Search

Background: This study compared young adults with and without a medical marijuana (MM) recommendation from a provider ("MM card") on their developmental trajectories of frequent marijuana use and marijuana-related problems in young adulthood.Methods: The analytic sample consists of young adult past month marijuana users (N = 671) who were part of a larger, diverse, and predominantly California cohort. Analyses are based on data from seven surveys completed from ages 13-19.Results: At age 19, 28% of participants reported having an MM card to legally purchase marijuana from an MM dispensary. A multiple group latent growth model indicated that young adults who had an MM card showed steeper increases in frequent marijuana use (i.e., 20-30 days of use in the past month) from ages 13-19 compared to young adults who did not have an MM card. Logistic regression models that matched MM cardholders and non-MM cardholders on individual sociodemographic characteristics found that MM cardholders were more likely to report marijuana negative consequences, selling marijuana/hashish, and driving under the influence of marijuana in the past year. In addition, MM cardholders were more likely to have tried cutting down or quitting in the past 3-months.Conclusions: Among young adult marijuana users, those with an MM card had a higher risk profile for marijuana use and related problems compared to those without an MM card. Given expanding state legalization of MM, this issue warrants further attention. [ABSTRACT FROM AUTHOR]

Background: Little is known about young adult medical marijuana patients (MMP) and their marijuana using patterns and practices, which includes frequency of use, sourcing of marijuana products, forms/modes of administration, and patterns of illicit/prescription drug misuse, compared to non-patient marijuana users (NPU).Methods: Young adults (N=366) aged 18-26 years old were sampled in Los Angeles in 2014-15 and segmented into NPU (n=156), marijuana users who never had a medical marijuana (MM) recommendation, and MMP (n=210), marijuana users with a current, verified MM recommendation. Differences regarding self-reported marijuana and other drug use during the past 90days are expressed as unadjusted risk ratios or differences in means.Results: MMP reported significantly greater mean days of use (76.4 vs. 59.2, p<0.001) and mean dollars spent on marijuana products (564.5 vs. 266.9, p<0.001) than NPU. Approximately one-quarter (22.6%) of both MMP and NPU report selling marijuana obtained from a dispensary to someone else in the past 90days. MMP were more likely to report vaporization modalities for concentrates (URR=1.5, 95% C.I.=1.2, 2.0) and for marijuana (URR=1.5, 95% C.I.=1.1, 2.1) than NPU. Though not significant, trends toward lower misuse of prescription drugs in the past 90days were observed among MMP compared to NPU.Conclusion: MMP reported greater access to marijuana via dispensaries, more frequent and intensive use of marijuana, and greater use of non-combustible forms of marijuana compared to NPU. MMP reported less recent misuse of prescription drugs compared to NPU. [ABSTRACT FROM AUTHOR]

Background: Rates of young adult cannabis use are rising, perceived harm is at its historical nadir, and most users do not want to quit. Most studies evaluating effects of cannabis use in young adults are cross-sectional, limiting causal inference. A method to reliably induce abstinence periods in cannabis users would allow assessment of the effects of abstinence and resumption of use on a variety of outcomes in a within-subjects, repeated measures design.Methods: We examined the efficacy and feasibility of a voucher-based contingency management procedure for incentivizing one month of continuous cannabis abstinence among young adults who reported at least weekly cannabis use, volunteered to participate in a laboratory study, and did not express a desire to discontinue cannabis use long-term. Continuous cannabis abstinence was reinforced with an escalating incentive schedule, and self-report of abstinence was confirmed by frequent quantitative assays of urine cannabis metabolite (THCCOOH) concentration. New cannabis use during the abstinence period was determined using an established algorithm of change in creatinine-adjusted cannabis metabolite concentrations between study visits.Results: Thirty-eight young adults, aged 18-25 years, enrolled and 34 (89.5%) attained biochemically confirmed 30-day abstinence. Among those who attained abstinence, 93.9% resumed regular use within two-weeks of incentive discontinuation.Conclusion: Findings support the feasibility and efficacy of contingency management to elicit short-term, continuous cannabis abstinence among young adult, non-treatment seeking, regular cannabis users. Further work should test the effectiveness of this contingency management procedure for cannabis abstinence in periods longer than one month, which may be required to evaluate some effects of abstinence. [ABSTRACT FROM AUTHOR]

