Marijuana Use and Addiction Prevention

In the United States (US), recreational cannabis use is on the rise. Since 2011, 11 states and the District of Columbia have legalized cannabis for adult recreational use. As additional states consider legalizing, there is an urgent need to assess associations between recreational cannabis legalization and maternal use in the preconception, prenatal, and postpartum periods—all critical windows for maternal and child health. Using cross-sectional data from the 2016 Pregnancy Risk Assessment Monitoring System, we assessed associations between state cannabis legalization and self-reported maternal cannabis use. Using logistic regression, we estimated the adjusted prevalence ratio (PR) of cannabis use during the preconception, prenatal, and postpartum period for women delivering a live-born infant in three states that had legalized recreational cannabis (Alaska, Colorado, and Washington) and three states that had not legalized (Maine, Michigan, and New Hampshire) by 2016. Our final sample size was 7258 women. We utilized 95% confidence intervals (CI) and a significance level of alpha = 0.05. After adjustment for potential confounders, women who resided in states with legalized recreational cannabis were significantly more likely to use cannabis during the preconception (PR 1.52; 95%CI ranging from 1.28–1.80; p < 0.001), prenatal (PR 2.21; 95% CI ranging from 1.67–2.94; p < 0.001), and postpartum (PR 1.73; 95%CI ranging from 1.30–2.30; p < 0.001) periods, compared to women who resided in states without legalized recreational cannabis. Although evidence about the effect of marijuana use during these periods is nascent, these findings show potential for increased incidence of child exposure to cannabis. Longitudinal research is needed to assess immediate and sustained impacts of maternal use before and after state legalization of recreational cannabis. Full article

Background: Vaping has become an increasingly common mode of administration for both nicotine and cannabis, with overlap among users, devices, as well as nicotine and cannabis companies. There is a need to understand patterns of use among youth, including the way nicotine and cannabis are administered. Methods: Data are from Wave 2 of the ITC Youth Tobacco and Vaping survey, an online survey conducted in 2018 among 16–19 year-olds recruited from commercial panels in Canada (n = 3757), England (n = 3819), and the U.S. (n = 3961). The prevalence of past 30-day vaping nicotine, non-nicotine and cannabis substances, as well as cannabis modes of use was examined. Logistic regression models examined between country differences in prevalence. Results: Past 30-day cannabis use was highest among Canadian youth (16.6%), followed by youth in the U.S. (13.8%) and England (9.0%). Vaping e-cigarettes was substantially more prevalent than vaping cannabis in all three countries. All forms of cannabis use were higher among Canadian and U.S. youth compared to England (p < 0.001 for all). Past 30-day cannabis users in the U.S. were more likely to report vaping cannabis oil (30.1%), and consuming solid concentrates such as wax and shatter (30.2%), compared to cannabis users in Canada (18.6% and 22.9%) and England (14.3% and 11.0%; p < 0.001 for all). Conclusions: Youth are administering cannabis and nicotine using a wide diversity of modes. Cannabis users in the U.S.—where an increasing number of states have legalized medical and non-medical cannabis—reported notably higher use of more potent cannabis products, including cannabis oils and extracts. Full article

The aims of this study were: (a) to estimate time trends in the prevalence of the co-use of cannabis and other cannabis-based products (CBP) with the misuse of tranquilizers, sedatives, and sleeping pills (TSSp) between 2009 and 2015; and (b) to identify the factors associated with the probability of the co-use of CBP with TSSp misuse during this period among Spanish younger adults (15–34 years old). We analyzed data collected from the Spanish National Surveys on Alcohol and Other Drugs (EDADES) in 2009, 2011, 2013, and 2015. CBP co-use with TSSp misuse were the dependent variables. We also analyzed sociodemographic features, self-perceived health status, lifestyle habits, perceived health risk of consumption, and perceived availability of substance using logistic regression models. The prevalence of CBP co-use with TSSp misuse has decreased in Spain. The factors associated with co-use were a lack of education (OR 2.34), alcohol (OR 7.2), tobacco (OR 6.3) and other illicit psychoactive drug (OR 6.5) consumption, perceived non-health risk for the consumption of CBP and TSSp (OR 3.27), and perceived availability of CBP (OR 2.96). Our study identified several factors that appear to affect CBP and TSSp co-use in younger adults, with potential implications for healthcare providers. Full article

