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Youth e-cigarette use drops, more warnings issued

10/20/20--According to the 2020 National Youth Tobacco Survey, conducted by researchers at the FDA and the Centers for Disease Control and Prevention, youth e-cigarette use declined by a third after 2 years of increases. It showed that 19.6% of high school students (3.02 million) reported e-cigarette use, down from 27.5% (4.11 million) in 2019. Among middle school students, 4.7% (550 000) reported e-cigarette use compared with 10.5% (1.24 million) in 2019. Read

Substance use disorder linked to higher COVID-19 risk

10/27/20--People with substance use disorder (SUD), particularly those with opioid use disorder (OUD) and Black individuals, are at an increased risk of coronavirus disease 2019 (COVID-19), according to a recent study coauthored by Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA). Volkow and her coauthors conducted a case-control study of deidentified electronic health records for nearly 73.1 million unique patients, including 12 030 with diagnosed COVID-19. Read

US drug use survey uncovers both promising and concerning trends

10/27/20--Among people aged 12 years or older in 2019, 60.1% reported having used a substance during the past month, according to the latest National Survey on Drug Use and Health, compiled by the Substance Abuse and Mental Health Services Administration. The most commonly reported substance used in the past month was alcohol, consumed by 50.8% of survey respondents, followed by tobacco, used by 21.1%. In addition, 13% used an illicit drug. Read

Rising rates of ED visits for suicidal ideation, suicide attempt

10/27/20--From 2008 to 2017, the rate of emergency department (ED) visits related to suicidal ideation or suicide attempt increased among all age groups 5 years or older, according to a recent report from the Agency for Healthcare Research and Quality (AHRQ). Overall, males were more likely than females to present to an ED because of suicidal ideation or a suicide attempt, although females aged 10 to 19 years had higher rates of ED visits for suicidal ideation or suicide attempt, with the highest rate of such visits among females aged 15 to 19 years  Read

Marijuana legalization proponents outraising opponents 36-to-1 in 2020

10/27/20--Proponents of state ballot measures have outraised opponents this election season by almost 36-to-1, a massive increase from four years ago when advocates outstripped the opposition by only 4-to-1. Supporters of the legalization measures in Arizona, Mississippi, Montana, New Jersey and South Dakota have brought in roughly $19.6 million so far, compared with only $546,000 raised by opponents, according to a Marijuana Business Daily analysis. Read

Trajectories of Nicotine and Cannabis Vaping and Polyuse From Adolescence to Young Adulthood

10/6/20--In this cohort study, the prevalence and type of nicotine vaping and cannabis vaping developmental trajectories from late adolescence to young adulthood were similar. Polysubstance vaping was common from late adolescence to young adulthood, particularly among those reporting more frequent vaping use. The findings suggest that public health policy and clinical interventions should address polysubstance vaping in both adolescence and young adulthood. Read

Assessment of Changes in Alcohol and Marijuana Abstinence, Co-Use, and Use Disorders Among US Young Adults From 2002 to 2018

10/12/20--The findings of this study suggest that US colleges and communities should create and maintain supportive resources for young adults as the substance use landscape changes, specifically as alcohol abstinence, marijuana use, and co-use increase. Interventions for polysubstance use, alcohol use disorder, and marijuana use disorder may provide valuable opportunities for clinicians to screen for prescription drug misuse. Read

CBD drug is approved for a third form of epilepsy

9/15/20--Epidiolex, is the only FDA-approved drug with CBD as an active ingredient, was approved to treat seizures associated with tuberous sclerosis complex (TSC) in patients aged 1 year or older. TSC is a genetic disease that causes benign tumors to grow throughout the body. Read

Assessment of menthol and nonmenthol cigarette consumption in the US, 2000 to 2018

