In Vitro Antimicrobial Effect of Tetrahydrocannabinol on Streptococcus mutans and Its Anticariogenic Potential.

Rates of recreational cannabis (ie, marijuana) use in the United States have increased in recent years as have rates of cannabis use disorder. The aim of this study was to assess theoretical correlates of intentions to initiate and sustain marijuana cessation among adult user-using domains of the Multi-Theory Model (MTM) of health behavior change. A cross-sectional survey was administered to a sample of adult cannabis users (n = 227; mean age = 40.9 years; 48.5% female; 85.5% non-Hispanic white). We assessed intention to quit cannabis using MTM constructs of initiation (participatory dialogue, behavioral confidence, changes in physical environment) and sustenance (emotional transformation, practice for change, changes in social environment). The structure of the MTM scale was assessed using confirmatory factor analysis. Hierarchical linear regression models were used to assess constructs of initiation and sustenance of cannabis use controlling for demographic characteristics and Cannabis Use Disorder Identification Test score (<12 and >12). The MTM scale evidenced good reliability (Cronbach's alphas > .7) and good model fit. Results indicated that only the change in physical environment construct was significantly associated with the intention of initiating cannabis cessation (B = 0.27, P < .001) while practice for change (B = 0.27, P < .001) and changes in social environment (B = 0.19, P = .001) was positively associated with the intentions of sustaining cannabis cessation. Results indicate that changes to physical and social environment are key features of initiating and sustaining cannabis use cessation, which aligns with research on tobacco cessation. Future research should explore how these factors interact and investigate additional influences on long-term cessation success.

Cannabis is one of the most common psychoactive substances used worldwide, and its use is increasing. Modern products vary widely in tetrahydrocannabinol (THC) concentrations and usage routes, creating challenges for anesthesia providers. This review summarizes current evidence on the pharmacology, pharmacokinetics, physiologic effects, and perioperative considerations of cannabis to help guide safe anesthetic management of cannabis-using patients. Cannabis contains over 100 phytocannabinoids, chiefly psychoactive Δ9-THC and nonpsychoactive cannabidiol (CBD), which act on cannabinoid type-1 (CB1) and type-2 (CB2) receptors. Chronic use downregulates CB1 signaling, contributing to tolerance, dependence, and withdrawal. Cannabis exerts widespread physiologic effects, including neuropsychiatric complications, cardiovascular changes, respiratory issues, delayed gastric emptying, appetite stimulation, and reproductive endocrine disruption. Cannabis use has been associated with increased propofol requirements, possibly via cytochrome P450 enzyme induction and CB1 receptor downregulation. It may also alter responses to opioids, ketamine, and gabapentinoids, and chronic users often report higher postoperative pain. Cannabis use influences anesthetic dosing, airway and cardiovascular stability, and postoperative pain control. Thorough preoperative assessment, individualized anesthetic planning, and vigilant monitoring are essential, and further research is needed to establish evidence-based perioperative guidelines.

Marijuana use in the United States (U.S.) has diversified alongside expanding legalization, yet little is known about the psychosocial factors that distinguish medical from recreational use. This study examined whether psychological distress mediates the association between perceived social isolation (i.e., loneliness) and marijuana use type among U.S. adults. We analyzed cross-sectional, nationally representative data from the 2024 Health Information National Trends Survey (HINTS, cycle 7). Marijuana use was categorized as medical (including medical and both medical/recreational) versus recreational. Perceived social isolation was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation t-score, and psychological distress was assessed with the Personal Health Questionnaire (PHQ)-4. Survey-weighted descriptive analyses and a weighted structural equation mediation model accounting for the complex sampling design were conducted. Medical marijuana users reported significantly higher levels of psychological distress and perceived social isolation than recreational users. Greater social isolation was strongly associated with higher psychological distress, and higher distress was associated with a greater likelihood of medical (vs. recreational) marijuana use. The indirect effect of social isolation on marijuana use type through psychological distress was statistically significant, while the direct effect of social isolation was not significant after accounting for distress. Overall, greater perceived social isolation predicted medical marijuana use primarily through elevated psychological distress. These findings suggest that medical marijuana use among U.S. adults may reflect coping with psychological distress linked to social disconnection, underscoring the importance of integrating mental health and social context into clinical and public health approaches to cannabis use.

