Lifetime Prevalence Of Cannabis Use Research Articles

Alerta Cannabis: A Tailored-Computer Web-Based Program for the Prevention of Cannabis Use in Adolescents: A Cluster-Randomized Controlled Trial Protocol

BackgroundThe growing use of cannabis in adolescence is a public health problem that must be addressed through prevention. In Spain, the average age of initiation of cannabis use in the adolescent population is 14.8 years. At 14 years, the lifetime prevalence of cannabis use is 11.7%, which increases to 51.,5% at the age of 18; the prevalence of cannabis use in the population aged 14 to 18 years is 28.6%, a figure that must be tried to reduce, that is why this school prevention program is proposed: Alerta Cannabis.MethodsThe Alerta Cannabis research project consists of design, implementation, and evaluation. In the first phase, a computer-tailored eHealth program (Alerta Cannabis) is developed based on the I-Change Model, an integrated model based on three main behavioral change processes: awareness, motivation, and action. This program consists of four 30-minute sessions that will provide culturally adapted and personalized advice to motivate students not to use cannabis through text feedback, animations, and gamification techniques. This phase will also include usability testing. In the implementation phase, secondary school students from Western Andalusia, Spain (Seville, Cádiz, Huelva, and Córdoba) and Eastern Andalusia (Jaén, Málaga, and Granada) will be randomized to an experimental condition (EC) or a control condition (CC) for a cluster randomized clinical trial (CRCT). Each condition will have 35 classes within 8 schools. GI will receive the online intervention Alerta Cannabis. EC and CC will have to fill out a questionnaire at baseline, six months, and twelve months of follow-up. In the last phase, the effect of Alerta Cannabis is evaluated. The primary outcomes are the lifetime prevalence of cannabis use and its use in the last 30 days and at 6 months. At 12 months of follow-up, the prevalence in the last 12 months will also be assessed. The secondary outcome is the intention to use cannabis.DiscussionThe study tests the effect of the innovative program specifically aimed to reduce the use of cannabis in the adolescent population through eHealth in Spain. The findings aim to develop and implement evidence-based cannabis prevention interventions, which could support school prevention, for instance, the assistance of school nurses. If the program proves to be effective, it could be useful to prevent cannabis use on a national and international scale.Trial registrationNCT05849636. Date of registration: March 16, 2023.

Brooklyn District Branch Honors Residents for Outstanding Research

Back to table of contents Previous article Next article APA & MeetingsFull AccessBrooklyn District Branch Honors Residents for Outstanding ResearchMark MoranMark MoranSearch for more papers by this authorPublished Online:4 May 2023https://doi.org/10.1176/appi.pn.2023.06.6.24aKunal Gandhi, M.D., of Brookdale University Hospital Medical Center received first prize for his oral presentation titled “Is Cannabis a Gateway Drug? A Retrospective Analysis of American Adolescents” at the Brooklyn Psychiatric Society Resident Scholarly Presentation Competition. His colleagues on the project were fellow trainees Nishat Kulkarni, M.D., and Saral Desai, M.D.The team analyzed 2019 data from the CDC’s Youth Risk Behavior Surveillance System to identify the prevalence of lifetime cannabis use among American adolescents, the prevalence of co-occurring substance use, and the odds of co-occurring substance use among participants with any lifetime cannabis use. They found that cannabis use was correlated with increased odds of ever using certain substances such as alcohol, tobacco, hallucinogens, and stimulants but was not correlated with increased odds of ever using opiates or injection drugs.Other oral presentations were by Galen Ballentine, M.D., of SUNY Downstate, Gabriela Arth, M.D., of Maimonides Medical Center, and Stanley Nkemjika, M.D., M.P.H., of Interfaith Medical Center.First prize for a poster presentation was awarded to Kelvin Oke, M.D., of Interfaith Medical Center for his research on “Adolescent Crimes: Association of Multiple Substance Use With Arrests Among Adolescents.” His colleagues on the project were Christian Nwabueze, M.D., Dr.P.H., Sana Kazi, M.D., Muhammad Azam, M.D., Bamidele Johnson, M.D., Ph.D., Jacky Petion, M.D., and Ayodeji Jolayemi, M.D.Oke and colleagues analyzed 2018 data from the Treatment Episode Data Set—Admission (TEDS-A), a national data system of annual admissions to, and discharges from, substance use treatment facilities.They looked at the association between multiple substance use in the past 30 days and criminal arrest within that same period. Multiple substance use is defined as use of at least one illicit drug (cocaine, heroin, hallucinogens, methamphetamines, and inhalants), and alcohol or marijuana or both.They found that use of multiple substances was associated with higher odds of arrests than the use of a single substance.Also presenting posters were Nishat Kulkarni, M.D., of Brookdale University Hospital Medical Center; Megan Hophing, M.D., of Maimonides Medical Center; and Hagar Kandel, M.B.B.Ch., of SUNY Downstate. ■ ISSUES NewArchived

The relevance of patterns of use: A survey to assess cannabis use related harm.

