The cannabis plant has been known to humanity for centuries as a remedy for pain, diarrhea and inflammation. Current research is inspecting the use of cannabis for many diseases, including multiple sclerosis, epilepsy, dystonia, and chronic pain. In inflammatory conditions cannabinoids improve pain in rheumatoid arthritis and:pain and diarrhea in Crohn's disease. Despite their therapeutic potential, cannabinoids are not free of side effects including psychosis, anxiety, paranoia, dependence and abuse. Controlled clinical studies investigating the therapeutic potential of cannabis are few and small, whereas pressure for expanding cannabis use is increasing. Currently, as long as cannabis is classified as an illicit drug and until further controlled studies are performed, the use of medical cannabis should be limited to patients who failed conventional better established treatment.
Van der Meersch, H; Verschuere, A P; Bottriaux, F
Pharmaceutical grade cannabis is available to Dutch patients from public pharmacies in the Netherlands. The first part of this paper reviews the pharmaceutical and pharmacological properties of medicinal cannabis. Detailed information about its composition and quality, potential applications, methods of administration, adverse reactions, drug interactions and safety during pregnancy or breastfeeding are given. The second part deals with the legal aspects of dispensing medicinal cannabis through pharmacies in view of the Belgian and Dutch legislation. The last part discusses the present Belgian regulation about the possession of cannabis.
Palali, A.; Ours, J. C. van
textabstractWe investigate the determinants of the support for cannabis legalization finding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this finding to self-interest and inside information about potential dangers of cannabis. While the self-interest effect is not very surprising, the effect of inside information suggests that cannabis use is not as harmful as cannabis users originally thought it was be...
Palali, A.; van Ours, J.C.
We investigate the determinants of the support for cannabis legalizationfinding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this to self-interest and inside information about potential dangers of cannabis use.
Palali, Ali; van Ours, Jan
We investigate the determinants of the support for cannabis legalization finding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this finding to self-interest and inside information about potential dangers of cann
Palali, A. (Ali); van Ours, J.C. (Jan C.)
textabstractWe investigate the determinants of the support for cannabis legalization finding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this finding to self-interest and inside information about potential dan
José Vicente Stalrich Canet
Full Text Available En los últimos 20 ó 30 años hemos visto nuevos tipos de drogas que anteriormente no existían en nuestro mundo occidental o bien tenían una difusión bastante localizada y estable; me refiero, sobre todo, a los psicofármacos, los opiáceos y la cannabis corno las más importantes sin olvidar, no obstante, otras también actuales: los alucinógenos (sintéticos y naturales, inhalantes, etc. Estas nuevas r drogas conviven en nuestra sociedad con las otras más clásicas y generadoras de multitud de problemas como son el alcohol y el tabaco
José Vicente Stalrich Canet
En los últimos 20 ó 30 años hemos visto nuevos tipos de drogas que anteriormente no existían en nuestro mundo occidental o bien tenían una difusión bastante localizada y estable; me refiero, sobre todo, a los psicofármacos, los opiáceos y la cannabis corno las más importantes sin olvidar, no obstante, otras también actuales: los alucinógenos (sintéticos y naturales), inhalantes, etc. Estas nuevas r drogas conviven en nuestra sociedad con las otras más clásicas y generadoras de multitud de pro...
Full Text Available Cannabis is a drug derived from hemp plant, Cannabis sativa, used both as a recreational drug or as medicine. It is a widespread illegal substance, generally smoked for its hallucinogenic properties. Little is known about the adverse effects of postnatal cannabis exposure throw breastfeeding because of a lack of studies in lactating women. The active substance of cannabis is the delta 9 TetraHydroCannabinol (THC. Some studies conclude that it could decrease motor development of the child at one year of age. Therefore, cannabis use and abuse of other drugs like alcohol, tobacco, or cocaine must be contraindicated during breastfeeding. Mothers who use cannabis must stop breastfeeding, or ask for medical assistance to stop cannabis use in order to provide her baby with all the benefits of human milk.
The cannabis plant (Cannabis sativa L.) has a long history as a recreational drug, but also as part of traditional medicine in many cultures. Nowadays, it is used by a large number of patients worldwide, to ameliorate the symptoms of diseases varying from cancer and AIDS to multiple sclerosis and migraine. The discovery of cannabinoid-receptors and the endocannabinoid system have opened up a new and exciting field of research. But despite the pharmaceutical potential of cannabis, its classifi...
The cannabis plant (Cannabis sativa L.) has a long history as a recreational drug, but also as part of traditional medicine in many cultures. Nowadays, it is used by a large number of patients worldwide, to ameliorate the symptoms of diseases varying from cancer and AIDS to multiple sclerosis and mi
Full Text Available Alcohol and cannabis misuse is currently the most frequent co-morbidity disorder of schizophrenia. The following four issues will be dealt with: 1 the neurobiological basis of the psychosis-inducing, pathogenic effects of THC, the agent contained in cannabis products. 2 Can cannabis use - and for comparison alcohol abuse - prematurely trigger or even cause schizophrenia? 3 Are persons genetically liable to schizophrenia, psychosis-prone individuals or young persons before completion of brain development at an increased risk? 4 What consequences does cannabis use have on the symptomatology and further course of schizophrenia? Results from recent literature and the ABC Schizophrenia Study show that the risk for cannabis use in schizophrenia is about twice the size in healthy controls. In most cases cannabis use starts before first admission, in a third of cases before schizophrenia onset. There is an increased affinity to misuse already at the prodromal stage. Cannabis can prematurely trigger schizophrenia onset - on average eight years earlier than in non-use - and cause the illness partly in interaction with predisposing factors. Cannabis use in the course of schizophrenia increases positive symptoms and reduces affective flattening, thus leading to dysfunctional coping in some cases.
Slijkhuis C; Hoving R; Blok-Tip L; Kaste D de; KCF
Medicinal Cannabis can be legally supplied by pharmacists to patients from the first of September 2003, although still only on prescription. The quality of this product is tested conform the monograph Cannabis flos. In this monograph tests and quality standards, such as characteristics, loss on dry
Järvinen, Margaretha; Ravn, Signe
A considerable part of today's sociological research on recreational drug use is (explicitly or implicitly) inspired by Howard Becker's classical model of deviant careers. The aim of the present paper is to directly apply Becker's theory to empirical data on present-day cannabis use and to suggest...... in treatment for cannabis problems in Copenhagen, Denmark. We suggest a revision of Becker's career model in relation to four aspects: initiation of cannabis use, differentiation between socially integrated and individualised, disintegrated use, social control from non-users, and the users' moral stance...... on cannabis. A central point of the paper is that social interaction may both motivate cannabis use, as Becker proposed, and serve as a protective factor against extensive, problematic use....
Simpson, Annabelle K; Magid, Viktoriya
Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population.
Rafael Faria Sanches
Full Text Available OBJETIVO: Avaliar as relações entre o uso agudo e crônico de cannabis e alterações do humor. MÉTODO: Os artigos foram selecionados por meio de busca eletrônica no indexador PubMed. Capítulos de livros e as listas de referências dos artigos selecionados também foram revisados. RESULTADOS: Observam-se elevados índices de comorbidade entre abuso/dependência de cannabis e transtornos afetivos em estudos transversais e em amostras clínicas. Estudos longitudinais indicam que, em longo prazo, o uso mais intenso de cannabis está relacionado com um risco maior de desenvolvimento de doença bipolar e, talvez, depressão maior em indivíduos inicialmente sem quadros afetivos; porém, os mesmos não encontraram maior risco de uso de cannabis entre aqueles com mania ou depressão sem esta comorbidade. Outra importante observação é que o uso de substâncias psicoativas em bipolares pode estar associado a uma série de características negativas, como dificuldade na recuperação dos sintomas afetivos, maior número de internações, piora na adesão ao tratamento, risco aumentado de suicídio, agressividade e a uma pobre resposta ao lítio. Tratamentos psicossociais e farmacológicos são indicados para o manejo da comorbidade entre cannabis e transtornos afetivos. CONCLUSÃO: As relações entre o uso de cannabis e alterações do humor são observadas tanto epidemiologicamente quanto nos contextos clínicos.OBJECTIVE: Evaluate the relationship between acute and chronic use of cannabis and mood changes. METHOD: Articles were selected by electronic search in PubMed. Chapters in books and reference lists of selected articles were also reviewed. As the research did not involve humans, there was no evaluation by a Research Ethics Committee. RESULTS: High rates of comorbidity between use/abuse/dependence of cannabis and affective disorders in longitudinal studies and in clinical samples were observed. Longitudinal studies indicate that, in long
Brancheau, Daniel; Blanco, Jessica; Gholkar, Gunjan; Patel, Brijesh; Machado, Christian
Cannabis or marijuana is the most used recreational, and until recently illegal, drug in the United States. Although cannabis has medicinal use, its consumption has been linked to motor vehicle accidents in dose dependent fashion. Marijuana and other cannabinoids produce a multitude of effects on the human body that may result in these motor vehicle accidents. Some of the effects that marijuana has been known to cause include altered sensorium, diminished reflexes, and increased vagal tone. We present a case of cannabis induced asystole from hypervagotonia.
Basu, Debasish; Malhotra, Anil; Varma, Vijoy K.
Association between cannabis use and various psychiatric syndromes does exist, but their nature remains elusive. Cannabis intoxication, ‘cannabis psychosis’ and certain other conditions related with cannabis use like flashbacks and prolonged depersonalization are discussed in this paper. The controversial nature of the cannabis - schizophrenia link is noted, and various methodological issues in clinical cannabis research are highlighted.
Ours, J. C. van
This paper uses information about prime age individuals living in Amsterdam, to study whether the use of alcohol, or tobacco stimulates the use cannabis, i.e. whether alcohol or cannabis are stepping stones for cannabis.The special element of the study is that it concerns the use in an environment where not only alcohol and tobacco but also cannabis is a legal drug.It turns out that alcohol and cannabis are intertemporal substitutes while tobacco and cannabis are intertemporal complements.Onl...
Soyka, M; Preuss, U; Hoch, E
Use and misuse of cannabis and marihuana are frequent. About 5% of the adult population are current users but only 1.2% are dependent. The medical use of cannabis is controversial but there is some evidence for improvement of chronic pain and spasticity. The somatic toxicity of cannabis is well proven but limited and psychiatric disorders induced by cannabis are of more relevance, e.g. cognitive disorders, amotivational syndrome, psychoses and delusional disorders as well as physical and psychological dependence. The withdrawal symptoms are usually mild and do not require pharmacological interventions. To date there is no established pharmacotherapy for relapse prevention. Psychosocial interventions include psychoeducation, behavioral therapy and motivational enhancement. The CANDIS protocol is the best established German intervention among abstinence-oriented therapies.
© 2015 American Society for Clinical Pharmacology and Therapeutics. Cannabis has been used in medicine for thousands of years prior to achieving its current illicit substance status. Cannabinoids, the active components of Cannabis sativa, mimic the effects of the endogenous cannabinoids (endocannabinoids), activating specific cannabinoid receptors, particularly CB1 found predominantly in the central nervous system and CB2 found predominantly in cells involved with immune function. Delta-9-tet...
Slijkhuis C; Hoving R; Blok-Tip L; Kaste D de; KCF
Medicinal Cannabis can be legally supplied by pharmacists to patients from the first of September 2003, although still only on prescription. The quality of this product is tested conform the monograph Cannabis flos. In this monograph tests and quality standards, such as characteristics, loss on drying, content of delta 9 -trans-tetrahydrocannabinol, microbial contamination, and pesticide residues are given. In this report the monograph is described together with a short explanation.
... produced from the flowering top of the hemp plant, cannabis sativa — should be used for symptom management ... a task) while completing a test of working memory. The cannabis group performed more poorly on the ...
van Ours, J.C.
This paper uses information about prime age individuals living in Amsterdam, to study whether the use of alcohol, or tobacco stimulates the use cannabis, i.e. whether alcohol or cannabis are stepping stones for cannabis.The special element of the study is that it concerns the use in an environment w
van Gastel, W.A.
Cannabis use has been implicated as a risk factor for mental health problems, (subclinical) psychotic symptoms in particular. If cannabis use was a cause of these problems, cessation would lead to improved public mental health. If cannabis use was a mere consequence of a predisposition for mental he
Cousijn, J.; Goudriaan, A.E.; Wiers, R.W.
Aims Repeated drug exposure can lead to an approach-bias, i.e. the relatively automatically triggered tendencies to approach rather that avoid drug-related stimuli. Our main aim was to study this approach-bias in heavy cannabis users with the newly developed cannabis Approach Avoidance Task (cannabi
Kronbæk, Mette; Asmussen Frank, Vibeke
of respondents with and without treatment experiences, we were able to compare perspectives on cannabis initiation and trajectories not commonly examined. FINDINGS - All the respondents had started to use cannabis socially as adolescents in the company of peers, using it with specific peer groups...... cannabis use were constructed from the users’ narratives. For some respondents, daily cannabis use in adulthood was an inclusive and non-problematic activity while others described their cannabis use developing into a problematic and exclusive habit. CONCLUSIONS - Trajectories into and continuation...
Engels, Frederike K; de Jong, Floris A; Mathijssen, Ron H J; Erkens, Joëlle A; Herings, Ron M; Verweij, Jaap
In The Netherlands, since September 2003, a legal medicinal cannabis product, constituting the whole range of cannabinoids, is available for clinical research, drug development strategies, and on prescription for patients. To date, this policy, initiated by the Dutch Government, has not yet led to the desired outcome; the amount of initiated clinical research is less than expected and only a minority of patients resorts to the legal product. This review aims to discuss the background for the introduction of legal medicinal cannabis in The Netherlands, the past years of Dutch clinical experience in oncology practice, possible reasons underlying the current outcome, and future perspectives.
Sigurbjörg Lára Kristinsdóttir 1991
The debate on whether or not cannabis should be legalized has been growing in recent years. The legality of cannabis varies from country to country. Possession of cannabis have been decriminalized or legalized in numerous countries. The main aim of the present study was to examine both what characterizes those who are in favor of cannabis legalization and the potential effect on the community and cannabis consumption if cannabis would be legalized. The participants were 1198 obtained from an ...
Cervený, J.; van Ours, J.C.; Chomynova, Pavla; Mravcik, Viktor
This paper examines the effect of a change in drugs policy on the age of onset of cannabis use. We use 2012 survey data from the Czech Republic where in 2010 a law was introduced decriminalizing personal possession of small quantities of several illicit drugs, including cannabis. We estimate the effect of the policy change using a mixed proportional hazards framework that models the starting rate of cannabis use, i.e. the transition to first cannabis use. We find that the decriminalization of...
Palali, Ali; van Ours, Jan C
In the Netherlands, cannabis use is quasi-legalized. Small quantities of cannabis can be bought in cannabis shops. We investigate how the distance to the nearest cannabis shop affects the age of onset of cannabis use. We use a mixed proportional hazard rate framework to take account of observable as well as unobservable characteristics that influence the uptake of cannabis. We find that distance matters. Individuals who grow up within 20 km of a cannabis shop have a lower age of onset.
Hazekamp, A; Fischedick, J T
The medicinal use of Cannabis is increasing as countries worldwide are setting up official programs to provide patients with access to safe sources of medicinal-grade Cannabis. An important question that remains to be answered is which of the many varieties of Cannabis should be made available for medicinal use. Drug varieties of Cannabis are commonly distinguished through the use of popular names, with a major distinction being made between Indica and Sativa types. Although more than 700 different cultivars have already been described, it is unclear whether such classification reflects any relevant differences in chemical composition. Some attempts have been made to classify Cannabis varieties based on chemical composition, but they have mainly been useful for forensic applications, distinguishing drug varieties, with high THC content, from the non-drug hemp varieties. The biologically active terpenoids have not been included in these approaches. For a clearer understanding of the medicinal properties of the Cannabis plant, a better classification system, based on a range of potentially active constituents, is needed. The cannabinoids and terpenoids, present in high concentrations in Cannabis flowers, are the main candidates. In this study, we compared cultivars obtained from multiple sources. Based on the analysis of 28 major compounds present in these samples, followed by principal component analysis (PCA) of the quantitative data, we were able to identify the Cannabis constituents that defined the samples into distinct chemovar groups. The study indicates the usefulness of a PCA approach for chemotaxonomic classification of Cannabis varieties.
Cervený, J.; van Ours, J.C.; Chomynova, Pavla; Mravcik, Viktor
This paper examines the effect of a change in drugs policy on the age of onset of cannabis use. We use 2012 survey data from the Czech Republic where in 2010 a law was introduced decriminalizing personal possession of small quantities of several illicit drugs, including cannabis. We estimate the eff
Palali, A.; van Ours, J.C.
In the Netherlands, cannabis use is quasi-legalized. Small quantities of cannabis can be bought in cannabis shops. We investigate how the distance to the nearest cannabis shop affects the age of onset of cannabis use. We use a mixed proportional hazard rate framework to take account of observable as
Palali, A.; van Ours, J.C.
Abstract: In the Netherlands cannabis use is quasi-legalized. Small quantities of cannabis can be bought in cannabis-shops. We investigate how the distance to the nearest cannabis- shop affects the age of onset of cannabis use. We use a Mixed Proportional Hazard rate framework to take account of obs
Aims: To investigate the links between the visibility of cannabis use in school (measured by teachers' reports of students being under the influence of cannabis on school premises), the proportion of cannabis users in the class, perceived availability of cannabis, as well as adolescent cannabis use. Methods: A multilevel regression model was…
Aims - To investigate the links between the visibility of cannabis use in school (measured by teachers’ reports of students being under the influence of cannabis on school premises), the proportion of cannabis users in the class, perceived availability of cannabis, as well as adolescent cannabis use
Ramaekers, J.G.; Wel, J.H. van; Spronk, D.B.; Toennes, S.W.; Kuypers, K.P.; Theunissen, E.L.; Verkes, R.J.
Cannabis use history as predictor of neurocognitive response to cannabis intoxication remains subject to scientific and policy debates. The present study assessed the influence of cannabis on neurocognition in cannabis users whose cannabis use history ranged from infrequent to daily use. Drug users
van Ours, J.C.; Williams, J.
This paper investigates whether cannabis use leads to worse mental health. To do so, we account for common unobserved factors affecting mental health and cannabis consumption by modeling mental health jointly with the dynamics of cannabis use. Our main finding is that using cannabis increases the li
Underner, M; Urban, T; Perriot, J; de Chazeron, I; Meurice, J-C
Cannabis is the most commonly smoked illicit substance in the world. It can be smoked alone in plant form (marijuana) but it is mainly smoked mixed with tobacco. The combined smoking of cannabis and tobacco is a common-place phenomenon in our society. However, its use is responsible for severe pulmonary consequences. The specific impact of smoking cannabis is difficult to assess precisely and to distinguish from the effect of tobacco. Marijuana smoke contains polycyclic aromatic hydrocarbons and carcinogens at higher concentration than tobacco smoke. Cellular, tissue, animal and human studies, and also epidemiological studies, show that marijuana smoke is a risk factor for lung cancer. Cannabis exposure doubles the risk of developing lung cancer. This should encourage clinicians to identify cannabis use and to offer patients support in quitting.
Rachel Melissa Burns
Full Text Available Collecting information about the prevalence of cannabis use is necessary but not sufficient for understanding the size, dynamics, and outcomes associated with cannabis markets. This paper uses two data sets describing cannabis consumption in the United States and Europe to highlight 1 differences in inferences about sub-populations based on the measure used to quantify cannabis-related activity; 2 how different measures of cannabis-related activity can be used to more accurately describe trends in cannabis usage over time; and 3 the correlation between frequency of use in the past month and average grams consumed per day. Key findings: Focusing on days of use instead of prevalence shows substantially greater increases in U.S. cannabis use in recent years; however, the recent increase is mostly among adults, not youth. Relatively more rapid growth in use days also occurred among the college-educated and Hispanic. Further, data from a survey conducted in several European countries show a strong positive correlation between frequency of use and quantity consumed per day of use, suggesting consumption is even more skewed toward the minority of heavy users than is suggested by days-of-use calculations.
The aim of the present study was to investigate the stability of cannabinoids in cannabis resin slabs and cannabis extracts upon long-term storage. The levels of tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD) and cannabigerol (CBG) on both neutral and acidic form were measured...... stored in extracted form at room temperature the degradation rate of acidic THC increased significantly relative to resin material with concentration halve-lives of 35 and 91 days in daylight and darkness, respectively. Once cannabis material is extracted into organic solvents, care should be taken...
Anthony, James C.; Lopez-Quintero, Catalina; Alshaarawy, Omayma
Background Globally, the most widely used set of compounds among the internationally regulated drugs is cannabis. Objective To review evidence from epidemiological research on cannabis, organized in relation to this field’s five main rubrics: quantity, location, causes, mechanisms, and prevention/control. Method The review covers a selection of evidence from standardized population surveys, official statistics, and governmental reports, as well as published articles and books identified via MEDLINE, Web of Science, and Google Scholar as of July 2016. Results In relation to quantity, an estimated 3% to 5% of the world population is thought to have tried a cannabis product, with at least one fairly recent use, mainly extra-medical and outside boundaries of prescribed use. Among cannabis users in the United States, roughly one in 7–8 has engaged in medical marijuana use. In relation to location, prevalence proportions reveal important variations across countries and between subgroups within countries. Regarding causes and mechanisms of starting to use cannabis, there is no compelling integrative and replicable conceptual model or theoretical formulation. Most studies of mechanisms have focused upon a ‘gateway sequence’ and person-to-person diffusion, with some recent work on disability-adjusted life years. A brief review of cannabis use consequences, as well as prevention and control strategies is also provided. Conclusion At present, we know much about the frequency and occurrence of cannabis use, with too little replicable definitive evidence with respect to the other main rubrics. Given a changing regulatory environment for cannabis products, new institutions such as an independent International Cannabis Products Safety Commission may be required to produce evidence required to weigh benefits versus costs. It is not clear that government sponsored research will be sufficient to meet consumer demand for balanced points of view and truly definitive evidence
Mather, Laurence E; Rauwendaal, Evert R; Moxham-Hall, Vivienne L; Wodak, Alex D
• After considering extensive scientific and medical evidence, a New South Wales Legislative Council multiparty committee recommended that medicinal cannabis should lawfully be made available for selected-use pharmacotherapy. • The evidence indicates that cannabis has genuine medicinal utility in patients with certain neuropathic conditions, with acceptable levels of risk from mostly mild side effects. • The potential medical benefits of cannabis pharmacotherapy have largely been overlooked, with research and society's attention, in most parts of the world, being directed towards the hazards of its recreational use. • The NSW Government has since dismissed the unanimous and compassionate recommendations of their committee.
Ammerman, Seth; Tau, Gregory
The use of cannabis for both legal (similar to alcohol) and medical purposes is becoming more common. Although cannabis remains an illegal Schedule 1 drug federally, as of November 2015, 23 states and the District of Columbia have legalized "medical" cannabis, and 4 states and the District of Columbia have legalized the use of cannabis for adults aged 21 years and older. It is very likely that more and more states will sooner rather than later allow cannabis for both medical and legal purposes. This review article will focus on a variety of issues relevant to the current debate about cannabis, and will address the following.
Feeney, Mistianne; Punja, Zamir K
Hemp (Cannabis sativa L.) suspension culture cells were transformed with Agrobacterium tumefaciens strain EHA101 carrying the binary plasmid pNOV3635. The plasmid contains a phosphomannose isomerase (PMI) selectable marker gene. Cells transformed with PMI are capable of metabolizing the selective agent mannose, whereas cells not expressing the gene are incapable of using the carbon source and will stop growing. Callus masses proliferating on selection medium were screened for PMI expression using a chlorophenol red assay. Genomic DNA was extracted from putatively transformed callus lines, and the presence of the PMI gene was confirmed using PCR and Southern hybridization. Using this method, an average transformation frequency of 31.23% ± 0.14 was obtained for all transformation experiments, with a range of 15.1-55.3%.
Clinical research regarding the therapeutic benefits of cannabis (“marijuana”) has been almost non-existent in the United States since cannabis was given Schedule I status in the Controlled Substances Act of 1970. In order to discover the benefits and adverse effects perceived by medical cannabis patients, especially with regards to chronic pain, we hand-delivered surveys to one hundred consecutive patients who were returning for yearly re-certification for medical cannabis use in Hawai‘i.
Griffith-Lendering, Merel Frederique Heleen
During early adolescence, there is no association between internalizing behaviour and cannabis use. There is an association between externalizing behaviour and cannabis use, where externalizing behaviour precedes cannabis use rather than the other way around. Secondly, during adolescence, there is a
SZNITMAN, SHARON R.; Bretteville-Jensen, Anne Line
Background Debate about medical cannabis legalization are typically informed by three beliefs: (1) cannabis has medical effects, (2) medical cannabis is addictive and (3) medical cannabis legalization leads to increased used of cannabis for recreational purposes (spillover effects). We examined how strongly these beliefs are associated with public support for medical cannabis legalization and whether this association differs across divergent medical cannabis policy regimes. Methods Robust reg...
Newton-Howes, Giles; McBride, Sam
There has been increased interest in cannabis as a medicine both nationally and internationally. Internationally, cannabis is accepted as a medication for a variety of purposes in a variety of legal guises and this, associated with anecdotes of the utility of cannabis as medication has led for calls for it to be 'medicalised' in New Zealand. This viewpoint discusses the issues associated with this approach to accessing cannabis and some of the difficulties that may be associated with it. It is important doctors are at the forefront of the debate surrounding medicalised cannabis. Recommendations as to the ongoing debate are offered.
Law, B.; Mason, P.A.; Moffat, A.C.; King, L.J.; Marks, V.
Six volunteers each smoked simultaneously, in a small unventilated room (volume 27 950 liter), a cannabis cigarette containing 17.1 mg delta 9-tetrahydrocannabinol (THC). A further four subjects - passive inhalers - remained in the room during smoking and afterwards for a total of 3 h. Blood and urine samples were taken from all ten subjects and analyzed by radioimmunoassay for THC metabolites. The blood samples from the passive subjects taken up to 3 h after the start of exposure to cannabis smoke showed a complete absence of cannabinoids. In contrast, their urine samples taken up to 6 h after exposure showed significant concentrations of cannabinoid metabolites (less than or equal to 6.8 ng ml-1). These data, taken with the results of other workers, show passive inhalation of cannabis smoke to be possible. These results have important implications for forensic toxicologists who are frequently called upon to interpret cannabinoid levels in body fluids.
Lubman, Dan I; Cheetham, Ali; Yücel, Murat
Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.
Maickel, Roger P.
A detailed discussion of marihuana (Cannabis sativa) providing the modes of use, history, chemistry, and physiologic properties of the drug. Cites research results relating to the pharmacologic effects of marihuana. These effects are categorized into five areas: behavioral, cardiovascular-respiratory, central nervous system, toxicity-toxicology,…
Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol - the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts.
... Use and Social Anxiety Study Parses Comorbidity of Cannabis Use and Social Anxiety Email Facebook Twitter October ... difficulties and other cannabis-related problems. SAD and Cannabis Use Severity Further analysis suggested that people with ...
Milin, Robert; Manion, Ian; Dare, Glenda; Walker, Selena
A study to identify and assess the withdrawal symptoms in adolescents afflicted with cannabis dependence is conducted. Results conclude that withdrawal symptoms of cannabis were present in adolescents seeking treatment for this substance abuse.
Ruchlemer, Rosa; Amit-Kohn, Michal; Raveh, David; Hanuš, Lumír
Medicinal cannabis is an invaluable adjunct therapy for pain relief, nausea, anorexia, and mood modification in cancer patients and is available as cookies or cakes, as sublingual drops, as a vaporized mist, or for smoking. However, as with every herb, various microorganisms are carried on its leaves and flowers which when inhaled could expose the user, in particular immunocompromised patients, to the risk of opportunistic lung infections, primarily from inhaled molds. The objective of this study was to identify the safest way of using medicinal cannabis in immunosuppressed patients by finding the optimal method of sterilization with minimal loss of activity of cannabis. We describe the results of culturing the cannabis herb, three methods of sterilization, and the measured loss of a main cannabinoid compound activity. Systematic sterilization of medicinal cannabis can eliminate the risk of fatal opportunistic infections associated with cannabis among patients at risk.
Shrivastava, Amresh; Johnston, Megan; Terpstra, Kristen; Bureau, Yves
Cannabis has been implicated as a risk factor for the development of schizophrenia, but the exact biological mechanisms remain unclear. In this review, we attempt to understand the neurobiological pathways that link cannabis use to schizophrenia. This has been an area of great debate; despite similarities between cannabis users and schizophrenia patients, the evidence is not sufficient to establish cause-and-effect. There have been advances in the understanding of the mechanisms of cannabis dependence as well as the role of the cannabinoid system in the development of psychosis and schizophrenia. The neurobiological mechanisms associated with the development of psychosis and effects from cannabis use may be similar but remain elusive. In order to better understand these associations, this paper will show common neurobiological and neuroanatomical changes as well as common cognitive dysfunction in cannabis users and patients of schizophrenia. We conclude that epidemiologic evidence highlights potential causal links; however, neurobiological evidence for causality remains weak.
Jansson, Mari; Tally, Molly
The aim of this study was to examine young adult cannabis users’ attitudes towards cannabis and their perception of the normalization of cannabis. The purpose was also to explore how their views of cannabis correspond with norms regarding cannabis. This study is based on interviews with five young adult cannabis users. The theoretical framework is based on Parker’s normalization thesis, Goffman’s notion of stigma, Becker’s definition of outsiders and the definition of social identity develope...
Webb, Charles W; Webb, Sandra M
Clinical research regarding the therapeutic benefits of cannabis ("marijuana") has been almost non-existent in the United States since cannabis was given Schedule I status in the Controlled Substances Act of 1970. In order to discover the benefits and adverse effects perceived by medical cannabis patients, especially with regards to chronic pain, we hand-delivered surveys to one hundred consecutive patients who were returning for yearly re-certification for medical cannabis use in Hawai'i. The response rate was 94%. Mean and median ages were 49.3 and 51 years respectively. Ninety-seven per cent of respondents used cannabis primarily for chronic pain. Average pain improvement on a 0-10 pain scale was 5.0 (from 7.8 to 2.8), which translates to a 64% relative decrease in average pain. Half of all respondents also noted relief from stress/anxiety, and nearly half (45%) reported relief from insomnia. Most patients (71%) reported no adverse effects, while 6% reported a cough or throat irritation and 5% feared arrest even though medical cannabis is legal in Hawai'i. No serious adverse effects were reported. These results suggest that Cannabis is an extremely safe and effective medication for many chronic pain patients. Cannabis appears to alleviate pain, insomnia, and may be helpful in relieving anxiety. Cannabis has shown extreme promise in the treatment of numerous medical problems and deserves to be released from the current Schedule I federal prohibition against research and prescription.
Underner, M; Urban, T; Perriot, J; Peiffer, G; Meurice, J-C
Cannabis is the most commonly smoked illicit substance in many countries including France. It can be smoked alone in plant form (marijuana) but in our country it is mainly smoked in the form of cannabis resin mixed with tobacco. The technique of inhaling cannabis differs from that of tobacco, increasing the time that the smoke spends in contact with the bronchial mucosal and its impact on respiratory function. One cigarette composed of cannabis and tobacco is much more harmful than a cigarette containing only tobacco. In cannabis smokers there is an increased incidence of respiratory symptoms and episodes of acute bronchitis. Cannabis produces a rapid bronchodilator effect; chronic use provokes a reduction in specific conductance and increase in airways resistance. Studies on the decline of Forced Expiratory Volume are discordant. Cannabis smoke and tetrahydrocannabinol irritate the bronchial tree. They bring about histological signs of airways inflammation and alter the fungicidal and antibacterial activity of alveolar macrophages. Inhalation of cannabis smoke is a risk factor for lung cancer. Stopping smoking cannabis will bring about important benefits for lung function. This should encourage clinicians to offer patients support in quitting smoking.
Alexander, Stephen P H
In this review, I will consider the dual nature of Cannabis and cannabinoids. The duality arises from the potential and actuality of cannabinoids in the laboratory and clinic and the 'abuse' of Cannabis outside the clinic. The therapeutic areas currently best associated with exploitation of Cannabis-related medicines include pain, epilepsy, feeding disorders, multiple sclerosis and glaucoma. As with every other medicinal drug of course, the 'trick' will be to maximise the benefit and minimise the cost. After millennia of proximity and exploitation of the Cannabis plant, we are still playing catch up with an understanding of its potential influence for medicinal benefit.
Carter, Gregory T; Weydt, Patrick; Kyashna-Tocha, Muraco; Abrams, Donald I
The medicinal value of cannabis (marijuana) is well documented in the medical literature. Cannabinoids, the active ingredients in cannabis, have many distinct pharmacological properties. These include analgesic, anti-emetic, anti-oxidative, neuroprotective and anti-inflammatory activity, as well as modulation of glial cells and tumor growth regulation. Concurrent with all these advances in the understanding of the physiological and pharmacological mechanisms of cannabis, there is a strong need for developing rational guidelines for dosing. This paper will review the known chemistry and pharmacology of cannabis and, on that basis, discuss rational guidelines for dosing.
Tian, Y.; Zhang, F.; Jia, K.; Wen, M.; Yuan, Ch.
Cannabis is an economically important plant that is used in many fields, in addition to being the most commonly consumed illicit drug worldwide. Monitoring the spatial distribution of cannabis cultivation and judging whether it is drug- or fiber-type cannabis is critical for governments and international communities to understand the scale of the illegal drug trade. The aim of this study was to investigate whether the cannabinoids content in cannabis could be spectrally quantified using a spectrometer and to identify the optimal wavebands for quantifying the cannabinoid content. Spectral reflectance data of dried cannabis leaf samples and the cannabis canopy were measured in the laboratory and in the field, respectively. Correlation analysis and the stepwise multivariate regression method were used to select the optimal wavebands for cannabinoid content quantification based on the laboratory-measured spectral data. The results indicated that the delta-9-tetrahydrocannabinol (THC) content in cannabis leaves could be quantified using laboratory-measured spectral reflectance data and that the 695 nm band is the optimal band for THC content quantification. This study provides prerequisite information for designing spectral equipment to enable immediate quantification of THC content in cannabis and to discriminate drug- from fiber-type cannabis based on THC content quantification in the field.
Reisfield, Gary M
Fourteen states and the District of Columbia have legalized the use of cannabis for medical purposes. A small, high-quality literature supports the efficacy of medical cannabis for the treatment of neuropathic pain. The smoked botanical product, however, is associated with a number of adverse medical and psychiatric consequences. Furthermore, experimental data indicate that acute use of cannabis results in impairment of every important metric related to the safe operation of a motor vehicle. Epidemiological data show associations between recent cannabis use and both psychomotor impairment and motor vehicle crashes, associations that are strengthened by the concomitant use of alcohol and other central nervous system depressants. Finally, data from pain clinics reveals an unusually high prevalence of cannabis use in nearly all age groups and an association between cannabis use and opioid and other substance misuse. Based on available data and expert opinion, concomitant use of cannabis and opioids is an absolute contraindication to the operation of a motor vehicle. In patients who use cannabis and are prescribed opioids, heightened vigilance for opioid- and other substance-related problems is warranted. It is appropriate to refrain from prescribing opioids to individuals using medical cannabis if there is reasonable suspicion that the combination will pose a risk to the patient or others.
Full Text Available People with schizophrenia frequently report cannabis use, and cannabis may be a risk factor for schizophrenia, mediated through effects on brain function and biochemistry. Thus, it is conceivable that cannabis may also influence cognitive functioning in this patients group. We report data from our own laboratory on the use of cannabis by schizophrenia patients, and review the existing literature on the effects of cannabis on cognition in schizophrenia and related psychosis. Of the 23 studies that were found, 14 reported that the cannabis users had better cognitive performance than the schizophrenia non-users. Eight studies reported no or minimal differences in cognitive performance in the two groups, but only one study reported better cognitive performance in the schizophrenia non-user group. Our own results confirm the overall impression from the literature review of better cognitive performance in the cannabis user group. These paradoxical findings may have several explanations, which are discussed. We suggest that cannabis causes a transient cognitive breakdown enabling the development of psychosis, imitating the typical cognitive vulnerability seen in schizophrenia. This is further supported by an earlier age of onset and fewer neurological soft signs in the cannabis-related schizophrenia group, suggesting an alternative pathway to psychosis.
Troutt, William D; DiDonato, Matthew D
Many advances have been made toward understanding the benefits of medical cannabis. However, less is known about medical cannabis patients themselves. Prior research has uncovered many important patient characteristics, but most of that work has been conducted with participants in California, who may not represent medical cannabis patients throughout the United States. Furthermore, it is unknown if medical cannabis legalization, which typically imposes strict regulations on cannabis cultivation and sale, impacts patients' experiences acquiring and using cannabis. The goal of this study was to address these limitations by (1) examining the characteristics, perceptions, and behaviors of medical cannabis patients in Arizona; and (2) questioning participants with a history of cannabis use regarding their experiences with cannabis before and after legalization. Patients in Arizona share many characteristics with those in California, but also key differences, such as average age and degree of cannabis consumption. Participants also had positive perceptions of the effect of medical cannabis legalization, reporting that feelings of safety and awareness were higher after legalization compared to before. The results are discussed in relation to evidence from patients in other states and in terms of their potential policy implications.
Lorenzetti, V.; Cousijn, J.; Preedy, V.R.
Cannabis use disorders (CUDs) affect 13.1. million individuals worldwide and represent the most vulnerable portion of regular cannabis users. Neuroanatomical alterations in the brain may mediate the adverse outcomes of CUDs. We reviewed findings from 16 structural neuroimaging studies of gray matter
Hjorthøj, Carsten; Nordentoft, Merete; Fink-Jensen, Anders
Abuse of alcohol and drugs often co-occur with psychotic disorders. In this article, we introduce to the reader a number of receptors and neurotransmitter-systems involved in cannabis-abuse. Subsequently, we introduce the connection between abuse - particularly cannabis-abuse - and psychotic...
van der Pol, P.M.
Young adults who often smoke cannabis are at higher risk of dependence, but most do not become dependent. This thesis examined the question: Which frequent cannabis users are/become/stay dependent, and seek treatment, and which do not? It was answered with a three-year prospective cohort of 600 youn
Hjorthoj, C.; Nordentoft, M.; Fink-Jensen, A.
Abuse of alcohol and drugs often co-occur with psychotic disorders. In this article, we introduce to the reader a number of receptors and neurotransmitter-systems involved in cannabis-abuse. Subsequently, we introduce the connection between abuse - particularly cannabis-abuse - and psychotic...
After its re-introduction in the 1960s, cannabis has become the most widely used illicit drug in Europe. Along with the spread of cannabis use, its social meaning has changed over time. Today old paradigms are having renewed appeal, in particular on the subject of cannabis and schizophrenia. Cannabi
Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele
This study evaluated the quality of Web-based information on cannabis use and addiction and investigated particular content quality indicators. Three keywords ("cannabis addiction," "cannabis dependence," and "cannabis abuse") were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed…
Gage, Suzanne H; Hickman, Matthew; Zammit, Stanley
Associations between cannabis use and psychotic outcomes are consistently reported, but establishing causality from observational designs can be problematic. We review the evidence from longitudinal studies that have examined this relationship and discuss the epidemiologic evidence for and against interpreting the findings as causal. We also review the evidence identifying groups at particularly high risk of developing psychosis from using cannabis. Overall, evidence from epidemiologic studies provides strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders. However, further studies are required to determine the magnitude of this effect, to determine the effect of different strains of cannabis on risk, and to identify high-risk groups particularly susceptible to the effects of cannabis on psychosis. We also discuss complementary epidemiologic methods that can help address these questions.
Santos, Rui Pedro; Resende, Cristina Isabel Pinho; Vieira, Ana Paula; Brito, Celeste
Cannabis arteritis (CA) is a major and underdiagnosed cause of peripheral arterial disease in young patients. A 34-year-old man, daily smoker of 20 cigarettes and two cannabis cigarettes for 14 years, presented with a necrotic plaque of left hallux for 3 weeks. The Doppler ultrasound and angiography were compatible with severe Buerger's disease. Submitted to a revascularisation procedure and hypocoagulation with rivaroxaban. He had ceased smoking but maintained consumption of cannabis. Owing to the persistence of distal necrosis, amputation of the hallux was performed with good evolution. CA is a subtype of Buerger's disease. It is poorly known but increasingly prevalent and manifests in cannabis users regardless of tobacco use. The drug is considered at least a cofactor of the arteriopathy. The most effective treatment is cessation of consumption. Being cannabis one of the most consumed drugs, its mandatory to ask about its use in all young patients with arteriopathy.
Cannabis is popularly believed to be a relatively benign substance. Cannabis is also considered to have potential medical benefits, and medical marijuana has been legislated in many parts of the world. However, a recent meta-analysis found that cannabinoids were associated with only modest benefits for chemotherapy-related nausea and vomiting, small and inconsistent benefits for pain and spasticity, and inconclusive benefits for other indications such as improvement of appetite and weight, reduction in tic severity, and improvement of mood or sleep. On the flip side, cannabinoids and cannabis have acute and long-term adverse effects. In randomized controlled trials, cannabinoids increase the risk of total adverse events, serious adverse events, and dropout due to adverse events. Cannabis impairs cognition, and driving after cannabis use is associated with an increased risk of traffic accidents, including fatal accidents. Long-term cannabis use may lead to dependence, respiratory conditions, psychosis, and possibly cancer, as well. Cannabis use during pregnancy may compromise certain pregnancy outcomes such as fetal growth, and use during adolescence may compromise neurodevelopment, social adjustment, and vocational success. The composition and bioavailability of cannabis vary across preparations of the substance and routes of administration; this limits the ability to generalize the findings of studies. The findings of older research may no longer apply to current strains of cannabis that are higher in psychotogenic content. It is important for medical professionals and the lay public to understand the limitations of the efficacy data and the seriousness of the risks associated with cannabis use in medical and recreational contexts.
Haney, Margaret; Ramesh, Divya; Glass, Andrew; Pavlicova, Martina; Bedi, Gillinder; Cooper, Ziva D
Given that cannabis use is increasing in the United States, pharmacological treatment options to treat cannabis use disorder are needed. Opioid antagonists modulate cannabinoid effects and may offer a potential approach to reducing cannabis use. In this double-blind, placebo-controlled human laboratory study, we assessed the effects of naltrexone maintenance on the reinforcing, subjective, psychomotor, and cardiovascular effects of active and inactive cannabis. Nontreatment-seeking, daily cannabis smokers were randomized to receive naltrexone (50 mg: n=18 M and 5 F) or placebo (0 mg; n=26 M and 2 F) capsules for 16 days. Before, during, and after medication maintenance, participants completed 10 laboratory sessions over 4-6 weeks, assessing cannabis' behavioral and cardiovascular effects. Medication compliance was verified by observed capsule administration, plasma naltrexone, and urinary riboflavin. Relative to placebo, maintenance on naltrexone significantly reduced both active cannabis self-administration and its positive subjective effects ('good effect'). Participants in the placebo group had 7.6 times (95% CI: 1.1-51.8) the odds of self-administering active cannabis compared with the naltrexone group. This attenuation of reinforcing and positive subjective effects also influenced cannabis use in the natural ecology. Naltrexone had intrinsic effects: decreasing ratings of friendliness, food intake, and systolic blood pressure, and increasing spontaneous reports of stomach upset and headache, yet dropout rates were comparable between groups. In summary, we show for the first time that maintenance on naltrexone decreased cannabis self-administration and ratings of 'good effect' in nontreatment-seeking daily cannabis smokers. Clinical studies in patients motivated to reduce their cannabis use are warranted to evaluate naltrexone's efficacy as a treatment for cannabis use disorder.
Budney, Alan J.; Sargent, James D.; Lee, Dustin C.
The proliferation of vaporization (‘vaping’) as a method for administering cannabis raises many of the same public health issues being debated and investigated in relation to e-cigarettes (e-cigs). Good epidemiological data on the prevalence of vaping cannabis are not yet available, but with current trends towards societal approval of medicinal and recreational use of cannabis, the pros and cons of vaping cannabis warrant study. As with e-cigs, vaping cannabis portends putative health benefit...
Russo, Ethan B.
This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain. PMID:27683558
Hollister, Leo E.
Literature pertaining to the effects of cannabis use and health which has been published during the past 11 years has been reviewed. Many older concerns about adverse effects on health (chromosomal damage, 'cannabinol psychosis', endocrine abnormalities, cardiac events, impaired immunity) no longer seem to elicit much interest. Continuing concerns about the adverse cognitive effects of chronic use indicate that these can be demonstrated by proper testing; some studies suggest that they may be long-lasting. Although cannabis does not produce a specific psychosis, the possibility exists that it may exacerbate schizophrenia in persons predisposed to that disorder. However, evidence from retrospective surveys must always be questioned. Tolerance and dependence have occurred in man, confirming previous findings in many other species. Addiction tends to be mild and is probably less severe than with other social drugs. Driving under the influence of cannabis is impaired acutely; how long such impairments last is still unknown. More exacting tasks, such as flying an airplane, may be impaired for as long as 24 hours. While there is no doubt that marijuana smoke contains carcinogens, an increase in cancer among users has thus far been anecdotal. Because of the long latent period between cancer induction and initiation of cigarette smoking, the full story is yet to be told. Marijuana use during pregnancy is not advised although the consequences are usually not greater than those of smoking cigarettes, and far less than those from alcohol use. Whether smoked marijuana should become a therapeutic agent requires a cost-benefit analysis of the potential benefits versus the adverse effects of such use as we now know them.
Palermo, Liana; Bianchini, Filippo; Iaria, Giuseppe; Tanzilli, Antonio; Guariglia, Cecilia
The long-term effects of cannabis on human cognition are still unclear, but, considering that cannabis is a widely used substance and, overall, its potential use in therapeutic interventions, it is important to evaluate them. We hypothesize that the discrepancies among studies could be attributed to the specific cognitive function investigated and that skills subserved by the hippocampus, such as the spatial orientation abilities and, specifically, the ability to form and use cognitive maps, should be more compromised than others. Indeed it has been showed that cannabis users have a reduced hippocampus and that the hippocampus is the brain region in which cannabis has the greatest effect since it contains the highest concentration of cannabinoid receptors. To test this hypothesis we asked 15 heavy cannabis users and 19 nonusers to perform a virtual navigational test, the CMT, that assesses the ability to form and use cognitive maps. We found that using cannabis has no effect on these hippocampus-dependent orientation skills. We discuss the implications of our findings and how they relate to evidence reported in the literature that the intervention of functional reorganization mechanisms in cannabis user allows them to cope with the cognitive demands of navigational tasks. PMID:22272167
Abrams, D I
Cannabis species have been used as medicine for thousands of years; only since the 1940s has the plant not been widely available for medical use. However, an increasing number of jurisdictions are making it possible for patients to obtain the botanical for medicinal use. For the cancer patient, cannabis has a number of potential benefits, especially in the management of symptoms. Cannabis is useful in combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available antiemetics, but for some patients, it is the only agent that works, and it is the only antiemetic that also increases appetite. Inhaled cannabis is more effective than placebo in ameliorating peripheral neuropathy in a number of conditions, and it could prove useful in chemotherapy-induced neuropathy. A pharmacokinetic interaction study of vaporized cannabis in patients with chronic pain on stable doses of sustained-release opioids demonstrated no clinically significant change in plasma opiates, while suggesting the possibility of synergistic analgesia. Aside from symptom management, an increasing body of in vitro and animal-model studies supports a possible direct anticancer effect of cannabinoids by way of a number of different mechanisms involving apoptosis, angiogenesis, and inhibition of metastasis. Despite an absence of clinical trials, abundant anecdotal reports that describe patients having remarkable responses to cannabis as an anticancer agent, especially when taken as a high-potency orally ingested concentrate, are circulating. Human studies should be conducted to address critical questions related to the foregoing effects.
Solymosi, Katalin; Köfalvi, Attila
Cannabis is one of the earliest cultivated plants. Cannabis of industrial utility and culinary value is generally termed as hemp. Conversely, cannabis that is bred for medical, spiritual and recreational purposes is called marijuana. The female marijuana plant produces a significant quantity of bio- and psychoactive phytocannabinoids, which regained the spotlight with the discovery of the endocannabinoid system of the animals in the early 90's. Nevertheless, marijuana is surrounded by controversies, debates and misconceptions related to its taxonomic classification, forensic identification, medical potential, legalization and its long-term health consequences. In the first part, we provide an in-depth review of the botany and taxonomy of Cannabis. We then overview the biosynthesis of phytocannabinoids within the glandular trichomes with emphasis on the role of peculiar plastids in the production of the secreted material. We also compile the analytical methods used to determine the phytocannabinoid composition of glandular trichomes. In the second part, we revisit the psychobiology and molecular medicine of marijuana. We summarize our current knowledge on the recreational use of cannabis with respect to the modes of consumption, short-term effects, chronic health consequences and cannabis use disorder. Next, we overview the molecular targets of a dozen major and minor bioactive cannabinoids in the body. This helps us introduce the endocannabinoid system in an unprecedented detail: its up-to-date molecular biology, pharmacology, physiology and medical significance, and beyond. In conclusion, we offer an unbiased survey about cannabis to help better weigh its medical value versus the associated risks.
Henry, Erika A.; Kaye, Jesse. T.; Bryan, Angela D.; Hutchison, Kent E.; Ito, Tiffany A.
Substance cue reactivity is theorized as having a significant role in addiction processes, promoting compulsive patterns of drug-seeking and drug-taking behavior. However, research extending this phenomenon to cannabis has been limited. To that end, the goal of the current work was to examine the relationship between cannabis cue reactivity and craving in a sample of 353 participants varying in self-reported cannabis use. Participants completed a visual oddball task whereby neutral, exercise,...
Wendy Swift; Alex Wong; Li, Kong M.; Arnold, Jonathon C.; McGregor, Iain S.
Recent analysis of the cannabinoid content of cannabis plants suggests a shift towards use of high potency plant material with high levels of Δ(9)-tetrahydrocannabinol (THC) and low levels of other phytocannabinoids, particularly cannabidiol (CBD). Use of this type of cannabis is thought by some to predispose to greater adverse outcomes on mental health and fewer therapeutic benefits. Australia has one of the highest per capita rates of cannabis use in the world yet there has been no previous...
Kastorp, Grith; Lindholst, Christian
Abstract. 180 seizures containing 667 different samples of cannabis products from 5 police districts in Jutland were examined from 2008 to the present. The samples were divided into the groups: hashish, marihuana (leaves and buds) and whole plants (indoors and outdoors). Cannabis seized from indoor...... cultivation was examined in order to determine THC content and yield. The results are used by the Danish Police Attorney to estimate expected yields in cases with unripe cannabis plants. The results indicate that the THC content found in locally grown marihuana is slightly higher than in hashish. However...
