Question Does use of high-potency cannabis (compared with use of low-potency cannabis) increase risks for problems resulting from cannabis use, common mental disorders, and psychotic experiences after controlling for early-life mental health symptoms and frequency of use?
Findings In this cohort study of 1087 participants who reported cannabis use in the previous year, after adjusting for frequency of cannabis use and early adolescent mental health, use of high-potency cannabis was associated with a significant increase in the frequency of cannabis use, likelihood of cannabis problems, and likelihood of anxiety disorder. Those using high-potency cannabis had a small increase in the likelihood of psychotic experiences; however, this risk was attenuated after adjustment for frequency of cannabis use.
Meaning Risks for cannabis use problems and anxiety disorders are higher among those reporting use of high-potency cannabis; provision of public health messaging regarding the importance of reducing both frequency of cannabis use and the potency of the drug, as well as limiting the availability of high-potency cannabis, may be effective for reducing these risks.
Importance Cannabis use is consistently linked to poorer mental health outcomes, and there is evidence that use of higher-potency cannabis increases these risks. To date, no studies have described the association between cannabis potency and concurrent mental health in a general population sample or addressed confounding using longitudinal data.
Objective To explore the association between cannabis potency and substance use and mental health outcomes, accounting for preceding mental health and frequency of cannabis use.
Design, Setting, and Participants This cohort study used data from the Avon Longitudinal Study of Parents and Children, a UK birth cohort of participants born between April 1, 1991, and December 31, 1992. Present data on outcomes and exposures were collected between June 2015 and October 2017 from 1087 participants at 24 years of age who reported recent cannabis use.
Exposures Self-reported type of cannabis most commonly used in the past year, coded to a binary exposure of use of high-potency cannabis or lower-potency cannabis.
Main Outcomes and Measures Outcomes were reported frequency of cannabis use, reported cannabis use problems, recent use of other illicit drugs, tobacco dependence, alcohol use disorder, depression, generalized anxiety disorder, and psychotic-like experiences. The study used secondary data; consequently, the hypotheses were formulated after data collection.
Results Past-year cannabis use was reported by 1087 participants (580 women; mean [SD] age at onset of cannabis use, 16.7 [3.0] years). Of these, 141 participants (13.0%) reported the use of high-potency cannabis. Use of high-potency cannabis was associated with increased frequency of cannabis use (adjusted odds ratio [AOR], 4.38; 95% CI, 2.89-6.63), cannabis problems (AOR, 4.08; 95% CI, 1.41-11.81), and increased likelihood of anxiety disorder (AOR, 1.92; 95% CI, 1.11-3.32). Adjustment for frequency of cannabis use attenuated the association with psychotic experiences (AOR 1.29; 95% CI, 0.67-2.50), tobacco dependence (AOR, 1.42; 95% CI, 0.89-2.27), and other illicit drug use (AOR, 1.29; 95% CI, 0.77-2.17). There was no evidence of association between the use of high-potency cannabis and alcohol use disorder or depression.
Conclusions and Relevance To our knowledge, this study provides the first general population evidence suggesting that the use of high-potency cannabis is associated with mental health and addiction. Limiting the availability of high-potency cannabis may be associated with a reduction in the number of individuals who develop cannabis use disorders, the prevention of cannabis use from escalating to a regular behavior, and a reduction in the risk of mental health disorders.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2765973?resultClick=1
Asociación entre la potencia del cannabis y el uso de sustancias y los resultados de salud mental, teniendo en cuenta la salud mental y la frecuencia del consumo de cannabis.
Este estudio de cohorte utilizó datos del estudio longitudinal Avon de Padres e Hijos, una cohorte de nacimiento del Reino Unido de participantes nacidos entre el 1 de abril de 1991 y el 31 de diciembre de 1992. Los datos actuales sobre los resultados y las exposiciones se recopilaron entre junio 2015 y octubre de 2017 de 1087 participantes de 24 años de edad que informaron el consumo reciente de cannabis.
Se informaron los resultados de frecuencia de consumo de cannabis, problemas de consumo de cannabis informados, uso reciente de otras drogas ilícitas, dependencia del tabaco, trastorno por consumo de alcohol, depresión, trastorno de ansiedad generalizada y experiencias psicóticas. El estudio utilizó datos secundarios; en consecuencia, las hipótesis se formularon después de la recopilación de datos.
El consumo de cannabis en el último año fue reportado por 1087 participantes (580 mujeres; edad media [DE] al inicio del consumo de cannabis, 16, 7 [3, 0] años). De estos, 141 participantes (13. 0%) informaron el uso de cannabis de alta potencia. El uso de cannabis de alta potencia se asoció con una mayor frecuencia de consumo de cannabis (odds ratio ajustado [AOR], 4. 38; IC del 95%, 2. 89-6. 63), problemas de cannabis (AOR, 4. 08; IC del 95%, 1. 41-11. 81), y mayor probabilidad de trastorno de ansiedad (AOR, 1. 92; IC 95%, 1. 11-3. 32). El ajuste por la frecuencia del consumo de cannabis atenuó la asociación con experiencias psicóticas (AOR 1. 29; IC del 95%, 0. 67-2. 50), dependencia del tabaco (AOR, 1. 42; IC del 95%, 0. 89-2. 27) y otro uso de drogas ilícitas (AOR, 1. 29 ; IC del 95%, 0, 77-2, 17). No hubo evidencia de asociación entre el uso de cannabis de alta potencia y el trastorno por consumo de alcohol o depresión.
Hasta donde sabemos, este estudio proporciona la primera evidencia general de la población que sugiere que el uso de cannabis de alta potencia está asociado con la salud mental y la adicción. La limitación de la disponibilidad de cannabis de alta potencia puede estar asociada con una reducción en el número de personas que desarrollan trastornos por consumo de cannabis, la prevención del consumo de cannabis a un comportamiento regular y una reducción en el riesgo de trastornos de salud mental.
