Cannabis är den vanligaste illegala drogen bland unga vuxna i Sverige. Det är en omdebatterad drog, debatterna handlar ofta om huruvida cannabis effekter är negativa eller inte. Detta examensarbete undersöker om det finns skillnader i problemnivå inom olika livsområden beroende på grad av cannabisbruk. Examensarbetet är en kvantitativstudie som genom ett antal statistiska analyser jämför tre grupper av unga vuxna samt predicerar sannolikheten för vilka som löper störst risk att vara regelbundna cannabisanvändare. Resultatet tyder på att problemnivån ökar inom flera livsområden beroende på grad av cannabisbruk. Högre involvering i cannabisbruk är förknippat med högre problemnivå i psykisk hälsa, narkotikabruk, narkotikabrott samt hereditet för narkotika. Vidare visar resultatet att faktorer som att vara man, bo i storstad och hereditet för narkotika är riskfaktorer som kan predicera ett regelbundet cannabisbruk. Examensarbetets slutsatser ger stöd för att ökad cannabisinvolvering tycks medverka till missbruk av andra illegala droger och tycks ha negativ påverkanseffekt på psykisk hälsa samt att benägenhet till brottslighet snarare har att göra med selektion än med involvering i cannabisbruk. / Cannabis is the most commonly used illicit drug among young adults in Sweden. It is a controversial drug, the debates about cannabis are often about whether cannabis effects are negative or not. This thesis examines whether there are differences in the level of problems in different areas of life depending on the extent of cannabis use. The thesis is a quantitative study by a number of statistical analyzes comparing three groups of young adults, and predicts the probability of which ones are most likely to be regular cannabis users. The results suggest that in many areas of life the problem level is increasing, depending on the extent of cannabis use. Higher involvement in cannabis use is associated with problems of higher levels in mental health, drug use, drug and family history of narcotics. Furthermore, the results show that factors such as being male, living in a big city and family history of illicit drugs are risk factors that can predict a regular cannabis use. The findings of the thesis provide support for that increased cannabis involvement seems to contribute to the abuse of other illicit drugs and seem to have a negative impact on mental health, and at last that the tendency to commit crime has rather to do with personality factors than cannabis use.

Background. Various studies show that cannabis use alters attention and cognitive functioning in healthy humans and may contribute to development of schizophrenia or worsening of pre-existing psychosis. However, the impact of cannabis use on brain function in humans is not well understood. Schizophrenia is associated with a deficit in prepulse inhibition (PPI), the normal inhibition of the startle reflex by a non-startling stimulus (prepulse), presented before the startle stimulus at short time intervals (lead-time intervals). Such PPI deficit is thought to reflect a sensorimotor gating dysfunction in schizophrenia. PPI is also modulated by attention and PPI reduction in schizophrenia is observed when patients are asked to attend to, not ignore, the stimuli producing PPI. The aim of the current study was to investigate the association between self-reported chronic cannabis use and attentional modulation of PPI in healthy controls and in patients with schizophrenia. Furthermore, the association between cannabis use and other startle reflex modulators, including prepulse facilitation (PPF) of the startle reflex magnitude at long lead-time intervals, prepulse facilitation of the startle reflex onset latency and habituation of the startle reflex magnitude, were examined. Method. Auditory-evoked electromyographic signals were recorded from orbicularis oculi muscles in chronic cannabis users (29 healthy controls and 5 schizophrenia patients) and non-users (22 controls and 14 patients). The data for 36 participants (12 non-user controls, 16 healthy cannabis users, and eight non-user patients) were used in the final analyses and the patient data were used as a pilot study, because relatively few participants met the rigorous exclusionary criteria. Participants were instructed to attend to or to ignore either the startle stimuli alone (70 100 dB) or prepulse (70 dB) and startle stimuli (100 dB) separated by short lead-time intervals (20 200 ms) and long lead-time intervals (1600 ms). In order to ignore the auditory stimuli the participants played a visually guided hand-held computer game. A pilot study showed that the response component of playing the game had no effects on attentional modulation of the startle reflex magnitude and onset latency. Results. Relative to controls, cannabis use in healthy humans was associated with a reduction in PPI similar to that observed in schizophrenia while attending to stimuli, and with an attention-dependent dysfunction in the startle reflex magnitude habituation. While ignoring the stimuli there were no statistical differences in PPI between cannabis users and controls, although PPI in cannabis users tended to differ from that of the patients. The reduction in PPI in cannabis users was correlated with the increased duration of cannabis use, in years, but not with the concentration of cannabinoid metabolites in urine or with the recency of cannabis use in the preceding 24 hours. Furthermore, cannabis use was not associated with any differences in PPF, onset latency facilitation, and startle reflex magnitude in the absence of prepulses. The accuracy of self-reports of substance use was also investigated in this study and was found to be excellent. In addition, the study examined the validity of the substance use module of the diagnostic interview, CIDI-Auto 2.1, which was found to be acceptable for cannabis misuse diagnoses (abuse and/or dependence). Finally, cannabis dependence was found to be associated with more diagnoses of mental illness other than schizophrenia (mainly depression). Conclusions. The results of the current study suggest that chronic cannabis use is associated with schizophrenia-like deficit in PPI in otherwise healthy humans. This PPI reduction is associated with attentional impairment rather than a global sensorimotor gating deficit in healthy cannabis users.

