Academic literature on the topic 'Cannabis use disorder'
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Journal articles on the topic "Cannabis use disorder"
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Duncan, Cameron, Kendra Butler, and Laurielyn Loa. "Cannabis use disorder." Nurse Practitioner 46, no. 3 (March 2021): 12–15. http://dx.doi.org/10.1097/01.npr.0000733712.67456.43.
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Hasin, Deborah, and Claire Walsh. "Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review." Journal of Clinical Medicine 10, no. 1 (December 23, 2020): 15. http://dx.doi.org/10.3390/jcm10010015.
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Background: The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. Methods: A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. Results: A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. Conclusions: Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.
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Reula, L. Montes, A. Portilla Fernández, and H. Saiz García. "Aspects of the psychological consequences of cannabis use." European Psychiatry 41, S1 (April 2017): S479. http://dx.doi.org/10.1016/j.eurpsy.2017.01.563.
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Cannabis is seen among general population as an “anti-depressive drug”. Many papers have been published in the field of investigation about the relationship between cannabis use and affective disorders. We pretend to find the aspect of the psychological consequences of cannabis use.MethodsUsing Pubmed and PsychInfo, we conducted a narrative review of the literature on cannabis and psychiatric comorbidity using the keywords cannabis, psychosis, mood, depression, mania, bipolar, and anxiety.ResultsThere is substantial evidence of an association between cannabis use and psychosis. A few reports suggest an association with bipolar disorder while the association with depression and anxiety disorders is mixed.ConclusionsThe present review confirms earlier findings of an association between cannabis use and a lower age at onset. Data shows that cannabis use, beginning in the adolescence and with a frequency higher than once a week, correlates with the development in adult age of affective symptoms and/or disorder, mainly in bipolar disorder, with a moderate relation with Depressive spectrum. Even more, some authors hypothesize that cannabis may play a role in the development of the disorder, that to say, affective disorder would not appear in the absence of cannabis use. The current findings suggest that recent cannabis use is associated with a more severe course of illness in the early phase of BD I.Recent cannabis use was also associated with more lifetime suicide attempts.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Singh, Shweta, Divya Taneja, Renu Mittal, and Subhash Kaushik. "Cannabis Use Disorder: A Review." Advancements in Homeopathic Research 7, no. 4 (December 21, 2022): 19–28. http://dx.doi.org/10.48165/ahr.2022.7.4.1.
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Background: Cannabis use is rising and becoming a trending drug among youth. The drug is used in different forms, leading to intoxication, acute and long-term consequences. About 2.8% of Indians aged 10-75 years are current users of any cannabis product. Withdrawal from the drug use requires medical intervention and counselling.
Objectives: To identify existing evidence in homoeopathy on drug deaddiction and cannabis use disorder and to update the physicians on diagnosis, risk behaviours, treatment and investigations associated with cannabis use disorder.
Methods: A review of existing literature was conducted through internet sources and the CCRH headquarters library using keywords i.e. substance use, substance abuse, marijuana, cannabis abuse, drug abuse, cannabis use disorder etc. Data from studies reporting drug abuse to identify the type of drug use and homoeopathic treatment response in the withdrawal and long-term management and treatment of drug dependents was tabulated.
Results: Although some studies have been conducted on drug withdrawal, no studies have been conducted on cannabis use disorder. More case studies and research on treatment of cannabis use disorder using Homoeopathy are needed.
Interpretation: Physicians need to update themselves on diagnosis, risk behaviours, treatment and investigations to counter the condition and contribute to generating evidence-based literature on the homoeopathic approach for treating cannabis use disorder.
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Schermitzler, Brandon S., Thomas J. Preston, and Richard J. Macatee. "Risk for Cannabis Use Disorder in People Who Use Cannabis to Cope with Internalizing Disorders: Implications for Policy and Practice." Policy Insights from the Behavioral and Brain Sciences 10, no. 2 (October 2023): 133–41. http://dx.doi.org/10.1177/23727322231195273.
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The prevalence of Cannabis Use Disorder (CUD) is increasing in the United States, likely related to increasing cultural and legal acceptance of cannabis. While most cannabis users will not develop a CUD, certain behaviors may increase risk. For example, smoking to cope with anxiety or depressive disorders is associated with higher rates of cannabis use. Users who smoke to cope with these internalizing disorders (anxiety, depression) increase the addictive potential of cannabis. Systems that potentially maintain problematic use in people with internalizing disorders include the reward processing and the stress responsivity systems. Both exhibit neurobiological changes after chronic heavy cannabis use and are affected across internalizing disorders. The shared importance of these systems may warrant several recommendations for policy and practice. Some reexamine cannabis-related policy, invest in local communities, and improve cannabis education.
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Copeland, Jan, Nicole Clement, and Wendy Swift. "Cannabis use, harms and the management of cannabis use disorder." Neuropsychiatry 4, no. 1 (February 2014): 55–63. http://dx.doi.org/10.2217/npy.13.90.
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Samso, B., A. López Fariña, C. González Navarro, L. Morado San Segundo, A. Bilbao Idarraga, U. López Puentes, R. F. Lopez Brokate, et al. "Cannabis use in different mental disorders: a descriptive study in a psychiatric hospital." European Psychiatry 66, S1 (March 2023): S334—S335. http://dx.doi.org/10.1192/j.eurpsy.2023.733.
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IntroductionIn the last decade, the prevalence of THC use is increasing among adolescents and adults. There is also strong evidence to suggest that cannabis use is associated with psychiatric comorbidities. The strongest evidence is found between cannabis use and psychotic disorder. However, the literature shows that those who have used cannabis in the past or for a large part of their lives are at higher risk of mood disorders, anxiety, personality disorder or other drug use than those who do not use cannabis in a harmful way.ObjectivesTo provide an overview of the association between cannabis use and the different mental pathologies presented by the patients admitted during the study period. To describe the prevalence of THC use in the study according to the mental pathology presented by the patient.MethodsA retrospective observational descriptive study was developed for 3 months, of all patients admitted to the acute unit of the psychiatric hospital. No exclusion criteria were included.ResultsDuring the period of study 172 patients were admitted to the hospital, classified according to the main diagnosis we have: 49 patients suffer from schizophrenia, 26 bipolar affective disorder, 20 with depressive disorder, 20 with personality disorder, 19 with substance use disorder, 18 with other unspecified disorders and 20 patients with no known previous diagnosis. The prevalence of THC use in the study sample according to diagnosis, would be schizophrenia 16%, Bipolar affective disorder 19%, Depressive disorder 5%, Personality disorder 45%, Substance use disorder 21%, Unspecified disorders 11% and patients with no known previous diagnosis 10%.ConclusionsThe results obtained in the study in terms of THC use are in agreement with those obtained in the literature. In our study, we observed that cannabis use is associated with psychotic disorders as well as with mood, personality and substance abuse disorders. Given that the frequency of use has increased and there is a strong association with different comorbid psychiatric diagnoses, guidance on modifications in medication strategies might be necessary.Disclosure of InterestNone Declared
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Mustapha, S. Ben, W. Homri, L. Jouini, and R. Labbane. "Bipolar disorder and co-occurring cannabis use disorders." European Psychiatry 41, S1 (April 2017): S466. http://dx.doi.org/10.1016/j.eurpsy.2017.01.522.
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AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ringen, P. A., A. Vaskinn, K. Sundet, J. A. Engh, H. Jónsdóttir, C. Simonsen, S. Friis, S. Opjordsmoen, I. Melle, and O. A. Andreassen. "Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia." Psychological Medicine 40, no. 8 (November 6, 2009): 1337–47. http://dx.doi.org/10.1017/s0033291709991620.
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BackgroundCannabis use is associated with altered neurocognitive functioning in severe mental disorders, but data are still inconclusive and there are no studies of bipolar disorder. The aim of this study was to investigate the association between cannabis use and neurocognition in bipolar disorder compared with schizophrenia in a naturalistic setting.MethodA total of 133 patients with bipolar disorder and 140 patients with schizophrenia underwent neuropsychological assessments and clinical characterization including measures of substance use. Relationships between cannabis users and neurocognitive function were explored in the two diagnostic groups. Possible interactions between diagnosis and cannabis use were investigated, and findings were controlled for possible confounders.ResultsIn bipolar disorder subjects, cannabis use was associated with better neurocognitive function, but the opposite was the case for the schizophrenia subjects. There was a statistically significant interaction effect of diagnosis and cannabis use on focused attention (p=0.019), executive functioning (verbal fluency – set shifting) (p=0.009), logical memory-learning (p=0.007) and on logical memory-recall (p=0.004). These differences in neurocognitive function could not be explained by putative confounders.ConclusionsThe findings suggest that cannabis use may be related to improved neurocognition in bipolar disorder and compromised neurocognition in schizophrenia. The results need to be replicated in independent samples, and may suggest different underlying disease mechanisms in the two disorders.
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Bicket, Mark C., and Emma E. McGinty. "Cannabis Use Disorder and Surgery." Anesthesiology 132, no. 4 (April 1, 2020): 612–13. http://dx.doi.org/10.1097/aln.0000000000003135.
Full textDissertations / Theses on the topic "Cannabis use disorder"
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McCabe, Patrick J. "Cannabis Use and Bipolar Disorder: Bipolar Disorder Case Identification and Cannabis Use Risk Assessment: A Dissertation." eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsbs_diss/584.
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Bipolar disorders (BD) are characterized by symptoms of grandiosity, decreased need for sleep, pressure to keep talking, flight of ideas, distractibility, increased goal-directed activities, psychomotor agitation, and excessive involvement in pleasurable activities. Those with a bipolar disorder have a high degree of psychiatric comorbidity including substance use disorders, and they also experience increased mortality. Despite the widespread recognition of BD as an important psychiatric condition, available population-based estimates for BD prevalence differs across data sources.
Cannabis is one of the most widely-used illicit substances. Evidence supports it as a risk factor for psychotic symptoms and disorders. Because populations with psychotic disorders and populations with bipolar disorder share genetic characteristics, cannabis may increase risk for bipolar disorders through the same pathways as it does with psychotic disorders. Limited and conflicting evidence regarding the association of cannabis use and bipolar disorder is currently available. This dissertation investigates cannabis use as a risk factor for incident manic symptoms and bipolar disorders in a large nationally representative longitudinal cohort.
