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      Jailhouse rock: Health status, patterns of use, and subjective benefits of cannabis use in a sample of inmates in Spanish prisons Translated title: Jailhouse rock: Estado de salud, patrones de consumo y beneficios subjetivos del uso de cannabis en una muestra de reclusos en prisiones españolas

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          Abstract

          Objectives

          To assess the perceived health and quality of life, perceived social support, prison life, and cannabis use among a sample of inmates in Spanish prisons.

          Material and methods

          We hosted a discussion with inmates in order to learn their reasons for using cannabis (phase 1). Then, a questionnaire was prepared specifically for this study (phase 2), containing indicators from the Catalan Health Survey and other items regarding patterns of cannabis use and life in prison. The questionnaire was administered by the authors to a sample of Catalan inmates.

          Results and discussion

          A sample of 63 inmates completed the questionnaire. Cannabis was used mainly for therapeutic purposes, which can be interpreted as a coping strategy related to the stress associated with prison life. Nearly half of the subjects used cannabis as a substitute for prescription medications and illicit drugs. It was found that the only variable that predicted self-perceived health status was the number of visits inmates received. This suggests that social support is a key factor for improving the health and well-being of inmates. Cannabis use in prison seems to be related to coping with a challenging context. The benefits and risks of this practice need to be further researched.

          Resumen

          Objetivos

          Caracterizar el estado de salud percibido, la calidad de vida, apoyo social percibido, vida en prision y uso de cannabis en una muestra de reclusos espanoles.

          Material y método

          Se organizo una serie de conversaciones con los reclusos con el objetivo de conocer las motivaciones que les llevaban a consumir cannabis (fase 1). En la fase 2 del proyecto, se desarrollo un cuestionario principalmente a partir de indicadores de salud de la Encuesta Catalana de Salud. Tambien se incluyeron otros items en relacion a los patrones de consumo de cannabis o la vida en prision. El cuestionario se administro por parte de los autores a poblacion reclusa de Cataluna.

          Resultados y discusión

          Un total de 63 reclusos respondieron el cuestionario. La principal motivacion para el uso de cannabis fue por razones terapeuticas, lo cual puede interpretarse como una estrategia de afrontamiento ante el estres generado por las condiciones en prision. Cerca de la mitad de los sujetos informaron de utilizar el cannabis como sustituto de medicaciones de prescripcion u otras drogas de abuso. Se encontro que la unica variable predictora de la salud auto-percibida era el numero de visitas que los reclusos recibian. Esto sugiere que el apoyo social es un factor clave para la mejora de la salud y el bienestar de los reclusos. El uso de cannabis en prision parece estar relacionado con el afrontamiento de un contexto desafiante. Los beneficios y riesgos de esta practica tendran que evaluarse en futuros estudios.

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          Most cited references19

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          Cannabis as a substitute for prescription drugs – a cross-sectional study

          Background The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs. Methods A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days. Subjects were surveyed via an online anonymous questionnaire on cannabis substitution effects. Participants were recruited through social media and cannabis dispensaries in Washington State. Results A total of 1,248 (46%) respondents reported using cannabis as a substitute for prescription drugs. The most common classes of drugs substituted were narcotics/opioids (35.8%), anxiolytics/benzodiazepines (13.6%) and antidepressants (12.7%). A total of 2,473 substitutions were reported or approximately two drug substitutions per affirmative respondent. The odds of reporting substituting were 4.59 (95% confidence interval [CI], 3.87–5.43) greater among medical cannabis users compared with non-medical users and 1.66 (95% CI, 1.27–2.16) greater among those reporting use for managing the comorbidities of pain, anxiety and depression. A slightly higher percentage of those who reported substituting resided in states where medical cannabis was legal at the time of the survey (47% vs. 45%, p=0.58), but this difference was not statistically significant. Discussion These patient-reported outcomes support prior research that individuals are using cannabis as a substitute for prescription drugs, particularly, narcotics/opioids, and independent of whether they identify themselves as medical or non-medical users. This is especially true if they suffer from pain, anxiety and depression. Additionally, this study suggests that state laws allowing access to, and use of, medical cannabis may not be influencing individual decision-making in this area.
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            Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder–Related Insomnia and Nightmares, Chronic Pain, Harm Reduction, and Other Indications

