Lifetime Cannabis Use Research Articles

Prospective Associations Between Anxiety Sensitivity, Distress Intolerance, Depressive Symptoms, and Indices of Alcohol and Cannabis Use Among Veterans.

There is substantial evidence linking anxiety sensitivity and distress intolerance to depressive symptoms, and further evidence linking depressive symptoms to alcohol and cannabis use. However, the prospective indirect associations of anxiety sensitivity and distress intolerance with alcohol and cannabis use through depressive symptoms remain uncertain. Thus, the current study examined whether depressive symptoms mediated the associations between anxiety sensitivity and distress intolerance with alcohol and cannabis use frequency, quantity, and problems in a longitudinal sample of veterans. Participants (N = 361; 93% male; 80% White) were military veterans with lifetime cannabis use recruited from a Veterans Health Administration in the Northeastern United States. Eligible veterans completed three semi-annual assessments. Prospective mediation models were used to test for the effects of baseline anxiety sensitivity and distress intolerance on alcohol and cannabis use quantity, frequency and problems at 12 months via depressive symptoms at 6 months. Baseline anxiety sensitivity was positively associated with 12-month alcohol problems. Baseline distress intolerance was positively associated with 12-month cannabis use frequency and quantity. Baseline anxiety sensitivity and distress intolerance significantly predicted increased alcohol problems and cannabis use frequency at 12 months through depressive symptoms at 6 months. There were no significant indirect effects of anxiety sensitivity and distress intolerance on alcohol use frequency or quantity, cannabis use quantity, or cannabis problems. Anxiety sensitivity and distress intolerance share a common pathway to alcohol problems and cannabis use frequency through depressive symptoms. Interventions focused on modulating negative affectivity may reduce cannabis use frequency and alcohol problems.

Cannabis use and psychotic disorders in diverse settings in the Global South: findings from INTREPID II.

Cannabis use has been linked to psychotic disorders but this association has been primarily observed in the Global North. This study investigates patterns of cannabis use and associations with psychoses in three Global South (regions within Latin America, Asia, Africa and Oceania) settings. Case-control study within the International Programme of Research on Psychotic Disorders (INTREPID) II conducted between May 2018 and September 2020. In each setting, we recruited over 200 individuals with an untreated psychosis and individually-matched controls (Kancheepuram India; Ibadan, Nigeria; northern Trinidad). Controls, with no past or current psychotic disorder, were individually-matched to cases by 5-year age group, sex and neighbourhood. Presence of psychotic disorder assessed using the Schedules for Clinical Assessment in Neuropsychiatry and cannabis exposure measured by the World Health Organisation Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Cases reported higher lifetime and frequent cannabis use than controls in each setting. In Trinidad, cannabis use was associated with increased odds of psychotic disorder: lifetime cannabis use (adj. OR 1.58, 95% CI 0.99-2.53); frequent cannabis use (adj. OR 1.99, 95% CI 1.10-3.60); cannabis dependency (as measured by high ASSIST score) (adj. OR 4.70, 95% CI 1.77-12.47), early age of first use (adj. OR 1.83, 95% CI 1.03-3.27). Cannabis use in the other two settings was too rare to examine associations. In line with previous studies, we found associations between cannabis use and the occurrence and age of onset of psychoses in Trinidad. These findings have implications for strategies for prevention of psychosis.

Cannabis use in sub-Saharan Africa: A systematic review and meta-analysis.

The most available data on the prevalence of cannabis use come from population surveys conducted in high-income countries in North America, Oceania and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population-level cannabis use in sub-Saharan Africa since 2010. A comprehensive search was conducted in PubMed, EMBASE, PsycINFO and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to 'substance', 'Substance-Related Disorders' and 'Prevalence' and 'Africa South of the Sahara' were used. Studies that reported cannabis use in the general population were selected, while studies from clinical populations and high-risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10-17 years) and adults (≥ 18 years) in sub-Saharan Africa were extracted. The study included 53 studies for the quantitative meta-analysis and included 13 239 participants. Among adolescents, the life-time, 12-month and 6-month prevalence of cannabis use were 7.9% [95% confidence interval (CI) = 5.4-10.9%], 5.2% (95% CI = 1.7-10.3%) and 4.5% (95% CI = 3.3-5.8%), respectively. The corresponding life-time, 12-month and 6-month prevalence of cannabis use among adults were 12.6% (95% CI = 6.1-21.2%), 2.2% (95% CI = 1.7-2.7%, with data only available from Tanzania and Uganda) and 4.7% (95% CI = 3.3-6.4%), respectively. The male-to-female life-time cannabis use relative risk was 1.90 (95% CI = 1.25-2.98) among adolescents and 1.67 (CI = 0.63-4.39) among adults. Life-time cannabis use prevalence in sub-Saharan Africa appears to be approximately 12% for adults and just under 8% for adolescents.