Lifetime prevalence of cannabis use is estimated 192 million adults worldwide (2017) and has increased by 16% in the last decade. However, data on quantity and frequency of use that can lead to harm is lacking. We have developed a survey to assess patterns of cannabis use and related harms in a sample of cannabis users. This paper focuses on evaluating the feasibility of the survey and the users' satisfaction in a pilot sample. Forty cannabis users were recruited (>18 years old, living in Spain, cannabis use at least once during the last 12 months) between December 2018 and January 2019. Participants answered an online survey (mental health, organic harm and injury) and an ad hoc questionnaire to assess accessibility, feasibility, satisfaction, design and content appropriateness. Of the participants, 93.23% (n = 37.3) were satisfied with the design, 94.92% (n = 38.2) were satisfied with the content, and 94.73% (n = 37.0) were satisfied with the accessibility of the survey; only minor changes were required to improve feasibility and accessibility. Participants used a median of 1.0 Standard Joint Unit per day (Interquartile Range [IQR] 1.0-2.0). Of the sample, 92.5% reported at least one related harm and suffers a median of 4.0 disorders (IQR, 1.25-5.0). The present study allows for designing a feasible online survey to conduct a cross-sectional study with a larger sample.

Cannabis use in Tunisian high school adolescents: MedSPAD 2021

IntroductionCannabis use is wrongly deemed “safe” by teenagers worldwide, despite its increased tetrahydrocannabinoids content and its psychosocial and cognitive harmful effectts.ObjectivesWe aimed to estimate the prevalence of cannabis use, identify associated factors among Tunisian adolescents and assess the risk of problem cannabis use among users.MethodsThe 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD) is a national survey, targeting Tunisian high school adolescents aged 16 to 18 years.Based on a self-administered questionnaire, adolescents were asked about their engagement in several risky behaviours including cannabis use. The 6-item Cannabis Abuse Screening Test (CAST) was intended for users to assess the risk of problem cannabis use.Binary logistic regression was performed to identify factors associated to cannabis use and Adjusted Odds Ratios (AORs) were presented with correspondent 95% confidence intervals (CI). Cspro and STATA software were used for data entry and analysis respectively.ResultsAmong 6201 participants (girls: 60.4%), lifetime prevalence of cannabis use was 7.9% ,95% CI [7.0, 8.9] significantly higher among boys (16.1 % Vs. 2.5 % in girls, p<10-4). Early onset (at 13 or younger) was reported by 8.6% of users.Multivariate analysis showed that cannabis use was more prevalent in Tunis district(p=0.04), and significantly associated to alcohol, tobacco and electronic-cigarettes use (AOR of 6.2, 4.2 and 2.6 respectively, p<10-3). Absenteeism for non-medical reasons and nights spent away from home were also independent factors significantly associated with cannabis use (p<10-3).The CAST indicated a high risk of cannabis-use-related problems in 67.2% of respondents (n=223).ConclusionsCannabis use is increasingly common in Tunisian adolescents. Moreover, the alarming risk of problem cannabis use warrant the urgent need for school-based interventions and screening programs to prevent and control cannabis use especially among vulnerable subgroups.Disclosure of InterestNone Declared

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 < 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 < 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.

Is pre-college interpersonal trauma associated with cannabis use?

Objective To examine the prevalence and correlates of lifetime cannabis use (i.e., experimental [use 1-5 times] and non-experimental [use ≥ 6 times]) in relation to interpersonal trauma (IPT) above and beyond relevant covariates. Participants A large (n = 9,889) representative sample of college students at an urban university in the southeastern part of the United States Methods Participants were 4 cohorts of first-year college students who completed measures of demographics, cannabis, alcohol, nicotine, and IPT. Associations were estimated using multinomial logistic regressions. Results The prevalence of lifetime cannabis use was 28.1% and 17.4% for non-experimental and experimental cannabis use, respectively. IPT was significantly associated with experimental and non-experimental cannabis use above and beyond effects of sex, race, cohort, alcohol, and nicotine. Conclusions Results show that cannabis use is prevalent among college students and is associated with IPT above and beyond associations with sex, race, and other substance use.

