Search

Background and Aims: As the legal status of cannabis changes across the United States and modes of administration expand, it is important to examine the potential impact on adolescent cannabis use. This study aimed to assess changes in prevalence of frequent cannabis use in adolescents in the United States and how far this varies by age and cohort. Design Analysis of Monitoring the Future, a nationally representative annual survey of 8th‐, 10th‐ and 12th‐grade students in the United States conducted from 1991 to 2018. Setting: In‐school surveys completed by US adolescents. Participants: A total of 1 236 159 8th‐, 10th‐ and 12th‐graders; 51.5% female, 59.6% non‐Hispanic white, 12.3% non‐Hispanic black, 13.4% Hispanic and 14.7% other race/ethnicity. Measurements Frequent cannabis use (FCU), defined as six or more occasions in the past 30 days, stratified by sex, race/ethnicity and parental education. Findings FCU among US adolescents increased over the study period; the peak in 2010–18 was 11.4% among 18‐year‐old students. This increase was best explained by both period and cohort effects. Compared with respondents in 2005, adolescents surveyed in 2018 had period effects in FCU that were 1.6 times greater. Adolescents in younger birth cohorts (those born > 1988) had a lower increase in FCU than those born prior to 1988. Results were consistent across sex, parent education and race/ethnicity, with period effects indicating increasing FCU after 2005 and cohort effects indicating a lower magnitude of increase in more recent birth cohorts. Age and parental education disparities in FCU have increased over time, whereas race/ethnicity differences have converged over time; black students were 0.67 [95% confidence interval (CI) = 0.64–0.70] times as likely to use cannabis frequently as white students from 1991 to 2000, and 1.03 (95% CI = 0.98–1.09) times as likely from 2011 to 2018 (P‐value for time interaction < 0.001). Conclusions: The prevalence of frequent cannabis use (FCU) increased from 1991 to 2018 among older adolescents in the United States. Racial/ethnic differences in FCU converged, whereas parental education differences have diverged. [ABSTRACT FROM AUTHOR]

Background and Aims Increased delta-9-tetrahydrocannabinol ( THC) concentrations in cannabis may lead to higher THC exposure, cannabis dependence and treatment need, but users may also adapt the actual intake of THC through reduced inhalation of THC containing smoke (titration). We investigated whether consumers of stronger cannabis use less cannabis per joint or inhale less smoke than those using less potent cannabis and whether these factors predict cannabis dependence severity. Methods Heavy cannabis users ( n = 98) brought their own cannabis, rolled a joint and smoked it ad libitum in a naturalistic setting. We analysed the content of the joint, its association with smoking behaviour and the cross-sectional and prospective (1.5-year follow-up) relations between smoking behaviour and cannabis dependence severity (total number of DSM- IV dependence symptoms). Results THC concentration in cannabis (range 1.10-24.70%) was correlated positively with cannabis dose per joint ( b = 0.008, P = 0.01), but the resulting THC concentration per joint (range 0.24-15.72%) was associated negatively with inhalation volume ( b = −0.05, P = 0.03). Smoking behaviour measures (number of puffs, inhaled volume, reduction of puff volume and puff duration while smoking) predicted follow-up dependence severity, independently of baseline dependence severity and monthly THC dose (number of joints × cannabis dose × cannabis THC concentration). Monthly THC dose only predicted follow-up dependence severity when unadjusted for baseline severity. Conclusions Cannabis users titrate their delta-9-tetrahydrocannabinol intake by inhaling lower volumes of smoke when smoking strong joints, but this does not fully compensate for the higher cannabis doses per joint when using strong cannabis. Thus, users of more potent cannabis are generally exposed to more delta-9-tetrahydrocannabinol. Smoking behaviour appears to be a stronger predictor for cannabis dependence severity than monthly delta-9-tetrahydrocannabinol dose. [ABSTRACT FROM AUTHOR]

In a 3-year qualitative longitudinal study the role of social relationships in cannabis use and dependence in young adults (all frequent users at baseline) was explored. Overall, cannabis use and dependence declined. Changes in use were, for a considerable part, attributable to processes and life events in social relationships with peers and partners, while parents had little influence. Negatively experienced events often triggered increased use and positively experienced events decreased use. Participants often adapted their use to others, depending on associate's use. Underlying mechanisms appear related to both socialization and selection. Gender-specific processes occurred, particularly with regard to partners; females selected using partners and males nonusing partners, and subsequent cannabis use increased (females) or decreased (males) by socialization. Transitions in cannabis dependence could be explained by using peers, cohabitation and, for females, a new partnership. Persistent and newly nondependent participants were less susceptible to social influences than dependent interviewees. [ABSTRACT FROM AUTHOR]