France holds the record for cannabis use in Europe, especially among adolescents. This drug of abuse is thus mainly used during a very sensitive period of brain development, education, vehicle driving and development of life projects. In addition, synthetic derivatives of tetrahydrocannabinol (THC), which are more noxious than cannabis itself are now appearing on the market. Traficking and cultivation for personnal use have intensified; products proposed for sale are richer in THC; and some methods of consumption (e-cigarettes, vaporizers, water pipes) increase the supply of THC to the lungs and thence to the body and brain. It is in this context that attempts are being made to legalize this drug of abuse. Other attempts are made to disguise it as a medication. Meanwhile, the list of its psychic as well as physical damages grows longer, with some very severe cases of major injuries. This evolution takes place in spite of numerous warnings expressed by the French Academy of Medicine. Subsequently, it is prompted to carefully and vigorously denounce these events. This will be the aim of this thematic session.
Hesse, Morten; Tutenges, Sébastien
Background In most western countries, the most prevalent type of illicit substance-use dependence in most is cannabis dependence. Historically, cannabis has been associated with several music genres, and the drug is widely used at music festivals. Methods Based on a survey of 380 music festival...... guests, we estimated the prevalence of cannabis dependence, as defined by a score of 3 or more on the Severity of Dependence Scale, as well as festival goers' use of cannabis during the past year. Results 143 (38%) reported having used cannabis within the past year (past year cannabis users......), and of these respondents, 21 (15%) screened positive for cannabis dependence. Compared to non-dependent cannabis users, the cannabis dependent respondents were more likely to be daily smokers, they reported having attended fewer music festivals during their lifetime, and they scored higher on self-reported sensation...
Ko, Gordon D.; Bober, Sara L; Mindra, Sean; Moreau, Jason M
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive...
Maloney, William James
The illicit use of the three main forms of cannabis-marijuana, hash, hash oil-pose certain obstacles and challenges to the dental professional. There are a number of systemic, as well as oral/head and neck manifestations, associated with cannabis use. Dentists need to be aware of these manifestations in order to take whatever precautions and/or modifications to the proposed treatment that might be necessary.
Focus Areas: Integrative Approaches to Care, Mental Health, Alleviating Pain Cannabis is now available to patients as a medicine in 18 states and the District of Columbia. Unfortunately, due to the long-standing prohibition, most providers have little information regarding the medicinal use of this versatile botanical. The history of cannabis as medicine will be reviewed. This presentation will summarize the main components of the plant and their pharmacologic effects, highlighting the entour...
Clinical observation suggests that cannabis is implicated in some types of psychiatric disturbance. A record of admissions to two urban and four rural hospitals in Jamaica is examined along with details of individual cases. One-third of male admissions to the psychiatric hospital have used cannabis. Of 74 males admitted to another psychiatric service over a 12-month period, 29 had used cannabis. Ten of these patients were diagnosed as "ganja psychosis," and four others were classified as "marijuana-modified mania." At another psychiatric service, 54 of 223 admissions (24.2%) for functional psychosis presented with cannabis usage as a comtributory factor. These 54 patients included 14 and seven cases of hypomanic and depressive reactions, respectively. At three other rural general hospitals, psychiatric admissions for psychosis showed 11 of 51, seven of 18, and 39 of 75 patients, respectively, in whom cannabis was considered directly responsible. These findings lend support to the idea of causation of illness or modification of existing illness. The negative findings of controlled studies in the same country are not inconsistent. A suggested classification for adverse reactions to cannabis offered by one author is recommended, because it is in accord with common local clinical experience.
Serban Ionela Lacramioara
Full Text Available Schizophrenia and psychotic disorders are major health issues with particular implications for both the individual and the medical system. Epidemiological data show a more frequent consumption of drugs in schizophrenic patients when compared to the general population. Studies have shown that the abuse of substances is the most common comorbidity associated with schizophrenia. Among illicit substances, cannabis is the most commonly encountered among patients with schizophrenia. Similar clinical features of schizophrenia and cannabis consumption could be explained by some common neurobiological implications. N-methyl-D-aspartate (NMDA receptor stimulation is associated with psychotic-type phenomena and schizophrenia and NMDA receptors are involved in the clinical effects of cannabis consumption. Thus, the CB1 receptors that are spread mainly at the level of the NMDA secretory neurons are activated by tetrahydrocannabinol, the psychoactive component of cannabis. Moreover, cannabis abuse in association with other factors may contribute in triggering schizophrenia. Therefore, patients diagnosed with schizophrenia that abuse substances such as cannabis could represent a special category of patients that require a complex therapeutic approach, especially considering the multiple problems implicated, such as reduced compliance with treatment, unfavorable evolution and prognosis with multiple relapses and frequent hospitalizations.
Wetherill, Reagan R.; Hager, Nathan; Jagannathan, Kanchana; Mashhoon, Yasmin; Pater, Heather; Childress, Anna Rose; Franklin, Teresa R.
Addiction theories posit that addiction is the result of a progressive transition from voluntary to habitual, compulsive drug use—changes that have been linked, in animals, to a shift from ventral to dorsal striatal control over drug-seeking behavior. Thus, we hypothesized that early-onset (EOs) cannabis users versus late-onset (LOs) cannabis users might exhibit, respectively, greater dorsal versus ventral striatal response to drug cues. We used functional magnetic resonance imaging and an event-related blood oxygen level-dependent backward-masking task to evaluate striatal responses to backward-masked cannabis cues (vs. neutral cues) in EOs (cannabis use patterns. Direct comparisons revealed that EOs showed greater response to cannabis cues in the dorsal striatum than LOs (p 50 voxels). Within-group analyses revealed that EOs showed greater neural response to cannabis cues in the dorsal striatum, whereas LOs exhibited greater neural response to cannabis cues in the ventral striatum. Although cross-sectional, these findings are consistent with recent addiction theories suggesting a progressive shift from ventral to dorsal striatal control over drug-seeking behavior and highlight the importance of age of onset of cannabis use on the brain and cognition.
N. Dekker; D.H. Linszen; L. de Haan
Background: Cannabis is one of the most commonly used substances in patients with a psychotic disorder and is associated with a higher risk of psychotic relapses. Identifying reasons for cannabis use and subjective effects in patients with psychotic disorders can provide insight into the functions o
McCrystal, Patrick; Winning, Kerry
At the beginning of 2004 the UK government downgraded the legal status of cannabis from a Class B to a Class C drug. Following a review of this decision two years later, cannabis remained a Class C substance--which for some contrasted with the potential harmful social and health effects associated with its use, particularly for young people. These…
van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M.
Background Frequent cannabis users are at high risk of dependence, still most (near) daily users are not dependent. It is unknown why some frequent users develop dependence, whereas others do not. This study aims to identify predictors of first-incidence DSM-IV cannabis dependence in frequent cannab
Van Laar, Margriet; Van Der Pol, Peggy; Niesink, Raymond
The Netherlands has seen an increase in Δ9-tetrahydrocannabinol (THC) concentrations from approximately 8% in the 1990s up to 20% in 2004. Increased cannabis potency may lead to higher THC-exposure and cannabis related harm. The Dutch government officially condones the sale of cannabis from so called 'coffee shops', and the Opium Act distinguishes cannabis as a Schedule II drug with 'acceptable risk' from other drugs with 'unacceptable risk' (Schedule I). Even in 1976, however, cannabis potency was taken into account by distinguishing hemp oil as a Schedule I drug. In 2011, an advisory committee recommended tightening up legislation, leading to a 2013 bill proposing the reclassification of high potency cannabis products with a THC content of 15% or more as a Schedule I drug. The purpose of this measure was twofold: to reduce public health risks and to reduce illegal cultivation and export of cannabis by increasing punishment. This paper focuses on the public health aspects and describes the (explicit and implicit) assumptions underlying this '15% THC measure', as well as to what extent these are supported by scientific research. Based on scientific literature and other sources of information, we conclude that the 15% measure can provide in theory a slight health benefit for specific groups of cannabis users (i.e., frequent users preferring strong cannabis, purchasing from coffee shops, using 'steady quantities' and not changing their smoking behaviour), but certainly not for all cannabis users. These gains should be weighed against the investment in enforcement and the risk of unintended (adverse) effects. Given the many assumptions and uncertainty about the nature and extent of the expected buying and smoking behaviour changes, the measure is a political choice and based on thin evidence.
Full Text Available OBJECTIVE: To provide an overview of the history and pharmacology of cannabis in relation to current scientific knowledge concerning actual and potential therapeutic uses of cannabis preparations and pure cannabinoids.
The research presented in this thesis focused on the effects of cannabis on mental functions and the brain. Specifically, the investigation aimed at exploring how cannabis affects creative thinking, awareness of errors, and the neurotransmitter dopamine among regular cannabis users. It was discovered that cannabis does not improve creativity and that it can decrease error awareness and impair dopaminergic functioning. Consequently, these findings allow for a better understanding of the nature...
Lidia Kotuła; Paulina Sobstyl; Jan Sobstyl; Paulina Chwil; Karol Terlecki; Jolanta Karwat; Paulina Gil-Kulik; Alicja Niedojadło; Janusz Kocki
Medical cannabis is the dried flowers of the female Cannabis sativa L. plant. Cannabis contains a number of active elements, including dronabinol (THC) and cannabidiol (CBD). Dronabinol is usually the main ingredient. The body’s own cannabinoid system has been identified. The discovery of this system, which comprises endocannabinoids and receptors, confirmed that cannabis has a positive effect on certain illnesses and conditions. Two types of cannabinoid receptors have been identified: CB1 an...
Dillon Paul; Gates Peter; Swift Wendy
Abstract Background The New South Wales State Government recently proposed a trial of the medical use of cannabis. Australians who currently use cannabis medicinally do so illegally and without assurances of quality control. Given the dearth of local information on this issue, this study explored the experiences of medical cannabis users. Methods Australian adults who had used cannabis for medical purposes were recruited using media stories. A total of 147 respondents were screened by phone a...
Gartner, Coral E
Legalization of cannabis is likely to lead to greater use. Balanced regulation of potentially less harmful modes of administration, such as vaporizers, is needed. Further research is warranted not only on the direct health effects of vaping cannabis, but also on its potential to decrease co-administration of tobacco with cannabis.
Zarfin, Yehoshua; Yefet, Enav; Abozaid, Said; Nasser, Wael; Mor, Tamer; Finkelstein, Yoram
We report on an infant who was admitted to hospital with severe neurological symptoms following passive inhalation of cannabis. To date, cannabis abuse has been described almost entirely in adolescents and adults. In early childhood, however, cannabis effects were almost exclusively discussed in the context of maternal prenatal exposure, and the…
The research presented in this thesis focused on the effects of cannabis on mental functions and the brain. Specifically, the investigation aimed at exploring how cannabis affects creative thinking, awareness of errors, and the neurotransmitter dopamine among regular cannabis users. It was discovere
van Ours, J.C.
In almost all countries supply, distribution and use of cannabis is prohibited. Nevertheless, cannabis is the most popular illicit drug. Prohibition does not seem to work. The debate on legalization of cannabis is often emotional with strong views of both proponents and opponents but ignorance preva
van Ours, J.C.
This paper uses a dataset collected among inhabitants of Amsterdam, to study whether wages of prime age male workers are affected by the use of cannabis and cocaine.The analysis shows that cocaine use and infrequent cannabis use do not affect wages.Frequent cannabis use has a negative wage effect.Th
Stringer, S; Minică, C C; Verweij, K J H; Mbarek, H; Bernard, M; Derringer, J; van Eijk, K R; Isen, J D; Loukola, A; Maciejewski, Dominique F.; Mihailov, E; van der Most, P J; Sánchez-Mora, C; Roos, L; Sherva, R; Walters, R; Ware, J J; Abdellaoui, A; Bigdeli, T B; Branje, S J T; Brown, S A; Bruinenberg, M; Casas, M; Esko, T; Garcia-Martinez, I; Gordon, S D; Harris, J M; Hartman, C A; Henders, A K; Heath, A C; Hickie, I B; Hickman, M; Hopfer, C J; Hottenga, J J; Huizink, A C; Irons, D E; Kahn, R S; Korhonen, T; Kranzler, H R; Krauter, K; van Lier, P A C; Lubke, G H; Madden, P A F; Mägi, R; McGue, M K; Medland, S E; Meeus, W H J; Miller, M B; Montgomery, G W; Nivard, M G; Nolte, I M; Oldehinkel, A J; Pausova, Z; Qaiser, B; Quaye, L; Ramos-Quiroga, J A; Richarte, V; Rose, R J; Shin, J; Stallings, M C; Stiby, A I; Wall, T L; Wright, M J; Koot, H M; Paus, T; Hewitt, J K; Ribasés, M; Kaprio, J; Boks, M P; Snieder, H; Spector, T; Munafò, M R; Metspalu, A; Gelernter, J; Boomsma, D I; Iacono, W G; Martin, N G; Gillespie, N A; Derks, E M; Vink, J M
Cannabis is the most widely produced and consumed illicit psychoactive substance worldwide. Occasional cannabis use can progress to frequent use, abuse and dependence with all known adverse physical, psychological and social consequences. Individual differences in cannabis initiation are heritable (
Stringer, S.; Minica, C. C.; Verweij, K. J. H.; Mbarek, H.; Bernard, M.; Derringer, J.; van Eijk, K. R.; Isen, J. D.; Loukola, A.; Maciejewski, D. F.; Mihailov, E.; van der Most, P. J.; Sanchez-Mora, C.; Roos, L.; Sherva, R.; Walters, R.; Ware, J. J.; Abdellaoui, A.; Bigdeli, T. B.; Branje, S. J. T.; Brown, S. A.; Bruinenberg, M.; Casas, M.; Esko, T.; Garcia-Martinez, I.; Gordon, S. D.; Harris, J. M.; Hartman, C. A.; Henders, A. K.; Heath, A. C.; Hickie, I. B.; Hickman, M.; Hopfer, C. J.; Hottenga, J. J.; Huizink, A. C.; Irons, D. E.; Kahn, R. S.; Korhonen, T.; Kranzler, H. R.; Krauter, K.; van Lier, P. A. C.; Lubke, G. H.; Madden, P. A. F.; Magi, R.; McGue, M. K.; Medland, S. E.; Meeus, W. H. J.; Miller, M. B.; Montgomery, G. W.; Nivard, M. G.; Nolte, I. M.; Oldehinkel, A. J.; Pausova, Z.; Qaiser, B.; Quaye, L.; Ramos-Quiroga, J. A.; Richarte, V.; Rose, R. J.; Shin, J.; Stallings, M. C.; Stiby, A. I.; Wall, T. L.; Wright, M. J.; Koot, H. M.; Paus, T.; Hewitt, J. K.; Ribases, M.; Kaprio, J.; Boks, M. P.; Snieder, H.; Spector, T.; Munafo, M. R.; Metspalu, A.; Gelernter, J.; Boomsma, D. I.; Iacono, W. G.; Martin, N. G.; Gillespie, N. A.; Derks, E. M.; Vink, J. M.
Cannabis is the most widely produced and consumed illicit psychoactive substance worldwide. Occasional cannabis use can progress to frequent use, abuse and dependence with all known adverse physical, psychological and social consequences. Individual differences in cannabis initiation are heritable (
Full Text Available A potentially powerful predictor for the course of drug (abuse is the approach-bias, that is, the pre-reflective tendency to approach rather than avoid drug-related stimuli. Here we investigated the neural underpinnings of cannabis approach and avoidance tendencies. By elucidating the predictive power of neural approach-bias activations for future cannabis use and problem severity, we aimed at identifying new intervention targets. Using functional Magnetic Resonance Imaging (fMRI, neural approach-bias activations were measured with a Stimulus Response Compatibility task (SRC and compared between 33 heavy cannabis users and 36 matched controls. In addition, associations were examined between approach-bias activations and cannabis use and problem severity at baseline and at six-month follow-up. Approach-bias activations did not differ between heavy cannabis users and controls. However, within the group of heavy cannabis users, a positive relation was observed between total lifetime cannabis use and approach-bias activations in various fronto-limbic areas. Moreover, approach-bias activations in the dorsolateral prefrontal cortex (DLPFC and anterior cingulate cortex (ACC independently predicted cannabis problem severity after six months over and beyond session-induced subjective measures of craving. Higher DLPFC/ACC activity during cannabis approach trials, but lower activity during cannabis avoidance trials were associated with decreases in cannabis problem severity. These findings suggest that cannabis users with deficient control over cannabis action tendencies are more likely to develop cannabis related problems. Moreover, the balance between cannabis approach and avoidance responses in the DLPFC and ACC may help identify individuals at-risk for cannabis use disorders and may be new targets for prevention and treatment.
Hazekamp, Arno; Bastola, Krishna; Rashidi, Hassan; Bender, Johan; Verpoorte, Rob
Cannabis is one of the oldest known medicinal plants, and a large variety of biological activities have been described. The main constituents, the cannabinoids, are thought to be most important for these activities. Although smoking of cannabis is by far the most common way of consumption, a significant part of medicinal users consume it in the form of a tea. However, not much is known about the composition of cannabis tea, or the effect of different parameters during preparation, handling or storage. In this study we used the high-grade cannabis available in Dutch pharmacies to study the cannabinoid composition of tea under standardized and quantitative conditions. Experimental conditions were systematically varied in order to mimic the possible variations made by medicinal users. During analysis there was a specific focus on the cannabinoid tetrahydrocannabinol and its acidic precursor, tetrahydrocannabinolic acid. Also the role of non-psychoactive cannabinoids as components of cannabis tea are discussed. The results obtained in this study provide a clear quantitative insight in the phytochemistry of cannabis tea preparation and can contribute to a better appreciation of this mode of cannabis administration.
The cannabis plant has been known to humanity for centuries as a remedy for pain, diarrhea, and inflammation. Current research has shown cannabis to be a useful remedy for many diseases, including multiple sclerosis, dystonia, and chronic pain. Cannabinoids are used to improve food intake in anorexia of AIDS patients and to prevent vomiting due to cancer chemotherapy. In inflammatory conditions cannabinoids improve pain in rheumatoid arthritis and pain and diarrhea in Crohn's disease. Cannabinoids reduce the size of brain infarct and cardiac reperfusion injury. However, cannabinoid treatment is not free of side effects including euphoria, psychosis, anxiety, paranoia, dependence and abuse. Since the cannabinoid system is involved in many physiological and pathological processes, the therapeutic potential is great. We must not be blind to the opportunity offered to us by medical cannabis just because it is an illicit drug, nor should we be temped by the quick response of patients to the central effect of cannabis. More research is warranted to explore the full potential of cannabis as medicine.
The studies presented in this thesis aimed to identify genetic and non-genetic (epidemiological) factors that shape the association between cannabis use and psychosis. We showed that the age of first use of cannabis is a determinant for the strength of the association between cannabis use and psycho
Full Text Available Recent analysis of the cannabinoid content of cannabis plants suggests a shift towards use of high potency plant material with high levels of Δ(9-tetrahydrocannabinol (THC and low levels of other phytocannabinoids, particularly cannabidiol (CBD. Use of this type of cannabis is thought by some to predispose to greater adverse outcomes on mental health and fewer therapeutic benefits. Australia has one of the highest per capita rates of cannabis use in the world yet there has been no previous systematic analysis of the cannabis being used. In the present study we examined the cannabinoid content of 206 cannabis samples that had been confiscated by police from recreational users holding 15 g of cannabis or less, under the New South Wales "Cannabis Cautioning" scheme. A further 26 "Known Provenance" samples were analysed that had been seized by police from larger indoor or outdoor cultivation sites rather than from street level users. An HPLC method was used to determine the content of 9 cannabinoids: THC, CBD, cannabigerol (CBG, and their plant-based carboxylic acid precursors THC-A, CBD-A and CBG-A, as well as cannabichromene (CBC, cannabinol (CBN and tetrahydrocannabivarin (THC-V. The "Cannabis Cautioning" samples showed high mean THC content (THC+THC-A = 14.88% and low mean CBD content (CBD+CBD-A = 0.14%. A modest level of CBG was detected (CBG+CBG-A = 1.18% and very low levels of CBC, CBN and THC-V (<0.1%. "Known Provenance" samples showed no significant differences in THC content between those seized from indoor versus outdoor cultivation sites. The present analysis echoes trends reported in other countries towards the use of high potency cannabis with very low CBD content. The implications for public health outcomes and harm reduction strategies are discussed.
Braakmann, Nils; Jones, Simon
This paper investigates the link between cannabis depenalisation and crime using individual-level panel data for England and Wales from 2003 to 2006. We exploit the declassification of cannabis in the UK in 2004 as a natural experiment. Specifically, we use the fact that the declassification changed expected punishments differently in various age groups due to thresholds in British criminal law and employ a difference-in-differences type design using data from the longitudinal version of the Offending, Crime and Justice Survey. Our findings suggest essentially no increases in either cannabis consumption, consumption of other drugs, crime and other forms of risky behaviour.
Amirav, Israel; Luder, Anthony; Viner, Yuri; Finkel, Martin
The legalization of cannabis for medicinal purposes is becoming increasingly widespread worldwide. The anticipated growing ease of access to cannabis may create an increased risk for passive and/or active ingestion by children. We report a case of a 1.5-year-old infant who presented with unexplained coma that was later proved to be associated with the ingestion of cannabis. This case highlights the importance of considering cannabis ingestion in the differential diagnosis of infantile and toddler coma and the need for public education regarding the risks of childhood exposure in the light of the legalization of cannabis for medical purposes and its greater availability.
Jonathan K Burns
Full Text Available The nature of the relationship between cannabis use and psychosis is complex and remains unclear. Researchers and clinicians remain divided regarding key issues such as whether or not cannabis is an independent cause of psychosis and schizophrenia. This paper reviews the field in detail, examining questions of causality, the neurobiological basis for such causality and for differential inter-individual risk, the clinical and cognitive features of psychosis in cannabis users, and patterns of course and outcome of psychosis in the context of cannabis use. The author proposes two major pathways from cannabis to psychosis based on a differentiation between early-initiated lifelong cannabis use and a scenario where vulnerable individuals without a lifelong pattern of use consume cannabis over a relatively brief period of time just prior to psychosis onset. Additional key factors determining the clinical and neurobiological manifestation of psychosis as well as course and outcome in cannabis users include: underlying genetic and developmental vulnerability to schizophrenia-spectrum disorders; and whether or not cannabis use ceases or continues after the onset of psychosis. Finally, methodological guidelines are presented for future research aimed at both elucidating the pathways that lead from cannabis to psychosis and clarifying the long-term outcome of the disorder in those who have a history of using cannabis.
Curran, H Valerie; Freeman, Tom P; Mokrysz, Claire; Lewis, David A; Morgan, Celia J A; Parsons, Loren H
In an increasing number of states and countries, cannabis now stands poised to join alcohol and tobacco as a legal drug. Quantifying the relative adverse and beneficial effects of cannabis and its constituent cannabinoids should therefore be prioritized. Whereas newspaper headlines have focused on links between cannabis and psychosis, less attention has been paid to the much more common problem of cannabis addiction. Certain cognitive changes have also been attributed to cannabis use, although their causality and longevity are fiercely debated. Identifying why some individuals are more vulnerable than others to the adverse effects of cannabis is now of paramount importance to public health. Here, we review the current state of knowledge about such vulnerability factors, the variations in types of cannabis, and the relationship between these and cognition and addiction.
Full Text Available While the effects of cannabis use on retrospective memory have been extensively examined, only a limited number of studies have focused on the links between cannabis use and prospective memory. We conducted two studies to examine the links between cannabis use and both time-based and event-based prospective memory as well as potential mechanisms underlying these links. For the first study, 805 students completed an online survey designed to assess cannabis consumption, problems with cannabis use indicative of a disorder, and frequency of experiencing prospective memory failures. The results showed small to moderate sized correlations between cannabis consumption, problems with cannabis use, and prospective memory. However, a series of mediation analyses revealed that correlations between problems with cannabis use and prospective memory were driven by self-reported problems with retrospective memory. For the second study, 48 non-users (who had never used cannabis, 48 experimenters (who had used cannabis five or fewer times in their lives, and 48 chronic users (who had used cannabis at least three times a week for one year were administered three objective prospective memory tests and three self-report measures of prospective memory. The results revealed no objective deficits in prospective memory associated with chronic cannabis use. In contrast, chronic cannabis users reported experiencing more internally-cued prospective memory failures. Subsequent analyses revealed that this effect was driven by self-reported problems with retrospective memory as well as by use of alcohol and other drugs. Although our samples were not fully characterized with respect to variables such as neurological disorders and family history of substance use disorders, leaving open the possibility that these variables may play a role in the detected relationships, the present findings indicate that cannabis use has a modest effect on self-reported problems with
Full Text Available Abstract Background Cannabis is the most commonly used illegal drug and its therapeutic aspects have a growing interest. Short-term psychotic reactions have been described but not clearly with synthetic oral THC, especially in occasional users. Case presentations We report two cases of healthy subjects who were occasional but regular cannabis users without psychiatric history who developed transient psychotic symptoms (depersonalization, paranoid feelings and derealisation following oral administration of cannabis. In contrast to most other case reports where circumstances and blood concentrations are unknown, the two cases reported here happened under experimental conditions with all subjects negative for cannabis, opiates, amphetamines, cocaine, benzodiazepines and alcohol, and therefore the ingested dose, the time-events of effects on behavior and performance as well as the cannabinoid blood levels were documented. Conclusion While the oral route of administration achieves only limited blood concentrations, significant psychotic reactions may occur.
Herrmann, Evan S; Weerts, Elise M; Vandrey, Ryan
Over 300,000 individuals enter treatment for cannabis-use disorders (CUDs) in the United States annually. Cannabis withdrawal is associated with poor CUD-treatment outcomes, but no prior studies have examined sex differences in withdrawal among treatment-seeking cannabis users. Treatment-seeking cannabis users (45 women and 91 men) completed a Marijuana Withdrawal Checklist (Budney, Novy, & Hughes, 1999, Budney, Moore, Vandrey, & Hughes, 2003) at treatment intake to retrospectively characterize withdrawal symptoms experienced during their most recent quit attempt. Scores from the 14-item Composite Withdrawal Discomfort Scale (WDS), a subset of the Marijuana Withdrawal Checklist that corresponds to valid cannabis withdrawal symptoms described in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; APA, 2013) were calculated. Demographic and substance-use characteristics, overall WDS scores, and scores on individual WDS symptoms were compared between women and men. Women had higher overall WDS scores than men, and women had higher scores than men on 6 individual symptoms in 2 domains, mood symptoms (i.e., irritability, restlessness, increased anger, violent outbursts), and gastrointestinal symptoms (i.e., nausea, stomach pain). Follow-up analyses isolating the incidence and severity of WDS symptoms demonstrated that women generally reported a higher number of individual withdrawal symptoms than men, and that they reported experiencing some symptoms as more severe. This is the first report to demonstrate that women seeking treatment for CUDs may experience more withdrawal then men during quit attempts. Prospective studies of sex differences in cannabis withdrawal are warranted.
Pillay, Srinivasan S; Rogowska, Jadwiga; Kanayama, Gen; Jon, Duk-In; Gruber, Staci; Simpson, Norah; Cherayil, Monisha; Pope, Harrison G; Yurgelun-Todd, Deborah A
The objective of this study was to identify the differences in cerebral activation between chronic cannabis smokers and controls in response to finger sequencing. We hypothesized that attentional areas related to motor function as well as primary and supplementary motor cortices would show diminished activation in chronic cannabis smokers. Nine cannabis smokers and 16 controls were included in these analyses. Scanning was performed on a GE 1.5T scanner. Echo planar images and high-resolution MR images were acquired. The challenge paradigm included left and right finger sequencing. Group differences in cerebral activation were examined for Brodmann areas (BA) 4, 6, 24, and 32 using ROI analyses in SPM. Cannabis users, tested within 4-36 h of discontinuation, exhibited significantly less activation than controls in BA 24 and 32 bilaterally during right- and left-sided sequencing and for BA 6 in all tasks except for left-sided sequencing in the left hemisphere. There were no statistically significant differences for BA 4. None of these regional activations correlated with urinary cannabis concentration and verbal IQ for smokers. These results suggest that recently abstinent chronic cannabis smokers produce reduced activation in motor cortical areas in response to finger sequencing compared to controls.
van Amsterdam JGC; van der Laan JW; Slangen JL; LGM
Recente literatuur werd geraadpleegd om na te gaan of langdurig gebruik van van grote hoeveelheden cannabis (dagelijks gebruik gedurende minimaal 6 maanden) leidt tot aanhoudende cognitieve effecten en effecten op het immuunsysteem. Het resultaat van deze studie is weergegeven in het huidige rappor
The unusual concentration of cannabinoids recently found in marijuana samples submitted to the forensic laboratory for chemical analysis prompted an investigation into whether genetic modifications have been made to the DNA of Cannabis sativa L. to increase its potency. Traditional methods for the detection of genetically modified organisms (GMO) were used to analyze herbal cannabis preparations. Our analyses support the hypothesis that marijuana samples submitted to forensic laboratories and characterized by an abnormal level of Δ(9)-THC are the product of breeding selection rather than of transgenic modifications. Further, this research has shown a risk of false positive results associated with the poor quality of the seized samples and probably due to the contamination by other transgenic vegetable products. On the other hand, based on these data, a conclusive distinction between the hypothesis of GMO plant contamination and the other of genetic modification of cannabis cannot be made requiring further studies on comparative chemical and genetic analyses to find out an explanation for the recently detected increased potency of cannabis.
Flores Sanchez, Isvett Josefina
Cannabis sativa L. plants produce a diverse array of secondary metabolites, which have been grouped in cannabinoids, flavonoids, stilbenoids, terpenoids, alkaloids and lignans; the cannabinoids are the best known group of natural products from this plant. The pharmacological aspects of this secondar
This article presents the results of a study of two SMS services aimed at providing young people with information on cannabis and helping them to reduce their consumption of the drug. The attitude of the 12 participants in the study towards the SMS services is generally positive, but they prefer ...
Attempts at medicinal cannabis law reform in Australia are not new. However, in historical perspective 2015 and 2016 will be seen as the time when community debate about legalisation of medicinal cannabis reached a tipping point in a number of Australian jurisdictions and when community impetus for change resulted in major reform initiatives. In order to contextualise the changes, the August 2015 Report of the Victorian Law Reform Commission (VLRC) and then the Access to Medicinal Cannabis Bill 2015 (Vic) introduced in December 2015 into the Victorian Parliament by the Labor Government are scrutinised. In addition, this editorial reviews the next phase of developments in the course of 2015 and 2016, including the Commonwealth Narcotic Drugs Amendment Act 2016 and the Queensland Public Health (Medicinal Canna- bis) Bill 2016. It identifies the principal features of the legislative initiatives against the backdrop of the VLRC proposals. It observes that the principles underlying the Report and the legislative developments in the three Australian jurisdictions are closely aligned and that their public health approach, their combination of evidence-based pragmatism, and their carefully orchestrated checks and balances against abuse and excess constitute a constructive template for medicinal cannabis law reform.
Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts. PMID:27757048
Cannabis has a long story, the story of an endless return through ages and countries, all over the world. There is no mention of an "hedonist" use of cannabis in Ancient Greek or Roman sources but cannabism is largely attested in Orient as early as in the Middle Ages, even if many tales about Haschishins and Crusaders remain highly controversial. The "come back" of cannabism can be traced back in Europe at the end of XVIIIth century after the Egyptian campaigns of Bonaparte. Thus was launched an increasing vogue of orientalism, soonly after followed by the emergence of cannabism in Paris or London and, half a century later, the United States. After a brief armistice, cannabis rises up again with force at the end of XXth century, all over the world. In our times cannabis remains in the centre of all discussions about hallucinogen substances and many ethical, moral or medical questions are still unanswered. Our final comments will go to the everlasting "come back" of cannabism: search of exotism, attempt to escape from reality or as suggested by recent physiologic studies, close inter-relations between sensorial paths and the upper brainstem centers.
Full Text Available Abstract Cannabis smoking can create respiratory problems. Vaporizers heat cannabis to release active cannabinoids, but remain cool enough to avoid the smoke and toxins associated with combustion. Vaporized cannabis should create fewer respiratory symptoms than smoked cannabis. We examined self-reported respiratory symptoms in participants who ranged in cigarette and cannabis use. Data from a large Internet sample revealed that the use of a vaporizer predicted fewer respiratory symptoms even when age, sex, cigarette smoking, and amount of cannabis used were taken into account. Age, sex, cigarettes, and amount of cannabis also had significant effects. The number of cigarettes smoked and amount of cannabis used interacted to create worse respiratory problems. A significant interaction revealed that the impact of a vaporizer was larger as the amount of cannabis used increased. These data suggest that the safety of cannabis can increase with the use of a vaporizer. Regular users of joints, blunts, pipes, and water pipes might decrease respiratory symptoms by switching to a vaporizer
Janichek Jennifer L
Full Text Available Abstract Background Medical cannabis dispensaries following the social or hybrid model offer supplementary holistic services in addition to dispensing medical cannabis. Historically, alternative physical health services have been the norm for these dispensaries, including services such as yoga, acupuncture, or chiropractor visits. A clinical service dearth remains for medical cannabis patients seeking substance use, misuse, dependence, and mental health services. This study examined patient desires for various clinical services and level of willingness to participate in specific clinical services. Methods Anonymous survey data (N = 303 were collected at Harborside Health Center (HHC, a medical cannabis dispensary in Oakland, CA. The sample was 70% male, 48% Caucasian and 21% African American. The mean male age was 38 years old and female mean age was 30. Sixty two percent of the male participants and 44% of the female participants are single. Sixteen percent of the population reported having a domestic partner. Forty six percent of the participants are employed full time, 41% have completed at least some college, and 49% make less than $40,000 a year. Results A significant portion of the sample, 62%, indicated a desire to participate in free clinical services at HHC, 34% would like more information about substances and use, and 41% want to learn more about reducing harms from substance use. About one quarter of the participants marked "would" or "likely would" participate in individual services such as consultation. Approximately 20% indicated "would" or "likely would" participate in psycho-educational forums, harm reduction information sharing sessions, online support groups, and coping, life, and social skills group. There was little interest in traditional NA/AA 12-step groups or adapted 12-step groups. Conclusions Desired clinical services can be qualified as a combination of harm reduction, educational, skills-based, peer support and
... Is Linked to IQ Decline Early-Onset, Regular Cannabis Use Is Linked to IQ Decline Email Facebook ... that cannabis use may harm the developing brain. Cannabis Use Correlates With Cognitive Decline The study participants ...
Full Text Available Tabea Schoeler, Sagnik BhattacharyyaDepartment of Psychosis Studies, King's College London, Institute of Psychiatry, London, UKAbstract: Investigating the effects of cannabis use on memory function appears challenging. While early observational investigations aimed to elucidate the longer-term effects of cannabis use on memory function in humans, findings remained equivocal and pointed to a pattern of interacting factors impacting on the relationship between cannabis use and memory function, rather than a simple direct effect of cannabis. Only recently, a clearer picture of the chronic and acute effects of cannabis use on memory function has emerged once studies have controlled for potential confounding factors and started to investigate the acute effects of delta-9-tetrahydrocannabinol (Δ9-THC and cannabidiol (CBD, the main ingredients in the extract of the cannabis plant in pharmacological challenge experiments. Relatively consistent findings have been reported regarding the acute impairments induced by a single dose of Δ9-THC on verbal and working memory. It is unclear whether they may persist beyond the intoxication state. In the long-term, these impairments seem particularly likely to manifest and may also persist following abstinence if regular and heavy use of cannabis strains high in Δ9-THC is started at an early age. Although still at an early stage, studies that employed advanced neuroimaging techniques have started to model the neural underpinnings of the effects of cannabis use and implicate a network of functional and morphological alterations that may moderate the effects of cannabis on memory function. Future experimental and epidemiological studies that take into consideration individual differences, particularly previous cannabis history and demographic characteristics, but also the precise mixture of the ingredients of the consumed cannabis are necessary to clarify the magnitude and the mechanisms by which cannabis
Daniela Luiza Baconi
Full Text Available Cannabis is one of the oldest psychotropic drugs known to humanity. The paper assesses the current knowledge on the cannabis, including the mechanisms of action and the therapeutic potential of cannabinoids. Three varieties of Cannabis plant are recognised: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. The variety indica is used predominantly to obtain the drugs. Cannabis herb is usually named marijuana, while the cannabis oleoresin secreted by the glandular hairs found mainly on the flowering or fruiting tops of the plant is known as hashish. More than 400 known chemicals are present in cannabis, at least 70 of which are called cannabinoids. The major psychoactive constituent in cannabis is delta-9-tetrahydrocannabinol (Δ9-THC. It is now recognized that there are three types of cannabinoids: natural (phytocannabinoids, endogenous cannabinoids, and synthetic cannabioids. Cannabinoids exert their actions by binding to specific membrane protein, the cannabinoid receptor. To date, two subtypes of cannabinoid receptors, named cannabinoid-1 (CB1, most abundantly expressed in the central nervous system and cannabinoid-2 (CB2 receptors, found predominantly in peripheral tissues with immune functions have been cloned. Therefore, the concept of endogenous cannabinoid system (endocannabinoid system, SEC has been developed. Based on the current scientific evidence, there are several effects of cannabinoids with potential therapeutic use: antiemetic, analgesic in cancerous pains, and chronic neuropathic pain, in multiple sclerosis or spinal cord injuries. Cannabis consume can result in a state of drug dependency and cannabis withdrawal has been included in DSM-V. Cannabis plant remains controversial in the twenty-first century and the potential therapeutic of specific cannabinoid compounds and medical marijuana remains under active medical research.
Cannabis has been known as a medicine for several thousand years across many cultures. It reached a position of prominence within Western medicine in the nineteenth century but became mired in disrepute and legal controls early in the twentieth century. Despite unremitting world-wide suppression, recreational cannabis exploded into popular culture in the 1960s and has remained easily obtainable on the black market in most countries ever since. This ready availability has allowed many thousands of patients to rediscover the apparent power of the drug to alleviate symptoms of some of the most cruel and refractory diseases known to humankind. Pioneering clinical research in the last quarter of the twentieth century has given some support to these anecdotal reports, but the methodological challenges to human research involving a pariah drug are formidable. Studies have tended to be small, imperfectly controlled, and have often incorporated unsatisfactory synthetic cannabinoid analogues or smoked herbal material of uncertain composition and irregular bioavailability. As a result, the scientific evaluation of medicinal cannabis in humans is still in its infancy. New possibilities in human research have been opened up by the discovery of the endocannabinoid system, a rapidly expanding knowledge of cannabinoid pharmacology, and a more sympathetic political environment in several countries. More and more scientists and clinicians are becoming interested in exploring the potential of cannabis-based medicines. Future targets will extend beyond symptom relief into disease modification, and already cannabinoids seem to offer particular promise in the treatment of certain inflammatory and neurodegenerative conditions. This chapter will begin with an outline of the development and current status of legal controls pertaining to cannabis, following which the existing human research will be reviewed. Some key safety issues will then be considered, and the chapter will conclude with
Hoff, Dominic A.; Andersen, Anette; Holstein, Bjorn E.
There is little information available on the topic of poor school satisfaction as a risk factor for cannabis use among adolescents. We examined if there was an association between poor school satisfaction, school class cannabis use and individual cannabis use. Further, we investigated if many cannabis users within the school class statistically…
José Luis G. Pinho Costa
Full Text Available OBJETIVOS: Diante das lacunas na efetividade das terapêuticas para transtornos por uso de Cannabis, a droga ilícita mais consumida no mundo, este trabalho propõe-se a rever os conhecimentos sobre o substrato neuroanatômico, biomolecular e celular do sistema endocanabinoide, descrever os mecanismos de neuroplasticidade dependente dos canabinoides e relacioná-los com a neurobiologia dos transtornos por uso de Cannabis (abuso e dependência. MÉTODOS: Recorreu-se às bases de dados Medline, Scopus e ISI Web of Knowledge; as palavras-chave pesquisadas foram "Cannabis", "neurobiology", "endocannabinoid system", "endocannabinoids", "receptors, cannabinoid", "neuronal plasticity", "long-term synaptic depression", "long-term potentiation", "marijuana abuse" e "tetrahydrocannabinol". Foram incluídos 80 trabalhos nesta revisão. DISCUSSÃO: A distribuição neuroanatômica, celular e biomolecular do sistema endocanabinoide adequa-se perfeitamente às suas funções de neuromodulação (via neuroplasticidade e metaplasticidade, nomeadamente em vias relacionadas aos transtornos por uso de substâncias. Os canabinoides exógenos perturbam essas funções. CONCLUSÃO: O sistema endocanabinoide contribui para a definição de setpoints em diversas vias neuronais, incluindo vias cruciais na instalação de transtornos por uso de substâncias; com o uso de Cannabis, esses setpoints tornar-se-ão mais permissivos, facilitando os transtornos por uso de Cannabis. Os avanços no entendimento da neurobiologia da Cannabis abrem uma janela de oportunidades para novas estratégias terapêuticas nos transtornos por uso de Cannabis.
Mark A Ware
Full Text Available Safety issues are a major barrier to the use of cannabis and cannabinoid medications for clinical purposes. Information on the safety of herbal cannabis may be derived from studies of recreational cannabis use, but cannabis exposure and effects may differ widely between medical and recreational cannabis users. Standardized, quality-controlled cannabinoid products are available in Canada, and safety profiles of approved medications are available through the Canadian formulary. In the present article, the evidence behind major safety issues related to cannabis use is summarized, with the aim of promoting informed dialogue between physicians and patients in whom cannabinoid therapy is being considered. Caution is advised in interpreting these data, because clinical experience with cannabinoid use is in the early stages. There is a need for long-term safety monitoring of patients using cannabinoids for a wide variety of conditions, to further guide therapeutic decisions and public policy.
Jehangir, Waqas; Stanton, Michael; Khan, Rafay; Sahgal, Puneet; Yousif, Abdalla
Cannabis is a substance that contains compounds that bind cannabinoid receptors, CB1 and CB2. Cannabis also contains substances that do not bind these receptors. Delta-9-tetrahydrocannabinol (THC) is the compound in cannabis responsible for its psychoactive effects and binding to cannabinoid receptors. Despite increasing popularity of the medical and recreational uses of cannabis, little attention has been paid to the adverse effects of the use of the substance. Evidence demonstrating an association between cannabis use and acute coronary syndromes has emerged with case reports and in vitro studies. This case report highlights an ST-segment myocardial infarction in a 27-year-old female with little cardiovascular risk factors, but a significant history of frequent cannabis use. PMID:28197241
D.J. Korf; M. Wouters; A. Benschop
The sale of cannabis to persons aged 18 or older is permitted in the Netherlands under certain conditions in commercial establishments called coffeeshops. The present Dutch government has proposed that access to coffeeshops be restricted to persons holding a cannabis ID, a mandatory membership card
AIM The overall aim of this thesis was to investigate the association between cannabis use and psychiatric disorders with emphasis on schizophrenia, other psychoses, depression and long term effects on mortality. Specific objectives were to: 1) investigate the long-term risk of schizophrenia, and other psychoses including brief psychoses among users and non-users of cannabis, (2) assess the risk of depression among users and non-users of cannabis, (3) determinate whet...
This overview covers a wide range of cannabis topics, initially examining issue in dispensaries and self-administration, plus regulatory requirement for production of cannabis-based medicines, particularly the Food and Drug Administration Botanical Guidance. The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical can...
This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanica...
Full Text Available OBJETIVO: Evidências de que o uso de cannabis prejudica funções cognitivas em humanos têm-se acumulado nas décadas recentes. O propósito desta revisão é o de atualizar o conhecimento nesta área com novos achados a partir da literatura mais recente. MÉTODO: As buscas na literatura foram realizadas utilizando-se o banco de dados Web of Science até fevereiro de 2010. Foram buscados os termos "cannabi*" ou "marijuana" e "cogniti*" ou "memory" ou "attention" ou "executive function", e os estudos em humanos foram revisados preferencialmente em relação aos estudos em animais. DISCUSSÃO: O uso de cannabis prejudica a memória, a atenção, o controle inibitório, as funções executivas e a tomada de decisões, tanto durante como após o período de intoxicação aguda, persistindo por horas, dias, semanas ou mais após o último uso. Os estudos de desafio farmacológico em humanos estão elucidando a natureza e os substratos neurais das alterações cognitivas associadas a vários canabinoides. O uso pesado ou de longo prazo de cannabis parece resultar em anormalidades cognitivas mais duradouras e possivelmente em alterações cerebrais estruturais. Efeitos cognitivos adversos maiores estão associados ao uso de cannabis quando este começa no início da adolescência. CONCLUSÃO: O sistema canabinoide endógeno está envolvido nos mecanismos de regulação neural que modulam os processos subjacentes a uma gama de funções cognitivas que estão prejudicadas pela cannabis. Os déficits em usuários humanos muito provavelmente refletem, portanto, neuroadaptações e o funcionamento alterado do sistema canabinoide endógeno.OBJECTIVE: Evidence that cannabis use impairs cognitive function in humans has been accumulating in recent decades. The purpose of this overview is to update knowledge in this area with new findings from the most recent literature. METHOD: Literature searches were conducted using the Web of Science database up to
Pomahacova, B; Van der Kooy, F; Verpoorte, R
Cannabis sativa is a well-known recreational drug and, as such, a controlled substance of which possession and use are illegal in most countries of the world. Due to the legal constraints on the possession and use of C. sativa, relatively little research on the medicinal qualities of this plant has been conducted. Interest in the medicinal uses of this plant has, however, increased in the last decades. The methods of administration for medicinal purposes are mainly through oral ingestion, smoking, and nowadays also inhalation through vaporization. During this study the commercially available Volcano vaporizing device was compared with cannabis cigarette smoke. The cannabis smoke and vapor (obtained at different temperatures) were quantitatively analyzed by high-performance liquid chromatography (HPLC). In addition, different quantities of cannabis material were also tested with the vaporizer. The cannabinoids:by-products ratio in the vapor obtained at 200 degrees C and 230 degrees C was significantly higher than in the cigarette smoke. The worst ratio of cannabinoids:by-products was obtained from the vaporized cannabis sample at 170 degrees C.
Järvinen, Margaretha; Ravn, Signe
A considerable part of today's sociological research on recreational drug use is (explicitly or implicitly) inspired by Howard Becker's classical model of deviant careers. The aim of the present paper is to directly apply Becker's theory to empirical data on present-day cannabis use and to suggest a revision of the theory. As part of this, we propose a stretch of the sociological approach represented by Becker and followers in order to include, not only recreational drug use, but also use for which young people have sought treatment. The paper is based on 30 qualitative interviews with young people in treatment for cannabis problems in Copenhagen, Denmark. We suggest a revision of Becker's career model in relation to four aspects: initiation of cannabis use, differentiation between socially integrated and individualised, disintegrated use, social control from non-users, and the users' moral stance on cannabis. A central point of the paper is that social interaction may both motivate cannabis use, as Becker proposed, and serve as a protective factor against extensive, problematic use.
Full Text Available Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. Cannabis contains psychoactive components, notably Δ9-tetrahydrocannbinol (THC, that interfere with the brain’s endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain’s developmental trajectory towards a disease-vulnerable state, predisposing early cannabis-users to motivational, affective and psychotic disorders. Numerous human studies, including prospective longitudinal studies, demonstrate that early cannabis use is associated with major depressive disorder and drug addiction. A strong association between schizophrenia and cannabis use is also apparent, especially when considering genetic factors that interact with this environmental exposure. These human studies set a foundation for carefully controlled animal studies which demonstrate similar patterns following early cannabinoid exposure. Given the vulnerable nature of adolescent neurodevelopment and the persistent changes that follow early cannabis exposure, the experimental findings outlined should be carefully considered by policymakers. In order to fully address the growing issues of psychiatric illnesses and to ensure a healthy future, measures should be taken to reduce cannabis use among teens.
Chadwick, Benjamin; Miller, Michael L; Hurd, Yasmin L
Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. cannabis contains psychoactive components, notably Δ(9)-tetrahydrocannabinol (THC), that interfere with the brain's endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain's developmental trajectory toward a disease-vulnerable state, predisposing early cannabis users to motivational, affective, and psychotic disorders. Numerous human studies, including prospective longitudinal studies, demonstrate that early cannabis use is associated with major depressive disorder and drug addiction. A strong association between schizophrenia and cannabis use is also apparent, especially when considering genetic factors that interact with this environmental exposure. These human studies set a foundation for carefully controlled animal studies which demonstrate similar patterns following early cannabinoid exposure. Given the vulnerable nature of adolescent neurodevelopment and the persistent changes that follow early cannabis exposure, the experimental findings outlined should be carefully considered by policymakers. In order to fully address the growing issues of psychiatric illnesses and to ensure a healthy future, measures should be taken to reduce cannabis use among teens.
Van der Kooy, F; Pomahacova, B; Verpoorte, R
Medicinal cannabis has attracted a lot of attention in recent times. Various forms of administration are used, of which smoking is very common but the least desirable. Smoking cannabis generates a large amount of unwanted side products, of which carcinogenic compounds are the most dangerous. A common practice among recreational drug users, and to a lesser degree patients who uses cannabis as medicine, is to mix the cannabis material with commercially available tobacco in order to increase the burning efficiency of the cigarette and to reduce the overall costs of the cigarette. In this study cannabis material has been mixed with tobacco in order to determine whether tobacco has an influence on the amount of and ratio between tetrahydrocannabinol (THC), cannabigerol (CBG), and cannabinol (CBN) administered while smoking. A small-scale smoking machine has been used and cannabis mixed with various ratios of tobacco was smoked. The trapped smoke was quantitatively analyzed by high-performance liquid chromatography (HPLC) and the amount of THC, CBG, and CBN was determined for each cigarette. We have found that tobacco increases the amount of THC inhaled per gram of cannabis from 32.70 +/- 2.29 mg/g for a 100% cannabis cigarette to 58.90 +/- 2.30 mg/g for a 25% cannabis cigarette. This indicates that tobacco increases the vaporization efficiency of THC by as much as 45% under the conditions tested.
Full Text Available Abstract More people are using the cannabis plant as modern basic and clinical science reaffirms and extends its medicinal uses. Concomitantly, concern and opposition to smoked medicine has occurred, in part due to the known carcinogenic consequences of smoking tobacco. Are these reactions justified? While chemically very similar, there are fundamental differences in the pharmacological properties between cannabis and tobacco smoke. Cannabis smoke contains cannabinoids whereas tobacco smoke contains nicotine. Available scientific data, that examines the carcinogenic properties of inhaling smoke and its biological consequences, suggests reasons why tobacco smoke, but not cannabis smoke, may result in lung cancer.
Ksir, Charles; Hart, Carl L
Interest in the relationship between cannabis use and psychosis has increased dramatically in recent years, in part because of concerns related to the growing availability of cannabis and potential risks to health and human functioning. There now exists a plethora of scientific articles addressing this issue, but few provide a clear verdict about the causal nature of the cannabis-psychosis association. Here, we review recent research reports on cannabis and psychosis, giving particular attention to how each report provides evidence relating to two hypotheses: (1) cannabis as a contributing cause and (2) shared vulnerability. Two primary kinds of data are brought to bear on this issue: studies done with schizophrenic patients and studies of first-episode psychosis. Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. The role of early and heavy cannabis use as a prodromal sign merits further examination, along with a variety of other problem behaviors (e.g., early or heavy use of cigarettes or alcohol and poor school performance). Future research studies that focus exclusively on the cannabis-psychosis association will therefore be of little value in our quest to better understand psychosis and how and why it occurs.
