In a high risk population of young adult frequent cannabis users, current problems are more important predictors of first incidence cannabis dependence than the level and type of cannabis exposure and stable vulnerability factors.

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Context: Ecstasy (street name for [±]-3,4-methylenedioxymethamphetamine [MDMA]) use has been associated with cognitive deficits, especially in verbal memory. However, owing to the cross-sectional and retrospective nature of currently available studies, questions remain regarding the causal direction and clinical relevance of these findings.Objective: To examine the relationship between Ecstasy use and subsequent cognitive performance.

Mental health differences between frequent cannabis users with and without dependence and the general population van der Pol, P.; Liebregts, N.; de Graaf, R.; ten Have, M.; Korf, D.J.; van den Brink, W.; van Laar, M. Published in: Addiction DOI:10.1111/add.12196 Link to publicationCitation for published version (APA): van der Pol, P., Liebregts, N., de Graaf, R., ten Have, M., Korf, D. J., van den Brink, W., & van Laar, M. (2013). Mental health differences between frequent cannabis users with and without dependence and the general population. Addiction, 108(8), 1459-1469. DOI: 10.1111/add.12196 General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. ABSTRACTAims To compare the prevalence of mental disorders between frequent cannabis users with and without dependence and the general population. Design Cross-sectional comparison of interview data. Setting Enriched community sample of frequent cannabis users and a representative sample of non-users and non-frequent users from the general population. Participants A total of 521 young adult (aged 18-30 years) frequent cannabis users, 252 of whom were with DSM-IV cannabis dependence (D+) and 269 without DSM-IV cannabis dependence (D-), and 1072 young adults from the general population. Measurements Multinomial logistic regression was used to compare groups regarding the presence of DSM-IV mental disorders. Detailed measures of cannabis use, childhood adversity and other substance use were considered confounders. Findings Compared with the general population, externalizing disorders were more prevalent in D-[odds ratio (OR) = 8.91, P < 0.001] and most prevalent in D+ (OR = 17.75, P < 0.001), but internalizing disorders were associated only with D+ (mood OR = 4.15, P < 0.001; anxiety OR = 2.20, P = 0.002). Associations were attenuated (and often became non-significant) after correction for childhood adversity and substance use other than cannabis. However, the prevalence of mental disorders remained higher in D+ compared with D-(OR = 2.40, P < 0.001), although cannabis use patterns were remarkably similar. Conclusions Cannabis use patterns, childhood adversity and the use of other substances are similar in dependent and non-dependent frequent cannabis users. With the exception of more externalizing disorders, the mental health ...

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Cannabis users titrate their delta-9-tetrahydrocannabinol intake by inhaling lower volumes of smoke when smoking strong joints, but this does not fully compensate for the higher cannabis doses per joint when using strong cannabis. Thus, users of more potent cannabis are generally exposed to more delta-9-tetrahydrocannabinol. Smoking behaviour appears to be a stronger predictor for cannabis dependence severity than monthly delta-9-tetrahydrocannabinol dose.

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