Cannabis and COVID-19: Reasons for Concern

The lockdown measures implemented to curb the spread of SARS-CoV-2 may affect (illicit) drug consumption patterns. This rapid response study investigated changes in cannabis use in a non-probability sample of cannabis users in the Netherlands during the early lockdown period. We fielded an online cross-sectional survey 4–6 weeks after implementation of lockdown measures in the Netherlands on March 15, 2020. We measured self-reported \motives for changes in use, and assessed cannabis use frequency (use days), number of joints per typical use day, and route of administration in the periods before and after lockdown implementation. 1,563 cannabis users were recruited. Mean age was 32.7 ± 12.0 years; 66.3% were male and 67.9% used cannabis (almost) daily. In total, 41.3% of all respondents indicated that they had increased their cannabis use since the lockdown measures, 49.4% used as often as before, 6.6% used less often, and 2.8% stopped (temporarily). One-third of those who were not daily users before the lockdown became (almost) daily users. Before the lockdown, most respondents (91.4%) used cannabis in a joint mixed with tobacco and 87.6% still did so. Among users of joints, 39.4% reported an increase in the average number consumed per use day; 54.2% stayed the same and 6.4% used fewer joints. This rapid response study found evidence that during the lockdown more users increased rather than decreased cannabis consumption according to both frequency and quantity. These data highlight the need to invest more resources in supporting cessation, harm reduction, and monitoring longer term trends in cannabis use.

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Drug Checking and Its Potential Impact on Substance Use

European Addiction Research ◽

10.1159/000507049 ◽

2020 ◽

Vol 27 (1) ◽

pp. 25-32

Author(s):

Felix Betzler ◽

Jonas Helbig ◽

Leonard Viohl ◽

Felicitas Ernst ◽

Lukas Roediger ◽

...

Keyword(s):

Substance Use ◽

Harm Reduction ◽

Illicit Drug ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Consumption Behavior ◽

Drug Checking ◽

The Usa ◽

Potential Impact

Objectives: Drug checking as a tool for harm reduction is offered in certain cities throughout Europe, the USA, and Australia, but in general, it is internationally still scarcely available and controversially discussed. This study aimed at investigating the potential impact of a drug-checking offer on Berlin nightlife attendees’ illicit drug use and at identifying the encouraging and discouraging factors for using or refraining from such an offer. Methods: Using an online questionnaire, we conducted a cross-sectional survey in a Berlin party scene. A total of 719 people participated in the survey that took part in 2019. Results: The vast majority of participants (92%) stated that they would use drug checking, if existent. If the test revealed the sample to contain a high amount of active ingredient, 91% indicated to take less of the substance than usual. Two-thirds (66%) would discharge the sample if it contained an unexpected/unwanted agent along with the intended substance. If the sample contained only unexpected/unwanted substances and not the intended substance at all, 93% stated to discharge the sample. Additional brief counseling was stated to be useful. Participants showed a comparatively high substance use. Conclusions: Drug checking as a harm reduction tool was highly accepted in the scene, and the majority of participants stated to align their consumption behavior accordingly, in a reasonable manner. A concomitant consultation would be appreciated, which may be used to direct educational information about harms and risks to users.

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Patterns and Correlates of Cannabis Use among Individuals with HIV/AIDS in Maritime Canada

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2014/301713 ◽

2014 ◽

Vol 25 (1) ◽

pp. e1-e7 ◽

Cited By ~ 23

Author(s):

Gregory E Harris ◽

Lise Dupuis ◽

Gerald J Mugford ◽

Lynn Johnston ◽

David Haase ◽

...

Keyword(s):

Income Level ◽

Cannabis Use ◽

Driving Under The Influence ◽

Long Term Effects ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Cannabis Consumption ◽