The first aim of this dissertation is to evaluate the implications for manic, hypomanic and major depressive episode prevalence estimates arising from the different approaches to assessing DSM-IV criterion between two national surveys. Differences in the assessment of impairment strongly influence manic or hypomanic classification within the NESARC. Compared to multiple imputation estimates (19.7% [95% CI: 19.3-20.1]) which treat depressed mood and anhedonia as separate symptoms, symptom assessment in the NESARC substantially underestimates major depressive episode prevalence (16.9% [95% CI: 16.1-17.6]).
The second research objective examined self-reported cannabis use as a risk factor for incident manic symptoms, bipolar spectrum disorders (including manic and hypomanic episodes) and SCID-based recalibrated BD I and II. Cannabis use risk was assessed in the population as a whole and in sub-populations defined by age, substance abuse/dependence status, and family history. Among those reporting no lifetime major depressive or manic symptoms at baseline, self-reported past-year cannabis use was associated with increased odds of an incident week of extremely elevated or irritable mood accompanied by at least two manic episode criterion B symptoms (adj. OR 1.69, 95% CI: 1.08-2.65, p=.02) over the three year follow-up period. Among adults (ages 26 to 45) >=1 reported use(s) of cannabis per week was associated with incident manic or hypomanic episodes (adjusted OR 2.52, 95% CI: 1.32-4.80, p=.006). Among those endorsing no major depressive symptoms, substance abuse/dependence, or anti-social traits in their first degree relatives, past year cannabis use is associated with increased risk for incident bipolar spectrum disorders (adjusted OR 2.27, 95% CI: 1.01-5.10, p=.05) and CIDI recalibrated BD I and II (adjusted OR 5.49, 95% CI: 1.38-21.9, p=.02). Past year cannabis use risk for DSM-IV manic or hypomanic episodes among those aged 26 to 45 is concentrated in those with a baseline history of a substance use disorder (adj. OR 2.00, 95% CI: 1.10-3.66, p=.02) as compared to those with no such history (adj. OR 1.87, 95% CI: 0.49-7.21, p=.36).
The third research objective of this dissertation was a sensitivity analysis using externally-predicted categorized exposures and continuous cannabis use propensities. The sensitivity analysis found evidence of exposure misclassification. Exposures defined by external propensity scores had improved cross-sectional association with bipolar spectrum disorders compared to reported use when both were compared to an external standard. No significant risk estimates were found for categorized predicted cannabis use among groups that were previously found to have significant risk from reported exposure. However, among adults 18 to 45 years of age with no manic or major depressive symptoms at baseline, past year cannabis use propensity (as a log transformed continuous measure) was associated with incident manic or hypomanic episodes (adj. OR 1.49, 95% CI: 1.10-2.03, p=.01). Elevated risk for high cannabis use propensity (>=1 use/week in the past year) was also found in this same group (adj. OR 1.33, 95% CI: 1.03-1.72, p=.03). Among those with no reported history of depression, substance abuse/dependence, or anti-social traits among their first-degree relatives, propensity for past year cannabis use (adj. OR 1.61, 95% CI: 1.11-2.32, p=.01) and propensity for >=1 use/week of cannabis in the past year (adj. OR 1.38, 95% CI: 1.03-1.85, p=.03) were associated with incident manic or hypomanic episodes. Among those without a substance use history at baseline, propensity for past year cannabis use (adj. OR 1.63, 95% CI: 1.33-1.55, p=1 use/week of cannabis in the past year (adj. OR 1.54, 95% CI: 1.26-1.88, p
The findings of the first aim support the conclusion that the AUDADIS substantially under-estimated lifetime major depressive episode prevalence compared to an imputed estimate that treated anhedonia and depressed mood as separate and concurrent MDE symptoms. The operationalization of impairment for manic disorders in both the AUDADIS and CIDI strongly influences case identification, with the CIDI having suppressed manic and hypomanic prevalence estimates. Evidence was found supporting the conclusion that self-reported cannabis use is a significant risk factor for incident bipolar spectrum outcomes within subpopulations in a nationally representative cohort. A sensitivity analysis finds evidence that supports the conclusion that increasing cannabis use propensity is associated with increased risk of bipolar spectrum outcomes within population subgroups, with the greatest increased risk among those with the lowest innate risk. Under-reporting of illicit substance use is a major limitation in this dissertation; further study is needed with improved exposure measures.
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Smolkina, Milana. "Epidemiological and genetic associations between Cannabis Use Disorder and Major Depressive Disorder." Thesis, King's College London (University of London), 2019. https://kclpure.kcl.ac.uk/portal/en/theses/epidemiological-and-genetic-associations-between-cannabis-use-disorder-and-major-depressive-disorder(aae240ea-e4b3-4c30-8fc0-fba14831b3a1).html.
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Background: Cannabis is the most commonly used illicit drug in the United Kingdom and worldwide. It is associated with a number of negative outcomes, which includes developing Cannabis Use Disorder (CUD). Individuals who meet criteria for CUD are at heightened risk for experiencing Major Depressive Disorder (MDD), the leading cause of disability worldwide. While this association has frequently been reported, the underlying mechanisms remain controversial. Aims of thesis: This thesis aims to investigate the degree of co-morbidity between lifetime rates of CUD and MDD, test whether this co-morbidity is accounted for by shared covariates, and test different twin models to investigate the sources (environmental or genetic) of and mechanisms underlying this co-morbidity. Methods: Data analysis was conducted on a sample of 3824 Australian twins and their non-twin siblings. Epidemiological analyses, using multivariable logistic regressions, tested whether CUD and MDD were significantly co-morbid in this sample, and to what extent covariates influenced this relationship. Twin models – bivariate correlated liabilities, discordant twin and co-morbidity models – examined whether the co-morbidity between the disorders could be explained by a) shared genetic and environmental factors, b) causal processes, and c) 13 different models of co-morbidity. Results: The epidemiological analyses found that MDD and CUD were significantly co-morbid in this sample: meeting diagnostic criteria for one disorder more than doubled the odds of meeting criteria for the other (odds ratio = 2.23, 95% confidence interval = 1.84–2.70). This co-morbidity could not be fully attributed to various psychiatric, trauma-related, parental, peer and demographic covariates. Bivariate twin analyses found that – when separated into genetic and environmental correlations – the only significant correlation between MDD and CUD was genetic (r =.41, 95% confidence interval = .24–.60). A possible causal relationship could not be excluded, because MDD and CUD were significantly associated (odds ratio = 2.83, 95% confidence interval = 1.12–7.19) in monozygotic twins discordant for both disorders. Co-morbidity model analyses indicated that the direction of influence was from CUD to MDD, and that CUD risk factors may cause MDD symptoms, particularly in individuals at high risk of CUD.
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Behrendt, Silke, Katja Beesdo-Baum, Michael Höfler, Axel Perkonigg, Gerhard Bühringer, Roselind Lieb, and Hans-Ulrich Wittchen. "The relevance of age at first alcohol and nicotine use for initiation of cannabis use and progression to cannabis use disorders." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-120008.
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Background: A younger age at onset of use of a specific substance is a well-documented risk-factor for a substance use disorder (SUD) related to that specific substance. However, the cross-substance relationship between a younger age at onset of alcohol use (AU) and nicotine use (NU) and the risk of cannabis use disorders (CUD) in adolescence and early adulthood remains unclear.
Aims: To identify the sequence of and latency between initial AU/NU and initial cannabis use (CU). To investigate whether younger age at AU- and NU-onset is associated with any and earlier CU-onset and a higher risk of transition from first CU to CUD, taking into account externalizing disorders (ED) and parental substance use disorders as putative influential factors.
Methods: Prospective-longitudinal community study with N = 3021 subjects (baseline age 14–24) and up to four assessment waves over up to ten years with additional direct parental and family history information. Substance use and CUD were assessed with the DSM-IV/M-CIDI.
Results: Most subjects with CU reported AU (99%) and NU (94%). Among users of both substances, 93% reported AU prior to CU (87% for NU). After adjustment for ED and parental substance use disorders younger age at AU-onset was associated with any CU. Younger age at NU-onset was associated with earlier CU initiation. Younger age at AU- and NU-onset was not associated with a higher risk of CUD.
Conclusions: The cross-substance relevance of younger age at first AU and NU for the risk of CUD is limited to early CU involvement.
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Behrendt, Silke, Katja Beesdo-Baum, Michael Höfler, Axel Perkonigg, Gerhard Bühringer, Roselind Lieb, and Hans-Ulrich Wittchen. "The relevance of age at first alcohol and nicotine use for initiation of cannabis use and progression to cannabis use disorders." Technische Universität Dresden, 2012. https://tud.qucosa.de/id/qucosa%3A27094.
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Background: A younger age at onset of use of a specific substance is a well-documented risk-factor for a substance use disorder (SUD) related to that specific substance. However, the cross-substance relationship between a younger age at onset of alcohol use (AU) and nicotine use (NU) and the risk of cannabis use disorders (CUD) in adolescence and early adulthood remains unclear.
Aims: To identify the sequence of and latency between initial AU/NU and initial cannabis use (CU). To investigate whether younger age at AU- and NU-onset is associated with any and earlier CU-onset and a higher risk of transition from first CU to CUD, taking into account externalizing disorders (ED) and parental substance use disorders as putative influential factors.
Methods: Prospective-longitudinal community study with N = 3021 subjects (baseline age 14–24) and up to four assessment waves over up to ten years with additional direct parental and family history information. Substance use and CUD were assessed with the DSM-IV/M-CIDI.
Results: Most subjects with CU reported AU (99%) and NU (94%). Among users of both substances, 93% reported AU prior to CU (87% for NU). After adjustment for ED and parental substance use disorders younger age at AU-onset was associated with any CU. Younger age at NU-onset was associated with earlier CU initiation. Younger age at AU- and NU-onset was not associated with a higher risk of CUD.
Conclusions: The cross-substance relevance of younger age at first AU and NU for the risk of CUD is limited to early CU involvement.