Decuyper, Ine; Ryckebosch, Hanne; Van Gasse, Athina L; Sabato, Vito; Faber, Margaretha; Bridts, Chris H; Ebo, Didier G
For about a decade, IgE-mediated cannabis (marihuana) allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may lead to a cannabis sensitization and/or allergy. The clinical manifestations of a cannabis allergy can vary from mild to life-threatening reactions, often depending on the route of exposure. In addition, sensitization to cannabis allergens can trigger various secondary cross-allergies, mostly for plant-derived food. This clinical entity, which we have designated as the "cannabis-fruit/vegetable syndrome" might also imply cross-reactivity with tobacco, latex and plant-food derived alcoholic beverages. These secondary cross-allergies are mainly described in Europe and appear to result from cross-reactivity between non-specific lipid transfer proteins or thaumatin-like proteins present in Cannabis sativa and their homologues that are ubiquitously distributed throughout plant kingdom. At present, diagnosis of cannabis-related allergies rests upon a thorough history completed with skin testing using native extracts from buds and leaves. However, quantification of specific IgE antibodies and basophil activation tests can also be helpful to establish correct diagnosis. In the absence of a cure, treatment comprises absolute avoidance measures including a stop of any further cannabis (ab)use.
Poulsen, H A; Sutherland, G J
The potency of cannabis plant and cannabis products seized in New Zealand over the period of 20 years is studied. The earlier part of the study includes mainly imported cannabis oil and cannabis resin, and both imported and locally grown cannabis plant, that was seized by the police. The later part of the study includes little imported material. Cannabis plant is now locally grown, cannabis oil is locally manufactured and imported cannabis resin is rarely seized. The average potency of the cannabis plant available to the user has not increased over the 20 years period. Cannabis leaf contains on average 1% THC and the female flowering heads on average 3.5% THC. The average potency of cannabis oil has dropped from its peak at 34% THC in 1985 to 13% THC in 1995.
Jacobus, Joanna; Tapert, Susan F
This article reviews neuroimaging, neurocognitive, and preclinical findings on the effects of cannabis on the adolescent brain. Marijuana is the second most widely used intoxicant in adolescence, and teens who engage in heavy marijuana use often show disadvantages in neurocognitive performance, macrostructural and microstructural brain development, and alterations in brain functioning. It remains unclear whether such disadvantages reflect pre-existing differences that lead to increased substances use and further changes in brain architecture and behavioral outcomes. Future work should focus on prospective investigations to help disentangle dose-dependent effects from pre-existing effects, and to better understand the interactive relationships with other commonly abused substances (e.g., alcohol) to better understand the role of regular cannabis use on neurodevelopmental trajectories.
Russo, Ethan B
Plants have been the predominant source of medicines throughout the vast majority of human history, and remain so today outside of industrialized societies. One of the most versatile in terms of its phytochemistry is cannabis, whose investigation has led directly to the discovery of a unique and widespread homeostatic physiological regulator, the endocannabinoid system. While it had been the conventional wisdom until recently that only cannabis harbored active agents affecting the endocannabinoid system, in recent decades the search has widened and identified numerous additional plants whose components stimulate, antagonize, or modulate different aspects of this system. These include common foodstuffs, herbs, spices, and more exotic ingredients: kava, chocolate, black pepper, and many others that are examined in this review.
Beck, Kenneth H; Caldeira, Kimberly M; Vincent, Kathryn B; O'Grady, Kevin E; Wish, Eric D; Arria, Amelia M
Few studies have investigated the association between the social context of cannabis use and cannabis use disorder (CUD). This longitudinal study of college students aimed to: develop a social context measure of cannabis use; examine the degree to which social context is associated with the transition from non-problematic cannabis use to CUD; and, examine the association between social context of cannabis use and depressive symptoms. The analytic sample consisted of 322 past-year cannabis users at baseline. Four distinct and internally consistent social context scales were found (i.e., social facilitation, emotional pain, sex seeking, and peer acceptance). Persistent CUD (meeting DSM-IV criteria for CUD at baseline and 12 months later) was associated with using cannabis in social facilitation or emotional pain contexts, controlling for frequency of cannabis use and alcohol use quantity. Students with higher levels of depressive symptoms were more likely to use cannabis in an emotional pain or sex-seeking context. These findings highlight the importance of examining the social contextual factors relating to substance use among college students.
Caldeira, Kimberly M; Arria, Amelia M; O'Grady, Kevin E; Vincent, Kathryn B; Wish, Eric D
This study reports the prevalence of cannabis use disorders (CUD) and other cannabis-related problems in a large cohort (n=1253) of first-year college students, 17 to 20 years old, at one large public university in the mid-Atlantic region of the U.S. Interviewers assessed past-year cannabis use, other drug use, and cannabis-related problems (including DSM-IV criteria for CUD). The prevalence of CUD was 9.4%(wt) among all first-year students and 24.6% among past-year cannabis users (n=739). Of those endorsing any CUD criteria, 33.8% could be classified as diagnostic orphans. Among 474 "at-risk" cannabis users (>or= 5 times in the past year), concentration problems (40.1%), driving while high (18.6%) and missing class (13.9%) were among the most prevalent cannabis-related problems, even among those who endorsed no CUD criteria. Placing oneself at risk for physical injury was also commonly reported (24.3%). A significant proportion of cannabis-using college students meet diagnostic criteria for disorder. Even in the absence of disorder, users appear to be at risk for potentially serious cannabis-related problems. Implications for prevention, service delivery, and future research are discussed.
Hartung, Benno; Schwender, Holger; Roth, Eckhard H; Hellen, Florence; Mindiashvili, Nona; Rickert, Annette; Ritz-Timme, Stefanie; Grieser, Almut; Monticelli, Fabio; Daldrup, Thomas
To assess the effects of cannabis on the ability required to ride a bicycle, repetitive practical cycling tests and medical examinations were carried out before and after inhalative consumption of cannabis. A maximum of three joints with body weight-adapted THC content (300 μg THC per kg body weight) could be consumed by each test subject. Fourteen regular cannabis-consuming test subjects were studied (12 males, 2 females). In summary, only a few driving faults were observed even under the influence of very high THC concentrations. A defined THC concentration that leads to an inability to ride a bicycle cannot be presented. The test subjects showed only slight distinctive features that can be documented using a medical test routinely run for persons under suspicion of driving under the influence of alcohol or drugs.
Bonnet, U; Harries-Hedder, K; Leweke, F M; Schneider, U; Tossmann, P
Actually, guidelines for treatment of substance-related disorders were written under the overall control of the DG-Sucht e. V. and the DGPPN e. V. This appears within the framework of the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft (AWMF). The leading objective of these guidelines is the description of the current scientifically proven and evidence-based medicine in addiction to derive recommendations to therapy. In this context, the guideline for treatment of cannabis-related disorders is introduced.
Zupan Mežnar, Anja; Brvar, Miran; Kralj, Gregor; Kovačič, Dragan
There are two main varieties of Cannabis sativa plant, namely, hemp which is cultivated for fiber and seeds and contains low amounts of psychoactive cannabinoids and the other which is cultivated for the drug cannabis or marijuana. Increasing popularity of hemp food products and alleged beneficial effects of cannabinoids in the drug variety of cannabis might lead to confusion in the lay population and unintentional ingestion of marijuana, as described in this case report. During a workshop on the use of hemp for medicinal purposes, there was a degustation of various hemp food products including also cookies that were brought by one of the attendees. Approximately 1 h after ingestion of cookies, people experienced nausea and vomiting, dizziness, sleepiness and difficulty walking. Twelve people were referred to emergency department, where two were admitted to intensive care because of central nervous system depression. They were all managed with supportive measures and were discharged home without health-related consequences.
Schuster, Randi Melissa; Fontaine, Madeleine; Nip, Emily; Zhang, Haiyue; Hanly, Ailish; Eden Evins, A
Young adults with psychiatric illnesses are more likely to use cannabis and experience problems from use. It is not known whether those with a lifetime psychiatric illness experience a prolonged cannabis withdrawal syndrome with abstinence. Participants were fifty young adults, aged 18-25, recruited from the Boston-area in 2015-2016, who used cannabis at least weekly, completed the Structured Clinical Interview for DSM-IV to identify Axis I psychiatric diagnoses (PD+ vs PD-), and attained cannabis abstinence with a four-week contingency management protocol. Withdrawal symptom severity was assessed at baseline and at four weekly abstinent visits using the Cannabis Withdrawal Scale. Cannabis dependence, age of initiation, and rate of abstinence were similar in PD+ and PD- groups. There was a diagnostic group by abstinent week interaction, suggesting a difference in time course for resolution of withdrawal symptoms by group, F(4,46)=3.8, p=0.009, controlling for sex, baseline depressive and anxiety symptoms, and frequency of cannabis use in the prior 90days. In post hoc analyses, there was a difference in time-course of cannabis withdrawal. PD- had significantly reduced withdrawal symptom severity in abstinent week one [t(46)=-2.2, p=0.03], while PD+ did not report improved withdrawal symptoms until the second abstinent week [t(46)=-4.1, p=0.0002]. Cannabis withdrawal symptoms improved over four weeks in young people with and without a lifetime psychiatric diagnosis. However, those with a psychiatric illness reported one week delayed improvement in withdrawal symptom severity. Longer duration of cannabis withdrawal may be a risk factor for cannabis dependence and difficulty quitting.
Borgelt, Laura M; Franson, Kari L; Nussbaum, Abraham M; Wang, George S
Cannabis, or marijuana, has been used for medicinal purposes for many years. Several types of cannabinoid medicines are available in the United States and Canada. Dronabinol (schedule III), nabilone (schedule II), and nabiximols (not U.S. Food and Drug Administration approved) are cannabis-derived pharmaceuticals. Medical cannabis or medical marijuana, a leafy plant cultivated for the production of its leaves and flowering tops, is a schedule I drug, but patients obtain it through cannabis dispensaries and statewide programs. The effect that cannabinoid compounds have on the cannabinoid receptors (CB(1) and CB(2) ) found in the brain can create varying pharmacologic responses based on formulation and patient characteristics. The cannabinoid Δ(9) -tetrahydrocannabinol has been determined to have the primary psychoactive effects; the effects of several other key cannabinoid compounds have yet to be fully elucidated. Dronabinol and nabilone are indicated for the treatment of nausea and vomiting associated with cancer chemotherapy and of anorexia associated with weight loss in patients with acquired immune deficiency syndrome. However, pain and muscle spasms are the most common reasons that medical cannabis is being recommended. Studies of medical cannabis show significant improvement in various types of pain and muscle spasticity. Reported adverse effects are typically not serious, with the most common being dizziness. Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations. This article will describe the pharmacology of cannabis, effects of various dosage formulations, therapeutics benefits and risks of cannabis for pain and muscle spasm, and safety concerns of medical cannabis use.
Cho, C M; Hirsch, R; Johnstone, S
Cannabis, commonly known as marijuana, is the most frequently used illicit drug in Australia. Therefore, oral health care providers are likely to encounter patients who are regular users. An upward trend in cannabis use is occurring in Australia, with 40 per cent of the population aged 14 and above having used the drug. There are three main forms of cannabis: marijuana, hash and hash oil, all of which contain the main psychoactive constituent delta-9-tetrahydrocannabinol (THC). Cannabis is most commonly smoked, however it can be added to foods. THC from cannabis enters the bloodstream and exerts its effects on the body via interaction with endogenous receptors. Cannabis affects almost every system of the body, particularly the cardiovascular, respiratory and immune systems. It also has acute and chronic effects on the mental health of some users. Therefore, chronic abuse is a concern because of its negative effects on general physical and mental health. Cannabis abusers generally have poorer oral health than non-users, with an increased risk of dental caries and periodontal diseases. Cannabis smoke acts as a carcinogen and is associated with dysplastic changes and pre-malignant lesions within the oral mucosa. Users are also prone to oral infections, possibly due to the immunosuppressive effects. Dental treatment on patients intoxicated on cannabis can result in the patient experiencing acute anxiety, dysphoria and psychotic-like paranoiac thoughts. The use of local anaesthetic containing epinephrine may seriously prolong tachycardia already induced by an acute dose of cannabis. Oral health care providers should be aware of the diverse adverse effects of cannabis on general and oral health and incorporate questions about patients' patterns of use in the medical history.
Vaucher, J; Keating, B J; Lasserre, A M; Gan, W; Lyall, D M; Ward, J; Smith, D J; Pell, J P; Sattar, N; Paré, G; Holmes, M V
Cannabis use is observationally associated with an increased risk of schizophrenia, but whether the relationship is causal is not known. Using a genetic approach, we took 10 independent genetic variants previously identified to associate with cannabis use in 32 330 individuals to determine the nature of the association between cannabis use and risk of schizophrenia. Genetic variants were employed as instruments to recapitulate a randomized controlled trial involving two groups (cannabis users vs nonusers) to estimate the causal effect of cannabis use on risk of schizophrenia in 34 241 cases and 45 604 controls from predominantly European descent. Genetically-derived estimates were compared with a meta-analysis of observational studies reporting ever use of cannabis and risk of schizophrenia or related disorders. Based on the genetic approach, use of cannabis was associated with increased risk of schizophrenia (odds ratio (OR) of schizophrenia for users vs nonusers of cannabis: 1.37; 95% confidence interval (CI), 1.09-1.67; P-value=0.007). The corresponding estimate from observational analysis was 1.43 (95% CI, 1.19-1.67; P-value for heterogeneity =0.76). The genetic markers did not show evidence of pleiotropic effects and accounting for tobacco exposure did not alter the association (OR of schizophrenia for users vs nonusers of cannabis, adjusted for ever vs never smoker: 1.41; 95% CI, 1.09-1.83). This adds to the substantial evidence base that has previously identified cannabis use to associate with increased risk of schizophrenia, by suggesting that the relationship is causal. Such robust evidence may inform public health messages about cannabis use, especially regarding its potential mental health consequences.Molecular Psychiatry advance online publication, 24 January 2017; doi:10.1038/mp.2016.252.
Toonen, M.A.J.; Ribot, S.A.; Thissen, J.T.N.M.
To obtain a reliable estimation on the yield of illicit indoor cannabis cultivation in The Netherlands, cannabis plants confiscated by the police were used to determine the yield of dried female flower buds. The developmental stage of flower buds of the seized plants was described on a scale from 1
Power, R.A.; Verweij, K.J.H.; Zuhair, M.; Montgomery, G.W.; Henders, A.K.; Heath, A.C.; Madden, P.A.F.; Medland, S.E.; Wray, N.R.; Martin, N.G.
Cannabis is the most commonly used illicit drug worldwide. With debate surrounding the legalization and control of use, investigating its health risks has become a pressing area of research. One established association is that between cannabis use and schizophrenia, a debilitating psychiatric disord
Barrus, Daniel G.; Capogrossi, Kristen L.; Cates, Sheryl C.; Gourdet, Camille K.; Peiper, Nicholas C.; Novak, Scott P.; Lefever, Timothy W.; Wiley, Jenny L.
Food products containing cannabis extract (edibles) have emerged as a popular and lucrative facet of the legalized market for both recreational and medicinal cannabis. The many formulations of cannabis extracts used in edibles present a unique regulatory challenge for policy makers. Though edibles are often considered a safe, discreet, and effective means of attaining the therapeutic and/or intoxicating effects of cannabis without exposure to the potentially harmful risks of cannabis smoking, little research has evaluated how ingestion differs from other methods of cannabis administration in terms of therapeutic efficacy, subjective effects, and safety. The most prominent difference between ingestion and inhalation of cannabis extracts is the delayed onset of drug effect with ingestion. Consumers often do not understand this aspect of edible use and may consume a greater than intended amount of drug before the drug has taken effect, often resulting in profoundly adverse effects. Written for the educated layperson and for policy makers, this paper explores the current state of research regarding edibles, highlighting the promises and challenges that edibles present to both users and policy makers, and describes the approaches that four states in which recreational cannabis use is legal have taken regarding regulating edibles. PMID:28127591
Calvigioni, Daniela; Hurd, Yasmin L; Harkany, Tibor; Keimpema, Erik
Cannabis remains one of the world's most widely used substance of abuse amongst pregnant women. Trends of the last 50 years show an increase in popularity in child-bearing women together with a constant increase in cannabis potency. In addition, potent herbal "legal" highs containing synthetic cannabinoids that mimic the effects of cannabis with unknown pharmacological and toxicological effects have gained rapid popularity amongst young adults. Despite the surge in cannabis use during pregnancy, little is known about the neurobiological and psychological consequences in the exposed offspring. In this review, we emphasize the importance of maternal programming, defined as the intrauterine presentation of maternal stimuli to the foetus, in neurodevelopment. In particular, we focus on cannabis-mediated maternal adverse effects, resulting in direct central nervous system alteration or sensitization to late-onset chronic and neuropsychiatric disorders. We compare clinical and preclinical experimental studies on the effects of foetal cannabis exposure until early adulthood, to stress the importance of animal models that permit the fine control of environmental variables and allow the dissection of cannabis-mediated molecular cascades in the developing central nervous system. In sum, we conclude that preclinical experimental models confirm clinical studies and that cannabis exposure evokes significant molecular modifications to neurodevelopmental programs leading to neurophysiological and behavioural abnormalities.
Biehl, Jason R; Burnham, Ellen L
Recent legislative successes allowing expanded access to recreational and medicinal cannabis have been associated with its increased use by the public, despite continued debates regarding its safety within the medical and scientific communities. Despite legislative changes, cannabis is most commonly used by smoking, although alternatives to inhalation have also emerged. Moreover, the composition of commercially available cannabis has dramatically changed in recent years. Therefore, developing sound scientific information regarding its impact on lung health is imperative, particularly because published data conducted prior to widespread legalization are conflicting and inconclusive. In this commentary, we delineate major observations of epidemiologic investigations examining cannabis use and the potential associated development of airways disease and lung cancer to highlight gaps in pulmonary knowledge. Additionally, we review major histopathologic alterations related to smoked cannabis and define specific areas in animal models and human clinical translational investigations that could benefit from additional development. Given that cannabis has an ongoing classification as a schedule I medication, federal funding to support investigations of modern cannabis use in terms of medicinal efficacy and safety profile on lung health have been elusive. It is clear, however, that the effects of inhaled cannabis on lung health remain uncertain and given increasing use patterns, are worthy of further investigation.
Gates, Peter J.; Norberg, Melissa M.; Dillon, Paul; Manocha, Ramesh
Cannabis is the most frequently used illicit drug by Australian secondary school students yet there is scant research investigating school staff responses to student cannabis use. As such, this study surveyed 1,692 school staff who attended "Generation Next" seminars throughout Australia. The self-complete survey identified that the…
Cawich, Shamir O; Downes, Ross; Martin, Allie C; Evans, Necia R; Mitchell, Derek I G; Williams, Eric
Body packing is one method of smuggling cannabis across international borders. The practice is prevalent in Jamaica. There has been one reported death from this practice in medical literature. We report a second fatal case of cannabis body packing, reinforcing the dangerous nature of this practice.
Napoli, M. Di; Zha, A.M.; Godoy, D.A.; Masotti, L.; Schreuder, F.H.B.M.; Popa-Wagner, A.; Behrouz, R.
OBJECTIVE: Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients. METHODS: An analysis of an international, multicenter, ob
Martinez, Julia A.; Roth, Madeline G.; Johnson, Douglas N.; Jones, Jane A.
Along with recent changes in cannabis legalization and decriminalization, there has been an increasing amount of attention aimed at cannabis use and outcomes in college. Although some amount of cannabis use might be expected under theories of collegiate identity development, public health research indicates that cannabis use ultimately associates…
The cannabis policy landscape is changing rapidly. In November 2012 voters in Colorado and Washington State passed ballot initiatives to remove the prohibition on the commercial production, distribution, and possession of cannabis. This paper does not address the question of whether cannabis should be legal; it instead focuses on the design considerations confronting jurisdictions that are pondering a change in cannabis policy. Indeed, whether or not cannabis legalization is net positive or negative for public health and public safety largely depends on regulatory decisions and how they are implemented. This essay presents eight of these design choices which all conveniently begin with the letter "P": production, profit motive, promotion, prevention, potency, purity, price, and permanency.
Patricia G. Erickson
Full Text Available
Canada was one of the first countries in the world to criminalise cannabis in 1923. It was not until the late 1960s and an associated upsurge of youthful cannabis use that the government and various stakeholders seriously interrogated the appropriateness of this punitive prohibition. Nevertheless, despite numerous opportunities for law reform for over four decades, cannabis possession continues to be illegal and as a result, hundreds of thousands of Canadians have received criminal records under these laws. This article reviews federal attempts at cannabis law reform and uses data spanning several decades to examine the characteristics of individuals convicted of cannabis possession and the implications of criminalisation on their lives.
Benard, Victoire; Rolland, Benjamin; Messaadi, Nassir; Petit, Aymeric; Cottencin, Olivier; Karila, Laurent
Cannabis use is now more frequent than alcohol drinking or tobacco smoking among young people (15-34years), whereas it may induce numerous medical aftermaths. Identifying and assessing cannabis use in general practice have become a current public health issue. The two steps of screening consist in spotting risky use of cannabis, and then in checking criteria for cannabis use disorder (CUD). Risky use requires a "brief intervention" by the general practitioner (GP). In case of CUD, the new DSM-5 criteria allow measuring the severity of the subsequent disorder, and listing the medical and social consequences. Using these criteria can help the GP to decide when the patient should be referred to an addiction-specialized unit. The GP has also to spot the different physical and psychiatric complications of cannabis use, in order to coordinate care between the different specialists.
Lanz, Christian; Mattsson, Johan; Soydaner, Umut; Brenneisen, Rudolf
Inhalation by vaporization is a promising application mode for cannabis in medicine. An in vitro validation of 5 commercial vaporizers was performed with THC-type and CBD-type cannabis. Gas chromatography/mass spectrometry was used to determine recoveries of total THC (THCtot) and total CBD (CBDtot) in the vapor. High-performance liquid chromatography with photodiode array detection was used for the quantitation of acidic cannabinoids in the residue and to calculate decarboxylation efficiencies. Recoveries of THCtot and CBDtot in the vapor of 4 electrically-driven vaporizers were 58.4 and 51.4%, 66.8 and 56.1%, 82.7 and 70.0% and 54.6 and 56.7% for Volcano Medic®, Plenty Vaporizer®, Arizer Solo® and DaVinci Vaporizer®, respectively. Decarboxylation efficiency was excellent for THC (≥ 97.3%) and CBD (≥ 94.6%). The gas-powered Vape-or-Smoke™ showed recoveries of THCtot and CBDtot in the vapor of 55.9 and 45.9%, respectively, and a decarboxylation efficiency of ≥ 87.7 for both cannabinoids. However, combustion of cannabis was observed with this device. Temperature-controlled, electrically-driven vaporizers efficiently decarboxylate inactive acidic cannabinoids and reliably release their corresponding neutral, active cannabinoids. Thus, they offer a promising application mode for the safe and efficient administration of medicinal cannabis.
Full Text Available Inhalation by vaporization is a promising application mode for cannabis in medicine. An in vitro validation of 5 commercial vaporizers was performed with THC-type and CBD-type cannabis. Gas chromatography/mass spectrometry was used to determine recoveries of total THC (THCtot and total CBD (CBDtot in the vapor. High-performance liquid chromatography with photodiode array detection was used for the quantitation of acidic cannabinoids in the residue and to calculate decarboxylation efficiencies. Recoveries of THCtot and CBDtot in the vapor of 4 electrically-driven vaporizers were 58.4 and 51.4%, 66.8 and 56.1%, 82.7 and 70.0% and 54.6 and 56.7% for Volcano Medic®, Plenty Vaporizer®, Arizer Solo® and DaVinci Vaporizer®, respectively. Decarboxylation efficiency was excellent for THC (≥ 97.3% and CBD (≥ 94.6%. The gas-powered Vape-or-Smoke™ showed recoveries of THCtot and CBDtot in the vapor of 55.9 and 45.9%, respectively, and a decarboxylation efficiency of ≥ 87.7 for both cannabinoids. However, combustion of cannabis was observed with this device. Temperature-controlled, electrically-driven vaporizers efficiently decarboxylate inactive acidic cannabinoids and reliably release their corresponding neutral, active cannabinoids. Thus, they offer a promising application mode for the safe and efficient administration of medicinal cannabis.
Beraha, E.M.; Cousijn, J.; Hermanides, E.; Goudriaan, A.E.; Wiers, R.W.
Cognitive biases, including implicit memory associations are thought to play an important role in the development of addictive behaviors. The aim of the present study was to investigate implicit affective memory associations in heavy cannabis users. Implicit positive-arousal, sedation, and negative
Jones, Sandra C.; Rossiter, John R.
This paper examines the believability of strong warnings about the negative consequences of drug use among young adults in Australia who have never tried, currently use, or have tried and rejected cannabis. It finds that the strong warnings about cannabis are generally believed by never-triers. The same warnings are perceived by current users as…
Smit, E.; Verdurmen, J.E.E.; Engels, R.C.M.E.; Vollebergh, W.A.M.
Aims: To investigate general and cannabis-specific parenting practices in relation to adolescent cannabis and other illicit drug use. Methods: Data were derived from the Dutch National School Survey on Substance Use among students (N = 3209; aged 12-16 years) and one of their parents in 2011. Result
Full Text Available Abstract Background The New South Wales State Government recently proposed a trial of the medical use of cannabis. Australians who currently use cannabis medicinally do so illegally and without assurances of quality control. Given the dearth of local information on this issue, this study explored the experiences of medical cannabis users. Methods Australian adults who had used cannabis for medical purposes were recruited using media stories. A total of 147 respondents were screened by phone and anonymous questionnaires were mailed, to be returned by postage paid envelope. Results Data were available for 128 participants. Long term and regular medical cannabis use was frequently reported for multiple medical conditions including chronic pain (57%, depression (56%, arthritis (35%, persistent nausea (27% and weight loss (26%. Cannabis was perceived to provide "great relief" overall (86%, and substantial relief of specific symptoms such as pain, nausea and insomnia. It was also typically perceived as superior to other medications in terms of undesirable effects, and the extent of relief provided. However, nearly one half (41% experienced conditions or symptoms that were not helped by its use. The most prevalent concerns related to its illegality. Participants reported strong support for their use from clinicians and family. There was almost universal interest (89% in participating in a clinical trial of medical cannabis, and strong support (79% for investigating alternative delivery methods. Conclusion Australian medical cannabis users are risking legal ramifications, but consistent with users elsewhere, claim moderate to substantial benefits from its use in the management of their medical condition. In addition to strong public support, medical cannabis users show strong interest in clinical cannabis research, including the investigation of alternative delivery methods.
Full Text Available The Center for Disease Control estimates 128,000 people in the U.S. are hospitalized annually due to food borne illnesses. This has created a demand for food safety testing targeting the detection of pathogenic mold and bacteria on agricultural products. This risk extends to medical Cannabis and is of particular concern with inhaled, vaporized and even concentrated Cannabis products . As a result, third party microbial testing has become a regulatory requirement in the medical and recreational Cannabis markets, yet knowledge of the Cannabis microbiome is limited. Here we describe the first next generation sequencing survey of the fungal communities found in dispensary based Cannabis flowers by ITS2 sequencing, and demonstrate the sensitive detection of several toxigenic Penicillium and Aspergillus species, including P. citrinum and P. paxilli, that were not detected by one or more culture-based methods currently in use for safety testing.
Full Text Available Abstract Background There has been a considerable amount of debate among the research community whether cannabis use may cause schizophrenia and whether cannabis use of patients with schizophrenia is associated with earlier and more frequent relapses. Considering that studies exploring patients' view on controversial topics have contributed to our understanding of important clinical issues, it is surprising how little these views have been explored to add to our understanding of the link between cannabis and psychosis. The present study was designed to elucidate whether patients with schizophrenia who use cannabis believe that its use has caused their schizophrenia and to explore these patients other beliefs and perceptions about the effects of the drug. Methods We recruited ten consecutive patients fulfilling criteria for paranoid schizophrenia and for a harmful use of/dependence from cannabis (ICD-10 F20.0 + F12.1 or F12.2 from the in- and outpatient clinic of the Psychiatric University Hospital Zurich. They were interviewed using qualitative methodology. Furthermore, information on amount, frequency, and effects of use was obtained. A grounded theory approach to data analysis was taken to evaluate findings. Results None of the patients described a causal link between the use of cannabis and their schizophrenia. Disease models included upbringing under difficult circumstances (5 or use of substances other than cannabis (e. g. hallucinogens, 3. Two patients gave other reasons. Four patients considered cannabis a therapeutic aid and reported that positive effects (reduction of anxiety and tension prevailed over its possible disadvantages (exacerbation of positive symptoms. Conclusions Patients with schizophrenia did not establish a causal link between schizophrenia and the use of cannabis. We suggest that clinicians consider our findings in their work with patients suffering from these co-occurring disorders. Withholding treatment or excluding
McArdle, P A
A popular internet site1 describes cannabis as “a leafy plant, the leaves and flowering tops (buds) of which may be either smoked or eaten. It also comes in a more concentrated resinous form called hashish, and as a sticky black liquid called hash oil”. It is said that users often report a pleasant “subjective enhancement of visual and auditory perception, sometimes with synaesthesia (sounds take on visual colourful qualities)” and the sense that time passes more quickly than real time, a “fa...
McArdle, P A
A popular internet site describes cannabis as "a leafy plant, the leaves and flowering tops (buds) of which may be either smoked or eaten. It also comes in a more concentrated resinous form called hashish, and as a sticky black liquid called hash oil". It is said that users often report a pleasant "subjective enhancement of visual and auditory perception, sometimes with synaesthesia (sounds take on visual colourful qualities)" and the sense that time passes more quickly than real time, a "fatuous euphoria", as well as relaxation and relief from stress.
Full Text Available Abstract Background Simultaneous use of alcohol and cannabis predicts increased negative consequences for users beyond individual or even concurrent use of the two drugs. Given the widespread use of the drugs and common simultaneous consumption, problems unique to simultaneous use may bear important implications for many substance users. Cognitive expectancies offer a template for future drug use behavior based on previous drug experiences, accurately predicting future use and problems. Studies reveal similar mechanisms underlying both alcohol and cannabis expectancies, but little research examines simultaneous expectancies for alcohol and cannabis use. Whereas research has demonstrated unique outcomes associated with simultaneous alcohol and cannabis use, this study hypothesized that unique cognitive expectancies may underlie simultaneous alcohol and cannabis use. Results: This study examined a sample of 2600 (66% male; 34% female Internet survey respondents solicited through advertisements with online cannabis-related organizations. The study employed known measures of drug use and expectancies, as well as a new measure of simultaneous drug use expectancies. Expectancies for simultaneous use of alcohol and cannabis predicted simultaneous use over and above expectancies for each drug individually. Discussion Simultaneous expectancies may provide meaningful information not available with individual drug expectancies. These findings bear potential implications on the assessment and treatment of substance abuse problems, as well as researcher conceptualizations of drug expectancies. Policies directing the treatment of substance abuse and its funding ought to give unique consideration to simultaneous drug use and its cognitive underlying factors.
Maule, W J
Marijuana (Cannabis sativa) has been used throughout the world medically, recreationally and spiritually for thousands of years. In South Africa, from the mid-19th century to the 1920s, practitioners prescribed it for a multitude of conditions. In 1928 it was classified as a Schedule I substance, illegal, and without medical value. Ironically, with this prohibition, cannabis became the most widely used illicit recreational drug, not only in South Africa, but worldwide. Cannabis is generally regarded as enjoyable and relaxing without the addictive risks of opioids or stimulants. In alternative medicine circles it has never lost its appeal. To date 23 States in the USA have legalised its medical use despite the federal ban. Unfortunately, little about cannabis is not without controversy. Its main active ingredient, δ-9-tetrahydrocannabinol (THC), was not isolated until 1964, and it was not until the 1990s that the far-reaching modulatory activities of the endocannabinoid system in the human body was studied. This system's elucidation raises the possibility of many promising pharmaceutical applications, even as restrictions show no sign of abating. Recreational use of cannabis continues to increase, despite growing evidence of its addictive potential, particularly in the young. Public approval drives medical cannabis legalisation efforts without the scientific data normally required to justify a new medication's introduction. This review explores these controversies and whether cannabis is a panacea, a scourge, or both.
Budney, Alan J; Sargent, James D; Lee, Dustin C
The proliferation of vaporization ('vaping') as a method for administering cannabis raises many of the same public health issues being debated and investigated in relation to e-cigarettes (e-cigs). Good epidemiological data on the prevalence of vaping cannabis are not yet available, but with current trends towards societal approval of medicinal and recreational use of cannabis, the pros and cons of vaping cannabis warrant study. As with e-cigs, vaping cannabis portends putative health benefits by reducing harm from ingesting toxic smoke. Indeed, vaping is perceived and being sold as a safer way to use cannabis, despite the lack of data on the health effects of chronic vaping. Other perceived benefits include better taste, more efficient and intense effects and greater discretion which allows for use in more places. Unfortunately, these aspects of vaping could prompt an increased likelihood of trying cannabis, earlier age of onset, more positive initial experiences, and more frequent use, thereby increasing the probability of problematic use or addiction. Sales and marketing of vaping devices with no regulatory guidelines, especially related to advertising or product development targeting youth, parallels concerns under debate related to e-cigs and youth. Thus, the quandary of whether or not to promote vaping as a safer method of cannabis administration for those wishing to use cannabis, and how to regulate vaping and vaping devices, necessitates substantial investigation and discussion. Addressing these issues in concert with efforts directed towards e-cigs may save time and energy and result in a more comprehensive and effective public health policy on vaping.
Full Text Available Medicinal cannabis has recently attracted much media attention in Australia and across the world. With the exception of a few countries, cannabinoids remain illegal-known for their adverse effects rather than their medicinal application and therapeutic benefit. However, there is mounting evidence demonstrating the therapeutic benefits of cannabis in alleviating neuropathic pain, improving multiple sclerosis spasticity, reducing chemotherapy induced nausea and vomiting, and many other chronic conditions. Many are calling for the legalisation of medicinal cannabis including consumers, physicians and politicians. Pharmacists are the gatekeepers of medicines and future administrators/dispensers of cannabis to the public, however very little has been heard about pharmacists' perspectives. Therefore the aim of this study was to explore pharmacists' views about medicinal cannabis; its legalisation and supply in pharmacy.Semi-structured interviews with 34 registered pharmacists in Australia were conducted. All interviews were audio-recorded, transcribed ad verbatim and thematically analysed using the NVivo software.Emergent themes included stigma, legislation, safety and collaboration. Overall the majority of pharmacists felt national legalisation of a standardised form of cannabis would be suitable, and indicated various factors and strategies to manage its supply. The majority of participants felt that the most suitable setting would be via a community pharmacy setting due to the importance of accessibility for patients.This study explored views of practicing pharmacists, revealing a number of previously undocumented views and barriers about medicinal cannabis from a supply perspective. There were several ethical and professional issues raised for consideration. These findings highlight the important role that pharmacists hold in the supply of medicinal cannabis. Additionally, this study identified important factors, which will help shape future
Mason, Barbara J.; Crean, Rebecca; Goodell, Vivian; Light, John M.; Quello, Susan; Shadan, Farhad; Buffkins, Kimberly; Kyle, Mark; Adusumalli, Murali; Begovic, Adnan; Rao, Santosh
There are no FDA-approved pharmacotherapies for cannabis dependence. Cannabis is the most widely used illicit drug in the world, and patients seeking treatment for primary cannabis dependence represent 25% of all substance use admissions. We conducted a phase IIa proof-of-concept pilot study to examine the safety and efficacy of a calcium channel/GABA modulating drug, gabapentin, for the treatment of cannabis dependence. A 12-week, randomized, double-blind, placebo-controlled clinical trial w...
Davitian, C; Uzan, M; Tigaizin, A; Ducarme, G; Dauphin, H; Poncelet, C
Marijuana is the most commonly used illegal drug, especially among young women in Western societies. The effects of cannabis use during pregnancy have been studied for many years. The vast majority of studies have shown a link between maternal consumption of cannabis and foetal development. Foetal growth restriction seems to be the major complication of cannabis exposure. Nevertheless, all these studies have suffered from several methodological biases. The maternal marijuana use should be first and foremost detected in pregnant women for a specific addiction management and pregnancy follow-up.
Schicho, Rudolf; Storr, Martin
In ancient medicine, cannabis has been widely used to cure disturbances and inflammation of the bowel. A recent clinical study now shows that the medicinal plant Cannabis sativa has lived up to expectations and proved to be highly efficient in cases of inflammatory bowel diseases. In a prospective placebo-controlled study, it has been shown what has been largely anticipated from anecdotal reports, i.e. that cannabis produces significant clinical benefits in patients with Crohn's disease. The mechanisms involved are not yet clear but most likely include peripheral actions on cannabinoid receptors 1 and 2, and may also include central actions.
Pierre, Joseph M; Gandal, Michael; Son, Maya
With mounting evidence that the risk of cannabis-induced psychosis may be related to both dose and potency of tetrahydrocannbinol (THC), increasing reports of psychosis associated with cannabinoids containing greater amounts of THC are anticipated. We report two cases of emergent psychosis after using a concentrated THC extract known as cannabis "wax," "oil," or "dabs" raising serious concerns about its psychotic liability. Although "dabbing" with cannabis wax is becoming increasingly popular in the US for both recreational and "medicinal" intentions, our cases raise serious concerns about its psychotic liability and highlight the importance of understanding this risk by physicians recommending cannabinoids for purported medicinal purposes.
Full Text Available Life course theory considers events in study and work as potential turning points in deviance, including illicit drug use. This qualitative study explores the role of occupational life in cannabis use and dependence in young adults. Two and three years after the initial structured interview, 47 at baseline frequent cannabis users were interviewed in-depth about the dynamics underlying changes in their cannabis use and dependence. Overall, cannabis use and dependence declined, including interviewees who quit using cannabis completely, in particular with students, both during their study and after they got employed. Life course theory appeared to be a useful framework to explore how and why occupational life is related to cannabis use and dependence over time. Our study showed that life events in this realm are rather common in young adults and can have a strong impact on cannabis use. While sometimes changes in use are temporary, turning points can evolve from changes in educational and employment situations; an effect that seems to be related to the consequences of these changes in terms of amount of leisure time and agency (i.e. feelings of being in control.
Kowal, Mikael A; van Steenbergen, Henk; Colzato, Lorenza S; Hazekamp, Arno; van der Wee, Nic J A; Manai, Meriem; Durieux, Jeffrey; Hommel, Bernhard
Cannabis has been suggested to impair the capacity to recognize discrepancies between expected and executed actions. However, there is a lack of conclusive evidence regarding the acute impact of cannabis on the neural correlates of error monitoring. In order to contribute to the available knowledge, we used a randomized, double-blind, between-groups design to investigate the impact of administration of a low (5.5 mg THC) or high (22 mg THC) dose of vaporized cannabis vs. placebo on the amplitudes of the error-related negativity (ERN) and error positivity (Pe) in the context of the Flanker task, in a group of frequent cannabis users (required to use cannabis minimally 4 times a week, for at least 2 years). Subjects in the high dose group (n=18) demonstrated a significantly diminished ERN in comparison to the placebo condition (n=19), whereas a reduced Pe amplitude was observed in both the high and low dose (n=18) conditions, as compared to placebo. The results suggest that a high dose of cannabis may affect the neural correlates of both the conscious (late), as well as the initial automatic processes involved in error monitoring, while a low dose of cannabis might impact only the conscious (late) processing of errors.
van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M.
This paper presents an overview of the prospective cohort design of the Dutch Cannabis Dependence (CanDep) study, which investigates (i) the three-year natural course of frequent cannabis use (≥ three days per week in the past 12 months) and cannabis dependence; and (ii) the factors involved in the
Tânia Moraes Ramos Andrade
Full Text Available A depressão é um dos transtornos psiquiátricos mais comuns na adolescência. Os quadros depressivos costumam apresentar elevadas taxas de comorbidades psiquiátricas, sendo freqüente o abuso de substâncias psicoativas. O artigo investiga a associação dos sintomas depressivos e o uso da cannabis. MÉTODO: Revisão sistemática, análise dos artigos indexados no Medline, PsycInfo, ProQuest, Web of Science e Lilacs, entre 2000 e 2005, descritores: depressive symptoms, depressive, adolescence, teenager e cannabis. RESULTADOS: Revisados 36 artigos completos, resultando no estudo de 9 artigos, que tratam de sintomas depressivos ou depressão e o uso ou dependência de cannabis em adolescentes. Os estudos confirmam a associação entre sintomas depressivos e o uso de cannabis na adolescência, sendo esta associação mais freqüente no uso precoce e regular de cannabis. CONCLUSÃO: Os sintomas depressivos/depressão estão relacionados ao uso/abuso e dependência de cannabis na adolescência. A investigação clínica e os programas de prevenção devem abordar estes transtornos na adolescência.Este artículo busca investigar la asociación de los síntomas depresivos y el uso de cannabis en la adolescencia. MÉTODO: Ha sido realizado, a través de revisión sistemática, el análisis de los artículos indexados localizados en los sistemas Medline, PsycInfo, ProQuest, Web of Science y Lilacs, entre 2000 y 2005, utilizando los descriptores: depressive symptoms, depressive, adolescence, teenager y cannabis. RESULTADOS: La mayoría de los estudios confirma existir una asociación entre síntomas depresivos y el uso de cannabis en la adolescencia, cabe destacar que esta asociación es más frecuente en el uso precoz y regular de cañabais. CONCLUSIÓN: Los síntomas depresivos/Depresión están relacionados al uso/abuso y dependencia de cañabais en la adolescencia, siendo entonces importante que estas variables puedan ser investigadas en la pr
Maciej S Buchowski
Full Text Available BACKGROUND: Cannabis dependence is a significant public health problem. Because there are no approved medications for this condition, treatment must rely on behavioral approaches empirically complemented by such lifestyle change as exercise. AIMS: To examine the effects of moderate aerobic exercise on cannabis craving and use in cannabis dependent adults under normal living conditions. DESIGN: Participants attended 10 supervised 30-min treadmill exercise sessions standardized using heart rate (HR monitoring (60-70% HR reserve over 2 weeks. Exercise sessions were conducted by exercise physiologists under medical oversight. PARTICIPANTS: Sedentary or minimally active non-treatment seeking cannabis-dependent adults (n = 12, age 25±3 years, 8 females met criteria for primary cannabis dependence using the Substance Abuse module of the Structured Clinical Interview for DSM-IV (SCID. MEASUREMENTS: Self-reported drug use was assessed for 1-week before, during, and 2-weeks after the study. Participants viewed visual cannabis cues before and after exercise in conjunction with assessment of subjective cannabis craving using the Marijuana Craving Questionnaire (MCQ-SF. FINDINGS: Daily cannabis use within the run-in period was 5.9 joints per day (SD = 3.1, range 1.8-10.9. Average cannabis use levels within the exercise (2.8 joints, SD = 1.6, range 0.9-5.4 and follow-up (4.1 joints, SD = 2.5, range 1.1-9.5 periods were lower than during the run-in period (both P<.005. Average MCQ factor scores for the pre- and post-exercise craving assessments were reduced for compulsivity (P = .006, emotionality (P = .002, expectancy (P = .002, and purposefulness (P = .002. CONCLUSIONS: The findings of this pilot study warrant larger, adequately powered controlled trials to test the efficacy of prescribed moderate aerobic exercise as a component of cannabis dependence treatment. The neurobiological mechanisms that account for these
Rechthand, Moshe M; Bashirelahi, Nasir
As the prevalence of marijuana use rises along with its legalization, it has become increasingly important for dentists to understand the potential benefits and risks of marijuana use. This article reviews potential effects of cannabis on oral and systemic health.
Feldman, H W; Mandel, J
In 1996, shortly after the San Francisco Cannabis Club was raided and (temporarily) closed by state authorities, the authors conducted an ethnographic study by interviewing selected former members to ascertain how they had benefited from the use of medical marijuana and how they had utilized the clubs. Interviews were augmented by participant observation techniques. Respondents reported highly positive health benefits from marijuana itself, and underscored even greater benefits from the social aspects of the clubs, which they described as providing important emotional supports. As such, cannabis clubs serve as crucial support mechanisms/groups for people with a wide variety of serious illnesses and conditions. The authors concluded that of the various methods so far proposed, the cannabis clubs afford the best therapeutic setting for providing medical cannabis and for offering a healing environment composed of like-minded, sympathetic friends.
Jovic, Sonia; Genolini, Christophe; Delpierre, Cyrille; Spilka, Stanislas; Ehlinger, Virginie; Ross, Jim; Arnaud, Catherine; Godeau, Emmanuelle
France presents one of the highest prevalence of teenagers aged 15-year-olds who report they already have experienced cannabis in Europe. Data from the French 2010 Health Behavior in School-aged Children (HSBC) survey and environmental parameters typifying schools' neighborhoods were used to study cannabis experimentation. We conducted a two-level logistic regression (clusters being schools) on 4,175 French 8th-10th graders from 156 schools. Several individual parameters were linked to cannabis experimentation. Living in a non-intact family, feeling insufficiently monitored, having poor communication with mother and being from a family with a high socio-economic status (SES) were all associated with increased risk of cannabis experimentation. At environmental level, only being in a priority education area was linked to this behavior, without explaining differences among schools.
This editorial reviews medicinal cannabis litigation in Canada's superior courts between 1998 and 2015. It reflects upon the outcomes of the decisions and the reasoning within them. It identifies the issues that have driven Canada's jurisprudence in relation to access to medicinal cannabis, particularly insofar as it has engaged patients' rights to liberty and security of the person. It argues that the sequence of medicinal schemes adopted and refined in Canada provides constructive guidance for countries such as Australia which are contemplating introduction of medicinal cannabis as a therapeutic option in compassionate circumstances for patients. In particular, it contends that Canada's experience suggests that strategies calculated to introduce such schemes in a gradualist way, enabling informed involvement by medical practitioners and pharmacists, and that provide for safe and inexpensive accessibility to forms of medicinal cannabis that are clearly distinguished from recreational use and unlikely to be diverted criminally maximise the chances of such schemes being accepted by key stakeholders.
Greydanus, D; Holt, M
Cannabis consumption has been popular for thousands of years and its historical use is noted in many parts of the world including ancient China, India, the Middle East. It is currently the most popular illicit drug in the world, is being utilized as a medicinal plant, and many parts of the world are legalizing this drug. This discussion considers various aspects of cannabis use including its prevalence, history, co-morbid drug abuse, designer cannabinoids, psychiatric adverse effects, medical adverse effects, and management options. The youth of the world should be comprehensively taught that cannabis is neither a safe nor a benign drug. Prevention with comprehensive drug education is the best plan for our youth since management of a chronic or heavy cannabis consummer remains difficult and fraught with failure if cessation is the goal. Caveat emptor!
Full Text Available Objective: The objective of this study is to examine Eysenck personality dimensions in cannabis users Method:100 regular cannabis users were selected and completed Eysenck Personality Questionnaire (EPQ which easures Neuroticism (N,Extraversion-Introversion (E-I and Psychoticism (P dimensions of Eysenck personality structures Results:The scores of 51% of cannabis users were higher than mean in all dimensions of EPQ. Also the mean score of N and P were higher than the score which Eysenck has reported for Iranian population Conclusions:This research reinforces our call for a public health information campaign about a drug which may young people still see as being risk-free.Psychiatric morbidity and cases of psychotic disorder could be prevented by discouraging cannabis use among vulnerable youths.
Katz, D; Katz, I; Porat-Katz, B S; Shoenfeld, Y
Legalization of cannabis' medicinal use is rapidly increasing worldwide, raising the need to evaluate medical implications of cannabis. Currently, evidence supports cannabis and its active ingredients as immune-modulating agents, affecting T-cells, B-cells, monocytes, and microglia cells, causing an overall reduction in pro-inflammatory cytokine expression and an increase in anti-inflammatory cytokines. Due to the supporting evidence of cannabinoids as an immune-modulating agent, research focusing on cannabinoids and autoimmunity has emerged. Several clinical trials in multiple sclerosis, inflammatory bowel disease, and fibromyalgia suggest cannabis' effectiveness as an immune-modulator. However, contradicting results and lack of large-scale clinical trials obscure these results. Although lacking clinical research, in vitro and in vivo experiments in rheumatoid arthritis, diabetes type 1, and systemic sclerosis demonstrate a correlation between disease activity and cannabinoids.
Tormey, William Patrick
A 37-year-old, one-pack-per-day tobacco smoker collapsed and died at home. At autopsy, he had an occluded left anterior descending coronary artery. Δ(9)-Tetrahydrocannabinol-carboxylic acid was found in his urine but no cannabinoids were detected in his blood. Misadventure was the inquest verdict on the basis of the urinary cannabis, with acute myocardial infarction as the primary cause and cannabis as the secondary cause of death. Such a conclusion is a misinterpretation of the evidence when the time duration for cannabis as a trigger for myocardial infarction is at most two hours. The absence of cannabis in the blood likely places the time since inhalation at more than two hours. The role of tobacco smoking as a trigger was ignored. Cotinine, the biochemical marker of tobacco smoke, should be added to the standard toxicological screen in the guidelines on autopsy practice of the Royal College of Pathologists.
Parolaa, Nathalie; Boyer, Laurent; Simon, Nicolas; Aghababian, Valérie; Lançon, Christophe
Addiction can involve substances (heroin, cannabis, cocaine) or be characterised by behaviour (pathological gambling, addiction to sport, etc.). The question is to establish whether or not there is a specific personality profile (character, temperament) and emotional functioning (anxiety, depression, alexithymia) in subjects presenting addictive behaviour with and without substance use. To find some answers, a team from Sainte-Marguerite General Hospital in Marseille carried out a study comparing a group of cannabis addicts and a group of pathological gamblers.
Sewell, R Andrew; Poling, James; Sofuoglu, Mehmet
The prevalence of both alcohol and cannabis use and the high morbidity associated with motor vehicle crashes has lead to a plethora of research on the link between the two. Drunk drivers are involved in 25% of motor vehicle fatalities, and many accidents involve drivers who test positive for cannabis. Cannabis and alcohol acutely impair several driving-related skills in a dose-related fashion, but the effects of cannabis vary more between individuals than they do with alcohol because of tolerance, differences in smoking technique, and different absorptions of Delta(9)-tetrahydrocannabinol (THC), the active ingredient in marijuana. Detrimental effects of cannabis use vary in a dose-related fashion, and are more pronounced with highly automatic driving functions than with more complex tasks that require conscious control, whereas alcohol produces an opposite pattern of impairment. Because of both this and an increased awareness that they are impaired, marijuana smokers tend to compensate effectively while driving by utilizing a variety of behavioral strategies. Combining marijuana with alcohol eliminates the ability to use such strategies effectively, however, and results in impairment even at doses which would be insignificant were they of either drug alone. Epidemiological studies have been inconclusive regarding whether cannabis use causes an increased risk of accidents; in contrast, unanimity exists that alcohol use increases crash risk. Furthermore, the risk from driving under the influence of both alcohol and cannabis is greater than the risk of driving under the influence of either alone. Future research should focus on resolving contradictions posed by previous studies, and patients who smoke cannabis should be counseled to wait several hours before driving, and avoid combining the two drugs.
van Bakel, Harm; Stout, Jake M.; Cote, Atina G; Tallon, Carling M; Sharpe, Andrew G; Hughes, Timothy R.; Page, Jonathan E.