Cannabis Use Is Associated With Depression Severity and Suicidality in the National Comorbidity Survey−Adolescent Supplement

To investigate the association of cannabis use with major depression and suicidal behavior in adolescence. Data are from the National Comorbidity Survey-Adolescent Supplement , a nationally representative survey of adolescents aged 13 to 18 years. Weighted logistic regression and ordinal regression analyses of major depression and suicidal behavior outcomes were conducted on cannabis variables, incorporating sociodemographic characteristics. Adolescents with lifetime cannabis use have 2.07 times higher odds of mild/moderate (adjusted odds ratio [aOR]; 95% ) and 3.32 times higher odds of severe major depressive disorder (MDD; aOR; 95% ). Cannabis use (aOR 6.90, 95% ), mild/moderate MDD (aOR 4.10, 95% ), and severe MDD (aOR 13.97, 95% CI = 7.59, 25.70) were associated with higher odds of suicide attempt. Past 12-month cannabis use (aOR 3.70, 95% CI = 2.16, 6.32), mild/moderate major depressive episodes (MDE) (aOR 7.85, 95% ), and severe MDE (aOR 36.36, 95% ) were associated with higher odds of suicide attempt. The frequency of past 12-month cannabis use was associated with higher odds of suicide attempt and with MDE severity, with higher odds among individuals who use cannabis 3 or more days than among individuals who use cannabis less frequently, suggesting a dose effect. Among cannabis users, older age of onset of cannabis use was associated with lower odds of suicidal behaviors. Cannabis use is associated with higher odds of depression and depression severity in adolescence. Furthermore, depression and cannabis use are independently associated with higher odds of suicide attempt. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

Effect of D2R, NMDAR and CB1R genetic variants associated with cannabis use and childhood trauma in first-episode psychosis in a Brazilian population

IntroductionGene-environment interactions increase psychosis risk (Gayer-Anderson et al. Soc Psychiatry Psychiatr Epidemiol 2020; 55(5):645-657). However, identifying the genetic variants involved and how they interact with environmental risk factors underlying psychosis remains challenging.ObjectivesTo investigate whether there are gene-environment interactions in the relationships of childhood trauma, lifetime cannabis use, and single nucleotide variants (SNVs) of dopamine D2 receptor (D2R: DRD2), N-methyl-d-aspartate receptor (NMDAR: GRIN1, GRIN2A and GRIN2B) and cannabinoid receptor type 1 (CB1R: CNR1) with psychosis.MethodsIn a population-based case-control study nested in an incident study (STREAM, Brazil) (Del-Ben et al. Br J of Psychiatry 2019; 215(6):726-729), part of the EU-GEI consortium (Gayer-Anderson et al. Soc Psychiatry Psychiatr Epidemiol 2020; 55(5):645-657), 143 first-episode psychosis patients and 286 community-based controls of both sexes aged between 16 and 64 years were included over a period of 3 years. Twenty-three SNVs of D2R (rs1799978, rs7131056, rs6275), NMDAR (GRIN1: rs4880213, rs11146020; GRIN2A: rs1420040, rs11866328; GRIN2B: rs890, rs2098469, rs7298664), and CB1R genes (CNR1: rs806380, rs806379, rs1049353, rs6454674, rs1535255, rs2023239, rs12720071, rs6928499, rs806374, rs7766029, rs806378, rs10485170, rs9450898), were genotyped from peripheral blood DNA using a custom Illumina HumanCoreExome-24 BeadChip. Environmental adversities were evaluated using the Cannabis Experience Questionnaire (Di Forti et al. The Lancet Psychiatry 2009; 6(5):427–436) and the Childhood Trauma Questionnaire (Grassi-Oliveira et al. Rev Saude Publica 2006; 40(2):249-55). Associations between SNVs and environmental risk factors were performed using the nonparametric multifactor dimensionality reduction software (version 3.0.2).ResultsSingle locus analysis showed no association among the 23 SNVs with psychosis; however, gene-environment analysis was significant for the polymorphic loci rs12720071 and rs7766029 in CNR1. The best association models were the two-factor representing by the combination of CNR1 rs12720071 with lifetime cannabis use (p<0.001), and CNR1 rs12720071 with childhood trauma (p<0.05), both suggesting an increased risk of psychosis. Additionally, when considering the interaction of both environmental factors in the same model, we found CNR1 rs7766029 to be associated with psychosis (p<0.001).ConclusionsOur study supports the hypothesis of gene-environment interactions for psychosis involving the T allele carriers of CNR1 SNVs (rs12720071 and rs7766029), childhood trauma and lifetime cannabis use in psychosis.Disclosure of InterestNone Declared

