An Exploration of Self-Reported Medicinal Cannabis Use Among a Sample of Eastern Canadian Postsecondary Students.

In October 2018, prior to the legalization of cannabis in Canada, a survey was completed by 1050 Memorial University of Newfoundland students. Both descriptive quantitative and thematic qualitative data analyzes were used. Approximately 16% of the sample reported ever using cannabis for medicinal purposes (n=175), with only 16.6% of medicinal users reporting authorization by a healthcare provider (HCP). The majority (80.2%) were aware of possible side effects of cannabis. Prior personal experience (65.3%) and peer influence (59.5%) informed participants' medicinal use. Approximately 40% reported having replaced/reduced prescribed medication. Roughly 60% of medicinal users had not disclosed their use to their HCP. Consistent with previous studies, medicinal cannabis use among postsecondary students appears to be largely motivated for mental health related conditions and is grounded in personal experience versus evidence-based guidelines. There is a need for increased communication between HCPs and patients to promote lower-risk use among medicinal cannabis users.

Correlates of Perceived Harmfulness of Regular Cannabis Use among Canadian University Students Before and After Legalization.

Objective: Among a prospective sample of Canadian university students, this study aimed to: 1) document changes in cannabis use and perceived harmfulness of use before and after the legalization of recreational cannabis; 2) examine correlates of perceived harmfulness; and 3) explore changes in perceived harmfulness as a function of cannabis use patterns. Method: A random sample of 871 students at one western Canadian university were assessed pre- and post-legalization of recreational cannabis. Descriptive and inferential statistics were used to explore changes in cannabis use and perceived harmfulness. A random effects model was developed to assess whether cannabis legalization was associated with perceptions of harmfulness of regular cannabis use. Results: Twenty-six percent of the sample used cannabis during the past three months at both timepoints. The majority of the sample perceived regular cannabis use as a high-risk behaviour at each timepoint (57.3% and 60.9%, respectively). Results from the random effects model showed that after controlling for covariates, cannabis legalization was not associated with changes in perceived harmfulness. Perceptions of harm remained relatively stable regardless of cannabis use pattern. Respondents who endorsed cannabis use at both timepoints reported a significant increase in their frequency of cannabis use post-legalization. Conclusions: Legalization of cannabis for recreational use was not associated with substantive changes in perceptions of harm among post-secondary students, yet it might lead to increases in cannabis use among those who already use the substance. Ongoing monitoring of policies is needed, as are targeted public health initiatives to identify post-secondary students who are at risk for cannabis-related consequences.

Interventions for cannabis use disorder.

How to treat adults and adolescents with a Cannabis Use Disorder is a burgeoning research area. This article reviews the empirical literature pertaining to several psychosocial approaches (cognitive-behavior therapy, motivational enhancement, and contingency management), all of which are associated with favorable outcomes. We also review the emerging research on the use of pharmacotherapy, brief interventions and technology-delivered interventions, and conclude with an overview of future research needs.

Protocol for a feasibility study investigating the UCalgary's Cannabis Café: education and harm reduction initiative for postsecondary students.

INTRODUCTION: High rates of cannabis consumption among emerging adults in Canada represent an important public health issue. As part of the legalisation of cannabis, health objectives were established by the Government of Canada including reducing risky patterns of consumption and cannabis related harm among vulnerable populations. Despite these ambitions, few evidenced based education programmes have been evaluated in the literature. The aim of this study is to describe and evaluate the acceptability of a novel harm reduction and education initiative titled, UCalgary's Cannabis Café. The Cannabis Café incorporates components shown to be effective in reducing risky substance consumption on campuses and substance related stigma. An important objective of the Café is the dissemination of methods to reduce risk in the form of Canada's Lower-Risk Cannabis Use Guidelines. METHODS AND ANALYSIS: The study will take the form of a non-experimental, observational cohort design, where participants will be asked to complete four surveys (baseline, immediate follow-up, 1 month and 3 months). The primary outcomes of the study will be the feasibility of the initiative including acceptability and implementation. Secondary outcomes include knowledge uptake of methods to reduce risk of cannabis related harm, descriptive cannabis norms and changes in cannabis consumption. ETHICS AND DISSEMINATION: The study was approved by the University of Calgary Conjoint Health Research Ethics Board (#REB18-1364). The investigators will develop a guideline outlining the Cannabis Café to assist in the replication of this initiative at other locations and publish the results from the study in a peer-reviewed manuscript.