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Tyler, Elizabeth. "An investigation of the relationship between bipolar disorder and cannabis use." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/an-investigation-of-the-relationship-between-bipolar-disorder-and-cannabis-use(e9aeb45d-d4f3-4d2b-b633-5a45d51aafd5).html.
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Substance abuse is very common in Bipolar Disorder (BD) and can lead an individual having an increased range of difficulties. Studies have indicated that cannabis is used very frequently, but most research into substance use and BD has focused on either alcohol use or substance use disorders generally. The relationship between BD and cannabis use specifically has received far less attention. This thesis specifically explored the co-occurring relationship between BD and cannabis use. In the first section the author examines and critically evaluates studies that have reported on the relationship between BD and cannabis use. The initial phase included a literature search of the area and the identification of relevant papers. A total of 13 research studies were identified and included in the final review. The studies varied considerably in terms of their research questions, design and methodological quality. The findings from the studies were synthesised in relation to a number of existing hypotheses for why BD and substance use in general co-occur. On the whole, the 13 studies contributed sufficient evidence both for and against the existing hypotheses. The findings suggest that there are a number of factors that contribute towards the high co-occurrence of BD and cannabis use (e.g. the use of cannabis to self-medicate symptoms).The second section was designed to investigate a number of the factors derived from the literature which might explain the high co-occurrence of BD and cannabis use. The Experience Sampling Methodology (ESM) was utilised to provide a close investigation of a number of factors over the course of daily life. Twenty-three participants with BD type I and type II completed diary entries for 6 days using ESM. The procedure allowed a close investigation into the associations between cannabis, mood, BD symptoms and Behavioural Activation System (BAS) sensitivity. Self-reported BAS was also measured to indicate the extent to which this predicted changes in mood, BD symptoms and cannabis use. The findings indicate that cannabis use is associated with a number of psychological effects, although no evidence for the self- medication of mood and BD symptoms was revealed in the daily life of the participants. An association between BAS sensitivity and positive affect and manic symptoms was revealed and this is consistent with the findings in current literature. The final section provides a critical reflection of the research process. This includes a rationale for the development of the literature review and the main research paper. This is followed by a description of the study context and then a reflection on the methodological and ethical issues which were faced. Finally it discusses theoretical, clinical and future implications for research in this area.
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Wittchen, Hans-Ulrich, Christine Fröhlich, Silke Behrendt, Agnes Günther, Jürgen Rehm, Petra Zimmermann, Roselind Lieb, and Axel Perkonigg. "Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-110270.
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Background: Whereas the role of externalizing disorders is relatively well established in predicting the onset of cannabis use (CU) or cannabis use disorder (CUD), the status of anxiety and mood disorders in predicting CU and CUD remains controversial.
Objective: (1) To examine cross-sectional and prospective associations of CU and CUD with a range of mental disorders and whether anxiety and mood disorders are associated with CU/CUD after adjusting for externalizing disorders.
Methods: N = 1395 community subjects aged 14–17 at baseline were followed-up at three waves prospectively over 10 years. Substance use, substance disorders and mental disorders were assessed using the DSM-IV/M-CIDI.
Results: (1) The baseline prevalence rates where 19.3% at t0 for CU and 2.6% for CUD. Cumulative incidence rates at t3 were 54.3% for CU and 13.7% for CUD. (2) In cross-sectional and prospective analyses other substance use disorders, mood and anxiety disorders were associated with CU and CUD. (3) Associations of panic-anxiety with CU and of depressive and bipolar disorders with CU and CUD were significant after controlling for externalizing disorders.
Conclusion: A range of psychopathological conditions, including depressive, bipolar and less consistently anxiety disorders as well as the degree of their comorbidity are significantly associated with incident CU and progression to CUD, even when controlling for externalising disorders. A better understanding of this complex interplay may result in better aetiological models and intervention strategies.
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Wittchen, Hans-Ulrich, Christine Fröhlich, Silke Behrendt, Agnes Günther, Jürgen Rehm, Petra Zimmermann, Roselind Lieb, and Axel Perkonigg. "Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents." Technische Universität Dresden, 2007. https://tud.qucosa.de/id/qucosa%3A26826.
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Background: Whereas the role of externalizing disorders is relatively well established in predicting the onset of cannabis use (CU) or cannabis use disorder (CUD), the status of anxiety and mood disorders in predicting CU and CUD remains controversial.
Objective: (1) To examine cross-sectional and prospective associations of CU and CUD with a range of mental disorders and whether anxiety and mood disorders are associated with CU/CUD after adjusting for externalizing disorders.
Methods: N = 1395 community subjects aged 14–17 at baseline were followed-up at three waves prospectively over 10 years. Substance use, substance disorders and mental disorders were assessed using the DSM-IV/M-CIDI.
Results: (1) The baseline prevalence rates where 19.3% at t0 for CU and 2.6% for CUD. Cumulative incidence rates at t3 were 54.3% for CU and 13.7% for CUD. (2) In cross-sectional and prospective analyses other substance use disorders, mood and anxiety disorders were associated with CU and CUD. (3) Associations of panic-anxiety with CU and of depressive and bipolar disorders with CU and CUD were significant after controlling for externalizing disorders.
Conclusion: A range of psychopathological conditions, including depressive, bipolar and less consistently anxiety disorders as well as the degree of their comorbidity are significantly associated with incident CU and progression to CUD, even when controlling for externalising disorders. A better understanding of this complex interplay may result in better aetiological models and intervention strategies.
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Kosty, Derek. "Trajectories of Cannabis Use Disorder: Risk and Developmental Factors, Clinical Characteristics, and Outcomes." Thesis, University of Oregon, 2015. http://hdl.handle.net/1794/19200.
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Efforts to objectively inform cannabis discourses include research on the epidemiology of cannabis abuse and dependence disorders or, collectively, cannabis use disorder (CUD). For my dissertation I identified classes of individuals based on intraindividual CUD trajectory patterns and contrasted trajectory classes with respect to clinical characteristics of CUD, developmental risk factors, and psychosocial outcomes.
Identifying differences between trajectory classes provides evidence for the validity of trajectory-based CUD constructs and informs the development of comprehensive models of CUD epidemiology and trajectory-specific intervention approaches. My dissertation used data from the Oregon Adolescent Depression Project, a prospective epidemiological study of the psychiatric and psychosocial functioning of a representative community-based sample randomly selected from nine high schools across western Oregon. Four waves of data collection occurred between mid-adolescence and early adulthood and included diagnostic interviews and self-report questionnaires. Onset and offset ages of all CUD episodes were recorded. The reference sample included 816 participants who completed all diagnostic interviews.
A series of latent class growth models revealed three distinct CUD trajectory classes through age 30: (1) a persistent increasing risk class; (2) a maturing out class, marked by increasing risk through age 20 and then a decreasing risk through early adulthood; and (3) a stable low risk class. Rates of cannabis dependence were similar across the persistent increasing and the maturing out classes. Trajectory classes characterized by a history of CUD were associated with a variety of childhood risk factors and measures of psychosocial functioning during early adulthood. Participants who were male, had externalizing disorders, and had psychotic experiences during early adulthood discriminated between the persistent increasing and the maturing out classes.
Future research based on more diverse samples is indicated, as are well-controlled tests of associations between risk factors, trajectory class membership, and psychosocial outcomes. A better understanding of these relationships will inform etiological theories of CUD and the development of effective intervention programs that target problematic cannabis use at specific developmental stages. Designing targeted versus undifferentiated interventions for those at greatest risk for adult psychosocial impairment could be a cost-effective way to mitigate the consequences of CUD.
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Rebgetz, Shane E. "Natural recovery of people with cannabis use and psychosis." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101576/1/Shane_Rebgetz_Thesis.pdf.
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People with psychosis who use cannabis have much worse outcomes, but treatments typically have only limited effects that are poorly sustained. This program of research explored how people with psychosis cease using cannabis without substantial assistance, to see if this shed light on how treatments could be improved. The studies suggested that greater focus on employment, separate accommodation, and social and emotional support for cessation would result in stronger outcomes than at present. Similar reasons were found for strategies to maintain a reduction in use; while relapse was associated with substance using peers, and problems with relationships and negative emotions.
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Hicks, Terrell A. "A Longitudinal Investigation of Interpersonal Trauma Exposure, Posttraumatic Stress Disorder, and Cannabis Use Phenotypes among College Students." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6066.
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College students have an increased risk for cannabis use, trauma exposure, and posttraumatic stress disorder (PTSD). Cannabis use disorder (CUD) and PTSD comorbidity is high, and given the negative consequences of the comorbidity (e.g., poor academic outcomes), there is a need to understand comorbid CUD-PTSD etiology. Two primary etiologic models exist: self-medication (i.e., PTSD à CUD) and high-risk (i.e., CUD à PTSD) hypotheses. This study 1) examined the prevalence and predictors of cannabis use and interpersonal trauma (IPT) exposure; 2) investigated the relationship between cannabis use and IPT; and 3) examined cannabis use, IPT, and PTSD through mediational self-medication and high-risk hypotheses lenses in a large (n = 9,889) longitudinal study of college students. Aim 1 found the prevalence of lifetime problematic (i.e., use ≥ 6 times) and experimental (i.e., use 1-5 times) cannabis use was 28.3% and 17.4%, respectively. Aim 1 results also estimated that the prevalence of lifetime IPT exposure was 35.9%. Aim 2 results supported the self-medication hypothesis, but not the high-risk hypothesis. Overall model fit from Aim 3 was poor. Nonetheless, Aim 3 results did not support the self-medication or high-risk hypotheses. Given the poor model fit of Aim 3, results should be interpreted with caution. However, as a whole, these findings provide preliminary support for the self-medication hypothesis, indicating that those reporting IPT exposure and probable PTSD may be at risk for cannabis use. Implications of these findings, in light of study limitations, are discussed.
Books on the topic "Cannabis use disorder"
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Elwood, William N. Fry: A study of adolescents' use of embalming fluid with marijuana and tobacco. Austin, Tex. (9001 North IH-35, Suite 105, Austin 78753-5233): Texas Commission on Alcohol and Drug Abuse, 1998.
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Montoya, Ivan D., and Susan R. B. Weiss, eds. Cannabis Use Disorders. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-90365-1.
