Increased Cannabis Use Research Articles

Cannabis Use Disorder Emergency Department Visits and Hospitalizations and 5-Year Mortality.

Cannabis use disorders (CUD) are associated with adverse health effects, including mental disorders and motor vehicle collision-related injuries. However, little is known about whether CUDs are associated with increased mortality risk. To examine whether individuals receiving incident hospital-based care (an emergency department visit or hospitalization) for a CUD is associated with increased risk of death. This population-based retrospective cohort study included all individuals aged 15 to 105 years living in Ontario, Canada, between 2006 and 2021 (n = 11 622 571 individuals). Overall and cause-specific mortality were compared between individuals with incident hospital-based CUD care and age- and sex-matched members of the general population or individuals with hospital-based care for other substance use disorders using cause-specific hazard models adjusted for comorbid mental health, substance use, and chronic health conditions. Statistical analysis was performed from September to December 2024. Incident hospital-based CUD care. Overall and cause-specific mortality identified using vital statistics. The matched analysis included 527 972 individuals (mean [SD] age, 29.9 [13.6] years; 330 034 [62.5%] female) with a median (IQR) follow-up of 5 (3-9) years; 106 994 had incident CUD. Within 5 years of incident hospital-based CUD care, 3770 individuals (3.5%) died compared with 3770 (0.6%) of matched general population members. After adjusting for comorbid conditions, individuals with incident hospital-based CUD care were at increased risk of death relative to the general population (adjusted hazard ratio [aHR], 2.79 [95% CI, 2.62-2.97]). Individuals with hospital-based CUD care were at increased risk of all investigated types of death and particularly elevated risk of death by suicide (aHR, 9.70 [95% CI, 6.04-15.57]), trauma (aHR, 4.55 [95% CI, 3.55-5.82]), opioid poisoning (aHR, 5.03 [95% CI, 2.86-8.84]), other drug poisonings (aHR, 4.56 [95% CI, 3.11-6.68]), and lung cancer (aHR, 3.81 [95% CI, 2.39-6.07]) relative to the general population. Compared with an individual with hospital-based care for CUD, individuals with hospital-based care for alcohol (aHR, 1.30 [95% CI, 1.26-1.34]), stimulants (aHR, 1.69 [95% CI, 1.62-1.75]), and opioids (aHR, 2.19 [95% CI, 2.10-2.27]) were at relatively increased risk of death within 5 years. In this cohort study of all residents of Ontario, Canada, individuals with incident hospital-based CUD care were at markedly increased risk of death compared with the general population. These findings suggest important clinical and policy implications, given global trends toward cannabis legalization and market commercialization accompanied by increasing cannabis use and CUDs.

Association of State Cannabis Legalization With Cannabis Use Disorder and Cannabis Poisoning

Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident. To examine state-level medical and recreational cannabis laws' associations with CUD and cannabis poisoning, overall and by sex and age subgroups. In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption difference-in-differences approach. Event studies were conducted to estimate the magnitude of the association for each year-quarter relative to the time of each policy implementation. This study was conducted among all adults aged 18 to 64 years enrolled in the Merative MarketScan Commercial Claims and Encounters Database, a database of employer-sponsored health insurance enrollees, with 1 year or more of continuous enrollment from 2011 to 2021. Data analysis was performed from January to August 2024. State implementation of an MCL, opening a medical cannabis dispensary (MCD), allowing home cultivation of medical cannabis (HC-MC), and passage of an RCL. CUD and cannabis poisoning diagnoses per 100 000 enrollees per quarter. This study included 110 256 536 enrollees, of whom 56 843 030 (52%) were female and the mean (SD) enrollee age was 41.0 (13.5) years. MCLs were associated with significant increases in CUD and cannabis poisoning by 31.09 (95% CI, 20.20-41.99; P < .001) and 0.76 (95% CI, 0.52-1.00; P < .001) diagnoses per 100 000 enrollees per quarter, respectively, and RCLs were associated with a significant increase in cannabis poisoning by 0.34 (95% CI, 0.19-0.48; P < .001) per 100 000 enrollees per quarter in states with RCLs compared to states without these laws. No significant associations were observed for MCDs or HC-MC. Relative increases in CUD associated with MCLs were higher among female enrollees and among enrollees aged 35 to 44 years compared with male enrollees and other age groups, respectively. Sensitivity analysis results of 2011 to 2019 data were consistent with the 2011 to 2021 results. In this longitudinal cohort study, MCLs were associated with increased CUD and cannabis poisoning diagnoses, and RCLs were associated with increased cannabis poisoning in adults aged 18 to 64 years with employer-sponsored health insurance. Communities with increased access to cannabis may experience increased health care use and costs due to increases in cannabis poisoning and CUD, and new clinical and policy interventions are needed to curb these rising diagnoses.

Predictors of Change in Cannabis Use Status from Pre- to Post-Recreational Cannabis Legalization in Canada: Evidence from a Two-Wave Longitudinal National Survey.

In October 2018, the Government of Canada legalized cannabis for recreational use nationwide. The effects of legalization on cannabis use have been primarily assessed through cross-sectional surveys. In the present study, a two-wave longitudinal design was used to explore potential demographic, substance use and behavioral addiction, and mental health predictors of change in cannabis use status following legalization. Canadian online panelists (18+) were initially surveyed about their gambling and substance use in 2018 (i.e., before cannabis legalization). From the original sample, 4,707 (46.2%) were retained in the follow-up survey one year later, post-cannabis legalization. These respondents were the focus of the present study. When queried about how legalization would impact their use, 61.8% said, 'I'll never use it', 21.1% stated "I'll use it about the same as I do now," 10.3% indicated, "I may try it for the first time," 5.0% answered, "I'll use it more," and 1.9% responded that, "I'll use it less." Consistent with these sentiments, within the retained sample there was a modest but significant increase in cannabis use from baseline (18.4%) to follow-up (26.1%). Regressions established that younger age, being male, substance use, tobacco or e-cigarette use, problematic gambling, and stated intention to use cannabis were predictors of later cannabis use. This national cohort design indicates that cannabis use appears to have increased in Canada following legalization. The present study makes a unique contribution by also identifying variables that statistically forecast movement toward and away from cannabis use.

Efficiency and safety of cannabinoid medical use: an analysis of discussions and observed trends on Instagram.

Cannabis and its derivatives show encouraging therapeutic effects in the treatment of various diseases. However, further studies are needed to better assess their efficacy and safety. A promising base for research in the field of medicine and additional pharmacovigilance is social networks, in which experience and knowledge are exchanged between researchers, doctors, and patients, as well as information about the potential risks and benefits of using drugs for medical purposes is disseminated. The aim of this study was to investigate the reported efficiency and safety of medical use of cannabinoids in patients using posts on the social media Instagram and analyze the observed trends. Social media listening platform Apify was used to collect data with hashtags as of June 4, 2024, including posts from 2023 and 2024, with some data extending into later periods, in compliance with a systematic approach to data collection. The analysis of the data obtained from the research was conducted using the RStudio platform. The analysis covered 1,466 posts containing hashtags related to cannabinoids. The posts studied were categorized as follows: 33.08% focused on advertising and commercialization, 25.58% on personal experience, 21.35% on other topics, and 19.99% contained educational content. An analysis of overall content relevance found that the majority of Instagram posts (81.79%) related to cannabis and cannabinoid hashtags are relevant. Most of the Instagram posts studied were posters, followed by personal photos and videos. The analysis shows that English dominates the studied category (70.74% of posts), while German, French, Spanish, and other languages also occupy a significant place, emphasizing the importance of a multilingual approach in content analysis. It has been revealed that organizations publish a larger percentage of posts under this study, with a higher percentage of relevance. Personal experience stories receive a significant number of "likes" indicating a strong emotional connection between audience and content. Instagram discussions about cannabinoid treatment support evidence from scientific studies about their effectiveness in treating a range of diseases, such as epilepsy with Lennox-Gastaut and Dravet syndromes, multiple sclerosis, cancer, and HIV-cachexia, nausea and vomiting caused by chemotherapy. At the same time, they emphasize the need for further clinical studies to better assess safety, side effects, and optimal dosages. Advertising and commercial posts can contribute to increased cannabis use, highlighting the need to raise awareness of risks and strengthen preventive measures. Analysis of content on the social media Instagram can complement traditional scientific research by providing information on the real use of cannabis and its derivatives, contributing to the development of safe and effective recommendations for its use.

Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case-control study from Thailand.

