Symptoms of obsessive-compulsive disorder predict cannabis misuse

IntroductionCannabis use has been linked to many psychological disorders. There is, however, a paucity of research investigating the link between cannabis use and obsessive-compulsive disorder (OCD). The present study sought to examine this link by exploring associations between severity of OCD symptoms, cannabis use, and cannabis misuse; determining whether these associations exist above and beyond symptoms of anxiety, depression, and stress; and testing the mediating role of cannabis coping motives (i.e., using cannabis to cope with negative affect and other problems).MethodsA large sample of young adult cannabis users (n = 430) completed an online survey containing measures of OCD symptoms, cannabis use, cannabis misuse, and cannabis use motives.ResultsSeverity of OCD (as indexed by higher scores on the Obsessive-Compulsive Inventory-Revised) was unrelated to frequency and quantity of cannabis use, but it was significantly, positively related to increased cannabis misuse. These effects persisted after controlling for anxiety, depression, and stress. The specific feature of obsessing was found to consistently predict cannabis misuse. Finally, an indirect effect of severity of OCD on cannabis misuse via coping motives was discovered.ConclusionsTogether, these findings indicate that there may be an association between OCD and cannabis misuse that is independent of anxiety, depression, and stress, and that is mediated by coping motives. Based on these findings, we recommend that individuals with OCD symptoms avoid using cannabis because they may be more vulnerable to the development of problematic use and cannabis use disorder.     

Predicting the transition from frequent cannabis use to cannabis dependence: A three-year prospective study

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.     

Correlates of lifetime cannabis use and cannabis use severity in a Canadian university sample

This study aimed to broaden previous investigations of correlates of lifetime cannabis use and problematic cannabis use among post-secondary students by examining the novel and contemporary issues of medicinal use and deep inhalation practices. The sample included 2212 undergraduate and graduate post-secondary students from Alberta, Canada, who completed the University of Calgary's Campus Experience with Cannabis Survey (average age 23.2, SD = 5.2). Nine variables were entered into the binary logistic regression to examine their differentiation of lifetime users from non-users. A multiple regression model was completed with past six-month users (n = 697), where the continuous dependent variable was cannabis use severity as measured by total scores on the Cannabis Use Disorder Identification Test-Revised. Twenty independent variables were entered simultaneously. Varsity athlete status, family mental illness, severity of alcohol use, greater support for legalization and lower perceived risk associated with regular cannabis use, differentiated lifetime users from non-users. Higher rates of religiosity and living with parents or relatives were associated with lower-lifetime rates. Male gender, earlier age of first cannabis use, cannabis use motives (including coping, enhancement and expansion), past six-month medicinal use and increased frequency of deep inhalation during consumption, were found to be significant correlates of severity. Different factors seem to predict lifetime cannabis use versus severity, and these differences may help inform the development and delivery of prevention efforts. Given that medicinal use and male gender were the largest correlates of severity, populations representing these groups may benefit most from targeted education and prevention.     

Dysregulation as a correlate of cannabis use and problem use

ObjectiveCannabis users with a dysregulatory risk factor may be particularly vulnerable to engaging in more frequent and problematic cannabis use. Contemporary models of dysregulated behavior suggest that dysregulation emerges due to distinct mechanisms. The current study seeks to examine the dysregulatory correlates of cannabis involvement, including working memory capacity, delay discounting, impulsivity, and reward sensitivity.MethodParticipants were 104 non-treatment seeking frequent cannabis users (the average participant used cannabis 71% of the days/past 60 days [SD = 22%], with an average of two uses per day [SD = 1.2]). Mean age was 21.3 (SD = 4.3); 36.5% were female. Working memory was assessed via the Trail-Making Test-B and the Digit Span subtests of the WAIS-III, delay discounting was assessed via a computer-based task, trait impulsivity was self-reported via the Barratt Impulsiveness Scale, and reward sensitivity was self-reported via the Reward Dependence Scale and the Snaith-Hamilton Pleasure Scale.ResultsStructural equation modeling estimated the associations between different facets of dysregulation and cannabis involvement. Results suggest that poor working memory capacity and high trait impulsivity were associated with both use and problem use. Greater delay discounting was associated with problem use, but not with frequency of use. Low reward sensitivity was associated with more frequent cannabis use, but not with problem use.ConclusionsResults confirm that the dysregulatory correlates of cannabis involvement consist of multiple dimensions of functioning. Prospective studies that assess the multidimensional structure of dysregulation and cannabis involvement are needed in order to disaggregate the dysregulatory antecedents and consequences of cannabis involvement.     

