Reported Marijuana Use Research Articles

Alcohol, Tobacco, and Marijuana use Among Individuals Receiving Prescription Opioids for Pain Management.

Substance use among individuals receiving prescription opioids for pain may be associated with poorer functioning. The purpose was to examine whether use of substances (i.e., alcohol, marijuana, or tobacco) among individuals prescribed opioids for pain management was associated with pain, psychiatric disorders, and opioid misuse. Patients with non-cancer pain and a new opioid prescription were recruited from two health systems. Participants (N= 827) completed measures regarding pain severity, pain interference, psychiatric symptoms, and substance use. Substance use was common with 58.0%, 26.2%, and 28.9% reporting alcohol, tobacco, and marijuana use, respectively. Use of tobacco or marijuana was associated with poorer functioning. Those with tobacco use had greater pain severity, interference, number of pain sites, and concern for opioid misuse, and were more likely to have probable depression, anxiety, and PTSD. Participants reporting marijuana use were more likely to have higher concern for opioid misuse scores and probable depression, anxiety, and PTSD. Use of alcohol was associated with lower pain severity and interference and fewer number of pain sites. Substance use is common among individuals receiving prescription opioids. Some types of substance use may be related to poorer opioid, pain, and psychiatric functioning. Clinicians prescribing opioids for pain management should assess for substance use, including tobacco, and be aware of the association with poorer functioning. Interventions could target pain, psychiatric symptoms, and substance use simultaneously to optimize outcomes for individuals with pain and substance use.

Substance Use Among African American College Students: Testing the Theory of African American Offending

Background: General criminological theories contend that African Americans’ substance use is due to overexposure to criminological risk factors. However, some scholars suggest that racial injustices (i.e., racial discrimination and criminal justice injustices) and racial socialization practices, which includes religiosity (church involvement), impact African American substance use. Objective: Drawing on Unnever and Gabbidon’s theory of African American offending, which considers racial injustices and racial socialization when explaining African American offending, the current research examined African American college students’ substance use behavior. Methods: African American college students (n = 131) completed an online and anonymous survey measuring substance use, criminal justice injustices, racial discrimination, racial socialization, religiosity, negative emotions, and school bonds. Results: African American college students who reported marijuana use had less confidence in the police and those who engaged in heavy/binge drinking reported more negative emotions and negative encounters with the police. Additionally, negative police encounters and racial socialization practices increased the odds of heavy/binge drinking, whereas religiosity decreased the odds of heavy/binge drinking. Conclusion: These results suggest that a relationship exists among criminal justice injustices, perceived racial bias, racial socialization, religiosity, and African American college students’ substance use. As such, the current research provides partial support for the Theory of African American Offending while demonstrating the need to consider racial experiences when examining African American substance use.

Assessment of Marijuana Use During Pregnancy and its Effects on Neonatal Outcomes

