Scoping Review of Cannabis-Reduction Psychosocial Interventions and Reasons for Use among Young Adults with Psychosis

Petros, Ryan; Walker, Denise D.; Pierce, Adam; Monroe-DeVita, Maria

doi:10.1080/15504263.2023.2226024

Cited by 6 publications

(2 citation statements)

References 102 publications

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“…A number of systematic and scoping reviews have examined cannabis use and legalization, though they are not specifically focused on Canada [ 28 – 32 ] or not focused on youth and young adult populations since legalization [ 26 , 33 , 34 ]. Among those reviews focusing on youth or young adults, most are not specific to Canada and concentrate on specific areas such as driving [ 35 ], cognitive functioning [ 36 ], co-occurring cannabis use with other substances or behaviours [ 37 ], and psychosocial interventions for cannabis reduction in young adults with psychosis [ 38 ]. Rubin-Kahana and colleagues [ 39 ] explored the impact of cannabis legalization on youth in Canada, but this was a narrative review that did not adhere to systematic or scoping review guidelines and did not have a list of studies selected for the review.…”

Section: Introductionmentioning

confidence: 99%

Understanding youth and young adult cannabis use in Canada post-legalization: a scoping review on a public health issue

Kourgiantakis,

Vicknarajah,

Logan

et al. 2024

Subst Abuse Treat Prev Policy

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Background Canada legalized recreational cannabis in 2018, and one of the primary objectives of the Cannabis Act was to protect youth by reducing their access to cannabis and providing public education. Canada has the highest prevalence of cannabis use worldwide, particularly among youth and young adults under the age of 25. Cannabis use is linked with many adverse effects for youth and young adults including psychosis, anxiety, depression, respiratory distress, cannabinoid hyperemesis syndrome, and impaired cognitive performance. Despite the high prevalence of cannabis use and the evolution of policies in Canada and globally, significant knowledge and research gaps remain regarding youth and young adult cannabis use. The aim of this scoping review is to map the extent, nature, and range of evidence available on youth and young adult cannabis use in Canada since its legalization, in order to strengthen policies, services, treatments, training, and public education strategies. Methods Using a scoping review framework developed by Arksey and O’Malley, along with the PRISMA-ScR guidelines, we conducted a rigorous search in five academic databases: MEDLINE, Embase, APA PsycINFO, CINAHL and Web of Science Core Collection. We included empirical studies that collected data in Canada after the legalization of recreational cannabis (October 2018) and focused on youth or young adults < 30. Two reviewers independently screened articles in two stages and extracted relevant information from articles meeting the inclusion criteria. Results Of the 47 articles meeting our inclusion criteria, 92% used quantitative methods, 6% were qualitative, and 2% used a mixed-methods approach. Over two-thirds (68%) used secondary data. These studies were categorized into six focus areas: (1) prevalence, patterns, and trends, (2) cannabis-related injuries and emergency department (ED) visits, (3) rates and patterns during the pandemic, (4) perceptions of cannabis use, (5) prevention tools, and (6) cannabis-related offenses. Key findings from the studies reviewed include an increase in cannabis use among 18-24-year-olds post-legalization, with mixed results for youth under 18. ED visits for intentional and unintentional cannabis-related injuries have increased in young children and teens. Perception studies show a mix of concern and normalization of cannabis use. Though limited, prevention studies are promising in raising awareness. A decline in cannabis-related offenses was noted by one study. The review highlights several research gaps, including the need for more qualitative data, disaggregation of demographic data, intervention research, and comprehensive studies on the physical and mental health impacts of cannabis use among youth and young adults. Conclusion Maintaining a public health approach is critical, with a focus on reducing the high prevalence of cannabis use among youth and young adults. This involves implementing prevention strategies to minimize harms, enhancing public education, minimizing commercialization, reducing youth access to cannabis, promoting guidelines for lower-risk cannabis use and harm reduction strategies, and increasing training for healthcare providers.

