The Health Effects of Cannabis and Cannabinoids The Current State of Evidence and Recommendations for Research (2017) / Chapter Skim
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14 Cannabis Use and the Abuse of Other Substances
14 Cannabis Use and the Abuse of Other Substances
Pages 357-376
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From page 357... ...
. In the United States, the number of individuals 12 years and older using illicit drugs rose each year between 2002 and 2013.
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From page 358... ...
For example, literature searches were limited to articles that included the search terms "longitudinal," "prospective," and "case-control," and the committee did not review controlled laboratory studies with cannabis. Although the committee did not find any fair- or good-quality systematic reviews covering these issues, 12 primary articles published since the 1999 IOM report were identified and are reviewed in this chapter.
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From page 359... ...
Data on 16,421 adults ages 18 to 34 were collected from two French nationwide health and behavior studies conducted in 2005 and 2010. The data used included the age of initiation of substance use (cannabis, tobacco, alcohol, other illicit drugs)
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From page 360... ...
Opioids Systematic Reviews The committee did not identify a good- or fairquality systematic review that reported on the association between cannabis use and the initiation of use of opioids. Primary Literature In the retrospective cohort study described earlier, Mayet and colleagues (2016)
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CONCLUSION 14-1 There is limited evidence of a statistical association between cannabis use and the initiation of tobacco use. Is There an Association Between Cannabis Use and the Rates and Use Patterns of Other Substances?
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From page 362... ...
Opioids Systematic Reviews The committee did not identify a good- or fairquality systematic review that reported on the association between cannabis use and the rates and use patterns of opioids. Primary Literature In a longitudinal study of a random sample of 120 adolescents ages 12 to 18 years who were admitted to a level 1 trauma center or an emergency department for injury, Whiteside and colleagues (2016)
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From page 363... ...
for those meeting this condition. Mixed Drug Use Systematic Reviews The committee did not identify a good- or fairquality systematic review that reported on the association between cannabis use and the rates and use patterns of substances other than cannabis.
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Patients were followed up after discharge at months 6, 12, and 18 to update the Psychiatric Research Interview for Substance and Mental Disorders. Responses were analyzed to assess cannabis use and return to substance abuse, sustained remission from substance abuse, and relapse to substance abuse after sustained remission.
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From page 365... ...
CONCLUSION 14-2 There is limited evidence of a statistical association between cannabis use and changes in the rates and use patterns of other licit and illicit substances. Is There an Association Between Cannabis Use and the Development of Other Substance Dependence or Other Substance Abuse Disorder?
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From page 366... ...
A major limitation of this study is that the participant population included children who had intact families in early childhood, families that were at high risk for developing AUD, and families of minority race/ ethnicity, thus limiting the generalizability of the study results. Tobacco/Nicotine Systematic Reviews The committee did not identify a good- or fairquality systematic review that reported on the association between cannabis use and the development of tobacco or nicotine dependence or tobacco or nicotine abuse disorder.
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From page 367... ...
Mixed Drug Use Systematic Reviews The committee did not identify a good- or fairquality systematic review that reported on the association between cannabis use and the development of substance dependence or substance abuse disorder. Primary Literature In a longitudinal U.S.
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NOTE: CI = confidence interval; OR = odds ratio. SOURCE: Adapted from Blanco et al., 2016.
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From page 369... ...
. Study limitations include the difficulty capturing the more severe cases in the cohort, as they are generally not reported; questions about the reliability of self-reporting; of the fact that covariates of substance abuse were not included in the logistic regression models; and the failure of the authors to impose clustering criteria or to distinguish between dependence with or without physiological symptoms (Palmer et al., 2009)
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From page 370... ...
The strengths of some studies cited include the study designs (longitudinal cohort stud TABLE 14-2 Adjusted Odds Ratios (and 95% Confidence Intervals) for at Least Weekly Cannabis Use and Risk Factors for Cannabis Use and Illicit Drug Abuse/Dependence, at Ages 16–17, 20–21, and 24–25 Adjusted Odds Ratios for at Least Weekly Frequency of Use of Cannabis and the Risk of Illicit Drug Use at Specific Ages Age aOR 95% CI 16–17 92.20 46.53–182.72 20–21 26.31 17.50–39.69 24–25 7.53 4.48–12.43 Adjusted Odds Ratios for at Least Weekly Frequency of Use of Cannabis and Risk of Illicit Drug Abuse/Dependence 16–17 117.92 26.31–523.74 20–21 27.61 11.24–67.90 24–25 6.49 2.19–19.20 NOTE: CI = confidence interval; aOR = adjusted odds ratio.
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From page 371... ...
RESEARCH GAPS To address the research gaps relevant to cannabis use and the abuse of other substances, the committee suggests the following: • Additional studies are needed to determine whether cannabis use is an independent risk factor for, or causally contributes to, the initiation or use of and dependence on other drugs of abuse later in life. • In states with legalized recreational cannabis, there need to be longitudinal studies that examine whether the prevalence of use of other drugs parallels the increase in prevalence of cannabis use.
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From page 372... ...
2015. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
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2012. Novel use of a lipid-lowering fibrate medication to prevent nicotine reward and re lapse: Preclinical findings.
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Part IV Research Barriers and Recommendations
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