Background: According to the American College of Obstetricians and Gynecologists (ACOG), marijuana is the most used drug during pregnancy, and its self-reported prevalence ranges from ~2% to 7%. ACOG currently recommends against marijuana use during pregnancy due to inconclusive data regarding its safety and health effects. However, we know that THC readily crosses the placenta and can reach high fetal concentrations on repeated exposures. Several reports have linked adverse infant outcomes, such as low birth weight and abnormal neurological development, to marijuana use in pregnancy. Yet, many pregnant women continue to use marijuana throughout gestation as they believe it is safe, highlighting the role that education on marijuana use in pregnancy may aid in decreasing its usage. Furthermore, the growing legalization of marijuana may lead to further increase in marijuana use during pregnancy. Purpose: We aimed to identify the reported use of marijuana during pregnancy in our patient population, prior to legalization, and examine its effects on maternal and neonatal outcomes. We hypothesized that those who reported using marijuana during pregnancy would have higher rates of maternal complications and adverse neonatal outcomes. Methods: A retrospective chart review (IRB #21-823) was conducted which included pregnant women and their neonates who were admitted and delivered in 2019 at HSHS St. John’s Hospital in Springfield, Illinois to assess marijuana use prior to legalization and to investigate neonatal outcomes of infants who were exposed to marijuana, including the need for respiratory support or assisted ventilation after delivery. Other data extracted included demographic characteristics, the mother’s medical and obstetrical history, intrapartum and postpartum events and all documented substance use during pregnancy including tobacco, marijuana and illicit drugs. A logistic regression was used to assess marijuana use as a predictor of respiratory outcomes in infants. Odds ratios with 95% confidence intervals (CI) are reported. Results: In our study, 599 charts were reviewed. Of those, 69 reported marijuana use during pregnancy, or 11.5%, which importantly, is higher than the reported national average of 2-7%. Previous studies have shown a high correlation between marijuana, tobacco and illicit drug use. Additionally, studies have demonstrated that tobacco and illicit drug use result in poor neonatal outcomes. Therefore, we focused on a subpopulation of mothers who only reported marijuana use during pregnancy to remove these confounders. As a result, 112 subjects were removed from the analysis who reportedly used tobacco and/or other illicit drugs in addition to marijuana in order to exclusively focus on the effect of maternal marijuana use on neonatal outcomes. In this subpopulation of 477 subjects, the rate of marijuana use was 5.5% (lower than the overall population), but the effects of marijuana on neonatal outcomes was found to be significant. Demographics were as follows: mean age 28.2 ± 0.25 years; race, ethnicity: 76% White, non-Hispanic and 23% were other (i.e., African American/black, Asian, native Hawaiian/pacific islander, white and Hispanic, non-white and Hispanic or another race). In this subpopulation, admission to the NICU and small for gestational age were not significantly different between marijuana users and non-users. However, marijuana users did have higher odds of preterm birth (OR=3.8, CI: 1.5-9.6; p=0.004). Additionally, marijuana users had increased odds of having an infant that required respiratory support (OR=3.9, CI: 1.4-10.3; p=0.005) and assisted ventilation (OR=4.6, CI: 1.6-13.1; p=0.003). Yet, no adverse maternal outcomes were associated with exclusive marijuana use. Conclusion: Rates of marijuana use during pregnancy in our population is higher than the reported national average. Moreover, infants whose mothers exclusively used marijuana during pregnancy experienced higher rates of neonatal complications. Thorough screening and counseling regarding marijuana use in pregnancy and during breastfeeding is recommended, although there is no uniform process at this time. Implementing a standardized screening methodology and approach to education on the adverse neonatal effects of marijuana use in pregnancy during prenatal visits may be an effective intervention to improve neonatal outcomes in our patient population. This education is of particular importance in light of the recent legalization of marijuana.

Substance use among individuals with cancer: A US population-based cohort study.

e23133 Background: The prevalence of concurrent substance use or comorbid substance use disorder (SUD) among individuals with a cancer diagnosis, and their participation in substance use treatment, has not yet been described in a large US population-based cohort. Methods: A population-based cohort study was conducted using cross-sectional survey data collected by the National Survey on Drug Use & Health (NSDUH) between 2015-2022. Descriptive statistics were calculated to describe two populations: those with any kind of cancer diagnosis within the preceding 12 months and either comorbid SUD as defined by the Diagnostic and Statistical Manual of Mental Illness (DSM)-5 or concurrent use of any of the following substances: alcohol, marijuana, cocaine, crack, heroin, methamphetamines, or misuse of prescription drugs. Chi-square tests were conducted to describe associations with the demographic and geographic characteristics of these individuals. Results: Between 2015-2022, 432,764 individuals (53% female) completed the survey. A total of 2,547 respondents had a cancer diagnosis in the preceding 12 months; the most common cancer types were breast cancer (17.0%), non-melanoma skin cancers (16.2%), and prostate or testicular cancer (11.0%). Among this cohort, 1,664 (65%) reported concurrent alcohol use, 354 (14%) reported marijuana use, and 82 (3%) reported illicit use of other substances. Among those with an active cancer diagnosis in the preceding 12 months, 103 (4%) met DSM-5 criteria for a comorbid SUD based on survey responses. Among individuals with a past-year cancer diagnosis, there was a statistically significant association between concurrent substance use and income bracket (X2 = 92.67, p < 0.001), concurrent substance use and race (X2=46.12, p< 0.001), and between concurrent substance use and population density (X2= 7.05, p = 0.029). Zero respondents with cancer and either concurrent substance use or comorbid SUD received outpatient treatment for substance use in the preceding year, three (0.002%) received inpatient treatment, and seven (0.004%) participated in a support group. Among respondents with comorbid SUD, many reported being recently asked by a healthcare professional about their alcohol (83%) or drug use (67%), while only 1.9% reported recently receiving information from a healthcare professional about substance use treatment. Conclusions: There is overlap between the population with a cancer diagnosis and that with concurrent substance use or comorbid SUD. Based on population-level survey data, these individuals have low rates of participation in outpatient or inpatient substance treatment, and report that they do not often receive information about substance use treatment from healthcare professionals. Describing this population may inform how providers approach their unique healthcare needs.

