Publications by authors named "Joanna Zeiger"

24 Publications

  • Page 1 of 1

Attitudes about cannabis mediate the relationship between cannabis knowledge and use in active adult athletes.

J Cannabis Res 2020 May 18;2(1):18. Epub 2020 May 18.

Canna Research Group, 3996 Savannah Ct, Boulder, CO, 80301, USA.

Background: Little is known about how cannabis knowledge and attitudes impact cannabis use behavior.

Objective: To test the knowledge-attitudes-behavior paradigm in active adult athletes.

Design: The Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data.

Participants: Self-defined active adult athletes (n = 1161).

Main Measures: Knowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use.

Key Results: A three-cluster solution was the best fit to the data. The clusters were named Conservative (n = 374, 32.2%), Unsure (n = 533, 45.9%), and Liberal (n = 254, 21.9). There was a significant difference among the clusters for all 11 attitudes items (all p < 0.001). Attitude cluster membership was significantly different by age (p < 0.001), primary sport (p < 0.05), and knowledge about cannabis (p < 0.001). Athletes in the liberal cluster answered the knowledge questions correctly most often. Attitudes mediated the relationship between cannabis knowledge and cannabis use [Never (32.4%), Past (41.6%), Current (26.0%)] with athletes in the liberal cluster showing more knowledge and greater likelihood to be a current cannabis user (p < 0.001). Among current cannabis users there were differential patterns of cannabis use depending on their attitudes and knowledge; liberal athletes tended to co-use THC and CBD and used cannabis longer. (p < 0.001).

Conclusions: Cannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.
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http://dx.doi.org/10.1186/s42238-020-00023-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819330PMC
May 2020

Cannabis attitudes and patterns of use among followers of the Allergy & Asthma Network.

Ann Allergy Asthma Immunol 2021 04 17;126(4):401-410.e1. Epub 2021 Jan 17.

Department of Allergy, Kaiser Permanente Southern California, San Diego, California.

Background: Cannabis use in patients with allergy/asthma, a high-risk group for adverse effects to cannabis, is unknown.

Objective: To determine the patterns of use and attitudes toward cannabis in patients with allergy/asthma.

Methods: An anonymous online survey on cannabis attitudes and use was conducted through the Adult Allergy & Asthma Network. The Asthma Control Test assessed asthma burden. Cluster analyses determined group phenotypes and factor analyses condensed cannabis subjective effects into similar response patterns.

Results: A total of 88 of 489 respondents (18.0%) currently use cannabis with most at the age of less than 50 years old, of female sex, and of White race. Of the noncannabis users (N = 401), 2.5% reported cannabis allergy. Cluster analysis revealed that a liberal attitude toward cannabis was associated with current cannabis use (P < .001). Among current cannabis users, 40.9% of their physicians inquired on cannabis use; only 37.5% of users wanted to discuss cannabis. In addition, 65.9% used cannabis for medical or medical/recreational purposes. Cannabinoids used were tetrahydrocannabinol (33.0%), cannabidiol (19.3%), or both (47.7%). Smoked and vaped cannabis were reported by 53.4% and 35.2%, respectively. Furthermore, 51 cannabis users (58.0%) reported current asthma with 39.2% uncontrolled; of these, 50% smoked cannabis. Compared with current participants with asthma not using cannabis, those currently using cannabis experienced similar levels of asthma control, quality of life, and frequency of asthma exacerbations. Positive effects were endorsed more than negative effects to cannabis (P < .001). Moreover, 19.3% of cannabis users reported coughing that was associated with smoking cannabis (P < .001).

Conclusion: Cannabis was used by less than 20% of the respondents with positive effects more frequent than negative effects. Half of cannabis users with uncontrolled asthma smoke cannabis, but only a minority of the physicians inquire about its use.
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http://dx.doi.org/10.1016/j.anai.2021.01.014DOI Listing
April 2021

The impact of mental toughness and postural abnormalities on dysfunctional breathing in athletes.

J Asthma 2021 Jan 25:1-15. Epub 2021 Jan 25.

Race Ready Coaching, Boulder, CO, USA.