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Hall, Wayne. Public perceptions of the health and psychological consequences of cannabis use. Canberra: Australian Government Publishing Service, 1995.
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Montoya, Ivan D., and Susan R. B. Weiss. Cannabis Use Disorder. Springer International Publishing AG, 2018.
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Feingold, Daniel, Eva Hoch, Aviv M. Weinstein, and Wayne Denis Hall, eds. Psychological Aspects of Cannabis Use and Cannabis Use Disorder. Frontiers Media SA, 2022. http://dx.doi.org/10.3389/978-2-88971-950-1.
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Danovitch, Itai, and Shahla J. Modir. Integrative Approach to Cannabis-Use Disorder. Edited by Shahla J. Modir and George E. Muñoz. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190275334.003.0006.
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Recreational cannabis use is widespread, with estimates of 2.8% to 4.5% of the world population having used in the past year, and many more having used over their lifetimes. While most occasional users do not suffer any consequences, among persons who have ever used cannabis, approximately 9% will develop a cannabis-use disorder at some point in their lives, and 1.8% will meet diagnostic criteria for cannabis-use disorder within the past year. Several interventions are available to treat cannabis-use disorder. Psychotherapy, delivered individually as well as in groups, is the most well-established treatment approach. Several medications may offer benefit, though evidence supporting their role is weak. Integrative treatment approaches also show promise, notwithstanding a paucity of evidence. This chapter reviews the current understanding of cannabis-use disorder, including diagnosis, epidemiology, neurobiology, and treatment. Psychotherapeutic, medication, and integrative interventions are reviewed, with a particular focus on integrative approaches.
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Rose, Mark, NetCE, and CE Resource. Cannabis and Cannabis Use Disorders. CE Resource, Incorporated, 2018.
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Rose, Mark, NetCE, and CE Resource. Cannabis and Cannabis Use Disorders. CE Resource, Incorporated, 2021.
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Brar, Jaspreet S. Epidemiology of Schizophrenia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199331505.003.0003.
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Epidemiology can help us understand who is at risk for developing a disorder, what may happen to them, and perhaps even why people get the disorder to begin with. In this chapter, we will review the incidence and prevalence of schizophrenia and related psychotic disorders, as well as factors affecting such rates. Risk factors for psychosis include socio-demographics (e.g., gender, age, migrant status, class), predisposing factors (e.g., season of birth, perinatal trauma), and precipitating factors (e.g., substance use, psychosocial stress). We will highlight controversial issues such as traumatic life events, prenatal infection, and cannabis use, considering how epidemiological factors can shed light on the pathogenesis of schizophrenia and related illnesses.
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Iversen, Leslie. Where Are We and Where Are We Going? Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190846848.003.0008.
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Cannabis research is flourishing despite the difficulties that scientists have in accessing high-quality cannabis. However, many questions remain: Can new medicines be discovered and developed based on the current knowledge of the biosynthesis, actions, and inactivation of endocannabinoids? Can genetic screening identify people who are particularly susceptible to cannabis use disorder and possibly to psychosis? Can researchers pinpoint in more detail how endocannabinoids modulate neural activity and how they change on exposure to stress? Scientific research will tackle all these questions and more in the coming decades. This chapter presents a broad view of the case for medical cannabis, along with some cautions. The case for the legalization of cannabis as a recreational drug is also presented.
Book chapters on the topic "Cannabis use disorder"
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Tomko, Rachel L., Amber N. Williamson, Aimee L. McRae-Clark, and Kevin M. Gray. "Cannabis Use Disorder as a Developmental Disorder." In Cannabis Use Disorders, 189–99. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_18.
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Narouze, Samer N., Caroline A. MacCallum, and Lauren de Freitas. "Cannabis Use Disorder." In Cannabinoids and Pain, 313–16. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-69186-8_38.
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Patel, Dhruti. "Cannabis Use Disorder." In Psychiatry Update, 33–40. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-86430-9_4.
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Metrik, Jane, and Divya Ramesh. "Cannabis Use Disorder." In Integrating Psychological and Pharmacological Treatments for Addictive Disorders, 150–71. New York, NY : Routledge, 2017. |: Routledge, 2017. http://dx.doi.org/10.4324/9781315683331-7.
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Lopez, Marsha, and Carlos Blanco. "Epidemiology of Cannabis Use Disorder." In Cannabis Use Disorders, 7–12. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_2.
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García-Gutiérrez, María S., Francisco Navarrete, Adrián Viudez-Martínez, Ani Gasparyan, Esther Caparrós, and Jorge Manzanares. "Cannabidiol and Cannabis Use Disorder." In Cannabis Use Disorders, 31–42. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_5.
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Budney, Alan J., Jacob T. Borodovsky, and Ashley A. Knapp. "Clinical Manifestations of Cannabis Use Disorder." In Cannabis Use Disorders, 85–91. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_10.
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Gorelick, David A. "Psychiatric Comorbidity of Cannabis Use Disorder." In Cannabis Use Disorders, 113–25. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_13.
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Mason, Barbara J. "Anticonvulsants to Treat Cannabis Use Disorder." In Cannabis Use Disorders, 213–20. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_21.
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Kiselica, Andrew M., and Amy Duhig. "Cannabis Use Disorder Treatment and Reimbursement." In Cannabis Use Disorders, 245–52. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90365-1_25.
Full textConference papers on the topic "Cannabis use disorder"
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Livne, Ofir, Deborah Hasin, and Silvia Martins. "Probability and Predictors of Cannabis Use Disorder Among Cannabis Users with Depressive Disorders." In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.44.
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Introduction and Aims: Cannabis use and cannabis use disorders (CUD) have been increasing in the US. Recent studies have aimed to assess the rates of transition from cannabis use to CUD over time across several sociodemographic corelates (e.g., age and sex). Depressive disorders are a strong clinical correlate of cannabis use, and carry a substantial burden of disease. The underlying mechanisms involved in the relationship between depression and cannabis use are still not fully understood. While certain studies have examined changes in rates of cannabis among depressed and non-depressed individuals over time, no studies have quantified the effect of depressive disorders on cannabis users’ transition rates to CUD. Methods: Participants were individuals ≥18 years interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III in 2012–2013. Survival plots assessed the probability of transition from cannabis use to CUD over time. Differences in probability of transition to CUD was assessed among cannabis users with and without predisposing depressive disorders ( major depressive disorder or dysthymia with an initial diagnosis prior to onset of cannabis use). Results: Among lifetime cannabis users (N = 11,272), the 5-year probability of transition to CUD was approximately 3.9% for cannabis users without depressive disorders and 7.3% for those with a depressive disorder. A higher probability of transition from cannabis use to CUD among those with a predisposing depressive disorder was observed over all time points that were examined in the study. Cannabis users with depressive disorders who were male and belonging to an early-onset of cannabis use age group (<16) transitioned significantly more rapidly to CUD than females and those with a later- onset of cannabis use Conclusions: This is the first study to explore the effect of depressive disorders on rates of transition from cannabis use to the DSM-5 CUD diagnosis. The current study identified specific predictors of this transition. Findings inform clinicians who treat individuals with depressive disorders that initiate cannabis use as to the risk of developing CUD and the need for harm prevention targeted at this specific population.
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Steuber, Amanda, and Carrie Cuttler. "Elucidating the Nature of the Links Between Cannabis Use and Attention Deficit/Hyperactivity Disorder." In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.04.
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Many individuals with mental health disorders use cannabis to self-medicate for their symptoms. Attention-deficit/hyperactivity disorder (ADHD) is a neurological disorder associated with increased cannabis use but, relative to other mental disorders (e.g., anxiety, psychosis, post-traumatic stress disorder), far less attention has been paid to examining cannabis use by people with ADHD. Nevertheless, there is some limited evidence to suggest that people with ADHD might use cannabis to self-medicate for their symptoms and that they perceive it to be beneficial for this purpose. The goal of this study was to better understand the nature of the relationships between cannabis use and A total of 1,382 undergraduate students completed an online survey measuring their ADHD symptoms, and cannabis use patterns. Participants who reported they have used cannabis to manage their ADHD were further asked to report their perceptions of whether acute and/or chronic cannabis use improves, worsens, or has no effect on their ADHD symptoms. Participants who reported they have been prescribed ADHD medication and use cannabis also reported their perception of how cannabis use affects the effectiveness of their medication, and ADHD medication side effects. Evidence from this study revealed that ADHD symptom severity is associated with consuming cannabis more frequently and with more severe symptoms of cannabis use disorder. Participants with ADHD reported that cannabis has acute detrimental effects on memory but beneficial effects on many of their other core symptoms of ADHD, including hyperactivity, impulsivity, restlessness, and mental frustration. While most participants on ADHD medications reported that cannabis does not influence their medication effectiveness, they did report that cannabis helps with many of the side effects associated with their ADHD medications including headaches, loss of appetite, sleep disturbances, moodiness/irritability, and anxiety. The knowledge gained from this study will help people with ADHD and their healthcare providers by providing them with a better understanding of the use of cannabis by individuals with ADHD including the possible risks and benefits of such use on cannabis use disorder, ADHD symptoms, and medication side effects.
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"CANNABIS USE AND ANXIETY DISORDERS DURING PREGNANCY - DUAL DISORDER TO DUAL PATIENTS." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p144s.
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Objectives From clinical cases of patients observed in Perinatal Psychiatry - Setúbal Hospital Center (Portugal), we conducted a review of the impact of both cannabis use and anxiety disorders during pregnancy. Methods and material Case reports and literature review of PubMed for cannabis use, anxiety disorders and pregnancy. Results and conclusions In Outpatient Perinatal Psychiatry we observed women with anxiety disorders who reported using cannabis during pregnancy. Indeed, pregnancy is a highly vulnerable period to the onset or worsening of previous anxiety symptoms. Anxiety disorders may adversely impact not only the mother, but also fetal maturation and child development. In fact, preterm labor and low birth weight are consistently linked with anxiety during pregnancy. Recent studies reveal a general increase in the use of cannabis during pregnancy, representing the most commonly used illicit drug during the perinatal period. The endocannabinoid system appears to be involved in the regulation of human fertility and pregnancy. Although still conflicting, there is data demonstrating that cannabis use during pregnancy is associated with stillbirth, preterm birth, small for gestational age, low birth weight, smaller head circumferences and increased admission to neonatal intensive care units. The use of cannabis during pregnancy is frequently a way to improve symptoms of anxiety disorders. All patients should be screened to substance use comorbid to other frequent psychiatric disorders during pregnancy, such as anxiety disorders, in order to improve the health and well-being not only of the mother, but also of the developing baby, as a dual disorder has a negative effect in both individuals.
