Trends in Marijuana Use Among Pregnant and Nonpregnant Reproductive-Aged Women, 2002-2014

Between 2001 and 2013, marijuana use among US adults more than doubled, many states legalized marijuana use, and attitudes toward marijuana became more permissive. In aggregated 2007-2012 data, 3.9% of pregnant women and 7.6% of nonpregnant reproductive-aged women reported past-month marijuana use. Although the evidence is mixed, human and animal studies suggest that prenatal marijuana exposure may be associated with poor offspring outcomes (eg, low birth weight, impaired neurodevelopment). The American College of Obstetricians and Gynecologists recommends that pregnant women and women contemplating pregnancy be screened for and discouraged from using marijuana and other substances. Whether marijuana use has changed over time among pregnant and nonpregnant reproductive-aged women is unknown

Trajectories of Sensation Seeking Among Puerto Rican Children and Youth

Objective: To document the natural course of sensation seeking from childhood to adolescence, characterize distinct sensation seeking trajectories, and examine how these trajectories vary according to selected predictors. Method: Data were obtained from the Boricua Youth Study, a longitudinal study of 2,491 children and adolescents of Puerto Rican background (3 assessments from 2000 to 2004). First, age-specific sensation seeking levels were characterized, and then age-adjusted residuals were analyzed using growth mixture models. Results: On average, sensation seeking was stable in childhood (ages 5–10 years) and increased during adolescence (ages 11–17 years). Mean scores of sensation seeking were higher in the South Bronx versus Puerto Rico and among males versus females. Four classes of sensation seeking trajectories were observed: most study participants had age-expected sensation seeking trajectories following the average for their age (“normative,” 43.8%); others (37.2%) remained consistently lower than the expected average for their age (“low” sensation seeking); some (12.0%) had an “accelerated” sensation seeking trajectory, increasing at a faster rate than expected; and a minority (7.0%) had a decreasing sensation seeking trajectory that started high but decreased, reaching scores slightly higher than the age-average sensation seeking scores (“stabilizers”). Site (South Bronx versus Puerto Rico) and gender were predictors of membership in a specific class of sensation seeking trajectory. Conclusion: It is important to take a developmental approach when examining sensation seeking and to consider gender and the social environment when trying to understand how sensation seeking evolves during childhood and adolescence

Prevalence of co-occurring conditions among youths receiving treatment with primary anxiety, ADHD, or depressive disorder diagnoses

Introduction: Anxiety disorders, depressive disorders, and attention-deficit/hyperactivity disorder (ADHD) are some of the most common conditions that youths (≤ 18 years old) receive mental health treatment for. These conditions are associated with high-risk substance use or substance use disorders (SUDs). This study sought to identify the proportion of youths (≤ 18 years old) with anxiety disorders, depressive disorders, or ADHD as a primary diagnosis in community mental health centers (CMHCs) having co-occurring high-risk substance use or a SUD. Methods: Analysis included binary logistic regression models using the Mental Health Client-Level Data 2017 to 2019 datasets which contains annual cross-sectional administrative data from mental health treatment facilities. The final sample included n = 458,888 youths with an anxiety disorder as a primary diagnosis, n = 570,388 youths with a depressive disorder as a primary diagnosis, and n = 945,277 youths with ADHD as a primary diagnosis. Results: In the subsample with anxiety as a primary diagnosis, approximately 5% of youth had high-risk substance use or a SUD. Approximately 10% of youth with depression as a primary diagnosis had high-risk substance use or a SUD. Among youth with ADHD as a primary diagnosis, 5% had high-risk substance use or a SUD. Odds of having a co-occurring high-risk substance use or SUD differed based on the youth's age, region, race and ethnicity, gender, and their number ofother mental health diagnoses. Conclusions: Effective care for this high-need youth population at CMHCs will require mental health clinicians to possess knowledge and skills related to substance use treatment

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

Health insurance, alcohol and tobacco use among pregnant and non-pregnant women of reproductive age

Background: Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant women and women planning to become pregnant. Methods: We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12–44 years old, by pregnancy status. The women (n = 97,788) were participants in the National Survey of Drug Use and Health (NSDUH) in 2010–2013. Logistic regression models assessed the association between health insurance (insured versus uninsured), past month tobacco and alcohol use, and whether this was modified by pregnancy status. Results: Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value ≤ 0.01) and alcohol use (p-value ≤ 0.01). Among pregnant women, being insured was associated with lower odds of alcohol use (adjusted odds ratio [AOR] = 0.47; 95% confidence interval [CI] = 0.27–0.82), but not associated with tobacco use (AOR = 1.14; 95% CI = 0.73–1.76). Among non-pregnant women, being insured was associated with lower odds of tobacco use (AOR = 0.67; 95% CI = 0.63–0.72), but higher odds of alcohol use (AOR = 1.23; 95% CI = 1.15–1.32). Conclusion: Access to health care, via health insurance coverage is a promising method to help reduce alcohol use during pregnancy. However, despite health insurance coverage, tobacco use persists during pregnancy, suggesting missed opportunities for prevention during prenatal visits

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