Are Cannabis Use Problems Comparable Across Individuals Using for Recreational and Medical Purposes? : An International Cross-Sectional Study of Individuals Who Use Self-Grown Cannabis

Background: Little is known about cannabis use problems among individuals who use cannabis for medical purposes and whether rates and determinants of cannabis use problems in medical users differ to those observed among individuals using for recreational reasons. This study examines whether Severity of Dependence Scale (SDS) scores differ across individuals who use self-grown cannabis for the following reasons: “recreational only”, “medical and recreational” and “medical only”. Furthermore, the study tests whether cannabis use frequency, cannabis strain, and type of cannabis influences the strength of the association between purpose of use and cannabis use problems. Methods: Data (n = 5,347) were collected from a subsample of the Global Cannabis Cultivation Research Consortium project, focusing on small-scale cannabis growers in 18 countries. Robust regressions analyzed differences in SDS scores across the three use motivation groups. Results: Compared with respondents reporting only recreational motivations of cannabis use, those with medical (with and without recreational) motivations were associated with lower SDS scores (B: -0.190 and B: -0.459, p < 0.001 respectively). Daily use was associated with significantly higher SDS scores across all cannabis motivation groups, albeit the magnitude of the association was significantly smaller among individuals with medical motivations of use. Conclusion: The extent to which people experience cannabis use problems, and the determinants of these problems may differ depending on whether cannabis use is motivated by recreational or medical purposes. As such, the findings of the current study suggest that public education efforts, harm reduction approaches and policy responses should be tailored depending on whether cannabis is used for recreational or medical purposes

Socially Integrated Drug Users : Between Deviance and Normality

The purpose of this thesis is to improve our knowledge of substance users in the normal population. The main concern is with how the meaning of drug use is constructed. To answer this, the thesis draws on different theoretical principles and mixed methods design. The thesis is made up of four sub-studies, with interconnected foci. The first three papers are based on a qualitative research project in which 44 socially integrated drug users in Stockholm were interviewed. The fourth paper is a cross-national quantitative analysis of nationally representative student samples. The first of the three qualitative papers explores the construction of the informant’s self-identity. The second paper analyses the informant’s perceptions of drug-related risk, whilst the third paper analyses the drug users’ perception of differences between men’s and women’s drug use. The fourth paper sets the detailed analyses of the first three papers in a broader comparative frame, exploring differences in the correlates of drug use, in light of the different levels of drug use in Sweden and Switzerland. The thesis reveals that the drug users are striving to be understood as normal integrated citizens of Swedish society. They present themselves as inherently different from drug abusers and the informants’ risk perceptions are based on a modified form of core Swedish cultural ideals of conscientiousness. The informants also waver back and forth when called upon to discuss gender and drug-taking. On the one hand they were explicit about existing differences between men’s and women’s drug use; on the other hand they were quite uncomfortable having to explicitly explain them, as this meant that they needed to draw on conservative gender roles, something which in Swedish society is a strong sign of being politically incorrect. Furthermore, the thesis shows that young drug abstainers and cannabis users are quite similar in regards to conventional social bonds

Socioeconomic background and high school completion: Mediation by health and moderation by national context

This study uses longitudinal data from the Norwegian Health Study linked with registry data (n = 13262) and the U.S. National Longitudinal Survey of Youth 1997 (n = 3604) to examine (1) whether adolescent health mediates the well-established relationship between socioeconomic background and successful high school completion, and (2) whether this mediated pathway of influence varies by national context. Adolescents from lower educated and lower income families reported poorer health, which negatively impacted their likelihood of graduating from high school. The partial mediational effect of adolescent health was stronger in the U.S. than in Norway. These results suggest that policies aimed at preventing high school dropout need to address adolescent health, in addition to the unequal opportunities derived from socioeconomic disadvantage.publishedVersio

The challenges and benefits of analyzing feedback comments in surveys: lessons from a cross-national online survey of small-scale cannabis growers.

It is common practice in survey questionnaires to include a general open and non-directive feedback question at the end, but the analysis of this type of data is rarely discussed in the methodological literature. While these open-ended comments can be useful, most researchers fail to report on this issue. The aim of this article is to illustrate and reflect upon the benefits and challenges of analyzing responses to open-ended feedback questions. The article describes the experiences of coding and analyzing data generated through a feedback question at the end of an international online survey with small-scale cannabis cultivators carried out by the Global Cannabis Cultivation Research Consortium. After describing the design and dataset of the web survey, the analytical approach and coding frame are presented. The analytical strategies chosen in this study illustrate the diversity and complexity of feedback comments which pose methodological challenges to researchers wishing to use them for data analyses. In this article, three types of feedback comments (political/policy comments, general comments of positive and negative appreciation, and methodological comments) are used to illustrate the difficulties and advantages of analyzing this type of data. The advantages of analyzing feedback comments are well known, but they seem to be rarely exploited. General feedback questions at the end of surveys are typically non-directive. If researchers want to use these data for research and analyses, they need a clear strategy. They ought to give enough thought to why they are including this type of question, and develop an analytical strategy at the design stage of the study

Cannabis use as a predictor and outcome of positive and negative affect in college students: An ecological momentary assessment study.

