“I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD

Mitchell, John T.; Sweitzer, Maggie M.; Tunno, Angela M.; Kollins, Scott H.; McClernon, F. Joseph

doi:10.1371/journal.pone.0156614

Cited by 102 publications

(92 citation statements)

References 50 publications

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“…Qualitative analysis involved identification of themes that emerged from participant interviews. These themes were identified through an iterative process following procedures similar to our past qualitative analysis approach [52,53]. That is, an initial list of anticipated themes based on the study team's experience with mSMART in other populations and separate experience with young MSM (e.g., liking and disliking different features of mSMART).…”

Section: Discussionmentioning

confidence: 99%

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Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial (Preprint)

Mitchell¹,

LeGrand²,

Hightow-Weidman³

et al. 2018

Preprint

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Background: Pre-exposure prophylaxis (PrEP) provides a strong preventative benefit to individuals at-risk for HIV. While PrEP adherence is highly correlated with its efficacy, adherence rates are variable both across and within persons. Objective: The objective of this study was to develop and pilot test a smartphone-based intervention, called mSMART, that targets PrEP adherence. mSMART provides contingency management (CM) in the form of monetary incentives for daily PrEP adherence based on a real-time adherence assessment using a camera-based medication event-monitoring tool, as well as medication reminders, PrEP education, individualized behavioral strategies to address PrEP adherence barriers, and medication adherence feedback. Methods: This was a four-week open-label, phase I trial in a community sample of young men who have sex with men already on PrEP (n = 10). Results: While adherence composite scores corresponding to PrEP biomarkers indicated 90% of the sample already had an acceptable baseline adherence in the protective range, by the end of the four-week period scores improved for 30% of the sample-adherence did not worsen for any participants. Participants reported mean PrEP adherence rates of 91% via daily entries in mSMART. At the end of the four-week period, participants indicated acceptable ratings of satisfaction, usability, and willingness to recommend mSMART to others. There were no technical difficulties associated with smartphone compatibility, user misunderstandings about mSMART features that interfered with daily use, or study attrition. Conclusion: This research is the first to apply CM to PrEP adherence. Findings indicated that mSMART is feasible and acceptable. Such an adherence intervention administered via a user-friendly smartphone application can allow for widespread dissemination. Future efficacy trials are needed.

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Section: Discussionmentioning

confidence: 99%

“…Each interview excerpt that was identified with a theme endorsement was transferred to an Excel document so that frequency counts for particular themes could be summed across the full sample. We have adopted similar procedures in past studies [52]. Inter-rater reliability between raters was assessed on a subset of interview excerpts.…”

Section: Discussionmentioning

confidence: 99%

Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial (Preprint)

Mitchell¹,

LeGrand²,

Hightow-Weidman³

et al. 2018

Preprint

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“…There are numerous qualitative and quantitative studies as well as a recent online study [1] reporting an association between attention deficit hyperactivity disorder (ADHD) and cannabis use [2-4]. Many studies, however, often interpret cannabis use as nonmedical, “recreational,” and/or drug abuse, not as a potential, albeit often illegal, form of (self-)medication.…”

Section: Introductionmentioning

confidence: 99%

Medical Cannabis for Adult Attention Deficit Hyperactivity Disorder: Sociological Patient Case Report of Cannabinoid Therapeutics in Finland

Hupli¹

2018

Med Cannabis Cannabinoids

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This paper presents a detailed patient case report of a male patient who was diagnosed in adulthood (aged 33) with attention deficit hyperactivity disorder (ADHD) and treated initially with immediate-release methylphenidate (Ritalin® 10 mg twice daily). After experiencing adverse effects from prolonged use of this medication and afterwards other medications that were prescribed as alternatives, the patient discovered that cannabinoid therapeutics (CT) had been experimented inside the EU area to treat patients with ADHD. Subsequently, he was evaluated by a physician in Germany (June 2010) who prescribed CT (Bedrocan®, Bediol®). A Finnish neurologist later confirmed the two prescribed medicines (Bedrocan®, October 2010; Bediol®, May 2011) in the patient’s own country of permanent residence (Finland). During a 5-year period of access, Bedrocan®, which mainly contains Δ9-tetrahydrocannabinol (Δ9-THC), was found to be helpful in alleviating the patient’s ADHD symptoms, in particular poor tolerance to frustration, outbursts of anger, boredom, and problems related to concentration. The second CT medication, Bediol®, which contains both Δ9-THC and the phytocannabinoid cannabidiol, was found to neutralize the excessive dronabinol effects of Bedrocan® as well as zo offer other medical benefits (e.g., improved sleep). In addition to the case report, this paper also offers a brief review of the literature surrounding the medical benefits of CT for AD(H)D, which includes observational studies, clinical case reports, and one randomized clinical experiment. This paper also briefly discusses the endocannabinoid system in relation to ADHD, although more preclinical and clinical research is warranted to establish the optimal levels of cannabinoids, terpenes, and dosing regimens, which vary between different ADHD patients.

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“…Different drugs of abuse including cocaine and marijuana have been posited to alleviate aspects of ADHD symptomatology, as theorized in the self-medication hypothesis of addictive disorders including cocaine 13 and echoed by patient surveys and anecdotal accounts. 14,15 …”

Section: Introductionmentioning

confidence: 99%

Mixed‐amphetamine salts increase abstinence from marijuana in patients with co‐occurring attention‐deficit/hyperactivity disorder and cocaine dependence

et al. 2016

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Background and Objectives The prevalence of ADHD is greater in substance use disorders than the general population, and ADHD and substance use disorders share neurobiological features such as dysregulation of reward circuitry. We tested the hypothesis that stimulants would decrease marijuana use in a randomized controlled trial of extended release mixed amphetamine salts (MAS-XR) for treatment of co-occurring ADHD and cocaine use disorders. Methods Marijuana users were defined as participants reporting use in the 30 days before study initiation, collected with timeline follow-back. The original 14-week trial utilized a 3-arm randomized design, comparing placebo, MAS-XR 60 mg, and MAS-XR 80 mg. For this analysis, both MAS-XR groups were combined, leaving n = 20 in the placebo group and n = 37 in the MAS-XR group. The primary outcome was proportion of subjects reporting any marijuana use per study week. Comparisons between groups were made using a logistic mixed effects model incorporating multiple predictors and modeling time-by-treatment interactions. Results There were no significant baseline differences in marijuana use frequency and quantity. There was a significant decrease in the proportion of participants using marijuana over time in the MAS-XR group, but no difference in the proportion of marijuana-use days over time. Discussion and Conclusions Treatment of ADHD and comorbid cocaine use disorders with MAS-XR is associated with increased weekly abstinence from marijuana but not with a decrease in the proportion of marijuana using days per week. Scientific Significance Stimulant treatment of ADHD and cocaine use disorders may diminish co-occurring cannabis use.

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“I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD

Cited by 102 publications

References 50 publications

Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial (Preprint)

Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial (Preprint)

Medical Cannabis for Adult Attention Deficit Hyperactivity Disorder: Sociological Patient Case Report of Cannabinoid Therapeutics in Finland

Mixed‐amphetamine salts increase abstinence from marijuana in patients with co‐occurring attention‐deficit/hyperactivity disorder and cocaine dependence

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