Medical Cannabis and Behavior

Rey Auditory Verbal Learning Test

All participants will complete a cognitive task battery measuring processes such as learning and memory. The Rey Auditory Verbal Learning Test requires individuals to learn a list of words across five learning trials followed by a distractor list then immediate recall of the initial word list then a 30-minute delayed recall. The minimum score on each trial is 0 and the maximum score on each trial is 15. Scores are tabulated for each of the eight trials. Scores on trials 1-5 reflect learning. Scores on trials 7 and 8 reflect immediate and delayed recall.

Digit Span Task

The digit span task is a measure of working memory and has a forward and a backward condition. On the forward condition, participants are presented with sequences of digits that are read aloud, beginning with two digits, which the participant must repeat in order. The sequence increases by one digit for each correct level of performance up to a maximum of 9 digits. On the backward condition, the presentation of digits is the same but participants must recall the digit sequences in backward order. The maximum forward and backward span that was correctly recalled is tabulated (min = 0; max = 9).

Verbal Fluency Task

Participants are told that they will hear a letter (e.g. F) and must generate as many words as they can that begin with that letter in a one-minute period while adhering to certain task rules. Three letters are presented in total, and the total number of words generated without errors is recorded for each letter (min = 0; max = unspecified).

Spatial Span Task

The spatial span task is a measure of working memory for locations and has a forward and a backward condition. On the forward condition, participants are presented with sequences of targeted locations, beginning with two, which the participant must repeat in order by touching those locations on a computer screen. The sequence increases by one location for each correct level of performance up to a maximum of 9 locations. On the backward condition, the presentation of locations is the same but participants must recall the spatial sequences in backward order. The maximum forward and backward spatial span that was correctly recalled is tabulated (min = 0; max = 9).

Alcohol Use Disorders Identification Test (AUDIT)

Participant alcohol use will be measured over time using the AUDIT, a 10-item screening tool developed by the World Health Organization (WHO) to assess alcohol consumption, drinking behaviors, and alcohol-related problems. Participants rate each item on a five point scale (0 to 4), and scores are summed across all 10 items to yield an index of problematic alcohol use (min score = 0; max score = 40). A score of 8 or more is considered to indicate hazardous or harmful alcohol use.

Brief Pain Inventory

Participants will complete the Brief Pain Inventory to assess their current pain levels and pain-related quality of life. This self report questionnaire asks patients to rate (a) four pain items (worst pain in 24 hours; average pain; least pain in 24 hours; pain right now) and (b) Extent to which pain interferes with general activity, mood, walking ability, sleep, normal work, relations with other people, and enjoyment of life. Each item is rated on a 10-point scale with 1 reflecting low/less pain scores and 10 reflecting high/high pain/high interference with life scores. In addition to scores on individual items, three scores are derived, one that sums responses to the four pain items (max score = 40) and one that sums responses to the interference items (max score = 70) and a total score (sum of all items; max score = 120). High scores reflect worse pain-related impairment.

Beck Depression Inventory (BDI)

The BDI is a 21-item self report questionnaire that assesses symptoms of clinical depression and their severity, each rated on a four point scale (0 = symptom is absent; 3 = full presence of the symptom). The questions assess mood and motivation, cognitive symptoms, suicidality, and vegetative symptoms (sleep; libido; eating/weight). Scores are summed across all 21 items to yield a depression severity score (range from 0 to 63). Scores above 21 indicate moderate to severe depression.

UPPS-P Impulsive Behavior Scale

The UPPS-P is a 59-item self-report questionnaire that measures five facets of impulsivity (sensation seeking (12 items; scores range from 12 to 48); positive urgency (14 items; scores range from 14 to 56 ); negative urgency (12 items; scores range from 12 to 48); lack of premeditation (11 items; scores range from 11 to 44); lack of perseverance (10 items; scores range from 10 to 40)). Each question is endorsed on a four point scale (1 = strongly agree; 4 = strongly disagree), and the five metrics are derived after implementing reverse-scoring on some items. These five facets of impulsivity will be examined before versus after use of medical cannabis.