Addiction

Cannabis (marijuana) and suicidal ideation

A previous post discussed cannabis (marijuana) use and Memory and academic performance and symptoms of depression and anxiety from cannabis withdrawal.

This post talks about a study looking at cannabis use and suicidal ideation.

What was the study (1)?

Dr Han and colleagues looked at data from 281 650 adult participants in the 2008-2019 National Surveys of Drug Use and Health data.

What were some study results (1)?

  • Past-year Cannabis use disorder, daily cannabis use, and nondaily cannabis use were associated with a higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes (eg, among individuals without Major depressive episode.)
  • The prevalence of suicidal ideation for those with vs without Cannabis use disorder was 13.9% vs 3.5% among women and 9.9% vs 3.0% among men; P < .001).
  • Suicide plan among those with Cannabis use disorder and major depressive episode was 52% higher for women [23.7%] than men [15.6%]; P < .001).

What are some caveats?

  • This is just one study and further research is needed.
  • While this study shows correlation between cannabis and suicidal ideation among those with depression, but does not show direct cause and effect.
  • Future research is needed to examine this increase in suicidality and to determine whether it is due to cannabis use or other overlapping risk factors.
  • According to this study, cannabis use can be concerning for suicidal ideation for those with and without major depressive disorder.

Additional information 

Treatment Facilities in the Columbus, Ohio area:

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Han B, Compton WM, Einstein EB, Volkow ND. Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status. JAMA Netw Open. 2021;4(6):e2113025. doi:10.1001/jamanetworkopen.2021.13025

Electronic Gaming and Mental Health

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Electronic gaming is very common among young adults and comes in many forms including smartphones, tablets, computers, game consoles, etc.

By some estimates, the market size for electronic gaming is almost the same size as the movie industry.

Almost 90% of people ages 16 to 24 play video games (1); and almost half were at risk of video game addiction (2).

While many adults engage in gaming in healthy ways, gaming addiction has been linked to insomnia, anxiety, depression, stress among college students (3).

One study looked at  gaming addiction, and depression (4).

Who was studied?

3267 undergraduate students from United States, China and Singapore(4).

What was studied?

Rates of addictions to Internet use, online gaming, and online social networking,

Their association with depressive symptoms (4).

What were the results?

31% of male students were addicted to online gaming, compared to 13% of female students (OR = 0.522, 95% CI = 0.440-0.620) (4)

37.3% of female students were addicted to social networking compared to 27.8% of male students (OR = 1.543, 95% CI = 1.329-1.791). (4)

Regarding depression rates:

  • Among students with online gaming addiction depression rates were 65.5% for students in United States, 70.8% for China, and 69.6% for Singapore. (4)
  • Among students with internet addiction, depression rates were 76.5% for students in United States, 88.9% for China, and 75.9% for Singapore. (4)
  • Among students with online social networking addiction, depression rates were 68.8% for students in United States, 76% for China, and 71% for Singapore. (4)

What are some signs of Internet gaming disorder?

While there is no uniform criteria, some signs could include (5,6):

  • Preoccupation. (The individual thinks about previous gaming activity or anticipates playing the next game; internet gaming becomes the dominant activity in daily life.)
  • Experienced withdrawal symptoms when internet gaming is taken away. (These symptoms are typically described as irritability, anxiety, or sadness, but there are no physical signs of pharmacological withdrawal.)
  • Developed Tolerance—the need to spend increasing amounts of time engaged in games.
  • Unsuccessful attempts to control the participation in gaming.
  • Continued excessive use despite knowledge of psychosocial problems.
  • Mislead/deceive family members, therapists, or others regarding the amount of gaming.
  • Use as escape or relieve a negative mood (e.g., feelings of helplessness, guilt, anxiety).
  • Loss of interest in previous hobbies and entertainment as a result of, and with the exception of gaming.
  • Jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in electronic gaming.

What are some caveats?

