultsAt baseline, 428 (61%) and 307 (53%) patients scored over the cutoffs on the ‘ASRS–memory’ and ‘ASRS–attention,’ respectively. Frequent cannabis use was associated with higher ‘ASRS–memory’ (OR: 1.7, 95% CI: 1.1–2.6) and ‘ASRS–attention’ (1.7, 1.1–2.5) scores compared with less or no use at baseline, though reduced score on the ‘ASRS–memory’ over time (0.7, 0.6–1.0). At baseline, frequent stimulant use (1.8, 1.0–3.2) and low educational attainment (0.1, 0.0–0.8) were associated with higher ‘ASRS–memory’ scores. In the subsample fulfilling the ASRS–screener, 45% of the patients were ‘ASRS–positive,’ of whom 13% with a registered ADHD diagnosis.ConclusionsOur findings illustrate a relationship between the ASRS–memory and –attention scores and frequent cannabis and stimulant use. Furthermore, nearly half of the subsample was ‘ASRS–positive.’ Patients receiving OAT might benefit from being further assessed for ADHD, but improved diagnostic methods are required.

Exploring Differences in Daily Vaping of Nicotine and Cannabis among People Who Use Drugs in New Zealand

Background: Little is known about daily vaping of different substances, particularly cannabis. Aim: To explore daily vaping of cannabis and nicotine products in a sample of people who use drugs in New Zealand. Method: The online New Zealand Drug Trends convenience survey (N = 23,500) was promoted to those aged 16+ via a targeted Facebook™ campaign, with 9,042 reporting vaping in the past six months. Multivariate logistic regression models were fitted to identify predictors of daily vaping of: (i) nicotine e-liquids, (ii) no-nicotine e-liquids, (iii) cannabis e-liquids/oils, (iv)cannabis herb. Results: Forty-two percent of past 6-month vapers used a vaporizing device “daily or near daily” (n = 3,508). Nicotine was most common substance used by daily vapers (96%), followed by dry herb cannabis (12%), no-nicotine e-liquids (10%) and cannabis e-liquid (6%). Daily vaping of no-nicotine e-liquids was associated with abstinence from tobacco use. Frequency of cannabis use was negatively correlated with daily vaping of nicotine liquids and positively correlated with daily vaping of no-nicotine and herbal cannabis. Younger age strongly predicted daily vaping of nicotine and no-nicotine liquids, but the reverse association was observed for daily vaping of herbal cannabis. Māori were less likely to daily vape cannabis herb than NZ Europeans. Daily vaping of both cannabis e-liquid and cannabis herb was associated with medicinal cannabis use. Conclusion: Daily vapers of nicotine and cannabis differed by several characteristics. Younger age group is at risk of daily vaping nicotine and non-nicotine, while herbal cannabis vaping is associated with older and medicinal use, suggesting a need for a nuanced vape policy response.

Ratings of executive function as a risk factor for adolescents' frequent cannabis use: A prospective longitudinal study.

We examined the extent to which behavioral ratings of children's executive function (EF) in early adolescence predicted adolescents' cannabis use, and whether associations were independent of parents' cannabis and alcohol use and adolescents' alcohol use. Participants were 198 offspring (44% boys) of 127 mothers and 106 fathers. Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF) at ages 11-14 years. Youth were interviewed repeatedly from ages 14 to 20 years regarding frequency of cannabis and alcohol use. Two-level models regressed dichotomous cannabis outcomes (annual, weekly, or daily use) on age at the within-person level and the random intercept of cannabis use on EF, parent substance use, and covariates (age 7 IQ indicators, child gender, parent education, and mean of ages assessed) at the between-person level. Poorer child EF predicted significantly (p < .05) higher likelihood of weekly (b[SE] = .64[.24]) and daily (b[SE] = .65[.25]), but not annual (b[SE] = .38[.22]), cannabis use. Parent cannabis use (b[SE] = .53[.25] to .81[.39], p < .05) independently predicted all three outcomes, and effects were distinct from those explained by parent alcohol use (b[SE] = .66[.29] to .81[.35], p < .05). EF remained a significant predictor of weekly and daily cannabis use after adjusting for parental alcohol and cannabis use, and adolescents' alcohol use. Children exhibiting poorer EF were more likely to use cannabis weekly and daily in later adolescence. Whereas literature suggests poorer EF may be a consequence of cannabis use, these findings suggest EF should be considered prior to cannabis use initiation. EF during childhood may be a fruitful prevention target. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cannabis Use and Sharing Practices Among Sexual Minority and Heterosexual Individuals During the COVID-19 Pandemic.