BACKGROUND: Reinforcement models identify negative affect (NA) and positive affect (PA) to be important momentary determinants and outcomes of cannabis use. Sensitization and allostatic models further suggest that these mood-cannabis associations are stronger among individuals with more cannabis-related problems. Despite this theoretical background and the fact that cannabis is commonly used for its mood-enhancing effects among college students, surprisingly, little is known about the momentary associations between mood and cannabis use in this population. AIMS: To examine the associations between (a) momentary within-person variations in NA (worried, stressed, nervous) and PA (happy, enthusiastic, proud, excited) and intention to use cannabis within the next hour, (b) the within-person variations in time elapsed since last cannabis use, amount used and momentary NA and PA, and (c) to test whether cannabis-related problems moderate the stated associations. METHOD: Eighty, more-than-weekly, cannabis using students at the University of Amsterdam reported on cannabis use, NA and PA three times daily for 14 consecutive days. Mixed-effects models were performed to analyze the dataset. RESULTS: Within-persons, relatively high PA and low NA were associated with a higher likelihood of intending to use cannabis. Within-persons, more recent and greater amounts of cannabis use were associated with relatively high PA. More recent cannabis use was associated with relatively low NA. Cannabis-related problems did not moderate the associations. CONCLUSIONS: While recent cannabis use related to higher PA and lower NA, high PA but low NA preceded use, supporting positive reinforcement rather than negative reinforcement in this college sample of regular cannabis users

The Effects of the Processing of Positive Memories Technique on Posttrauma Affect and Cognitions Among Survivors of Trauma: Protocol for a Daily Diary Study

BACKGROUND: The Processing of Positive Memories Technique (PPMT) is a promising new treatment approach for posttraumatic stress disorder (PTSD), which involves detailed narration and processing of specific positive autobiographical memories. Indeed, preliminary case-series studies have found reductions in PTSD symptoms, negative affect, and negative cognitions among survivors of trauma who have received PPMT. However, PPMT's effects have not been investigated at the daily level. In this study, we describe the protocol for a study that will examine the daily-level impacts of PPMT in a trauma-exposed, nonclinical community sample. OBJECTIVE: This study uses an innovative research protocol that combines case-series design and daily diary approaches to examine changes in daily affect, daily cognitions, and daily PTSD symptoms pre- and post-PPMT. We hypothesize that at the daily level, in comparison to their own pre-PPMT levels, following the PPMT intervention, participants will report (1) a lower count of endorsed daily PTSD symptoms, (2) increases in daily positive affect and decreases in daily negative affect, (3) increases in positive affect reactivity to daily positive events, and (4) decreases in daily posttrauma cognitions. METHODS: We are currently recruiting participants (target n=70) from a metroplex in the southwest United States. Following a screening survey, eligible participants complete a preintervention baseline survey, followed by 21 daily surveys in their natural environments. Then, they receive 4 PPMT sessions on a weekly basis. After the conclusion of the PPMT intervention, participants complete a postintervention outcome survey and 21 daily surveys. To compare daily affect, daily cognitions, and daily PTSD symptoms before and after PPMT, we will use the daily diary report data and conduct multilevel random intercepts and slopes linear regression models. RESULTS: Data collection was initiated in March 2022 and is expected to end by June 2024. As of November 28, 2023, a total of 515 participants had consented to the study in the screening phase. No analyses will be conducted until data collection has been completed. CONCLUSIONS: Study findings could clarify whether deficits in positive autobiographical memory processes may also characterize PTSD alongside deficits in traumatic memory processes. Furthermore, PPMT could be an additional therapeutic tool for clinicians to help clients reduce posttraumatic distress in their everyday lives. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51838

Cannabis use as a predictor and outcome of positive and negative affect in college students: An ecological momentary assessment study

BACKGROUND: Reinforcement models identify negative affect (NA) and positive affect (PA) to be important momentary determinants and outcomes of cannabis use. Sensitization and allostatic models further suggest that these mood-cannabis associations are stronger among individuals with more cannabis-related problems. Despite this theoretical background and the fact that cannabis is commonly used for its mood-enhancing effects among college students, surprisingly, little is known about the momentary associations between mood and cannabis use in this population. AIMS: To examine the associations between (a) momentary within-person variations in NA (worried, stressed, nervous) and PA (happy, enthusiastic, proud, excited) and intention to use cannabis within the next hour, (b) the within-person variations in time elapsed since last cannabis use, amount used and momentary NA and PA, and (c) to test whether cannabis-related problems moderate the stated associations. METHOD: Eighty, more-than-weekly, cannabis using students at the University of Amsterdam reported on cannabis use, NA and PA three times daily for 14 consecutive days. Mixed-effects models were performed to analyze the dataset. RESULTS: Within-persons, relatively high PA and low NA were associated with a higher likelihood of intending to use cannabis. Within-persons, more recent and greater amounts of cannabis use were associated with relatively high PA. More recent cannabis use was associated with relatively low NA. Cannabis-related problems did not moderate the associations. CONCLUSIONS: While recent cannabis use related to higher PA and lower NA, high PA but low NA preceded use, supporting positive reinforcement rather than negative reinforcement in this college sample of regular cannabis users