While asthma and exercise-induced bronchoconstriction (EIB) can explain some cases of exertional dyspnea, the differential diagnosis of dyspnea is extensive. Dysfunctional breathing (DB) is a condition that is often overlooked and underdiagnosed. Pharmacologic treatments are available and widely utilized by clinicians for exertional dyspnea, but a better understanding of the non-pharmacologic treatments as well as psychological factors that play a role in DB can provide professional, elite amateurs, and recreational athletes with more therapeutic options. Given the psychological components involved with these conditions, a tool to measure domains of sports mental toughness in athletes could help medical providers create a more comprehensive athlete profile which can be used in conjunction with standard pharmacologic therapy to provide a more effective treatment plan. While normal breathing mechanics help shape appropriate posture and spinal stabilization, DB has been shown to contribute to pain and motor control deficits resulting in dysfunctional movement patterns, which further contribute to DB. Most respiratory specialists are unaware of how to assess the role of faulty sports technique, especially running gait, in dysfunctional breathing patterns making it difficult to recommend appropriate treatment and offer referrals for relevant therapies. Three key components of proper running gait are reviewed and described in detail including trunk counter-rotation, extension of atlanto-occipital joint in conjunction with a forward tilted trunk, and ankle and hip joint range of motion. When underlying gait abnormalities and mental skills are addressed properly, they can disrupt poor breathing mechanics, facilitating a transition away from DB and toward healthier breathing patterns. KEY POINTS  In summary, the following points should be considered when evaluating athletes who are having difficulty breathing even when compliant with their medications or if there is not an indication of asthma or EIB: Assess dysfunctional breathing (DB) with Nijmegen questionnaire (NQ). If DB is present, measure mental skills using the Sisu Quiz to determine an athlete's mental skills profile. Evaluate postural changes that may impact an athlete's ability to breathe. Using the three tools of the NQ, Sisu Quiz, and Postural assessments creates an athlete profile that is clinically useful to improve breathing technique. DB is often mistaken for other conditions for which medications are prescribed. By identifying DB early and making appropriate changes may negate or reduce the need for pharmacotherapy. Improving DB will improve athletic performance.
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http://dx.doi.org/10.1080/02770903.2021.1871739DOI Listing
January 2021

Occupational Allergies to Cannabis.

J Allergy Clin Immunol Pract 2020 Nov - Dec;8(10):3331-3338

Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Philadelphia, Pa; Jane & Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, Pa; Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pa. Electronic address:

Within the last decade there has been a significant expansion in access to cannabis for medicinal and adult nonmedical use in the United States and abroad. This has resulted in a rapidly growing and diverse workforce that is involved with the growth, cultivation, handling, and dispensing of the cannabis plant and its products. The objective of this review was to educate physicians on the complexities associated with the health effects of cannabis exposure, the nature of these exposures, and the future practical challenges of managing these in the context of allergic disease. We will detail the biological hazards related to typical modern cannabis industry operations that may potentially drive allergic sensitization in workers. We will highlight the limitations that have hindered the development of objective diagnostic measures that are essential in separating "true" cannabis allergies from nonspecific reactions/irritations that "mimic" allergy-like symptoms. Finally, we will discuss recent advances in the basic and translational scientific research that will aid the development of diagnostic tools and therapeutic standards to serve optimal management of cannabis allergies across the occupational spectrum.
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http://dx.doi.org/10.1016/j.jaip.2020.09.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837257PMC
June 2020

Reply to "COVID-19 pandemic and home-based physical activity".

J Allergy Clin Immunol Pract 2020 09 28;8(8):2834. Epub 2020 May 28.

Lake Allergy, Asthma and Immunology, Tavares, Fla.

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http://dx.doi.org/10.1016/j.jaip.2020.05.019DOI Listing
September 2020

Exercise and Fitness in the Age of Social Distancing During the COVID-19 Pandemic.

J Allergy Clin Immunol Pract 2020 Jul - Aug;8(7):2152-2155. Epub 2020 Apr 28.

Lake Allergy, Asthma and Immunology, Tavares, Fla.

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http://dx.doi.org/10.1016/j.jaip.2020.04.039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7187829PMC
July 2020

Cannabis: An Emerging Occupational Allergen?

Ann Work Expo Health 2020 08;64(7):679-682

Department of Medicine, Center for Translational Medicine and Division of Pulmonary Allergy and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, PA, USA.

