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Sleep is an incredibly important contributor to maintaining physical and psychological health; positive body image may be difficult to achieve if you are sleep-deprived.
Substance use – from drinking alcohol to vaping – may seem fairly common, but can be incredibly detrimental to your health. Being body positive includes treating your body well and not using substances.
Our bodies change with age; this is completely normal even if it is sometimes very uncomfortable.
Many of us will experience health concerns and even chronic health conditions as we age. This makes it extra important to take good care of our bodies and approach them with acceptance.
Research regarding quitting cannabis use often excludes patients with severe mental illness (SMI). We investigated facilitating and impeding factors in SMI patients and their advice to others, using semi-structured interviews with 12 SMI-patients, who were daily cannabis users for ≥12 months and had fully stopped using for ≥6 months.
Results
Seeking distraction, social contacts in personal environment, avoiding temptation and support from professionals were facilitating factors in stopping. Impeding factors were withdrawal symptoms, user environment, experiencing stress and user's routine. Advice to other patients included to just do it, seek support from others, quit ‘cold turkey’ and acknowledge that cannabis use is a problem. Advice to mental health professionals is to discuss cannabis use from the start of treatment.
Clinical implications
It is important to inform patients that cannabis use has negative consequences and limits the effects of treatment. Do not judge cannabis use or force the patient to stop.
Edited by
Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine,David Castle, University of Tasmania, Australia,Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Rising rates of cannabis use during pregnancy and potential negative impacts on offspring health has generated concern. A small and equivocal, but rapidly developing, literature suggests that frequent and heavy pre-natal cannabis exposure (PCE) is associated with adverse neonatal outcomes (e.g., reduced birthweight and gestational age at birth) and may be associated with child psychopathology risk (e.g., externalizing behaviour and psychosis proneness, with less evidence linking PCE to internalizing problems and cognition). Non-human animal models suggest that PCE may causally influence these outcomes; however, in humans it remains unclear whether associations are independent of confounds (e.g., genetic and environmental liability). Mixed findings may be explained on the basis of small samples, limited phenotyping, stigma, confounds, and minimal consideration of timing and frequency of exposure. In particular, given that the central endocannabinoid type 1 receptor to which cannabis constituents bind are not known to be expressed in the foetus until the second half of the first trimester, it is possible that a lack of consideration of timing of exposure may explain null associations in some studies. Collectively, data highlight concerns that PCE is associated with adverse outcomes and suggest that cannabis use during pregnancy should be discouraged while more research is conducted.
Edited by
Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine,David Castle, University of Tasmania, Australia,Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Cannabis and cannabinoids are widely used, both as recreational substances with potential for addiction, and as treatments for a number of disorders. A large body of literature has investigated the harmful and/or beneficial effects of cannabis and/or cannabinoids employing observational and interventional methodologies. These individual studies have been pooled in many meta-analyses. Further, Mendelian Randomization (MR) studies have reported on a causal association between cannabis use and certain outcomes. This chapter reviews existing meta-analyses that pooled observational and interventional studies, and MR studies reporting on health outcomes after exposure to cannabis and/or cannabinoids in the general population, and selected clinical populations. We show that evidence from observational, interventional, and MR studies point towards an association between cannabis and psychosis. Several additional detrimental effects of cannabis emerged, including other psychiatric symptoms, cognitive impairment, and risk of motor vehicle accident (MVA). In terms of therapeutic benefits, cannabidiol seems to be effective for certain types of epilepsy, notably in children. Also, cannabis-based medicines can be effective in improving muscle spasticity in multiple sclerosis, ameliorating chronic pain syndromes, and reducing nausea/vomiting in palliative care settings. Risk–benefit ratios should be discussed with individual patients.
Edited by
Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine,David Castle, University of Tasmania, Australia,Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Cannabis is among the most widely-used substances worldwide. Because cannabis use can incur some harms to health, understanding the prevalence of cannabis use and cannabis use disorder in the general population and how this has changed over time is an important public health priority. The prevalence of cannabis use varies widely across countries, demographic characteristics, and time. However, prevalence is consistently highest among young adults. Rates are generally higher in males, although this may be changing in younger US cohorts. Across regions, prevalence rates of past-year cannabis use were lowest in Asian countries and some countries in Central and South America, and intermediate in Australia, New Zealand, and many European countries. Highest prevalences and greatest increases over time were found in adult participants in recent surveys in North America, including the United States and Canada, where public perception of risk in cannabis use is decreasing. Cannabis use disorder is defined by the same criteria that are used to define other substance use disorders. The risk of cannabis use disorder among adult cannabis users is now much higher than it was in the early 1990s, ranging from 20–33% of users, depending on their frequency of use.