Association between cannabis use and ten-year estimated atherosclerotic cardiovascular disease risk in a middle-aged population survey

BackgroundThe association between cardiovascular (CV) risk and cannabis use remains inconsistent. The purpose of this study was to examine sex stratified associations of the different lifetime aspects of cannabis use and estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk levels among the general UK Biobank population. MethodsAmong 104,092 volunteers of the UK Biobank population, cannabis use status was assessed by questionnaire and range as heavy, moderate, low, and never users. Associations between cannabis use and ASCVD risk were estimated using multiple regressions. ResultsMales presented a higher estimated 10-year ASCVD risk compared to females (7.96% vs. 2.24%, p < 0.001) and a higher proportion of heavy lifetime cannabis users (4.00% vs 2.01%, p < 0.001). In all covariate adjusted models, lifetime heavy cannabis use was associated with an increase in estimated 10-year ASCVD risk in both males and females, but with a higher effect among males (in males, B = 0.51 (0.34; 068), in females, B = 0.14 (0.05; 0.23)). When considering high estimated 10-year ASCVD risk (superior to 7.5%), similar results were observed, in males, OR=2.14 [1.82–2.51] and in females: OR=2.07 [1.35–3.17]). The current consumption of cannabis was associated with increased ASCVD risk in both males and females (p < 0.001). When considering the overall population, a significant interaction was observed between sex and cannabis use (p < 0.001). ConclusionA positive association between estimated 10-year ASCVD risk and heavy lifetime cannabis use was observed but this was higher in males. Longitudinal studies are needed in general populations to highlight the causal effects of cannabis on the atherosclerosis process.

Association between lifetime cannabis use and arterial stiffness in a middle-aged general population.

No studies have investigated the association between arterial stiffness index (ASI) and cannabis use. The purpose of this study is to examine sex-stratified associations of cannabis use and ASI levels in a middle-aged general population. Cannabis use of 46 219 volunteers of the middle-aged UK Biobank population was assessed by questionnaire and investigates several aspects of cannabis use (lifetime, frequency and current status). Associations between cannabis use and ASI were estimated using sex multiple linear regressions. Covariates were tobacco status, diabetes dyslipidaemia, alcohol status, BMI categories, hypertension, mean blood pressure and heart rate. Men presented higher ASI levels compared with women (respectively, 9.826 vs. 8.578 m/s, P < 0.001), a higher heavy lifetime cannabis users (4.0 vs. 1.9%, P < 0.001), higher current cannabis users (3.1 vs. 1.7%, P < 0.001), higher current smokers (8.4 vs. 5.8%, P < 0.001) and higher alcohol users (95.6 vs. 93.4%, P < 0.001). After adjustment for all covariates in sex models, heavy lifetime cannabis users were associated with higher ASI levels in men [b = 0.19, 95% confidence interval (0.02; 0.35)] but not in women [b = -0.02 (-0.23; 0.19)]. Current cannabis users were associated with higher ASI levels in men [b = 0.17 (0.01; 0.32)] but not in women [b = -0.01 (-0.20; 0.18)] and among cannabis users, every day frequency was associated with increased ASI levels in men [b = 0.29 (0.07; 0.51)] but not in women [b = 0.10 (-0.17; 0.37)]. The observed association between cannabis use and ASI could participate in accurate and appropriate cardiovascular risk reduction strategies among cannabis users.