Cannabis is the most commonly used psychoactive drug. In recent years, Cannabis access has expanded for both medicinal and non-medicinal has grown. This is also marked with an increasing number of individuals gaining employment in this emerging industry. In this article, we briefly discuss the health hazards associated with Cannabis exposure with an emphasis on the potential for allergic reactions in workers who handle and process Cannabis plant.
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http://dx.doi.org/10.1093/annweh/wxaa043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407602PMC
August 2020

Special Considerations and Perspectives for Exercise-Induced Bronchoconstriction (EIB) in Olympic and Other Elite Athletes.

J Allergy Clin Immunol Pract 2020 Jul - Aug;8(7):2194-2201. Epub 2020 Jan 30.

CompleWare Corporation, Iowa City, Iowa.

Diagnosing and treating elite and Olympic athletes with exercise-induced bronchoconstriction has been well established. However, a subset of elite and Olympic athletes with exercise-induced bronchoconstriction experience symptoms of breathlessness due to lack of adherence, improper medications, and/or generalized breathing dysfunction. A short review of traditional treatment plans for elite and Olympic athletes is presented along with the challenges of adherence, managing dysfunctional breathing, and measuring and treating mental skills deficits that may impact breathing. Elite and Olympic athletes may not respond to traditional treatment for exercise-induced bronchospasm, and we present some of the reasons why the athletes fail to respond. Furthermore, we present information on how to detect and treat elite and Olympic athletes with difficult-to-treat asthma. As part of this review we developed a flow diagram for medical providers to identify the reasons for lack of response to traditional treatment plans for exercise-induced bronchoconstriction with options for other treatment modalities.
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http://dx.doi.org/10.1016/j.jaip.2020.01.041DOI Listing
January 2020

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes.

J Cannabis Res 2019 Jul 29;1(1). Epub 2019 Jul 29.

Canna Research Group, 3996 Savannah Ct., Boulder, CO, 80301, USA.

Background: There is a paucity of information regarding cannabis use behaviors in adult community-based athletes as most research in athletes has focused on misuse of cannabis in elite, adolescent, university-based athletes. We aimed to determine whether age related differences exist in patterns of cannabis use and subjective effects to cannabis in adult athletes.

Methods: The Athlete PEACE Survey used mainly social media and email blasts to recruit and SurveyGizmo to collect data. Cannabis patterns of use (duration of use, frequency of use, routes of administration, cannabinoid used, concurrent use with exercise), benefits, and adverse effects were reported. Age was reported by decade from 21 to ≥60. Age trends in cannabis use patterns and subjective effects were assessed using linear trend analysis.

Results: Of the 1161 participants, 301 (26%) athletes currently used cannabis. Younger athletes compared to older athletes reported significantly more positive and adverse subjective effects to cannabis, used cannabis longer, and used both tetrahydrocannabinol and cannabidiol for medical and recreational purposes. Younger athletes used cannabis concurrently with exercise more often than older athletes and consumed edibles, vaporized, and smoked more than older athletes.

Conclusions: We found age-related cannabis patterns of use and subjective effects to cannabis. Concerns about cannabis mis-use and abuse in athletes maybe overstated with the potential benefits (improved sleep, decreased anxiety, less pain) outweighing the adverse effects (increased anxiety, increased appetite, difficulty concentrating).
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http://dx.doi.org/10.1186/s42238-019-0006-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819305PMC
July 2019

Cannabis use in active athletes: Behaviors related to subjective effects.

PLoS One 2019 28;14(6):e0218998. Epub 2019 Jun 28.

Canna Research Group, Boulder, CO, United States of America.