8/7/20--According to a study, menthol cigarette market share increased by nearly 10 percentage points from 2000 to 2018. Overall, cigarette consumption declined 46.0% from 2000 (435.6 billion cigarettes) to 2018 (235.3 billion cigarettes), but the decline was greater among nonmenthol cigarettes (52.9%; 322.8 billion to 152.0 billion cigarettes) than for menthol cigarettes (26.1%; 112.8 billion to 83.3 billion cigarettes in 2018). Read

Trends in mortality from drug poisonings, suicide, and alcohol-induced deaths in the United States From 2000 to 2017

9/11/20--This serial cross-sectional study using US mortality data from 2000 to 2017, including 1,446 ,177 drug poisoning, suicide, and alcohol-induced premature deaths found that demographic characteristics and geographic patterns varied by cause of death, suggesting that increasing death rates from these causes were not concentrated in 1 group or region. Specialized interventions tailored for the underlying drivers of each cause of death are urgently needed.. Read

Assessment of menthol and nonmenthol cigarette consumption in the US, 2000 to 2018

8/7/20--This serial cross-sectional study estimates menthol and nonmenthol cigarette consumption from 2000 to 2018 with a previously used approach. Results indicate that the large decline in cigarette consumption in the US over the last 2 decades is overwhelmingly attributed to nonmenthol cigarettes, and this trend is more pronounced since the signing of the TCA. Read

The Current Status of Psychedelics in Psychiatry

7/29/20--Until very recently, no companies would manufacture medical-grade psychedelics, which made getting regulatory approval for clinical research—especially clinical trials—very difficult and in some countries (eg, Germany) impossible. Read

Content Analysis of Instagram Posts From 2019 With Cartoon-Based Marketing of e-Cigarette–Associated Products

7/20/20--Studies have indicated that cartoons are an effective strategy in increasing product recognition and susceptibility to use e-cigarettes. Recently, the US Food and Drug Administration announced it is prioritizing enforcement against e-cigarette companies that use marketing likely to promote youth use. This study aimed to determine if companies were using cartoon-based strategies to market and promote e-cigarette–associated products in 2019 on Instagram. Read

Effect of inhaled cannabis for pain in adults with sickle cell disease a randomized clinical trial

7/17/20-- This randomized clinical trial found that, compared with vaporized placebo, vaporized cannabis did not statistically significantly reduce pain and associated symptoms, except interference in mood, in patients with SCD with chronic pain. Read

Association of state policies allowing medical cannabis for opioid use disorder with dispensary marketing for this indication

7/14/20--According to this study, state-level policies designating opioid use disorder (OUD) as a qualifying condition for medical cannabis were associated with more dispensaries claiming cannabis can treat OUD. Future studies linking dispensary advertisements to health outcomes in people with OUD (eg, use of MOUDs, overdose mortality) are warranted, as are investigations into advertising that addresses other conditions with major morbidity and mortality consequences. Read

Reducing Impaired Driving Fatalities: Data Need to Drive Testing, Enforcement, and Policy

6/22/20--The 2 studies evaluating the association of recreational cannabis laws with motor vehicle crash deaths by Santaella-Tenorio et al and Kamer et al in this issue of JAMA Internal Medicine contribute to an emerging body of research necessary to inform policy on cannabis and impaired driving. Both studies use natural experiments in policy implementation to provide a high-level perspective of how legalization of recreational cannabis use may affect motor vehicle crash deaths in the population. Read

Association of Recreational Cannabis Laws in Colorado and Washington State With Changes in Traffic Fatalities, 2005-2017

6/22/20--Using a synthetic control approach, this ecological study found that recreational cannabis laws were associated with increases in traffic fatalities in Colorado (mean of 75 excess fatalities per year) but not in Washington State. These findings suggest that unintended effects of recreational cannabis laws can be heterogeneous and may be specific to variations in how these laws are implemented (eg, density of recreational cannabis stores). Read

Changes in traffic fatality rates in the first 4 states to legalize recreational marijuana

