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Prevalence and associated factors of cannabis consumption in medical students: the BOURBON nationwide study

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Abstract

France has been identified with one of the highest rates of cannabis consumption of Western European countries. Yet we lack data in medical students who are at risk of addictive behavior. The objective of the study is to determine the prevalence of cannabis consumption and cannabis use disorder (CUD) among French medical students and their association with psychotropic drug consumption and psychosocial factors. Medical students were recruited from 35 French universities of medicine through administration mailing lists and social networks, between December 2016 and May 2017. Cannabis consumption was self-declared by anonymous questionnaire and CUD was defined by a Cannabis Abuse Screening Test (CAST) score ≥ 3. 10,985 medical students with a mean age of 21.8 years (± 3.3) were included, 32% of which were men. Overall, 1642 [14.9 (14.3; 15.6)%] reported cannabis consumption and 622 [5.7 (5.2; 6.1)%] students were identified with CUD at screening. Men were at two-time higher risk of cannabis consumption and three-time higher risk of CUD (22.4% and 10.6% for men vs. 11.5% and 3.4%, respectively, for women). In multivariate analyses, men sex, alcohol use disorder, tobacco smoking, parents’ divorce, and history of physical assault and lower rates of lower rates of ≥ 40 weekly worked hours were identified as common associated factors for cannabis consumption and CUD. Hypnotic consumption, psychiatric follow-up, and history of sexual assault were identified as factors associated specifically with CUD, suggesting that these factors were associated with more severe cannabis consumption. Only 17% of students identified with CUD reported a psychiatric follow-up. Altogether, these results suggest that health policies should target cannabis consumption in medical students that is frequent, especially in men, with low rates of psychiatric follow-up. We have identified psychological factors and increased hypnotic drug consumption in CUD participants suggesting that psychiatric follow-up should be systematically proposed to this group.

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References

  1. Karila L, Roux P, Rolland B et al (2014) Acute and long-term effects of cannabis use: a review. CPD 20:4112–4118. https://doi.org/10.2174/13816128113199990620

    Article  CAS  Google Scholar 

  2. Lev-Ran S, Roerecke M, Le Foll B et al (2014) The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychol Med 44:797–810. https://doi.org/10.1017/S0033291713001438

    Article  CAS  PubMed  Google Scholar 

  3. European drug report (2017) European Drug Report 2017: Trends and Developments. | www.emcdda.europa.eu. https://www.emcdda.europa.eu/publications/edr/trends-developments/2017_en. Accessed 2 Mar 2020

  4. Papazisis G, Siafis S, Tsakiridis I et al (2018) Prevalence of cannabis use among medical students: a systematic review and meta-analysis. Subst Abuse. https://doi.org/10.1177/1178221818805977

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gignon M, Havet E, Ammirati C et al (2015) Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey. Workplace Health Saf 63:54–63. https://doi.org/10.1177/2165079915570917

    Article  CAS  PubMed  Google Scholar 

  6. Brooks SK, Chalder T, Gerada C (2011) Doctors vulnerable to psychological distress and addictions: treatment from the Practitioner Health Programme. J Ment Health 20:157–164. https://doi.org/10.3109/09638237.2011.556168

    Article  PubMed  Google Scholar 

  7. Kansoun Z, Boyer L, Hodgkinson M et al (2019) Burnout in French physicians: a systematic review and meta-analysis. J Affect Disord 246:132–147. https://doi.org/10.1016/j.jad.2018.12.056

    Article  PubMed  Google Scholar 

  8. Tian-Ci Quek T, Wai-San Tam W, Tran XB et al (2019) The Global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph16152735

    Article  PubMed Central  Google Scholar 

  9. Fond G, Gavaret M, Vidal C et al (2016) (Mis)use of prescribed stimulants in the medical student community: motives and behaviors. Medicine (Baltimore). https://doi.org/10.1097/MD.0000000000003366