Tuberculosis (TB) is a chronic lung disease caused by Mycobacterium tuberculosis. Tobacco smoking and sharing of instruments have been reported to increase TB risk. In 2022, cannabis was legalized in Thailand. To address for the potential increase in cannabis use after legalization and the reported increased TB risk associated with cannabis usage, we aimed to estimate the odds ratio and population-attributable fraction (PAF) of different types of cannabis use. A matched case-control study was conducted in the Songkhla Province of Southern Thailand in 2023. Face-to-face interviews were conducted to collect information on cannabis consumption. Multivariate logistic regression was performed to estimate the odds ratios representing TB risk from the independent variables. PAF was also calculated to compare the public health impacts of the variables. Among the 148 TB cases and 117 healthy controls, we observed lower socioeconomic status and higher proportions of tobacco and alcohol use in these cases. Eleven percent of the controls were current cannabis users, while nearly 19% had ever experienced cannabis use. The proportions of ever-used, smoked, and shared cannabis use were significantly higher in these cases. After adjusting for covariates, the best-fit model showed an odds ratio of 4.22 (95% confidence interval: 1.47-12.07) for smoking and sharing a bong of cannabis. No statistical significance was found for the other types of consumption. PAF of smoked and shared bongs of cannabis was 12.16, which was slightly lower than that found in smoking tobacco (12.62). Increased numbers of cannabis users, especially shared smokers, may have an impact on TB risk in lower-middle-income countries, where TB is already highly prevalent.

Understanding the presence of Cannabis across the Holocene in Central India

Pollen records from sediment cores do not allow understanding of past human use of Cannabis because Cannabis may also grow naturally or increase incidentally in the presence of human settlements. This is particularly true in Asia, where Cannabis was not used as hemp as often as it was in Europe; hemp retting makes it easy to identify Cannabis use as it causes characteristically high increases in Cannabis fossil pollen in strata where it was used. In this study, we evaluate the evidence for Cannabis cultivation and use in Central India, where Cannabis fossil pollen occur in sediment cores from ∼ 12.2 ka (1 ka= 1000 y ago). While the public perception is that Cannabis has a long history of use in South Asia, textual sources suggest significant increases in Cannabis use ∼1–2 ka. To disentangle Cannabis presence due to natural dispersal and due to use, we develop a new approach. Artemisia grows alongside Cannabis and disperses in similar conditions, whether naturally or due to increase in human settlements. We investigate when Cannabis increased in the paleo-record independent of Artemisia, and find that Cannabis increased ∼ 2.5 ka in areas close to major early historic settlements, where Cannabis displays characteristic patterns of cultivation. Cannabis does not display these patterns away from the early historic settlements. These dates are similar to findings of Cannabis use as hemp in the Himalayas (2.5 ka) and as a drug in China (2.7 ka), but pre-date the proliferation of Cannabis presence in textual sources. Overall, Cannabis pollen presence in pre-historic India (<2.5 ka), although common, is likely to be because of natural dispersal of Cannabis.

Abstract B014: Cannabis use among cancer survivors and its association with cardiometabolic risk factors: Findings from the All of Us Research Program

Abstract Purpose: Cannabis use has been linked to alleviating symptoms such as sleep issues, mental health, and physical problems resulting from cancer treatment among cancer survivors. However, in the US general population, evidence suggests that an increase in cannabis use increases the risk for cardiovascular disease including high blood pressure, type 2 diabetes, and high cholesterol. This is even more alarming since users who have been diagnosed with cancer have an even greater independent risk of cardiovascular events due to the toxicities of cancer therapeutic drugs. Given the US trend in cannabis legalization and decriminalization and the limited knowledge of the association between cannabis use and cardiometabolic biomarkers among cancer survivors, we aim to assess the independent associations between cannabis use and several cardiometabolic biomarkers and explore racial/ethnic and sex differences among a sample of cancer survivors from the All of Us (AoU) Program. Methods: Cross-sectional cannabis data and cardiometabolic risk factor biomarkers were obtained from adult cancer survivors in the AoU Research Program from 2018-2022. Cannabis use was defined as never use (in a lifetime or past three months), occasional use (twice or monthly in the past three months), and frequent/regular use (weekly or daily). Cardiometabolic outcomes included cardiovascular (e.g., systolic, diastolic blood pressure, hypertension), immune (i.e., White Blood Cell [WBC] counts, C-reactive protein [CRP]), and metabolic systems biomarkers (e.g. waist-to-hip ratio, lipids, HbA1c), were dichotomized from continuous values to elevated vs normal where high values, defined by clinically established cutoffs or &amp;gt;75th percentile, represented elevated biomarkers. Multivariable logistic regression and stratified models if interactions were statistically significant, adjusting for treatment, smoking, hazardous alcohol use, and sociodemographic variables were used. Results: Our cohort (N=6,985) consisted of 7.6% Hispanic, 6.2% Black, and 86.2% White survivors. Overall, 8.2% of survivors reported occasional and frequent/regular cannabis use, with Black survivors (9.7%) reporting a greater proportion of frequent/regular use compared to White (3.2%) and Hispanic (4.7%) survivors. Similarly, female (2.8%) survivors reported a lower frequency of frequent/regular cannabis use compared to male (4.2%) survivors. Compared to never users, frequent/regular users were 3.35(95% CI=1.10-10.53) times as likely to report elevated WBC count. No significant associations were found between cannabis use and CRP, cardiovascular, and metabolic systems biomarkers. Similarly, no race/ethnicity or sex (both pinteraction &amp;gt; 0.05) differences were found in the cannabis and WBC association. Conclusion: Our results underscore that more frequent cannabis use may have a detrimental effect on immune risk factors like WBC counts among survivors. Being that high WBC may be predictive of cardiovascular diseases and mortality, future studies should explore the longitudinal effects of cannabis use on WBC. Citation Format: Angel Arizpe, Claudia M. Toledo-Corral, Carol Y. Ochoa-Dominguez, Stephanie Navarro, Sue E. Kim, Albert J. Farias. Cannabis use among cancer survivors and its association with cardiometabolic risk factors: Findings from the All of Us Research Program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B014.