Background Cannabis sativa has been cultivated throughout human history as a source of fiber, oil and food, and for its medicinal and intoxicating properties. Selective breeding has produced cannabis plants for specific uses, including high-potency marijuana strains and hemp cultivars for fiber and seed production. The molecular biology underlying cannabinoid biosynthesis and other traits of interest is largely unexplored. Results We sequenced genomic DNA and RNA from the marijuana strain Pur...
Dufresnes, C.; Jan, C.; Bienert, F.; Goudet, J; Fumagalli, L
Cannabis (hemp and marijuana) is an iconic yet controversial crop. On the one hand, it represents a growing market for pharmaceutical and agricultural sectors. On the other hand, plants synthesizing the psychoactive THC produce the most widespread illicit drug in the world. Yet, the difficulty to reliably distinguish between Cannabis varieties based on morphological or biochemical criteria impedes the development of promising industrial programs and hinders the fight against narcotrafficking....
An editorial in this issue describes a cannabis policy framework document issued by a major Canadian research centre, calling for legalization of non-medical use under strict controls to prevent increase in use, especially by adolescents and young adults who are most vulnerable to adverse effects of cannabis. It claims that such a system would eliminate the severe personal, social and monetary costs of prohibition, diminish the illicit market, and provide more humane management of cannabis use disorders. It claims that experience with regulation of alcohol and tobacco will enable a system based on public health principles to control access of youth to cannabis without the harm caused by prohibition. The present critique argues that the claims made against decriminalization and for legalization are unsupported, or even contradicted, by solid evidence. Early experience in other jurisdictions suggests that legalization increases use by adolescents and its attendant harms. Regulation of alcohol use does not provide a good model for cannabis controls because there is widespread alcohol use and harm among adolescents and young adults. Government monopolies of alcohol sale have been used primarily as sources of revenue rather than for guarding public health, and no reason has been offered to believe they would act differently with respect to cannabis. Good policy decisions require extensive unbiased information about the individual and social benefits and costs of both drug use and proposed control measures, and value judgments about the benefit/harm balance of each option. Important parts of the necessary knowledge about cannabis are not yet available, so that the value judgments are not yet possible. Therefore, a better case can be made for eliminating some of the harms of prohibition by decriminalization of cannabis possession and deferring decision about legalization until the necessary knowledge has been acquired.
Sami Isaac; Bandana Saini; Chaar, Betty B
Background Medicinal cannabis has recently attracted much media attention in Australia and across the world. With the exception of a few countries, cannabinoids remain illegal–known for their adverse effects rather than their medicinal application and therapeutic benefit. However, there is mounting evidence demonstrating the therapeutic benefits of cannabis in alleviating neuropathic pain, improving multiple sclerosis spasticity, reducing chemotherapy induced nausea and vomiting, and many oth...
Preparations derived from Cannabis nativa have been used as medicines throughout Europe and Asiasince the earliest written records, especially in the treatment of pain and inflammation. A number ofstudies have focused on specific aspects of Cannabis and its constituents, but very little commercialdevelopment activity has focused on the production of high quality, high value, standardised extracts(preferably low in the psychoactive constituent THC) which are orally active and suitable for clin...
Abdul I. Mahmad
Conclusion: Our patient reported the vomiting episodes were associated with the regular usage of cannabis over 19 years. One theory on the effectiveness of hot showers states that it may correct the disequilibrium of the thermoregulatory system in the hypothalamus. Another theory suggests that the concept of peripheral vasodilation and redistribution of blood flow from the splanchnic circulation to peripheral musculature helps decrease vomiting. This research gap shows that further studying of cannabis and its effects are still needed.
Pinarkara,Emine; Seyit A. KAYIS; Hakki, Erdogan E.; Sag,Ayla
Cannabis sativa L. is a multiple-use plant. However, its cultivation is strictly controlled due to its psychoactive nature and usage in producing drugs such as marijuana, and hashish. In this study, psychoactive type Cannabis samples, which were seized from 29 different locations of Turkey, were used. Interests were to identify the genetic relatedness of the seized samples and to partition molecular variance between and within populations. Randomly Amplified Polymorphic DNAs were employed for...
Full Text Available Medical cannabis is the dried flowers of the female Cannabis sativa L. plant. Cannabis contains a number of active elements, including dronabinol (THC and cannabidiol (CBD. Dronabinol is usually the main ingredient. The body’s own cannabinoid system has been identified. The discovery of this system, which comprises endocannabinoids and receptors, confirmed that cannabis has a positive effect on certain illnesses and conditions. Two types of cannabinoid receptors have been identified: CB1 and CB2 receptors. The first type CB1 is mostly found in the central nervous system, modulate pain. It also has an anti-emetic effect, and has influence on the memory and the motor system. The second type of receptors CB2 is peripheral, and it is primarily found in immune system cells and it is responsible for the immunomodulatory effects of cannabinoids. Medical cannabis can help in cases of the neurodegeneration disorders, for example Parkinson’s disease, Huntington’s Disease, Amyotrophic Lateral Sclerosis. Patients generally tolerate medical cannabis well.
Becker, Mary P; Collins, Paul F; Lim, Kelvin O; Muetzel, R L; Luciana, M
Diffusion tensor imaging (DTI) studies of cannabis users report alterations in brain white matter microstructure, primarily based on cross-sectional research, and etiology of the alterations remains unclear. We report findings from longitudinal voxelwise analyses of DTI data collected at baseline and at a 2-year follow-up on 23 young adult (18-20 years old at baseline) regular cannabis users and 23 age-, sex-, and IQ-matched non-using controls with limited substance use histories. Onset of cannabis use was prior to age 17. Cannabis users displayed reduced longitudinal growth in fractional anisotropy in the central and parietal regions of the right and left superior longitudinal fasciculus, in white matter adjacent to the left superior frontal gyrus, in the left corticospinal tract, and in the right anterior thalamic radiation lateral to the genu of the corpus callosum, along with less longitudinal reduction of radial diffusion in the right central/posterior superior longitudinal fasciculus, corticospinal tract, and posterior cingulum. Greater amounts of cannabis use were correlated with reduced longitudinal growth in FA as was relatively impaired performance on a measure of verbal learning. These findings suggest that continued heavy cannabis use during adolescence and young adulthood alters ongoing development of white matter microstructure, contributing to functional impairment.
Benschop, Annemieke; Liebregts, Nienke; van der Pol, Peggy; Schaap, Rick; Buisman, Renate; van Laar, Margriet; van den Brink, Wim; de Graaf, Ron; Korf, Dirk J
The Marijuana Motives Measure (MMM) has so far been examined mainly in student populations, often with relatively limited involvement in cannabis use. This study evaluated the factor structure of the MMM in a demographically mixed sample of 600 young adult (18-30 years) frequent (≥ 3 days per week) cannabis users in the Netherlands. Analysis confirmed a five-factor solution, denoting coping, enhancement, social, conformity and expansion motives. Additionally, the original MMM was extended with two items (boredom and habit), which formed a distinct, internally consistent sixth factor labelled routine motives. In a multivariable logistic regression analysis, coping and routine motives showed significant associations with 12-month DSM-IV cannabis dependence. The results suggest general reliability and validity of the MMM in a heterogeneous population of experienced cannabis users.
Toftdahl, Nanna Gilliam; Nordentoft, Merete; Hjorthøj, Carsten
OBJECTIVE: It remains unclear whether there is an association between severity of cannabis use and psychotic symptom severity over time. Shedding light on this under-researched matter could have clinical implications for this patient group. METHODS: This was a secondary analysis of a randomized......, parallel-group, superiority, assessor-blinded trial. We followed 60 patients with dually diagnosed psychosis and cannabis use disorders from the Danish CapOpus trial, which included assessments at baseline, post-treatment (6 months) and 10 months. Cannabis use was registered by self-report assisted...... and persistent cannabis use (severe use group) had significantly higher scores, as compared to those with minor use, on the positive symptom (17.0, 95% CI [4.7-19.2] vs. 12.7, 95% CI [10.4-15.0], respectively, adjusted p
Buckner, Julia D; Zvolensky, Michael J; Ecker, Anthony H; Jeffries, Emily R
Social anxiety disorder appears to be a risk factor for cannabis-related problems. Although it is presumed that increases in cannabis craving during elevated social anxiety reflect an intent to cope with greater negative affectivity, it is unclear whether increases in physiological arousal during social stress are related to cannabis craving, especially among those with social anxiety disorder. Similarly, no studies have assessed motivational reasons for cannabis use during elevated social stress. Thus, the current study tested whether increases in state social anxiety (measured subjectively and via physiological arousal) were related to greater cannabis craving among 126 current cannabis users (88.9% with cannabis use disorder, 31.7% with social anxiety disorder, 54.0% non-Hispanic Caucasian) randomly assigned to either a social interaction or reading task. As predicted, cannabis users in the social interaction condition reported greater cannabis craving than those in the reading condition. This effect was particularly evident among those with social anxiety disorder. Although physiological arousal did not moderate the relationship between condition and craving, coping motives were the most common reasons cited for wanting to use cannabis and were reported more among those in the social interaction task. These experimental results uniquely add to a growing literature suggesting the importance of elevated state social anxiety (especially among those with social anxiety disorder) in cannabis use vulnerability processes.
Ivonne Marie Figueroa-Rivera
Full Text Available Despite well-established antiemetic properties of marijuana, there has been increasing evidence of a paradoxical effect in the gastrointestinal tract and central nervous system, given rise to a new and underrecognized clinical entity called the Cannabinoid Hyperemesis Syndrome. Reported cases in the medical literature have established a series of patients exhibiting a classical triad of symptoms: cyclic vomiting, chronic marijuana use, and compulsive bathing. We present a case of a 29-year-old man whose clinical presentation strongly correlates with cannabinoid hyperemesis syndrome. Despite a diagnosis of exclusion, this syndrome should be considered plausible in the setting of a patient with recurrent intractable vomiting and a strong history of cannabis use as presented in this case.
Lucy J. Troup
Full Text Available As part of an ongoing research program into the relationship between cannabis use and emotion processing, participants were assessed on their level of cannabis exposure using the Recreational Cannabis Use Examination, a measure developed specifically to assess cannabis use in Colorado post state legalization. Three groups were created based on self-reported use: a control group who have never used, a casual user group and a chronic user group. Each participant also completed two measures of mood assessment, the Center for Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory. Relationships between cannabis use groups and scores on these measures were then analyzed using both correlations and multivariate analysis of variance. Results indicate a relationship between casual cannabis use and scoring highly for depressive symptomatology on the Center for Epidemiologic Studies Depression Scale. There were no significant relationships between cannabis use and scores on the State-Trait Anxiety Inventory.
Kreuter, M; Nowak, D; Rüther, T; Hoch, E; Thomasius, R; Vogelberg, C; Brockstedt, M; Hellmann, A; Gohlke, H; Jany, B; Loddenkemper, R
In this position paper, the adverse health effects of cannabis are reviewed based on the existing scientific literature; in addition possible symptom-relieving effects on some diseases are depicted. In Germany, cannabis is the most widely used illicit drug. Approximately 600,000 adult persons show abusive or addictive cannabis consumption. In 12 to 17 year old adolescents, cannabis use increased from 2011 to 2014 from 2.8 to 6.4%, and the frequency of regular use from 0.2 to 1.5%. Currently, handling of cannabinoids is much debated in politics as well as in general public. Health aspects have to be incorporated into this debate. Besides analysing mental and neurological side effects, this position paper will mainly focus on the influences on the bronchopulmonary and cardiovascular system. There is strong evidence for the induction of chronic bronchitis. Allergic reactions including asthma are known, too. Associations with other diseases like pulmonary emphysema, lung cancer and pneumonia are not sufficiently proven, however cannot be excluded either. In connection with the use of cannabis cardiovascular events such as coronary syndromes, peripheral vascular diseases and cerebral complications have been noted. Often, the evidence is insufficient due to various reasons; most notably, the overlapping effects of tobacco and cannabis use can frequently not be separated adequately. Empirically, early beginning, high-dosed, long-lasting and regular cannabis consumption increase the risk of various psychological and physical impairments and negatively affect age-based development. Concerns therefore relate especially to children and adolescents. There is only little scientific evidence for medical benefits through cannabis as a remedy; systematic research of good quality, in particular prospective, randomised, placebo-controlled double-blinded studies are rare. The medical societies signing this position paper conclude that cannabis consumption is linked to adverse health
Henquet, C.J.; Krabbendam, L.; Spauwen, P.H.M.; Kaplan, C.; Lieb, R.; Wittchen, H.U.; Os, J. van
OBJECTIVE: To investigate the relation between cannabis use and psychotic symptoms in individuals with above average predisposition for psychosis who first used cannabis during adolescence. DESIGN: Analysis of prospective data from a population based sample. Assessment of substance use, predispositi
Fischedick, Justin Thomas; Hazekamp, Arno; Erkelens, Tjalling; Choi, Young Hae; Verpoorte, Rob
Cannabis sativa L. is an important medicinal plant. In order to develop cannabis plant material as a medicinal product quality control and clear chemotaxonomic discrimination between varieties is a necessity. Therefore in this study 11 cannabis varieties were grown under the same environmental conditions. Chemical analysis of cannabis plant material used a gas chromatography flame ionization detection method that was validated for quantitative analysis of cannabis monoterpenoids, sesquiterpenoids, and cannabinoids. Quantitative data was analyzed using principal component analysis to determine which compounds are most important in discriminating cannabis varieties. In total 36 compounds were identified and quantified in the 11 varieties. Using principal component analysis each cannabis variety could be chemically discriminated. This methodology is useful for both chemotaxonomic discrimination of cannabis varieties and quality control of plant material.
Hartman, Christie A.; Gelhorn, Heather; Crowley, Thomas J.; Sakai, Joseph T.; Stallings, Michael; Young, Susan E.; Rhee, Soo Hyun; Corley, Robin; Hewitt, John K.; Hopfer, Christian J.
A study to examine the DSM-IV criteria for cannabis abuse and dependence among adolescents is conducted. Results conclude that abuse and dependence criteria were not found to affect the different levels of severity in cannabis use.
Wium-Andersen, Ida Kim; Wium-Andersen, Marie Kim; Becker, Ulrik
Early onset of tobacco and cannabis use predicts later substance abuse and risk behaviour and has large health consequences.......Early onset of tobacco and cannabis use predicts later substance abuse and risk behaviour and has large health consequences....
Baggio, S.; Deline, S.; Studer, J.; Mohler-Kuo, M.; Daeppen, J.B.; Gmel, G.
PURPOSE: Little is known regarding cannabis administration routes for nonmedical use-that is, its delivery methods (e.g., joints, water pipe, food). Therefore, we examined the prevalence rates of different cannabis delivery methods and assessed the relationship of the distinct administration routes with problematic drug use. Subgroups of cannabis users were also investigated (i.e., "pure" cannabis users, previously described as employing a harmless route of administration, and water pipe user...
Yücel, M; Lorenzetti, V; Suo, C; Zalesky, A; Fornito, A; Takagi, M J; Lubman, D I; Solowij, N
Shifting policies towards legalisation of cannabis for therapeutic and recreational use raise significant ethical issues for health-care providers seeking evidence-based recommendations. We investigated whether heavy cannabis use is associated with persistent harms to the hippocampus, if exposure to cannabidiol offers protection, and whether recovery occurs with abstinence. To do this, we assessed 111 participants: 74 long-term regular cannabis users (with an average of 15.4 years of use) and 37 non-user healthy controls. Cannabis users included subgroups of participants who were either exposed to Δ9-tetrahydrocannabinol (THC) but not to cannabidiol (CBD) or exposed to both, and former users with sustained abstinence. Participants underwent magnetic resonance imaging from which three measures of hippocampal integrity were assessed: (i) volume; (ii) fractional anisotropy; and (iii) N-acetylaspartate (NAA). Three curve-fitting models across the entire sample were tested for each measure to examine whether cannabis-related hippocampal harms are persistent, can be minimised (protected) by exposure to CBD or recovered through long-term abstinence. These analyses supported a protection and recovery model for hippocampal volume (P=0.003) and NAA (P=0.001). Further pairwise analyses showed that cannabis users had smaller hippocampal volumes relative to controls. Users not exposed to CBD had 11% reduced volumes and 15% lower NAA concentrations. Users exposed to CBD and former users did not differ from controls on any measure. Ongoing cannabis use is associated with harms to brain health, underpinned by chronic exposure to THC. However, such harms are minimised by CBD, and can be recovered with extended periods of abstinence.
Lopez-Pelayo, H.; Batalla, A.; Balcells, M.M.; Colom, J.; Gual, A.
BACKGROUND: Cannabis use and misuse have become a public health problem. There is a need for reliable screening and assessment tools to identify harmful cannabis use at an early stage. We conducted a systematic review of published instruments used to screen and assess cannabis use disorders. METHOD:
Hesse, Morten; Thylstrup, Birgitte
Background Evidence is accumulating that a cannabis withdrawal syndrome is common, of clinical significance, and has a clear time course. Up till now, very limited data exist on the cannabis withdrawal symptoms in patients with co-morbid substance use disorders, other than cannabis use and tobacc...
van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M.
Aims: To examine the course and the predictors of the persistence of cannabis dependence. Methods: Through cannabis outlets and chain referral, a prospective enriched community cohort of 207 young adults (aged 18-30) with DSM-IV cannabis dependence at baseline (T0) was formed and followed-up after 1
Marroun, H. el; Tiemeier, H.; Steegers, E.A.P.; Roos-Hesselink, J.W.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; Brink, W. van den; Huizink, A.C.
Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. Aims: This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. Methods: This study was embedded in the Gener
El Marroun, H.; Tiemeier, H.; Steegers, E.A.P.; Roos-Hesselink, J.W.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; van den Brink, W.; Huizink, A.C.
Background: Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. Aims: This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. Methods: This study was embedded
Hazekamp, Arno; Heerdink, Eibert R.
A growing number of countries are providing pharmaceutical grade cannabis to chronically ill patients. However, little published data is known about the extent of medicinal cannabis use and the characteristics of patients using cannabis on doctor's prescription. This study describes a retrospective
Cousijn, J.; van Benthem, P.; van der Schee, E.; Spijkerman, R.
Cannabis use disorders (CUDs) are the most prevalent substance use disorders among adolescents in treatment. Yet, little is known about the neuropsychological mechanisms underlying adolescent CUDs. Studies in adult cannabis users suggest a significant role for cognitive control and cannabis-oriented
Russo, Ethan B.
Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin, cannabigerol and cannabichromene, exert additional effects of therapeutic interest. Innovative conventional plant breeding has yielded cannabis chemotypes expres...
G.R. Potter; M.J. Barratt; A. Malm; M. Bouchard; T. Blok; A.S. Christensen; T. Decorte; V. Asmussen Frank; P. Hakkarainen; A. Klein; S. Lenton; J. Perälä; B. Werse; M. Wouters
Aims: To provide an overview of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; personal use of cannabis and other drugs; participation in cannabis and other drug markets; contacts with the criminal justice system for res
El Marroun, Hanan; Tiemeier, Henning; Steegers, Eric A. P.; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; van den Brink, Wim; Huizink, Anja C.
Objective: Cannabis is the most commonly consumed illicit drug among pregnant women. Intrauterine exposure to cannabis may result in risks for the developing fetus. The importance of intrauterine growth on subsequent psychological and behavioral child development has been demonstrated. This study examined the relation between maternal cannabis use…
Black, Shimrit K.; de Moor, Carl; Kendall, Ashley D.; Shrier, Lydia A.
This study examines the feasibility of recruiting and retaining adolescents and young adults with frequent cannabis use for a 2-week momentary sampling study of cannabis use. Participants responded to random signals on a handheld computer with reports of their use. Participants also initiated reports pre- and post-cannabis use. Participants had…
Cannabis is the most widely used illicit drug in the world. Although the risk of problematic cannabis use is relatively low, the lifetime prevalence of dependence is greater than for all other illicit drugs. As such, the population burden of problematic cannabis use warrants attention. Many health and psychosocial risks associated with cannabis…
Bender, Kimberly; Tripodi, Stephen J.; Sarteschi, Christy; Vaughn, Michael G.
Objective: This meta-analytic review assesses the effectiveness of substance abuse interventions to reduce adolescent cannabis use. Method: A systematic search identified 15 randomized controlled evaluations of interventions to reduce adolescent cannabis use published between 1960 and 2008. The primary outcome variables, frequency of cannabis use,…
H. El Marroun (Hanan)
textabstractSince centuries, cannabis is used for recreational, spiritual and medicinal purposes. Today, cannabis is one of the most commonly used illicit substances, also among pregnant women. In the last decades, levels of Δ9-tetrahydrocannabinol in cannabis products have increased, and these high
Verweij, K.J.H.; Agrawal, A.; Nat, N.O.; Creemers, H.E.; Huizink, A.C.; Martin, N.G.; Lynskey, M.T.
Background Various studies support the inclusion of cannabis withdrawal in the diagnosis of cannabis use disorder (CUD) in the upcoming DSM-5. The aims of the current study were to (1) estimate the prevalence of DSM-5 cannabis withdrawal (criterion B), (2) estimate the role of genetic and environmen
Stringer, S; Minică, C C; Verweij, K J H; Mbarek, H; Bernard, M; Derringer, J; van Eijk, K R; Isen, J D; Loukola, A; Maciejewski, D F; Mihailov, E; van der Most, P J; Sánchez-Mora, C; Roos, L; Sherva, R; Walters, R; Ware, J J; Abdellaoui, A; Bigdeli, T B; Branje, S J T; Brown, S A; Bruinenberg, M; Casas, M; Esko, T; Garcia-Martinez, I; Gordon, S D; Harris, J M; Hartman, C A; Henders, A K; Heath, A C; Hickie, I B; Hickman, M; Hopfer, C J; Hottenga, J J; Huizink, A C; Irons, D E; Kahn, R S; Korhonen, T; Kranzler, H R; Krauter, K; van Lier, P A C; Lubke, G H; Madden, P A F; Mägi, R; McGue, M K; Medland, S E; Meeus, W H J; Miller, M B; Montgomery, G W; Nivard, M G; Nolte, I M; Oldehinkel, A J; Pausova, Z; Qaiser, B; Quaye, L; Ramos-Quiroga, J A; Richarte, V; Rose, R J; Shin, J; Stallings, M C; Stiby, A I; Wall, T L; Wright, M J; Koot, H M; Paus, T; Hewitt, J K; Ribasés, M; Kaprio, J; Boks, M P; Snieder, H; Spector, T; Munafò, M R; Metspalu, A; Gelernter, J; Boomsma, D I; Iacono, W G; Martin, N G; Gillespie, N A; Derks, E M; Vink, J M
Cannabis is the most widely produced and consumed illicit psychoactive substance worldwide. Occasional cannabis use can progress to frequent use, abuse and dependence with all known adverse physical, psychological and social consequences. Individual differences in cannabis initiation are heritable (40–48%). The International Cannabis Consortium was established with the aim to identify genetic risk variants of cannabis use. We conducted a meta-analysis of genome-wide association data of 13 cohorts (N=32 330) and four replication samples (N=5627). In addition, we performed a gene-based test of association, estimated single-nucleotide polymorphism (SNP)-based heritability and explored the genetic correlation between lifetime cannabis use and cigarette use using LD score regression. No individual SNPs reached genome-wide significance. Nonetheless, gene-based tests identified four genes significantly associated with lifetime cannabis use: NCAM1, CADM2, SCOC and KCNT2. Previous studies reported associations of NCAM1 with cigarette smoking and other substance use, and those of CADM2 with body mass index, processing speed and autism disorders, which are phenotypes previously reported to be associated with cannabis use. Furthermore, we showed that, combined across the genome, all common SNPs explained 13–20% (P<0.001) of the liability of lifetime cannabis use. Finally, there was a strong genetic correlation (rg=0.83; P=1.85 × 10−8) between lifetime cannabis use and lifetime cigarette smoking implying that the SNP effect sizes of the two traits are highly correlated. This is the largest meta-analysis of cannabis GWA studies to date, revealing important new insights into the genetic pathways of lifetime cannabis use. Future functional studies should explore the impact of the identified genes on the biological mechanisms of cannabis use. PMID:27023175
Zgair, Atheer; Wong, Jonathan Cm; Lee, Jong Bong; Mistry, Jatin; Sivak, Olena; Wasan, Kishor M; Hennig, Ivo M; Barrett, David A; Constantinescu, Cris S; Fischer, Peter M; Gershkovich, Pavel
There has been an escalating interest in the medicinal use of Cannabis sativa in recent years. Cannabis is often administered orally with fat-containing foods, or in lipid-based pharmaceutical preparations. However, the impact of lipids on the exposure of patients to cannabis components has not been explored. Therefore, the aim of this study is to elucidate the effect of oral co-administration of lipids on the exposure to two main active cannabinoids, Δ(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD). In this study, oral co-administration of lipids enhanced the systemic exposure of rats to THC and CBD by 2.5-fold and 3-fold, respectively, compared to lipid-free formulations. In vitro lipolysis was conducted to explore the effect of lipids on the intestinal solubilisation of cannabinoids. More than 30% of THC and CBD were distributed into micellar fraction following lipolysis, suggesting that at least one-third of the administered dose will be available for absorption following co-administration with lipids. Both cannabinoids showed very high affinity for artificial CM-like particles, as well as for rat and human CM, suggesting high potential for intestinal lymphatic transport. Moreover, comparable affinity of cannabinoids for rat and human CM suggests that similar increased exposure effects may be expected in humans. In conclusion, co-administration of dietary lipids or pharmaceutical lipid excipients has the potential to substantially increase the exposure to orally administered cannabis and cannabis-based medicines. The increase in patient exposure to cannabinoids is of high clinical importance as it could affect the therapeutic effect, but also toxicity, of orally administered cannabis or cannabis-based medicines.
Danovitch, Itai; Gorelick, David A
The treatment of cannabis dependence can be viewed as a cup half empty or half full. On the one hand, few people who might benefit from treatment actually receive it. Among those who undergo treatment in randomized trials, long-term abstinence is achieved by fewer than 20%. Moderate use goals have been associated with decreases in consequences, but the differential impact of such goals on the long-term course of cannabis dependence is unknown. Optimal duration of treatment is unclear, and certain populations, particularly patients with co-occurring disorders, have not been studied adequately. Twelve-step programs are low cost, effective for other substance use disorders, and readily available in most regions of the world. However, their role and efficacy in cannabis dependence has not been examined. Finally, effective pharmacologic treatments are under development, but none have yet been firmly established. On the other hand, psychotherapeutic strategies used to treat other substance use disorders can be effective for cannabis dependence. A recent meta-analysis of psychosocial interventions for illicit substance use disorders found that treatments for cannabis dependence had comparatively larger effect sizes than treatments for other substance use disorders. Combination therapies have proven most effective, particularly those that begin with a motivational intervention, utilize incentives to enhance the commitment to change, and teach behavioral and cognitive copings skills to prevent relapse. Among adolescents, family engagement and collaboration with community stakeholders adds substantial value. Although only 9% of cannabis users develop cannabis dependence, the volume of people who smoke cannabis ensures that the total number of people in need of help is larger than the capacity of substance abuse specialty services. Thus, although efforts to refine and improve the efficacy of treatment interventions continue, innovations that increase the availability and
Full Text Available Abstract Background Substitution can be operationalized as the conscious choice to use one drug (legal or illicit instead of, or in conjunction with, another due to issues such as: perceived safety; level of addiction potential; effectiveness in relieving symptoms; access and level of acceptance. This practice of substitution has been observed among individuals using cannabis for medical purposes. This study examined drug and alcohol use, and the occurrence of substitution among medical cannabis patients. Methods Anonymous survey data were collected at the Berkeley Patient's Group (BPG, a medical cannabis dispensary in Berkeley, CA. (N = 350 The sample was 68% male, 54% single, 66% White, mean age was 39; 74% have health insurance (including MediCal, 41% work full time, 81% have completed at least some college, 55% make less than $40,000 a year. Seventy one percent report having a chronic medical condition, 52% use cannabis for a pain related condition, 75% use cannabis for a mental health issue. Results Fifty three percent of the sample currently drinks alcohol, 2.6 was the average number of drinking days per week, 2.9 was the average number of drinks on a drinking occasion. One quarter currently uses tobacco, 9.5 is the average number of cigarettes smoked daily. Eleven percent have used a non-prescribed, non OTC drug in the past 30 days with cocaine, MDMA and Vicodin reported most frequently. Twenty five percent reported growing up in an abusive or addictive household. Sixteen percent reported previous alcohol and/or drug treatment, and 2% are currently in a 12-step or other recovery program. Forty percent have used cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs and 66% as a substitute for prescription drugs. The most common reasons given for substituting were: less adverse side effects (65%, better symptom management (57%, and less withdrawal potential (34% with cannabis. Conclusion The substitution of one
Tormey, W P
BACKGROUND: The elevated risk of triggering a myocardial infarction by smoking cannabis is limited to the first 2 h after smoking. AIM: To examine the possible role of cannabis in cardiac deaths. CASES AND RESULTS: From 3,193 coroners\\' cases over 2 years, there were 13 cases where the clinical information was compatible with a primary cardiac cause of death. An inquest was held in three cases. Myocardial infarction was the primary cause of death in 54%. Other causes were sudden adult death syndrome, sudden death in epilepsy, and poisoning by alcohol and diazepam. Cannabis was mentioned once only on a death certificate, but not as a cause of death. Blood delta9-tetrahydrocannabinol-carboxylic acid was recorded in one case and in no case was plasma tetrahydrocannabinol (THC) measured. CONCLUSIONS: To attribute sudden cardiac death to cannabis, plasma THC should be measured in the toxicology screen in coroners\\' cases where urine cannabinoids are positive. A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis.
Walsh, Zach; Gonzalez, Raul; Crosby, Kim; S Thiessen, Michelle; Carroll, Chris; Bonn-Miller, Marcel O
This review considers the potential influences of the use of cannabis for therapeutic purposes (CTP) on areas of interest to mental health professionals, with foci on adult psychopathology and assessment. We identified 31 articles relating to the use of CTP and mental health, and 29 review articles on cannabis use and mental health that did not focus on use for therapeutic purposes. Results reflect the prominence of mental health conditions among the reasons for CTP use, and the relative dearth of high-quality evidence related to CTP in this context, thereby highlighting the need for further research into the harms and benefits of medical cannabis relative to other therapeutic options. Preliminary evidence suggests that CTP may have potential for the treatment of PTSD, and as a substitute for problematic use of other substances. Extrapolation from reviews of non-therapeutic cannabis use suggests that the use of CTP may be problematic among individuals with psychotic disorders. The clinical implications of CTP use among individuals with mood disorders are unclear. With regard to assessment, evidence suggests that CTP use does not increase risk of harm to self or others. Acute cannabis intoxication and recent CTP use may result in reversible deficits with the potential to influence cognitive assessment, particularly on tests of short-term memory.
Chandra, Suman; Lata, Hemant; ElSohly, Mahmoud A; Walker, Larry A; Potter, David
As studies continue to reveal favorable findings for the use of cannabidiol in the management of childhood epilepsy syndromes and other disorders, best practices for the large-scale production of Cannabis are needed for timely product development and research purposes. The processes of two institutions with extensive experience in producing large-scale cannabidiol chemotype Cannabis crops-GW Pharmaceuticals and the University of Mississippi-are described, including breeding, indoor and outdoor growing, harvesting, and extraction methods. Such practices have yielded desirable outcomes in Cannabis breeding and production: GW Pharmaceuticals has a collection of chemotypes dominant in any one of eight cannabinoids, two of which-cannabidiol and cannabidivarin-are supporting epilepsy clinical trial research, whereas in addition to a germplasm bank of high-THC, high-CBD, and intermediate type cannabis varieties, the team at University of Mississippi has established an in vitro propagation protocol for cannabis with no detectable variations in morphologic, physiologic, biochemical, and genetic profiles as compared to the mother plants. Improvements in phytocannabinoid yields and growing efficiency are expected as research continues at these institutions. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy".
Koppel, Barbara S
Cannabis has been used for many medicinal purposes, including management of spasms, dystonia, and dyskinesias, with variable success. Its use for tetanus was described in the second century BCE, but the literature continues to include more case reports and surveys of its beneficial effects in managing symptoms of hyperkinetic movement disorders than randomized controlled trials, making evidence-based recommendations difficult. This paper reviews clinical research using various formulations of cannabis (botanical products, oral preparations containing ∆(9)-tetrahydrocannabinol and/or cannabidiol) and currently available preparations in the USA (nabilone and dronabinol). This has been expanded from a recent systematic review of cannabis use in several neurologic conditions to include case reports and case series and results of anonymous surveys of patients using cannabis outside of medical settings, with the original evidence classifications marked for those papers that followed research protocols. Despite overlap in some patients, dyskinesias will be treated separately from dystonia and chorea; benefit was not established beyond individual patients for these conditions. Tics, usually due to Tourettes, did respond to cannabis preparations. Side effects reported in the trials will be reviewed but those due to recreational use, including the dystonia that can be secondary to synthetic marijuana preparations, are outside the scope of this paper.
The medical properties of cannabis have been known for many centuries; its first documented use dates back to 2800 BC when it was described for its hallucinogenic and pain-relieving properties. In the first half of the twentieth century, a number of pharmaceutical companies marked cannabis for indications such as asthma and pain, but since then its use has sharply declined, mainly due to its unpredictable effects, but also for socio-political issues. Recently, great attention has been directed to the medical properties of phytocannabinoids present in the cannabis plant alongside the main constituent Δ⁹-Tetrahydrocannabinol (THC); these include cannabinoids such as cannabidiol (CBD), cannabigerol (CBG), and tetrahydrocannabivarin (THCV). Evidence suggests an association between cannabis and schizophrenia: schizophrenics show a higher use of marijuana as compared to the healthy population. Additionally, the use of marijuana can trigger psychotic episodes in schizophrenic patients, and this has been ascribed to THC. Given the need to reduce the side effects of marketed antipsychotics, and their weak efficacy on some schizophrenic symptoms, cannabinoids have been suggested as a possible alternative treatment for schizophrenia. CBD, a non-psychoactive constituent of the Cannabis sativa plant, has been receiving growing attention for its anti-psychotic-like properties. Evidence suggests that CBD can ameliorate positive and negative symptoms of schizophrenia. Behavioural and neurochemical models suggest that CBD has a pharmacological profile similar to that of atypical anti-psychotic drugs and a clinical trial reported that this cannabinoid is a well-tolerated alternative treatment for schizophrenia.
Yoshimatsu, Kayo; Kitazawa, Takashi; Kawano, Noriaki; Iida, Osamu; Kawahara, Nobuo
Illegal cannabis (Cannabis sativa L.) cultivation is still a social problem worldwide. Fifty inquiries on cannabis that Research Center for Medicinal Plant Resources (Tsukuba Division) received between January 1, 2000 and March 31, 2009 were itemized in to 8 categories; 1: seed identification, 2: plant identification, 3: indoor cultivation, 4: outdoor cultivation, 5: germination and growth characteristics, 6: expected amount of cannabis products derived from illegal cannabis plant, 7: non-narcotic cannabis and 8: usage of medicinal cannabis. Top three inquiries were 1: seed identification (16 cases), 3: indoor cultivation (10 cases) and 4: outdoor cultivation (6 cases). Characteristics of cannabis, namely seed morphology, germination and growth characteristics, and distinction from kenaf (Hibiscus cannabinus L.) that is frequently misjudged as cannabis, were studied to contribute for prevention of illegal cannabis cultivation.
Russo, Ethan B; Guy, Geoffrey W; Robson, Philip J
Cannabis sativa L. has been utilized for treatment of pain and sleep disorders since ancient times. This review examines modern studies on effects of Delta9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on sleep. It goes on to report new information on the effects on sleep in the context of medical treatment of neuropathic pain and symptoms of multiple sclerosis, employing standardized oromucosal cannabis-based medicines containing primarily THC, CBD, or a 1 : 1 combination of the two (Sativex). Sleep-laboratory results indicate a mild activating effect of CBD, and slight residual sedation with THC-predominant extracts. Experience to date with Sativex in numerous Phase I-III studies in 2000 subjects with 1000 patient years of exposure demonstrate marked improvement in subjective sleep parameters in patients with a wide variety of pain conditions including multiple sclerosis, peripheral neuropathic pain, intractable cancer pain, and rheumatoid arthritis, with an acceptable adverse event profile. No tolerance to the benefit of Sativex on pain or sleep, nor need for dosage increases have been noted in safety extension studies of up to four years, wherein 40-50% of subjects attained good or very good sleep quality, a key source of disability in chronic pain syndromes that may contribute to patients' quality of life.
Pitts, J E; O'Neil, P J; Leggo, K P
The tetrahydrocannabinol (THC) content of more than 180 samples of fresh illicit Cannabis products, seized by H.M. Customs and Excise on entry into Great Britain and Northern Ireland over the period 1984-1989, has been determined by gas chromatography. The average THC content of herbal cannabis remained high due to good quality cannabis from Jamaica and the USA, but that of cannabis resin was slightly lower. Resin from Morocco has changed significantly in its physical appearance. There was no fresh seizure of cannabis oil in this period.
Adlaf, Edward M; Mann, Robert E; Paglia, Angela
Little is known about the risk of injury among adolescents who drive after the use of alcohol or cannabis or ride in cars driven by drunk drivers. We examined data from self-administered interviews with 1846 students in grades 7 to 13 who participated in the 2001 Ontario Student Drug Use Survey about their experiences related to alcohol, cannabis and driving during the 12 months preceding the survey. In all, 31.9% of the students reported being a passenger in a car driven by a drunk driver; of the students in grades 10 to 13 who had a driver's licence, 15.1% reported driving within an hour after consuming 2 or more drinks, and 19.7% reported driving within an hour after using cannabis. Our study shows that a sizeable proportion of adolescents are exposed to alcohol- and drug-related driving risks.
Hartman, Rebecca L; Brown, Timothy L; Milavetz, Gary; Spurgin, Andrew; Pierce, Russell S; Gorelick, David A; Gaffney, Gary; Huestis, Marilyn A
Although evidence suggests cannabis impairs driving, its driving-performance effects are not fully characterized. We aimed to establish cannabis' effects on driving longitudinal control (with and without alcohol, drivers' most common drug combination) relative to psychoactive ∆(9) -tetrahydrocannabinol (THC) blood concentrations. Current occasional (≥1×/last 3 months, ≤3 days per week) cannabis smokers drank placebo or low-dose alcohol, and inhaled 500 mg placebo, low (2.9%), or high (6.7%) THC vaporized cannabis over 10 min ad libitum in separate sessions (within-subject, six conditions). Participants drove (National Advanced Driving Simulator, University of Iowa) simulated drives 0.5-1.3 h post-inhalation. Blood and breath alcohol samples were collected before (0.17 and 0.42 h) and after (1.4 and 2.3 h) driving. We evaluated the mean speed (relative to limit), standard deviation (SD) of speed, percent time spent >10% above/below the speed limit (percent speed high/percent speed low), longitudinal acceleration, and ability to maintain headway relative to a lead vehicle (headway maintenance) against blood THC and breath alcohol concentrations (BrAC). In N=18 completing drivers, THC was associated with a decreased mean speed, increased percent speed low and increased mean following distance during headway maintenance. BrAC was associated with increased SD speed and increased percent speed high, whereas THC was not. Neither was associated with altered longitudinal acceleration. A less-than-additive THC*BrAC interaction was detected in percent speed high (considering only non-zero data and excluding an outlying drive event), suggesting cannabis mitigated drivers' tendency to drive faster with alcohol. Cannabis was associated with slower driving and greater headway, suggesting a possible awareness of impairment and attempt to compensate. Copyright © 2016 John Wiley & Sons, Ltd.
Erkens, J A; Janse, A F C; Herings, R M C
Since September 2003, cannabis is available for medicinal purposes in Dutch pharmacies to. It was anticipated that the medicinal cannabis use via illegal ways would decrease. The objective of this study was to get insight in the use of medicinal cannabis in daily practise as dispensed by community pharmacies and to characterize the users as well as the symptoms and conditions cannabis is prescribed for.A prospective follow-up study among 200 patients who filled a prescription for medicinal cannabis was performed in the period between September 2003 and January 2004. The patients filled out a structured questionnaire concerning symptoms and conditions and their experience with cannabis. Of all patients, 42% suffered from multiple sclerosis, 11% suffered from rheumatic diseases, and 60% of respondents already used cannabis before the legalization. Cannabis was mainly used for chronic pain and muscle cramp/stiffness.The indication of medicinal cannabis use was in accordance with the labeled indications. However, more than 80% of the patients still obtained cannabis for medicinal purpose from the illegal circuit. Because of the higher prices in pharmacies, ongoing debate on the unproven effectiveness of the drug and the hesitation by physicians to prescribe cannabis.
Gillman, Arielle S; Hutchison, Kent E; Bryan, Angela D
Policies regarding cannabis use are rapidly changing, yet public officials have limited access to scientific information that might inform the creation of these policies. One important area in which to begin investigations is the link between recreational cannabis use and health, specifically exercise. There are common anecdotal reports that cannabis decreases motivation, including motivation to exercise. On the other hand, there are also anecdotal reports that cannabis is used prior to athletic activity. In fact, the World Anti-Doping Agency includes cannabis as a prohibited substance in sport, partly because it is believed that it may enhance sports performance. At the current time, there is limited scientific evidence to support either one of these opposing lay perspectives. Given recent political, cultural, and legal trends, and the growing acceptance of recreational cannabis use, it is important to develop a more nuanced understanding of the relationship between cannabis and exercise, specifically the potential effects of use on exercise performance, motivation, and recovery.
Ribeiro, Luis IG; Ind, Philip W
As cannabis use increases, physicians need to be familiar with the effects of both cannabis and tobacco on the lungs. However, there have been very few long-term studies of cannabis smoking, mostly due to legality issues and the confounding effects of tobacco. It was previously thought that cannabis and tobacco had similar long-term effects as both cause chronic bronchitis. However, recent large studies have shown that, instead of reducing forced expiratory volume in 1 s and forced vital capacity (FVC), marijuana smoking is associated with increased FVC. The cause of this is unclear, but acute bronchodilator and anti-inflammatory effects of cannabis may be relevant. Bullous lung disease, barotrauma and cannabis smoking have been recognised in case reports and small series. More work is needed to address the effects of cannabis on lung function, imaging and histological changes. PMID:27763599
Baker, P B; Gough, T A; Johncock, S I; Taylor, B J; Wyles, L T
The tetrahydrocannabinol (THC) contents of 220 samples of fresh illicit Cannabis products seized on entry into the United Kingdom of Great Britain and Northern Ireland over the period 1979-1981 have been determined by gas chromatography. During that period there was a general increase in the quality of both cannabis and cannabis resin, but with wide variations in THC contents both within and between countries. Some very high quality samples of cannabis, cannabis resin and cannabis oil from the Indian sub-continent have been analysed. There have been considerable changes in the number of fresh samples from several countries, compared with the previous survey. Fresh cannabis oil samples were very rare during the period covered by this survey.
Shorey, Ryan C; Haynes, Ellen; Strauss, Catherine; Temple, Jeff R; Stuart, Gregory L
Dating violence is a serious and prevalent problem on college campuses. Although there is a robust literature documenting that alcohol use is consistently associated with increased risk for perpetrating dating violence, little research has examined the role of cannabis in dating violence perpetration. With increasing legalisation of cannabis throughout the world, it is imperative to understand what role, if any, cannabis may play in the important public health problem of dating violence. In this commentary, we discuss the current state of the research on cannabis and dating violence and suggest avenues for additional research in this area. It is critical that we conduct methodologically sound research on the association between cannabis and dating violence so that we can understand what role, if any, cannabis exerts on this important problem. [Shorey RC, Haynes E, Strauss C, Temple JR, Stuart GL. Cannabis use and dating violence among college students: A call for research. Drug Alcohol Rev 2017;36:17-19].
Full Text Available The present article reviews the main toxic effects of cannabis and cannabinoids in animals. Toxic effects can be separated into acute and chronic classifications. Acute toxicity studies show that it is virtually impossible to die from acute administration of marijuana or tetrahydrocannabinol, the main psychoactive component of cannabis. Chronic toxicity involves lesions of airway and lung tissues, as well as problems of neurotoxicity, tolerance and dependence, and dysregulations in the immune and hormonal systems. Animal toxicity data, however, are difficult to extrapolate to humans.
Honório Káthia Maria
Full Text Available Several cannabinoid compounds present therapeutic properties, but also have psychotropic effects, limiting their use as medicine. Nowadays, many important discoveries on the compounds extracted from the plant Cannabis sativa (cannabinoids have contributed to understand the therapeutic properties of these compounds. The main discoveries in the last years on the cannabinoid compounds were: the cannabinoid receptors CB1 and CB2, the endogenous cannabinoids and the possible mechanisms of action involved in the interaction between cannabinoid compounds and the biological receptors. So, from the therapeutical aspects presented in this work, we intended to show the evolution of the Cannabis sativa research and the possible medicinal use of cannabinoid compounds.
Thomas, Brian F.; Pollard, Gerald T.
Cannabis is classified as a schedule I controlled substance by the US Drug Enforcement Agency, meaning that it has no medicinal value. Production is legally restricted to a single supplier at the University of Mississippi, and distribution to researchers is tightly controlled. However, a majority of the population is estimated to believe that cannabis has legitimate medical or recreational value, numerous states have legalized or decriminalized possession to some degree, and the federal government does not strictly enforce its law and is considering rescheduling. The explosive increase in open sale and use of herbal cannabis and its products has occurred with widely variable and in many cases grossly inadequate quality control at all levels—growing, processing, storage, distribution, and use. This paper discusses elements of the analytical and regulatory system that need to be put in place to ensure standardization for the researcher and to reduce the hazards of contamination, overdosing, and underdosing for the end-user. PMID:27630566
Butsic, Van; Brenner, Jacob C.
Cannabis agriculture is a multi-billion dollar industry in the United States that is changing rapidly with policy liberalization. Anecdotal observations fuel speculation about associated environmental impacts, and there is an urgent need for systematic empirical research. An example from Humboldt County California, a principal cannabis-producing region, involved digitizing 4428 grow sites in 60 watersheds with Google Earth imagery. Grows were clustered, suggesting disproportionate impacts in ecologically important locales. Sixty-eight percent of grows were >500 m from developed roads, suggesting risk of landscape fragmentation. Twenty-two percent were on steep slopes, suggesting risk of erosion, sedimentation, and landslides. Five percent were cannabis agriculture documented in our study demands that it be regulated and researched on par with conventional agriculture.
Brian Frazier Thomas
Full Text Available Cannabis is classified as a schedule I controlled substance by the US Drug Enforcement Agency, meaning that it has no medicinal value. Production is legally restricted to a single supplier at the University of Mississippi, and distribution to researchers is tightly controlled. However, a majority of the population is estimated to believe that cannabis has legitimate medical or recreational value, numerous states have legalized or decriminalized possession to some degree, and the federal government does not strictly enforce its law and is considering rescheduling. The explosive increase in open sale and use of herbal cannabis and its products has occurred with widely variable and in many cases grossly inadequate quality control at all levels—growing, processing, storage, distribution, and use. This paper discusses elements of the analytical and regulatory system that need to be put in place to ensure standardization for the researcher and to reduce the hazards of contamination, overdosing and underdosing for the end-user.
Ferdinand, R.F.; Sondeijker, F.; Ende, J. van den; Huizink, A.C.; Verhulst, F.C.
Aims - To assess if cannabis use is a risk factor for future psychotic symptoms, and vice versa, in adolescents and young adults from the general population. Design Cohort study. Setting/participants - 'Zuid Holland' study, a 14-year follow-up study of 1580 initially 4-16-year-olds who were drawn ra
J. Cousijn; F. Filbey
The existence of cannabis dependence has been questioned for a long time (Murray et al., 2007). This debate has partly stemmed from an outdated view on substance use disorders (SUDs; Leshner, 1997), which measured the relative harm of substances of abuse through the severity of physical dependence (
Hurd, Yasmin L; Michaelides, Michael; Miller, Michael L; Jutras-Aswad, Didier
The adolescent brain is a period of dynamic development making it vulnerable to environmental factors such as drug exposure. Of the illicit drugs, cannabis is most used by teenagers since it is perceived by many to be of little harm. This perception has led to a growing number of states approving its legalization and increased accessibility. Most of the debates and ensuing policies regarding cannabis were done without consideration of its impact on one of the most vulnerable population, namely teens, or without consideration of scientific data. We provide an overview of the endocannabinoid system in relation to adolescent cannabis exposure and provide insights regarding factors such as genetics and behavioral traits that confer risk for subsequent addiction. While it is clear that more systematic scientific studies are needed to understand the long-term impact of adolescent cannabis exposure on brain and behavior, the current evidence suggests that it has a far-reaching influence on adult addictive behaviors particularly for certain subsets of vulnerable individuals. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'.
Szaflarski, Jerzy P; Bebin, E Martina
Recreational cannabis use in adults with epilepsy is widespread. The use of cannabis for medicinal purposes is also becoming more prevalent. For this purpose, various preparations of cannabis of varying strengths and content are being used. The recent changes in the legal environment have improved the availability of products with high cannabidiol (CBD) and low tetrahydrocannabinol (THC) concentrations. There is some anecdotal evidence of their potential efficacy, but the mechanisms of such action are not entirely clear. Some suspect an existence of synergy or "entourage effect" between CBD and THC. There is strong evidence that THC acts via the cannabinoid receptor CB1. The mechanism of action of CBD is less clear but is likely polypharmacological. The scientific data support the role of the endocannabinoid system in seizure generation, maintenance, and control in animal models of epilepsy. There are clear data for the negative effects of cannabis on the developing and mature brain though these effects appear to be relatively mild in most cases. Further data from well-designed studies are needed regarding short- and long-term efficacy and side effects of CBD or high-CBD/low-THC products for the treatment of seizures and epilepsy in children and adults.
Full Text Available Abstract Although little evidence supports cannabis-induced amotivational syndrome, sources continue to assert that the drug saps motivation 1, which may guide current prohibitions. Few studies report low motivation in chronic users; another reveals that they have higher subjective wellbeing. To assess differences in motivation and subjective wellbeing, we used a large sample (N = 487 and strict definitions of cannabis use (7 days/week and abstinence (never. Standard statistical techniques showed no differences. Robust statistical methods controlling for heteroscedasticity, non-normality and extreme values found no differences in motivation but a small difference in subjective wellbeing. Medical users of cannabis reporting health problems tended to account for a significant portion of subjective wellbeing differences, suggesting that illness decreased wellbeing. All p-values were above p = .05. Thus, daily use of cannabis does not impair motivation. Its impact on subjective wellbeing is small and may actually reflect lower wellbeing due to medical symptoms rather than actual consumption of the plant.