    Article  Google Scholar 

  10. Micoulaud-Franchi J-A, MacGregor A, Fond G (2014) A preliminary study on cognitive enhancer consumption behaviors and motives of French Medicine and Pharmacology students. Eur Rev Med Pharmacol Sci 18:1875–1878

    PubMed  Google Scholar 

  11. Bourbon A, Boyer L, Auquier P et al (2019) Anxiolytic consumption is associated with tobacco smoking and severe nicotine dependence. Results from the national French medical students (BOURBON) study. Prog Neuropsychopharmacol Biol Psychiatry 94:109645. https://doi.org/10.1016/j.pnpbp.2019.109645

    Article  CAS  PubMed  Google Scholar 

  12. Legleye S (2018) The Cannabis abuse screening test and the DSM-5 in the general population: optimal thresholds and underlying common structure using multiple factor analysis. Int J Methods Psychiatr Res 27:e1597. https://doi.org/10.1002/mpr.1597

    Article  PubMed  Google Scholar 

  13. Legleye S, Piontek D, Kraus L (2011) Psychometric properties of the Cannabis Abuse Screening Test (CAST) in a French sample of adolescents. Drug Alcohol Depend 113:229–235. https://doi.org/10.1016/j.drugalcdep.2010.08.011

    Article  PubMed  Google Scholar 

  14. Legleye S, Kraus L, Piontek D et al (2012) Validation of the Cannabis abuse screening test in a sample of Cannabis inpatients. EAR 18:193–200. https://doi.org/10.1159/000336553

    Article  Google Scholar 

  15. Gache P, Michaud P, Landry U et al (2005) The alcohol use disorders identification test (AUDIT) as a screening tool for excessive drinking in primary care: reliability and validity of a French version. Alcohol Clin Exp Res 29:2001–2007

    Article  Google Scholar 

  16. Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54:343–349. https://doi.org/10.1016/S0895-4356(00)00314-0

    Article  CAS  PubMed  Google Scholar 

  17. ONDPS (2015) Observatoire national des professions de santé (ONDPS), Rapport 2013–2014

  18. OFDT (2017) Cannabis: usages actuels en population adulte—Tendances n° 119 - juin 2017—OFDT. https://www.ofdt.fr/publications/collections/periodiques/lettre-tendances/cannabis-usages-actuels-en-population-adulte-tendances-n-119-juin-2017. Accessed 1 Mar 2020

  19. Khan SS, Secades-Villa R, Okuda M et al (2013) Sex differences in cannabis use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions. Drug Alcohol Depend 130:101–108. https://doi.org/10.1016/j.drugalcdep.2012.10.015

    Article  PubMed  Google Scholar 

  20. Becker JB, McClellan ML, Reed BG (2017) Sex differences, sex and addiction. J Neurosci Res 95:136–147. https://doi.org/10.1002/jnr.23963

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Fond G, Bourbon A, Auquier P et al (2018) Venus and Mars on the benches of the faculty: influence of sex on mental health and behavior of medical students. Results from the BOURBON national study. J Affect Disord 239:146–151. https://doi.org/10.1016/j.jad.2018.07.011

    Article  CAS  PubMed  Google Scholar 

  22. Meier MH, Caspi A, Ambler A et al (2012) Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci USA 109:E2657–E2664. https://doi.org/10.1073/pnas.1206820109

    Article  PubMed  PubMed Central  Google Scholar 

  23. Blanco C, Hasin DS, Wall MM et al (2016) Cannabis use and risk of psychiatric disorders: prospective evidence from a US National Longitudinal Study. JAMA Psychiatry 73:388–395. https://doi.org/10.1001/jamapsychiatry.2015.3229

    Article  PubMed  Google Scholar 

  24. Hanna RC, Perez JM, Ghose S (2017) Cannabis and development of dual diagnoses: a literature review. Am J Drug Alcohol Abuse 43:442–455. https://doi.org/10.1080/00952990.2016.1213273

