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Results from the Colorado Cannabis Users Survey on Health (CUSH), 2016

  • Alexandra Elyse ContrerasEmail author
  • Katelyn E. Hall
  • Daniel I. Vigil
  • Allison Rosenthal
  • Alejandro Azofeifa
  • Michael Van Dyke
Original Article

Abstract

Patterns of cannabis consumption among regular users within a legalized environment have not been explored in detail. We aimed to conduct a survey among regular cannabis users to collect detailed information on frequency of use, methods of use, amounts consumed, and adverse health effects experienced. Data was collected via the Cannabis Users Survey on Health, a self-administered, anonymous online survey. Participants were adults (age 21+), residing in Colorado, who used cannabis at least once in the past month. Survey administration occurred June through October 2016. Of 1297 participant responses, 65.1% used cannabis at least once daily and smoking was the most common method of use (83.1%). Cannabis flower was the product most frequently purchased (n = 1006) and in the largest average amount per month (10 g). Adverse health effects were experienced by ~ 40%; most prevalent was paranoia (20.8%). The Cannabis Users Survey on Health provided data needed to inform public health on patterns of cannabis use in Colorado. Surveillance of adverse effects is needed to assess severity. High prevalence of daily use and smoking are concerning for long-term health effects. Continued data collection will allow public health to better assess the effects of increased cannabis availability on use patterns and health.

Keywords

Cannabis use Cannabis legalization Cannabis health effects Public health surveillance Cannabis survey 

Notes

Acknowledgements

The authors would like to thank Lisa Barker, Maria Butler, Michele Coleman, Troy Curtis, Erika Kelley, David Ross, Aaron Shipman, Amber Vaughn, and the Council of State and Territorial Epidemiologists (CSTE).

Funding

This publication was supported by the Council of State and Territorial Epidemiologists (CSTE), with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) through the Centers for Disease Control (CDC) cooperative agreement number 5U38OT00143. The contents are solely the responsibility of the authors and do not necessarily represent the official views of CSTE, SAMHSA, CDC, or the Department of Health and Human Services.

This study/report was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded through the Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 1U38OT000143-04 by the Substance Abuse and Mental Health Services Administration.