Background: Both Attention Deficit Hyperactivity Disorder (ADHD) and chronic cannabis (CAN) use have been associated with brain structural abnormalities, although little is known about the effects of both in young adults.Methods: Participants included: those with a childhood diagnosis of ADHD who were CAN users (ADHD_CAN; n=37) and non-users (NU) (ADHD_NU; n=44) and a local normative comparison group (LNCG) who did (LNCG_CAN; n=18) and did not (LNCG_NU; n=21) use CAN regularly. Multiple regressions and MANCOVAs were used to examine the independent and interactive effects of a childhood ADHD diagnosis and CAN group status and age of onset (CUO) on subcortical volumes and cortical thickness.Results: After controlling for age, gender, total brain volume, nicotine use, and past-year binge drinking, childhood ADHD diagnosis did not predict brain structure; however, persistence of ADHD was associated with smaller left precentral/postcentral cortical thickness. Compared to all non-users, CAN users had decreased cortical thickness in right hemisphere superior frontal sulcus, anterior cingulate, and isthmus of cingulate gyrus regions and left hemisphere superior frontal sulcus and precentral gyrus regions. Early cannabis use age of onset (CUO) in those with ADHD predicted greater right hemisphere superior frontal and postcentral cortical thickness.Discussion: Young adults with persistent ADHD demonstrated brain structure abnormalities in regions underlying motor control, working memory and inhibitory control. Further, CAN use was linked with abnormal brain structure in regions with high concentrations of cannabinoid receptors. Additional large-scale longitudinal studies are needed to clarify how substance use impacts neurodevelopment in youth with and without ADHD. [ABSTRACT FROM AUTHOR]

Objective: This short communication reports on the association of annual measures of young adult (age 18-24) past month cannabis use with cannabis use disorder (CUD) treatment admissions by state in the U.S. from 2008 to 2017.Methods: Annual data on percentage of past month cannabis use and the total number of CUD treatment admissions among young adults were acquired for each state from SAMHSA NSDUH and TEDS-A data sets. For each state, the correlation over time between cannabis use and treatment admissions rate was calculated and visualized in a choropleth map. Fixed-effects regression, where effects are fixed by state, was used to investigate the association of cannabis use with treatment admissions rate.Results: In 38 out of 50 states, including seven out of the eight states legalizing recreational cannabis during the study period, as young adult cannabis use increased, treatment admissions declined. Cannabis use is significantly and negatively associated with treatment admissions (β = -7.21, 95% CI = -11.88, -2.54), even after controlling for health insurance coverage, criminal justice referral, treatment center availability, and cannabis legalization status.Conclusions: While it is possible that across the U.S. more young adults are using cannabis without developing CUD, we speculate that increasing social acceptance of cannabis use, and declining perception of harm, may influence treatment seeking behavior, potentially resulting in growing unmet need for CUD treatment among young adults. Monitoring state-level trends in cannabis use, CUD prevalence, and treatment admissions is key to developing CUD prevention and treatment policies targeted to timely, state-specific conditions. [ABSTRACT FROM AUTHOR]

