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Item Arrhythmia-related Hospitalization and Comorbid Cannabis Use Disorder: Trend Analysis in US Hospitals (2010-2014)(Cureus, 2019-09-09) Jaladi, Paul Rahul; Patel, Viralkumar; Kuduva Rajan, Shanthini; Rashid, Wahida; Madireddy, Sowmya; Ajibawo, Temitope; Imran, Sundus; Patel, Rikinkumar S.; Neurology, School of MedicineObjective To study the trends of arrhythmia hospitalizations with cannabis use disorders (CUDs) in terms of demographic characteristics and inpatient outcomes. Methods We used the nationwide inpatient sample (NIS) data during the post-legalization period (2010-2014) and included 570,556 arrhythmia inpatients (age, 15-54 years), and 14,426 inpatients had comorbid CUD (2.53%). We used the linear-by-linear association test and independent-sample T-test for assessing the change in hospital outcomes in inpatients with CUD. Results Arrhythmia hospitalizations with CUD increased by 31% (2010-2014). This increasing trend was seen in adults (45-54 years, P < 0.001) and was predominant in males (77.6%). Hypertension (40.6%), hyperlipidemia (17.6%), and obesity (15%) were prevalent medical comorbidities with variable trends over the five years. Among substance use disorders, tobacco (50.9%), and alcohol (31.4%) were major comorbidities with a variable trend (P = 0.003 for each). There was a 71.4% increase in the inpatient mortality rate between 2010 (0.7%) and 2014 (1.2%). The mean length of stay was three days, and the total hospitalization charges have been increasing (P < 0.001), averaging $35,812 per hospital admission. Conclusion Chronic cannabis use or abuse worsens hospitalization outcomes in arrhythmic patients, and more clinical studies are needed to study the causal association between these conditions due to the rising mortality risk.Item Characterizing chronic pain in late adolescence and early adulthood: prescription opioids, marijuana use, obesity, and predictors for greater pain interference(Wolters Kluwer, 2018-11-22) Anastas, Tracy; Colpitts, Kelsey; Ziadni, Maisa; Darnall, Beth D.; Wilson, Anna C.; Psychology, School of ScienceIntroduction: Chronic pain in late adolescence and young adults is understudied and poorly characterized. Objectives: We sought to characterize key variables that may impact pain interference in late adolescents and young adults with chronic pain, including prescription opioid use, marijuana use, psychological symptoms, and obesity. Methods: Retrospective, cross-sectional medical chart review for patients aged 17 to 23 years (N = 283; 61% Females) seeking care at a tertiary care pain clinic. Data on pain characteristics, health behaviors, and mental health distress were examined, in addition to self-reported pain intensity and interference. Results: Overlapping pain conditions were common in this young adult sample (mean ≥ 2 pain conditions). Back pain was the most commonly cited pain condition, and the majority of pain was of unknown etiology. Results revealed high rates for current opioid prescription, overweight or obese status, and mental health problems. Those using prescription opioids were more likely to endorse tobacco use and had greater pain interference. Importantly, the presence of mental health distress and opioid use were predictive of higher levels of pain-related interference. Conclusion: Treatment-seeking adolescents and young adults with chronic pain evidence complex care needs that include pain and mental comorbidities, as well as risky health behaviors. Pain and mental health distress were associated with poorer physical health, opioid prescription and marijuana use, and pain-related interference. Findings underscore the need for additional research on pain, treatment patterns, and health behaviors and their impact on developmental trajectories, as well as the need to develop and apply effective early interventions in this at-risk population.Item Community Conditions Favorable for Substance Use(The Center for Health Policy, 2018-04-01) Jacinto, Corey; Greene, Marion S.The probability of whether an individual engages in substance use is associated with several risk and protective factors. Effective prevention requires understanding these factors. The social-ecological model considers the complex interactions between individual, relationship, community, and societal factors. This can help us understand substance use in a public health context and design strategies to address the problem across multiple levels.Item Critical Comparison of Total Vaporization- Solid Phase Microextraction vs Headspace- Solid Phase Microextraction(2021-05) Train, Alexandra; Goodpaster, John; Manicke, Nicholas; Picard, ChristineSolid Phase Microextraction (SPME) is a popular sampling technique that can be paired with Gas Chromatography/Mass