Abstract: Background: Frequent cannabis users are at high risk of dependence, still most (near) daily users are not dependent. It is unknown why some frequent users develop dependence, whereas others do not. This study aims to identify predictors of first-incidence DSM-IV cannabis dependence in frequent cannabis users. Methods: A prospective cohort of frequent cannabis users (aged 18–30, n =600) with baseline and two follow-up assessments (18 and 36 months) was used. Only participants without lifetime diagnosis of DSM-IV cannabis dependence at baseline (n =269) were selected. Incidence of DSM-IV cannabis dependence was established using the Composite International Diagnostic Interview version 3.0. Variables assessed as potential predictors of the development of cannabis dependence included sociodemographic factors, cannabis use variables (e.g., motives, consumption habits, cannabis exposure), vulnerability factors (e.g., childhood adversity, family history of mental disorders or substance use problems, personality, mental disorders), and stress factors (e.g., life events, social support). Results: Three-year cumulative incidence of cannabis dependence was 37.2% (95% CI=30.7–43.8%). Independent predictors of the first incidence of cannabis dependence included: living alone, coping motives for cannabis use, number and type of recent negative life events (major financial problems), and number and type of cannabis use disorder symptoms (impaired control over use). Cannabis exposure variables and stable vulnerability factors did not independently predict first incidence of cannabis dependence. Conclusions: In a high risk population of young adult frequent cannabis users, current problems are more important predictors of first incidence cannabis dependence than the level and type of cannabis exposure and stable vulnerability factors. [Copyright &y& Elsevier]

Aims To compare the prevalence of mental disorders between frequent cannabis users with and without dependence and the general population. Design Cross-sectional comparison of interview data. Setting Enriched community sample of frequent cannabis users and a representative sample of non-users and non-frequent users from the general population. Participants A total of 521 young adult (aged 18-30 years) frequent cannabis users, 252 of whom were with DSM-IV cannabis dependence ( D+) and 269 without DSM-IV cannabis dependence ( D−), and 1072 young adults from the general population. Measurements Multinomial logistic regression was used to compare groups regarding the presence of DSM-IV mental disorders. Detailed measures of cannabis use, childhood adversity and other substance use were considered confounders. Findings Compared with the general population, externalizing disorders were more prevalent in D− [odds ratio ( OR) = 8.91, P < 0.001] and most prevalent in D+ ( OR = 17.75, P < 0.001), but internalizing disorders were associated only with D+ (mood OR = 4.15, P < 0.001; anxiety OR = 2.20, P = 0.002). Associations were attenuated (and often became non-significant) after correction for childhood adversity and substance use other than cannabis. However, the prevalence of mental disorders remained higher in D+ compared with D− ( OR = 2.40, P < 0.001), although cannabis use patterns were remarkably similar. Conclusions Cannabis use patterns, childhood adversity and the use of other substances are similar in dependent and non-dependent frequent cannabis users. With the exception of more externalizing disorders, the mental health condition of non-dependent frequent cannabis users is similar to that of the general population, whereas it is worse in dependent frequent cannabis users. [ABSTRACT FROM AUTHOR]

The Severity of Dependence Scale (SDS) measures with five items the degree of psychological dependence on several illicit drugs, including cannabis. Its psychometric properties have not yet been examined in young adult frequent cannabis users, an eminently high-risk group for cannabis dependence. Internal consistency and criterion validity of the SDS were investigated within an enriched community based sample of 577 Dutch frequent (≥ three days per week in the past 12 months) cannabis users between 18-30 years. Criterion validity was tested against the Composite International Diagnostic Interview (CIDI) 3.0 DSM-IV diagnosis cannabis dependence, and psychometric properties were assessed separately for males and females and for ethnic subgroups. Principal component analysis showed that all items of the scale loaded on a single factor and reliability of the SDS total score was good (Cronbach's α = 0.70). However, criterion validity against the CIDI diagnosis cannabis dependence was low: area under curve (AUC) was 0.68 (95% confidence interval: 0.64-0.73) and at the optimal differentiating cut-off (SDS ≥ 4), sensitivity was 61.3% and specificity 63.5%. Results were similar for subgroups on gender and ethnicity. While internal consistency of the SDS is good, its use as a screener to differentiate between dependence and non-dependence within populations of young adult frequent cannabis users is not recommended. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper presents an overview of the prospective cohort design of the Dutch Cannabis Dependence (CanDep) study, which investigates (i) the three-year natural course of frequent cannabis use (≥ three days per week in the past 12 months) and cannabis dependence; and (ii) the factors involved in the transition from frequent non-dependent cannabis use to cannabis dependence, and remission from dependence. Besides its scientific relevance, this knowledge may contribute to improve selective and indicated prevention, early detection, treatment and cannabis policies. The secondary objectives are the identification of factors related to treatment seeking and the validation of self report measures of cannabis use. Between September 2008 and April 2009, baseline data were collected from 600 frequent cannabis users with an average age of 22.1 years, predominantly male (79.3%) and an average cannabis use history of 7.1 years; 42.0% fulfilled a (12-month DSM-IV) diagnosis of cannabis dependence. The response rate was 83.7% after the first follow up at 18 months. The second and last follow-up is planned at 36 months. Computer assisted personal interviews (CAPI) were conducted which covered: cannabis use (including detailed assessments of exposure, motives for use and potency preference); use of other substances; DSM-IV internalizing and externalizing mental disorders; treatment seeking; personality; life events; social support and social functioning. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: The relatively high levels of cannabis use among young people is a cause of concern because of the positive relationship between its early onset use, antisocial behaviours and associated lifestyle. Amongst a survey of 3919 young people at school year 11 in Northern Ireland (aged 14/15 years) 142 reported daily cannabis use. These young people also reported particularly high levels of legal and illegal drug use and accounted for a high proportion of use of hard drugs such as cocaine and heroin for the full school cohort. Daily cannabis users also reported high levels of antisocial behaviour and disaffection with school. The findings perhaps raise questions about the existence of a potentially ‘hidden’ high risk school based group of young people during adolescence who require specific targeted prevention strategies. [Copyright &y& Elsevier]