Onset Of Cannabis Use Research Articles

T10 - Age of Onset of Cannabis Use Predicts Anxiety, Psychoticism, and Anger-Hostility Mental Health Symptoms in Severe Concurrent Disorder Inpatients

T10 - Age of Onset of Cannabis Use Predicts Anxiety, Psychoticism, and Anger-Hostility Mental Health Symptoms in Severe Concurrent Disorder Inpatients

Association between cannabis use disorder and greater apathy in adults with HIV

BackgroundApathy is prevalent among people with HIV (PWH) and is associated with poor clinical outcomes. Cannabis use and Cannabis Use Disorder (CUD) are also disproportionately prevalent among PWH. CUD and younger onset of cannabis use may be linked to apathy in the general population; however, patterns of use most strongly associated with apathy have not been firmly established, and it is unclear whether cannabis use is linked to apathy in PWH. MethodsWe examined associations in 311 adult PWH between Apathy Evaluation Scale-Self (AES-S) scores and CUD history (current/past/no CUD/no cannabis use) and between AES-S scores and age of CUD onset (adolescent-onset/adult-onset). We also examined robustness of associations to adjustment for depressive symptoms (which may overlap with apathy symptoms) and alcohol use. ResultsCurrent CUD was associated with greater AES-S scores relative to cannabis users with no CUD history (β = 2.13, 95 % CI = 0.37–3.90, p = 0.018). Adolescent-onset CUD was not associated with greater apathy relative to adult-onset CUD (β = 0.56, 95 % CI = -2.57 – 3.68, p = 0.7). Associations became nonsignificant after adjustment for depressive symptoms, but not after adjustment for alcohol use. Alcohol use was correlated with apathy (r = 0.19, 95 % CI: 0.076–0.29, p = 0.001). ConclusionsCannabis Use Disorder and at-risk alcohol use are associated with apathy among PWH; this finding highlights the need for substance use disorder prevention and treatment among PWH.

Investigating sex differences and age of onset in emotion regulation, executive functioning, and cannabis use in adolescents and young adults

BackgroundYoung adults have historically high levels of cannabis use at a time which coincides with emotional and cognitive development. Age of regular onset of cannabis use and sex at birth are hypothesized to influence the relationship between cannabis use and cognition. Here we investigated past 6-month cannabis use in relation to emotional and executive functioning. We further considered age of onset and sex in subgroup analyses.MethodYoung adults (N = 225; ages 16–22) completed a substance use interview and cognitive battery, including the Emotional Word-Emotional Face Stroop and NIH toolbox executive functioning tasks. Linear regressions examined relationships between past 6-month cannabis use episodes and performance. Subgroup analyses investigated whether age of onset or sex impacted relationships.ResultsAfter correcting for multiple comparisons, greater past 6-month cannabis use episodes were related to poorer Emotional Stroop Congruent Accuracy (p = .0004, FDR-p = .002) and List Sorting Working Memory (p = .02, FDR-p = .10) performance. Younger age of regular use onset marginally related to lower Emotional Stroop Congruent Accuracy performance (p = .03, FDR-p = .13). There were no cannabis use by sex interactions on cognition.ConclusionsConsistent with prior findings, results suggest small reductions in cannabis-related performance in processing speed during emotional Stroop and working memory tasks. Age of onset was modestly related to Stroop performance, but not sex. Longitudinal studies which detail patterns of cannabis and other substance use are needed to better assess brain-behavior relationships and other factors (e.g., age of onset of regular use, sex) which could influence cannabis-related impairments in cognitive functioning.

Uneven effects of twenty years of Chile's cannabis policy implementation in cannabis onset

BackgroundIn Chile, Laws 19366 and 20000, implemented in 1995 and 2005 respectively, regulated and sanctioned cannabis’ personal use, cultivation and trafficking. MethodsWe use thirteen biannual cross-sectional national surveys data from 1994 to 2018 to examine the effect of Laws 19366 and 20000—using the rate of individuals incarcerated per 100000 population due to drug-related crimes as proxy—on the age of onset of cannabis use over time. We estimate the effect of these policies using a mixed proportional hazards framework that models the transition to first cannabis use in 47,832 individuals aged 12-21. ResultsOverall, changes in these laws did not affect the transition to first cannabis use. However, increases in the rate of individuals incarcerated were associated with decreases on the age of onset of cannabis use in females and individuals living in affluent neighborhoods or in specific regions. ConclusionWe find no evidence of cannabis policy changes affecting the age of onset of cannabis use across all individuals aged 12-21. Policy effects associated with decreases in cannabis onset age in females and individuals from affluent neighborhoods or specific regions can be explained by using theoretical frames that recognize specific dynamics of cannabis supply and demand.