Purpose: Cannabis behaviors during the COVID-19 pandemic among sexual minority (SM) individuals in the United States remain understudied. This study assessed the prevalence and correlates of cannabis use and cannabis sharing, a potential risk for COVID-19 transmission, among SM and heterosexual-identified individuals in the United States during the COVID-19 pandemic. Methods: This cross-sectional study used data from an anonymous, US-based web survey on cannabis-related behaviors from August to September 2020. Included participants reported past-year nonmedical cannabis use. Associations between frequency of cannabis use and sharing behaviors by sexual orientation were evaluated using logistic regression analysis. Results: Overall, 1112 respondents reported past-year cannabis use; mean age 33 years (standard deviation = 9.4), 66% male identified (n = 723), and 31% SM identified adults (n = 340). Increased cannabis use during the pandemic was similar among SM (24.7%; n = 84) and heterosexual (24.9%; n = 187) respondents. Any sharing during the pandemic was 81% for SM adults (n = 237) and 73% for heterosexual adults (n = 486). In the fully adjusted models, the odds of daily/weekly cannabis use and the odds of any cannabis sharing among SM respondents were 0.56 (95% confidence interval [CI] = 0.42-0.74) and 1.60 (95% CI = 1.13-2.26), respectively, compared with heterosexual respondents. Conclusions: SM respondents were less likely to use cannabis with high frequency during the pandemic but more likely to share cannabis compared with heterosexual respondents. Sharing cannabis was high overall, which may increase COVID-19 risk. Public health messaging around sharing may be important during COVID-19 surges and respiratory pandemics especially as cannabis becomes more widely available in the United States.

Adverse childhood experiences and adolescent cannabis use trajectories: findings from a longitudinal UK birth cohort

Adverse childhood experiences (ACEs) are classically defined as physical abuse, sexual abuse, emotional abuse, emotional neglect, bullying, parental substance use or abuse, violence between parents, parental mental health problems or suicide, parental separation, or a parent convicted of criminal offence. Exposure to ACEs can be associated with cannabis use, but no comparisons across all adversities have been made while also considering timing and frequency of cannabis use. We aimed to explore the association between ACEs and cannabis use timing and frequency in adolescence, considering the cumulative number of ACEs and individual ACEs. We used data from the Avon Longitudinal Study of Parents and Children, a longitudinal UK birth cohort study. Longitudinal latent classes of cannabis use frequency were derived from self-reported data at multiple timepoints in participants aged 13-24 years. ACEs between ages 0 years and 12 years were derived from prospective and retrospective reports at multiple timepoints by parents and the participant. Multinomial regression was used to analyse the effect of both cumulative exposure to all ACEs and the ten individual ACEs on cannabis use outcomes. 5212 participants (3132 [60·0%] were female and 2080 [40·0%] were male; 5044 [96·0%] were White and 168 [4·0%] were Black, Asian, or minority ethnic) were included in this study. After adjustment for polygenic risk and environmental risk factors, participants who had 4 or more ACEs at age 0-12 years were at increased risk of early persisting regular cannabis use (relative risk ratio [RRR] 3·15 [95% CI 1·81-5·50]), later onset regular use (1·99 [1·14-3·74]), and early persisting occasional use (2·55 [1·74-3·73]) compared with low or no cannabis use. After adjustment, early persisting regular use was associated with parental substance use or abuse (RRR 3·90 [95% CI 2·10-7·24]), parental mental health problems (2·02 [1·26-3·24]), physical abuse (2·27 [1·31-3·98]), emotional abuse (2·44 [1·49-3·99]), and parental separation (1·88 [1·08-3·27]) compared with low or no cannabis use. Risks for problematic adolescent cannabis use are highest for individuals reporting 4 or more ACEs, and were particularly raised for those with parental substance use or abuse. Public health measures to address ACEs might reduce adolescent cannabis use. The Wellcome Trust, UK Medical Research Council, Alcohol Research UK.

“Wake-and-bake” cannabis use: Predictors and cannabis-related outcomes of use shortly after waking

BackgroundGiven recent historical increases in young adults frequent cannabis use and changes in cannabis policies throughout the United States, there is a need to examine high-risk patterns of use. This paper examined predictors and cannabis-related outcomes of “wake-and-bake” cannabis use, operationalized as use within 30min of waking. MethodsParticipants were 409 young adults (Mage=21.61 years, 50.8% female) enrolled in a longitudinal study on simultaneous alcohol and cannabis use (i.e., using alcohol and cannabis at the same time such that their effects overlap). Eligibility criteria included reporting alcohol use 3+ times and simultaneous alcohol and cannabis use 1+ times in the past month. Participants completed twice-daily surveys for six 14-day bursts across two calendar years. Aims were tested using multilevel models. ResultsAnalyses were limited to cannabis use days (9406 days; 33.3% of all sampled days), and thereby to participants who reported using cannabis (384 participants; 93.9% of the sample). Wake-and-bake use was reported on 11.2% of cannabis use days and at least once by 35.4% of participants who used cannabis. On wake-and-bake use days, participants were high for more hours and had greater odds of driving under the influence of cannabis, but did not experience more negative consequences, relative to non-wake-and-bake cannabis use days. Participants who reported more cannabis use disorder symptoms and those reporting higher average social anxiety motives for cannabis use reported more frequent wake-and-bake use. ConclusionsWake-and-bake cannabis use may be a useful marker of high-risk cannabis use, including driving under the influence of cannabis.

Do Anxiety Symptoms Mediate the Association Between Cannabis Use Frequency and Psychotic-Like Experiences in Emerging Adult Undergraduates?

Cannabis is commonly used by Canadian emerging adults (ages 18-25 years), many of whom attend post-secondary institutions. Frequent cannabis use is linked with psychotic-like experiences (PLEs); however, the exact nature of this association remains unclear. Anxiety symptoms may mediate this association, as they are prevalent in emerging adults and have been independently linked with both cannabis use and PLEs. Past work found that anxiety mediated the association between cannabis use frequency and attenuated positive psychotic symptoms (further along the psychosis continuum than PLEs), however this research had yet to be validated in the Canadian population, and trait rather than state anxiety (frequency of anxiety symptoms) was studied. Thus, our primary objective was to examine if anxiety symptoms mediated the association between cannabis use frequency and PLEs in Canadian emerging adult undergraduates. Despite known sex differences in cannabis use, expression of anxiety, and PLEs, past work did not evaluate the potential impact of biological sex on the anxiety-mediated model, and thus is the secondary objective of the present study. 1,266 first-/second-year emerging adult undergraduates from five Canadian universities provided cross-sectional, self-report survey data in fall 2021 semester. Validated measures of cannabis use frequency, anxiety, and PLEs were administered. Path analyses supported mediation from cannabis use to PLEs through anxiety (b = 0.07, P < 0.001, 95% bootstrap CI [0.03, 0.10]). No direct effect was found (P = 0.457), suggesting that the cannabis-to-PLEs association was mediated by anxiety. Mediation did not depend on biological sex (i.e., bootstrapped 95% CIs crossed zero). Anxiety symptoms mediated the association between cannabis use and PLEs in emerging adults regardless of their biological sex. Assuming replication in prospective research, results highlight anxiety as an important intervention target in frequent cannabis-using emerging adults, to potentially prevent development/worsening of PLEs, and in turn psychotic illness.

Dimensionality and differential functioning of DSM-5 cannabis use disorder criteria in an online sample of adults with frequent cannabis use

The DSM-5 criteria for cannabis use disorder (CUD) combine DSM-IV dependence and abuse criteria (without legal problems) and new withdrawal and craving criteria. Information on dimensionality, internal reliability, and differential functioning of the DSM-5 CUD criteria is lacking. Additionally, dimensionality of the DSM-5 withdrawal items is unknown. This study examined the psychometric properties of the DSM-5 CUD criteria among adults who used cannabis in the past 7 days (N = 5,119). Adults with frequent cannabis use were recruited from the US general population through social media and filled in a web-based survey about demographics and cannabis use behaviors. Factor analysis was used to assess dimensionality, and item response theory analysis models were used to explore relationships between the criteria and the underlying latent trait (CUD), and whether each criterion and the criteria set functioned differently by demographic and clinical characteristics: sex, age, state-level cannabis laws, reasons for cannabis use, and frequency of use. The DSM-5 CUD criteria showed unidimensionality and provided information about the CUD latent trait across the severity spectrum. The cannabis withdrawal items indicated one underlying latent factor. While some CUD criteria functioned differently in specific subgroups, the criteria set as a whole functioned similarly across subgroups. In this online sample of adults with frequent cannabis use, evidence supports the reliability, validity, and utility of the DSM-5 CUD diagnostic criteria set, which can be used for determining a major risk of cannabis use, i.e., CUD, to inform cannabis policies and public health messaging, and for developing intervention strategies.

