Dose-response effect between cannabis use and psychosis liability in a non-clinical population: evidence from a snowball sample.

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Ruiz-Veguilla, Miguel; Barrigón, María Luisa; Hernández, Laureano; Rubio, José Luis; Gurpegui, Manuel; Sarramea, Fernando; Cervilla, Jorge; Gutiérrez, Blanca; James, Anthony; Ferrin, Maite

2013-08-01

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Psychoactive constituents of cannabis and their clinical implications: a systematic review.

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Casajuana Köguel, Cristina; López-Pelayo, Hugo; Balcells-Olivero, Mª Mercedes; Colom, Joan; Gual, Antoni

2018-04-15

Objective This systematic review aims to summarize current evidence on which naturally present cannabinoids contribute to cannabis psychoactivity, considering their reported concentrations and pharmacodynamics in humans. Design Following PRISMA guidelines, papers published before March 2016 in Medline, Scopus-Elsevier, Scopus, ISI-Web of Knowledge and COCHRANE, and fulfilling established a-priori selection criteria have been included. Results In 40 original papers, three naturally present cannabinoids (∆-9-Tetrahydrocannabinol, ∆-8-Tetrahydrocannabinol and Cannabinol) and one human metabolite (11-OH-THC) had clinical relevance. Of these, the metabolite produces the greatest psychoactive effects. Cannabidiol (CBD) is not psychoactive but plays a modulating role on cannabis psychoactive effects. The proportion of 9-THC in plant material is higher (up to 40%) than in other cannabinoids (up to 9%). Pharmacodynamic reports vary due to differences in methodological aspects (doses, administration route and volunteers' previous experience with cannabis). Conclusions Findings reveal that 9-THC contributes the most to cannabis psychoactivity. Due to lower psychoactive potency and smaller proportions in plant material, other psychoactive cannabinoids have a weak influence on cannabis final effects. Current lack of standard methodology hinders homogenized research on cannabis health effects. Working on a standard cannabis unit considering 9-THC is recommended.

Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial.

Directory of Open Access Journals (Sweden)

Jose M Trigo

Full Text Available The current lack of pharmacological treatments for cannabis use disorder (CUD warrants novel approaches and further investigation of promising pharmacotherapy. We previously showed that nabiximols (27 mg/ml Δ9-tetrahydrocannabinol (THC/ 25 mg/ml cannabidiol (CBD, Sativex® can decrease cannabis withdrawal symptoms. Here, we assessed in a pilot study the tolerability and safety of self-titrated nabiximols vs. placebo among 40 treatment-seeking cannabis-dependent participants.Subjects participated in a double blind randomized clinical trial, with as-needed nabiximols up to 113.4 mg THC/105 mg CBD or placebo daily for 12 weeks, concurrently with Motivational Enhancement Therapy and Cognitive Behavioral Therapy (MET/CBT. Primary outcome measures were tolerability and abstinence, secondary outcome measures were days and amount of cannabis use, withdrawal, and craving scores. Participants received up to CDN$ 855 in compensation for their time.Medication was well tolerated and no serious adverse events (SAEs were observed. Rates of adverse events did not differ between treatment arms (F1,39 = 0.205, NS. There was no significant change in abstinence rates at trial end. Participants were not able to differentiate between subjective effects associated with nabiximols or placebo treatments (F1,40 = 0.585, NS. Cannabis use was reduced in the nabiximols (70.5% and placebo groups (42.6%. Nabiximols reduced cannabis craving but no significant differences between the nabiximols and placebo groups were observed on withdrawal scores.Nabiximols in combination with MET/CBT was well tolerated and allowed for reduction of cannabis use. Future clinical trials should explore the potential of high doses of nabiximols for cannabis dependence.

Evaluating the relationship between cannabis use and IQ in youth and young adults at clinical high risk of psychosis.

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Buchy, Lisa; Seidman, Larry J; Cadenhead, Kristin S; Cannon, Tyrone D; Cornblatt, Barbara A; McGlashan, Thomas H; Perkins, Diana O; Stone, William; Tsuang, Ming T; Walker, Elaine F; Woods, Scott W; Bearden, Carrie E; Mathalon, Daniel H; Addington, Jean

2015-12-30

Among people with psychosis, those with a history of cannabis use show better cognitive performance than those who are cannabis naïve. It is unknown whether this pattern is present in youth at clinical high risk (CHR) of psychosis. We evaluated relationships between IQ and cannabis use while controlling for use of other substances known to impact cognition in 678 CHR and 263 healthy control (HC) participants. IQ was estimated using the Vocabulary and Block Design subtests of the Wechsler Abbreviated Scale of Intelligence. Drug and alcohol use severity and frequency were assessed with the Alcohol and Drug Use Scale, and we inquired participants' age at first use. CHR were further separated into early and late age at onset of cannabis use sub-groups, and low-, moderate- and high-frequency sub-groups. No significant differences in IQ emerged between CHR or HC cannabis users vs. non-users, or between use frequency groups. CHR late-onset users showed significantly higher IQ than CHR early-onset users. Age at onset of cannabis use was significantly and positively correlated with IQ in CHR only. Results suggest that age at onset of cannabis may be a more important factor for IQ than use current use or use frequency in CHR. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[MEDICAL CANNABIS].

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Naftali, Timna

2016-02-01

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.

Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults.

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Maciej S Buchowski

2011-03-01

Full Text Available 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.To examine the effects of moderate aerobic exercise on cannabis craving and use in cannabis dependent adults under normal living conditions.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.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.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.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.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 beneficial effects on cannabis use may lead to understanding of the physical and

Naltrexone Maintenance Decreases Cannabis Self-Administration and Subjective Effects in Daily Cannabis Smokers

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Haney, Margaret; Ramesh, Divya; Glass, Andrew; Pavlicova, Martina; Bedi, Gillinder; Cooper, Ziva D

2015-01-01

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. PMID:25881117

Medicinal cannabis does not influence the clinical pharmacokinetics of irinotecan and docetaxel.

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Engels, Frederike K; de Jong, Floris A; Sparreboom, Alex; Mathot, Ron A A; Loos, Walter J; Kitzen, Jos J E M; de Bruijn, Peter; Verweij, Jaap; Mathijssen, Ron H J

2007-03-01

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 concurrent with anticancer drugs, and undertook a drug-interaction study to evaluate the effect of concomitant medicinal cannabis on the pharmacokinetics of irinotecan and docetaxel, both subject to CYP3A-mediated biotransformation. Twenty-four cancer patients were treated with i.v. irinotecan (600 mg, n = 12) or docetaxel (180 mg, n = 12), followed 3 weeks later by the same drugs concomitant with medicinal cannabis (200 ml herbal tea, 1 g/l) for 15 consecutive days, starting 12 days before the second treatment. Blood samples were obtained up to 55 hours after dosing and analyzed for irinotecan and its metabolites (SN-38, SN-38G), respectively, or docetaxel. Pharmacokinetic analyses were performed during both treatments. Results are reported as the mean ratio (95% confidence interval [CI]) of the observed pharmacokinetic parameters with and without concomitant medicinal cannabis. Medicinal cannabis administration did not significantly influence exposure to and clearance of irinotecan (1.04; CI, 0.96-1.11 and 0.97; CI, 0.90-1.05, respectively) or docetaxel (1.11; CI, 0.94-1.28 and 0.95; CI, 0.82-1.08, respectively). Coadministration of medicinal cannabis, as herbal tea, in cancer patients treated with irinotecan or docetaxel does not significantly influence the plasma pharmacokinetics of these drugs. The evaluated variety of medicinal cannabis can be administered concomitantly with both anticancer agents without dose adjustments.

Cannabis e humor Cannabis and mood

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Rafael Faria Sanches

2010-06-01

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

Treatment of Cannabis Use Disorder: Current Science and Future Outlook

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Sherman, Brian J.; McRae-Clark, Aimee L.

2016-01-01

Cannabis is the most commonly used illicit substance in the United States. Rates of cannabis use and cannabis use disorder have increased in the past decade, paralleling changes in the legal and political climate favoring legalization. Almost 20 million people aged 12 years or older report past-month cannabis use, and 8 million report daily or near-daily use. Concurrently, the perception that cannabis use poses a significant risk of negative consequences has decreased. Contrary to this perception, heavy cannabis use is associated with cognitive impairment, increased risk for psychotic disorders and other mental health problems, lower education attainment, and unemployment. Clinical trials of various treatments for cannabis use disorder have likewise increased, focusing primarily on psychotherapy treatments, specifically, motivational enhancement therapy, cognitive behavioral therapy, and contingency management. Their findings suggest that a combination of these three modalities produces the best abstinence outcomes, although abstinence rates remain modest and decline after treatment. More recently, pharmacotherapy trials have been conducted as adjunctive interventions to psychosocial treatment. N-acetylcysteine and gabapentin are two of the most promising medications, although no pharmacologic treatment has emerged as clearly efficacious. In this review, we provide a detailed summary of clinical trials that evaluated psychotherapy and pharmacotherapy for treating cannabis use disorder and discuss emerging areas of clinical research and cannabis-specific barriers to treatment. PMID:27027272

Decision-Making Does not Moderate the Association between Cannabis Use and Body Mass Index among Adolescent Cannabis Users.

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Ross, J Megan; Graziano, Paulo; Pacheco-Colón, Ileana; Coxe, Stefany; Gonzalez, Raul

2016-10-01

Results from research conducted on the association between cannabis use and body mass index (BMI) reveal mixed findings. It is possible that individual differences in decision-making (DM) abilities may influence these associations. This study analyzed how amount of cannabis use, DM performance, and the interaction of these variables influenced BMI and clinical classifications of weight among adolescents (ages 14 to 18 years; 56% male; 77% Hispanic). The sample consisted primarily of cannabis users (n=238) without a history of significant developmental disorders, birth complications, neurological conditions, or history of mood, thought, or attention deficit/hyperactivity disorder at screening. Furthermore, few participants engaged frequently in other drug use (except for alcohol and nicotine). Analyses revealed that more lifetime cannabis use was associated with a higher BMI and greater likelihood of being overweight/obese. Interactions between DM and cannabis use on BMI were not significant, and DM was not directly associated with BMI. Our findings suggest that among adolescents, cannabis use is associated with a greater BMI regardless of DM abilities and this association is not accounted for by other potential factors, including depression, alcohol use, nicotine use, race, ethnicity, or IQ. (JINS, 2016, 22, 944-949).

Chemistry, metabolism, and toxicology of cannabis: clinical implications.

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Sharma, Priyamvada; Murthy, Pratima; Bharath, M M Srinivas

2012-01-01

Cannabis is one of the most widely abused substances throughout the world. The primary psychoactive constituent of cannabis, delta 9-tetrahydrocannabinol (▵(9_)THC), produces a myriad of pharmacological effects in animals and humans. Although it is used as a recreational drug, it can potentially lead to dependence and behavioral disturbances and its heavy use may increase the risk for psychotic disorders.Many studies that endeavor to understand the mechanism of action of cannabis concentrate on pharmacokinetics and pharmacodynamics of cannabinoids in humans. However, there is limited research on the chronic adverse effects and retention of cannabinoids in human subjects.Cannabis can be detected in body fluids following exposure through active/passive inhalation and exposure through breastfeeding. Cannabis detection is directly dependent on accurate analytical procedures for detection of metabolites and verification of recent use.In this review, an attempt has been made to summarize the properties of cannabis and its derivatives, and to discuss the implications of its use with emphasis on bioavailability, limit of detection, carry over period and passive inhalation, important factors for detection and diagnosis.

Chemistry, Metabolism, and Toxicology of Cannabis: Clinical Implications

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M.M. Srinivas Bharath

2012-12-01

Full Text Available Cannabis is one of the most widely abused substances throughout the world. The primary psychoactive constituent of cannabis, delta 9-tetrahydrocannabinol (Δ9_THC, produces a myriad of pharmacological effects in animals and humans. Although it is used as a recreational drug, it can potentially lead to dependence and behavioral disturbances and its heavy use may increase the risk for psychotic disorders.Many studies that endeavor to understand the mechanism of action of cannabis concentrate on pharmacokinetics and pharmacodynamics of cannabinoids in humans. However, there is limited research on the chronic adverse effects and retention of cannabinoids in human subjects.Cannabis can be detected in body fluids following exposure through active/passive inhalation and exposure through breastfeeding. Cannabis detection is directly dependent on accurate analytical procedures for detection of metabolites and verification of recent use.In this review, an attempt has been made to summarize the properties of cannabis and its derivatives, and to discuss the implications of its use with emphasis on bioavailability, limit of detection, carry over period and passive inhalation, important factors for detection and diagnosis.

History of cannabis use is associated with altered gait.

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Pearson-Dennett, Verity; Todd, Gabrielle; Wilcox, Robert A; Vogel, Adam P; White, Jason M; Thewlis, Dominic

2017-09-01

Despite evidence that cannabinoid receptors are located in movement-related brain regions (e.g., basal ganglia, cerebral cortex, and cerebellum), and that chronic cannabis use is associated with structural and functional brain changes, little is known about the long-term effect of cannabis use on human movement. The aim of the current study was to investigate balance and walking gait in adults with a history of cannabis use. We hypothesised that cannabis use is associated with subtle changes in gait and balance that are insufficient in magnitude for detection in a clinical setting. Cannabis users (n=22, 24±6years) and non-drug using controls (n=22, 25±8years) completed screening tests, a gait and balance test (with a motion capture system and in-built force platforms), and a clinical neurological examination of movement. Compared to controls, cannabis users exhibited significantly greater peak angular velocity of the knee (396±30 versus 426±50°/second, P=0.039), greater peak elbow flexion (53±12 versus 57±7°, P=0.038) and elbow range of motion (33±13 versus 36±10°, P=0.044), and reduced shoulder flexion (41±19 versus 26±16°, P=0.007) during walking gait. However, balance and neurological parameters did not significantly differ between the groups. The results suggest that history of cannabis use is associated with long-lasting changes in open-chain elements of walking gait, but the magnitude of change is not clinically detectable. Further research is required to investigate if the subtle gait changes observed in this population become more apparent with aging and increased cannabis use. Copyright © 2017 Elsevier B.V. All rights reserved.

Cannabis use and destructive periodontal diseases among adolescents.

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López, Rodrigo; Baelum, Vibeke

2009-03-01

The aim of this experiment was to investigate the association between cannabis use and destructive periodontal disease among adolescents. Data from a population screening examination carried out among Chilean high school students from the Province of Santiago were used to determine whether there was an association between the use of cannabis and signs of periodontal diseases as defined by (1) the presence of necrotizing ulcerative gingival (NUG) lesions or (2) the presence of clinical attachment loss (CAL) > or =3 mm. The cannabis exposures variables considered were "Ever use of cannabis" (yes/no) and "Regular use of cannabis" (yes/no). The associations were investigated using multiple logistic regression analyses adjusted for age, gender, paternal income, paternal education, frequency of tooth-brushing and time since last dental visit. Multiple logistic regression analyses showed that "Ever use of cannabis" was significantly negatively associated with the presence of NUG lesions (OR=0.47 [0.2;0.9]) among non-smokers only. No significant associations were observed between the presence of CAL > or =3 mm and cannabis use in either of the smoking groups. There was no evidence to suggest that the use of cannabis is positively associated with periodontal diseases in this adolescent population.

Neuronal substrates and functional consequences of prenatal cannabis exposure.

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Calvigioni, Daniela; Hurd, Yasmin L; Harkany, Tibor; Keimpema, Erik

2014-10-01

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.

Cream of the Crop: Clinical Representativeness of Eligible and Ineligible Cannabis Users in Research.

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Rosen, Alexis S; Sodos, Louise M; Hirst, Rayna B; Vaughn, Dylan; Lorkiewicz, Sara A

2018-03-06

Experts have recommended criteria (Gonzalez et al., 2002) for recruiting pure chronic cannabis users (i.e., those without polysubstance use or psychiatric illness) when evaluating cannabis' non-acute effects on cognition. We sought to demonstrate the implications of using such criteria by examining characteristics of respondents who completed an eligibility screening for a parent study evaluating the cognitive effects of chronic cannabis use. Over a 3-year, 8-month period, 612 respondents from the community completed an eligibility screening based on recommendations in the cannabis literature. Using independent samples t-tests and chi-square tests, we examined whether qualified/eligible respondents (n = 219) differed from non-qualified/ineligible respondents (n = 393). Compared to ineligible cannabis users, eligible cannabis-using respondents were significantly younger, used cannabis more frequently, used alcohol less frequently, and were less likely to have a history of other drug use, a psychiatric diagnosis, or to have used psychiatric medication. Conclusions/Importance: Our findings indicate that eligible/pure cannabis users are not representative of typical cannabis users in the general community (i.e., ineligible users with polysubstance use and/or psychiatric diagnoses) who ultimately comprised the majority of our cannabis-using sample (65.2%). Thus, typical cannabis users may be more accurately characterized as polysubstance users, posing a number of challenges related to the generalizability of findings from studies utilizing pure samples of cannabis users. Recruiting samples of typical cannabis users will improve external validity in research. Furthermore, reporting comprehensive characteristics of such samples will enable consumers to gauge the applicability of study findings to populations of interest.

Solitary cannabis use in adolescence as a correlate and predictor of cannabis problems.

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Creswell, Kasey G; Chung, Tammy; Clark, Duncan B; Martin, Christopher S

2015-11-01

Most adolescent cannabis use occurs in social settings among peers. Solitary cannabis use during adolescence may represent an informative divergence from normative behavior with important implications for understanding risk for cannabis problems. This longitudinal study examined associations of adolescent solitary cannabis use with levels of cannabis use and problems in adolescence and in young adulthood. Cannabis using-adolescents aged 12-18 were recruited from clinical programs (n=354; 43.8% female; 83.3% Caucasian) and community sources (n=93; 52.7% female; 80.6% Caucasian). Participants reported on cannabis use patterns and diagnostic symptoms at baseline and multiple follow-ups into young adulthood. Compared to social-only users, adolescent solitary cannabis users were more likely to be male and reported more frequent cannabis use and more DSM-IV cannabis use disorder (CUD) symptoms. Regression analyses showed that solitary cannabis use in adolescence predicted CUD symptom counts in young adulthood (age 25) after controlling for demographic variables and the frequency of adolescent cannabis use. However, solitary adolescent cannabis use was no longer predictive of age 25 CUD symptoms after additionally controlling for adolescent CUD symptoms. Solitary cannabis use is associated with greater cannabis use and problems during adolescence, but evidence is mixed that it predicts young adult cannabis problems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An Australian nationwide survey on medicinal cannabis use for epilepsy: History of antiepileptic drug treatment predicts medicinal cannabis use.

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Suraev, Anastasia S; Todd, Lisa; Bowen, Michael T; Allsop, David J; McGregor, Iain S; Ireland, Carol; Lintzeris, Nicholas

2017-05-01

Epilepsy Action Australia conducted an Australian nationwide online survey seeking opinions on and experiences with the use of cannabis-based products for the treatment of epilepsy. The survey was promoted via the Epilepsy Action Australia's main website, on their Facebook page, and by word of mouth. The survey consisted of 39 questions assessing demographics, clinical factors, including diagnosis and seizure types, and experiences with and opinions towards cannabis use in epilepsy. A total of 976 responses met the inclusion criteria. Results show that 15% of adults with epilepsy and 13% of parents/guardians of children with epilepsy were currently using, or had previously used, cannabis products to treat epilepsy. Of those with a history of cannabis product use, 90% of adults and 71% of parents reported success in reducing seizure frequency after commencing cannabis products. The main reasons for medicinal cannabis use were to manage treatment-resistant epilepsy and to obtain a more favorable side-effect profile compared to standard antiepileptic drugs. The number of past antiepileptic drugs tried was a significant predictor of medicinal cannabis use in both adults and children with epilepsy. Fifty-six percent of adults with epilepsy and 62% of parents/guardians of children with epilepsy expressed willingness to participate in clinical trials of cannabinoids. This survey provides insight into the use of cannabis products for epilepsy, in particular some of the likely factors influencing use, as well as novel insights into the experiences of and attitudes towards medicinal cannabis in people with epilepsy in the Australian community. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy". Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Cannabis finds its way into treatment of Crohn's disease.

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Schicho, Rudolf; Storr, Martin

2014-01-01

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. © 2013 S. Karger AG, Basel.

[Clinical prognosis of schizophrenic patients with cannabis addiction. Between nihilism and hope].

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Schnell, T

2014-09-01

Comorbid substance use disorders in schizophrenia are mostly associated with an unfavorable course of the disease and with difficulties in clinical management. Therefore, some therapists tend to react to these patients in a resigned manner. However, there is growing evidence for higher cognitive functioning and less severe deficits in brain morphology of these patients compared to patients without cannabis use. A common interpretation refers to relatively low vulnerability for psychosis in some of these patients, who mainly became schizophrenic because of the pro-psychotic properties of cannabis. Low vulnerability is reflected by a higher cognitive functioning; therefore, the pessimistic view of therapists seems unjustified for at least a subgroup of young patients. Provided that patients are treated in adequate therapeutic settings and that they stop using cannabis, a lower vulnerability may be associated with overall better socio-rehabilitative outcome parameters.

Chemistry, Metabolism, and Toxicology of Cannabis: Clinical Implications

OpenAIRE

Sharma, Priyamvada; Murthy, Pratima; Bharath, M.M. Srinivas

2012-01-01

Cannabis is one of the most widely abused substances throughout the world. The primary psychoactive constituent of cannabis, delta 9-tetrahydrocannabinol (?9_THC), produces a myriad of pharmacological effects in animals and humans. Although it is used as a recreational drug, it can potentially lead to dependence and behavioral disturbances and its heavy use may increase the risk for psychotic disorders. Many studies that endeavor to understand the mechanism of action of cannabis concentrate o...

A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults

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Mason, Barbara J; Crean, Rebecca; Goodell, Vivian; Light, John M; Quello, Susan; Shadan, Farhad; Buffkins, Kimberly; Kyle, Mark; Adusumalli, Murali; Begovic, Adnan; Rao, Santosh

2012-01-01

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 (pbrain stress systems that are dysregulated in drug dependence and withdrawal. PMID:22373942

Cue-induced craving for marijuana in cannabis-dependent adults.

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Lundahl, Leslie H; Johanson, Chris-Ellyn

2011-06-01

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. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

The Effect of Changes in Cannabis Exposure on Psychotic Symptoms in Patients With Comorbid Cannabis Use Disorder

DEFF Research Database (Denmark)

Toftdahl, Nanna Gilliam; Nordentoft, Merete; Hjorthøj, Carsten

2016-01-01

abstract: 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...... with severe 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

Cannabis-associated arterial disease.

Science.gov (United States)

Desbois, Anne Claire; Cacoub, Patrice

2013-10-01

The aim of this study was to describe the different arterial complications reported in cannabis smokers. This study was a literature review. Cannabis use was found to be associated with stroke, myocardial infarction, and lower limb arteritis. Arterial disease involved especially young men. There was a very strong temporal link between arterial complications and cannabis use for stroke and myocardial infarction episodes. Patient outcome was closely correlated with cannabis withdrawal and relapses associated with cannabis rechallenge. Cannabis use was associated with particular characteristics of arterial disease. The increased risk of myocardial infarction onset occurred within 1 hour of smoking marijuana compared with periods of non-use. Strokes occurred mainly in the posterior cerebral circulation. Compared with cohorts of thromboangiitis obliterans patients, those with cannabis-associated limb arteritis were younger, more often male, and had more frequent unilateral involvement of the lower limbs at clinical presentation. Cannabis use is associated with arterial disease such as stroke, myocardial infarction, and limbs arteritis. It appears essential to investigate cannabis use in young patients presenting with such arterial manifestations, as outcome is closely correlated with cannabis withdrawal. Copyright © 2013 Elsevier Inc. All rights reserved.

A proof-of-concept randomized controlled study of gabapentin: effects on cannabis use, withdrawal and executive function deficits in cannabis-dependent adults.

Science.gov (United States)

Mason, Barbara J; Crean, Rebecca; Goodell, Vivian; Light, John M; Quello, Susan; Shadan, Farhad; Buffkins, Kimberly; Kyle, Mark; Adusumalli, Murali; Begovic, Adnan; Rao, Santosh

2012-06-01

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 (pcannabis 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.

Change in cannabis use, clinical symptoms and social functioning among patients with first-episode psychosis

DEFF Research Database (Denmark)

Clausen, L; Hjorthøj, C R; Thorup, Anne A.E.

2014-01-01

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...... patients included in the OPUS trial. The patients included were in the age range of 18 to 45 years old and 59% were male. Cannabis use was extracted from the Schedule for Clinical Assessment in Neuropsychiatry. At follow-up, the patients were divided into different groups according to the variable cannabis...... use: abstainers, stoppers, starters and continuers. Psychotic, negative and disorganized dimensions (ranging from zero to five) were calculated for each of the four groups based on the Schedule for the Assessment of Positive and Negative Symptoms in Schizophrenia. RESULTS: Cannabis users were younger...

Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

OpenAIRE

Russo, Ethan B.

2016-01-01

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...

Therapeutic potential of cannabis-related drugs.

Science.gov (United States)

Alexander, Stephen P H

2016-01-04

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. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical Approach to the Heavy Cannabis User in the Age of Medical Marijuana.

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Cermak, Timmen L

2016-01-01

This article begins with a case vignette exemplifying the common clinical problem of heavy marijuana users. The epidemiology and basic science underlying cannabis dependence is outlined, followed by clinical strategies for basing a therapeutic alliance on known research findings and using motivational interviewing to deal with typical patterns of denial.

Psychiatric effects of cannabis use.

Science.gov (United States)

Tunving, K

1985-09-01

That cannabis use may provoke mental disturbances is well known to Scandinavian psychiatrists today. A review of the psychiatric aspects of cannabis use is given, and the clinical signs of 70 cases of cannabis psychoses collected in Sweden are described. The bluntness and "amotivation" following chronic cannabis use are discussed. Anxiety reactions, flashbacks, dysphoric reactions and an abstinence syndrome are all sequels of cannabis use. Three risk groups begin to emerge: a) Young teenage cannabis users who lose some of their capacity to learn complex functions and who flee from reality to a world of dreams. With its sedative effect, cannabis could modify such emotions as anger and anxiety and slow down the liberation process of adolescence. b) Heavy daily users, often persons who cannot cope with depression or their life circumstances. c) Psychiatric patients whose resistance to relapses into psychotic reactions might be diminished according to the psychotropic effects of cannabis.

Recreational cannabis use: pleasures and pitfalls.

Science.gov (United States)

Rella, Joseph G

2015-11-01

Cannabis is widely used for a variety of reasons, and its changing legal status may foster more new users. Although the acute clinical effects of cannabis are generally benign, clinicians should be aware of health complications and testing limitations. Copyright © 2015 Cleveland Clinic.

Avoiding emotional bonds: An examination of the dimensions of therapeutic alliance among cannabis users

Directory of Open Access Journals (Sweden)

Alison eHealey

2013-07-01

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

Alcohol consumption moderates the link between cannabis use and cannabis dependence in an internet survey.

Science.gov (United States)

Smucker Barnwell, Sara; Earleywine, Mitch; Gordis, Elana B

2005-06-01

The link between cannabis use and cannabis dependence remains poorly understood. Some people use cannabis regularly without signs of dependence; others show dependence despite using less. This study examined alcohol consumption as a moderator of this association. A sample of 476 people (primarily Caucasian men) who used cannabis at least once per week reported their alcohol consumption, cannabis use, and cannabis dependence symptoms in an Internet survey. Regressions revealed significant interactions between measures of cannabis use and alcohol consumption when predicting cannabis dependence. Cannabis use covaried with cannabis dependence, particularly in people who consumed alcohol frequently or in large amounts per week. Despite limitations, these data suggest that alcohol may decrease the safety of cannabis consumption. Copyright 2005 APA, all rights reserved.

Prevalence and correlates of "Vaping" as a route of cannabis administration in medical cannabis patients.

Science.gov (United States)

Cranford, James A; Bohnert, Kipling M; Perron, Brian E; Bourque, Carrie; Ilgen, Mark

2016-12-01

To examine the prevalence and correlates of vaporization (i.e., "vaping") as a route of cannabis administration in a sample of medical cannabis patients. Adults ages 21 and older (N=1485M age=45.1) who were seeking medical cannabis certification (either for the first time or as a renewal) at medical cannabis clinics in southern Michigan completed a screening assessment. Participants completed measures of route of cannabis administration, cannabis use, alcohol and other substance use. An estimated 39% (n=511) of the sample reported past-month cannabis vaping, but vaping as the sole route of cannabis administration was rare. Specifically, only 30 participants (2.3% of the full sample and 5.9% of those who reported any vaping) indicated vaping as the sole route of cannabis administration. The majority (87.3%) of those who reported vaping also reported smoking (combustion) as a route of cannabis administration. Being younger than age 44, having more than a high school education, engaging in nonmedical stimulant use, being a returning medical cannabis patient, and greater frequency of cannabis use were associated with higher odds of vaping at the bivariate level and with all variables considered simultaneously. Vaping appears to be relatively common among medical cannabis patients, but is seldom used as the sole route of cannabis administration. highlight the importance of monitoring trends in vaping and other substance use behaviors in this population and underscore the need for longitudinal research into the motives, correlates, and consequences of cannabis vaping in medical cannabis patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Baclofen in the management of cannabis dependence syndrome.

Science.gov (United States)

Imbert, Bruce; Labrune, Nathalie; Lancon, Christophe; Simon, Nicolas

2014-02-01

Cannabis is the most commonly used illicit drug in the world. However, only few studies have shown the efficacy of pharmacologic agents in targeting cannabis withdrawal symptoms or reducing the reinforcing effects of cannabis. Baclofen has been shown to reduce cannabis withdrawal symptoms and the subjective effects of cannabis. We think that the clinical utility of baclofen for cannabis dependence is a reasonable approach. A case report using baclofen is presented and provides preliminary support for the use of baclofen in the management of cannabis dependence.

The Role of Medicinal Cannabis in Clinical Therapy: Pharmacists' Perspectives.

Science.gov (United States)

Isaac, Sami; Saini, Bandana; Chaar, Betty B

2016-01-01

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 policies for the

The Role of Medicinal Cannabis in Clinical Therapy: Pharmacists' Perspectives.

Directory of Open Access Journals (Sweden)

Sami Isaac

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

Cannabis Smoking in 2015

Science.gov (United States)

Biehl, Jason R.

2015-01-01

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. PMID:25996274

Exposure to cannabis in popular music and cannabis use among adolescents.

Science.gov (United States)

Primack, Brian A; Douglas, Erika L; Kraemer, Kevin L

2010-03-01

Cannabis use is referenced frequently in American popular music, yet it remains uncertain whether exposure to these references is associated with actual cannabis use. We aimed to determine if exposure to cannabis in popular music is associated independently with current cannabis use in a cohort of urban adolescents. We surveyed all 9th grade students at three large US urban high schools. We estimated participants' exposure to lyrics referent to cannabis with overall music exposure and content analyses of their favorite artists' songs. Outcomes included current (past 30 days) and ever use of cannabis. We used multivariable regression to assess independent associations between exposures and outcomes while controlling for important covariates. Each of the 959 participants was exposed to an estimated 27 cannabis references per day [correction added on 19 January 2010, after first online publication: 40 has been changed to 27] (standard deviation = 73 [correction added on 19 January 2010, after first online publication: 104 has been changed to 73]). Twelve per cent (n = 108) were current cannabis users and 32% (n = 286) had ever used cannabis. Compared with those in the lowest tertile of total cannabis exposure in music, those in the highest tertile of exposure were almost twice as likely to have used cannabis in the past 30 days (odds ratio = 1.83; 95% confidence interval = 1.04, 3.22), even after adjusting for socio-demographic variables, personality characteristics and parenting style. As expected, however, there was no significant relationship between our cannabis exposure variable and a sham outcome variable of alcohol use. This study supports an independent association between exposure to cannabis in popular music and early cannabis use among urban American adolescents.

