The cannabis product and regulatory landscape is changing in the United States

The centerpiece of the CSC’s work so far is an ongoing preclinical study called Impact of Cannabinoids Across the Lifespan.Piomelli, who directs the study while a team of UC Irvine principal investigators conducts the bulk of the research, characterizes it as a broad research project with many components, from which a stream of independent discoveries and publications is expected over the next 3 or 4 years.Piomelli reports that the study’s main purpose is to study THC’s effect on adolescents — and particularly on the adolescent brain.The human brain routinely produces neurotransmitters known as endocannabinoids — molecules, similar to cannabis derivatives, that are important in learning, memory and experiencing emotion.The key questions that the study addresses are these: Does exposure to THC, in a persistent way, change the brain’s endocannabinoid system? If so, what changes at the cellular and molecular level explain the alterations? Does exposure to THC during adolescence carry lasting implications for learning and emotion? The study has received a $9 million Center of Excellence Grant from the National Institute on Drug Abuse.Another new entrant into cannabis research is the UCLA Cannabis Research Initiative, founded in 2017 with a broad remit — “to understand how cannabis affects bodies, brains and society.” The initiative, encompassing an interdisciplinary team of 40 faculty members from 15 university departments, aims to function as an education, research and service organization that leads public discussions of cannabis, policy and health.The initiative got its start in the months before Proposition 64 was approved by voters.According to Jeffrey Chen, the initiative’s director, leadership at the Semel Institute for Neuroscience and Human Behavior anticipated that legalization would soon create the world’s largest market for recreational cannabis — and that California and particularly Los Angeles would “play an outsize role in establishing normative behaviors” around cannabis.Los Angeles, in Chen’s view, has become the world’s cannabis capital overnight.He and his colleagues hypothesize that, given the city’s status as a major tourist destination and an exporter of culture, “what happens in Los Angeles is very likely to be transmitted around the world.” So far, Chen says, the initiative’s research remains mainly oriented toward health-related issues.One study — soon to start, and led by Kate Wolitzky-Taylor,greenhouse benches an assistant clinical professor in UCLA’s Department of Psychiatry and Biobehavioral Sciences — seeks to develop and evaluate a behavioral treatment for young adults who exhibit cannabis use disorder and who use cannabis to cope with anxiety, depression and the like.

Cannabis, according to the researchers, is the most commonly used drug among young adults, and it can be harmful when its use qualifies as a “maladaptive way” of contending with negative experiences.Wolitzky-Taylor reports that the research project is a randomized clinical trial focusing on participants’ reactions to the anxiety and depression that might lead them to use cannabis.The treatment, she says, will draw on strategies such as “mindfulness, cognitive reappraisal skills, problem solving and … gradual exposure to distressing but objectively safe stimuli.” The treatment was developed in an iterative manner — an early version has already been tested with a small group of patients and further refinements may be made after the clinical trial is complete.The research is funded by a 3-year, $450,000 grant from the National Institute on Drug Abuse.Individuals with cannabis use disorder, if they are 18 to 25 years old, are encouraged to email the project’s coordinator, Nick Pistolesi , regarding participation in the study.A second example of the initiative’s work is decidedly nonmedical.Brett Hollenbeck, an assistant professor of marketing at the UCLA Anderson School of Management, analyzed — along with Kosuke Uetake of Yale University — a large dataset of cannabis transactions in the state of Washington to learn about firm and consumer behavior in legal cannabis markets.Their goal was to provide policymakers, including in California, information useful for optimal development of cannabis taxation and regulation — optimal in the sense of maximizing tax revenues, safeguarding public health and discouraging a black market for cannabis.Washington created a legal framework for growing and selling cannabis in 2012.Legal sales began there in 2014.Since then, every cannabis transaction in the state has been recorded in an administrative dataset.The researchers used the data to model consumer demand for cannabis products and measure price elasticity.Their analysis, covering the period from November 2014 to September 2017, indicates that Washington’s strict cap on cannabis retailers — some 550 are allowed in the entire state — has permitted retailers to command high prices and behave like local monopolies.The researchers report that when prices for regulated cannabis rise in Washington, consumers often switch to cheaper cannabis alternatives available from regulated retailers, rather than seeking out blackmarket cannabis.

Indeed, the researchers argue that Washington’s 37% sales tax rate for cannabis, though it appears high, does not drive down tax revenue, and in fact the state could generate higher revenue by raising the tax rate to 40% or higher.Further, the researchers calculate that Washington could substantially increase its revenue if it acted as the state’s sole cannabis retailer, as it did for alcohol sales until 2012, and could do so without causing an increase in cannabis prices.Cannabis use is on the rise, among some groups of US adolescents, due to increased availability, less overall negative perceptions, and a proliferation of e-cigarettes and vaping.Recent population studies show rates of use in 8th and 10th grades at 15 % and 34 % respectively.Past-year cannabis use among justice-involved youth steadily increased between 2002–2017 and JIY report higher rates of cannabis use than their same-age non-justice-involved peers; often starting cannabis use by age 13.As part of the fourth wave of juvenile justice reform , legislation has increasingly moved toward diverting youth from detention to community supervision.System advances including implementation of specific behavioral health screening tools for youth in detention and on probation increased identification of youth with treatment needs.Research to identify feasible and acceptable substance use interventions to implement and sustain within juvenile justice settings to prevent or decrease substance use is emerging , but in tremendous need given the shortage of such services.Efficacious substance use interventions for JIY include family, are intensive, and typically address secondary or tertiary prevention of substance use ; these are not typically feasible for implementation within busy, often overburdened and under-resourced juvenile justice settings, yet research on brief substance use prevention interventions for JIY is lacking.Individual level, modifiable factors that can be incorporated into brief interventions and feasibly delivered within juvenile justice settings to prevent and/or reduce youth substance use must be identified.Brief, empirically-supported substance use interventions with adolescents/young adults focus on addressing social attitudes, beliefs, and cognitions and enhancing motivation to abstain from or reduce use.Research with JIY highlights increased likelihood of substance use secondary to psychiatric symptoms, trauma exposure and symptoms, chronic absenteeism/truancy and family factors.But, data on social cognitive influences on substance use among JIY are limited.