Racial Disparities in Patterns and Modes of Current and Daily Marijuana Use among Adults Living with Children.

This study sought to examine racial disparities in marijuana use among U.S. adults living with children. Data are drawn from the 2022 Behavioral Risk Factor Surveillance System to examine the prevalence of current (past month) and frequent (≥20 days in the last 30 days) marijuana use along with the mode of marijuana use by 7 racial and ethnic groups (non-Hispanic [NH] White, NH-Black, Hispanic, NH American Indian or Alaskan Native [AI/AN], NH-Asian, NH Native Hawaiian or other Pacific Islander only [NH/PI], and other/multiple races, n=22,659). Compared to NH White adults with children, NH Black adults had a higher prevalence of current marijuana use (23.1% vs. 16.9%, p=0.003) and NH AI/AN adults had two times higher prevalence of frequent use (17.3% vs. 8.4%, p=0.0003). Adults living in recreational marijuana legal states (vs. no) were also more likely to report marijuana use, and there were significant age × race/ethnicity and education × race/ethnicity interactions (p<0.05) on marijuana use. Regarding the mode of use, racial minority users except Asians also reported a higher prevalence of smoking marijuana than their White counterparts. Substantial racial disparities in marijuana use patterns among adults who live with children highlight a potential risk for adolescents' health. Addressing these differences is essential for promoting equitable health outcomes in diverse communities.

Marijuana Use Increases Risk of Hematoma Formation in Patients Undergoing Abdominal Body Contouring Surgery

Abstract Goals/Purpose The physiological effect of marijuana is thought to include platelet inhibition and poor wound healing, however, there is mixed clinical evidence in the plastic surgery literature regarding this topic. As marijuana usage continues to increase, this study sought to identify the effect of marijuana on postoperative complication rates in patients undergoing abdominal body contouring surgery (ABCS) while controlling for tobacco consumption and other comorbidities. Methods/Technique A retrospective cohort study was conducted in patients who underwent panniculectomy or abdominoplasty at our institution between 2016 and 2021. Patients were separated into groups of active (at time of surgery), former, and no marijuana use. Demographic characteristics, smoking history, laboratory results, comorbidities, operative details, and postoperative complications including hematoma, deep vein thrombosis (DVT) and pulmonary embolism (PE), and wound healing complications were analyzed. Parametric, nonparametric, and multivariable regression modeling was used for analysis. Results/Complications 815 patients who underwent panniculectomy or abdominoplasty were included in the study. 61 patients (7.5%) reported active marijuana use at time of their surgery, and 31 patients (3.8%) reported former marijuana use (defined as last use &amp;gt;2 months prior). Patients who reported any marijuana use were significantly younger (40.5 years vs 45.9 years; p&amp;lt;0.0001) and more likely to identify as Black (OR=2.34; p=0.005). Any marijuana use was significantly associated with reported tobacco use (OR=4.80; p&amp;lt;0.001; 95% CI 1.69-12.69) After adjusting for age, BMI, tobacco use, platelet count, and comorbidity index, active marijuana use was associated with significantly higher risk of hematoma formation (OR=2.55; P= 0.03; 95% CI 1.12-6.55) as well as any complication combined (OR=1.73; p=0.02, 95% CI 1.15-3.56). Other complications, including venous thromboembolism, infection, seroma, umbilical necrosis, wound dehiscence, or anesthetic-related complications were not significantly associated with reported marijuana use. Conclusion When controlling for multiple confounders, marijuana use appears to be independently associated with increased risk of hematoma development in patients undergoing abdominal body contouring surgery with either abdominoplasty or panniculectomy. Further research is warranted to investigate the exact relationships and mechanisms of action behind this finding.

Pedestrians injuries in the north east region of Jamaica: a cross sectional study

ABSTRACT To describe the sociodemographic data of injured pedestrians, temporal patterns of injury, injury patterns, and the independent predictors of hospital admission. A two year cross-sectional study was conducted at the Saint Ann’s Bay Regional Hospital in pedestrians with injuries post collision with a motor vehicle. A census was performed in all patients who received either emergency room treatment, hospital admission, or surgical intervention. A 30-item interviewer questionnaire was administered to collect the data. A logical regression model was used to determine independent predictors for hospital admission. Ninety pedestrians were included. Age range: 6-86 years old (Mean=39.9). Males were 63.3%, 75.6% were employed, 31% had a chronic illness and 27% reported marijuana use. Most injuries occurred in April, lowest injury rates occurred in August and September. Twenty two percent of collisions occurred on Saturdays. Most injuries occurred at 5pm and 3pm. Many (54.4%) had a fracture, 73.5% were closed. Approximately 32% had contusions and 6.7% had lacerations. Independent predictors of admission were history of marijuana use and having a fracture. Those with history of marijuana use were 4.21 times more likely to be admitted. Those with fractures were 7.10 times more likely to be admitted. Injury patterns spanned a wide age range. They often involved a high energy mechanism of injury as evidenced by the frequency of fractures, hospital admission and surgery intervention rates. The data also suggests a need to implement marijuana testing programmes in our road users.