Cannabis Use and Its Impact on Mental Health in Youth in Australia and the United States: A Scoping Review.

Cannabis is a widely used substance among the youth population, with an estimated 2.8% currently smoking cannabis. Its popularity is growing due to the perception of its harmless nature and lack of dependence. However, this increase in use has been linked to mental health issues, especially since its partial decriminalisation in some part of the United States and Australia. The objective of this scoping review was to investigate the mental health impact of cannabis use among young people in Australia and the United States. A scoping review was conducted according to the Joanna Briggs Institute (JBI) protocol, and articles were searched from ProQuest Central and EBSCO Host (MEDLINE and CINAHL databases). A total of 24 articles were analysed, including systematic reviews, meta-analyses, and cohort, longitudinal, and cross-sectional studies. The findings indicate that cannabis use is associated with depression, psychosis, suicide, cannabis use disorder, dependence, decline in cognitive function, and the development of externalising behaviour, particularly attention deficit hyperactivity disorder. However, the relationship between cannabis use and anxiety is equivocal. Mental health issues were more prevalent with increased frequency, duration, intensity, and type of use. Female, minority, LGBTQI, African American, Aboriginal, and Torres Strait Islander youth and the age of onset of cannabis use were significant factors for the development of mental health problems. The increasing prevalence of cannabis use among high school and college students suggests the need for intervention by teachers, parents, and community health professionals to make them aware of its potential negative mental health outcomes. Moreover, policy-level interventions by the government are required to discourage young people from using cannabis.

The influence of peer's social networks on adolescent's cannabis use: a systematic review of longitudinal studies.

A systematic review was performed to summarize the key findings of the peer influence on cannabis use through Social Network Analysis (SNA) studies and identify limitations and gaps with the purpose of informing future research and practice. Longitudinal studies were included since they provide robust information about social relationships change over time. Adolescents' cannabis use is a global problem, which has awakened an interest in its determinants such as social influences. Research has shown the importance of these influences on cannabis uptake and use. SNA is an useful relational approach to examine socialization mechanisms related to the onset of cannabis use in adolescents. A search was conducted in PyscINFO, PubMed, Scopus and Web of Science for longitudinal articles published until February 2023, to examine cannabis use and peer's social networks. We focus on peers' influence of peers on cannabis use. Additionally, information about effect of cannabis use for peer selection was collected. The results of the included studies (n = 8) showed that friends' cannabis use was most often/strongly associated with cannabis use. There was also an increase of cannabis use when the adolescent did not feel close to the school's peers, had a higher proportion of friendships relative to the total number of ties in the neighborhood, had a central position, did not belong to any group but had ties to members of two or more groups, had cannabis user friends (especially in early ages), and lived in a neighborhood where cannabis was used. Cannabis use is mainly related to friends' use. Yet, future studies are warranted to control for relevant selection effects to further knowledge on network effects on cannabis use, improving the design, and improving the modeling of the network. This systematic review may inform about the critical aspects of preventing cannabis use among adolescents, taking into consideration their complex social environment.

Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults

Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics. Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use. Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use. Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.

Risk Factors for Quantity of Cannabis Use Per Day among College Students Who Violated Their University Drug Use Policy.

Cannabis use among college students represents a continued public health issue. The objective was to assess risk factors and reasons for cannabis use among students who violated their university's drug use policy, and whether risk factors influenced cannabis use quantity. This cross-sectional survey study included 99 college students enrolled at a large U.S. public university. Descriptive statistics were calculated, and an ordinary least squares regression analysis was conducted. Students reported using cannabis an average of 7.4 (SD = 10.2) days in the past month, with 8% reporting daily use. On average, students consumed slightly over 0.25 (SD = 0.25) grams per day, with 40% reporting greater than one gram per day. The average age of onset of cannabis use was 16.8 (SD = 1.8) years old. The top reasons for cannabis use were to: relax or relieve tension (75.8%), feel good or get high (62.6%), and have a good time with friends (60.6%). Students perceived an average of 47% of their peers engaged in past-month cannabis use and only slight risk was associated with regular use. Students perceived their loved ones would mostly approve of a reduction in their cannabis use. Regression results indicated past-month cannabis frequency (p = .002) and being of racial/ethnic minority descent (p = .05) were positively associated with quantity of cannabis per day, while perceived risk of regular cannabis use (β = -0.21) was negatively associated. Evidence-based cannabis interventions for students who violate their university's drug use policies are critically needed that aim to reduce cannabis use and mitigate its associated negative consequences.

