Pain Relief as a Motivation for Cannabis Use Among Young Adult Users With and Without Chronic Pain

This study aims to determine the rate of chronic pain in a community sample of young adult cannabis users, assess the extent to which pain relief is an important motivation for cannabis use, and explore differences in consumption patterns and problem behaviors between users with and without chronic pain. The study design was cross-sectional. Self-selected community-dwelling young adults (ages 18–29 years; n = 143) who regularly use cannabis completed an online survey. Results revealed that approximately 40% of the sample met the criteria for chronic pain, and pain relief was their primary motivation for use. There were no differences between groups with respect to frequency of use or estimated potency of their preferred strains; however, users with chronic pain reported using a wider variety of administration methods and a greater quantity of cannabis with each use. Users with chronic pain also reported more extensive histories of use, with younger age at initiation and longer duration of regular use. Despite riskier consumption patterns, there were no between-group differences in negative consequences owing to use after controlling for gender and educational status. On average, the total sample reported approximately 8 problems in the past 30 days owing to use. These findings suggest that chronic pain is commonly experienced among young adult cannabis users and pain relief is the primary motivation for users with pain. For some users, clinically significant chronic pain and pain-related interference persist despite heavy use. Cannabis users with and without chronic pain report experiencing several negative consequences owing to their use.PerspectiveThis article compares motivations for cannabis use and describes differences in consumption patterns among a community sample of young adult users with and without chronic pain. This information may be useful for providers who assess and treat pain in young adults, particularly in settings that have legalized recreational use.     

Treatment process,alliance and outcome in brief versus extended treatments for marijuana dependence

Aims The Marijuana Treatment Project, a large multi‐site randomized clinical trial, compared a delayed treatment control condition with a brief (two‐session) and extended (nine‐session) multi‐component treatment among 450 marijuana‐dependent participants. In this report we present treatment process data, including the fidelity of treatment delivery in the three community‐based treatment settings as well as the relationships between treatment process and outcome. Design Independent evaluations of clinician adherence and competence ratings were made based on 633 videotaped sessions from 163 participants. Relationships between clinician adherence and competence, ratings of the working alliance and marijuana treatment outcomes were evaluated. Findings Protocol treatments were implemented with strong fidelity to manual specifications and with few significant differences in adherence and competence ratings across sites. In the brief two‐session treatment condition, only the working alliance was associated significantly with frequency of marijuana use, but in the extended treatment therapist ratings of working alliance predicted outcomes, as did the interaction of alliance and curvilinear adherence. Conclusions Behavioral treatments for marijuana use were delivered in community settings with good fidelity. Participant and therapist working alliance scores were associated significantly with improved marijuana use outcomes in a brief behavioral treatment for adults with marijuana dependence. In extended treatment the therapist ratings of working alliance were associated with more positive outcome. However, in that treatment there was also a significant interaction between alliance and curvilinear adherence.     

The effects of e‐cigarette minimum legal sale age laws on youth substance use

We use difference‐in‐differences models and individual‐level data from the national and state Youth Risk Behavior Surveillance System from 2005 to 2015 to examine the effects of e‐cigarette minimum legal sale age (MLSA) laws on youth cigarette smoking, alcohol consumption, and marijuana use. Our results suggest that these laws increased youth smoking participation by about one percentage point and approximately half of the increased smoking participation could be attributed to smoking initiation. We find little evidence of higher cigarette smoking persisting beyond the point at which youth age out of the laws. Our results also show little effect of the laws on youth drinking, binge drinking, and marijuana use. Taking these together, our findings suggest a possible unintended effect of e‐cigarette MLSA laws—rising cigarette use in the short term while youth are restricted from purchasing e‐cigarettes.     

Patterns of Co-occurring Modes of Marijuana Use Among Colorado High School Students

PurposeThe purpose of the study was to understand how adolescents concurrently use different modes of marijuana consumption.MethodsUsing data from the 2017 Healthy Kids Colorado Survey, we examined how modes of marijuana use (smoking/ingesting/vaping/dabbing/other) co-occur. We estimated the prevalence of all combinations of these modes among adolescents who reported past 30-day marijuana use (n = 3,618). We then estimated the prevalence of any use of each mode by each mode usually used.ResultsForty-one percent reported only smoking, another 10% reported smoking and dabbing, and 9.8% reported smoking and ingesting. Only about 10% used a combination of modes that did not include smoking. Smoking was the most common additional mode for all other usual modes of consumption.ConclusionsSmoking in combination with dabbing and/or ingesting were the most common multimode patterns of use. Nearly all adolescents who use marijuana smoke some or most of the time.     

The effects of prenatal marijuana exposure on delinquent behaviors are mediated by measures of neurocognitive functioning

We hypothesized that there would be an association between prenatal marijuana exposure (PME) and delinquency and that the effects of PME on neurocognitive development would mediate this association. Mothers and offspring enrolled in a longitudinal study of the effects of prenatal substance exposure on child development, were interviewed from the fourth prenatal month through 14 years. There were 580 mother/child dyads at the 14-year phase. A standardized protocol assessed psychological, neurocognitive, social, environmental, and demographic characteristics, and substance use at each phase. The Self Report Delinquency scale (Loeber et al., 1998) and the Child Behavior checklist (Achenbach, 1991) delinquency subscale were combined to represent delinquent behavior. First trimester PME was used as a dichotomous variable, daily use versus all other use. Offspring of heavier marijuana users were significantly more likely to report delinquent behavior at age 14. The odds ratio for delinquency among those who were exposed to one or more joints per day during gestation was 1.76 (C.I. 1.05 - 2.96). PME significantly predicted child depressive symptoms and attention problems at age 10, after controlling for other significant covariates. Child depressive symptoms and attention problems at age 10 significantly predicted delinquency at 14 years. Theassociation between PME and delinquent behavior at 14 years was mediated by depressive symptoms and attention problems in the offspring at 10 years.