ABSTRACT Objective This study aims to investigate the relationship between sexual debut age and subsequent marijuana experimentation and regular use. Methods Data from NHANES 2015–2016 was utilized. The study included 3414 participants. Sexual debut age were assessed through the MEC Interview, while marijuana experimentation and regular use were evaluated using the Drug Use Questionnaire. Logistic regression analysis was conducted to examine associations, with RCS curves used to visualize these relationships. Results Among participants who experimented with marijuana, 50.76% transitioned to regular user, with an average onset age of 18.01 ± 5.13 years. Positive associations were found between sexual debut and both marijuana experimentation (OR = 11.911, 95% CI: 6.604–21.744) and regular use (OR = 10.012, 95% CI: 4.335–23.124) after adjusting for covariates. A negative association was observed between sexual debut age and both marijuana experimentation (OR = 0.770, 95% CI: 0.748–0.793) and regular use (OR = 0.734, 95% CI: 0.706–0.763) after adjusting for covariates. Conclusions The study highlights the early age at which individuals begin regular marijuana use and the association between sexual behaviors and marijuana consumption. Furthermore, a delayed sexual debut age is linked to lower rates of marijuana experimentation and regular use.

Despite policies designed to preserve family structures, Indigenous children in the U.S. and Canada remain disproportionately removed from their homes and communities. This systemic removal represents an ongoing form of historical trauma with intergenerational consequences, yet research on its long-term psychosocial effects remains limited. To examine the prevalence of foster care and adoption among a sample of Indigenous youth and their associations with psychosocial outcomes in early adulthood. Data come from a community-based participatory longitudinal study of Indigenous families from eight reservations and reserves in the U.S. and Canada (N=708), collected between 2002 and 2020. Multivariate regression models assessed associations between any child welfare involvement during childhood/adolescence (i.e., foster care and/or adoption) and young adult family (i.e., family satisfaction and cohesion) and psychosocial (i.e., flourishing, depressive symptoms, and marijuana use) outcomes. Overall, 16.73% of participants experienced child welfare placement during childhood or adolescence. Compared with Indigenous youth who were never placed in child welfare, those who experienced placement had lower odds of family satisfaction (OR=0.40; p<.05), reported decreased family cohesion (b=-1.38; p<.05), lower rates of flourishing (b=-1.44; p<.05). Despite showing significant bivariate associations, child welfare placement was not associated with depressive symptoms (b=0.20; p=.15), and only marginally associated with marijuana use (b=0.59; p=.06). Indigenous family involvement in the child welfare system remains disproportionately high and is associated with adverse psychosocial outcomes in adulthood. Findings underscore the need for systemic reforms and culturally responsive, community-driven interventions to support Indigenous families.