Cannabis use has not been well characterized in athletes. Studies primarily examine problematic use or its categorization by anti-doping bodies as a banned substance. Patterns of use, reasons for use, and responses to cannabis consumption have not been studied in a community-based sample of adult athletes. The Athlete PEACE Survey examined cannabis use patterns and subjective effects to cannabis in a community-based cohort of adult athletes. We used mainly social media and email blasts to recruit and SurveyGizmo to collect data. 1,161 (91.1%) of the 1,274 athletes taking the survey completed it. Current cannabis use was evaluated by asking "In the past two weeks, have you used marijuana (including THC and/or CBD)?" and cannabis type used was assessed by asking "What do you primarily use THC, CBD, or both?". Cannabis benefits and adverse effects (i.e. subjective effects) and patterns of use were reported. 302 athletes (26%) currently use cannabis of whom 301 had complete data for cluster analysis. Cluster analysis was used to determine cannabis user phenotypes and exploratory factor analysis (EFA) was used to create subjective effects factors. Associations between cannabis user phenotype clusters and the subjective effects factors were explored using multivariate analysis. Cluster analysis identified three statistically distinct cannabis user phenotypes: (1) older athletes who primarily use medical CBD, (2) mixed age athletes who use cannabis mainly recreationally with both THC and CBD use, and (3) mixed age athletes who used cannabis the longest with primary THC and CBD use. EFA showed three subjective effects factors: (1) Well-being, (2) Calm, and (3) Adverse. Mean positive subjective were higher than mean adverse subjective effects (p<0.001). The cluster using THC and CBD showed the highest mean scores for all three subjective effects factors (p<0.001). Athletes who use a combination of THC and CBD exhibited the most benefit to well-being and calm with minimal adverse effects. Our methodology can be used to develop real-world evidence to inform future use of medical cannabis products.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218998PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598761PMC
February 2020

Mental toughness latent profiles in endurance athletes.

PLoS One 2018 23;13(2):e0193071. Epub 2018 Feb 23.

Department of Allergy Kaiser Permanente Southern California Region, San Diego, CA, United States of America.

Mental toughness in endurance athletes, while an important factor for success, has been scarcely studied. An online survey was used to examine eight mental toughness factors in endurance athletes. The study aim was to determine mental toughness profiles via latent profile analysis in endurance athletes and whether associations exist between the latent profiles and demographics and sports characteristics. Endurance athletes >18 years of age were recruited via social media outlets (n = 1245, 53% female). Mental toughness was measured using the Sports Mental Toughness Questionnaire (SMTQ), Psychological Performance Inventory-Alternative (PPI-A), and self-esteem was measured using the Rosenberg Self-Esteem Scale (RSE). A three-class solution emerged, designated as high mental toughness (High MT), moderate mental toughness (Moderate MT) and low mental toughness (Low MT). ANOVA tests showed significant differences between all three classes on all 8 factors derived from the SMTQ, PPI-A and the RSE. There was an increased odds of being in the High MT class compared to the Low MT class for males (OR = 1.99; 95% CI, 1.39, 2.83; P<0.001), athletes who were over 55 compared to those who were 18-34 (OR = 2.52; 95% CI, 1.37, 4.62; P<0.01), high sports satisfaction (OR = 8.17; 95% CI, 5.63, 11.87; P<0.001), and high division placement (OR = 2.18; 95% CI, 1.46,3.26; P<0.001). The data showed that mental toughness latent profiles exist in endurance athletes. High MT is associated with demographics and sports characteristics. Mental toughness screening in athletes may help direct practitioners with mental skills training.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193071PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825049PMC
May 2018

Exercise-induced bronchoconstriction update-2016.

J Allergy Clin Immunol 2016 11 21;138(5):1292-1295.e36. Epub 2016 Sep 21.

The first practice parameter on exercise-induced bronchoconstriction (EIB) was published in 2010. This updated practice parameter was prepared 5 years later. In the ensuing years, there has been increased understanding of the pathogenesis of EIB and improved diagnosis of this disorder by using objective testing. At the time of this publication, observations included the following: dry powder mannitol for inhalation as a bronchial provocation test is FDA approved however not currently available in the United States; if baseline pulmonary function test results are normal to near normal (before and after bronchodilator) in a person with suspected EIB, then further testing should be performed by using standardized exercise challenge or eucapnic voluntary hyperpnea (EVH); and the efficacy of nonpharmaceutical interventions (omega-3 fatty acids) has been challenged. The workgroup preparing this practice parameter updated contemporary practice guidelines based on a current systematic literature review. The group obtained supplementary literature and consensus expert opinions when the published literature was insufficient. A search of the medical literature on PubMed was conducted, and search terms included pathogenesis, diagnosis, differential diagnosis, and therapy (both pharmaceutical and nonpharmaceutical) of exercise-induced bronchoconstriction or exercise-induced asthma (which is no longer a preferred term); asthma; and exercise and asthma. References assessed as relevant to the topic were evaluated to search for additional relevant references. Published clinical studies were appraised by category of evidence and used to document the strength of the recommendation. The parameter was then evaluated by Joint Task Force reviewers and then by reviewers assigned by the parent organizations, as well as the general membership. Based on this process, the parameter can be characterized as an evidence- and consensus-based document.
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http://dx.doi.org/10.1016/j.jaci.2016.05.029DOI Listing
November 2016

Genetic and environmental influences on the allocation of adolescent leisure time activities.