Cannabis species and cannabinoid concentration preference among sleep-disturbed medicinal cannabis users.

Science.gov (United States)

Belendiuk, Katherine A; Babson, Kimberly A; Vandrey, Ryan; Bonn-Miller, Marcel O

2015-11-01

Individuals report using cannabis for the promotion of sleep, and the effects of cannabis on sleep may vary by cannabis species. Little research has documented preferences for particular cannabis types or cannabinoid concentrations as a function of use for sleep disturbances. 163 adults purchasing medical cannabis for a physical or mental health condition at a cannabis dispensary were recruited. They provided self-report of (a) whether cannabis use was intended to help with sleep problems (e.g. insomnia, nightmares), (b) sleep quality (PSQI), (c) cannabis use (including preferred type), and (d) symptoms of DSM-5 cannabis dependence. 81 participants reported using cannabis for the management of insomnia and 14 participants reported using cannabis to reduce nightmares. Individuals using cannabis to manage nightmares preferred sativa to indica strains (Fisher's exact test (2) = 6.83, p < 0.05), and sativa users were less likely to endorse DSM-5 cannabis dependence compared with those who preferred indica strains (χ(2)(2) = 4.09, p < 0.05). Individuals with current insomnia (t(9) = 3.30, p < 0.01) and greater sleep latency (F(3,6) = 46.7, p < 0.001) were more likely to report using strains of cannabis with significantly higher concentrations of CBD. Individuals who reported at least weekly use of hypnotic medications used cannabis with lower THC concentrations compared to those who used sleep medications less frequently than weekly (t(17) = 2.40, p < 0.05). Associations between sleep characteristics and the type of cannabis used were observed in this convenience sample of individuals using cannabis for the management of sleep disturbances. Controlled prospective studies are needed to better characterize the impact that specific components of cannabis have on sleep. Copyright © 2015. Published by Elsevier Ltd.

The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use.

Science.gov (United States)

Vermeulen-Smit, E; Verdurmen, J E E; Engels, R C M E; Vollebergh, W A M

2015-02-01

To investigate general and cannabis-specific parenting practices in relation to adolescent cannabis and other illicit drug use. 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. Logistic regression analyses revealed that 1) parental cannabis use was significantly related to more adolescent lifetime and recent cannabis use, and 2) restrictive cannabis-specific parental rules were associated with less adolescent recent cannabis and lifetime use of other illicit drugs, even when controlled for sociodemographic factors, general parenting, adolescent tobacco use, and tobacco-specific parenting. In addition, no significant interaction was observed between parental cannabis use and cannabis-specific rules in their relation to adolescent cannabis and other illicit drug use, indicating that cannabis rules are evenly associated with adolescent drug use for families with and without parental cannabis experience. In addition to general parenting practices, restrictive cannabis-specific rules are related to lower adolescent cannabis and other illicit drug rates. Parents who ever used cannabis have children with a higher prevalence of cannabis use. However, their restrictive cannabis-specific rules are equally related to a lower chance of adolescent cannabis use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cannabis and its derivatives: review of medical use.

Science.gov (United States)

Leung, Lawrence

2011-01-01

Use of cannabis is often an under-reported activity in our society. Despite legal restriction, cannabis is often used to relieve chronic and neuropathic pain, and it carries psychotropic and physical adverse effects with a propensity for addiction. This article aims to update the current knowledge and evidence of using cannabis and its derivatives with a view to the sociolegal context and perspectives for future research. Cannabis use can be traced back to ancient cultures and still continues in our present society despite legal curtailment. The active ingredient, Δ9-tetrahydrocannabinol, accounts for both the physical and psychotropic effects of cannabis. Though clinical trials demonstrate benefits in alleviating chronic and neuropathic pain, there is also significant potential physical and psychotropic side-effects of cannabis. Recent laboratory data highlight synergistic interactions between cannabinoid and opioid receptors, with potential reduction of drug-seeking behavior and opiate sparing effects. Legal rulings also have changed in certain American states, which may lead to wider use of cannabis among eligible persons. Family physicians need to be cognizant of such changing landscapes with a practical knowledge on the pros and cons of medical marijuana, the legal implications of its use, and possible developments in the future.

Prevalence and Correlates of “Vaping” as a Route of Cannabis Administration in Medical Cannabis Patients

Science.gov (United States)

Cranford, James A.; Bohnert, Kipling M.; Perron, Brian E.; Bourque, Carrie; Ilgen, Mark

2016-01-01

Purpose To examine the prevalence and correlates of vaporization (i.e., “vaping”) as a route of cannabis administration in a sample of medical cannabis patients. Procedures Adults ages 21 and older (N = 1,485 M age = 45.1) who were seeking medical cannabis certification (either for the first time or as a renewal) at medical cannabis clinics in southern Michigan completed a screening assessment. Participants completed measures of route of cannabis administration, cannabis use, alcohol and other substance use. Findings An estimated 39% (n=511) of the sample reported past-month cannabis vaping, but vaping as the sole route of cannabis administration was rare. Specifically, only 30 participants (2.3% of the full sample and 5.9% of those who reported any vaping) indicated vaping as the sole route of cannabis administration. The majority (87.3%) of those who reported vaping also reported smoking (combustion) as a route of cannabis administration. Being younger than age 44, having more than a high school education, engaging in nonmedical stimulant use, being a returning medical cannabis patient, and greater frequency of cannabis use were associated with higher odds of vaping at the bivariate level and with all variables considered simultaneously. Conclusions Vaping appears to be relatively common among medical cannabis patients, but is seldom used as the sole route of cannabis administration. Results highlight the importance of monitoring trends in vaping and other substance use behaviors in this population and underscore the need for longitudinal research into the motives, correlates, and consequences of cannabis vaping in medical cannabis patients. PMID:27770657

Medical cannabis: considerations for the anesthesiologist and pain physician.

Science.gov (United States)

Beaulieu, Pierre; Boulanger, Aline; Desroches, Julie; Clark, Alexander J

2016-05-01

New regulations are in place at the federal and provincial levels in Canada regarding the way medical cannabis is to be controlled. We present them together with guidance for the safe use of medical cannabis and recent clinical trials on cannabis and pain. The new Canadian regulations on the use of medical cannabis, the provincial regulations, and the various cannabis products available from the Canadian Licensed Producers were reviewed from Health Canada, provincial licensing authorities, and the licensed producers website, respectively. Recent clinical trials on cannabis and pain were reviewed from the existing literature. Health Canada has approved a new regulation on medical marijuana/cannabis, the Marihuana for Medical Purposes Regulations: The production of medical cannabis by individuals is illegal. Health Canada, however, has licensed authorized producers across the country, limiting the production to specific licenses of certain cannabis products. There are currently 26 authorized licensed producers from seven Canadian provinces offering more than 200 strains of marijuana. We provide guidance for the safe use of medical cannabis. The recent literature indicates that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain. The science of medical cannabis and the need for education of healthcare professionals and patients require continued effort. Although cannabinoids work to decrease pain, there is still a need to confirm these beneficial effects clinically and to exploit them with acceptable benefit-to-risk ratios.

Legalization, decriminalization & medicinal use of cannabis: a scientific and public health perspective.

Science.gov (United States)

Svrakic, Dragan M; Lustman, Patrick J; Mallya, Ashok; Lynn, Taylor Andrea; Finney, Rhonda; Svrakic, Neda M

2012-01-01

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.

Differential effects of childhood trauma and cannabis use disorders in patients suffering from schizophrenia.

Science.gov (United States)

Baudin, G; Godin, O; Lajnef, M; Aouizerate, B; Berna, F; Brunel, L; Capdevielle, D; Chereau, I; Dorey, J M; Dubertret, C; Dubreucq, J; Faget, C; Fond, G; Gabayet, F; Laouamri, H; Lancon, C; Le Strat, Y; Tronche, A M; Misdrahi, D; Rey, R; Passerieux, C; Schandrin, A; Urbach, M; Vidalhet, P; Llorca, P M; Schürhoff, F

2016-08-01

Childhood trauma (CT) and cannabis use are both environmental and modifier risk factors for schizophrenia. However, little is known about how they interact in schizophrenia. We examined the main effect of each of these two environmental factors on the clinical expression of the disease using a large set of variables, and we tested whether and how cannabis and CT interact to influence the course and the presentation of the illness. A sample of 366 patients who met the DSM-IV-TR criteria for schizophrenia was recruited through the FACE-SCZ (Fondamental Advanced Centre of Expertise - Schizophrenia) network. Patients completed a large standardized clinical evaluation including Structured Clinical Interview for DSM Disorders-I (SCID-I), Positive and Negative Symptoms Scale (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Global Assessment of Functioning (GAF), Short-Quality of Life-18 (S-QoL-18), and Medication Adherence Rating Scale (MARS). We assessed CT with the Childhood Trauma Questionnaire and cannabis status with SCID-I. CT significantly predicted the number of hospitalizations, GAF, and S-QoL-18 scores, as well as the PANSS total, positive, excitement, and emotional distress scores. Cannabis use disorders significantly predicted age of onset, and MARS. There was no significant interaction between CT and cannabis use disorders. However, we found evidence of a correlation between these two risk factors. CT and cannabis both have differential deleterious effects on clinical and functional outcomes in patients with schizophrenia. Our results highlight the need to systematically assess the presence of these risk factors and adopt suitable therapeutic interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

Long term stability of cannabis resin and cannabis extracts

DEFF Research Database (Denmark)

Lindholst, Christian

2010-01-01

  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...

Examining the profile of high-potency cannabis and its association with severity of cannabis dependence.

Science.gov (United States)

Freeman, T P; Winstock, A R

2015-11-01

Cannabis use is decreasing in England and Wales, while demand for cannabis treatment in addiction services continues to rise. This could be partly due to an increased availability of high-potency cannabis. Adults residing in the UK were questioned about their drug use, including three types of cannabis (high potency: skunk; low potency: other grass, resin). Cannabis types were profiled and examined for possible associations between frequency of use and (i) cannabis dependence, (ii) cannabis-related concerns. Frequent use of high-potency cannabis predicted a greater severity of dependence [days of skunk use per month: b = 0.254, 95% confidence interval (CI) 0.161-0.357, p effect became stronger as age decreased (b = -0.006, 95% CI -0.010 to -0.002, p = 0.004). By contrast, use of low-potency cannabis was not associated with dependence (days of other grass use per month: b = 0.020, 95% CI -0.029 to 0.070, p = 0.436; days of resin use per month: b = 0.025, 95% CI -0.019 to 0.067, p = 0.245). Frequency of cannabis use (all types) did not predict severity of cannabis-related concerns. High-potency cannabis was clearly distinct from low-potency varieties by its marked effects on memory and paranoia. It also produced the best high, was preferred, and most available. High-potency cannabis use is associated with an increased severity of dependence, especially in young people. Its profile is strongly defined by negative effects (memory, paranoia), but also positive characteristics (best high, preferred type), which may be important when considering clinical or public health interventions focusing on cannabis potency.

Cannabis Use Disorder in Adolescence.

Science.gov (United States)

Simpson, Annabelle K; Magid, Viktoriya

2016-07-01

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Time-course of the DSM-5 cannabis withdrawal symptoms in poly-substance abusers

DEFF Research Database (Denmark)

Hesse, Morten; Thylstrup, Birgitte

2013-01-01

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 tobacco...... the DSM-5 Withdrawal Symptom Check List with withdrawal symptoms from all classes of substances, with no indication that the described symptoms should be attributed to withdrawal. Self-reported time since last use of cannabis was used as a predictor of cannabis withdrawal severity. Results...... With the exception of loss of appetite, time since last use of cannabis was associated with all types of withdrawal symptoms listed in the DSM-5. Only four of 19 symptoms intended to measure withdrawal from other substances were related to time since last use of cannabis, including vivid, unpleasant dreams...

Pain, Cannabis Species, and Cannabis Use Disorders

Science.gov (United States)

Cohen, Nicole L.; Heinz, Adrienne J.; Ilgen, Mark; Bonn-Miller, Marcel O.

2016-01-01

Objective: The purpose of this study was to examine whether individuals who used medical cannabis for chronic pain were at increased risk for cannabis use problems compared with individuals who used medical cannabis for other reasons (e.g., anxiety, insomnia, and muscle spasms). An additional aim was to determine whether individuals who used cannabis for chronic pain, as well as those who reported greater within-group pain levels, demonstrated a species preference (i.e., sativa, indica, hybrids) and the extent to which species preference was associated with cannabis use problems. Method: Participants were 163 medical cannabis users (77% male), recruited from a medical marijuana dispensary in California, who completed assessments of medical cannabis use motives, history, preferences (species type), and problems, as well as current pain level. Results: Individuals who used cannabis to manage chronic pain experienced fewer cannabis use problems than those who did not use it for pain; among those who used it for pain, the average pain level in the past week was not associated with cannabis use problems. Furthermore, individuals who used cannabis for chronic pain were more likely to use indica over sativa. Preference for indica was associated with fewer cannabis use problems than preference for hybrid species. Conclusions: Individuals who use cannabis to manage chronic pain may be at a lower risk for cannabis use problems, relative to individuals who use it for other indications, potentially as a function of their species preference. PMID:27172585

Pain, Cannabis Species, and Cannabis Use Disorders.

Science.gov (United States)

Cohen, Nicole L; Heinz, Adrienne J; Ilgen, Mark; Bonn-Miller, Marcel O

2016-05-01

The purpose of this study was to examine whether individuals who used medical cannabis for chronic pain were at increased risk for cannabis use problems compared with individuals who used medical cannabis for other reasons (e.g., anxiety, insomnia, and muscle spasms). An additional aim was to determine whether individuals who used cannabis for chronic pain, as well as those who reported greater within-group pain levels, demonstrated a species preference (i.e., sativa, indica, hybrids) and the extent to which species preference was associated with cannabis use problems. Participants were 163 medical cannabis users (77% male), recruited from a medical marijuana dispensary in California, who completed assessments of medical cannabis use motives, history, preferences (species type), and problems, as well as current pain level. Individuals who used cannabis to manage chronic pain experienced fewer cannabis use problems than those who did not use it for pain; among those who used it for pain, the average pain level in the past week was not associated with cannabis use problems. Furthermore, individuals who used cannabis for chronic pain were more likely to use indica over sativa. Preference for indica was associated with fewer cannabis use problems than preference for hybrid species. Individuals who use cannabis to manage chronic pain may be at a lower risk for cannabis use problems, relative to individuals who use it for other indications, potentially as a function of their species preference.

Cannabis and related impairment: the unique roles of cannabis use to cope with social anxiety and social avoidance.

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Buckner, Julia D; Zvolensky, Michael J

2014-01-01

Social anxiety appears to be a risk factor for cannabis-related problems. Socially anxious individuals are vulnerable to using cannabis to cope in social situations and to avoiding social situations if marijuana is unavailable. Yet, the relative impact of cannabis use to cope with social anxiety relative to use to cope with negative affect more broadly has yet to be examined. The present study used the Marijuana to Cope with Social Anxiety Scale (MCSAS) to examine the incremental validity of using cannabis use to cope in social situations (MCSAS-Cope) and avoidance of social situations if cannabis is unavailable (MCSAS-Avoid) in a community-recruited sample of 123 (34.1% female) current cannabis users. After controlling for age of first cannabis use, gender, alcohol and tobacco use, other cannabis use motives, and cannabis expectancies, MCSAS-Cope remained significantly positively related to cannabis use frequency and cannabis-related problems. After controlling for age of first cannabis use, gender, alcohol and tobacco use, and experiential avoidance, MCSAS-Avoid remained significantly related to cannabis problems but not frequency. The present findings suggest that cannabis use to manage social forms of anxiety may be important to understanding cannabis use behaviors. The current findings identify cognitive/motivational factors implicated in more frequent cannabis use and in cannabis-related impairment, which may be essential to inform efforts to further refine prevention and treatment efforts. © American Academy of Addiction Psychiatry.

Medical cannabis - the Canadian perspective.

Science.gov (United States)

Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M

2016-01-01

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.

Is cannabis treatment for anxiety, mood, and related disorders ready for prime time?

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Turna, Jasmine; Patterson, Beth; Van Ameringen, Michael

2017-11-01

Anxiety and related disorders are the most common mental conditions affecting the North American population. Despite their established efficacy, first-line antidepressant treatments are associated with significant side effects, leading many afflicted individuals to seek alternative treatments. Cannabis is commonly viewed as a natural alternative for a variety of medical and mental health conditions. Currently, anxiety ranks among the top five medical symptoms for which North Americans report using medical marijuana. However, upon careful review of the extant treatment literature, the anxiolytic effects of cannabis in clinical populations are surprisingly not well-documented. The effects of cannabis on anxiety and mood symptoms have been examined in healthy populations and in several small studies of synthetic cannabinoid agents but there are currently no studies which have examined the effects of the cannabis plant on anxiety and related disorders. In light of the rapidly shifting landscape regarding the legalization of cannabis for medical and recreational purposes, it is important to highlight the significant disconnect between the scientific literature, public opinion, and related policies. The aim of this article is to provide a comprehensive review of the current cannabis treatment literature, and to identify the potential for cannabis to be used as a therapeutic intervention for anxiety, mood, and related disorders. Searches of five electronic databases were conducted (PubMed, MEDLINE, Web of Science, PsychINFO, and Google Scholar), with the most recent in February 2017. The effects of cannabis on healthy populations and clinical psychiatric samples will be discussed, focusing primarily on anxiety and mood disorders. © 2017 Wiley Periodicals, Inc.

Cannabis Allergy: What do We Know Anno 2015.

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Decuyper, Ine; Ryckebosch, Hanne; Van Gasse, Athina L; Sabato, Vito; Faber, Margaretha; Bridts, Chris H; Ebo, Didier G

2015-10-01

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.

Medicinal cannabis in oncology.

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Engels, Frederike K; de Jong, Floris A; Mathijssen, Ron H J; Erkens, Joëlle A; Herings, Ron M; Verweij, Jaap

2007-12-01

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.

Cannabis use and support for cannabis legalization

OpenAIRE

Palali, A. (Ali); Ours, Jan

2016-01-01

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...

Effect of reclassification of cannabis on hospital admissions for cannabis psychosis: a time series analysis.

Science.gov (United States)

Hamilton, Ian; Lloyd, Charlie; Hewitt, Catherine; Godfrey, Christine

2014-01-01

The UK Misuse of Drugs Act (1971) divided controlled drugs into three groups A, B and C, with descending criminal sanctions attached to each class. Cannabis was originally assigned by the Act to Group B but in 2004, it was transferred to the lowest risk group, Group C. Then in 2009, on the basis of increasing concerns about a link between high strength cannabis and schizophrenia, it was moved back to Group B. The aim of this study is to test the assumption that changes in classification lead to changes in levels of psychosis. In particular, it explores whether the two changes in 2004 and 2009 were associated with changes in the numbers of people admitted for cannabis psychosis. An interrupted time series was used to investigate the relationship between the two changes in cannabis classification and their impact on hospital admissions for cannabis psychosis. Reflecting the two policy changes, two interruptions to the time series were made. Hospital Episode Statistics admissions data was analysed covering the period 1999 through to 2010. There was a significantly increasing trend in cannabis psychosis admissions from 1999 to 2004. However, following the reclassification of cannabis from B to C in 2004, there was a significant change in the trend such that cannabis psychosis admissions declined to 2009. Following the second reclassification of cannabis back to class B in 2009, there was a significant change to increasing admissions. This study shows a statistical association between the reclassification of cannabis and hospital admissions for cannabis psychosis in the opposite direction to that predicted by the presumed relationship between the two. However, the reasons for this statistical association are unclear. It is unlikely to be due to changes in cannabis use over this period. Other possible explanations include changes in policing and systemic changes in mental health services unrelated to classification decisions. Copyright © 2013 Elsevier B.V. All rights

[Cannabis: A Cognitive Illusion].

Science.gov (United States)

Galván, Gonzalo; Guerrero-Martelo, Manuel; Vásquez De la Hoz, Francisco

The vision of cannabis as a soft drug is due to the low risk perception that young and old people have of the drug. This perception is based on erroneous beliefs that people have about the drug. To compare the beliefs of cannabis use and consequences among adolescents with a lifetime prevalence of cannabis use and those without a lifetime prevalence of cannabis use. Quantitative, descriptive and cross-sectional study with a probability sample of 156 high school students who completed an ad-hoc questionnaire that included sociodemographic data and 22 questions about the beliefs that young people had about cannabis use and its consequences. The lifetime prevalence of cannabis use was 13.5%. The prevalence group consisted mostly of males. Statistically significant differences between different groups and different beliefs were found. The group with no lifetime prevalence of cannabis use perceived higher risk as regards the damage that cannabis can cause to memory, other cognitive functions, neurons, mental health, and general health. The group with a lifetime prevalence of cannabis use perceived a lower risk as regards the use of cannabis, and think that intelligent people smoke cannabis, and that cannabis has positive effects on the brain, increasing creativity. and is used to cure mental diseases. Those who used cannabis once in their life perceive the use of the substance as less harmful or less potential danger to health compared to those who never consumed. In fact those who consumed at some time even have beliefs that suggest positive effects in those people that consume it. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Cannabis Withdrawal in Adults With Attention-Deficit/Hyperactivity Disorder.

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Chauchard, Emeline; Hartwell, Karen J; McRae-Clark, Aimee L; Sherman, Brian J; Gorelick, David A

2018-02-22

Cannabis withdrawal has not been studied in adults with attention-deficit/hyperactivity disorder (ADHD) who have high rates of cannabis use. We aimed to describe cannabis withdrawal, motivations to quit, and strategies to quit cannabis use in cannabis-dependent adults with ADHD. Twenty-three adults with ADHD enrolled in a controlled clinical trial of pharmacotherapy (atomoxetine) for cannabis dependence (DSM-IV criteria) completed the Marijuana Quit Questionnaire (MJQQ) to provide information on their "most serious" quit attempt made without formal treatment. The study was conducted between November 2005 and June 2008. Participants were predominantly male (82.6%, n = 19), with a mean (SD) age of 27.4 (8.5) years (range, 18-53) at the start of their index quit attempt. The most common motive for quitting cannabis was "to save money" (87%, n = 20); the most common strategy to maintain abstinence was "stopped associating with people who smoke marijuana" (43%, n = 10). Almost all (96%, n = 22) subjects reported ≥ 1 cannabis withdrawal symptom; 7 (30%) met DSM-5 diagnostic criteria for cannabis withdrawal syndrome. Participants with comorbid ADHD and cannabis dependence reported withdrawal symptoms similar to other samples of non-treatment-seeking cannabis-dependent adults with no psychiatric comorbidity. These findings suggest that ADHD does not influence cannabis withdrawal in the way that it does tobacco (nicotine) withdrawal. Data used in this secondary analysis came from ClinicalTrials.gov identifier: NCT00360269. © Copyright 2018 Physicians Postgraduate Press, Inc.

First positive reactions to cannabis constitute a priority risk factor for cannabis dependence.

Science.gov (United States)

Le Strat, Yann; Ramoz, Nicolas; Horwood, John; Falissard, Bruno; Hassler, Christine; Romo, Lucia; Choquet, Marie; Fergusson, David; Gorwood, Philip

2009-10-01

To assess the association between first reactions to cannabis and the risk of cannabis dependence. A cross-sectional population-based assessment in 2007. A campus in a French region (Champagne-Ardennes). A total of 1472 participants aged 18-21 years who reported at least one life-time cannabis consumption, of 3056 students who were screened initially [the Susceptibility Addiction Gene Environment (SAGE) study]. Positive and negative effects of first cannabis consumptions, present cannabis dependence and related risk factors were assessed through questionnaires.   The effects of first cannabis consumptions were associated dose-dependently with cannabis dependence at age 18-21 years, both according to the transversal approach of the SAGE study and to the prospective cohort of the Christchurch Health and Development Study (CHDS) assessed at the age of 25 years. Participants of the SAGE study who reported five positive effects of their first cannabis consumption had odds of life-time cannabis dependence that were 28.7 (95% confidence interval: 14.6-56.5) higher than those who reported no positive effects. This association remains significant after controlling for potentially confounding factors, including individual and familial variables. This study suggests an association between positive reactions to first cannabis uses and risk of life-time cannabis dependence, this variable having a central role among, and through, other risk factors. © 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction.

Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain.

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Cranford, James A; Arnedt, J Todd; Conroy, Deirdre A; Bohnert, Kipling M; Bourque, Carrie; Blow, Frederic C; Ilgen, Mark

2017-11-01

To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Adults ages 21 and older (N=801,M age=45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Biological aspects of cannabis consumption in schizophrenia

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Serban Ionela Lacramioara

2015-01-01

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.

Cannabis Use and Support for Cannabis Legalization

NARCIS (Netherlands)

Palali, A.; van Ours, J.C.

2014-01-01

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.

Pathways from cannabis to psychosis: a review of the evidence

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Jonathan K Burns

2013-10-01

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.

The therapeutic potential of cannabis and cannabinoids.

Science.gov (United States)

Grotenhermen, Franjo; Müller-Vahl, Kirsten

2012-07-01

Cannabis-based medications have been a topic of intense study since the endogenous cannabinoid system was discovered two decades ago. In 2011, for the first time, a cannabis extract was approved for clinical use in Germany. Selective literature review. Cannabis-based medications exert their effects mainly through the activation of cannabinoid receptors (CB1 and CB2). More than 100 controlled clinical trials of cannabinoids or whole-plant preparations for various indications have been conducted since 1975. The findings of these trials have led to the approval of cannabis-based medicines (dronabinol, nabilone, and a cannabis extract [THC:CBD=1:1]) in several countries. In Germany, a cannabis extract was approved in 2011 for the treatment of moderate to severe refractory spasticity in multiple sclerosis. It is commonly used off label for the treatment of anorexia, nausea, and neuropathic pain. Patients can also apply for government permission to buy medicinal cannabis flowers for self-treatment under medical supervision. The most common side effects of cannabinoids are tiredness and dizziness (in more than 10% of patients), psychological effects, and dry mouth. Tolerance to these side effects nearly always develops within a short time. Withdrawal symptoms are hardly ever a problem in the therapeutic setting. There is now clear evidence that cannabinoids are useful for the treatment of various medical conditions.

Medical cannabis – the Canadian perspective

Science.gov (United States)

Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M

2016-01-01

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 use and abuse correlates in a homogenous South African schizophrenia population

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Liezl Koen

2009-03-01

Full Text Available Objective. Worldwide, cannabis is the most widely used illicit substance, and it has been identified as a correlate in schizophrenia samples for poorer symptomatic and functional outcomes in many international studies. The object of this retrospective study was to identify the prevalence of cannabis use/abuse and the demographic and clinical correlates therefor in a large homogeneous South African schizophrenia population. Methods. As part of a large genetic study, 547 subjects with a diagnosis of schizophrenia were recruited. Demographic and clinical data were collected and each participant underwent a urinary drug screen. Use/abuse of cannabis was defined as using cannabis more than 21 times in a single year. Subjects with and without cannabis use/abuse were statistically compared. Results. Significant differences between the two groups were found in terms of gender, marital status, age of onset of schizophrenia, number of hospitalisations and relapses, alcohol abuse, smoking, the Scale for the Assessment of Positive Symptoms (SAPS scores for hallucinations, delusions, bizarre behaviour and formal thought disorder, and the Scale for the Assessment of Negative Symptoms (SANS score for avolition/apathy. Conclusion. The prevalence of cannabis use/abuse in this study was high, and our findings were comparable with those of previous international studies. Abuse/use started mainly in the teenage years, was more prevalent among males than females, and was associated with negative overall outcomes. There was also a positive correlation between cannabis and nicotine and alcohol use/abuse. Determination of cannabis abuse based solely on history was found to be reliable, and urine cannabis testing appeared to be of limited value in routine management of this group of schizophrenic patients.

Integrating cannabis into clinical cancer care

OpenAIRE

Abrams, D.I.

2016-01-01

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.

Decreased respiratory symptoms in cannabis users who vaporize

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Barnwell Sara

2007-04-01

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

[Therapeutic potential of Cannabis sativa].

Science.gov (United States)

Avello L, Marcia; Pastene N, Edgar; Fernández R, Pola; Córdova M, Pia

2017-03-01

Cannabis sativa (marihuana) is considered an illicit drug due to its psychoactive properties. Recently, the Chilean government opened to the use cannabis in the symptomatic treatment of some patients. The biological effects of cannabis render it useful for the complementary treatment of specific clinical situations such as chronic pain. We retrieved scientific information about the analgesic properties of cannabis, using it as a safe drug. The drug may block or inhibit the transmission of nervous impulses at different levels, an effect associated with pain control. Within this context and using adequate doses, forms and administration pathways, it can be used for chronic pain management, considering its effectiveness and low cost. It could also be considered as an alternative in patients receiving prolonged analgesic therapies with multiple adverse effects.

Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.

Science.gov (United States)

Lotan, Itay; Treves, Therese A; Roditi, Yaniv; Djaldetti, Ruth

2014-01-01

The use of cannabis as a therapeutic agent for various medical conditions has been well documented. However, clinical trials in patients with Parkinson disease (PD) have yielded conflicting results. The aim of the present open-label observational study was to assess the clinical effect of cannabis on motor and non-motor symptoms of PD. Twenty-two patients with PD attending the motor disorder clinic of a tertiary medical center in 2011 to 2012 were evaluated at baseline and 30 minutes after smoking cannabis using the following battery: Unified Parkinson Disease Rating Scale, visual analog scale, present pain intensity scale, Short-Form McGill Pain Questionnaire, as well as Medical Cannabis Survey National Drug and Alcohol Research Center Questionnaire. Mean (SD) total score on the motor Unified Parkinson Disease Rating Scale score improved significantly from 33.1 (13.8) at baseline to 23.2 (10.5) after cannabis consumption (t = 5.9; P effects of the drug were observed. The study suggests that cannabis might have a place in the therapeutic armamentarium of PD. Larger, controlled studies are needed to verify the results.

Cannabis Liberalization and Adolescent Cannabis Use: A Cross-National Study in 38 Countries

Science.gov (United States)

Shi, Yuyan; Lenzi, Michela; An, Ruopeng

2015-01-01

Aims To assess the associations between types of cannabis control policies at country level and prevalence of adolescent cannabis use. Setting, Participants and Design Multilevel logistic regressions were performed on 172,894 adolescents 15 year of age who participated in the 2001/2002, 2005/2006, or 2009/2010 cross-sectional Health Behaviour in School-Aged Children (HBSC) survey in 38 European and North American countries. Measures Self-reported cannabis use status was classified into ever use in life time, use in past year, and regular use. Country-level cannabis control policies were categorized into a dichotomous measure (whether or not liberalized) as well as 4 detailed types (full prohibition, depenalization, decriminalization, and partial prohibition). Control variables included individual-level sociodemographic characteristics and country-level economic characteristics. Findings Considerable intra-class correlations (.15-.19) were found at country level. With respect to the dichotomized cannabis control policy, adolescents were more likely to ever use cannabis (odds ratio (OR) = 1.10, p = .001), use in past year (OR = 1.09, p = .007), and use regularly (OR = 1.26, p = .004). Although boys were substantially more likely to use cannabis, the correlation between cannabis liberalization and cannabis use was smaller in boys than in girls. With respect to detailed types of policies, depenalization was associated with higher odds of past-year use (OR = 1.14, p = .013) and regular use (OR = 1.23, p = .038), and partial prohibition was associated with higher odds of regular use (OR = 2.39, p = .016). The correlation between cannabis liberalization and regular use was only significant after the policy had been introduced for more than 5 years. Conclusions Cannabis liberalization with depenalization and partial prohibition policies was associated with higher levels of regular cannabis use among adolescents. The correlations were heterogeneous between genders and

Psychosocial functioning among regular cannabis users with and without cannabis use disorder.

