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Oklahoma's medical cannabis is some of the least restrictive in the US. Previous research suggests that American Indian/Alaska Native (AIAN) have higher rates of cannabis use than other racial or ethnic groups. The goals of this paper are, first, to look at cannabis use among high school students living on the Cherokee Nation Reservation before (2017) and after (2019) medical cannabis because legal in Oklahoma (2018) utilizing the Cherokee Nation Youth Risk Behavior Survey (CNYRBS). Second, to describe the socio-demographic characteristics of youth using cannabis in the Cherokee Nation Reservation. Data were retrieved from the 2017 and 2019 CNYRBS. The data for this study included 1,216 high school students who completed the 2017 and 1,476 who completed the 2019 CNYRBS. After removal of incomplete records, there were 2,602 students whose data was analyzed in this study. Data were weighted to be representative of public-school students attending grades 9–12 within Cherokee Nation Reservation. Despite the legalization of medical cannabis in Oklahoma in 2018, there was no change in cannabis use among youth between 2017 and 2019. There were variations in cannabis use based on demographic factors and other substance uses. AIAN individuals had higher odds of current cannabis use compared to non-Hispanic White students, but there were no differences based on ethnicity. Additionally, the use of cigarettes, e-cigarettes, alcohol, and illegal drugs were associated with increased odds of cannabis use among both current and former users compared to those who had never used it. There was no spike in use among youth at least immediately after the legalization of cannabis in the Cherokee Nation Reservation. There were socio-demographic as well as substance use disparities in the use of cannabis. [ABSTRACT FROM AUTHOR]

The legalization of recreational cannabis consumption in Canada created a cultural conflict for international students from China, where the use of cannabis is heavily criminalized and deemed immoral. This conceptual paper theorizes this cultural conflict experienced by Chinese international students in Canada by applying three theories from macro to micro levels. Neoliberalism is first used to understand how this cultural conflict exposes collisions between the neoliberal West and the rising economic power of China as illustrated through Chinese students studying in Canada. Next, acculturation theory focuses on these students' cultural transition and provides further insight into potential strategies for their handling of specific cultural conflicts such as cannabis use. Lastly, Cloninger's theory of substance use is adopted to explore Chinese international students' individual reasoning about cannabis use, particularly how they make decisions based on evaluations of various conditions. Building upon the above analyses, an integrated conceptual model is further formed to help us understand Chinese students' potential perception of cannabis use in Canada. This conceptual framework provides an important theoretical and conceptual base for future research and practice, from which to further explore cannabis use in the context of cultural transition of different immigrant and migrant groups. [ABSTRACT FROM AUTHOR]

Background and aims: There are concerns that availability of recreational cannabis dispensaries (RCDs) and point‐of‐sale marketing may lead to increased cannabis use in jurisdictions where cannabis retail sale is legal. This paper examined whether the availability RCDs and the presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs were associated with cannabis use and risk perceptions. Design: Cross‐sectional, secondary data analysis. Setting: California, USA. Participants: A representative sample of 3385 adults in California who participated in the 2020 probability‐based Marijuana Use and Environment Survey. Measurements Binary outcomes included past‐month overall cannabis use, perceiving cannabis smoking as harmful and past‐month cannabis use by purpose (medical only, recreational only and dual). The objectively assessed predictors included proximity and density of RCDs and presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs. Findings In terms of proximity, thepresence of storefront signage in the nearest RCD was associated with smaller odds of perceiving cannabis smoking as harmful [odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.39, 0.99] if the RCD was located within 2 miles of home. Presence of health benefit signs in the nearest RCD was associated with greater odds of overall cannabis use (OR = 2.45, 95% CI = 1.17, 5.16) and recreational use (OR = 3.50, 95% CI = 1.027, 11.91) if the RCD was located within 2–4 miles of home. In terms of density, count of RCDs, count of RCDs with storefront signage and count of RCDs with health benefit signs within 2 miles of home were each separately associated with greater odds of overall cannabis use and cannabis use for dual purposes. Conclusions: The availability of recreational cannabis dispensaries within 2 miles of one's home and the presence of storefront signage indicating the availability of cannabis and signs promoting health benefits of cannabis appear to be associated with increased cannabis use and reduced risk perceptions among adults in California, USA. [ABSTRACT FROM AUTHOR]

