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Marijuana use predicts cognitive impairment and white matter alterations
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
be presented from a population-based survey in California on the relationship of health status with attitudes toward and use of MM. Methods: The California Quality of Life Survey (2012–13) is a telephone follow-back survey of a subset of individuals (n = 2267) who had participated in a statewide probability survey. The followback survey obtained information on health conditions, attitudes, and behaviors. Analyses examined socio-demographic characteristics and health conditions associated with attitudes toward and use of MM in the past year. All estimates were weighted to account for survey design. Results: Overall, 27.4% of the sample disapproved of MM use and was higher among females; Asians and Hispanics; and individuals that were married/cohabitating, had lower education and SES, were foreign-born, heterosexual (vs. sexual minority), in fair/poor health, and had no illicit drug use in past year (all p < 0.05). Less disapproval of MM use was associated with having diabetes, chronic back problems, major depression, and alcohol or drug abuse/dependence (all p < 0.05). An estimated 5.2% reported that they had obtained MM in the past year. Past-year use of MM was associated with younger age, unmarried status, less than college degree, U.S. birth, and illicit use of drugs (all p < 0.05). Although there was no difference in their selfreported overall health status, MM users had higher rates of drug abuse/dependence, alcohol dependence, major depression, chronic pain, HIV/AIDS, and gynecological problems (all p < 0.05). Conclusions: Disapproval of MM was associated with poorer overall health status, but was less among individuals that had several health conditions commonly associated with MM use. Study findings may be used to inform policies related to MM use and interventions to reduce behavioral health problems among users. Financial support: NIDA grant R01DA020826. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.273 Hookah use among college students: Prevalence, mental health and drug use Alice Grinberg 1 , Carl L. Hart 2,3 , Jack Shapiro 4 , Diana Keith 3 , Farah Taha 1 , Michael P. McNeil 3 , Renee Goodwin 1,4 1 The Graduate Center (CUNY) at Queens College, Queens, NY, United States 2 New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY, United States 3 Columbia University, New York, NY, United States 4 Mailman School of Public Health, Columbia University, New York, NY, United States
Aims: Evidence indicates that hookah use is as, if not more harmful in terms of physical health consequences, than cigarette use. Yet, it seems that hookah users may underestimate the deleterious effects of hookah use, potentially due to the lack of regulation of this substance in the US. This study examines the prevalence, demographic characteristics, relation to other alcohol and substance use, and the mental health and stress levels associated with hookah use among undergraduates at a small, Northeastern university. Methods: Data were drawn from the American Health Association-National College Health Assessment (Spring 2009; N = 1799) at one large, northeastern university. Relationships between hookah use and other drug use, mental health problems, and stress levels were examined using logistic regression analyses. Results: 14.1% (253/1799) of undergraduates in this sample used hookah in the past month. Hookah users were more likely to be male, older, and participants of Greek life than non-hookah users. Hookah users were more likely to use other substances, including
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cigarettes, cannabis, alcohol, cocaine, and amphetamines, compared with those who had not used hookah. Of all the substances measured, alcohol and cigarette use were most strongly associated with hookah use. Hookah use was not significantly associated with increased mental health problem or higher stress levels. Conclusions: Hookah users are significantly more likely to use other substances, including alcohol, cigarettes, cannabis, cocaine, and amphetamines, compared with those who have not used hookah. This is similar to cigarette smoking, yet, unlike cigarette smoking, hookah use shows no link with mental health problems or stress. Policymakers should consider regulating hookah products and hookah lounges to demystify the perception that hookah smoking is safer and less addictive than cigarette smoking. Financial support: None. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.274 Marijuana use predicts cognitive impairment and white matter alterations Staci A. Gruber 1,2 , M. Dahlgren 1 , K. Sagar 1 , M. Dreman 1 , M. Racine 1 , A. Gonenc 1,2 , Scott E. Lukas 2,3 1 Imaging Center, McLean Hospital, Belmont, MA, United States 2 Department of Psychiatry, Harvard Medical School, Boston, MA, United States 3 Behavioral Psychopharmacology Research Lab, McLean Hospital, Belmont, MA, United States
Aims: As legalization of medical and recreational marijuana (MJ) continues to spread, topping headlines and ballots across the country, conversations about MJ often highlight potential benefits. Not surprisingly, national trends show the perception of risk and harm related to MJ is at an all-time low. This view persists despite investigations which highlight significant cognitive and neural alterations in MJ smokers. Given the rise in MJ use, specifically among youth, it is critical to determine if patterns of MJ use can predict impairments in cognitive functioning and white matter alterations. Methods: Regression analyses of 44 chronic, heavy MJ smokers revealed that more smoking episodes and higher grams of MJ used per week predicted worse performance on cognitive tasks, particularly those of executive function, including the Stroop Color Word Task and the Wisconsin Card Sorting Test (WCST). Results: Specifically, more smoking episodes and grams used per week predicted increased commission errors and lower percent accuracy on the Stroop, as well as increased losses of set on the WCST. Higher urinary cannabinoid level predicted fewer WCST categories and increased perseverative errors. Patterns of MJ use also predicted white matter alterations, with higher amounts and more frequent use of MJ predicting increased fractional anisotropy (FA), a measure of white matter coherence. Interestingly, once divided into early (MJ use prior to age 16) and late (MJ use after age 16) onset groups, results indicated the relationship between FA and MJ use was entirely attributed to the early onset group, suggesting a differential impact of MJ based on initiation of use. Conclusions: Findings suggest that early exposure to MJ may result in a potential failure to prune unnecessary connections during neuromaturation. These data have implications for more efficient treatment options, as strategies may be individualized based on age of onset and current patterns of MJ use. Financial support: NIDA 1 R01 DA032646-01. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.275