Salentijn, E.M.J.; Zhang, Qingying; Amaducci, Stefano; Yang, Ming; Trindade, L.M.
Fiber hemp (Cannabis sativa L.) is a sustainable and high yielding industrial crop that can help to meet the high global demand for fibers. Hemp can be grown for fiber, seeds, and/or for dual purpose in a wide range of geographic zones and climates. Currently the main hemp producing regions in th
Werf, van der H.
Fibre hemp ( Cannabis sativa L.) may be an alternative to wood as a raw material for the production of paper pulp. The effects of enviromnental factors and cultural measures on the functioning, yield and quality of fibre hemp crops in the Netherlands were investigated.Until flowering (generally in
Ronan, Patrick J; Wongngamnit, Narin; Beresford, Thomas P
Cannabis has been cultivated and used by humans for thousands of years. Research for decades was focused on understanding the mechanisms of an illegal/addictive drug. This led to the discovery of the vast endocannabinoid system. Research has now shifted to understanding fundamental biological questions related to one of the most widespread signaling systems in both the brain and the body. Our understanding of cannabinoid signaling has advanced significantly in the last two decades. In this review, we discuss the state of knowledge on mechanisms of Cannabis signaling in the brain and the modulation of key brain neurotransmitter systems involved in both brain reward/addiction and psychiatric disorders. It is highly probable that various cannabinoids will be found to be efficacious in the treatment of a number of psychiatric disorders. However, while there is clearly much potential, marijuana has not been properly vetted by the medical-scientific evaluation process and there are clearly a range of potentially adverse side-effects-including addiction. We are at crossroads for research on endocannabinoid function and therapeutics (including the use of exogenous treatments such as Cannabis). With over 100 cannabinoid constituents, the majority of which have not been studied, there is much Cannabis research yet to be done. With more states legalizing both the medicinal and recreational use of marijuana the rigorous scientific investigation into cannabinoid signaling is imperative.
Full Text Available The current communication includes a general overview of the scientific interest and medicianl chemistry aspects of Cannabis compounds. It relates to metabolism, pharmacological action and phisico-chemical analysis of these compounds, as well as of some isomers differing in spatial arrangement of functional groups.
Smith, Paul F
Prior to 2002, few clinical data were available to indicate whether cannabis extracts may be beneficial. However, in the last two years, results of several placebo-controlled clinical trials of orally administered compounds have been published, and these cast doubt on the efficacy of delta9-tetrahydrocannabinol (delta9-THC) in objectively reducing spasticity in MS. By contrast, it has been claimed that sublingually administered cannabis extracts that contain approximately equal concentrations of delta9-THC and cannabidiol, a natural cannabinoid that does not act on the CB1 receptor, can produce a statistically and clinically significant reduction in spasticity, although this claim has yet to be thoroughly validated. Nonetheless, results of preclinical trials also lend support to the hypothesis that the endogenous cannabinoid system may be involved in the regulation of spasticity and pain. A better indication of the clinical potential of the different cannabis extracts will have to await the publication of the most recent clinical trial data. This review critically evaluates the most recent evidence available on the potential use of medicinal extracts of cannabis to relieve pain and spasticity in multiple sclerosis.
Cannabis and ecstasy are among the most widely used illicit drugs in the world. However, there are substantial concerns about their neurotoxic potential for brain and brain function. Despite previous research, some crucial questions regarding the causality, course and clinical relevance have remaine
Huijbregts, Stephan C. J.; Griffith-Lendering, Merel F. H.; Vollebergh, Wilma A. M.; Swaab, Hanna
Background: Cannabis use has been associated with neurocognitive impairments and psychopathology. The strength of such associations does however appear to depend on many different factors, such as duration and intensity of use, but also differential susceptibility due to genetic make-up and environm
Reddy, Doodipala Samba; Golub, Victoria M
Recently, cannabis has been suggested as a potential alternative therapy for refractory epilepsy, which affects 30% of epilepsy, both adults and children, who do not respond to current medications. There is a large unmet medical need for new antiepileptics that would not interfere with normal function in patients with refractory epilepsy and conditions associated with refractory seizures. The two chief cannabinoids are Δ-9-tetrahyrdrocannabinol, the major psychoactive component of marijuana, and cannabidiol (CBD), the major nonpsychoactive component of marijuana. Claims of clinical efficacy in epilepsy of CBD-predominant cannabis or medical marijuana come mostly from limited studies, surveys, or case reports. However, the mechanisms underlying the antiepileptic efficacy of cannabis remain unclear. This article highlights the pharmacological basis of cannabis therapy, with an emphasis on the endocannabinoid mechanisms underlying the emerging neurotherapeutics of CBD in epilepsy. CBD is anticonvulsant, but it has a low affinity for the cannabinoid receptors CB1 and CB2; therefore the exact mechanism by which it affects seizures remains poorly understood. A rigorous clinical evaluation of pharmaceutical CBD products is needed to establish the safety and efficacy of their use in the treatment of epilepsy. Identification of mechanisms underlying the anticonvulsant efficacy of CBD is also critical for identifying other potential treatment options.
Moosmann, Bjoern; Roth, Nadine; Auwärter, Volker
Hair analysis for cannabinoids is extensively applied in workplace drug testing and in child protection cases, although valid data on incorporation of the main analytical targets, ∆9-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-THC (THC-COOH), into human hair is widely missing. Furthermore, ∆9-tetrahydrocannabinolic acid A (THCA-A), the biogenetic precursor of THC, is found in the hair of persons who solely handled cannabis material. In the light of the serious consequences of positive test results the mechanisms of drug incorporation into hair urgently need scientific evaluation. Here we show that neither THC nor THCA-A are incorporated into human hair in relevant amounts after systemic uptake. THC-COOH, which is considered an incontestable proof of THC uptake according to the current scientific doctrine, was found in hair, but was also present in older hair segments, which already grew before the oral THC intake and in sebum/sweat samples. Our studies show that all three cannabinoids can be present in hair of non-consuming individuals because of transfer through cannabis consumers, via their hands, their sebum/sweat, or cannabis smoke. This is of concern for e.g. child-custody cases as cannabinoid findings in a child's hair may be caused by close contact to cannabis consumers rather than by inhalation of side-stream smoke.
Cerdá, Magdalena; Moffitt, Terrie E; Meier, Madeline H; Harrington, HonaLee; Houts, Renate; Ramrakha, Sandhya; Hogan, Sean; Poulton, Richie; Caspi, Avshalom
With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18-38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (n=1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence.
Mané, Anna; Fernández-Expósito, Miguel; Bergé, Daniel; Gómez-Pérez, Laura; Sabaté, Agnés; Toll, Alba; Diaz, Laura; Diez-Aja, Cristobal; Perez, Victor
The mechanism underneath the relationship between cannabis and psychosis remains controversial, for which several hypotheses have been proposed, including cannabis as self-medication and cannabis as a risk for the development of psychosis. The aim of this work was to study the relationship between cannabis and psychosis in first-episode psychosis cannabis users and non-users, and non-psychotic cannabis users. The age at the first psychotic episode, duration of untreated psychosis, psychopathology and reasons for cannabis use were assessed. First-episode psychosis cannabis users showed an earlier age at psychosis onset than non-user patients. No significant differences in symptomatology were found. The distinguishing reasons to use cannabis for patients with first-episode psychosis with respect to non-psychotic users were to arrange their thoughts and deal with hallucinations and suspiciousness. These findings are in agreement with both hypotheses: self-medication and secondary psychosis hypothesis. However, longitudinal prospective cohort studies assessing reasons for cannabis use are needed to investigate both hypotheses and their complementarity.
Hwang, Joy; Arneson, Tom; St. Peter, Wendy
Objectives To assess Minnesota pharmacists’ preparedness for the state’s medical cannabis program in terms of professional competency in policies and regulations and in pharmacotherapy, as well as their concerns and perceptions about the impact on their practice. The secondary objective was to identify pharmacists’ perceptions about ways to reduce potential gaps in knowledge. Methods A Web-based 14-item questionnaire was distributed to all pharmacists whose email addresses were registered with the Minnesota Board of Pharmacy. Results Pharmacists reported limited knowledge of Minnesota state-level cannabis policies and regulations and felt that they were inadequately trained in cannabis pharmacotherapy. Most pharmacists were unprepared to counsel patients on medical cannabis and had many concerns regarding its availability and usage. Only a small proportion felt that the medical cannabis program would impact their practice. Pharmacists’ leading topics of interest for more education included Minnesota’s regulations on the medical cannabis program, cannabis pharmacotherapy, and the types and forms of cannabis products available for commercialization. Preferred modes of receiving information were electronic-based, including email and online continuing education credit. Since the survey’s completion, educational presentations have been provided to pharmacists and health professionals in Minnesota. Conclusion Pharmacists need more training and education on the regulatory and clinical aspects of cannabis in preparation for their work with patients in the medical cannabis program. PMID:27904305
de Jong, Floris A
Since 2003, medicinal cannabis has been legally cultivated and distributed in the Netherlands under the auspices of the Dutch Office of Medicinal Cannabis (BMC), part of the Ministry of Health, Welfare and Sport. As a result of this measure, the indication, dosage, administration route, and safety of cannabis can now be investigated, information necessary for justifying its potentially future position as a standard medicinal product. Despite the current lack of reliable scientific efficacy data, standardised medicinal cannabis without microbes has also been made available on prescription. This has led to a safer and more responsible use. However, it is a bridge too far to say that 'it doesn't hurt to try'. The legalization of medicinal cannabis has also stimulated the development of new purified cannabis-based products, although it is claimed that some patients specifically benefit from using cannabis as a whole product. Despite disappointing sales at the end of 2007, the Minister of Health, Welfare and Sport has announced that the current policy will be extended for a further five years. The Minister also indicated that he would consider discontinuing the availability of medicinal cannabis for patients, if new cannabis products are granted market authorization. This might, however, give rise to a new era of illegal cannabis use for medicinal purposes, notably for the use as a whole product.
Schmits, Emilie; Maurage, Pierre; Thirion, Romain; Quertemont, Etienne
Cannabis is one of the most commonly drugs used by teenagers. Expectancies about its effects play a crucial role in cannabis consumption. Various tools have been used to assess expectancies, mainly self-report questionnaires measuring explicit expectancies, but implicit measures based on experimental tasks have also been developed, measuring implicit expectancies. The aim of this study was to simultaneously assess implicit/explicit expectancies related to cannabis among adolescent users and non-users. 130 teenagers attending school (55 girls) were enrolled (Age: M=16.40 years); 43.84% had never used cannabis ("non-users") and 56.16% had used cannabis ("users"). They completed self-report questionnaires evaluating cannabis use, cannabis-related problems, effect expectancies (explicit expectancies), alcohol use, social and trait anxiety, depression, as well as three Implicit Association Tests (IAT) assessing implicit expectancies. Adolescents manifested more implicit affective associations (relaxation, excitation, negative) than neutral ones regarding cannabis. These were not related to explicit expectancies. Cannabis users reported more implicit relaxation expectancies and less negative explicit expectancies than non-users. The frequency of use and related problems were positively associated with the explicit expectancies regarding relaxation and enhancement, and were negatively associated with negative explicit expectancies and negative implicit expectancies. Findings indicate that implicit and explicit expectancies play different roles in cannabis use by adolescents. The implications for experimentation and prevention are discussed.
Looby, Alison; Earleywine, Mitch
Research reveals mixed results for the effects of cannabis on cognitive functioning. These divergent results might stem from stereotype threat (ST), which occurs when individuals believe that a group to which they belong is inferior, resulting in poor test performance. Widespread media coverage of purported cannabis-related deficits in cognitive functioning may elicit ST among cannabis users, particularly among men, who may be more likely than women to identify with the cannabis-user stereotype. To investigate this hypothesis, cannabis users (30 male, 27 female) read a summary of research indicating either that cannabis produced deficits (ST condition), or that cannabis actually created no changes in cognitive functions. Participants then completed cognitive tests. Examination of the gender x condition interaction revealed significant results on 4 tests: the California Verbal Learning Test-II immediate recall task, the Controlled Oral Word Association Test for number of words generated and number of switches between clusters, and the Digit Symbol Substitution Task. Males exposed to ST performed worse on all tests compared to men not exposed to ST, while women exposed to ST performed better than women not exposed. These results suggest that cognitive deficits observed in male cannabis users may be attributed to ST rather than decreased functioning. Surprisingly, women in the ST condition scored higher than controls. Perhaps female users do not identify with the typical cannabis stereotype. This study highlights the importance of disconfirming relevant stereotypes prior to examination of the cognitive abilities of cannabis users.
Rotherham, D; Harbison, S A
Cannabis sativa is both an illegal drug and a legitimate crop. The differentiation of illegal drug Cannabis from non-drug forms of Cannabis is relevant in the context of the growth of fibre and seed oil varieties of Cannabis for commercial purposes. This differentiation is currently determined based on the levels of tetrahydrocannabinol (THC) in adult plants. DNA based methods have the potential to assay Cannabis material unsuitable for analysis using conventional means including seeds, pollen and severely degraded material. The purpose of this research was to develop a single nucleotide polymorphism (SNP) assay for the differentiation of "drug" and "non-drug"Cannabis plants. An assay was developed based on four polymorphisms within a 399 bp fragment of the tetrahydrocannabinolic acid (THCA) synthase gene, utilising the snapshot multiplex kit. This SNP assay was tested on 94 Cannabis plants, which included 10 blind samples, and was able to differentiate between "drug" and "non-drug"Cannabis in all cases, while also differentiating between Cannabis and other species. Non-drug plants were found to be homozygous at the four sites assayed while drug Cannabis plants were either homozygous or heterozygous.
Full Text Available There is a growing need to provide treatment for cannabis users, yet engaging and maintaining this population in treatment is particularly difficult. Although past research has focused on the importance of therapeutic alliance on drug treatment outcomes, this is the first study to examine the dimensions of therapeutic alliance for cannabis users compared with users of alcohol or other drugs in a naturalistic setting. The acceptability of Internet-delivered interventions for drug and alcohol treatments is also investigated. Participants (N = 77 included clients who were receiving outpatient drug and alcohol treatment at a publicly-funded health service, including a Specialist Cannabis Clinic. The results indicated that one particular domain of alliance, Bond, was consistently lower, from both client and clinician perspectives, for current cannabis users relative to those not currently using cannabis. Client perceptions of Bond decreased as the severity of cannabis use increased (r =-0.373, p=0.02. Cannabis Clinic clients did not report a significantly lower Bond with their clinicians, suggesting that specialised cannabis services may be better placed to provide appropriate treatment for this population than embedding cannabis treatment within traditional drug and alcohol treatment teams. In addition, Internet/computer based treatments may be one potential way to engage, transition or retain cannabis users in treatment.Trial Registration: Australian Clinical Trial Registration Number: ACTRN12611000382976
Bruins, Jojanneke; Pijnenborg, Marieke Gh; Bartels-Velthuis, Agna A; Visser, Ellen; van den Heuvel, Edwin R; Bruggeman, Richard; Jörg, Frederike
Objective: In the general population cannabis use is associated with better cardiometabolic outcomes. Patients with severe mental illness frequently use cannabis, but also present increased cardiometabolic risk factors. We explore the association between cannabis use and cardiometabolic risk factors
Dufresnes, Christophe; Jan, Catherine; Bienert, Friederike; Goudet, Jérôme; Fumagalli, Luca
Cannabis (hemp and marijuana) is an iconic yet controversial crop. On the one hand, it represents a growing market for pharmaceutical and agricultural sectors. On the other hand, plants synthesizing the psychoactive THC produce the most widespread illicit drug in the world. Yet, the difficulty to reliably distinguish between Cannabis varieties based on morphological or biochemical criteria impedes the development of promising industrial programs and hinders the fight against narcotrafficking. Genetics offers an appropriate alternative to characterize drug vs. non-drug Cannabis. However, forensic applications require rapid and affordable genotyping of informative and reliable molecular markers for which a broad-scale reference database, representing both intra- and inter-variety variation, is available. Here we provide such a resource for Cannabis, by genotyping 13 microsatellite loci (STRs) in 1 324 samples selected specifically for fibre (24 hemp varieties) and drug (15 marijuana varieties) production. We showed that these loci are sufficient to capture most of the genome-wide diversity patterns recently revealed by NGS data. We recovered strong genetic structure between marijuana and hemp and demonstrated that anonymous samples can be confidently assigned to either plant types. Fibres appear genetically homogeneous whereas drugs show low (often clonal) diversity within varieties, but very high genetic differentiation between them, likely resulting from breeding practices. Based on an additional test dataset including samples from 41 local police seizures, we showed that the genetic signature of marijuana cultivars could be used to trace crime scene evidence. To date, our study provides the most comprehensive genetic resource for Cannabis forensics worldwide. PMID:28107530
Dufresnes, Christophe; Jan, Catherine; Bienert, Friederike; Goudet, Jérôme; Fumagalli, Luca
Cannabis (hemp and marijuana) is an iconic yet controversial crop. On the one hand, it represents a growing market for pharmaceutical and agricultural sectors. On the other hand, plants synthesizing the psychoactive THC produce the most widespread illicit drug in the world. Yet, the difficulty to reliably distinguish between Cannabis varieties based on morphological or biochemical criteria impedes the development of promising industrial programs and hinders the fight against narcotrafficking. Genetics offers an appropriate alternative to characterize drug vs. non-drug Cannabis. However, forensic applications require rapid and affordable genotyping of informative and reliable molecular markers for which a broad-scale reference database, representing both intra- and inter-variety variation, is available. Here we provide such a resource for Cannabis, by genotyping 13 microsatellite loci (STRs) in 1 324 samples selected specifically for fibre (24 hemp varieties) and drug (15 marijuana varieties) production. We showed that these loci are sufficient to capture most of the genome-wide diversity patterns recently revealed by NGS data. We recovered strong genetic structure between marijuana and hemp and demonstrated that anonymous samples can be confidently assigned to either plant types. Fibres appear genetically homogeneous whereas drugs show low (often clonal) diversity within varieties, but very high genetic differentiation between them, likely resulting from breeding practices. Based on an additional test dataset including samples from 41 local police seizures, we showed that the genetic signature of marijuana cultivars could be used to trace crime scene evidence. To date, our study provides the most comprehensive genetic resource for Cannabis forensics worldwide.
Akre, Christina; Michaud, Pierre-Andre; Berchtold, Andre; Suris, Joan-Carles
The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative…
Cunningham, John A; van Mierlo, Trevor
This brief report describes the development and first year of use of an Internet-based screener for Cannabis users. Two versions of the Check Your Cannabis screener were compared, one linked to an already established harm reduction website for young Cannabis users (as an exercise called "Check how I compare with others," on www.WhatsWithWeed.ca) and the other a standalone version (www.CheckYourCannabis.net). The What's With Weed version attracted ten times more users and had a significantly younger audience as compared to the standalone version, underlining the benefits of targeting a website to a specific audience and linking to websites with already established reputations. Further work is needed to establish any impact on actual Cannabis use from taking the Check Your Cannabis screener.
Le Guen, P-Y; Gestin, S; Plat, E; Quéhé, P; Bressollette, L
Cannabis is the most widely consumed drug in the world, particularly among young subjects. Cocaine is the third leading illicit drug. Cases of renal infarction associated with combined consumption of cannabis and cocaine have been reported in the literature. We describe the case of a 24-year-old man who presented renal and spleen infarction after massive consumption of cannabis and cocaine. Both vascular events arose on healthy arteries. Etiological tests were negative leading to the conclusion that the events resulted from a toxic cause related to cannabis and cocaine consumption. Different mechanisms, potentially including thrombosis, might explain the association of cannabis and cocaine with vascular events. We suggest that a systematic search for cannabis and cocaine consumption among young victims of vascular disease might be useful.
Schwitzer, Thomas; Gillet, Claudine; Bisch, Michaël; Di Patrizio, Paolo; Schwan, Raymund; Laprevote, Vincent
Cannabis and tobacco are two of the most prevalent addictive drugs used worldwide. Concurrent use of cannabis and tobacco is common, whether simultaneous in joints or not. In France, cannabis is mainly used in joints also containing tobacco. According to the current literature, combined use of cannabis and tobacco exacerbates on additive or multiplicative mode the somatic, psychological and social consequences of each drug. In addition, concurrent use of cannabis and tobacco potentiates tobacco and cannabis dependence, which maintains the use of both drugs, increases the risk of relapse and reduces motivation to care. Combined use thus leads to a reduced likelihood of therapeutic success. We discuss the usefulness of simultaneous cessation treatment together with the use of currently available pharmacological and psychological help as valuable therapeutic tools.
Jarvinen, Margaretha; Demant, Jakob Johan
This paper analyses ‘techniques of neutralisation’ among young people discussing cannabis in focus group interviews. The paper is based on data from focus group interviews with young Danes followed from when they were 14–15 years old in 2004 until they were 18–19 years old in 2008. In this period......, the participants’ attitudes towards cannabis undergo a radical change from being negative and sceptical into being predominantly positive and accepting; a change we describe as a ‘normalisation’ of cannabis use. Four techniques of neutralisation are identified in this process. First, the participants redefine...... the setting of cannabis use, simultaneously creating a new type of togetherness: relaxed social intoxication. Second, the effects of cannabis use are transformed from being ‘strange’ and ‘unpredictable’ to being ‘controllable’ by the individual user. Third, participants change their classification of cannabis...
Jin, Lexie Zhiyan; Rangan, Anna; Mehlsen, Jesper
Cannabis use has been found to stimulate appetite and potentially promote weight gain via activation of the endocannabinoid system. Despite the fact that the onset of cannabis use is typically during adolescence, the association between adolescence cannabis use and long-term change in body weight...... is generally unknown. This study aims to examine the association between adolescence cannabis use and weight change to midlife, while accounting for the use of other substances. The study applied 20 to 22 years of follow-up data on 712 Danish adolescents aged between 15 and 19 years at baseline. Self......-reported height and weight, cannabis, cigarette and alcohol use, socioeconomic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985. The follow-up survey was conducted in 2005. In total 19.1% (n = 136) of adolescents reported having used/using cannabis. Weight...
Raynal, Patrick; Chabrol, Henri
The aim of the study was to examine the association of schizotypal and borderline personality traits to cannabis use. Participants were 476 college students (95 males; 381 females; mean age of males=21; mean age of females=20.7) who completed self-report questionnaires assessing cannabis use, schizotypal and borderline personality traits. Problematic cannabis use, depressive symptoms, borderline and schizotypal traits were significantly inter-correlated. A logistic regression analysis showed that only borderline traits contributed significantly to cannabis use in the total sample. A multiple regression analysis showed that only schizotypal traits were positively and uniquely associated to problematic cannabis use symptoms among users. These results may imply that schizotypal traits are not a risk factor for initiating use, but may facilitate the development of problematic use symptoms among users. This study showed the necessity of taking into account schizotypal traits when exploring the relationships between depressive symptoms, borderline traits and cannabis use.
Full Text Available Cannabis is the most frequently used illicit drug worldwide. Cross-sectional neuroimaging studies suggest that chronic cannabis exposure and the development of cannabis use disorders may affect brain morphology. However, cross-sectional studies cannot make a conclusive distinction between cause and consequence and longitudinal neuroimaging studies are lacking. In this prospective study we investigate whether continued cannabis use and higher levels of cannabis exposure in young adults are associated with grey matter reductions. Heavy cannabis users (N = 20, age baseline M = 20.5, SD = 2.1 and non-cannabis using healthy controls (N = 22, age baseline M = 21.6, SD = 2.45 underwent a comprehensive psychological assessment and a T1- structural MRI scan at baseline and 3 years follow-up. Grey matter volumes (orbitofrontal cortex, anterior cingulate cortex, insula, striatum, thalamus, amygdala, hippocampus and cerebellum were estimated using the software package SPM (VBM-8 module. Continued cannabis use did not have an effect on GM volume change at follow-up. Cross-sectional analyses at baseline and follow-up revealed consistent negative correlations between cannabis related problems and cannabis use (in grams and regional GM volume of the left hippocampus, amygdala and superior temporal gyrus. These results suggests that small GM volumes in the medial temporal lobe are a risk factor for heavy cannabis use or that the effect of cannabis on GM reductions is limited to adolescence with no further damage of continued use after early adulthood. Long-term prospective studies starting in early adolescence are needed to reach final conclusions.
Rieder, Michael J
Cannabis is a psychoactive compound with a long history of recreational and therapeutic use. Current considerations regarding cannabis use for medical purposes in children have been stimulated by recent case reports describing its beneficial effect with refractory epilepsy. Overall, there are insufficient data to support either the efficacy or safety of cannabis use for any indications in children, and an increasing body of data suggests possible harm, most importantly in specific conditions....
Abdel-Salam, Omar M.E.; El-Din M. Gaafar, Alaa; El Sayed El-Shamarka, Marawa; Salem, Neveen A.
Haloperidol is a classic antipsychotic drug known for its propensity to cause extrapyramidal symptoms due to blockade of dopamine D2 receptors in the striatum. Interest in medicinal uses of cannabis is growing. Cannabis sativa has been suggested as a possible adjunctive in treatment of Parkinson's disease. The present study aimed to investigate the effect of repeated administration of an extract of Cannabis sativa on catalepsy and brain oxidative stress induced by haloperidol administration i...
In several countries with a National medicinal cannabis program, pharmaceutical regulations specify that herbal cannabis products must adhere to strict safety standards regarding microbial contamination. Treatment by gamma irradiation currently seems the only method available to meet these requirements. We evaluated the effects of irradiation treatment of four different cannabis varieties covering different chemical compositions. Samples were compared before and after standard gamma-irradiati...
Camera Ariella A
Full Text Available Abstract Background Cannabis use can frequently have adverse affects in those that use it and these can be amplified by various characteristics of an individual, from demographic and environmental variations to familial predisposition for mental illnesses. Methods The current study of 100 individuals, who were cannabis users during their adolescence and may still be users, was a survey of the self perceived effects of cannabis and their correlates. A reliable family member was also interviewed for determination of family history of various major mental illnesses and substance use. Results As many as 40% of cannabis users had paranoid feelings (suspiciousness when using cannabis, although the most frequent effect was feeling relaxed (46%. Having a familial background for mental illnesses such as depression or schizophrenia did not determine the effects of cannabis nor its pattern of use, although the number of subjects with such a history was small. An age at which an individual began using cannabis did have an effect on how heavily it was used and the heavier the cannabis use, the more likely the individual was also to have had psychotic symptoms after use. There were no sex differences in effects of cannabis. These results are tempered by the reliance on self-report for many of the variables ascertained. Conclusion Cannabis can frequently have negative effects in its users, which can be amplified by certain demographic and/or psychosocial factors. Thus, users with a specific profile may be at a higher risk of unpleasant effects from cannabis use and caution should be noted when cannabis is administered to young people for medicinal purposes.
In several countries with a National medicinal cannabis program, pharmaceutical regulations specify that herbal cannabis products must adhere to strict safety standards regarding microbial contamination. Treatment by gamma irradiation currently seems the only method available to meet these requirements. We evaluated the effects of irradiation treatment of four different cannabis varieties covering different chemical compositions. Samples were compared before and after standard gamma-irradiati...
Rentzsch, Johannes; Stadtmann, Ada; Montag, Christiane; Kunte, Hagen; Plöckl, Doris; Hellweg, Rainer; Gallinat, Jürgen; Kronenberg, Golo; Jockers-Scherübl, Maria Christiane
Long-term cannabis use may confer cognitive deficits and increased risk of psychosis. However, the relationship between cannabis use and schizophrenia is complex. In particular, little is known about the effects of chronic cannabis use on the attention-related electric brain response in schizophrenia. We investigated auditory novelty and oddball P300 evoked potentials in a mixed sample of first-episode and chronic schizophrenic patients and healthy controls with (SZCA, n = 20; COCA, n = 20, abstinence ≥28 days) or without (SZ, n = 20; CO, n = 20) chronic cannabis use. Duration of regular cannabis use was 8.3 ± 5.6 (SZCA) and 9.1 ± 7.1 (COCA) years. In general, schizophrenic patients showed reduced P300 amplitudes. Cannabis use was associated with both a reduced early and late left-hemispheric novelty P300. There was a significant 'diagnosis × cannabis' interaction for the left-hemispheric late novelty P300 in that cannabis use was associated with a reduced amplitude in the otherwise healthy but not in the schizophrenic group compared with their relative control groups (corrected p 0.9, respectively). The left-hemispheric late novelty P300 in the otherwise healthy cannabis group correlated inversely with amount and duration of cannabis use (r = -0.50, p = 0.024; r = -0.57, p = 0.009, respectively). Our study confirms attentional deficits with chronic cannabis use. However, cannabis use may lead to different cognitive sequelae in patients with schizophrenia and in healthy controls, possibly reflecting preexisting alterations in the endocannabinoid system in schizophrenia.
Aladić, K.; S. Jokić; Moslavac, T.; Tomas, S.; S Vidović; Vladić, J.; Šubarić, D.
In the past few decades, the Cannabis sativa L. hemp variety has been unfairly neglected because of its similarity to the illegal kind Cannabis indica used as a narcotic. The objective of this study was to evaluate the process of oil extraction from Cannabis sativa seeds by cold pressing, followed by extraction with supercritical CO2. In the pressing experiments, the response surface methodology was conducted in order to study the effects of temperature, frequency, and nozzle size on oil reco...
Jin, Lexie Zhiyan; Rangan, Anna; Mehlsen, Jesper; Andersen, Lars Bo; Larsen, Sofus C.; Heitmann, Berit L.
Cannabis use has been found to stimulate appetite and potentially promote weight gain via activation of the endocannabinoid system. Despite the fact that the onset of cannabis use is typically during adolescence, the association between adolescence cannabis use and long-term change in body weight is generally unknown. This study aims to examine the association between adolescence cannabis use and weight change to midlife, while accounting for the use of other substances. The study applied 20 to 22 years of follow-up data on 712 Danish adolescents aged between 15 and 19 years at baseline. Self-reported height and weight, cannabis, cigarette and alcohol use, socioeconomic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985. The follow-up survey was conducted in 2005. In total 19.1% (n = 136) of adolescents reported having used/using cannabis. Weight gain between adolescence and midlife was not related to cannabis exposure during adolescence in either crude or adjusted models, and associations were not modified by baseline alcohol intake or smoking. However, cannabis use was significantly associated with cigarette smoking (p<0.001) and alcohol intake (p<0.001) and inversely associated with physical activity levels (p = 0.04). In conclusion, this study does not provide evidence of an association between adolescence cannabis use and weight change from adolescence to midlife. PMID:28060830
Leite, Rafaela Torres Portugal; Nogueira, Sarah de Oliveira; do Nascimento, João Paulo Rodrigues; de Lima, Laisa Soares; da Nóbrega, Taís Bastos; Virgínio, Mariana da Silva; Moreno, Lucas Monte da Costa; Sampaio, Bruno Henrique Barbosa; Souza, Fábio Gomes de Matos e
Introduction. Bipolar disorder (BD) implies risk of suicide. The age at onset (AAO) of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts. Materials and Methods. PubMed database was searched for articles using key words “bipolar disorder,” “suicide attempts,” “cannabis,” “marijuana,” “early age at onset,” and “early onset.” Results. The following percentages in bipolar patients were found: suicide attempts 3.6–42%; suicide attempts and substance use 5–60%; suicide attempts and cannabis use 15–42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD) was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide. Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear. PMID:26097750
Cunningham, John A; van Mierlo, Trevor
This brief report describes the development and first year of use of an Internet-based screener for Cannabis users. Two versions of the Check Your Cannabis screener were compared, one linked to an already established harm reduction website for young Cannabis users (as an exercise called “Check how I compare with others,” on www.WhatsWithWeed.ca) and the other a standalone version (www.CheckYourCannabis.net). The What’s With Weed version attracted ten times more users and had a significantly y...
Minor, Kyle S; Firmin, Ruth L; Bonfils, Kelsey A; Chun, Charlotte A; Buckner, Julia D; Cohen, Alex S
Evidence suggests that divergent thinking (DT), a measure of creativity, is associated with positive schizotypy and cannabis use. Given the high rates of cannabis use among those with schizotypy, it is unclear if the relation of DT to schizotypy is due to co-occurring cannabis use. In this study, we examined the relations between DT, schizotypy, and cannabis use among positive schizotypy (n=66), negative schizotypy (n=22), and non-schizotypy (n=60) groups. Results revealed that DT was greater in the positive schizotypy group, on the order of small to medium effects, compared to negative and non-schizotypy groups. Cannabis use and DT were associated in the non-schizotypy group, but not in the positive or negative schizotypy groups. Across all groups, positive schizotypy significantly predicted DT; however, cannabis use was not a significant predictor of DT. In line with previous findings, cannabis use and DT were only related in individuals low in creativity. This suggests that a ceiling effect may be present, with only cannabis users who are low in creativity receiving any increase in DT. Future research should aim to clarify the DT-cannabis relationship.
In several countries with a National medicinal cannabis program, pharmaceutical regulations specify that herbal cannabis products must adhere to strict safety standards regarding microbial contamination. Treatment by gamma irradiation currently seems the only method available to meet these requirements. We evaluated the effects of irradiation treatment of four different cannabis varieties covering different chemical compositions. Samples were compared before and after standard gamma-irradiation treatment by performing quantitative UPLC analysis of major cannabinoids, as well as qualitative GC analysis of full cannabinoid and terpene profiles. In addition, water content and microscopic appearance of the cannabis flowers was evaluated. This study found that treatment did not cause changes in the content of THC and CBD, generally considered as the most important therapeutically active components of medicinal cannabis. Likewise, the water content and the microscopic structure of the dried cannabis flowers were not altered by standard irradiation protocol in the cannabis varieties studied. The effect of gamma-irradiation was limited to a reduction of some terpenes present in the cannabis, but keeping the terpene profile qualitatively the same. Based on the results presented in this report, gamma irradiation of herbal cannabis remains the recommended method of decontamination, at least until other more generally accepted methods have been developed and validated.
Full Text Available In several countries with a National medicinal cannabis program, pharmaceutical regulations specify that herbal cannabis products must adhere to strict safety standards regarding microbial contamination. Treatment by gamma irradiation currently seems the only method available to meet these requirements. We evaluated the effects of irradiation treatment of four different cannabis varieties covering different chemical compositions. Samples were compared before and after standard gamma-irradiation treatment by performing quantitative HPLC analysis of major cannabinoids, as well as qualitative GC analysis of full cannabinoid and terpene profiles. In addition, water content and microscopic appearance of the cannabis flowers was evaluated. This study found that treatment did not cause changes in the content of THC and CBD, generally considered as the most important therapeutically active components of medicinal cannabis. Likewise, the water content and the microscopic structure of the dried cannabis flowers were not altered by standard irradiation protocol in the cannabis varieties studied. The effect of gamma-irradiation was limited to a reduction of some terpenes present in the cannabis, but keeping the terpene profile qualitatively the same. Based on the results presented in this report, gamma irradiation of herbal cannabis remains the recommended method of decontamination, at least until other more generally accepted methods have been developed and validated.
Woodruff, Susan I.; McCabe, Cameron T.; Hohman, Melinda; Clapp, John D.; Shillington, Audrey M.; Eisenberg, Kimberly; Sise, C. Beth; Castillo, Edward M.; Chan, Theodore C.; Sise, Michael J.
Abstract Emergency department (ED) settings have gained interest as venues for illegal drug misuse prevention and intervention, with researchers and practitioners attempting to capitalize on the intersection of need and opportunity within these settings. This study of 686 adult patients visiting two EDs for various reasons who admitted drug use compared daily cannabis-only users, nondaily cannabis-only users, and other drug users on sociodemographic and drug-related severity outcomes. The three drug use groups did not differ on most sociodemographic factors or medical problem severity scores. Forty-five percent of the sample was identified as having a drug use problem. ED patients who used drugs other than cannabis were at particular risk for high drug use severity indicators and concomitant problems such as psychiatric problems and alcohol use severity. However, 19–29% of cannabis-only users were identified as having problematic drug use. Furthermore, daily cannabis-only users fared less well than nondaily cannabis users with regard to drug use severity indicators and self-efficacy for avoiding drug use. Results may assist emergency medicine providers and medical social workers in matching patients to appropriate intervention. For example, users of drugs other than cannabis (and perhaps heavy, daily cannabis-only users) may need referral to specialty services for further assessment. Enhancement of motivation and self-efficacy beliefs could be an important target of prevention and treatment for cannabis-only users screened in the ED. PMID:27689138
Troup, Lucy J; Bastidas, Stephanie; Nguyen, Maia T; Andrzejewski, Jeremy A; Bowers, Matthew; Nomi, Jason S
The effect of cannabis on emotional processing was investigated using event-related potential paradigms (ERPs). ERPs associated with emotional processing of cannabis users, and non-using controls, were recorded and compared during an implicit and explicit emotional expression recognition and empathy task. Comparisons in P3 component mean amplitudes were made between cannabis users and controls. Results showed a significant decrease in the P3 amplitude in cannabis users compared to controls. Specifically, cannabis users showed reduced P3 amplitudes for implicit compared to explicit processing over centro-parietal sites which reversed, and was enhanced, at fronto-central sites. Cannabis users also showed a decreased P3 to happy faces, with an increase to angry faces, compared to controls. These effects appear to increase with those participants that self-reported the highest levels of cannabis consumption. Those cannabis users with the greatest consumption rates showed the largest P3 deficits for explicit processing and negative emotions. These data suggest that there is a complex relationship between cannabis consumption and emotion processing that appears to be modulated by attention.
Agüí Palomo, Antonio
El cannabis es conocido en nuestra sociedad por su uso como droga de abuso, bien en forma de marihuana, de hachís y, menos frecuentemente de aceite de hachís. Además, la planta del cáñamo (cannabis sativa) es utilizada para producción de fibras, biocombustibles, grasas vegetales, etc. ¿Qué situación legal encontramos en el cultivo del cannabis? ¿Está permitida la producción de plantas con determinados contenidos en THC? Cannabis is known in our society for iys use as a drug ...
Rafaela Torres Portugal Leite
Full Text Available Introduction. Bipolar disorder (BD implies risk of suicide. The age at onset (AAO of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts. Materials and Methods. PubMed database was searched for articles using key words “bipolar disorder,” “suicide attempts,” “cannabis,” “marijuana,” “early age at onset,” and “early onset.” Results. The following percentages in bipolar patients were found: suicide attempts 3.6–42%; suicide attempts and substance use 5–60%; suicide attempts and cannabis use 15–42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide. Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear.
Full Text Available Cannabis sativa is an annual plant in the Cannabaceae family, species of the genus Cannabis. Cannabis contains active elements, including Δ9-tetrahydrocanabinol (THC and cannabidiol (CBD. Neurological disorders are typically associated with neurodegeneration. It means that there is no causal treatment. Usually we can only modulate disease. It is very necessary to patients to reduce pain sensation or excessive muscle tension. The paper contains a description of therapeutic possibilities treatment of cannabis in neurological disorders such as Alzheimer’s disease, multiple sclerosis, Tourette syndrome and spasticity.
van Rossum, Inge; Boomsma, Maarten; Tenback, Diederik
. Additionally, cannabis users experienced less satisfaction with life and had a lower probability of having a relationship compared with nonusers. There was little evidence that cannabis-outcome associations were mediated by third variables. An independent impact of cannabis use on psychopathologic outcomes...... treatment outcome measures was examined over the course of 1 year, as well as the effects on these associations of third mediating variables. Over 12 months of treatment, cannabis users exhibited less compliance and higher levels of overall illness severity, mania, and psychosis compared with nonusers...
Full Text Available Abstract Background Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs. Methods Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426, Colombia (n = 5,782 and the United States (USA; n = 8,228. The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO users across these surveyed populations. Results The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004 and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001. Conclusions This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that
GW Pharmaceuticals is undertaking a major research programme in the UK to develop and market distinct cannabis-based prescription medicines [THC:CBD, High THC, High CBD] in a range of medical conditions. The cannabis for this programme is grown in a secret location in the UK. It is expected that the product will be marketed in the US in late 2003. GW's cannabis-based products include selected phytocannabinoids from cannabis plants, including D9 tetrahydrocannabinol (THC) and cannabidiol (CBD). The company is investigating their use in three delivery systems, including sublingual spray, sublingual tablet and inhaled (but not smoked) dosage forms. The technology is protected by patent applications. Four different formulations are currently being investigated, including High THC, THC:CBD (narrow ratio), THC:CBD (broad ratio) and High CBD. GW is also developing a specialist security technology that will be incorporated in all its drug delivery systems. This technology allows for the recording and remote monitoring of patient usage to prevent any potential abuse of its cannabis-based medicines. GW plans to enter into agreements with other companies following phase III development, to secure the best commercialisation terms for its cannabis-based medicines. In June 2003, GW announced that exclusive commercialisation rights for the drug in the UK had been licensed to Bayer AG. The drug will be marketed under the Sativex brand name. This agreement also provides Bayer with an option to expand their license to include the European Union and certain world markets. GW was granted a clinical trial exemption certificate by the Medicines Control Agency to conduct clinical studies with cannabis-based medicines in the UK. The exemption includes investigations in the relief of pain of neurological origin and defects of neurological function in the following indications: multiple sclerosis (MS), spinal cord injury, peripheral nerve injury, central nervous system damage, neuroinvasive
Cannabis sativa L. (Cannabaceae) is the oldest known medicinal plant. For millennia, the plant has also been used for fibre and oil production.The most prominent feature of C. sativa is the psychoactive effect ascribed to its secondary metabolites, cannabinoids (mainly to tetrahydrocannabinol, THC). However, many other pharmacological properties of the aforementioned specialized compounds have been described. Currently, the demand for THC for various medical applications is substantial, while...
Bjoern Moosmann; Nadine Roth; Volker Auwärter
Hair analysis for cannabinoids is extensively applied in workplace drug testing and in child protection cases, although valid data on incorporation of the main analytical targets, ∆9-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-THC (THC-COOH), into human hair is widely missing. Furthermore, ∆9-tetrahydrocannabinolic acid A (THCA-A), the biogenetic precursor of THC, is found in the hair of persons who solely handled cannabis material. In the light of the serious consequences of positive tes...
Mason, Barbara J; Crean, Rebecca; Goodell, Vivian; Light, John M; Quello, Susan; Shadan, Farhad; Buffkins, Kimberly; Kyle, Mark; Adusumalli, Murali; Begovic, Adnan; Rao, Santosh
There are no FDA-approved pharmacotherapies for cannabis dependence. Cannabis is the most widely used illicit drug in the world, and patients seeking treatment for primary cannabis dependence represent 25% of all substance use admissions. We conducted a phase IIa proof-of-concept pilot study to examine the safety and efficacy of a calcium channel/GABA modulating drug, gabapentin, for the treatment of cannabis dependence. A 12-week, randomized, double-blind, placebo-controlled clinical trial was conducted in 50 unpaid treatment-seeking male and female outpatients, aged 18-65 years, diagnosed with current cannabis dependence. Subjects received either gabapentin (1200 mg/day) or matched placebo. Manual-guided, abstinence-oriented individual counseling was provided weekly to all participants. Cannabis use was measured by weekly urine toxicology and by self-report using the Timeline Followback Interview. Cannabis withdrawal symptoms were assessed using the Marijuana Withdrawal Checklist. Executive function was measured using subtests from the Delis-Kaplan Executive Function System. Relative to placebo, gabapentin significantly reduced cannabis use as measured both by urine toxicology (p=0.001) and by the Timeline Followback Interview (p=0.004), and significantly decreased withdrawal symptoms as measured by the Marijuana Withdrawal Checklist (pGabapentin was also associated with significantly greater improvement in overall performance on tests of executive function (p=0.029). This POC pilot study provides preliminary support for the safety and efficacy of gabapentin for treatment of cannabis dependence that merits further study, and provides an alternative conceptual framework for treatment of addiction aimed at restoring homeostasis in brain stress systems that are dysregulated in drug dependence and withdrawal.
The marijuana plant Cannabis sativa and its derivatives, cannabinoids, have grown increasingly popular as a potential therapy for inflammatory bowel disease (IBD). Studies have shown that modulation of the endocannabinoid system, which regulates various functions in the body and has been shown to play a key role in the pathogenesis of IBD, has a therapeutic effect in mouse colitis. Epidemiologic data and human therapy studies reveal a possible role for cannabinoids in the symptomatic treatment of IBD, although it has yet to be determined in human populations whether cannabinoids have therapeutic anti-inflammatory effects in IBD or are simply masking its many debilitating symptoms. Large, double-blind, randomized, placebo-controlled trials using serial inflammatory markers, biopsy findings, and endoscopic disease severity to demonstrate objective improvement in IBD are necessary before cannabis can be empirically accepted and recommended as an IBD treatment option. Questions concerning its safety profile and adverse effects prompt the need for further research, particularly in regard to dosing and route of administration to maximize benefits and limit potential harms. Cannabis use should be reserved for symptomatic control in patients with severe IBD refractory to the currently available standard-of-care and complementary and alternative medicines. PMID:28035196
Walker, Denise D; Stephens, Robert S; Towe, Sheri; Banes, Kelsey; Roffman, Roger
Substance use disorders, including cannabis use disorders and associated negative consequences, are best considered chronic and in need of continuing care. In contrast, most treatment efficacy studies evaluate a fixed number of intervention sessions at a single point in time. The present study evaluated the efficacy of posttreatment maintenance check-ups (MCUs) in maintaining and improving outcomes following nine sessions of motivational enhancement treatment/cognitive behavioral treatment (MET/CBT). Adults dependent on cannabis (n=74) were randomly assigned to the MCU or a no check-up (NCU) condition and followed up at 3- and 9-months. MCU sessions occurred 1 and 4months following the completion of the base treatment. Additional MET/CBT sessions were available to participants throughout the follow-up period. The MCUs specifically encouraged treatment re-entry for those showing ongoing signs of disorder. Participants in the MCU condition reported significantly greater abstinent rates at both follow-ups and were using on fewer days at the 3-month but not the 9-month follow-up. Contrary to hypotheses, MCU participants did not attend more additional treatment and differences in rates of cannabis use emerged prior to the first MCU session. Future research with longer follow-up periods and longer monitoring of outcomes is needed to fully evaluate the utility of MCUs or other forms of continuing care.
Full Text Available A high dose of delta9-tetrahydrocannabinol, the main Cannabis sativa (cannabis component, induces anxiety and psychotic-like symptoms in healthy volunteers. These effects of delta9-tetrahydrocannabinol are significantly reduced by cannabidiol (CBD, a cannabis constituent which is devoid of the typical effects of the plant. This observation led us to suspect that CBD could have anxiolytic and/or antipsychotic actions. Studies in animal models and in healthy volunteers clearly suggest an anxiolytic-like effect of CBD. The antipsychotic-like properties of CBD have been investigated in animal models using behavioral and neurochemical techniques which suggested that CBD has a pharmacological profile similar to that of atypical antipsychotic drugs. The results of two studies on healthy volunteers using perception of binocular depth inversion and ketamine-induced psychotic symptoms supported the proposal of the antipsychotic-like properties of CBD. In addition, open case reports of schizophrenic patients treated with CBD and a preliminary report of a controlled clinical trial comparing CBD with an atypical antipsychotic drug have confirmed that this cannabinoid can be a safe and well-tolerated alternative treatment for schizophrenia. Future studies of CBD in other psychotic conditions such as bipolar disorder and comparative studies of its antipsychotic effects with those produced by clozapine in schizophrenic patients are clearly indicated.
Full Text Available BACKGROUND: Both environmental risk and genetic variation is believed to play a role in substance use. A candidate environmental variable is parenting. Recent studies have found support for the idea that the dopamine system affects the susceptibility to environmental influences. In the present study we will examine the interplay between effects of parental monitoring and the presence of the DRD4 7-repeat allele in adolescent lifetime cannabis use and the developmental course of cannabis use. METHODS: A total of 311 adolescents participated in a five-wave longitudinal design. First, we conducted logistic regression analyses to examine the prospective associations between parental monitoring, the DRD4 polymorphism, their interaction and lifetime cannabis use. Second, individual growth parameters were calculated for frequency of cannabis use. Linear regression was used to assess the relationship between parental monitoring, the DRD4 polymorphism, their interaction, and the frequency of cannabis use. RESULTS: There were no significant main effects of parental monitoring or the DRD4 polymorphism. However, both analyses showed that over a period of four years, a when experiencing low levels of parental monitoring, individuals with the 7-repeat allele were more likely to show lifetime cannabis use and a stronger increase in frequency of cannabis use than individuals without this allele; b when experiencing high levels of parental monitoring, individuals with the 7-repeat allele were less likely to show lifetime cannabis use and they showed a smaller increase in frequency of cannabis use than individuals without the 7-repeat allele. CONCLUSIONS: This study shows that carriers of the DRD4 7-repeat allele are disproportionally affected by the negative and positive effects of parental monitoring such that carriers of the DRD4 7-repeat allele, as compared to non-carriers, are more likely to use cannabis when levels of parental monitoring are low, and less
Brunt, Tibor M; van Genugten, Marianne; Höner-Snoeken, Kathrin; van de Velde, Marco J; Niesink, Raymond J M
In The Netherlands, pharmaceutical-grade cultivated cannabis is distributed for medicinal purposes as commissioned by the Ministry of Health. Few studies have thus far described its therapeutic efficacy or subjective (adverse) effects in patients. The aims of this study are to assess the therapeutic satisfaction within a group of patients using prescribed pharmaceutical-grade cannabis and to compare the subjective effects among the available strains with special focus on their delta-9-tetrahydrocannabinol and cannabidiol content. In a cross-sectional and natural design, users of pharmaceutical-grade cannabis were investigated with questionnaires. Medical background of the patients was asked as well as experienced therapeutic effects and characteristics of cannabis use. Subjective effects were measured with psychometric scales and used to compare among the strains of cannabis used across this group of patients. One hundred two patients were included; their average age was 53 years and 76% used it for more than a year preceding this study. Chronic pain (53%; n = 54) was the most common medical indication for using cannabis followed by multiple sclerosis (23%; n = 23), and 86% (n = 88) of patients (almost) always experienced therapeutic satisfaction when using pharmaceutical cannabis. Dejection, anxiety, and appetite stimulation were found to differ among the 3 strains of cannabis. These results show that patients report therapeutic satisfaction with pharmaceutical cannabis, mainly pain alleviation. Some subjective effects were found to differ among the available strains of cannabis, which is discussed in relation to their different tetrahydrocannabinol/cannabidiol content. These results may aid in further research and critical appraisal for medicinally prescribed cannabis products.