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Shephard, Aaron, Simal Dölek, Sherry Stewart, and Sean Barrett. "Investigating predictors of problematic cannabis use in polysubstance users." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.35.
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Introduction: Since its legalization in 2018, cannabis use has substantially increased in Canada. This increased use is concerning, as one in every eleven cannabis users will go on to develop a cannabis use disorder. Further, problematic cannabis use is often related to the use of additional substances, particularly nicotine and alcohol, and there is evidence to suggest that the degree of harms associated with cannabis use increases when cannabis is used in conjunction with other substances. Additionally, personality is a known risk factor for problematic substance use, although to date problematic cannabis use has not been consistently linked to any specific personality trait. This study aimed to investigate the relationship between substance use, personality, and problematic cannabis use in a sample of cannabis using polysubstance users. Method: A sample of 521 polysubstance users (past 30-day users of cannabis, alcohol, and nicotine) completed an online survey measuring their substance use, dependence, and personality. Levels of substance specific dependence was measured using the Cannabis Use Disorder Identification Test – Revised, the Alcohol Use Disorders Identification Test, and the Fagerström Tests for Cigarette and E-cigarette Dependence, while personality was measured using the Substance Use Risk Profile Scale (SURPS). Results: Regression analyses showed that the top predictors for problematic cannabis use levels were levels of alcohol dependence, cigarette/e-cigarette dependence, impulsivity, and sensation seeking. Further analyses compared those who met the criteria for problematic cannabis use to those who did not; problematic cannabis users had significantly higher levels of alcohol and nicotine dependence, as well as higher levels of impulsivity and sensation seeking (all p’s <.001). Discussion: This study identified strong relationships of problematic cannabis use with problematic alcohol and cigarette/e-cigarette use, and with sensation seeking and impulsivity. The findings have implications for screening, intervention, and policy. For example, the strong relations of problematic cannabis use with problematic alcohol use speak to the inadvisability of the co-location of cannabis and alcohol sales, as is the case in several jurisdictions.
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Cowie, Kiefer, Helene Chokron Garneau, Anne Bellows Lee, Melissa Garcia, Frances Kay-Lambkin, Alan Budney, Alfonso Ang, and Suzette Glasner. "Preliminary Effects of a Facebook Intervention on Polysubstance Use and Transdiagnostic Psychological Symptoms Among Adults With Cannabis Use Disorder and Major Depression." In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.38.
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Purpose: Cannabis Use Disorders are associated with a quadrupling of the risk of developing depression, and the use of cannabis to alleviate depressive symptoms is increasingly widespread. Despite high rates of cannabis use among individuals with affective disorders, those who suffer from depression do not frequently access traditional treatment. Our prior work has demonstrated that a technology- and social media-assisted intervention combining cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), and social media support via Facebook showed promise in changing cannabis use and mood symptoms among depressed individuals with cannabis use disorder (CUD). The current project examined alcohol co-use and anxiety in this population, effectiveness of this approach in changing drinking behaviors and anxiety, and perceived helpfulness of the intervention. Methods: In a 10-week pilot intervention study, adults (N=20) with CUD and Major Depressive Disorder (MDD) received an intervention combining computer-assisted CBT/MET targeting depression and cannabis use with peer and therapist support via Facebook, Connected Cannabis Users’ Network for Enhancement of Cognitive Therapy (CONNECT). Self-reported past 30 day alcohol and cannabis use was assessed using a calendar-assisted timeline follow back interview at baseline and treatment-end. Anxiety was measured using the GAD-7. Perceived helpfulness of the intervention was evaluated qualitatively in individual participant interviews. Results: From baseline to treatment-end, CONNECT participants reduced the frequency of both cannabis use (M=24 vs. 8.9 days, p<0.05) and heavy alcohol use (M=1.7 vs. 0.4 days, p<0.05). Anxiety also declined over the course of treatment (M=5.4 vs. 3.2, p<0.05). More than half (57%) of CONNECT participants reported the social media intervention was helpful for their mood as well as cannabis use, and 72% indicated that they would recommend it to a friend. Qualitative data indicate that CONNECT was most helpful in 3 core areas: (1) social support/not feeling alone with their problems, (2) CBT skills training, (3) bolstering motivation to change substance use. Conclusion: Combining technology-assisted and social media interventions may be an effective strategy for populations struggling with concurrent depression and CUD. Beyond primary outcome variables (i.e., depression and cannabis use), participants also reported reductions in heavy alcohol use and anxiety, indicating that this intervention may effectively produce transdiagnostic process changes. In light of the growing demand for telemedicine and digital health interventions in the wake of COVID-19, further research and potential dissemination of this approach appears warranted.
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Fitzke, Reagan, Daniel Lee, Denise Tran, Jordan Davis, and Eric Pedersen. "Military sexual violence and cannabis use disorder among OEF/OIF veterans." In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.47.
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Sexual violence experienced during military service can have lasting negative psychosocial effects on veterans long after service ends. Current research reports veterans who have experienced military sexual violence are more likely to develop mental health and substance use disorders. Little is known, though, about the relationship between military sexual violence and subsequent cannabis use disorder (CUD). The current study investigated prevalence of military sexual violence among a large sample of OEF/OIF veterans (N = 1,005), its effect on later CUD, and the potential moderating role of resilience. First, t-tests examined differences in experience of military sexual violence between LGBQ vs. heterosexual and female vs. male veterans. Then, using logistic regressions controlling for sex, sexual orientation, and race/ethnicity, we assessed the effects of sexual violence on CUD (Cannabis Use Disorder Identification Test score of 12 or higher), followed by adding resilience into the model to examine independent and moderation effects. T-test results indicated that female (t(99) = -7.46, p < 0.001) and LGBQ veterans (t(38) = -3.85, p < 0.001) were significantly more likely to experience military sexual violence. Veterans who experienced military sexual violence had higher odds of screening for CUD (OR = 3.37; 95% CI = [1.76, 6.45]). Greater resilience was associated with lower odds of CUD (OR = 0.40; 95% CI = [0.23, 0.70]), but it did not moderate the relationship between sexual violence and CUD. Our findings are in line with prior work that female and LGBQ veterans may experience sexual violence during military service at higher rates. We also showed that veterans who experience military sexual violence are at increased risk for subsequent CUD. This suggests the importance of screening for military sexual violence among veterans, including among those seeking care for CUD, as well as screening for CUD symptoms among those who have experienced military sexual violence. Since we found that greater levels of resilience were associated with lower odds of CUD, programs and treatments aimed at building resilience to adverse events may have independent protective effects on CUD.
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Lopez-Quintero, Catalina, Alyssa Falise, James Cury, Vinita Sharma, Ellen Terry, Yan Wang, and Robert Cook. "Medical Cannabis Use Among Adults Who Report Non-Medical Use of Prescription Opioids for Pain Relief." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.23.
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Objectives: This study uses a nationally representative sample of adults to investigate racial-ethnic differences in reasons for cannabis use among those reporting past 12-month misuse of prescription opioids for pain relief. Methods: Data from the 2015-2019 National Surveys on Drug Use and Health were used to study 3,093 adults 18 to 49 years old reporting past 12-month pain-related prescription pain reliever (opioid) misuse. Logistic regressions assessed the association between past 12-month cannabis use – (non medical vs. any medical) – and multiple socio-demographic, psycho-social and drug use correlates. NSDUH analysis weights were applied to accommodate for the sampling design. Results: Half of individuals who reported misuse of prescription opioids for pain relief used cannabis in the past 12-months. In this sample of cannabis users, 87.6% (95%CI = 86.1, 88.9) used non-medically, and 12.4 (95%CI = 11.1, 13.9) used for both medical and recreational reasons. Individuals with past 12 months diagnosis of opioid use disorder were 1.8 (95%CI = 1.29, 2.63) times as likely to be medical cannabis users compared to those without a disorder. Conclusions: The findings indicate that medical cannabis might be an alternative for nearly one in eight individuals misusing pain relievers to alleviate their pain, primarily those with an opioid use disorder. Despite increased rates of cannabis use among males and non-Hispanic Whites in the general population, no gender or racial-ethnic differences were found in the selected sample. Future studies should investigate simultaneous use and the analgesic effects of co-use in this sample.
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Shah, Rishika, Sarah Okey, and William Corbin. "The Role of Impulsivity on Cannabis and Alcohol Use Frequency and Problems Among Frequent Cannabis Users." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.14.