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Foster, Katherine T; Arterberry, Brooke J; Iacono, William G; McGue, Matt; Hicks, Brian M

2017-11-27

In the United States, cannabis accessibility has continued to rise as the perception of its harmfulness has decreased. Only about 30% of regular cannabis users develop cannabis use disorder (CUD), but it is unclear if individuals who use cannabis regularly without ever developing CUD experience notable psychosocial impairment across the lifespan. Therefore, psychosocial functioning was compared across regular cannabis users with or without CUD and a non-user control group during adolescence (age 17; early risk) and young adulthood (ages 18-25; peak CUD prevalence). Weekly cannabis users with CUD (n = 311), weekly users without CUD (n = 111), and non-users (n = 996) were identified in the Minnesota Twin Family Study. Groups were compared on alcohol and illicit drug use, psychiatric problems, personality, and social functioning at age 17 and from ages 18 to 25. Self-reported cannabis use and problem use were independently verified using co-twin informant report. In both adolescence and young adulthood, non-CUD users reported significantly higher levels of substance use problems and externalizing behaviors than non-users, but lower levels than CUD users. High agreement between self- and co-twin informant reports confirmed the validity of self-reported cannabis use problems. Even in the absence of CUD, regular cannabis use was associated with psychosocial impairment in adolescence and young adulthood. However, regular users with CUD endorsed especially high psychiatric comorbidity and psychosocial impairment. The need for early prevention and intervention - regardless of CUD status - was highlighted by the presence of these patterns in adolescence.

Survey of Australians using cannabis for medical purposes

Directory of Open Access Journals (Sweden)

Dillon Paul

2005-10-01

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.

Past year cannabis use and problematic cannabis use among adults by ethnicity in Ontario.

Science.gov (United States)

Tuck, Andrew; Hamilton, Hayley A; Agic, Branka; Ialomiteanu, Anca R; Mann, Robert E

2017-10-01

Rates of cannabis use differ around the world; in Ontario, the rate of use has been stable since about 2005. Understanding which population groups are at greater risk for problematic cannabis use can help reduce long-term health effects and service expenses. The aim of this study was to explore differences in cannabis use among Canadian adults of different ethnic origins living in Ontario. Data are based on telephone interviews with 11,560 respondents and are derived from multiple cycles (2005-2011) of the Centre for Addiction and Mental Health's (CAMH) Monitor survey, an ongoing cross-sectional survey of adults in Ontario, Canada, aged 18 years and older. Data were analyzed using bivariate cross-tabulations and logistic regression. Problematic cannabis use was determined with a score of 8+ on the ASSIST-CIS to identify moderate/high problematic users. Lifetime, past year and problematic cannabis use (in the past 3 months) occurs among all ethnic groups: Canadian, East Asian, South East Asian, South Asian, Caribbean, African, East European, South European, North European, and Central West European. When compared to the Canadian group the odds of past year cannabis use was significantly lower for East Asians and South Asians, but higher for the Caribbean group. Significantly higher odds of problematic cannabis use were found for Caribbeans and Northern Europeans compared to Canadians. These results of this study provide an important basis for considering the possible impact of the impending legalization of cannabis in Canada among different ethnic groups. Copyright © 2017 Elsevier B.V. All rights reserved.

Cannabis Withdrawal Among Detained Adolescents: Exploring the Impact of Nicotine and Race

OpenAIRE

Soenksen, Shayna; Stein, L.A.R.; Brown, Joanna D.; Stengel, JoAnn R.; Rossi, Joseph S.; Lebeau, Rebecca

2015-01-01

Rates of marijuana use among detained youths are exceptionally high. Research suggests a cannabis withdrawal syndrome is valid and clinically significant; however, these studies have mostly been conducted in highly controlled laboratory settings with treatment-seeking, White adults. The present study analyzed archival data to explore the magnitude of cannabis withdrawal symptoms within a diverse sample of detained adolescents while controlling for tobacco use and investigating the impact of r...

A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults

OpenAIRE

Mason, Barbara J; Crean, Rebecca; Goodell, Vivian; Light, John M; Quello, Susan; Shadan, Farhad; Buffkins, Kimberly; Kyle, Mark; Adusumalli, Murali; Begovic, Adnan; Rao, Santosh

2012-01-01

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...

Safety Issues Concerning the Medical Use of Cannabis and Cannabinoids

Directory of Open Access Journals (Sweden)

Mark A Ware

2005-01-01

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.

Cannabis effects on driving skills.

Science.gov (United States)

Hartman, Rebecca L; Huestis, Marilyn A

2013-03-01

Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ(9)-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use. We review and evaluate the current literature on cannabis' effects on driving, highlighting the epidemiologic and experimental data. Epidemiologic data show that the risk of involvement in a motor vehicle accident (MVA) increases approximately 2-fold after cannabis smoking. The adjusted risk of driver culpability also increases substantially, particularly with increased blood THC concentrations. Studies that have used urine as the biological matrix have not shown an association between cannabis and crash risk. Experimental data show that drivers attempt to compensate by driving more slowly after smoking cannabis, but control deteriorates with increasing task complexity. Cannabis smoking increases lane weaving and impaired cognitive function. Critical-tracking tests, reaction times, divided-attention tasks, and lane-position variability all show cannabis-induced impairment. Despite purported tolerance in frequent smokers, complex tasks still show impairment. Combining cannabis with alcohol enhances impairment, especially lane weaving. Differences in study designs frequently account for inconsistencies in results between studies. Participant-selection bias and confounding factors attenuate ostensible cannabis effects, but the association with MVA often retains significance. Evidence suggests recent smoking and/or blood THC concentrations 2-5 ng/mL are associated with substantial driving impairment, particularly in occasional smokers. Future cannabis-and-driving research should emphasize challenging tasks, such as divided attention, and include occasional and

Cannabis smoke condensate III: the cannabinoid content of vaporised Cannabis sativa.

Science.gov (United States)

Pomahacova, B; Van der Kooy, F; Verpoorte, R

2009-11-01

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.

Cannabis Withdrawal Among Detained Adolescents: Exploring the Impact of Nicotine and Race.

Science.gov (United States)

Soenksen, Shayna; Stein, L A R; Brown, Joanna D; Stengel, JoAnn R; Rossi, Joseph S; Lebeau, Rebecca

2015-04-01

Rates of marijuana use among detained youths are exceptionally high. Research suggests a cannabis withdrawal syndrome is valid and clinically significant; however, these studies have mostly been conducted in highly controlled laboratory settings with treatment-seeking, White adults. The present study analyzed archival data to explore the magnitude of cannabis withdrawal symptoms within a diverse sample of detained adolescents while controlling for tobacco use and investigating the impact of race on symptom reports. Adolescents recruited from a juvenile correctional facility (N=93) completed a background questionnaire and the Marijuana Withdrawal Checklist. Analyses revealed a significant main effect for level of tobacco use on severity of irritability, and for level of marijuana use on severity of craving to smoke marijuana and strange/wild dreams. Furthermore, a significant main effect for race was found with Black adolescents reporting lower withdrawal discomfort scores and experiencing less severe depressed mood, difficulty sleeping, nervousness/anxiety, and strange/wild dreams. Although exploratory, these findings may have significant clinical implications for providers in juvenile detention facilities, allowing the execution of proper medical and/or behavioral interventions to assist adolescents presenting with problematic cannabis and/or tobacco withdrawal.

Cannabis use and family history in adolescent first episode ...

African Journals Online (AJOL)

Objectives: To investigate the clinical correlates of cannabis use in adolescents with first episode psychosis (FEP). Methods: Inpatient psychiatric records provided demographic, lifetime cannabis use, family history of mental illness, and clinical data on 45 FEP adolescents, aged 12–18 years, admitted to a psychiatric unit in ...

The Use of Cannabis for Headache Disorders

Science.gov (United States)

Lochte, Bryson C.; Beletsky, Alexander; Samuel, Nebiyou K.; Grant, Igor

2017-01-01

Abstract Headache disorders are common, debilitating, and, in many cases, inadequately managed by existing treatments. Although clinical trials of cannabis for neuropathic pain have shown promising results, there has been limited research on its use, specifically for headache disorders. This review considers historical prescription practices, summarizes the existing reports on the use of cannabis for headache, and examines the preclinical literature exploring the role of exogenous and endogenous cannabinoids to alter headache pathophysiology. Currently, there is not enough evidence from well-designed clinical trials to support the use of cannabis for headache, but there are sufficient anecdotal and preliminary results, as well as plausible neurobiological mechanisms, to warrant properly designed clinical trials. Such trials are needed to determine short- and long-term efficacy for specific headache types, compatibility with existing treatments, optimal administration practices, as well as potential risks. PMID:28861505

Do patients think cannabis causes schizophrenia? - A qualitative study on the causal beliefs of cannabis using patients with schizophrenia

Directory of Open Access Journals (Sweden)

Schaub Michael

2010-09-01

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

Cannabis arteritis.

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El Omri, Naoual; Eljaoudi, Rachid; Mekouar, Fadwa; Jira, Mohammed; Sekkach, Youssef; Amezyane, Taoufik; Ghafir, Driss

2017-01-01

Cannabis is the most consumed psychoactive substance by young people. Chronic use of cannabis can lead to cannabis arteritis, which is a very rare peripheral vascular disease similar to Buerger's disease. It is affecting young adults, especially men, consuming cannabis. A 27-year old woman, with no particular past medical history except for long-term use of cannabis and tobacco developed a digital necrosis in the left hand. She denied using other illicit drugs. Doppler ultrasound examination of the upper limbs was unremarkable. Toxicological analysis revealed the presence of cannabis in both biological fluid and hair strand. Despite medical treatment, cessation of the cannabis and tobacco consumption and hyperbaric oxygen therapy, an amputation of necrotic parts was then required. This case shows the prolonged use of cannabis could be a risk factor for young adult arteritis. Faced with a rapidly progressive arteritis occurring in young adult, the physician should consider the history of use of cannabis. Hair analysis can be useful for confirmation of the chronic consumption of drugs.

A randomized controlled trial testing the efficacy of a brief cannabis universal prevention program among adolescents in primary care.

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Walton, Maureen A; Resko, Stella; Barry, Kristen L; Chermack, Stephen T; Zucker, Robert A; Zimmerman, Marc A; Booth, Brenda M; Blow, Frederic C

2014-05-01

To examine the efficacy of a brief intervention delivered by a therapist (TBI) or a computer (CBI) in preventing cannabis use among adolescents in urban primary care clinics. A randomized controlled trial comparing: CBI and TBI versus control. Urban primary care clinics in the United States. Research staff recruited 714 adolescents (aged 12-18 years) who reported no life-time cannabis use on a screening survey for this study, which included a baseline survey, randomization (stratified by gender and grade) to conditions (control; CBI; TBI) and 3-, 6- and 12-month assessments. Using an intent-to-treat approach, primary outcomes were cannabis use (any, frequency); secondary outcomes included frequency of other drug use, severity of alcohol use and frequency of delinquency (among 85% completing follow-ups). Compared with controls, CBI participants had significantly lower rates of any cannabis use over 12 months (24.16%, 16.82%, respectively, P cannabis use at 3 and 6 months (P cannabis use or frequency, but had significantly less other drug use at 3 months (P prevent and reduce cannabis use. Both computer and therapist delivered brief interventions appeared to have small effects in reducing other risk behaviors, but these dissipated over time. © 2013 Society for the Study of Addiction.

Decreased spontaneous eye blink rates in chronic cannabis users: evidence for striatal cannabinoid-dopamine interactions.

Directory of Open Access Journals (Sweden)

Mikael A Kowal

Full Text Available Chronic cannabis use has been shown to block long-term depression of GABA-glutamate synapses in the striatum, which is likely to reduce the extent to which endogenous cannabinoids modulate GABA- and glutamate-related neuronal activity. The current study aimed at investigating the effect of this process on striatal dopamine levels by studying the spontaneous eye blink rate (EBR, a clinical marker of dopamine level in the striatum. 25 adult regular cannabis users and 25 non-user controls matched for age, gender, race, and IQ were compared. Results show a significant reduction in EBR in chronic users as compared to non-users, suggesting an indirect detrimental effect of chronic cannabis use on striatal dopaminergic functioning. Additionally, EBR correlated negatively with years of cannabis exposure, monthly peak cannabis consumption, and lifetime cannabis consumption, pointing to a relationship between the degree of impairment of striatal dopaminergic transmission and cannabis consumption history.

Cannabis; Epidemiological, Neurobiological and Psychopathological Issues: An Update.

Science.gov (United States)

De Luca, Maria Antonietta; Di Chiara, Gaetano; Cadoni, Cristina; Lecca, Daniele; Orsolini, Laura; Papanti, Duccio; Corkery, John; Schifano, Fabrizio

2017-01-01

Cannabis is the illicit drug with both the largest current levels of consumption and the highest reported lifetime prevalence levels in the world. Across different countries, the prevalence of cannabis use varies according to the individual income, with the highest use being reported in North America, Australia and Europe. Despite its 'soft drug' reputation, cannabis misuse may be associated with several acute and chronic adverse effects. The present article aims at reviewing several papers on epidemiological, neurobiological and psychopathological aspects of the use of cannabis. The PubMed database was here examined in order to collect and discuss a range of identified papers. Cannabis intake usually starts during late adolescence/early adulthood (15-24 years) and drastically decreases in adulthood with the acquisition of working, familiar and social responsibilities. Clinical evidence supports the current socio-epidemiological alarm concerning the increased consumption among youngsters and the risks related to the onset of psychotic disorders. The mechanism of action of cannabis presents some analogies with other abused drugs, e.g. opiates. Furthermore, it has been well demonstrated that cannabis intake in adolescence may facilitate the transition to the use and/or abuse of other psychotropic drugs, hence properly being considered a 'gateway drug'. Some considerations on synthetic cannabimimetics are provided here as well. In conclusion, the highest prevalence of cannabis use and the social perception of a relatively low associated risk are in contrast with current knowledge based on biological and clinical evidence. Indeed, there are concerns relating to cannabis intake association with detrimental effects on both cognitive impairment and mental health. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cannabis Effects on Driving Skills

Science.gov (United States)

Hartman, Rebecca L.; Huestis, Marilyn A.

2013-01-01

BACKGROUND Cannabis is the most prevalent illicit drug identified in impaired drivers. The effects of cannabis on driving continue to be debated, making prosecution and legislation difficult. Historically, delays in sample collection, evaluating the inactive Δ9-tetrahydrocannabinol (THC) metabolite 11-nor-9-carboxy-THC, and polydrug use have complicated epidemiologic evaluations of driver impairment after cannabis use. CONTENT We review and evaluate the current literature on cannabis’ effects on driving, highlighting the epidemiologic and experimental data. Epidemiologic data show that the risk of involvement in a motor vehicle accident (MVA) increases approximately 2-fold after cannabis smoking. The adjusted risk of driver culpability also increases substantially, particularly with increased blood THC concentrations. Studies that have used urine as the biological matrix have not shown an association between cannabis and crash risk. Experimental data show that drivers attempt to compensate by driving more slowly after smoking cannabis, but control deteriorates with increasing task complexity. Cannabis smoking increases lane weaving and impaired cognitive function. Critical-tracking tests, reaction times, divided-attention tasks, and lane-position variability all show cannabis-induced impairment. Despite purported tolerance in frequent smokers, complex tasks still show impairment. Combining cannabis with alcohol enhances impairment, especially lane weaving. SUMMARY Differences in study designs frequently account for inconsistencies in results between studies. Participant-selection bias and confounding factors attenuate ostensible cannabis effects, but the association with MVA often retains significance. Evidence suggests recent smoking and/or blood THC concentrations 2–5 ng/mL are associated with substantial driving impairment, particularly in occasional smokers. Future cannabis-and-driving research should emphasize challenging tasks, such as divided attention

Cannabis-Associated Asthma and Allergies.

Science.gov (United States)

Chatkin, J M; Zani-Silva, L; Ferreira, I; Zamel, N

2017-09-18

Inhalation of cannabis smoke is its most common use and the pulmonary complications of its use may be the single most common form of drug-induced pulmonary disease worldwide. However, the role of cannabis consumption in asthma patients and allergic clinical situations still remains controversial. To review the evidence of asthma and allergic diseases associated with the use of marijuana, we conducted a search of English, Spanish, and Portuguese medical using the search terms asthma, allergy, marijuana, marihuana, and cannabis. Entries made between January 1970 and March 2017 were retrieved. Several papers have shown the relationship between marijuana use and increase in asthma and other allergic diseases symptoms, as well as the increased frequency of medical visits. This narrative review emphasizes the importance to consider cannabis as a precipitating factor for acute asthma and allergic attacks in clinical practice. Although smoking of marijuana may cause respiratory symptoms, there is a need for more studies to elucidate many aspects in allergic asthma patients, especially considering the long-term use of the drug. These patients should avoid using marijuana and be oriented about individual health risks, possible dangers of second-hand smoke exposure, underage use, safe storage, and the over smoking of marijuana.

[CANNABIS: ALTERNATIVE REALITIES (CRA)].

Science.gov (United States)

Galván, Gonzalo Daniel; Guerrero, Manuel; Pinedo López, Jhon; García, Ricardo

2015-01-01

In this cross sectional and descriptive study, secondary school students trom the city of Santa Rosa were questioned about their beliefs about cannabis and their risk perception derived from it. The sample consisted in 83 male and 71 female 17 year-old teenagers. On the one hand, it was found that the highest risk perceptions were related to the legal issues that might arise due to cannabis consumption, and to its effects on neurons. On the other hand, the lowest risk perceptions were associated with the belief/ idea that smoking tobacco affects the lungs more than smoking cannabis, which might create dependence, and its use can cause mental disorders. Several significant differences were found as regards gender, since the female students noticed more risk than male students in that the consumption of cannabis can develop mental disorders, amotivational syndrome, lack of enthusiasm and less satisfaction with life. The teenager's risk perception about cannabis is variable.

A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population- a meta-analysis of 31 studies

Science.gov (United States)

2014-01-01

Background The aim of the current study was to investigate the association between anxiety and cannabis use/cannabis use disorders in the general population. Methods A total of N = 267 studies were identified from a systematic literature search (any time- March 2013) of Medline and PsycInfo databases, and a hand search. The results of 31 studies (with prospective cohort or cross-sectional designs using non-institutionalised cases) were analysed using a random-effects meta-analysis with the inverse variance weights. Lifetime or past 12-month cannabis use, anxiety symptoms, and cannabis use disorders (CUD; dependence and/or abuse/harmful use) were classified according to DSM/ICD criteria or scores on standardised scales. Results There was a small positive association between anxiety and either cannabis use (OR = 1.24, 95% CI: 1.06-1.45, p = .006; N = 15 studies) or CUD (OR = 1.68, 95% CI: 1.23-2.31, p = .001; N = 13 studies), and between comorbid anxiety + depression and cannabis use (OR = 1.68, 95% CI: 1.17-2.40, p = .004; N = 5 studies). The positive associations between anxiety and cannabis use (or CUD) were present in subgroups of studies with ORs adjusted for possible confounders (substance use, psychiatric illness, demographics) and in studies with clinical diagnoses of anxiety. Cannabis use at baseline was significantly associated with anxiety at follow-up in N = 5 studies adjusted for confounders (OR = 1.28, 95% CI: 1.06-1.54, p = .01). The opposite relationship was investigated in only one study. There was little evidence for publication bias. Conclusion Anxiety is positively associated with cannabis use or CUD in cohorts drawn from some 112,000 non-institutionalised members of the general population of 10 countries. PMID:24884989

Cannabis use and support for cannabis legalization

NARCIS (Netherlands)

Palali, Ali; van Ours, Jan

2017-01-01

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

Clinical trials of medicinal cannabis for appetite-related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation.

Science.gov (United States)

Luckett, T; Phillips, J; Lintzeris, N; Allsop, D; Lee, J; Solowij, N; Martin, J; Lam, L; Aggarwal, R; McCaffrey, N; Currow, D; Chye, R; Lovell, M; McGregor, I; Agar, M

2016-11-01

Australian clinical trials are planned to evaluate medicinal cannabis in a range of clinical contexts. To explore the preferences, attitudes and beliefs of patients eligible and willing to consider participation in a clinical trial of medicinal cannabis for poor appetite and appetite-related symptoms from advanced cancer. A cross-sectional anonymous survey was administered from July to December 2015 online and in eight adult outpatient palliative care and/or cancer services. Respondents were eligible if they were ≥18 years, had advanced cancer and poor appetite/taste problems/weight loss and might consider participating in a medicinal cannabis trial. Survey items focused on medicinal rather than recreational cannabis use and did not specify botanical or pharmaceutical products. Items asked about previous medicinal cannabis use and preferences for delivery route and invited comments and concerns. There were 204 survey respondents, of whom 26 (13%) reported prior medicinal cannabis use. Tablets/capsules were the preferred delivery mode (n = 144, 71%), followed by mouth spray (n = 84, 42%) and vaporiser (n = 83, 41%). Explanations for preferences (n = 134) most commonly cited convenience (n = 66; 49%). A total of 82% (n = 168) of respondents indicated that they had no trial-related concerns, but a small number volunteered concerns about adverse effects (n = 14) or wanted more information/advice (n = 8). Six respondents volunteered a belief that cannabis might cure cancer, while two wanted assurance of efficacy before participating in a trial. Justification of modes other than tablets/capsules and variable understanding about cannabis and trials will need addressing in trial-related information to optimise recruitment and ensure that consent is properly informed. © 2016 Royal Australasian College of Physicians.

U-shaped curve of psychosis according to cannabis use: New evidence from a snowball sample.

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Brañas, Antía; Barrigón, María L; Garrido-Torres, Nathalia; Perona-Garcelán, Salvador; Rodriguez-Testal, Juan F; Lahera, Guillermo; Ruiz-Veguilla, Miguel

2016-12-01

The aim of this study was to investigate the relationship between psychotic-like experiences (PLEs) assessed using the Community Assessment of Psychic Experience (CAPE) questionnaire and the pattern of cannabis use in a non-clinical sample collected by snowball sampling. Our sample was composed of 204 subjects, distributed into three groups by their cannabis use pattern: 68 were non-cannabis users, 40 were moderate cannabis users and 96 were daily cannabis users. We assessed the psychotic experiences in each group with the CAPE questionnaire; and then controlled for the effect of possible confounding factors like sex, age, social exclusion, age of onset of cannabis use, alcohol use and other drug use. We found a significant quadratic association between the frequency of cannabis use and positive (β = -1.8; p = 0.004) and negative dimension scores (β = -1.2; p = 0.04). The first-rank and mania factors showed a significant quadratic association (p < 0.05), while the voices factor showed a trend (p = 0.07). Scores for the different groups tended to maintain a U-shape in their values for the different factors. When we adjusted for gender, age, social exclusion, age of onset of cannabis use, and use of alcohol and other drugs, only the first-rank experiences remained significant. We found there was a U-shaped curve in the association between cannabis use and the positive and negative dimensions of the CAPE score. We also found this association in mania and first-rank experiences. © The Author(s) 2016.

Patterns and correlates of cannabis use among individuals with HIV/AIDS in Maritime Canada

Science.gov (United States)

Harris, Gregory E; Dupuis, Lise; Mugford, Gerald J; Johnston, Lynn; Haase, David; Page, Ginny; Haldane, Heather; Harris, Nicholas; Midodzi, William K; Dow, Gordon

2014-01-01

BACKGROUND: The prevalence of cannabis use in HIV-infected individuals is high and its long-term effects are unclear. METHODS: The prevalence, perceived benefits and consequences, and predictors of cannabis use were studied using a cross-sectional survey in two immunodeficiency clinics in Maritime Canada. RESULTS: Current cannabis use was identified in 38.5% (87 of 226) of participants. Almost all cannabis users (85 of 87 [97.7%]) acknowledged its use for recreational purposes, with 21.8% (19 of 87) reporting medicinal cannabis use. The majority of patients enrolled in the present study reported mild or no symptoms related to HIV (n=179). Overall, 80.5% (70 of 87) of the cannabis-using participants reported a symptom-relieving benefit, mostly for relief of stress, anorexia or pain. Participants consumed a mean (± SD) of 18.3±21.1 g of cannabis per month and spent an average of $105.15±109.87 on cannabis per month. Cannabis use was associated with rural residence, lower income level, driving under the influence of a substance, and consumption of ecstasy and tobacco. Income level, ecstasy use and tobacco use were retained as significant predictors in regression modelling. Cannabis use was not associated with adverse psychological outcomes. DISCUSSION: Prolonged previous cannabis consumption and the substantial overlap between recreational and medicinal cannabis use highlight the challenges in obtaining a tenable definition of medicinal cannabis therapy. PMID:24634690

Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

Science.gov (United States)

Fiz, Jimena; Durán, Marta; Capellà, Dolors; Carbonell, Jordi; Farré, Magí

2011-04-21

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. 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). 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 (pcannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. 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.

The Cannabis Dilemma: A Review of Its Associated Risks and Clinical Efficacy

OpenAIRE

Zhang, Melvyn Weibin; Ho, Roger C. M.

2015-01-01

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 re...

Analysis of cannabis seizures in NSW, Australia: cannabis potency and cannabinoid profile.

Directory of Open Access Journals (Sweden)

Wendy Swift

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.

Cannabis use and adult ADHD symptoms.

Science.gov (United States)

Fergusson, David M; Boden, Joseph M

2008-05-01

The present study examined the associations between cannabis use in adolescence and young adulthood and self-reported adult attention deficit/hyperactivity disorder (ADHD) symptoms in adulthood. A 25-year prospective longitudinal study of the health, development, and adjustment of a birth cohort of 1265 New Zealand children. Measures included assessments of adolescent and young adult cannabis use and ADHD symptoms at age 25, measures of childhood socioeconomic disadvantage, family adversity, childhood and early adolescent behavioural adjustment and cognitive ability, and adolescent and young adult other drug use. Cannabis use by age 25 was significantly (pADHD symptoms at age 25. Adjustment of the association for potentially confounding factors from childhood and early adolescence reduced the magnitude of the association, but it remained statistically significant (pcannabis use and adult ADHD symptoms to statistical non-significance (p>.20). The current study suggested that the association between cannabis use and adult ADHD symptoms was mediated by other substance use that was associated with cannabis use. The results suggest that cannabis use leads to other drug use, which in turn leads to increased ADHD symptoms. However, it should be noted that the potential influence of such factors as genetic predispositions may still be unaccounted for.

Attitudes of cannabis growers to regulation of cannabis cultivation under a non-prohibition cannabis model.

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Lenton, Simon; Frank, Vibeke A; Barratt, Monica J; Dahl, Helle Vibeke; Potter, Gary R

2015-03-01

How cannabis cultivation is dealt with under various examples of cannabis legalization or regulation is an important consideration in design of such schemes. This study aimed to (i) investigate support among current or recent cannabis growers, for various potential policy options for cannabis cultivation if prohibition were repealed, and (ii) explore the support for these options across countries, scale of growing operations, demographics, drug use and cannabis supply involvement variables. This study utilized data from the online web survey of largely 'small-scale' cannabis cultivators, aged 18yrs and over, in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Data from 1722 current and recent cannabis growers in Australia, Denmark and the UK, who were all asked about policy, were included in the analysis. It investigated support for various frameworks for cultivation: (no regulation (free market); adult only; growing licenses; restrictions on plant numbers; licensed business-only sale; approved commercial growing; etc.). Among current growers, support for these options were compared across countries, across scale of growing operations, and by demographics, drug use and crime variables. Although there were some between country differences in support for the various policy options, what was striking was the similarity of the proportions for each of the eight most popular policy options. Among current growers, many of these positions were predicted by demographic, drug use and cannabis growing variables which were conceptually congruent with these positions. The results have relevance for the provisions regarding cannabis cultivation in the design of new non-prohibitionist models of cannabis which are increasingly under consideration. It should be of interest to policy makers, drug policy researchers, law enforcement and cannabis cultivators. Copyright © 2014 Elsevier B.V. All rights reserved.

Medicinal cannabis.

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Murnion, Bridin

2015-12-01

A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4.

Cannabis and tobacco smoke are not equally carcinogenic

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Melamede Robert

2005-10-01

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.

Role of cannabis in digestive disorders.

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Goyal, Hemant; Singla, Umesh; Gupta, Urvashi; May, Elizabeth

2017-02-01

Cannabis sativa, a subspecies of the Cannabis plant, contains aromatic hydrocarbon compounds called cannabinoids. [INCREMENT]-Tetrahydrocannabinol is the most abundant cannabinoid and is the main psychotropic constituent. Cannabinoids activate two types of G-protein-coupled cannabinoid receptors: cannabinoid type 1 receptor and cannabinoid type 2 receptor. There has been ongoing interest and development in research to explore the therapeutic potential of cannabis. [INCREMENT]-Tetrahydrocannabinol exerts biological functions on the gastrointestinal (GI) tract. Cannabis has been used for the treatment of GI disorders such as abdominal pain and diarrhea. The endocannabinoid system (i.e. endogenous circulating cannabinoids) performs protective activities in the GI tract and presents a promising therapeutic target against various GI conditions such as inflammatory bowel disease (especially Crohn's disease), irritable bowel syndrome, and secretion and motility-related disorders. The present review sheds light on the role of cannabis in the gut, liver, and pancreas and also on other GI symptoms, such as nausea and vomiting, cannabinoid hyperemesis syndrome, anorexia, weight loss, and chronic abdominal pain. Although the current literature supports the use of marijuana for the treatment of digestive disorders, the clinical efficacy of cannabis and its constituents for various GI disorders remains unclear.

Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

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Jimena Fiz

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.

Comparing adults who use cannabis medically with those who use recreationally: Results from a national sample.

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Lin, Lewei A; Ilgen, Mark A; Jannausch, Mary; Bohnert, Kipling M

2016-10-01

Cannabis has been legalized for medical use in almost half of the states in the U.S. Although laws in these states make the distinction between medical and recreational use of cannabis, the prevalence of people using medical cannabis and how distinct this group is from individuals using cannabis recreationally is unknown at a national level. Data came from the 2013 National Survey on Drug Use and Health (NSDUH). All adults endorsing past year cannabis use who reported living in a state that had legalized medical cannabis were divided into recreational cannabis use only and medical cannabis use. Demographic and clinical characteristics were compared across these two groups. 17% of adults who used cannabis in the past year used cannabis medically. There were no significant differences between those who used medically versus recreationally in race, education, past year depression and prevalence of cannabis use disorders. In adjusted analyses, those with medical cannabis use were more likely to have poorer health and lower levels of alcohol use disorders and non-cannabis drug use. A third of those who reported medical cannabis use endorsed daily cannabis use compared to 11% in those who reported recreational use exclusively. Adults who use medical and recreational cannabis shared some characteristics, but those who used medical cannabis had higher prevalence of poor health and daily cannabis use. As more states legalize cannabis for medical use, it is important to better understand similarities and differences between people who use cannabis medically and recreationally. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cannabis 'tinny' houses in New Zealand: implications for the use and sale of cannabis and other illicit drugs in New Zealand.