Retrospective cohort study. To describe patterns of postoperative analgesia use (opioids, antidepressants, gabapentinoids, muscle relaxants, and benzodiazepines) among postoperative marijuana users after anterior cervical discectomy and fusion (ACDF) and lumbar fusion. The use of marijuana for pain management is a controversial topic that lacks extensive research. As social and legal acceptance of marijuana increases, questions have arisen about its therapeutic potential alongside prescription analgesic pharmaceutical agents, necessitating further studies on this topic. Adult patients who underwent either ACDF or lumbar fusion surgery and used marijuana postoperatively were identified. A 1:1 propensity match incorporating patient demographics and levels fused was conducted to compare postoperative marijuana users to nonmarijuana users. One year preoperative and 1 year postoperative opioid use was obtained from the Pennsylvania Prescription Drug Monitoring Program (PDMP). Preoperative and postoperative utilization of antidepressants, gabapentinoids, muscle relaxants, and benzodiazepines was obtained from patient chart review and PDMP. Of the 126 included patients, 63 (50%) used marijuana postoperatively. A greater proportion of marijuana users undergoing lumbar fusion used opioids preoperatively compared with nonmarijuana users ( P =0.048). No significant differences in preoperative opioid use were demonstrated among ACDF patients. In both ACDF and lumbar fusion cohorts, no differences in postoperative opioid consumption were observed between marijuana and nonmarijuana users. Marijuana usage was associated with higher utilization of serotonin-norepinephrine reuptake inhibitors (SNRIs), specifically duloxetine, in the ACDF cohort ( P =0.024). No significant differences in rates of utilization of tricyclic antidepressants, gabapentinoids, muscle relaxants, and benzodiazepines were observed in patients who consumed marijuana compared with nonmarijuana users. Postoperative marijuana use was significantly associated with preoperative opioid use in lumbar fusion patients and duloxetine use in ACDF patients. Postoperative marijuana use was not significantly associated with gabapentinoid, muscle relaxant, or benzodiazepine use.

Influence of cannabis use on length of stay in patients admitted to the epilepsy monitoring unit.

Examination of the DSM-5 level 2 substance use measure using Rasch modeling with United States parents.

241. CBD use among U.S. adolescents: Prevalence and its association with Marijuana use patterns

Although the transitional pain service (TPS) has been proposed to manage patients at risk for persistent postsurgical opioid use, no standard criteria exist to identify high-risk patients for TPS management. Specifically, the 2 to 3 months after surgery are critical for the transition from short-term to persistent opioid use, yet little is known about opioid refills during this period. This retrospective cohort study included 11,087 adult patients, regardless of opioid-naïve status, who underwent inpatient spine surgery at an academic medical center and were discharged between January 2017 and December 2023. The cohort was identified, and data were obtained from electronic medical records. Data were analyzed using multiple logistic and linear regression and Fisher's exact test. Of the patients, 25.4% and 14.8% received opioid refills at 31 to 60 and 61 to 90 days postdischarge, respectively. Among the independent risk factors, a refill at 31 to 60 days was the strongest predictor of a refill at 61 to 90 days (aOR 6.71, 95% CI, 5.90-7.65), regardless of preoperative opioid use, cervical or lumbar procedures, or surgical service. Refill rates at 31 to 60 and 61 to 90 days were linearly correlated (P < .0001, slope = 0.73). A refill at 31 to 60 days predicted a refill at 61 to 90 days with a negative predictive value (NPV) of 94.3% and a positive predictive value (PPV) of 41.5%, with consistently high NPVs across subgroups defined by preoperative opioid use, surgical procedure, or surgeon. A refill at 1 to 30 days; preoperative use of opioids, marijuana, and benzodiazepine; the first postoperative pain score recorded on the hospital floor; and depression were all associated with increased odds of refills at both 31 to 60 and 61 to 90 days. In contrast, the total dose of discharge opioid prescriptions had minimal impact on refills. A refill at 31 to 60 days after discharge may serve as a predictor of high-risk patients who could benefit from TPS management to mitigate further opioid use. Moreover, each refill prescription should be carefully managed to prevent subsequent refills.

Emotion-Related Impulsivity is Associated with Marijuana Susceptibility and Use Among Adolescents with Congenital Heart Disease: A Cross-Sectional Study of Variable- and Person-Oriented Approaches.