Early onset psychosis and cannabis use: Prevalence, clinical presentation and influence of daily use.

Most of the studies examining the impact of cannabis use in first episode psychosis (FEP) have been carried out in samples with adult-onset FEP. Data in persons with early onset psychosis (EOP) is scarce. The aims of the study were: To describe the prevalence of lifetime cannabis use, current use, and daily use in patients with EOP compared to healthy controls. To study the differences in clinical presentation between cannabis users and non-users. To examine the risk of presenting an EOP associated with cannabis use and the effect of doses and age of onset of use. An observational cross-sectional study was performed in 90 EOP cases and 62 healthy controls, aged between 7 and 17 years. Our results show a higher prevalence of lifetime use (p = 0002), current use (p < 0.001), and daily use (p < 0.001) in EOP cases in comparison with healthy controls. Regarding clinical presentation, we did not find significant differences in any subscale of the Positive and Negative Syndrome Scale (PANSS). Non-user patients presented more severe depressive symptoms (p = 0002) and worse social functioning than cannabis users (p = 0026). Compared with subjects who never used cannabis, the risk of an EOP was significantly higher for those with a lifetime use (OR = 2.88, p = 0.002)current use (O.R = 6.09, p < 0001), and especially in those with daily use (O.R = 42.77, p = <0001). We found a higher risk of EOP in patients that have used cannabis before 15 years of age. In conclusion, it is necessary to develop early- detection and specific treatment programs for adolescents with cannabis use.

Age-specific rates of onset of cannabis use in Mexico

BackgroundOver the previous two decades, the lifetime prevalence of cannabis use has risen among Mexico’s population. AimsEstimate the sex- and age-specific rates of onset of cannabis use over time. DesignFive nationally representative cross-sectional surveys, the Mexican National Surveys of Addictions (1998, 2002, 2008, 2012) and the Mexican National Survey on Drugs, Alcohol, and Tobacco Consumption (2016). SettingMexico. ParticipantsPooled sample of 141,342 respondents aged between 12 and 65 years of which 43.6%(n = 61,658) are male and 56.4% (n = 79,684) are female. MeasurementsWe estimated the age-specific rates of onset of cannabis as the conditional rate of consuming cannabis for the first time at a specific age. MethodsTime-to-event flexible-parametric models with spline specifications of the hazard function. Stratified analysis by sex and control for temporal trends by year of data collection or decennial birth cohort. FindingsAge-specific rates of onset of cannabis use per 1,000 individuals increased over time for females and males. Peak rates of onset of cannabis use per 1,000 ranged from 0.935 (95%CI = [0.772, 1.148]) in 1998, to 5.391 (95%CI = [4.924, 5.971]) in 2016 for females; and from 7.513 (95%CI = [6.732, 10.063]) in 1998, to 26.107 (95%CI = [25.918,30.654]) in 2016 for males. Across decennial birth-cohorts, peak rates of onset of cannabis use per 1,000 individuals for females ranged from 0.234 (95%CI = [0.078, 0.768]) for those born in the 1930s, to 14.611 (95%CI = [13.243, 16.102]) for those born in the 1990s; and for males, from 4.086 (95%CI = [4.022, 7.857]) for those born in the 1930s, to 38.693 (95%CI = [24.847, 48.670]) for those born in the 1990s. ConclusionRates of onset of cannabis increased over the previous two decades for both females and males but remained higher for males. Across recent cohorts, the rates of onset have increased at a faster rate among females than males.

Association between the use of Cannabis and elevated suicide risk in high school adolescents from Santa Marta, Colombia