Background: Substance use can have lifelong consequences for adolescents and the rates of substance use in Canadian adolescents are increasing. This is a serious public health issue which needs to be addressed. The purpose of this study is to determine the impact of public health unit (PHU) engagement in school-based substance use prevention programs on student substance use. Methods: Data was collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study over the 2018/19 data collection year. A multi-level logistic regression was used to analyze the associations between PHU engagement and student substance use. Results: The analyses found that 70% of schools had PHU engagement in substance use prevention programs. Overall, PHU engagement made no difference on student substance use. However, when PHU engagement was divided into five levels of engagement (with zero being no engagement and five being the highest level of engagement) it was found that students from schools where PHUs solved problems jointly (level two) had statistically significantly greater odds of binge drinking, alcohol use and cannabis use. Schools were also divided into low and high-use schools for each substance. It was found that students in low-use schools had statistically significantly greater odds of binge drinking, alcohol and cannabis use with some levels of PHU engagement and students from high-use schools had statistically significantly lower odds of cannabis and cigarette use with some levels of PHU engagement compared to a similar student from a school without PHU engagement. Conclusions: Our findings show that there is opportunity for greater PHU engagement with schools in substance use prevention programming. Furthermore, it is important that PHUs are working with schools to ensure school-based substance use prevention programs are evidence-based and tailored to the specific needs and risk-levels of the students. / Thesis / Master of Science in Nursing (MSN) / The purpose of this study is to determine the impact of public health unit (PHU) engagement in school-based substance use prevention programs on student substance use. Data for this study was collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study. The results show that 70% of schools had PHU engagement in substance use prevention programs. Across all schools, when PHUs and schools solved problems jointly an increase in student binge drinking, alcohol and cannabis use was found. When schools were divided into low and high-use schools, similar results were found when PHUs engaged with low-use schools whereas when PHUs engaged in high-use schools a reduced odds of student cannabis and cigarette use was found in some situations. These findings highlight the importance for PHUs to consider the specific needs and risk-levels of the students and schools they are engaging with.

Cannabis use is considered a component cause of psychotic disorder interacting with genetic and environmental risk factors in increasing psychosis risk (Henquet et al., 2008). Recently, two cross-sectional and one prospective study provided evidence that cannabis use interacts additively with trauma to increase psychosis risk (Houston et al., 2008, Harley et al., 2010 and Konings et al., 2011). In an attempt at further replication, we examined prospective data from the German Early Developmental Stages of Psychopathology (EDSP) study (Wittchen et al., 1998b and Lieb et al., 2000).