Antonio Waldo Zuardi
Full Text Available Cannabis as a medicine was used before the Christian era in Asia, mainly in India. The introduction of cannabis in the Western medicine occurred in the midst of the 19th century, reaching the climax in the last decade of that century, with the availability and usage of cannabis extracts or tinctures. In the first decades of the 20th century, the Western medical use of cannabis significantly decreased largely due to difficulties to obtain consistent results from batches of plant material of different potencies. The identification of the chemical structure of cannabis components and the possibility of obtaining its pure constituents were related to a significant increase in scientific interest in such plant, since 1965. This interest was renewed in the 1990's with the description of cannabinoid receptors and the identification of an endogenous cannabinoid system in the brain. A new and more consistent cycle of the use of cannabis derivatives as medication begins, since treatment effectiveness and safety started to be scientifically proven.Antes da Era Cristã, a cannabis foi utilizada na Ásia como medicamento, com grande importância na Índia. A introdução da cannabis na Medicina Ocidental ocorreu em meados do século XIX, atingindo o clímax na última década deste século, com a disponibilidade e o uso de extratos e tinturas da cannabis. Nas primeiras décadas do século XX, o uso médico da cannabis no Ocidente diminuiu significativamente, em grande parte pela dificuldade na obtenção de resultados consistentes de amostras da planta com diferentes potências. A identificação da estrutura química de componentes da cannabis e a possibilidade de se obter seus constituintes puros foram relacionadas a um aumento significativo no interesse científico pela planta, desde 1965. Este interesse foi renovado nos anos 90, com a descrição dos receptores de canabinóides e a identificação de um sistema canabinóide endógeno no cérebro. Usos
Scholes-Balog, Kirsty E.; Hemphill, Sheryl A.; Patton, George C.; Toumbourou, John W.
The current study documents the changing rates of cannabis use, misuse and cannabis-related social harms among Australian adolescents as they grow into young adulthood. It utilised data from a longitudinal study of young people at ages 15, 16, 17, and 19. The rates of cannabis use were found to increase as participants aged; past year use…
Fischer, Benedikt; Dawe, Meghan; Mcguire, Fraser; Shuper, Paul A; Jones, Wayne; Rudzinski, Katherine; Rehm, Jurgen
Aims: Assess key cannabis use, risk and outcome characteristics among high-frequency cannabis users within a university student sample in Toronto, Canada. Methods: N = 134 active universities students (ages of 18-28) using cannabis at least three times per week were recruited by mass advertisement, telephone-screened and anonymously assessed by an…
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Exemption of certain cannabis plant material, and... ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Exempt Cannabis Plant... cannabis plant material, and products made therefrom, that contain tetrahydrocannabinols. (a) Any...
Menghrajani, P.; Klaue, K.; Dubois-Arber, F.; Michaud, P.-A.
Few studies have attempted to investigate the nature of adolescents and adults conceptions and perceptions of cannabis use. Our objectives were to explore adolescent and adult perception of use and misuse of cannabis, and their opinions and beliefs about the current legal context and preventive strategies. We used focus group discussions with four…
Maharajh, Hari D; Konings, Monique
Cannabis use and suicidal behaviour are causes of adolescent morbidity and mortality worldwide. Changing trends in these behaviours in younger age groups, higher incidence, gender differences and sociocultural variations present an enormous challenge. There is no consensus whether these complex relationships are either a direct or an indirect effect due to other mental disorders, or a social response of disclosure of drug taking habits to family members and school authorities. This paper reviews the epidemiology of suicidal behaviour and cannabis use among adolescents and looks at the relationship of these behaviours regionally and internationally. The Caribbean islands have an established use of cannabis with higher suicidal rates, which provides an ideal setting to investigate the interrelationship of these disorders. Preliminary research findings in Trinidad indicate high rates of cannabis use among school students with higher rates in vocational schools compared to grammar schools. Utilising the CAPE questionnaire, depressive and psychotic experiences were common findings in adolescent cannabis users with a significant preponderance of depressive experiences (prelationship between suicidal behaviour and cannabis use, the latter awakening depressive experiences. Suicidal behaviour and cannabis use are major public health problems and require a multidimensional approach with culturally competent preventive interactions. School based prevention programmes are necessary at the levels of parent-teacher partnership and classroom intervention. The treatment of adolescent disorders remains a major challenge of the future. Double disorders such as cannabis use and suicidal behaviour are uncharted areas and need novel approaches.
Murray, Robin M; Quigley, Harriet; Quattrone, Diego; Englund, Amir; Di Forti, Marta
Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose-response relationship between the level of use and the risk of later psychosis. High-potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co-administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high-potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.
Matthew Timothy Welling; Timothy Shapter; Terry James Rose; Lei Liu; Rhia Stanger; Graham John King
Cannabis is a predominantly diecious phenotypically diverse domesticated genus with few if any extant natural populations. International narcotics conventions and associated legislation have constrained the establishment, characterization, and use of Cannabis genetic resource collections. This has resulted in the underutilization of genepool variability in cultivar development and has limited the inclusion of secondary genepools associated with genetic improvement strategies of the Green Revo...
Koenders, L.; Machielsen, M.W.; van der Meer, F.J.; van Gasselt, A.C.; Meijer, C.J.; van den Brink, W.; Koeter, M.W.; Caan, M.W.; Cousijn, J.; den Braber, A.; van 't Ent, D.; Rive, M.M.; Schene, A.H.; van de Giessen, E.; Huyser, C.; de Kwaasteniet, B.P.; Veltman, D.J.; de Haan, L.
BACKGROUND: Schizophrenia is highly comorbid with cannabis use disorders (CUDs), and this comorbidity is associated with an unfavourable course. Early onset or frequent cannabis use may influence brain structure. A key question is whether comorbid CUDs modulate brain morphology alterations associate
Koenders, L.; Machielsen, M.W.; Meer, F.J. van der; Gasselt, A.C. van; Meijer, C.J.W.; Brink, W. van den; Koeter, M.W.; Caan, M.W.; Cousijn, J.; Braber, A.; Ent, D. van 't; Rive, M.M.; Schene, A.H.; Giessen, E. van de; Huyser, C.; Kwaasteniet, B.P. de; Veltman, D.J.; Haan, L. de
BACKGROUND: Schizophrenia is highly comorbid with cannabis use disorders (CUDs), and this comorbidity is associated with an unfavourable course. Early onset or frequent cannabis use may influence brain structure. A key question is whether comorbid CUDs modulate brain morphology alterations associate
Adolescent cannabis use has been shown in many studies to increase the risk of later psychosis. Childhood trauma is associated with both substance misuse and risk for psychosis. In this study our aim was to investigate whether there is a significant interaction between cannabis use and childhood trauma in increasing the risk for experiencing psychotic symptoms during adolescence.
Liemburg, Edith J.; Bruins, Jojanneke; van Beveren, Nico; Islam, Md Atiqul; Alizadeh, Behrooz Z.; Bruggeman, R.; Wiersma, D.; Cahn, W.; Kahn, R. S.; de Haan, L.; Meijer, C. J.; Myin-Germeys, I.; van Os, J.
Cannabis use has been associated with favorable outcomes on metabolic risk factors. The cause of this relation is still unknown. In this study we investigated whether this effect is mediated by the AKT1 gene, as activation of the related enzyme by cannabis may cause metabolic changes. Six Single Nuc
Liemburg, Edith; Bruins, Jojanneke; Van Beveren, Nico J.M.; Bruggeman, Richard; Alizadeh, Behrooz
Background: Cardiovascular and metabolic problems combined with a bad lifestyle are a major cause of a shortened life expectancy in chronic psychotic disorders. While the incidence of cannabis use is twice as high in psychosis compared to the general population, use of cannabis has been associated w
F.K. Engels (Frederike); F.A. de Jong (Floris); A. Sparreboom (Alex); R.A. Mathot (Ron); W.J. Loos (Walter); J.J.E.M. Kitzen (Jos); P. de Bruijn (Peter); J. Verweij (Jaap); A.H.J. Mathijssen (Ron)
textabstractObjective. To date, data regarding the potential of cannabinoids to modulate cytochrome P450 isozyme 3A (CYP3A) activity are contradictory. Recently, a standardized medicinal cannabis product was introduced in The Netherlands. We anticipated an increased use of medicinal cannabis concurr
Chabrol, Henri; Beck, Charline; Laconi, Stéphanie
The Marijuana Motives Measure (MMM), which is derived from a scale measuring alcohol use motives, has been the main instrument used to explore the role of motives in cannabis use and related problems. Two studies attempted to developed specific cannabis use motives but none of them showed a unique association to cannabis use and problems when controlling for MMM motives. The aim of our study was to examine if additional motives contributed to problematic use beyond MMM motives and psychopathological symptoms. Participants were 249 high-school students who completed the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) assessing cannabis use and problematic use, the MMM and a new scale measuring motives derived from clinical experience with adolescents using cannabis (CED motives), and scales measuring anxiety and depressive symptoms and borderline personality traits. Among the 107 participants using cannabis, 39 reached the cut-off score for problematic cannabis use. Hierarchical multiple regression analyses controlling for psychopathological variables showed that only one CED motives, Health (sleep, form, energy, appetite, health), was a significant predictor of both frequency of use and problematic use symptoms. The importance of Health motive may be linked to the role of depressive symptoms and may have implication for treatment. We suggest to add the Health subscale to the MMM and to further study the role of health motive in both use and dependence.
Murray, Robin M.; Quigley, Harriet; Quattrone, Diego; Englund, Amir; Di Forti, Marta
Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose‐response relationship between the level of use and the risk of later psychosis. High‐potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co‐administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high‐potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high‐potency cannabis and synthetic cannabinoids. PMID:27717258
Gates, Peter J.; Norberg, Melissa M.; Dillon, Paul; Manocha, Ramesh
The high prevalence of cannabis use by Australian secondary school students makes schools an ideal setting for the delivery of substance use prevention programs. Although efficacious school-based cannabis prevention programs exist, there is scant research investigating the perceived role legitimacy and role importance of school staff. As such,…
Zalesky, Andrew; Solowij, Nadia; Yucel, Murat; Lubman, Dan I.; Takagi, Michael; Harding, Ian H.; Lorenzetti, Valentina; Wang, Ruopeng; Searle, Karissa; Pantelis, Christos; Seal, Marc
Cannabis use typically begins during adolescence and early adulthood, a period when cannabinoid receptors are still abundant in white matter pathways across the brain. However, few studies to date have explored the impact of regular cannabis use on white matter structure, with no previous studies examining its impact on axonal connectivity. The…
Griffith-Lendering, Merel F. H.; Huijbregts, Stephan C. J.; Huizink, Anja C.; Ormel, Hans; Verhulst, Frank C.; Vollebergh, Wilma A. M.; Swaab, Hanna
Social skills (cooperation, assertion, and self-control) were assessed by teachers for a longitudinal cohort of (pre)adolescents, with measurements at average ages 11.1 (baseline) and 16.3 years (follow-up). Prospective associations with participants' self-reported use of cannabis, (age of) onset of cannabis use, and frequency of use at follow-up…
Griffith-Lendering, Merel F H; Wigman, Johanna T W; Prince van Leeuwen, Andrea; Huijbregts, Stephan C J; Huizink, Anja C; Ormel, Johan; Verhulst, Frank C; van Os, Jim; Swaab, Hanna; Vollebergh, Wilma A M
AIMS: To examine the direction of the longitudinal association between vulnerability for psychosis and cannabis use throughout adolescence. DESIGN: Cross-lagged path analysis was used to identify the temporal order of vulnerability for psychosis and cannabis use, while controlling for gender, family
Full Text Available Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a patients with subclinical depressive symptoms at least once during follow-up (DPG, and (b patients without subclinical depressive symptoms during follow-up (NDPG. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms using the Hamilton Depression Rating Scale (HDRS-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF. A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001 and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009.Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.
Harvey, Megan A; Sellman, John D; Porter, Richard J; Frampton, Christopher M
Research indicates that cannabis continues to be a popular illegal drug internationally. Furthermore, adolescent rates of use appear to be significant. Whilst the non-acute effect of cannabis use on adult cognition has been extensively researched, there has been less examination of adolescents. This study aimed to investigate the non-acute relationship between cannabis and cognitive function in a sample of adolescents with a continuum of cannabis use, taking into account additional predictor variables (psychiatric functioning, general functioning, demographics and other drug use). Seventy adolescents were recruited from clinical and community sources as well as through newspaper advertisements. After 12 hours abstinence from cannabis, adolescents completed a two-hour interview covering: demographics; alcohol and drug use history; drug use in the past 28 days; depression; further psychiatric functioning (including ADHD and Conduct Disorder); and cognitive functioning as measured by computerised tasks (CANTAB) and traditional pen and paper tests. Adolescents who were regular cannabis users (more than once a week) had a significantly poorer performance on four measures of cognitive function reflecting attention, spatial working memory and learning. Cannabis use remained an independent predictor of performance on the working memory and strategy measures after additional predictor variables were included in a multivariate regression analysis. The results suggest that aspects of adolescent cognitive function are independently related to the frequency of cannabis use beyond acute intoxication.
Neveen Abd El Moneim Hussein
Conclusion: The protective effect of cannabis extract is more pronounced in group taking cannabis before DMNA. Cannabinoids might exert their anti-tumor effects by the direct induction of apoptosis and can decrease telomerase activity by inhibiting the expression of the TERT gene. Coordination between inhibition of telomerase activity and induction of apoptosis might be a potential therapeutic agent for cancer treatment.
Bruci, Zana; Papoutsis, Ioannis; Athanaselis, Sotirios; Nikolaou, Panagiota; Pazari, Ermira; Spiliopoulou, Chara; Vyshka, Gentian
Cannabis products (marijuana, hashish, cannabis oil) are the most frequently abused illegal substances worldwide. Delta-9-tetrahydrocannabinol (THC) is the main psychoactive component of Cannabis sativa plant, whereas cannabidiol (CBD) and cannabinol (CBN) are other major but no psychoactive constituents. Many studies have already been carried out on these compounds and chemical research was encouraged due to the legal implications concerning the misuse of marijuana. The aim of this study was to determine THC, CBD and CBN in a significant number of cannabis samples of Albanian origin, where cannabis is the most frequently used drug of abuse, in order to evaluate and classify them according to their cannabinoid composition. A GC-MS method was used, in order to assay cannabinoid content of hemp samples harvested at different maturation degree levels during the summer months and grown in different areas of Albania. This method can also be used for the determination of plant phenotype, the evaluation of psychoactive potency and the control of material quality. The highest cannabinoid concentrations were found in the flowers of cannabis. The THC concentrations in different locations of Albania ranged from 1.07 to 12.13%. The influence of environmental conditions on cannabinoid content is discussed. The cannabinoid content of cannabis plants were used for their profiling, and it was used for their classification, according to their geographical origin. The determined concentrations justify the fact that Albania is an area where cannabis is extensively cultivated for illegal purposes.
Full Text Available Jan Copeland, Izabella Pokorski UNSW Medicine, University of New South Wales, Sydney, NSW, Australia Abstract: Cannabis is the most widely used and variably regulated drug in the world, with increasing trends of use being reported in the US, Australia, Asia, and Africa. Evidence has shown a decrease in the age of commencement of cannabis use in some developed countries and a prolongation of risk of initiation to cannabis use beyond adolescence among more recent users. Cannabis use is associated with numerous health risks and long-term morbidity, as well as risk of developing cannabis-use disorders. Cannabis users infrequently seek professional treatment, and normally do so after a decade of use. Cannabis-use disorders are currently treated using a selection of psychosocial interventions. Severity of withdrawal is a factor that increases the risk of relapse, and is the target of pharmacotherapy studies. Currently, there is no approved pharmacotherapy for cannabis-use disorders. A number of approaches have been examined, and trials are continuing to find a safe and effective medication with little abuse liability. Keywords: marijuana, treatment, intervention, withdrawal, cannabinoid
Huizink, Anja C.; Ferdinand, Robert F.; Ormel, Johan; Verhulst, Frank C.
Aims To identify early onset cannabis users by measuring basal hypothalamic-pituitary-adrenal (HPA) axis activity, which may be a risk factor for early onset substance use when showing low activity. Design In a prospective cohort study, adolescents who initiated cannabis use at an early age (9-12 ye
Cannabis use in highly prevalent among young adults with recent-onset schizophrenia and has been associated with an adverse course of the illness. Despite these association, the evidence for effective interventions for treating cannabis use in patients with psychosis is limited. This thesis focuses
Álvarez, Arturo; Gamella, Juan F; Parra, Iván
First, this paper estimates the dimensions of the market for cannabis in Spain using data on the extent of consumption and the main patterns of use of consumers. Then the paper reviews the hypothetical production and distribution costs of these drugs in different production regimes under different legal conditions. The review shows that current prices of cannabis in the illegal market could be notably reduced if production and distribution of cannabis were decriminalized and even more if they were performed by legal enterprises. Thirdly, we examine the relationship between prices and consumption levels by analysing the price elasticity of demand. A fall in the prices of cannabis products will likely result in an increase in the number of users and in the total amount consumed. Lastly we consider several alternatives for the taxation of cannabis derivatives to counteract the likely fall in prices, and their pros and cons.
Carter, Gregory T; Javaher, Simone P; Nguyen, Michael Hv; Garret, Sharon; Carlini, Beatriz H
The field of pain medicine is at a crossroads given the epidemic of addiction and overdose deaths from prescription opioids. Cannabis and its active ingredients, cannabinoids, are a much safer therapeutic option. Despite being slowed by legal restrictions and stigma, research continues to show that when used appropriately, cannabis is safe and effective for many forms of chronic pain and other conditions, and has no overdose levels. Current literature indicates many chronic pain patients could be treated with cannabis alone or with lower doses of opioids. To make progress, cannabis needs to be re-branded as a legitimate medicine and rescheduled to a more pharmacologically justifiable class of compounds. This paper discusses the data supporting re-branding and rescheduling of cannabis.
Ware, M A; Adams, H; Guy, G W
The use of cannabis for medical purposes is a controversial but an important topic of public and scientific interest. We report on the results of a self-administered questionnaire study conducted in the United Kingdom between 1998 and 2002. The questionnaire consisted of 34 items and included demographic data, disease and medication use patterns and cannabis use profiles. Subjects were self-selected; 3663 questionnaires were distributed and 2969 were returned [1805 (60.9%) women, mean age 52.7 years (SD 12.7)]. Medicinal cannabis use was reported by patients with chronic pain (25%), multiple sclerosis and depression (22% each), arthritis (21%) and neuropathy (19%). Medicinal cannabis use was associated with younger age, male gender and previous recreational use (p cannabis and cannabinoids with standardised and quality-controlled products.
Popovici, Ioana; French, Michael T
Uncertainty exists regarding the direction and magnitude of the association between cannabis use and labor market outcomes. Using panel data from waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions, the current paper estimates the associations between several patterns of cannabis use during the past year, current employment, and annual personal income. In the single-equation models (wave 2 data), nearly all patterns of cannabis use are significantly associated with worse labor market outcomes (p < 0.05). However, when using fixed-effects techniques to address unobserved and time-invariant individual heterogeneity, the estimates are generally smaller in magnitude and less likely to be statistically significant vis-à-vis the benchmark estimates. These findings suggest that unobserved individual heterogeneity is an important source of bias in models of cannabis use and labor market outcomes. Moreover, cannabis use may be less detrimental in the labor market than other studies have reported.
Volkow, Nora D; Swanson, James M; Evins, A Eden; DeLisi, Lynn E; Meier, Madeline H; Gonzalez, Raul; Bloomfield, Michael A P; Curran, H Valerie; Baler, Ruben
With a political debate about the potential risks and benefits of cannabis use as a backdrop, the wave of legalization and liberalization initiatives continues to spread. Four states (Colorado, Washington, Oregon, and Alaska) and the District of Columbia have passed laws that legalized cannabis for recreational use by adults, and 23 others plus the District of Columbia now regulate cannabis use for medical purposes. These policy changes could trigger a broad range of unintended consequences, with profound and lasting implications for the health and social systems in our country. Cannabis use is emerging as one among many interacting factors that can affect brain development and mental function. To inform the political discourse with scientific evidence, the literature was reviewed to identify what is known and not known about the effects of cannabis use on human behavior, including cognition, motivation, and psychosis.
Hesse, Morten; Tutenges, Sébastien; Schliewe, Sanna
users who had not used a substance in the past 12 months. Results: New onset of tobacco use was reported by 9.2% of never-smokers, and new onset of cannabis use was reported by 9.3% of never-smokers of cannabis. Resumption of tobacco use was reported by 24% of past year abstainers, and resumption...... of cannabis use was reported by 30% of past year abstainers. New onset of other types of substances was reported by less than 0.5% of subjects, but among past year abstainers, 5–10% reported resumption of amphetamine, ketamine, MDMA and cocaine use. New onset smokers of cannabis were significantly younger...... than never-smokers. Conclusion: Music festivals such as the Roskilde Festival may be important arenas for the prevention of onset of tobacco and cannabis use and for a return to substance use....
Jaques, S C; Kingsbury, A; Henshcke, P; Chomchai, C; Clews, S; Falconer, J; Abdel-Latif, M E; Feller, J M; Oei, J L
To review and summarise the literature reporting on cannabis use within western communities with specific reference to patterns of use, the pharmacology of its major psychoactive compounds, including placental and fetal transfer, and the impact of maternal cannabis use on pregnancy, the newborn infant and the developing child. Review of published articles, governmental guidelines and data and book chapters. Although cannabis is one of the most widely used illegal drugs, there is limited data about the prevalence of cannabis use in pregnant women, and it is likely that reported rates of exposure are significantly underestimated. With much of the available literature focusing on the impact of other illicit drugs such as opioids and stimulants, the effects of cannabis use in pregnancy on the developing fetus remain uncertain. Current evidence indicates that cannabis use both during pregnancy and lactation, may adversely affect neurodevelopment, especially during periods of critical brain growth both in the developing fetal brain and during adolescent maturation, with impacts on neuropsychiatric, behavioural and executive functioning. These reported effects may influence future adult productivity and lifetime outcomes. Despite the widespread use of cannabis by young women, there is limited information available about the impact perinatal cannabis use on the developing fetus and child, particularly the effects of cannabis use while breast feeding. Women who are using cannabis while pregnant and breast feeding should be advised of what is known about the potential adverse effects on fetal growth and development and encouraged to either stop using or decrease their use. Long-term follow-up of exposed children is crucial as neurocognitive and behavioural problems may benefit from early intervention aimed to reduce future problems such as delinquency, depression and substance use.
Chunsheng Gao; Pengfei Xin; Chaohua Cheng; Qing Tang; Ping Chen; Changbiao Wang; Gonggu Zang; Lining Zhao
Cannabis sativa L. is an important economic plant for the production of food, fiber, oils, and intoxicants. However, lack of sufficient simple sequence repeat (SSR) markers has limited the development of cannabis genetic research. Here, large-scale development of expressed sequence tag simple sequence repeat (EST-SSR) markers was performed to obtain more informative genetic markers, and to assess genetic diversity in cannabis (Cannabis sativa L.). Based on the cannabis transcriptome, 4,577 SS...
Huestis, Marilyn A.; Gustafson, Richard A.; Moolchan, Eric T.; Bames, Allan; Bourland, James A.; Sweeney, Stacy A.; Hayes, Eugene F.; Carpenter, Patrick M.; Smith, Michael L.
Fifty-three head hair specimens were collected from 38 males with a history of cannabis use documented by questionnaire, urinalysis and controlled, double blind administration of Δ9-tetrahydrocannabinol (THC) in an institutional review board approved protocol. The subjects completed a questionnaire indicating daily cannabis use (N = 18) or non-daily use, i.e. 1 to 5 cannabis cigarettes per week, (N = 20). Drug use was also documented by a positive cannabinoid urinalysis, a hair specimen was collected from each subject and they were admitted to a closed research unit. Additional hair specimens were collected following smoking of two 2.7% THC cigarettes (N = 13) or multiple oral doses totaling 116 mg THC (N = 2). Cannabinoid concentrations in all hair specimens were determined by ELISA and GCMSMS. Pre- and post dose detection rates did not differ statistically, therefore, all 53 specimens were considered as one group for further comparisons. Nineteen specimens (36%) had no detectable THC or 11-nor-9-carboxy-THC (THCCOOH) at the GCMSMS limits of quantification (LOQ) of 1.0 and 0.1 pg/mg hair, respectively. Two specimens (3.8%) had measurable THC only, 14 (26%) THCCOOH only, and 18 (34%) both cannabinoids. Detection rates were significantly different (p 0.3, Fisher's exact test). For specimens with detectable cannabinoids, concentrations ranged from 3.4 to > 100 pg THC/mg and 0.10 to 7.3 pg THCCOOH/mg hair. THC and THCCOOH concentrations were positively correlated (r = 0.38, p < 0.01, Pearson's product moment correlation). Using an immunoassay cutoff concentration of 5 pg THC equivalents/mg hair, 83% of specimens that screened positive were confirmed by GCMSMS at a cutoff concentration of 0.1 pg THCCOOH/mg hair. PMID:16963215
Ziegler, Angelika; Matoušek, Jaroslav; Steger, Gerhard; Schubert, Jörg
Hemp (Cannabis sativa) was found to be a useful propagation host for hop latent virus, a carlavirus. However, when virus preparations were analysed by electron microscopy, along with the expected filamentous particles, spherical particles with a diameter of around 34 nm were found. RNA from virus preparations was purified, and cDNA was prepared and cloned. Sequence information was used to search databases, and the greatest similarity was found with Primula malacoides virus 1, a putative new member of the genus Partitivirus. The full sequences of RNA 1 and RNA 2 of this new hemp cryptic virus were obtained.
Despite an intensive national campaign of information, the drugs most frequently consumed by young adults undoubtedly continue to be alcohol, tobacco and cannabis. If the impact of these drugs on the health of the consumers can be evaluated in conjunction with the clinical and epidemiologic data, the consequences on the embryo due to their consumption by the pregnant women can be appreciated thanks to the abundant literature describing their effects in the gravid animal. Taking into account the abundant literature available in multiple animal species, the zero drug recommendation should be widely diffused to pregnant women.
Enzi, Björn; Lissek, Silke; Edel, Marc-Andreas; Tegenthoff, Martin; Nicolas, Volkmar; Scherbaum, Norbert; Juckel, Georg; Roser, Patrik
Alterations in reward and punishment processing have been reported in adults suffering from long-term cannabis use. However, previous findings regarding the chronic effects of cannabis on reward and punishment processing have been inconsistent. In the present study, we used functional magnetic resonance imaging (fMRI) to reveal the neural correlates of reward and punishment processing in long-term cannabis users (n = 15) and in healthy control subjects (n = 15) with no history of drug abuse. For this purpose, we used the well-established Monetary Incentive Delay (MID) task, a reliable experimental paradigm that allows the differentiation between anticipatory and consummatory aspects of reward and punishment processing. Regarding the gain anticipation period, no significant group differences were observed. In the left caudate and the left inferior frontal gyrus, cannabis users were - in contrast to healthy controls - not able to differentiate between the conditions feedback of reward and control. In addition, cannabis users showed stronger activations in the left caudate and the bilateral inferior frontal gyrus following feedback of no punishment as compared to healthy controls. We interpreted these deficits in dorsal striatal functioning as altered stimulus-reward or action-contingent learning in cannabis users. In addition, the enhanced lateral prefrontal activation in cannabis users that is related to non-punishing feedback may reflect a deficit in emotion regulation or cognitive reappraisal in these subjects.
Full Text Available The link between cannabis and psychosis has been debated although there is substantial epidemiological evidence showing that cannabis increases the risk of psychosis. It has been hypothesized that schizophrenia patients carrying particular risk genes might be more sensitive to the psychosis-inducing effects of cannabis than other patients and healthy test subjects. Here we review the effects of cannabinoids on a mutant mouse model for the schizophrenia candidate gene neuregulin 1 (Nrg1. The studies suggest a complex interaction between cannabis and Nrg1: the neuro-behavioural effects of cannabinoids were different in Nrg1 mutant and control mice and depended on exposure time, sex and age of test animals. This research provides the first evidence of complex cannabis-Nrg1 interactions suggesting Nrg1 as a prime target for future clinical investigations. Furthermore, it highlights that animal model research can broaden our understanding of the complex multi-factorial aetiology of schizophrenia. Finally, the findings are important to preventive psychiatry: if the genes that confer genetic vulnerability to cannabis-induced psychosis were identified patients at-high risk could be forewarned of the potential dangers of cannabis abuse.
Lundahl, Leslie H; Johanson, Chris-Ellyn
Recent interest in the development of medications for treatment of cannabis-use disorders indicates the need for laboratory models to evaluate potential compounds prior to undertaking clinical trials. To investigate whether a cue-reactivity paradigm could induce marijuana craving in cannabis-dependent adults, 16 (eight female) cannabis-dependent and 16 (eight female) cannabis-naïve participants were exposed to neutral and marijuana-related cues, and subsequent changes in mood, self-reported craving, and physiologic function were assessed. Significant Group X cue interactions were found on all three VAS craving indices as well as on the Compulsivity scale of the Marijuana Craving Questionnaire-Brief Form (MCQ-BF). Cannabis-dependent individuals responded to marijuana-related cues with significantly increased reports of marijuana craving compared to neutral cue exposure, although there were no cue-induced changes in any of the physiological measures. There were no significant gender differences on any of the measures. These results indicate that marijuana craving can be induced and assessed in cannabis-dependent, healthy adults within a laboratory setting, and support the need for further research of the cue reactivity paradigm in the development of medications to treat cannabis-use disorders.
Zorica Terzic Supic
Full Text Available Background: Adolescence is transitional stage of physical and mental human development occuring between childhood and adult life. Social interactions and environmental factors together are important predictors of adolescent cannabis use. This study aimed to examine the relationship between the social determinants and adolescents behavior with cannabis consumption.Methods: A cross sectional study as part of the European School Survey Project on Alcohol and other Drugs was conducted among 6.150 adolescents aged 16 years in three regions of Serbia, and three types of schools (gymnasium, vocational – professional, and vocational – handicraft during May – June 2008. A multivariate logistic regression analysis was carried out to obtain adjusted odds ratios with 95% conﬁdence intervals in which the dependent variable was cannabis consumption non-user and user.Results: Among 6.7% of adolescents who had tried cannabis at least one in their lives, boys were more involved in cannabis use than girls, especially boys from gymnasium school. Well off family, lower education of mother, worse relations with parents were significantly associated with cannabis use (P < 0.05. Behaviors like skipping from schools, frequent evening outs, and playing on slot machines were also related to cannabis use (P < 0.05.Conclusions: The study confirmed the importance of family relationship development. Drug use preventive programmes should include building interpersonal trust in a family lifecycle and school culture.
Dujourdy, Laurence; Besacier, Fabrice
Cannabis contains a unique class of compounds known as the cannabinoids. Pharmacologically, the principal psychoactive constituent is Δ(9)-tetrahydrocannabinol (THC). The amount of THC in conjunction with selected additional cannabinoid compounds (cannabidiol/CBD, cannabinol/CBN), determines the strength or potency of the cannabis product. Recently, reports have speculated over the change in the quality of cannabis products, from nearly a decade, specifically concerning the increase in cannabinoid content. This article exploits the analytical data of cannabis samples analyzed in the five French forensic police laboratories over 25 years. The increase potency of both herbal and resin cannabis in France is proved through the monitoring of THC content. For cannabis resin, it has slowly risen from 1992 to 2009, before a considerable increase in the last four years (mean THC content in mid-2016 is 23% compared to 10% in 2009). For herbal cannabis, it has known three main stages of growth (mean THC content is 13% in 2015 and mid-2016 compared to 7% in 2009 and 2% in 1995). The calculation of THC/CBD ratios in both herbal and resin samples confirms the recent change in chemotypes in favor of high potency categories. Finally, the CBN/THC ratios in marijuana samples were measured in order to evaluate the freshness of French seized hemp.
Aggarwal, Sunil K; Carter, Gregory T; Sullivan, Mark D; ZumBrunnen, Craig; Morrill, Richard; Mayer, Jonathan D
Cannabis (marijuana) has been used for medicinal purposes for millennia, said to be first noted by the Chinese in c. 2737 BCE. Medicinal cannabis arrived in the United States much later, burdened with a remarkably checkered, yet colorful, history. Despite early robust use, after the advent of opioids and aspirin, medicinal cannabis use faded. Cannabis was criminalized in the United States in 1937, against the advice of the American Medical Association submitted on record to Congress. The past few decades have seen renewed interest in medicinal cannabis, with the National Institutes of Health, the Institute of Medicine, and the American College of Physicians, all issuing statements of support for further research and development. The recently discovered endocannabinoid system has greatly increased our understanding of the actions of exogenous cannabis. Endocannabinoids appear to control pain, muscle tone, mood state, appetite, and inflammation, among other effects. Cannabis contains more than 100 different cannabinoids and has the capacity for analgesia through neuromodulation in ascending and descending pain pathways, neuroprotection, and anti-inflammatory mechanisms. This article reviews the current and emerging research on the physiological mechanisms of cannabinoids and their applications in managing chronic pain, muscle spasticity, cachexia, and other debilitating problems.
Tang, Sephora M.; Ansarian, Aylar; Courtney, Darren B.
Objectives To examine the association between clozapine treatment and frequency of cannabis use in adolescents with co-occurring psychotic and cannabis use disorder in a retrospective cohort chart review. Method We conducted a retrospective cohort chart review of patients diagnosed with a psychotic disorder and concurrent cannabis use disorder admitted to a tertiary care youth inpatient unit from 2010–2012. Longitudinal exposure and outcome data was coded month-by-month. Frequency of cannabis use was measured using a 7-point ordinal scale. Severity of psychosis was measured on a 3-point ordinal scale. Mixed effects regression modeling was used to describe the relationship between exposure and outcome variables. Results Thirteen patients had exposure to clozapine and fourteen had no exposure to clozapine. Cannabis use decreased in patients treated with clozapine, compared to patients treated with other antipsychotics (OR 2.8; 95% CI 0.97–7.9). Compared to no medication, clozapine exposure was associated with significantly less cannabis use (OR 7.1; 95% CI 2.3–22.3). Relative to treatment with other antipsychotics, clozapine exposure was significantly associated with lower severity of psychotic symptoms (OR 3.7; 95% CI 1.2–11.8). Conclusions Clozapine may lead to decreased cannabis use and psychotic symptoms in adolescents with concurrent psychosis and substance use. Clinical trials are warranted. PMID:28331504
Morales-Muñoz, Isabel; Jurado-Barba, Rosa; Ponce, Guillermo; Martínez-Gras, Isabel; Jiménez-Arriero, Miguel Ángel; Moratti, Stephan; Rubio, Gabriel
Cannabis-induced psychotic disorder (CIPD) refers to psychotic symptoms that arise in the context of cannabis intoxication. Prepulse inhibition (PPI) deficits have been extensively identified in schizophrenia and in cannabis abusers. We aimed to characterize PPI in CIPD patients. We used a sample of 48 CIPD patients, 54 schizophrenia patients and cannabis abuse (SCHZ), 44 cannabis dependents (CD), and 44 controls. CIPD, SCHZ and CD were abstinent of cannabis consumption for 9 months. Participants were assessed with PPI at 30, 60, and 120 ms. At 30 ms, CIPD showed lower PPI levels than controls, and SCHZ obtained worse functioning than controls and CD. At 60 ms, only SCHZ exhibited worse PPI percentages (of object) than controls. Finally, at 120 ms, CIPD showed higher PPI levels than SCHZ, and SCHZ obtained lower percentages than controls. We found that CIPD and SCHZ patients showed deficits at the most pre-attentional levels, whereas CIPD patients performed better than SCHZ at higher attentional levels. These results suggest that CIPD constitutes a different group of patients than that of SCHZ. Deficits in PPI functioning at 30 ms could be a useful psychophysiological measure to detect CIPD patients, who are frequently confused with cannabis abusers whose symptoms may mimic that of schizophrenia.
Nelemans, Stefanie A; Hale, William W; Raaijmakers, Quinten A W; Branje, Susan J T; van Lier, Pol A C; Meeus, Wim H J
There appear to be contradicting theories and empirical findings on the association between adolescent Social Anxiety Disorder (SAD) symptoms and cannabis use, suggesting potential risk as well as protective pathways. The aim of this six-year longitudinal study was to further examine associations between SAD symptoms and cannabis use over time in adolescents from the general population, specifically focusing on the potential role that adolescents' involvement with their peers may have in these associations. Participants were 497 Dutch adolescents (57 % boys; M age = 13.03 at T1), who completed annual self-report questionnaires for 6 successive years. Cross-lagged panel analysis suggested that adolescent SAD symptoms were associated with less peer involvement 1 year later. Less adolescent peer involvement was in turn associated with lower probabilities of cannabis use as well as lower frequency of cannabis use 1 year later. Most importantly, results suggested significant longitudinal indirect paths from adolescent SAD symptoms to cannabis use via adolescents' peer involvement. Overall, these results provide support for a protective function of SAD symptoms in association with cannabis use in adolescents from the general population. This association is partially explained by less peer involvement (suggesting increased social isolation) for those adolescents with higher levels of SAD symptoms. Future research should aim to gain more insight into the exact nature of the relationship between anxiety and cannabis use in adolescents from the general population, especially regarding potential risk and protective processes that may explain this relationship.
State laws on the legalization of medical and recreational cannabis are rapidly evolving. Similar to other crops, cannabis is susceptible to multiple pests during cultivation. Growers have an economic incentive to produce large yields and high quality plants, and may resort to pesticides to achieve these outcomes. Currently, there are no pesticides registered for cannabis in the United States, given its illegal status by the federal government. This discrepancy creates a regulatory vacuum and dilemma for States with legal medical and recreational cannabis that seek to balance lawful compliance with pesticides and worker or public health. Pesticide use presents occupational safety issues that can be mitigated through established worker protection measures. The absence of approved products for cannabis may result in consumer exposures to otherwise more hazardous pesticides or higher residue levels. While many legal and scientific hurdles exist to register conventional pesticides for use on cannabis, legalized States have explored other opportunities to leverage the present regulatory infrastructure. Stakeholder engagement and outreach to the cannabis industry from credible sources could mitigate pesticide misuse and harm.
Legal reforms in the Americas are influencing the public debate on cannabis policy. Uruguay and the two US states of Colorado and Washington have taken steps to regulate and legitimize the production, distribution, and use of cannabis and its derivatives. Earlier experiences with medical cannabis in the United States and limited access and production models in Europe have been insightful. However, these reforms are going further still, venturing into a new area of cannabis policy. A lack of empirical evidence regarding the effects of such reforms poses a challenge for policymakers. These examples will inform the design and implementation of any future cannabis policies. Therefore, a clear understanding of the details of each jurisdiction is necessary in developing future legal changes. Literature comparing the models of Uruguay, Colorado, and Washington is thin. This paper is based on an exhaustive examination of the laws, regulations, and discussions with regulators and functionaries of each jurisdiction. The research and analysis herein will provide policymakers with a greater understanding of the laws and regulations relevant to legal cannabis in these three jurisdictions, as well as draw to their attention some potential impacts and challenges of cannabis reform that require additional consideration to ensure public safety and health.
Aspis, Itay; Feingold, Daniel; Weiser, Mark; Rehm, Jurgen; Shoval, Gal; Lev-Ran, Shaul
Cannabis is the most widely used illicit substance among individuals with depressive disorders. This study aimed to evaluate whether among individuals with depressive disorders, higher frequency of cannabis use would be associated with poorer Quality of Life (QoL), based on a large nationally representative US sample. Individuals with depressive disorders (N=3416) were divided into categories according to no use (N=3096), occasional use (less than weekly, N=176) and regular (at least weekly, N=144) use of cannabis in the past 12 months. QoL was assessed using the Short-Form 12 (SF-12) questionnaire. Women who used cannabis regularly had a significantly lower SF-12 Mental Component Summary score (MCS) compared to non-users, with a mean difference of 0.4 Standard Deviations (SDs). Comparison of subscale scores showed no significant differences. No significant difference was noted when comparing women who used cannabis occasionally to non-users. No differences were found among men when comparing MCS and mental subscale scores of both regular and occasional users to non-users. Our findings highlight the importance of taking gender and the frequency of cannabis use into account, when assessing functional and emotional aspects of cannabis use among individuals with depressive disorders.
Bottorff Joan L
Full Text Available Abstract Background Despite its increasing prevalence and acceptance among the general public, cannabis use continues to be viewed as an aberrant activity in many contexts. However, little is known about how stigma associated with cannabis use affects individuals who use cannabis for therapeutic purposes (CTP and what strategies these individuals employ to manage associated stigma. The aim of this Canadian study was to describe users’ perceptions of and responses to the stigma attached to using CTP. Methods Twenty-three individuals who were using CTP for a range of health problems took part in semi-structured interviews. Transcribed data were analyzed using an inductive approach and comparative strategies to explore participants’ perceptions of CTP and identify themes. Results Participant experiences of stigma were related to negative views of cannabis as a recreational drug, the current criminal sanctions associated with cannabis use, and using cannabis in the context of stigmatizing vulnerability (related to existing illness and disability. Strategies for managing the resulting stigma of using CTP included: keeping CTP ‘undercover’; educating those who did not approve of or understand CTP use; and using cannabis responsibly. Conclusions Understanding how individuals perceive and respond to stigma can inform the development of strategies aimed at reducing stigma associated with the use of CTP and thereby address barriers faced by those using this medicine.
Ruud van Winkel
Full Text Available Familial correlations underlie heritability estimates of psychosis. If gene-environment interactions are important, familial correlation will vary as a function of environmental exposure.Associations between sibling and parental schizotypy (n = 669 pairs, n = 1222 observations, and between sibling schizotypy and patient CAPE psychosis (n = 978 pairs, n = 1723 observations were examined as a function of sibling cannabis use. This design is based on the prediction that in unaffected siblings who are not exposed, vulnerability for psychosis will remain latent, whereas in case of exposure, latent psychosis vulnerability may become expressed, at the level of schizotypal symptoms, causing the phenotypic correlation between relatives to become "visible" under the influence of cannabis.Siblings exposed to recent cannabis use resembled their patient-relative more closely in terms of positive schizotypy (urinalysis(+:B = 0.30, P<.001; urinalysis(-:B = 0.10, p<0.001; p-interaction = 0.0135. Similarly, the familial correlation in positive schizotypy between parent and sibling was significantly greater in siblings recently exposed to cannabis (urinalysis(+:B = 0.78, P<.001; urinalysis(-:B = 0.43, p<0.001; p interaction = 0.0017. Results were comparable when using lifetime cannabis frequency of use as exposure instead of recent use. Parental schizotypy did not predict cannabis use in the healthy sibling, nor in the patient. Similarly, parental cannabis use was not associated with level of schizotypy in the sibling, nor with psychotic symptoms in the patient, making gene-environment correlation unlikely.Familial correlation of psychosis-related experiences varies considerably as a function of exposure to cannabis, confirming the importance of gene-cannabis interaction in shifts of expression of psychosis-related experiences.
Bedi, Gillinder; Lindquist, Martin A; Haney, Margaret
Drug dependence may be at its core a pathology of choice, defined by continued decisions to use drugs irrespective of negative consequences. Despite evidence of dysregulated decision making in addiction, little is known about the neural processes underlying the most clinically relevant decisions drug users make: decisions to use drugs. Here, we combined functional magnetic resonance imaging (fMRI), machine learning, and human laboratory drug administration to investigate neural activation underlying decisions to smoke cannabis. Nontreatment-seeking daily cannabis smokers completed an fMRI choice task, making repeated decisions to purchase or decline 1-12 placebo or active cannabis 'puffs' ($0.25-$5/puff). One randomly selected decision was implemented. If the selected choice had been bought, the cost was deducted from study earnings and the purchased cannabis smoked in the laboratory; alternatively, the participant remained in the laboratory without cannabis. Machine learning with leave-one-subject-out cross-validation identified distributed neural activation patterns discriminating decisions to buy cannabis from declined offers. A total of 21 participants were included in behavioral analyses; 17 purchased cannabis and were thus included in fMRI analyses. Purchasing varied lawfully with dose and cost. The classifier discriminated with 100% accuracy between fMRI activation patterns for purchased vs declined cannabis at the level of the individual. Dorsal striatum, insula, posterior parietal regions, anterior and posterior cingulate, and dorsolateral prefrontal cortex all contributed reliably to this neural signature of decisions to smoke cannabis. These findings provide the basis for a brain-based characterization of drug-related decision making in drug abuse, including effects of psychological and pharmacological interventions on these processes.
Full Text Available We present a case of imaging proven cerebral vasospasm causing ischemic stroke in a young patient chronically on buprenorphine-naloxone for heroin remission who started smoking cannabis on a daily basis. With cannabis legalization spreading across the states in the USA, it is important for physicians not only to be aware of cannabis reported association with cerebral vasospasm in some patients but also to be on the lookout for possible interacting medications that can synergistically affect cerebral vessels causing debilitating strokes.
Svrakic, Dragan M; Lustman, Patrick J; Mallya, Ashok; Lynn, Taylor Andrea; Finney, Rhonda; Svrakic, Neda M
Empirical and clinical studies clearly demonstrate significant adverse effects of cannabis smoking on physical and mental health as well as its interference with social and occupational functioning. These negative data far outweigh a few documented benefits for a limited set of medical indications, for which safe and effective alternative treatments are readily available. If there is any medical role for cannabinoid drugs, it lies with chemically defined compounds, not with unprocessed cannabis plant. Legalization or medical use of smoked cannabis is likely to impose significant public health risks, including an increased risk of schizophrenia, psychosis, and other forms of substance use disorders.
Melvyn Weibin Zhang
Full Text Available Cannabis, also known as marijuana, has 9-tetrahydrocannabinol as the main constituent. There has been strict legislation governing the utilization of cannabis locally and worldwide. However, there has been an increasing push to make cannabis legalized, in view of its potential medical and therapeutic effects, for various medical disorders ranging from development disorders to cancer treatment, and being an adjunctive medication for various neurological conditions. It is the aim of this review paper to explore the evidence base for its proposed therapeutic efficacy and to compare the evidence base supporting its proposed therapeutic efficacy with its known and well-researched medical and psychiatric side effects.
Møller, Kim; Lindholst, Christian
Domestically cultivated cannabis, referred to as sinsemilla, constitutes a growing share of the illicit drug markets in the Scandinavian countries. In this study we present forensic evidence of THC content in sinsemilla and resin confiscated by the Danish police from 2008 to 2012. The purpose...... that courts do not apply a yield-percentage estimate. The specificities of domestic cannabis cultivation also relate to the sanction criteria „professionalism”. Firstly, the number of plants found can provide for calculation of an aggregate quantum. Secondly, this can be related to the formal quantum......-scale cannabis cases would improve by applying a 1:1 potency level between sinsemilla and resin....
Shakoor, Sania; Zavos, Helena M S; McGuire, Philip; Cardno, Alastair G; Freeman, Daniel; Ronald, Angelica
Cannabis users are more likely to have psychotic experiences (PEs). The degree to which these associations are driven by genetic or environmental influences in adolescence is unknown. This study estimated the genetic and environmental contributions to the relationship between cannabis use and PEs. Specific PEs were measured in a community-based twin sample (4830 16-year-old pairs) using self-reports and parent-reports. Adolescents reported on ever using cannabis. Multivariate liability threshold structural equation model-fitting was conducted. Cannabis use was significantly correlated with PEs. Modest heritability (37%), common environmental influences (55%) and unique environment (8%) were found for cannabis use. For PEs, modest heritability (27-54%), unique environmental influences (E=12-50%) and little common environmental influences (11-20%), with the exception of parent-rated Negative Symptoms (42%), were reported. Environmental influences explained all of the covariation between cannabis use and paranoia, cognitive disorganization and parent-rated negative symptoms (bivariate common environment=69-100%, bivariate unique environment=28-31%), whilst the relationship between cannabis use and hallucinations indicated familial influences. Cannabis use explains 2-5% of variance in positive, cognitive, and negative PEs. Cannabis use and psychotic experience co-occur due to environmental factors. Focus on specific environments may reveal why adolescent cannabis use and psychotic experiences tend to 'travel together'.
Full Text Available Previous studies have mostly shown positive effects of cannabis use on cognition in patients with schizophrenia, which could reflect lower neurocognitive vulnerability. There are however no studies comparing whether such cognitive differences have neuronal correlates. Thus, the aim of the present study was to compare whether patients with previous cannabis use differ in brain activation from patients who has never used cannabis. The patients groups were compared on the ability to up-regulate an effort mode network during a cognitive task and down-regulate activation in the same network during a task-absent condition. Task-present and task-absent brain activation was measured by functional magnetic resonance neuroimaging (fMRI. Twenty-six patients with a DSM-IV and ICD-10 diagnosis of schizophrenia were grouped into a previous cannabis user group and a no-cannabis group. An auditory dichotic listening task with instructions of attention focus on either the right or left ear stimulus was used to tap verbal processing, attention and cognitive control, calculated as an aggregate score. When comparing the two groups, there were remaining activations in the task-present condition for the cannabis group, not seen in the no-cannabis group, while there was remaining activation in the task-absent condition for the no-cannabis group, not seen in the cannabis group. Thus, the patients with previous cannabis use showed increased activation in an effort mode network and decreased activation in the default mode network as compared to the no-cannabis group. It is concluded that the present study show some differences in brain activation to a cognitively challenging task between previous cannabis and no-cannabis schizophrenia patients.
Ruiz-Veguilla, Miguel; Barrigón, María Luisa; Hernández, Laureano; Rubio, José Luis; Gurpegui, Manuel; Sarramea, Fernando; Cervilla, Jorge; Gutiérrez, Blanca; James, Anthony; Ferrin, Maite
This study aimed to explore the associations between daily cannabis use and the specific profiles of subclinical symptoms in a non-clinical population obtained through snowball sampling, taking into account alcohol use, other drug use, social exclusion and age at onset of cannabis use. We included 85 daily cannabis users and 100 non-daily cannabis users. Both the case and the control populations were identified by snowball sampling. Daily cannabis use was associated with more alcohol intake and other drug use, as well as with early onset in the use of cannabis. Daily cannabis use appeared to exert a dose-response effect on first-rank symptoms, mania symptoms and auditory hallucinations, even after adjusting for sex, age, other drug use, social exclusion and age at onset of cannabis use. The paranoid dimension was only associated with the heaviest consumption of cannabis. Initial age of cannabis use modified the effects of daily cannabis use on the first-rank and voices experiences. Daily cannabis use was associated with significantly more first-rank and voices experiences among those subjects who started to use cannabis before 17 years of age. Our study supports the association of psychotic experiences with cannabis use even among non-psychotic subjects.
Katz, Daphna; Katz, Itay; Golan, Amir
Medical uses of Cannabis sativa have been known for over 6,000 years. Nowadays, cannabis is mostly known for its psychotropic effects and its ability to relieve pain, even though there is evidence of cannabis use for autoimmune diseases like rheumatoid arthritis centuries ago. The pharmacological therapy in autoimmune diseases is mainly based on immunosuppression of diffefent axes of the immune system while many of the drugs have major side effects. In this review we set out to examine the rule of Cannabis sativa as an immunomodulator and its potential as a new treatment option. In order to examine this subject we will focus on some major autoimmune diseases such as diabetes type I and rheumatoid arthritis.