Distress tolerance and cessation-related cannabis processes: The role of cannabis use coping motives

Robust evidence implicates perceived distress tolerance as a risk factor for maladaptive cannabis use and poorer cannabis cessation outcomes. Past work suggests that perceived distress tolerance may be related to an array of clinically-relevant cannabis processes and outcomes via cannabis coping motives. Although promising, the generalizability of this work to racially/ethnically diverse samples of adult cannabis users is unknown. Additionally, investigation into alternative cannabis processes has been limited and has not controlled for the effects of other cannabis motives. Thus, the present study investigated cannabis coping motives as an explanatory variable for the relation between perceived distress tolerance and cannabis use processes that may impede cessation (e.g., cannabis use cravings, perceived barriers to cannabis cessation, and withdrawal symptoms) among an ethnically diverse sample of current cannabis using adults. Participants included 131 adult cannabis users (M_age = 36.67 years; 29.8% female; 59.2% Black, 26.2% White, 16.0% Hispanic). Results indicated that perceived distress tolerance was indirectly associated with all criterion variables through cannabis coping motives after controlling for the variance attributable to four other motives. The current study builds upon previous theoretically-supported work by examining these models among an ethnically diverse sample of current cannabis using adults and testing alternative cessation-related cannabis processes while controlling for the independent effects of four other cannabis motives.     

Cannabis use motives on weekends versus weekdays: Direct and indirect relations with cannabis use and related problems

College cannabis users report using more cannabis during the weekend than on weekdays, yet little attention has been paid to the role of weekend and weekday-specific motives for use. The present investigation evaluated the impact of weekend and weekday-specific cannabis motives on cannabis use and related problems among current (past-3 month) cannabis using undergraduates (N = 276). Participants reported more cannabis use motives during the weekend than weekday. Enhancement and social motives were greater than coping, conformity, and expansion motives during weekends. Enhancement and conformity motives were indirectly related to problems via cannabis use frequency for both weekdays and weekends. Yet social, coping, and expansion motives were indirectly related to problems via cannabis use frequency for only weekdays. Findings support the differential impact of weekend and weekday-specific motives on cannabis use and related problems.     

Factors associated with cannabis use change in youth: Evidence from the COMPASS study

IntroductionHarmful effects of cannabis use in youth scale with frequency. In the context of approaching legalization in Canada, understanding the distinctions between youth who change and who maintain their cannabis use is essential for designing interventions and policy. A substantial number of characteristics may play a role. This study assessed whether and how youth who change their cannabis use differ from those who do not.MethodsCannabis use was reported by 8375 Canadian high school students participating in the COMPASS study. GEE multiple logistic regressions were then used to establish impact of 13 baseline demographic and behavioural exposure variables on the likelihood of membership in four frequency change groups at follow-up a year later: reduction, cessation, escalation, and maintenance.ResultsGroups were found to differ in several ways. Cessation group members (19.4% of users) were less likely to binge drink (OR 0.82), vape (OR 0.82), or attend class without completing homework (OR 0.72) than maintainers. Students who reduced their use (14.6% of users) were more likely to binge drink (OR 1.36), smoke (OR 1.20), and skip class (OR 1.21). Those who escalated (29.5% of users) were more likely to be male (OR 1.35) and to vape (OR 1.22).ConclusionsStudents who change their cannabis use differ in several demographic and behavioural characteristics. The results raise further concerns about the impact of e-cigarettes and the role of poly-substance use in high-risk trajectories. Distinct classes of cannabis users, essential for policy and intervention development, can be identified in high school populations.     

Cross-domain correlates of cannabis use disorder severity among young adults

BackgroundCorrelates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative.MethodsThis study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25 years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition.ResultsOf the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ≤.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90 days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability.ConclusionsCannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.     

