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Background Purpose Cannabis use in the general population is prevalent and is rising because of increased acceptance of its use, legalization in most US states, and perceived health benefits. Cannabis product potency has dramatically increased with higher delta‐9‐tetrahydrocannabinol content. Cannabis has documented antiemetic properties and cannabinoid pharmaceuticals are used in disorders like chemotherapy‐induced nausea and vomiting.Forty to eighty percent of cyclic vomiting syndrome (CVS) patients use cannabis products, which reportedly reduce stress as well as nausea and vomiting. Cannabinoid hyperemesis syndrome (CHS) has a presentation similar to CVS, but is associated with longstanding, high dose cannabis use, and is thought to be relieved by sustained cannabis abstinence. Most CHS patients have used cannabis on a daily or near‐daily basis for more than 2 years. Compulsive hot‐water bathing behaviors are reported by most CHS patients, but are not specific for this disorder as they are also noted by about half of CVS patients. Episodic vomiting associated with cannabis use contributes to extensive health resource use, including emergency department visits and inpatient hospitalizations, and impacts patients and their families negatively. Treatment for CHS overlaps with CVS although cannabis abstinence remains the cornerstone of its management. Challenges associated with cannabis use cessation in CHS include patient skepticism of the role of cannabis as a cause of symptoms, perceived benefits of cannabis, and a lack of other effective therapies. In this review, we highlight cannabis use patterns in the US and discuss diagnosis and management of CHS and gaps in knowledge about this disorder. [ABSTRACT FROM AUTHOR]

Background: Despite the evidence that energy balance is regulated differently in females and that the endocannabinoid system is sexually dimorphic, previous studies on the endocannabinoid system and energy balance predominantly used male models. Here, we characterize the effects of cannabinoid receptor deletion on body weight gain and glucose metabolism in female C57BL mice. Methods: Female mice lacking the cannabinoid-1 receptor (CB1R-/-), cannabinoid-2 receptor (CB2R-/-), or both receptors (CB1R-/-/CB2R-/-) and wild-type (WT) mice were fed with a low (LFD; 10% of calories from fat) or high-fat diet (HFD; 45% of calories from fat) for six weeks. Results: Female WT mice fed with HFD gained significantly more weight than WT mice fed with LFD (p < 0.001). Similar pattern was observed for CB2/- mice fed with HFD compared to CB2R-/- mice fed with LFD (p < 0.001), but not for CB1R-/- fed with HFD vs. LFD (p = 0.22) or CB1R-/-/CB2R-/- fed with HFD vs. LFD (p = 0.96). Comparing the 4 groups on LFD, weight gain of CB1R-/- mice was greater than all other genotypes (p < 0.05). When fed with HFD, the deletion of CB1R alone in females did not attenuate weight gain compared to WT mice (p = 0.72). Female CB1R-/-/CB2R-/- mice gained less weight than WT mice when fed with HFD (p = 0.007) despite similar food intake and locomotor activity, potentially owing to enhanced thermogenesis in the white adipose tissue. No significant difference in weight gain was observed for female CB2R-/- and WT mice on LFD or HFD. Fasting glucose, however, was higher in CB2R-/- mice fed with LFD than all other groups (p < 0.05). Conclusion: The effects of cannabinoid receptor deletion on glucose metabolism in female mice were similar to previously published findings on male mice, yet the effects on body weight gain and thermogenesis were attenuated in CB1R-/- mice. [ABSTRACT FROM AUTHOR]

Background and Objectives: The prevalence of cocaine use has increased in the United States, with an estimated 5.5 million people have used it at least once in 2019. We report trends in cocaine use for reproductive age females who participated in the National Survey on Drug Use and Health (NSDUH, 2005–2019). Methods: Interviewers for NSDUH recruited and assessed a representative sample of the US noninstitutionalized population. The prevalence of cocaine use was estimated annually for females (15–44 years; n = 295,751). Joinpoint regression was then used to test for significant changes in trends. Results: Approximately 2.4% of females (n = 8136) reported past 12‐month cocaine use. Joinpoint regression revealed an initial decline in cocaine use prevalence between 2005 and 2011, followed by a robust increase (2011–2019 annual percent change = 5.2; 95% confidence interval = 2.6, 7.8%). This nonlinear trend was observed for all subgroups, except for adolescent and pregnant females for whom a decrease in cocaine use prevalence was observed. Discussion and Conclusions: Although the prevalence of cocaine use remains scarce among US females, the uptake in use after a period of initial decline is concerning, highlighting the need for continued public health awareness and action. Scientific Significance: Cocaine use among females of reproductive age is particularly concerning given the increased likelihood of transitioning to disordered use and the risk of use during pregnancy. Previous studies have not reported cocaine use estimates specific to reproductive age females or only reported co‐drug use patterns, without detail of specific cocaine use trends. [ABSTRACT FROM AUTHOR]

