Temporal associations between substance use and delinquency among youth with a first time offense

Objective

Substance use and delinquency among adolescents have been shown to be positively associated; however, the temporal relationship is not well understood. Examining the association between delinquency and substance use is especially relevant among adolescents with a first-time substance use related offense as they are at-risk for future problems.

Method

Data from 193 adolescents at time of diversion program entry and six months later was examined using cross-lagged path analysis to determine whether substance use and related consequences were associated with other types of delinquency across time.

Results

Results demonstrated that delinquency at program entry was related to subsequent reports of heavy drinking and alcohol consequences, but not marijuana use or its consequences. In contrast, alcohol and marijuana use at program entry were not related to future reports of delinquency.

Conclusions

Findings emphasize the need to build in comprehensive assessments and interventions for youth with a first time offense in order to prevent further escalation of substance use and criminal behaviors.     

Trends of Cannabis Use Disorder in the Inpatient: 2002 to 2011

Objectives

The nationwide prevalence of cannabis use/abuse has more than doubled from 2002 to 2011. Whether the outpatient trend is reflected in the inpatient setting is unknown. We examined the prevalence and incidence of cannabis abuse/dependence as determined by discharge coding in a 10-year (2002-2011) National Inpatient Sample, as well as various trends among demographics, comorbidities, and hospitalization outcomes.

The safety of modafinil in combination with oral ∆9-tetrahydrocannabinol in humans

Marijuana (cannabis) is the most widely used illicit substance globally, and cannabis use is associated with a range of adverse consequences. Currently, no medications have been proven to be effective for the treatment of cannabis addiction. The goals of this study were to examine the safety and efficacy of a potential treatment medication, modafinil, in combination with oral ?9-tetrahydrocannabinol (THC). Twelve male and female occasional cannabis users participated in an outpatient double-blind, placebo-controlled, crossover study. Across four sessions, participants were randomly assigned to a sequence of four oral treatments: (1) 400 mg modafinil + placebo, (2) 15 mg THC + placebo, (3) 400 mg modafinil + 15 mg THC, or (4) placebo + placebo. Outcome measures included heart rate, blood pressure, performance on the Rapid Visual Information Processing (RVIP), and the Hopkins Verbal Learning Test (HVLT), and subjective measures. Oral THC increased heart rate, and produced increased subjective ratings of feeling “high” and “sedated,” as well as increased ratings of euphoria. Modafinil alone increased the Profiles of Mood States (POMS) subscales of vigor and tension. These findings support the safety of modafinil in combination with THC. The effects of modafinil in combination with a range of doses of THC need to be determined in future studies.     

Combined effects of HIV and marijuana use on neurocognitive functioning and immune status

The current study examined the independent and combined effects of HIV and marijuana (MJ) use (no use, light use, and moderate-to-heavy use) on neurocognitive functioning among a convenience sample of HIV-positive (HIV+) and HIV-negative (HIV–) individuals recruited from HIV community care clinics and advertisements in the Greater Los Angeles area. MJ users consisted of individuals who reported regular use of MJ for at least 12 months, with last reported use within the past month. Participants included 89 HIV+ (n?=?55) and HIV– (n?=?34) individuals who were grouped into non-users, light users, and moderate-to-heavy users based on self-reported MJ use. Participants were administered a brief cognitive test battery and underwent laboratory testing for CD4 count and viral load. HIV+ individuals demonstrated lower performance on neurocognitive testing than controls, and moderate-to-heavy MJ users performed more poorly on neurocognitive testing than light users or non-users. Moderate-to-heavy HIV+ users performed significantly lower on learning/memory than HIV– moderate-to-heavy users (M_D?=??8.34; 95% CI: ?16.11 to ?0.56) as well as all other comparison groups. In the domain of verbal fluency, HIV+ light users outperformed HIV– light users (M_D?=?7.28; 95% CI: 1.62–12.39), but no HIV group differences were observed at other MJ use levels. HIV+ MJ users demonstrated lower viral load (M_D?=??0.58; 95% CI: ?1.30 to 0.14) and higher CD4 count than non-users (M_D?=?137.67; 95% CI: 9.48–265.85). The current study findings extend the literature by demonstrating the complex relationship between HIV status and MJ use on neurocognitive and clinical outcomes.     