Spectrometry (GC-MS). SPME-GC-MS is used in forensic chemistry due to its simplification of the sample preparation process. Headspace-Solid Phase Microextraction (HS-SPME) is a technique where the sample is heated to generate volatiles in the headspace of the vial. A SPME fiber is then inserted into the vial and the compounds in the headspace will bind to the fiber. Total Vaporization- Solid Phase Microextraction (TV-SPME) is a technique that is derived from the HS-SPME technique. In Chapter 1, the critical comparison of HS-SPME and TV-SPME is discussed. Samples including marijuana, essential oils, and CBD oil were utilized to compare the two techniques. The compounds of interest in marijuana are the three main cannabinoids: cannabinol (CBN), cannabidiol (CBD), and tetrahydrocannabinol (THC). The sample preparation and GC-MS parameters were kept the same for all samples to determine which SPME technique works best for these sample types and yielded the greatest sensitivity. It was found that HS-SPME shows greater sensitivity with CBN and equivalent sensitivity with essential oils, THC and CBD. In Chapter 2, the detection of synthetic cannabinoids utilizing liquid-liquid injection as well as HS-SPME and TV-SPME is discussed. The detection of these compounds is important because this type of drug has become more prevalent in the United States because they can be chemically altered slightly so they still have the effects of a drug but can evade drug legislation. The detection of synthetic cannabinoids using liquid injection was found to be successful but detection using HS-SPME and TV-SPME was found to be unsuccessful. In Chapter 3, the analyses of real and artificial saliva utilizing HS-SPME and TV-SPME is discussed. Determining the compounds present in real saliva and artificial saliva will be of importance for future research into determining if the presence of drugs in saliva can be analyzed with these techniques. The analyses of real and artificial saliva were found to be successful using HS-SPME, without derivatization, and TV-SPME, with and without derivatization. Many of the compounds present in the real saliva were detected and were confirmed to be compounds regularly found in saliva by other scientific literature.Item Drug Use in Indiana: A Regional Perspective(The Center for Health Policy, 2019-05-01) Gutta, Jyosna; Greene, MarionIndiana consists of 92 counties, which can be divided into 8 service regions. The prevalence of substance misuse can differ between the individual regions. Compared to the state’s average, rates of underage drinking, smoking, and illicit drug use were particularly high in Indiana’s Western region. The most frequently used substances among Indiana students in grades 8, 10, and 12 were alcohol, electronic vape products, marijuana, traditional (combustible) cigarettes, and prescription drugs. Understanding each region’s unique needs is a vital component to designing programs dedicated to improving overall Hoosier health.Item The effects of delta-9-tetrahydrocannabinol and nabilone on respiratory smooth muscle(1979) Orzelek, Rita MariaItem Exploring relationships among negative urgency, marijuana use mechanisms, and marijuana use behaviors across men and women(2018) VanderVeen, John Davis; Cyders, Melissa A.; Hirsh, Adam T.; Lapish, Christopher C.; Zapolski, Tamika C.B.Marijuana use is associated with many health risks, but is increasingly becoming more accepted; thus, use rates, as well as negative consequences, are growing. There is a need to better understand marijuana use behaviors so as to reduce its negative effects. The current study sought to test the viability of applying urgency theory to marijuana use behaviors by examining several pathways among negative urgency, marijuana-related attentional bias, coping motives, and marijuana use behaviors, across men and women. Participants (n=120, mean age= 26.61 years (SD=9.28), 50% women, 63% White/Caucasian) were recruited from the Indianapolis, IN area to participate in a cross-sectional study in which they completed self-report measures and a visual-probe computer task with eye-tracking following negative mood induction. Regression analyses and the PROCESS macro were used to examine study hypotheses. Several pathways were supported: Negative urgency was significantly associated with coping motives (β=0.24, p=0.01), coping motives were significantly associated with marijuana use behaviors (ΔR2= 0.55, p<0.01), and a serial mediation model was supported, in which the relationship between negative urgency and negative marijuana consequences was mediated by coping motives and then by marijuana use frequency (c’= 0.20, 95%CI= 0.06 to 0.50). Competing models were examined and not supported. There were no statistically significant pathways involving the