After school: Volunteering in community emergency services and substance use among Israeli adolescents

AbstractVolunteering can serve as a protective factor against substance abuse. Yet, it is unclear whether volunteering in specific community organizations, such as emergency services, promotes or protects against substance use. We aimed to (1) describe community volunteering characteristics among adolescents; (2) investigate differences in the prevalence of substance use according to community volunteering type; and (3) determine whether volunteering type was a predictor of substance use. We analyzed data from the 2018–2019 Health Behavior in School‐aged Children survey among Israeli adolescents aged 11–17 years (N = 3972). Most participants (N = 2452; 61.7%) did not volunteer at all, 27.1% (N = 1077) volunteered in youth movements/councils, and 11.2% (N = 443) volunteered in community emergency services. In comparison to the emergency services group, there was a higher volunteering frequency among the youth movements/councils group. Of the three groups (nonvolunteering, volunteering in youth movements/councils, and volunteering in community emergency services), those in the community emergency services group reported a significantly higher prevalence of weekly alcohol use, lifetime cannabis use, and new psychoactive drug use, while no significant between‐group differences were observed in smoking tobacco prevalence. Volunteering in the community emergency services has been linked to substance use, requiring the development of intervention programs by the school staff, before their active volunteering (e.g., guidance on emotional stress and substance abuse). Also, teachers can act as a protective factor for students, and identify emotional distress and anxiety in their students to prevent substance abuse. Furthermore, emergency services workers and instructors should also be aware of the higher risk of substance use among volunteering youth and should be given tools to better collaborate with parents and teachers in dealing with it.

Cannabis use and episodic memory performance among adolescents: Moderating effects of depression symptoms and sex.

Cannabis use has been linked to poorer episodic memory. However, little is known about whether depression and sex may interact as potential moderators of this association, particularly among adolescents. The current study addresses this by examining interactions between depression symptoms and sex on the association between cannabis use and episodic memory in a large sample of adolescents. Cross-sectional data from 360 adolescents (M age = 17.38, SD = .75) were analyzed at the final assessment wave of a two-year longitudinal study. We used the Drug Use History Questionnaire to assess for lifetime cannabis use, and the Computerized Diagnostic Interview Schedule for Children, Fourth edition to assess the number of depression symptoms in the past year. Subtests from the Wechsler Memory Scale, Fourth Edition and the California Verbal Learning Test, Second Edition were used to assess episodic memory performance. The effect of the three-way interaction among cannabis use, depression symptoms, and sex did not have a significant impact on episodic memory performance. However, follow-up analyses revealed a significant effect of the two-way interaction of cannabis use and depression symptoms on episodic memory, such that associations between cannabis use and episodic memory were only significant at lower and average levels of depression symptoms. Contrary to our hypotheses, we found that as depression symptoms increased, the negative association between cannabis use and episodic memory diminished. Given the use of a predominantly subsyndromic sample, future studies should attempt to replicate findings among individuals with more severe depression.

Expanded Adverse Childhood Experiences (ACEs) and Adult Cannabis Use: A Latent Class Analysis.

In addition to traditionally assessed abuse, neglect, and household dysfunction, adverse childhood experiences (ACEs) include adversities like racial discrimination, community violence, and bullying. Prior research established associations between the original ACEs and substance use, but few used Latent Class Analysis (LCA) to examine patterns of ACEs. Examining patterns of ACEs may yield additional insights beyond cumulative risk studies focusing only on the number of different ACEs experiences. Therefore, we identified associations between latent classes of ACEs and cannabis use. Studies on ACES rarely examine cannabis use outcomes, which is important as cannabis remains one of the most commonly used substances and is associated with negative effects on health. Yet it is still unclear how ACEs influence cannabis use. Participants were adults in Illinois (n = 712) recruited through Qualtrics' online quota-sampling method. They completed measures of 14 ACEs, past 30-day and lifetime cannabis use, medical cannabis use (DFACQ) and probable cannabis use disorders (CUDIT-R-SF). Latent class analyses were performed using ACEs. We identified four classes, labeled: Low Adversity, Interpersonal Harm, Interpersonal Abuse and Harm, and High Adversity. The largest effect sizes (p<.05) were observed for those in the High Adversity class, who had elevated risks for lifetime (OR =6.2), 30-day (OR = 5.05), and medicinal cannabis use (OR = 17.9) relative to those in the Low Adversity class. Those in the Interpersonal Abuse and Harm and Interpersonal Harm classes also had increased odds (p<.05) for lifetime (OR =2.44/OR=2.82), 30-day (OR = 4.88/OR= 2.53), and medicinal cannabis use (OR = 2.59/OR =1.67(ns)) relative to those in the Low Adversity class. However, no class with elevated ACEs had higher odds for CUD relative to the Low Adversity class. Additional research could further disentangle these findings using extensive measures of CUD. Additionally, as participants in the High Adversity class had higher odds of medicinal cannabis use, future research could carefully study their consumption patterns.