ResumenIntroducción. La prevalencia del consumo de Cannabis sigue en aumento en el mundo, especialmente, entre adolescentes. Dicho consumo se sobrepone al de cigarrillos y otras sustancias lícitas e ilícitas, y se ha asociado con síntomas depresivos e incremento del riesgo suicida. En el contexto colombiano poco se conoce sobre la relación entre el consumo de Cannabis y el riesgo de suicidio.Objetivo. Evaluar la asociación entre el consumo de Cannabis y el riesgo suicida en adolescentes escolarizados de Santa Marta, Colombia.Materiales y métodos. Se hizo un estudio transversal con una muestra probabilística de estudiantes de media vocacional entre los 13 y los 17 años de edad en colegios oficiales y privados. Se indagó sobre el consumo de Cannabis alguna vez en la vida y se cuantificó el riesgo suicida con la Center for Epidemiologic Studies on Depression Scale. Las puntuaciones superiores a ocho se categorizaron como riesgo suicida elevado. Se estimó la razón de oportunidad (OR) cruda y la ajustada.Resultados. Participaron 1.462 estudiantes. La media para la edad fue de 14,4 años (desviación estándar, DE=0,8) y el 60,3 % correspondía a mujeres. La prevalencia del consumo de Cannabis alguna vez en la vida fue del 11,6 % (IC95% 10,0-13,2) y el 13,3 % (IC95% 11,6-15,0) de los estudiantes presentó riesgo suicida elevado. El consumo de Cannabis se asoció con dicho riesgo ajustado por otras variables (OR=1,88; IC95% 1,23-2,88). Conclusiones. El consumo de Cannabis se asoció con el riesgo suicida elevado en adolescentes escolarizados de Santa Marta, Colombia. Es necesario analizar otras variables que pueden mediar esta asociación.

Correlates of lifetime blunt/spliff use among cigarette smokers in substance use disorders treatment

BackgroundCo-use of tobacco and cannabis has been associated with greater dependence on and lower quit rates for both substances. Tobacco/cannabis co-use among individuals with substance use disorders (SUDs), a population with high rates of cigarette smoking, may hinder the effectiveness of smoking cessation interventions. We examined rates of lifetime (i.e., ever vs. never) cannabis use among current cigarette smokers in SUD treatment, and we identified the subgroup who had used tobacco and cannabis together in the form of blunts and/or spliffs. We then examined variables associated with lifetime use of blunts and/or spliffs. MethodsWe surveyed 562 clients in 20 residential SUD treatment programs in California, USA, in 2019. Measures included demographics, lifetime use of any cannabis product, lifetime use of blunt/spliffs, patterns of tobacco use, and smoking cessation-related questions. We asked current cigarette smokers who also reported lifetime cannabis use whether they had ever used blunts and/or spliffs. We then assessed relationships of demographic, tobacco use, use of cannabis/tetrahydrocannabinol (THC) in e-cigarettes/vape pens, and smoking cessation–related variables with ever use versus never use of blunts/spliffs. ResultsAmong 340 current cigarette smokers, 93.2% (n = 317) reported lifetime use of any cannabis product. Among current cigarette smokers with lifetime cannabis use, 64.4% reported lifetime blunt/spliff use. Compared to those who had never used blunts/spliffs, lifetime blunt/spliff users were more likely to be younger (OR = 0.93, 95% CI 0.90–0.95), more likely to report lifetime use of cigars/cigarillos (OR = 2.95, CI 1.37–6.32), and to have ever used cannabis/THC in e-cigarettes/vape pens (OR = 4.26, CI 1.54–11.80). They were less often ready to quit smoking within 30 days (OR = 0.37, CI 0.23–0.60), but more likely to want help with smoking cessation (OR = 2.39, CI 1.52–3.77). ConclusionCurrent cigarette smokers in SUD treatment reported a high prevalence of lifetime cannabis use. Smokers with a history of blunt/spliff use were more likely to report lifetime use of e-cigarettes/vape pens for cannabis/THC delivery. They wanted help to quit smoking, but felt less prepared to quit in the next 30 days. Cannabis co-use may warrant clinicians' attention when providing smoking cessation interventions during SUD treatment.

[Current Situation of Cannabis Use in Japan: Based on Data from the Nationwide General Population Survey on Drug Use in Japan 2017].

This study aimed to review the current state and trends in cannabis use in Japan, using data from several national epidemiological surveys. The number of cannabis users in the general population was estimated approximately 1.3 million people. Cannabis use increased between 2015 and 2017. In 2017, the lifetime prevalence of cannabis use was greater than that of inhalants, and cannabis had become the most abused drug in Japan. The increase in cannabis users is thought influenced by increased access to illegal cultivation and positive thinking about cannabis use among many people, especially younger individuals.

Cannabis use in individuals at clinical high-risk for psychosis: a comprehensive review.