The Impact of Marijuana Use on Postoperative Outcomes in Abdominal-based Free Flap Breast Reconstruction.

There is an increasing prevalence of marijuana use in the general population yet clinical studies on marijuana's effect on surgical outcomes remain limited. Marijuana's effect on wound healing, venous thromboembolism (VTE) due to endothelial inflammation, and bleeding due to inhibited platelet function have been cited based on animal models but have not been evaluated clinically in patients undergoing microsurgical reconstruction. Retrospective chart review was performed on all patients who underwent abdominal-based free flap breast reconstruction in a single institute from August 2018 to December 2022. Patient self-reported marijuana use, demographics, total narcotic use during hospitalization converted to oral morphine milligram equivalent (MME), and 90-day complications were collected and compared. A total of 162 patients were included and 13 patients (8.5%) had reported marijuana use on presurgical history. Marijuana users are more likely to be younger and report concurrent nicotine smoking. Marijuana users were also at a significantly elevated risk of developing symptomatic VTE (15 vs. 1%; odds ratio (OR) 13.4 [95% confidence interval (CI) 1.71-104.2]; p = 0.01) and marijuana use remained a significant risk factor with multivariate analysis. On postoperative 90-day complications, there was no increased risk of flap loss, reoperation, postoperative transfusion, or hematoma associated with marijuana use, and no significantly increased risk for overall donor or recipient site complications. Marijuana users required significantly more narcotics for pain control during hospitalization (100 ± 77 vs. 49 ± 45 MME; p = 0.0003), although they had similar lengths of stay, achievement of mobilization on post operative day (POD)1, and maximal pain scores. Marijuana use increases the risks of postoperative VTE and increased postoperative narcotic requirements in patients who underwent abdominal-based free flap breast reconstruction. Future prospective cohort study is required to further understand marijuana-associated risks in microsurgical procedures.

Tobacco or marijuana use and infertility: a committee opinion

In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. Although the negative impact of tobacco use in pregnancy is well documented, the impact of tobacco and marijuana on fertility and reproduction is less clear. This committee opinion reviews the potential deleterious effects of tobacco, nicotine, and marijuana use on conception, ovarian follicular dynamics, sperm parameters, gamete mutations, early pregnancy, and assisted reproductive technology outcomes. It also reviews the current status of tobacco smoking cessation strategies. This document replaces the 2018 American Society for Reproductive Medicine Practice Committee document entitled Smoking and Infertility: a committee opinion (Fertil Steril 2018).

Factors Associated with Provider Counseling Against Breastfeeding in the Setting of Marijuana Use: A Population-Based Survey.

The purpose of this study was to explore patient demographic factors associated with counseling against breastfeeding and concurrent marijuana use. A cross-sectional study derived using data from the Centers for Disease Control and Prevention administered Pregnancy Risk Assessment Monitoring System (PRAMS) in collaboration with state and local health departments. This study sample included survey participants whose responses indicate they received counseling discouraging breastfeeding with concurrent marijuana use. Bivariate and multivariate regression analyses assessed the relationship between factors associated with counseling against breastfeeding and concurrent marijuana use. Of the 10,911 participants in this sample, 9,695 participants who answered the question about receiving counseling discouraging breastfeeding while using marijuana were included in the analysis (89% response rate for the total sample). Twenty nine percent of participants were advised by a provider not to breastfeed while using marijuana. Participants who received this counseling were more likely to be people of color, age less than or equal to 29, with a high school education or less, unmarried, report governmental or no insurance prepregnancy, and report marijuana use postpartum. In the multivariate analysis, age less than or equal to 20 (P = .001), being unmarried (P = .023), and marijuana use postpartum (P = .034) remained associated with counseling against breastfeeding. Our results suggest that individuals are being counseled differently. Unmarried and young people (age <20 years) were more likely to report receiving counseling against breastfeeding with concurrent marijuana use. Given the growing national acceptability of marijuana use, the known benefits of breastfeeding, and the unclear risks of marijuana in human milk, there is a need to standardize counseling to avoid a missed opportunity to educate breastfeeding populations who use marijuana and to reduce the risk of counseling based on providers' personal attitudes and biases not aligned with evidence-based guidelines.