The association of psychotic experiences with clinical and sociodemographic characteristics in cannabis users

ABSTRACT Objective The term psychotic experiences (PEs) encompass subclinical hallucinatory and delusional experiences. There are limited number of studies on PEs clinical and socio-demographic characteristics. We aimed to investigate the association between PEs and patterns of cannabis use, cognitive functions, schizotypy and childhood traumas. Methods Participants were recruited from specialized units using the snowball method. All of the participants were regular cannabis users. Participants with PEs and without PEs were compared by looking into socio-demographic and clinical correlates. Significant variables at univariate comparisons were included in binary multivariate logistic regression analysis with PEs as the dependent variable. Results Forty participants were recruited (20 with PEs, 20 without PEs). Adolescence onset of cannabis use (χ2 = 8.120; p < 0.05), positive schizotypy (t = 3.762; p < 0.01), Trail Making Test A (TMT A) Scores (u = 98.5; p < 0.01) and emotional neglect (u = 128; p = 0.05) were significantly associated with PEs. The binary regression model included a significant contribution of positive schizotypy (OR = 1.16, CI 1.025–1.330) and TMT A Score (OR = 1.22, CI 1.03–1.44). Conclusions Results showed a novel positive association of PEs with adolescent-onset cannabis use, TMT A Scores, positive schizotypy and emotional neglect. PEs were predicted independently by positive schizotypy and TMT A Scores.

Can drug policies modify cannabis use starting choice? Insights from criminalisation in Italy

A key question in the ongoing drug policy debate is whether legalising cannabis leads to an increase in cannabis use. In Europe although no country has yet moved to legalisation, many have decriminalised personal possession. However, some jurisdictions are still discussing increased sanctions or have further strengthened penalties for the possession of illicit substances in order to deter widespread cannabis use. This is the case in Italy, where a law introduced in 2006 and repealed in 2014 de facto criminalised personal drug possession, and a potential increase in penalties is currently being debated as a policy option. Despite the intense public debate surrounding the legal status of cannabis, limited empirical research has been conducted in Europe to assess the population-level effects of drug policy reforms, mainly due to data availability constraints. In this study, we analyse the effect of criminalisation on the age of onset of cannabis use using an unique dataset that combines seven waves (2001–2017) of the nationally representative Italian Population Survey on Alcohol and other Drugs with relevant socio-economic data. The final dataset comprises 77,650 observations. Leveraging the rare opportunity to examine the effects of a policy that remained in force for a limited period, our empirical investigation employs a Complementary Log-Log model to analyse the starting rate, that is, the transition rate from non-use to use. To do so, we use self-reported data on the age of first cannabis use. Our results suggest that the implementation of stricter punishments has a significant effect in reducing the likelihood of early cannabis use initiation. The observed impact of criminalisation is limited in younger ages and diminished as adulthood approaches. This paper also discusses other considerations related to the social costs of criminalisation, which should also be taken into account in the ongoing policy debate.

The Association Between Cannabis Use and Subsequent Nicotine Electronic Cigarette Use Among US Adolescents

