Literature Review "Persistent increased severity of cannabis use disorder symptoms in adolescents compared to adults: a one-year longitudinal study"
Lees, R., Lawn, W., Petrilli, K. et al. Persistent increased severity of cannabis use disorder symptoms in adolescents compared to adults: a one-year longitudinal study. Eur Arch Psychiatry Clin Neurosci (2024). https://doi.org/10.1007/s00406-024-01806-y
Abstract
This one-year longitudinal study investigates the severity of Cannabis Use Disorder (CUD) symptoms in adolescents (aged 16-17) compared to adults (aged 26-29). The research reveals that adolescents consistently exhibit higher CUD symptom severity than adults, scoring an average of 3.7 points higher on the Cannabis Use Disorder Identification Test-Revised (CUDIT-R), even when controlling for factors such as cannabis quantity, gender, and the impact of the COVID-19 pandemic. The study highlights the persistent nature of CUD symptoms in adolescents, despite a general linear decrease in symptoms over the year in both groups. In terms of standard THC units, adolescents reported higher cannabis use, and the quantity of cannabis consumed did not fully explain the increased severity of CUD symptoms, indicating the presence of other underlying vulnerabilities. The study underscores the significant impact of cannabis use on adolescents' daily lives, interfering with obligations, such as school attendance and performance. These findings emphasize the need for targeted interventions and evidence-based policies to address cannabis use among adolescents, particularly in the potential legalization of recreational marijuana.
Keywords: Cannabis Use Disorder (CUD) Adolescents Cannabis Use Patterns THC CUDIT-R
A recent study titled "Persistent increased severity of cannabis use disorder symptoms in adolescents compared to adults: a one-year longitudinal study" provides significant insights into the prevalence and severity of Cannabis Use Disorder (CUD) symptoms in adolescents compared to adults. The findings of this study are particularly pertinent in the current discussions surrounding the potential inclusion of recreational marijuana on the ballot in Florida.
?This article highlights the ongoing concern that, despite the legal age restrictions, adolescents are still able to obtain alcohol quickly. The potential legalization of recreational marijuana poses a significant risk, potentially leading to easier access for adolescents and the subsequent harm to their health and well-being. As someone who works extensively with young people and is involved in shaping policies, I received this article from a colleague who understands the importance of this issue. I believe policymakers and the community must take the time to review and consider the contents of this document and understand the potential harm to our youth.
The study tracked the progression of CUD symptoms over 12 months in both adolescents (aged 16-17) and adults (aged 26-29) who regularly used cannabis. One key revelation from the study was the persistent higher severity of CUD symptoms in adolescents compared to adults. On average, adolescents scored 3.7 points higher on the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) than adults, even after accounting for factors such as cannabis quantity, gender, and the impact of the COVID-19 pandemic.
What’s particularly noteworthy is that while both groups exhibited a linear decrease in CUD symptoms over the year, indicating a potential 'maturing out' effect where individuals naturally reduce their substance use as they age, adolescents consistently reported higher symptoms. This trend raises concerns about the enduring impact of cannabis use on the developing brains of adolescents.
Besides the severity of CUD symptoms, the study also shed light on the cannabis use patterns among adolescents. It was observed that adolescents reported higher cannabis use in terms of standard THC units. Importantly, even when accounting for the higher cannabis use in adolescents, it did not fully account for the increased CUD symptoms. This suggests the presence of other underlying vulnerabilities in adolescents, such as social and environmental factors that contribute to the heightened severity of CUD symptoms compared to adults.
Furthermore, the impact of cannabis use on daily life was particularly notable among adolescents. Many adolescents reported that cannabis use interfered with their daily obligations, such as school attendance and performance, and consumed significant time, potentially disrupting their personal and academic lives.
These findings underscore the importance of addressing cannabis use among adolescents and implementing evidence-based, targeted interventions to mitigate the impact of CUD on this vulnerable population. Furthermore, as policymakers deliberate on the potential inclusion of recreational marijuana on the ballot in Florida, these findings serve as crucial evidence to inform the development of evidence-based policies and interventions. The decisions made now will have a significant impact on the future of our youth.
?Recommendations for Further Research
1. Longer Follow-Up Periods: Extending the follow-up period beyond one year to understand the long-term trajectory of CUD symptoms from adolescence into adulthood.
2. Broader Age Range: To capture a more comprehensive picture of CUD development and persistence, a wider age range of adolescents and adults will be included.
3. Mental Health and Substance Use Disorders: Investigating the co-occurrence of other mental health disorders and substance use disorders to understand their role in the persistence of CUD symptoms.
4. Genetic and Environmental Factors: This study explores genetic predispositions and environmental factors that may contribute to adolescents' increased vulnerability to CUD.
5. Intervention Studies: Intervention studies test the effectiveness of various treatment and prevention strategies tailored specifically for adolescents.
6. Measurement Tools: Validating and potentially developing new tools for assessing CUD symptoms sensitive to developmental differences between adolescents and adults.
These recommendations aim to deepen the understanding of CUD in adolescents and inform more effective prevention and treatment strategies.