Medicinal Cannabis ◽

Maritime Canada ◽

Almost All

BACKGROUND: The prevalence of cannabis use in HIV-infected individuals is high and its long-term effects are unclear.METHODS: The prevalence, perceived benefits and consequences, and predictors of cannabis use were studied using a cross-sectional survey in two immunodeficiency clinics in Maritime Canada.RESULTS: Current cannabis use was identified in 38.5% (87 of 226) of participants. Almost all cannabis users (85 of 87 [97.7%]) acknowledged its use for recreational purposes, with 21.8% (19 of 87) reporting medicinal cannabis use. The majority of patients enrolled in the present study reported mild or no symptoms related to HIV (n=179). Overall, 80.5% (70 of 87) of the cannabis-using participants reported a symptom-relieving benefit, mostly for relief of stress, anorexia or pain. Participants consumed a mean (± SD) of 18.3±21.1 g of cannabis per month and spent an average of $105.15±109.87 on cannabis per month. Cannabis use was associated with rural residence, lower income level, driving under the influence of a substance, and consumption of ecstasy and tobacco. Income level, ecstasy use and tobacco use were retained as significant predictors in regression modelling. Cannabis use was not associated with adverse psychological outcomes.DISCUSSION: Prolonged previous cannabis consumption and the substantial overlap between recreational and medicinal cannabis use highlight the challenges in obtaining a tenable definition of medicinal cannabis therapy.

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Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey

The Lancet ◽

10.1016/s0140-6736(12)61034-4 ◽

2012 ◽

Vol 380 (9845) ◽

pp. 908-915 ◽

Cited By ~ 159

Author(s):

Bregje D Onwuteaka-Philipsen ◽

Arianne Brinkman-Stoppelenburg ◽

Corine Penning ◽

Gwen JF de Jong-Krul ◽

Johannes JM van Delden ◽

...

Keyword(s):

The Netherlands ◽

End Of Life ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Before And After

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Faculty Opinions recommendation of Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717957653.793462053 ◽

2012 ◽

Author(s):

Tom Woodcock

Keyword(s):

The Netherlands ◽

End Of Life ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Before And After

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‘Code‐95’ rapid response calls for patients under airborne precautions in the COVID‐19 ‐era: a cross‐sectional survey of healthcare worker perceptions

Internal Medicine Journal ◽

10.1111/imj.15145 ◽

2021 ◽

Vol 51 (4) ◽

pp. 494-505

Author(s):

Ashwin Subramaniam ◽

Alexandr Zuberav ◽

Robert Wengritzky ◽

Christopher Bowden ◽

Ravindranath Tiruvoipati ◽

...

Keyword(s):

Healthcare Worker ◽

Rapid Response ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Worker Perceptions

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Hidden bedside rationing in the Netherlands: a cross-sectional survey among physicians in internal medicine

BMC Health Services Research ◽

10.1186/s12913-021-06229-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ursula W. de Ruijter ◽

Hester F. Lingsma ◽

Willem A. Bax ◽

Johan Legemaate

Keyword(s):

Internal Medicine ◽

The Netherlands ◽

Patient Choice ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Physician Characteristics ◽

Distribution Of Resources ◽

Healthcare Rationing ◽

Do So

Abstract Background Healthcare rationing can be defined as withholding beneficial care for cost reasons. One form in particular, hidden bedside rationing, is problematic because it may result in conflicting loyalties for physicians, unfair inequality among patients and illegitimate distribution of resources. Our aim is to establish whether bedside rationing occurs in the Netherlands, whether it qualifies as hidden and what physician characteristics are associated with its practice. Methods Cross-sectional online questionnaire on knowledge of -, experience with -, and opinion on rationing among physicians in internal medicine within the Dutch healthcare system. Multivariable ordinal logistic regression was used to explore relations between hidden bedside rationing and physician characteristics. Results The survey was distributed among 1139 physicians across 11 hospitals with a response rate of 18% (n = 203). Most participants (n = 129; 64%) had experience prescribing a cheaper course of treatment while a more effective but more expensive alternative was available, suggesting bedside rationing. Subsequently, 32 (24%) participants never disclosed this decision to their patient, qualifying it as hidden. The majority of participants (n = 153; 75%) rarely discussed treatment cost. Employment at an academic hospital was independently associated with more bedside rationing (OR = 17 95%CI 6.1–48). Furthermore, residents were more likely to disclose rationing to their patients than internists (OR = 3.2, 95%CI 2.1–4.7), while salaried physicians were less likely to do so than physicians in private practice (OR = 0.5, 95%CI 0.4–0.8). Conclusion Hidden bedside rationing occurs in the Netherlands: patient choice is on occasion limited with costs as rationale and this is not always disclosed. To what extent distribution of healthcare should include bedside rationing in the Netherlands, or any other country, remains up for debate.

