Patterns of substance use and arrest among hospitalized people living with HIV: A latent class analysis (original) (raw)
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Journal of Women's Health
Background: Medical cannabis (MC) utilization continues to expand in the United States, as a growing body of evidence supports the use of cannabis and cannabinoids in the treatment of a range of chronic conditions. To date, gender-related differences in MC use are not widely reported, and little is known regarding physicians' support of patients' use of MC to address symptoms associated with chronic conditions. Materials and Methods: We conducted a cross-sectional online survey of MC users in Illinois (n = 361). We summarized participants' qualifying conditions, symptoms treated with MC, perceived physician support for MC use, use of MC and prescription medications, then analyzed differences by participant gender. Results: Bivariate analyses indicate that men report higher levels of support for MC use from both specialist and primary care physicians. Women were significantly more likely to increase use of cannabis after acquiring an MC card, and to discontinue prescription medications through MC use. Multivariable analyses indicate that being a woman, using MC to treat multiple symptoms, and reporting higher levels of support for MC use from a primary care provider significantly increased the likelihood of discontinuing prescription medication through MC use. Discussion: Women are more likely to report decreased use of prescription medications to treat symptoms, and report lower levels of support from physicians for MC use. Future research on gender differences in this population may benefit from more detailed data related to symptomology, utilization, dosing, and outcomes associated with MC, and interactions with the health care system to extend these findings.
Drug and Alcohol Dependence
BACKGROUND: To examine gender differences among individuals diagnosed with DSM-IV lifetime cannabis use disorder (CUD). METHODS: A nationally representative sample of U.S. adults aged 18 years or older that were diagnosed with lifetime CUD (n=3297): Men (n=2080), Women (n=1217). Data were drawn from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n=43,093). The survey response rate was 81%. RESULTS: Nearly all individuals with CUD had a psychiatric comorbidity (95.6% of men, 94.1% of women). Men with lifetime CUD were more likely than women to be diagnosed with any psychiatric disorder, any substance use disorder and antisocial personality disorder, whereas women with CUD had more mood and anxiety disorders. After adjusting for gender differences in sociodemographic correlates and the prevalence of psychiatric disorders in the general population, women with CUD were at greater risk for externalizing disorders. Men with CUD met more criteria for cannabis abuse, had longer episodes of CUD, smoked more joints, and were older at remission when compared to women with CUD. Women experienced telescoping to CUD. Treatment-seeking rates were very low for both genders, and there were no gender differences in types of services used or reasons for not seeking treatment. CONCLUSIONS: There are important gender differences in the clinical characteristics and psychiatric comorbidities among individuals with CUD.
Drug and Alcohol Dependence, 2012
Background: There are few valid clinical assessment instruments for cannabis. Self-Efficacy, or the ability of users to resist temptation, is a central feature of social cognitive theory. This study outlines the development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), which measures the situational confidence to refuse cannabis. Method: One thousand two hundred and forty-six patients referred for cannabis assessment completed the CRSEQ including measures of cannabis consumption and dependence severity (Severity of Dependence Scale-Cannabis, SDS-C). The CRSEQ was subject to independent exploratory (n= 621, mean age 26.88, 78.6% male) and confirmatory (n= 625, mean age 27.51, 76.8% male) factor analysis. Results: Three factors: Emotional Relief, Opportunistic and Social Facilitation were identified. They provided a good statistical and conceptual fit for the data. Emotional Relief cannabis refusal self-efficacy was identified as most predictive of cannabis dependence, after controlling for cannabis consumption.
Gender influences on cannabis use among treatment-seeking adults: a qualitative study
Drugs: Education, Prevention and Policy, 2023
Background: Gender differences in cannabis use, related harms, and in the development and progression of cannabis use disorder have been reported. Better understanding and identifying why these differences exist is important in developing and tailoring prevention and treatment approaches. Methods: this qualitative interview study explored influences of gender on cannabis use trajectories. twenty-three adults (10 cisgender women, 12 cisgender men, 1 non-binary person) who had received treatment for cannabis-related problems were asked about the relationship between their gender and cannabis experiences. Results: Reflexive thematic analysis was used to develop five themes. First, many participants seemingly did not perceive a strong relationship between their gender and cannabis use. second, men's cannabis use was impacted by masculinity facilitating the initiation and escalation of use, while simultaneously acting as a barrier to seeking treatment. third, men's motivations for using cannabis were almost always reported to be recreational, which is likely linked to men's use being more normative. Fourth, almost all women reportedly used cannabis to cope, especially with mental health problems. Fifth, social relationships and gender dynamics constrained women's cannabis use, particularly where many felt pressured into seeking treatment due to increased stigma for women who use cannabis. Conclusions: Our findings revealed gender differences in cannabis use trajectories, including treatment seeking, barriers, and facilitators, emphasizing the importance of developing gender-specific approaches for reducing cannabis-related harms.