Citations:
?In a recent study, researchers observed that adolescents, particularly those in the 16-17 age group, consistently showed more severe symptoms of Cannabis Use Disorder (CUD) compared to adults aged 26-29 over a year. An intriguing finding was that adolescents scored, on average, 3.7 points higher on the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) than adults, even after controlling for variables such as the quantity of cannabis consumed, gender and the impact of the COVID-19 pandemic.
An essential aspect of the study was the consideration of cannabis quantity. To accurately gauge cannabis intake, the study employed a measure called "standard THC units," where one unit corresponds to 5 mg of THC, the primary psychoactive component of cannabis. This measure played a crucial role in estimating the mean weekly THC consumption for each participant. Notably, the analysis adjusted for this variable to ensure that any differences observed in CUD symptoms were not purely attributed to variations in the amount of cannabis consumed.
?These findings underscore the need for a comprehensive understanding of the impact of cannabis use, particularly among adolescents, and the significance of considering various factors in assessing CUD severity. This information is vital for clinicians and policymakers aiming to develop effective intervention and prevention strategies tailored to different age groups and cannabis consumption patterns.
?Recommendations for Future Research
1. Longitudinal Study: Extending the follow-up period beyond one year to investigate the long-term trajectory of CUD symptoms from adolescence into adulthood.
2. Expanded Age Range: Encompassing a broader age range of adolescents and adults to understand CUD development and persistence better.
3. Comorbidity Investigation: Examining the co-occurrence of mental health disorders and substance use disorders to elucidate their impact on the persistence of CUD symptoms.
4. Genetic and Environmental Factors: This section explores genetic predispositions and environmental influences contributing to adolescents' heightened susceptibility to CUD.
5. Intervention Research: Evaluating the effectiveness of tailored treatment and prevention strategies for adolescents.
6. Psychometric Tools: Validating and potentially developing new assessment tools for CUD symptoms that account for developmental discrepancies between adolescents and adults[1][2][8].
The study's findings underscore the critical imperative for targeted public health interventions aimed at addressing the heightened susceptibility of adolescents to Cannabis Use Disorder (CUD). The ramifications of this research advocate for the implementation of concrete strategies, encompassing the following critical implications:
Integrated Youth Services: Emphasizing the formulation and implementation of integrated healthcare services that span a broader age spectrum, from 12 to 25 years, is paramount to ensuring the seamless transition of care from adolescence into adulthood. This approach aims to provide a continuum of support and medical attention to mitigate the adverse effects of CUD across developmental stages.
Education and Harm Reduction: Tailoring educational programs and harm reduction strategies to young individuals' specific needs and vulnerabilities is imperative. By providing age-appropriate resources and interventions, we can effectively address the risks associated with cannabis use, thereby fostering healthier decision-making and reducing the likelihood of substance abuse among this demographic.
Policy Changes: An essential facet of addressing the vulnerability of adolescents to CUD involves dismantling stigmas and barriers associated with seeking treatment for cannabis-related issues and increasing the accessibility of support services for young people. Policy reforms aimed at destigmatizing treatment-seeking behaviors and bolstering support services can effectively dismantle systemic obstacles that hinder adolescents from receiving necessary care and assistance.
These strategies are fundamental in not only safeguarding the well-being of adolescents but also in fostering a healthier, more resilient future generation. Therefore, it is paramount that policymakers and stakeholders integrate these implications into public health policies to effectively address the unique needs of young individuals within the broader context of substance abuse prevention and intervention.
These measures could help mitigate the long-term negative impacts of early cannabis use on adolescents' mental health and overall well-being.
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Chart 1
?Demographic Characteristics of Participants
The study included two groups of participants: adolescents and adults. Here are the key demographic characteristics:
?Participants
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- Total Participants: 146
??- Adolescents: 76 (aged 16-17)
??- Adults: 70 (aged 26-29)
?Gender
- Adolescents: 50% female
- Adults: 45.7% female
?Ethnicity
- Adolescents:
??- White: 68%
??- Asian: 2.7%
??- Mixed: 20%
??- Black: 5.3%
??- Other: 4%
- Adults:
??- White: 64.3%
??- Asian: 15.7%
??- Mixed: 10%
??- Black: 8.6%
??- Other: 1.4%
?Socioeconomic Status
- Adolescents: Mean SES score of 58.67
- Adults: Mean SES score of 44.93
?Maternal Education
- Adolescents:
??- Undergraduate degree or above: 41.33%
- Adults:
??- Undergraduate degree or above: 55.10%
?Cannabis Use Patterns
- Days per week of cannabis use:
??- Adolescents: Mean of 14.6 days
??- Adults: Mean of 12.96 days
- Mean age of first cannabis use:
??- Adolescents: 13.16 years
??- Adults: 28.57 years
?Other Substance Use
- Daily cigarette smoking:
??- Adolescents: 2.63%
??- Adults: 25.71%
- Alcohol use (≥ two days per week):
??- Adolescents: 59.21%
??- Adults: 7.90%
- Other drug use (≥ one day per month):
??- Adolescents: 12.71%
??- Adults: 7.62%
?Mental Health
- Depression (Beck Depression Inventory scores):
??- Adolescents: Mean of 12.49 (SD = 10.12)
- Anxiety (Beck Anxiety Inventory scores):
??- Data not provided in the summary
These characteristics provide a comprehensive overview of the demographic and behavioral profiles of the study participants.
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