scholarly journals Where, When and With Whom: Cannabis Use, Settings and Self-Regulation Rules

2021 ◽  
pp. 009145092110339
Author(s):  
Kostas Skliamis ◽  
Annemieke Benschop ◽  
Nienke Liebregts ◽  
Dirk J. Korf
Keyword(s):  
Self Regulation ◽  
Cannabis Use ◽  
Risk Avoidance ◽  
Convenience Sample ◽  
Problematic Use ◽  
Formal Control ◽  
National Differences ◽  
Frequency Of Use ◽  
Nuanced Understanding ◽  
Cannabis Policy

This article examines to what extent and how cannabis users in different countries, with different cannabis legislation and policies practice normalization and self-regulation of cannabis use in everyday life. Data were collected in a survey among a convenience sample of 1,225 last-year cannabis users aged 18–40 from seven European countries, with cannabis policies ranging from relatively liberal to more punitive. Participants were recruited in or in the vicinity of Dutch coffeeshops. We assessed whether cannabis users experience and interpret formal control and informal social norms differently across countries with different cannabis policies. The findings suggest that many cannabis users set boundaries to control their use. Irrespective of national cannabis policy, using cannabis in private settings and setting risk avoidance rules were equally predominant in all countries. This illustrates that many cannabis users are concerned with responsible use, demonstrating the importance that they attach to discretion. Overall, self-regulation was highest in the most liberal country (the Netherlands). This indicates that liberalization does not automatically lead to chaotic or otherwise problematic use as critics of the policy have predicted, as the diminishing of formal control (law enforcement) is accompanied by increased importance of informal norms and stronger self-regulation. In understanding risk-management, societal tolerance of cannabis use seems more important than cross-national differences in cannabis policy. The setting of cannabis use and self-regulation rules were strongly associated with frequency of use. Daily users were less selective in choosing settings of use and less strict in self-regulation rules. Further differences in age, gender, and household status underline the relevance of a differentiated, more nuanced understanding of cannabis normalization.

scholarly journals Assessing Cannabis Use Disorder in Medical Cannabis Patients: Interim Analyses from an Observational, Longitudinal Study

Cannabis ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 47-59
Author(s):  
Kelly Sagar ◽  
M. Kathryn Dahlgren ◽  
Rosemary Smith ◽  
Ashley Lambros ◽  
Staci Gruber
Keyword(s):  
Longitudinal Study ◽  
Cannabis Use ◽  
Screening Tools ◽  
Cannabis Use Disorder ◽  
Medical Cannabis ◽  
Problematic Use ◽  
Treatment Information ◽  
Frequent Use ◽  
Frequency Of Use ◽  
Disorder Identification

Background: To date, no studies have directly assessed potential cannabis use disorder (CUD) in medical cannabis (MC) patients pre- vs post-MC treatment. Given that MC patients use cannabis for symptom alleviation rather than intoxication, we hypothesized that MC patients would exhibit few symptoms of CUD after initiating MC treatment. Methods: As part of an ongoing observational, longitudinal study, 54 MC patients completed baseline assessments prior to initiating MC use and returned for at least one follow-up assessment after three, six, and/or twelve months of a self-selected MC treatment regimen; detailed MC treatment information was collected and quantified. All patients completed the Cannabis Use Disorder Identification Test - Revised (CUDIT-R) at each visit. Changes in individual items scores and total scores were assessed over time, and we examined whether total CUDIT-R scores correlated with frequency of MC use, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) exposure. Further, Cronbach’s alpha analyses were conducted to provide preliminary data regarding the psychometric properties of the CUDIT-R when used among MC patients. Results: Although total CUDIT-R scores increased relative to baseline, on average, ratings fell below the ‘hazardous use’ threshold at each visit. Analyses of individual items revealed that increases in total scores were primarily attributable to increases in frequency of use and not necessarily other aspects of problematic use. Total CUDIT-R scores were not associated with number of MC uses or CBD exposure, but a significant relationship was detected between increased THC exposure and higher CUDIT-R scores. Importantly however, analyses revealed that the CUDIT-R does not appear to be an appropriate tool for identifying CUD in MC patients. Conclusions: Screening tools specifically designed to assess CUD in MC patients are needed and should distinguish between frequent use and problematic use; exposure to individual cannabinoids must also be considered.

scholarly journals Beyond the high: Mapping patterns of use and motives for use of cannabis as medicine

2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Sleep Disturbances ◽  
Online Survey ◽  
Cannabis Use ◽  
Health Conditions ◽  
Convenience Sample ◽  
Mental Health Conditions ◽  
Patient Organisations ◽  
Patterns Of Use

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.

scholarly journals The “black box” of treatment: Patients’ perspective on what works in opioid maintenance treatment for opioid dependence