A qualitative study of experiences among young adults who increased their cannabis use during the COVID-19 pandemic

BackgroundYoung adults face unique vulnerabilities during major life disruptions like the COVID-19 pandemic. The pandemic contributed to increases in mental health challenges and substance use among young adults. This study explores the experiences of young adults who increased their cannabis use during the pandemic.MethodsParticipants were recruited from the Nicotine Dependence in Teens (NDIT) study, and qualitative data were collected through semi-structured interviews conducted via Zoom. A total of 25 participants (ages 33–34) reporting increased cannabis use during the pandemic were included. Thematic analysis and gender-based analysis was employed to extract key themes.ResultsFive themes emerged: (1) No disruption in cannabis use; (2) Cannabis use to manage declines in mental health; (3) Cannabis use to break up pandemic boredom; (4) Cannabis use as an expression of freedom; (5) Cannabis use as “another way to chill out.”ConclusionsThis research provides valuable perspectives on how major life disruptions, like the COVID-19 pandemic, influence cannabis use among young adults. The findings offer guidance for public health initiatives and highlight avenues for further investigation.

DNA methylation, but not microRNA expression, is affected by in vitro THC exposure in bovine granulosa cells

BackgroundA global increase in cannabis use has led to questions about its effects on fertility. The rise in consumption amongst women of reproductive age is a growing concern, as this group is vulnerable in terms of reproductive health. Ample evidence suggests that the psychoactive component of cannabis, Δ9-Tetrahydrocannabinol (THC), interacts with the endocannabinoid system (ECS), that helps regulate mammalian reproduction. This study aimed to research the epigenetic effects of THC in bovine granulosa cells (GCs) by (1) investigating global DNA methylation via measuring 5-mC and 5-hmC levels; (2) measuring key methylation regulators, including the methylating enzymes DNMT1, DNMT3a, DNMT3b and the demethylases TDG and TET1/2/3; and (3) assessing fertility-associated miRNAs key in developmental competency, including miR-21, -155, -33b, -324 and -346.MethodsBovine GCs were used as a translational model for reproductive toxicity in humans. To determine THC effects, GCs were isolated from Cumulus-Oocyte-Complexes (COCs) from bovine ovaries, cultured in vitro for 7 days, or until confluent, and cryopreserved at passage 1 (P1). For experimentation, cells were thawed, cultured until passage 2 (P2), serum restricted for 24-h and treated for 24-h in one of five groups: control, vehicle (1:1:18 ethanol: tween: saline) and three clinically relevant THC doses (0.032, 0.32 and 3.2 μM). Global methylation was assessed by measuring 5-mC and 5-hmC levels with flow cytometry. To assess mRNA and protein expression of methylation regulators and miRNA profiles, qPCR and Western Blotting were utilized. Shapiro-Wilk test was used to determine normality within datasets. One-way ANOVA was applied to determine statistical significance using GraphPad Prism 6.0.0.ResultsResults indicate a significant decrease (p = 0.0435) in 5-mC levels following low THC exposure, while no changes were observed in 5-hmC levels. A significant increase in DNMT1 following high THC exposure at the RNA level (p < 0.05) and a significant increase following low THC exposure at the protein level (p = 0.0048) were also observed. No significant differences were observed in DNMT3a/3b, TDG, TET1/2/3 mRNAs or in any of the miRNAs analyzed.ConclusionsThis research suggests that THC mainly affects DNA methylation, but not miRNA profiles, ultimately altering gene expression and likely impairing oocyte competence, maturation, and fertilization potential.