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Wilkins, Chris; Reilly, James L; Casswell, Sally

2005-07-01

To examine the impact of the emergence of cannabis 'tinny' houses on the use and sale of cannabis and other illicit drugs in New Zealand. A national sample of 5800 people aged 13-45 years were interviewed about their drug use using a computer-assisted telephone interview (CATI) system as part of the 2001 National Drug Survey. A question on cannabis procurement was used to create two subgroups of cannabis buyers for further analysis: (i) 'tinny' house buyers--those who had purchased 'some', 'most' or 'all' of their cannabis from a 'tinny' house (n = 145) and (ii) personal market buyers--those who had purchased 'none' or 'hardly any' of their cannabis from a 'tinny' house (n = 342). The two groups of cannabis buyers were compared for a range of variables. ['Tinny' houses are residential properties converted for the 'supermarket' sale of cannabis and other illicit drugs to anyone who attends the premises with cash.] Those purchasing cannabis from 'tinny' houses were significantly more likely than those purchasing cannabis from the personal market to smoke one joint or more on a typical occasion, to purchase cannabis weekly or more often, to purchase small weights of cannabis, to be sold lower quality cannabis than they paid for, to know their cannabis dealer sells other illicit drug types and to use high potency strains of cannabis. There was no significant difference between the 'tinny' house and personal market cannabis buyers with respect to the frequency of cannabis use, prices paid for the same weights of cannabis, levels of other victimization, levels of other drug use or levels of encouragement by cannabis sellers to purchase other drug types. Those purchasing cannabis from 'tinny' houses were more likely to be aged 15-17 years old and to be of Maori ethnicity than those purchasing cannabis from the personal market. Cannabis 'tinny' houses attracted more adolescent and more Maori clientele. However, 'tinny' houses did not appear to be contributing to the spread

Contribution of health motive to cannabis use among high-school students.

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Chabrol, Henri; Beck, Charline; Laconi, Stéphanie

2017-01-01

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. Copyright © 2016. Published by Elsevier Ltd.

Δ9-Tetrahydrocannabinol content in cannabis samples seized in Novi Sad during 2008

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MAJA DJURENDIĆ-BRENESEL

2010-07-01

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.

Cannabis-based medicines--GW pharmaceuticals: high CBD, high THC, medicinal cannabis--GW pharmaceuticals, THC:CBD.

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2003-01-01

conditions: pain in spinal cord injury, pain and sleep in MS and spinal cord injury, neuropathic pain in MS and general neuropathic pain (presented as allodynia). Results from these trials show that THC:CBD (narrow ratio) caused statistically significant reductions in neuropathic pain in patients with MS and other conditions. In addition, improvements in other MS symptoms were observed as well. Phase II studies of THC:CBD (narrow ratio) have also been completed in patients with MS, spinal cord injury, neuropathic pain and a small number of patients with peripheral neuropathy secondary to diabetes mellitus or AIDS. A phase II trial of THC:CBD (broad ratio) has also been completed in a small number of patients with rheumatoid arthritis, as has a trial of High CBD in patients with neurogenic symptoms. A phase II trial has also been evaluated with High THC in small numbers of patients for the treatment of perioperative pain. The phase II trials provided positive results and confirmed an excellent safety profile for cannabis-based medicines. GW Pharmaceuticals received an IND approval to commence phase II clinical trials in Canada in patients with chronic pain, multiple sclerosis and spinal cord injury in 2002. Following meetings with the US FDA, Drug Enforcement Agency (DEA), the Office for National Drug Control Policy, and National Institute for Drug Abuse, GW was granted an import license from the DEA and has imported its first cannabis extracts into the US. Preclinical research with these extracts in the US is ongoing.

Maternal use of cannabis and pregnancy outcome.

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Fergusson, David M; Horwood, L John; Northstone, Kate

2002-01-01

To document the prevalence of cannabis use in a large sample of British women studied during pregnancy, to determine the association between cannabis use and social and lifestyle factors and assess any independent effects on pregnancy outcome. Self-completed questionnaire on use of cannabis before and during pregnancy. Over 12,000 women expecting singletons at 18 to 20 weeks of gestation who were enrolled in the Avon Longitudinal Study of Pregnancy and Childhood. Any association with the use of cannabis before and during pregnancy with pregnancy outcome was examined, taking into account potentially confounding factors including maternal social background and other substance use during pregnancy. Late fetal and perinatal death, special care admission of the newborn infant, birthweight, birth length and head circumference. Five percent of mothers reported smoking cannabis before and/or during pregnancy; they were younger, of lower parity, better educated and more likely to use alcohol, cigarettes, coffee, tea and hard drugs. Cannabis use during pregnancy was unrelated to risk of perinatal death or need for special care, but, the babies of women who used cannabis at least once per week before and throughout pregnancy were 216 g lighter than those of non-users, had significantly shorter birth lengths and smaller head circumferences. After adjustment for confounding factors, the association between cannabis use and birthweight failed to be statistically significant (P = 0.056) and was clearly non-linear: the adjusted mean birthweights for babies of women using cannabis at least once per week before and throughout pregnancy were 90 g lighter than the offspring of other women. No significant adjusted effects were seen for birth length and head circumference. The results of this study suggest that the use of cannabis during pregnancy was not associated with increased risk of perinatal mortality or morbidity in this sample. However, frequent and regular use of cannabis

Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.

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Lucas, Philippe; Walsh, Zach

2017-04-01

In 2014 Health Canada replaced the Marihuana for Medical Access Regulations (MMAR) with the Marihuana for Medical Purposes Regulations (MMPR). One of the primary changes in the new program has been to move from a single Licensed Producer (LP) of cannabis to multiple Licensed Producers. This is the first comprehensive survey of patients enrolled in the MMPR. Patients registered to purchase cannabis from Tilray, a federally authorized Licenced Producer (LP) within the MMPR, were invited to complete an online survey consisting of 107 questions on demographics, patterns of use, and cannabis substitution effect. The survey was completed by 271 respondents. Cannabis is perceived to be an effective treatment for diverse conditions, with pain and mental health the most prominent. Findings include high self-reported use of cannabis as a substitute for prescription drugs (63%), particularly pharmaceutical opioids (30%), benzodiazepines (16%), and antidepressants (12%). Patients also reported substituting cannabis for alcohol (25%), cigarettes/tobacco (12%), and illicit drugs (3%). A significant percentage of patients (42%) reported accessing cannabis from illegal/unregulated sources in addition to access via LPs, and over half (55%) were charged to receive a medical recommendation to use cannabis, with nearly 25% paying $300 or more. The finding that patients report its use as a substitute for prescription drugs supports prior research on medical cannabis users; however, this study is the first to specify the classes of prescription drugs for which cannabis it is used as a substitute, and to match this substitution to specific diagnostic categories. The findings that some authorized patients purchase cannabis from unregulated sources and that a significant percentage of patients were charged for medical cannabis recommendations highlight ongoing policy challenges for this federal program. Copyright © 2017 Elsevier B.V. All rights reserved.

Two cases of "cannabis acute psychosis" following the administration of oral cannabis

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Pin Marie

2005-04-01

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.

Therapeutic benefits of cannabis: a patient survey.

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Webb, Charles W; Webb, Sandra M

2014-04-01

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.

CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience.

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Tzadok, Michal; Uliel-Siboni, Shimrit; Linder, Ilan; Kramer, Uri; Epstein, Orna; Menascu, Shay; Nissenkorn, Andrea; Yosef, Omer Bar; Hyman, Eli; Granot, Dorit; Dor, Michael; Lerman-Sagie, Tali; Ben-Zeev, Bruria

2016-02-01

To describe the experience of five Israeli pediatric epilepsy clinics treating children and adolescents diagnosed as having intractable epilepsy with a regimen of medical cannabis oil. A retrospective study describing the effect of cannabidiol (CBD)-enriched medical cannabis on children with epilepsy. The cohort included 74 patients (age range 1-18 years) with intractable epilepsy resistant to >7 antiepileptic drugs. Forty-nine (66%) also failed a ketogenic diet, vagal nerve stimulator implantation, or both. They all started medical cannabis oil treatment between 2-11/2014 and were treated for at least 3 months (average 6 months). The selected formula contained CBD and tetrahydrocannabinol at a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg/kg/d. Seizure frequency was assessed by parental report during clinical visits. CBD treatment yielded a significant positive effect on seizure load. Most of the children (66/74, 89%) reported reduction in seizure frequency: 13 (18%) reported 75-100% reduction, 25 (34%) reported 50-75% reduction, 9 (12%) reported 25-50% reduction, and 19 (26%) reported CBD withdrawal. In addition, we observed improvement in behavior and alertness, language, communication, motor skills and sleep. Adverse reactions included somnolence, fatigue, gastrointestinal disturbances and irritability leading to withdrawal of cannabis use in 5 patients. The results of this multicenter study on CBD treatment for intractable epilepsy in a population of children and adolescents are highly promising. Further prospective, well-designed clinical trials using enriched CBD medical cannabis are warranted. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Changes in tobacco consumption in cannabis dependent patients with schizophrenia versus non-psychiatric controls during 28-days of cannabis abstinence.

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Rabin, Rachel A; Dermody, Sarah S; George, Tony P

2018-04-01

Tobacco and cannabis are highly co-morbid in the general population and in patients with schizophrenia. Given the putative causal mechanisms facilitating co-use, it is important to determine how cannabis cessation may influence concurrent tobacco use. Using a 28-day cannabis abstinence paradigm, we prospectively examined changes in tobacco consumption in patients with schizophrenia and controls with cannabis dependence and daily cigarette use. Cannabis dependent patients with schizophrenia (n = 19) and controls (n = 20) completed the study with abstinence rates of 42% and 55%, respectively. Participants completed measures of substance use, withdrawal, and clinical symptoms weekly. Urine samples were collected twice weekly to biochemically verify abstinence. Patients reported a greater increase in cigarettes smoked per day (CPD) on Day 7 relative to baseline (2.97 cigarette increase for abstinent subgroup, p cannabis use related to greater increases in CPD relative to baseline in the patient subsample (simple slope = -2.31, p = .05), but by Day 28, CPD returned to baseline levels independent of cannabis use. CPD changes were unrelated to cannabis withdrawal. Results were similar for changes in caffeine consumption, but not for alcohol. Findings suggest transient tobacco substitution for cannabis in patients with schizophrenia. This provides further support for a strong association between cannabis and tobacco in schizophrenia. Future studies should focus on targeting underlying mechanisms that promote co-use to better address potential changes in concurrent substance use during treatment interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state.

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Smart, Rosanna; Caulkins, Jonathan P; Kilmer, Beau; Davenport, Steven; Midgette, Greg

2017-12-01

To (1) assess trends and variation in the market share of product types and potency sold in a legal cannabis retail market and (2) estimate how potency and purchase quantity influence price variation for cannabis flower. Secondary analysis of publicly available data from Washington State's cannabis traceability system spanning 7 July 2014 to 30 September 2016. Descriptive statistics and linear regressions assessed variation and trends in cannabis product variety and potency. Hedonic regressions estimated how purchase quantity and potency influence cannabis flower price variation. Washington State, USA. (1) A total of 44 482 176 million cannabis purchases, including (2) 31 052 123 cannabis flower purchases after trimming price and quantity outliers. Primary outcome measures were (1) monthly expenditures on cannabis, total delta-9-tetrahydrocannabinol (THC) concentration and cannabidiol (CBD) concentration by product type and (2) excise tax-inclusive price per gram of cannabis flower. Key covariates for the hedonic price regressions included quantity purchased, THC and CBD. Traditional cannabis flowers still account for the majority of spending (66.6%), but the market share of extracts for inhalation increased by 145.8% between October 2014 and September 2016, now comprising 21.2% of sales. The average THC-level for cannabis extracts is more than triple that for cannabis flowers (68.7% compared to 20.6%). For flower products, there is a statistically significant relationship between price per gram and both THC [coefficient = 0.012; 95% confidence interval (CI) = 0.011-0.013] and CBD (coefficient = 0.017; CI = 0.015-0.019). The estimated discount elasticity is -0.06 (CI = -0.07 to -0.05). In the state of Washington, USA, the legal cannabis market is currently dominated by high-THC cannabis flower, and features growing expenditures on extracts. For cannabis flower, both THC and CBD are associated with higher per-gram prices, and there are small but

Distance to Cannabis-Shops and Age of Onset of Cannabis Use

NARCIS (Netherlands)

Palali, A.; van Ours, J.C.

2013-01-01

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

The toxicology of cannabis and cannabis prohibition.

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Grotenhermen, Franjo

2007-08-01

The acute side effects caused by cannabis use are mainly related to psyche and cognition, and to circulation. Euphoria, anxiety, changes in sensory perception, impairment of memory and psychomotor performance are common effects after a dose is taken that exceeds an individually variable threshold. Cannabis consumption may increase heart rate and change blood pressure, which may have serious consequences in people with heart disease. Effects of chronic use may be induction of psychosis and development of dependency to the drug. Effects on cognitive abilities seem to be reversible after abstinence, except possibly in very heavy users. Cannabis exposure in utero may have negative consequences on brain development with subtle impairment of cognitive abilities in later life. Consequences of cannabis smoking may be similar to those of tobacco smoking and should be avoided. Use by young people has more detrimental effects than use by adults. There appear to be promising therapeutic uses of cannabis for a range of indications. Use of moderate doses in a therapeutic context is usually not associated with severe side effects. Current prohibition on cannabis use may also have harmful side effects for the individual and the society, while having little influence on prevalence of use. Harm is greatest for seriously ill people who may benefit from a treatment with cannabis. This makes it difficult to justify criminal penalties against patients.

Social Anxiety and Cannabis Use: An Analysis from Ecological Momentary Assessment

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Buckner, Julia D.; Crosby, Ross D.; Wonderlich, Stephen A.; Schmidt, Norman B.

2011-01-01

Individuals with elevated social anxiety appear especially vulnerable to cannabis-related problems, yet little is known about the antecedents of cannabis-related behaviors among this high-risk population. The present study used ecological momentary assessment (EMA) to examine the relations among social anxiety, cannabis craving, state anxiety, situational variables, and cannabis use in the natural environment during ad-lib cannabis use episodes. Participants were 49 current cannabis users. During the two-week EMA period, social anxiety significantly interacted with cannabis craving to predict cannabis use both cross-sectionally and prospectively. Specifically, individuals with higher social anxiety and craving were most likely to use cannabis. There was a significant social anxiety X state anxiety X others’ use interaction such that when others were using cannabis, those with elevations in both trait social anxiety and state anxiety were the most likely to use cannabis. PMID:22246109

How beneficial is vaping cannabis to respiratory health compared to smoking?

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Tashkin, Donald P

2015-11-01

While vaping cannabis reduces respiratory exposure to toxic particulates in cannabis smoke, the resultant reduction in clinically evident harms to lung health is probably smaller than that likely to result from substituting e-cigarettes for smoked tobacco due to the comparatively greater harms of tobacco than cannabis smoking to lung health.

Medicinal cannabis does not influence the clinical pharmacokinetics of irinotecan and docetaxel

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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)

2007-01-01

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

Cannabis sativa allergy: looking through the fog.

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Decuyper, I I; Van Gasse, A L; Cop, N; Sabato, V; Faber, M A; Mertens, C; Bridts, C H; Hagendorens, M M; De Clerck, L; Rihs, H P; Ebo, D G

2017-02-01

IgE-mediated Cannabis (C. sativa, marihuana) allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may trigger a C. sativa sensitization and/or allergy. The clinical presentation of a C. sativa allergy varies from mild to life-threatening reactions and often seems to depend on the route of exposure. In addition, sensitization to cannabis allergens can result in various cross-allergies, mostly for plant foods. This clinical entity, designated as the 'cannabis-fruit/vegetable syndrome', might also imply cross-reactivity with tobacco, natural latex and plant-food-derived alcoholic beverages. Hitherto, these cross-allergies are predominantly reported in Europe and appear mainly to rely upon cross-reactivity between nonspecific lipid transfer proteins or thaumatin-like proteins present in C. sativa and their homologues, ubiquitously distributed throughout plant kingdom. At present, diagnosis of cannabis-related allergies predominantly rests upon a thorough history completed with skin testing using native extracts from crushed 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. Whether avoidance of further use will halt the extension of related cross-allergies remains uncertain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of cannabis and other drugs on age at onset of psychosis.

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González-Pinto, Ana; Vega, Patricia; Ibáñez, Berta; Mosquera, Fernando; Barbeito, Sara; Gutiérrez, Miguel; Ruiz de Azúa, Sonia; Ruiz, Iván; Vieta, Eduard

2008-08-01

The aim of this study was to investigate the relationship between age and cannabis use in patients with a first psychotic episode, and to analyze the mediating effect of comorbid use of other drugs and sex on age at onset of psychosis. All consenting patients (aged 15 to 65 years) with a first psychotic episode needing inpatient psychiatric treatment during a 2-year period between February 1997 and January 1999 were considered, confirming a total of 131 patients. Subjects were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders, and clinical and demographic data were collected. We used general linear models with age at onset as the response variable and survival Cox models to confirm the results. Both a multivariate linear model and the corresponding Cox model were fitted with a covariate that summarizes the most significant contributors that seemed to decrease age at onset. Regarding the effect of cannabis use, a significant gradual reduction on age at onset was found as dependence on cannabis increased, consisting in a decrement of 7, 8.5, and 12 years for users, abusers, and dependents, respectively, with respect to nonusers (p = .004, p drugs or by gender. The finding was similar in the youngest patients, suggesting that this effect was not due to chance. The major contribution of this investigation is the independent and strong link between cannabis use and early age at onset of psychosis, and the slight or nonexistent effect of sex and comorbid substance abuse in this variable. These results point to cannabis as a dangerous drug in young people at risk of developing psychosis.

Abnormal maximal finger tapping in abstinent cannabis users.

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Flavel, Stanley C; White, Jason M; Todd, Gabrielle

2013-11-01

To investigate movement speed and rhythmicity in abstinent cannabis users, we hypothesized that abstinent cannabis users exhibit decreased maximal finger tapping frequency and increased variability of tapping compared with non-drug users. The study involved 10 healthy adult cannabis users and 10 age-matched and gender-matched controls with no history of illicit drug use. Subjects underwent a series of screening tests prior to participation. Subjects were then asked to tap a strain gauge as fast as possible with the index finger of their dominant hand (duration 5 s). The average intertap interval did not significantly differ between groups, but the coefficient of variation of the intertap interval was significantly greater in the cannabis group than in controls (p=0.011). The cannabis group also exhibited a slow tapping frequency at the beginning of the task. Rhythmicity of finger tapping is abnormal in individuals with a history of cannabis use. The abnormality appears to be long lasting and adds to the list of functional changes present in abstinent cannabis users. Copyright © 2013 John Wiley & Sons, Ltd.

Implicit associations and explicit expectancies towards cannabis in heavy cannabis users and controls

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Esther eBeraha

2013-06-01

Full Text Available 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 associations towards cannabis were measured with three Single Category Implicit Association Tests (SC-IAT’s and compared between 59 heavy cannabis users and 89 controls. Moreover, we investigated the relationship between these implicit affective associations and explicit expectancies, subjective craving, cannabis use, and cannabis related problems. Results show that heavy cannabis users had stronger implicit positive-arousal associations but weaker implicit negative associations towards cannabis compared to controls. Moreover, heavy cannabis users had stronger sedation but weaker negative explicit expectancies towards cannabis compared to controls. Within heavy cannabis users, more cannabis use was associated with stronger implicit negative associations whereas more cannabis use related problems was associated with stronger explicit negative expectancies, decreasing the overall difference on negative associations between cannabis users and controls. No other associations were observed between implicit associations, explicit expectancies, measures of cannabis use, cannabis use related problems, or subjective craving. These findings indicate that, in contrast to other substances of abuse like alcohol and tobacco, the relationship between implicit associations and cannabis use appears to be weak in heavy cannabis users.

The association between lifetime cannabis use and dysthymia across six birth decades.

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Livne, Ofir; Razon, Liat; Rehm, Jürgen; Hasin, Deborah S; Lev-Ran, Shaul

2018-07-01

Though high rates of co-occurring cannabis use and depression are well-documented, data regarding the association between cannabis use and dysthymia is scarce. The aim of this cross-sectional study was to explore clinical correlations of cannabis use among individuals with dysthymia, as well as the changes in the association between cannabis use and dysthymia across six decades of birth cohorts. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013; N = 36,309). Participants were divided into six birth cohorts (1940s-1990s), based on their decade of birth, and individuals with dysthymia were further categorized by 3 levels of lifetime cannabis use: non-users, non-CUD users, and CUD-users. We compared rates of co-occurring psychiatric and substance use disorders among cannabis users vs non-users and conducted logistic regression analyses in order to determine the odds of dysthymia among cannabis users across six decades. Rates of several psychiatric disorders, such as personality disorders, and substance use disorders were higher among individuals with dysthymia who used cannabis compared to those who did not. The interaction between cannabis use (without a CUD) and birth cohort was associated with a decrease in the odds of dysthymia (OR=0.90, 95% CI 0.84-0.97) and remained significant after controlling for confounding variables. Similar changes over time were not demonstrated for CUD users. Likelihood for recall bias and misclassification based on cross-sectional nature of the study and on respondents' self-reports of symptoms throughout their lifetime. Our study's findings demonstrate that the association between cannabis use (but not CUDs) and dysthymia has weakened over time. These findings highlight the need for further research examining changes over time in the relationship between cannabis use and associated psychiatric disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

Prescribing medical cannabis in Canada: Are we being too cautious?

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Lake, Stephanie; Kerr, Thomas; Montaner, Julio

2015-04-30

There has been much recent discussion and debate surrounding cannabis in Canada, including the prescribing of medical cannabis for therapeutic purposes. Certain commentators - including the Canadian Medical Association (CMA) - have denounced the prescribing of cannabis for medical purposes due to a perceived lack of evidence related to the drug's efficacy, harms, and mechanism of action. In this commentary, we present arguments in favour of prescribing medical cannabis in Canada. We believe the anti-cannabis position taken by CMA and other commentators is not entirely evidence-based. Using the example of neuropathic pain, we present and summarize the clinical evidence surrounding smoked or vapourized cannabis, including recent evidence pertaining to the effectiveness of cannabis in comparison to existing standard pharmacotherapies for neuropathy. Further, we outline how the concerns expressed regarding cannabis' mechanism of action are inconsistent with current decision-making processes related to the prescribing of many common pharmaceuticals. Finally, we discuss potential secondary public health benefits of prescribing cannabis for pain-related disorders in Canada and North America.

Medicinal cannabis does not influence the clinical pharmacokinetics of irinotecan and docetaxel

NARCIS (Netherlands)

Engels, Frederike K.; de Jong, Floris A.; Sparreboom, Alex; Mathot, Ron A. A.; Loos, Walter J.; Kitzen, Jos J. E. M.; de Bruijn, Peter; Verweij, Jaap; Mathijssen, Ron H. J.

2007-01-01

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 concurrent with anticancer

US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws: 1991-1992 to 2012-2013.

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Hasin, Deborah S; Sarvet, Aaron L; Cerdá, Magdalena; Keyes, Katherine M; Stohl, Malka; Galea, Sandro; Wall, Melanie M

2017-06-01

Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time. To present national data on state MML and degree of change in the prevalence of cannabis use and disorders. Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Early-MML states passed MML between NLAES and NESARC ("earlier period"). Late-MML states passed MML between NESARC and NESARC-III ("later period"). Past-year illicit cannabis use and DSM-IV cannabis use disorder. Overall, from 1991-1992 to 2012-2013, illicit cannabis use increased significantly more in states that passed MML than in other states (1.4-percentage point more; SE, 0.5; P = .004), as did cannabis use disorders (0.7-percentage point more; SE, 0.3; P = .03). In the earlier period, illicit cannabis use and disorders decreased similarly in non-MML states and in California (where prevalence was much higher to start with). In contrast, in remaining early-MML states, the prevalence of use and disorders increased. Remaining early-MML and non-MML states differed significantly for use (by 2.5 percentage points; SE, 0.9; P = .004) and disorder (1.1 percentage points; SE, 0.5; P = .02). In the later period, illicit use increased by the following percentage points: never-MML states, 3.5 (SE, 0.5); California, 5.3 (SE, 1.0); Colorado, 7.0 (SE, 1.6); other early-MML states, 2.6 (SE, 0.9); and late-MML states, 5.1 (SE, 0.8). Compared with never-MML states, increases in use were

Psychomotor performance, subjective and physiological effects and whole blood Δ⁹-tetrahydrocannabinol concentrations in heavy, chronic cannabis smokers following acute smoked cannabis.

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Schwope, David M; Bosker, Wendy M; Ramaekers, Johannes G; Gorelick, David A; Huestis, Marilyn A

2012-07-01

Δ⁹-Tetrahydrocannabinol (THC) is the illicit drug most frequently observed in accident and driving under the influence of drugs investigations. Whole blood is often the only available specimen collected during such investigations, yet few studies have examined relationships between cannabis effects and whole blood concentrations following cannabis smoking. Nine male and one female heavy, chronic cannabis smokers resided on a closed research unit and smoked ad libitum one 6.8% THC cannabis cigarette. THC, 11-hydroxy-THC and 11-nor-9-carboxy-THC were quantified in whole blood and plasma. Assessments were performed before and up to 6 h after smoking, including subjective [visual analog scales (VAS) and Likert scales], physiological (heart rate, blood pressure and respirations) and psychomotor (critical-tracking and divided-attention tasks) measures. THC significantly increased VAS responses and heart rate, with concentration-effect curves demonstrating counter-clockwise hysteresis. No significant differences were observed for critical-tracking or divided-attention task performance in this cohort of heavy, chronic cannabis smokers. The cannabis influence factor was not suitable for quantifying psychomotor impairment following cannabis consumption and was not precise enough to determine recent cannabis use with accuracy. These data inform our understanding of impairment and subjective effects following acute smoked cannabis and interpretation of whole blood cannabinoid concentrations in forensic investigations.

Cannabis and Breastfeeding

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Aurélia Garry

2009-01-01

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 Dilemma: A Review of Its Associated Risks and Clinical Efficacy.

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Zhang, Melvyn Weibin; Ho, Roger C M

2015-01-01

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.

The Cannabis Dilemma: A Review of Its Associated Risks and Clinical Efficacy

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Melvyn Weibin Zhang

2015-01-01

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.

Cannabis use predicts shorter duration of untreated psychosis and ...

African Journals Online (AJOL)

Objective: Cannabis use/abuse is a common co-morbid problem in patients experiencing a first episode of psychotic illness (FEP). The relationship between the clinical presentation of FEP and cannabis abuse is complex and warrants further investigation, especially within the South African context. Method: We tested ...

Sintomas depressivos e uso de Cannabis em adolescentes Síntomas depresivos en adolescentes usuarios de Cannabis Depressive symptoms in young Cannabis users

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Tânia Moraes Ramos Andrade

2008-09-01

áctica clínica como también en programas de prevención que aborden de forma simultánea estos síntomas/trastornos en este período de la vida.The association between depressive symptoms and cannabis use is investigated. Due to the fact that depression has been a common psyquiatric disorder in adolescence, depressive cases usually present high rates of psychiatric comorbidities and the abuse of psychoactive substances is frequent. Systematic review, studies at PsycInfo, ProQuest, Web of Science and Lilacs databases analyzed between 2000 and 2005 are discussed. Results show that nine out of the thirty-six studies discuss depression and cannabis use or addiction in adolescents. Whereas the association between depressive symptoms and the use of cannabis during adolescence is confirmed, it is more frequent in an early and continuous cannabis use. Research shows that depressive symptoms are related to cannabis use, abuse and dependence during adolescence. Abovementioned variables must be investigated in clinical practice and in prevention programs that simultaneously focus on these disorders.

Statistics on cannabis users skew perceptions of cannabis use

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Rachel Melissa Burns

2013-11-01

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.

In silico gene expression profiling in Cannabis sativa.

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Massimino, Luca

2017-01-01

The cannabis plant and its active ingredients (i.e., cannabinoids and terpenoids) have been socially stigmatized for half a century. Luckily, with more than 430,000 published scientific papers and about 600 ongoing and completed clinical trials, nowadays cannabis is employed for the treatment of many different medical conditions. Nevertheless, even if a large amount of high-throughput functional genomic data exists, most researchers feature a strong background in molecular biology but lack advanced bioinformatics skills. In this work, publicly available gene expression datasets have been analyzed giving rise to a total of 40,224 gene expression profiles taken from cannabis plant tissue at different developmental stages. The resource presented here will provide researchers with a starting point for future investigations with Cannabis sativa .

[Medicinal cannabis].

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Van der Meersch, H; Verschuere, A P; Bottriaux, F

2006-01-01

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.

Cannabis withdrawal in chronic, frequent cannabis smokers during sustained abstinence within a closed residential environment.

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Lee, Dayong; Schroeder, Jennifer R; Karschner, Erin L; Goodwin, Robert S; Hirvonen, Jussi; Gorelick, David A; Huestis, Marilyn A

2014-01-01

Chronic, frequent cannabis smokers may experience residual and offset effects, withdrawal, and craving when abstaining from the drug. We characterized the prevalence, duration, and intensity of these effects in chronic frequent cannabis smokers during abstinence on a closed research unit. Non-treatment-seeking participants (N = 29 on admission, 66% and 34% remaining after 2 and 4 weeks) provided subjective effects data. A battery of five instruments was computer-administered daily to measure psychological, sensory, and physical symptoms associated with cannabinoid intoxication and withdrawal. Plasma and oral fluid specimens were concurrently collected and analyzed for cannabinoids. Outcome variables were evaluated as change from admission (Day 0) with regression models. Most abstinence effects, including irritability and anxiety were greatest on Days 0-3 and decreased thereafter. Cannabis craving significantly decreased over time, whereas decreased appetite began to normalize on Day 4. Strange dreams and difficulty getting to sleep increased over time, suggesting intrinsic sleep problems in chronic cannabis smokers. Symptoms likely induced by residual drug effects were at maximum intensity on admission and positively correlated with plasma and oral fluid cannabinoid concentrations on admission but not afterward; these symptoms showed overall prevalence higher than cannabis withdrawal symptoms. The combined influence of residual/offset drug effects, withdrawal, and craving was observed in chronic cannabis smokers during monitored abstinence. Abstinence symptoms were generally more intense in the initial phase, implying importance of early intervention in cannabis quit attempts. Sleep disturbance persisting for an extended period suggests that hypnotic medications could be beneficial in treating cannabis dependence. © American Academy of Addiction Psychiatry.

Pharmacology and toxicology of Cannabis derivatives and endocannabinoid agonists.