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Background: Although the relation between impulsivity and substance use outcomes is well-documented (Jones et al., 2014; Stautz et al., 2017), less is known about individual facets of impulsivity among individuals who use cannabis. There is some research suggesting that positive urgency, sensation seeking, and lack of premeditation are associated with greater cannabis use problems, but much of this research has been conducted in normative adolescent or young adult samples (VanderVeen et al., 2016). Given that more than 11% of legal cannabis users currently use daily/near daily (Goodman et al., 2020), this study examined relations between individual facets of impulsivity and cannabis use, alcohol use, simultaneous cannabis and alcohol use, and problem use within a sample of frequent, adult cannabis users. Methods: Individuals (n=167) with a mean age of 34.89 (SD=11.19) who reported using cannabis on average once per day completed measures of individual facets of impulsivity (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking; UPPS-P), cannabis use frequency, alcohol use frequency, simultaneous cannabis and alcohol use frequency, cannabis use problems, cannabis use disorder, and alcohol use disorder. Path models were used to predict frequency of use (cannabis, alcohol, and simultaneous cannabis/alcohol) and problem use (cannabis consequences, cannabis use disorder, and alcohol use disorder) from each facet of impulsivity. Models were first run using sex, age, and race as covariates, and subsequently run after adding depressive and anxiety symptoms as covariates. Results: After controlling for sex, age, and race, positive urgency was associated with less frequent cannabis use (b=-0.28, S.E.=0.13, p=0.03), more frequent simultaneous cannabis and alcohol use (b= 0.24, S.E.=0.11, p=.04), and greater cannabis consequences (b=0.30, S.E.=0.10, p=0.002). Negative urgency was associated with greater cannabis consequences (b=0.31, S.E.=0.09, p<0.001), cannabis use disorder (b=0.27, S.E.=0.09, p=0.002), and alcohol use disorder (b=0.27, S.E.=0.10, p=0.01). After including depressive and anxiety symptoms as covariates, relations with positive urgency, but not negative urgency, remained significant. Conclusions: The findings of the current study suggest that positive urgency may be uniquely linked to riskier behavior in frequent cannabis users given that no other facet of impulsivity was significantly associated with cannabis use outcomes after all covariates were included in the model. Although not directly assessed in the current study, the findings suggest that relations between negative urgency and cannabis use frequency and cannabis and alcohol use disorder may be mediated by depressive and anxiety symptoms. This possibility should be explicitly examined in future studies. The lack of relations between other facets of impulsivity and alcohol and cannabis use outcomes in the current study suggest that effects of impulsivity among daily users may be restricted to urgency, in contrast to studies in normative adolescent and young adult samples (VanderVeen et al., 2016).
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Hetelekides, Eleftherios, Verlin Joseph, Adrian Bravo, Mark Prince, Bradley Conner, and Matthew Pearson. "Early Birds and Night Owls: Distinguishing Profiles of Cannabis Use Habits by Use Times with Latent Class Analysis." In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.19.
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Negative consequences associated with excessive use of cannabis are well documented. Previous findings indicate timing of use is an important factor when assessing severity of dependence for use of substances including alcohol and cigarettes. However, little attention in the academic literature has been paid to timing of cannabis use and its associations with negative consequences. The present study employed a latent class analysis on data collected from college students who use cannabis, located across four U.S. universities in four different states (N = 1,122). The goal was to examine whether distinct classifications of cannabis use exist based on timing (i.e., hour of day and day of week), and whether these classifications differ on cannabis use indicators (Marijuana Use Grid; MUG), cannabis-related negative consequences (Marijuana Consequences Questionnaire; MACQ), and cannabis use disorder symptoms (Cannabis Use Disorder Identification Test-Revised; CUDIT-R). The MUG assesses the amount (in grams) of cannabis used during a week of typical marijuana use in the past 30 days on each of the seven days per week (Monday-Sunday) during each of six 4-hour time periods (12a-4a, 4a-8a, 8a-12p, 12p-4p, 4p-8p, 8p-12p). By summing across time periods for each day, we binarized the presence of cannabis use (0 = no use, 1 = use) for each day of the week. By summing across days for each time period, we binarized the presence of cannabis use for each time period. Based on the Lo-Mendell-Rubin Likelihood Ratio Test (LRT) and other fit indices, we found support for a 4-class solution with high classification precision (relative entropy = .905). The four classes were characterized as follows: (1) daily (greater than 98% of the class endorsed use on each day of the week), common morning use (N = 140.17, 12.5%), (2) daily (greater than 88% of the class endorsed use each day of the week), uncommon morning use (N = 241.02, 21.5%), (3) weekend, common morning use (N = 72.22, 6.4%), and (4) weekend, uncommon morning use (N = 668.59, 59.6%). Individuals reporting daily, common morning use experienced the highest cannabis-related negative consequences (MACQ M = 7.53) and reported the highest levels of cannabis use disorder symptoms (CUDIT-R M = 15.74), whereas individuals reporting weekend, uncommon morning use experienced few cannabis-related negative consequences (MACQ M = 2.24)) and reported low cannabis use disorder symptoms (CUDIT-R M = 5.45). Taken together, our classes were defined by crossing the presence/absence of morning cannabis use by the presence/absence of weekday cannabis use, and we found evidence that both the timing of week and timing of day contribute to the level of cannabis-related harms that individuals experience. Additional research is needed to explore the unique contributions of time of week and time of day while controlling for other characteristics of one’s cannabis use (i.e., frequency, quantity, product type, route of administration, etc.).
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Blessing, Alexis, Patricia Russell, Willie Hale, and Sandra Morissette. "Cannabis Use Disorder Uniquely Predicts Educational Impairment in College Students Over and Above other Mental Health Disorders." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.34.
Full textAbstract:
Background: Approximately 40% of college students report using cannabis in the past year (Scholenberg et al., 2020) and nearly 1 in 10 (9.4%) first-year college students meet criteria for a cannabis use disorder (CUD; Caldiera et al., 2008). The prevalence CUD is concerning as it is linked to greater number of skipped classes and failure to graduate from college (Arria et al., 2015; Hunt et al., 2010). In addition, CUD is often co-morbid with other substance use and mental health symptoms that impact educational outcomes, including post-traumatic stress disorder (PTSD; Morissette et al., 2020), major depressive disorder (De Roma et al., 2009), and alcohol use disorder (AUD; Meda et al., 2017), yet the impact of CUD has not been examined within the larger context of these mental health problems. The aim of the current study was to examine the impact of CUD on education functioning and GPA within the context of co-occurring PTSD, MDD, and AUD. It was predicted that CUD, measured both continuously (CUD symptom severity) and dichotomously (presence/absence), would predict greater educational impairment and lower current overall GPA, even after taking into account age, gender, and presence of probable PTSD, MDD, and AUD. Method: College students (N = 210) who reported using cannabis within the past six months completed self-report questionnaires assessing trauma exposure (LEC-5), educational impairment (IPF-ES), CUD (CUDIT-R), PTSD (PCL-5), depression (PHQ-9), and AUD (AUDIT-R). Overall GPA was retrieved from college transcripts. Results: A series of hierarchical multiple regression analyses were conducted in SPSS version 25. In the continuous model, younger age (β = -.13, p < .05), presence of probable PTSD (β = .26, p < .01), and CUD symptom severity (β = .20, p < .01) significantly predicted educational impairment, with CUD symptom severity significantly improving model fit (R2 =.20; F(1, 203) = 10.13, p <.01). In the dichotomous model, younger age (β = -.13, p < .05), male gender (β = -.16, p < .05), presence of probable MDD (β = .17, p < .05), probable PTSD (β = .26, p < .01), significantly predicted educational impairment, however probable CUD did not ((β = .01, p = .151). Similar models for GPA indicated CUD symptom severity was the only significant predictor of low GPA (β = -.15, p < .01), yet presence of probable CUD was not significant (β = -.09, p = .183). Model fit was poor for both measurement types (Continuous Model: R2 =.01; F(1, 203) = 4.09, p <.05; Dichotomous Model: R2 = .00, F(1, 203) = 1.78, p = .183). Conclusion: CUD symptom severity negatively predicted both educational impairment and GPA, whereas probable CUD did not predict either outcome. Importantly, CUD symptom severity predicted over and above other common mental health conditions among college students. In the context of rapid legalization of cannabis, these data suggest that university counseling centers may need to incorporate CUD into treatment planning, particularly when students are experiencing educational challenges.
Reports on the topic "Cannabis use disorder"
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McDonagh, Marian S., Jesse Wagner, Azrah Y. Ahmed, Benjamin Morasco, Devan Kansagara, and Roger Chou. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain: May 2021 Update. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccerplantpain3.
Full textAbstract:
Overview This is the third quarterly progress report for an ongoing living systematic review on cannabis and other plant-based treatments for chronic pain. The first progress report was published in January 2021 and the second in March 2021. The draft systematic review was available for public comment from May 19 through June 15, 2021, on the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care website. The systematic review synthesizes evidence on the benefits and harms of plant-based compounds (PBCs), such as cannabinoids and kratom, used to treat chronic pain, addressing concerns about severe adverse effects, abuse, misuse, dependence, and addiction. The purpose of this progress report is to describe the cumulative literature identified thus far. This report will be periodically updated with new studies as they are published and identified, culminating in an annual systematic review that provides a synthesis of the accumulated evidence. Main Points In patients with chronic (mainly neuropathic) pain with short-term treatment (4 weeks to <6 months): • Studies of cannabis-related products were grouped based on their tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio using the following categories: high THC to CBD, comparable THC to CBD, and low THC to CBD. • Comparable THC to CBD ratio oral spray is probably associated with small improvements in pain severity and may be associated with small improvements in function. There was no effect in pain interference or serious adverse events. There may be a large increased risk of dizziness and sedation, and a moderate increased risk of nausea. • Synthetic THC (high THC to CBD) may be associated with moderate improvement in pain severity and increased risk of sedation, and large increased risk of nausea. Synthetic THC is probably associated with a large increased risk of dizziness. • Extracted whole-plant high THC to CBD ratio products may be associated with large increases in risk of withdrawal due to adverse events and dizziness. • Evidence on whole-plant cannabis, low THC to CBD ratio products (topical CBD), other cannabinoids (cannabidivarin), and comparisons with other active interventions was insufficient to draw conclusions. • Other key adverse event outcomes (psychosis, cannabis use disorder, cognitive deficits) and outcomes on the impact on opioid use were not reported. • No evidence on other plant-based compounds, such as kratom, met criteria for this review.
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McDonagh, Marian S., Jesse Wagner, Azrah Y. Ahmed, Rongwei Fu, Benjamin Morasco, Devan Kansagara, and Roger Chou. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer250.