The objectives of this review were to understand the prevalence of cannabis use and how cannabis is associated with transition to psychosis, symptoms, cognition, trauma and family history in clinical high risk (CHR) for psychosis individuals. A systematic literature review was conducted to find studies that examined cannabis use in CHR individuals, with no limitations on the geographical area, and included publications up to November 2018. Studies were screened for inclusion based on detailed criteria, and data were extracted on cannabis use and associated outcomes. A quantitative synthesis by meta-analysis was performed where appropriate, otherwise, a qualitative synthesis was conducted. Overall, 36 studies met inclusion criteria with an average age of 20.1years and 58.4% males. Prevalence of lifetime cannabis use was 48.7%, whereas current cannabis use was 25.8% and the prevalence of cannabis use disorder/abuse or dependence was 14.9% across the studies. All cannabis use results had statistically significant heterogeneity ranging from 75.7 to 92.8%. The most commonly reported association with cannabis use was transition to psychosis, although the pooled relative risk (RR) was not statistically significant (RR = 1.11, 95% confidence interval = 0.89-1.37). For all other outcomes including symptoms, cognition, trauma, and family history, the evidence was limited, and therefore, the results were synthesized qualitatively. Almost half of CHR individuals have ever used cannabis. However, cannabis use has not been thoroughly researched regarding frequency and dose of use, and how other factors, such as symptoms, are associated with cannabis in CHR individuals.

Association between cannabis use and sexual behavior among adolescents aged 12–15 years in 21 low- and middle-income countries

AimsTo investigate the relationship between cannabis use and two sexual behaviors (ever had sex, multiple partners) in a large representative sample of adolescents aged 12–15 years from 21 low- and-middle income countries. MethodsData from 84,867 adolescents aged 12–15 years participating in the Global School-based Student Health Survey were analyzed. Participants reported lifetime frequency of cannabis use (analyzed as 0, 1–2, 3–19 or ≥ 20 times), whether they had ever had sexual intercourse (yes/no) and, if yes, their lifetime number of sexual partners. We used multivariable logistic regression to analyze associations, adjusting for a range of relevant covariates. Results12.7% of the sample reported having had sexual intercourse, and of these adolescents, 53.1% had had multiple sexual partners. The prevalence of lifetime cannabis use of 1–2 times, 3–19 times, and ≥ 20 times were 1.1%, 1.2%, and 0.4%, respectively. Those who reported using cannabis 1–2 times, 3–9 times, and ≥ 20 times had 2.32 (95%CI = 1.47–3.65), 2.34 (95%CI = 1.34–4.07), and 5.45 (95%CI = 2.22–13.40) times higher odds of having had sexual intercourse than those who had never used cannabis. Among those who had ever had sexual intercourse, the respective odds ratios (95%CIs) for having multiple sexual partners were 1.56 (0.93–2.62), 1.70 (0.92–3.14), and 5.66 (2.97–10.82). There were no significant interactions by sex for these associations. ConclusionsAdolescents from LMIC who use cannabis are more likely to have ever had sexual intercourse than those who do not. Among those who have had sexual intercourse, those who use cannabis are more likely to have had multiple sexual partners.

PERCEPTION OF HARM AND BENEFITS OF CANNABIS USE AMONG ADOLESCENTS FROM LATIN AMERICA AND CARIBE

ABSTRACT Objective: to investigate the perception of harms and benefits associated with cannabis use among adolescents and how regulatory changes might affect their intention to use marijuana. Method: this multi-centric cross-sectional survey study. participants included 2717 students aged 15-17 from 10 cities in Belize, Brazil, Chile, Colombia, Dominican Republic, Jamaica, Mexico, St. Kitts and Nevis, and Trinidad and Tobago. Results: an average lifetime prevalence of cannabis use of 30.6% (25.8% past year, 15.8% past 30 days). Most participants reported that their closest friends use cannabis (60%); many (55%) stated that they would not use marijuana, even if it were legally available. Conclusion: statistics revealed that a strong perception of benefits, a low perception of risk, and friends’ use of cannabis were associated with individual use as well as intention to use within a hypothetical context of regulatory change.

Time since first cannabis use and 12-month prevalence of cannabis use disorder among youth and emerging adults in the United States.