be presented from a population-based survey in California on the relationship of health status with attitudes toward and use of MM. Methods: The California Quality of Life Survey (2012–13) is a telephone follow-back survey of a subset of individuals (n = 2267) who had participated in a statewide probability survey. The followback survey obtained information on health conditions, attitudes, and behaviors. Analyses examined socio-demographic characteristics and health conditions associated with attitudes toward and use of MM in the past year. All estimates were weighted to account for survey design. Results: Overall, 27.4% of the sample disapproved of MM use and was higher among females; Asians and Hispanics; and individuals that were married/cohabitating, had lower education and SES, were foreign-born, heterosexual (vs. sexual minority), in fair/poor health, and had no illicit drug use in past year (all p < 0.05). Less disapproval of MM use was associated with having diabetes, chronic back problems, major depression, and alcohol or drug abuse/dependence (all p < 0.05). An estimated 5.2% reported that they had obtained MM in the past year. Past-year use of MM was associated with younger age, unmarried status, less than college degree, U.S. birth, and illicit use of drugs (all p < 0.05). Although there was no difference in their selfreported overall health status, MM users had higher rates of drug abuse/dependence, alcohol dependence, major depression, chronic pain, HIV/AIDS, and gynecological problems (all p < 0.05). Conclusions: Disapproval of MM was associated with poorer overall health status, but was less among individuals that had several health conditions commonly associated with MM use. Study findings may be used to inform policies related to MM use and interventions to reduce behavioral health problems among users. Financial support: NIDA grant R01DA020826. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.273 Hookah use among college students: Prevalence, mental health and drug use Alice Grinberg 1 , Carl L. Hart 2,3 , Jack Shapiro 4 , Diana Keith 3 , Farah Taha 1 , Michael P. McNeil 3 , Renee Goodwin 1,4 1 The Graduate Center (CUNY) at Queens College, Queens, NY, United States 2 New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY, United States 3 Columbia University, New York, NY, United States 4 Mailman School of Public Health, Columbia University, New York, NY, United States
Aims: Evidence indicates that hookah use is as, if not more harmful in terms of physical health consequences, than cigarette use. Yet, it seems that hookah users may underestimate the deleterious effects of hookah use, potentially due to the lack of regulation of this substance in the US. This study examines the prevalence, demographic characteristics, relation to other alcohol and substance use, and the mental health and stress levels associated with hookah use among undergraduates at a small, Northeastern university. Methods: Data were drawn from the American Health Association-National College Health Assessment (Spring 2009; N = 1799) at one large, northeastern university. Relationships between hookah use and other drug use, mental health problems, and stress levels were examined using logistic regression analyses. Results: 14.1% (253/1799) of undergraduates in this sample used hookah in the past month. Hookah users were more likely to be male, older, and participants of Greek life than non-hookah users. Hookah users were more likely to use other substances, including
e131
cigarettes, cannabis, alcohol, cocaine, and amphetamines, compared with those who had not used hookah. Of all the substances measured, alcohol and cigarette use were most strongly associated with hookah use. Hookah use was not significantly associated with increased mental health problem or higher stress levels. Conclusions: Hookah users are significantly more likely to use other substances, including alcohol, cigarettes, cannabis, cocaine, and amphetamines, compared with those who have not used hookah. This is similar to cigarette smoking, yet, unlike cigarette smoking, hookah use shows no link with mental health problems or stress. Policymakers should consider regulating hookah products and hookah lounges to demystify the perception that hookah smoking is safer and less addictive than cigarette smoking. Financial support: None. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.274 Marijuana use predicts cognitive impairment and white matter alterations Staci A. Gruber 1,2 , M. Dahlgren 1 , K. Sagar 1 , M. Dreman 1 , M. Racine 1 , A. Gonenc 1,2 , Scott E. Lukas 2,3 1 Imaging Center, McLean Hospital, Belmont, MA, United States 2 Department of Psychiatry, Harvard Medical School, Boston, MA, United States 3 Behavioral Psychopharmacology Research Lab, McLean Hospital, Belmont, MA, United States
Aims: As legalization of medical and recreational marijuana (MJ) continues to spread, topping headlines and ballots across the country, conversations about MJ often highlight potential benefits. Not surprisingly, national trends show the perception of risk and harm related to MJ is at an all-time low. This view persists despite investigations which highlight significant cognitive and neural alterations in MJ smokers. Given the rise in MJ use, specifically among youth, it is critical to determine if patterns of MJ use can predict impairments in cognitive functioning and white matter alterations. Methods: Regression analyses of 44 chronic, heavy MJ smokers revealed that more smoking episodes and higher grams of MJ used per week predicted worse performance on cognitive tasks, particularly those of executive function, including the Stroop Color Word Task and the Wisconsin Card Sorting Test (WCST). Results: Specifically, more smoking episodes and grams used per week predicted increased commission errors and lower percent accuracy on the Stroop, as well as increased losses of set on the WCST. Higher urinary cannabinoid level predicted fewer WCST categories and increased perseverative errors. Patterns of MJ use also predicted white matter alterations, with higher amounts and more frequent use of MJ predicting increased fractional anisotropy (FA), a measure of white matter coherence. Interestingly, once divided into early (MJ use prior to age 16) and late (MJ use after age 16) onset groups, results indicated the relationship between FA and MJ use was entirely attributed to the early onset group, suggesting a differential impact of MJ based on initiation of use. Conclusions: Findings suggest that early exposure to MJ may result in a potential failure to prune unnecessary connections during neuromaturation. These data have implications for more efficient treatment options, as strategies may be individualized based on age of onset and current patterns of MJ use. Financial support: NIDA 1 R01 DA032646-01. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.275