For example, data on cannabis use expectancies with JIY are limited to a single, small detained sample in one U.S.state.Findings suggest negative cannabis use expectancies are associated with less cannabis use, while positive expectancies are unrelated.The authors posit consequences associated with use may be more salient for youth completing these measures while detained, and different associations regarding positive expectancies may have emerged if measured outside detention.Of note, the negative expectancies sub-scale had very low internal consistency, thus replication of their findings with other JIY samples is warranted.Other adolescent studies show negative expectancies associated with cannabis use among Black females are related to less cannabis use over time and among a racially and ethnically diverse U.S.high school student sample changes in positive substance use expectancies most saliently predicted substance use onset and changes in negative expectancies was associated with onset of cannabis use only.Brief individual interventions addressing substance use motivations and expectancies have been successful in reducing adolescent cannabis use ; however, research on preventing initiation through brief intervention and among JIY is nascent.Extension of expectancies research with JIY samples is necessary, particularly using prospective data and examining the role of positive expectancies and cannabis use outside detention when there is greater opportunity for use.Studies of school-based and general adolescent samples have also demonstrated the importance of understanding reasons for and protective factors against cannabis use.Data from the Monitoring the Future Survey examining past 10-year trends demonstrates adolescents cite more coping-related reasons than any other motivations for use.Individual factors that positively influence social cognition and behaviors appear to buffer against substance use among early adolescents in public school , and higher self-esteem is associated with less substance use among Black adolescents exposed to community violence and with high family stress.Enhanced emotion regulation skills,growers equipment which are influenced by social cognitive factors , are also protective against cannabis use initiation among Black adolescents.Justice-involved youth, who experience high rates of trauma, poverty, stigma and discrimination, may cite multiple reasons to use cannabis as a coping strategy, however, research in this area is lacking.Reducing early initiation of cannabis use is key to preventing negative long-term health and associated psychosocial consequences.In this large sample of first-time JIY, rates of early onset cannabis use were high and 15 % of youth newly initiated cannabis use in the year following first justice contact.Youth’s internal distress, affect dysregulation, and positive expectancies about cannabis use drove new initiation, even after accounting for known associated factors.The justice system largely focuses on interventions to address co-occurring mental health and delinquent behavior, primarily through group or family-based intervention, but our data suggest there is a critical and unique window of opportunity to prevent cannabis use initiation among youth by addressing internalizing symptoms, teaching emotion regulation skills, and modifying expectancies.Such interventions can be brief and feasible to implement within existing individual-based court and justice-related services.Since adolescent cannabis use can be associated with future worse public health and legal outcomes, developing effective brief primary prevention interventions for JIY is critical; these are not mutually exclusive from essential development and empirical testing of structural-level public health and legal policy interventions to delay or reduce JIY substance use.Only two studies have tested brief interventions to reduce substance use among justice involved or diverted truant populations.Spirito and colleagues tested the preliminary efficacy of a combined family-based and individual adolescent based brief motivational enhancement therapy intervention ; the latter targeting adolescent substance use related attitudes, beliefs and norms and demonstrating feasibility, acceptability and reductions in youth cannabis use at 3 month follow-up.

Dembo and colleagues tested the efficacy of a brief intervention with youth and parents compared to youth-only BI and Standard Truancy Services in reducing cannabis use and sexual risk behavior over 12 months.No significant intervention effects were found; however, the authors note certain subgroups showed differential response to the intervention.Although mixed in success, both studies addressed individual level factors commonly associated with increased likelihood of substance use among JIY.Our data suggest with first-time JIY who have not initiated use, a brief individual youth intervention targeting internalizing symptoms, emotion regulation skills, and cannabis use expectancies is important for future intervention development and testing.Single session interventions are a cost-effective and feasible way to address youth internalizing symptoms and increase access to mental health interventions for under served youth.SSIs focused on motivational enhancement therapy for sexual risk reduction have been feasible and acceptable to deliver to large numbers of detained youth.The concept of SSIs has yet to be explored for substance use prevention among JIY, but our study suggests a SSI addressing internalizing symptoms, emotion regulation, and cannabis use expectancies and intentions may be efficacious in delaying or preventing cannabis use initiation, both of which have significant positive public health implications.SSIs could also be developed to shift expectancies and intentions about continued use for those with early onset, who are at greater risk for worse outcomes due to being younger upon first using and greater likelihood of continued use and consequences.Our results suggest incorporating alcohol use content might also be important for those already using cannabis at first-time justice contact.SSIs are also likely more feasible to implement within real-world settings already serving JIY and have strong potential to address a highly concerning gap in access to substance use intervention for community-supervised JIY.One possible approach for substance use SSIs is motivational interviewing , a communication technique used to reduce alcohol and cannabis use among school-mandated college students and in two studies of general substance using adolescent populations ; however, the limited data available suggest MI for universal prevention may not be as effective.

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