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PloS One 2023Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. (Observational Study)
Observational Study
BACKGROUND
Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents.
OBJECTIVES
To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents.
METHODS
We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10-19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm.
RESULTS
807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3-1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001).
CONCLUSIONS
Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention.
Topics: Adolescent; Female; Humans; Cross-Sectional Studies; Inpatients; Marijuana Abuse; Self-Injurious Behavior; Substance-Related Disorders; United States
PubMed: 37847698
DOI: 10.1371/journal.pone.0292922 -
Substance Abuse Treatment, Prevention,... Jul 2023Substance use constitutes a major public health issue especially among adolescents as it has associated adverse behavioural, health, social and economic outcomes....
BACKGROUND
Substance use constitutes a major public health issue especially among adolescents as it has associated adverse behavioural, health, social and economic outcomes. However, there is a paucity of comprehensive evidence on the prevalence and associated factors of substance use (alcohol, marijuana and amphetamine) among school-going adolescents in sub-Saharan Africa (SSA). This study examined the magnitude of substance use and its associated factors among school-going adolescents in eight eligible sub-Saharan Africa countries.
METHODS
Data for the study were obtained from the Global School-based Health Survey (2012-2017) of 8 countries in SSA (N = 16,318).
RESULTS
Findings showed overall prevalence rates of 11.3% (95%CI = 10.8 - 11.8%), 2% (95%CI = 1.8 - 2.2%) and 2.6% (95%CI = 2.3 - 2.9%) for current alcohol use, current marijuana use and lifetime amphetamine use, respectively between 2012 and 2017. Late adolescence (15-18 years), being male, anxiety, bullying, fighting, truancy, having close friends, current cigarette smoking and tobacco use are significant risk factors for alcohol use. Anxiety, truancy, current cigarette smoking, tobacco use and suicidal attempt are significant risk factors for marijuana use. Anxiety, bullying, truancy, current cigarette smoking, tobacco use and suicidal attempt are significant risk factors for amphetamine use. Parental knowledge of activity, supervision and respect of privacy are significant protective factors of substance use.
CONCLUSION
There is the need for comprehensive public health policies beyond school-based psycho-behavioural interventions targeting the significant risk factors of substance use among school-going adolescents in SSA.
Topics: Humans; Male; Adolescent; Female; Prevalence; Substance-Related Disorders; Alcohol Drinking; Risk Factors; Africa South of the Sahara
PubMed: 37420290
DOI: 10.1186/s13011-023-00542-1 -
Psychiatry and Clinical Neurosciences Sep 2023Evidence for case-control studies suggests that cannabis use is a risk factor for the development of psychosis. However, there have been limited prospective studies and...
AIMS
Evidence for case-control studies suggests that cannabis use is a risk factor for the development of psychosis. However, there have been limited prospective studies and the direction of this association remains controversial. The primary aim of the present study was to examine the association between cannabis use and the incidence of psychotic disorders in people at clinical high risk of psychosis. Secondary aims were to assess associations between cannabis use and the persistence of psychotic symptoms, and with functional outcome.
METHODS
Current and previous cannabis use were assessed in individuals at clinical high risk of psychosis (n = 334) and healthy controls (n = 67), using a modified version of the Cannabis Experience Questionnaire. Participants were assessed at baseline and followed up for 2 years. Transition to psychosis and persistence of psychotic symptoms were assessed using the Comprehensive Assessment of At-Risk Mental States criteria. Level of functioning at follow up was assessed using the Global Assessment of Functioning disability scale.
RESULTS
During follow up, 16.2% of the clinical high-risk sample developed psychosis. Of those who did not become psychotic, 51.4% had persistent symptoms and 48.6% were in remission. There was no significant association between any measure of cannabis use at baseline and either transition to psychosis, the persistence of symptoms, or functional outcome.
CONCLUSIONS
These findings contrast with epidemiological data that suggest that cannabis use increases the risk of psychotic disorder.
