Search

Background: With a rise in public pressure to increase veteran access to medicinal cannabis, free cannabis collectives for military veterans are proliferating across the US. Objectives: The aim of the current study was to document which cannabis formulations and routes of administration are chosen by veterans with increased access to cannabis, and to determine whether cannabis is being used as a substitute for other licit and illicit drugs. Method: The current study collected cross-sectional self-report data on cannabis use, cannabinoid constituent composition, primary indication of use, and substitution practices among a sample of 93 US military veterans (84.9% male) with access to free cannabis. Result: Most of the sample reported using cannabinoids as a substitute for either alcohol, tobacco, prescription medications, or illicit substances, reported that they use cannabis frequently (Modal frequency >4x/day, Modal quantity = 5 to 8 grams/week), and primarily select higher-risk cannabis formulations (i.e., high THC/low CBD, smoked). The majority of the sample reported that they use cannabis to self-treat multiple physical and mental health conditions/symptoms. Conclusions: Results of the current study suggest that military Veterans with reduced barriers to access cannabis could be making both helpful and harmful choices regarding their cannabis use. These findings suggest that more guidance on the selection of cannabis-based products in this population is warranted, particularly as barriers to medicinal cannabis access are reduced.

Cannabis remains the most frequently used illicit drug in the United States. As its legal status has changed, more people have turned to oral administration ("edibles"). 172 individuals who reported an uncomfortable experience with edible cannabis completed an online survey. Despite the aversive nature of the experience, 62.9% of the sample reported that the edible experience was at least somewhat meaningful and the majority of participants (95.2%) did not report any medical problems. The most common non-medical problem reported was going to bed early or lying down (75.8%). Most participants (69.2%) reported that dose was the key contributor to their negative experience. Participants who rated the experience as more aversive were less likely to use edibles again, r (167) = - .180, p < . 05. In addition, the duration of the aversive experience correlated positively with aversiveness rating, r (167) = . 244, p < . 05. With increased legalization of cannabis, edible use may rise. Dose seems to be associated with uncomfortable experiences with edible cannabis. Notwithstanding these uncomfortable experiences, the vast majority of the sample used cannabis edibles again, reported that the experience was at least somewhat meaningful, and did not report significant problems associated with the experience. [ABSTRACT FROM AUTHOR]

Accumulating evidence suggests that the endocannabinoid system is a promising target for the treatment of a variety of health conditions. Two paths of cannabinoid drug development have emerged. One approach is focused on developing medications that are directly derived from the cannabis plant. The other utilizes a single molecule approach whereby individual phytocannabinoids or novel cannabinoids with therapeutic potential are identified and synthesized for pharmaceutical development. This commentary discusses the unique challenges and merits of botanical vs single molecule cannabinoid drug development strategies, highlights how both can be impacted by legalization of cannabis via legislative processes, and also addresses regulatory and public health considerations that are important to consider as cannabinoid medicine advances as a discipline. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated the ability of non-active smoked cannabis cigarettes to induce subjective effects of intoxication (i.e., placebo effect). No studies have been conduced to test whether edible forms of cannabis, which are associated with a significant delay in onset of effect, are able to induce a placebo effect. In the present study, 20 participants were told that they would receive an edible cannabis lollipop containing a high dose of tetrahydrocannabinol (THC), but were instead given a placebo control. Measures of intoxication and mood were taken at baseline, 30 minutes, and 60 minutes post-ingestion of the placebo lollipop. Results of four repeated-measures ANOVAs found significant and quadratic changes across time in cannabis (ARCI m-scale) intoxication (F(2,18) = 4.90,p = .01, η2 = .22) and negative mood (F(2,18) = 3.99,p = .05, η2 = .19). Changes in positive mood and the overall measure of general intoxication (ARCI) failed to reach significance. The present study provides preliminary evidence that a placebo effect can be induced with inert edible agents when participants are told that they are receiving active THC. This is the first known study to demonstrate an edible cannabis intoxication placebo effect. [ABSTRACT FROM PUBLISHER]

Introduction: The present study is the first to test whether veterans who use cannabis specifically for the purposes of self-medication for their reported PTSD symptoms differ from veterans who use cannabis medicinally for other reasons, or recreationally, in terms of patterns of cannabis use, use of alcohol, and reactivity to written combat trauma reminders.Methods: Assessment measures were administered online to a sample of veterans with a history of cannabis use (n=1971). Cued arousal was assessed pre/post via a prompt about combat experiences. Hypotheses were tested using a series of Bonferroni corrected one-way analyses of variance, t-tests, bivariate and partial correlations, and a Chi-square test.Results: Compared to recreational users, veterans who identify as medicinal cannabis users reported greater combat exposure (d=0.56), PTSD symptoms (d=1.02), subjective arousal when cued (d=0.25), and cannabis use (dfrequency=0.40; ddensity=0.42), but less alcohol use (d=0.28). Few differences were observed between medicinal users who reported using for PTSD versus those who reported using for other reasons.Conclusions: Compared to those who use cannabis recreationally, veterans who report that they use cannabis medicinally use more cannabis and endorse significantly more symptoms of arousal following a prompt about combat trauma experiences. [ABSTRACT FROM AUTHOR]