Cannabis Use from Early Adolescence to the Mid-Twenties in Children of Immigrant and Nonimmigrant Parents: Findings from a Prospective Longitudinal Cohort Study

AbstractThis study compares the developmental course of cannabis use in adolescents with versus without an immigrant background. Data came from a Swiss prospective-longitudinal cohort study (n = 1445) with nine assessments between ages 7 and 24. Parents reported their immigration history; adolescents self-reported their past-year cannabis use five times between ages 13 (in 2011) and 24 years (in 2022). Latent growth curve models revealed a curvilinear increase in cannabis use, with a peak at age 20. Adolescents whose parents had immigrated showed a less steep increase in cannabis use during adolescence and a lower cumulative prevalence of cannabis use by age 24. Specific cultural and religious backgrounds were linked with lower odds of cannabis use. Interventions in early adolescence need to consider immigration, cultural, and religious backgrounds.

Historical Trends in Cannabis Use Among U.S. Adults Ages 19-55, 2013-2021.

The current study used U.S. national data to examine trends in cannabis use from 2013 to 2021, focusing on changes in cannabis prevalence during young and middle adulthood and whether trends differed by sociodemographic characteristics. Data from 2013 to 2021 from 21,182 respondents ages 19-30 and 29,871 ages 35-55 in the national Monitoring the Future panel study (followed since they were in 12th grade in 1976-2020) were used to model historical trends in cannabis prevalence (any 12-month use, any 30-day use, and near-daily use [≥20 occasions in the past 30 days]). Prevalence of 12-month, 30-day, and near-daily cannabis use significantly increased from 2013 to 2021 for both young and middle adults. Trends for all three behaviors indicated either consistent linear increases or two-slope increases in which the slope estimate was larger in more recent years. Historical increases in 12-month and 30-day use were similar for young and middle adulthood; the historical increase in near-daily use among middle adults had some evidence for a possible pandemic-related deviation. Historical trends did not differ by race/ethnicity or college degree. Trends for 12-month and 30-day use differed by sex, with women increasing more than men over time, especially during middle adulthood. Significant increases in the prevalence of cannabis use have occurred over the past decade for young and middle adults across sociodemographic groups, with some indication that near-daily use increased among middle adults at the onset of the pandemic. Although men continue to have a higher prevalence than women, the gap has narrowed, with greater increases in cannabis use among women.

Disproportionate increase in cannabis use among people with serious psychological distress and associations with psychiatric service use in the United States, 2009–2019

BackgroundCannabis use is on the rise, but it is unclear how use is changing among individuals with serious psychological distress (SPD) compared to the general population as well as what associations this may have with mental health service use. MethodsRetrospective cohort study using the National Survey on Drug Use and Health (NSDUH) 2009–19 public use files of 447,228 adults aged ≥ 18 years. Multivariable logistic regression and predictive margin methods were used to estimate linear time trends in any and greater-than-weekly levels of cannabis use by year and SPD status and rates of psychiatric hospitalization and outpatient mental health care.Findings: Rates of any and weekly-plus cannabis use increased similarly among individuals with SPD compared to those without from 200 to 2014 but more rapidly in SPD every year from 2015 to 2019 (p < 0.001). Among individuals with SPD, no use was associated with a 4.2 % probability of psychiatric hospitalization, significantly less than less-than-weekly (5.0 %, p = 0.037) and weekly-plus cannabis use (5.1 %, p = 0.028). For outpatient mental health care, no use was associated with a 27.4 % probability (95 % CI 26.7–28.1 %) of any outpatient care, significantly less than less than weekly use (32.6 % probability, p < 0.001) and weekly-plus use (29.9 % probability, p = 0.01). ConclusionsCannabis use is increasing more rapidly among individuals with SPD than the general population, and is associated with increased rates of psychiatric hospitalization and outpatient service use. These findings can inform policy makers looking to tailor regulations on advertising for cannabis and develop public health messaging on cannabis use by people with mental illness.