The U.S. population is aging and increasing numbers of older adults are using cannabis. Cognitive decline is common in older age and subjective memory complaints (SMC) have been associated with increased risk for dementia. While residual cognitive effects of cannabis use at younger ages are well understood, the links between cannabis use and cognition in older adults is less clear. The present study represents the first population-level analysis of cannabis use and SMC in older adults in the U.S.
Method:
We used the National Survey of Drug Use and Health (NSDUH) dataset to evaluate SMC in respondents over age 50 (N = 26,399) according to past-year cannabis use.
Results:
Results revealed that 13.2% (95%CI: 11.5%−15.0%) of those who reported cannabis use also reported SMC, compared to 6.4% (95%CI: 6.1%–6.8%) among individuals with no cannabis use. Logistic regression revealed a two-fold increase (OR = 2.21, 95%CI: 1.88–2.60) of reporting SMC in respondents who had used cannabis in the past year, which was attenuated (OR = 1.38, 95%CI: 1.10–1.72) when controlling for additional factors. Other covariates, including physical health conditions, misuse of other substances, and mental illness also significantly contributed to SMC outcomes.
Conclusions:
Cannabis use represents a modifiable lifestyle factor that has potential for both risk and protective properties that may impact the trajectory of cognitive decline in older age. These hypothesis generating results are important for characterizing and contextualizing population-level trends related to cannabis use and SMC in older adults.
This study examined cannabis use motives in individuals with anxiety disorders and compared motives between infrequent and frequent cannabis users. It was hypothesised that coping motives would be endorsed at a significantly higher rate than other motives, and that frequent cannabis users would endorse coping motives significantly more than infrequent users. Participants were 144 adults seeking clinical services for anxiety disorders who reported using cannabis. Cannabis use was categorized by infrequent (n = 54) and frequent (n = 90) use. Anxiety symptoms were assessed and deemed clinically significant. Participants completed measures of cannabis use motives, cannabis use patterns, and cannabis use disorder symptoms, cross-sectionally. Cannabis use motives were examined for the entire sample and compared between frequent and infrequent users. In general, cannabis users endorsed coping (i.e., use for managing distress) and enhancement (i.e., use for fun, pleasant feeling, or the high) motives at equal rates (p = .265) and more than other motives (p < .001). Frequent users reported using cannabis for coping and expansion motives (i.e., use to change one's thinking) significantly more than infrequent users. These results indicate that individuals with anxiety disorders use cannabis for various reasons, some of which may not be directly related to their mental health symptoms. Future research is needed to compare motives for cannabis use in those with anxiety disorders, other mental health populations, and the general population, as well as examine motives for cannabis use within specific anxiety disorders.
Recent reports suggest that Delta-8 THC use has surged during the past year. Although Delta-8 THC is believed to have relatively low psychoactive potency, its effects are not well characterized and the associated individual and public health risks are unknown.
Objectives
Identify patterns of Delta-8 THC use among US adult cannabis users and examine associations with sociodemographic characteristics and cannabis use-related variables.
Methods
We surveyed 4,349 US adult cannabis users recruited via online advertisements. We calculated frequencies of sociodemographic characteristics in past 30-day Delta-8 THC users. Odds ratios were used to indicate associations between sociodemographic characteristics and past 30-day Delta-8 THC use.
Results
Respondents aged 45–64 years were significantly more likely than other age groups to have used Delta-8 THC during the past 30 days (odds ratio=1.48, 95% CI 1.04, 2.11). Fifty-eight percent of the sample had heard of Delta-8 THC, 66.8% of which had first heard of it during the last year and 37.1% first heard of it via social media. The most common methods of consumption were vaping concentrates and edibles. We identified motivations for use of Delta-8 THC that potentially indicate a preference for legal options and/or a perception that Delta-8 THC has medical benefits.
Conclusions
This study provides a snapshot of patterns of Delta-8 THC use among US adult cannabis users. Further investigation of the perceived medical benefits of Delta-8 THC, the role of social media in promoting its use, and the effectiveness of restrictions on Delta-8 THC products would provide further information to guide public health policy regarding Delta-8 THC.
Cannabinoids are commonly perceived by the public as safe and effective for improving mental health, despite limited evidence to support their use. We discuss reasons why cannabinoids may be particularly compelling for our patients and provide strategies for how psychiatrists can counsel and educate patients on the evidence regarding cannabinoids.