Pilot trial of a telehealth-delivered behavioral economic intervention promoting cannabis-free activities among adults with cannabis use disorder

BackgroundCannabis is increasingly consumed and increasingly perceived as harmless. Among those whose use develops into a cannabis use disorder (CUD), <5% initiate and engage in treatment. Thus, novel options for low-barrier, appealing treatments are needed to foster engagement in care. MethodsWe conducted an open trial of a telehealth-delivered multicomponent behavioral economic intervention for non-treatment-engaged adults with CUD. Participants with CUD were recruited from a health system and screened for eligibility. Participants completed behavioral economic indices (cannabis demand, proportionate cannabis-free reinforcement), measures of cannabis use and mental health symptoms, and provided open-ended feedback on the intervention experience. ResultsOf the 20 participants who enrolled and engaged in the initial intervention session, 70% (14 out of 20) completed all intervention components. All participants were satisfied/very satisfied with the intervention and 85.7% reported the telehealth delivery made it at least slightly easier/more likely for them to receive substance use care. Baseline to immediate post-treatment, behavioral economic cannabis demand decreased (intensity: Hedges' g = 0.14, maximum total expenditure: Hedges' g = 0.53, maximum expenditure for a single hit: Hedges' g = 0.10) and proportionate cannabis-free reinforcement (Hedges' g = 0.12) increased. Past-month total cannabis use decreased by 8.9% from baseline to post-treatment (Hedges' g = 0.39), along with decreases in recent depression (Hedges' g = 0.50) and anxiety symptoms (Hedges’ g = 0.29). DiscussionThese preliminary findings suggest that this behavioral economic intervention was highly acceptable and feasible for adults with untreated CUD. Changes in potential mechanisms of behavior change (cannabis demand, proportionate cannabis-free reinforcement) were consistent with reduced frequency of cannabis use and improved mental health outcomes.

Open-label pilot of lorcaserin (a serotonin 2C-receptor agonist) for cannabis use disorder

ABSTRACT Background and Objective Cannabis Use Disorder (CUD) has no FDA-approved treatment. Serotonin-2c (5HT2c) agonists have preclinical and human laboratory evidence for their potential efficacy for CUD. We assessed the tolerability and effects of lorcaserin (5HT2c agonist) on CUD. Methods In a 10-week, open label, uncontrolled trial, the tolerability of lorcaserin was tested in outpatients with CUD. Adverse events (AE) were assessed weekly. Cannabis use was assessed twice weekly by the Timeline follow-back and quantitative urine metabolites. Results Seventeen participants enrolled, and 14 received medication. Participants’ average age was 35 years; majority were male (N = 12). The medication was well tolerated in males. There were no serious adverse events (SAE). The most common AE’s were headache/migraine (N = 4, all females), anorexia (N = 3), and irritability (N = 2). Participants decreased their frequency of cannabis use significantly (p < 0.001), adjusted for baseline use. By the end of the trial, participants decreased by 1.76 (SE = 0.47) cannabis using days/week. Average daily amount of cannabis and urine THC metabolite levels did not change significantly. Conclusions Lorcaserin was well tolerated in males but not females, suggesting possible sex differences. Future trials of other 5HT2c agonists (lorcaserin was withdrawn at the request of the FDA) should consider longer dose titration phases.

Riesgos inducidos por la mariguana recreativa vs. la utilidad de los cannabinoides en el COVID-19

Introduction: the SARS-CoV-2 virus pandemic has caused a crisis in the health sector due to the lack of medical and pharmacological resources to treat the COVID-19 disease. Recent findings have shown that some compounds isolated from cannabis can reduce the entry of the SARS-CoV-2 virus into host cells, and prevent the proinflammatory cytokine storm, which is why they are considered drugs with potential for the treatment of COVID-19. On the other hand, frequent or chronic recreational use of cannabis may facilitate SARS-CoV-2 infection by depressing the immune system but also promote proinflammatory cytokine storm, worsening the disease. Objective: to discuss the proposed mechanisms of action of cannabinoids in the treatment of COVID-19 and the difference between the immunological effects produced by the chronic recreational use of marijuana and the pharmacological use of the isolated and purified compounds of cannabis for the treatment of this disease. Method: the most recent scientific articles published in PubMed were browsed, in which the effects of cannabinoids in relation to the SARS-CoV-2 virus were studied, as well as articles about the effects of chronic cannabis use on the immune system. Discussion and conclusions: high and frequent use of marijuana could worsen the disease caused by SARS-CoV-2, while the use of isolated and purified compounds can attenuate COVID-19 disease.

Microvascular Health is Reduced in Frequent Cannabis Users

BACKGROUND: Microvascular dysfunction is a marker of endothelial vascular damage and is considered one of the earliest indicators of cardiovascular disease (CVD) development. Frequent cannabis use has been previously linked to increased CVD risk. However, whether microvascular health is impacted by cannabis use in otherwise healthy young adults has not been explored yet. PURPOSE: The purpose of this study was to investigate the impact of frequent cannabis usage on microvascular health in young healthy adults. METHODS: Thirteen frequent cannabis users (CU, 5 males and 8 females; age:23±3 yo; used cannabis 2.5±2 days/week) and thirteen demographical matched never users (NU, 5 males and 8 females; age:22±1 yo) completed a comprehensive assessment of microvascular function. Microvascular health was assessed using Laser Doppler Imaging coupled with Post Occlusive Reactive Hyperemia (PORH), to evaluate overall microvascular function, and Local Thermal Hyperemia (LTH) to evaluate neurogenic and endothelial mechanisms of vascular function. Blood flow was calculated as cutaneous vascular conductance, considering red blood cell flux and mean arterial blood pressure. RESULTS: Cannabis users exhibited significantly ( p=0.01) lower microvascular function when compared to never users (PORH, CU: 0.68±0.18 vs. NU: 0.85±0.14 mmHg/PU). Of note, microvascular function was significantly ( p=0.03) reduced in those that use cannabis more than 2.5 days/week (n=5; 0.55±0.10) when compared to those who used it less frequently (n=8; 0.76±0.18 mmHg/PU). In addition, neurogenic mechanisms (CU:1.31±0.57 vs. NU: 1.89±0.48 mmHg/PU; p=0.009) and endothelial mechanisms (CU: 1.61±0.44 vs. NU: 1.96±0.35 mmHg/PU; p=0.03) were significantly lower in cannabis users when compared to never users. CONCLUSIONS: Our results suggest that frequent cannabis users exhibit reduced microvascular health in comparison to never users, suggesting worse long-term CVD outcomes. Specifically, those that use cannabis more than 2 times per week exhibit lower microvascular function. In addition, cannabis use negatively impact neurogenic and endothelial microvascular mechanisms that warrant further investigation. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Income inequality and daily use of cannabis, cigarettes, and e-cigarettes among Canadian secondary school students: Results from COMPASS 2018-19.

Cannabis, cigarette, and e-cigarette use among Canadian adolescents is a major public health concern. Income inequality has been associated with adverse mental health among youth and may contribute to the risk of frequent cannabis, cigarette, and e-cigarette use. We tested the association between income inequality and the risk of daily cannabis, cigarette, and e-cigarette use among Canadian secondary school students. We used individual-level survey data from Year 6 (2018/19) of Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary Behavior (COMPASS) and area-level data from the 2016 Canadian Census. Three-level logistic models were used to assess the relationship between income inequality and adolescent daily and current cannabis use, cigarette smoking, and e-cigarette use. The analytic sample included 74,501 students aged 12-19. Students were most likely to report being male (50.4%), white (69.1%), and having weekly spending money over $100 (23.5%). We found that a standard deviation unit increase in Gini coefficient was significantly associated with increased likelihood of daily cannabis use (OR=1.25, 95% CI=1.01-1.54) when adjusting for relevant covariates. We found no significant relationship between income inequality and daily smoking. While Gini was not significantly associated with daily e-cigarette use, we observed a significant interaction between Gini and gender (OR=0.87, 95% CI= 0.80-0.94), indicating that increased income inequality was associated with higher risk of reporting daily e-cigarette use among females only. An association between income inequality and the likelihood of reporting daily cannabis use across all students and daily e-cigarette use in females were observed. Schools in higher income inequalityareasmay benefit from targeted prevention and harm reduction programs. Resultsemphasize the need for upstream discussion on policies that can mitigate thepotentialeffects income inequality.

Changes in Immune-Related Biomarkers and Endocannabinoids as a Function of Frequency of Cannabis Use in People Living With and Without HIV.