Substance Use, Sleep Duration, and Health Among Adults in Ohio.

Substance use affects approximately 46.3 million people aged 12 years or older (16.5% of the US population) and is associated with poor sleep health overall. We conducted a cross-sectional secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System survey in Ohio. The sample comprised 14,676 adults. We examined associations between the use of 2 types of substances (marijuana and nonprescribed prescription pain medication) and short sleep duration (<6 hours per night) and overall health (mental, physical, and general). We used linear and logistic regression modeling while adjusting for individual-level (age, sex, race and ethnicity, education, income, and body mass index) and area-level (socioeconomic deprivation) covariates. Of survey respondents who answered questions, 9.2% (1,140 of 12,362) reported using marijuana, and 1.4% (111 of 8,203) used nonprescribed prescription pain medication. Respondents who used marijuana used it an average 17.3 days per month. In adjusted logistic regression models, the odds of reporting short sleep duration were 2.4 times greater among respondents who used nonprescribed prescription pain medication (vs those who did not). The odds of reporting short sleep duration, poor mental health, poor physical health, and poor general health were 1.5, 1.3, 2.1, and 1.9 times greater, respectively, among respondents who reported marijuana use (vs those who did not). In the linear regression models (adjusted), more days of marijuana use were associated with longer sleep duration, worse mental health, and worse general health. Understanding the connection between substance use and health outcomes is needed to improve trajectories of substance use and recovery. Sleep duration is often underassessed among people who use substances. Expanding diagnostics and treatment options for those who use substances may result in lower levels of substance use and improved overall health.

PATTERNS OF MARIJUANA USE IN THE US OLDER ADULT POPULATION

Abstract Marijuana use is increasing in the U.S. population, including among adults 50 and older, but research on population characteristics of marijuana use in middle aged and older adults is limited. We use data from the 2018-2021 Behavioral Risk Factor Surveillance System (BRFSS) surveys, which are representative of U.S. state populations, to estimate prevalence and frequency of marijuana use by age. The data are from 39 states that included the module on marijuana use in the past 30 days (n=466,469). We also examine age patterns in use by legalization status and reasons for use of marijuana. Reported marijuana use is much lower among those ages 50 and older (6.49%) than 18-49 (16.3%). Multivariable regression analyses show that marijuana use declines with age (p&amp;lt;.001) and is lower among women (p&amp;lt;.001). Marijuana use among older adults is slightly lower in states where it is illegal compared to states that have legalized (4.6% vs. 7.1%, p&amp;lt;.001). Use of marijuana for medical reasons increases with age; nearly two-thirds of adults 80+ who use marijuana report doing so for medical reasons. Adults 80+ also report the highest frequency of use, likely reflecting greater medical need. The most common conditions reported among adults 50+ who use marijuana for medical reasons are arthritis (61%), depression (36%), asthma (20%), and COPD (18%). Our prevalence estimates of use at older ages match those from other national surveys, but our findings suggest older adults are using marijuana largely for medical reasons.

Marijuana Use among Pregnant and Nonpregnant Women of Reproductive Age, 2013–2019

Background Marijuana is the most commonly used federally illicit substance among reproductive-age women in the United States. Updated information on marijuana use in this population can inform clinical and public health interventions. Methods Data from the 2013–2019 National Survey on Drug Use and Health was used to report weighted prevalence estimates of marijuana use in the past month, past 2–12 months, and past year among women aged 18–44 years with self-reported pregnancy status. Bivariate analyses and general linear regression models with Poisson distribution using appropriate survey procedures identified factors associated with past-year marijuana use by pregnancy status. Results Among pregnant women, 4.9% (95% confidence interval [CI]: 4.1–5.6) reported marijuana use in the past month, 10.4% (95% CI: 9.3–11.5) in the past 2–12 months, and 15.2% (95% CI: 13.9–16.6) in the past year. Among nonpregnant women, 11.8% (95% CI: 11.5–12.0) reported marijuana use in the past month, 7.8% (95% CI: 7.6–8.0) in the past 2–12 months, and 19.5% (95% CI: 19.2–19.9) in the past year. After adjusting for sociodemographic characteristics, past-year marijuana use was 2.3–5.1 times more likely among pregnant, and 2.1 to 4.6 times more likely among nonpregnant women who reported past-year tobacco smoking, alcohol use, or other illicit drug use compared to those reporting no substance use. Conclusions Pregnant and nonpregnant women reporting marijuana use, alone or with other substances, can benefit from substance use screening and treatment facilitation.