This paper introduces the special issue on cannabis use in Europe. It describes data on the prevalence of cannabis use in Europe and the more limited data on the prevalence of cannabis use disorders, one of the most common forms of drug problem treated in many countries in Europe. It summarises what research has indicated about the adverse effects of acute and chronic cannabis use and discusses potential health system responses that may reduce some of these harms. These include public education about the risks of cannabis use; screening and brief interventions in primary medical settings; and specialist treatment for cannabis use disorders. It briefly indicates the special issues that may need to be addressed in dealing with the high rates of comorbidity between cannabis use disorders, other types of drug use disorders, and common mental disorders. [ABSTRACT FROM AUTHOR]

College cannabis use continues to rise, yet few students voluntarily seek treatment for cannabis use, despite use-related problems. Thus, the campus judicial system may be one way to identify high-risk cannabis users and intervene with them. Despite research indicating that brief motivational interventions (BMIs) decrease risky alcohol use among students sanctioned for psychological services following campus alcohol policies violations, extant data do not support BMI for students who violate cannabis polices. Thus, the aims of this review paper are to (a) review the extant literature of BMI for cannabis use among sanctioned students, (b) discuss some unique issues concerning BMI for cannabis use, and (c) provide case examples of promising novel ways BMI may be used to address unique needs of these students. Given the wide range of cannabis use and related problems experienced by these students, personalized approaches to BMI-based interventions may improve outcomes for these students. [ABSTRACT FROM AUTHOR]

College cannabis use continues to rise, yet few students voluntarily seek treatment for cannabis use, despite use-related problems. Thus, the campus judicial system may be one way to identify high-risk cannabis users and intervene with them. Despite research indicating that brief motivational interventions (BMIs) decrease risky alcohol use among students sanctioned for psychological services following campus alcohol policies violations, extant data do not support BMI for students who violate cannabis polices. Thus, the aims of this review paper are to (a) review the extant literature of BMI for cannabis use among sanctioned students, (b) discuss some unique issues concerning BMI for cannabis use, and (c) provide case examples of promising novel ways BMI may be used to address unique needs of these students. Given the wide range of cannabis use and related problems experienced by these students, personalized approaches to BMI-based interventions may improve outcomes for these students. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to review cannabis use among a cross section of Israeli high school, school dropouts, university students, hospitality workers, and adults in drug treatment. Based on national statistics, 27.0% last year and 19.1% last month cannabis (i.e., marijuana and hashish) use has been reported among 18-65 year olds. This is a higher rate than what is reported in the USA and European countries. Findings across the study groups evidence high rates of cannabis among school dropouts and adults in drug treatment. University students tend to have a higher rate of current use than hospitality workers. Secular status, regardless of the study group, tends to influence cannabis use. Israeli origin university students and hospitality workers report a higher level of current cannabis use than those with other country origin status (i.e., the former Soviet Union). This paper suggests multiple factors be considered, organized, and sustained for policy and prevention purposes. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia spectrum disorders (SSD) are mental diseases caused by a combination of genetic susceptibility and a number of environmental factors. Among these factors, the role of traumatic events suffered in childhood, as well as that of substance use, have been of particular research interest. Objectives: To conduct a systematic review to clarify whether there is an interaction between childhood trauma and substance use related to the diagnosis or symptoms of SSD. It was also the objective of this review to collate the associations that may exist between the three variables of the study (trauma, substance use and psychosis). Methods: We conducted a systematic search resulting in 240 articles. We considered all of the original articles that explored childhood trauma and substance use in patients suffering from SSD. Results: Twenty-three articles were selected for this review. Several of the reviewed papers found associations between childhood trauma and substance use with SSD, as well as interactions between trauma and drug use on SSD. Conclusions: The results suggest that childhood trauma and substance use may be present at the basis of psychosis. This double hit on the pathogenesis could have clinical implications, since each of these impacts could be considered a window of opportunity for the primary prevention of SSD. [ABSTRACT FROM AUTHOR]