PurposeThe current study assessed the association between cannabis use among youth never e-cigarette users and subsequent e-cigarette use. MethodsThe Population Assessment of Tobacco and Health Study is a nationally representative cohort study. Participants aged 12 years and older were selected using a 4-stage, stratified probability sample design from the US civilian, noninstitutionalized population. We included adolescents who participated in both wave 4.5 (2017–2018) and wave 5 (2018–2019) of Population Assessment of Tobacco and Health, and were never e-cigarette users at baseline (N = 9,925). Through multivariable logistic regressions, we examined the prospective association between cannabis use and subsequent e-cigarette use. ResultsE-cigarette use at wave five was significantly more common among youth cannabis users at wave 4.5. The adjusted relative risks between ever cannabis use and subsequent past 12-month, past 30-day, and frequent e-cigarette use (≥20 days per month) were 1.53 (95% CI, 1.26–1.81), 1.70 (95% CI, 1.25–2.15), and 2.10 (95% CI, 1.17–3.03), respectively. The adjusted relative risks between past 30-day cannabis use and subsequent past 12-month, past 30-day, and frequent e-cigarette use were 1.54 (95% CI, 1.04–2.28), 2.01 (95% CI, 1.23–3.29), and 2.87 (95% CI, 1.44–5.71), respectively. We also found significant associations between ever cannabis vaping with subsequent e-cigarette use. DiscussionWhile previous research associates e-cigarette use with subsequent onset of cannabis use, we identify a reverse directional effect, where adolescent cannabis use is associated with increased likelihood of future e-cigarette use.

Complex post-traumatic stress disorder (CPTSD) of ICD-11 in youths with childhood maltreatment: Associations with age of exposure and clinical outcomes

BackgroundExposure to childhood maltreatment (CM) increases the risk of psychiatric morbidity in youths. The new Complex Post-Traumatic Stress Disorder (CPTSD) diagnosis captures the heterogeneity and complexity of clinical outcomes observed in youths exposed to CM. This study explores CPTSD symptomatology and its association with clinical outcomes, considering the impact of CM subtypes and age of exposure. MethodsExposure to CM and clinical outcomes were evaluated in 187 youths aged 7–17 (116 with psychiatric disorder; 71 healthy controls) following the Tools for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV) structured interview criteria. CPTSD symptomatology was explored by confirmatory factor analysis, considering four subdomains: post-traumatic stress symptoms, emotion dysregulation, negative self-concept and interpersonal problems. ResultsYouths exposed to CM (with or without psychiatric disorders) showed greater internalizing, externalizing and other symptomatology, worse premorbid adjustment and poorer overall functioning. Youth with psychiatric disorder and exposed to CM reported more CPTSD symptomatology, psychiatric comorbidity and polypharmacy and earlier onset of cannabis use. Different subtypes of CM and the developmental stage of exposure differentially impact CPTSD subdomains. LimitationsSmall percentage of resilient youths was studied. It was not possible to explore specific interactions between diagnostic categories and CM. Direct inference cannot be assumed. ConclusionsGathering information on type and age of exposure to CM is clinically useful to understand the complexity of psychiatric symptoms observed in youths. Inclusion of the CPTSD diagnosis should increase the implementation of early specific interventions, improving youths' functioning and reducing the severity of clinical outcomes.

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.

Investigating predictors of problematic alcohol, cannabis, and nicotine use among legal users of all three substances.

The three most used substances-alcohol, cannabis, and nicotine-are frequently concurrently. Use of each substance has been connected to an increased probability of use of the other substances, and the problematic use of each substance has been linked to demographic factors, substance use factors, and personality. However, little is known about which risk factors are most important for consumers of all three substances. This study examined the extent to which various factors are associated with dependence on alcohol, cannabis, and/or nicotine in users of all three substances. 516 Canadian adults with past month use of alcohol, cannabis, and nicotine completed online surveys querying their demographics, personality, substance use history, and levels substance dependence. Hierarchical linear regressions were used to determine which factors best predicted levels of dependence on each substance. Alcohol dependence was associated with levels of cannabis and nicotine dependence, and impulsivity, with 44.9% of variance explained. Cannabis dependence was predicted by alcohol and nicotine dependence levels, impulsivity, and the age of onset of cannabis use, with 47.6% of variance explained. Nicotine dependence was best predicted by alcohol and cannabis dependence levels, impulsivity, and dual use of cigarettes and e-cigarettes, with 19.9% of variance explained. Alcohol dependence, cannabis dependence, and impulsivity were the strongest predictors for dependence on each of the substances. A strong relationship between alcohol and cannabis dependence was evident, warranting further research.

Functional correlates of neurological soft signs in heavy cannabis users.