Demographics and Reported Symptoms Associated With Marijuana Use Among Adolescents and Young Adults.

Purpose Marijuana use has been increasing in the adolescent population. Our objective was to examine the prevalence of marijuana use among a sample of adolescents and young adults, determine an association with risk-taking behaviors, identify reported medical symptoms, and delineate common beliefs about marijuana use. Methods A questionnaire was administered to a sample of patients aged between 12 and 23 years old presenting to the emergency department of Penn State Hershey Medical Center, Hershey, Pennsylvania. Data were stratified by marijuana users and non-users, and further stratified by traditional (vape, pipe, edibles) and non-traditional (oils/concentrates, topical creams) use. Results The analysis was based on 200 questionnaires. Thirty-nine percent (n=78) reported marijuana use. Marijuana users were more likely to report previous sexual intercourse (79.5% vs. 32.8%; p=<0.0001), as well as the use of alcohol (50.0% vs. 10.7%; p=<0.0001), cigarettes (41% vs. 8.2%; p=<0.0001), prescription pain medications (20.5% vs. 4.1%; p=0.002), and cocaine (14.1% vs. 0.8%; p=0.0017). Users more likely reported texting while driving (41.0% vs. 13.1%; p=0.005) and experienced physical or electronic victimization due to bullying (43.6% vs. 19.7%; p=0.002). Users were more likely to report gastroesophageal reflux disease (GERD), attention deficit disorder (ADD), anxiety, and depression. The most common symptoms associated with marijuana use were anxiety (65.4%), headache (61.6%), nausea/vomiting (53.8%), cough (51.3%), and abdominal pain (47.4%). Sixty-nine percent of respondents believed marijuana was "safer than other drugs". Conclusion Based on our sample, we identified risk-taking behaviors, medical symptoms, and beliefs associated with marijuana use. Healthcare professionals may use these data to provide screening and anticipatory guidance to adolescents who use marijuana and consider marijuana use in their differential diagnosis.

Marijuana use disorder among adults with functional disabilities-A US population-based cross-sectional study.

Recent studies suggest a growing trend in marijuana use, compared to a stable prevalence of marijuana use disorder among US adults over the first 15 years of the 21st century. This study investigated the recent patterns of marijuana use disorder among people with disabilities (PWD). We extracted a nationally representative sample (N = 209,058) from the 2015-2019 National Survey on Drug Use and Health data set and examined associations by functional disability status (any disability, disability by type, and number of disabling limitations) with marijuana use disorder using a series of independent multivariable logistic regression models. We also performed trend analyses during the study period. The prevalence of marijuana use disorder (from 1.7% to 2.3%) increased significantly among PWD between 2015 and 2019 (p-trend < .001). PWD were significantly more likely to report marijuana use disorder (odds ratio [OR], 1.37, 95% confidence interval [CI], 1.24-1.52) than people without disability (PWoD). Those with cognitive limitation only (OR, 1.78, 95% CI, 1.53-2.06) and ≥2 limitations (OR, 1.29, 95% CI, 1.10-1.51) were more likely to report marijuana use disorder than PWoD. PWD had a consistently higher prevalence of marijuana use disorder than PWoD. Additionally, the level of risk for marijuana use disorder varied by disability type and number of disabling limitations. Our study provided new nuance on disparities in marijuana use disorder between PWD and PWoD and further revealed the varied risks for marijuana use disorder across different disability statuses.

Impulsivity and Alcohol Use during Pregnancy and Postpartum: Insights from Novel Methodological Approaches within the Context of the COVID-19 Pandemic.