6/22/20--Researchers have not yet conclusively determined if a state’s legalizing recreational marijuana is associated with traffic fatality rates. Two early studies reported no significant change in roadway deaths following legalization in Colorado and Washington, whereas a study including Oregon reported a temporary increase. A more recent study, including 2017 data, found a statistically significant increase in fatal crashes only after commercial stores opened, suggesting that the effect of legalization may take more time to observe. Read

Assessment of Incorporation of Lessons from Tobacco Control in City and County Laws Regulating Legal Marijuana in California

6/19/20--The aim of this cross-sectional study is to assess the extent to which potential best practices, including those from tobacco control, were incorporated into state and local marijuana policies in California. Results indicate that all 539 California cities and counties found that jurisdictions differed widely in how they regulated marijuana and that key public health recommendations and lessons from tobacco control have generally not been adopted, although local innovation is emerging. Read

Association of electronic nicotine delivery system use with cigarette smoking relapse among former smokers in the United States

6/5/20--In this study, risk of cigarette smoking relapse among former cigarette smokers was higher among those who used electronic nicotine delivery systems or other tobacco products compared with those who did not. Furthermore, for clinicians treating former smokers who have successfully quit all nicotine products, the implications are that use of ENDS products should be discouraged, just as use of all other tobacco products is discouraged. Read

Association of socioeconomic position with e-cigarette use among individuals who quit smoking in England, 2014 to 2019

6/5/20--In this study, lower socioeconomic position was associated with higher rates of e-cigarette use among those who quit smoking after e-cigarettes became widely available, likely reflecting continued use of e-cigarettes as a long-term cessation aid among individuals with lower socioeconomic positions. Read

Associations of flavored e-cigarette uptake with subsequent smoking initiation and cessation

6/5/20--In this cohort study with 17, 929 participants, multivariable analyses of nationally representative, longitudinal survey data evaluated differences in smoking initiation and cessation subsequent to vaping uptake among those who used flavored vs unflavored e-cigarettes, separately by age group. Results indicate that adults who began vaping nontobacco-flavored e-cigarettes were more likely to quit smoking than those who vaped tobacco flavors. More research is needed to establish the relationship between e-cigarette flavors and smoking and to guide related policy. Read

Interventions to Prevent Illicit and Nonmedical Drug Use in Children, Adolescents, and Young Adults Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

5/26/20--The study was designed to review the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force. Evidence concludes that behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Read

Primary Care–Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults US Preventive Services Task Force Recommendation Statement

5/26/20--To update its 2014 recommendation, the USPSTF commissioned a review of the evidence on the potential benefits and harms of interventions to prevent illicit drug use in children, adolescents, and young adults. It has been concluded that the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs, in children, adolescents, and young adults. Read

Association of Naturalistic Administration of Cannabis Flower and Concentrates With Intoxication and Impairment

6/10/20--This study provides information about the association of pharmacological and neurobehavioral outcomes with legal market cannabis. Short-term use of concentrates was associated with higher levels of THC exposure. Across forms of cannabis and potencies, users’ domains of verbal memory and proprioception-focused postural stability were primarily associated with THC administration. Read

Association of high-potency cannabis use with mental health and substance use in adolescence

5/27/20--A study designed to explore the association between cannabis potency and substance use and mental health outcomes, accounting for preceding mental health and frequency of cannabis use suggests that the use of high-potency cannabis is associated with mental health and addiction. Limiting the availability of high-potency cannabis may be associated with a reduction in the number of individuals who develop cannabis use disorders, the prevention of cannabis use from escalating to a regular behavior, and a reduction in the risk of mental health disorders. Read

Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults

5/26/20--Based on a study designed to review the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force, evidence for behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Health, social, and legal outcomes were sparsely reported, and few showed improvements. Read

Primary Care–Based Interventions to Prevent Illicit Drug Use in Children, Adolescents, and Young Adults