Topics: Cannabis; Incidence; Psychotic Disorders; Risk Factors; Surveys and Questionnaires; Age of Onset; Marijuana Abuse; Humans; Male; Female; Adolescent; Young Adult; Adult
PubMed: 37070555
DOI: 10.1111/pcn.13555 -
Journal of the American College of... Aug 2023Substance abuse is common in patients with psychiatric emergencies. To further understand the connection between substance abuse and psychiatric disorders, a...
OBJECTIVES
Substance abuse is common in patients with psychiatric emergencies. To further understand the connection between substance abuse and psychiatric disorders, a retrospective chart review was done that included positive drug screens among patients with psychiatric emergencies and to determine whether there was an association between substances used and the psychiatric diagnosis.
METHODS
A retrospective chart review of patients seen in an emergency department with psychiatric emergencies was conducted. The review comprised 1000 charts with diagnoses of anxiety, depression, schizophrenia, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, alcohol abuse, or schizoaffective disorder. Data collected included patient demographics, tobacco abuse, chief complaint, arrival mode, voluntary versus involuntary status, suicide attempt on presentation, psychiatric diagnoses, urine drug screen, and ethanol results. Chi-square statistical analysis was conducted to examine the relationship between substances of abuse and psychiatric diagnoses.
RESULTS
Approximately 58% of patients with a history of psychiatric illness had a positive urine drug screen. Of 245 patients with schizoaffective disorder, 69 (28%) were positive for tetrahydrocannabinol (THC) and 48 (20%) were positive for cocaine. Of 225 patients with depression, 59 (29%) were positive for THC and 33 (15%) were positive for cocaine. Cannabis was the most commonly reported substance used among patients with depression, schizophrenia, anxiety, schizoaffective disorder, and bipolar disorder, and ethanol was most common in patients with ADHD. No significant correlations were found between psychiatric diagnosis and positive drug screens. A statistically significant secondary end point was found that White people using cannabinoids were more likely to attempt suicide than were African American people ( = 0.02).
CONCLUSIONS
Positive drug screens were common among patients presenting to an ED with psychiatric emergencies. Cannabis was the most commonly reported substance used among patients independent of diagnosis. Ethanol was the most common in patients with ADHD. Urine drug screens are unlikely to provide insights into relationships between specific substance use and psychiatric emergencies.
PubMed: 37600902
DOI: 10.1002/emp2.13028 -
Psychopharmacology Jul 2023Cannabis self-administration studies may be helpful for identifying factors that influence cannabis consumption and subjective response to cannabis. Additionally, these... (Review)
Review
Cannabis self-administration studies may be helpful for identifying factors that influence cannabis consumption and subjective response to cannabis. Additionally, these paradigms could be useful for testing novel pharmacotherapies for cannabis use disorder. This scoping review aims to summarize the findings from existing ad libitum cannabis self-administration studies to determine what has been learned from these studies as well as their limitations. We examined studies that specifically examined cannabis smoking, focusing on subjective response and self-administration behavior (e.g., smoking topography). A systematic search was conducted using PubMed and Embase from inception to October 22, 2022. Our search strategy identified 26 studies (total N = 662, 79% male) that met our eligibility criteria. We found that tetrahydrocannabinol (THC) concentration significantly affected subjective response to cannabis in some but not all studies. In general, cannabis self-administration tended to be most intense at the beginning of the laboratory session and decreased in later parts of the session. There was limited data on cannabis self-administration in adults older than 55. Data on external validity and test-retest reliability were also limited. Addressing these limitations in future ad libitum cannabis self-administration studies could lead to more valid and generalizable paradigms, which in turn could be used to improve our understanding of cannabis use patterns and to help guide medication development for cannabis use disorder.