Sensorimotor dysfunction has been previously reported in persons with cannabis dependence. Such individuals can exhibit increased levels of neurological soft signs (NSS), particularly involving motor coordination, sensorimotor integration and complex motor task performance. Abnormal NSS levels can also be detected in non-dependent individuals with heavy cannabis use (HCU), yet very little is known about the functional correlates underlying such deficits. Here, we used resting-state functional magnetic resonance imaging (MRI) to investigate associations between NSS and intrinsic neural activity (INA) in HCU (n= 21) and controls (n= 26). Compared with controls, individuals with HCU showed significantly higher NSS across all investigated subdomains. Three of these subdomains, that is, motor coordination, sensorimotor integration and complex motor task behaviour, were associated with specific use-dependent variables, particularly age of onset of cannabis use and current cannabis use. Between-group comparisons of INA revealed lower regional homogeneity (ReHo) in left precentral gyrus, left inferior occipital gyrus, right triangular pat of the inferior frontal gyrus and right precentral gyrus in HCU compared with controls. In addition, HCU showed also higher ReHo in right cerebellum and left postcentral gyrus compared with controls. Complex motor task behaviour in HCU was significantly related to INA in postcentral, inferior frontal and occipital cortices. Our findings indicate abnormal ReHo in HCU in regions associated with sensorimotor, executive control and visuomotor-integration processes. Importantly, we show associations between ReHo, cannabis-use behaviour and execution of complex motor tasks. Given convergent findings in manifest psychotic disorders, this study suggests an HCU endophenotype that may present with a cumulative risk for psychosis.

Age of onset and alcohol and cannabis use disorders among Mexican American young adults: Robust substance-specific effects of early use as a risk factor

We investigated the substance-specific and cross-substance risk associated with early onset (before age 15) of drunkenness and cannabis use in the subsequent development of alcohol (AUD) and cannabis use disorder (CUD) in Mexican American young adults. Survival analyses employed Cox proportional hazards models for AUD and CUD, separately. In cross-risk analyses, we modeled estimates for those participants reporting lifetime use of both substances. Early onset of drunkenness and early onset of cannabis use were associated with shorter time to AUD and CUD, respectively, even after accounting for psychiatric disorders. While there were no cross-risk associations, adjusting for psychiatric disorders and early onset cannabis use attenuated the association of early drunkenness with AUD.

Estimating the effects of legalizing recreational cannabis on newly incident cannabis use.

Liberalized state-level recreational cannabis policies in the United States (US) fostered important policy evaluations with a focus on epidemiological parameters such as proportions [e.g., active cannabis use prevalence; cannabis use disorder (CUD) prevalence]. This cannabis policy evaluation project adds novel evidence on a neglected parameter-namely, estimated occurrence of newly incident cannabis use for underage (<21 years) versus older adults. The project's study populations were specified to yield nationally representative estimates for all 51 major US jurisdictions, with probability sample totals of 819,543 non-institutionalized US civilian residents between 2008 and 2019. Standardized items to measure cannabis onsets are from audio computer-assisted self-interviews. Policy effect estimates are from event study difference-in-difference (DiD) models that allow for causal inference when policy implementation is staggered. The evidence indicates no policy-associated changes in the occurrence of newly incident cannabis onsets for underage persons, but an increased occurrence of newly onset cannabis use among older adults (i.e., >21 years). We offer a tentative conclusion of public health importance: Legalized cannabis retail sales might be followed by the increased occurrence of cannabis onsets for older adults, but not for underage persons who cannot buy cannabis products in a retail outlet. Cannabis policy research does not yet qualify as a mature science. We argue that modeling newly incident cannabis use might be more informative than the modeling of prevalences when evaluating policy effects and provide evidence of the advantages of the event study model over regression methods that seek to adjust for confounding factors.

Differences in alcohol and cannabis use amongst substance use disorder patients with and without comorbid attention-deficit/hyperactivity disorder.