    Article  PubMed  Google Scholar 

  25. Crippa JA, Zuardi AW, Martín-Santos R et al (2009) Cannabis and anxiety: a critical review of the evidence. Hum Psychopharmacol 24:515–523. https://doi.org/10.1002/hup.1048

    Article  CAS  PubMed  Google Scholar 

  26. Orsolini L, Chiappini S, Volpe U et al (2019) Use of Medicinal Cannabis and synthetic cannabinoids in post-traumatic stress disorder (PTSD): a systematic review. Medicina (Kaunas). https://doi.org/10.3390/medicina55090525

    Article  Google Scholar 

  27. Babson KA, Sottile J, Morabito D (2017) Cannabis, cannabinoids, and sleep: a review of the literature. Curr Psychiatry Rep 19:23. https://doi.org/10.1007/s11920-017-0775-9

    Article  PubMed  Google Scholar 

  28. Budney AJ, Moore BA, Vandrey RG, Hughes JR (2003) The time course and significance of cannabis withdrawal. J Abnorm Psychol 112:393–402. https://doi.org/10.1037/0021-843X.112.3.393

    Article  PubMed  Google Scholar 

  29. Vandrey R, Smith MT, McCann UD et al (2011) Sleep disturbance and the effects of extended-release zolpidem during cannabis withdrawal. Drug Alcohol Depend 117:38–44. https://doi.org/10.1016/j.drugalcdep.2011.01.003

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Wittchen H-U, Fröhlich C, Behrendt S et al (2007) Cannabis use and cannabis use disorders and their relationship to mental disorders: a 10-year prospective-longitudinal community study in adolescents. Drug Alcohol Depend 88(Suppl 1):S60–70. https://doi.org/10.1016/j.drugalcdep.2006.12.013

    Article  PubMed  Google Scholar 

  31. Lev-Ran S, Le Foll B, McKenzie K et al (2013) Bipolar disorder and co-occurring cannabis use disorders: characteristics, co-morbidities and clinical correlates. Psychiatry Res 209:459–465. https://doi.org/10.1016/j.psychres.2012.12.014

    Article  PubMed  Google Scholar 

  32. Gates PJ, Sabioni P, Copeland J et al (2016) Psychosocial interventions for cannabis use disorder. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD005336.pub4

    Article  PubMed  PubMed Central  Google Scholar 

  33. Wang D, Wang Y, Wang Y et al (2014) Impact of physical exercise on substance use disorders: a meta-analysis. PLoS One 9:e110728. https://doi.org/10.1371/journal.pone.0110728

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Olmos A, Tirado-Muñoz J, Farré M, Torrens M (2018) The efficacy of computerized interventions to reduce cannabis use: a systematic review and meta-analysis. Addict Behav 79:52–60. https://doi.org/10.1016/j.addbeh.2017.11.045

    Article  PubMed  Google Scholar 

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Acknowledgements

We express all our thanks to the participants and the universities, which were included in the present study.

Funding

This work was funded by HUM (Hôpitaux Universitaires de Marseille).

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Authors and Affiliations

  1. Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d’Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ, 27 Boulevard Jean Moulin, 13005, Marseille, France

    Guillaume Fond, A. Picot, A. Bourbon, M. Boucekine, P. Auquier, C. Lançon & L. Boyer

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  1. Guillaume Fond
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  2. A. Picot
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  3. A. Bourbon
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Correspondence to Guillaume Fond.

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Communicated by Andrea Schmitt.

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Fond, G., Picot, A., Bourbon, A. et al. Prevalence and associated factors of cannabis consumption in medical students: the BOURBON nationwide study. Eur Arch Psychiatry Clin Neurosci 271, 857–864 (2021). https://doi.org/10.1007/s00406-020-01131-0

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  • DOI: https://doi.org/10.1007/s00406-020-01131-0

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