Background: Cannabis use is common among people living with HIV (PLWH). Some observational studies of PLWH have linked cannabis use to lower immune markers; however, this is yet to be confirmed. In addition, whether HIV affects the endogenous cannabinoid system has not been studied. Our objective was to examine changes in immune-related biomarkers and endocannabinoids as a function of cannabis use frequency in people living with and without HIV. Materials and Methods: Data were obtained from a longitudinal study of men who have sex with men living in Los Angeles with, or at risk for, HIV. By design, half were PLWH. Those eligible for the parent study were willing and able to return for follow-up every 6 months. Those eligible for inclusion in this study reported varying levels of current cannabis use at follow-up. Specifically, one visit corresponded to a period of daily use and another to a period of infrequent use (weekly, monthly, or less than monthly). Banked serum from all eligible participants was analyzed for immune-related biomarkers, endocannabinoids, and paracannabinoids. Results: The analysis included 36 men, 19 of whom were PLWH. PLWH reported greater lifetime methamphetamine or amphetamine use (68% vs. 0%) and current cigarette use (55% vs. 20%) than people without HIV. Serum levels of HIV-related immune biomarkers including tumor necrosis factor receptor 2 (TNFR2; p=0.013) and CD27 (p=0.004) were greater in PLWH, alongside lower anandamide (AEA) (F1,34=5.337, p=0.027) and oleoylethanolamide (OEA) (F1,34=8.222, p=0.007) levels relative to people without HIV. Frequency of cannabis use did not impact the serum analytes in our study. Conclusions: Higher levels of TNFR2 and CD27 and lower levels of AEA and OEA in PLWH underscore the role of the TNF/TNFR superfamily in HIV, while highlighting a new role for the enzymatic activity of fatty acid amide hydrolase (the enzyme that hydrolyzes AEA and OEA) in HIV. Findings that cannabis frequency did not impact the immune phenotype may not generalize to other populations of PLWH. Additional work is required to further clarify the relationship between immune markers and endocannabinoids as a function of cannabis use frequency in PLWH. ClinicalTrials.gov ID: NCT01201083.

Self-reported THC content and associations with perceptions of feeling high among cannabis consumers.

Few studies have examined consumer knowledge and communication of tetrahydrocannabinol (THC) content among cannabis consumers, including potential differences by cannabis legislation. The study sought to: (i) examine self-reported knowledge of THC content across 10 cannabis products; (ii) examine self-reported intoxication levels; and (iii) examine association between self-reported THC levels and intoxication levels. Repeat cross-sectional surveys were conducted in Canada and the United States in September-November 2020 as part of the International Cannabis Policy Study. Respondents were past 12-month cannabis consumers, aged 16-65 (n = 13,689). A weighted logistic regression model examined the association between expected intoxication of dried flower, jurisdiction and frequency of cannabis use. Across all 10 cannabis products, approximately two-thirds of consumers did not know the quantitative THC level of the cannabis product they last used. Qualitative levels of THC (e.g., 'low' or 'high' THC) showed moderate correspondence with quantitative self-reported THC levels for most products. Approximately half of consumers across all products reported achieving their desired intoxication level at last use, with higher levels among more frequent consumers and Canadian consumers of dried flower (F = 2.54, p = 0.019). Overall, comprehension of THC levels in cannabis products is low among consumers in both illegal and legal markets.

Explaining the Impact of Legal Access to Cannabis on Attitudes toward Users

AbstractLaws and public policies can change social norms by signaling which behaviors are legal or illegal. Recent cannabis legalization policies might have this effect. Does cannabis legalization increase social acceptance toward its users? This article focuses on understanding the impact of Uruguayan cannabis legalization on attitudes toward cannabis users by taking advantage of having legal and illegal mechanisms for getting cannabis under the same national context. To do so, we conducted a conjoint experiment in a national face-to-face survey (N = 2,181). Participants were presented with two different profiles of potential neighbors and asked to choose one. These profiles randomized attributes such as being a registered user, mechanism of cannabis acquisition, frequency of cannabis use, as well as sociodemographic characteristics. Participants rated each profile from 1 to 7 based on how much they would like to have them as neighbors. Subsequently, we estimated the average marginal component effect as the critical causal quantity of interest. Results reveal that users who access cannabis through a legal mechanism are more preferred as neighbors than those who do not. Thus, the evidence presented in this article indicates that regulation, by proving legal access, increases the social acceptance of cannabis users.