Translating the lived experience of illicit drinkers into program guidance for cannabis substitution: Experiences from the Canadian Managed Alcohol Program Study.

A small but growing body of research has suggested the potential for cannabis substitution to support Managed Alcohol Program (MAP) service users to reduce acute and chronic alcohol-related harms. In 2022, researchers from the Canadian Managed Alcohol Program Study (CMAPS) noted a dearth of accessible, alcohol-specific educational resources to support service users and program staff to implement cannabis substitution pilots at several MAP sites in Canada. In this essay, we draw on over 10-years of collaboration between CMAPS, and organizations of people with lived experience (the Eastside Illicit Drinkers Group for Education (EIDGE) and SOLID Victoria) to describe our experiences co-creating cannabis education resources where none existed to support MAP sites interested in beginning to provide cannabis to participants. The research team relied on the unique lived experiences and informal cannabis-related harm reduction strategies described by EIDGE and SOLID members to create cannabis education resources that were accurate and relevant to MAP sites. EIDGE was familiar with creating peer-oriented educational resources and convened meetings and focus groups to engage peers. CMAPS research team members created standard cannabis unit equivalencies to support program delivery, and clinical advisors ensured that the stated risks and benefits of cannabis substitution, as well as tapering guidance for withdrawal management, were safe and feasible. The collaboration ultimately produced tailored client-facing and provider-facing resources. Our experience demonstrates that the lived expertise of drinkers can play an integral role in creating alcohol harm reduction informational materials, specifically those related to cannabis substitution, when combined with data from rigorous, community-based programs of research like CMAPS. We close by listing additional considerations for cannabis substitution program design for MAP settings emerging from this process of collaboration between illicit drinkers, service providers, clinicians, and researchers for consideration by other programs.

The Protective Role of Grit against Alcohol and Cannabis Use through Young Adulthood.

Introduction: Problematic substance use in young adulthood is consistently related to negative outcomes later in life. Understanding the factors that protect against problematic substance provides opportunities for early preventive intervention. We examine the protective role of grit - passion and perseverance for long-term goals - on substance use through young adulthood, a period of heightening risks for substance use. Methods: In this research, we use cross-lagged panel models and data from the Victoria Healthy Youth Survey (N = 477, 52% female) to test the reciprocal within-time associations and the directional relationships between grit (passion and perseverance) and substance use (cannabis and alcohol) across three assessments (6 years, ages 18-29). All models controlled for sex and SES. Results: Significant findings show negative within-time associations between passions and perseverance and cannabis use at T1 (ages 18-24) and at T2 (ages 20-26), and significant, negative within-time associations between passion and perseverance and alcohol use (heavy episodic drinking) at T1 but not at T2. No significant across-time associations between passion and perseverance and substance use were found. Conclusion: Preventive interventions to enhance passion and perseverance may provide important targets for interventions for young adults to reduce current substance use. However, grit did not have an effect beyond the stability of cannabis use or alcohol use over time, suggesting effects may act by substituting proactive goals for current substance use.

Comparing Medical and Recreational Cannabis Users on Socio-Demographic, Substance and Medication Use, and Health and Disability Characteristics.

BACKGROUND: While recreational cannabis use is common, medical cannabis programs have proliferated across North America, including a federal program in Canada. Few comparisons of medical and recreational cannabis users (RCUs) exist; this study compared these groups on key characteristics. METHODS: Data came from a community-recruited sample of formally approved medical cannabis users (MCUs; n = 53), and a sub-sample of recreational cannabis users (RCUs; n = 169) from a representative adult survey in Ontario (Canada). Samples were telephone-surveyed on identical measures, including select socio-demographic, substance and medication use, and health and disability measures. Based on initial bivariate comparisons, multivariate logistical regression with a progressive adjustment approach was performed to assess independent predictors of group status. RESULTS: In bivariate analyses, older age, lower household income, lower alcohol use, higher cocaine, prescription opioid, depression and anxiety medication use, and lower health and disability status were significantly associated with medical cannabis use. In the multivariate analysis, final model, household income, alcohol use, and disability levels were associated with medical cannabis use. Conclusions/Scientific Significance: Compared to RCUs, medical users appear to be mainly characterized by factors negatively influencing their overall health status. Future studies should investigate the actual impact and net benefits of medical cannabis use on these health problems.