This study seeks to determine the prevalence and nature of cannabis use in patients with headache in a tertiary headache clinic and to explore patients’ empiric experience in using cannabinoids therapeutically.
Background:
Many patients with headache report cannabinoid use as an effective abortive and/or preventive therapy. Mounting evidence implicates cannabinoids in pain mechanisms pertaining to migraine and other headache types.
Methods:
A cross-sectional study surveyed 200 patients presenting with any headache disorder to a tertiary headache clinic in Calgary, Alberta. Descriptive analyses were applied to capture information about headache diagnoses and the frequency, doses and methods of cannabinoid delivery employed, as well as patients’ perceptions of therapeutic benefit and selected negative side effects.
Results:
Active cannabinoid users comprised 34.0% of respondents. Approximately 40% of respondents using cannabinoids engaged in very frequent use (≥300 days/year). Of cannabinoid modalities, liquid concentrates were most popular (39.2%), followed by smoked cannabis (33.3%). Patients endorsed cannabinoid use for both prevention and acute therapy of headaches, often concurrently. Sixty percent of respondents felt cannabinoids reduced headache severity, while 29.2% perceived efficacy in aborting headaches. Nearly 5% of respondents volunteered that they had encountered a serious problem such as an argument, fight, accident, or work issue as a result of their cannabis use. Approximately 35.4% of users had attempted to reduce their use.
Conclusion:
This survey shows that over one-third of patients with headache disorders in a tertiary headache clinic use cannabis as a treatment for their headaches. Of these, about 25% and 60% perceive improvements in headache frequency and severity, respectively. The results of this survey will aid neurologists and headache specialists in understanding the landscape of cannabinoid use in a more severely affected population and inform future-controlled studies of cannabinoids in headache patients.
Mailer’s philosophy of the Hipster is one of his most provocative: Outlined most clearly in “The White Negro,” “Reflections on Hip,” and “Hip, Hell, and the Navigator,” his figuration of the Hipster is an existentialist rebel, an “urban frontiersman” who lives in “the undercurrents and underworlds of American life” amongst “the defeated, the isolated, the violent, the tortured, and the warped.” Mailer’s characterization of the Hipster is the foundation for more than one of his later characters, and is reflective of his place on the periphery of countercultural groups like the Beats.
This chapter provides a brief overview of notable Mailer scholarship, addressing The Mailer Review and the digital hub Project Mailer, as well as the recent authorized biography of Mailer and the publication of his selected letters. The chapter focuses primarily on Lipton’s Journal, Mailer’s personal journal from the 1950s, arguing that this is a key to unlocking many aspects of Mailer’s work, and that it is the way forward in Mailer Studies this century.
Sleep disorders are a substantial public health issue with serious consequences on patients’ quality of life. Cannabis has been recently suggested as a potential treatment for patients with sleep disorders; however, research on the relationship between cannabis and sleep is still in its infancy.
Objectives
The aim of this investigation was to assess whether cannabis use was associated with improved sleep quality.
Methods
Our study comprised 173 participants, 42 cannabis users and 131 non-cannabis users, who completed the Pittsburgh Sleep Quality Index (PSQI), the most common self-reported measure of sleep quality. The scale provides a global PSQI score and seven component domain scores, including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime functions.
Results
Cannabis users self-reported statistically significantly healthier scores than non-cannabis users in the global PSQI as well as the specific domains of subjective sleep quality, sleep latency, as well as sleep disturbances.
Conclusions
This preliminary evidence points to the possibility that cannabis could provide effective treatment for patients with sleep disorders. Research into the constituents of cannabis that may have a differential impact on sleep and sleep disorders is warranted.
Marijuana is widely used among people, recreationally and medically. However, recent studies have shown that Marijuana has negative effects on brain structures and functions.
Objectives
To discuss the effects of Marijuana use on brain development in adolescence.
Methods
The method that is used in this study is literature review, through analyzing and summarizing the data that were collected from PubMed, epidemiology articles from BNN and CDC, and other online journals to understand the effects of Marijuana on the brain development in adolescence. There were 25499 articles that were filtered and screened resulting in 10 articles that were used as data of this literature review.
Results
Marijuana effects on the brain are divided into structural changes and functional changes. Structural changes are seen in the brain hemispheres, amygdala, hippocampus, and nucleus accumbens. While functional changes are seen in behavioral and cognitive changes in everyday life and even psychotic disorders.
Conclusions
Marijuana use has shown negative effects on the human body, organs that are rich in cannabinoid receptors, especially the Brain. Therefore, Marijuana use among adolescents may disrupt their developing brain, and cause adolescents to have structural and functional changes in the brain.