Mental health and cannabis use among Canadian youth: Integrated findings from cross-sectional and longitudinal analyses.

Using data from two methodologically independent youth research studies in Canada, the Health Behaviour in School-aged Children (HBSC) study and the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study, the objective of this study was to compare associations between youth's mental health and cannabis use across samples. Using similar indicators in both studies, our goal was to affirm the potential for nationally representative cross-sectional analyses (HBSC) to replicate findings found in a longitudinal non-representative data source (COMPASS), enhancing opportunity for causal inferences. Data were collected from grade 9 and 10 Canadian students participating in the 2017/18 HBSC (n=8462) and 2017/18 to 2018/19 waves of COMPASS (n=32,023). Using multivariable Poisson regression models, the strength and statistical significance of the effects of mental health indicators on cannabis use outcomes were estimated within both studies and compared for consistency. Using a 2-year linked sample of students participating in COMPASS, models examining the impact of mental health indicators on cannabis use initiation and maintenance over time were similarly fit using Poisson regression to estimate relative risk. Similar associations between mental health problems and cannabis use were observed in both data sources. The direction, magnitude, and precision of the estimates for restless sleep, loneliness, poor wellbeing, and cannabis use were highly comparable across both studies. Worse mental health was consistently associated with current and lifetime cannabis use among youth. Cross-sectional and longitudinal findings from two large methodologically diverse studies in Canada demonstrate a replicable association between indicators of mental health and youth cannabis use. Similarities were identified and two generalizations may be concluded: 1) potentially causal etiological relationships inferred from HBSC data were supported in longitudinal findings based on COMPASS, and 2) longitudinal COMPASS data aligns with nationally representative data from HBSC.

Longitudinal associations between age 20 problematic substance use and opioid use disorder incidence at age 30 – findings from an urban cohort

This study used data from a longitudinal prevention study in an urban cohort to examine associations between nicotine dependence, alcohol, and cannabis use disorder and disorder criteria at age 20, with opioid use disorder (OUD) incidence or criteria onset by age 30. The study sample included 1408 participants (57.5% female, 72.5% African American) drawn from two cohorts of participants in a mid-Atlantic region of the U.S. as part of a series of randomized controlled trials of elementary school-based universal prevention interventions. Lifetime cannabis use disorder (CUD), alcohol use disorder (AUD; both DSM-IV), and current nicotine dependence (Fagerstrom Test for Nicotine Dependence, FTND) assessed at age 20 were used to predict (1) DSM-IV lifetime OUD at age 30, and (2) OUD criteria between ages 20 and 30 in multivariable logistic regression models. Covariates for all analyses included sociodemographics (sex, race, and free/reduced-priced lunch status), community disadvantage, and intervention status. Nicotine dependence (FTND≥3) at age 20 predicted age 30 DSM-IV lifetime OUD (aOR = 2.37; 95% CI 1.02,5.54). The number of CUD criteria (aOR = 1.30; 95% CI 1.09,1.57) and nicotine dependence severity scores (aOR = 1.22; 95% CI = 1.05,1.41) at age 20 predicted any OUD criteria between the ages of 20 and 30. Findings are consistent with previous research on opioid use behavior in young adulthood and suggest that nicotine dependence and CUD criteria among urban young people predict onset of OUD and OUD criteria in young adulthood.

Early-onset smoking and vaping of cannabis: Prevalence, correlates and trends in New Zealand 14-15-year-olds.