Increased susceptibility to memory intrusions and the Stroop interference effect during acute marijuana intoxication

The marijuana-induced acute memory impairment was assessed in a double-blind, crossover experiment. Twelve males smoked NIDA-supplied cigarettes containing 1.2% delta-9-tetrahydrocannabinol (THC) or cannabinoid-exhausted marijuana (placebo) in counterbalanced order on 2 days 1–3 weeks apart. Practice, pre- and postsmoking test sessions were conducted with the Paced Auditory Serial Addition Test, Stroop Color and Word Test, and alternate forms of the Randt Memory Battery and the Controlled Oral Word Association Test. A significantly greater number of short story omissions and intrusions occurred in delayed free recall after marijuana. Immediate and sustained attention, controlled retrieval from semantic memory, and speed of reading and naming colors were not affected. The Stroop interference effect was significantly greater following marijuana. Subjects appeared to experience parallel difficulties in inhibiting associations to the new material and inhibiting the overlearned response of reading in a new learning task. Marijuana may compromise associative control, presumably a cognitive process inherent in memory function.This research was supported in part by grants DA01696, DA00053 and DA03473 from the National Institute on Drug Abuse and BRSG Grant SO7-RR05755 awarded by the Biomedical Research Support Grant Program, Division of Research Resources, National Institutes of Health     

Poor sleep quality as a risk factor for lapse following a cannabis quit attempt

Treatments for cannabis dependence are associated with high rates of lapse/relapse, underscoring the importance of identifying malleable risk factors that are associated with quit failure. Whereas research has demonstrated that poor sleep quality following cannabis discontinuation is related to subsequent use, there has yet to be an examination of whether poor sleep quality prior to a quit attempt results in a similar pattern of lapse. The present study addressed this gap by examining the role of pre-quit sleep quality on early lapse to cannabis use following a self-guided quit attempt, among 55 cannabis dependent military veterans. Results indicated that participants who experienced poor pre-quit sleep quality had greater risk for lapse within the first 2 days (out of 7) following their quit attempt. Findings are discussed in terms of improving treatments for individuals who report poor sleep quality prior to a cannabis quit attempt.     

A Marijuana Screening Inventory (Experimental Version): Description and Preliminary Psychometric Properties

Objective: Marijuana use prevalence, culturally confusing messages about marijuana risks, assessment dilemmas, and current screening inadequacies justify developing a marijuana specific screening inventory for assessment purposes. This article describes the Marijuana Screening Inventory (MSI‐X) and its preliminary psychometric reliability, factor analyses, and factor structure. Method: The MSI‐X was administered to a community sample of 420 Army reservists participating in substance abuse educational classes. Participants responded anonymously to the 39‐item MSI‐X. SPSS analyses were performed with 408 returned MSI‐Xs from a sample of 49% males and 40% females. Results: Analyses revealed 61% smoked marijuana during their lifetime. Reliability of the MSI‐X was. 89. Exploratory factor analyses of 31 scored items by principal components and varimax rotation supported a nine‐factor structure, explaining 65.8% of the variance, with all items loading ≥ .30. Within the sample, 7.84% scored ≥ 7 suggesting “at risk” with marijuana; 6.12% scored 4 to 6 “suggestive of risk”; 20.83% scored 1 to 3 reflecting “normal or experimental” use; and 65.4% scored 0 suggesting “no problem.” Conclusions: The reliability, variance explained, factor‐loading matrix of the nine‐factor MSI‐X structure and clinically predetermined scoring ranges appear useful for screening marijuana use patterns. Factor‐based subscales were derived from the factor‐loading matrix and described as a base for future confirmatory factor analysis. Although the MSI‐X version needs psychometric strengthening, it shows potential as a marijuana‐specific screening inventory for use in general mental health and primary care settings.