The use of psychoactive substances is present in different political and socio-cultural contexts. The harm reduction can be a strategy that can prevent its abuse and provide solutions that validate the autonomy of individuals. Thus, less formal proposals for teaching, but which prioritize drug education, forms of consumption and harm reduction methods were used through different pedagogical paths to bring participants closer to the themes, creating learning environments and helping them to make autonomous decisions, generating a better relationship between drugs and society. The extension activities carried out addressed the use and abuse of marijuana, alcohol, nicotine and LSD through films, emotionally immersing viewers in the subject; in lectures, exposing technical and scientific information on mechanisms of action and social factors; and in conversation circles, bringing proximity to the exchange of information, establishing a horizontal dispersion of knowledge. This highlights the importance of tackling the issue of psychoactive drugs, which is neglected in the face of national policies and can be worked on in extension activities, reaching places that are difficult to access and providing information in a welcoming way that can be easily disseminated in society.

Objective Substance use and misuse remain significant public health challenges in the United States. Although individuals who use one substance often use multiple substances, theories and research have largely focused on single-substance use. The present study aimed to identify patterns of substance use across multiple substances using latent class analysis (LCA) and to explore correlates of these patterns, including traits related to emotion and emotion regulation, sensation-seeking, and drinking motives. Method In Study 1 (N = 353) undergraduate students completed an online questionnaire battery. LCA was used to identify classes of substance use. Covariate analyses tested associations of age, urgency, emotion dysregulation, distress tolerance, and sensation seeking with class membership. Study 2 (N = 559) extended Study 1 by testing drinking motives as additional covariates in community adults with hazardous alcohol use and/or non-suicidal self-injury. Results In Study 1, LCA identified three classes: nonuse, alcohol and marijuana use, and polysubstance use. Urgency, difficulties regulating emotions, and low distress tolerance predicted membership in the substance use classes versus the no-use classes. In Study 2, LCA identified three classes: alcohol use, alcohol and marijuana use, and polysubstance use. Coping and enhancement drinking motives differentiated the three classes. Conclusions In both undergraduate and community samples, substance use was characterized by three classes representing alcohol-only or no-use, alcohol and marijuana use, and polysubstance use. Urgency, difficulties regulating emotions, distress tolerance, sensation-seeking, and drinking motives significantly distinguished between different substance use profiles.

Erectile dysfunction (ED) is a condition characterized by difficulty in achieving or maintaining an erection, consequently affecting sexual performance. ED is often a symptom of underlying health conditions such as cardiovascular heart disease and can lead to psychological distress. Previous studies show an association between marijuana use and ED through its potential impact on the endocannabinoid pathways. However, few studies have explored this relationship among sexual minority men (SMM). Considering this knowledge gap, this study aims to assess the association between marijuana use and erectile dysfunction in a sample of SMM in the United States. A secondary analysis of the Men's Body Project (MBP)-a cross-sectional study involving an online survey assessing SMM health outcomes-data was conducted. Multivariable logistic regression and bivariate analyses were used to examine the association between marijuana use and ED. Participants provided demographic information, self-reported ED, erection confidence, erection difficulty, and history of substance use. A total of 549 participants completed the survey (52.1% gay and 47.9% bisexual). The prevalence of ED was higher in bisexual men compared to gay men. Results from the adjusted logistic regression analysis suggested that people who use marijuana had 1.83 times the odds (95% CI: 1.23, 2.74) of reporting erectile dysfunction compared to non-users. Our results suggest a significant association between marijuana use and elevated odds of experiencing erectile dysfunction. These findings highlight the importance of integrating sexual health screening into primary care and considering substance use during sexual health assessments to support early identification and management of ED. Additional research is needed to explore temporal and causal relationships between marijuana use frequency and erectile function.