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Gerra, Gilberto; Zaimovic, Amir; Gerra, Maria L; Ciccocioppo, Roberto; Cippitelli, Andrea; Serpelloni, Giovanni; Somaini, Lorenzo

2010-01-01

For centuries Cannabis sativa and cannabis extracts have been used in natural medicine. Delta(9)-tetrahydrocannabinol (THC) is the main active ingredient of Cannabis. THC seems to be responsible for most of the pharmacological and therapeutic actions of cannabis. In a few countries THC extracts (i.e. Sativex) or THC derivatives such as nabilone, and dronabinol are used in the clinic for the treatment of several pathological conditions like chemotherapy-induced nausea and vomiting, multiple sclerosis and glaucoma. On the other hand the severe side effects and the high abuse liability of these agents represent a serious limitation in their medical use. In addition, diversion in the use of these active ingredients for recreational purpose is a concern. Over recent years, alternative approaches using synthetic cannabinoid receptor agonists or agents acting as activators of the endocannabinoid systems are under scrutiny with the hope to develop more effective and safer clinical applications. Likely, in the near future few of these new molecules will be available for clinical use. The present article review recent study and patents with focus on the cannabinoid system as a target for the treatment of central nervous system disorders with emphasis on agonists.

Cannabis Involvement and Nonsuicidal Self-Injury: A Discordant Twin Approach.

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Few, Lauren R; Grant, Julia D; Nelson, Elliot C; Trull, Timothy J; Grucza, Richard A; Bucholz, Kathleen K; Verweij, Karin J H; Martin, Nicholas G; Statham, Dixie J; Madden, Pamela A F; Heath, Andrew C; Lynskey, Michael T; Agrawal, Arpana

2016-11-01

Cannabis use, particularly at an early age, has been linked to suicidal thoughts and behavior, but minimal work has examined the association between cannabis use and lifetime nonsuicidal self-injury (NSSI). The current study aims to characterize the overlap between lifetime and early cannabis use and NSSI and to examine genetic and environmental mechanisms of this association. Adult male and female twins from the Australian Twin Registry (N = 9,583) were used to examine the odds of NSSI associated with lifetime cannabis use and early cannabis use (i.e., accounting for the age at onset of cannabis use and NSSI. Lifetime cannabis use (odds ratio [OR] = 2.84, 95% CI [2.23, 3.61]) and early cannabis use were associated with increased odds of NSSI (OR = 2.15, 95% CI [1.75, 2.65]), and this association remained when accounting for covariates. The association was only significant, however, in MZ twin pairs discordant for early cannabis use (OR = 3.20, 95% CI [1.17, 8.73]). Replication analyses accounting for the temporal ordering of cannabis use and NSSI yielded similar findings of nominal significance. Results suggest that NSSI is associated with cannabis involvement via differing mechanisms. For lifetime cannabis use, the lack of association in discordant pairs suggests the role of shared genes and family environment. However, in addition to such shared familial influences, person-specific and putatively causal factors contribute to the relationship between early cannabis use and NSSI. Therefore, delaying the onset of cannabis use may reduce exposure to influences that exacerbate vulnerabilities to NSSI.

Blunted stress reactivity in chronic cannabis users.

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Cuttler, Carrie; Spradlin, Alexander; Nusbaum, Amy T; Whitney, Paul; Hinson, John M; McLaughlin, Ryan J

2017-08-01

One of the most commonly cited reasons for chronic cannabis use is to cope with stress. Consistent with this, cannabis users have shown reduced emotional arousal and dampened stress reactivity in response to negative imagery. To our knowledge, the present study represents the first to examine the effects of an acute stress manipulation on subjective stress and salivary cortisol in chronic cannabis users compared to non-users. Forty cannabis users and 42 non-users were randomly assigned to complete either the stress or no stress conditions of the Maastricht Acute Stress Test (MAST). The stress condition of the MAST manipulates both physiological (placing hand in ice bath) and psychosocial stress (performing math under conditions of social evaluation). Participants gave baseline subjective stress ratings before, during, and after the stress manipulation. Cortisol was measured from saliva samples obtained before and after the stress manipulation. Further, cannabis cravings and symptoms of withdrawal were measured. Subjective stress ratings and cortisol levels were significantly higher in non-users in the stress condition relative to non-users in the no stress condition. In contrast, cannabis users demonstrated blunted stress reactivity; specifically, they showed no increase in cortisol and a significantly smaller increase in subjective stress ratings. The stress manipulation had no impact on cannabis users' self-reported cravings or withdrawal symptoms. Chronic cannabis use is associated with blunted stress reactivity. Future research is needed to determine whether this helps to confer resiliency or vulnerability to stress-related psychopathology as well as the mechanisms underlying this effect.

Using Ecological Momentary Assessment to Identify Mechanisms of Change: An Application From a Pharmacotherapy Trial With Adolescent Cannabis Users.

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Treloar Padovano, Hayley; Miranda, Robert

2018-03-01

The present study used youth's in vivo reports of subjective responses to cannabis while smoking in their natural environments to identify real-world mechanisms of topiramate treatment for cannabis misuse. Participants were 40 cannabis users (≥ twice weekly in past 30 days), ages 15-24 years (47.5% female), with at least one cannabis use episode during the final 3 weeks of a 6-week, randomized clinical trial. Youth reported subjective "high" while smoking, stimulation, sedation, stress, craving, and grams of marijuana used in the natural environment via wireless electronic devices. Bayesian multilevel structural equation modeling (MSEM) evaluated mediation via indirect effect tests. Significant within (daily) and between (person) variability and distinctive within and between effects supported the MSEM approach. Subjective high while smoking was significantly reduced for youth in the topiramate condition, relative to placebo, and the indirect effect of reduced subjective high on total grams of cannabis smoked that day was significant. Indirect effects through other subjective responses were not significant. The results of this initial study suggest that altering subjective responses to smoking, specifically subjective high, may be a key target for developing adjunctive pharmacotherapies for cannabis misuse. More generally, this work provides an example for applying ecological momentary assessment and analytic techniques to evaluate mechanisms of behavior change in longitudinal data.

The Mediating Roles of Coping, Sleep, and Anxiety Motives in Cannabis Use and Problems among Returning Veterans with PTSD and MDD

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Metrik, Jane; Jackson, Kristina; Bassett, Shayna S.; Zvolensky, Michael J.; Seal, Karen; Borsari, Brian

2016-01-01

Veterans with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), the two most prevalent mental health disorders in the Iraq and Afghanistan veterans, are at increased risk for cannabis use and problems including cannabis use disorder (CUD). The present study examined the relationship of PTSD and MDD with cannabis use frequency, cannabis problems, and CUD as well as the role of three coping-oriented cannabis use motives (coping with negative affect, situational anxiety, and sleep) that might underlie this relationship. Participants were veterans (N = 301) deployed post 9/11/2001 recruited from Veterans Health Administration facility in the Northeast US based on self-reported lifetime cannabis use. There were strong unique associations between PTSD and MDD and cannabis use frequency, cannabis problems, and CUD. Mediation analyses revealed the three motives accounted, in part, for the relationship between PTSD and MDD with three outcomes in all cases but for PTSD with cannabis problems. When modeled concurrently, sleep motives, but not situational anxiety or coping with negative affect motives, significantly mediated the association between PTSD and MDD with use. Together with coping motives, sleep motives also fully mediated the effects of PTSD and MDD on CUD and in part the effect of MDD on cannabis problems. Findings indicate the important role of certain motives for better understanding the relation between PTSD and MDD with cannabis use and misuse. Future work is needed to explore the clinical utility in targeting specific cannabis use motives in the context of clinical care for mental health and CUD. PMID:27786514

Cannabis intoxication in three Green iguanas (Iguana iguana).

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Girling, S J; Fraser, M A

2011-02-01

This report describes clinical signs and plasma biochemical changes associated with significant cannabis consumption in three Green iguanas (Iguana iguana) which resulted in seizures, cardiovascular and digestive tract aberrations, elevated hepatic enzymes and bile acid concentrations for a number of weeks post recovery. One case required extensive antiseizuring therapy to recover. All Green iguanas eventually made a full recovery. © 2011 British Small Animal Veterinary Association.

Negative consequences associated with dependence in daily cannabis users

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Earleywine Mitch

2007-01-01

Full Text Available Abstract Background Cannabis is the most widely consumed illicit substance in America, with increasing rates of use. Some theorists tend to link frequency of use with cannabis dependence. Nevertheless, fewer than half of daily cannabis users meet DSM-IV-TR criteria for cannabis dependence. This study seeks to determine whether the negative aspects associated with cannabis use can be explained by a proxy measure of dependence instead of by frequency of use. Results Over 2500 adult daily cannabis users completed an Internet survey consisting of measures of cannabis and other drug use, in addition to measures of commonly reported negative problems resulting from cannabis use. We compared those who met a proxy measure of DSM-IV-TR criteria for cannabis dependence (N = 1111 to those who did not meet the criteria (N = 1770. Cannabis dependent subjects consumed greater amounts of cannabis, alcohol, and a variety of other drugs. They also had lower levels of motivation, happiness, and satisfaction with life, with higher levels of depression and respiratory symptoms. Conclusion Although all of our subjects reported daily use, only those meeting proxy criteria for cannabis dependence reported significant associated problems. Our data suggest that dependence need not arise from daily use, but consuming larger amounts of cannabis and other drugs undoubtedly increases problems.

A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome.

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Tripp, Dean A; Nickel, J Curtis; Katz, Laura; Krsmanovic, Adrijana; Ware, Mark A; Santor, Darcy

2014-11-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic pelvic pain condition largely refractory to treatment. Cannabis (marijuana) use has been reported for a wide variety of chronic pain conditions, but no study has examined prevalence of cannabis use, symptom benefit or side effects, or frequency in CP/CPPS. Participants were recruited from an outpatient CP/CPPS urology clinic (n = 98) and online through the Prostatitis Foundation website (n = 244). Participants completed questionnaires (demographics, CP/CPPS, depression, cannabis). The clinic sample included Canadian patients and the online sample included primarily American patients. Due to differences, groups were examined separately. Almost 50% of respondents reported using cannabis (clinic n = 49; online n = 89). Of the cannabis users, 36.8% of clinic and 75% of online respondents reported that it improved their symptoms. Most of the respondents (from the clinic and online groups) reported that cannabis improved their mood, pain, muscle spasms, and sleep. However, they did not note any improvements for weakness, fatigue, numbness, ambulation, and urination. Overall, the effectiveness of cannabis for CP/CPPS was "somewhat/very effective" (57% clinic; 63% online). There were no differences between side effects or choice of consumption and most reported using cannabis rarely. These are the first estimates in men suffering from CP/CPPS and suggest that while cannabis use is prevalent, its medical use and benefit are unknown. This is an understudied area and the benefit or hazard for cannabis use awaits further study.

Roadside sobriety tests and attitudes toward a regulated cannabis market

Directory of Open Access Journals (Sweden)

Earleywine Mitch

2007-01-01

Full Text Available Abstract Background Many argue that prohibition creates more troubles than alternative policies, but fewer than half of American voters support a taxed and regulated market for cannabis. Some oppose a regulated market because of concerns about driving after smoking cannabis. Although a roadside sobriety test for impairment exists, few voters know about it. The widespread use of a roadside sobriety test that could detect recent cannabis use might lead some voters who currently oppose a regulated market to support it. In contrast, a question that primes respondents about the potential for driving after cannabis use might lead respondents to be less likely to support a regulated market. Methods Phone interviews with a national sample of 1002 registered voters asked about support for a regulated cannabis market and support for such a market if a reliable roadside sobriety test were widely available. Results In this sample of registered voters, 36% supported a regulated cannabis market. Exploratory chi-square tests revealed significantly higher support among men and Caucasians but no link to age or education. These demographic variables covaried significantly. Logistic regression revealed that gender, ethnicity, and political party were significant when all predictors were included. Support increased significantly with a reliable roadside sobriety test to 44%, but some respondents who had agreed to the regulated market no longer agreed when the sobriety test was mentioned. Logistic regression revealed that ethnicity and political affiliation were again significant predictors of support with a reliable sobriety test, but gender was no longer significant. None of these demographic variables could identify who would change their votes in response to the reliable roadside test. Conclusion Increased awareness and use of roadside sobriety tests that detect recent cannabis use could increase support for a regulated cannabis market. Identifying concerns of

Cannabis Smoking in 2015: A Concern for Lung Health?

Science.gov (United States)

Biehl, Jason R; Burnham, Ellen L

2015-09-01

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.

Adverse health effects of non-medical cannabis use.

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Hall, Wayne; Degenhardt, Louisa

2009-10-17

For over two decades, cannabis, commonly known as marijuana, has been the most widely used illicit drug by young people in high-income countries, and has recently become popular on a global scale. Epidemiological research during the past 10 years suggests that regular use of cannabis during adolescence and into adulthood can have adverse effects. Epidemiological, clinical, and laboratory studies have established an association between cannabis use and adverse outcomes. We focus on adverse health effects of greatest potential public health interest-that is, those that are most likely to occur and to affect a large number of cannabis users. The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.

Sex-dependent effects of cannabis-induced analgesia.

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Cooper, Ziva D; Haney, Margaret

2016-10-01

Preclinical studies demonstrate that cannabinoid-mediated antinociceptive effects vary according to sex; it is unknown if these findings extend to humans. This retrospective analysis compared the analgesic, subjective and physiological effects of active cannabis (3.56-5.60% THC) and inactive cannabis (0.00% THC) in male (N=21) and female (N=21) cannabis smokers under double-blind, placebo-controlled conditions. Pain response was measured using the Cold-Pressor Test (CPT). Participants immersed their hand in cold water (4°C); times to report pain (pain sensitivity) and withdraw the hand (pain tolerance) were recorded. Subjective drug ratings were also measured. Among men, active cannabis significantly decreased pain sensitivity relative to inactive cannabis (pcannabis failed to decrease pain sensitivity relative to inactive. Active cannabis increased pain tolerance in both men women immediately after smoking (pcannabis also increased subjective ratings of cannabis associated with abuse liability ('Take again,' 'Liking,' 'Good drug effect'), drug strength, and 'High' relative to inactive in both men and women (pcannabis smokers, men exhibit greater cannabis-induced analgesia relative to women. These sex-dependent differences are independent of cannabis-elicited subjective effects associated with abuse-liability, which were consistent between men and women. As such, sex-dependent differences in cannabis's analgesic effects are an important consideration that warrants further investigation when considering the potential therapeutic effects of cannabinoids for pain relief. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychosis and cannabis

Directory of Open Access Journals (Sweden)

Heinz Häfner

2005-01-01

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.

Medical Cannabis in Arizona: Patient Characteristics, Perceptions, and Impressions of Medical Cannabis Legalization.

Science.gov (United States)

Troutt, William D; DiDonato, Matthew D

2015-01-01

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.

The dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users.

Science.gov (United States)

Vandrey, Ryan; Stitzer, Maxine L; Mintzer, Miriam Z; Huestis, Marilyn A; Murray, Jeannie A; Lee, Dayong

2013-02-01

Prior studies have separately examined the effects of dronabinol (oral THC) on cannabis withdrawal, cognitive performance, and the acute effects of smoked cannabis. A single study examining these clinically relevant domains would benefit the continued evaluation of dronabinol as a potential medication for the treatment of cannabis use disorders. Thirteen daily cannabis smokers completed a within-subject crossover study and received 0, 30, 60 and 120mg dronabinol per day for 5 consecutive days. Vital signs and subjective ratings of cannabis withdrawal, craving and sleep were obtained daily; outcomes under active dose conditions were compared to those obtained under placebo dosing. On the 5th day of medication maintenance, participants completed a comprehensive cognitive performance battery and then smoked five puffs of cannabis for subjective effects evaluation. Each dronabinol maintenance period occurred in a counterbalanced order and was separated by 9 days of ad libitum cannabis use. Dronabinol dose-dependently attenuated cannabis withdrawal and resulted in few adverse side effects or decrements in cognitive performance. Surprisingly, dronabinol did not alter the subjective effects of smoked cannabis, but cannabis-induced increases in heart rate were attenuated by the 60 and 120mg doses. Dronabinol's ability to dose-dependently suppress cannabis withdrawal may be therapeutically beneficial to individuals trying to stop cannabis use. The absence of gross cognitive impairment or side effects in this study supports safety of doses up to 120mg/day. Continued evaluation of dronabinol in targeted clinical studies of cannabis treatment, using an expanded range of doses, is warranted. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Cannabis use during a voluntary quit attempt: an analysis from ecological momentary assessment.

Science.gov (United States)

Buckner, Julia D; Zvolensky, Michael J; Ecker, Anthony H

2013-10-01

There is little research that has sought to identify factors related to quit success and failure among cannabis users. The current study examined affective, cognitive, and situational factors related to cannabis use among current cannabis users undergoing a voluntary, self-guided quit attempt. The sample consisted of 30 (33% female) current cannabis users, 84% of whom evinced a current cannabis use disorder. Ecological momentary assessment was used to collect multiple daily ratings of cannabis withdrawal, negative affect, peer cannabis use, reasons for use, and successful coping strategies over two weeks. Findings from generalized linear models indicated that cannabis withdrawal and positive and negative affect were significantly higher during cannabis use than non-use episodes. Additionally, when negative and positive affect were entered simultaneously, negative affect, but not positive affect, remained significantly related to use. Participants were significantly more likely to use in social situations than when alone. When participants were in social situations, they were significantly more likely to use if others were using. Participants tended to use more behavioral than cognitive strategies to abstain from cannabis. The most common reason for use was to cope with negative affect. Overall, these novel findings indicate that cannabis withdrawal, affect (especially negative affect), and peer use play important roles in cannabis use among self-quitters. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

No significant effect of cannabis use on the count and percentage of circulating CD4 T-cells in HIV-HCV co-infected patients (ANRS CO13-HEPAVIH French cohort).

Science.gov (United States)

Marcellin, Fabienne; Lions, Caroline; Rosenthal, Eric; Roux, Perrine; Sogni, Philippe; Wittkop, Linda; Protopopescu, Camelia; Spire, Bruno; Salmon-Ceron, Dominique; Dabis, François; Carrieri, Maria Patrizia

2017-03-01

Despite cannabis use being very common in patients co-infected with HIV and hepatitis C virus (HCV), its effect on these patients' immune systems remains undocumented. Documenting the potential effect of cannabis use on HIV immunological markers would help caregivers make more targeted health recommendations to co-infected patients. We performed a longitudinal analysis of the relationship between cannabis use and peripheral blood CD4 T-cell measures in co-infected patients receiving antiretroviral therapy. Cannabis use was assessed using annual self-administered questionnaires in 955 patients (2386 visits) enrolled in the ANRS CO13-HEPAVIH cohort. The effect of cannabis use on circulating CD4 T-cell count and percentage was estimated using multivariate linear regression models with generalised estimating equations. Sensitivity analyses were conducted after excluding visits where (i) tobacco use and (ii) smoking >=10 tobacco cigarettes/day were reported. At the first visit, 48% of patients reported cannabis use during the previous four weeks, and 58% of these patients also smoked ≥10 tobacco cigarettes/day. After multiple adjustment, cannabis use was not significantly associated with either circulating CD4 T-cell count [model coefficient (95% confidence interval): 0.27 (-0.07; 0.62), P = 0.12] or percentage [-0.04 (-0.45; 0.36), P = 0.83]. Sensitivity analyses confirmed these results. Findings show no evidence for a negative effect of cannabis use on circulating CD4 T-cell counts/percentages in HIV-HCV co-infected patients. In-depth immunological studies are needed to document whether cannabis has a harmful effect on CD4 levels in lungs and on cells' functional properties. [Marcellin F, Lions C, Rosenthal E, Roux P, Sogni P, Wittkop L, Protopopescu C, Spire B, Salmon-Ceron D, Dabis F, Carrieri MP, HEPAVIH ANRS CO13 Study Group. No significant effect of cannabis use on the count and percentage of circulating CD4 T-cells in HIV-HCV co-infected patients

[Motivations for cannabis cessation, coping and adaptation strategies, and perceived benefits: impact on cannabis use relapse and abstinence].

Science.gov (United States)

Chauchard, E; Septfons, A; Chabrol, H

2013-12-01

energetic (reported by 68%) and more active during the day (62%), being able to control their life (67%), proving themselves they could quit (60%), saving money (60%), as well being less worried about their health (57%) were also reported as motivations to quit cannabis use. Different coping and adaptation strategies were also reported. First, environmental strategies such as disposing of both cannabis (71%) and equipment to smoke (71%), no longer going to places where cannabis is smoked (33%) or lifestyle changes (68%) were used to cope with cannabis cessation. Then cognitive strategies such as motivation, willingness (71%), self-control and having a positive perception of the situation (68%) were also reported. Regarding coping strategies, participants accepted and learned how to live with the new situation (68%), and social support from family (32%) and friends (30%) were reported. Perceived benefits were linked with motivations for cannabis cessation. Thus, participants reported having more energy (75%), being more active (73%), less tired (70%) and recovering memory (57%) after cannabis cessation. Fifty-two percent of participants relapsed after the quit attempt. Abstainers had significantly higher scores on two subscales: the "negative impact of cannabis use on one's health and on self and social image" (t(61)=-3.84; Pchange, relapse, and abstinence. Social and family support, as well as social network appears to be of prime importance in relapses and prevention programs for cannabis use. New perspectives for research on cannabis cessation self-change and relapses are thus highlighted, notably regarding factors that could predict relapse or success in cessation of smoking cannabis. Research on cannabis self-change and relapse are warranted for both prevention and therapeutic programs. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Brain reactivity to alcohol and cannabis marketing during sobriety and intoxication.

Science.gov (United States)

de Sousa Fernandes Perna, Elizabeth B; Theunissen, Eef L; Kuypers, Kim P C; Evers, Elisabeth A; Stiers, Peter; Toennes, Stefan W; Witteman, Jurriaan; van Dalen, Wim; Ramaekers, Johannes G

2017-05-01

Drugs of abuse stimulate striatal dopamine release and activate reward pathways. This study examined the impact of alcohol and cannabis marketing on the reward circuit in alcohol and cannabis users while sober and intoxicated. It was predicted that alcohol and cannabis marketing would increase striatal activation when sober and that reward sensitivity would be less during alcohol and cannabis intoxication. Heavy alcohol (n = 20) and regular cannabis users (n = 21) participated in a mixed factorial study involving administration of alcohol and placebo in the alcohol group and cannabis and placebo in the cannabis group. Non-drug users (n = 20) served as between group reference. Brain activation after exposure to alcohol and cannabis marketing movies was measured using functional magnetic resonance imaging and compared between groups while sober and compared with placebo while intoxicated. Implicit alcohol and cannabis cognitions were assessed by means of a single-category implicit association test. Alcohol and cannabis marketing significantly increased striatal BOLD activation across all groups while sober. Striatal activation however decreased during intoxication with alcohol and cannabis. Implicit associations with cannabis marketing cues were significantly more positive in alcohol and cannabis users as compared with non-drug using controls. Public advertising of alcohol or cannabis use elicits striatal activation in the brain's reward circuit. Reduction of marketing would reduce brain exposure to reward cues that motivate substance use. Conversely, elevated dopamine levels protect against the reinforcing potential of marketing. © 2016 Society for the Study of Addiction.

A comparison of symptoms and family history in schizophrenia with and without prior cannabis use: implications for the concept of cannabis psychosis.

Science.gov (United States)

Boydell, J; Dean, K; Dutta, R; Giouroukou, E; Fearon, P; Murray, R

2007-07-01

There is considerable interest in cannabis use in psychosis. It has been suggested that the chronic psychosis associated with cannabis use, is symptomatically distinct from idiopathic schizophrenia. Several studies have reported differences in psychopathology and family history in people with schizophrenia according to whether or not they were cannabis users. We set out to test the hypotheses arising from these studies that cannabis use is associated with more bizarre behaviour, more thought disorder, fewer negative symptoms including blunted affect, more delusions of reference, more paranoid delusions and a stronger family history of schizophrenia. We used a case register that contained 757 cases of first onset schizophrenia, 182 (24%) of whom had used cannabis in the year prior to first presentation, 552 (73%) had not and 3% had missing data. We completed the OPCRIT checklist on all patients and investigated differences in the proportion of people with distractibility, bizarre behaviour, positive formal thought disorder, delusions of reference, well organised delusions, any first rank symptom, persecutory delusions, abusive/accusatory hallucinations, blunted affect, negative thought disorder, any negative symptoms (catatonia, blunted affect, negative thought disorder, or deterioration), lack of insight, suicidal ideation and a positive family history of schizophrenia, using chi square tests. Logistic regression modelling was then used to determine whether prior cannabis use affected the presence of the characteristics after controlling for age, sex and ethnicity. There was no statistically significant effect of cannabis use on the presence of any of the above. There remained however a non-significant trend towards more insight (OR 0.65 p=0.055 for "loss of insight") and a finding of fewer abusive or accusatory hallucinations (OR 0.65 p=0.049) of borderline significance amongst the cannabis users. These were in the hypothesised direction. There was no evidence of

Cannabis Decriminalization and the Age of Onset of Cannabis Use

OpenAIRE

Cervený, J.; van Ours, J.C.; Chomynova, Pavla; Mravcik, Viktor

2015-01-01

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...

Cannabis use in persons with traumatic spinal cord injury in Denmark

DEFF Research Database (Denmark)

Andresen, Sven Robert; Biering-Sørensen, Fin; Hagen, Ellen Merete

2017-01-01

/larger cities, tobacco-smoking, high alcohol intake and higher muscle stiffness were significantly associated with cannabis use. Those who had never tried cannabis reported that they would mainly use cannabis to alleviate pain and spasticity if it were legalized. CONCLUSION: Cannabis use is more frequent among...

Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users.

Science.gov (United States)

Bonn-Miller, Marcel O; Boden, Matthew Tyler; Bucossi, Meggan M; Babson, Kimberly A

2014-01-01

Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use. In the present cross-sectional study, we investigated the demographic profile of 217 adults currently receiving medical cannabis, as well as differences in problematic use and perceived helpfulness in terms of (i) symptoms of psychological disorders and pain, and (ii) motives for use. Findings indicated that medical cannabis users (i) use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and (ii) report similar rates of disordered use as compared with population estimates among regular users. Furthermore, problematic cannabis use was predicted by several symptoms of psychological disorders (e.g. depression) and a variety of use motives (e.g. coping), while cannabis was reported as particularly helpful among those with several psychological symptoms (e.g. traumatic intrusions), as well as those reporting use for social anxiety reasons. Results are discussed in terms of future directions for research given the current debates regarding legalization of cannabis for medical purposes and, more generally, the lack of empirical data to inform such debates.

Maternal age and trajectories of cannabis use.

Science.gov (United States)

De Genna, Natacha M; Cornelius, Marie D; Goldschmidt, Lidush; Day, Nancy L

2015-11-01

Becoming a mother is a developmental transition that has been linked to desistance from substance use. However, timing of motherhood may be a key determinant of cannabis use in women, based on preliminary evidence from teenage mothers. The goal of this study was to identify trajectories of maternal cannabis use, and to determine if maternal age was associated with different trajectories of use. This prospective study examined 456 pregnant women recruited at a prenatal clinic, ranging in age from 13 to 42 years. The women were interviewed about their cannabis use 1 year prior to pregnancy and during each trimester of pregnancy, and at 6, 10, 14, and 16 years post-partum. A growth mixture model of cannabis use reported at each time point clearly delineated four groups: non/unlikely to use, decreasing likelihood of use, late desistance, and increasing likelihood/chronic use (Lo-Mendell-Rubin adjusted LRT test statistic=35.7, pdepressive symptoms were also associated with more frequent use. These findings have implications for both prevention and treatment of cannabis use in mothers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Cannabis Information Helpline: Assessing Interest in the Medicinal Use of Cannabis in Australia.

Science.gov (United States)

Gates, Peter J; Albertella, Lucy

2017-10-15

The majority of Australians support a change in legislation to allow the use of cannabis for medical purposes. Despite strong public support, very little is known about the patterns of medicinal cannabis use among Australians. This study aims to gain a better understanding of Australian medicinal cannabis users and their patterns of use. The nature of calls to the Cannabis Information and Helpline (N = 15701), a free national service for Australians with concerns regarding cannabis use, were investigated to determine the number of calls made by those who inquired about the medicinal use of cannabis (N = 275) and the implied reasons for use among those who identify using cannabis in this way. The majority of medicinal cannabis inquirers mentioned cannabis to alleviate pain. Further, compared to other callers, medicinal cannabis inquirers were more likely to be male, unemployed, older, and have recently started using cannabis. These findings highlight the need for future research to better understand the issues faced by Australians regarding the use of cannabis for medicinal purposes and how they may be meaningfully addressed. Particular focus should be placed toward older, unemployed males.

Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS).

Science.gov (United States)

Ware, Mark A; Wang, Tongtong; Shapiro, Stan; Collet, Jean-Paul

2015-12-01

Cannabis is widely used as a self-management strategy by patients with a wide range of symptoms and diseases including chronic non-cancer pain. The safety of cannabis use for medical purposes has not been systematically evaluated. We conducted a prospective cohort study to describe safety issues among individuals with chronic non-cancer pain. A standardized herbal cannabis product (12.5% tetrahydrocannabinol) was dispensed to eligible individuals for a 1-year period; controls were individuals with chronic pain from the same clinics who were not cannabis users. The primary outcome consisted of serious adverse events and non-serious adverse events. Secondary safety outcomes included pulmonary and neurocognitive function and standard hematology, biochemistry, renal, liver, and endocrine function. Secondary efficacy parameters included pain and other symptoms, mood, and quality of life. Two hundred and fifteen individuals with chronic pain were recruited to the cannabis group (141 current users and 58 ex-users) and 216 controls (chronic pain but no current cannabis use) from 7 clinics across Canada. The median daily cannabis dose was 2.5 g/d. There was no difference in risk of serious adverse events (adjusted incidence rate ratio = 1.08, 95% confidence interval = .57-2.04) between groups. Medical cannabis users were at increased risk of non-serious adverse events (adjusted incidence rate ratio = 1.73, 95% confidence interval = 1.41-2.13); most were mild to moderate. There were no differences in secondary safety assessments. Quality-controlled herbal cannabis, when used by patients with experience of cannabis use as part of a monitored treatment program over 1 year, appears to have a reasonable safety profile. Longer-term monitoring for functional outcomes is needed. The study was registered with www.controlled-trials.com (ISRCTN19449752). This study evaluated the safety of cannabis use by patients with chronic pain over 1 year. The study found that there was a higher

Cannabis and psychosis

DEFF Research Database (Denmark)

Shevlin, Mark; McElroy, Eoin; Murphy, Jamie

2017-01-01

Purpose: While research has consistently identified an association between cannabis use and psychosis, few studies have examined this relationship in a polydrug context (i.e. combining cannabis with other illicit substances). The paper aims to discuss this issue. Design/methodology/approach: The ......Purpose: While research has consistently identified an association between cannabis use and psychosis, few studies have examined this relationship in a polydrug context (i.e. combining cannabis with other illicit substances). The paper aims to discuss this issue. Design....../methodology/approach: The present study sought to examine the association between recreational drug use (cannabis only vs polydrug) and psychotic disorders. Analysis was conducted on a large, representative survey of young Danish people aged 24 (n=4,718). Participants completed self-report measures of lifetime drug use...... and this information was linked to the Danish psychiatric registry system. Findings: Multivariate binary logistic regression analysis was used to examine the association between drug use (no drug use, cannabis only, cannabis and other drug) and ICD-10 psychotic disorders, while controlling for gender and parental...