Widespread cannabis use is a concern in Israel, and its popularity continues to grow despite government and non-government prevention, education, and treatment efforts. The National Service for Treatment of Addiction (Service), Israel Ministry of Social Affairs and Social Services maintains a fundamental position that cannabis is an illegal, harmful, and addictive substance. The purpose of this paper is to provide an overview of cannabis use in the country and provide insight of the challenges being faced resulting from use of the substance. Particular attention is given to the Negev region of the country, Israel’s arid southern region that has been referred to as the country’s “barn for drugs.” Concern is expressed about the investment of limited resources needed for cannabis problem management, outreach service, prevention, and treatment when there are other national priorities to address such as security, education, health care, and employment opportunities to address. [ABSTRACT FROM AUTHOR]

This paper aims to review patterns of cannabis (i.e., marijuana and hashish) use among high-risk Israeli youth and young adults based on research conducted by the Ben-Gurion University, Regional Alcohol and Drug Abuse Research Center. A total of 1074 Israeli youth (67.0% male, 33.0% female) were studied from 2004 to 2016. The youth and young adults included those placed in residential programs for learning and/or behavior problems (youth villages) and were school dropouts referred to a 90-day treatment facility for drug abuse. Country of origin, determined by mother’s birthplace, revealed 42.4% of the youth was of Israeli origin and 57.6% from other countries—mostly the former Soviet Union and Ethiopia. About “village” youth, no gender or religious status (secular/non-secular) differences were found for lifetime and last month cannabis use. Immigrant origin youth, than those with Israeli status, reported more lifetime and last month use as well as cannabis availability. Youth from families with low socio-economics status reported a higher rate of last month cannabis use than those with better economic conditions. Among school dropouts, no gender or religious status differences were found for lifetime and last month cannabis use and availability. For all study youth, binary logistic regression results indicated six factors significantly predicted last month cannabis use: male gender, age, last month binge drinking, illicit drug selling, reduced relations with friends, and cannabis availability. In terms of policy and service provision, high-risk youth (e.g., those in residential programs, whether for learning and/or behavior problems) should be priority for drug prevention efforts. [ABSTRACT FROM AUTHOR]

About one-third of the Israel’s Negev region population is Bedouin-Arab. During the past two decades or so, the Bedouin society has undergone rapid social and cultural change with positive and negative consequences including living conditions that are triggers for drug use—smoking, alcohol use even if forbidden by Islamic religious tenets, cannabis, synthetic cannabis, and other harmful substances. This paper reviews multiple factors that are related to emergency conditions including a war with drugs. [ABSTRACT FROM AUTHOR]

In contemporary societies, risk culture and risk profiling lead to the stigmatization of unhealthy behaviours as ‘risky’. Risk denial theory refers to a cognitive way to deal with risky behaviours and can be considered as an updated variant of Sykes and Matza's neutralization theory. People neutralize the ‘risky’ label using specific techniques that must be added to those previously enlisted by Sykes and Matza. This paper introduces and discusses three techniques of risk denial: scapegoating, self-confidence and comparison between risks. As it is usually defined and studied as a ‘risky behaviour’, cannabis use provides a relevant example to illustrate these types of risk denial, thanks to various ethnographic studies (including Becker's seminal work on marijuana smokers) and quantitative French data from the 1999 European School Survey on Alcohol and Other Drugs (ESPAD). In order to deny the ‘risky’ label, cannabis users scapegoat ‘hard drugs’ users, they emphasize their own ability to control their consumption personally, or they compare cannabis and alcohol risks. The paper concludes with suggestions for further analyses of risk denial. [ABSTRACT FROM AUTHOR]