Initiating cannabis use at an early age elevates risk of harm. Cannabis vaping is an emerging issue, and it is unknown whether the patterning and correlates of early-onset cannabis vaping differ from those of cannabis smoking. We used repeat cross-sectional data from a nationally representative biennial survey (2012-2018) of students aged 14-15 years in New Zealand (N=11,405), response rate 65% (2012), 64% (2014-2016) and 59% (2018). Between 2012 and 2018 lifetime cannabis use decreased, but regular use (past month, weekly, daily) was stable. Prevalence of past month, weekly and daily use in 2016-2018 (pooled) was 8.6%, 3.4% and 1.5%, respectively. Cannabis vaping was reported by 24% of past month cannabis users. The demographic profile of early-onset cannabis smokers and vapers was similar, with elevated use of both modes among Māori (Indigenous), same- or both-sex attracted students and those in low decile (high-deprivation) schools. Correlates were similar for both modes. Cannabis use was strongly associated with tobacco and alcohol use. The next strongest associations (after adjustment) were exposure to second-hand smoke at home, student income >$50/week and low parental monitoring of whereabouts. Past week social media use, psychological distress and low parental monitoring of spending were also associated with both modes. Early-onset cannabis use is much higher in structurally disadvantaged groups, and among those who use tobacco and alcohol. Comprehensive multisubstance approaches to prevention are indicated in this age group. Efforts to reduce socio-economic inequity and exposure to other risk factors may reduce cannabis-related harm.

Patterns of polysubstance use and clinical comorbidity among persons seeking substance use treatment: An observational study

IntroductionPolysubstance use is common among individuals seeking treatment for substance use disorders (SUD). However, we know less about patterns and correlates of polysubstance use among treatment-seeking populations. The current study aimed to identify latent patterns of polysubstance use and associated risk factors in persons entering SUD treatment. MethodsPatients (N = 28,526) being admitted for substance use treatment reported on their use of thirteen substances (e.g., alcohol, cannabis, cocaine, amphetamines, methamphetamines, other stimulants, heroin, other opioids, benzodiazepines, inhalants, synthetics, hallucinogens, and club drugs) in the month before treatment and prior to the month before treatment. Latent class analysis (LCA) determined the relationship between class membership and gender, age, employment status, unstable housing, self-harm, overdose, past treatment, depression, generalized anxiety disorder, and/or post-traumatic stress disorder (PTSD). ResultsIdentified classes included: 1) Alcohol primary, 2) Moderate probability of past-month alcohol, cannabis, and/or opioid use; 3) Alcohol primary, Lifetime cannabis and cocaine use; 4) Opioid primary, Lifetime use of alcohol, cannabis, hallucinogens, club drugs, amphetamines, and cocaine; 5) Moderate probability of past-month alcohol, cannabis, and/or opioid use, Lifetime use of various substances; 6) Alcohol and cannabis primary, Lifetime use of various substances; and 7) High past-month polysubstance use. Individuals who engaged in past-month polysubstance use attended to face elevated risk of screening positive for recent unstable housing, unemployment, depression, anxiety, PTSD, self-harm, and overdose. ConclusionsCurrent polysubstance use is associated with significant clinical complexity. Tailored treatments that reduce harms resulting from polysubstance use and related psychiatric comorbidity may improve treatment outcomes in this population.

Lifetime cannabis use and childhood trauma associated with CNR1 genetic variants increase the risk of psychosis: findings from the STREAM study.

Gene-environment interactions increase the risk of psychosis. The objective of this study was to investigate gene-gene and gene-environment interactions in psychosis, including single nucleotide variants (SNVs) of dopamine-2 receptor (D2R), N-methyl-d-aspartate receptor (NMDAR), and cannabinoid receptor type 1 (CB1R), lifetime cannabis use, and childhood trauma. Twenty-three SNVs of genes encoding D2R (DRD2: rs1799978, rs7131056, rs6275), NMDAR (GRIN1: rs4880213, rs11146020; GRIN2A: rs1420040, rs11866328; GRIN2B: rs890, rs2098469, rs7298664), and CB1R (CNR1: rs806380, rs806379, rs1049353, rs6454674, rs1535255, rs2023239, rs12720071, rs6928499, rs806374, rs7766029, rs806378, rs10485170, rs9450898) were genotyped in 143 first-episode psychosis patients (FEPp) and 286 community-based controls by Illumina HumanCoreExome-24 BeadChip. Gene-gene and gene-environment associations were assessed using nonparametric Multifactor Dimensionality Reduction software. Single-locus analyses among the 23 SNVs for psychosis and gene-gene interactions were not significant (p > 0.05 for all comparisons); however, both environmental risk factors showed an association with psychosis (p < 0.001). Moreover, gene-environment interactions were significant for an SNV in CNR1 and cannabis use. The best-performing model was the combination of CNR1 rs12720071 and lifetime cannabis use (p < 0.001), suggesting an increased risk of psychosis. Our study supports the hypothesis of gene-environment interactions for psychosis involving T-allele carriers of CNR1 SNVs, childhood trauma, and cannabis use.