Prescribing smoked cannabis for chronic noncancer pain

Science.gov (United States)

Kahan, Meldon; Srivastava, Anita; Spithoff, Sheryl; Bromley, Lisa

2014-01-01

Objective To offer preliminary guidance on prescribing smoked cannabis for chronic pain before the release of formal guidelines. Quality of evidence We reviewed the literature on the analgesic effectiveness of smoked cannabis and the harms of medical and recreational cannabis use. We developed recommendations on indications, contraindications, precautions, and dosing of smoked cannabis, and categorized the recommendations based on levels of evidence. Evidence is mostly level II (well conducted observational studies) and III (expert opinion). Main message Smoked cannabis might be indicated for patients with severe neuropathic pain conditions who have not responded to adequate trials of pharmaceutical cannabinoids and standard analgesics (level II evidence). Smoked cannabis is contraindicated in patients who are 25 years of age or younger (level II evidence); who have a current, past, or strong family history of psychosis (level II evidence); who have a current or past cannabis use disorder (level III evidence); who have a current substance use disorder (level III evidence); who have cardiovascular or respiratory disease (level III evidence); or who are pregnant or planning to become pregnant (level II evidence). It should be used with caution in patients who smoke tobacco (level II evidence), who are at increased risk of cardiovascular disease (level III evidence), who have anxiety or mood disorders (level II evidence), or who are taking higher doses of opioids or benzodiazepines (level III evidence). Cannabis users should be advised not to drive for at least 3 to 4 hours after smoking, for at least 6 hours after oral ingestion, and for at least 8 hours if they experience a subjective “high” (level II evidence). The maximum recommended dose is 1 inhalation 4 times per day (approximately 400 mg per day) of dried cannabis containing 9% delta-9-tetrahydrocannabinol (level III evidence). Physicians should avoid referring patients to “cannabinoid” clinics (level

Cannabis Use in Psychiatrie Patients.

Science.gov (United States)

Chaudhury, S; Sudarsanan, S; Salujha, S K; Srivastava, K

2005-02-01

Cannabis abuse has been associated with psychiatric disorders. The pattern of cannabis use and incidence of cannabis dependence and cannabis psychosis among 471 consecutive patients admitted to a tertiary care psychiatric center was investigated. Cannabis use was reported by 67 (14.23%) patients of whom 42 (8.92%) were occasional users, 18 (3.82%) were classified as frequent users while 7 (1.49%) fulfilled criteria for cannabis dependence. 3 (0.64%) patients showed symptoms which were characteristic of cannabis psychosis. Among the 67 cannabis users, 56 (83.58%) had their first exposure to cannabis before entering service at 13-19 years of age. The remaining 14 (16.09%) began consuming cannabis 1-5 years after joining service. The reasons given for using cannabis were curiosity about its effects 32 (47.76%), peer pressure 17 (25.37%) or traditional use during festivals 18 (26.87%).

History of cannabis as a medicine: a review História da cannabis como medicamento: uma revisão

Directory of Open Access Journals (Sweden)

Antonio Waldo Zuardi

2006-06-01

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

Cannabis abstinence during treatment and one-year follow-up: relationship to neural activity in men.

Science.gov (United States)

Kober, Hedy; DeVito, Elise E; DeLeone, Cameron M; Carroll, Kathleen M; Potenza, Marc N

2014-09-01

Cannabis is among the most frequently abused substances in the United States. Cognitive control is a contributory factor in the maintenance of substance-use disorders and may relate to treatment response. Therefore, we assessed whether cognitive-control-related neural activity before treatment differs between treatment-seeking cannabis-dependent and healthy individuals and relates to cannabis-abstinence measures during treatment and 1-year follow-up. Cannabis-dependent males (N=20) completed a functional magnetic resonance imaging (fMRI) cognitive-control (Stroop) task before a 12-week randomized controlled trial of cognitive-behavioral therapy and/or contingency management. A healthy-comparison group (N=20) also completed the fMRI task. Cannabis use was assessed by urine toxicology and self-report during treatment, and by self-report across a 1-year follow-up period (N=18). The cannabis-dependent group displayed diminished Stroop-related neural activity relative to the healthy-comparison group in multiple regions, including those strongly implicated in cognitive-control and addiction-related processes (eg, dorsolateral prefrontal cortex and ventral striatum). The groups did not differ significantly in response times (cannabis-dependent, N=12; healthy-comparison, N=14). Within the cannabis-dependent group, greater Stroop-related activity in regions including the dorsal anterior cingulate cortex was associated with less cannabis use during treatment. Greater activity in regions including the ventral striatum was associated with less cannabis use during 1-year posttreatment follow-up. These data suggest that lower cognitive-control-related neural activity in classic 'control' regions (eg, dorsolateral prefrontal cortex and dorsal anterior cingulate) and classic 'salience/reward/learning' regions (eg, ventral striatum) differentiates cannabis-dependent individuals from healthy individuals and relates to less abstinence within-treatment and during long-term follow

Cannabis and Breastfeeding

OpenAIRE

Garry, Aurélia; Rigourd, Virginie; Amirouche, Ammar; Fauroux, Valérie; Aubry, Sylvie; Serreau, Raphaël

2009-01-01

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 ...

The International Cannabis Consortium: What did we learn about the genetics of cannabis

NARCIS (Netherlands)

Verweij, K.J.H.; Minica, C.C.; Stringer, S.; Most, P.J. van der; Mbarek, H.; Nivard, M.G.; Abdellaoui, A.; Hottenga, J.J.; Martin, N.G.; Boomsma, D.I.; Gillespie, N.A.; Derks, E.M.; Vink, J.M.

2017-01-01

Background: Cannabis is the most frequently used and abused illicit drug worldwide and cannabis (ab)use is associated with social, physical, and psychological problems. Twin and family studies have shown that cannabis use and abuse are heritable traits. The International Cannabis Consortium was

E-Cigarettes: A Review of New Trends in Cannabis Use

Science.gov (United States)

Giroud, Christian; de Cesare, Mariangela; Berthet, Aurélie; Varlet, Vincent; Concha-Lozano, Nicolas; Favrat, Bernard

2015-01-01

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. PMID:26308021

E-Cigarettes: A Review of New Trends in Cannabis Use

Directory of Open Access Journals (Sweden)

Christian Giroud

2015-08-01

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.

E-Cigarettes: A Review of New Trends in Cannabis Use.

Science.gov (United States)

Giroud, Christian; de Cesare, Mariangela; Berthet, Aurélie; Varlet, Vincent; Concha-Lozano, Nicolas; Favrat, Bernard

2015-08-21

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.

Carbonyl Compounds Produced by Vaporizing Cannabis Oil Thinning Agents.

Science.gov (United States)

Troutt, William D; DiDonato, Matthew D

2017-11-01

Cannabis use has increased in the United States, particularly the use of vaporized cannabis oil, which is often mixed with thinning agents for use in vaporizing devices. E-cigarette research shows that heated thinning agents produce potentially harmful carbonyls; however, similar studies have not been conducted (1) with agents that are commonly used in the cannabis industry and (2) at temperatures that are appropriate for cannabis oil vaporization. The goal of this study was to determine whether thinning agents used in the cannabis industry produce potentially harmful carbonyls when heated to a temperature that is appropriate for cannabis oil vaporization. Four thinning agents (propylene glycol [PG], vegetable glycerin [VG], polyethylene glycol 400 [PEG 400], and medium chain triglycerides [MCT]) were heated to 230°C and the resulting vapors were tested for acetaldehyde, acrolein, and formaldehyde. Each agent was tested three times. Testing was conducted in a smoking laboratory. Carbonyl levels were measured in micrograms per puff block. Analyses showed that PEG 400 produced significantly higher levels of acetaldehyde and formaldehyde than PG, MCT, and VG. Formaldehyde production was also significantly greater in PG compared with MCT and VG. Acrolein production did not differ significantly across the agents. PG and PEG 400 produced high levels of acetaldehyde and formaldehyde when heated to 230°C. Formaldehyde production from PEG 400 isolate was particularly high, with one inhalation accounting for 1.12% of the daily exposure limit, nearly the same exposure as smoking one cigarette. Because PG and PEG 400 are often mixed with cannabis oil, individuals who vaporize cannabis oil products may risk exposure to harmful formaldehyde levels. Although more research is needed, consumers and policy makers should consider these potential health effects before use and when drafting cannabis-related legislation.

Medicinal versus recreational cannabis use: Patterns of cannabis use, alcohol use, and cued-arousal among veterans who screen positive for PTSD.

Science.gov (United States)

Loflin, Mallory; Earleywine, Mitch; Bonn-Miller, Marcel

2017-05-01

The present study is the first to test whether veterans who use cannabis specifically for the purposes of self-medication for their reported PTSD symptoms differ from veterans who use cannabis medicinally for other reasons, or recreationally, in terms of patterns of cannabis use, use of alcohol, and reactivity to written combat trauma reminders. Assessment measures were administered online to a sample of veterans with a history of cannabis use (n=1971). Cued arousal was assessed pre/post via a prompt about combat experiences. Hypotheses were tested using a series of Bonferroni corrected one-way analyses of variance, t-tests, bivariate and partial correlations, and a Chi-square test. Compared to recreational users, veterans who identify as medicinal cannabis users reported greater combat exposure (d=0.56), PTSD symptoms (d=1.02), subjective arousal when cued (d=0.25), and cannabis use (d frequency =0.40; d density =0.42), but less alcohol use (d=0.28). Few differences were observed between medicinal users who reported using for PTSD versus those who reported using for other reasons. Compared to those who use cannabis recreationally, veterans who report that they use cannabis medicinally use more cannabis and endorse significantly more symptoms of arousal following a prompt about combat trauma experiences. Published by Elsevier Ltd.

Cannabis and Breast feeding

Energy Technology Data Exchange (ETDEWEB)

Garry, A [Department dIngenierie Biologique, Ecole Polytechnique de Universite de Nice - Sophia Antipolis, 1645 Route des Lucioles, 06410 Biot (France); Virginie Rigourd, V; Aubry, S [Lactarium d' Ile de France, Institut de Puericulture et de Perinatalogie, 26 Boulevard Brune, 75014 Paris (France); Amirouche, A; Fauroux, V [Centre de Recherche Clinique Paris Centre, 89 rue d' Assas, 75006 Paris (France); Serreau, R [Centre de Recherche Clinique Paris Centre EA 3620, 89 rue d' Assas 75006 Paris (France)

2009-07-01

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 breast feeding 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 breast feeding. Mothers who use cannabis must stop breast feeding, or ask for medical assistance to stop cannabis use in order to provide her baby with all the benefits of human milk.

Cannabis and Breast feeding

International Nuclear Information System (INIS)

Garry, A.; Virginie Rigourd, V.; Aubry, S.; Amirouche, A.; Fauroux, V.; Serreau, R.

2009-01-01

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 breast feeding 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 breast feeding. Mothers who use cannabis must stop breast feeding, or ask for medical assistance to stop cannabis use in order to provide her baby with all the benefits of human milk.

Attitudes of Irish patients with chronic pain towards medicinal cannabis.

Science.gov (United States)

Rochford, Ciaran; Edgeworth, Deirdre; Hashim, Mohammad; Harmon, Dominic

2018-02-08

Medicinal cannabis use is topical in the media in Ireland. A recent Health Products Regulatory Authority review, however, has recommended against its use for patients with chronic pain. This is despite evidence for its effectiveness in this patient's cohort and the inadequate pain management of these patients. The aim of this study was to evaluate the attitudes of Irish patients with chronic pain towards medicinal cannabis. After institutional ethics committee approval, a 12-item questionnaire (excluding demographics) was randomly assigned to patients attending a chronic pain clinic (University Hospital Limerick). The questionnaire was designed to incorporate patient's attitudes on a variety of medicinal cannabis related topics. Ninety-six adult patients were surveyed. 88.54% agreed that cannabis should be legalised for chronic pain medicinal purposes. 80.21% believed it would have health benefits for them and 73.96% agreed it would be socially acceptable to use cannabis for this purpose. 33.33% perceived cannabis to be addictive while 68.75% would be willing to try it if prescribed by a medical professional. The study highlights the attitudes of chronic pain patients in Ireland towards medicinal cannabis. It shows their desire to have medical cannabis legalised for chronic pain and that they view it as a reasonable pain management option.

N-acetyl Aspartate Levels in Adolescents With Bipolar and/or Cannabis Use Disorders

Science.gov (United States)

Bitter, Samantha M.; Weber, Wade A.; Chu, Wen-Jang; Adler, Caleb M.; Eliassen, James C.; Strakowski, Stephen M.; DelBello, Melissa P.

2014-01-01

Objective Bipolar and cannabis use disorders commonly co-occur during adolescence, and neurochemical studies may help clarify the pathophysiology underlying this co-occurrence. This study compared metabolite concentrations in the left ventral lateral prefrontal cortex among: adolescents with bipolar disorder (bipolar group; n=14), adolescents with a cannabis use disorder (cannabis use group, n=13), adolescents with cannabis use and bipolar disorders (bipolar and cannabis group, n=25), and healthy adolescents (healthy controls, n=15). We hypothesized that adolescents with bipolar disorder (with or without cannabis use disorder) would have decreased N-acetyl aspartate levels in the ventral lateral prefrontal cortex compared to the other groups, and that the bipolar and cannabis group would have the lowest N-acetyl aspartate levels of all groups. Methods N-acetyl aspartate concentrations in the left ventral lateral prefrontal cortex were obtained using Proton Magnetic Resonance Spectroscopy. Results Adolescents with bipolar disorder showed significantly lower left ventral lateral prefrontal cortex N-acetyl aspartate levels, but post-hoc analyses indicated that this was primarily due to increased N-acetyl aspartate levels in the cannabis group. The cannabis use disorder group had significantly higher N-acetyl aspartate levels compared to the bipolar disorder and the bipolar and cannabis groups (p=0.0002 and p=0.0002, respectively). Pearson correlations revealed a significant positive correlation between amount of cannabis used and N-acetyl aspartate concentrations. Conclusions Adolescents with cannabis use disorder showed higher levels of N-acetyl aspartate concentrations that were significantly positively associated with the amount of cannabis used; however, this finding was not present in adolescents with comorbid bipolar disorder. PMID:24729763

Impact of ADHD and cannabis use on executive functioning in young adults.

Science.gov (United States)

Tamm, Leanne; Epstein, Jeffery N; Lisdahl, Krista M; Molina, Brooke; Tapert, Susan; Hinshaw, Stephen P; Arnold, L Eugene; Velanova, Katerina; Abikoff, Howard; Swanson, James M

2013-12-01

Attention-deficit/hyperactivity disorder (ADHD) and cannabis use are each associated with specific cognitive deficits. Few studies have investigated the neurocognitive profile of individuals with both an ADHD history and regular cannabis use. The greatest cognitive impairment is expected among ADHD Cannabis Users compared to those with ADHD-only, Cannabis use-only, or neither. Young adults (24.2 ± 1.2 years) with a childhood ADHD diagnosis who did (n=42) and did not (n=45) report past year ≥ monthly cannabis use were compared on neuropsychological measures to a local normative comparison group (LNCG) who did (n=20) and did not (n=21) report past year regular cannabis use. Age, gender, IQ, socioeconomic status, and past year alcohol and smoking were statistical covariates. The ADHD group performed worse than LNCG on verbal memory, processing speed, cognitive interference, decision-making, working memory, and response inhibition. No significant effects for cannabis use emerged. Interactions between ADHD and cannabis were non-significant. Exploratory analyses revealed that individuals who began using cannabis regularly before age 16 (n=27) may have poorer executive functioning (i.e., decision-making, working memory, and response inhibition), than users who began later (n=32); replication is warranted with a larger sample. A childhood diagnosis of ADHD, but not cannabis use in adulthood, was associated with executive dysfunction. Earlier initiation of cannabis use may be linked to poor cognitive outcomes and a significantly greater proportion of the ADHD group began using cannabis before age 16. Regular cannabis use starting after age 16 may not be sufficient to aggravate longstanding cognitive deficits characteristic of ADHD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Childhood and current ADHD symptom dimensions are associated with more severe cannabis outcomes in college students.

Science.gov (United States)

Bidwell, L C; Henry, E A; Willcutt, E G; Kinnear, M K; Ito, T A

2014-02-01

Numerous studies have shown that attention deficit/hyperactivity disorder (ADHD) is associated higher risk of cannabis use disorders (CUD). However, these studies are limited in that most did not: (a) differentiate the role of hyperactivity-impulsivity (HI) and inattention (IN); (b) control for associated psychopathology; and (c) consider more fine-grained CUD-related measures. Our aim was to clarify the unique and interactive contributions of inattention and hyperactivity symptoms to age of cannabis initiation and DSM-IV cannabis dependence, craving, and severity of problems related to cannabis use while statistically controlling for symptoms of comorbid psychopathology in a non-clinical sample of young adults. Cannabis variables, current use of cigarettes and alcohol, current and childhood ADHD, and comorbid internalizing and externalizing psychopathology were assessed in 376 male and female undergraduates. Results indicate that current and childhood IN were independently associated with more severe cannabis use, craving, and problem use-related outcomes in young adulthood (p'scannabis (pcannabis use. Associations with ADHD symptom dimensions and current use of alcohol and cigarettes were also present. Thus, current and childhood inattention symptoms as well as childhood hyperactive-impulsive symptoms emerged as significant factors in cannabis-related outcomes in young adults, even after statistically controlling for important confounding variables. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cannabis use and the course and outcome of major depressive disorder: A population based longitudinal study.

Science.gov (United States)

Feingold, Daniel; Rehm, Jürgen; Lev-Ran, Shaul

2017-05-01

Cannabis use has been reported to affect the course of various psychiatric disorders, however its effect on the course of major depressive disorder (MDD) is not yet clear. We used data from Wave 1 and Wave 2 of the National Epidemiologic survey on Alcohol and Related Conditions (NESARC). Individuals with baseline MDD (N=2,348) were included in the study. Cannabis users without a Cannabis Use Disorder (CUDs) and individuals with a CUD were compared to nonusers using linear and logistic regression analyses controlling for sociodemographics, psychiatric disorders and substance use disorders at baseline. No differences were found in rates of remission between the groups. Level of cannabis use was associated with significantly more depressive symptoms at follow-up, particularly anhedonia, changes in body weight, insomnia or hypersomnia and psychomotor problems. After adjusting for baseline confounding factors, no associations were found between cannabis use and suicidality, functionality and quality of life. We conclude that many of the associations between cannabis use and a more severe course of MDD do not seem to be attributed to cannabis use itself but to associated sociodemographic and clinical factors. Further longitudinal studies using depression severity indices are required. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Oral fluid/plasma cannabinoid ratios following controlled oral THC and smoked cannabis administration.

Science.gov (United States)

Lee, Dayong; Vandrey, Ryan; Milman, Garry; Bergamaschi, Mateus; Mendu, Damodara R; Murray, Jeannie A; Barnes, Allan J; Huestis, Marilyn A

2013-09-01

Oral fluid (OF) is a valuable biological alternative for clinical and forensic drug testing. Evaluating OF to plasma (OF/P) cannabinoid ratios provides important pharmacokinetic data on the disposition of drug and factors influencing partition between matrices. Eleven chronic cannabis smokers resided on a closed research unit for 51 days. There were four 5-day sessions of 0, 30, 60, and 120 mg oral ∆(9)-tetrahydrocannabinol (THC)/day followed by a five-puff smoked cannabis challenge on Day 5. Each session was separated by 9 days ad libitum cannabis smoking. OF and plasma specimens were analyzed for THC and metabolites. During ad libitum smoking, OF/P THC ratios were high (median, 6.1; range, 0.2-348.5) within 1 h after last smoking, decreasing to 0.1-20.7 (median, 2.1) by 13.0-17.1 h. OF/P THC ratios also decreased during 5-days oral THC dosing, and after the smoked cannabis challenge, median OF/P THC ratios decreased from 1.4 to 5.5 (0.04-245.6) at 0.25 h to 0.12 to 0.17 (0.04-5.1) at 10.5 h post-smoking. In other studies, longer exposure to more potent cannabis smoke and oromucosal cannabis spray was associated with increased OF/P THC peak ratios. Median OF/P 11-nor-9-carboxy-THC (THCCOOH) ratios were 0.3-2.5 (range, 0.1-14.7) ng/μg, much more consistent in various dosing conditions over time. OF/P THC, but not THCCOOH, ratios were significantly influenced by oral cavity contamination after smoking or oromucosal spray of cannabinoid products, followed by time-dependent decreases. Establishing relationships between OF and plasma cannabinoid concentrations is essential for making inferences of impairment or other clinical outcomes from OF concentrations.

Medical cannabis: A forward vision for the clinician.

Science.gov (United States)

Fitzcharles, M A; Eisenberg, E

2018-03-01

Medical cannabis has entered mainstream medicine and is here to stay. Propelled by public advocacy, the media and mostly anecdote rather than sound scientific study, patients worldwide are exploring marijuana use for a vast array of medical conditions including management of chronic pain. Contrary to the usual path of drug approval, medical cannabis has bypassed traditional evidence-based study and has been legalized as a therapeutic product by legislative bodies in various countries. While there is a wealth of basic science and preclinical studies demonstrating effects of cannabinoids in neurobiological systems, especially those pertaining to pain and inflammation, clinical study remains limited. Cannabinoids may hold promise for relief of symptoms in a vast array of conditions, but with many questions as yet unanswered. Rigorous study is needed to examine the true evidence for benefits and risks for various conditions and in various patient populations, the specific molecular effects, ideal methods of administration, and interaction with other medications and substances. In the context of prevalent use, there is an urgency to gather pertinent clinical information about the therapeutic effects as well as risks. Even with considerable uncertainties, the health care community must adhere to the guiding principle of clinical care 'primum non nocere' and continue to provide empathetic patient care while exercising prudence and caution. The health care community must strongly advocate for sound scientific evidence regarding cannabis as a therapy. Legalization of medical cannabis has bypassed usual drug regulatory procedures in jurisdictions worldwide. Pending sound evidence for effect in many conditions, physicians must continue to provide competent empathetic care with attention to harm reduction. A vision to navigate the current challenges of medical cannabis is outlined. © 2018 European Pain Federation - EFIC®.

Association between increased EEG signal complexity and cannabis dependence.

Science.gov (United States)

Laprevote, Vincent; Bon, Laura; Krieg, Julien; Schwitzer, Thomas; Bourion-Bedes, Stéphanie; Maillard, Louis; Schwan, Raymund

2017-12-01

Both acute and regular cannabis use affects the functioning of the brain. While several studies have demonstrated that regular cannabis use can impair the capacity to synchronize neural assemblies during specific tasks, less is known about spontaneous brain activity. This can be explored by measuring EEG complexity, which reflects the spontaneous variability of human brain activity. A recent study has shown that acute cannabis use can affect that complexity. Since the characteristics of cannabis use can affect the impact on brain functioning, this study sets out to measure EEG complexity in regular cannabis users with or without dependence, in comparison with healthy controls. We recruited 26 healthy controls, 25 cannabis users without cannabis dependence and 14 cannabis users with cannabis dependence, based on DSM IV TR criteria. The EEG signal was extracted from at least 250 epochs of the 500ms pre-stimulation phase during a visual evoked potential paradigm. Brain complexity was estimated using Lempel-Ziv Complexity (LZC), which was compared across groups by non-parametric Kruskall-Wallis ANOVA. The analysis revealed a significant difference between the groups, with higher LZC in participants with cannabis dependence than in non-dependent cannabis users. There was no specific localization of this effect across electrodes. We showed that cannabis dependence is associated to an increased spontaneous brain complexity in regular users. This result is in line with previous results in acute cannabis users. It may reflect increased randomness of neural activity in cannabis dependence. Future studies should explore whether this effect is permanent or diminishes with cannabis cessation. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

Does cannabis use affect treatment outcome in bipolar disorder? A longitudinal analysis

DEFF Research Database (Denmark)

van Rossum, Inge; Boomsma, Maarten; Tenback, Diederik

2009-01-01

Research suggests that cannabis use affects negatively on onset and outcome of schizophrenia, but less is known about possible effects in mood disorders. Bipolar in- and outpatients (N = 3459) were enrolled in an observational study. The influence of cannabis exposure on clinical and social...... 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....... 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...

Cannabis careers revisited

DEFF Research Database (Denmark)

Järvinen, Margaretha; Ravn, Signe

2014-01-01

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....

Postoperative Shivering Among Cannabis Users at a Public Hospital in Trinidad, West Indies.

Science.gov (United States)

Sankar-Maharaj, Sasha; Chen, Deryk; Hariharan, Seetharaman

2018-02-01

Postoperative shivering has been anecdotally observed to be frequent and severe in Cannabis smokers following general anesthesia in the Caribbean. The aim of this study was to compare the frequency and intensity of postoperative shivering in Cannabis users versus non-users. A prospective, cross-sectional, observational design was used. Demographic data were obtained. Patients were grouped into Cannabis users and non-users. All patients received standardized general anesthesia and were administered warmed fluids intraoperatively. Ambient room temperatures and clinical data were recorded. Patients' core body temperature was recorded at 10-minute intervals both in the operating room and the post-anesthesia care unit (PACU). Postoperatively an independent observer assessed the patients who had shivering using a scoring system ranging from 0 to 3. Treatment for shivering and post-treatment shivering scores were also recorded. Fifty-five patients were studied, of which 71% were male. There were 25 (45%) Cannabis users, of which 50% smoked 10 joints per week; 30 (55%) patients were non-users. The overall incidence of postoperative shivering was 36%; 16% had a shivering score of '3', 13% had '2' and 7% had a score of '1'. The incidence of postoperative shivering among Cannabis users was 40% while it was 33.3% in non-users. Also, 90% of Cannabis users had shivering scores of 2 and 3, compared to 70% of non-users. There was a higher incidence and intensity of shivering in Cannabis smokers, although the study could not establish a statistically significant difference in the frequency and severity of shivering between Cannabis users and non-users. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

When cannabis is available and visible at school - A multilevel analysis of students' cannabis use

NARCIS (Netherlands)

Kuntsche, E.N.

2010-01-01

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

Attitudes to cannabis and patterns of use among Canadians with multiple sclerosis.

Science.gov (United States)

Banwell, Emma; Pavisian, Bennis; Lee, Liesly; Feinstein, Anthony

2016-11-01

Canada has the highest incidence of MS worldwide. Anecdotal evidence reveals that people with MS smoke, ingest or vaporize cannabis for a multiplicity of reasons. With the legal situation in relation to use currently in flux, we undertook a study investigating patterns of use amongst people with MS and their attitudes towards the drug. A consecutive sample of people with MS (n=246) attending a neurology (n=118) and a neuropsychiatry (n=107) clinic was enrolled and asked to complete a questionnaire containing demographic, disease and cannabis related variables. Of the 246 people approached, 225 (91.8%) agreed to participant. Attitude towards cannabis revealed that 122 (54.3%) participants approved of the drug while 75 (33.2%) were neutral. Legalization was endorsed by 98 (43.7%) participants, while 98 (43.7%) were in favour of legalization for medical use only. Current use was endorsed by 44 (19.5%) people with 125 (56.1%) reporting lifetime use. If cannabis were legal, 113 (50.2%) participants would use it. The most common symptoms for which cannabis was being used were: sleep (86%), pain (75%), anxiety (73%) and spasticity (68%). Participants attending the neuropsychiatry clinic were more likely to use cannabis for managing depression (χ 2 =4.99; p=0.03) and pain (χ 2 =3.85; p=0.05). There is a wide acceptance of cannabis within the MS patient community. One in five people currently use the drug for reasons that differ between neuropsychiatry and neurology clinics. Use could potentially more than double if the drug were legalized. Copyright © 2016 Elsevier B.V. All rights reserved.

Cannabis, cannabinoids, and health.

Science.gov (United States)

Lafaye, Genevieve; Karila, Laurent; Blecha, Lisa; Benyamina, Amine

2017-09-01

Cannabis (also known as marijuana) is the most frequently used illicit psychoactive substance in the world. Though it was long considered to be a "soft" drug, studies have proven the harmful psychiatric and addictive effects associated with its use. A number of elements are responsible for the increased complications of cannabis use, including the increase in the potency of cannabis and an evolution in the ratio between the two primary components, Δ 9 -tetrahydrocannabinol (Δ 9 -THC) and cannabidiol (toward a higher proportion of Δ 9 -THC), Synthetic cannabinoid (SC) use has rapidly progressed over the last few years, primarily among frequent cannabis users, because SCs provide similar psychoactive effects to cannabis. However, their composition and pharmacological properties make them dangerous substances. Cannabis does have therapeutic properties for certain indications. These therapeutic applications pertain only to certain cannabinoids and their synthetic derivatives. The objective of this article is to summarize current developments concerning cannabis and the spread of SCs. Future studies must further explore the benefit-risk profile of medical cannabis use.

Sex Differences in Cannabis Use and Effects: A Cross-Sectional Survey of Cannabis Users

Science.gov (United States)

Cuttler, Carrie; Mischley, Laurie K.; Sexton, Michelle

2016-01-01

Abstract Introduction: Despite known sex differences in the endocannabinoid system of animals, little attention has been paid to sex differences in human's cannabis use patterns and effects. The purpose of the present study was to examine sex differences in cannabis use patterns and effects in a large sample of recreational and medical cannabis users. Methods: A large sample (n=2374) of cannabis users completed an anonymous, online survey that assessed their cannabis use practices and experiences, including the short-term acute effects of cannabis and withdrawal effects. A subsample of 1418 medical cannabis users further indicated the medical conditions for which they use cannabis and its perceived efficacy. Results: The results indicated that men reported using cannabis more frequently and in higher quantities than did women. Men were more likely to report using joints/blunts, vaporizers, and concentrates, while women were more likely to report using pipes and oral administration. Men were more likely than women to report increased appetite, improved memory, enthusiasm, altered time perception, and increased musicality when high, while women were more likely than men to report loss of appetite and desire to clean when high. Men were more likely than women to report insomnia and vivid dreams during periods of withdrawal, while women were more likely than men to report nausea and anxiety as withdrawal symptoms. Sex differences in the conditions for which medical cannabis is used, and its efficacy, were trivial. Conclusions: These results may be used to focus research on biological and psychosocial mechanisms underlying cannabis-related sex differences, to inform clinicians treating individuals with cannabis use disorders, and to inform cannabis consumers, clinicians, and policymakers about the risks and benefits of cannabis for both sexes. PMID:28861492

Sex Differences in Cannabis Use and Effects: A Cross-Sectional Survey of Cannabis Users.

Science.gov (United States)

Cuttler, Carrie; Mischley, Laurie K; Sexton, Michelle

2016-01-01

Introduction: Despite known sex differences in the endocannabinoid system of animals, little attention has been paid to sex differences in human's cannabis use patterns and effects. The purpose of the present study was to examine sex differences in cannabis use patterns and effects in a large sample of recreational and medical cannabis users. Methods: A large sample ( n =2374) of cannabis users completed an anonymous, online survey that assessed their cannabis use practices and experiences, including the short-term acute effects of cannabis and withdrawal effects. A subsample of 1418 medical cannabis users further indicated the medical conditions for which they use cannabis and its perceived efficacy. Results: The results indicated that men reported using cannabis more frequently and in higher quantities than did women. Men were more likely to report using joints/blunts, vaporizers, and concentrates, while women were more likely to report using pipes and oral administration. Men were more likely than women to report increased appetite, improved memory, enthusiasm, altered time perception, and increased musicality when high, while women were more likely than men to report loss of appetite and desire to clean when high. Men were more likely than women to report insomnia and vivid dreams during periods of withdrawal, while women were more likely than men to report nausea and anxiety as withdrawal symptoms. Sex differences in the conditions for which medical cannabis is used, and its efficacy, were trivial. Conclusions: These results may be used to focus research on biological and psychosocial mechanisms underlying cannabis-related sex differences, to inform clinicians treating individuals with cannabis use disorders, and to inform cannabis consumers, clinicians, and policymakers about the risks and benefits of cannabis for both sexes.

