Leagues ahead of the natural adaptive skills of adults who are often clunky at social modification, adolescents are primed to quickly, and often seamlessly, integrate novel information and behavioral adjustment that facilitates their capacity to rapidly adapt and adjust in numerous novel and shifting social and community contexts . To this end, adolescents are arguably better prepared to modify and shift their behavior successfully than adults , who are much less facile in adapting their behavior to be congruent in novel social contexts. Here, we believe that potentially novel clinical approaches, and particularly those that incorporate the role of social and family context in youth substance use behavior, are likely to show promise for catalyzing reductions in adolescent substance use. Examples of this include adolescents’ capacities to drastically reduce use when they are outside of risk environments . The greatest challenge here may be to identify how best to work with adolescents’ developing cognitive skills to translate potential reductions in use in one context, to other social contexts . Harnessing drive for autonomy. One aspect of addiction treatment that is largely overlooked in existing treatments is adolescents’ inherent drive for autonomy. The social psychology literature echoes adolescents’ strong desire for sculpting out their own place of standing . Here, we believe that non-traditional approaches that allow adolescents to engage and utilize their voice for change, may give them the opportunity to channel this inherent drive toward positive contributions within their peer and sociocultural communities. Non-traditional approaches of promise include encouraging adolescents to engage as advocates for change in positive arenas of interest . Additionally, cannabis grower it is worthwhile to consider that while adolescents are developing their “voice”, they are developing meta-cognition, including how to self-reflect on how their choices and behaviors may impact others, from more immediate levels to broader spheres of communication .
Clinical efforts that work with adolescents to identify the lines of connection may help adolescents play an active role in their evolving sense of self. Parents are not out of the picture yet. The last consideration that we believe may be under discussed in current addiction approaches, that largely happens on a one-on-one treatment level in adult addiction treatment, is the role of the family in addiction treatment outcomes. While adolescents “look like” adults, by and large, many continue to live in family contexts throughout the adolescent years. Further, data continue to reflect that the developing brain is modified by parent factors . Similarly, parent and family-based approaches still continue to show some of the largest successes in adolescent addiction treatment outcomes . Relevant to the shifting social contexts of adolescents, parents and families can represent one beneficial constant in a world of ever-evolving social landscapes. Thus, here, we encourage clinicians to incorporate parents and families whenever practical and possible to maximize positive development and change. This reviews offers one step toward understanding the nature of the developing adolescent brain, and how those neuro developmental data can inform next-step modifications or innovations to adolescent addiction treatment. This represents one critical foundational element in a much-larger cascade of health care approaches for this age group. In other words, in order to have adolescent addiction interventions generate maximal impact, they have to be effective, but they also have to be accessible to and specific for this age group. We suggest four key neuro developmental factors that we believe will enhance addiction treatment approaches and directly-linked clinical approaches that we believe will enhance treatment outcomes in this age group .
And, we encourage methods for examining adolescent treatment response, and highlight their related neural relevance, including: working towards consensus for common adolescent treatment outcomes ; examining pre-post changes in interference in functioning, as assessed with empirically validated “problems” measures; conducting comparable follow-up windows of adolescent treatment outcomes ; evaluating and reporting outcomes across all types of adolescent substance use; and evaluating parent/family factors in adolescent substance use outcomes. Already, at present, the field is moving very rapidly in the domain of methodological, statistical, and technological innovations, including rapid advances in predictive algorithms and machine learning . Our teamrepresents one lab explicitly linking the integration of neuroimaging technology into the adolescent treatment context , and similar advances in identifying and understanding variability are emerging in other adolescent treatment fields . We look forward to seeing innovations that stem from the integration of these neurodevelopmental perspectives in adolescent addiction treatment approaches and outcomes.Cannabichromene is a cannabinoid of special interest because it has been reported as both scalemic and racemic from Cannabis plants with an unknown absolute stereochemistry. This observation can be explained by the racemization of the natural, or original, single CBC enantiomer produced through biosynthesis. CBC was resolved chromatographically, and the enantiomer matching the major enantiomer of scalemic CBC isolated from commercially available, naturally derived cannabinoid products was identified. It was determined that CBC racemized rather slowly under laboratory conditions. However, irradiation of CBC with sunlight can lead to facile racemization. Due to unsuccessful attempts of resolving CBC as well as to prevent its potential racemization, CBC was converted to its [2 + 2] cycloaddition product, cannabicyclol . Natural CBC was determined as the R absolute stereochemistry based on chiroptical data for related natural products and the absolute configuration of a CBL analog determined by X-ray crystallography. The derivatization of indoles is an important transformation because of the numerous biologically relevant indole-containing compounds.