Peer effects in adolescent cannabis are difficult to estimate, due in part to the lack of appropriate data on behaviour and social ties. This paper exploits survey data that have many desirable properties and have not previously been used for this purpose. The data set, collected from teenagers in three annual waves from 2002 to 2004 contains longitudinal information about friendship networks within schools (N = 5020). We exploit these data on network structure to estimate peer effects on adolescents from their nominated friends within school using two alternative approaches to identification. First, we present a cross-sectional instrumental variable (IV) estimate of peer effects that exploits network structure at the second degree , i.e. using information on friends of friends who are not themselves ego’s friends to instrument for the cannabis use of friends. Second, we present an individual fixed effects estimate of peer effects using the full longitudinal structure of the data. Both innovations allow a greater degree of control for correlated effects than is commonly the case in the substance-use peer effects literature, improving our chances of obtaining estimates of peer effects than can be plausibly interpreted as causal. Both estimates suggest positive peer effects of non-trivial magnitude, although the IV estimate is imprecise. Furthermore, when we specify identical models with behaviour and characteristics of randomly selected school peers in place of friends’, we find effectively zero effect from these ‘placebo’ peers, lending credence to our main estimates. We conclude that cross-sectional data can be used to estimate plausible positive peer effects on cannabis use where network structure information is available and appropriately exploited. [ABSTRACT FROM AUTHOR]

Background: Cannabis prohibition can generally be regarded as the main driver for home growing of marijuana. In this paper, I discuss the impact of drug prohibition on cannabis cultivators from the three German-speaking countries: Germany, Austria and Switzerland. In particular, this refers to the questions; how illicitness influences motivations for growing; which precautionary measures are taken against the risk of discovery; how penal consequences differ in the three countries and how these aspects are linked to each other.Methods: The results come from a sample of 1578 respondents from the German-language online survey conducted following the International Cannabis Cultivation Questionnaire (ICCQ). The survey was carried out in late 2012 and early 2013.Results: While most of the reasons for growing cannabis relate to avoiding negative consequences of prohibition, the illicitness of cannabis also plays a major role for concern about the cultivation activities as well as measures to avoid negative consequences. Swiss growers are less worried about their activity compared to respondents from Germany or Austria.Conclusion: The results confirm the notion that the illicitness of cannabis is the main drive for the private cultivation of the plant. At the same time, prohibition is the principal reason for concern regarding the growing activity. The severity of possible sentences seems to be linked to the degree of concern and precautionary measures. [ABSTRACT FROM AUTHOR]

Previous research has provided considerable support for idea that increased parental support and control are strong determinants of lower prevalence levels of adolescent risk behavior. Much less is known on the association between specific parenting practices, such as concrete rules with respect to smoking and drinking and adolescent risk behavior. The present paper examined whether such concrete parental rules (1) have an effect on the targeted behaviors and (2) predict other, frequently co-occurring, risk behaviors (i.e., cannabis use and early sexual intercourse). These hypotheses were tested in a nationally representative sample of 12- to 16-year-old adolescents in the Netherlands. We found that both types of rules were associated with a lower prevalence of the targeted behaviors (i.e., smoking and drinking). In addition, independent of adolescent smoking and drinking behaviors, parental rules on smoking predicted a lower prevalence of cannabis use and early sexual intercourse, and parental rules on alcohol use also predicted a lower prevalence of early sexual intercourse. This study showed that concrete parental rule setting is more strongly related to lower levels of risk behaviors in adolescents compared to the more general parenting practices (i.e., support and control). Additionally, the effects of such rules do not only apply to the targeted behavior but extend to related behaviors as well. These findings are relevant to the public health domain and suggest that a single intervention program that addresses a limited number of concrete parenting practices, in combination with traditional support and control practices, may be effective in reducing risk behaviors in adolescence. [ABSTRACT FROM AUTHOR]

