Depression among young teens linked to cannabis use at 18
Seattle-focused study suggests earlier intervention with depressed youths could reduce rate of cannabis-use disorder
July 17, 2017
Science Daily/University of Washington Health Sciences/UW Medicine
A study looking at the cumulative effects of depression in youth, found that young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence.
The study led by UW Medicine researchers interviewed 521 students recruited from four Seattle public middle schools. Researchers used data from annual assessments when students were ages 12-15 and then again when they were 18. The results were published in the journal Addiction.
"The findings suggest that if we can prevent or reduce chronic depression during early adolescence, we may reduce the prevalence of cannabis use disorder," said lead author Isaac Rhew, research assistant professor of psychiatry and behavioral sciences at the University of Washington School of Medicine.
What researchers called "a 1 standard deviation increase" in cumulative depression during early adolescence was associated with a 50 percent higher likelihood of cannabis-use disorder.
According to researchers, during the past decade cannabis has surpassed tobacco with respect to prevalence of use among adolescents. Cannabis and alcohol are the two most commonly used substances among youth in the United States. They pointed to one national study showing increases in prevalence of cannabis use disorder and alcohol use disorder in the United States, especially among young adults.
Longitudinal studies looking at the link between depression and later use of alcohol and cannabis, however, have been mixed. Some show a link. Others don't. But most studies have assessed adolescent depression at a single point in time -- not cumulatively, said the researchers. Further, there have been differences in how substance use has been measured ranging from the initiation of any use to heavier problematic forms of use.
The study oversampled for students with depressive and/or conduct problems. The researchers were surprised to see that the prevalence of cannabis and alcohol use disorder in this study was notably higher than national estimates with 21 percent meeting criteria for cannabis use disorder and 20 percent meeting criteria for alcohol use disorder at age 18.
What effect the easing of marijuana laws in Washington state had on the youth is unclear. Researchers said it would be informative to conduct a similar study in a state with more strict marijuana laws to understand whether the relationship between depression and cannabis misuse would still hold in areas where marijuana may be less accessible.
The age 18 substance abuse assessments occurred between 2007-2010. Washington state legalized medical cannabis in 1998 and its medical cannabis market expanded greatly after 2009 when the federal justice department issued a ruling known as the Ogden Memo. And in 2003, the city of Seattle made cannabis offenses the lowest enforcement priority for police and the city attorney.
https://www.sciencedaily.com/releases/2017/07/170717151031.htm
Cannabis use disorder: The policy climate matters
January 23, 2019
Science Daily/Columbia University's Mailman School of Public Health
Adolescents and young adults living in states with more liberal policies reported higher average rates of past-year cannabis use than those in states with more conservative policies. However, the rates of cannabis use disorder -- abuse or dependence on the drug -- were significantly lower in states with more liberal policies compared to states with more conservative policies. The study is one of the first to assess the relationship between policy liberalism and health outcomes, and specifically cannabis use-related outcomes.
Adolescents and young adults living in states with more liberal policies reported higher average rates of past-year cannabis use than those in states with more conservative policies, according to a new study conducted at Columbia University Mailman School of Public Health. However, the rates of cannabis use disorder -- abuse or dependence on the drug -- were significantly lower in states with more liberal policies compared to states with more conservative policies, for ages 12 to 17, and marginally lower for ages 26 and older. These results remained significant even when controlling for the presence of medical cannabis laws. This study is one of the first to assess the relationship between policy liberalism and health outcomes, and specifically cannabis use-related outcomes. The findings are published in the International Journal of Drug Policy.
"The majority of existing work has explored the relationship between medical cannabis laws and cannabis outcomes, whereas our results identified important relationships between the state-level policy context as a whole, and cannabis use outcomes," said Morgan Philbin, PhD, assistant professor of Sociomedical Sciences, and first author. "While this research does not suggest that being in a liberal state causes people to use cannabis, or have lower rates of cannabis use disorder, it does highlight how states may differ beyond substance use policies, and how these differences also merit attention."
Using nationally-representative state-level data, the researchers examined the associations between policy liberalism and cannabis use and cannabis use disorder among past year users. Data were obtained for ages 12-17, 18-25, and 26 and older from the 2004-2006 and 2010-2012 National Survey on Drug Use and Health.
Past year cannabis use was consistently higher in liberal compared to conservative states, and remained significantly higher for ages 12-17 and 18-25 after adjusting for medical cannabis law status. As of December 2018, a total of 33 states had approved medical cannabis laws and eight states plus Washington, D.C. had legalized cannabis use.
Prevalence of cannabis use has increased overall since 2007 which has raised concerns about potential negative consequences associated with problematic use, specifically cannabis use disorder. "These latest findings could directly inform policymakers and public health practitioners about the degree to which other broader contextual factors also influence cannabis use patterns in the U.S.," noted Philbin.
States were categorized as liberal, moderate, or conservative based on the 2005 and 2011 State Rank on Policy Liberalism Index, which is based on policy indicators for which liberals and conservatives commonly differ. The Index ranked each state from 1 (most liberal) to 50 (most conservative) based on its policies regulating gun control, abortion access, Temporary Assistance to Needy families, collective bargaining, and tax structure.
Average state-level prevalence of past-year cannabis use by age was lowest for ages 26 and older and highest for ages 18 to 25 throughout the study period. Average prevalence increased for ages 18-25 in liberal states, from 33 percent to 37 percent, and rose marginally in conservative states, from 25 percent to 26 percent. The same pattern of use was observed for ages 26 and over in liberal (8 percent to 10 percent) and conservative (6 percent to 7 percent) states. For ages 12-17, however, past year use did not significantly change from 2004-2006 to 2010-2012 in liberal or conservative states.