Changes in cannabis involvement in emergency department visits for anxiety disorders after cannabis legalization: a repeated cross-sectional study

An increasing number of countries have or are considering legalizing cannabis. One concern is that legalization of cannabis will result in increased cannabis use and in turn a higher prevalence of anxiety disorders. We examined changes in emergency department (ED) visits for anxiety disorders with cannabis involvement in Ontario, over a period that involved medical and non-medical cannabis legalization. This repeated cross-sectional population-based study identified all ED visits for anxiety disorders from residents of Ontario, Canada aged 10-105 between 2008 and 2022 (n=15.7 million individuals). We used interrupted time series analyses to examine immediate and gradual changes in cannabis-involvement and alcohol-involvement (control condition) over four policy periods: medical cannabis legalization (January 2008-November 2015), expanded medical access (December 2015-September 2018), non-medical cannabis legalization with restrictions (October 2018-February 2020), and commercialization which overlapped with the COVID-19 pandemic (March 2020-December 2022). Poisson models were used to generate incidence rate ratios with 95% confidence intervals. Over the 14-year study, there were 438,700 individuals with one or more ED visits for anxiety disorders of which 3880 (0.89%) individuals had cannabis involvement and 6329 (1.45%) individuals had alcohol involvement. During the commercialization/COVID-19 period monthly rates of anxiety disorders with cannabis-involvement were 156% higher (0.11 vs 0.29 per 100,000 individuals) relative to the pre-legalization period, compared to a 27% increase for alcohol-involvement (0.27 vs 0.35 per 1100,000 individuals). Rates of anxiety ED visits with cannabis involvement per 100,000 individuals increased gradually over the study period with no immediate or gradual changes after expanded medical access, legalization with restrictions or commercialization/COVID-19. However, during the commercialization/COVID-19 period there were large declines in total anxiety disorder ED visits and anxiety disorder ED visits with alcohol-involvement. Consequently, during this period there was an immediate 31.4% relative increase in the proportion of anxiety visits with cannabis-involvement (incidence rate ratio [IRR], 1.31; 95% CI 1.05-1.65). We found large relative increases in anxiety disorder ED visits with cannabis involvement over a 14-year period involving medical and non-medical cannabis legalization. These findings may reflect increasing anxiety disorder problems from cannabis use, increasing self-medication of anxiety disorders with cannabis use, or both. The proportion of anxiety ED visits with cannabis involvement increased during the final period of the study but could have been the results of the market commercialization, COVID-19 or both and ongoing monitoring is indicated. Canadian Institutes of Health Research (grant #452360).

Sex differences in the acute effects of oral THC: a randomized, placebo-controlled, crossover human laboratory study.

Recent reports have shown increased cannabis use among women, leading to growing concerns about cannabis use disorder (CUD). While there is preclinical evidence suggesting biological sex influences cannabinoid effects, human research remains scant. We investigated sex differences in the acute response to oral tetrahydrocannabinol (THC) in humans. 56 healthy men and women with prior exposure to cannabis but no history of CUD participated in a randomized, placebo-controlled, human laboratory study where they received a single 10mg dose of oral THC (dronabinol). Subjective psychoactive effects were assessed by the visual analog scale of "high", psychotomimetic effects by the Clinician-Administered Dissociative Symptoms Scale and Psychotomimetic States Inventory, verbal learning and memory by Rey Auditory Verbal Learning Test (RAVLT), and physiological effects by heart rate. Outcomes were regularly measured on the test day, except for the RAVLT, which was assessed once. Peak differences from baseline were analyzed using a nonparametric method for repeated measures. Oral THC (10mg) demonstrated significant dose-related effects in psychotomimetic and physiological domains, but not in RAVLT outcomes. A notable interaction between THC dose and sex emerged concerning the subjective "high" scores, with women reporting heightened sensations (p = 0.05). No other significant effects of sex and THC dose interaction were observed. Oral THC (10mg) yields similar acute psychotomimetic and physiological effects across sexes, but women may experience a pronounced subjective psychoactive effect. Further research is needed to identify individual vulnerabilities and facilitate tailored interventions addressing CUD. GOV REGISTRATION: https://clinicaltrials.gov/study/NCT02781519?term=Ranganathan&intr=THC&rank=3 .