Abstract: This paper investigates whether cannabis use affects physical and mental health. To do so, information on prime aged individuals living in Amsterdam in 1994 is used. Dutch data offer a clear advantage in estimating the health impacts of cannabis use because the legal status of cannabis in the Netherlands ensures that estimates are free from confounding with the physical and psychological effects of engaging in a criminal activity. Accounting for selection into cannabis use and shared frailties in mental and physical health, the results suggest that cannabis use reduces the mental wellbeing of men and women and the physical wellbeing of men. Although statistically significant, the magnitude of the effect of using cannabis on mental and physical health is found to be small. [Copyright &y& Elsevier]

Abstract: Background: This paper examined the implications of the business cycle for cannabis and alcohol use. What little we know about cannabis use suggests that young Americans (teenagers and adults in their early 20s) seem more inclined to use illicit drugs and to use them more frequently with rises in the unemployment rate. In contrast, a more fulsome alcohol literature suggests that participation in drinking is unaffected by the business cycle. Heavy drinkers drink less during economic downturns and their reduced use counteracts the fact that light drinkers might drink a little more. Method: Using individual level data from repeated cross-sections of Australia''s National Drug Strategy Household Survey (NDSHS), spanning 1991–2007, this study examined the relationship between cannabis and alcohol use of Australians aged 14–49 years and the unemployment rate and real income per capita, two indicators of the business cycle. Results: Australians in their late 20s, 30s and 40s drink less frequently during economic downturns. If unemployment rate rises are accompanied by falls in income per capita, younger Australians will also drink less frequently. Recent participation in cannabis use (within the last year) increases with falls in income per capita regardless of age, although the increase is less marked for young people (14–24 years). Whereas the participation rate of people aged 25–49 years also falls with rising unemployment rates, the participation of younger people increases. Cannabis users younger than 35 will use more frequently as the unemployment rate rises. In contrast, older Australians will use less frequently. Conclusion: Australia''s recent economic slowdown has been characterised by rising unemployment rates without accompanying falls in income per capita. Based on our findings this slowdown should have encouraged young Australians aged 14–24 years to both drink and use cannabis more frequently. The slowdown would have had little impact on the frequency of drinking of older Australians. However it should have discouraged older Australians from using cannabis, and encouraged people in their late 30s and 40s to use less frequently, whilst encouraging those aged 25–34 years to use more frequently. [Copyright &y& Elsevier]

Issues. The key objective of Dutch cannabis policy is to prevent and limit the risks of cannabis consumption for users, their direct environment and society ('harm reduction'). This paper will focus on the tolerated sale of cannabis in 'coffee shops'. Approach. We give a brief overview of Dutch policy on coffee shops, its history and recent developments. Furthermore, we present epidemiological data that may be indicative of the effects of the coffee shop policy on cannabis and other drug use. Key Findings. Dutch coffee shop policy has become more restrictive in recent years and the number of coffee shops has decreased. Cannabis prevalence rates in the adult population are somewhat below the European average; the rate is relatively high among adolescents; and age of first use appears to be low. On a European level, the use of hard drugs in both the Dutch adult and adolescent population is average to low (except for ecstasy among adults). Implications and Conclusions. International comparisons do not suggest a strong, upward effect of the coffee shop system on levels of cannabis use, although prevalence rates among Dutch adolescents give rise to concern. Furthermore, the coffee shop system appears to be successful in separating the hard and soft drugs markets. Nevertheless, in recent years, issues concerning the involvement of organised crime and the public nuisance related to drug tourism have given rise to several restrictive measures on the local level and have sparked a political debate on the reform of Dutch drug policy.[Monshouwer K, van Laar M, Vollebergh WA. Buying cannabis in 'coffee shops'. Drug Alcohol Rev 2011;30:148-156] [ABSTRACT FROM AUTHOR]

In this paper we use individual level data from the Australian National Drug Strategy Household Survey to study the relationship between initiation into cannabis use and educational attainment. Using bivariate duration analysis we find that those initiating into cannabis use are much more likely to dropout of school, and that the reduction in years of education depends on the age at which initiation into cannabis occurs. We also find that the impact of cannabis uptake is larger for females than males. [Copyright &y& Elsevier]