Biomed Res Int 2014 20;2014:805476. Epub 2014 May 20.

Institute for Behavioral Genetics, University of Colorado Boulder, Campus Box 447, Boulder, CO 80309-0447, USA.

There is a growing recognition of the importance of the out-of-school activities in which adolescents choose to participate. Youth activities vary widely in terms of specific activities and in time devoted to them but can generally be grouped by the type and total duration spent per type. We collected leisure time information using a 17-item leisure time questionnaire in a large sample of same- and opposite-sex adolescent twin pairs (N = 2847). Using both univariate and multivariate genetic models, we sought to determine the type and magnitude of genetic and environmental influences on the allocation of time toward different leisure times. Results indicated that both genetic and shared and nonshared environmental influences were important contributors to individual differences in physical, social, intellectual, family, and passive activities such as watching television. The magnitude of these influences differed between males and females. Environmental influences were the primary factors contributing to the covariation of different leisure time activities. Our results suggest the importance of heritable influences on the allocation of leisure time activity by adolescents and highlight the importance of environmental experiences in these choices.
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http://dx.doi.org/10.1155/2014/805476DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055149PMC
February 2015

Prevalence and correlates of alcohol and cannabis use disorders in the United States: results from the national longitudinal study of adolescent health.

Drug Alcohol Depend 2014 Mar 14;136:158-61. Epub 2013 Dec 14.

Department of Psychiatry, Health Sciences Center, University of Colorado, Denver, CO, USA.

Background: Limited current information on the epidemiology of lifetime alcohol and cannabis use disorders in the United States is available.

Aims: To present detailed information about the prevalence and sociodemographic correlates of lifetime alcohol and cannabis use disorders rates in the United States. To examine gender differences in hazard ratios for the onset of alcohol and cannabis dependence.

Methods: Participants in Wave IV of the National Longitudinal Study of Adolescent Health (N=15,500, age range: 24-32) were interviewed between 2008 and 2009. Participants who exceeded screening thresholds were queried about lifetime DSM-IV alcohol and marijuana abuse and dependence symptoms. Age of substance dependence onset was queried.

Results: Lifetime rates of alcohol abuse and dependence were 11.8 and 13.2%. Lifetime rates of cannabis abuse and dependence were 3.9 and 8.3%. Lifetime alcohol and cannabis dependence onset peaks were 23 and 20. Correlates of lifetime alcohol abuse included being male (OR 1.4), African-American (OR 0.7), income in the 2nd or 3rd quartile (OR 0.7 and 0.6). Correlates of lifetime alcohol dependence were: being male (OR 1.8), African-American (OR 0.5), and never being married (OR 1.5), and regions outside of the west (Midwest OR 0.7, South OR 0.6, Northeast OR 0.6). Correlates of cannabis abuse and dependence were being male (OR 1.8 and 1.4).

Conclusions: Lifetime alcohol and cannabis use disorders are highly prevalent in the US population. Men are at higher risk for alcohol and cannabis use disorders. Alcohol use disorders demonstrated specific sociodemographic correlates while marijuana use disorders did not.
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http://dx.doi.org/10.1016/j.drugalcdep.2013.11.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963405PMC
March 2014

Subjective effects for alcohol, tobacco, and marijuana association with cross-drug outcomes.

Drug Alcohol Depend 2012 Jun 22;123 Suppl 1:S52-8. Epub 2012 Mar 22.

Institute for Behavioral Genetics, University of Colorado, Campus Box 447, Boulder, CO 80309-0447, USA.

Methods: The cross-drug relationship of subjective experiences between alcohol, tobacco, and marijuana and problem drug use behaviors were examined. Data were drawn from 3853 individuals between the ages of 11 and 30 years of age participating in the Colorado Center on Antisocial Drug Dependence [CADD]. Subjective experiences were assessed using a 13-item questionnaire that included positive and negative responses for alcohol, tobacco, and marijuana. Lifetime abuse and dependence on these three drugs was assessed using the Composite International Diagnostic Interview, Substance Abuse Module [CIDI-SAM].