5/26/20--Illicit drug use is associated with many negative health, social, and economic consequences and is a significant contributor to 3 of the leading causes of death among young persons (aged 10-24 years): unintentional injuries including motor vehicle crashes, suicide, and homicide. However, the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care–based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs, in children, adolescents, and young adults. Read

Recommendations from the USPSTF for prevention and cessation of tobacco use in children and adolescents

4/28/20--In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents updated recommendations on prevention and cessation of tobacco use among children and adolescents seen in primary care settings. The USPSTF recommends education and brief counseling with a clinician to prevent initiation of tobacco use. The USPSTF also concludes that evidence is insufficient to assess the balance of benefits and harms of primary care–feasible interventions for the cessation of tobacco use among school-aged children and adolescents. Read

Changes in prevalence of vaping among youths in the United States, Canada, and England from 2017 to 2019

5/4/20--The prevalence of vaping increased between 2018 and 2019 within all 3 countries, but was substantially more prevalent in Canada and the US compared with England. Vaping was substantially higher among individuals who reported smoking than other respondents in all 3 countries, although increases between 2017 and 2019 were observed across all subgroups for most measures of vaping in the US and Canada including among those who reported never smoking. Read

Youth perceptions of Juul in the United States

5/4/20--The use of e-cigarettes among youths has reached epidemic proportions in the United States. Juul is the most popular brand of e-cigarettes among youth, and it has been criticized for marketing that targets youths. Concerns of serious short-term and long-term health outcomes from e-cigarette use have led to actions from the US Food and Drug Administration, states, and municipalities to ban or restrict the sale of e-cigarettes. Read

Primary Care Interventions for Prevention and Cessation of Tobacco Use in Children and Adolescents

4/28/20--Tobacco use is the leading cause of preventable death in the US. An estimated annual 480,000 deaths are attributable to tobacco use in adults, including from secondhand smoke. The USPSTF commissioned a review of the evidence on the benefits and harms of primary care interventions for tobacco use prevention and cessation in children and adolescents. The current systematic review newly included e-cigarettes as a tobacco product. Read

Trends in the Incidence and Lethality of Suicidal Acts in the United States, 2006 to 2015

4/22/20--In this cross-sectional study based on national representative data of 1,222,419 suicidal acts, increased suicide rates were associated with an increase in both incidence rates and lethality of suicidal acts from 2006 to 2015. In subgroup analyses, incidence of suicidal acts increased among female persons, adolescents, and older adults aged 65 to 74 years, whereas suicidal acts became more lethal among both sexes and persons aged 20 to 64 years. Read

Trends in marijuana vaping and edible consumption from 2015 to 2018 among adolescents in the United States

4/6/20--There is growing evidence associating adolescent marijuana use with developmental and societal consequences. Prevalence and trends from 2015 to 2018 in noncombustible marijuana use and differences by use frequency and sociodemographic characteristics have been documented. Vaping has increased rapidly among adolescents, and Regional data suggest boys vape more than girls, but there are conflicting reports of sex differences in edible use, and differences across modes of use for race/ethnicity, and socioeconomic status (SES). Read

Trends in alcohol-induced deaths in the United States, 2000-2016

2/21/20--A serial cross-sectional study using US mortality data from 2000 to 2016 found large increases in alcohol-induced death rates across age and racial/ethnic subgroups of the US population, which have accelerated over recent years. Large increases in alcohol-induced deaths among younger age groups may be associated with future increases in alcohol-related disease. Read

Dose-ranging effect of adjunctive oral cannabidiol vs placebo on convulsive seizure frequency in Dravet Syndrome

3/2/20--Adjunctive cannabidiol at doses of 10 and 20 mg/kg/d led to similar clinically relevant reductions in convulsive seizure frequency with a better safety and tolerability profile for the 10-mg/kg/d dose in children with treatment-resistant Dravet syndrome. Dose increases of cannabidiol to greater than 10 mg/kg/d should be tailored to individual efficacy and safety. Read