Heavy, frequent cannabis use covaries with cannabis-associated problems. With cannabis policy changing worldwide, identifying risk factors for cannabis-associated problems is crucial. While researchers have consistently studied frequency and quantity of use as important risks, clinical lore suggests that the timing of use might also contribute to problems. Similar to morning use of alcohol among alcohol-dependent individuals, morning use of marijuana may indicate dependence and increased cannabis-related impairment. Morning use also has the potential to lend itself to straightforward intervention. The present study sought to examine the relation between morning cannabis use and self-reported cannabis-associated problems. The study compared daily marijuana users who reported morning use (n = 257) to daily marijuana users who reported no use before noon (n = 76) using the brief Cannabis-Associated Problems Questionnaire. Morning users reported significantly more problems than non-morning users, and morning use accounted for significant unique variance in problems. Exploratory mediational analyses did not support the idea that morning use led to problems via withdrawal. The present study provides evidence that timing of cannabis use is an important factor in examining the cannabis-associated problems. [ABSTRACT FROM AUTHOR]

A new method for administering cannabinoids, called butane hash oil ("dabs"), is gaining popularity among marijuana users. Despite press reports that suggest that "dabbing" is riskier than smoking flower cannabis, no data address whether dabs users experience more problems from use than those who prefer flower cannabis. Objective The present study aimed to gather preliminary information on dabs users and test whether dabs use is associated with more problems than using flower cannabis. Method Participants (n=357) reported on their history of cannabis use, their experience with hash oil and the process of "dabbing," reasons for choosing "dabs" over other methods, and any problems related to both flower cannabis and butane hash oil. Results Analyses revealed that using "dabs" created no more problems or accidents than using flower cannabis. Participants did report that "dabs" led to higher tolerance and withdrawal (as defined by the participants), suggesting that the practice might be more likely to lead to symptoms of addiction or dependence. Conclusions The use of butane hash oil has spread outside of the medical marijuana community, and users view it as significantly more dangerous than other forms of cannabis use. [ABSTRACT FROM AUTHOR]

Marijuana, the most commonly used illicit drug among college students, remains the most cited reason for entering treatment for substance abuse and dependency (Johnston, L.D., O'Malley, P.M., Bachman, J.G., & Schulenberg, J.E. (2009). Monitoring the future: National survey results on drug use, 1975-2008. Volume II: College students and adults aged 19-50. Bethesda, MD: National Institute on Drug Abuse). Current models now include craving as a potential indicator of drug problems (Goldstein, R.Z., & Volkow, N.D. (2002). Drug addiction and its underlying neurobiological basis: Neuroimaging evidence for the involvement of the frontal cortex. American Journal of Psychiatry, 159, 1642-1652). Memory-expectancy and cue-reactance manipulations are increasingly common in the study of craving. Such manipulations rely on the use of relevant cues to prime thoughts associated with the substance of interest. Nevertheless, manipulations involving marijuana primes remain limited; most only using visual and over-stereotyped cues and are tested using samples that already meet criteria for problematic use. The current experiment tested an olfactory manipulation for priming thoughts of marijuana using a sample of 85 college students that represent an array of past marijuana use. Two 2 × 3 χ2 tests revealed that participants who smelled cannabis reported a higher proportion of primed words associated with marijuana than those who smelled a control scent. Logistic regression revealed that history of cannabis use did not alter the magnitude of this priming effect. Results support the use of this study's novel olfactory cue as an appropriate manipulation for the study of marijuana priming effects within college-aged samples. [ABSTRACT FROM AUTHOR]

Background: Cannabis use is associated with psychiatric illness and suicidality, which are prevalent among U.S. military veterans. However, the psychiatric burden of cannabis use and cannabis use disorder (CUD) among veterans is unclear. Using data from a nationally representative sample of veterans, we evaluated associations of lifetime cannabis use and CUD with psychiatric problems, suicidality, and treatment utilization.Methods: Participants were 3,157 veterans aged 21 to 96 years from the National Health and Resilience in Veterans Study (NHRVS). Cannabis use and CUD were assessed using the Mini International Neuropsychiatric Interview. Psychiatric morbidities, suicidal ideation and attempts, and treatment utilization were assessed and compared between three cannabis groups: [1] no lifetime cannabis use (never-use); [2] lifetime cannabis use but never met criteria for CUD (non-CUD cannabis use); [3] lifetime CUD (CUD).Results: Relative to the never-use group, veterans who used cannabis had elevated odds of current and lifetime posttraumatic stress disorder (PTSD), mood, anxiety, and substance use disorders, current suicidal ideation, lifetime suicide attempts, and current and lifetime mental health treatment utilization [odds ratios (ORs)=1.5-8.3]. Veterans with CUD had higher odds of current and lifetime PTSD, mood, and anxiety disorders, lifetime nicotine and alcohol dependence, and current suicidal ideation, relative to veterans who used cannabis but never met criteria for CUD (ORs=1.6-2.7).Limitations: The cross-sectional design of this study precludes causal inference.Conclusions: Cannabis use and CUD are associated with substantial psychiatric and suicide-related burden among veterans, highlighting the need for screening, education, and treatment to mitigate potential cannabis-related harm. [ABSTRACT FROM AUTHOR]