This study estimated whether and how the 12-month prevalence of cannabis use disorder among US youth aged 12-17 and emerging adults aged 18-25 varied by time since first cannabis use. Repeated cross-sectional survey data from the 2015-17 National Surveys on Drug Use and Health (NSDUH). United States. A total of 101 000 NSDUH participants aged 12-25. Past 12-month cannabis use disorder was assessed using DSM-IV criteria. Among youth, the life-time prevalence of cannabis use was 15.3% [95% confidence interval (CI)=14.86-15.65%]. Among emerging adults, the life-time prevalence of cannabis use was 52.4% (95% CI=51.77-53.01%). The adjusted 12-month prevalence of cannabis use disorder among youth with life-time cannabis use was 10.9% (95% CI=9.24-12.75%) in the first year after starting cannabis use, 15.3% (95% CI=13.68-17.12%) in the second year, 17.7% (95% CI=15.55-19.97%) in the third year and 20.6% (95% CI=18.23-23.17%) in the fourth year and beyond, which was consistently higher after the first year (linear trend only: P<0.0001). The adjusted 12-month prevalence of cannabis use disorder among emerging adults with life-time use ranged from 5.6% (95% CI=4.26-7.23%) in the first year after starting cannabis use, 7.7% (95% CI=6.45-9.17%) in the second year and 9.1% (95% CI=7.81-10.57%) in the third year to 10.5% (95% CI=9.87%-11.12%) in the fourth year and beyond, which was consistently higher after the first year (linear trend only: P<0.0001). Within each time-frame since first cannabis use, the adjusted 12-month prevalence of cannabis use disorder was higher among youth life-time users than their emerging adult counterparts. Among youth and emerging adults in the United States, the prevalence of cannabis use disorder appears to increase with time since initiation of use and is higher among youth than among emerging adults during each examined time-frame.

Cannabis use and suicide attempts among 86,254 adolescents aged 12–15 years from 21 low- and middle-income countries

Background: Evidence suggests that cannabis use may be associated with suicidality in adolescence. Nevertheless, very few studies have assessed this association in low- and middle-income countries (LMICs). In this cross-sectional survey, we investigated the association of cannabis use and suicidal attempts in adolescents from 21 LMICs, adjusting for potential confounders.Method: Data from the Global school-based Student Health Survey was analyzed in 86,254 adolescents from 21 countries [mean (SD) age = 13.7 (0.9) years; 49.0% girls]. Suicide attempts during past year and cannabis during past month and lifetime were assessed. Multivariable logistic regression analyses were conducted.Results: The overall prevalence of past 30-day cannabis use was 2.8% and the age-sex adjusted prevalence varied from 0.5% (Laos) to 37.6% (Samoa), while the overall prevalence of lifetime cannabis use was 3.9% (range 0.5%–44.9%). The overall prevalence of suicide attempts during the past year was 10.5%. Following multivariable adjustment to potential confounding variables, past 30-day cannabis use was significantly associated with suicide attempts (OR = 2.03; 95% CI: 1.42–2.91). Lifetime cannabis use was also independently associated with suicide attempts (OR = 2.30; 95% CI: 1.74–3.04).Conclusion: Our data indicate that cannabis use is associated with a greater likelihood for suicide attempts in adolescents living in LMICs. The causality of this association should be confirmed/refuted in prospective studies to further inform public health policies for suicide prevention in LMICs.

The impact of cohort substance use upon likelihood of transitioning through stages of alcohol and cannabis use and use disorder: Findings from the Australian National Survey on Mental Health and Wellbeing.

We used population-level Australian data to estimate prevalence, age of onset and speed of transitions across stages of alcohol and cannabis use, abuse and dependence, and remission from disorder, and consider the potential impacts that an individual's age cohort's level of substance use predicted transitions into and out of substance use. Data on use, DSM-IV use disorders, and remission from these disorders were collected from participants (n = 8463) in the 2007 Australian National Survey of Mental Health and Wellbeing using the Composite International Diagnostic Interview. Lifetime prevalence (95% confidence interval) of alcohol use, regular use, abuse and dependence were 94.1% (93.3-94.8%), 64.5% (62.9-66.2%), 18.7% (17.4-19.9%) and 4.0% (3.4-4.6%). Lifetime prevalence of cannabis use, abuse and dependence were 19.8% (18.6-20.9%), 4.4% (3.8-5.0%) and 1.9% (1.5-2.4%). Among those with the disorder, rates of remission from cannabis abuse, alcohol abuse, cannabis dependence and alcohol dependence were 90.5% (87.4-93.6%), 86.2% (83.8-88.7%), 79.6% (71.1-88.1%) and 53.8% (46.6-61.0%). Increases in the estimated proportion of people in the respondent's age cohort who used alcohol/cannabis as of a given age were significantly associated with most transitions from use through to remission beginning at the same age. Clear associations were documented between cohort-level prevalence of substance use and personal risk of subsequent transitions of individuals in the cohort from use to greater substance involvement. This relationship remained significant over and above associations involving the individual's age of initiation. These findings have important implications for our understanding of the causal pathways into and out of problematic substance use.