Results: Positive and negative subjective experience scales were similar for alcohol, tobacco, and marijuana, although the hierarchical ordering of items differed by drug. Subjective experience scales for each of the three drugs examined correlated significantly, with the strongest relationship being for alcohol and marijuana experiences. Significant associations were identified between how a person experienced a drug and abuse and dependence status for the same or different drug.

Conclusion: Cross-drug relationships provide evidence for a common liability or sensitivity towards responding in a similar manner to drugs of abuse within and across different pharmacological classes.
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http://dx.doi.org/10.1016/j.drugalcdep.2012.02.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729264PMC
June 2012

Common and drug-specific genetic influences on subjective effects to alcohol, tobacco and marijuana use.

Addiction 2011 Jan 19;106(1):215-24. Epub 2010 Oct 19.

Institute for Behavioral Genetics, University of Colorado, Boulder, CO, USA.

Aim: To examine variation in positive and negative subjective effects to alcohol, tobacco and marijuana and covariation between these three drugs and each effect.

Design: Retrospective self-reports of subjective effects were collected to estimate the genetic and environmental influences and the extent of their specificity across three drugs.

Participants: Data were drawn from 1299 adolescent and young adult same- and opposite sex twin- and sibling-pairs participating in the Colorado Center for Antisocial Drug Dependence (CADD).

Setting: A large, collaborative, longitudinal study of substance use and antisocial behavior in community and clinical adolescents.

Measurement:   Subjective effects were assessed using a 13-item questionnaire that included positive and negative responses to alcohol, tobacco and marijuana.

Findings: Heritable influences contributed moderately (additive genetic effects 16-56%) to positive and negative subjective effects to all three drugs and did not differ for males and females. Genetic and environmental contributions to positive and negative subjective effects are largely non-overlapping for tobacco and marijuana. Multivariate genetic modeling indicated that subjective effects to alcohol, tobacco and marijuana share a common, heritable etiology and that drug-specific genetic influences were an important contributor to individual differences in drug response.

Conclusions:   Results from our genetic analyses suggest that subjective effects to these commonly used and misused drugs are heritable and that the genetic and environmental influences on effects to one drug also influence subjective effects to other drugs.
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http://dx.doi.org/10.1111/j.1360-0443.2010.03129.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3006038PMC
January 2011

Subjective effects to marijuana associated with marijuana use in community and clinical subjects.

Drug Alcohol Depend 2010 Jun 9;109(1-3):161-6. Epub 2010 Feb 9.

Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO 80309, United States.

Introduction: Marijuana is the most commonly used illicit drug among adolescents. Marijuana use induces both psychological and physiological responses, which can be interpreted by an individual in a variety of ways (i.e. subjective effects). We have examined subjective effects in adolescent, young adult community, and clinical populations to determine how patterns of use may be predicted by an individual's subjective experiences with the drug.

Method: Participants were community and clinical sample subjects drawn from the Colorado Center of Antisocial Drug Dependence (CADD) and a sample of adjudicated youth from the Denver metropolitan area (aged 11-30). They were evaluated with the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM) and the Lyons battery for subjective effects. Scales for subjective effects were created using Mokken scale analysis. Multivariate linear and logistic regression was used to examine associations between the subjective scales and marijuana outcomes.

Results: Mokken scaling revealed two subjective effects scales, positive and negative. Both scales were significantly positively associated with marijuana abuse or dependence in both the community and clinical sample and regular use in the community sample. The negative scale was negatively associated with past six-month use in the community sample (p<0.05) and clinical sample, after controlling for age and gender effects.

Conclusions: These findings suggest that diverse subjective experiences with marijuana can be ordered hierarchically and that the resulting short scales can be used in either clinical or community settings. Further, they suggest that the potential for marijuana use problems is related to the type of subjective experience from marijuana exposure.
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http://dx.doi.org/10.1016/j.drugalcdep.2009.12.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000695PMC
June 2010

Association of candidate genes with antisocial drug dependence in adolescents.