Background: Legalization of medical and recreational cannabis in US states has been accompanied by increases in availability, acceptability, and diversity in methods of cannabis use, as well as an increase in devices and methods for cannabis-tobacco co-use. Updated and specific survey measures of cannabis and cannabis-tobacco co-use are needed.Methods: We employed a mixed-methods approach to identify sources of specification and measurement error in cannabis and cannabis-tobacco co-use measures. We surveyed and interviewed 36 young adult (age 18-29) cannabis and tobacco co-users in California (2017-2018), triangulated with document analysis of online cannabis websites and forums. We investigated how survey reports of cannabis use and cannabis-tobacco co-use compared to narrative descriptions provided during in-depth interviews. We identify key strategies for researchers collecting self-reported survey data to enhance accuracy and comprehensiveness of measures.Findings: Potential sources of survey error included: broad variation in cannabinoid content and concentration, inconsistent interpretation of questions between participants and researchers (e.g. blunts were not considered co-use), and substantial variation in dosage within and between products. No evidence of survey recall bias or response editing was detected.Conclusion: To enhance survey accuracy, we recommend surveys specify which cannabis delivery methods and forms are included and excluded in each measure, differentiate between cannabis products, and explicitly include or exclude CBD product use. [ABSTRACT FROM AUTHOR]

Background: The ways in which young people learn about cannabis product availability and where they obtain cannabis products are important to understand for prevention and intervention efforts.Methods: Young adults who reported past month cannabis use (N = 758) completed an online survey in 2018-2019 on how they obtained cannabis and the products they used in a newly legalized market in Los Angeles (mean age 21.6; 44% Hispanic, 27% white, 15% Asian).Results: Overall, 59.1% obtained cannabis from recreational cannabis retailers (RCRs), 51.5% from family or friends, 39.1% from medical cannabis dispensaries (MCDs), and 5.5% from strangers or dealers in the past month. Compared to those getting cannabis from family or friends, those getting cannabis from MCDs or RCRs spent more money, used more cannabis products, were more likely to use alone, used greater quantities of bud/flower, and reported more consequences from use. Further, those obtaining cannabis from MCDs were more likely to screen positive for cannabis use disorder (CUD). For type of products, those obtaining cannabis from MCDs or RCRs were more likely to use joints, bongs, pipes, dabs, vape, and consume edibles relative to those obtaining from family or friends. Subgroup differences were found for both source patterns and cannabis-related outcomes. Males and those with a cannabis medical card reported spending more money on cannabis, using more types of products, and indicated more frequent use and greater CUD symptoms and consequences. Compared to Whites, Blacks spent more money on cannabis and used more products, and Hispanics reported using more products and greater quantities of cannabis bud/flower.Conclusions: Findings highlight the different ways that young adults obtain cannabis, and how young adults with a medical cannabis card may be at greater risk for problems compared to young adults who use cannabis recreationally. [ABSTRACT FROM AUTHOR]

This study aimed to broaden previous investigations of correlates of lifetime cannabis use and problematic cannabis use among post-secondary students by examining the novel and contemporary issues of medicinal use and deep inhalation practices. The sample included 2212 undergraduate and graduate post-secondary students from Alberta, Canada, who completed the University of Calgary's Campus Experience with Cannabis Survey (average age 23.2, SD = 5.2). Nine variables were entered into the binary logistic regression to examine their differentiation of lifetime users from non-users. A multiple regression model was completed with past six-month users (n = 697), where the continuous dependent variable was cannabis use severity as measured by total scores on the Cannabis Use Disorder Identification Test-Revised. Twenty independent variables were entered simultaneously. Varsity athlete status, family mental illness, severity of alcohol use, greater support for legalization and lower perceived risk associated with regular cannabis use, differentiated lifetime users from non-users. Higher rates of religiosity and living with parents or relatives were associated with lower-lifetime rates. Male gender, earlier age of first cannabis use, cannabis use motives (including coping, enhancement and expansion), past six-month medicinal use and increased frequency of deep inhalation during consumption, were found to be significant correlates of severity. Different factors seem to predict lifetime cannabis use versus severity, and these differences may help inform the development and delivery of prevention efforts. Given that medicinal use and male gender were the largest correlates of severity, populations representing these groups may benefit most from targeted education and prevention. [ABSTRACT FROM AUTHOR]