In contrast, cannabis use disorder among past-year cannabis users decreased from 2004-2006 to 2010-2012 among those aged 18-25 in conservative states (22 percent to 18 percent) and liberal states (20 percent to 17 percent). Among individuals ages 26 and over, cannabis use disorder among past-year users decreased in liberal states (11 percent to 8 percent). For 12-17 year olds, cannabis use disorder decreased in conservative states (28 percent to 25 percent), though still remained marginally higher than in liberal states (24 percent).
"Our study highlights the need for researchers and public health professionals to distinguish between cannabis use and cannabis use disorder when interacting with patients at the individual level and when developing primary prevention strategies and interventions at the population level," said Silvia Martins, MD, PhD, associate professor of Epidemiology and senior author. "This line of research not only helps identify how state-level policies as a whole impact cannabis use outcomes, but ultimately supports the development of more health-promoting policies."
The work was funded by the National Institutes of Health/National Institute on Drug Abuse (DA037866, DA039804A, DA031099).
Co-authors are Pia Mauro, Julian Santaella-Tenorio, Christine Mauro, and Elizabeth Kinnard, Columbia Mailman School; and Magdalena Cerdá, New York University.
https://www.sciencedaily.com/releases/2019/01/190123091158.htm
Does teen cannabis use lead to behavior problems -- or vice versa?
November 26, 2018
Science Daily/Annenberg Public Policy Center of the University of Pennsylvania
New research finds that cannabis use among teens doesn't appear to lead to greater conduct problems or greater affiliation with other teens who smoke cannabis. Instead, it's adolescents with conduct problems or whose friends use cannabis who are more likely to gravitate toward cannabis use.
More youth use cannabis than smoke cigarettes in the United States. In other parts of the world, cannabis use has become almost as regular as tobacco use among adolescents and young adults.
With relaxed laws governing cannabis use in many U.S. states and localities, there is mixed and limited research on whether increasing legalization could lead to other unhealthy behaviors in addition to substance use disorders.
Now, new research led by the Annenberg Public Policy Center of the University of Pennsylvania finds that cannabis use among teens does not appear to lead to greater conduct problems or greater affiliation with other teens who smoke cannabis, associations that previous research had suggested to be possible.
Instead, it's the other way around: It is adolescents with conduct problems or whose friends use cannabis who are more likely to gravitate toward cannabis use. And that "cascading chain of events" appears to predict cannabis use disorder as the teens become young adults, according to the study, newly published in the journal Addiction.
"Cannabis use in and of itself does not appear to lead to conduct problems or increasing attraction to peers who use cannabis," said coauthor Dan Romer, research director of the Annenberg Public Policy Center (APPC).
The study follows a group of Philadelphia adolescents over eight years. "Previous studies have not been as able to isolate the effects of cannabis use in adolescents," Romer added. "But because we had measurements over the entire period of adolescence, we were able to disentangle the effects of cannabis use itself from other influences."
The Philadelphia Trajectory Study
The research uses data from the Philadelphia Trajectory Study, a six-wave study that began in 2004 with interviews of nearly 400 10- to 12-year-olds in Philadelphia. The adolescents were tested annually from 2004 to 2010, and then again in 2012 for a final two-year follow-up. The current study uses data from 364 teens from the final four waves of the study. The observational study is based on self-reports from the adolescents which were then validated by urine screening.
Ivy Defoe, the lead author and former APPC postdoctoral fellow, said, "Interestingly, the results show that not only do conduct problems such as school truancy and theft predict cannabis use, but adolescents who display conduct problems are also drawn to cannabis-using peers. These affiliations predict increases in cannabis use and, eventually, cannabis use disorder, as our results show," added Defoe, now a postdoctoral researcher at the University of Twente, the Netherlands.
Defoe said some theories would suggest that teens with conduct problems may be using cannabis as a coping mechanism to deal with disapproval of their behavior problems and perhaps to self-medicate. The study concludes that if youth with conduct problems "use unprescribed cannabis to cope with their condition, then healthier alternative coping strategies and support should be made available."
Concerns about cannabis
One concern about use of an illegal drug is that it will lead adolescents to socialize with deviant peer groups, such as those who sell and use illegal drugs. However, the study suggests that adolescents using cannabis are no more likely to start affiliating with peers using cannabis.
The findings do suggest that with increasing legalization, there will be greater access to cannabis and thus a greater likelihood for youth to develop cannabis use disorder. However, just as with alcohol, which is legal for adults, research conducted as part of this project suggests that less than a quarter of youthful users would develop a mild cannabis use disorder.
"Disentangling longitudinal relations between youth cannabis use, peer cannabis use, and conduct problems: developmental cascading links to cannabis use disorder" is published open access in the journal Addiction.
In addition to Defoe and Romer, the coauthors are Atika Khurana, Ph.D., an APPC distinguished research fellow at the University of Oregon, and Laura M. Betancourt, Ph.D., and Hallam Hurt, M.D., of the Children's Hospital of Philadelphia.
The research was supported by grants from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
The Annenberg Public Policy Center was established in 1993 to educate the public and policy makers about the media's role in advancing public understanding of political, health, and science issues at the local, state and federal levels.
https://www.sciencedaily.com/releases/2018/11/181126134248.htm