Drug Alcohol Depend 2008 Jul 1;96(1-2):90-8. Epub 2008 Apr 1.

Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO 80309, USA.

The Colorado Center For Antisocial Drug Dependence (CADD) is using several research designs and strategies in its study of the genetic basis for antisocial drug dependence in adolescents. This study reports single nucleotide polymorphism (SNP) association results from a targeted gene assay (SNP chip) of 231 primarily Caucasian male probands in treatment with antisocial drug dependence and a matched set of community controls. The SNP chip was designed to assay 1500 SNPs distributed across 50 candidate genes that have had associations with substance use disorders and conduct disorder. There was an average gene-wide inter-SNP interval of 3000 base pairs. After eliminating SNPs with poor signals and low minor allele frequencies, 60 nominally significant associations were found among the remaining 1073 SNPs in 18 of 49 candidate genes. Although none of the SNPs achieved genome-wide association significance levels (defined as p<.000001), two genes probed with multiple SNPs (OPRM1 and CHRNA2) emerged as plausible candidates for a role in antisocial drug dependence after gene-based permutation tests. The custom-designed SNP chip served as an effective and flexible platform for rapid interrogation of a large number of plausible candidate genes.
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http://dx.doi.org/10.1016/j.drugalcdep.2008.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574676PMC
July 2008

The neuronal nicotinic receptor subunit genes (CHRNA6 and CHRNB3) are associated with subjective responses to tobacco.

Hum Mol Genet 2008 Mar 30;17(5):724-34. Epub 2007 Nov 30.

Institute for Behavioral Genetics, University of Colorado, Boulder, CO 80309, USA.

Neuronal nicotinic acetylcholine receptors have been implicated in various measures of nicotine dependence. In this paper, we present findings from an exploratory study of single nucleotide polymorphisms (SNPs) in the CHRNB3 and CHRNA6 genes with tobacco and alcohol phenotypes, including frequency of use and three subjective response factors occurring shortly after initiation of use. Subjects were 1056 ethnically diverse adolescents ascertained from clinical and community settings. The most significant associations were found between two CHRNB3 SNPs (rs4950 and rs13280604) and the three subjective response factors to initial tobacco use. These findings were replicated in a separate community sample of 1524 families participating in the National Longitudinal Study of Adolescent Health. Both CHRNB3 SNPs were found to be associated with similar measures of subjective response to tobacco. These results indicate that early subjective response to nicotine may be a valuable endophenotype for genetic studies aimed at uncovering genes contributing to nicotine use and addiction.
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http://dx.doi.org/10.1093/hmg/ddm344DOI Listing
March 2008

Association of the neuronal nicotinic receptor beta2 subunit gene (CHRNB2) with subjective responses to alcohol and nicotine.

Am J Med Genet B Neuropsychiatr Genet 2007 Jul;144B(5):596-604

Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado 80309, USA.

Nicotine addiction and alcohol dependence are highly comorbid disorders that are likely to share overlapping genetic components. We have examined two neuronal nicotinic receptor subunit genes (CHRNA4 and CHRNB2) for possible associations with nicotine and alcohol phenotypes, including measures of frequency of use and measures of initial subjective response in the period shortly after first using the drugs. The subjects were 1,068 ethnically diverse young adults participating in ongoing longitudinal studies of adolescent drug behaviors at the University of Colorado, representing both clinical and community samples. Analysis of six SNPs in the CHRNA4 gene provided modest support for an association with past 6 month use of alcohol in Caucasians (three SNPs with P < 0.08), but no evidence for an association with tobacco and CHRNA4 was detected. However, a SNP (rs2072658) located immediately upstream of CHRNB2 was associated with the initial subjective response to both alcohol and tobacco. This study provides the first evidence for association between the CHRNB2 gene and nicotine- and alcohol-related phenotypes, and suggests that polymorphisms in CHRNB2 may be important in mediating early responses to nicotine and alcohol.
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http://dx.doi.org/10.1002/ajmg.b.30464DOI Listing
July 2007

Oral clefts, maternal smoking, and TGFA: a meta-analysis of gene-environment interaction.

Cleft Palate Craniofac J 2005 Jan;42(1):58-63

Johns Hopkins Bloomberg School of Hygiene and Public Health, Baltimore, Maryland, USA.