Motives for cannabis use as a moderator variable of distress among young adults

This study examined the moderating effect of social and coping motives on distress among young cannabis-using adults. A random sample of 2031 young Swiss adults was interviewed by means of a computer-assisted telephone interview. Cannabis users showed more distress, less positive health behaviour and higher hedonism compared to non-users. Taking motive for use as a moderator variable into consideration, it became evident that only cannabis users with coping motives showed lower mental health, more symptoms of psychopathology, more psychosocial distress and more life events than non-users. Young adults with social motives for use on the other hand did not differ from non-users in terms of distress. These differences between cannabis users with social and those with coping motives remained stable over two years. In both subgroups, participants with regular cannabis use at baseline did not increase distress nor did participants with higher distress at baseline increase the frequency of their cannabis use. Our results suggest that secondary prevention for cannabis users should target especially young adults with coping motives for use.     

The Interactive Influence of Cannabis-Related Negative Expectancies and Coping Motives on Cannabis Use Behavior and Problems

Objectives: The present study tested whether coping motives for cannabis use moderate the effect of negative expectancies on cannabis use. Methods: Participants were 149 (36.2% female, 61.59% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of cannabis-related expectancies and motives for use. Hierarchical multiple regressions were employed to investigate the predictive value of the interaction between negative expectancies and coping motives on cannabis use outcomes. Results: Results revealed interactions between negative expectancies and coping motives with respect to past 90 day cannabis use frequency and cannabis problems. Global negative effects expectancies were associated with less frequent cannabis use, particularly among those with fewer coping motives. However, negative expectancies were related to more cannabis problems, particularly among those with higher coping motives. Conclusions: These results suggest it may be advisable to take coping motives into account when addressing expectancies among cannabis users.     

Cannabis use under prohibitionism – the interplay between motives,contexts and subjects

Abstract

A key question in drugs research is why people use psychoactive substances. Diverse motives such as boredom, habit, and pain relief have served as explanations, but little is known about how adult cannabis users motivate their use in prohibitionist policy contexts, like Sweden. The aim is to explore what motives a sample of adult Swedish cannabis users refer to when they give meaning to their use. We ask: what aspects of cannabis use (e.g. drug effects, individual characteristics and social contexts) are emphasized in their accounts, and how are such aspects combined to describe motives and justify use? In this study, motives are perceived as culturally situated action, and our analysis is based on online text messages (n?=?238) and interviews (n?=?12). Participants emphasized either the characteristics of the use situation (motives such as party, relaxation and social function) or of him-/herself as an individual (motives such as mindfulness, identity marker and somatic function). They often mentioned medical and recreational motives in the same account, and carefully presented themselves as rational individuals. The motives reflect that the drugs discourse is increasingly medicalized, that responsibility is highly esteemed in contemporary societies, and that cannabis use is still stigmatized in Sweden.     

Perceived Importance of Factors in Cannabis Purchase Decisions: A Best-worst Scaling Experiment

BackgroundConsumers’ access to cannabis has been considerably expanded in US states where recreational cannabis was legalized and commercialized. However, little is known about the important factors influencing consumers’ purchase decisions in cannabis retail dispensaries. This study examined cannabis users’ perceptions of the relative importance of policy-relevant factors when they made cannabis purchase decisions.MethodsAn online survey was administered to 817 adult cannabis users in seven states in the US (California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington) that had approved cannabis commercialization by the time of interview in January 2018. Twenty policy-relevant cannabis attributes were evaluated, including those pertaining to product characteristics, quality, package characteristics, price and free sample, store characteristics, and restrictions on use. A best-worst scaling experiment was employed, which asked respondents to select the most and the least important attributes in a choice scenario. Each respondent answered 10 choice scenarios, each including a random combination of four attributes out of the 20. The relative importance of each attribute was evaluated using hierarchical Bayesian estimation of mixed logit models.ResultsOverall, ‘quality’, ‘strain type’, ‘price’, ‘THC’ (tetrahydrocannabinol) and ‘pesticide’ were the top five important attributes affecting cannabis users’ willingness to buy cannabis in a dispensary. These five attributes jointly accounted for approximately half of the total importance. In subsample analysis, both recreational and dual-purpose users attached higher importance to ‘quality’, ‘THC’, and ‘price’, whereas medical users tended to think ‘CBD’ (cannabidiol) and ‘pesticide’ were more important. All cannabis users perceived ‘package’ to be the least important attribute. Gender had no major differences in perceptions.ConclusionsCannabis users in general perceived product characteristics, quality, and price to be important factors in their willingness to buy cannabis in dispensaries. There were heterogeneities in the perceptions by cannabis use purposes. The findings might deserve consideration in cannabis policy design.     