Prevalence of Cannabis Use Among Medical Students: A Systematic Review and Meta-analysis.

Objective:Cannabis is reported to be the most common illicit substance used among medical students; however, the number of related studies is limited and their results are not systematically reviewed. The aim of our study was to analyze the prevalence of lifetime and current use of cannabis among medical students worldwide.Methods:A systematic review and meta-analysis was performed with adherence to the PRISMA guidelines. The electronic databases PubMed, Scopus, and Cochrane library were searched for studies on the prevalence of cannabis use among medical students. Prevalence of lifetime, past-year, and past-month cannabis use was extracted. Pooled prevalence and relative risk for sex were calculated using the random effects model and subgroup analyses were conducted.Results:A total of 38 observational (cross-sectional and cohort) studies were included (total number of participants 19 932), and most of them were conducted in Europe, Central and Southern America, and the United States. Overall pooled prevalence of lifetime cannabis use was 31.4% (95% confidence interval [CI]: 23.7%-39.6%), past-year use was 17.2% (95% CI: 10.8%-24.6%), and past-month use was 8.8% (95% CI: 5.6%-12.5%). Men displayed higher rates of cannabis use with a pooled relative risk of 1.55 (95% CI: 1.32-1.81). Heterogeneity was high (I2 > 75%) and there were differences among continents in all outcomes (P < .001).Conclusions:In conclusion, 1 in 3 medical students has used cannabis, whereas 8.8% were current users. Significant differences among continents were observed, but common finding was that male students tend to consume cannabis more often than female students.

Cannabis and Amphetamine Use Among Adolescents in Five Asian Countries.

IntroductionThere has been a global increase in illicit drug use among young people. The aim of this study was to estimate the prevalence of lifetime cannabis and amphetamine use, as well as to explore factors associated with substance use among adolescents in five Asian countries: Iraq, Kuwait, Malaysia, Mongolia, and Vietnam.Methods38,941 school children (mean age 15.4 years, SD=1.5) completed the cross-sectional Global School-Based Student Health Survey (GSHS). Topics covered in the questionnaire included cannabis and amphetamine use. Personal, parental, and environmental attributes were explored as predictors of cannabis and amphetamine use. Logistic regression was used to assess the contribution of potential predictors on lifetime cannabis and lifetime amphetamine use.ResultsOverall, the prevalence of lifetime cannabis use was 0.9% and lifetime amphetamine use was 1.0% among research participants. Cannabis use was influenced by male gender (Kuwait, Mongolia), parental smoking habits (Kuwait, Iraq), and current cigarette smoking in all countries. Amphetamine use was associated with suicidal ideation (Kuwait, Malaysia, Vietnam), school truancy (Malaysia, Mongolia, Vietnam), being a victim of physical assault (Kuwait, Mongolia), bullying victimization (Iraq, Malaysia, Vietnam), as well as anxiety and current cigarette use in all countries.ConclusionsOur preliminary results show the importance of personal attributes such as mental distress and environmental stressors on lifetime cannabis and lifetime amphetamine use. Future prospective studies are needed to identify causal relationships among personal attributes, parental attributes, environmental stressors, and illicit substance use.

Trends in Lifetime Cannabis Use among Czech School-aged Children from 2002 to 2014.

The aim of the study was to examine trends in the prevalence of lifetime cannabis use among the Czech 15-year old students. Data from the nationally representative Health Behaviour in School-aged Children Survey, conducted in the Czech Republic in 2002, 2006, 2010 and 2014, were used. Trends in cannabis use among both boys and girls were modelled through binary logistic regression with period as a predictor of the lifetime cannabis use. The prevalence of lifetime cannabis use has significantly decreased among young Czechs, particularly among boys. Gender differences in cannabis use have been also gradually decreasing since 2002, with no significant differences between genders in recent period. Although there are positive changes in the prevalence of adolescent cannabis use, from the European perspective, Czech students still belong to those with significantly higher rates in this respect. Thus, alongside with the use of other substances, adolescent cannabis consumption remains an important challenge for the national public health policy.