[pt] O uso de cannabis é um problema de saúde pública crescente, associado a diversos desfechos negativos. A identificação de fatores de risco é relevante para a prevenção, pois nem sempre tratamentos são eficazes. O abuso sexual infantil é considerado um forte preditor de uso e transtorno por uso de cannabis (TUC). Com a expansão da internet a violência sexual assumiu novos formatos, fazendo surgir um fenômeno contemporâneo denominado vitimização sexual on-line (VSO). Esta dissertação se dedicou ao aprofundamento do tema e realizou uma revisão narrativa com o objetivo de sintetizar o conceito de VSO e seus paralelos com abuso sexual off-line. Além disso, foi investigado exploratoriamentea VSO na infância e adolescência e suas associações com o uso de cannabis e TUC. Análises de regressão investigaram o efeito preditivo de VSO no uso de cannabis ao menos uma vez na vida e na idade do primeiro uso de cannabis. Mais de 70 por cento da amostra relatou ter sofrido VSO na infância e adolescência. Mulheres apresentaram quase o dobro de prevalência que os homens, com médias mais elevadas nas subescalas de insistência e ameaça. Minorias sexuais foram mais prevalentes que heterossexuais em todas as subescalas. A VSO foi capaz de prever significativamente o uso de cannabis pelo menos uma vez na vida e a idade do primeiro uso, mas somente a subescala de disseminação. Os resultados sugerem que VSO na infância e na adolescência é um fenômeno com alta prevalência, que pode estar associada ao uso de cannabis. Crianças e adolescentes merecem atenção especial porque utilizam a internet com maior freqüência, ficando expostos a riscos. Dessa maneira, é necessário pensar estratégias para prevenção de ocorrência de VSO e seusefeitos adversos. / [en] Cannabis use is a growing public health problem, associated with a variety of negative outcomes. The identification of risk factors is relevant for prevention, as treatments are not always effective. Child sexual abuse is considered a strong predictor of cannabis use and cannabis use disorder (CUD). With the expansion of the internet, sexual violence took on new formats, giving rise to a contemporary phenomenon called online sexual victimization (OSV). This dissertation was dedicated to deepening the theme and carried out a narrative review with the objective of synthesizing the concept of OSV and its parallels with offline sexual abuse. In addition, we exploratory investigated OSV in childhood and adolescence and its associations with cannabis use and CUD. Regression analyzes investigated the predictive effect of OSV on lifetime cannabis use and age of first cannabis use. More than 70 percent ofthe sample reported having suffered OSV in childhood and adolescence. Women had almost twice the prevalence of men, with higher means in the insistence and threat subescales. Sexual minorities were more prevalent than heterosexualin allsubscales. The OSV was able to significantly predict lifetime cannabis use and age atfirst use, but only the spread subscale. The results suggest that OSV in childhood and adolescence is a highly prevalent phenomenon that maybe associated with cannabis use. Children and teenagers deserv especial attention because they use the internet more frequently and are exposed to risks. Thus, it is necessary to think about strategies to prevent the occurence of OSV and its adverse effects.

No description available.

Background: A younger age at onset of use of a specific substance is a well-documented risk-factor for a substance use disorder (SUD) related to that specific substance. However, the cross-substance relationship between a younger age at onset of alcohol use (AU) and nicotine use (NU) and the risk of cannabis use disorders (CUD) in adolescence and early adulthood remains unclear. Aims: To identify the sequence of and latency between initial AU/NU and initial cannabis use (CU). To investigate whether younger age at AU- and NU-onset is associated with any and earlier CU-onset and a higher risk of transition from first CU to CUD, taking into account externalizing disorders (ED) and parental substance use disorders as putative influential factors. Methods: Prospective-longitudinal community study with N = 3021 subjects (baseline age 14–24) and up to four assessment waves over up to ten years with additional direct parental and family history information. Substance use and CUD were assessed with the DSM-IV/M-CIDI. Results: Most subjects with CU reported AU (99%) and NU (94%). Among users of both substances, 93% reported AU prior to CU (87% for NU). After adjustment for ED and parental substance use disorders younger age at AU-onset was associated with any CU. Younger age at NU-onset was associated with earlier CU initiation. Younger age at AU- and NU-onset was not associated with a higher risk of CUD. Conclusions: The cross-substance relevance of younger age at first AU and NU for the risk of CUD is limited to early CU involvement.

Le cannabis est la substance illicite la plus consommée à l’adolescence et ce, mondialement. Nous savons qu’un usage problématique de cannabis est susceptible d’entraîner une multitude de conséquences sur les plans physiques, psychologiques, sociaux et économiques. Or, les consommateurs constituent un groupe au profil hétérogène et n’expérimenteront pas tous des problèmes significatifs reliés à cet usage. Il s’avère donc important d’identifier les usagers à risque élevé de conséquences et de spécifier la nature de ces problèmes afin d’intervenir de façon efficace auprès de cette clientèle. Pourtant, bien que la littérature scientifique soulève l’idée que certains types de consommateurs présentent davantage de risques, l’état des connaissances ne révèle que peu d’informations de nature empirique qui permettraient de distinguer des autres usagers les profils d’adolescents davantage à risque. À cet effet, les typologies disponibles à ce jour sont généralement théoriques ou limitées aux études cliniques, font référence à des problèmes particuliers ou se basent sur des indicateurs spécifiques de la consommation tels que la fréquence d’usage. De plus, aucune étude jusqu’à maintenant n’est en mesure de nous pister quant aux types de problèmes associés plus spécifiquement à certains profils de consommation ni de préciser quels profils sont davantage représentés pour des conséquences données. Cette étude est basée sur les classes latentes de consommation découvertes dans l’étude de Fallu, Brière et Janosz (2014) à partir de plusieurs caractéristiques de consommation et comparées sur plusieurs prédicteurs et problèmes associés à la consommation. Son échantillon est constitué de 1618 élèves consommateurs de cannabis en secondaire 4. Cette étude examine quels sont les problèmes attribués et non-attribués les plus fréquents pour chacune des classes. Elle examine également quelles sont les classes les plus représentées pour différents problèmes attribués et non-attribués. Enfin, elle compare les résultats obtenus pour les problèmes attribués et non-attribués. La stratégie analytique employée a consisté à conduire des analyses descriptives, des analyses de Chi carrés ainsi que des analyses de variance univariée, parfois suivies d’une analyse post-hoc. Les résultats ont démontré que la classe d’appartenance peut prédire la survenue des différents problèmes que rencontrent les jeunes consommateurs, que certaines classes sont plus représentées pour certains problèmes et que les adolescents aux profils les plus lourds sont à risque de sous-estimer certains problèmes liés à leur consommation. L’une des principales découvertes concerne les deux classes précoces. Il semble que la classe des consommateurs modérés précoces présente un profil de problèmes davantage intériorisé et la classe des polyconsommateurs lourds précoces, davantage extériorisé. Les implications de ces résultats sont finalement discutées. / Cannabis is the most widely used illicit substance among adolescents worldwide. We know that cannabis misuse is likely to cause a variety of effects at physical, psychological, social and economic levels. However, consumers are a heterogeneous group and not all will experience significant problems associated with such use. It is therefore important to identify high-risk users and to specify the nature of these problems in order to intervene effectively with this clientele. Yet, although the scientific literature raises the idea that certain types of consumers are at higher risk, the current state of knowledge reveals little empirical information that would distinguish adolescents with higher risk profiles. To this end, the typologies available today are generally limited to theoretical or clinical studies, refer to specific problems, or are based on specific consumption indicators such as frequency of use. Furthermore, no study has yet been able to reveal the types of problems associated specifically with certain consumer profiles or to specify which profiles are more prone to various consequences. The present study is based on a latent class consumption model developed from several consumer characteristics found in the study by Fallu, Briere and Janosz (2014). They were compared with several predictors and problems associated with the consumption. The sample comes from within the context of evaluation of the New Approaches New Solutions (NANS) dropout prevention program, and consists of 1618 students who used cannabis in 10th grade. The subjects were annually evaluated from the 7th grade until the 11th. This study examines which attributed and non-attributed problems are most common for each class. It also examines which classes are most frequently assigned to different attributed and non-attributed problems. Finally, it compares the results obtained for the attributed and non-attributed problems. The analytical strategy used was to conduct descriptive analysis, chi-square analysis and univariate analysis of variance (ANOVA), sometimes followed by post-hoc tests when relevant. The results show that the class can predict the occurrence of various problems that young people face, that some classes are more represented for some problems, and that teenagers with heavier profiles are at risk of underestimating certain problems associated with their consumption. One of the main findings regarding the two early classes. It seems that early-moderate use students have a more internalized problems profile and those with early-heavy and polydrug use, a more externalized problems profile. Finally, the implications of these results are discussed.