Impaired emotion regulation and impulsivity have been linked to substance use. This study evaluated the association between emotion regulation difficulties-specifically impulsivity-and substance use within the context of the COVID-19 pandemic among pregnant (n = 49) and postpartum (n = 20) women. Participants from a prospective cohort ENRICH-2 completed a baseline phone survey of COVID-19-related experiences and impulsivity followed by a 14-day (3x/day) mobile ecological momentary assessment (mEMA) of impulsivity and substance use. Between-subject (BS) and within-subject (WS) associations for baseline impulsivity and momentary impulsivity with respect to substance use were examined using mixed effects models. At the BS level, momentary impulsivity scores that were higher than the overall group average were positively associated with subsequent momentary reports of marijuana use (β = 1.25; p = 0.04) when controlling for pregnancy status and COVID-19-related stress. At the WS level, momentary impulsivity scores that were higher than an individual's average score were positively associated with subsequent reports of momentary alcohol use (β = 0.08; p = 0.04). This research supports the idea that impulsivity varies based on individual situations, such as stress associated with the COVID-19 pandemic, and may be an important correlate of substance use in pregnant and postpartum women. Future research might consider investigation of additional factors, which may serve to moderate or mediate the relationship between impulsivity and substance use.

The effect of the COVID-19 pandemic on substance use patterns and physiological dysregulation in pregnant and postpartum women.

The SARS-CoV-2/COVID-19 pandemic has been associated with increased stress levels and higher alcohol use, including in pregnant and postpartum women. In the general population, alcohol use is associated with dysregulation in the autonomic nervous system (ANS), which is indexed by heart rate variability (HRV). The objectives of this study were to: (1) characterize changes in substance use during the SARS-CoV-2/COVID-19 pandemic via a baseline self-report survey followed by mobile ecological momentary assessment (mEMA) of substance use; and (2) examine the associations between momentary substance use and ambulatory HRV measures in pregnant and postpartum women. Pregnant and postpartum women were identified from the ENRICH-2 prospective cohort study. Participants were administered a baseline structured phone interview that included the Coronavirus Perinatal Experiences (COPE) survey and ascertained the prevalence of substance use. Over a 14-day period, momentary substance use was assessed three times daily, and HRV measurements were captured via wearable electronics. Associations between momentary substance use and HRV measures (root mean square of successive differences [RMSSD] and low frequency/high frequency [LF/HF] ratio) were examined using a mixed effects model that included within-subject (WS) and between-subject (BS) effects and adjusted for pregnancy status and participant age. The sample included 49 pregnant and 22 postpartum women. From a combination of a baseline and 14-day mEMA surveys, 21.2% reported alcohol use, 16.9% reported marijuana use, and 8.5% reported nicotine use. WS effects for momentary alcohol use were associated with the RMSSD (β = -0.14; p = 0.005) and LF/HF ratio (β = 0.14; p = 0.01) when controlling for pregnancy status and maternal age. No significant associations were observed between HRV measures and instances of marijuana or nicotine use. These findings highlight the negative effect of the SARS-CoV-2/COVID-19 pandemic on the psychological health of pregnant and postpartum women associated with substance use, and in turn, ANS dysregulation, which potentially puts some women at risk of developing a substance use disorder.

Sources for prescription stimulant misuse: A person-centered approach to understanding links to substance use and psychiatric impairment.

Prescription stimulant misuse (PSM) is most prevalent among college students and is associated with numerous negative academic and psychosocial outcomes. A large body of literature has identified predictors of PSM in this population, however few studies have utilized a person-centered approach to examine how the sources from which students procure prescription stimulants are associated with substance-related and psychiatric impairment. We used latent class analysis (LCA) to classify a geographically and racially/ethnically diverse sample of U.S. undergraduates (N = 538) who misused prescription stimulants into groups based on their endorsement of nine sources of medication. We selected a five-group classification from the LCA with classes of peer/dealer, given by friend, own prescription, lower multiple sources (i.e., relatively infrequent endorsement of multiple sources), and any source. Compared to the reference group (given by friend), the own prescription class was less likely to report marijuana use, simultaneous alcohol and marijuana use, alcohol or marijuana consequences, and nonoral routes of administration. On the other hand, the own prescription class was more likely to screen positive for anxiety, anger, and suicidality. Similarly, the lower multiple sources group was more likely to screen positive for depression, anxiety, anger, and suicidality. Prevention and intervention efforts focused on PSM may be tailored differently for students who are misusing their own medication and/or endorsing multiple sources. Specifically, these students may need broader assistance with comorbid psychiatric conditions, particularly suicidality, while students who obtain stimulants from peers or a dealer may benefit more from substance-focused interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Characteristics and outcomes of Marijuana users admitted with sudden cardiac arrest

