An epidemiological, developmental and clinical overview of cannabis use during pregnancy

The objective of the current narrative literature review is to provide an epidemiological, developmental and clinical overview on cannabis use during pregnancy. Cannabis use in pregnancy poses major health concerns for pregnant mothers and their developing children. Although studies on the short- and long-term consequences of prenatal cannabis exposure are increasing, findings have been inconsistent or difficult to interpret due to methodological issues. Thus, consolidating these findings into clinical recommendations based on the mixed studies in the literature remains a challenge. Synthesizing the available observational studies is also difficult, because some of the published studies have substantial methodological weaknesses. Improving observational studies will be an important step toward understanding the extent to which prenatal exposure to cannabis influences neurodevelopment in the offspring. Therefore, further research on prenatal cannabis exposure and the long-term consequences to offspring health in representative samples are needed to guide and improve clinical care for pregnant women and their children. Future research should also investigate the role of policies on prenatal cannabis use

An epidemiological, developmental and clinical overview of cannabis use during pregnancy

The objective of the current narrative literature review is to provide an epidemiological, developmental and clinical overview on cannabis use during pregnancy. Cannabis use in pregnancy poses major health concerns for pregnant mothers and their developing children. Although studies on the short- and long-term consequences of prenatal cannabis exposure are increasing, findings have been inconsistent or difficult to interpret due to methodological issues. Thus, consolidating these findings into clinical recommendations based on the mixed studies in the literature remains a challenge. Synthesizing the available observational studies is also difficult, because some of the published studies have substantial methodological weaknesses. Improving observational studies will be an important step toward understanding the extent to which prenatal exposure to cannabis influences neurodevelopment in the offspring. Therefore, further research on prenatal cannabis exposure and the long-term consequences to offspring health in representative samples are needed to guide and improve clinical care for pregnant women and their children. Future research should also investigate the role of policies on prenatal cannabis use

The widening gender gap in marijuana use prevalence in the U.S. during a period of economic change, 2002–2014

Aim: Concurrently with increasingly permissive attitudes towards marijuana use and its legalization, the prevalence of marijuana use has increased in recent years in the U.S. Substance use is generally more prevalent in men than women, although for alcohol, the gender gap is narrowing. However, information is lacking on whether time trends in marijuana use differ by gender, or whether socioeconomic status in the context of the Great Recession may affect these changes. Methods: Using repeated cross-sectional data from the National Survey on Drug Use and Health (2002–2014), we examined changes over time in prevalence of past-year marijuana use by gender, and whether gender differences varied across income levels. After empirically determining a change point in use in 2007, we used logistic regression to test interaction terms including time, gender, and income level. Results: Prevalence of marijuana use increased for both men (+4.0%) and women (+2.7%) from 2002 to 2014, with all of the increase occurring from 2007 to 2014. Increases were greater for men, leading to a widening of the gender gap over time (p < 0.001). This divergence occurred primarily due to increased prevalence among men in the lowest income level (+6.2%) from 2007 to 2014. Conclusion: Our findings are consistent with other studies documenting increased substance use during times of economic insecurity, especially among men. Corresponding with the Great Recession and lower employment rate beginning in 2007, low-income men showed the greatest increases in marijuana use during this period, leading to a widening of the gender gap in prevalence of marijuana use over time

Trends in cannabis polysubstance use during early pregnancy among patients in a large health care system in Northern California.

Question: Is prenatal cannabis use increasing more rapidly over time among pregnant patients without vs those with co-occurring prenatal substance use? Findings: In this cross-sectional time-series study using data from 367 138 pregnancies among 281 590 unique pregnant patients screened for prenatal substance use during early pregnancy as part of routine prenatal care in Kaiser Permanente Northern California, rates of prenatal use of only cannabis increased faster than rates of use of cannabis and 1 other substance, while rates of use of cannabis and 2 or more substances decreased. Meaning: This study suggests that increases in prenatal cannabis use may be associated in part with pregnant individuals who use only cannabis and no other substances, which could reflect growing acceptability of cannabis use and decreasin

An international, multidisciplinary consensus set of patient-centered outcome measures for substance-related and addictive disorders

Background: In 1990, the United States’ Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drug treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction: it is thus timely to build international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum Set of outcome measures for people who seek treatment for addiction. Methods: Twenty-six addiction experts from 11 countries and five continents, including people with lived experience (n=5; 19%) convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum Set of Outcome Measures,. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum Set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting Set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are quantity-frequency of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for evaluation of addiction treatment services and dissemination of best practices. The consensus Set of recommended outcomes is freely available for adoption in healthcare settings globally

An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders.

Peer reviewed: TrueAcknowledgements: This work is in memory of Christpher Wait. We acknowledge and would like to thank all individuals involved in completing the open review feedback survey aimed at improving the set recommendation. We would also like to acknowledge individuals with lived experience expertise who were involved and participated in this research. We acknowledge and thank Umanga de Silva (ICHOM) for their administrative support.Publication status: PublishedFunder: NHS England and NHS ImprovementFunder: the NSW Agency for Clinical Innovation, AustraliaFunder: Providence Health Care, USAFunder: egion Västra Götaland, SwedenBackground: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally