The purpose of this integrative literature review was to understand the effects of medical cannabis for chronic pain management in adults. Anecdotal reports suggest the use of medical marijuana as a pain management therapy could be an alternative to opioids and other medications which have long term consequences. Potential uses span the health care continuum, from prescribed outpatient symptom management, to acute care, extended care, home care, and hospice treatment settings. The methodology included a review and synthesis of relevant research articles from 2012 to 2018, written in the English language. The findings suggest medical cannabis has the potential of effectively managing chronic pain in older adults. Adverse effects, if present, are mild and resolve without intervention. Lower doses of medical cannabis were reported to be more effective in treating chronic pain compared to higher doses. Inconsistencies in the efficacy of THC were noted compared to CBD for managing neuropathic pain. Implication for nursing practice, policy, education, and recommendation for future research were discussed along with study limitations.

No description available.

No description available.

<p>Marijuana use has been shown to increase and peak during young adulthood (i.e., ages 18-35). However, it appears that Black individuals do not decline in use at rates similar to other race groups. Marijuana use among Black adults has been linked to more problems such as increased arrests, greater mental health disorder diagnoses, and substance dependence. The biopsychosocial model of racism and race-based theoretical framework aims to understand how factors such as racial discrimination as a traumatic event could be associated with marijuana behaviors, particularly among Black adults. The present study aims to examine the association between racial discrimination and marijuana use and problem use above and beyond trauma exposure. Further, I aimed to explore whether gender or vocation (college, community, and military) moderated the relationships. 391 Black adults (57.5% female; mean age 24.9) completed measures on marijuana use and problems, trauma exposure, and racial discrimination distress. Hierarchical linear regression and Hayes PROCESS macro were used to evaluate the study aims. Racial discrimination distress was associated with marijuana use above and beyond trauma exposure (DR2=.016, <em>p</em>=.004). However, racial discrimination distress did not add significant variance within the model for problem marijuana use (DR2=.001, <em>p</em>=.419). Additionally, moderation by gender and vocation were not supported in either model. Taken together, the present results support that examining psychological and health outcomes among Black young adults should include an evaluation of racial discrimination distress. Further, future studies should continue to evaluate sociodemographic factors in larger more representative community-based studies to better understand potential variation in risk among Black young adults.</p>

Indiana University-Purdue University Indianapolis (IUPUI) / Marijuana use has been shown to increase and peak during young adulthood (i.e., ages 18-35). However, it appears that Black individuals do not decline in use at rates similar to other race groups. Marijuana use among Black adults has been linked to more problems such as increased arrests, greater mental health disorder diagnoses, and substance dependence. The biopsychosocial model of racism and race-based theoretical framework aims to understand how factors such as racial discrimination as a traumatic event could be associated with marijuana behaviors, particularly among Black adults. The present study aims to examine the association between racial discrimination and marijuana use and problem use above and beyond trauma exposure. Further, I aimed to explore whether gender or vocation (college, community, and military) moderated the relationships. 391 Black adults (57.5% female; mean age 24.9) completed measures on marijuana use and problems, trauma exposure, and racial discrimination distress. Hierarchical linear regression and Hayes PROCESS macro were used to evaluate the study aims. Racial discrimination distress was associated with marijuana use above and beyond trauma exposure (R2=.016, p=.004). However, racial discrimination distress did not add significant variance within the model for problem marijuana use (R2=.001, p=.419). Additionally, moderation by gender and vocation were not supported in either model. Taken together, the present results support that examining psychological and health outcomes among Black young adults should include an evaluation of racial discrimination distress. Further, future studies should continue to evaluate sociodemographic factors in larger more representative community-based studies to better understand potential variation in risk among Black young adults.

Background With the impending legalization of recreational cannabis in Canada, it is important to examine the strength of association between cannabis use and common mental health concerns including depression, anxiety, and suicide and the extent to which these associations have changed over time. It is also important to examine the moderating effects of developmental age and biological sex on these associations. Methods This study uses Statistics Canada data from the 2002 and 2012 Canadian Community Health Survey’s Mental Health Component (CCHS-MH) which represent repeated cross-sectional surveys from nationally representative samples of Canadians 15 years of age and older (2002 n=36,984; 2012 n=25,113). Stepwise multivariate analyses were performed using linear regression for psychological distress and binary logistic regression for Major Depressive Episode (MDE) and suicidal thoughts and attempts. Time was accounted for as a binary indicator (2002 vs. 2012) and an interaction term between cannabis use and time was added to all the models. Additional interaction terms were added to the models to test the moderating effects of cannabis frequency, developmental age, and biological sex. Sensitivity analyses were performed to adjust for other substance use and socioeconomic covariates. Weighting and bootstrapping was utilized to present results reflective of the Canadian population. Results Cannabis use was positively associated with emotional problems, and this association strengthened over time, particularly for depression and suicidal thoughts and attempts. These temporal associations were similar across age groups and for males and females, and remained after controlling for other substance use and socioeconomic status. Conclusions Findings provide a baseline assessment of the Canadian population prior to legalization and direction for health promotion and prevention campaigns. Results highlight the need for awareness and regular monitoring of the cooccurrence of cannabis use and emotional problems and offer guidance for future research. / Thesis / Master of Health Sciences (MSc) / Using Statistics Canada data from the 2002 and 2012 Canadian Community Health Survey’s Mental Health Component, this dissertation determines the strength of association between cannabis use and common mental health concerns including depression, anxiety, and suicide and the extent to which these associations have changed over time. Cannabis use was positively associated with emotional problems, and this association strengthened over time, particularly for depression and suicidal thoughts and attempts. These temporal associations were similar across age groups and for males and females, and remained after controlling for other substance use and socioeconomic status. These results add novel insights to the existing literature about the changing relationship between cannabis use and emotional problems over time and potential mechanisms of this change are discussed. Given the impending legalization of recreational cannabis in Canada, clinical and research implications of results are discussed at length.

No description available.

Après avoir été longtemps sujet aux sermons moraux, le consommateur de stupéfiants navigue aujourd'hui dans une prohibition presque totale de son comportement. Les politiques criminelles ont successivement renforcé ces interdictions dans une politique de « tolérance zéro » vis-à-vis des stupéfiants. Dans cet océan prohibitif, certains États ont eu des approches différentes, en dépénalisant la consommation par exemple. Le Canada a quant à lui légalisé la production, la vente, ainsi que la consommation de cannabis depuis 2018. Cette recherche se situe entre les approches des politiques criminelles canadiennes et françaises du consommateur de stupéfiants. À partir de ces dernières donc, il est possible de dégager des figures pénales du consommateur de stupéfiants. Ces dernières témoignent d'une certaine approche des politiques criminelles et des visions qu'elles ont du consommateur. Mais au-delà d'une relation unilatérale, ces figures peuvent également contraindre une politique criminelle à s'adapter. D'un consommateur délinquant, malade ou à risque, de nouvelles figures pénales modernes du consommateur émergent depuis. Dans le creux de la vague, le consommateur citoyen fait valoir ses droits et ses libertés pour espérer échapper à la stigmatisation et à la répression. En retraçant l'évolution des politiques criminelles relatives à la consommation simple de stupéfiants, et de la figure pénale associée à la pratique de celles-ci, cette recherche compare pour faire ressortir les contrastes entre des approches aujourd'hui très différentes. En prônant une approche fondée sur les enjeux médicaux, sanitaires et sociaux de la consommation, certaines figures pénales de l'usager de stupéfiants interrogent le rôle du droit pénal, ses finalités, mais aussi les moyens mis en œuvre par une politique criminelle.

La légalisation du cannabis au Canada en octobre 2018 pose à la fois des défis et des opportunités à saisir, notamment en ce qui concerne la réorientation des fonds publics pour améliorer l'efficacité de la prévention chez les jeunes. Alors que les jeunes âgés entre 15 et 24 ans sont caractérisés par un usage de cannabis supérieur à toutes les autres tranches d'âges, les méfaits associés à la substance sont amplifiés lorsque la consommation est fréquente et précoce. L'objectif de cette recherche consiste alors à déterminer quels sont les différents segments de consommateurs et de non-consommateurs de cannabis que l'on peut retrouver dans une population d'adolescents et jeunes adultes. De fait, les non-consommateurs de cannabis ne sont pas un groupe homogène. La création des profils à l'aide de l'analyse typologique repose sur les variables de segmentation suivantes: les motivations à consommer ou à ne pas consommer du cannabis, les croyances quant aux effets du cannabis, la recherche de sensations et l'attitude envers la substance. Un échantillon de 338 répondants âgés entre 15 et 24 ans comprenant 139 consommateurs et 198 non-consommateurs de cannabis a permis de révéler la présence de six profils distincts. Parmi les consommateurs, quatre profils se distinguent : les expérimentateurs, les usagers réguliers, les épicuriens et les occasionnels. En ce qui concerne les non-consommateurs, on retrouve plutôt deux profils : les résolus et les vulnérables. De tous ces profils, les consommateurs réguliers et les non-consommateurs vulnérables apparaissent plus susceptibles à la consommation de cannabis, et devraient, pour cette raison, retenir l'attention des gestionnaires en marketing sociétal. Enfin, une analyse discriminante a permis de révéler l'importance de la recherche de sensations pour discriminer entre les groupes de consommateurs et entre les groupes de nonconsommateurs, ce qui suppose la pertinence de tenir compte du niveau de recherche de sensations des profils les plus vulnérables afin de mieux orienter les messages de prévention. / The legalization of cannabis in Canada in October 2018 poses both challenges and opportunities, especially when it comes to the redirection of public funds for the purpose of improving the effectiveness of the prevention among young people. As the share of young people aged between 15 and 24 years old is characterized by a greater usage of cannabis than any other age group, the harms associated with the substance use are amplified in the case of an early and frequent use. Hence, the objective of the present study is to determine which segments of consumers and non-consumers of cannabis can be found in a population of adolescents and young adults. Indeed, the non-consumers of cannabis do not form a homogeneous group. The profile creation through cluster analysis is based on the following segmentation variables: the motivations that lead to use or not to use cannabis, the beliefs about the effects of cannabis, the search for sensations and the attitude toward the substance. A sample of 338 respondents aged between 15 and 24 years old, comprising 139 consumers and 198 non-consumers of cannabis, revealed six distinct profiles. Four profiles are found among the consumers: the experimenters, the epicureans, the regular and the occasional users. As regards the non-consumers, two profiles are identified: the determined and the vulnerable. Of all these profiles, the regular consumers and the vulnerable non-consumers seem to be more likely to use cannabis and should therefore justify more attention from societal marketing managers. All in all, a discriminant analysis exposed the relevance of the search for sensations in discriminating the groups of consumers and non-consumers, which implies the relevance to take into account the degree of the search for sensations when it comes to most at-risk profiles, in order to better target the prevention messages.

Le chemin menant à la légalisation du cannabis au Canada en 2018 semble aussi sinueux que celui menant à sa prohibition en 1923. De nombreux acteurs ont contribué à la réforme, mais les données disponibles ne permettent pas toujours de comprendre l’influence que ceux-ci ont pu avoir. Ce mémoire de maitrise se compose de deux études scientifiques complémentaires visant le même objectif principal: contribuer à la compréhension de la légalisation du cannabis, et particulièrement à la compréhension des rôles joués par l’opinion publique et par les médias. D’emblée, une étude de la portée de la littérature (scoping review) rassemble les connaissances scientifiques actuelles à propos de l’opinion publique et des drogues au Canada. Elle présente 161 références sélectionnées parmi 29 260 études, dont la plus ancienne remonte à 1956. Elle montre que l’opinion publique par rapport au cannabis est sous-étudiée au Canada en comparaison avec l’alcool et le tabac. Elle montre aussi la faible présence des auteurs et des théories en sciences sociales. Enfin, elle révèle la complexité de tracer l’évolution de l’opinion publique avec le peu de données disponibles, et donc de comprendre son impact sur la légalisation. Une seconde étude examine ensuite par analyse textuelle automatisée le traitement médiatique du cannabis au Canada et au Québec dans 29 955 articles tirés de six médias de 1985 à 2020. Cette étude offre une double contribution théorique en mesurant d’abord la normalisation du cannabis selon la théorie de Parker et al. (1998), pour ensuite clarifier le rôle des médias dans l’évolution du cadrage du cannabis selon le modèle de l’activation en cascade de Entman (2004). Les résultats montrent un traitement médiatique du cannabis plus neutre, voire plus positif depuis 2015. En 2019, la probabilité est plus élevée qu’un média aborde le cannabis sous un angle économique plutôt que judiciaire. L’étude expose l’apparition de discours alternatifs dans les médias dès les années 1990, faisant compétition au cadrage prohibitionniste défendu par les gouvernements. Ensemble, ces deux études offrent des indicateurs supplémentaires sur les influences de l’opinion publique et des médias, et appellent à davantage de recherches afin de peindre le portrait complet de la route ayant mené à la légalisation du cannabis au Canada en octobre 2018. / The road to the legalization of cannabis in Canada in 2018 seems as winding as the road to its prohibition in 1923. Many actors have contributed to the reform, but the available data do not always allow to understand the influence they may have had. This master’s thesis consists of two complementary studies with the same main objective: to contribute to the understanding of the legalization of cannabis and particularly to the understanding of the roles played by public opinion and the media. First of all, a scoping review brings together current scientific knowledge about public opinion and drugs in Canada. It presents 161 references selected from 29,260 studies, the oldest of which dates back to 1956. It shows that public opinion about cannabis is under-studied in Canada compared to alcohol and tobacco. It also shows the low presence of authors and theories from the social sciences. Finally, it reveals the complexity of tracing the evolution of public opinion with the limited data available, and thus of understanding its impact on legalization. A second study then examines by automated textual analysis the media treatment of cannabis in Canada and Quebec in 29,955 articles drawn from six media from 1985 to 2020. This study makes a double theoretical contribution by first measuring the normalization of cannabis according to the theory of Parker, Aldridge, & Measham (1998), and then clarifying the role of the media in the evolution of the framing of cannabis according to Entman’s (2004) cascade activation model. The results show a more neutral or even positive media treatment of cannabis since 2015. In 2019, there is a higher probability that the media will approach cannabis from an economic rather than a judicial perspective. The study also shows the emergence of alternative discourses in the media as early as the 1990s, competing with the prohibitionist framework put forward by governments. Taken together, these two studies provide additional indicators of public and media influences, and call for more researches to paint a complete picture of the road to cannabis legalization in Canada in October 2018.