Background: Marijuana or Cannabis is the most commonly used illicit drug in the United States. An estimated 2 million adults who reported marijuana use also have cardiovascular disease. Marijuana use has been associated with acute myocardial infarction, heart failure and arrhythmias. However, the implications of marijuana use on sudden cardiac arrest outcomes is unknown. Methods: Using the National Inpatient Sample of the years 2018 &amp; 2019, patient characteristics and in-hospital outcomes were compared between marijuana users and non-marijuana users admitted with sudden cardiac arrest. Results: The median age of marijuana users was lower at 46.8years. They had significantly lower prevalence of congestive heart failure, coronary artery disease, valvular heart disease, pulmonary circulation disorders, atrial fibrillation, hypertension, and diabetes and a significantly higher prevalence of chronic liver disease, depression, alcohol use, tobacco use, amphetamine/psychostimulant use, opioid use, cocaine use, and sedative use. Multivariable logistic regression analysis showed significantly higher odds for ventricular fibrillation (OR: 1.24; 95% CI: 1.09- 1.41; p- 0.001) but lower odds for mortality (OR: 0.86; 95% CI: 0.78- 0.96; p-0.011), need for mechanical ventilation (OR: 0.76; 95% CI: 0.67- 0.86; p- 0.000), and tracheostomy (OR: 0.46; 95% CI: 0.34- 0.62; p- 0.000). Marijuana users were also more likely to be discharged home with self-care (25.25% vs 11.53%). Conclusion: Among patients admitted with sudden cardiac arrest, marijuana users were found to have significantly higher odds for ventricular fibrillation. They were found to have lower odds for in-hospital mortality, mechanical ventilation, and tracheostomy and were more likely to be discharged home with selfcare, but this is mostly because marijuana users who are admitted with sudden cardiac arrest were younger and had considerably fewer chronic medical conditions. Large prospective cohort studies are needed to ascertain the health risks associated with marijuana use.

S11 Impact of Marijuana in Ulcerative Colitis With Nstemi Hospitalizations: Insights From National Inpatient Sample 2016-2019.

Background: Marijuana use is increasingly prevalent in patients with ulcerative colitis (UC). Clinical symptoms such as abdominal pain, reduced appetite, and diarrhea improve in some patients after marijuana use; partly due to its psychotropic, neuromodulatory, and immunomodulatory effects via the endocannabinoid pathway. Marijuana use and underlying UC can lead to adverse cardiovascular outcomes, and we aim to study its impact on NSTEMI hospitalizations. Methods: A retrospective analysis of the 2016-2019 NIS was conducted to identify hospitalization (Age ≥18 & non-elective) with acute NSTEMI and concomitant history of UC using ICD-10 codes. Variables were screened with univariate regression, intermediate, co-linear variables were removed before a multivariable regression analysis model was built and performed to calculate the odds ratio. Discharge-level weight analysis was used to produce a national estimate. Results: Out of 142,420,378 hospitalizations, only 7,010 had acute NSTEMI and underlying UC. Only 0.78% of these hospitalizations also reported marijuana use. The mean age of patients who used marijuana was 57.55 yrs vs 70.58 yrs for those who did not. A total of 560 (7.99%) hospitalizations had fatal outcomes; however, the difference in deaths between those who used marijuana vs those who did not was statistically insignificant (9.09% vs 7.99%, P 0.89). Upon multivariate analysis, marijuana is not a risk factor for mortality in UC + NSTEMI (OR 1.11, P 0.907). Factors associated with increased mortality were shock (OR 5.88, P 0.00), AKI (OR 3.44, P 0.00), mech ventilation > 24h (OR 3.44, P 0.00). Marijuana use is also not associated with increased hospital resource utilization (-22557.46$, P 0.42). Factors associated with increased total charges of hospitalization are urban teaching hospital location (rural -48272.37$ p 0.00, urban non-teaching -23378.35$, P 0.00), mech ventilation >24 hr (+170339.6$, P 0.00), HF (+25197.46$, P 0.00), CABG (+152736.6$, P 0.00), and shock (+50532.01$, P 0.000). Marijuana, however, is associated with a lower mean length of stay (LOS) by 3.4 days (P 0.02). Factors associated with higher mean LOS are elixhauser comorbidity (+0.48d, P 0.00), mech ventilation > 24h (+7.35d, P 0.00), shock (+1.72d, p 0.01), ventricular arrhythmias (+1.90d, P 0.02), ESRD on HD (+5.20d, P 0.04), AKI (+2.11d, P 0.00), CABG (+5.62d, P 0.000), and anemia (+1.09d, P 0.02). Conclusion(s): Marijuana is not associated with increase in mortality or total charges of hospitalization in UC patients admitted for acute NSTEMI. Additionally, it is associated with reduced LOS in these hospitalizations, likely due to the lower mean age resulting in quicker recovery and discharge.