Topics: Female; Humans; Male; Cannabinoid Receptor Agonists; Cannabis; Dronabinol; Hallucinogens; Marijuana Abuse; Marijuana Smoking; Reproducibility of Results
PubMed: 37157001
DOI: 10.1007/s00213-023-06360-4 -
Addiction (Abingdon, England) Feb 2024
Topics: Humans; Cannabis; Driving Under the Influence; Hallucinogens; Dronabinol; Cannabinoid Receptor Agonists; Policy; Marijuana Smoking; Automobile Driving; Substance Abuse Detection
PubMed: 37877315
DOI: 10.1111/add.16372 -
Association between cannabis use disorder and schizophrenia stronger in young males than in females.Psychological Medicine Nov 2023Previous research suggests an increase in schizophrenia population attributable risk fraction (PARF) for cannabis use disorder (CUD). However, sex and age variations in...
BACKGROUND
Previous research suggests an increase in schizophrenia population attributable risk fraction (PARF) for cannabis use disorder (CUD). However, sex and age variations in CUD and schizophrenia suggest the importance of examining differences in PARFs in sex and age subgroups.
METHODS
We conducted a nationwide Danish register-based cohort study including all individuals aged 16-49 at some point during 1972-2021. CUD and schizophrenia status was obtained from the registers. Hazard ratios (HR), incidence risk ratios (IRR), and PARFs were estimated. Joinpoint analyses were applied to sex-specific PARFs.
RESULTS
We examined 6 907 859 individuals with 45 327 cases of incident schizophrenia during follow-up across 129 521 260 person-years. The overall adjusted HR (aHR) for CUD on schizophrenia was slightly higher among males (aHR = 2.42, 95% CI 2.33-2.52) than females (aHR = 2.02, 95% CI 1.89-2.17); however, among 16-20-year-olds, the adjusted IRR (aIRR) for males was more than twice that for females (males: aIRR = 3.84, 95% CI 3.43-4.29; females: aIRR = 1.81, 95% CI 1.53-2.15). During 1972-2021, the annual average percentage change in PARFs for CUD in schizophrenia incidence was 4.8 among males (95% CI 4.3-5.3; < 0.0001) and 3.2 among females (95% CI 2.5-3.8; < 0.0001). In 2021, among males, PARF was 15%; among females, it was around 4%.
CONCLUSIONS
Young males might be particularly susceptible to the effects of cannabis on schizophrenia. At a population level, assuming causality, one-fifth of cases of schizophrenia among young males might be prevented by averting CUD. Results highlight the importance of early detection and treatment of CUD and policy decisions regarding cannabis use and access, particularly for 16-25-year-olds.
Topics: Male; Humans; Female; Schizophrenia; Marijuana Abuse; Cohort Studies; Substance-Related Disorders; Cannabis
PubMed: 37140715
DOI: 10.1017/S0033291723000880 -
Addiction & Health Feb 2024Substance abuse by adolescents and young adults is a major public health issue. This study aimed to (i) show the transition of sociodemographic and substance abuse...
The Transition of Sociodemographic and Substance Abuse Characteristics, Pairwise Co-occurrences and Factors Associated with Polysubstance Use Among US Adolescents and Young Adults.
BACKGROUND
Substance abuse by adolescents and young adults is a major public health issue. This study aimed to (i) show the transition of sociodemographic and substance abuse characteristics from 1992 to 2017 among US adolescents and young adults, (ii) evaluate the likelihood of co-occurrence of substances, and (iii) identify significant sociodemographic characteristics in association with polysubstance abuse.
METHODS
This study extracted data for adolescents and young adults from 1992 and 2017 Treatment Episode Data Set-Admission (TEDS-A) datasets. The extracted sample included 337858 admissions in 1992 and 333322 in 2017.
FINDINGS
Both years experienced significant admissions. A significant transition in 2017 compared to 1992 was evident in education, living status, and ethnicity. Substance-specific transition showed alcohol was dominant in 1992, while marijuana/ hashish was dominant in 2017. Also, heroin, other opiates/synthetics, and methamphetamine experienced an increase, while cocaine/crack decreased. The pairwise co-occurrences exhibited a considerable variation in the likelihood of using one substance given another one. The odds ratios (ORs) obtained from generalized ordered logit models showed significantly higher odds of one or more substances with age, while education showed the opposite scenario. A mixed effect of gender was evident in 1992, whereas females were significantly less likely with one or more substances than males in 2017. Other significant vulnerable groups were those not in the labor force, homeless, white, and Mexican Americans.
