Kirstin J. Lauritsen

Self-Medication of Somatic and Psychiatric Conditions Using Botanical Marijuana

Abstract As a complement to research evaluating botanical marijuana as a medical therapy for various somatic and psychiatric conditions, there is a growing body of research assessing marijuana users’ self-reports of the symptoms and conditions for which they use marijuana without a physician’s recommendation. As part of two larger web-based surveys and one in-situ survey at an outdoor marijuana festival, we asked regular marijuana users if they consumed the drug without a physician’s recommendation and, if so, to describe (or select from a checklist) the conditions for which they used marijuana as a medication. Participants reported using marijuana to self-medicate a wide variety of both somatic conditions (such as pain, diabetes, and irritable bowel syndrome) and psychiatric conditions (such as depression, anxiety, and insomnia). Because fewer than half of the American states, and only a few countries, allow physicians to recommend medicinal marijuana, these findings may be of interest to clinicians as they treat patients, to lawmakers and policymakers as they consider legislation allowing physicians to recommend botanical marijuana for somatic and psychiatric conditions, and to researchers evaluating conditions that individuals elect to self-medicate using botanical marijuana.

Patterns of Use, Acute Subjective Experiences, and Motivations for Using Synthetic Cathinones (“Bath Salts”) in Recreational Users

ABSTRACT Given the variety and potential toxicity of synthetic cathinones, clinicians and educators would benefit from information about patterns of and motivations for use, frequency of psychosocial consequences, and experience of acute subjective effects. We administered a comprehensive, web-based survey to 104 recreational users of synthetic cathinones. Sixty percent of respondents consumed synthetic cathinones once or more per month, usually snorting or swallowing these drugs, typically at home, usually with others, customarily during the evening and nighttime hours, and often in combination with another drug such as alcohol or marijuana. Acute subjective effects attributed to synthetic cathinones were similar to those of other psychostimulants, including increased energy, rapid heartbeat, racing thoughts, difficulty sleeping, euphoria, decreased appetite, open-mindedness, and increased sex drive. Reported reasons for using synthetic cathinones included its stimulating effects, curiosity, substitution for another drug, and being at a party/music event. Respondents had experienced an average of six negative consequences of using synthetic cathinones during the previous year (e.g., tolerance, neglecting responsibilities, personality change). In combination with previously published investigations, these findings increase our understanding of the reported rationales and outcomes of recreational use of synthetic cathinones.

Comparison of outcome expectancies for synthetic cannabinoids and botanical marijuana.

ABSTRACT Background: Although initially developed for medical purposes, synthetic cannabinoids have also been consumed for recreational purposes. Objective: To evaluate whether agreement with positive and negative outcome expectancies differed for synthetic cannabinoids versus botanical marijuana, and assess reported reasons for using synthetic cannabinoids. Method: Using a web-based recruitment and data collection procedure, 186 adults who had used both synthetic cannabinoids and botanical marijuana and 181 adults who had used botanical marijuana but not synthetic cannabinoids, completed measures of outcome expectancies and other relevant questionnaires. Results: A significant interaction revealed that participants who had used both synthetic cannabinoids and botanical marijuana indicated lower agreement with positive expectancies for synthetic cannabinoids, and higher agreement with positive expectancies for botanical marijuana, than did those participants who used only botanical marijuana. There was no interaction between type of drug and use history on agreement with negative expectancies, and participants agreed more strongly with negative outcome expectancies for synthetic cannabinoids than for botanical marijuana whether they had used one or both types of these drugs. The most frequently provided reasons for using synthetic cannabinoids included availability, perceived legality, cost, curiosity, and social interaction. Conclusion: Given growing public acceptance of recreational and medical marijuana, coupled with negative perceptions and increasing regulation of synthetic cannabinoid compounds, botanical marijuana is likely to remain more available and more popular than synthetic cannabinoids.

Acceptability of non-abstinence goals among students enrolled in addiction studies programs across the United States

BACKGROUND Previous studies of acceptability of non-abstinence recruited older, experienced addiction professionals; its possible that younger, emerging addiction professionals may be more accepting of non-abstinence, perhaps due to training in harm reduction. METHODS One hundred seventy graduate and undergraduate students enrolled in college/university-based programs offering training in addiction studies across the United States were recruited to complete a Web-based questionnaire assessing whether acceptability of non-abstinence outcome goals varied depending on the specific substance a client consumes, severity of diagnosis, and finality of outcome goal. RESULTS More respondents rated non-abstinence an acceptable Intermediate goal for clients diagnosed with a Moderate cannabis use disorder (57%) or Moderate alcohol use disorder (45%) than for clients diagnosed with any other listed Moderate substance use disorder (32% to 36%). Similarly, larger proportions of respondents rated non-abstinence an acceptable Final goal for clients diagnosed with a Moderate cannabis use disorder (37%) or Moderate alcohol use disorder (31%) than for clients diagnosed with any other listed Moderate substance use disorder (19% to 23%). Only 14% to 26% of respondents rated non-abstinence an acceptable Final goal for clients diagnosed with a Severe substance use disorder, but 28% to 42% rated non-abstinence acceptable for clients diagnosed with a Severe substance use disorder when non-abstinence was an Intermediate goal. CONCLUSIONS Compared with previous research examining the acceptability of non-abstinence, these results suggest that students enrolled in addiction studies training programs may be more accepting of clients who decide to pursue non-abstinence either as an intermediate step on the way to abstinence or as a final goal.

University students’ attributions for abstinence from synthetic cannabinoids and synthetic cathinones

ABSTRACT Background: Synthetic cannabinoids and synthetic cathinones are two increasingly available and potentially dangerous classes of substances. Objective: We designed this study to test whether university students rated the influence of different types of reasons for abstaining differently as a function of type of drug (synthetic cannabinoids vs. synthetic cathinones) and gender (male vs. female). Method: Using a web-based survey, 176 male and 437 female undergraduate university students rated the degree to which each of 42 reasons for not taking drugs influenced their abstinence from those two classes of substances. Results: Exploratory factor analyses suggested four subscales of reasons applicable to both substances: (1) psychological and behavioral impairment, (2) somatic and physiological concerns, (3) social approval and self-image concerns, and (4) insufficient knowledge and limited access. Both men and women rated all four subscales of reasons as having more influence on their abstinence from synthetic cathinones than synthetic cannabinoids, and women rated each subscale except somatic and physiological concerns as having more influence than did men. Conclusions: Although there were main effects for type of drug, because students typically reported the same types of reasons as being more or less influential for both classes of substances, prevention interventions could focus simultaneously on reasons to avoid or delay use of both types of substances.