Biology of sex differences, 2017
Cannabis will soon become legalized in Canada, and it is currently unclear how this will impact public health. Methadone maintenance treatment (MMT) is the most common pharmacological treatment for opioid use disorder (OUD), and despite its documented effectiveness, a large number of patients respond poorly and experience relapse to illicit opioids. Some studies implicate cannabis use as a risk factor for poor MMT response. Although it is well established that substance-use behaviors differ by sex, few of these studies have considered sex as a potential moderator. The current study aims to investigate sex differences in the association between cannabis use and illicit opioid use in a cohort of MMT patients. This multicentre study recruited participants on MMT for OUD from Canadian Addiction Treatment Centre sites in Ontario, Canada. Sex differences in the association between any cannabis use and illicit opioid use were investigated using multivariable logistic regression. A secondar...
Clinical profile of participants in a brief intervention program for cannabis use disorder
Journal of Substance Abuse Treatment, 2001
The increasing demand for cannabis dependence treatment has led to the identification of significant gaps in the knowledge of effective interventions. A randomized controlled trial of brief cognitive ± behavioral interventions (CBT) for cannabis dependence was undertaken to address this issue. A total of 229 participants were assessed and allocated to either a 6-session CBT program, a single-session brief intervention, or a delayed-treatment control group. This paper demonstrates that individuals with cannabis use disorder will present for a brief intervention program. While they report similar patterns of cannabis use to nontreatment samples, they report a range of serious health and psychosocial consequences. While they appear relatively socially stable, they typically demonstrated severe cannabis dependence and significantly elevated levels of psychological distress, with the most commonly cited reason for cannabis use being stress relief. There were clinically relevant gender differences among the sample. This study provides more evidence of the demand for, and nature of issues relevant to, interventions for cannabis use disorders, and supports the need for further research into how best to assist individuals with these disorders. D
Sex- and Gender-Based Analysis in Cannabis Treatment Outcomes: A Systematic Review
International Journal of Environmental Research and Public Health
There is evidence that sex- and gender-related factors are involved in cannabis patterns of use, health effects and biological mechanisms. Women and men report different cannabis use disorder (CUD) symptoms, with women reporting worse withdrawal symptoms than men. The objective of this systematic review was to examine the effectiveness of cannabis pharmacological interventions for women and men and the uptake of sex- and gender-based analysis in the included studies. Two reviewers performed the full-paper screening, and data was extracted by one researcher. The search yielded 6098 unique records—of which, 68 were full-paper screened. Four articles met the eligibility criteria for inclusion. From the randomized clinical studies of pharmacological interventions, few studies report sex-disaggregated outcomes for women and men. Despite emergent evidence showing the influence of sex and gender factors in cannabis research, sex-disaggregated outcomes in pharmacological interventions is la...
Sex Differences in Cannabis Use and Effects: A Cross-Sectional Survey of Cannabis Users
Introduction: Despite known sex differences in the endocannabinoid system of animals, little attention has been paid to sex differences in human's cannabis use patterns and effects. The purpose of the present study was to examine sex differences in cannabis use patterns and effects in a large sample of recreational and medical cannabis users. Methods: A large sample (n = 2374) of cannabis users completed an anonymous, online survey that assessed their cannabis use practices and experiences, including the short-term acute effects of cannabis and withdrawal effects. A subsample of 1418 medical cannabis users further indicated the medical conditions for which they use cannabis and its perceived efficacy. Results: The results indicated that men reported using cannabis more frequently and in higher quantities than did women. Men were more likely to report using joints/blunts, vaporizers, and concentrates, while women were more likely to report using pipes and oral administration. Men were more likely than women to report increased appetite, improved memory, enthusiasm, altered time perception, and increased musicality when high, while women were more likely than men to report loss of appetite and desire to clean when high. Men were more likely than women to report insomnia and vivid dreams during periods of withdrawal, while women were more likely than men to report nausea and anxiety as withdrawal symptoms. Sex differences in the conditions for which medical cannabis is used, and its efficacy, were trivial. Conclusions: These results may be used to focus research on biological and psychosocial mechanisms underlying cannabis-related sex differences, to inform clinicians treating individuals with cannabis use disorders, and to inform cannabis consumers, clinicians, and policymakers about the risks and benefits of cannabis for both sexes.
Social cognitive predictors of treatment outcome in cannabis dependence
Drug and Alcohol Dependence, 2017
Highlights Expectancies and self-efficacy are key cognitive constructs in cannabis dependence First study to measure both constructs as treatment outcome predictors Emotional relief refusal self-efficacy was robust predictor of treatment outcome Negative cannabis expectancy predicted lower likelihood of lapse Self-efficacy may mediate risk conveyed by positive cannabis expectancy ABSTRACT Background: Drug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence. Design: Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested. Setting: A university hospital alcohol and drug outpatient clinic. Participants: 221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence. Measurements: Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session. Findings: Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p = .004), more days of use (p < .001), and larger amount used (p < .001). Negative cannabis expectancies predicted greater likelihood of abstinence (p = .024). Higher positive expectancies were associated with lower emotional relief self-efficacy, mediating its association with outcome (p < .001). Conclusions: Emotional relief refusal self-efficacy and negative expectancies are predictive of better treatment outcomes for cannabis dependence. Positive expectancies may indirectly predict poorer outcome because of a negative association with self-efficacy, but this conclusion remains tentative as directionality could not be established.