CONCLUSION
The findings may help to understand the overall changes between 1992 and 2017 and take necessary measures to reduce the burden of this public health problem.
PubMed: 38651027
DOI: 10.34172/ahj.2024.1460 -
Medical & Biological Engineering &... Dec 2023Substance use disorders present similar behaviors and psychopathologies related to impaired decision making/inhibition control and information processing, suggesting...
Substance use disorders present similar behaviors and psychopathologies related to impaired decision making/inhibition control and information processing, suggesting common alterations in frontal and limbic brain areas. To test this hypothesis, we identified three uni-substance use cohorts with dependence to only one type of substance from the Human Connectome Project: marijuana dependence, nicotine dependence, and alcohol dependence. Fifty-nine marijuana uses, 34 nicotine smokers, 35 alcohol drinkers, and their age and sex-matched non-substance use controls were identified. We used brain entropy mapping to probe brain alterations in substance use disorders. Compared to non-substance use individuals, all three substance use disorder cohorts had increased brain entropy. Marijuana dependence and nicotine dependence showed overlapped hyper-brain entropy in bilateral dorso-lateral prefrontal cortex, anterior cingulate cortex, and right insula. Hyper-brain entropy in marijuana dependence and alcohol dependence overlap in left insula, left doso-lateral prefrontal cortex, and posterior cingulate. Hyper-brain entropy in nicotine dependence and alcohol dependence overlap only in left dorso-lateral prefrontal cortex. Hyper-brain entropy in those areas was correlated with increased impulsivity or reduced inhibition control in substance use disorder but not in controls. Drug dependence is associated with hyper-brain entropy in the prefrontal cortex and the meso-limbic system, independent of a specific addictive drug. Brain entropy in this circuit provides a sensitive marker to detect brain and behavioral alterations in substance user disorders.
Topics: Humans; Nicotine; Tobacco Use Disorder; Marijuana Smoking; Alcoholism; Marijuana Use; Entropy; Smoking; Substance-Related Disorders; Marijuana Abuse; Brain Mapping; Magnetic Resonance Imaging
PubMed: 37718388
DOI: 10.1007/s11517-023-02932-w -
Frontiers in Sociology 2023Labor trafficking in marijuana production remains a concealed epidemic within the expanding cannabis industry. This abstract brings attention to the systemic...
Labor trafficking in marijuana production remains a concealed epidemic within the expanding cannabis industry. This abstract brings attention to the systemic exploitation of vulnerable individuals engaged in cultivating, harvesting, and processing cannabis. It explores the factors contributing to labor trafficking, including demand for cheap labor, inadequate regulation, and the vulnerability of the workforce. By compiling published cases, both in peer-reviewed literature and the media, this perspective piece investigates the extent of health issues experienced by labor-trafficked victims. These include chronic pain from repetitive tasks, respiratory problems due to exposure to pesticides and other toxic substances, musculoskeletal injuries, malnutrition, and mental health disorders stemming from trauma and extreme stress. Additionally, this perspective article examines the factors contributing to poor health outcomes of labor-trafficked victims, including hazardous working conditions, lack of access to healthcare, and physical and psychological abuse. Addressing the health challenges faced by labor-trafficked victims in the cannabis industry requires multidimensional solutions: awareness among healthcare providers, comprehensive medical services, and mental health support. Furthermore, collaborative efforts among government agencies, healthcare providers, labor organizations, and the cannabis industry are essential in preventing trafficking and addressing the health disparities faced by labor-trafficked victims.
PubMed: 38152460
DOI: 10.3389/fsoc.2023.1244579