Abstract: Aims: Non-injecting heroin use (NIU) has been identified as a potential precursor for the transition to injecting drug use (IDU). This paper examines and compares heroin transition risks between two groups of Mexican American cannabis users (daily (DU) vs. non-daily (NDU)) who are NIUs. Methods: Data for this analysis are from structured interviews with 300 street-based recruited male and female NIUs in San Antonio, Texas using an adaptive sampling methodology. Three variables (being a former injector, daily heroin use, and being dependent on heroin) were used to create a summative scale measuring heroin transition risk and dichotomized into “no attributes” and “1–3 attributes”. Results: Initial univariate logistic regression analysis indicated an association between heroin transition risk and the cannabis user groups with three fourths of the NDU having transition risk attributes. In the multivariate model, three factors were found to be independently associated with heroin transition risk. Heroin transition risk was positively associated with having used heroin for a longer period of time. An inverse relationship was found with DU of cannabis and those reporting alcohol use in the past month being less likely to be associated with heroin transition risks. Conclusions: Findings tentatively indicate that DU of cannabis may be interpreted as a form of self-regulation and potentially deterring problematic heroin use among Mexican American NIUs and possibly other polydrug users in similar social environments. However, the authors discuss alternative interpretations of these findings. Nevertheless, findings may be used to inform specific policies and intervention strategies to prevent transitions to injecting and other harmful health consequences among NIUs. [Copyright &y& Elsevier]

This paper uses duration models and self-reported cannabis histories from young Australians to study the dynamics of cannabis use. We find that low cannabis prices are associated with early initiation into cannabis use. While the decision to quit does not appear to be directly influenced by price, we find that the younger an individual is when they start using cannabis the less likely they are to quit. Therefore, low cannabis prices lead to early use and because of that they lead to a low quit rate and hence a longer duration of use. [Copyright &y& Elsevier]

Abstract: Although cannabis is the most commonly used illicit drug, duration of cannabis use is typically short, with many of those who initiate cannabis use ceasing use by their late twenties. In this paper we analyze data from a volunteer Australian cohort of 6265 male and female twins to examine whether the duration of cannabis use is an informative phenotype for future genetic analyses. Genetic modeling indicated: (a) moderate genetic influences on duration of cannabis use in both males (41%; 95% CI=31–51) and females (55%; 95% CI=46–63); (b) strong genetic influences on cannabis dependence in both males (72%, 95% CI=61–81) and females (62%, 95% CI=48–74); (c) no evidence of shared environmental influences on duration of cannabis use or on cannabis dependence in either males or females. Importantly, this model fitting indicated that a substantial component of genetic influences (r g =.90, 95% CI=.77–.99 (males); .70, 95% CI=.57–.83 (females)) on duration of cannabis use was shared with those influencing liability to cannabis dependence. While there were high genetic correlations in both women and men, lifetime duration of cannabis may be uniquely informative in assessing components of liability to cannabis use. [Copyright &y& Elsevier]

Objective: To review the evidence on the mental health and psychosocial consequences of rising rates of cannabis use among young people in developed countries. Method: This paper critically reviews epidemiological evidence on the following psychosocial consequences of adolescent cannabis use: cannabis dependence; the use of heroin and cocaine; educational underachievement; and psychosis. Leading electronic databases such as PubMed have been searched to identify large-scale longitudinal studies of representative samples of adolescents and young adults conducted in developed societies over the past 20 years. Results: Cannabis is a drug of dependence, the risk of which increases with decreasing age of initiation. Cannabis dependence in young people predicts increased risks of using other illicit drugs, underperforming in school, and reporting psychotic symptoms. Uncertainty remains about which of these relationships are causal although the evidence is growing that cannabis is a contributory cause of psychotic symptoms. Conclusions: We face major challenges in communicating with young people about the most probable risks of cannabis use (dependence, educational underachievement and psychosis) given uncertainties about these risks and polarized community views about the policies that should be adopted to reduce them. [ABSTRACT FROM AUTHOR]