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Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211018655 ◽

2021 ◽

pp. 104990912110186

Author(s):

James Alton Croker ◽

Julie Bobitt ◽

Sara Sanders ◽

Kanika Arora ◽

Keith Mueller ◽

...

Keyword(s):

Palliative Care ◽

End Of Life ◽

Fast Track ◽

Hospice Care ◽

Cannabis Use ◽

Care Plan ◽

Medical Cannabis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

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Satisfaction of Postoperative Patients on Pain Management Program its Relationship to the Knowledge and Attitudes of Chinese Nurses: A Cross-Sectional Survey

Tobacco Regulatory Science ◽

10.18001/trs.7.6.134 ◽

2021 ◽

Vol 7 (6) ◽

pp. 6609-6626

Author(s):

Shuyuan Li

Keyword(s):

Pain Management ◽

Optimal Level ◽

Management Program ◽

Chinese Patients ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Pain Management Program ◽

Before And After ◽

Knowledge And Attitude

This study is a cross-sectional survey of the satisfaction of postoperative patients its relationship to the knowledge and attitudes of Chinese nurses on pain management. Data were sourced out from two groups of respondents participated in the study, 75 post-operative patients and 97 in-service nurses from the health institutions China. The study was conducted for five-months. Ethics protocols were observed before and after the conduct of the study. Findings showed that post-operative pain management program among the participating medical institutions in China were assessed to have moderate level of satiation by the patients. All the components namely pain relief experience, care provided by the nurses, education provided as to pain management, and therapeutic dialogue provided by the nurses were all assessed by postoperative Chinese patients at a fair level. Meanwhile, gender and education of post-operative patients can be considered as factors in the planning and implementation of pain management program. Consequently, similar to studies conducted worldwide, Chinese nurses do not establish yet an optimal level of knowledge and attitude towards pain management. Meanwhile age, experience, education are factors on the knowledge and attitude on pain management among nurses. Finally, positive moderate relationship is established between patient satisfaction and knowledge and attitudes of nursing staff towards pain management. The findings of these study call for action and reform in the implementation of pain management program focusing on the major role and development of 21st century nurses. Practical implications of the study are discussed.

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Influencing factors associated with facial skin problems due to wearing masks during COVID-19 in China (Preprint)

10.2196/preprints.30254 ◽

2021 ◽

Author(s):

Shigui Yang ◽

Chenyang Huang ◽

Qingmiao Sun ◽

Daixi JIang ◽

Xiaobao Zhang ◽

...

Keyword(s):

Sleep Time ◽

Facial Skin ◽

Skin Damage ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Before And After ◽

History Of ◽

Potential Factors ◽

Functional Pathway

BACKGROUND Background: Wearing a mask is one of the most effective measures to prevent COVID-19 virus infection and it is not yet clear what potential factors may be associated with facial skin problems while wearing masks. OBJECTIVE Objective: seek most suitable mask-wearing habits for public to avoid facial skin problem. METHODS Method: A cross-sectional survey was conducted through online and offline questionnaires on patterns of mask wearing and facial skin problems during COVID-19 from May 30-July 1, 2020. Multivariable regression was used to explore the potential factors associated with skin problems. We also recruited 19 subjects and compared the differences in their facial microbiomes before and after wearing masks. RESULTS Results: A total of 4385 valid questionnaires were finally analyzed and 1323 (33.1%) participants reported having facial skin problems while wearing masks. The risk factors associated with skin problems were having a history of facial skin problems (OR: 3.25, 95% CI: 2.80-3.76), facial skin allergies (OR: 1.37, 95% CI: 1.20-1.56), face washing frequency (≥3 times per day) (OR: 1.61, 95% CI: 1.07-2.43), daily sleep time <6 hours (OR: 2.38, 95% CI: 1.81-3.13), and average time spent wearing masks uninterruptedly ≥6 hours (OR: 1.67, 95% CI: 1.24-2.25). The analysis of the facial microbiome revealed that the abundance of Prevotella and Hemophilus decreased, and the functional pathway associated with cytochrome c was more predominant with the prolongation of wearing time. CONCLUSIONS Conclusion: The habit of wearing a mask and life behavior affect the occurrence of skin damage. Suitable mask types and mask-wearing habits should be recommended to avoid facial skin problems. CLINICALTRIAL NA

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