Objective: A meta-analysis was performed to examine the association among maternal cigarette smoking, infant genotype at the Taq1 site in the transforming growth factor alpha (TGFA) locus, and risk of nonsyndromic oral clefts, both cleft palate (CP) and cleft lip with or without cleft palate (CL/P).

Design: Five published case-control studies were included in the meta-analyis. Pooled Mantel-Haenszel odds ratios (OR) and 95% confidence intervals (CIs) were computed. Gene-environment interaction was also assessed by using the pooled data in a case-only analysis and polytomous logistic regression.

Results: Among nonsmoking mothers, there was no evidence of any increased risk for CP if the infant carried the TGFA Taq1 C2 allele. If the mother reported smoking, however, there was an overall increased risk for CP if the infant carried the C2 allele (ORsmokers = 1.95; 95% CI = 1.22 to 3.10). TGFA genotype did not increase risk to CL/P, regardless of maternal smoking status. Polytomous logistic regression revealed a significant overall smoking effect for CL/P (OR = 1.64, 95% CI = 1.33 to 2.02) and CP (OR = 1.42, 95% CI = 1.06 to 1.90).

Conclusions: While maternal smoking was a consistent risk factor for both CL/P and CP across all studies, the suggestive evidence for gene-environment interaction between the infant's genotype at the Taq1 marker in TGFA and maternal smoking was limited to CP. Furthermore, evidence for such gene-environment interaction was strongest in a case-control study drawn from a birth defect registry where infants with non-cleft defects served as controls.
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http://dx.doi.org/10.1597/02-128.1DOI Listing
January 2005

Evidence for linkage of nonsyndromic cleft lip with or without cleft palate to a region on chromosome 2.

Eur J Hum Genet 2003 Nov;11(11):835-9

Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

Results from a genome-wide screen of 10 multiplex families ascertained through probands with nonsyndromic cleft lip with or without cleft palate (CL/P) in Mexico, Argentina, and the United States yielded suggestive evidence of linkage to chromosomes 2, 6, 17 and 18. Fine mapping excluded all regions except chromosome 2. Subsequent analysis was performed on the original 10 families plus an additional 16 families using 31 markers on chromosome 2. This analysis showed intriguing evidence of linkage to 2q (Zlr=2.26, empirical P-value=0.028 in a chromosome-wide analysis). Transmission disequilibrium tests also revealed evidence of linkage and disequilibrium for two markers in this region (D2S168 and D2S1400 with P-values=0.022 and 0.006, respectively). A subset of these 26 families provided additional evidence for a susceptibility gene for CL/P on 2q, suggesting that further studies of genes in this region are warranted.
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http://dx.doi.org/10.1038/sj.ejhg.5201052DOI Listing
November 2003

Genetic and environmental risk factors for sagittal craniosynostosis.

J Craniofac Surg 2002 Sep;13(5):602-6

Johns Hopkins Bloomberg School of Hygiene and Public Health, Johns Hopkins School of Medicine, Baltimore, MD, USA.

The authors investigated whether genetic and environmental factors influence risk for sagittal craniosynostosis. Cases were ascertained from craniofacial clinics in the Baltimore-Washington metropolitan region. Controls were recruited from the Johns Hopkins newborn nursery and a large pediatric practice in Baltimore County. Forty-two probands with isolated, nonsyndromic sagittal craniosynostosis born in the mid-Atlantic region were included in this analysis. Controls are infants born in Maryland without any known birth defects (n = 182). Odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. Cases were genotyped at several loci implicated in malformation syndromes including craniosynostosis. There were no elevated risks for craniosynostosis related to maternal or paternal smoking or maternal vitamin usage. Case mothers consumed less alcohol (OR = 0.38, 95% CI = 0.17-0.85) and had less education than control mothers ( < 0.001). All cases that were sequenced were negative for mutations at the following genes: exon IIIa 755C->G, (exons IIIa and IIIc,), exon IIIa, and exon 1. These findings suggest that whereas TWIST and the genes are important for syndromic craniosynostosis, they are unlikely to be involved in isolated sagittal craniosynostosis. Parental education and alcohol consumption were associated with sagittal craniosynostosis in this study.
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http://dx.doi.org/10.1097/00001665-200209000-00002DOI Listing
September 2002