OBJECTIVE: The present study used youth's in vivo reports of subjective responses to cannabis while smoking in their natural environments to identify real-world mechanisms of topiramate treatment for cannabis misuse. METHOD: Participants were 40 cannabis users (≥ twice weekly in past 30 days), ages 15-24 years (47.5% female), with at least one cannabis use episode during the final 3 weeks of a 6-week, randomized clinical trial. Youth reported subjective "high" while smoking, stimulation, sedation, stress, craving, and grams of marijuana used in the natural environment via wireless electronic devices. Bayesian multilevel structural equation modeling (MSEM) evaluated mediation via indirect effect tests. RESULTS: Significant within (daily) and between (person) variability and distinctive within and between effects supported the MSEM approach. Subjective high while smoking was significantly reduced for youth in the topiramate condition, relative to placebo, and the indirect effect of reduced subjective high on total grams of cannabis smoked that day was significant. Indirect effects through other subjective responses were not significant. CONCLUSIONS: The results of this initial study suggest that altering subjective responses to smoking, specifically subjective high, may be a key target for developing adjunctive pharmacotherapies for cannabis misuse. More generally, this work provides an example for applying ecological momentary assessment and analytic techniques to evaluate mechanisms of behavior change in longitudinal data.
RCT Entities:
OBJECTIVE: The present study used youth's in vivo reports of subjective responses to cannabis while smoking in their natural environments to identify real-world mechanisms of topiramate treatment for cannabis misuse. METHOD:Participants were 40 cannabis users (≥ twice weekly in past 30 days), ages 15-24 years (47.5% female), with at least one cannabis use episode during the final 3 weeks of a 6-week, randomized clinical trial. Youth reported subjective "high" while smoking, stimulation, sedation, stress, craving, and grams of marijuana used in the natural environment via wireless electronic devices. Bayesian multilevel structural equation modeling (MSEM) evaluated mediation via indirect effect tests. RESULTS: Significant within (daily) and between (person) variability and distinctive within and between effects supported the MSEM approach. Subjective high while smoking was significantly reduced for youth in the topiramate condition, relative to placebo, and the indirect effect of reduced subjective high on total grams of cannabis smoked that day was significant. Indirect effects through other subjective responses were not significant. CONCLUSIONS: The results of this initial study suggest that altering subjective responses to smoking, specifically subjective high, may be a key target for developing adjunctive pharmacotherapies for cannabis misuse. More generally, this work provides an example for applying ecological momentary assessment and analytic techniques to evaluate mechanisms of behavior change in longitudinal data.
Authors: Madeline H Meier; Avshalom Caspi; Antony Ambler; HonaLee Harrington; Renate Houts; Richard S E Keefe; Kay McDonald; Aimee Ward; Richie Poulton; Terrie E Moffitt Journal: Proc Natl Acad Sci U S A Date: 2012-08-27 Impact factor: 11.205
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Authors: Henry R Kranzler; Jonathan Covault; Richard Feinn; Stephen Armeli; Howard Tennen; Albert J Arias; Joel Gelernter; Timothy Pond; Cheryl Oncken; Kyle M Kampman Journal: Am J Psychiatry Date: 2014-04 Impact factor: 18.112
Authors: Robert Miranda; Lara Ray; Alexander Blanchard; Elizabeth K Reynolds; Peter M Monti; Thomas Chun; Alicia Justus; Robert M Swift; Jennifer Tidey; Chad J Gwaltney; Jason Ramirez Journal: Addict Biol Date: 2013-03-13 Impact factor: 4.280
Authors: Rachel L Tomko; Erin A McClure; Lindsay M Squeglia; Hayley Treloar Padovano; Aimee L McRae-Clark; Nathaniel L Baker; Matthew J Carpenter; Kevin M Gray Journal: Curr Opin Psychol Date: 2019-01-28
Authors: Hayley Treloar Padovano; Tim Janssen; Noah N Emery; Ryan W Carpenter; Robert Miranda Journal: Subst Use Misuse Date: 2019-07-15 Impact factor: 2.164