Lawrence A. Osborn

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.

Recovery-oriented services in an inpatient setting: The role of consumers’ views of therapeutic alliance and practitioner directiveness on recovery and well-being.

Using a sample of 60 adults with serious mental illness in an inpatient psychiatric hospital, the present study examined the role of therapeutic relationship characteristics between consumers and mental health providers and consumers’ views of recovery-oriented service delivery and individual well-being. Specifically, the present study examined how consumers’ reports of working alliance and provider directiveness were associated with consumers’ views of recovery-oriented service delivery and individual well-being. After controlling for demographic characteristics, self-reported psychiatric symptoms and number of hospitalizations, findings suggested that consumers’ reports of stronger working alliance and higher levels of provider directiveness were significantly related to higher perceptions of recovery-orientation in the inpatient hospital setting. Findings indicated that consumers’ views of stronger working alliance were associated with higher levels of individual well-being. Implications of findings are discussed.