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Section: Introductionmentioning

confidence: 99%

Understanding youth and young adult cannabis use in Canada post-legalization: a scoping review on a public health issue

Kourgiantakis,

Vicknarajah,

Logan

et al. 2024

Subst Abuse Treat Prev Policy

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“…In response to this challenge, there is a growing interest in innovative harm reduction interventions to help individuals with FEP and persistent cannabis use [12][13][14]. Cannabis harm reduction is an approach that has been endorsed in public health or government reports, as well as by clinicians and young people using cannabis [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Cannabis Harm Reduction Intervention for People With First-Episode Psychosis: Protocol for a Pilot Multicentric Randomized Trial

Coronado-Montoya,

Abdel-Baki,

Côté

et al. 2023

JMIR Res Protoc

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Background Cannabis use is highly prevalent in young people with first-episode psychosis (FEP). Most report cannabis use and are often diagnosed with a cannabis use disorder upon admission to specialized services for psychosis. Cannabis use in this population is associated with worse clinical and psychosocial outcomes, rendering it an important clinical target. Despite this, few cannabis-specific interventions have been developed for FEP and empirically evaluated through randomized controlled trials. Most evaluated interventions have targeted cannabis abstinence, with limited efficacy, but none have centered on harm reduction outcomes for people with FEP who use cannabis. Early intervention services (EIS), the standard of care for FEP, have not successfully addressed problematic cannabis use in people with FEP either. Clinical trials are needed to explore the potential of harm reduction strategies, although these should be preceded by robust pilot studies to establish optimal design and approaches. Objective Recognizing the need for harm reduction strategies for individuals with FEP who use cannabis and based on research on patients’ preferences supporting harm reduction interventions, we developed a mobile app–based cannabis harm reduction intervention for this population. This intervention is called Cannabis Harm–reducing Application to Manage Practices Safely (CHAMPS). Here, we describe the protocol for a multicenter, 2-arm, parallel group, randomized pilot trial evaluating the acceptability of CHAMPS for people with FEP who use cannabis and the feasibility of conducting a full-scale trial in this population using CHAMPS. The impact on key clinical outcomes will also be explored. Methods This pilot trial aims to recruit 100 young people with FEP using cannabis from 6 Canadian EIS clinics. Participants will be randomized in a 1:1 ratio to CHAMPS+EIS or EIS-only. CHAMPS acceptability will be assessed using completion rates for the intervention arm. Trial feasibility will be assessed using a retention rate for randomized participants. Secondary outcomes will explore tendencies of change in the use of protective behavioral strategies and in motivation to change strategies. Exploratory outcomes include cannabis use–related problems, other substance use, the severity of dependence, psychotic symptoms, and health care service use. Results Recruitment began in December 2021. Data collection and analysis are expected to be completed in early 2024. Study results describing CHAMPS acceptability and trial feasibility will then be submitted for publication in a peer-reviewed journal. Conclusions CHAMPS uniquely combines evidence-based approaches, patient perspectives, and mobile health technology to support harm reduction in people with FEP who use cannabis. Attaining adequate acceptability and feasibility through this trial may justify further exploration of harm reduction tools, particularly within the context of conducting a larger-scale randomized controlled trial. This pilot trial has the potential to advance knowledge for researchers and clinicians regarding a feasible and user-acceptable research design in the cannabis and early psychosis fields. Trial Registration ClinicalTrials.gov NCT04968275, https://clinicaltrials.gov/ct2/show/NCT04968275 International Registered Report Identifier (IRRID) DERR1-10.2196/53094

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Characterization of substance use in homeless patients with mental disorders

Elmquist,

Henriksen,

Handest

et al. 2024

Nordic Journal of Psychiatry

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Scoping Review of Cannabis-Reduction Psychosocial Interventions and Reasons for Use among Young Adults with Psychosis

Cited by 6 publications

References 102 publications

Understanding youth and young adult cannabis use in Canada post-legalization: a scoping review on a public health issue

Understanding youth and young adult cannabis use in Canada post-legalization: a scoping review on a public health issue

Evaluation of a Cannabis Harm Reduction Intervention for People With First-Episode Psychosis: Protocol for a Pilot Multicentric Randomized Trial

Characterization of substance use in homeless patients with mental disorders

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