Trajectories of Young People’s Cannabis Use During the COVID-19 Pandemic in Germany

Abstract: Objectives: This analysis aims to examine different trajectories of cannabis use within adolescents and young adults in Germany before and during the first two years of the COVID-19 pandemic. Methods: A cross-sectional online survey was conducted between January and Mid-February 2022 with 16,765 German youths aged 14 to 21 years (51.4 % female). Group-based trajectory modelling based on retrospective data on cannabis use before and during different stages of the COVID-19 pandemic was calculated with subsequent multinomial analysis predicting trajectory group membership by sociodemographic variables, sensation seeking and experienced pandemic related burdens. Results: Five different trajectory groups of cannabis users were observed: rare cannabis users (53 %), increasing cannabis users, rare pre-pandemic use (22 %), increasing cannabis users, moderate pre-pandemic use (12 %), decreasing cannabis users (8 %), and (nearly) daily cannabis users (6 %). Individuals with older age, male gender, higher sensation seeking, lower education, and a higher pandemic-related burden were significantly more likely to report a more frequent/heavy cannabis use during the COVID-19 pandemic. Conclusion: The large proportion of youths with an increased cannabis use during the COVID-19 pandemic shows need for low threshold help offers, and cannabis prevention programs. Due to the study design, one should be careful with causal interpretations.

Impact of Legalization on Cannabis Use, Attitudes, and Purchasing Preferences: A Repeated Cross-Sectional Survey of Canadian Young Adults.

The Government of Canada legalized recreational cannabis use in October of 2018 with the implementation of the Cannabis Act. The act aimed to reduce the illicit cannabis market, improve consumer health outcomes, and reduce youth access to cannabis. However, little is known about the attitudes and behaviors of young adults, who have been shown to have a high prevalence of cannabis use, towards cannabis after legalization. In this descriptive study, we examined cannabis use, attitudes, and purchasing preferences among Canadian university-attending young adults both before and after the legalization of cannabis. Participants were recruited from a large Canadian university from 2017 to 2021. Our findings showed that there was an increase in cannabis use immediately following legalization that subsequently decreased in later years. Additionally, attitudes about the legalization of cannabis became more favorable in later years (following legalization), particularly among those who did not use cannabis. Most young adults were also keen to purchase cannabis from a government-owned store before legalization. However, with the exception of past-month consumers, this preference decreased substantially following legalization. The current research adds to the knowledge base about changes in cannabis-related attitudes and use after legalization and focuses on a key population - young adults.

Cannabis Use Characteristics Associated with Self-Reported Cognitive Function in a Nationally Representative U.S. sample

Background With increases in cannabis use and potency, there is a need to improve our understanding of the impact of use on cognitive function. Previous research indicates long-term cannabis use may have a negative effect on executive function. Few studies have examined persistence of it in protracted abstinence, and there is limited evidence of predictors of worse cognitive function in current and former users. In this study, we aim to evaluate the associations between cannabis use status (current, former, and never use) and self-report cognition. Further, we investigate if cannabis use characteristics predict self-report cognitive function. Methods Cross-sectional cannabis use data from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III), a national survey (N = 36,309) conducted in the USA between 2012 and 2013 were used alongside the Executive Function Index scales. The data were analyzed by using Ordinary Least Squares regression. Results Current (N = 3,681, Female = 37.7%) and former users (N = 7,448, Female = 45.4%) reported poorer cognition than never users (N = 24,956, Female = 56.6%). Self-reported cognition of former users was in-between that of current and never users. Several cannabis use characteristics were associated with self-reported cognition in current and former users. Conclusion While prospective studies are required to confirm, findings suggest cannabis use is linked to worse cognition. There may be some limited recovery of cognition in former users and some cannabis use characteristics predict impairment. These findings add to our understanding of the cognitive impact of cannabis use. As worse cognitive function may impact relapse, findings have implications for personalization of cannabis use disorder treatment.

Trends and factors associated with illicit drug use in South Africa: Findings from multiple national population-based household surveys, 2002–2017