Compliance with Ethical Standards

Authors Alexandra Elyse Contreras, Katelyn E. Hall, Daniel I. Vigil, Allison Rosenthal, Alejandro Azofeifa, and Michael Van Dyke ensure accepted principles of ethical and professional conduct have been followed regarding human participants and informed consent.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. American Heart Association. (2018). About Arrhythmia. Retrieved December 2, 2018, from http://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
  2. Azofeifa, A., Sherman, L. J., Mattson, M. E., & Pacula, R. L. (2017). Marijuana buyers in the United States, 2010-2014. Drug and Alcohol Dependence, 183, 34–42.  https://doi.org/10.1016/j.drugalcdep.2017.10.019.CrossRefPubMedGoogle Scholar
  3. Barber, P. A., Pridmore, H. M., Krishnamurthy, V., Roberts, S., Spriggs, D. A., Carter, K. N., & Anderson, N. E. (2013). Cannabis, ischemic stroke, and transient ischemic attack: a case-control study. Stroke, 44(8), 2327–2329.  https://doi.org/10.1161/strokeaha.113.001562.CrossRefPubMedGoogle Scholar
  4. Blanco, C., Hasin, D. S., Wall, M. M., Florez-Salamanca, L., Hoertel, N., Wang, S., et al. (2016). Cannabis use and risk of psychiatric disorders: prospective evidence from a US National Longitudinal Study. JAMA Psychiatry, 73(4), 388–395.  https://doi.org/10.1001/jamapsychiatry.2015.3229.CrossRefPubMedGoogle Scholar
  5. Colorado Department of Revenue. (2015). Marijuana equivalency in portion and dosage. Retrieved April 6, 2017, from https://www.colorado.gov/pacific/enforcement/marijuana-related-reports-studies
  6. Colorado Department of Public Health and Environment. (2016). Cannabis Users Survey on Health (CUSH). Unpublished data. Google Scholar
  7. Colorado Department of Public Health and Environment. (2017). 2016 Behavioral Risk Factor Surveillance System Data. Available from: https://www.cohealthdata.dphe.state.co.us/Home/DataByTopic#Google Scholar
  8. D'Souza, D. C., Perry, E., MacDougall, L., Ammerman, Y., Cooper, T., Wu, Y. T., . . . Krystal, J. H. (2004). The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis. Neuropsychopharmacology, 29(8), 1558–1572. doi: https://doi.org/10.1038/sj.npp.1300496.CrossRefPubMedGoogle Scholar
  9. Englund, A., Atakan, Z., Kralj, A., Tunstall, N., Murray, R., & Morrison, P. (2016). The effect of five day dosing with THCV on THC-induced cognitive, psychological and physiological effects in healthy male human volunteers: a placebo-controlled, double-blind, crossover pilot trial. Journal of Psychopharmacology, 30(2), 140–151.  https://doi.org/10.1177/0269881115615104.CrossRefPubMedGoogle Scholar
  10. Falkstedt, D., Wolff, V., Allebeck, P., Hemmingsson, T., & Danielsson, A. K. (2017). Cannabis, tobacco, alcohol use, and the risk of early stroke: a population-based cohort study of 45 000 Swedish men. Stroke, 48(2), 265–270.  https://doi.org/10.1161/strokeaha.116.015565.CrossRefPubMedGoogle Scholar
  11. Feingold, D., Weiser, M., Rehm, J., & Lev-Ran, S. (2015). The association between cannabis use and anxiety disorders: results from a population-based representative sample. European Neuropsychopharmacology, 26, 493–505.  https://doi.org/10.1016/j.euroneuro.2015.12.037.CrossRefPubMedGoogle Scholar
  12. Frost, L., Mostofsky, E., Rosenbloom, J. I., Mukamal, K. J., & Mittleman, M. a. (2013). Marijuana use and long-term mortality among survivors of acute myocardial infarction. American Heart Journal, 165(2), 170–175.  https://doi.org/10.1016/j.ahj.2012.11.007.CrossRefPubMedGoogle Scholar
  13. Geller, T., Loftis, L., & Brink, D. S. (2004). Cerebellar infarction in adolescent males associated with acute marijuana use. Pediatrics, 113(4), e365–e370.CrossRefGoogle Scholar
  14. Grotenhermen, F. (2003). Pharmacokinetics and pharmacodynamics of cannabinoids. Clinical Pharmacokinetics, 42(4), 327–360.  https://doi.org/10.2165/00003088-200342040-00003.CrossRefPubMedGoogle Scholar
  15. Hackam, D. G. (2015). Cannabis and stroke: systematic appraisal of case reports. Stroke, 46(3), 852–856.  https://doi.org/10.1161/STROKEAHA.115.008680.CrossRefPubMedGoogle Scholar
  16. Hemachandra, D., McKetin, R., Cherbuin, N., & Anstey, K. J. (2016). Heavy cannabis users at elevated risk of stroke: evidence from a general population survey. Australian and New Zealand Journal of Public Health, 40(3), 226–230.  https://doi.org/10.1111/1753-6405.12477.CrossRefPubMedGoogle Scholar
  17. Jouanjus, E., Lapeyre-Mestre, M., Micallef, J., French Association of the Regional, A, & Dependence Monitoring Centres Working Group on Cannabis, C. (2014). Cannabis use: signal of increasing risk of serious cardiovascular disorders. Journal of the American Heart Association, 3(2), e000638.  https://doi.org/10.1161/JAHA.113.000638.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Kalla, A., Krishnamoorthy, P. M., Gopalakrishnan, A., & Figueredo, V. M. (2018). Cannabis use predicts risks of heart failure and cerebrovascular accidents: results from the National Inpatient Sample. Journal of Cardiovascular Medicine (Hagerstown, Md.), 19(9), 480–484.  https://doi.org/10.2459/JCM.0000000000000681.CrossRefGoogle Scholar