Cannabis: A Treasure Trove or Pandora's Box?

Science.gov (United States)

Solymosi, Katalin; Köfalvi, Attila

2017-01-01

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-todate 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. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Utility of the comprehensive marijuana motives questionnaire among medical cannabis patients.

Science.gov (United States)

Bohnert, Kipling M; Bonar, Erin E; Arnedt, J Todd; Conroy, Deirdre A; Walton, Maureen A; Ilgen, Mark A

2018-01-01

Little is known about motives for cannabis use among the population of adults using cannabis medically. Therefore, we evaluated the performance of the 12 factor, 36-item Comprehensive Marijuana Motives Questionnaire (CMMQ) among a sample of medical cannabis patients. Study participants were adults ages 21years or older with scheduled appointments to obtain new or renewed medical cannabis certification from clinics in one Midwestern state (n=1116). Confirmatory factor analysis was used to evaluate properties of the CMMQ. Multiple regressions were used to estimate associations between motives and cannabis use, physical health functioning, and mental health functioning. Fit indices were acceptable, and factor loadings ranged from 0.57 to 0.94. Based on regression analyses, motives accounted for 7% of the variance in recent cannabis use, and independent of cannabis use, accounted for 5% and 19% of physical and mental health functioning, respectively. Regression analyses also revealed that distinct motives were associated with cannabis use and physical and mental health functioning. Among adults seeking medical cannabis certification, the factor structure of the CMMQ was supported, and consistent with prior studies of adolescents and young adults using cannabis recreationally. Thus, individuals who use cannabis medically may have diverse reasons for use that extend beyond the management of medical symptoms. In addition, coping and sleep-related motives may be particularly salient for this population. Findings support the utility of the CMMQ in future research on medical cannabis use; however, expansion of the scale may be needed to address medical motives for use. Published by Elsevier Ltd.

Drowsiness and uncommon fever in a child after cannabis ingestion.

Science.gov (United States)

Feliu, Catherine; Cazaubon, Yoann; Fouley, Aurélie; Guillemin, Hélène; Millart, Hervé; Gozalo, Claire; Djerada, Zoubir

2017-08-01

Trivialization of cannabis consumption goes hand in hand with a growing exposure of children and the number of cannabis poisoning cases is steadily increasing. As clinical presentation can be different from what is currently seen in adults, added to the fact that it is not always suspected, diagnosis of cannabis intoxication in children is often delayed or missed. A 16-month-old girl was admitted to the pediatric emergency unit for an important drowsiness combined to moderate fever. After elimination of infectious causes, a toxic origin was considered and biological analyses led to the diagnosis of involuntary acute cannabis intoxication. In conclusion, cannabis intoxication in child has uncommon presentations compared to that seen in adults. In this context, biological analyses have a great importance for a rapid diagnosis and also for the understanding intoxication circumstance. This is of paramount importance because it may lead to consider child protection measures.

Chronic toxicology of cannabis.

Science.gov (United States)

Reece, Albert Stuart

2009-07-01

Cannabis is the most widely used illicit drug worldwide. As societies reconsider the legal status of cannabis, policy makers and clinicians require sound knowledge of the acute and chronic effects of cannabis. This review focuses on the latter. A systematic review of Medline, PubMed, PsychInfo, and Google Scholar using the search terms "cannabis," "marijuana," "marihuana," "toxicity," "complications," and "mechanisms" identified 5,198 papers. This list was screened by hand, and papers describing mechanisms and those published in more recent years were chosen preferentially for inclusion in this review. There is evidence of psychiatric, respiratory, cardiovascular, and bone toxicity associated with chronic cannabis use. Cannabis has now been implicated in the etiology of many major long-term psychiatric conditions including depression, anxiety, psychosis, bipolar disorder, and an amotivational state. Respiratory conditions linked with cannabis include reduced lung density, lung cysts, and chronic bronchitis. Cannabis has been linked in a dose-dependent manner with elevated rates of myocardial infarction and cardiac arrythmias. It is known to affect bone metabolism and also has teratogenic effects on the developing brain following perinatal exposure. Cannabis has been linked to cancers at eight sites, including children after in utero maternal exposure, and multiple molecular pathways to oncogenesis exist. Chronic cannabis use is associated with psychiatric, respiratory, cardiovascular, and bone effects. It also has oncogenic, teratogenic, and mutagenic effects all of which depend upon dose and duration of use.

Dopaminergic function in cannabis users and its relationship to cannabis-induced psychotic symptoms.

Science.gov (United States)

Bloomfield, Michael A P; Morgan, Celia J A; Egerton, Alice; Kapur, Shitij; Curran, H Valerie; Howes, Oliver D

2014-03-15

Cannabis is the most widely used illicit drug globally, and users are at increased risk of mental illnesses including psychotic disorders such as schizophrenia. Substance dependence and schizophrenia are both associated with dopaminergic dysfunction. It has been proposed, although never directly tested, that the link between cannabis use and schizophrenia is mediated by altered dopaminergic function. We compared dopamine synthesis capacity in 19 regular cannabis users who experienced psychotic-like symptoms when they consumed cannabis with 19 nonuser sex- and age-matched control subjects. Dopamine synthesis capacity (indexed as the influx rate constant [Formula: see text] ) was measured with positron emission tomography and 3,4-dihydroxy-6-[(18)F]-fluoro-l-phenylalanine ([(18)F]-DOPA). Cannabis users had reduced dopamine synthesis capacity in the striatum (effect size: .85; t36 = 2.54, p = .016) and its associative (effect size: .85; t36 = 2.54, p = .015) and limbic subdivisions (effect size: .74; t36 = 2.23, p = .032) compared with control subjects. The group difference in dopamine synthesis capacity in cannabis users compared with control subjects was driven by those users meeting cannabis abuse or dependence criteria. Dopamine synthesis capacity was negatively associated with higher levels of cannabis use (r = -.77, p < .001) and positively associated with age of onset of cannabis use (r = .51, p = .027) but was not associated with cannabis-induced psychotic-like symptoms (r = .32, p = .19). These findings indicate that chronic cannabis use is associated with reduced dopamine synthesis capacity and question the hypothesis that cannabis increases the risk of psychotic disorders by inducing the same dopaminergic alterations seen in schizophrenia. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Treatment of Crohn's disease with cannabis: an observational study.

Science.gov (United States)

Naftali, Timna; Lev, Lihi Bar; Yablecovitch, Doron; Yablekovitz, Doron; Half, Elisabeth; Konikoff, Fred M

2011-08-01

The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published. To describe the effects of cannabis use in patients suffering from CD. In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.

Cannabis consumption patterns among frequent consumers in Uruguay.

Science.gov (United States)

Boidi, María Fernanda; Queirolo, Rosario; Cruz, José Miguel

2016-08-01

In 2013, Uruguay became the first country to fully regulate the cannabis market, which now operates under state control. Cannabis can be legally acquired in three ways: growing it for personal use (self-cultivation), cannabis club membership, and from pharmacies (not yet implemented). Users must be entered into a confidential official registry to gain access. This article presents findings of a Respondent Driven Sample survey of 294 high-frequency cannabis consumers in the Montevideo metropolitan area. Frequent consumers resort to more than one method for acquiring cannabis, with illegal means still predominating after 1 year of the new regulation law. Cannabis users overwhelmingly support the current regulation, but many of them are reluctant to register. Some of the attitudes and behaviors of the high-frequency consumers pose a challenge to the success of the cannabis law. Individuals relying on more than one method of access defy the single access clause, a prerequisite for legal use, while the maximum amount of cannabis individuals can access monthly seems too high even for most frequent consumers, which might promote the emergence of a grey market. Reluctance to register among a significant proportion of high-frequency consumers raises doubts about the law's ability to achieve its stated objectives. Copyright © 2016 Elsevier B.V. All rights reserved.

Utilizing Big Data and Twitter to Discover Emergent Online Communities of Cannabis Users

Directory of Open Access Journals (Sweden)

Peter Baumgartner

2017-05-01

Full Text Available Large shifts in medical, recreational, and illicit cannabis consumption in the United States have implications for personalizing treatment and prevention programs to a wide variety of populations. As such, considerable research has investigated clinical presentations of cannabis users in clinical and population-based samples. Studies leveraging big data, social media, and social network analysis have emerged as a promising mechanism to generate timely insights that can inform treatment and prevention research. This study extends a novel method called stochastic block modeling to derive communities of cannabis consumers as part of a complex social network on Twitter. A set of examples illustrate how this method can ascertain candidate samples of medical, recreational, and illicit cannabis users. Implications for research planning, intervention design, and public health surveillance are discussed.

When Cannabis Is Available and Visible at School--A Multilevel Analysis of Students' Cannabis Use

Science.gov (United States)

Kuntsche, Emmanuel

2010-01-01

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…

[Medicinal cannabis for diseases of the nervous system: no convincing evidence of effectiveness].

Science.gov (United States)

Killestein, J; Bet, P M; van Loenen, A C; Polman, C H

2004-11-27

--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.

Cannabis, possible cardiac deaths and the coroner in Ireland.

LENUS (Irish Health Repository)

Tormey, W P

2012-01-10

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.

Cannabis, possible cardiac deaths and the coroner in Ireland.

Science.gov (United States)

Tormey, W P

2012-12-01

The elevated risk of triggering a myocardial infarction by smoking cannabis is limited to the first 2 h after smoking. 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. 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.

Medicinsk cannabis

OpenAIRE

Salehi, Nazu; Lambert-Jensen, Mikkel Mørch; Hansen, Sebastian Lorentz; Hansen, Caroline Pulz; Nadir, Atifa Mohammad; Ernst, Line; Showiki, Omar Isac

2016-01-01

AbstractCannabis har, blandt nogle kulturer, været værdsat for sine medicinske egenskaber i årtusinder. Formålet med denne rapport er, at undersøge de helende effekter cannabis har på cancer og multipel sclerose. Dette gør vi, ved at se på moderne forskning indenfor emnet. Endvidere vil vi prøve at forudsige, hvilke fremtidige studier der skal foretages for at opnå implementering af medicinsk cannabis, ved at bruge Rogers’ Diffusion of Innovations. VI har valgt at interviewe 3 forskellige per...

Public opinion and medical cannabis policies: examining the role of underlying beliefs and national medical cannabis policies

OpenAIRE

Sznitman, Sharon R.; Bretteville-Jensen, Anne Line

2015-01-01

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...

Neuroprotection in Experimental Autoimmune Encephalomyelitis and Progressive Multiple Sclerosis by Cannabis-Based Cannabinoids.

Science.gov (United States)

Pryce, Gareth; Riddall, Dieter R; Selwood, David L; Giovannoni, Gavin; Baker, David

2015-06-01

Multiple sclerosis (MS) is the major immune-mediated, demyelinating, neurodegenerative disease of the central nervous system. Compounds within cannabis, notably Δ9-tetrahydrocannabinol (Δ9-THC) can limit the inappropriate neurotransmissions that cause MS-related problems and medicinal cannabis is now licenced for the treatment of MS symptoms. However, the biology indicates that the endocannabinoid system may offer the potential to control other aspects of disease. Although there is limited evidence that the cannabinoids from cannabis are having significant immunosuppressive activities that will influence relapsing autoimmunity, we and others can experimentally demonstrate that they may limit neurodegeneration that drives progressive disability. Here we show that synthetic cannabidiol can slow down the accumulation of disability from the inflammatory penumbra during relapsing experimental autoimmune encephalomyelitis (EAE) in ABH mice, possibly via blockade of voltage-gated sodium channels. In addition, whilst non-sedating doses of Δ9-THC do not inhibit relapsing autoimmunity, they dose-dependently inhibit the accumulation of disability during EAE. They also appear to slow down clinical progression during MS in humans. Although a 3 year, phase III clinical trial did not detect a beneficial effect of oral Δ9-THC in progressive MS, a planned subgroup analysis of people with less disability who progressed more rapidly, demonstrated a significant slowing of progression by oral Δ9-THC compared to placebo. Whilst this may support the experimental and biological evidence for a neuroprotective effect by the endocannabinoid system in MS, it remains to be established whether this will be formally demonstrated in further trials of Δ9-THC/cannabis in progressive MS.

Randomised Controlled Trial (RCT) of cannabinoid replacement therapy (Nabiximols) for the management of treatment-resistant cannabis dependent patients: a study protocol.

Science.gov (United States)

Bhardwaj, Anjali K; Allsop, David J; Copeland, Jan; McGregor, Iain S; Dunlop, Adrian; Shanahan, Marian; Bruno, Raimondo; Phung, Nghi; Montebello, Mark; Sadler, Craig; Gugusheff, Jessica; Jackson, Melissa; Luksza, Jennifer; Lintzeris, Nicholas

2018-05-18

The cannabis extract nabiximols (Sativex®) effectively supresses withdrawal symptoms and cravings in treatment resistant cannabis dependent individuals, who have high relapse rates following conventional withdrawal treatments. This study examines the efficacy, safety and cost-effectiveness of longer-term nabiximols treatment for outpatient cannabis dependent patients who have not responded to previous conventional treatment approaches. A phase III multi-site outpatient, randomised, double-blinded, placebo controlled parallel design, comparing a 12-week course of nabiximols to placebo, with follow up at 24 weeks after enrolment. Four specialist drug and alcohol outpatient clinics in New South Wales, Australia. One hundred forty-two treatment seeking cannabis dependent adults, with no significant medical, psychiatric or other substance use disorders. Nabiximols is an oromucosal spray prescribed on a flexible dose regimen to a maximum daily dose of 32 sprays; 8 sprays (total 21.6 mg tetrahydrocannabinol (THC) and 20 mg cannabidiol (CBD)) four times a day, or matching placebo, dispensed weekly. All participants will receive six-sessions of individual cognitive behavioural therapy (CBT) and weekly clinical reviews. Primary endpoints are use of non-prescribed cannabis (self-reported cannabis use days, urine toxicology), safety measures (adverse events and abuse liability), and cost effectiveness (incremental cost effectiveness in achieving additional Quality Adjusted Life Years). Secondary outcomes include, improvement in physical and mental health parameters, substance use other than cannabis, cognitive functioning and patient satisfaction measures. This is the first outpatient community-based randomised controlled study of nabiximols as an agonist replacement medication for treating cannabis dependence, targeting individuals who have not previously responded to conventional treatment approaches. The study and treatment design is modelled upon an earlier study with

Inspired by Mary Jane? Mechanisms underlying enhanced creativity in cannabis users.

Science.gov (United States)

LaFrance, Emily M; Cuttler, Carrie

2017-11-01

Previous research suggests cannabis may enhance some aspects of creativity, although the results remain somewhat equivocal. Moreover, it is unclear whether differences in cannabis users' personalities may account for any potentially beneficial effects of cannabis on creativity. This study was designed to examine whether sober cannabis users demonstrate superior self-reported and objective creativity test performance relative to non-users, and to determine whether any of the Big 5 personality domains underlie these effects. A sample of sober cannabis users (n=412) and non-users (n=309) completed measures of cannabis consumption, personality, self-reported and objective creativity. Relative to non-users, sober cannabis users self-reported higher creativity, and performed significantly better on a measure of convergent thinking. Controlling for cannabis users' higher levels of openness to experience abolished these effects. Therefore, while cannabis users appear to demonstrate enhanced creativity, these effects are an artifact of their heightened levels of openness to experience. Copyright © 2017 Elsevier Inc. All rights reserved.

Is cannabis an effective treatment for joint pain?

Science.gov (United States)

Miller, Richard J; Miller, Rachel E

2017-01-01

Cannabis has been used to treat pain for thousands of years. However, since the early part of the 20th century, laws restricting cannabis use have limited its evaluation using modern scientific criteria. Over the last decade, the situation has started to change because of the increased availability of cannabis in the United States for either medical or recreational purposes, making it important to provide the public with accurate information as to the effectiveness of the drug for joint pain among other indications. The major psychotropic component of cannabis is Δ9-tetrahydrocannabinol (THC), one of some 120 naturally occurring phytocannabinoids. Cannabidiol (CBD) is another molecule found in herbal cannabis in large amounts. Although CBD does not produce psychotropic effects, it has been shown to produce a variety of pharmacological effects. Hence, the overall effects of herbal cannabis represent the collective activity of THC, CBD and a number of minor components. The action of THC is mediated by two major G-protein coupled receptors, cannabinoid receptor type 1 (CB1) and CB2, and recent work has suggested that other targets may also exist. Arachidonic acid derived endocannabinoids are the normal physiological activators of the two cannabinoid receptors. Natural phytocannabinoids and synthetic derivatives have produced clear activity in a variety of models of joint pain in animals. These effects are the result of both inhibition of pain pathway signalling (mostly CB1) and anti-inflammatory effects (mostly CB2). There are also numerous anecdotal reports of the effectiveness of smoking cannabis for joint pain. Indeed, it is the largest medical request for the use of the drug. However, these reports generally do not extend to regulated clinical trials for rheumatic diseases. Nevertheless, the preclinical and human data that do exist indicate that the use of cannabis should be taken seriously as a potential treatment of joint pain.

The Pharmacological Basis of Cannabis Therapy for Epilepsy.

Science.gov (United States)

Reddy, Doodipala Samba; Golub, Victoria M

2016-04-01

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. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

Psychotic-like symptomatology and reward responsivity in chronic ketamine and cannabis users

OpenAIRE

Joye, A. M.

2015-01-01

This thesis assesses psychotic-like symptomatology and reward responsivity in chronic users of two illicit drugs, cannabis and ketamine. As use of these drugs is steadily increasing, with cannabis being the most widely used drug worldwide (following alcohol, caffeine and tobacco) and the recent proliferation of ketamine misuse in parts of Asia, Europe and the United States, it is important to examine the effects of their habitual use. While research has linked cannabis use to sub-clinical psy...

Reaching out towards cannabis: approach-bias in heavy cannabis users predicts changes in cannabis use

NARCIS (Netherlands)

Cousijn, Janna; Goudriaan, Anna E.; Wiers, Reinout W.

2011-01-01

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

Substitution and Complementarity of Alcohol and Cannabis: A Review of the Literature.

Science.gov (United States)

Subbaraman, Meenakshi Sabina

2016-09-18

Whether alcohol and cannabis are used as substitutes or complements remains debated, and findings across various disciplines have not been synthesized to date. This article is a first step towards organizing the interdisciplinary literature on alcohol and cannabis substitution and complementarity. Electronic searches were performed using PubMed and ISI Web of Knowledge. Behavioral studies of humans with "alcohol" (or "ethanol") and "cannabis" (or "marijuana") and "complement(*)" (or "substitut(*)") in the title or as a keyword were considered. Studies were organized according to sample characteristics (youth, general population, clinical and community-based). These groups were not set a priori, but were informed by the literature review process. Of the 39 studies reviewed, 16 support substitution, ten support complementarity, 12 support neither and one supports both. Results from studies of youth suggest that youth may reduce alcohol in more liberal cannabis environments (substitute), but reduce cannabis in more stringent alcohol environments (complement). Results from the general population suggest that substitution of cannabis for alcohol may occur under more lenient cannabis policies, though cannabis-related laws may affect alcohol use differently across genders and racial groups. Alcohol and cannabis act as both substitutes and complements. Policies aimed at one substance may inadvertently affect consumption of other substances. Future studies should collect fine-grained longitudinal, prospective data from the general population and subgroups of interest, especially in locations likely to legalize cannabis.

Analysis of Cannabis Seizures in NSW, Australia: Cannabis Potency and Cannabinoid Profile

Science.gov (United States)

Li, Kong M.; Arnold, Jonathon C.; McGregor, Iain S.

2013-01-01

Recent analysis of the cannabinoid content of cannabis plants suggests a shift towards use of high potency plant material with high levels of Δ9-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 (cannabis with very low CBD content. The implications for public health outcomes and harm reduction strategies are discussed. PMID:23894589

Cannabis exacerbates depressive symptoms in rat model induced by reserpine.

Science.gov (United States)

Khadrawy, Yasser A; Sawie, Hussein G; Abdel-Salam, Omar M E; Hosny, Eman N

2017-05-01

Cannabis sativa is one of the most widely recreational drugs and its use is more prevalent among depressed patients. Some studies reported that Cannabis has antidepressant effects while others showed increased depressive symptoms in Cannabis users. Therefore, the present study aims to investigate the effect of Cannabis extract on the depressive-like rats. Twenty four rats were divided into: control, rat model of depression induced by reserpine and depressive-like rats treated with Cannabis sativa extract (10mg/kg expressed as Δ9-tetrahydrocannabinol). The depressive-like rats showed a severe decrease in motor activity as assessed by open field test (OFT). This was accompanied by a decrease in monoamine levels and a significant increase in acetylcholinesterase activity in the cortex and hippocampus. Na + ,K + -ATPase activity increased in the cortex and decreased in the hippocampus of rat model. In addition, a state of oxidative stress was evident in the two brain regions. This was indicated from the significant increase in the levels of lipid peroxidation and nitric oxide. No signs of improvement were observed in the behavioral and neurochemical analyses in the depressive-like rats treated with Cannabis extract. Furthermore, Cannabis extract exacerbated the lipid peroxidation in the cortex and hippocampus. According to the present findings, it could be concluded that Cannabis sativa aggravates the motor deficits and neurochemical changes induced in the cortex and hippocampus of rat model of depression. Therefore, the obtained results could explain the reported increase in the depressive symptoms and memory impairment among Cannabis users. Copyright © 2017 Elsevier B.V. All rights reserved.

Who are the adolescents saying "No" to cannabis offers.

Science.gov (United States)

Burdzovic Andreas, Jasmina; Pape, Hilde; Bretteville-Jensen, Anne Line

2016-06-01

Adolescents who refuse direct cannabis offers and remain non-users represent a potentially very informative, yet surprisingly understudied group. We examined a range of risk and protective factors putatively associated with this poorly understood "cannabis-resilient" profile. Paper-and-pencil questionnaires assessing substance use, peer and family relations, and behavioral and personality characteristics were completed by 19,303 middle- and high-school students from 82 schools in Norway (response rate 84%) The lifetime prevalence of cannabis use was 7.6%. Another 10.4% reported no use of the drug despite having received recent cannabis offers. Results from the multinomial logistic regression revealed a set of characteristics differentiating adolescents who resisted such offers from those who: (a) neither received the offers nor used, and, more importantly, (b) used the drug. Specifically, parent-child relationship quality, negative drug-related beliefs, absence of close relationships with cannabis-users, low delinquency, no regular tobacco use, and infrequent alcohol intoxication were all associated with increased odds of being in the cannabis-resilient vs. cannabis-user group. This pattern of results was comparable across middle- and high-school cohorts, but the parent-child relationship quality and delinquency were significantly associated with cannabis-resilient vs. cannabis-use outcome only among younger and older adolescents, respectively. Among other low-risk characteristics, better relationships with parents and beliefs that drug use is problematic were associated with adolescents' refusals to accept cannabis offers. These results may have implications for novel preventive strategies targeting cannabis-exposed adolescents. Copyright © 2016. Published by Elsevier Ireland Ltd.

Examining effects of medical cannabis narratives on beliefs, attitudes, and intentions related to recreational cannabis: A web-based randomized experiment.

Science.gov (United States)

Sznitman, Sharon R; Lewis, Nehama

2018-04-01

This experimental study tests effects of exposure to video narratives about successful symptom relief with Medical Cannabis (MC) on attitudes, beliefs, and intentions related to recreational cannabis use. Patient video testimonials were modeled after those found in extant media coverage. Israeli participants (N = 396) recruited through an online survey company were randomly assigned to view a narrative or a non-narrative video containing equivalent information about MC. Video content was further manipulated based on whether the protagonist had a stigmatized disease or not, and whether attribution of responsibility for his disease was internal or external. Exposure to patient testimonials indirectly increased positive attitudes, beliefs and intentions related to recreational cannabis use through changing attitudes, beliefs and intentions related to MC. Furthermore, exposure to narratives in which the patient was presented as not to blame for contracting his illness (external attribution) was associated with more positive attitudes, beliefs and intentions toward MC, a factor that was significantly associated with more positive attitudes, beliefs and intentions related to recreational cannabis use. These results suggest that narrative news media coverage of MC may influence public attitudes toward recreational cannabis. Because such media stories continue to be commonplace, it is important to examine potential spillover effects of this coverage on public perceptions of recreational cannabis. Cannabis prevention programs should address the role of media coverage in shaping public opinion and address the distinction between medical and recreational cannabis use. Copyright © 2018 Elsevier B.V. All rights reserved.

Cannabis use patterns and motives: A comparison of younger, middle-aged, and older medical cannabis dispensary patients.

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Haug, Nancy A; Padula, Claudia B; Sottile, James E; Vandrey, Ryan; Heinz, Adrienne J; Bonn-Miller, Marcel O

2017-09-01

Medical cannabis is increasingly being used for a variety of health conditions as more states implement legislation permitting medical use of cannabis. Little is known about medical cannabis use patterns and motives among adults across the lifespan. The present study examined data collected at a medical cannabis dispensary in San Francisco, California. Participants included 217 medical cannabis patients who were grouped into age-defined cohorts (younger: 18-30, middle-aged: 31-50, and older: 51-72). The age groups were compared on several measures of cannabis use, motives and medical conditions using one-way ANOVAs, chi-square tests and linear regression analyses. All three age groups had similar frequency of cannabis use over the past month; however, the quantity of cannabis used and rates of problematic cannabis use were higher among younger users relative to middle-aged and older adults. The association between age and problematic cannabis use was moderated by age of regular use initiation such that earlier age of regular cannabis use onset was associated with more problematic use in the younger users, but not among older users. Middle-aged adults were more likely to report using medical cannabis for insomnia, while older adults were more likely to use medical cannabis for chronic medical problems such as cancer, glaucoma and HIV/AIDS. Younger participants reported cannabis use when bored at a greater rate than middle-aged and older adults. Findings suggest that there is an age-related risk for problematic cannabis use among medical cannabis users, such that younger users should be monitored for cannabis use patterns that may lead to deleterious consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cannabis Use Patterns and Motives: A Comparison of Younger, Middle-Aged, and Older Medical Cannabis Dispensary Patients

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Haug, Nancy A.; Padula, Claudia B.; Sottile, James E.; Vandrey, Ryan; Heinz, Adrienne J.; Bonn-Miller, Marcel O.

2017-01-01

Introduction Medical cannabis is increasingly being used for a variety of health conditions as more states implement legislation permitting medical use of cannabis. Little is known about medical cannabis use patterns and motives among adults across the lifespan. Methods The present study examined data collected at a medical cannabis dispensary in San Francisco, California. Participants included 217 medical cannabis patients who were grouped into age-defined cohorts (younger: 18–30, middle-aged: 31–50, and older: 51–72). The age groups were compared on several measures of cannabis use, motives and medical conditions using one-way ANOVAs, chi-square tests and linear regression analyses. Results All three age groups had similar frequency of cannabis use over the past month; however, the quantity of cannabis used and rates of problematic cannabis use were higher among younger users relative to middle-aged and older adults. The association between age and problematic cannabis use was moderated by age of regular use initiation such that earlier age of regular cannabis use onset was associated with more problematic use in the younger users, but not among older users. Middle-aged adults were more likely to report using medical cannabis for insomnia, while older adults were more likely to use medical cannabis for chronic medical problems such as cancer, glaucoma and HIV/AIDS. Younger participants reported cannabis use when bored at a greater rate than middle-aged and older adults. Conclusions Findings suggest that there is an age-related risk for problematic cannabis use among medical cannabis users, such that younger users should be monitored for cannabis use patterns that may lead to deleterious consequences. PMID:28340421

Antecedents and consequences of cannabis use among racially diverse cannabis users: an analysis from Ecological Momentary Assessment.

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Buckner, Julia D; Zvolensky, Michael J; Crosby, Ross D; Wonderlich, Stephen A; Ecker, Anthony H; Richter, Ashley

2015-02-01

Cannabis remains the most commonly used illicit substance and use rates are rising. Notably, the prevalence of cannabis use disorders (CUD) nearly equals that of other illicit substance use disorders combined. Thus, the present study aimed to identify cognitive, affective, and situational predictors and consequences of ad-lib cannabis use in a racially diverse sample. The sample consisted of 93 current cannabis users (34.4% female; 57.1% non-Hispanic Caucasian), 87.1% of whom evinced a current CUD. Ecological Momentary Assessment was used to collect frequent ratings of cannabis withdrawal, craving, affect, cannabis use motives, and peer cannabis use over two weeks. Mixed effects linear models examined within- and between-day correlates and consequences of cannabis use. Withdrawal and craving were higher on cannabis use days than non-use days. Withdrawal, craving, and positive and negative affect were higher immediately prior to cannabis use compared to non-use episodes. Withdrawal and craving were higher among those who subsequently used cannabis than those who did not. Cannabis use resulted in less subsequent withdrawal, craving, and negative affect. Enhancement and coping motives were the most common reasons cited for use. Withdrawal and negative affect were related to using cannabis for coping motives and social motives. Participants were most likely to use cannabis if others were using, and withdrawal and craving were greater in social situations when others were using. Data support the contention that cannabis withdrawal and craving and affect and peer use play important roles in the maintenance of cannabis use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The potential impact of cannabis legalization on the development of cannabis use disorders.

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Budney, Alan J; Borodovsky, Jacob T

2017-11-01

Specific provisions of legal cannabis legislation and regulation could influence cannabis initiation, frequency and quantity of use, and progression to cannabis use disorder. This brief essay highlights scientifically based principles and risk factors that underlie substance use and addiction that can be leveraged to inform policies that might mitigate the development and consequences of cannabis use disorder. Specifically, pharmacologic, access/availability, and environmental factors are discussed in relation to their influence on substance use disorders to illustrate how regulatory provisions can differentially affect these factors and risk for addiction. Relevant knowledge from research and experience with alcohol and tobacco regulation are also considered. Research designed to inform regulatory policy and to evaluate the impact of cannabis legislation on cannabis use and problems is progressing. However, definitive findings will come slowly, and more concerted efforts and resources are needed to expedite this process. In the meantime, policymakers should take advantage of the large body of scientific literature on substance use to foster empirically-guided, common sense approaches to cannabis policy that focus on prevention of addiction. Copyright © 2017 Elsevier Inc. All rights reserved.

Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.

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Vujcic, Isidora; Pavlovic, Aleksandar; Dubljanin, Eleonora; Maksimovic, Jadranka; Nikolic, Aleksandra; Sipetic-Grujicic, Sandra

2017-07-29

Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. To determine medical students' attitudes toward medical cannabis legalization and to examine the factors influencing their attitudes. Fourth-year medical students at the Faculty of Medicine, University of Belgrade, had participated in a cross-sectional study. Data were collected by an anonymous questionnaire. Overall, 63.4% students supported medical cannabis legalization, and only 20.8% supported its legalization for recreational use. Students who previously used marijuana (p medical cannabis legalization compared with students who never used them. Support for marijuana recreational use was also related to prior marijuana (p cancer (90.4%) and chronic pain (74.2%) were correctly reported approved medical indications by more than half the students. Students who supported medical cannabis legalization showed better knowledge about indications, in contrast to opponents for legalization who showed better knowledge about side effects. Beliefs that using medical cannabis is safe and has health benefits were correlated with support for legalization, and previous marijuana and alcohol use, while beliefs that medical cannabis poses health risks correlated most strongly with previous marijuana use. Conclusions/Importance: The medical students' attitudes toward medical cannabis legalization were significantly correlated with previous use of marijuana and alcohol, knowledge about medical indications and side effects, and their beliefs regarding medical cannabis health benefits and risks.