Background: Suicide rates in the U.S. have continued to rise over the last 2 decades. The increased availability and broader legalization of cannabis is a public health concern, particularly among adolescents. The objective of this study was to examine the association between the age of cannabis initiation and lifetime suicidal ideations and attempts in a sample of adults aged 18 or older. Methods: Data are from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001 to 2003 (N = 15 238). The primary objective of the CPES was to collect data about the prevalence of mental disorders, impairments associated with these disorders, and their treatment patterns from representative samples of majority and minority adult populations in the U.S. Logistic regression analyses were conducted to test the association between cannabis initiation age (early ⩽14 years old; later >14 years old) and outcomes of lifetime suicide ideation and attempts. Cigarette use, cannabis use, gender, income, race, education, and age were controlled for the analyses. Results: Overall, 12.5% of participants reported suicide ideation, while 4.2% reported attempt. Early cannabis use was associated with a higher risk of suicide ideation (AOR = 3.32, 95% CI [2.75, 3.80]) than later cannabis use (AOR = 2.15, 95% CI [1.92, 2.39]). Early cannabis use was associated with a higher risk of suicide attempt (AOR = 4.38, 95% CI [3.48, 5.52]) than later cannabis use (AOR = 2.56, 95% CI [2.14, 3.06]). Wald chi-squared tests revealed significant differences between the early and late initiation for both ideation (χ2 = 26.99; P < .001) and attempts (χ2 = 26.02; P < .001). Conclusions: Significant associations were found between early initiation of cannabis and suicide behaviors. As suicide rates continue to rise, it is recommended that clinicians, treatment providers, and other professionals consider the use of cannabis at an early age as a risk for subsequent suicide behaviors.

Background: A younger age at onset of use of a specific substance is a well-documented risk-factor for a substance use disorder (SUD) related to that specific substance. However, the cross-substance relationship between a younger age at onset of alcohol use (AU) and nicotine use (NU) and the risk of cannabis use disorders (CUD) in adolescence and early adulthood remains unclear. Aims: To identify the sequence of and latency between initial AU/NU and initial cannabis use (CU). To investigate whether younger age at AU- and NU-onset is associated with any and earlier CU-onset and a higher risk of transition from first CU to CUD, taking into account externalizing disorders (ED) and parental substance use disorders as putative influential factors. Methods: Prospective-longitudinal community study with N = 3021 subjects (baseline age 14–24) and up to four assessment waves over up to ten years with additional direct parental and family history information. Substance use and CUD were assessed with the DSM-IV/M-CIDI. Results: Most subjects with CU reported AU (99%) and NU (94%). Among users of both substances, 93% reported AU prior to CU (87% for NU). After adjustment for ED and parental substance use disorders younger age at AU-onset was associated with any CU. Younger age at NU-onset was associated with earlier CU initiation. Younger age at AU- and NU-onset was not associated with a higher risk of CUD. Conclusions: The cross-substance relevance of younger age at first AU and NU for the risk of CUD is limited to early CU involvement.