Prevalence of electronic cigarette use among adolescents in New Jersey and association with social factors

2/12/20--In a survey study of 4183 respondents examining factors associated with use of electronic cigarettes (e-cigarettes), including JUUL, among high school students, inclusion of a JUUL use measure produced higher estimates of current use than assessing the use of e-cigarettes or JUUL alone, and 88.8% of youth reported using the JUUL brand. In addition, current use of other tobacco products, endorsing a tobacco brand on social media, having tobacco-branded merchandise, having close friends who used JUUL, and seeing JUUL used on school grounds were significantly associated with current and frequent e-cigarette use, inclusive of JUUL. Read

Medical Cannabis

2/11/20--Medical cannabis refers to preparations of the cannabis plant that patients use to treat medical conditions, and it has been used for medicinal purposes for thousands of years by many civilizations. As of January 2020, 33 states and the District of Columbia had put laws into place so physicians can certify the use of “medical marijuana,” or medical cannabis, for debilitating medical conditions—although cannabis remains illegal federally. Read

What should I know about medical cannabis?

2/11/20--The JAMA Internal Medicine Patient Page outlines pertinent details about medical marijuana, it's use, the dangers, and how it's regulated in the United States. Read 

Can cannabis cure cancer?

1/16/20--As published in JAMA Oncology, a thorough review by the US National Academies of Sciences, Engineering, and Medicine found moderate evidence of no statistical association between cannabis use and the development of lung and head and neck cancers. Furthermore, limited evidence of a statistical association was found between cannabis use and the development of nonseminomatous testicular carcinomas without good support for a causative effect. Read

e-Cigarette use among youth in the United States, 2019

11/5/19--In a cross-sectional survey conducted in 2019 that included 19,018 participants to examine the estimated frequency of the current (past 30-day) use of e-cigarettes among US high school and middle school students in 2019, the findings indicate that the prevalence of self-reported current e-cigarette use was high among US high school and middle school students. Read

Cannabidiol products are everywhere, but should people be using them?

11/20/19--Although the CBD market has exploded in recent months, with products ranging from bath salts to coffee and tea to maple bacon–flavored dog biscuits, research suggests that many actually do not contain CBD. And the compound’s murky status raises a host of questions: Is it safe? Is it effective? Is it legal? Is it a dietary supplement or a drug? Read

Association between recreational marijuana legalization in the United States and changes in marijuana use and cannabis use disorder from 2008 to 2016

11/13/19--Findings in a multilevel, difference-in-difference survey study with 505 796 respondents comparing marijuana use before and after the legalization of recreational marijuana in the United States, revealed that the proportion of respondents aged 12 to 17 years reporting cannabis use disorder increased from 2.18% to 2.72%, while the proportion of respondents 26 years or older reporting frequent marijuana use increased from 2.13% to 2.62% and those with cannabis use disorder, from 0.90% to 1.23%. Read

The opioid crisis, corporate responsibility, and lessons from the tobacco master settlement agreement

11/1/19--The opioid crisis has accounted for 770 000 deaths in the United States over the past 20 years, and this crisis has contributed to the decline in US overall life expectancy for 3 consecutive years. Responsibility for holding corporations accountable for their role in the opioid epidemic—and ensuring they contribute to solutions—falls primarily to state attorneys general who are responsible for protecting the public and can act individually or as a group through lawsuits or negotiations when public health is threatened. Read

A national survey of marijuana use among US adults with medical conditions, 2016-2017

9/20/19--This survey study using data from 169,036 participants in the 2016 and 2017 Behavioral Risk Factor Surveillance System surveys found that, compared with adults without medical conditions, adults with medical conditions had a significantly higher prevalence of current and daily marijuana use, were more likely to report using marijuana for medical reasons, and were less likely to report using marijuana for recreational purposes. Read