Míguez Varela, M Del Carmen; Becoña, Elisardo
This article examined the relationship between cigarette smoking or alcohol consumption and cannabis use and problem gambling among a random and representative sample of 1447 Spanish adolescents (797 males and 650 females with an average of 12.8 years). An ad-hoc questionnaire was used to assess cigarette smoking, alcohol consumption (beer, wine and spirits) and cannabis use. Gambling was assessed with the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA). Results indicated a positive and significant association between cigarette smoking and alcohol consumption and the two aforementioned variables. A larger percentage of cigarette smokers and drinkers was found among those participants who had consumed cannabis before or scored significantly in problem gambling. Additionally, multiple regression analysis confirmed that both cigarette smoking and alcohol consumption (beer and wine) were the most determinant variables for cannabis use and problem gambling.
MacDonald, Kai; Pappas, Katherine
In this review, we provide a historical perspective on marijuana, and survey contemporary research investigating its potential negative effects on the brain. We discuss the evidence regarding cannabis dependence, driving under the influence of cannabis, underachievement, inducing (or worsening) certain psychiatric conditions, and the potential for progression to use of more dangerous drugs-summarized by the acronym DDUMB, a cognitive tool that may help healthcare providers in their risk/benefit discussions with patients who use cannabis. We also review and discuss the impact of marijuana use on target populations, including adolescents (who are at increased risk of harm); heavy users; and people suffering from-or at high risk of- mental illness. While cannabis presents certain subjective, healthrelated, and pecuniary benefits to users, growers, and other entities, it is also associated with several brainbased risks. Understanding these risks aids clinicians and their patients in making informed and balanced decisions regarding the initiation or continuance of marijuana use.
Full Text Available Abstract Introduction The outcome of cerebral ischemic stroke associated with cannabis use is usually favorable. Here we report the first case of cannabis-related stroke followed by neuropsychiatric sequelae. Case presentation A 24-year-old Caucasian man was discovered in a deeply comatose non-reactive state after cannabis use. A magnetic resonance imaging scan of his brain showed bilateral multiple ischemic infarcts. The patient remained deeply comatose for four days, after which time he developed other behavioral impairments and recurrent seizures. Conclusion Stroke related to cannabis use can be followed by severe neuropsychiatric sequelae. Concomitant alcohol intoxication is essential neither to the occurrence of this neurologic event nor to its severity.
Flores-Sanchez, Isvett J; Linthorst, Huub J M; Verpoorte, Robert
Cannabinoids, flavonoids, and stilbenoids have been identified in the annual dioecious plant Cannabis sativa L. Of these, the cannabinoids are the best known group of this plant's natural products. Polyketide synthases (PKSs) are responsible for the biosynthesis of diverse secondary metabolites, including flavonoids and stilbenoids. Biosynthetically, the cannabinoids are polyketide substituted with terpenoid moiety. Using an RT-PCR homology search, PKS cDNAs were isolated from cannabis plants. The deduced amino acid sequences showed 51%-73% identity to other CHS/STS type sequences of the PKS family. Further, phylogenetic analysis revealed that these PKS cDNAs grouped with other non-chalcone-producing PKSs. Homology modeling analysis of these cannabis PKSs predicts a 3D overall fold, similar to alfalfa CHS2, with small steric differences on the residues that shape the active site of the cannabis PKSs.
Isvett J. Flores-Sanchez
Full Text Available Cannabinoids, flavonoids, and stilbenoids have been identified in the annual dioecious plant Cannabis sativa L. Of these, the cannabinoids are the best known group of this plant's natural products. Polyketide synthases (PKSs are responsible for the biosynthesis of diverse secondary metabolites, including flavonoids and stilbenoids. Biosynthetically, the cannabinoids are polyketide substituted with terpenoid moiety. Using an RT-PCR homology search, PKS cDNAs were isolated from cannabis plants. The deduced amino acid sequences showed 51%-73% identity to other CHS/STS type sequences of the PKS family. Further, phylogenetic analysis revealed that these PKS cDNAs grouped with other non-chalcone-producing PKSs. Homology modeling analysis of these cannabis PKSs predicts a 3D overall fold, similar to alfalfa CHS2, with small steric differences on the residues that shape the active site of the cannabis PKSs.
Venderová, Katerina; Růzicka, Evzen; Vorísek, Viktor; Visnovský, Peter
An anonymous questionnaire sent to all patients attending the Prague Movement Disorder Centre revealed that 25% of 339 respondents had taken cannabis and 45.9% of these described some form of benefit.
Bersani, Francesco Saverio; Santacroce, Rita; Coviello, Marialuce; Imperatori, Claudio; Francesconi, Marta; Vicinanza, Roberto; Minichino, Amedeo; Corazza, Ornella
In a society highly focused on physical appearance, people are increasingly using the so-called performance and image-enhancing drugs (PIEDs) or life-style drugs as an easy way to control weight. Preliminary data from online sources (e.g. websites, drug forums, e-newsletters) suggest an increased use of cannabis amongst the general population as a PIED due to its putative weight-loss properties. The use of cannabis and/or cannabis-related products to lose weight may represent a new substance-use trend that should be carefully monitored and adequately investigated, especially in light of the well-known adverse psychiatric and somatic effects of cannabis, its possible interaction with other medications/drugs and the unknown and potentially dangerous composition of synthetic cannabimimetics preparations.
Haney, Margaret; Evins, A Eden
There have been extensive policy shifts in the legality of recreational and therapeutic use of cannabis in the United States, as well as a steady increase in the number of people using the drug on a regular basis. Given these rapid societal changes, defining what is known scientifically about the consequences of cannabis use on mental health takes on added public health significance. The purpose of this circumspectives piece is to discuss evidence of cannabis' effects on two psychiatric conditions: post-traumatic stress disorder and psychotic disorders. Dr Haney and Dr Evins will discuss two viewpoints regarding the benefit and harm of cannabis use for these conditions, while outlining what remains unproven and requires further testing to move the field forward.
Angelucci, Francesco; Ricci, Valerio; Spalletta, Gianfranco; Pomponi, Massimiliano; Tonioni, Federico; Caltagirone, Carlo; Bria, Pietro
Chronic cannabis use produces effects within the central nervous system (CNS) which include deficits in learning and attention tasks and decreased brain volume. Neurotrophins, in particular nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), are proteins that serve as survival factors for CNS neurons. Deficits in the production and utilization of these proteins can lead to CNS dysfunctions including those associated with cannabis abuse. In this study we measured by enzyme-linked immunosorbent assay (ELISA) the NGF and BDNF serum levels in two groups of subjects: cannabis-dependent patients and healthy subjects. We found that NGF serum levels were significantly reduced in cannabis abusers as compared to healthy subjects. These findings indicate that NGF may have a role in the central action of cannabis and potentially in the neurotoxicity induced by this drug. These data also suggest that chronic cannabis consumption may be a risk factor for developing psychosis among drug users.
Lynch, Stephanie Marie
Rationale: Converging evidence suggests that cannabis use can induce psychosis and is a distinct risk factor for schizophrenia. Taken together with the effects of Tetrahydrocannabinol (THC) on neural systems, dopamine and endocannabinoids it is likely that cannabis use may also produce sub- clinical psychosis-linked changes in a much larger number of regular recreational users; observable in schizophrenia-sensitive assessments. Use of the drug by individuals with genetic risk factors for schi...
Welling, Matthew T; Shapter, Tim; Rose, Terry J; Liu, Lei; Stanger, Rhia; King, Graham J
Cannabis is a predominantly diecious phenotypically diverse domesticated genus with few if any extant natural populations. International narcotics conventions and associated legislation have constrained the establishment, characterization, and use of Cannabis genetic resource collections. This has resulted in the underutilization of genepool variability in cultivar development and has limited the inclusion of secondary genepools associated with genetic improvement strategies of the Green Revolution. The structured screening of ex situ germplasm and the exploitation of locally-adapted intraspecific traits is expected to facilitate the genetic improvement of Cannabis. However, limited attempts have been made to establish the full extent of genetic resources available for pre-breeding. We present a thorough critical review of Cannabis ex situ genetic resources, and discuss recommendations for conservation, pre-breeding characterization, and genetic analysis that will underpin future cultivar development. We consider East Asian germplasm to be a priority for conservation based on the prolonged historical cultivation of Cannabis in this region over a range of latitudes, along with the apparent high levels of genetic diversity and relatively low representation in published genetic resource collections. Seed cryopreservation could improve conservation by reducing hybridization and genetic drift that may occur during Cannabis germplasm regeneration. Given the unique legal status of Cannabis, we propose the establishment of a global virtual core collection based on the collation of consistent and comprehensive provenance meta-data and the adoption of high-throughput DNA sequencing technologies. This would enable representative core collections to be used for systematic phenotyping, and so underpin breeding strategies for the genetic improvement of Cannabis.
Matthew Timothy Welling
Full Text Available Cannabis is a predominantly diecious phenotypically diverse domesticated genus with few if any extant natural populations. International narcotics conventions and associated legislation have constrained the establishment, characterization and use of Cannabis genetic resource collections. This has resulted in the underutilization of genepool variability in cultivar development and has limited the inclusion of secondary genepools associated with genetic improvement strategies of the Green Revolution. The structured screening of ex situ germplasm and the exploitation of locally-adapted intraspecific traits is expected to facilitate the genetic improvement of Cannabis. However, limited attempts have been made to establish the full extent of genetic resources available for pre-breeding. We present a thorough critical review of Cannabis ex situ genetic resources, and discuss recommendations for conservation, pre-breeding characterization and genetic analysis that will underpin future cultivar development. We consider East Asian germplasm to be a priority for conservation based on the prolonged historical cultivation of Cannabis in this region over a range of latitudes, along with the apparent high levels of genetic diversity and relatively low representation in published genetic resource collections. Seed cryopreservation could improve conservation by reducing hybridization and genetic drift that may occur during Cannabis germplasm regeneration. Given the unique legal status of Cannabis, we propose the establishment of a global virtual core collection based on the collation of consistent and comprehensive provenance meta-data and the adoption of high-throughput DNA sequencing technologies. This would enable representative core collections to be used for systematic phenotyping, and so underpin breeding strategies for the genetic improvement of Cannabis.
Fischer, Benedikt; Kuganesan, Sharan; Room, Robin
While prohibition has been the dominant regime of cannabis control in most countries for decades, an increasing number of countries have been implementing cannabis control reforms recently, including decriminalization or even legalization frameworks. Canada has held out from this trend, although it has among the highest cannabis use rates in the world. Cannabis use is universally criminalized, and the current (conservative) federal government has vowed not to implement any softening reforms to cannabis control. As a result of several higher court decisions, the then federal government was forced to implement a 'medical marijuana access regulations' program in 2001 to allow severely ill patients therapeutic use and access to therapeutic cannabis while shielding them from prosecution. The program's regulations and approval processes were complex and subject to extensive criticism; initial uptake was low and most medical marijuana users continued their use and supply outside the program's auspices. This year, the government introduced new 'marijuana for medical purposes regulations', which allow physicians to 'authorize' medical marijuana use for virtually any health condition for which this is considered beneficial; supply is facilitated by licensed commercial producers. It is expected that some 500,000 users, and dozens of commercial producers will soon be approved under the program, arguably constituting - as with medical marijuana schemes elsewhere, e.g. in California--de facto 'legalization'. We discuss the question whether the evolving scope and realities of 'medical cannabis' provisions in Canada offer a 'sneaky side door' or a 'better third way' to cannabis control reform, and what the potential wider implications are of these developments.
Hari D. Maharajh
Full Text Available Cannabis use and suicidal behaviour are causes of adolescent morbidity and mortality worldwide. Changing trends in these behaviours in younger age groups, higher incidence, gender differences and sociocultural variations present an enormous challenge. There is no consensus whether these complex relationships are either a direct or an indirect effect due to other mental disorders, or a social response of disclosure of drug taking habits to family members and school authorities. This paper reviews the epidemiology of suicidal behaviour and cannabis use among adolescents and looks at the relationship of these behaviours regionally and internationally. The Caribbean islands have an established use of cannabis with higher suicidal rates, which provides an ideal setting to investigate the interrelationship of these disorders. Preliminary research findings in Trinidad indicate high rates of cannabis use among school students with higher rates in vocational schools compared to grammar schools. Utilising the CAPE questionnaire, depressive and psychotic experiences were common findings in adolescent cannabis users with a significant preponderance of depressive experiences (p<0.01. Our findings suggest that there is a convincing relationship between suicidal behaviour and cannabis use, the latter awakening depressive experiences. Suicidal behaviour and cannabis use are major public health problems and require a multidimensional approach with culturally competent preventive interactions. School based prevention programmes are necessary at the levels of parent-teacher partnership and classroom intervention. The treatment of adolescent disorders remains a major challenge of the future. Double disorders such as cannabis use and suicidal behaviour are uncharted areas and need novel approaches.
Lucas Philippe G
Full Text Available Abstract Background In response to a number of court challenges brought forth by Canadian patients who demonstrated that they benefited from the use of medicinal cannabis but remained vulnerable to arrest and persecution as a result of its status as a controlled substance, in 1999 Canada became the second nation in the world to initiate a centralized medicinal cannabis program. Over its six years of existence, this controversial program has been found unconstitutional by a number of courts, and has faced criticism from the medical establishment, law enforcement, as well as the patient/participants themselves. Methods This critical policy analysis is an evidence-based review of court decisions, government records, relevant studies and Access to Information Act data related to the three main facets of Health Canada's medicinal cannabis policy – the Marihuana Medical Access Division (MMAD; the Canadians Institute of Health Research Medical Marijuana Research Program; and the federal cannabis production and distribution program. This analysis also examines Canada's network of unregulated community-based dispensaries. Results There is a growing body of evidence that Health Canada's program is not meeting the needs of the nation's medical cannabis patient community and that the policies of the Marihuana Medical Access Division may be significantly limiting the potential individual and public health benefits achievable though the therapeutic use of cannabis. Canada's community-based dispensaries supply medical cannabis to a far greater number of patients than the MMAD, but their work is currently unregulated by any level of government, leaving these organizations and their clients vulnerable to arrest and prosecution. Conclusion Any future success will depend on the government's ability to better assess and address the needs and legitimate concerns of end-users of this program, to promote and fund an expanded clinical research agenda, and to work in
Hakki, Erdogan E.; Seyit A. KAYIS; Pinarkara,Emine; Sag,Ayla
Cannabis sativa L. is a multiple-use plant that provides raw material for the production of seed oil, natural fiber for textiles, automotive and pulp industries. It has also been used in insulating boards, ropes, varnishes, animal feed, and as medicinal agents. Cannabis has potential to be used for phytoremediation: however, its cultivation is strictly controlled due to its psychoactive nature and usage in producing drugs such as marijuana, and hashish. In this study, psychoactive type Cannab...
Comelli, Francesca; Bettoni, Isabella; Colleoni, Mariapia; Giagnoni, Gabriella; Costa, Barbara
Abstract Neuropathy is the most common complication of diabetes and it is still considered to be relatively refractory to most of the analgesics. The aim of the present study was to explore the antinociceptive effect of a controlled cannabis extract (eCBD) in attenuating diabetic neuropathic pain. Repeated treatment with cannabis extract significantly relieved mechanical allodynia and restored the physiological thermal pain perception in streptozotocin (STZ)-induced diabetic rats w...
Full Text Available Analyzes the dialectic between problem discovery and formulation, ethical considerations, and the public dissemination of research results. Author describes his personal experience of fieldwork, the moral-ethical dilemmas it involved, and the circulation of research findings on cannabis production and consumption in St. Vincent. He became frustrated that his academic publications were only accessible to a tiny portion of St. Vincent's population and therefore decided to publish about cannabis in the local media.
Full Text Available Background: Cannabis is the world's most commonly used illicit drug, with approximately 200 to 300 million regular users. It occupies fourth place in worldwide popularity among psychoactive drugs, after caffeine, nicotine and alcohol. Nowadays, cannabis is widely used by young people and, the prevalence of lifetime use of cannabis by young adults has increased in many developed countries over the past several decades. Methods: It was a one year cross-sectional observational study. The study included 60 patients, who had been taking cannabis for at least previous six months with a frequency of minimum 20 days/month. The eligible patients fulfilling inclusion and exclusion criteria and giving written informed consent were enrolled in the study. Results: Most common co-morbid psychiatric disorders were bipolar affective disorders, current manic episode with or without psychotic features (25.0%. Second most common co-morbid disorder was cannabis induced psychosis which was present in thirteen patients (21.7%. Seven patients (11.7% had acute and transient psychosis; six patients (10.0% were diagnosed as schizophrenia, whereas three patients (5.0% had Psychosis Not Otherwise Specified (NOS. Anxiety disorder and depressive disorder accounted for 10% and 3.4% of comorbidity, respectively. Two patients (3.3% were having cannabis dependence syndrome with withdrawal state and three patients (5.0% were having cannabis dependence syndrome only without any associated psychiatric comorbidity. Conclusion: Among the various psychiatric disorders, bipolar affective disorder, current episode mania with or without psychotic features was the most prevalent disorder.Most of cannabis users seeking treatment suffer from various psychiatric comorbid disorders particularly psychotic disorders (38.4%. [Natl J Med Res 2016; 6(1.000: 58-61
González-Pinto, Ana; González-Ortega, Itxaso; Alberich, Susana; Ruiz de Azúa, Sonia; Bernardo, Miguel; Bioque, Miquel; Cabrera, Bibiana; Corripio, Iluminada; Arango, Celso; Lobo, Antonio; Sánchez-Torres, Ana M.; Cuesta, Manuel J.
The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis. PMID:27513670
Rooke Sally E
Full Text Available Abstract Background In order to improve treatments for cannabis use disorder, a better understanding of factors associated with successful quitting is required. Method This study examined differences between successful (n = 87 and unsuccessful (n = 78 cannabis quitters. Participants completed a questionnaire addressing demographic, mental health, and cannabis-related variables, as well as quitting strategies during their most recent quit attempt. Results Eighteen strategies derived from cognitive behavioral therapy were entered into a principal components analysis. The analysis yielded four components, representing (1 Stimulus Removal, (2 Motivation Enhancement, (3 (lack of Distraction, and (4 (lack of Coping. Between groups comparisons showed that unsuccessful quitters scored significantly higher on Motivation Enhancement and (lack of Coping. This may indicate that unsuccessful quitters focus on the desire to quit, but do not sufficiently plan strategies for coping. Unsuccessful quitters also had significantly more symptoms of depression and stress; less education; lower exposure to formal treatment; higher day-to-day exposure to other cannabis users; and higher cannabis dependence scores. Conclusions The findings suggest that coping, environmental modification, and co-morbid mental health problems may be important factors to emphasize in treatments for cannabis use disorder.
Crippa José AS
Full Text Available Abstract Background Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition. Objective To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis. Methods A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review. Results The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol. Conclusion Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.
Fischedick, Justin; Van Der Kooy, Frank; Verpoorte, Robert
Cannabis sativa L. (cannabis) extracts, vapor produced by the Volcano vaporizer and smoke made from burning cannabis joints were analyzed by GC-flame ionization detecter (FID), GC-MS and HPLC. Three different medicinal cannabis varieties were investigated Bedrocan, Bedrobinol and Bediol. Cannabinoids plus other components such as terpenoids and pyrolytic by-products were identified and quantified in all samples. Cannabis vapor and smoke was tested for cannabinoid receptor 1 (CB1) binding activity and compared to pure Delta(9)-tetrahydrocannabinol (Delta(9)-THC). The top five major compounds in Bedrocan extracts were Delta(9)-THC, cannabigerol (CBG), terpinolene, myrcene, and cis-ocimene in Bedrobinol Delta(9)-THC, myrcene, CBG, cannabichromene (CBC), and camphene in Bediol cannabidiol (CBD), Delta(9)-THC, myrcene, CBC, and CBG. The major components in Bedrocan vapor (>1.0 mg/g) were Delta(9)-THC, terpinolene, myrcene, CBG, cis-ocimene and CBD in Bedrobinol Delta(9)-THC, myrcene and CBD in Bediol CBD, Delta(9)-THC, myrcene, CBC and terpinolene. The major components in Bedrocan smoke (>1.0 mg/g) were Delta(9)-THC, cannabinol (CBN), terpinolene, CBG, myrcene and cis-ocimene in Bedrobinol Delta(9)-THC, CBN and myrcene in Bediol CBD, Delta(9)-THC, CBN, myrcene, CBC and terpinolene. There was no statistically significant difference between CB1 binding of pure Delta(9)-THC compared to cannabis smoke and vapor at an equivalent concentration of Delta(9)-THC.
Russo, Ethan B
Cannabis sativa L. is possibly one of the oldest plants cultivated by man, but has remained a source of controversy throughout its history. Whether pariah or panacea, this most versatile botanical has provided a mirror to medicine and has pointed the way in the last two decades toward a host of medical challenges from analgesia to weight loss through the discovery of its myriad biochemical attributes and the endocannabinoid system wherein many of its components operate. This study surveys the history of cannabis, its genetics and preparations. A review of cannabis usage in Ancient Egypt will serve as an archetype, while examining first mentions from various Old World cultures and their pertinence for contemporary scientific investigation. Cannabis historians of the past have provided promising clues to potential treatments for a wide array of currently puzzling medical syndromes including chronic pain, spasticity, cancer, seizure disorders, nausea, anorexia, and infectious disease that remain challenges for 21st century medicine. Information gleaned from the history of cannabis administration in its various forms may provide useful points of departure for research into novel delivery techniques and standardization of cannabis-based medicines that will allow their prescription for treatment of these intractable medical conditions.
Killestein, J; Bet, P M; van Loenen, A C; Polman, C H
--In 1996, the Netherlands Health Council issued a negative recommendation regarding the use of medication on the basis of cannabis (marihuana). However, interest in medicinal cannabis has certainly not waned since. --The neurological diseases for which cannabis could presently be used therapeutically are: multiple sclerosis, chronic (neuropathic) pain and the syndrome of Gilles de la Tourette. --Since September 2003, the Dutch Ministry of Health, Welfare and Sport delivers medicinal cannabis to Dutch pharmacies, so that now for the first time, medicinal cannabis can be given to patients on a prescription basis within the framework of the Opium Law. The result of this is that doctors and patients now assume that this is a medication for which the efficacy and safety have been established. --The question arises whether new scientific data have become available since 1996 that provide scientific support for the current Governmental policy. --In a recent clinical trial that has aroused much discussion, patients with multiple sclerosis and problematic spasticity were treated with oral cannabis or a placebo. There was no significant effect of treatment on the primary outcome measure, i.e. objectively determined spasticity. Nevertheless, it was concluded that the mobility was improved and that the pain was subjectively decreased. --Until now, convincing scientific evidence that cannabinoids are effective in neurological conditions is still lacking. --However, it is also not possible to conclude definitely that cannabinoids are ineffective; still, this is no basis for official stimulation of their use.
Full Text Available The three main cannabinoids Δ9-tetrahydrocannabinol (Δ9-THC, cannabidiol (CBD and cannabinol (CBN were identified and determined quantitatively using a GCD (GC-EI instrument in 280 samples of illicit herbal cannabis, seized by the Police authorities in Novi Sad, during 2008. The samples were sent to the Institute of Forensic Medicine, Clinical Center Vojvodina, for forensic chemical analysis. The cannabinoid content of the samples enabled the classification of the cannabis into three chemical phenotypes and the differentiation into drug and textile-cannabis, using the Waller classification index. This differentiation has great forensic significance in the classification of certain cases as a criminal action. The experimental results showed that the Δ9-THC content in illicitly circulated cannabis slightly decreased from January to December 2008, as did the quality of the drug-cannabis. The reasons for the quality variations could lie in the geographical origin of the cannabis plants, the conditions of plants storage, various parts of the plants in samples and the time elapsed between harvesting and chemical analysis.
Sexton, Michelle; Cudaback, Eiron; Abdullah, Rehab A; Finnell, John; Mischley, Laurie K; Rozga, Mary; Lichtman, Aron H; Stella, Nephi
Cannabinoids affect immune responses in ways that may be beneficial for autoimmune diseases. We sought to determine whether chronic Cannabis use differentially modulates a select number of immune parameters in healthy controls and individuals with multiple sclerosis (MS cases). Subjects were enrolled and consented to a single blood draw, matched for age and BMI. We measured monocyte migration isolated from each subject, as well as plasma levels of endocannabinoids and cytokines. Cases met definition of MS by international diagnostic criteria. Monocyte cell migration measured in control subjects and individuals with MS was similarly inhibited by a set ratio of phytocannabinoids. The plasma levels of CCL2 and IL17 were reduced in non-naïve cannabis users irrespective of the cohorts. We detected a significant increase in the endocannabinoid arachidonoylethanolamine (AEA) in serum from individuals with MS compared to control subjects, and no significant difference in levels of other endocannabinoids and signaling lipids irrespective of Cannabis use. Chronic Cannabis use may affect the immune response to similar extent in individuals with MS and control subjects through the ability of phytocannabinoids to reduce both monocyte migration and cytokine levels in serum. From a panel of signaling lipids, only the levels of AEA are increased in individuals with MS, irrespective of Cannabis use or not. Our results suggest that both MS cases and controls respond similarly to chronic Cannabis use with respect to the immune parameters measured in this study.
C. Da Porto
Full Text Available Summary. This study investigated the use of ultrasound-assisted extraction (UAE to recovery volatile compounds from the inflorescences of a fiber type Cannabis sativa L. cultivar. The results show that ultrasonic treatment not longer than 5 min allows to obtain an enhanced concentration of terpenes in comparison with maceration. Instead, an ultrasonic treatment longer than 5 min increased the concentration of δ-9-tetraidrocannabinol (THC. A preliminary screening of cannabis inflorescences scent was performed by headspace solid-phase microextraction (HS-SPME with gas chromatography-mass spectrometry (GC-MS avoiding the chemical modification and artifact formation that can occur in conventional methods . Industrial relevance. Inflorescences of fiber type Cannabis sativa cultivars are generally considered waste parts for fiber industry, although the inflorescences’ volatiles are pleasant to the human sensory system. Cannabis scent originate from volatile monoterpenes and sesquiterpenes . Traditionally, the recovery of floral fragrances from plants is by water distillation (hydro-distillation or steam distillation to produce essential oils. However, these techniques take at least several hours and require the application of heating, which can produce the degradation of thermo labile compounds present in the starting plant material. Ultrasound-assisted extraction can be use as alternative method to extract aroma compounds from inflorescences of fiber type Cannabis sativa. The extracts so obtained could be used as ingredients for perfumes (cosmetic industry or flavorings for beverages (food industry.Keywords. Ultrasound; Extraction; Cannabis sativa L.; terpenes; THC; HS-SPME
Full Text Available Abstract Background Research on cannabis use has emphasized frequency as a predictor of problems. Studies of other drugs reveal that frequency relates to psychological and physiological outcomes, but quantity also plays an important role. In the study of cannabis, quantity has been difficult to assess due to the wide range of products and means of consumption. Methods The present study introduces three new measures of quantity, and examines their contribution to cannabis-related problems. Over 5,900 adults using cannabis once or more per month completed an internet survey that inquired about use, dependence, social problems and respiratory health. In addition to detailing their frequency of cannabis use, participants also reported three measures of quantity: number of quarter ounces consumed per month, usual intensity of intoxication, and maximum intensity of intoxication. Results Frequency of use, monthly consumption, and levels of intoxication predicted respiratory symptoms, social problems and dependence. What is more, each measure of quantity accounted for significant variance in outcomes after controlling for the effects of frequency. Conclusion These findings indicate that quantity is an important predictor of cannabis-related outcomes, and that the three quantity measures convey useful information about use.
Alfonso L. Palmer
Full Text Available Spain is one of the European countries with the highest prevalence of cannabis and cocaine use among young people. The aim of this study was to investigate the factors related to the consumption of cocaine and cannabis among adolescents. A questionnaire was administered to 9,284 students between 14 and 18 years of age in Palma de Mallorca (47.1% boys and 52.9% girls whose mean age was 15.59 years. Logistic regression and decision trees were carried out in order to model the consumption of cannabis and cocaine. The results show the use of legal substances and committing fraudulence or theft are the main variables that raise the odds of consuming cannabis. In boys, cannabis consumption and a family history of drug use increase the odds of consuming cocaine, whereas in girls the use of alcohol, behaviours of fraudulence or theft and difficulty in some personal skills influence their odds of consuming cocaine. Finally, ease of access to the substance greatly raises the odds of consuming cocaine and cannabis in both genders. Decision trees highlight the role of consuming other substances and committing fraudulence or theft. The results of this study gain importance when it comes to putting into practice effective prevention programmes.
Full Text Available Objective: The aim of this study was to describe the characteristics of cannabis users and their levels of satisfaction with Stop-cannabis, an app intended for cannabis users who want to stop or reduce their cannabis use or prevent relapse. Methods: A cross-sectional online survey was administered to users of Stop-cannabis, a French-language app for iOS and Android devices. All app users were invited to participate in the survey via a message sent to the app. Results: For hundred and eighty-two users answered the survey. The app was used daily by 348 of the participants (around 70%. More than 80% of participants (397 considered the app to have helped them a little or a lot to stop or reduce cannabis consumption. Most of the users’ suggestions were related to the number or the quality of the messages sent by, or displayed in, the app.Conclusion: This pilot study supports the feasibility of such an app and its perceived usefulness. A self-selection bias however limits the conclusions of the study. The efficacy of the app should be evaluated in a randomized controlled trial.
Samantha J. Broyd
Full Text Available Prolonged heavy exposure to cannabis is associated with impaired cognition and brain functional and structural alterations. We recently reported attenuated mismatch negativity (MMN and altered P50 sensory gating in chronic cannabis users. This study investigated the extent of brain functional recovery (indexed by MMN and P50 in chronic users after cessation of use. Eighteen ex-users (median 13.5 years prior regular use; median 3.5 years abstinence and 18 nonusers completed (1 a multifeature oddball task with duration, frequency, and intensity deviants and (2 a P50 paired-click paradigm. Trend level smaller duration MMN amplitude and larger P50 ratios (indicative of poorer sensory gating were observed in ex-users compared to controls. Poorer P50 gating correlated with prior duration of cannabis use. Duration of abstinence was positively correlated with duration MMN amplitude, even after controlling for age and duration of cannabis use. Impaired sensory gating and attenuated MMN amplitude tended to persist in ex-users after prolonged cessation of use, suggesting a lack of full recovery. An association with prolonged duration of prior cannabis use may indicate persistent cannabis-related alterations to P50 sensory gating. Greater reductions in MMN amplitude with increasing abstinence (positive correlation may be related to either self-medication or an accelerated aging process.
Filbey, Francesca M; Dunlop, Joseph; Ketcherside, Ariel; Baine, Jessica; Rhinehardt, Tyler; Kuhn, Brittany; DeWitt, Sam; Alvi, Talha
Although there is emergent evidence illustrating neural sensitivity to cannabis cues in cannabis users, the specificity of this effect to cannabis cues as opposed to a generalized hyper-sensitivity to hedonic stimuli has not yet been directly tested. Using fMRI, we presented 53 daily, long-term cannabis users and 68 non-using controls visual and tactile cues for cannabis, a natural reward, and, a sensory-perceptual control object to evaluate brain response to hedonic stimuli in cannabis users. The results showed an interaction between group and reward type such that the users had greater response during cannabis cues relative to natural reward cues (i.e., fruit) in the orbitofrontal cortex, striatum, anterior cingulate gyrus, and ventral tegmental area compared to non-users (cluster-threshold z = 2.3, P behavior correlations between neural response to cannabis cues in fronto-striatal-temporal regions and subjective craving, marijuana-related problems, withdrawal symptoms, and levels of THC metabolites (cluster-threshold z = 2.3, P < 0.05). These findings demonstrate hyper-responsivity, and, specificity of brain response to cannabis cues in long-term cannabis users that are above that of response to natural reward cues. These observations are concordant with incentive sensitization models suggesting sensitization of mesocorticolimbic regions and disruption of natural reward processes following drug use. Although the cross-sectional nature of this study does not provide information on causality, the positive correlations between neural response and indicators of cannabis use (i.e., THC levels) suggest that alterations in the reward system are, in part, related to cannabis use. Hum Brain Mapp 37:3431-3443, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
Full Text Available BACKGROUND: The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. METHODS: Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS. Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ, the Pittsburgh Sleep Quality Index (PSQI and the Short Form 36 Health Survey (SF-36. RESULTS: Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%, oral (46% and combined (43%. The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001 reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05 in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. CONCLUSIONS: The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.
Full Text Available The therapeutic potential of cannabis has been known for centuries. Cannabinoids express their effects through two types of receptors, cannabinoid receptor 1 (CB1 and cannabinoid receptor 2 (CB2. Present studies indicate that cannabis-based drugs can make a positive impact in the treatment of different diseases. For many years, multiple sclerosis patients have self-medicated with illegal street cannabis to alleviate spasticity, a common and debilitating symptom that impairs quality of life.
Ameur, S; Haddou, B; Derriche, Z; Canselier, J P; Gourdon, C
A cloud point extraction coupled with high performance liquid chromatography (HPLC/UV) method was developed for the determination of Δ(9)-tetrahydrocannabinol (THC) in micellar phase. The nonionic surfactant "Dowfax 20B102" was used to extract and pre-concentrate THC from cannabis resin, prior to its determination with a HPLC-UV system (diode array detector) with isocratic elution. The parameters and variables affecting the extraction were investigated. Under optimum conditions (1 wt.% Dowfax 20B102, 1 wt.% Na2SO4, T = 318 K, t = 30 min), this method yielded a quite satisfactory recovery rate (~81 %). The limit of detection was 0.04 μg mL(-1), and the relative standard deviation was less than 2 %. Compared with conventional solid-liquid extraction, this new method avoids the use of volatile organic solvents, therefore is environmentally safer.
Ledbetter, M.C.; Krikorian, A.D.
Direct examination of fresh, unfixed and uncoated specimens from vegetative and floral parts of Cannabis sativa with the scanning electron microscope enables one to obtain a faithful representation of their surface morphology. The presence of two major types of trichomes has been confirmed: a glandular type comprising or terminating in a globoid structure, and a conically-shaped nonglandular type. Moreover, three or possibly four distinct glandular types can be distinguished: sessile globoid, small-stalked and large-stalked globoid, and a peltate type. The nonglandular trichomes can be distinguished by the nature of their surfaces: those with a warty surface, and those which are relatively smooth. The range of size and distribution, and the special features of all these types of trichomes are also provided.
Vergara, Daniela; White, Kristin H; Keepers, Kyle G; Kane, Nolan C
Cannabis and Humulus are sister genera comprising the entirety of the Cannabaceae sensu stricto, including C. sativa L. (marijuana, hemp), and H. lupulus L. (hops) as two economically important crops. These two plants have been used by humans for many purposes including as a fiber, food, medicine, or inebriant in the case of C. sativa, and as a flavoring component in beer brewing in the case of H. lupulus. In this study, we report the complete chloroplast genomes for two distinct hemp varieties of C. sativa, Italian "Carmagnola" and Russian "Dagestani", and one Czech variety of H. lupulus "Saazer". Both C. sativa genomes are 153 871 bp in length, while the H. lupulus genome is 153 751 bp. The genomes from the two C. sativa varieties differ in 16 single nucleotide polymorphisms (SNPs), while the H. lupulus genome differs in 1722 SNPs from both C. sativa cultivars.
Pollastro, Federica; Taglialatela-Scafati, Orazio; Allarà, Marco; Muñoz, Eduardo; Di Marzo, Vincenzo; De Petrocellis, Luciano; Appendino, Giovani
The waxy fraction from the variety Carma of fiber hemp (Cannabis sativa) afforded the unusual cannabinoid 4, identified as the farnesyl prenylogue of cannabigerol (CBG, 1) on the basis of its spectroscopic properties. A comparative study of the profile of 4 and 1 toward metabotropic (CB1, CB2) and ionotropic (TRPV1, TRPV2, TRPM8, TRPA1) targets of phytocannabinoids showed that prenylogation increased potency toward CB2 by ca. 5-fold, with no substantial difference toward the other end-points, except for a decreased affinity for TRPM8. The isolation of 4 suggests that C. sativa could contain yet-to-be-discovered prenylogous versions of medicinally relevant cannabinoids, for which their biological profiles could offer interesting opportunities for biomedical exploitation.
Poisa, Liena; Adamovics, Aleksandrs
Hemp is suitable as a renewable energy resource. The aim of this study was to clarify local hemp's (Cannabis sativa L.) possibilities for energy use. Arsenic (As), cadmium (Cd), lead (Pb) and titanium (Ti) presence in hemp was determined using an inductively coupled plasma optical emission spectrometer Optima 2100 DV. If there were increased N fertilizer rates, there were increased hemp `Pūriņi' seeds and shive yield increases, but the oil content was reduced. Arsenic content was higher in the shives than in the stems with fibre. The ash content depends on non-organic substances which the plants absorb during the vegetation season. The lignin content depends on several factors: plant parts, and the N fertilizer rate. The unexplored factors have a great effect on the ash and lignin content. Hemp is suitable for cultivation and for bio-energy production in the agro-climatic conditions in Latvia.
Li, Si-Yu; Stuart, James D; Li, Yi; Parnas, Richard S
Cannabis sativa Linn, known as industrial hemp, was utilized for biodiesel production in this study. Oil from hemp seed was converted to biodiesel through base-catalyzed transesterification. The conversion is greater than 99.5% while the product yield is 97%. Several ASTM tests for biodiesel quality were implemented on the biodiesel product, including acid number, sulfur content, flash point, kinematic viscosity, and free and total glycerin content. In addition, the biodiesel has a low cloud point (-5 degrees C) and kinematic viscosity (3.48mm(2)/s). This may be attributed to the high content of poly-unsaturated fatty acid of hemp seed oil and its unique 3:1 ratio of linoleic to alpha-linolenic acid.
Ruglass, Lesia M.; Shevorykin, Alina; Radoncic, Vanja; Smith, Kathryn M. Z.; Smith, Philip H.; Galatzer-Levy, Isaac R.; Papini, Santiago; Hien, Denise A.
Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed. PMID:28178207
Andre, Christelle M; Hausman, Jean-Francois; Guerriero, Gea
Cannabis sativa L. is an important herbaceous species originating from Central Asia, which has been used in folk medicine and as a source of textile fiber since the dawn of times. This fast-growing plant has recently seen a resurgence of interest because of its multi-purpose applications: it is indeed a treasure trove of phytochemicals and a rich source of both cellulosic and woody fibers. Equally highly interested in this plant are the pharmaceutical and construction sectors, since its metabolites show potent bioactivities on human health and its outer and inner stem tissues can be used to make bioplastics and concrete-like material, respectively. In this review, the rich spectrum of hemp phytochemicals is discussed by putting a special emphasis on molecules of industrial interest, including cannabinoids, terpenes and phenolic compounds, and their biosynthetic routes. Cannabinoids represent the most studied group of compounds, mainly due to their wide range of pharmaceutical effects in humans, including psychotropic activities. The therapeutic and commercial interests of some terpenes and phenolic compounds, and in particular stilbenoids and lignans, are also highlighted in view of the most recent literature data. Biotechnological avenues to enhance the production and bioactivity of hemp secondary metabolites are proposed by discussing the power of plant genetic engineering and tissue culture. In particular two systems are reviewed, i.e., cell suspension and hairy root cultures. Additionally, an entire section is devoted to hemp trichomes, in the light of their importance as phytochemical factories. Ultimately, prospects on the benefits linked to the use of the -omics technologies, such as metabolomics and transcriptomics to speed up the identification and the large-scale production of lead agents from bioengineered Cannabis cell culture, are presented.
Christelle M Andre
Full Text Available Cannabis sativa L. is an important herbaceous species originating from Central Asia, which has been used in folk medicine and as a source of textile fibre since the dawn of times. This fast-growing plant has recently seen a resurgence of interest because of its multi-purpose applications: it is indeed a treasure trove of phytochemicals and a rich source of both cellulosic and woody fibres. Equally highly interested in this plant are the pharmaceutical and construction sectors, since its metabolites show potent bioactivities on human health and its outer and inner stem tissues can be used to make bioplastics and concrete-like material, respectively. In this review, the rich spectrum of hemp phytochemicals is discussed by putting a special emphasis on molecules of industrial interest, including cannabinoids, terpenoids and phenolic compounds, and their biosynthetic routes. Cannabinoids represent the most studied group of compounds, mainly due to their wide range of pharmaceutical effects in humans, including psychotropic activities. The therapeutic and commercial interests of some terpenoids and phenolic compounds, and in particular stilbenoids and lignans, are also highlighted in view of the most recent literature data. Biotechnological avenues to enhance the production and bioactivity of hemp secondary metabolites are proposed by discussing the power of plant genetic engineering and tissue culture. In particular two systems are reviewed, i.e. cell suspension and hairy root cultures. Additionally, an entire section is devoted to hemp trichomes, in the light of their importance as phytochemical factories. Ultimately, prospects on the benefits linked to the use of the -omics technologies, such as metabolomics and transcriptomics to speed up the identification and the large-scale production of lead agents from bioengineered Cannabis cell culture, are presented.
Patients who experience the onset of psychotic illness with a comorbid diagnosis of cannabis dependence experience poor clinical outcomes. Few studies have identified interventions that reduce cannabis use and improve clinical outcome in this population.
Full Text Available Background: Cannabis is the illicit psychoactive substance the most consumed in the world. Little is known about the association between the use of cannabis and the risk of lung cancer.Objective:The objective of this meta-analysis is to determine whether use of cannabis is a risk factor for lung cancer.Methods: We conducted a systematic review and meta-analyses of all languages articles using relevant computerised databases. MEDLINE (online PubMed, Web of knowledge, Embase, EBSCO CINAHL, ScienceDirect, Scopus, Cochrane Library, and Directory of Open Access Journals were searched to September 2014 for cohorts and case-control studies that assessed the risk of lung cancer associated with cannabis smoking. The literature search was performed with a combination of medical subject headings terms, "cannabis" and "lung neoplasms". Data extraction: Two investigators independently analysed and extracted results from eligible studies.Our study's registration number on PROSPERO is CRD42014008872.Results: The search strategy identified 2476 citations. 13 studies were eligible for inclusion: 2 pooled analysis of 9 case-control studies, one case-control study and 3 cohorts.The cumulative analysis for all the studies under a fixed-effects model showed that cannabis smoking determined an increased risk of developing lung cancer in the future (relative risk 1.22, 95% confidence interval 0.999–1.5; p=0.051, with no evidence of heterogeneity across the studies (I2: 34%; p¼0.01.Conclusions: The use of cannabis with or without tobacco smoking is associated with an increased risk for lung cancer.
Ellis, Ronald J; Toperoff, Will; Vaida, Florin; van den Brande, Geoffrey; Gonzales, James; Gouaux, Ben; Bentley, Heather; Atkinson, J Hampton
Despite management with opioids and other pain modifying therapies, neuropathic pain continues to reduce the quality of life and daily functioning in HIV-infected individuals. Cannabinoid receptors in the central and peripheral nervous systems have been shown to modulate pain perception. We conducted a clinical trial to assess the impact of smoked cannabis on neuropathic pain in HIV. This was a phase II, double-blind, placebo-controlled, crossover trial of analgesia with smoked cannabis in HIV-associated distal sensory predominant polyneuropathy (DSPN). Eligible subjects had neuropathic pain refractory to at least two previous analgesic classes; they continued on their prestudy analgesic regimens throughout the trial. Regulatory considerations dictated that subjects smoke under direct observation in a hospital setting. Treatments were placebo and active cannabis ranging in potency between 1 and 8% Delta-9-tetrahydrocannabinol, four times daily for 5 consecutive days during each of 2 treatment weeks, separated by a 2-week washout. The primary outcome was change in pain intensity as measured by the Descriptor Differential Scale (DDS) from a pretreatment baseline to the end of each treatment week. Secondary measures included assessments of mood and daily functioning. Of 127 volunteers screened, 34 eligible subjects enrolled and 28 completed both cannabis and placebo treatments. Among the completers, pain relief was greater with cannabis than placebo (median difference in DDS pain intensity change, 3.3 points, effect size=0.60; p=0.016). The proportions of subjects achieving at least 30% pain relief with cannabis versus placebo were 0.46 (95%CI 0.28, 0.65) and 0.18 (0.03, 0.32). Mood and daily functioning improved to a similar extent during both treatment periods. Although most side effects were mild and self-limited, two subjects experienced treatment-limiting toxicities. Smoked cannabis was generally well tolerated and effective when added to concomitant analgesic
Creemers, H.E.; Dijkstra, J.K.; Vollebergh, W.A.M.; Ormel, J.; Verhulst, F.C.; Huizink, A.C.
Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to life-time cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods
Creemers, H.E.; Dijkstra, J.K.; Vollebergh, W.; Ormel, J.; Verhulst, F.C.; Huizink, A.C.
Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to lifetime cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods
Creemers, Hanneke E.; Dijkstra, Jan K.; Vollebergh, Wilma A. M.; Ormel, Johan; Verhulst, Frank C.; Huizink, Anja C.
Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to life-time cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods
Skyler G. Shollenbarger
Conclusions: Consistent with prior findings, cannabis use was associated with reduced frontolimbic WM integrity. WM integrity was also moderated by FAAH genotype, in that cannabis-using FAAH C/C carriers and A carrying controls had reduced WM integrity compared to control C/C carriers. Observed frontolimbic white matter abnormalities were linked with increased depressive and apathy symptoms in the cannabis users.
Gelders, Dave; Laenen, Freya Vander
Over the last five years, the announced new policy on drugs, cannabis in particular, has been the subject of much debate within the Belgian Federal Government and between the government and the opposition parties. Unclear policies and poor public communication from the Federal Government, the competent minister and the other parties caused immense…
Fischer, Jane A; Clavarino, Alexandra M; Plotnikova, Maria; Najman, Jackob M
Cannabis is generally used to enhance mood (quality of life), but it is not known whether it has this effect in the medium to longer term. Little is currently known about the temporal sequence between cannabis use and the quality of life (QOL). Data are taken from a prospective longitudinal study of pregnant women recruited at their first antenatal visit in Brisbane, Australia. Offspring data from the follow-ups with 14-year-olds and 21-year-olds are used here. Indicators of QOL, happiness, and satisfaction at 14 years are considered as predictors of subsequent cannabis use. The association between cannabis use and QOL at 21 years, adjusting for prior QOL (14 years), is also examined. Socio-demographic characteristics were included as potential confounders relevant to QOL assessments. In this cohort, lower QOL in the early teenage years predicted subsequent onset of cannabis use in young adulthood. After adjustment for socio-demographic characteristics and for QOL pre-cannabis use, participants who used cannabis more frequently had a lower QOL at the 21-years follow-up. Frequent use of cannabis does not appear to enhance the user's QOL and appears to be associated with a reduced QOL into young adulthood.
Szoke, Andrei; Galliot, Anne-Marie; Richard, Jean-Romain; Ferchiou, Aziz; Baudin, Grégoire; Leboyer, Marion; Schürhoff, Franck
Cannabis consumption can cause abuse and dependence and increase risk of developing psychiatric and somatic disorders. Several literature reviews explored the link between cannabis consumption and schizophrenia but none summarized the rich literature on cannabis and psychometric schizotypy. The aim of our review is to synthesize data from studies that explored the association between cannabis consumption and schizoptypal dimensions. A systematic review of the literature and, when needed, contact with the authors, allowed us to gather data from 29 cross-sectional studies. We compared schizotypy scores between subjects that never used cannabis and subjects that used it at least once ("never vs. ever") and between current users and subjects that do not use cannabis currently ("current vs. other"). We conducted separate analyses for total schizotypy score and each of the three classical schizotypal dimensions (positive, negative, disorganized). For all eight comparisons, the cannabis group ("ever" or "current") had higher schizotypy scores. Differences were in the small or medium range and, with the exception of the negative score in the current vs. other comparison, statistically significant. Cannabis consumption is associated with increased schizotypal traits. More research, using different approaches (e.g. longitudinal studies) is needed to explore the cause of this association.
Verweij, C.J.H.; Zietsch, B.P.; Lynskey, M.T.; Medland, S.E.; Neale, M.C.; Martin, N.G.; Boomsma, D.I.; Vink, J.M.
Background Because cannabis use is associated with social, physical and psychological problems, it is important to know what causes some individuals to initiate cannabis use and a subset of those to become problematic users. Previous twin studies found evidence for both genetic and environmental inf
Verweij, K.J.H.; Huizink, A.C.; Agrawal, A.; Martin, N.G.; Lynskey, M.T.
Background: Several studies have shown that early cannabis use is correlated with poor educational performance including high school drop-out. The predominant explanation for this relationship is that cannabis use causes disengagement from education. Another explanation is that the association betwe
Hjorthøj, Carsten Rygaard; Orlovska, Sonja; Fohlmann, Allan;
Randomized trials targeting cannabis use disorders in patients with psychosis have generally been unsuccessful. One of the largest such trials was the CapOpus trial, which had an impact on the number of monthly joints used, but not on the number of days with cannabis use or positive or negative...
Jager, G.; Block, R.I.; Luijten, M.; Ramsey, N.F.
Adolescents' risk-taking behavior has been linked to a maturational imbalance between reward (“go”) and inhibitory-control (“stop”)-related brain circuitry. This may drive adolescent drug-taking, such as cannabis use. In this study, we assessed the non-acute effects of adolescent cannabis use on rew
Happyana, Nizar; Agnolet, Sara; Muntendam, Remco; Van Dam, Annie; Schneider, Bernd; Kayser, Oliver
Trichomes, especially the capitate-stalked glandular hairs, are well known as the main sites of cannabinoid and essential oil production of Cannabis sativa. In this study the distribution and density of various types of Cannabis sativa L trichomes, have been investigated by scanning electron microsc
van Leeuwen, Andrea Prince; Creemers, Hanneke E.; Verhulst, Frank C.; Ormel, Johan; Huizink, Anja C.
Objective: This study examined (a) the predictive value of observed versus reported measures of impulsivity on the onset of cannabis use and determined if lifetime tobacco and cannabis users can be differentiated by their level of impulsivity and (b) the predictive value of observed versus reported
Creemers, Hanneke E.; Korhonen, Tellervo; Kaprio, Jaakko; Vollebergh, Wilma A. M.; Ormel, Johan; Verhulst, Frank C.; Huizink, Anja C.
Background: While temperamental characteristics have been related to the onset of cannabis use, it is not clear at what point(s) along the trajectory from early onset of tobacco use (EOT) to early onset of cannabis use (EOC) these characteristics exert their impact. This study examined if (1) temper
El Marroun, H.; Hudziak, J.J.; Tiemeier, H.; Creemers, H.; Steegers, E.A.P.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; van den Brink, W.; Huizink, A.C.
Background: The development of the fetal endocannabinoid receptor system may be vulnerable to maternal cannabis use during pregnancy and may produce long-term consequences in children. In this study, we aimed to determine the relationship between gestational cannabis use and childhood attention prob
Creemers, H.E.; Korhonen, T.; Kaprio, J; Vollebergh, W.A.M.; Ormel, J.; Verhulst, F.C.; Huizink, A.C.