  19. Kedzior, K. K., & Laeber, L. T. (2014). A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population—a meta-analysis of 31 studies. BMC Psychiatry, 14(1), 136.  https://doi.org/10.1186/1471-244x-14-136.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Mason, O., Morgan, C. J., Dhiman, S. K., Patel, A., Parti, N., Patel, A., & Curran, H. V. (2009). Acute cannabis use causes increased psychotomimetic experiences in individuals prone to psychosis. Psychological Medicine, 39(6), 951–956.  https://doi.org/10.1017/S0033291708004741.CrossRefPubMedGoogle Scholar
  21. Mittleman, M. A., Lewis, R. A., Maclure, M., Sherwood, J. B., & Muller, J. E. (2001). Triggering myocardial infarction by marijuana. Circulation, 103(23), 2805–2809.CrossRefGoogle Scholar
  22. Morgan, C. J., Rothwell, E., Atkinson, H., Mason, O., & Curran, H. V. (2010). Hyper-priming in cannabis users: a naturalistic study of the effects of cannabis on semantic memory function. Psychiatry Research, 176(2–3), 213–218.  https://doi.org/10.1016/j.psychres.2008.09.002.CrossRefPubMedGoogle Scholar
  23. Morrison, P. D., Zois, V., McKeown, D. A., Lee, T. D., Holt, D. W., Powell, J. F., et al. (2009). The acute effects of synthetic intravenous Delta9-tetrahydrocannabinol on psychosis, mood and cognitive functioning. Psychological Medicine, 39(10), 1607–1616.  https://doi.org/10.1017/s0033291709005522.CrossRefPubMedGoogle Scholar
  24. Mukamal, K. J., Maclure, M., Muller, J. E., & Mittleman, M. a. (2008). An exploratory prospective study of marijuana use and mortality following acute myocardial infarction. American Heart Journal, 155(3), 465–470.  https://doi.org/10.1016/j.ahj.2007.10.049.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Reis, J. P., Auer, R., Bancks, M. P., Goff, D. C., Jr., Lewis, C. E., Pletcher, M. J., et al. (2017). Cumulative lifetime marijuana use and incident cardiovascular disease in middle age: the Coronary Artery Risk Development in Young Adults (CARDIA) study. American Journal of Public Health, 107(4), 601–606.  https://doi.org/10.2105/ajph.2017.303654.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Rumalla, K., Reddy, A. Y., & Mittal, M. K. (2016). Recreational marijuana use and acute ischemic stroke: a population-based analysis of hospitalized patients in the United States. Journal of the Neurological Sciences, 364, 191–196.  https://doi.org/10.1016/j.jns.2016.01.066.CrossRefPubMedGoogle Scholar
  27. Sidney, S., Beck, J. E., Tekawa, I. S., Quesenberry, C. P., & Friedman, G. D. (1997). Marijuana use and mortality. American Journal of Public Health, 87(4), 585–590.CrossRefGoogle Scholar
  28. Substance Abuse and Mental Health Services Administration. (2015). 2015 National survey on drug use and health (NSDUH): final CAI specifications for programming (english version). Retrieved March 26, 2017 from http://samhda.s3-us-gov-west-1.amazonaws.com/s3fs-public/field-uploads-protected/studies/NSDUH-2015/NSDUH-2015-datasets/NSDUH-2015-DS0001/NSDUH-2015-DS0001-info/NSDUH-2015-DS0001-info-questionnaire-specs.pdf.
  29. Substance Abuse and Mental Health Services Administration. (2017). Population data/NSDUH. Available from: https://www.samhsa.gov/data/population-data-nsduh/
  30. Thanvi, B. R., & Treadwell, S. D. (2009). Cannabis and stroke: is there a link? Postgraduate Medical Journal, 85(1000), 80–83.  https://doi.org/10.1136/pgmj.2008.070425.CrossRefPubMedGoogle Scholar
  31. Twomey, C. D. (2017). Association of cannabis use with the development of elevated anxiety symptoms in the general population: a meta-analysis. Journal of Epidemiology and Community Health, 71(8), 811–816.  https://doi.org/10.1136/jech-2016-208145.CrossRefPubMedGoogle Scholar
  32. Vigil, D., Hall, K., Contreras, E., Anderson Mellies, A., Bui, A. G., Tolliver, R., & Van Dyke, M. (2017). Monitoring changes in marijuana use patterns: behavioral risk factor surveillance system (BRFSS) 2014–2015 Survey Results. Retrieved January 25, 2017, from https://www.colorado.gov/cdphe/marijuana-health-report
  33. Vin-Raviv, N., Akinyemiju, T., Meng, Q., Sakhuja, S., & Hayward, R. (2017). Marijuana use and inpatient outcomes among hospitalized patients: analysis of the nationwide inpatient sample database. Cancer Medicine, 6(1), 320–329.  https://doi.org/10.1002/cam4.968.CrossRefPubMedGoogle Scholar
  34. Westover, A. N., McBride, S., & Haley, R. W. (2007). Stroke in young adults who abuse amphetamines or cocaine: a population-based study of hospitalized patients. Archives of General Psychiatry, 64(4), 495–502.  https://doi.org/10.1001/archpsyc.64.4.495.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Alexandra Elyse Contreras
    • 1
    Email author
  • Katelyn E. Hall
    • 1
  • Daniel I. Vigil
    • 1
  • Allison Rosenthal
    • 1
  • Alejandro Azofeifa
    • 2
  • Michael Van Dyke
    • 1
  1. 1.Colorado Department of Public Health and EnvironmentDenverUSA
  2. 2.Independent ScholarWashington, D.C.USA

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