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Teresa C. Silva ◽  
Fredrik B. Andersson
Keyword(s):  
Opioid Dependence ◽  
Maintenance Treatment ◽  
Treatment Plan ◽  
Black Box ◽  
Opioid Maintenance Treatment ◽  
Convenience Sample ◽  
Problematic Use ◽  
Treatment Stage ◽  
Pre Treatment ◽  
Patients Perspective

Abstract Background A lack of conceptual modeling of how the components of opioid maintenance treatment (OMT) for opioid dependence (OD) work causes it to occasionally be labeled the “black-box” of treatment. This study had a two-fold objective: First, to analyze which factors related to OMT for OD contribute to the abstinence of problematic use of non-prescribed opioids and sustain recovery, from the patients’ perspective; second, to understand which changes OMT produced in the individuals’ lives might significantly contribute to relapse prevention. Methods We used qualitative methods of design, inquiry, and analysis from a convenience sample of 19 individuals in a Swedish treatment setting. Results All the participants reported previous cycles of problematic use of non-prescribed opioids and other non-prescribed psychoactive substances, treatment, abstinence, recovery, and relapse before starting the current OMT program. During the pre-treatment stage, specific events, internal processes, and social environments enhanced motivation toward abstinence and seeking treatment. During the treatment stage, participants perceived the quality of the human relationships established with primary social groups as important as medication and the individual plan of care in sustaining recovery. From the participants’ perspective, OMT was a turning point in their life course, allowing them a sense of self-fulfillment and the reconstruction of personal and social identity. However, they still struggled with the stigmatization produced by a society that values abstinence-oriented over medication-assisted treatments. Conclusion OMT is not an isolated event in individuals’ lives but rather a process occurring within a specific social context. Structural factors and the sense of acceptance and belonging are essential in supporting the transformation. Treatment achievements and the risk for relapse vary over time, so the objectives of the treatment plan must account for characteristics of the pre-treatment stage and the availability and capacity of individuals to restructure their social network, besides the opioid maintenance treatment and institutional social care.

scholarly journals Cannabis for Chronic Pain: Case Series and Implications for Clinicians

2002 ◽  
Vol 7 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Mark A Ware ◽  
Ann Gamsa ◽  
Jan Persson ◽  
Mary-Ann Fitzcharles
Keyword(s):  
Chronic Pain ◽  
Health Centre ◽  
Case Series ◽  
Cannabis Use ◽  
Median Frequency ◽  
Median Dose ◽  
Night Time ◽  
Day Range ◽  
Frequency Of Use ◽  
Mcgill University

BACKGROUND:Chronic pain is one of the most common reasons for therapeutic cannabis use.OBJECTIVES:To describe therapeutic cannabis use among patients with chronic pain.METHODS:Patients with chronic pain who voluntarily indicated that they used cannabis therapeutically completed a questionnaire about the type of cannabis used, the mode of administration, the amount used and the frequency of use, and their perception of the effectiveness of cannabis on a set of pain-associated symptoms and side effects. The study was approved by the McGill University Health Centre Research Ethics Board.RESULTS:Fifteen patients (10 male) were interviewed (median age 49.5 years, range 24 to 68 years). All patients smoked herbal cannabis for therapeutic reasons (median duration of use six years, range two weeks to 37 years). Seven patients only smoked at night-time (median dose eight puffs, range two to eight puffs), and eight patients used cannabis mainly during the day (median dose three puffs, range two to eight puffs); the median frequency of use was four times per day (range one to 16 times per day). Twelve patients reported improvement in pain and mood, while 11 reported improvement in sleep. Eight patients reported a 'high'; six denied a 'high'. Tolerance to cannabis was not reported.CONCLUSIONS:The results of this self-selected case series must be interpreted with caution. Small doses of smoked cannabis may improve pain, mood and sleep in some patients with chronic pain. Clinical trials are warranted to test these effects. Further prospective studies should examine the patterns and prevalence of cannabis use among chronic pain populations.

scholarly journals Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution

2021 ◽  
Vol 12 ◽  
Author(s):  
David Dias Neto ◽  
Ana Nunes da Silva ◽  
Magda Sofia Roberto ◽  
Jelena Lubenko ◽  
Marios Constantinou ◽  
...  
Keyword(s):  
Perceived Stress ◽  
Illness Perceptions ◽  
Early Stage ◽  
Self Regulation ◽  
Illness Perception ◽  
Preventive Behaviors ◽  
Illness Perception Questionnaire ◽  
National Differences ◽  
Comprehensive Picture ◽  
Regulation Model

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors.Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors.Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context.Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.

