Research News Roundup: March 23, 2023

    Delta-8-THC Association with Psychosis: A Case Report with Literature Review

    Journal: Frontiers in Psychiatry, 2023, doi: 10.3389/fpsyt.2023.1103123

    Authors: Chelsea R. Miller, Bradley G. Burk, Rachel E. Fargason & Badari Birur


    Background: Cannabis (Δ9-THC) is the most commonly consumed illicit drug. The Agricultural Improvement Act of 2018 removed hemp, a strain of Cannabis sativa, as a controlled substance. This law allowed the plant to be processed into its components, which contain <0.3% Δ9-THC. As a result, delta-8-tetrahydrocannabinol (Δ8-THC), a federally unregulated substance, grew in popularity in 2020. Δ8-THC is readily available in most gas stations or head shops and may be considered harmless by patients. However, an increasing number of patients admitted for psychiatric hospitalization report use, with limited literature on the effects.

    Case presentations: This case report describes three individual cases of patients who required admission to a university psychiatric hospital after the regular use solely of Δ8-THC. All three patients developed psychotic and paranoid symptoms concurrently with the use of Δ8-THC, with a severity exceeding their previous historical presentations. The presenting psychotic symptoms were also atypical for all three patients. New-onset violence and visual hallucinations were noted in two of the patients, one patient with no previous psychiatric history and one patient while on a therapeutic dose of his antipsychotic. In the third case, a new onset of bizarre, fixed delusions of puppies dissolving in the bathtub developed.

    Conclusion: This report adds to the limited body of evidence on Δ8-THC documenting a temporal association between Δ8-THC use and the development of psychotic symptoms. A strong body of research already correlates the continued use of Δ9-THC with psychosis, and Δ8-THC acts at the same CB1 and CB2 receptors as Δ9-THC. Therefore, it is hypothesized that Δ8-THC may have similar adverse psychiatric effects as Δ9-THC. These conclusions are not without speculation, due to the need for self or collateral-reporting of Δ8-THC use as urine drug screening cannot distinguish Δ8-THC from Δ9-THC, and the patients’ symptoms could be explained by medication non-adherence and primary psychotic disorders. However, physicians should be encouraged to gather a specific history of Δ8-THC use and treat patients with Δ8-THC-related intoxication and symptoms.

    To read the full text of the article, please visit the publisher’s website.

    A National Portrait of Public Attitudes toward Opioid Use in the US: A Latent Class Analysis

    Journal: International Journal of Environmental Research & Public Health, 2023, doi: 10.3390/ijerph20054455

    Authors: Suzan M. Walters, Weiwei Liu, Phoebe Lamuda, Jimi Huh, Russell Brewer, O’Dell Johnson, Ricky N. Bluthenthal, Bruce Taylor & John A. Schneider


    Background: Opioid overdose rates have steadily been increasing in the United States (US) creating what is considered an overdose death crisis. The US has a mixture of public health and punitive policies aimed to address opioid use and the overdose crisis, yet little is known about public opinion relating to opioid use and policy support. Understanding the intersection of public opinion about opioid use disorder (OUD) and policy can be useful for developing interventions to address policy responses to overdose deaths.

    Methods: A national sample of cross-sectional data from the AmeriSpeak survey conducted from 27 February 2020 through 2 March 2020 was analyzed. Measures included attitudes toward OUD and policy beliefs. Latent class analysis, a person-centered approach, was used to identify groups of individuals endorsing similar stigma and policy beliefs. We then examined the relationship between the identified groups (i.e., classes) and key behavioral and demographic factors.

    Results: We identified three distinct groups: (1) “High Stigma/High Punitive Policy”, (2) “High Stigma/Mixed Public Health and Punitive Policy”, and (3) “Low Stigma/High Public Health Policy”. People with higher levels of education had reduced odds of being in the “High Stigma/High Punitive Policy” group.

    Conclusion: Public health policies are most effective in addressing OUD. We suggest targeting interventions toward the “High Stigma/Mixed Public Health and Punitive Policy” group since this group already displays some support for public health policies. Broader interventions, such as eliminating stigmatizing messaging in the media and redacting punitive policies, could reduce OUD stigma among all groups.

    To read the full text of the article, please visit the publisher’s website.