A pilot of a mindfulness based stress reduction intervention for female caregivers of youth who are experiencing substance use disorders.

Families play a critical role in supporting adolescents with substance use disorders. Little research has been done to investigate interventions targeting the significant stress of caring for an adolescent with problematic substance use and its subsequent impact on self-compassion in families. The aim of this pilot study was to trial an 8-week Mindfulness Based Stress Reduction (MBSR) program as a post treatment aftercare intervention among female caregivers of youth with substance use disorders. Forty-three female caregivers were recruited and randomly assigned to either a treatment (n = 21) or a waitlist control group (n = 22). Participants completed surveys pre/post-intervention to assess perceived stress and self-compassion. Qualitative interviews at post-intervention were designed to explore participants' perceptions and experiences of the MBSR program. Five main themes captured the participants' experience: improved self-compassion, increased capacity to manage stress, enhanced interpersonal effectiveness, improved overall physical wellness, and benefits of attending the program with women who have shared experience. Overall, this pilot MBSR program was found to significantly enhance the participants' sense of well-being through reducing their perceived stress and increasing self-compassion. These findings show promise that MBSR may be an effective intervention for caregivers of youth with substance use disorders.

Correlates of lifetime cannabis use and cannabis use severity in a Canadian university sample.

This study aimed to broaden previous investigations of correlates of lifetime cannabis use and problematic cannabis use among post-secondary students by examining the novel and contemporary issues of medicinal use and deep inhalation practices. The sample included 2212 undergraduate and graduate post-secondary students from Alberta, Canada, who completed the University of Calgary's Campus Experience with Cannabis Survey (average age 23.2, SD = 5.2). Nine variables were entered into the binary logistic regression to examine their differentiation of lifetime users from non-users. A multiple regression model was completed with past six-month users (n = 697), where the continuous dependent variable was cannabis use severity as measured by total scores on the Cannabis Use Disorder Identification Test-Revised. Twenty independent variables were entered simultaneously. Varsity athlete status, family mental illness, severity of alcohol use, greater support for legalization and lower perceived risk associated with regular cannabis use, differentiated lifetime users from non-users. Higher rates of religiosity and living with parents or relatives were associated with lower-lifetime rates. Male gender, earlier age of first cannabis use, cannabis use motives (including coping, enhancement and expansion), past six-month medicinal use and increased frequency of deep inhalation during consumption, were found to be significant correlates of severity. Different factors seem to predict lifetime cannabis use versus severity, and these differences may help inform the development and delivery of prevention efforts. Given that medicinal use and male gender were the largest correlates of severity, populations representing these groups may benefit most from targeted education and prevention.

Cannabis Use for Medicinal Purposes among Canadian University Students.

OBJECTIVE: The study sought to describe a Canadian sample of university students' medicinal use of cannabis, including prevalence of cannabis use disorder (CUD) and replacement of traditional treatments with cannabis. METHOD: A random sample of 4000 university students was asked to complete a cross-sectional web-based survey. The survey was completed by 2212 (average age 23.2 years, SD = 5.2 years), representing a 55.3% response rate. To be eligible, students had to be enrolled in a class on campus and were 18 years or older. RESULT: Half (52%) of respondents used cannabis at least once in their lifetime, with ∼11% reporting medicinal cannabis use. Recreational motives to use cannabis were common among medicinal users (85%), several (38%) replaced traditional medication with cannabis, and more than a third received authorization by a health care provider. Of the medicinal users, 13.6% met the criteria for CUD. Common ailments for medicinal cannabis use were anxiety, sleep problems, depression, and pain. When mental health-related categories are combined, 78.2% of medicinal users used for at least 1 mental health condition. CONCLUSIONS: Medicinal cannabis use occurs among university students. None of the ailments listed by medicinal users meet the Canadian Family Physicians prescribing guidelines, and most are not among those viewed by the National Academies of Science, Engineering, and Medicine as having strong evidence for therapeutic value. The results raise concerns for health care providers who are authorizing or counselling patients' considering medicinal cannabis.