BackgroundSubstance use disorders (SUDs) continue to be a public health problem. Attention-deficit/hyperactivity disorder (ADHD) is seen as a risk factor for SUD. Prevalence of alcohol and cannabis use amongst adults with SUD and comorbid ADHD impacts both disorders cognitively and behaviourally.AimOur study aimed to compare alcohol and cannabis use between treatment-seeking SUD patients with ADHD and SUD patients without ADHD symptomatology.SettingVarious rehabilitation centres, including the South African National Council on Alcoholism and Drug Dependence (SANCA) Centres, and Private and Provincial Government Substance Abuse Treatment Centres.MethodsA cross-sectional study of adults on drug rehabilitation was conducted. Data on socio-demographic information and alcohol and cannabis use from 185 post-detox inpatients were collected. Diagnoses were based on DSM-IV criteria. Attention-deficit/hyperactivity disorder diagnosis was confirmed by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). SUD+ADHD (n = 52) and SUD-ADHD (n = 128) groups were compared on alcohol and cannabis use as a function of gender.ResultsNo significant differences in the use of alcohol between the SUD+ADHD and SUD-ADHD groups were found. However, the SUD+ADHD group showed increased cannabis consumption. Especially, the SUD+ADHD females showed an earlier age of onset of cannabis use than the SUD-ADHD females and revealed that they use cannabis for a longer period compared with the SUD-ADHD females and SUD+ADHD and SUD-ADHD males.ConclusionThe results revealed the relationship between ADHD and cannabis use, especially amongst females with ADHD and reinforce the need to consider ADHD in cannabis use SUD in clinical interventions.

Cannabis and schizophrenia: characterisation of a risk factor in a sample of Moroccan patients hospitalised for psychosis

BackgroundIn addition to the biological plausibility widely described through a very large number of studies, the causal link between cannabis uses and schizophrenia disorders has become illicit internationally and given the scarcity of similar studies in Morocco. Our study consists of a prospective descriptive study in the psychiatric department of the Moulay ben Abdallah Hospital in Essaouira. The sample consisted of 95 patients diagnosed with schizophrenia according to the DSM5 criteria. The diagnostic assessment included the Positive and Negative Syndrome Scale to assess the severity of positive and negative symptoms of schizophrenia as well as the patient’s general psychopathology, the Clinician-Rated Dimensions of Psychosis Symptom Severity to assess the symptom severity of the psychotic dimensions according, and the Cannabis Abuse Screening Test to assess the extent of cannabis use.ResultsThe mean age of the patients recruited in the study was 33.7 ± 9.37 years with a clear male predominance (p < 0.0001). Cannabis users compared to non-users were younger and comprised only men. Cannabis users also have a lower educational and economic level than non-users. Furthermore, a clear dose effect of cannabis uses on the onset of positive and negative symptoms of schizophrenia. The temporality criterion is clear in our study, since the predictivity of the parameter: “age of onset of cannabis use” is highly significant (p = 0.000). These results suggest that cannabis use can be considered as the most illicit risk factor for the development and/or onset of schizophrenia.ConclusionsThese results suggest that there is a causal relationship between cannabis use and/or dependence (problematic use) and the onset and/or worsening of schizophrenic disorder. This means that problematic cannabis use can be considered as a real risk factor for the emergence and development of schizophrenic disorder.

Validating a brief screening measure for early-onset substance use during adolescence in a diverse, nationwide birth cohort

The Loeber Risk Score (LRS) was developed to predict early-onset cannabis use in adolescence from late childhood, facilitating early identification. However, the LRS was developed in non-representative historical samples, leaving uncertain its generalizability to children/adolescents across the U.S. today. We externally validated the LRS in a diverse, nationwide cohort (N = 4,898) weighted to the composition of the U.S. Census. Participants in 20 cities completed assessments when youth were approximately 5, 9, and 15 years old. Parents completed the LRS at the age ∼5 and ∼9 interviews. At the age ∼15 interview, youth reported on the onset of alcohol/drug use before age 15, monthly drinking/binge drinking at ages 14–16, and use of cannabis multiple times per month at ages 14–16. First, we validated the LRS measured at age ∼9. Area under the receiver operating curve was 0.62 for onset of cannabis use before age 15, 0.68 for onset of cigarette use before age 15, and 0.62 for use of cannabis multiple times per month at ages 14–16. For drinking outcomes, LRS performance could not be distinguished from chance prediction. The recommended screening cutoff of LRS ≥ 2 identified 24% of children, among whom early-onset cannabis/cigarette use outcomes occurred 1.4–2.2 times more frequently than the general population. The LRS’ performance did not vary significantly by sex, race, or ethnicity. When the LRS was measured at age ∼5, AUROC was significantly lower for some outcomes. Together, findings support the LRS measure as a potential tool for identifying children in early or late childhood at risk of early-onset drug use in adolescence.