Gender differences in circumstances associated with cannabis use
Corresponding Author
Erin L. Martin PhD
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Correspondence Erin L. Martin, PhD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty St., Suite 190, Charleston, SC 29425, USA.
Email: [email protected]
Search for more papers by this authorNathaniel L. Baker MS
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorViswanathan Ramakrishnan PhD
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorBrian Neelon PhD
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorMichael E. Saladin PhD
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorAimee L. McRae-Clark PharmD
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA
Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
Search for more papers by this authorCorresponding Author
Erin L. Martin PhD
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Correspondence Erin L. Martin, PhD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty St., Suite 190, Charleston, SC 29425, USA.
Email: [email protected]
Search for more papers by this authorNathaniel L. Baker MS
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorViswanathan Ramakrishnan PhD
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorBrian Neelon PhD
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorMichael E. Saladin PhD
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina, USA
Search for more papers by this authorAimee L. McRae-Clark PharmD
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA
Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
Search for more papers by this authorAbstract
Background and Objectives
Identifying circumstances associated with cannabis use is critical to the development of effective interventions for cannabis use disorder (CUD) and circumstances may differ by gender. The Inventory of Drug Taking Situations (IDTS) assesses the types of situations in which individuals most often use drugs through eight subscales: dealing with (1) Unpleasant Emotions; (2) Physical Discomfort; (3) Pleasant Emotions; (4) Testing Personal Control; (5) Urges/Temptations; (6) Conflict with Others; (7) Social Pressure; and (8) Pleasant Times with Others. The aims of this study were to determine if IDTS scores varied by gender in individuals with CUD, and to ascertain if behavioral factors such as cannabis use or stress were differentially associated with IDTS scores by gender.
Methods
Baseline data were obtained from a study of 148 nontreatment-seeking individuals with CUD. Data included demographic characteristics, IDTS scores, self-reported past 90-day substance use, and measures of past-month and childhood stress.
Results
Women reported using cannabis more than men in negative affective contexts, namely when experiencing conflict with others, testing personal control, physical discomfort, and unpleasant emotions. IDTS subscale scores associated with negative affect and pleasant emotions were positively associated with past 90-day cannabis use sessions across genders, use when experiencing negative affect was associated with childhood stress across genders, and use when experiencing unpleasant emotions was differentially associated with recent stress by gender.
Conclusion and Scientific Significance
Findings suggest gender differences in circumstances associated with cannabis use with implications for therapeutic development for CUD.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
REFERENCES
- 1 SAMHSA. Results From the 2022 National Survey on Drug Use and Health: Detailed Tables; 2023. https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables
- 2Sherman BJ, McRae-Clark AL. Treatment of cannabis use disorder: current science and future outlook. Pharmacotherapy. 2016; 36(5): 511-535. doi:10.1002/phar.1747
- 3Cooper ZD, Haney M. Investigation of sex-dependent effects of cannabis in daily cannabis smokers. Drug Alcohol Depend. 2014; 136: 85-91. doi:10.1016/j.drugalcdep.2013.12.013.INVESTIGATION
- 4Kerridge BT, Pickering R, Chou P, Saha TD, Hasin DS. DSM-5 cannabis use disorder in the national epidemiologic survey on alcohol and related Conditions-III: gender-specific profiles. Addict Behav. 2018; 76: 52-60. doi:10.1016/j.addbeh.2017.07.012
- 5Sherman BJ, McRae-Clark AL, Baker NL, et al. Gender differences among treatment-seeking adults with cannabis use disorder: clinical profiles of women and men enrolled in the achieving cannabis cessation-evaluating N-acetylcysteine treatment (ACCENT) study: ACCENT-Gender differences and CUD. Am J Addict. 2017; 26(2): 136-144. doi:10.1111/ajad.12503
- 6McHugh RK, DeVito EE, Dodd D, et al. Gender differences in a clinical trial for prescription opioid dependence. J Subst Abuse Treat. 2013; 45(1): 38-43. doi:10.1016/j.jsat.2012.12.007
- 7McHugh RK, Geyer RB, Chase AR, Griffin ML, Bogunovic O, Weiss RD. Sex differences in benzodiazepine misuse among adults with substance use disorders. Addict Behav. 2021; 112:106608. doi:10.1016/j.addbeh.2020.106608
- 8Lehavot K, Stappenbeck CA, Luterek JA, Kaysen D, Simpson TL. Gender differences in relationships among PTSD severity, drinking motives, and alcohol use in a comorbid alcohol dependence and PTSD sample. Psychol Addict Behav. 2014; 28(1): 42-52. doi:10.1037/a0032266
- 9Hartwell KJ, Back SE, McRae-Clark AL, Shaftman SR, Brady KT. Motives for using: a comparison of prescription opioid, marijuana and cocaine dependent individuals. Addict Behav. 2012; 37(4): 373-378. doi:10.1016/j.addbeh.2011.11.014
- 10Cooper ML, Kuntsche E, Levitt A, Barber LL, Wolf S. In: KJ Sher, ed. Motivational Models of Substance Use. Vol 1. Oxford University Press; 2015. doi:10.1093/oxfordhb/9780199381678.013.017
- 11Hyman SM, Sinha R. Stress-related factors in cannabis use and misuse: implications for prevention and treatment. J Subst Abuse Treat. 2009; 36(4): 400-413. doi:10.1016/j.jsat.2008.08.005
- 12Buckner JD, Silgado J, Schmidt NB. Marijuana craving during a public speaking challenge: understanding marijuana use vulnerability among women and those with social anxiety disorder. J Behav Ther Exp Psychiatry. 2011; 42(1): 104-110. doi:10.1016/j.jbtep.2010.07.005
- 13Larson ER, Moussa-Tooks AB, Tullar RL, et al. Sex differences in neuroendocrine, sympathetic nervous system, and affect responses to acute stress in cannabis users. Psychopharmacology. 2023; 240(8): 1805-1821. doi:10.1007/s00213-023-06400-z
- 14Reed SC, Haney M, Manubay J, et al. Sex differences in stress reactivity after intranasal oxytocin in recreational cannabis users. Pharmacol Biochem Behav. 2019; 176: 72-82. doi:10.1016/j.pbb.2018.11.008
- 15Glodosky NC, Cuttler C. Motives matter: cannabis use motives moderate the associations between stress and negative affect. Addict Behav. 2020; 102:106188. doi:10.1016/j.addbeh.2019.106188
- 16Merrick MT, Ford DC, Ports KA, et al. Vital signs: estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention—25 states, 2015–2017. MMWR Morb Mortal Wkly Rep. 2019; 68(44): 999-1005. doi:10.15585/mmwr.mm6844e1
- 17Barahmand U, Khazaee A, Hashjin GS. Emotion dysregulation mediates between childhood emotional abuse and motives for substance use. Arch Psychiatr Nurs. 2016; 30(6): 653-659. doi:10.1016/j.apnu.2016.02.007
- 18Smith PH, Saddleson ML, Homish GG, McKee SA, Kozlowski LT, Giovino GA. The relationship between childhood physical and emotional abuse and smoking cessation among U.S. women and men. Psychol Addict Behav. 2015; 29(2): 338-346. doi:10.1037/adb0000033
- 19Evans EA, Grella CE, Upchurch DM. Gender differences in the effects of childhood adversity on alcohol, drug, and polysubstance-related disorders. Soc Psychiatry Psychiatr Epidemiol. 2017; 52(7): 901-912. doi:10.1007/s00127-017-1355-3
- 20 American Psychiatric Association, American Psychiatric Association, eds. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. American Psychiatric Association; 2013.
10.1176/appi.books.9780890425596 Google Scholar
- 21Annis HM, Martin G. Inventory of Drug-Taking Situations. Addiction Research Foundation; 1985.
- 22Turner NE, Annis HM, Sklar SM. Measurement of antecedents to drug and alcohol use: Psychometric properties of the Inventory of Drug-Taking Situations (IDTS). Behav Res Ther. 1997; 35(5): 465-483. doi:10.1016/S0005-7967(96)00119-2
- 23Sobell LC, Sobell MB. Timeline follow-back. In: RZ Litten, JP Allen, eds. Measuring Alcohol Consumption. Humana Press; 1992: 41-72.