Background: While temperamental characteristics have been related to the onset of cannabis use, it is not clear at what point(s) along the trajectory from early onset of tobacco use (EOT) to early onset of cannabis use (EOC) these characteristics exert their impact. This study examined if (1) temper
van Laar, Margriet; Frijns, Tom; Trautmann, Franz; Lombi, Linda
Demand-based estimates of total cannabis consumption rarely consider differences among different user types and variation across countries. To describe cannabis consumption patterns and estimate annual consumption for different user types across EU Member States, a web survey in Bulgaria, Czech Republic, Italy, the Netherlands, Portugal, Sweden and United Kingdom (England & Wales) collected data on cannabis use patterns from 3,922 persons who had consumed cannabis at least once in the past year. They were classified into four groups based on their number of use days in the past 12 months: infrequent users or chippers (users (11-50 days), regular users (51-250 days) and intensive users (>250 days). User type specific data on typical amounts consumed were matched with data on numbers of users per user type estimated from existing population surveys, taking differences in mode of consumption, age and gender into account. Estimates were supplemented with data from populations of problem users to compensate for under coverage. Results showed remarkably consistent differences among user groups across countries. Both the average number of units consumed per typical use day and the average amount of cannabis consumed per unit increased across user types of increasing frequency of use. In all countries except Portugal, intensive users formed the smallest group of cannabis users but were responsible for the largest part of total annual cannabis consumption. Annual cannabis consumption varied across countries but confidence intervals were wide. Results are compared with previous estimates and discussed in the context of improving estimation methods.
Jager, G; Kahn, RS; Van den Brink, W; Van Ree, JM; Ramsey, NF
Rationale: Excessive use of cannabis may have long-term effects on cognitive abilities. Mild impairments have been found in several cognitive domains, particularly in memory and attention. It is not clear, however, whether these effects also occur with moderate, recreational use of cannabis. Further
Bou-Matar Ché B
Full Text Available Abstract Background Cannabis (marijuana had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of cannabis in 1996, and it was recently estimated that between 250,000 and 350,000 Californians may now possess the physician's recommendation required to use it medically. More limited medical use has also been approved in 12 additional states and new initiatives are being considered in others. Despite that evidence of increasing public acceptance of "medical" use, a definitional problem remains and all use for any purpose is still prohibited by federal law. Results California's 1996 initiative allowed cannabis to be recommended, not only for serious illnesses, but also "for any other illness for which marijuana provides relief," thus maximally broadening the range of allowable indications. In effect, the range of conditions now being treated with federally illegal cannabis, the modes in which it is being used, and the demographics of the population using it became potentially discoverable through the required screening of applicants. This report examines the demographic profiles and other selected characteristics of 4117 California marijuana users (62% from the Greater Bay Area who applied for medical recommendations between late 2001 and mid 2007. Conclusion This study yielded a somewhat unexpected profile of a hitherto hidden population of users of America's most popular illegal drug. It also raises questions about some of the basic assumptions held by both proponents and opponents of current policy.
Guillem, Eric; Notides, Christine; Vorspan, Florence; Debray, Marcel; Nieto, Isabel; Leroux, Mayliss; Lépine, Jean-Pierre
The aim of this study was to evaluate the psychometric properties of the French version of the Marijuana Effect Expectancy Questionnaire (48 items) and study the cannabis expectancies according to the patterns of substance use and psychiatric disorders (DSM-IV). A sample of 263 subjects (average age 33.1 years [SD = 8.7], 56% men) consisting of cannabis users (n = 64), psychiatric inpatients (n = 175, most of whom were hospitalized for withdrawal), and a control group (n = 24) completed the questionnaire. Internal reliability was good (α= .87) and temporal reliability was satisfactory, with 24 of 48 items having a significant κ ≥ .41. Factor analysis showed four main factors that explained 42.1% of the total variance. The women feared Cognitive Impairment and Negative Effects, and Negative Behavioral Effects more than the men. The onset age of cannabis use, onset age of abuse, abuse and dependence were associated with fewer negative expectancies. Cannabis dependents differed from abusers by more Relaxation and Social Facilitation expectancies. Patients with major depressive episodes, panic disorder, social anxiety disorder, or posttraumatic stress disorder feared negative effects the most. Schizophrenic patients expected more Perceptual Enhancement and Craving. The French version of the Marijuana Effect Expectancy Questionnaire has good psychometric properties and is valid to assess cannabis expectancies in adolescents and adults with substance use disorders.
Mathalone, Nurit; Wolf, Alvit; Geyer, Orna
Glaucoma causes damage to the optic nerve and compromises the visual field. The main risk factor of the disease is the level of the intra-ocular pressure. Therapeutic options include medical and surgical treatment, aimed to lower the intra-ocular pressure. Consumption of the cannabis plant (Cannabis Satival has been known since ancient times. It can be consumed orally, topically, intra-venous or by inhalation. The main active ingredient of cannabis is THC (Tetra-Hydro-Cannabinol). One of THC's reported effects is the reduction of intra-ocular pressure. Several studies have demonstrated temporary intra-ocular pressure decrease in both healthy subjects and glaucoma patients following topical application or systemic consumption. The effect was a short term one. It was followed by the development of resistance to the drug after prolonged intake and it was also accompanied by topical and systemic side effects. Cannabis may be considered as a therapeutic option in glaucoma. Its limited effect, development of resistance, acquired side effects and the accompanying psycho-active influence limit its advantage and cause its efficacy to be dubious. Therefore, cannabis treatment for glaucoma currently seems impractical and is not recommended by either the Israeli or the American glaucoma societies.
There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabinoids can prevent the development of tolerance to and withdrawal from opiates, and can even rekindle opiate analgesia after a prior dosage has become ineffective. Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates. Despite a lack of regulatory oversight by federal governments in North America, community-based medical cannabis dispensaries have proven successful at supplying patients with a safe source of cannabis within an environment conducive to healing, and may be reducing the problematic use of pharmaceutical opiates and other potentially harmful substances in their communities.
Brand, E. Joseph; Zhao, Zhongzhen
Cannabis sativa L. (Cannabaceae) has a long history of utilization as a fiber and seed crop in China, and its achenes (“seeds”) as well as other plant parts have been recorded in Chinese medical texts for nearly 2000 years. While the primary applications of cannabis in Chinese medicine center around the use of the achenes, ancient indications for the female inflorescence, and other plant parts include conditions such as pain and mental illness that are the subject of current research into cannabinoids such as cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC). However, little previous research has been conducted to analyze the Chinese medical literature in light of recent advances in the pharmacology and taxonomy of cannabis, and most of the relevant Chinese historical records have not yet been translated into Western languages to facilitate textual research. Furthermore, many key questions remain unresolved in the Chinese literature, including how various traditional drug names precisely correspond to different plant parts, as well as the implications of long-term selection for fiber-rich cultivars on the medical applications of cannabis in Chinese medicine. In this article, prominent historical applications of cannabis in Chinese medicine are chronologically reviewed, and indications found in ancient Chinese literature that may relate to cannabinoids such as CBD and Δ9-THC are investigated. PMID:28344554
Kirst, Maritt; Kolar, Kat; Chaiton, Michael; Schwartz, Robert; Emerson, Brian; Hyshka, Elaine; Jesseman, Rebecca; Lucas, Philippe; Solomon, Robert; Thomas, Gerald
Support for a public health approach to cannabis policy as an alternative to prohibition and criminalization is gaining momentum. Recent drug policy changes in the United States suggest growing political feasibility for legal regulation of cannabis in other North American jurisdictions. This commentary discusses the outcomes of an interdisciplinary policy meeting with Canadian experts and knowledge users in the area of substance use interventions. The meeting explored possibilities for applying cross-substance learning on policy interventions for alcohol, tobacco and cannabis, towards the goal of advancing a public health framework for reducing harms associated with substance use in Canada. The meeting also explored how the shift in approach to cannabis policy can provide an opportunity to explore potential changes in substance use policy more generally, especially in relation to tobacco and alcohol as legally regulated substances associated with a heavy burden of illness. Drawing from the contributions and debates arising from the policy meeting, this commentary identifies underlying principles and opportunities for learning from policy interventions across tobacco, alcohol and cannabis, as well as research gaps that need to be addressed before a public health framework can be effectively pursued across these substances.
Full Text Available In order to examine allelopathic effect of Cannabis sativa L. on germination capability and seedling growth of Lactuca sativa L., a study was performed in laboratory conditions. Treatments were set up in randomised block design in four replications for each of four concentration ranges of 25, 50, 75 and 100 % of aqueous extract made of shoot parts and 4 identical extract concentrations made of root of cannabis. Control variant was lettuce seed treated by distilled water. During the studies shoot and seminal root length of lettuce seedlings were measured after treatments with different concentrations of extracts made of root and shoot parts of cannabis, and the obtained values were compared with the control. The obtained results suggest that the extract from the shoot parts of cannabis in high concentrations of 75 and 100 % had inhibiting effect to the germination indices while the extract from the root had no statistically significant effect on germination of lettuce seeds. Extract made of root part of cannabis showed also stimulatory effect to shoot and seminal root length of lettuce seedlings in extract concentrations of 50, 75 and 100 %.
Full Text Available BACKGROUND: History of drug abuse which included Gutka/cannabis and not alcohol intake has been found in psychiatric patients attending Psychiatry outpatients. AIMS: To find out prevalence of cannabis/Gutka misuse among psychiatric patients , to find out socio - demographic variables , and pattern of psychiatric disorders among cannabis/g utka misusers. METHOD: Out of 150 psychiatric patients 18 were identified for cannabis/gutka misuse. These patients were examined and categorized according to socio - demographic characteristics and types of mental disorders diagnosed by using DSM - IV. RESULT S: Most of the psychiatric patients who had history of cannabis/Gutka intake were male (96.4% and 76% were in age group of 15 - 35 years. 48.6% bipolar type - 1 , 23% schizophreniform psychosis , 14% had drug induced psychosis and 1.4% psychosis NOS patients we re found in this study. CONCLUSIONS: Young male patients were more commonly involved in drug misuse and most of them belong to rural area.
Andresen, Sven Robert; Biering-Sørensen, Fin; Hagen, Ellen Merete
OBJECTIVE: To evaluate recreational and medical cannabis use in individuals with traumatic spinal cord injury, including reasons and predictors for use, perceived benefits and negative consequences. DESIGN: Cross-sectional survey in Denmark. METHODS: A 35-item questionnaire was sent to 1,101 pati......OBJECTIVE: To evaluate recreational and medical cannabis use in individuals with traumatic spinal cord injury, including reasons and predictors for use, perceived benefits and negative consequences. DESIGN: Cross-sectional survey in Denmark. METHODS: A 35-item questionnaire was sent to 1......,101 patients with spinal cord injury who had been in contact with a rehabilitation centre between 1990 and 2012. RESULTS: A total of 537 participants completed the questionnaire. Of these, 36% had tried cannabis at least once and 9% were current users. Of current users, 79% had started to use cannabis before...... their spinal cord injury. The main reason for use was pleasure, but 65% used cannabis partly for spinal cord injury-related consequences and 59% reported at least good effect on pain and spasticity. Negative consequences of use were primarily inertia and feeling quiet/subdued. Lower age, living in rural areas...
Moulay Abdelaziz El Alaoui
Full Text Available The extraction and purification of nucleic acids is the first step in most molecular biology analysis techniques. The objective of this work is to obtain highly purified nucleic acids derived from Cannabis sativa resin seizure in order to conduct a DNA typing method for the individualization of cannabis resin samples. To obtain highly purified nucleic acids from cannabis resin (Hashish free from contaminants that cause inhibition of PCR reaction, we have tested two protocols: the CTAB protocol of Wagner and a CTAB protocol described by Somma (2004 adapted for difficult matrix. We obtained high quality genomic DNA from 8 cannabis resin seizures using the adapted protocol. DNA extracted by the Wagner CTAB protocol failed to give polymerase chain reaction (PCR amplification of tetrahydrocannabinolic acid (THCA synthase coding gene. However, the extracted DNA by the second protocol permits amplification of THCA synthase coding gene using different sets of primers as assessed by PCR. We describe here for the first time the possibility of DNA extraction from (Hashish resin derived from Cannabis sativa. This allows the use of DNA molecular tests under special forensic circumstances.
John T Mitchell
Full Text Available Attention-deficit/hyperactivity disorder (ADHD is a risk factor for problematic cannabis use. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resources. Given that the Internet is increasingly utilized as a source of healthcare information and may influence perceptions, we conducted a qualitative analysis of online forum discussions, also referred to as threads, on the effects of cannabis on ADHD to systematically characterize the content patients and caregivers may encounter about ADHD and cannabis.A total of 268 separate forum threads were identified. Twenty percent (20% were randomly selected, which yielded 55 separate forum threads (mean number of individual posts per forum thread = 17.53 scored by three raters (Cohen's kappa = 0.74. A final sample of 401 posts in these forum threads received at least one endorsement on predetermined topics following qualitative coding procedures.Twenty-five (25% percent of individual posts indicated that cannabis is therapeutic for ADHD, as opposed to 8% that it is harmful, 5% that it is both therapeutic and harmful, and 2% that it has no effect on ADHD. This pattern was generally consistent when the year of each post was considered. The greater endorsement of therapeutic versus harmful effects of cannabis did not generalize to mood, other (non-ADHD psychiatric conditions, or overall domains of daily life. Additional themes emerged (e.g., cannabis being considered sanctioned by healthcare providers.Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD-this is the first study to identify such a trend. This type of online information could shape ADHD patient and caregiver perceptions, and influence cannabis use and clinical care.
Dines, Alison M; Wood, David M; Galicia, Miguel; Yates, Christopher M; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Sedefov, Roumen; Dargan, Paul I
Cannabis is the most commonly used illicit drug in Europe, and is generally regarded as having low acute toxicity. We present the findings of the first 6 months of data collection from the Euro-DEN project on presentations related to cannabis use to further understand the acute toxicity related to the use of cannabis. Data was extracted on clinical features, treatment and outcome from the Euro-DEN minimum dataset for all cases of acute recreational drug toxicity reported 1st October 2013 to 31st March 2014 for all cannabis-related presentations. Of 2198 presentations reported by 14 of the 16 Euro-DEN centres, 356 (16.2 %) involved cannabis either alone or together with other drugs/alcohol. There were 36 that involved lone use of cannabis (1.6 % of all presentations). Of the 35 non-fatal lone cannabis presentations, the most commonly reported features were neuro-behavioural (agitation/aggression 8 (22.9 %), psychosis 7 (20.0 %), anxiety 7 (20.0 %)) and vomiting 6 (17.1 %). Most patients (25, 71.4 %) received no treatment and 30 (85.7 %) were discharged/self-discharged from the ED. There was one fatality amongst these lone-cannabis cases: an 18-year-old male collapsed with an asystolic cardiac arrest whilst smoking cannabis and suffered hypoxic brain injury related to prolonged cardiac arrest. THC was detected in a urine sample taken at ED arrival; no other drugs were detected. Lone acute cannabis toxicity was typically associated with neuro-behavioural symptoms and vomiting. Although uncommon, severe toxicity including cardiovascular toxicity and death may be under-recognised, and it is important that Emergency Physicians are aware of this.
Turner, Suzanne D.; Spithoff, Sheryl; Kahan, Meldon
Résumé Objectif Étudier les caractéristiques et complications cliniques de la consommation à risque de cannabis et du trouble de consommation de cannabis, et présenter un protocole en cabinet pour le dépistage, l’identification et la prise en charge de ces problèmes. Sources des données Une recherche des essais contrôlés, des études d’observation et des révisions sur l’usage de cannabis par les adolescents et les jeunes adultes; les méfaits psychiatriques et médicaux liés au cannabis; le trouble de consommation de cannabis et son traitement; et les lignes directrices sur la consommation à faible risque de cannabis a été effectuée dans PubMed. Message principal Les médecins doivent questionner tous leurs patients quant à leur usage de cannabis. Ils doivent questionner plus souvent les adolescents et jeunes adultes de même que les personnes qui présentent un risque élevé de problèmes liés au cannabis (qui ont un trouble psychiatrique ou de consommation de drogue concomitant). Les problèmes pouvant être causés par le cannabis, comme les troubles de l’humeur, la psychose et les symptômes respiratoires, devraient susciter des questions sur la consommation de cannabis. Aux patients qui rapportent un usage de cannabis, les médecins devraient poser des questions sur la fréquence et la quantité consommée, la présence de symptômes de tolérance ou de sevrage, les tentatives de réduire leur consommation et la présence de problèmes liés au cannabis. Les usagers à faible risque fument, inhalent ou ingèrent le cannabis occasionnellement sans aucun signe de dysfonctionnement scolaire, professionnel ou social; les personnes dont l’usage est problématique consomment tous les jours ou presque tous les jours, ont de la difficulté à réduire leur consommation et leur fonctionnement scolaire, professionnel et social est perturbé. Les médecins devraient offrir à tous les patients dont l’usage est problématique des conseils
Weiblen, George D; Wenger, Jonathan P; Craft, Kathleen J; ElSohly, Mahmoud A; Mehmedic, Zlatko; Treiber, Erin L; Marks, M David
Cannabis sativa is an economically important source of durable fibers, nutritious seeds, and psychoactive drugs but few economic plants are so poorly understood genetically. Marijuana and hemp were crossed to evaluate competing models of cannabinoid inheritance and to explain the predominance of tetrahydrocannabinolic acid (THCA) in marijuana compared with cannabidiolic acid (CBDA) in hemp. Individuals in the resulting F2 population were assessed for differential expression of cannabinoid synthase genes and were used in linkage mapping. Genetic markers associated with divergent cannabinoid phenotypes were identified. Although phenotypic segregation and a major quantitative trait locus (QTL) for the THCA/CBDA ratio were consistent with a simple model of codominant alleles at a single locus, the diversity of THCA and CBDA synthase sequences observed in the mapping population, the position of enzyme coding loci on the map, and patterns of expression suggest multiple linked loci. Phylogenetic analysis further suggests a history of duplication and divergence affecting drug content. Marijuana is distinguished from hemp by a nonfunctional CBDA synthase that appears to have been positively selected to enhance psychoactivity. An unlinked QTL for cannabinoid quantity may also have played a role in the recent escalation of drug potency.
Fridberg, Daniel J.; Queller, Sarah; Ahn, Woo-Young; Kim, Woojae; Bishara, Anthony J.; Busemeyer, Jerome R.; Porrino, Linda; Stout, Julie C.
Chronic cannabis users are known to be impaired on a test of decision-making, the Iowa Gambling Task (IGT). Computational models of the psychological processes underlying this impairment have the potential to provide a rich description of the psychological characteristics of poor performers within particular clinical groups. We used two computational models of IGT performance, the Expectancy-Valence Learning model (EVL) and the Prospect-Valence Learning model (PVL), to assess motivational, memory, and response processes in 17 chronic cannabis abusers and 15 control participants. Model comparison and simulation methods revealed that the PVL model explained the observed data better than the EVL model. Results indicated that cannabis abusers tended to be under-influenced by loss magnitude, treating each loss as a constant and minor negative outcome regardless of the size of the loss. In addition, they were more influenced by gains, and made decisions that were less consistent with their expectancies relative to non-using controls. PMID:20419064
Clausen, L; Hjorthøj, C R; Thorup, Anne A.E.
BACKGROUND: Several studies indicate that cannabis use among patients with psychotic disorders is associated with worse outcome, but only a few studies have controlled for baseline condition and medication. METHOD: At 5-year follow-up, interviews were carried out with 314 first-episode psychosis.......26, 95% CI 2.13-14.39, p = 0.01). Those who stopped using cannabis between entry and 5-year follow-up had a significantly lower level of psychotic symptoms at 5-year follow-up even after controlling for baseline level of psychotic symptoms and for insufficient antipsychotic medication (adjusted...... difference in psychotic dimension -1.04, 95% CI -1.77 to -0.31, p = 0.006). CONCLUSIONS: Continuous cannabis use was associated with higher levels of psychotic symptoms after 5 years, and this association was only partly explained by insufficient antipsychotic medication....
Consumo de cannabis en los estudiantes de secundaria de Barcelona: inicio en el consumo, efectos experimentados y expectativas Cannabis consumption among secondary school pupils of Barcelona [Spain]: initial use, reported effects and expectancies
Full Text Available Objetivos: Describir las circunstancias del inicio del consumo, las razones para hacerlo, los efectos experimentados y las expectativas relacionadas con el consumo de cannabis en adolescentes de Barcelona. Métodos: Encuesta transversal realizada a una muestra de escolares de 3.º de ESO en 2005. El cuestionario era confidencial y autocumplimentado. Se dispone de datos de 2.043 alumnos de 47 centros escolares de Barcelona. Resultados: El 37,5% de los escolares declaró haber probado el cannabis, de los cuales un 10% lo hizo en el último mes. El consumo fue superior en centros públicos que en concertados-privados (p Objectives: To describe the circumstances of initial use of Cannabis, as well as the reasons for consumption, reported effects and expectations related to cannabis use, among adolescents in Barcelona. Methods: A cross-sectional survey was conducted in a sample of pupils in the third year of compulsory secondary education in 2005. The questionnaire was confidential and self-completed. Data were gathered from 2,043 secondary school pupils from 47 schools in Barcelona. Results: A total of 37.5% of students reported cannabis consumption at some time, and 10.0% of these students had used cannabis in the previous month. Cannabis use was more common in public schools than in subsidized or private schools (p < 0.001. More than half the adolescents (60.3% smoked cannabis for the first time in parks or on the street. Most (88.4% of the adolescents obtained cannabis from a classmate or friend and 92.3% did so without paying for it. The main reason for initial consumption was curiosity, and reasons for continuing use were a desire to feel better and to forget problems. The most frequently reported effects were memory loss, sadness and difficulties in studying or working. Cannabis use was positively related to the expectation that the drug induces relaxation and aids social and sexual relations, and negatively to the beliefs that the drug can
Full Text Available The emergence of electronic cigarettes (e-cigs has given cannabis smokers a new method of inhaling cannabinoids. E-cigs differ from traditional marijuana cigarettes in several respects. First, it is assumed that vaporizing cannabinoids at lower temperatures is safer because it produces smaller amounts of toxic substances than the hot combustion of a marijuana cigarette. Recreational cannabis users can discretely “vape” deodorized cannabis extracts with minimal annoyance to the people around them and less chance of detection. There are nevertheless several drawbacks worth mentioning: although manufacturing commercial (or homemade cannabinoid-enriched electronic liquids (e-liquids requires lengthy, complex processing, some are readily on the Internet despite their lack of quality control, expiry date, and conditions of preservation and, above all, any toxicological and clinical assessment. Besides these safety problems, the regulatory situation surrounding e-liquids is often unclear. More simply ground cannabis flowering heads or concentrated, oily THC extracts (such as butane honey oil or BHO can be vaped in specially designed, pen-sized marijuana vaporizers. Analysis of a commercial e-liquid rich in cannabidiol showed that it contained a smaller dose of active ingredient than advertised; testing our laboratory-made, purified BHO, however, confirmed that it could be vaped in an e-cig to deliver a psychoactive dose of THC. The health consequences specific to vaping these cannabis preparations remain largely unknown and speculative due to the absence of comprehensive, robust scientific studies. The most significant health concerns involve the vaping of cannabinoids by children and teenagers. E-cigs could provide an alternative gateway to cannabis use for young people. Furthermore, vaping cannabinoids could lead to environmental and passive contamination.
Kylie Lee, K S; Sukavatvibul, Krisakorn; Conigrave, Katherine M
Anecdotal reports have linked cannabis use to violence in some remote Australian Aboriginal communities. We examine the relationship between cannabis use and presentations to local clinics for violence-related trauma at a population level. As part of a larger study, estimates of cannabis and alcohol use status were obtained for 264 randomly selected individuals aged 14-42. These estimates were collected from Aboriginal health workers and respected community informants using a previously validated approach. Clinic records for the sample were audited for physical trauma presentations between January 2004 and June 2006. One in 3 individuals (n = 88/264) presented to the clinic with physical trauma. Of these, the majority (65.9%, n = 58/88) had at least one presentation that was violence-related. Nearly 2 in every 3 of the total presentations for trauma following violence (n = 40/63) involved the use of a weapon. Hunting tools were most often used, followed by wooden or rock implements. Individuals who reported any current cannabis use were nearly 4 times more likely than nonusers to present at least once for violent trauma after adjusting for current alcohol use, age, and sex (OR = 3.8, 95% CI [1.5, 9.8]). Aboriginal individuals in these remote communities experience high rates of physical trauma and violence, often involving weapons. A comprehensive study is needed to explore the association between cannabis and violence. At the same time, an investment in local programmes is needed to address cannabis use and underlying risk factors for substance use and for violence.
Giroud, Christian; de Cesare, Mariangela; Berthet, Aurélie; Varlet, Vincent; Concha-Lozano, Nicolas; Favrat, Bernard
The emergence of electronic cigarettes (e-cigs) has given cannabis smokers a new method of inhaling cannabinoids. E-cigs differ from traditional marijuana cigarettes in several respects. First, it is assumed that vaporizing cannabinoids at lower temperatures is safer because it produces smaller amounts of toxic substances than the hot combustion of a marijuana cigarette. Recreational cannabis users can discretely "vape" deodorized cannabis extracts with minimal annoyance to the people around them and less chance of detection. There are nevertheless several drawbacks worth mentioning: although manufacturing commercial (or homemade) cannabinoid-enriched electronic liquids (e-liquids) requires lengthy, complex processing, some are readily on the Internet despite their lack of quality control, expiry date, and conditions of preservation and, above all, any toxicological and clinical assessment. Besides these safety problems, the regulatory situation surrounding e-liquids is often unclear. More simply ground cannabis flowering heads or concentrated, oily THC extracts (such as butane honey oil or BHO) can be vaped in specially designed, pen-sized marijuana vaporizers. Analysis of a commercial e-liquid rich in cannabidiol showed that it contained a smaller dose of active ingredient than advertised; testing our laboratory-made, purified BHO, however, confirmed that it could be vaped in an e-cig to deliver a psychoactive dose of THC. The health consequences specific to vaping these cannabis preparations remain largely unknown and speculative due to the absence of comprehensive, robust scientific studies. The most significant health concerns involve the vaping of cannabinoids by children and teenagers. E-cigs could provide an alternative gateway to cannabis use for young people. Furthermore, vaping cannabinoids could lead to environmental and passive contamination.
Full Text Available Cannabis is the most commonly used illicit drug worldwide, with approximately 5 million daily users worldwide. Emerging evidence supports a number of associations between cannabis and psychosis/psychotic disorders, including schizophrenia. These associations based on case-studies, surveys, epidemiological studies, and experimental studies indicate that cannabinoids can produce acute, transient effects; acute, persistent effects as well as delayed, persistent effects that recapitulate the psychopathology and psychophysiology seen in psychotic illness such as schizophrenia. Acute exposure to both cannabis and synthetic cannabinoids (Spice/ K2 can produce a full range of transient psychotomimetic symptoms, cognitive deficits, and psychophysiological abnormalities that bear a striking resemblance to symptoms of schizophrenia. In individuals with an established psychotic disorder, cannabinoids can exacerbate symptoms, trigger relapse, and have negative consequences on the course of the illness. Several factors appear to moderate these associations, including family history, genetic factors, history of childhood abuse, and the age at onset of cannabis use. Exposure to cannabinoids in adolescence confers a higher risk for psychosis outcomes in later life and the risk is dose-related. Individuals with polymorphisms of COMT and AKT1 genes may be at increased risk for psychotic disorders in association with cannabinoids, as are individuals with a family history of psychotic disorders or a history of childhood trauma. The relationship between cannabis and schizophrenia fulfills many but not all of the standard criteria for causality, including temporality, biological gradient, biological plausibility, experimental evidence, consistency, and coherence. At the present time, the evidence indicates that cannabis may be a component cause in the emergence of psychosis, and warrants serious consideration from the point of view of public health policy.
Jacob N. Ablin
Full Text Available Background While medical cannabis has been used for thousands of years in the treatment of pain and other symptoms, evidence-based use is limited and practitioners face multiple areas of uncertainty regarding the rational use of these compounds. Nonetheless, an increasing public interest and advocacy in favor of medical cannabis is causing the issue to be encountered ever more frequently by physicians in different fields of medicine and particularly in rheumatology. In view of this situation, we have surveyed the attitudes of Israeli rheumatologists to the use of medical cannabis. Objectives As rheumatologists are specialized in caring for patients presenting with musculoskeletal complaints, the confidence of rheumatologists’ knowledge of cannabinoids was surveyed. Methods All members of the Israeli Society of Rheumatology were surveyed by e-mail for their confidence and knowledge of cannabinoids and their perceived competence to prescribe herbal cannabis. Results A total of 23 out of 119 (19.3% Israeli rheumatologists approached returned the questionnaire. Three-quarters of responders were not confident about their knowledge of cannabinoid molecules or ability to write a prescription for herbal cannabis, and 78% were not confident to write a prescription for herbal cannabis; 74% of responders held the opinion that there was some role for cannabinoids in the management of rheumatic disease. Conclusion Israeli rheumatologists lack confidence in their knowledge of cannabinoids in general, yet are open to the possibility of introducing this treatment. Additional data and guidance are necessary in order to allow rational utilization of cannabinoids for management of rheumatic pain.
Full Text Available Abstract Aims The purpose of this paper is to summarize the psychometric properties of four short screening scales to assess problematic forms of cannabis use: Severity of Dependence Scale (SDS, Cannabis Use Disorders Identification Test (CUDIT, Cannabis Abuse Screening Test (CAST and Problematic Use of Marijuana (PUM. Methods A systematic computer-based literature search was conducted within the databases of PubMed, PsychINFO and Addiction Abstracts. A total of 12 publications reporting measures of reliability or validity were identified: 8 concerning SDS, 2 concerning CUDIT and one concerning CAST and PUM. Studies spanned adult and adolescent samples from general and specific user populations in a number of countries worldwide. Results All screening scales tended to have moderate to high internal consistency (Cronbach's α ranging from .72 to .92. Test-retest reliability and item total correlation have been reported for SDS with acceptable results. Results of validation studies varied depending on study population and standards used for validity assessment, but generally sensitivity, specificity and predictive power are satisfactory. Standard diagnostic cut-off points that can be generalized to different populations do not exist for any scale. Conclusion Short screening scales to assess dependence and other problems related to the use of cannabis seem to be a time and cost saving opportunity to estimate overall prevalences of cannabis-related negative consequences and to identify at-risk persons prior to using more extensive diagnostic instruments. Nevertheless, further research is needed to assess the performance of the tests in different populations and in comparison to broader criteria of cannabis-related problems other than dependence.
González-Blanch, César; Gleeson, John F; Koval, Peter; Cotton, Sue M; McGorry, Patrick D; Alvarez-Jimenez, Mario
The aim of the study was to investigate trajectories of social functioning in young people with first-episode psychosis (FEP) with and without cannabis misuse using a secondary analysis of data from the Episode-II trial. Forty-two young people with FEP and comorbid cannabis use disorder were compared with 39 young people with FEP but without a cannabis use disorder. Social functioning was assessed every 6 months during a 30-month follow-up. Multilevel linear growth curve modeling was used to compare the social functioning trajectories over time for those with and without cannabis misuse. Cannabis misuse was not associated with social functioning at baseline assessment. Over a 30-month follow-up, FEP patients without cannabis disorder showed significant improvements in their social functioning, whereas patients with cannabis misuse at baseline displayed no such improvement. Patients with and without cannabis misuse differed significantly in their levels of social functioning after 24 months. Similar results were obtained after adjusting for potential confounders (i.e., age, gender, negative symptoms, premorbid functioning, DSM-IV diagnoses, baseline social functioning and other substance use). In the context of a specialized early intervention service, patients with cannabis misuse at baseline did not attain the improvements in social outcomes observed in their counterparts without cannabis misuse. There is a need to develop effective interventions to reduce cannabis misuse to ultimately improve social outcomes in young people with psychosis.
Full Text Available The aim of the study was to investigate trajectories of social functioning in young people with first-episode psychosis (FEP with and without cannabis misuse using a secondary analysis of data from the Episode-II trial. Forty-two young people with FEP and comorbid cannabis use disorder were compared with 39 young people with FEP but without a cannabis use disorder. Social functioning was assessed every 6 months during a 30-month follow-up. Multilevel linear growth curve modeling was used to compare the social functioning trajectories over time for those with and without cannabis misuse. Cannabis misuse was not associated with social functioning at baseline assessment. Over a 30-month follow-up, FEP patients without cannabis disorder showed significant improvements in their social functioning, whereas patients with cannabis misuse at baseline displayed no such improvement. Patients with and without cannabis misuse differed significantly in their levels of social functioning after 24 months. Similar results were obtained after adjusting for potential confounders (i.e., age, gender, negative symptoms, premorbid functioning, DSM-IV diagnoses, baseline social functioning and other substance use. In the context of a specialized early intervention service, patients with cannabis misuse at baseline did not attain the improvements in social outcomes observed in their counterparts without cannabis misuse. There is a need to develop effective interventions to reduce cannabis misuse to ultimately improve social outcomes in young people with psychosis.
Westfall, Rachel E; Janssen, Patricia A; Lucas, Philippe; Capler, Rielle
A majority of women experience some nausea and/or vomiting during pregnancy. This condition can range from mild nausea to extreme nausea and vomiting, with 1-2% of women suffering from the life-threatening condition hyperemesis gravidarum. Cannabis (Cannabis sativa) may be used therapeutically to mitigate pregnancy-induced nausea and vomiting. This paper presents the results of a survey of 84 female users of medicinal cannabis, recruited through two compassion societies in British Columbia, Canada. Of the seventy-nine respondents who had experienced pregnancy, 51 (65%) reported using cannabis during their pregnancies. While 59 (77%) of the respondents who had been pregnant had experienced nausea and/or vomiting of pregnancy, 40 (68%) had used cannabis to treat the condition, and of these respondents, 37 (over 92%) rated cannabis as 'extremely effective' or 'effective.' Our findings support the need for further investigations into cannabis therapy for severe nausea and vomiting during pregnancy.
Camoni, I. [ed.] [Istituto Superiore di Sanita`, Rome (Italy). Lab. di Tossicologia Applicata; Mucci, N. [ed.] [ISPESL, Monteporzio Catone, Roma (Italy). Dip. di Medicina del Lavoro; Paroli, E. [ed.] [Rome, Univ. `La Sapienza` (Italy). Fac. di Medicina, Ist. di Farmacologia
This recommendation of the Italian National Toxicological Committee (CCTN) regards the possible toxic effects of some products derived from Cannabis sativa, indica variety. The CCTN has especially evaluated genotoxic, immunological and toxic to reproduction effects of these substances, on the basis of the results from both experimental studies and observations on humans. [Italiano] Il documento contiene il parere della CCTN sui potenziali effetti tossici di alcuni derivati della Cannabis sativa, varieta` indica. Il parere e` stato elaborato sulla base dei risultati sia di studi sperimentali sia dei limitati studi sull`uomo, prendendo in particolare considerazione gli effetti genotossici, tossico-riproduttivi ed immunologici.
Martínez Lorca, Manuela; Alonso Sanz, C.; Montañés Rodríguez, Juan
El objetivo del presente trabajo es conocer la prevalencia del consumo de drogas (tabaco, alcohol y cannabis) en adolescentes de la Comunidad Autónoma de Castilla-La Mancha. Para ello, se confeccionó un cuestionario ad hoc a través del cual se midieron los consumos de tabaco, alcohol y cannabis, así como diferentes variables de personalidad, escolares, familiares, cognitivas, de ocupación del tiempo libre, etc. La muestra está compuesta por 243 alumnos de 1º E.S.O. pertenecientes a cuatro c...
El consumo de cannabis es uno de los principales problemas de salud pública, especialmente entre los jóvenes, dadas sus prevalencias de consumo. Esta droga puede provocar alteraciones psicomotrices en el individuo, por ello, el presente trabajo de investigación tiene como objetivo principal comprobar si el consumo de cannabis supone un riesgo añadido a la práctica físico-deportiva. Para alcanzar dicho objetivo, se dividió el trabajo en dos estudios interrelacionados entre sí. En el primer est...
Bersani, Giuseppe; Iannitelli, Angela
In Italy a political parliamentary majority, recognized by all the press as "cross party", is going to approve the law that will legalize the use of cannabis. As diversified in different Countries, it is a phenomenon which affects substantially homogeneous many European nations, as well as several states of the USA and other Countries of the world. The authors, after listing the main harmful effects of cannabis, especially in young people, on cognitive functions and on the onset of several psychotic disorders, express the need for reflection by the mental health experts on a problem of extreme relevance and urgency care.
Tariq. A. L
Full Text Available The plant leaves were identified as Cannabis sativa L. The cannabniods were extracted by aqueous extract found a total yield of 3.8g while as acetone extract 4.8g. The protein content in crude extract of Cannabis sativa L for aqeous extract found 112μg/ml and for acetone extract 160μg/ml. The molecular weight of protein by SDS PGAGE found to be 70KDa. The HPLC intension percentage for aqueous was 11 while for acetone extract it found 25. The actone extract exhibited more anticancer activity against HT29, MCF7 and SF-26 Cells
Ko GD; Bober SL; Mindra S; Moreau JM
Gordon D Ko,1,2 Sara L Bober,1 Sean Mindra,3 Jason M Moreau1 1Apollo Applied Research Inc., 2Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, 3University of Ottawa Medical School, Ottawa, ON, Canada Abstract: Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is...
Tipparat, Prapatsorn; Natakankitkul, Surapol; Chamnivikaipong, Pipop; Chutiwat, Sirot
The Thai government has recognized the possibility for legitimate cultivation of hemp. Further study of certain cannabinoid characteristics is necessary in establishing criteria for regulation of cannabis cultivation in Thailand. For this purpose, factors affecting characteristics of cannabinoids composition of Thai-grown cannabis were investigated. Plants were cultivated from seeds derived from the previous studies under the same conditions. 372 cannabis samples from landraces, three different trial fields and seized marijuana were collected. 100g of each sample was dried, ground and quantitatively analyzed for THC, CBD and CBN contents by GC-FID. The results showed that cannabis grown during March-June which had longer vegetative stages and longer photoperiod exposure, had higher cannabinoids contents than those grown in August. The male plants grown in trial fields had the range of THC contents from 0.722% to 0.848% d.w. and average THC/CBD ratio of 1.9. Cannabis in landraces at traditional harvest time of 75 days had a range of THC contents from 0.874% to 1.480% d.w. and an average THC/CBD ratio of 2.6. The THC contents and THC/CBD ratios of cannabis in second generation crops grown in the same growing season were found to be lower than those grown in the first generation, unless fairly high temperatures and a lesser amount of rainfall were present. The average THC content in seized fresh marijuana was 2.068% d.w. while THC/CBD ratios were between 12.6 and 84.09, which is 10-45 times greater than those of similar studied cannabis samples from the previous study. However, most Thai cannabis in landraces and in trial fields giving a low log(10) value of THC/CBD ratio at below 1 may be classified as intermediate type, whereas seized marijuana giving a higher log(10) value at above 1 could be classified as drug type. Therefore, the expanded information provided by the current study will assist in the development of criteria for regulation of hemp cultivation in
Reece, Albert Stuart
Cannabis use is common, controversial and its clinical toxicology is likely under-recognised. A 56-year-old man presented with disabling shortness of breath. He smoked up to 7 g cannabis daily for 25 years (maximum 63 875 g) plus large amounts of hashish oil. Chest x ray suggested giant bullae. CT of the chest revealed over 40 bullae, the largest being 11 cm in diameter. Osteoporosis with multiple vertebral crush fractures was noted on plain films and bone densitometry (t=−3.19). His dental h...
Clare Kelly, PhD
Full Text Available One of the most salient long-term implications of a childhood diagnosis of ADHD is an increased risk for substance use, abuse, or dependence in adolescence and adulthood. The extent to which cannabis use affects ADHD-related alterations in brain functional organization is unknown, however. To address this research gap, we recruited a sample of 75 individuals aged 21–25 years with and without a childhood diagnosis of ADHD Combined Type, who were either frequent users or non-users of cannabis. These participants have been followed longitudinally since age 7–9.9 years as part of a large multi-site longitudinal study of ADHD, the Multimodal Treatment Study of Children with ADHD (MTA. We examined task-independent intrinsic functional connectivity (iFC within 9 functional networks using a 2 × 2 design, which compared four groups of participants: (1 individuals with a childhood diagnosis of ADHD who currently use cannabis (n = 23; (2 individuals with ADHD who do not currently use cannabis (n = 22; (3 comparisons who currently use cannabis (n = 15; and (4 comparisons who do not currently use cannabis (n = 15. The main effects of childhood ADHD were primarily weakened iFC in networks supporting executive function and somatomotor control. Contrary to expectations, effects of cannabis use were distinct from those of diagnostic group and no interactions were observed. Exploratory brain-behavior analyses suggested that ADHD-related effects were primarily linked with poorer neurocognitive performance. Deficits in the integrity of functional networks supporting executive function and somatomotor control are consistent with the phenotypic and neurocognitive features of ADHD. Our data suggest that cannabis use does not exacerbate ADHD-related alterations, but this finding awaits replication in a larger sample. Longitudinal neuroimaging studies are urgently required to delineate the neurodevelopmental cascade that culminates in positive and
Domingo-Salvany, Antónia; Barrio Anta, Gregorio; Sánchez Mañez, Amparo; Llorens Aleixandre, Noelia; Brime Beteta, Begoña; Vicente, Julián
The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14–18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments' items (10.5–12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too. PMID:25969832
Bar-Sela, Gil; Vorobeichik, Marina; Drawsheh, Saher; Omer, Anat; Goldberg, Victoria; Muller, Ella
Background. Cancer patients using cannabis report better influence from the plant extract than from synthetic products. However, almost all the research conducted to date has been performed with synthetic products. We followed patients with a medicinal cannabis license to evaluate the advantages and side effects of using cannabis by cancer patients. Methods. The study included two interviews based on questionnaires regarding symptoms and side effects, the first held on the day the license was issued and the second 6-8 weeks later. Cancer symptoms and cannabis side effects were documented on scales from 0 to 4 following the CTCAE. The distress thermometer was used also. Results. Of the 211 patients who had a first interview, only 131 had the second interview, 25 of whom stopped treatment after less than a week. All cancer or anticancer treatment-related symptoms showed significant improvement (P cannabis use (P = 0.002) were noted. Conclusion. The positive effects of cannabis on various cancer-related symptoms are tempered by reliance on self-reporting for many of the variables. Although studies with a control group are missing, the improvement in symptoms should push the use of cannabis in palliative treatment of oncology patients.
Full Text Available Background. Cancer patients using cannabis report better influence from the plant extract than from synthetic products. However, almost all the research conducted to date has been performed with synthetic products. We followed patients with a medicinal cannabis license to evaluate the advantages and side effects of using cannabis by cancer patients. Methods. The study included two interviews based on questionnaires regarding symptoms and side effects, the first held on the day the license was issued and the second 6–8 weeks later. Cancer symptoms and cannabis side effects were documented on scales from 0 to 4 following the CTCAE. The distress thermometer was used also. Results. Of the 211 patients who had a first interview, only 131 had the second interview, 25 of whom stopped treatment after less than a week. All cancer or anticancer treatment-related symptoms showed significant improvement (P<0.001. No significant side effects except for memory lessening in patients with prolonged cannabis use (P=0.002 were noted. Conclusion. The positive effects of cannabis on various cancer-related symptoms are tempered by reliance on self-reporting for many of the variables. Although studies with a control group are missing, the improvement in symptoms should push the use of cannabis in palliative treatment of oncology patients.
Imam, A; Ajao, M S; Akinola, O B; Ajibola, M I; Ibrahim, A; Amin, A; Abdulmajeed, W I; Lawal, Z A; Ali-Oluwafuyi, A
The most abused illicit drug in both the developing and the developed world is Cannabis disposing users to varying forms of personality disorders. However, the effects of cannabis on cortico-hippocampal architecture and cognitive behaviours still remain elusive. The present study investigated the neuro-cognitive implications of oral cannabis use in rats. Eighteen adult Wistar rats were randomly grouped to three. Saline was administered to the control rats, cannabis (20 mg/kg) to the experimental group I, while Scopolamine (1 mg/kg. ip) was administered to the last group as a standard measure for the cannabis induced cognitive impairment. All treatments lasted for seven consecutive days. Open Field Test (OFT) was used to assess locomotor activities, Elevated Plus Maze (EPM) for anxiety-like behaviour, and Y maze paradigm for spatial memory and data subjected to ANOVA and T test respectively. Thereafter, rats were sacrificed and brains removed for histopathological studies. Cannabis significantly reduced rearing frequencies in the OFT and EPM, and increased freezing period in the OFT. It also reduced percentage alternation similar to scopolamine in the Y maze, and these effects were coupled with alterations in the cortico-hippocampal neuronal architectures. These results point to the detrimental impacts of cannabis on cortico-hippocampal neuronal architecture and morphology, and consequently cognitive deficits.
Lavins, Eric S; Lavins, Bethany D; Jenkins, Amanda J
It is well known that United States paper currency in general circulation is contaminated with trace amounts of illicit substances such as cocaine, heroin and marijuana. As is the case with cocaine, differentiating "background levels" of the various cannabinoid constituents of Cannabis sativa L., namely, Delta(9)-tetrahydrocannabinol (THC), cannabinol (CBN), and cannabidiol (CBD) contaminating currency found in the general circulation from currency associated with illegal drug activity is imperative if a legal nexus is to be established with the latter. We analyzed 165 randomly collected paper currency notes from 12 U.S. cities (N = 125) and 4 foreign countries (N = 40) for THC, CBD, CBN, 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol, and 11-hydroxy-Delta(9)-tetrahydrocannabinol. Uncirculated US 1 dollar notes were added as negative controls. Drug residues were washed from individual bills, extracted using a liquid-liquid extraction protocol, derivatized, and quantitated by gas chromatography-mass spectrometry by selected ion monitoring. For the US 1 dollar currency, THC was present in 1.6% (2 notes), CBN 10.31% (13 notes), CBD 1.6% (2 notes). The following concentrations were determined: 0.085 microg/bill and 0.146 microg/bill for THC; 0.014-0.774 microg/bill (mean 0.166 microg/bill) for CBN; and 0.032 microg/bill and 0.086 microg/bill for CBD. For the foreign currency (Colombia, Qatar, India, and New Zealand), THC and CBN were present in 22.5% (9 notes). The following concentration ranges were determined: THC 0.026-0.065 microg/bill (mean 0.049 microg/bill), CBN 0.061-0.197 microg/bill (mean 0.115 microg/bill). All of the positive THC and CBN were found in the New Zealand polypropylene notes. This study demonstrated that marijuana (cannabinoids) may contaminate both paper and plastic currency.
Docimo, Teresa; Caruso, Immacolata; Ponzoni, Elena; Mattana, Monica; Galasso, Incoronata
Globulins are the predominant class of seed storage proteins in a wide variety of plants. In many plant species globulins are present in several isoforms encoded by gene families. The major seed storage protein of Cannabis sativa L. is the globulin edestin, widely known for its nutritional potential. In this work, we report the isolation of seven cDNAs encoding for edestin from the C. sativa variety Carmagnola. Southern blot hybridization is in agreement with the number of identified edestin genes. All seven sequences showed the characteristic globulin features, but they result to be divergent members/forms of two edestin types. According to their sequence similarity four forms named CsEde1A, CsEde1B, CsEde1C, CsEde1D have been assigned to the edestin type 1 and the three forms CsEde2A, CsEde2B, CsEde2C to the edestin type 2. Analysis of the coding sequences revealed a high percentage of similarity (98-99%) among the different forms belonging to the same type, which decreased significantly to approximately 64% between the forms belonging to different types. Quantitative RT-PCR analysis revealed that both edestin types are expressed in developing hemp seeds and the amount of CsEde1 was 4.44 ± 0.10 higher than CsEde2. Both edestin types exhibited a high percentage of arginine (11-12%), but CsEde2 resulted particularly rich in methionine residues (2.36%) respect to CsEde1 (0.82%). The amino acid composition determined in CsEde1 and CsEde2 types suggests that these seed proteins can be used to improve the nutritional quality of plant food-stuffs.
Stamler, R T; Fahlman, R C; Vigeant, H
In 1984 cannabis derivatives, in particular marijuana, hashish and liquid hashish, continued to be the most readily available drugs of abuse in Canada. Marijuana originating in Colombia decreased on the illicit marijuana market in Canada from an estimated 45 per cent in 1983 to 30 per cent in 1984, but it remained the largest source of marijuana supply. Marijuana originating in Thailand remained at approximately the same level (20 per cent) in 1984 as in 1983, while marijuana of Jamaican origin increased its share in the illicit market from 10 per cent in 1983 to 20 per cent in 1984. Approximately 10 per cent of marijuana on the illicit market originated in Canada, 10 per cent in Mexico, and 10 per cent in the United States of America. In 1984 an estimated 85 per cent of hashish on the illicit market in Canada originated in Lebanon (55 per cent in 1983), 10 per cent in India or Pakistan (31 per cent in 1983) and 5 per cent in Jamaica (2 per cent in 1983). Illicit shipments in tonnes of hashish originating in Lebanon made this the dominant source of supply of the drug. Liquid hashish originating in Jamaica shared 88 per cent of the illicit market of this drug in Canada during 1984, while 10 per cent of the drug originated in Lebanon and 2 per cent in Canada. In 1984 an estimated 40 per cent of smuggled marijuana entered the illicit market in Canada by air and approximately the same amount by sea, while 20 per cent was smuggled over land. During the same year, hashish was smuggled into Canada primarily by sea, while air accounted for 5 per cent and land for 1 per cent only. Liquid hashish, in contrast, entered Canada primarily by air, and only 9 per cent by land and 1 per cent by sea.
Ceccarini, Jenny; Kuepper, Rebecca; Kemels, Dieter; van Os, Jim; Henquet, Cécile; Van Laere, Koen
Δ(9) -Tetrahydrocannabinol, the main psychoactive component of cannabis, exerts its central effects through activation of the cerebral type 1 cannabinoid (CB1 ) receptor. Pre-clinical studies have provided evidence that chronic cannabis exposure is linked to decreased CB1 receptor expression and this is thought to be a component underlying drug tolerance and dependence. In this study, we make first use of the selective high-affinity positron emission tomography (PET) ligand [(18) F]MK-9470 to obtain in vivo measurements of cerebral CB1 receptor availability in 10 chronic cannabis users (age = 26.0 ± 4.1 years). Each patient underwent [(18) F]MK-9470 PET within the first week following the last cannabis consumption. A population of 10 age-matched healthy subjects (age = 23.0 ± 2.9 years) was used as control group. Parametric modified standardized uptake value images, reflecting CB1 receptor availability, were calculated. Statistical parametric mapping and volume-of-interest (VOI) analyses of CB1 receptor availability were performed. Compared with controls, cannabis users showed a global decrease in CB1 receptor availability (-11.7 percent). VOI-based analysis demonstrated that the CB1 receptor decrease was significant in the temporal lobe (-12.7 percent), anterior (-12.6 percent) and posterior cingulate cortex (-13.5 percent) and nucleus accumbens (-11.2 percent). Voxel-based analysis confirmed this decrease and regional pattern in CB1 receptor availability in cannabis users. These findings revealed that chronic cannabis use may alter specific regional CB1 receptor expression through neuroadaptive changes in CB1 receptor availability, opening the way for the examination of specific CB1 -cannabis addiction interactions which may predict future cannabis-related treatment outcome.