Cognitive,physical, and mental health outcomes between long-term cannabis and tobacco users

IntroductionCannabis intoxication adversely affects health, yet persistent effects following short-term abstinence in long-term cannabis users are unclear. This matched-subjects, cross-sectional study compared health outcomes of long-term cannabis and long-term tobacco-only users, relative to population norms.MethodsNineteen long-term (mean 32.3 years of use, mean age 55.7 years), abstinent (mean 15 h) cannabis users and 16 long-term tobacco users (mean 37.1 years of use, mean age 52.9 years), matched for age, educational attainment, and lifetime tobacco consumption, were compared on measures of learning and memory, response inhibition, information-processing, sustained attention, executive control, and mental and physical health.ResultsCannabis users exhibited poorer overall learning and delayed recall and greater interference and forgetting than tobacco users, and exhibited poorer recall than norms. Inhibition and executive control were similar between groups, but cannabis users had slower reaction times during information processing and sustained attention tasks. Cannabis users had superior health satisfaction and psychological, somatic, and general health than tobacco users and had similar mental and physical health to norms whilst tobacco users had greater stress, role limitations from emotional problems, and poorer health satisfaction.ConclusionsLong-term cannabis users may exhibit deficits in some cognitive domains despite short-term abstinence and may therefore benefit from interventions to improve cognitive performance. Tobacco alone may contribute to adverse mental and physical health outcomes, which requires appropriate control in future studies.     

Cannabis use patterns and motives: A comparison of younger,middle-aged,and older medical cannabis dispensary patients

IntroductionMedical cannabis is increasingly being used for a variety of health conditions as more states implement legislation permitting medical use of cannabis. Little is known about medical cannabis use patterns and motives among adults across the lifespan.MethodsThe present study examined data collected at a medical cannabis dispensary in San Francisco, California. Participants included 217 medical cannabis patients who were grouped into age-defined cohorts (younger: 18–30, middle-aged: 31–50, and older: 51–72). The age groups were compared on several measures of cannabis use, motives and medical conditions using one-way ANOVAs, chi-square tests and linear regression analyses.ResultsAll three age groups had similar frequency of cannabis use over the past month; however, the quantity of cannabis used and rates of problematic cannabis use were higher among younger users relative to middle-aged and older adults. The association between age and problematic cannabis use was moderated by age of regular use initiation such that earlier age of regular cannabis use onset was associated with more problematic use in the younger users, but not among older users. Middle-aged adults were more likely to report using medical cannabis for insomnia, while older adults were more likely to use medical cannabis for chronic medical problems such as cancer, glaucoma and HIV/AIDS. Younger participants reported cannabis use when bored at a greater rate than middle-aged and older adults.ConclusionsFindings suggest that there is an age-related risk for problematic cannabis use among medical cannabis users, such that younger users should be monitored for cannabis use patterns that may lead to deleterious consequences.     

Patterns of high-intensity drinking among young adults in the United States: A repeated measures latent class analysis

ObjectiveUsing a national sample of young adults, this study identified latent classes of alcohol use including high-intensity drinking (10+ drinks) from ages 18 to 25/26, and explored associations between time-invariant covariates measured at age 18 and class membership.MethodLongitudinal data from the national Monitoring the Future study were available for 1078 individuals (51% female) first surveyed as 12th grade students in 2005–2008, and followed through modal age 25/26. Repeated measures latent class analysis was used to identify latent classes based on self-reported alcohol use: no past 30-day drinking, 1–9 drinks per occasion in the past 2 weeks, and 10+ drinks per occasion.ResultsFour latent classes of alcohol use from ages 18 to 25/26 were identified: (1) Non-Drinkers (21%); (2) Legal Non-High-Intensity Drinkers (23%); (3) Persistent Non-High-Intensity Drinkers (40%); and (4) High-Intensity Drinkers (16%). Membership in the High-Intensity Drinkers class was characterized by higher than average probabilities of high-intensity drinking at all ages, with the probability of high-intensity drinking increasing between ages 18 and 21/22. Both gender and race/ethnicity significantly differentiated class membership, whereas neither parental education (a proxy for socioeconomic status) nor college plans at 12th grade showed significant associations.ConclusionsMore than one in seven individuals who were seniors in high school experienced a long-term pattern of high-intensity drinking lasting into middle young adulthood. Young adult high-intensity drinking is often preceded by high-intensity drinking in high school, suggesting the importance of screening and prevention for high-intensity drinking during adolescence.