    Qualitative Reactions to a Low Nicotine Product Standard for Cigarettes from Adolescents and Young Adults Living in the United States Who Smoke

    Journal: Preventive Medicine Reports, 2023, doi: 10.1016/j.pmedr.2023.102163

    Authors: Rachel L. Denlinger-Apte, Rachel N. Cassidy, Eric C. Donny, Julissa Godin, Dorothy K. Hatsukami, Ashley E. Strahley, Kimberly D. Wiseman, Suzanne M. Colby & Jennifer W. Tidey


    The Biden Administration is considering a low nicotine product standard for cigarettes. This qualitative study examined reactions to a nicotine reduction policy among adolescents and young adults (AYA) who smoke cigarettes. After completing a lab study involving masked exposure either to low nicotine or normal nicotine research cigarettes and unmasked exposure to e-cigarettes varying in nicotine concentration and flavor, we conducted follow-up semi-structured interviews (N = 25) to explore participants’ knowledge, attitudes, and perceptions of a low nicotine product standard and their anticipated tobacco use behavior after policy implementation. Interviews were audio-recorded, transcribed verbatim, double-coded, and analyzed using reflexive thematic analysis. Nearly half of participants supported the policy because they thought it would prevent young people from starting smoking and/or would help people quit. Reasons some participants opposed the policy included beliefs that adults should have the choice to smoke or that a nicotine reduction policy is counterintuitive because the government benefits from cigarette sales. Others believed the policy would be ineffective because youth could circumvent the policy (e.g., illicit market) or would increase their smoking to maintain the same nicotine level. Almost half of participants said they would quit smoking while the other half said they would continue smoking, although potentially reduce their smoking. Overall, our qualitative findings point to the need for pre-policy media campaigns targeting AYA who smoke to minimize negative reactions, dispel fears, and correct misperceptions as well as encourage quitting and provide information on accessing cessation resources.

    To read the full text of the article, please visit the publisher’s website.

    An Integrative Literature Review of Substance Use Treatment Service Need and Provision to Pregnant and Postpartum Populations in Carceral Settings

    Journal: Women’s Health, 2023, doi: 10.1177/17455057221147802

    Authors: Mollee K. Steely Smith, Stephanie H. Wilson & Melissa J. Zielinski


    Pregnancy is a critical time to provide access to substance use treatment; this is especially true among incarcerated populations, who are known to be at particularly high risk of poor health outcomes. In this integrated literature review, we (1) report what is known about the prevalence of substance use among incarcerated pregnant and postpartum populations; (2) describe substance use treatment programs and current care practices of pregnant and postpartum populations in carceral settings; and (3) explore recommendations and strategies for increasing access to substance use treatment for incarcerated pregnant and postpartum populations. A comprehensive search of seven electronic databases yielded in the retrieval of 139 articles that were assessed for inclusion. Of the retrieved articles, 33 articles met criteria for inclusion in this review. A review of the literature revealed that the understanding of substance use prevalence among pregnant incarcerated women is limited. We also found that treatment of substance use disorders among pregnant and postpartum populations is not routinely available, enhanced perinatal services are sorely needed, and substance use treatment programs are feasible with the help of community partnerships. More research is required to understand current substance use treatment initiatives and outcomes for pregnant women in prison. In addition, strategies for integrating evidence-based, substance use treatment in carceral settings is also needed. Future directions are discussed.

    To read the full text of the article, please visit the publisher’s website.

    Flavors Increase Adolescents’ Willingness to Try Nicotine and Cannabis Vape Products

    Journal: Drug and Alcohol Dependence, 2023, doi: 10.1016/j.drugalcdep.2023.109834

    Authors: Benjamin W. Chaffee, Elizabeth T. Couch, Monica L. Wilkinson, Candice D. Donaldson, Nancy F. Cheng, Niloufar Ameli, Xueying Zhang & Stuart A. Gansky


    Background: Certain product characteristics, such as flavor, may increase adolescents’ willingness to try vaped nicotine and cannabis (marijuana) products.

    Methods: A discrete choice experiment embedded within the 2021–2022 California Teens Nicotine and Tobacco Project Online Survey was administered to a non-probability sample of N = 2342 adolescents ages 12–17. Participants were sequentially presented four randomly-generated pairs of hypothetical vape products that varied in device type (disposable, refillable), content (nicotine, marijuana, “just vapor”), and flavor (seven options) and asked which of these (or neither) they would be more willing to try if a best friend offered. Conditional logistic regression quantified associations between product characteristics and participants’ selections, including interactions by past 30-day use of e-cigarettes, marijuana, or both.

    Results: Candy/dessert, fruit, and fruit-ice combination flavors were all associated with greater willingness to try a vape product (versus tobacco flavor) among participants not using e-cigarettes or marijuana, those using only e-cigarettes, and those co-using e-cigarettes and marijuana. Among participants only using marijuana, the most preferred flavors were no flavor, candy/dessert, and icy/frost/menthol. Among participants not using e-cigarettes or marijuana, model-predicted willingness to try a displayed vape product was greater when products were sweet or fruit flavored than tobacco or unflavored, regardless of whether displayed options contained nicotine (fruit/sweet: 21 %, tobacco/unflavored: 4 %), marijuana (fruit/sweet: 18 %, tobacco/unflavored: 6 %), or “just vapor” (fruit/sweet: 29 %, tobacco/unflavored: 16 %).

    Conclusions: In this online non-probability sample, flavors in nicotine and cannabis vape products increased adolescents’ willingness to try them. Comprehensive bans on flavored vapes would likely reduce adolescent use.

    To read the full text of the article, please visit the publisher’s website.


    March 2023