Genetic support of a causal relationship between cannabis use and educational attainment: a two-sample Mendelian randomization study of European ancestry.

Excessive cannabis use may lead to lower educational attainment. However, this association may be due to confounders and reverse causality. We tested the potential causal relationship between cannabis use disorder (CUD) or life-time cannabis use (LCU) and educational attainment. Bidirectional two-sample Mendelian randomization (MR) study was conducted. Our primary method was inverse-variance weighted (IVW) MR, with a series of sensitivity analyses. Multivariable MR (MVMR) was performed to estimate any direct effect independent of intelligence, smoking initiation or attention deficit hyperactivity disorder (ADHD). European ancestry individuals. The sample sizes of the genome-wide association study ranged from 55 374 to 632 802 participants. Genetic variants of CUD, LCU or educational attainment. Using univariable MR, we found evidence of a potential causal effect of genetic liability to CUD on a lower educational attainment [MR, 95% confidence interval (CI)inverse variance weighted (IVW) = -1.2month (-1.9month, -0.5month); P = 0.0008]. However, we found no evidence of an effect of genetic liability to LCU on educational attainment [MR, 95% CIIVW = 0.5month (-1.5month, 2.6month), P = 0.6032]. Reverse direction analysis suggested that genetic liability to higher educational attainment had a potential causal effect on lower risk of CUD [odds ratio (OR), 95% CIIVW = 0.39 (0.29, 0.52), P = 1.69 × 10-10 ]. We also found evidence of potential causal effect from genetic liability to higher educational attainment to higher risk of LCU [OR, 95% CIIVW = 1.35 (1.11, 1.66), P = 0.0033]. Genetic liability to cannabis use disorder may lead to lower educational attainment. Genetic liability to higher educational attainment may also lead to higher life-time cannabis use risk and lower cannabis use disorder risk. However, the bidirectional effect between cannabis use disorder and educational attainment may be due to shared risk factors (e.g. attention-deficit hyperactivity disorder).

The intersection of neighborhood and race in urban adolescent health risk behaviors.

Racial variability in associations of neighborhood socioeconomic disadvantage and neighborhood disorder with adolescent health risk behaviors remains under-researched, which this study examined over 1 year among racially diverse adolescents. High school students (N = 345; 18% Asian, 44% Black, 16% Multiracial, 22% White) completed surveys assessing neighborhood socioeconomic disadvantage and neighborhood disorder, and health risk behaviors (lifetime alcohol, cannabis, and cigarette use, number of sexual partners) at baseline (Year 1) and 1-year follow-up (Year 2). Asian, Black, and Multiracial adolescents were more likely to endorse health risk behaviors in Year 2 compared to White adolescents living in similarly disadvantaged neighborhoods at Year 1. Associations of neighborhood disorder with health risk behavior did not differ by race. Neighborhood socioeconomic disadvantage (but not neighborhood disorder) may predispose Asian, Black, and Multiracial adolescents to health risk behaviors. Findings may inform interventions to address racial disparities in adolescent health risk behaviors.

Associations between Oral Health and Cannabis Use among Adolescents and Young Adults: Implications for Orthodontists.

Cannabis use is prevalent among adolescents and young adults in the US. Virtually all modes of cannabis consumption involve the oral cavity, and previous studies have linked cannabis use with poorer oral health. We sought to identify associations between cannabis use and various oral health outcomes and behaviors among individuals 12-25 years of age, and to discuss implications for orthodontists who largely interact with this age group over an extended period of treatment time. We examined data from patient electronic health records (N = 14,657) obtained between 2015 and 2021. Associations between lifetime and current self-reported cannabis use and several oral health outcomes or related behaviors that reflect periodontal health, caries status, oral lesions, and physical integrity of tooth structure and restorations were examined in a bivariable and multivariable manner, controlling for patient age, sex, and self-reported tobacco and alcohol use. Reporting lifetime cannabis use was associated with higher risk for having oral lesions (aPR = 1.41, 95% CI: 1.07-1.85), bruxism (aPR = 1.31, 95% CI: 1.09-1.58), and frequent consumption of sugary beverages and snacks (aPR = 1.27, 95% CI: 1.12-1.41). Reporting current cannabis use was associated with higher risk for oral lesions (aPR = 1.45, 95% CI: 1.03-2.06) and frequent consumption of sugary beverages and snacks (aPR = 1.26, 95% CI: 1.07-1.48). Cannabis users aged 12-25 are at increased risk for bruxism, oral lesions, and frequent consumption of sugary beverages and snacks. Orthodontists and other dental professionals should probe for drug use and be cognizant of increased risk for oral health problems in patients that report actively using cannabis.

Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa.

There is a high prevalence of cannabis use in patients with schizophrenia spectrum and other psychotic disorders, with comorbid cannabis use in this population being associated with poorer long-term outcomes. To determine the prevalence of cannabis use in patients with a schizophrenia spectrum and other psychotic disorders. The study was conducted at a psychiatric hospital in Durban, KwaZulu-Natal Province, South Africa. A review of clinical records of patients admitted to the hospital for the period, June 2018 to June 2020, was conducted. A total of 370 clinical records were reviewed, of which 48.9% reported current and 51.1% lifetime cannabis use. Being male was significantly associated with current and lifetime cannabis use (OR = 4.90, 95% CI 2.49-9.62 and OR = 6.27, 95% CI 3.28-11.95, respectively). Current alcohol use was also associated with current cannabis use (CCU) (OR = 3.06, 95% CI 1.78-5.28), and age 45 years and older was associated with a lower odds of cannabis use (OR = 0.30, 95% CI 0.09-0.96). Forty-eight per cent of participants were admitted three or more times, and readmission was associated with cannabis use (p = 0.01). There was a lack of association between cannabis use, readmission and human immunodeficiency virus (HIV) status, after controlling for variables such as alcohol use and gender. Almost 50% of people admitted with schizophrenia spectrum and other psychotic disorders have comorbid current and lifetime cannabis use. There is a need for dual diagnosis units to address comorbid substance use in people with psychotic disorders, as it leads to poorer outcomes. The study found that there is a high prevalence of cannabis use in people with psychosis. Therefore, it is imperative that we revise treatment programs in our psychiatric units and there is an urgent need for dual diagnosis programs that address substance use in this group of patients.

Cannabis use in Tunisian adolescents: Alarming trends from 2013 to 2021

Abstract Background Cannabis is the most widely used illicit psychoactive substance worldwide. In Tunisia, the prevalence of cannabis use and its association with other risky behaviours were reported in several publications interesting mainly early adolescence. However, no publications exploring trends based on national epidemiological data are available yet. Our purpose was to determine cannabis prevalence in Tunisian high school adolescents and assess significant trends from 2013 to 2021. Methods Pooled data from Mediterranean school surveys on alcohol and other drugs conducted in 2013, 2017, and 2021, were used. Based on three-stage stratification sampling method, first and second grade secondary education students were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Self-administered standardized questionnaire was used in data collection. We studied weighted lifetime prevalence of cannabis use and chi square test for trend was used for global, by gender and by sector (private/public) trends assessement. STATA software was used for statistical analysis. Results A total of 14.723 students were enrolled with sex ratio (M/F) equal to 0.61 and mean age of 16.2±0.8 years. The prevalence of cannabis use increased from 1.4%, to 3.8% then to 7.9% for 2013, 2017 and 2021 respectively. Trend assessement concludes to significant increase in overall cannabis use (p &amp;lt; 10-3). Besides, there was a significant increase in both public and private schools, and among both boys and girls. However, the greatest increase was among male students (3.5% in 2013, 9.2% in 2017 and 16.1% in 2021) (p &amp;lt; 10-3). Conclusions Despite the reinforcement of restrictive legislative measures, the prevalence of cannabis use among Tunisian high school adolescents is significantly increasing. Moreover, it’s important to further investigate problematic cannabis use and its effects on adolescents’ physical and mental health. Key messages • Trend assessement confirmed the significant increase in lifetime cannabis use in high school adolescents in Tunisia, for both sexes and for both private and public sector. • This alarming public health issue requires urgent legislation review and close multisectoral collaboration to control supply and demand.