Marijuana commercialization and adolescent substance treatment outcomes in Colorado.

BACKGROUND AND OBJECTIVES: In Colorado, marijuana was legalized for medical use in 2000, commercialized in 2009, and approved for recreational purposes in 2012. Little is known about the association between recent policy changes and adolescent substance treatment outcomes measured by urine drug screens (UDS). This study addressed this research gap. METHODS: Participants were youth (N = 523) aged 11-19 years who were enrolled in an outpatient motivational interviewing (MI)/cognitive behavioral therapy (CBT) plus contingency management (CM) in Denver, Colorado from October 2007 to June 2014. The measures included UDS collected during weekly treatment sessions and sent to a commercial laboratory for quantitative analysis of tetrahydrocannabinol (THC)/Creatinine (Cr). Linear regression models and logistic regression models using a Generalized Estimating Equations (GEE) approach for repeated measures were completed to answer the study aims. RESULTS: Males, but not females, had a marginally significant increasing trend over time in monthly average THC/Cr (ß = 1.99, p = 0.046). There was a significant increasing trend over time (per 30 days) in the odds of having a negative UDS within 6 sessions (OR = 1.02, 95%CI = 1.003-1.04, p = 0.006). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Based on these data, substance treatment outcomes from MI and CBT are mixed, but overall treatment appears to remain effective in a state with legalized marijuana. (Am J Addict 2017;26:802-806).

Practical Aspects of Discussing Marijuana in a New Era.

The use of marijuana for the treatment of medical conditions is a highly controversial topic. Misconceptions by both patients and providers concerning the safety of and evidence-based indications for marijuana can complicate treatment planning and outcomes. Maintaining skills such as motivational interviewing, providing evidence-based informed consent, and increasing access to care remain top priorities for providing quality patient care. The goal of this article is to offer guidance to clinical providers who are adapting to the changing realities of medical marijuana and legalized recreational marijuana.

Substance Abuse Prevention.

Substance use disorders account for approximately 6% of deaths worldwide and cost about $700 billion in the United States. Approximately 80% of drug users begin using during adolescence, underscoring the public health importance of effective substance prevention programs for youth and families. Prevention science designates 3 intervention categories: (1) universal prevention, targeting all individuals in the population, (2) selective interventions, targeting high-risk groups, and (3) indicated prevention interventions for youth with risk-taking behaviors. School-based and non-school-based interventions are reviewed, as well as the limitations of existing research, gaps in access and availability, and directions for future research and development.

Telemental health for children and adolescents.

Most children and adolescents across the USA fail to receive adequate mental health services, especially in rural or underserved communities. The supply of child and adolescent psychiatrists is insufficient for the number of children in need of services and is not anticipated to grow. This calls for novel approaches to mental health care. Telemental health (TMH) offers one approach to increase access. TMH programmes serving young people are developing rapidly and available studies demonstrate that these services are feasible, acceptable, sustainable and likely as effective as in-person services. TMH services are utilized in clinical settings to provide direct care and consultation to primary care providers (PCPs), as well as in non-traditional settings, such as schools, correctional facilities and the home. Delivery of services to young people through TMH requires several adjustments to practice with adults regarding the model of care, cultural values, participating adults, rapport-building, pharmacotherapy and psychotherapy. Additional infrastructure accommodations at the patient site include space and staffing to conduct developmentally appropriate evaluations and treatment planning with parents, other providers, and community services. For TMH to optimally impact young people's access to mental health care, collaborative models of care are needed to support PCPs as frontline mental health-care providers, thereby effectively expanding the child and adolescent mental health workforce.

Buffer Standards for the Physiological pH of the Zwitterionic Compound, DIPSO from 5 to 55 degrees C.

The values of the second dissociation constant, pK(2), and related thermodynamic quantities of 3-[N,N-bis (2-hydroxyethyl)amino]-2-hydroxypropanesulfonic acid (DIPSO) have already been reported over the temperature range 5 to 55 degrees C including 37 degrees C. This paper reports the pH values of four NaCl-free buffer solutions and four buffer composition containing NaCl salt at I = 0.16 mol.kg(-1). Conventional pa(H) values are reported for all eight buffer solutions. The operational pH values have been calculated for four buffer solutions recommended as pH standards, at 25 and 37 degrees C after correcting the liquid junction potentials with the flowing junction cell.

Buffer Standards for the Biochemical pH of 3-(N-morpholino)-2-hydroxypropanesulfonic Acid from (278.15 to 328.15) K.

The values of the second dissociation constant pK(2) and related thermodynamic quantities of the ampholyte 3-(N-morpholino)-2-hydroxypropanesulfonic acid (MOPSO) have been previously determined at temperatures from (278.15 to 328.15) K. In this study, the pH values of two buffer solutions without NaCl and three buffer solutions with NaCl having ionic strengths (I = 0.16 mol·kg(-1)) similar to those in blood plasma, have been evaluated at 12 temperatures from (278.15 to 328.15) K using an extended form of the Debye-Hückel equation, since the Bates-Guggenheim convention is valid up to I = 0.1 mol·kg(-1). The liquid junction potentials (E(j)) between the buffer solutions of MOPSO and saturated KCl solution of the calomel electrode at (298.15 and 310.15) K have been estimated by measurement with a flowing junction cell. These values of E(j) have been used to ascertain the operational pH values at (298.15 and 310.15) K. Three buffer solutions of MOPSO are recommended as useful reference solutions for pH measurements in saline media of ionic strength I = 0.16 mol·kg(-1).