Cannabis inhalation and voice disorders

8/8/19--In a systematic review of 6 human studies and 13 basic science and animal studies, cannabis inhalation was associated with dark vocal folds on laryngoscopy as well as respiratory symptoms and negative lung function changes attributable to degradation byproducts generated during smoke exposure, especially in large doses. Read

Medical use of cannabis in 2019

8/9/19--As of August 2019, 33 states and the District of Columbia have initiated policies allowing the use of cannabis or cannabinoids for the management of specific medical conditions. Yet, insufficient evidence exists for the use of medical cannabis for most conditions for which its use is advocated. Despite the lack of evidence, various US state governments have recommended cannabis for the management of more than 50 medical conditions. Read

Acute effects of smoked and vaporized cannabis in healthy adults who infrequently use marijuana

11/30/18--Significant, sometimes adverse, drug effects can occur at relatively low THC doses in infrequent marijuana users, and accordingly this data should be considered with regard to regulation of retail marijuana products and education for individuals initiating marijuana use. Read

Alcohol, cigarette, and marijuana use between 2002 and 2016 in pregnant women from a nationally representative sample

11/5/18--In the National Survey of Drug Use and Health, the adjusted prevalence of past 30-day cannabis use in pregnant women aged 18 to 44 years rose from 2.37% in 2002 to 3.85% in 2014. Another study found a relatively similar increase from 4.2% in 2009 to 7.1% in 2014. Corresponding rates of alcohol use and cigarette smoking during pregnancy have generally decreased. These reports encourage more detailed characterization of patterns of substance use during the course of pregnancy. Read

Effect of cannabidiol on medial temporal, midbrain, and striatal dysfunction in people at clinical high risk of psychosis

11/8/18--In this investigation comparing 33 individuals at clinical high risk of psychosis who were part of a double-blind randomized clinical trial and 19 healthy control individuals, a single oral dose of cannabidiol modulated activation in the striatum, medial temporal cortex, and midbrain. In each of these regions, the level of activation following administration of cannabidiol to patients at clinical high risk of psychosis was intermediate between the response in healthy control individuals who did not receive any drug and in patients at clinical high risk receiving placebo. Read

Combustible and electronic tobacco and marijuana products in hip-hop music videos

10/15/18--Combustible and electronic tobacco and marijuana use frequently occurred in popular hip-hop music videos from 2013 to 2017. The genre’s broad appeal, use of branded products by influential artists, and rise of electronic product and marijuana use may contribute to a growing public health concern of tobacco and marijuana use. Read

Health, polysubstance use, and criminal justice involvement among adults with opioid use

7/6/18--In this cross-sectional analysis, individuals who reported any level of opioid use were more likely than individuals who reported no opioid use to have physical and mental health conditions and co-occurring substance use. Involvement in the criminal justice system increased with intensity of opioid use, and any level of opioid use was significantly associated with involvement in the criminal justice system in the past year. Read

Prevalence of fetal alcohol spectrum disorders in 4 US communities

2/6/18--Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States ranged from 1.1% to 5.0% using a conservative approach. These findings may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities. Read

Implications of higher than expected prevalence of fetal alcohol spectrum disorders

2/6/18--Fetal alcohol spectrum disorders are a group of serious, chronic, systemic diseases that are caused by prenatal alcohol exposure and characterized by central nervous system damage and physical deficits that subsequently lead to a wide range of permanent and lifelong health consequences. A study featured in JAMA reports the prevalence of fetal alcohol spectrum estimates are 10 times higher than those previously reported. However, the authors caution that their findings may not be generalized to all US communities, but also suggested that their estimates are likely more accurate than previously reported estimates for the United States. Read

FDA pursues unproven cancer claims

12/19/17--Four companies have received FDA warning letters for selling products online that agency officials said made unproven anticancer claims and contained a component of the marijuana plant. The products reportedly contained cannabidiol (CBD), which isn’t FDA approved for any indication. Read