BackgroundIllicit drug use results in considerable global morbidity, but there is little data on its trends and factors associated with it in sub-Saharan Africa. We consider these questions using national data from South Africa for 2002–2017. MethodsWe analysed data among individuals aged 15 years or older from five national population-based household surveys in South Africa (2002–2017; n = 89,113). Recent drug use was defined as the last three-months use of illicit drugs, i.e., any use of cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens, opioids, and/or other illicit drugs. Time trends in recent drug use were assessed using logistic regression. Multivariable logistic regression assessed the association between recent drug use and socio-demographic factors and between drug use and sexual risk behaviours, HIV-related and other well-being variables. ResultsThe prevalence of recent drug use increased from 1·5% to 10·0% from 2002 to 2017, driven by increases in cannabis use (1·5% to 7·8%) and use of opioids (0·01% to 1·6%), cocaine (0·02% to 1·8%), or amphetamines (0·1% to 1·5%). In adjusted analyses, male gender, younger age, living in urban areas, mixed-ancestry or white ethnicity (compared to black-African), and unemployment were positively associated with recent drug use. Recent drug use was associated with: multiple sexual partners (adjusted odds ratio [aOR] 2·13, 95% confidence interval [CI]: 1·80–2·51); sexual debut before 15 years old (aOR 1·70, 95%CI: 1·29–2·23); hazardous/harmful alcohol use (aOR 2·50, 95%CI: 2·14–2·93) or alcohol dependence (aOR 3·33, 95%CI 2·92–3·80); ever experiencing intimate partner violence (aOR 1·56, 95%CI 1·12–2·17); psychological distress (aOR 1·53, 95%CI: 1·28–1·82); and lower chance of ever testing for HIV (aOR 0·89, 95%CI 0·80–1·00). Recent drug use was not associated with HIV positivity, condom use or being on antiretroviral therapy. ConclusionIllicit drug use has increased substantially in South Africa and is associated with numerous socio-demographic characteristics, higher sexual risk behaviours and other well-being variables.

Cannabis reduction among adolescents as spillover from successful tobacco control

BackgroundNational programs that reduce adolescent cannabis use warrant renewed attention in light of current discussions to reform cannabis legislation, including the possibility of legalization for recreational use. This study measures the size of a decrease in a country's prevalence of adolescent cannabis use that accompanies a decrease in its prevalence of adolescents who had ever smoked a cigarette. MethodsData are from the European School Survey Project on Alcohol and Other Drugs (ESPAD), which is a collaborative effort of more than 40 European countries to surveil adolescent substance use. This study uses data from the seven survey administrations in 1995, 1999, 2003, 2007, 2011, 2015, and 2019. The main analysis is a fixed-effect regression analysis of country-level, four-year changes in adolescent lifetime cannabis use prevalence on country-level, four-year changes in adolescent lifetime cigarette use prevalence. ResultsDecreases in the national prevalence of adolescents who had ever smoked a cigarette were accompanied by decreases half as large in national prevalence of adolescent lifetime cannabis use. ConclusionFor European countries considering the legalization of adult recreational cannabis use, tobacco control can offer a tool to help counter potential increases in cannabis use among adolescents.

Cannabis use and its association with psychopathological symptoms in a Swiss adult population: a cross-sectional analysis.

As the most commonly used illicit substance, cannabis is gaining global acceptance through increasing legalization efforts. This shift intensifies the need for research to guide policymakers and healthcare providers in harm reduction and treatment strategies. Nonetheless, the relationship between psychopathological symptoms and cannabis use remains inadequately understood. A sample of regular cannabis consumers completed self-reported assessments for depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), Attention-Deficit/Hyperactivity Disorder (ADHD; Adult ADHD Self-Report Scale V1.1), and psychosis (Early Recognition Inventory based on IRAOS) as well as previous black-market cannabis use patterns. Cannabis Use Disorder Identification Test Revised (CUDIT-R) was used to identify cannabis use disorder (CUD). To understand psychopathological symptom load related to cannabis consumption as well as cannabis use motives, multiple regression models were performed to identify psychopathological variables predicting cannabis use frequency and quantity. Linear regression and correlation analyses were conducted, adjusting for relevant covariates (age, gender, education, alcohol, other substance use). Three-hundred-sixty regular cannabis users interested in a study on regulated cannabis access in Basel, Switzerland were examined. In bivariate analysis, cannabis use frequency correlated with depressive (r(358) = 0.16, p = 0.003) and anxiety symptom load (r(358) = 0.11, p = 0.034). Cannabis quantity correlated with depressive (r(358) = 0.15, p = 0.005), ADHD (r(358) = 0.14, p = 0.008), and psychosis symptom load (r(358) = 0.16, p = 0.002). However, in the adjusted regression models only depressive and ADHD symptom loads were significantly associated with cannabis use frequency (p = 0.006 and p = 0.034, respectively) and quantity (p = 0.037 and p = 0.019, respectively). No significant correlations between cannabis consumption and anxiety or psychosis remained after adjustment. ADHD and depressive symptoms correlate with increased cannabis use in a cohort of regular users, suggesting potential self-medication in nonclinical populations. With the rising availability of cannabis worldwide, these results highlight the necessity for longitudinal studies to disentangle the complex dynamics between cannabis consumption and mental health symptoms.