Full textAbstract:
Objectives. To evaluate the evidence on benefits and harms of cannabinoids and similar plant-based compounds to treat chronic pain. Data sources. Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Library, and SCOPUS® databases, reference lists of included studies, submissions received after Federal Register request were searched to July 2021. Review methods. Using dual review, we screened search results for randomized controlled trials (RCTs) and observational studies of patients with chronic pain evaluating cannabis, kratom, and similar compounds with any comparison group and at least 1 month of treatment or followup. Dual review was used to abstract study data, assess study-level risk of bias, and rate the strength of evidence. Prioritized outcomes included pain, overall function, and adverse events. We grouped studies that assessed tetrahydrocannabinol (THC) and/or cannabidiol (CBD) based on their THC to CBD ratio and categorized them as high-THC to CBD ratio, comparable THC to CBD ratio, and low-THC to CBD ratio. We also grouped studies by whether the product was a whole-plant product (cannabis), cannabinoids extracted or purified from a whole plant, or synthetic. We conducted meta-analyses using the profile likelihood random effects model and assessed between-study heterogeneity using Cochran’s Q statistic chi square and the I2 test for inconsistency. Magnitude of benefit was categorized into no effect or small, moderate, and large effects. Results. From 2,850 abstracts, 20 RCTs (N=1,776) and 7 observational studies (N=13,095) assessing different cannabinoids were included; none of kratom. Studies were primarily short term, and 75 percent enrolled patients with a variety of neuropathic pain. Comparators were primarily placebo or usual care. The strength of evidence (SOE) was low, unless otherwise noted. Compared with placebo, comparable THC to CBD ratio oral spray was associated with a small benefit in change in pain severity (7 RCTs, N=632, 0 to10 scale, mean difference [MD] −0.54, 95% confidence interval [CI] −0.95 to −0.19, I2=28%; SOE: moderate) and overall function (6 RCTs, N=616, 0 to 10 scale, MD −0.42, 95% CI −0.73 to −0.16, I2=24%). There was no effect on study withdrawals due to adverse events. There was a large increased risk of dizziness and sedation and a moderate increased risk of nausea (dizziness: 6 RCTs, N=866, 30% vs. 8%, relative risk [RR] 3.57, 95% CI 2.42 to 5.60, I2=0%; sedation: 6 RCTs, N=866, 22% vs. 16%, RR 5.04, 95% CI 2.10 to 11.89, I2=0%; and nausea: 6 RCTs, N=866, 13% vs. 7.5%, RR 1.79, 95% CI 1.20 to 2.78, I2=0%). Synthetic products with high-THC to CBD ratios were associated with a moderate improvement in pain severity, a moderate increase in sedation, and a large increase in nausea (pain: 6 RCTs, N=390 to 10 scale, MD −1.15, 95% CI −1.99 to −0.54, I2=39%; sedation: 3 RCTs, N=335, 19% vs. 10%, RR 1.73, 95% CI 1.03 to 4.63, I2=0%; nausea: 2 RCTs, N=302, 12% vs. 6%, RR 2.19, 95% CI 0.77 to 5.39; I²=0%). We found moderate SOE for a large increased risk of dizziness (2 RCTs, 32% vs. 11%, RR 2.74, 95% CI 1.47 to 6.86, I2=0%). Extracted whole-plant products with high-THC to CBD ratios (oral) were associated with a large increased risk of study withdrawal due to adverse events (1 RCT, 13.9% vs. 5.7%, RR 3.12, 95% CI 1.54 to 6.33) and dizziness (1 RCT, 62.2% vs. 7.5%, RR 8.34, 95% CI 4.53 to 15.34). We observed a moderate improvement in pain severity when combining all studies of high-THC to CBD ratio (8 RCTs, N=684, MD −1.25, 95% CI −2.09 to −0.71, I2=50%; SOE: moderate). Evidence on whole-plant cannabis, topical CBD, low-THC to CBD, other cannabinoids, comparisons with active products, and impact on use of opioids was insufficient to draw conclusions. Other important harms (psychosis, cannabis use disorder, and cognitive effects) were not reported. Conclusions. Low to moderate strength evidence suggests small to moderate improvements in pain (mostly neuropathic), and moderate to large increases in common adverse events (dizziness, sedation, nausea) and study withdrawal due to adverse events with high- and comparable THC to CBD ratio extracted cannabinoids and synthetic products in short-term treatment (1 to 6 months). Evidence for whole-plant cannabis, and other comparisons, outcomes, and PBCs were unavailable or insufficient to draw conclusions. Small sample sizes, lack of evidence for moderate and long-term use and other key outcomes, such as other adverse events and impact on use of opioids during treatment, indicate that more research is needed.
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Chou, Roger, Jesse Wagner, Azrah Y. Ahmed, Benjamin J. Morasco, Devan Kansagara, Shelley Selph, Rebecca Holmes, and Rongwei Fu. Living Systematic Review on Cannabis and Other Plant-Based Treatments for iii Chronic Pain: 2022 Update. Agency for Healthcare Research and Quality (AHRQ), September 2022. http://dx.doi.org/10.23970/ahrqepccer250update2022.
Full textAbstract:
Objectives. To update the evidence on benefits and harms of cannabinoids and similar plant-based compounds to treat chronic pain using a living systematic review approach. Data sources. Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Library, and SCOPUS® databases; reference lists of included studies; and submissions received after Federal Register request were searched to April 4, 2022. Review methods. Using dual review, we screened search results for randomized controlled trials (RCTs) and observational studies of patients with chronic pain evaluating cannabis, kratom, and similar compounds with any comparison group and at least 1 month of treatment or followup. Dual review was used to abstract study data, assess study-level risk of bias, and rate the strength of evidence (SOE). Prioritized outcomes included pain, overall function, and adverse events. We grouped studies that assessed tetrahydrocannabinol (THC) and/or cannabidiol (CBD) based on their THC to CBD ratio and categorized them as comparable THC to CBD ratio, high-THC to CBD ratio, and low-THC to CBD ratio. We also grouped studies by whether the product was a whole-plant product (cannabis), cannabinoids extracted or purified from a whole plant, or a synthetic product. We conducted meta-analyses using the profile likelihood random effects model and assessed between-study heterogeneity using Cochran’s Q statistic chi square test and the I2 statistic. Magnitude of benefit was categorized as no effect or small, moderate, and large effects. Results. From 3,283 abstracts, 21 RCTs (N=1,905) and 8 observational studies (N=13,769) assessing different cannabinoids were included; none evaluated kratom. Studies were primarily short term, and 59 percent enrolled patients with neuropathic pain. Comparators were primarily placebo or usual care. The SOE was low unless otherwise noted. Compared with placebo, comparable THC to CBD ratio oral spray was associated with a small benefit in change in pain severity (7 RCTs, N=632, 0 to10 scale, mean difference [MD] −0.54, 95% confidence interval [CI] −0.95 to −0.19, I2=39%; SOE: moderate) and overall function (6 RCTs, N=616, 0 to 10 scale, MD −0.42, 95% CI −0.73 to −0.16, I2=32%). There was no effect on study withdrawals due to adverse events. There was a large increased risk of dizziness and sedation, and a moderate increased risk of nausea (dizziness: 6 RCTs, N=866, 31.0% vs. 8.0%, relative risk [RR] 3.57, 95% CI 2.42 to 5.60, I2=0%; sedation: 6 RCTs, N=866, 8.0% vs. 1.2%, RR 5.04, 95% CI 2.10 to 11.89, I2=0%; and nausea: 6 RCTs, N=866, 13% vs. 7.5%, RR 1.79, 95% CI 1.19 to 2.77, I2=0%). Synthetic products with high-THC to CBD ratios were associated with a moderate improvement in pain severity, a moderate increase in sedation, and a large increase in nausea (pain: 6 RCTs, N=390, 0 to 10 scale, MD −1.15, 95% CI −1.99 to −0.54, I2=48%; sedation: 3 RCTs, N=335, 19% vs. 10%, RR 1.73, 95% CI 1.03 to 4.63, I2=28%; nausea: 2 RCTs, N=302, 12.3% vs. 6.1%, RR 2.19, 95% CI 0.77 to 5.39; I²=0%). We also found moderate SOE for a large increased risk of dizziness (2 RCTs, 32% vs. 11%, RR 2.74, 95% CI 1.47 to 6.86, I2=40%). Extracted whole-plant products with high-THC to CBD ratios (oral) were associated with a large increased risk of study withdrawal due to adverse events (1 RCT, 13.9% vs. 5.7%, RR 3.12, 95% CI 1.54 to 6.33) and dizziness (1 RCT, 62.2% vs. 7.5%, RR 8.34, 95% CI 4.53 to 15.34); outcomes assessing benefit were not reported or insufficient. We observed a moderate improvement in pain severity when combining all studies of high-THC to CBD ratio (8 RCTs, N=684, MD −1.25, 95% CI −2.09 to −0.71, I2=58%; SOE: moderate). Evidence (including observational studies) on whole-plant cannabis, topical or oral CBD, low-THC to CBD, other cannabinoids, comparisons with active products or between cannabis-related products, and impact on use of opioids was insufficient to draw conclusions. Other important harms (psychosis, cannabis use disorder, and cognitive effects) were not reported. Conclusions. Low to moderate strength evidence suggests small to moderate improvements in pain (mostly neuropathic), and moderate to large increases in common adverse events (dizziness, sedation, nausea) with high- and comparable THC to CBD ratio extracted cannabinoids and synthetic products during short-term treatment (1 to 6 months); high-THC to CBD ratio products were also associated with increased risk of withdrawal due to adverse events. Evidence for whole-plant cannabis and other comparisons, outcomes, and plant-based compounds was unavailable or insufficient to draw conclusions. Small sample sizes, lack of evidence for moderate and long-term use and other key outcomes, such as other adverse events and impact on use of opioids during treatment, indicate that more research is needed.
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Chou, Roger, Azrah Y. Ahmed, Benjamin J. Morasco, Christina Bougatsos, Tracy Dana, Rongwei Fu, and Terran Gilbreath. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain: 2023 Update. Agency for Healthcare Research and Quality, August 2023. http://dx.doi.org/10.23970/ahrqepccer250update2023.