Pregnant women with criminal justice-system involvement (CJI) and substance use disorders (SUD) face considerable barriers that impact substance use treatment outcomes. However, limited research has investigated such factors among this population. To address this gap, we investigated associations of sociodemographic and treatment-related factors with reduced substance use and treatment completion among CJI pregnant women who utilized outpatient treatment. Data came from the 2021-2022 Treatment Episode Dataset-Discharges (TEDS-D). The sample included 1,903 CJI pregnant women discharged from outpatient treatment. Multivariable logistic regression was used to measure associations of sociodemographic and treatment-related predictors with reduced substance use and treatment completion. Compared to alcohol use, marijuana use was associated with lower odds of reduced use, whereas opioid and stimulant use were each associated with lower odds of treatment completion. Self-help group attendance was associated with higher odds of both outcomes. Findings suggest that substance type may be an important consideration for treatment planning. Examining substance-specific factors that facilitate positive treatment outcomes is a practical next step for future studies. Self-help groups were a key facilitator of positive outcomes, suggesting that the integration of peer recovery support models into formal substance use treatment services warrants consideration.

Sexual-identity disparities in substance use among U.S. veterans, and whether mental-health treatment mitigates risk for those with depression, remain under-examined. Using data on veterans from the 2021-2023 National Survey on Drug Use and Health (NSDUH; N = 7,212), disparities were estimated in past-30-day nicotine, marijuana, binge drinking, and polysubstance use, as well as severe psychological distress (K6≥13) and past-year suicidal ideation. Guided by a biosocial/minority-stress framework, multiple imputation was applied (m = 20) and survey-weighted logistic regression adjusting for age, year, race/ethnicity, sex, education, metro status, insurance, marital status, employment, and income; among veterans with a past-year major depressive episode (MDE), interactions were tested between sexual identity and (a) depression-related clinical contact (DRC) and (b) prescription medication for depressive feelings. Bisexual veterans showed the highest prevalence of marijuana (33.5%) and polysubstance use (30.6%), exceeding that of heterosexual (11.8%, 14.9%) and gay/lesbian veterans (24.0%, 18.8%). Models restricted to veterans with MDE, past-year DRC (DRC defined as any visit or conversation with a health professional about depressive feelings) moderated risk for gay/lesbian veterans, with DRC associated with lower odds of binge drinking and polysubstance use; prescription medication showed a similar moderating pattern for nicotine and polysubstance outcomes. Findings for severe psychological distress and suicidal ideation were mixed and consistent with confounding by indication. Results should be interpreted cautiously given the cross-sectional data, self-report, small sexual-minority subgroups, and non-aligned recall windows (past-year mental health/treatment vs past-30-day substance use). Overall, sexual-identity disparities in substance use are evident, with bisexual veterans bearing the greatest burden, and engagement in DRC and medication among veterans with MDE, particularly gay/lesbian veterans, showing associations consistent with a buffering effect of affirming care. Longitudinal and qualitative studies are needed to test causal pathways and to illuminate lived experiences, and policy/clinical efforts should expand culturally competent, integrated services and routine SOGI data collection to monitor and reduce inequities.

Introduction: The increasing legalization of recreational marijuana worldwide necessitates a comprehensive understanding of its use. While data exists on marijuana use among theater actors and sport athletes, no data on its use within the dancer population exist, hence this study aims to describe the effects and motives of cannabis use within a dancer cohort. Methods: An online survey was conducted October 1, 2023 to January 31, 2024, involving dancers worldwide who had used cannabis in the past 6 months. The survey focused on motives for cannabis use and the Cannabis Use Disorder Identification Test-Revised (CUDIT-R). Qualitative methodology with thematic content analysis was employed, and statistical analysis was performed using t-test and chi-square. Results: One hundred and eight dancers completed the survey. Sixteen dancers (14.8%) reported failing to do what was normally expected from them as a dancer due to cannabis use. T-test results revealed that these dancers had an average CUDIT-R score of 19.5, significantly higher than the average score of 7.7 for dancers who did not report such failure (P < .001). Chi-square analysis showed that on average, 93.8% of participants who failed to meet dancer expectations due to cannabis scored above 12 on the CUDIT-R compared to 18.5% of those who did not report failure (P < .001). On average, 56.2% of participants who scored above 12 on the CUDIT-R indicated a coping motive for cannabis use compared to 31.6% of those who scored 12 or below (P = .029). On average, 43.8% of participants who scored above 12 on the CUDIT-R indicated an expansion motive for cannabis use compared to 18.4% of those who scored 12 or below (P = .005). Conclusion: Dancers with high CUDIT-R scores are more likely to fail to do what was normally expected from them as a dancer because of using cannabis, and more likely to cite coping and expansion as motives for cannabis use.Level of Evidence: Level 4.