Background: While prescription psychotherapeutic drug use (PPDU) and nicotine use pose substantial problems in isolation, they pose an increased risk in combination. This study aimed to estimate the prevalence of PPDU for young people, stratified by nicotine use status. A trend analysis was used to examine changes in PPDU and nicotine use over time. Methods: We used a cross-sectional population-based sample of young people aged 16–25 years (n = 10,454) from the National Health and Nutrition Examination Survey (NHANES, 2003–2018). For each data cycle, the prevalence of self-reported PPDU and nicotine including pain relievers, sedatives, stimulants, and tranquilizers was estimated. Using Joinpoint regression, we tested for significant changes in trends using a log-linear model and permutation test approach and produced the average data cycle percentage change (ADCPC). Results: From 2003 to 2018, 6.7% of young people had PPDU and 27.3% used nicotine. The prevalence of cigarette smoking decreased while other nicotine product use increased (p's < 0.001). Those who used nicotine were more likely to have PPDU (8.2%; 95% CI = 6.5%, 9.8%) vs. non-nicotine use (6.1%; 95% CI = 5.1%, 7.0%; p = 0.01). Results indicated a decreasing trend for nicotine use (ADCPC = −3.8, 95% CI = −7.2, −0.3; p = 0.04), but not for PPDU (ADCPC = 1.3; 95% CI = −4.7, 7.8; p = 0.61). On further examination, opioid use decreased, sedative use remained stable, and stimulant and tranquilizer use increased over time. Conclusions: From 2003 to 2018, young people who used nicotine had a higher prevalence of PPDU than those who did not. Clinicians should communicate the association between nicotine use and prescription drugs when prescribing or managing young patients' medications. [ABSTRACT FROM AUTHOR]

The timing of prenatal exposure to tobacco cigarette smoking can be crucial for the developing fetus. Pushing the field beyond prior pregnancy trimester-focused smoking estimates, we estimated month-specific prevalence proportions for tobacco cigarette smoking among pregnant and non-pregnant women of the United States, with consideration of tobacco dependence (TD) as well. In advance, we posited that pregnancy onset might prompt smoking cessation in early months, before the end of the 1st trimester, and that TD might account for sustained smoking in later months, especially months 8-9, when there are added reasons to quit. Estimates are from the 2002-2009 National Surveys on Drug Use and Health Restricted-Data Analysis System (R-DAS), with large nationally representative samples of US civilians, including 12-44 year old women (n ~ 70,000) stratified by pregnancy status and month of pregnancy, with multi-item assessment of TD as well as recently active smoking. Age was held constant via the Breslow-Day indirect standardization approach, a methodological detail of potential interest to other research teams conducting online R-DAS analyses. Among 12-44 year old women in Month 1 of pregnancy, as well as non-pregnant women, just over one in four was a recently active smoker (26-27 %), and approximately one-half of these smokers qualified as a TD case (52 %). Corresponding estimates for women in Month 3 were 17.6 % and two-thirds, respectively, lending some support for our advance hypotheses. Nonetheless, our a priori TD hypothesis about Months 8-9 seems to be contradicted: an increased concentration of TD among smokers surfaced early in pregnancy. Evidence of a possible ameliorative pregnancy effect on smoking prevalence as well as TD's effect on smoking persistence might be seen quite early in pregnancy. Substitution of a month-specific view for the traditional trimester view sheds new light on how pregnancy might shape smoking behavior before the end of trimester 1, with TD seeming to thwart a public health goal of 100 % cessation, early in pregnancy. Electronic supplementary material The online version of this article (doi:10.1007/s10995-014-1599-4) contains supplementary material, which is available to authorized users., Author(s): Omayma Alshaarawy[sup.1] , James C. Anthony[sup.1] Author Affiliations: (1) Department of Epidemiology and Biostatistics, Michigan State University, 48824, East Lansing, MI, USA Introduction The timing of prenatal tobacco smoking [...]

Background and Aims: In the United States, the prevalence of cannabis use during pregnancy has increased whereas tobacco smoking has decreased. This study aimed to estimate the prevalence of tobacco cigarette smoking and cannabis use among new mothers, stratified by breastfeeding status. Additionally, trend analysis was used to examine changes in tobacco and cannabis use over time. Design Cross‐sectional study based on the National Health and Nutrition Examination Survey (NHANES, 2001–18). Setting: United States. Participants: Population‐based sample of new mothers (within 2 years of childbirth) aged 20–44 years (n = 1332). Measurements For each NHANES data cycle, the prevalence of tobacco smoking measured by self‐report or serum cotinine was estimated. Additionally, we estimated the prevalence of cannabis use measured by self‐report. Using Joinpoint Regression, we tested for significant changes in trends and produced the average 'data‐cycle' percentage change (APC). Findings From 2001 to 2018, more than one in five new mothers were tobacco cigarette smokers. New mothers who were breastfeeding were less likely to smoke cigarettes [7.4%, 95% confidence interval (CI) = 4.9%, 10.9% compared with mothers who were not breastfeeding (25.7%, 95% CI = 22.3%, 29.3%]. Results from Joinpoint regression indicated no robust temporal trends for self‐reported tobacco smoking (APC = −1.3, 95% CI = −8.6, 6.7; P = 0.7) or for cotinine levels ≥ 4.47 ng/ml (APC = 0.3, 95% CI = −5.0, 5.9; P = 0.9), whereas cannabis use had increased among new mothers (APC = 23.7, 95% CI = 4.8, 46.0; P = 0.02). Conclusions: Consistent with the increase seen among other subgroups, cannabis use has approximately doubled among US new mothers since 2005. There is no significant evidence of a change in tobacco smoking among US new mothers since 2001. [ABSTRACT FROM AUTHOR]