Adolescence into young adulthood represents a sensitive period in which brain development significantly diverges by sex. Regular cannabis use by young people is associated with neuropsychological vulnerabilities, but the potential impact of sex on these relationships is unclear.
Method:
In a cross-sectional study, we examined sex differences in multi-domain neuropsychological functioning using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and tested whether sex moderated the relationship between cognitive performance and age of initiation, frequency of cannabis use, amount of cannabis use, and withdrawal symptoms in at least weekly adolescent and young adult cannabis users (n = 171; aged 13–25 years; 46.2% female).
Results:
Male cannabis users had poorer visual recognition memory and female cannabis users showed worse attention and executive functions, with medium to large effect sizes. These sex effects persisted, when controlling for age, IQ, amount of alcohol and nicotine use, mood and anxiety symptoms, emotional stability and impulsive behavior. Earlier age of initiated use and more use were associated with worse attentional functions in females, but not males. More use was more strongly associated with worse episodic memory in males than in females. More use was associated with poorer learning in males only.
Conclusions:
Domain-specific patterns of neuropsychological performance were found by sex, such that males showed poorer visual memory and females showed worse performance on measures of attention (sustained visual, multitasking) and executive functioning (spatial planning/working memory subdomains). Larger studies including healthy controls are needed to determine if the observed sex differences are more exaggerated relative to non-users.
Recent cannabis exposure has been associated with lower rates of neurocognitive impairment in people with HIV (PWH). Cannabis’s anti-inflammatory properties may underlie this relationship by reducing chronic neuroinflammation in PWH. This study examined relations between cannabis use and inflammatory biomarkers in cerebrospinal fluid (CSF) and plasma, and cognitive correlates of these biomarkers within a community-based sample of PWH.
Methods:
263 individuals were categorized into four groups: HIV− non-cannabis users (n = 65), HIV+ non-cannabis users (n = 105), HIV+ moderate cannabis users (n = 62), and HIV+ daily cannabis users (n = 31). Differences in pro-inflammatory biomarkers (IL-6, MCP-1/CCL2, IP-10/CXCL10, sCD14, sTNFR-II, TNF-α) by study group were determined by Kruskal–Wallis tests. Multivariable linear regressions examined relationships between biomarkers and seven cognitive domains, adjusting for age, sex/gender, race, education, and current CD4 count.
Results:
HIV+ daily cannabis users showed lower MCP-1 and IP-10 levels in CSF compared to HIV+ non-cannabis users (p = .015; p = .039) and were similar to HIV− non-cannabis users. Plasma biomarkers showed no differences by cannabis use. Among PWH, lower CSF MCP-1 and lower CSF IP-10 were associated with better learning performance (all ps < .05).
Conclusions:
Current daily cannabis use was associated with lower levels of pro-inflammatory chemokines implicated in HIV pathogenesis and these chemokines were linked to the cognitive domain of learning which is commonly impaired in PWH. Cannabinoid-related reductions of MCP-1 and IP-10, if confirmed, suggest a role for medicinal cannabis in the mitigation of persistent inflammation and cognitive impacts of HIV.
The variability of findings in studies examining the effects of chronic cannabis use on neuropsychological functioning highlights the importance of examining contributing factors. Few studies examine the role of sex in the relationship between cannabis and neuropsychological functioning, despite known neurobiological structural differences between males and females. This study examined whether males and females experience differential cognitive effects of chronic cannabis use.
Method:
Chronic cannabis users (3+ days per week for >12 months, n = 110, 72% male) and non-users (n = 71, 39% male) completed a neuropsychological test battery. Two multivariate analyses of covariance (MANCOVAs) examined for sex differences in performance within users and non-users on neuropsychological tests, controlling for potential confounding variables. Bonferroni corrections were applied to adjust for multiple comparisons.
Results:
Male and female cannabis users did not differ in cannabis use variables. Female cannabis users performed better than males on multiple subtests of the California Verbal Learning Test-II (CVLT-II), a verbal learning and memory test. Male cannabis users performed better than female users on Trial 1 of the CVLT-II (p = .002), and Trail Making Test B (p = .001), which measure attention and cognitive flexibility, respectively. Non-user males and females performed comparably, with the exception of Trail Making Test B (p = .001).
Conclusions:
Results suggest that chronic cannabis use differentially impacts males and females, with females exhibiting better verbal learning and memory despite males demonstrating better attention and cognitive flexibility. Further research is needed to understand the potential protective mechanism of female sex on learning and memory effects of cannabis use.
