Pro-cannabis social media linked to youths’ intentions to use
PULLMAN, Wash. – Despite laws against advertising cannabis to teens, young people reported in surveys that they still see a lot of positive cannabis messages through social media posts.
Washington State University researchers found these messages were also connected to the teens’ intentions to use cannabis, and for college students, with their actual use. Anti-cannabis messages also had an effect in lessening use-intentions, but young people saw less of those types of messages.
“Youth, in particular, have really grown up bombarded with cannabis information compared to previous generations,” said Jessica Willoughby, first author on the study published in the journal Health Communication and an associate professor in WSU’s Murrow College of Communication. “We found that they were seeing more positive messages about using cannabis and a lot less about the risks.”
For this study, the researchers surveyed 350 teens and 966 college students from across Washington state, where recreational marijuana has been legal since 2012.
The state does have regulations aimed at preventing advertising cannabis to minors, such as prohibiting the use of cartoons or youth-oriented celebrities. This does not prevent individuals from posting about cannabis on social media, however.
Of the study participants, the vast majority, over 80%, reported seeing pro-cannabis messages on social media, such as posts about being high or claims that marijuana is harmless. The pro-cannabis messages most often encountered were those from celebrities or lyrics in songs.
“Parents might not understand that if their kid is using a social media site—whether it’s Twitter, YouTube, Instagram, Facebook or Snapchat —they are going to see cannabis messages. That's just the reality,” said co-author Stacey Hust, a professor at WSU’s Murrow College of Communication. “This means we need to be getting training into schools at much younger ages. At the very least middle school and high school health classes need to talk about cannabis and how it can be harmful to the developing brain.”
The study participants also reported seeing some anti-cannabis messages, such as that cannabis can cause harm or that smoking it is gross or for losers, but they saw these types of messages less often than pro-cannabis ones.
The youth, both teens and college students, who reported seeing higher levels of positive messages were more likely to indicate an intention to use cannabis. The college students were also asked about actual use and there was a positive connection between exposure to pro-cannabis posts and use for that group.
The good news is that seeing the anti-cannabis messages had some effect, although indirectly. Among the youth who already held beliefs that cannabis use could cause negative outcomes, such as damaging their brain or doing worse in school, seeing anti-cannabis messages appeared to lower their intentions to use.
The researchers said this finding indicates a good area for parents and counselors to target.
“Prevention efforts can have an impact,” said Willoughby. “Since youth are seeing more of that positive cannabis content, it's worthwhile to put out more content highlighting the risks, especially to the young people like them.”
This study received partial funding through Washington state’s initiative measure 502 which taxes production processing and wholesale retail sales of marijuana.
ARTICLE TITLE
Exposure to Pro and Anti-Cannabis Social Media Messages and Teens’ and College Students’ Intentions to Use Cannabis
Medical cannabis for chronic pain may help patients on long-term opioid treatment reduce dosages
New York, NY | January 30, 2023 — A new study from New York State and CUNY researchers suggests that receiving medical cannabis for thirty days or more may help patients on long-term opioid treatment to lower their dose over time.
The study, published today in the Journal of the American Medical Association (JAMA) Network Open, found an association between receiving medical cannabis for chronic pain for a longer duration and a reduction in prescription opioid dosages among patients on long-term opioid therapy. Patients who were on higher baseline dosages of prescription opioids when they started receiving medical cannabis experienced larger reductions in opioid dosages.
These findings leverage existing population-level data to contribute robust evidence for clinicians regarding the potential clinical benefits of medical cannabis in reducing the opioid burden for long-term opioid therapy patients, and possibly reducing their risk for use of illicit substances and overdose. The findings could further inform policies in other jurisdictions, where medical cannabis is not yet legalized.
