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Substance misuse and comorbid psychiatric disorders
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Excessive use of drugs and/or alcohol is very common among youth with schizophrenia. Psychosis is also associated with the use of a number of substances, particularly, but not exclusively, cannabis (Arseneault et al., 2004; Henquet et al., 2005; Murray et al., 2007). In a study by Hambrecht and Häfner (2000), a vulnerability hypothesis was constructed to help explain the frequent use of marijuana in patients with schizophrenia. This vulnerability hypothesis was divided to cover three groups of people. Those who were frequent users in Group 1 might have decreased the threshold for the appearance of schizophrenia because they had used substances for several years before the onset of the disorder. People in Group 2 may be in a group in which the dopaminergic stress factor may precipitate the onset of schizophrenia. People in this group developed schizophrenia in the same month in which they began to use marijuana. Group 3 may describe people who use the marijuana to self-medicate because they developed marijuana abuse after the onset of the schizophrenia.
Hallucinogenic Agents
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Psychological tolerance and addiction, characterized by compulsive drug-seeking behavior and abuse despite its known harmful effects on social functioning, has been documented with long-term marijuana abuse. Some physical tolerance is also noted—withdrawal from long-term use results in irritability, sleeplessness, decreased appetite, weight loss, and anxiety. Withdrawal symptoms begin within about 1 day following abstinence, peak at 2–3 days, and subside within 1 or 2 weeks following drug cessation. Some pharmacological tolerance to the cardiovascular effects is also observable. In addition, increase in activation of the stress–response system and changes in activity of dopaminergic neurons have been noted with cannabinoid withdrawal in chronically exposed animals.
Genetic influences on antisocial behaviour, problem substance use and schizophrenia: evidence from quantitative genetic and molecular genetic studies
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Pamela J Taylor, Marianne BM van den Bree, Nigel Williams, Terrie E Moffitt
In the Vietnam Era Twin Study, Tsuang et al. (1998) found that, in males, marijuana abuse, more than abuse of other drugs, was influenced by shared environmental factors, and that each category of drug, except psychedelics, also had unique genetic influences, not shared with other drug categories, with heroin misuse most genetically influenced. Kendler et al. (2003a) also conducted a study in male twins and found that the genetic and shared environmental effects on risk for use and misuse of illicit drugs were largely or entirely non-specific, while a common genetic factor had a strong influence on all drugs. Environmental experiences unique to the person largely determined whether predisposed individuals used or misused one class of psychoactive substance or another. Using a discordant co-twin design, Lynskey et al. (2003) reported that individuals who used cannabis by age 17 years had 2–3 times the risk of going on to other drug use – whether alcohol or illicit drugs – than their co-twin who did not use cannabis before age 17 years, suggestive of unique environmental influence. Karkowski et al. (2000), using the Kendler registry, found that females appeared similar to males in this respect. An extension of this work included both licit and illicit drug dependence (cannabis, cocaine, alcohol, caffeine, and nicotine) by both sexes (Kendler et al., 2007). Findings indicated there are two genetic factors – one predisposing largely to licit drug dependence and one to illicit drug dependence; evidence was for quite large specific genetic influences on both nicotine and caffeine dependence.
A Pilot Randomized Controlled Trial (RCT) of Acceptance and Commitment Therapy Versus Cognitive Behavioral Therapy for Chronic Insomnia
Published in Behavioral Sleep Medicine, 2023
Renatha El Rafihi-Ferreira, Charles M Morin, Rosa Hasan, Israel S Brasil, José Humberto Zago Ribeiro, Andrea Cecília Toscanini
To confirm eligibility, participants underwent a medical and neuropsychiatric evaluation by an experienced clinician. The neuropsychiatric evaluation was based on the Mini International Neuropsychiatric Interview (MINI; Amorim, 2000). The following exclusion criteria were used: (a) presence of a progressive or unstable physical illness (e.g., cancer, acute pain) or neurological degenerative disease (e.g., dementia); (b) unstable psychiatric comorbidities, e.g., a lifetime diagnosis of a psychotic or bipolar disorder or more than two lifetime episodes of major depressive disorder or an untreated current major depressive disorder; (c) evidence of sleep apnea (apnea/hypopnea index >15), restless legs or periodic limb movements during sleep (PLMS with arousal >15 per hour) or a circadian-based sleep disorder (e.g., delayed or advanced sleep phase syndrome); (d) a current alcohol and/or substance misuse problem; (e) marijuana abuse (use more than once a week); (f) illiteracy; (g) working night shifts and being unable to discontinue this work pattern during the trial; (h) unavailability for attending the in-person sessions. Participants were not excluded for use of sleep medication (including over the counter); however, to avoid confounds between behavioral treatment and medication effects, only participants taking stabilized sleep medications for at least 3 months were accepted. These participants were instructed not to change the medication and/or increase the dose during the research period.
Photovoice as a tool for exploring perceptions of marijuana use among Appalachian adolescents
Published in Journal of Ethnicity in Substance Abuse, 2023
Dana Harley, Theda Rose, Trenette Clark Goings, James Canfield
Marijuana is the second most common drug for which rural people receive substance abuse treatment (Rural Health Reform Policy Research Center, 2014). However, substance use among rural and Appalachian adolescents remains understudied relative to their counterparts. Substance use has increased in rural Appalachia over the past 20 years (Centers for Disease Control and Prevention [CDC], 2015). In light of marijuana’s legalization in several states and the known negative consequences of its use during adolescence, more information is needed about the factors that contribute to and protect against marijuana abuse (Hawkins et al., 1992). Identifying these factors is essential to the development of effective prevention programs and policies. This article describes how a qualitative technique referred to as photovoice may be used to identify factors associated with marijuana use among understudied cultural groups. These results may, in turn, inform the development of prevention programs and policies.
Predictors of motives for marijuana use in African American adolescents and emerging adults
Published in Journal of Ethnicity in Substance Abuse, 2022
Vinetra L. King, Sylvie Mrug, Michael Windle
Adolescents and emerging adults are at higher risk for experiencing trauma than younger children, with some of these individuals experiencing significant reactions to trauma exposure, characterized by PTSD symptoms (Finkelhor et al., 2015; Kaminer et al., 2005). Exposure to traumatic events, such as physical and sexual assault or witnessing violence, has been consistently associated with increased marijuana use and risk for marijuana abuse among adolescents (e.g., Kilpatrick et al., 2000; Vermeiren et al., 2003), which may be explained by adolescents using marijuana to cope with PTSD symptoms (Kilpatrick et al., 2000). In fact, adolescents with more PTSD symptoms are more likely to use marijuana for coping rather than social, enhancement, or conformity motives; however, both studies were conducted with a primarily Caucasian sample (Bonn-Miller et al., 2007; Bujarski et al., 2012). Since African American adolescents are more likely to be exposed to traumatic events and experience PTSD, it is important to understand the role of PTSD symptoms in relation to marijuana use motives in this at-risk group (Andrews et al., 2015; Finkelhor et al., 2015; Roberts et al., 2011).