attentional bias measures; although there was a pattern of small effect sizes demonstrating that attentional biases may relate to marijuana use behaviors in men and not in women. Findings from the current study serve as preliminary support for applying urgency theory to marijuana use behaviors. Overall, these findings suggest that negative urgency is a distal risk factor that influences the development of other, more proximal, predictors of marijuana use and negative marijuana consequences. Future studies should examine the time order of these relationships longitudinally to replicate and provide more confidence in the causal order of the model supported in the present study.Item Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample(Elsevier, 2014) Roberts, Walter; Peters, Jessica R.; Adams, Zachary W.; Lynam, Donald R.; Milich, Richard; Psychiatry, School of MedicineAdults with attention-deficit/hyperactivity disorder (ADHD) are at higher risk to use substances than their nonclinical peers. Increased levels of impulsivity are generally thought to contribute to their increased levels of risk. Impulsivity is a multifaceted construct, however, and little research to date has attempted to identify which facets of impulsivity contribute to the increased rates of substance abuse among individuals with ADHD. The current study examined the relation among ADHD symptom clusters (i.e., hyperactivity/impulsivity and inattention), substance use rates (i.e., alcohol use, nicotine use, and marijuana use), and personality processes associated with impulsive behavior in a group of young adults. Participants were 361 undergraduate students. Both symptom clusters were positively associated with rates of substance use. Specifically, hyperactive/impulsive symptoms were associated with alcohol and nicotine use, and inattentive symptoms were associated with alcohol use. Several pathways from hyperactive/impulsive symptoms to alcohol, nicotine, and marijuana use via specific facets of impulsivity were identified. These findings have implications for understanding the relation between ADHD symptoms and substance use, as well as clinical implications for preventing and treating substance use problems in individuals with symptoms of ADHD.Item Marijuana use, fetal growth, and uterine artery Dopplers(Taylor & Francis, 2022) Bruno, Ann M.; Blue, Nathan R.; Allshouse, Amanda A.; Haas, David M.; Shanks, Anthony L.; Grobman, William A.; Simhan, Hyagriv; Reddy, Uma M.; Silver, Robert M.; Metz, Torri D.; Obstetrics and Gynecology, School of MedicineObjective: Marijuana (MJ) use is associated with adverse effects on fetal growth. We aimed to investigate the timing of suboptimal fetal growth onset in MJ-exposed pregnancies. In addition, we aimed to explore the relationship between MJ-exposure and both abnormal uterine artery (UtA) Doppler parameters and small for gestational age (SGA). Study design: This was a secondary analysis of a prospective multicenter cohort that enrolled nulliparous individuals delivering non-anomalous fetuses beyond 20 weeks' gestation. Marijuana exposure was ascertained by self-report or clinical urine toxicology testing. Ultrasound estimated fetal weights (EFWs) were assessed in participants at both 16w0d-21w6d and 22w0d-29w6d. EFWs and birth weight (BW) were converted to weight percentiles (wPCT). EFW and BW wPCTs were calculated using population-based standards. Additionally, a customized standard designed to be applicable to both EFWs and BWs within the same model was also used to allow for EFW to BW percentile trajectories. The primary outcome, longitudinal wPCT, was compared between individuals with and without MJ use in a linear mixed-effects regression model adjusting for tobacco. For modeling, wPCT was smoothed across gestational age; MJ was estimated as an intercept and linear difference in the slope of gestational age. UtA Doppler notching, resistance index (RI), and pulsatility index (PI) at 16w0d-21w6d were compared using t-test and χ2. SGA at delivery was also compared. Results: Nine thousand one hundred and sixty-three individuals met inclusion criteria; 136 (1.5%) used MJ during pregnancy. Individuals who used MJ were more likely to be younger, identify as non-Hispanic Black, and have had less education. Fetuses exposed to MJ had lower wPCT beginning at 28 weeks using population-based and customized standards, when compared to those without exposure. UtA notching, PI, and RI were similar between groups. SGA was more frequent in neonates exposed to MJ using both population-based (22 vs. 9%, p<.001) and customized (25 vs. 14%, p<.001) curves. Conclusions: MJ-exposed fetuses were estimated to be smaller than unexposed fetuses starting at 28 weeks' gestation across both growth standards without a difference in UtA Doppler parameters.