- 24Cohen S, Williamson GM. Perceived stress in a probability sample of the United States. In: S Spacapan, S Oskamp, eds. The Social Psychology of Health. Sage; 1988: 31-67.
- 25Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998; 14(4): 245-258. doi:10.1016/S0749-3797(98)00017-8
- 26Oláh B, Fekete Z, Kuritárné Szabó I, Kovács-Tóth B. Validity and reliability of the 10-Item Adverse Childhood Experiences Questionnaire (ACE-10) among adolescents in the child welfare system. Front Public Health. 2023; 11:1258798. doi:10.3389/fpubh.2023.1258798
- 27Ford DC, Merrick MT, Parks SE, et al. Examination of the factorial structure of adverse childhood experiences and recommendations for three subscale scores. Psychol Violence. 2014; 4(4): 432-444. doi:10.1037/a0037723
- 28Budney AJ, Hughes JR. The cannabis withdrawal syndrome. Curr Opin Psychiatry. 2006; 19(3): 233-238. doi:10.1097/01.yco.0000218592.00689.e5
- 29Brammer WA, Conn BM, Iverson E, Lankenau SE, Dodson C, Wong CF. Coping motives mediate the association of trauma history with problematic cannabis use in young adult medical cannabis patients and Non-Patient cannabis users. Subst Use Misuse. 2022; 57(5): 684-697. doi:10.1080/10826084.2022.2026970
- 30Rudenstine S, Espinosa A, McGee AB, Routhier E. Adverse childhood events, adult distress, and the role of emotion regulation. Traumatology. 2019; 25(2): 124-132. doi:10.1037/trm0000176
10.1037/trm0000176 Google Scholar
- 31Poole JC, Dobson KS, Pusch D. Do adverse childhood experiences predict adult interpersonal difficulties? The role of emotion dysregulation. Child Abuse Negl. 2018; 80: 123-133. doi:10.1016/j.chiabu.2018.03.006
- 32Cavalli JM, Cservenka A. Emotion dysregulation moderates the association between stress and problematic cannabis use. Front Psychiatry. 2021; 11:597789. doi:10.3389/fpsyt.2020.597789
- 33Kozak K, H. Smith P, Lowe DJE, et al. A systematic review and meta-analysis of sex differences in cannabis use disorder amongst people with comorbid mental illness. Am J Drug Alcohol Abuse. 2021; 47(5): 535-547. doi:10.1080/00952990.2021.1946071
- 34Foster KT, Li N, McClure EA, Sonne SC, Gray KM. Gender differences in internalizing symptoms and suicide risk among men and women seeking treatment for cannabis use disorder from late adolescence to middle adulthood. J Subst Abuse Treat. 2016; 66: 16-22. doi:10.1016/j.jsat.2016.01.012
- 35Buckner JD, Mallott MA, Schmidt NB, Taylor J. Peer influence and gender differences in problematic cannabis use among individuals with social anxiety. J Anxiety Disord. 2006; 20(8): 1087-1102. doi:10.1016/j.janxdis.2006.03.002
- 36Rozin P, Royzman EB. Negativity bias, negativity dominance, and contagion. Personal Soc Psychol Rev. 2001; 5(4): 296-320. doi:10.1207/S15327957PSPR0504_2
- 37Gardener EKT, Carr AR, MacGregor A, Felmingham KL. Sex differences and emotion regulation: an event-related potential study. PLoS One. 2013; 8(10):e73475. doi:10.1371/journal.pone.0073475
- 38Bujarski SJ, Norberg MM, Copeland J. The association between distress tolerance and cannabis use-related problems: the mediating and moderating roles of coping motives and gender. Addict Behav. 2012; 37(10): 1181-1184. doi:10.1016/j.addbeh.2012.05.014
- 39Schultz NR, Bassett DT, Messina BG, Correia CJ. Differential role of cannabis use motives in predicting impairment across three measures. J Stud Alcohol Drugs. 2019; 80(1): 26-31. doi:10.15288/jsad.2019.80.26
- 40Fox CL, Towe SL, Stephens RS, Walker DD, Roffman RA. Motives for cannabis use in high-risk adolescent users. Psychol Addict Behav. 2011; 25(3): 492-500. doi:10.1037/a0024331