Researchers from the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), the New York State Department of Health, and the New York State Office of Cannabis Management used a combination of two large state databases to analyze data from eight thousand adult New Yorkers during 2017-2019. They evaluated prescription opioid dosages of participants during the 12 months prior to receipt of medical cannabis and up to eight months later. For each month of the study, the researchers compared the average daily morphine milligram equivalent (MME) for those who received medical cannabis for more than 30 days vs. those who received 30 days or less. The following results were observed eight months after patients started receiving medical cannabis:
- Among patients with the lowest MME (less than 50 MME), the average daily MME at the end of the follow-up period for patients with longer medical cannabis duration was reduced 48% from baseline. In contrast, there was a 4% reduction from baseline for patients with shorter medical cannabis duration. This resulted in a total MME net reduction of -14.53 (range, -17.45 to -11.61) over eight months for patients receiving medical cannabis for a longer duration.
- Among patients with a baseline MME of 50 to 89, the average daily MME at the end of the follow-up period for patients with longer medical cannabis duration showed a 47% reduction from baseline versus 9% reduction for patients with a shorter medical cannabis duration. This resulted in a total MME net reduction of -29.49 (range, -35.94 to -23.04) over eight months for patients receiving medical cannabis for a longer duration.
- For adults with a baseline MME at 90 or greater, by the end of the follow-up period, the daily MME for patients with longer medical cannabis duration, there was a 51% reduction from baseline versus 14% reduction for patients with shorter medical cannabis duration. This resulted in the largest MME net reduction of -69.81 (range, -87.09 to -52.53) over eight months for patients receiving longer medical cannabis duration.
"This study found meaningful reductions among patients receiving medical cannabis for longer duration,” said lead author Dr. Trang Nguyen of the Department of Health. “Patients’ daily opioid dosages were reduced by 47%-51% of the baseline dosages after eight months. In contrast, patients receiving medical cannabis for a shorter duration reduced their initial dosages by just 4%-14%."
“These findings have important implications for clinicians and policy makers,” said co-author Dr. Danielle Greene of CUNY SPH. “They provide evidence for another tool to be used in response to the opioid epidemic. Changes in attitudes and policies toward opioid prescribing over the past decade have left some patients dependent on long-term high dosage prescriptions but fewer providers willing to write these prescriptions. Previous research has shown that abrupt disruption in opioid prescriptions among patients on high dosages and long-term opioid therapy can lead to patients’ use of illicit drugs, overdose, and self-harm. Our study suggests a more humane option for achieving lower prescription dosages and potentially reducing those risks. Equitable implementation of these findings will require addressing disparities in both access to medical cannabis due to high cost and the high rate of patients receiving long-term opioid therapy in Medicaid and other programs.”
“Since the inception of the Medical Cannabis Program in New York State, we’ve heard anecdotal evidence from patients, caregivers and health care providers suggesting that medical cannabis can reduce the amount of opioids patients take to manage pain – and now we have the study demonstrating a statistically significant reduction for those patients who were on medical cannabis for a longer duration,” said co-author Nicole Quackenbush of the NYS Office of Cannabis Management. “Research is critical to further our knowledge of the potential risks and benefits of cannabis and the OCM will be continuing efforts to promote cannabis knowledge and research in New York State.”
Nguyen T, Li Y, Greene D, Stancliff S, Quackenbush N. Changes in Prescribed Opioid Dosages Among Patients Receiving Medical Cannabis for Chronic Pain, New York State, 2017-2019. JAMA Netw Open. 2023;6(1):e2254573. doi:10.1001/jamanetworkopen.2022.54573
For media inquiries, contact:
Ariana Costakes
Communications Editorial Manager
ariana.costakes@sph.cuny.edu
About CUNY SPH
The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to promoting and sustaining healthier populations in New York City and around the world through excellence in education, research and service in public health and by advocating for sound policy and practice to advance social justice and improve health outcomes for all. sph.cuny.edu
JOURNAL
JAMA Network Open
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Changes in Prescribed Opioid Dosages Among Patients Receiving Medical Cannabis for Chronic Pain, New York State, 2017-2019
ARTICLE PUBLICATION DATE
30-Jan-2023
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