scholarly journals Dissection of neuroinflammation in schizophrenia

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S274-S275
Author(s):  
Fizah Muratib ◽  
Yuya Mizuno ◽  
Ines Carreira Figueiredo ◽  
Oliver Howes ◽  
Tiago Reis Marques
Keyword(s):  
Risk Factor ◽  
Grey Matter ◽  
Psychotic Disorders ◽  
Positive Association ◽  
Brain Regions ◽  
Regions Of Interest ◽  
Cannabis Use ◽  
Similar Response ◽  
Frequency Of Use ◽  
The Brain

AimsSchizophrenia is notoriously becoming one of the world's most debilitating mental disorders, affecting 1 in 100 people. There is increasing evidence that neuroinflammation plays a part in the pathogenesis of schizophrenia and other psychotic disorders; microglial activity acting as a marker for neuroinflammatory reactions in the brain. Furthermore, cannabis is an illicit substance that also evokes a similar response in the neuroimmune activity. This project explores how cannabis exposure influences an elevation in neuroinflammatory responses through TSPO levels, and whether this information can help us determine if cannabis use and increased TSPO levels can be associated with a risk factor for developing psychosis.Method55 participants (36 males and 19 females) were recruited from the community by the IRIS (Inflammatory Reaction in Schizophrenia) team at the IoPPN, King's College London, from which 34 patients with a diagnosis of schizophrenia and 21 healthy controls took part in the study. The eligible participants underwent clinical assessments and PET scanning, from which cannabis use history and PET data were collected. Participant neuroinflammatory levels are represented by [18F]DPA-714 volume and different regions of grey matter in the brain were analysed through multivariate analyses, the confounding variables being age and TSPO genotype.ResultA statistically significant association is shown between participants who have had exposure to cannabis and participants who have not had any exposure in their lifetime. The differences across the prioritised brain regions of interest were robust, the association appearing more apparent and statistically significant in the total (p = .00) and temporal grey matter (p = .00) regions of the brain. This may suggest that cannabis exposure influences the [18F]DPA-714 VT in the significant regions of interest. However, a negative association is seen with current use, the quantity of use, and the frequency of use.ConclusionThe initial findings for cannabis exposure show us a positive association with increased TSPO levels, however, limitations must be taken into account. Although we cannot readily establish that elevated TSPO levels in cannabis users can presently act as a risk factor marker for developing psychosis from this particular study, we can utilise this data to continue our research in disclosing a new system to predict the occurrence of psychosis.

scholarly journals Governance quality indicators for organ procurement policies

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252686
Author(s):  
David Rodríguez-Arias ◽  
Alberto Molina-Pérez ◽  
Ivar R. Hannikainen ◽  
Janet Delgado ◽  
Benjamin Söchtig ◽  
...  
Keyword(s):  
Organ Procurement ◽  
Policy Support ◽  
Sample Survey ◽  
General Tendency ◽  
Convenience Sample ◽  
Quantitative Survey ◽  
Ethical Implications ◽  
National Differences ◽  
Opt Out ◽  
Governance Quality

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data.

Self-Regulation of Driving Behavior Under the Influence of Cannabis: The Role of Driving Complexity and Driver Vision

2021 ◽  
pp. 001872082110477
Author(s):  
Sonia Ortiz-Peregrina ◽  
Oscar Oviedo-Trespalacios ◽  
Carolina Ortiz ◽  
Rosario G. Anera
Keyword(s):  
Contrast Sensitivity ◽  
Visual Function ◽  
Self Regulation ◽  
Lateral Position ◽  
Cannabis Use ◽  
Negative Effects ◽  
Lateral Control ◽  
Awareness Campaigns ◽  
Visual Status

Objective This study analyzed the self-regulation behaviors of drivers under the influence of cannabis and its relationship with road complexity and some driver traits, including visual deterioration. Background Cannabis is the illicit drug most often detected in drivers; its use results in significant negative effects in terms of visual function. Self-regulation behaviors involve the mechanisms used by drivers to maintain or reduce the risk resulting from different circumstances or the driving environment. Methods Thirty-one young, occasional cannabis users were assessed both in a baseline session and after smoking cannabis. We evaluated the visual function (visual acuity and contrast sensitivity) and driver self-regulation variables of both longitudinal and lateral control as the speed adaptation and standard deviation of lateral position (SDLP). Results Visual function was significantly impaired after cannabis use. Recreational cannabis use did not result in self-regulation, although some road features such as curved roads did determine self-regulation. Male participants adopted mean faster driving speeds with respect to the speed limit. Driver age also determined better lateral control with lower SDLPs. In addition, visual impairment resulting from cannabis use (contrast sensitivity) was linked with self-regulation by changes in longitudinal and lateral control. Conclusion Contrast sensitivity could be a good indicator of individual visual status to help determine how drivers self-regulate their driving both in normal conditions and while under the influence of cannabis. Application The findings provide new insights about driver self-regulation under cannabis effects and are useful for policy making and awareness campaigns.

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