Full textAbstract:
Objectives. To update the evidence on benefits and harms of cannabinoids and other plant-based compounds to treat sub-acute and chronic pain in adults and adolescents using a living systematic review approach. Data sources. Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Library, and SCOPUS® databases; and reference lists of included studies were searched to April 23, 2023. Review methods. An updated protocol with expanded inclusion criteria (addition of sub-acute [4 to 12 weeks’ duration] pain and adolescents) was posted on the PROSPERO registry. We grouped studies based on their THC to CBD ratio and by product type, i.e. whole-plant (extracted or purified), or synthetic. We conducted random effects meta-analyses and categorized magnitude of benefit (large, moderate, small, or no effect [less than small]). Results. Two new RCTs (n=115 and 15) and two new observational studies (N=2,071) were added for this annual update; no study addressed subacute pain or adolescents. One new RCT compared high and low THC to CBD ratio products versus placebo; the other new RCT evaluated was very small and had methodological limitations. Since the inception of this living review, from 5,228 total abstracts identified, 23 RCTs (N=2,035) and 10 observational studies (N=15,840) assessing different cannabinoids were included; no study evaluated kratom. Studies were primarily short term, and 58 percent enrolled patients with neuropathic pain. Comparators were primarily placebo or usual care. Strength of evidence was low, unless indicated otherwise. Compared with placebo, plant-extracted, comparable ratio THC to CBD oral spray was associated with a small decrease in pain severity (7 RCTs, N=632, 0 to 10 scale, mean difference [MD] −0.54, 95% confidence interval [CI] −0.95 to −0.19, I2=39%; SOE: moderate) and overall function (6 RCTs, N=616, 0 to 10 scale, MD −0.42, 95% CI −0.73 to −0.16, I2=32%; SOE: moderate) versus placebo. There was no effect on study withdrawals due to adverse events. There was a large increased risk of dizziness and sedation, and a moderate increased risk of nausea (dizziness: 6 RCTs, N=866, 31.0% vs. 8.0%, relative risk [RR] 3.57, 95% CI 2.42 to 5.60, I2=0%; sedation: 6 RCTs, N=866, 8.0% vs. 1.2%, RR 5.04, 95% CI 2.10 to 11.89, I2=0%; and nausea: 6 RCTs, N=866, 13% vs. 7.5%, RR 1.79, 95% CI 1.19 to 2.77, I2=0%). Synthetic high-THC to CBD ratio products were associated with a small improvement in pain severity, a moderate increase in sedation, and a large increase in risk of nausea following the addition of one new RCT (pain: 7 RCTs, N=448, 0 to 10 scale, MD −0.95, 95% CI −1.81 to −0.25, I2=60%; sedation: 4 RCTs, N=386, 19% vs. 12%, RR 1.60, 95% CI 1.01 to 2.95, I2=8%; nausea: 3 RCTs, N=353, 11.1% vs. 5.2%, RR 2.22, 95% CI 0.90 to 5.05; I²=0%). There was also moderate SOE for a large increased risk of dizziness (3 RCTs, N=353, 29% vs. 11%, RR 2.52, 95% CI 1.20 to 4.82, I2=41%). Extracted whole-plant high-THC to CBD ratio products (oral) were associated with a large increased risk of study withdrawal due to adverse events (1 RCT, viii 13.9% vs. 5.7%, RR 3.12, 95% CI 1.54 to 6.33) and dizziness (1 RCT, 62.2% vs. 7.5%, RR 8.34, 95% CI 4.53 to 15.34); outcomes assessing benefit were not reported or insufficient. Evidence (including observational studies) on whole-plant cannabis, topical or oral CBD, low-THC to CBD products (2 new RCTs), other cannabinoids, comparisons with active non-cannabis treatments or between cannabis-related products, and impact on use of opioids also remained insufficient. Evidence was not available on important harms such as psychosis, cannabis use disorder, and cognitive effects. Conclusions. Low to moderate strength evidence suggests small improvements in pain (mostly neuropathic), and moderate to large increases in common adverse events (dizziness, sedation, nausea) with high and comparable THC to CBD ratio extracted cannabinoids and synthetic products versus placebo during short-term treatment (1 to 6 months) in adults with chronic pain. Evidence for low-THC to CBD ratio products, whole-plant cannabis, and other comparisons, outcomes, and plant-based compounds was unavailable or insufficient to draw conclusions.
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Chou, Roger, Azrah Y. Ahmed, Christina Bougatsos, Benjamin J. Morasco, Rebecca Holmes, Terran Gilbreath, and Rongwei Fu. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain: 2022 Update—Surveillance Report 2. Agency for Healthcare Research and Quality (AHRQ), January 2023. http://dx.doi.org/10.23970/ahrqepccer250.2022updatesr2.
Full textAbstract:
Objectives. To update the evidence on benefits and harms of cannabinoids and similar plant-based compounds to treat chronic pain using a living systematic review approach. Data sources. Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Library, and SCOPUS® databases; reference lists of included studies; and submissions received after Federal Register request were searched to October 24, 2022. Review methods. Using dual review, we screened search results for randomized controlled trials (RCTs) and observational studies of patients with chronic pain evaluating cannabis, kratom, and similar compounds with any comparison group and at least 1 month of treatment or followup. Dual review was used to abstract study data, assess study-level risk of bias, and rate the strength of evidence (SOE). Prioritized outcomes included pain, overall function, and adverse events. We grouped studies that assessed tetrahydrocannabinol (THC) and/or cannabidiol (CBD) based on their THC to CBD ratio and categorized them as comparable THC to CBD ratio, high-THC to CBD ratio, and low-THC to CBD ratio. We also grouped studies by whether the product was a whole-plant product (cannabis), cannabinoids extracted or purified from a whole plant, or a synthetic product. We conducted meta-analyses using the profile likelihood random effects model and assessed between-study heterogeneity using Cochran’s Q statistic chi square test and the I2 statistic. Magnitude of benefit was categorized as no effect or small, moderate, and large effects. Results. From a total of 3,568 abstracts, 21 RCTs (N=1,905) and 9 observational studies (N=15,079) assessing different cannabinoids were included; none evaluated kratom. Studies were primarily short term, and 60 percent enrolled patients with neuropathic pain. Comparators were primarily placebo or usual care. The SOE was low unless otherwise noted. Compared with placebo, comparable THC to CBD ratio oral spray was associated with a small benefit in pain severity (7 RCTs, N=632, 0 to 10 scale, mean difference [MD] −0.54, 95% confidence interval [CI] −0.95 to −0.19, I2=39%; SOE: moderate) and overall function (6 RCTs, N=616, 0 to 10 scale, MD −0.42, 95% CI −0.73 to −0.16, I2=32%). There was no effect on study withdrawals due to adverse events. There was a large increased risk of dizziness and sedation, and a moderate increased risk of nausea (dizziness: 6 RCTs, N=866, 31.0% vs. 8.0%, relative risk [RR] 3.57, 95% CI 2.42 to 5.60, I2=0%; sedation: 6 RCTs, N=866, 8.0% vs. 1.2%, RR 5.04, 95% CI 2.10 to 11.89, I2=0%; and nausea: 6 RCTs, N=866, 13% vs. 7.5%, RR 1.79, 95% CI 1.19 to 2.77, I2=0%). Synthetic products with high-THC to CBD ratios were associated with a moderate improvement in pain severity, a moderate increase in sedation, and a large increase in nausea (pain: 6 RCTs, N=390, 0 to 10 scale, MD −1.15, 95% CI −1.99 to −0.54, I2=48%; sedation: 3 RCTs, N=335, 19% vs. 10%, RR 1.73, 95% CI 1.03 to 4.63, I2=28%; nausea: 2 RCTs, N=302, 12.3% vs. 6.1%, RR 2.19, 95% CI 0.77 to 5.39; I²=0%). We also found moderate SOE for a large increased risk of dizziness (2 RCTs, 32% vs. 11%, RR 2.74, 95% CI 1.47 to 6.86, I2=40%). Extracted whole-plant products with high-THC to CBD ratios (oral) were associated with a large increased risk of study withdrawal due to adverse events (1 RCT, 13.9% vs. 5.7%, RR 3.12, 95% CI 1.54 to 6.33) and dizziness (1 RCT, 62.2% vs. 7.5%, RR 8.34, 95% CI 4.53 to 15.34); outcomes assessing benefit were not reported or insufficient. We observed a moderate improvement in pain severity when combining all studies of high-THC to CBD ratio (8 RCTs, N=684, MD −1.25, 95% CI −2.09 to −0.71, I2=58%; SOE: moderate). Evidence (including observational studies) on whole-plant cannabis, topical or oral CBD, low-THC to CBD, other cannabinoids, comparisons with active products or between cannabis-related products, and impact on use of opioids was insufficient to draw conclusions. Other important harms (psychosis, cannabis use disorder, and cognitive effects) were not reported. Conclusions. Low to moderate strength evidence suggests small to moderate improvements in pain (mostly neuropathic), and moderate to large increases in common adverse events (dizziness, sedation, nausea) with high and comparable THC to CBD ratio extracted cannabinoids and synthetic products during short-term treatment (1 to 6 months); high-THC to CBD ratio products were also associated with increased risk of withdrawal due to adverse events. Evidence for whole-plant cannabis and other comparisons, outcomes, and plant-based compounds was unavailable or insufficient to draw conclusions. Small sample sizes, lack of evidence for moderate and long-term use and other key outcomes, such as other adverse events and impact on use of opioids during treatment, indicate that more research is needed.
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Dutra, Lauren M., Matthew C. Farrelly, Brian Bradfield, Jamie Ridenhour, and Jamie Guillory. Modeling the Probability of Fraud in Social Media in a National Cannabis Survey. RTI Press, September 2021. http://dx.doi.org/10.3768/rtipress.2021.mr.0046.2109.
Full textAbstract:
Cannabis legalization has spread rapidly in the United States. Although national surveys provide robust information on the prevalence of cannabis use, cannabis disorders, and related outcomes, information on knowledge, attitudes, and beliefs (KABs) about cannabis is lacking. To inform the relationship between cannabis legalization and cannabis-related KABs, RTI International launched the National Cannabis Climate Survey (NCCS) in 2016. The survey sampled US residents 18 years or older via mail (n = 2,102), mail-to-web (n = 1,046), and two social media data collections (n = 11,957). This report outlines two techniques that we used to problem-solve several challenges with the resulting data: (1) developing a model for detecting fraudulent cases in social media completes after standard fraud detection measures were insufficient and (2) designing a weighting scheme to pool multiple probability and nonprobability samples. We also describe our approach for validating the pooled dataset. The fraud prevention and detection processes, predictive model of fraud, and the methods used to weight the probability and nonprobability samples can be applied to current and future complex data collections and analysis of existing datasets.