The prevalence of illicit drug misuse, including cannabis, in Croatian touristic regions is alarming. This study aimed to identify the prevalence of cannabis consumption (CC), to identify associations between sociodemographic and sport factors and CC, and to evaluate the predictors of CC initiation in adolescents residing in touristic regions. This study enrolled 644 adolescents from two touristic regions in Croatia (Split-Dalmatia and Dubrovnik-Neretva County) who were tested at baseline (16 years of age) and follow-up (18 years of age). The study instrument consisted of questions focused on predictors (age, gender (male, female), place of residence (urban or rural environment), familial social status, and different sport-related factors) and CC outcome. The results indicated a high prevalence of cannabis consumption (>30% of adolescents consumed cannabis), with a higher prevalence in males, and adolescents from rural communities. The prevalence of CC increased by 10% during the study period, with no significant differences between genders in trajectories of changes. Quitting sports was a risk factor for CC at baseline and follow-up. Better sport competitive results (odds ratio (OR): 0.80, 95% confidence interval (CI): 0.65–0.96) and familial social status (socioeconomic status: OR: 0.66, 95% CI: 0.39–0.91; maternal education: OR: 0.65, 95% CI: 0.48–0.88) were associated with lower likelihood of CC at baseline. The adolescents who reported better sport competitive results were at increased risk for initiation of CC during the course of the study (OR: 1.40, 95% CI: 1.03–2.01). The protective effects of sports at baseline were most likely related to various factors that prevent the consumption of substances in youth athletes (i.e., commitment to results, adult supervision); with the end of active participation, adolescent athletes are at high risk for CC initiation. Full article

Marijuana is the most consumed illicit drug in the world, with over 192 million users. Due to the current legalization push of marijuana in the United States, there has been a lack of oversight regarding its public health policies, as marijuana advocates downplay the drug’s negative effects. This paper’s approach is from a public health perspective, focusing specifically on the cases of violence amongst some marijuana users. Here, we present 14 cases of violence with chronic marijuana users that highlight reoccurring consequences of: marijuana induced paranoia (exaggerated, unfounded distrust) and marijuana induced psychosis (radical personality change, loss of contact with reality). When individuals suffering from pre-existing medical conditions use marijuana in an attempt to alleviate their symptoms, ultimately this worsens their conditions over time. Although marijuana effects depend on the individual’s endocannabinoid receptors (which control behavioral functions, like aggression) and the potency level of tetrahydrocannabinol (THC) in the drug, scientifically documented links between certain marijuana users and violence do exist. Wider public awareness of the risks and side effects of marijuana, as well as a more prudent health policy, and government agency monitoring of the drug’s composition, creation, and distribution, are needed and recommended. Full article

Evidence for an association between cannabis and psychosis has been documented in literature in many forms including experimental studies, epidemiological data, and case series. The association has implications for psychotic outcomes ranging from mild to severe and occurring over minutes to years. Due to the huge variety of exposures and outcome measures reported, creating a coherent account of all the available information is difficult. A useful way to conceptualize these wide-ranging results is to consider the association between cannabis and psychosis as it occurs within the context of widely used DSM-5 diagnoses. In the present review we examine cannabis/psychosis associations as they pertain to Cannabis Intoxication, Cannabis-Induced Psychotic Disorder, and Schizophrenia. This allows for an understanding of the cannabis and psychosis association along something approaching a continuum. Cannabis intoxication becomes Cannabis-Induced Psychotic Disorder once certain severity and duration criteria are met and Cannabis-Induced Psychotic Disorder is heavily associated with future schizophrenia diagnoses. Full article

The legality, recreational and medical use of cannabis varies widely by country and region but remains largely prohibited internationally. In October 2018, Canada legalized the recreational use of cannabis—a move many viewed as controversial. Proponents of legalization have emphasized the potential to eradicate the marijuana black market, improve quality and safety control, increase tax revenues, improve the availability of medical cannabis, and lower gang-related drug violence. Conversely, opponents of legalization have stressed concerns about cannabis’ addictive potential, second-hand cannabis exposure, potential exacerbation of underlying and established mental illnesses, as well as alterations in perception that affect safety, particularly driving. This systematic review synthesizes recent international literature on the clinical and public health implications of cannabis legalization. Full article