Due to their electron-rich nature, indoles typically behave as nucleophiles in a reaction. However, indoles containing a leaving group on the nitrogen and an electron-withdrawing group on the ring can undergo a cine substitution reaction allowing for C2-functionalization. Pioneering work of Somei showed the cine substitution of N-methoxy 3-formylindole with a variety of oxygen-, nitrogen-, and carbon-centered nucleophiles. However, due to the lack of availability of N-methoxy indoles and challenge of making them, N-sulfonyl indoles were chosen as ideal substrates for cine substitution. The cine substitution of N-phenylsulfonyl 3-substituted indoles with primary alkyl alcohol nucleophiles afforded the desired products in 67 to 88% yield. Formation of side products, for example, 3-substituted indole and sulfonylated nucleophile, can be greatly dependent on the reaction conditions.Data for the present study were taken from a national cross-sectional survey using a convenience sample of young adult smokers. Recruitment methods and survey design have been described in detail previously. Briefly, young adults between the ages of 18 and 25, who reported smoking at least one cigarette in the past 30 days, were recruited online between 4/1/09 and 12/31/10. Three recruitment methods were used: 1) a paid advertisement campaign on Facebook; 2) a free campaign on Craigslist; and 3) a paid email advertising campaign through a survey sampling company.Only entries from advertisements targeting tobacco use were used in the present study so as not to inflate the prevalence of marijuana use in this population. Advertisements invited young adults to participate in a 20-minute online survey on tobacco use with a chance to win a prize in a drawing worth either US $25 or $400. Advertisements contained a hyperlink directing potential participants to the study’s institutional review board -approved consent form, which mentioned assessment of marijuana use; to a screener for eligibility criteria; and to a secure online survey with data encryption for added security. Computer IP addresses were tracked, and only one entry was allowed from a single computer to prevent duplicate entries from the same person; however, multiple entries were allowed from the same internet connection .During the recruitment period, the online survey received more than 6423 hits, and 6176 people gave online consent to determine eligibility; of these, 3512 were eligible and deemed to be valid cases. Of eligible and valid cases, 2998 completed information about demographic and tobacco use only, and 1808 completed the entire 20–30 minute survey. Those who completed the survey differed from those who didn’t on some demographic variables, but the differences were small . The majority of the sample was male , Caucasian , living in an urban area , not currently a student , and smoked marijuana daily . Among current smokers,growing cannabis outdoors the overall prevalence of marijuana use was 53%. There was a significantly higher prevalence of marijuana use among males compared with females; among those aged 18 to 20 compared with those aged 21 to 25; among those with higher household income; among those living in urban versus rural areas; and among nondaily versus daily smokers. There were no differences in prevalence of recent cannabis use by ethnicity, census region, residence in a medical marijuana state, or student status. Among past-month marijuana users, the median number of days using marijuana was 18.0 in the past 30 days . Non-students used marijuana on significantly more days than students, and daily smokers used on significantly more days than non-daily smokers. There were no differences in the number of days using marijuana in the past month by gender, age, ethnicity, household income, region, urban versus rural residence, or residence in a medical marijuana state. The proportion of days using both substances out of all past-month using days was a median of 45.5% . There was a higher proportion of tobacco and marijuana co-use among Caucasian respondents compared with those of other ethnic groups, among those residing in the Northeast compared to other census regions, among those residing in rural versus urban areas, among non-students, and among daily versus non-daily smokers . There were no differences in percentage of days with co-use by gender, age, household income, or residence in a medical marijuana state.The findings from this online anonymous survey of young adult smokers with national coverage indicate a greater prevalence of marijuana use than has been reported in epidemiological studies using household interviews.
For example, in 2009, the US Substance Abuse and Mental Health Services Administration National Survey on Drug Use and Health reported that 34.6% of past-month smokers age 18 to 25 used marijuana, compared with 53.1% reported in the present study. The present sample was recruited online, primarily through social media, and the survey was completely anonymously, potentially allowing for reduced bias in reporting of illegal substance use . High prevalence of use was observed across demographic groups and regions, suggesting the issue of marijuana and tobacco co-use is of national relevance. The highest prevalence of marijuana use was observed among males, younger people, those with a higher household income and living in urban areas, and non-daily tobacco smokers. Consistent with previous epidemiological studies, young adult males tended to use marijuana at higher levels than young adult females, and young adults tended to reduce substance use as they reached developmental milestones of emerging adulthood, including leaving home, obtaining stable employment, and starting a family [30]. Greater use among those in urban areas and from wealthier households reflects factors related to availability and is also consistent with national trends from household survey data. Notably, although daily tobacco smokers were slightly less likely to use marijuana than non-daily smokers, when they did use, they used it more frequently. There was a two-fold greater frequency of use among daily smokers compared with non-daily smokers and elevated frequency of use among non-students. Non-students and daily smokers also had greater co-use. Given the potential for detrimental effects of co-use among daily smokers, these findings support the broadening of interventions for daily tobacco smokers to consider use of both substances. Future research should examine the potential for substitution or compensatory effects during attempts to quit either substance. Study limitations include convenience sampling and self-reported data; however, face-to-face surveys often similarly rely on self-reported drug use, and we have previously demonstrated strong reliability and validity of tobacco and marijuana online surveys with young adults. The survey completion rate in this study was comparable to online survey studies with young adults but lower than that typically seen in nationally representative surveys. For example, weighted response rates for the 2010 SAMHSA-sponsored National Survey on Drug Use and Health were 88.8% for household screening and 74.7% for household interviewing. Our respondents could leave the survey at any time; methods considered to encourage completion would have compromised participant anonymity. Sampling procedures and online data collection could have led to higher prevalence of marijuana use and co-use than is typical of representative surveys that have procedures to increase response rates .