            Abstract Nabilone is a synthetic cannabinoid that has shown promise for the treatment of posttraumatic stress disorder (PTSD)–related insomnia and nightmares as well as efficacy in the management of chronic pain. It has also been proposed for harm reduction in cannabis dependence. Its effectiveness for management of concurrent disorders in seriously mentally ill correctional populations has not been evaluated. This retrospective study of 104 male inmates with serious mental illness prescribed nabilone analyzes the indications, efficacy, and safety of its use. Medications discontinued with the initiation of nabilone were also reviewed. The results showed nabilone targeting a mean of 3.5 indications per patient, thus likely reducing polypharmacy risk. The mean final dosage was 4.0 mg. Results indicated significant improvement in PTSD-associated insomnia, nightmares, PTSD symptoms, and Global Assessment of Functioning and subjective improvement in chronic pain. Medications associated with greater risk for adverse effects or abuse than nabilone were often able to be discontinued with the initiation of nabilone, most often antipsychotics and sedative/hypnotics. There was no evidence of abuse within this high-risk population or reduction of efficacy when nabilone was given in powder form with water rather than as a capsule. This study supports the promise of nabilone as a safe, effective treatment for concurrent disorders in seriously mentally ill correctional populations. Prospective, randomized controlled trials are required to confirm our preliminary results. Follow-up in the community will be required to confirm effectiveness in harm reduction.
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              The medicinal use of cannabis and cannabinoids--an international cross-sectional survey on administration forms.

              Cannabinoids, including tetrahydrocannabinol and cannabidiol, are the most important active constituents of the cannabis plant. Over recent years, cannabinoid-based medicines (CBMs) have become increasingly available to patients in many countries, both as pharmaceutical products and as herbal cannabis (marijuana). While there seems to be a demand for multiple cannabinoid-based therapeutic products, specifically for symptomatic amelioration in chronic diseases, therapeutic effects of different CBMs have only been directly compared in a few clinical studies. The survey presented here was performed by the International Association for Cannabinoid Medicines (IACM), and is meant to contribute to the understanding of cannabinoid-based medicine by asking patients who used cannabis or cannabinoids detailed questions about their experiences with different methods of intake. The survey was completed by 953 participants from 31 countries, making this the largest international survey on a wide variety of users of cannabinoid-based medicine performed so far. In general, herbal non-pharmaceutical CBMs received higher appreciation scores by participants than pharmaceutical products containing cannabinoids. However, the number of patients who reported experience with pharmaceutical products was low, limiting conclusions on preferences. Nevertheless, the reported data may be useful for further development of safe and effective medications based on cannabis and single cannabinoids.
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                Author and article information

                Journal
                Rev Esp Sanid Penit
                Rev Esp Sanid Penit
                sanipe
                Revista Española de Sanidad Penitenciaria
                Sociedad Española de Sanidad Penitenciaria
                1575-0620
                2013-6463
                Jan-Apr 2022
                31 March 2022
                : 24
                : 1
                : 9-14
                Affiliations
                [1 ] originalCentre d’Atenció i Seguiment de les Drogodependències (CAS), Brians-FSYC, Barcelona, Spain. orgnameCentre d’Atenció i Seguiment de les Drogodependències (CAS), Brians-FSYC Barcelona, Spain
                [2 ] originalICEERS - International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain. orgnameICEERS - International Center for Ethnobotanical Education, Research and Service Barcelona, Spain
                [3 ] originalUniversitat Rovira i Virgili, Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Tarragona, Spain. normalizedUniversitat Rovira i Virgilu orgnameUniversitat Rovira i Virgili orgdiv1Medical Anthropology Research Center (MARC) orgdiv2Department of Anthropology, Philosophy and Social Work Tarragona, Spain
                Author notes
                [* ] Correspondence: José Carlos Bouso. C/ Sepúlveda, 65 Bajos 2. 08015 Barcelona, Spain. E-mail: jcbouso@ 123456iceers.org
                Article
                10.18176/resp.00044
                9017606
                35411912
                e214f833-3e80-43b0-a915-d102bb3baba3

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 16 December 2020
                : 11 July 2021
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 17, Pages: 6
                Categories
                Original

                cannabis,prison,prisoners,allied health personnel,adaptation psychological,prision,prisioneros,trabajadores de apoyo de la salud,adaptacion psicologica

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