To evaluate the associations between cannabis use and neurocognitive functioning, including self-reported attention deficit hyperactivity disorder (ADHD) symptoms, in a large sample of emerging adults (ages 21–25) using a cross-sectional design. A secondary objective was to examine age of cannabis initiation as a moderator.
Methods:
Participants were high-risk drinking emerging adults (n = 598) reporting past-month cannabis use in the following categories: 1) non-users (i.e., never or not in the past month; n = 276), 2) occasional users (i.e., monthly or weekly users; n = 201), and 3) daily users (n = 121). Categorical comparisons were conducted on working memory, attention, behavioral inhibition, delay and probability discounting, verbal intelligence, and ADHD symptoms. Complementary dimensional analyses examined cannabis severity in relation to neurocognition using regressions. Covariates were age, race, sex, income, years of education, tobacco use, and alcohol use.
Results:
Frequency of cannabis use was significantly associated with poorer working memory performance, more impulsive delay discounting, and greater endorsement of ADHD symptoms, but not other domains. Effect sizes were small and poorer performance was selectively present among daily, not occasional, cannabis users. Earlier age of initiation was not independently or interactively associated with neurocognitive performance.
Conclusions:
Daily cannabis use was selectively adversely associated with aspects of memory, impulsivity, and subjective attentional functioning, but most cognitive indicators were not implicated, and evidence of amplification by earlier age of initiation was not observed. Ascertaining causal versus consequential roles of cannabis in neurocognitive functioning is an important priority.
Cannabis consumption is a modifiable risk factor associated with psychosis, but not all cannabis users develop psychosis. Animal studies suggest that an antecedent active immune system interacts with subsequent cannabis exposure and moderates the cannabis–psychosis association, supporting the two-hit hypothesis. The clinical investigations are few, and it is unclear if the immune system is a biological candidate moderating the cannabis–psychosis association or whether cannabis increases inflammation, which in turn, augments psychosis likelihood.
Methods
We explored the mediating and moderating role of blood inflammation using PROCESS macro. We used data from a cross-sectional study, including 153 first-episode psychosis patients and 256 community-based controls. Participants answered the Cannabis Experience Questionnaire (cannabis frequency, age of onset, and duration), and plasma cytokines were measured [interleukin (IL)-1β, IL-6, IL-4, IL-10, tumour necrosis factor-α (TNF-α), interferon-γ (IFN-γ), transforming growth factor-β (TGF-β); multiplex]. We computed an inflammatory composite score (ICS) to represent the systemic inflammatory state. Confounders included sex, age, ethnicity, educational level, body mass index, tobacco smoking, lifetime use of other drugs, and antipsychotic treatment.
Results
Mediation: Cannabis consumption was not associated with increased inflammation, thus not supporting a mediating effect of inflammation. Moderation: Daily use and age of onset <17 interacted significantly with the ICS to increase the odds of psychosis beyond their individual effects and were only associated with psychosis among those scoring medium–high in the ICS.
Conclusions
Immune dysregulation might be part of the pathophysiology of psychosis, not explained by cannabis use or other confounders. We provide the first and initial evidence that immune dysregulation modifies the cannabis–psychosis association, in line with a two-hit hypothesis.
Despite public sentiment to the contrary, recreational marijuana use is deleterious to adolescent health and development. Prospective studies of marijuana use trajectories and their predictors are needed to differentiate risk profiles and inform intervention strategies. Using data on 15,960 participants in the National Longitudinal Study of Adolescent to Adult Health, variable-centered approaches were used to examine the impact of childhood polyvictimization on marijuana onset, marijuana use from age 15 to 24 years, and marijuana dependence symptoms. Zero-Inflated Poisson latent class growth analysis (ZIP-LCGA) was used to identify marijuana use subgroups, and their associations with childhood polyvictimization were tested via multinomial logit regression within ZIP-LCGA. Results showed that the overall probability and frequency of marijuana use increased throughout adolescence, peaked in early adulthood, and diminished gradually thereafter. Polyvictimization was associated with earlier onset and greater overall use, frequency of use, and dependence symptoms. ZIP-LCGA uncovered four subgroups, including non-users and three classes of users: adolescence-limited users, escalators, and chronic users. Polyvictimization distinguished non-users from all classes of marijuana users. The findings underscore the lasting developmental implications of significant childhood trauma. Children who experience polyvictimization represent a group that may benefit from selective interventions aimed at preventing early, frequent, chronic, and dependent marijuana use.