IntroductionFollowing marijuana legalization in several U.S. states, motivations for its use have expanded, especially among marginalized populations. While prior research links marijuana use with disordered eating, little is known about this relationship within sexual minority groups, who are already at elevated risk for body dissatisfaction and unhealthy weight control behaviors. This study examines associations between marijuana use and unhealthy weight control and muscle-enhancing behaviors among sexual minority men in the U.S.MethodsWe conducted a secondary analysis using data from the Men’s Body Project, a cross-sectional study on body image and health behaviors. The sample included sexual minority men across diverse backgrounds. Logistic regression was used to assess associations between marijuana use and seven behaviors considered risk factors linked to body image concerns: fasting, vomiting, laxative use, diet pill use, muscle-building supplement use, protein powder use, and anabolic steroid use.ResultsMarijuana users had significantly greater odds of engaging in all measured behaviors. Adjusted odds ratios (AORs) ranged from 1.88 (fasting) to 3.12 (diet pill use), all with p-values < 0.001. Other notable associations included vomiting (AOR = 2.61), laxative use (AOR = 2.23), protein powder use (AOR = 2.60), and anabolic steroid use (AOR = 2.62).ConclusionOur results suggest a significant association between marijuana use and elevated odds of engaging in unhealthy weight control and muscle-enhancing behaviors among sexual minority men. Findings highlight the need for tailored public health interventions addressing both substance use and body image within LGBTQ + communities.

Objectives To evaluate the effectiveness of the Weaving Healthy Families (WHF) program in reducing alcohol and substance use among U.S. Indigenous adults and youth, addressing health disparities and premature mortality driven by alcohol misuse. Design setting A longitudinal dynamic, open cohort stepped-wedge trial conducted in U.S. Indigenous communities, grounded in over a decade of community-based participatory research (CBPR) and Indigenous knowledge (McKinley et al., 2023). Participants A total of 218 adults and 354 youth participated in the study. Intervention WHF is a psychoeducational and experiential family-centered intervention consisting of 2.5-hr sessions. Each session began with a shared family meal and included components on nutrition, health, communication, and promotive family rituals. Main outcome measures Multilevel longitudinal modeling assessed outcomes across five points (i.e., pretest; posttest; and 6-, 9-, and 12-month follow-ups). Measures included the Alcohol Use Disorders Identification Test (AUDIT) and individual indicators of alcohol and substance use. Results Among adults, significant reductions were observed postintervention, including declines in alcohol use disorder (AUD; B = −0.67, p < 0.001), overall alcohol use as measured by the AUDIT (B = −0.32, p = 0.0002), and number of drinks in the last month (B = −0.09, p = 0.0001). There were also significant decreases in past 30-d alcohol use (B = −0.53, p < 0.0001) and marijuana use (B = −0.27, p = 0.03). Sex differences were found in AUD use and feelings of guilt, with variations by gender. Among youth, postintervention reductions were seen in AUD use (B = −0.09, p < 0.03), with sex differences approaching significance (B = −0.09, p < 0.057), where female respondents showed greater declines than male respondents. Conclusions Significant postintervention reductions in alcohol misuse and hazardous drinking indicate strong support for the WHF program in preventing alcohol misuse among U.S. Indigenous families. These findings replicate pilot results and provide a robust foundation for culturally grounded, efficacious alcohol misuse prevention efforts in Indigenous communities. Clinical Trial NCT03924167