  • Further study is needed in the area of internet, and gaming addiction.
  • To learn more about internet addiction, click here.
  • While this study shows that males were more likely to have gaming addiction and female students were more likely to have internet addiction, newer research indicates that this gap appears to be narrowing.
  • For other studies on men and mental health, click here, and here.
  • To learn more about disparities of men, suicide, and mental health, go here:  Movember National Men’s Health Campaign.

Any other useful links?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Brand J. (2012). Digital Australia (2012). National Research Prepared by Bond University for the Interactive Games and Entertainment Association. School of Communication and Media, Faculty of Humanities and Social Sciences, Bond University.
  2. Hussain Z, Griffiths MD, Baguley T. Online gaming addiction: classification, prediction and associated risk factors. Addict Res Theory. 2012;20:359-371.
  3. Younes F, Halawi G, Jabbour H, et al. Internet addiction and relationships with insomnia, anxiety, Depression, stress and self-esteem in university students: a cross-sectional designed study. PLoS One. 2016;11:e0161126
  4. Catherine So-Kum Tang, PhD, Yee Woen Koh, PhD, and YiQun Gan, PhD Asia Pacific Journal of Public Health Vol 29, Issue 8, pp. 673 – 682 First Published November 30, 2017 https://doi.org/10.1177/1010539517739558
  5. American Psychiatric Association: Diagnostic and StatisticalManual of Mental Disorders, 5th ed. Washington, DC, American Psychiatric Publishing, 2013Section III (“Emerging Measures and Models”) of DSM-5 (1, pp. 795–796).
  6. Andrew K. Przybylski, Ph.D., Netta Weinstein, Ph.D., Kou Murayama, Ph.D. Internet Gaming Disorder: Investigating the Clinical Relevance of a New Phenomenon. Am J Psychiatry 2017; 174:230–236; doi: 10.1176/appi.ajp.2016.16020224.

Study: Impact of Cannabis on Alcohol

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

As of 2015, about 22 million individuals in the United States reported using cannabis / marijuana in the last month (1). In 2011, almost 70 million Americans reported binge drinking in the last month ( binge drinking defined by the survey as 5 or more drinks on one occasion) (2).

Some individuals may consider marijuana use as they are reducing alcohol use. A recent study looked at how cannabis use might impact alcohol use.

What was the study? (3)

1,383 newly abstinent alcohol dependent individuals were  participating in a multi-site randomized control trial for treatment options of alcohol use disorder in the landmark COMBINE study (4-5).

Researchers compared alcohol use among those who used cannabis versus those who did not use cannabis.

What were the study results?

The authors (3) found that compared to no cannabis use, ANY cannabis use during treatment for alcohol use disorder was related to LESS alcohol abstinence at end of treatment.

They found that each additional day of cannabis use was associated with approximately 4–5 fewer days of abstinence from alcohol (3).

In this study, cannabis use impacted how often the participants drank, but not how many drinks they had (3).

Further study in this area is needed.

What does this mean?

This study suggests that it may not be a good idea to use cannabis if you are trying to abstain from alcohol.

What are some useful resources regarding cannabis?

Drug treatment group at OSU Office of Student Life Counseling and Consultation Service.

Treatment Facilities Here in Columbus

 

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). 2016. http://www.samhsa.gov.proxy.lib.ohio-state.edu/data/
  2. Center for Behavioral Health Statistics and Quality. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50); 2015.
  3. Subbaraman, M. S., Metrik, J., Patterson, D., and Swift, R. (2016) Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes. Addiction, doi: 10.1111/add.13693.
  4. Anton R. F., O’Malley S. S., Ciraulo D. A., Cisler R. A., Couper D., Donovan D. M.et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 2006; 295: 2003–2017.
  5. Combine Study Research Group. Testing combined pharmacotherapies and behavioral interventions in alcohol dependence: rationale and methods. Alcohol Clin Exp Res 2003; 27: 1107–1122.