Cannabis exposure as an interactive cardiovascular risk factor and accelerant of organismal ageing: a longitudinal study.

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Reece, Albert Stuart; Norman, Amanda; Hulse, Gary Kenneth

2016-11-07

Many reports exist of the cardiovascular toxicity of smoked cannabis but none of arterial stiffness measures or vascular age (VA). In view of its diverse toxicology, the possibility that cannabis-exposed patients may be ageing more quickly requires investigation. Cross-sectional and longitudinal, observational. Prospective. Single primary care addiction clinic in Brisbane, Australia. 11 cannabis-only smokers, 504 tobacco-only smokers, 114 tobacco and cannabis smokers and 534 non-smokers. known cardiovascular disease or therapy or acute exposure to alcohol, amphetamine, heroin or methadone. Radial arterial pulse wave tonometry (AtCor, SphygmoCor, Sydney) performed opportunistically and sequentially on patients between 2006 and 2011. Algorithmically calculated VA. other central haemodynamic variables. Differences between group chronological ages (CA, 30.47±0.48 to 40.36±2.44, mean±SEM) were controlled with linear regression. Between-group sex differences were controlled by single-sex analysis. Mean cannabis exposure among patients was 37.67±7.16 g-years. In regression models controlling for CA, Body Mass Index (BMI), time and inhalant group, the effect of cannabis use on VA was significant in males (p=0.0156) and females (p=0.0084). The effect size in males was 11.84%. A dose-response relationship was demonstrated with lifetime exposure (pcannabis was robust to adjustment and was unrelated to its acute effects. Significant power interactions between cannabis exposure and the square and cube of CA were demonstrated (from pCannabis is an interactive cardiovascular risk factor (additional to tobacco and opioids), shows a prominent dose-response effect and is robust to adjustment. Cannabis use is associated with an acceleration of the cardiovascular age, which is a powerful surrogate for the organismal-biological age. This likely underlies and bi-directionally interacts with its diverse toxicological profile and is of considerable public health and regulatory

Discriminating the effects of Cannabis sativa and Cannabis indica: a web survey of medical cannabis users.

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Pearce, Daniel D; Mitsouras, Katherine; Irizarry, Kristopher J

2014-10-01

To evaluate the opinions of medical cannabis (MC) users on the effects of Cannabis indica vs. those of Cannabis sativa on conditions and symptoms through an online survey. Survey of 95 non-randomly assigned MC users. A two-sided chi-square test followed by Bonferroni post hoc multiple comparison and Fisher exact test were used to determine correlations. The Cronbach α was used to determine internal consistency. Announcements on 13 MC websites with links to SurveyMonkey.com. Self-identified MC users. Web survey. Species effects were compared regarding health symptoms, conditions, purpose, route, and trust in product label. Trust in the purity, the route of administration, or the purpose (recreational vs. medicinal) did not differ between the two species. A preference for C. indica was statistically significant for pain management (p=0.001), helping with sedation (p=0.015), and sleep (p<0.001). C. sativa was preferred for euphoria (p<0.001) and enhancing energy (p=0.022). The conditions reaching statistical significance for C. indica preference were: nonmigraine headaches (p=0.042), glaucoma (p=0.036), neuropathy (p=0.024), spasticity (p=0.048), seizures (p=0.031), insomnia (p<0.001), and joint pain (p=0.048). For C. sativa, no conditions reached significance. The MC websites' descriptions of effects that agreed with the survey results are listed. Some conditions had very few respondents. The internal consistency/reliability (Cronbach α) was adequate for the condition scale but not for the symptom survey. In this anonymous Web survey, which had limitations, the two species had different effect associations on symptoms and conditions, possibly because of ingredient differences. Future surveys and subsequent prospective definitive trials are needed to confirm the findings.

Regulating compassion: an overview of Canada's federal medical cannabis policy and practice

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Lucas Philippe G

2008-01-01

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

Regulating compassion: an overview of Canada's federal medical cannabis policy and practice

Science.gov (United States)

Lucas, Philippe G

2008-01-01

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 cooperation with community

Medical cannabis ‒ the Canadian perspective 

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Ko GD

2016-09-01

Full Text Available 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 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. Keywords: randomized controlled trials

Cannabis and sport.

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Saugy, M; Avois, L; Saudan, C; Robinson, N; Giroud, C; Mangin, P; Dvorak, J

2006-07-01

Cannabis is on the list of prohibited substances in the practice of sport, although its performance enhancing effect has not yet been proved. Its popularity among the younger generations as a social drug puts cannabis at the top of the list of compounds detected by the anti-doping laboratories accredited by the World Anti-Doping Agency worldwide. The management of the results of urine analysis is quite difficult for the medical and disciplinary committees not only because of the social use of the substance, but also because of the interpretation of the analytical data from urine samples. This paper gives an overview of what is presently known about cannabis in relation with the practice of sport. Review of literature on the cannabis and exercise, its effect in the body, and the problems with interpretation of results when it is detected in urine. The paper outlines the major effects of cannabis in the context of its social use and its use for sport activities. The difficulties in the interpretation of urine sample analysis results because of the protracted excretion time of the main metabolite, long after the intake, are described. There is an urgent need for sport authorities to take measures necessary to avoid players misusing cannabis.

Reliability and validity of the Marijuana Motives Measure among young adult frequent cannabis users and associations with cannabis dependence.

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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

2015-01-01

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study.

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Malouff, John M; Johnson, Caitlin E; Rooke, Sally E

2016-01-01

Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages.

The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration.

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Schlienz, Nicolas J; Lee, Dustin C; Stitzer, Maxine L; Vandrey, Ryan

2018-06-01

There is a clear need for advancing the treatment of cannabis use disorders. Prior research has demonstrated that dronabinol (oral THC) can dose-dependently suppress cannabis withdrawal and reduce the acute effects of smoked cannabis. The present study was conducted to evaluate whether high-dose dronabinol could reduce cannabis self-administration among daily users. Non-treatment seeking daily cannabis users (N = 13) completed a residential within-subjects crossover study and were administered placebo, low-dose dronabinol (120 mg/day; 40 mg tid), or high-dose dronabinol (180-240 mg/day; 60-80 mg tid) for 12 consecutive days (order counterbalanced). During each 12-day dronabinol maintenance phase, participants were allowed to self-administer smoked cannabis containing <1% THC (placebo) or 5.7% THC (active) under forced-choice (drug vs. money) or progressive ratio conditions. Participants self-administered significantly more active cannabis compared with placebo in all conditions. When active cannabis was available, self-administration was significantly reduced during periods of dronabinol maintenance compared with placebo maintenance. There was no difference in self-administration between the low- and high-dose dronabinol conditions. Chronic dronabinol dosing can reduce cannabis self-administration in daily cannabis users and suppress withdrawal symptoms. Cannabinoid agonist medications should continue to be explored for therapeutic utility in the treatment of cannabis use disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

Predicting creativity: the role of psychometric schizotypy and cannabis use in divergent thinking.

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Minor, Kyle S; Firmin, Ruth L; Bonfils, Kelsey A; Chun, Charlotte A; Buckner, Julia D; Cohen, Alex S

2014-12-15

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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cannabis cultivation: Methodological issues for obtaining medical-grade product.

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Chandra, Suman; Lata, Hemant; ElSohly, Mahmoud A; Walker, Larry A; Potter, David

2017-05-01

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". Copyright © 2016. Published by Elsevier Inc.

Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.

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Russo, Ethan B; Guy, Geoffrey W; Robson, Philip J

2007-08-01

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.

Anormalidades cognitivas no uso da cannabis Cognitive abnormalities and cannabis use

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Nadia Solowij

2010-05-01

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

Cannabis Mobile Apps: A Content Analysis.

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Ramo, Danielle E; Popova, Lucy; Grana, Rachel; Zhao, Shirley; Chavez, Kathryn

2015-08-12

Mobile technology is pervasive and widely used to obtain information about drugs such as cannabis, especially in a climate of rapidly changing cannabis policy; yet the content of available cannabis apps is largely unknown. Understanding the resources available to those searching for cannabis apps will clarify how this technology is being used to reflect and influence cannabis use behavior. We investigated the content of 59 cannabis-related mobile apps for Apple and Android devices as of November 26, 2014. The Apple and Google Play app stores were searched using the terms "cannabis" and "marijuana." Three trained coders classified the top 20 apps for each term and each store, using a coding guide. Apps were examined for the presence of 20 content codes derived by the researchers. Total apps available for each search term were 124 for cannabis and 218 for marijuana in the Apple App Store, and 250 each for cannabis and marijuana on Google Play. The top 20 apps in each category in each store were coded for 59 independent apps (30 Apple, 29 Google Play). The three most common content areas were cannabis strain classification (33.9%), facts about cannabis (20.3%), and games (20.3%). In the Apple App Store, most apps were free (77%), all were rated "17+" years, and the average user rating was 3.9/5 stars. The most popular apps provided cannabis strain classifications (50%), dispensary information (27%), or general facts about cannabis (27%). Only one app (3%) provided information or resources related to cannabis abuse, addiction, or treatment. On Google Play, most apps were free (93%), rated "high maturity" (79%), and the average user rating was 4.1/5. The most popular app types offered games (28%), phone utilities (eg, wallpaper, clock; 21%) and cannabis food recipes (21%); no apps addressed abuse, addiction, or treatment. Cannabis apps are generally free and highly rated. Apps were most often informational (facts, strain classification), or recreational (games), likely

[Cannabis-induced disorders].

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Soyka, M; Preuss, U; Hoch, E

2017-03-01

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.

Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety.

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Di Blasi, Maria; Cavani, Paola; Pavia, Laura; Tosto, Crispino; La Grutta, Sabina; Lo Baido, Rosa; Giordano, Cecilia; Schimmenti, Adriano

2017-01-01

The relationship between social anxiety (SA) and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between SA and cannabis use severity in a sample of 343 young adults (74.3% male) who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test) and SA symptoms (Social Interaction Anxiety Scale and Social Phobia Scale). A multiple mediation analysis was used to test whether marijuana effect expectancies mediate SA effect on problematic cannabis use. SA was negatively associated with cannabis use severity in this sample, and we found evidence that cannabis use expectancies fully mediated this relationship. Specifically, global negative effect expectancies influence the relationship between SA and problematic cannabis use. These findings may inform current prevention strategies and clinical intervention for young adults who use cannabis.

Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety

Directory of Open Access Journals (Sweden)

Maria Di Blasi

2017-11-01

Full Text Available The relationship between social anxiety (SA and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between SA and cannabis use severity in a sample of 343 young adults (74.3% male who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test and SA symptoms (Social Interaction Anxiety Scale and Social Phobia Scale. A multiple mediation analysis was used to test whether marijuana effect expectancies mediate SA effect on problematic cannabis use. SA was negatively associated with cannabis use severity in this sample, and we found evidence that cannabis use expectancies fully mediated this relationship. Specifically, global negative effect expectancies influence the relationship between SA and problematic cannabis use. These findings may inform current prevention strategies and clinical intervention for young adults who use cannabis.

Cannabis abuse in patients with schizophrenia pattern and effects on symptomatology

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Rehman, I U; Farooq, S [Lady Reading Hospital, Peshawar (Pakistan). Dept. of Provincial Health

2007-03-15

To determine the relationship between cannabis abuse and its impact on the short-term outcome and severity of illness. ICD-10 criteria were used for diagnosis of schizophrenia. Severity and type of schizophrenic symptoms were assessed with the help of PANSS. Cases were identified as having problem with cannabis use with the help of section 12 of Schedule for Clinical Assessment in Neuropsychiatry (SCAN) W.H.O. 1994. Amount, duration and frequency of cannabis use was also noted. Patients with cannabis use were younger had shorter duration of illness and earlier age at onset of illness. They exhibited more positive symptoms. A total of 20% cases met ICD-10 criteria of harmful use of cannabinoid, 76% met ICD-10 criteria of cannabinoid dependence syndrome. Schizophrenic patients with comorbid cannabis abuse exhibited more positive symptoms and violent behavior, and may be more likely to lead to dependence in persons with schizophrenia. This has implication for service development to meet the perceived needs of this group. (author)

Cannabis abuse in patients with schizophrenia pattern and effects on symptomatology

International Nuclear Information System (INIS)

Rehman, I.U.; Farooq, S.

2007-01-01

To determine the relationship between cannabis abuse and its impact on the short-term outcome and severity of illness. ICD-10 criteria were used for diagnosis of schizophrenia. Severity and type of schizophrenic symptoms were assessed with the help of PANSS. Cases were identified as having problem with cannabis use with the help of section 12 of Schedule for Clinical Assessment in Neuropsychiatry (SCAN) W.H.O. 1994. Amount, duration and frequency of cannabis use was also noted. Patients with cannabis use were younger had shorter duration of illness and earlier age at onset of illness. They exhibited more positive symptoms. A total of 20% cases met ICD-10 criteria of harmful use of cannabinoid, 76% met ICD-10 criteria of cannabinoid dependence syndrome. Schizophrenic patients with comorbid cannabis abuse exhibited more positive symptoms and violent behavior, and may be more likely to lead to dependence in persons with schizophrenia. This has implication for service development to meet the perceived needs of this group. (author)

Cannabidiol, a Cannabis sativa constituent, as an antipsychotic drug

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Zuardi A.W.

2006-01-01

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.

Online self-help forums on cannabis: A content assessment.

Science.gov (United States)

Greiner, Christian; Chatton, Anne; Khazaal, Yasser

2017-10-01

To investigate online self-help forums related to cannabis users who were searching for help on the Internet. We analyzed the content of 717 postings by 328 users in three online forums in terms of fields of interest and self-help mechanisms. Only English-language forums that were free of charge and without registration were investigated. The main self-help mechanisms were disclosure and symptoms, with relatively few posts concerning legal issues and social perceptions. The forums differed significantly in all fields of interest and self-help mechanisms except for social network and financial and vocational issues. Highly involved users more commonly posted on topics related to diagnosis, etiology/research, and provision of information and less commonly on those related to gratitude. Correlation analysis showed a moderate negative correlation between emotional support and illness-related aspects and between emotional support and exchange of information. Cannabis forums share similarities with other mental health forums. Posts differ according to user involvement and the specific orientation of the forum. The Internet offers a viable source of self-help and social support for cannabis users, which has potential clinical implications in terms of referring clients to specific forums. Copyright © 2017 Elsevier B.V. All rights reserved.

Dental treatment planning considerations for patients using cannabis: A case report.

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Grafton, Sarah Essek; Huang, Po Ning; Vieira, Alexandre R

2016-05-01

There is a deficit in clinical research on the potential risks involved in treating dental patients who use cannabis for either medicinal or recreational purposes. The aim of this case report is to illustrate the need for additional education for oral health care professionals so they can understand the wide variety of available cannabis options and their potential effects on dental treatment. A 27-year-old man sought care at the dental clinic with a nonrestorable molar requiring extraction. During the review of his medical history, the patient reported taking a "dab" of marijuana approximately 5 hours before his appointment. Because of the admission of recent illicit drug use, no treatment was rendered. The patient was offered an appointment the next day but he refused, citing bias in regard to his cannabis use. The number of Americans using marijuana is increasing rapidly. Twenty-three states and the District of Columbia have laws legalizing cannabis to some degree, and Alaska, Colorado, Oregon, and Washington have legalized marijuana for recreational use. This drastic upswing in availability and usage will require dentists to address the possible effects of cannabis on dental practices. It is imperative that dental care providers make clinical decisions based on scientific evidence regarding the pharmacologic and psychological effects of marijuana, not on the societal stigma associated with illegal drug use. Dentists should be familiar with popular delivery systems and understand the differences between various marijuana options. Clinical guidelines may need to be developed to help providers assess the patient's degree of cognitive impairment. Dentists should be able to advise patients on the potential consequences of this habit on their oral health. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Determination of Pesticide Residues in Cannabis Smoke

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Nicholas Sullivan

2013-01-01

Full Text Available The present study was conducted in order to quantify to what extent cannabis consumers may be exposed to pesticide and other chemical residues through inhaled mainstream cannabis smoke. Three different smoking devices were evaluated in order to provide a generalized data set representative of pesticide exposures possible for medical cannabis users. Three different pesticides, bifenthrin, diazinon, and permethrin, along with the plant growth regulator paclobutrazol, which are readily available to cultivators in commercial products, were investigated in the experiment. Smoke generated from the smoking devices was condensed in tandem chilled gas traps and analyzed with gas chromatography-mass spectrometry (GC-MS. Recoveries of residues were as high as 69.5% depending on the device used and the component investigated, suggesting that the potential of pesticide and chemical residue exposures to cannabis users is substantial and may pose a significant toxicological threat in the absence of adequate regulatory frameworks.

Effects of Cannabis sativa extract on haloperidol-induced catalepsy and oxidative stress in the mice

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Abdel-Salam, Omar M.E.; El-Sayed El-Shamarka, Marawa; Salem, Neveen A.; El-Din M. Gaafar, Alaa

2012-01-01

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 in mice. Cannabis extract was given by subcutaneous route at 5, 10 or 20 mg/kg (expressed as Δ9-tetrahydrocannabinol) once daily for 18 days and the effect on haloperidol (1 mg/kg, i.p.)-induced catalepsy was examined at selected time intervals using the bar test. Mice were euthanized 18 days after starting cannabis injection when biochemical assays were carried out. Malondialdehyde (MDA), reduced glutathione (GSH) and nitric oxide (the concentrations of nitrite/nitrate) were determined in brain and liver. In saline-treated mice, no catalepsy was observed at doses of cannabis up to 20 mg/kg. Mice treated with haloperidol at the dose of 1 mg/kg, exhibited significant cataleptic response. Mice treated with cannabis and haloperidol showed significant decrease in catalepsy duration, compared with the haloperidol only treated group. This decrease in catalepsy duration was evident on days 1-12 after starting cannabis injection. Later the effect of cannabis was not apparent. The administration of only cannabis (10 or 20 mg/kg) decreased brain MDA by 17.5 and 21.8 %, respectively. The level of nitric oxide decreased by 18 % after cannabis at 20 mg/kg. Glucose in brain decreased by 20.1 % after 20 mg/kg of cannabis extract. The administration of only haloperidol increased MDA (22.2 %), decreased GSH (25.7 %) and increased brain nitric oxide by 44.1 %. The administration of cannabis (10 or 20 mg/kg) to haloperidol-treated mice resulted in a significant decrease in brain MDA and nitric

Nicotine dependence predicts cannabis use disorder symptoms among adolescents and young adults.

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Dierker, Lisa; Braymiller, Jessica; Rose, Jennifer; Goodwin, Renee; Selya, Arielle

2018-06-01

We evaluate if cigarette smoking and/or nicotine dependence predicts cannabis use disorder symptoms among adolescent and young adult cannabis users and whether the relationships differ based on frequency of cannabis use. Data were drawn from seven annual surveys of the NSDUH to include adolescents and young adults (age 12-21) who reported using cannabis at least once in the past 30 days (n = 21,928). Cannabis use frequency trends in the association between cigarette smoking, nicotine dependence and cannabis use disorder symptoms were assessed using Varying Coefficient Models (VCM's). Over half of current cannabis users also smoked cigarettes in the past 30 days (54.7% SE 0.48). Cigarette smoking in the past 30 days was associated with earlier onset of cannabis use, more frequent cannabis use and a larger number of cannabis use disorder symptoms compared to those who did not smoke cigarettes. After statistical control for socio-demographic characteristics and other substance use behaviors, nicotine dependence but not cigarette smoking quantity or frequency was positively and significantly associated with each of the cannabis use disorder symptoms as well as the total number of cannabis symptoms endorsed. Higher nicotine dependence scores were consistently associated with the cannabis use disorder symptoms across all levels of cannabis use from 1 day used (past month) to daily cannabis use, though the relationship was strongest among infrequent cannabis users. Prevention and treatment efforts should consider cigarette smoking comorbidity when addressing the increasing proportion of the US population that uses cannabis. Copyright © 2018 Elsevier B.V. All rights reserved.

What does a mouse tell us about neuregulin 1 – cannabis interactions?

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Tim eKarl

2013-02-01

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.

Sudden onset unexplained encephalopathy in infants: think of cannabis intoxication.

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Lavi, Eran; Rekhtman, David; Berkun, Yackov; Wexler, Isaiah

2016-03-01

The use of cannabis as both a therapeutic agent and recreational drug is common, and its availability is increasing as a result of legalization in many countries. Among older children, the manifestations of cannabis intoxication are numerous and include both neurological and systemic manifestations that are frequently non-specific. There have been only a few reports detailing cannabis intoxication in infants and toddlers. We describe three infants who presented to the emergency department with encephalopathic signs without prominent systemic manifestations. During the initial interview of caregivers, no history of exposure to neurotoxic agents was obtained. All three patients were subsequently diagnosed with cannabis intoxication based on urine toxic screens for delta-9-tetrahydrocannabinol (THC). The infants recovered with supportive care that included fluids and monitoring. The non-specific symptomatology of cannabis intoxication in infants together with the wide differential for unexplained acute onset encephalopathy may delay diagnosis and lead to inappropriate procedures and interventions such as antimicrobial treatments and imaging studies. Healthcare personnel of emergency rooms, urgent care centers, and general clinics should be aware of the potential risk of cannabis ingestion in young infants. A thorough medical history and toxic screen are warranted in all infants with unexplained decreased sensorium.

Cannabis Use, Employment, and Income: Fixed-effects Analysis of Panel Data

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Popovici, Ioana; French, Michael T.

2013-01-01

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 (NESARC), 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 (ptechniques 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. PMID:23793384

Terpene synthases from Cannabis sativa.

Science.gov (United States)

Booth, Judith K; Page, Jonathan E; Bohlmann, Jörg

2017-01-01

Cannabis (Cannabis sativa) plants produce and accumulate a terpene-rich resin in glandular trichomes, which are abundant on the surface of the female inflorescence. Bouquets of different monoterpenes and sesquiterpenes are important components of cannabis resin as they define some of the unique organoleptic properties and may also influence medicinal qualities of different cannabis strains and varieties. Transcriptome analysis of trichomes of the cannabis hemp variety 'Finola' revealed sequences of all stages of terpene biosynthesis. Nine cannabis terpene synthases (CsTPS) were identified in subfamilies TPS-a and TPS-b. Functional characterization identified mono- and sesqui-TPS, whose products collectively comprise most of the terpenes of 'Finola' resin, including major compounds such as β-myrcene, (E)-β-ocimene, (-)-limonene, (+)-α-pinene, β-caryophyllene, and α-humulene. Transcripts associated with terpene biosynthesis are highly expressed in trichomes compared to non-resin producing tissues. Knowledge of the CsTPS gene family may offer opportunities for selection and improvement of terpene profiles of interest in different cannabis strains and varieties.

Medicinsk cannabis : En litteraturstudie om användningen av medicinsk cannabis inom cancervården

OpenAIRE

Nygård, Sofia

2017-01-01

Detta examensarbete handlar om användningen av medicinsk cannabis inom cancervården. Syftet med examensarbetet var att undersöka vilken roll cannabis kan ha i cancervården. Frågeställningarna var: Hur upplever patienten användning av medicinsk cannabis? Vilken hjälp kan patienten väntas få av medicinsk cannabis? vilka attityder har vårdpersonal mot medicinsk cannabis? Som utgångsteorier i denna studie användes Ruland och Moors teori om ett fridfullt slut på livet samt Erikssons teori om ...

Approach-bias predicts development of cannabis problem severity in heavy cannabis users: results from a prospective FMRI study.

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Janna Cousijn

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.

Approach-bias predicts development of cannabis problem severity in heavy cannabis users: results from a prospective FMRI study.

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Cousijn, Janna; Goudriaan, Anna E; Ridderinkhof, K Richard; van den Brink, Wim; Veltman, Dick J; Wiers, Reinout W

2012-01-01

A potentially powerful predictor for the course of drug (ab)use 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.

Cannabis use amongst patients with inflammatory bowel disease.

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Lal, Simon; Prasad, Neeraj; Ryan, Manijeh; Tangri, Sabrena; Silverberg, Mark S; Gordon, Allan; Steinhart, Hillary

2011-10-01

Experimental evidence suggests the endogenous cannabinoid system may protect against colonic inflammation, leading to the possibility that activation of this system may have a therapeutic role in inflammatory bowel disease (IBD). Medicinal use of cannabis for chronic pain and other symptoms has been reported in a number of medical conditions. We aimed to evaluate cannabis use in patients with IBD. One hundred patients with ulcerative colitis (UC) and 191 patients with Crohn's disease (CD) attending a tertiary-care outpatient clinic completed a questionnaire regarding current and previous cannabis use, socioeconomic factors, disease history and medication use, including complimentary alternative medicines. Quality of life was assessed using the short-inflammatory bowel disease questionnaire. A comparable proportion of UC and CD patients reported lifetime [48/95 (51%) UC vs. 91/189 (48%) CD] or current [11/95 (12%) UC vs. 30/189 (16%) CD] cannabis use. Of lifetime users, 14/43 (33%) UC and 40/80 (50%) CD patients have used it to relieve IBD-related symptoms, including abdominal pain, diarrhoea and reduced appetite. Patients were more likely to use cannabis for symptom relief if they had a history of abdominal surgery [29/48 (60%) vs. 24/74 (32%); P=0.002], chronic analgesic use [29/41 (71%) vs. 25/81 (31%); Pmedicine use [36/66 (55%) vs. 18/56 (32%); P=0.01] and a lower short inflammatory bowel disease questionnaire score (45.1±2.1 vs. 50.3±1.5; P=0.03). Patients who had used cannabis [60/139 (43%)] were more likely than nonusers [13/133 (10%); Pcannabis for IBD. Cannabis use is common amongst patients with IBD for symptom relief, particularly amongst those with a history of abdominal surgery, chronic abdominal pain and/or a low quality of life index. The therapeutic benefits of cannabinoid derivatives in IBD may warrant further exploration.

Trends in Lifetime Cannabis Use among Czech School-aged Children from 2002 to 2014.

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Kážmér, Ladislav; Csémy, Ladislav; Ružbarská, Ingrid; Pavelka, Jan; Hamřík, Zdeněk; Kalman, Michal

2017-07-01

The aim of the study was to examine trends in the prevalence of lifetime cannabis use among the Czech 15-year old students. Data from the nationally representative Health Behaviour in School-aged Children Survey, conducted in the Czech Republic in 2002, 2006, 2010 and 2014, were used. Trends in cannabis use among both boys and girls were modelled through binary logistic regression with period as a predictor of the lifetime cannabis use. The prevalence of lifetime cannabis use has significantly decreased among young Czechs, particularly among boys. Gender differences in cannabis use have been also gradually decreasing since 2002, with no significant differences between genders in recent period. Although there are positive changes in the prevalence of adolescent cannabis use, from the European perspective, Czech students still belong to those with significantly higher rates in this respect. Thus, alongside with the use of other substances, adolescent cannabis consumption remains an important challenge for the national public health policy. Copyright© by the National Institute of Public Health, Prague 2017

Standardized Cannabis sativa extract attenuates tau and stathmin gene expression in the melanoma cell line.

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Vaseghi, Golnaz; Taki, Mohamad Javad; Javanmard, Shaghayegh Haghjooy

2017-10-01

Metastasis is the main cause of death in patients with melanoma. Cannabis-based medicines are effective adjunctive drugs in cancer patients. Tau and Stathmin proteins are the key proteins in cancer metastasis. Here we have investigated the effect of a standardized Cannabis sativa extract on cell migration and Tau and Stathmin gene expression in the melanoma cell line. In the treatment group, melanoma (B1617) was treated 48 hr with various concentrations of standardized C. sativa extract. Cells with no treatment were considered as the control group, then study was followed by Quantitative RT-Real Time PCR assay. Relative gene expression was calculated by the ΔΔct method. Migration assay was used to evaluate cancer metastasis. Tau and stathmin gene expression was significantly decreased compared to the control group. Cell migration was also significantly reduced compared to controls. C. sativa decreased tau and stathmin gene expression and cancer metastasis. The results may have some clinical relevance for the use of cannabis-based medicines in patients with metastatic melanoma.

Behavioral Characterization of the Effects of Cannabis Smoke and Anandamide in Rats.

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Adriaan W Bruijnzeel

Full Text Available Cannabis is the most widely used illicit drug in the world. Delta-9-tetrahydrocannabinol (Δ9-THC is the main psychoactive component of cannabis and its effects have been well-studied. However, cannabis contains many other cannabinoids that affect brain function. Therefore, these studies investigated the effect of cannabis smoke exposure on locomotor activity, rearing, anxiety-like behavior, and the development of dependence in rats. It was also investigated if cannabis smoke exposure leads to tolerance to the locomotor-suppressant effects of the endogenous cannabinoid anandamide. Cannabis smoke was generated by burning 5.7% Δ9-THC cannabis cigarettes in a smoking machine. The effect of cannabis smoke on the behavior of rats in a small and large open field and an elevated plus maze was evaluated. Cannabis smoke exposure induced a brief increase in locomotor activity followed by a prolonged decrease in locomotor activity and rearing in the 30-min small open field test. The cannabinoid receptor type 1 (CB1 receptor antagonist rimonabant increased locomotor activity and prevented the smoke-induced decrease in rearing. Smoke exposure also increased locomotor activity in the 5-min large open field test and the elevated plus maze test. The smoke exposed rats spent more time in the center zone of the large open field, which is indicative of a decrease in anxiety-like behavior. A high dose of anandamide decreased locomotor activity and rearing in the small open field and this was not prevented by rimonabant or pre-exposure to cannabis smoke. Serum Δ9-THC levels were 225 ng/ml after smoke exposure, which is similar to levels in humans after smoking cannabis. Exposure to cannabis smoke led to dependence as indicated by more rimonabant-precipitated somatic withdrawal signs in the cannabis smoke exposed rats than in the air-control rats. In conclusion, chronic cannabis smoke exposure in rats leads to clinically relevant Δ9-THC levels, dependence, and has

Cannabis og psykose

DEFF Research Database (Denmark)

Nordentoft, Merete

2006-01-01

Longitudinal studies of the association between use of cannabis and later psychosis or schizophrenia were reviewed. Studies included were studies in the general population and in conscripts, using information from interviews about use of cannabis and register-based follow-up in psychiatric case......-registers or in personal interviews. There was a consistent finding that use of cannabis was associated with an increased risk of later psychosis with an odds ratio of approximately 2, when adjusted for predisposition to mental illness and socio-demographic risk factors....

Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors.

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Lucas, Philippe; Walsh, Zach; Crosby, Kim; Callaway, Robert; Belle-Isle, Lynne; Kay, Robert; Capler, Rielle; Holtzman, Susan

2016-05-01

Recent years have witnessed increased attention to how cannabis use impacts the use of other psychoactive substances. The present study examines the use of cannabis as a substitute for alcohol, illicit substances and prescription drugs among 473 adults who use cannabis for therapeutic purposes. The Cannabis Access for Medical Purposes Survey is a 414-question cross-sectional survey that was available to Canadian medical cannabis patients online and by hard copy in 2011 and 2012 to gather information on patient demographics, medical conditions and symptoms, patterns of medical cannabis use, cannabis substitution and barriers to access to medical cannabis. Substituting cannabis for one or more of alcohol, illicit drugs or prescription drugs was reported by 87% (n = 410) of respondents, with 80.3% reporting substitution for prescription drugs, 51.7% for alcohol, and 32.6% for illicit substances. Respondents who reported substituting cannabis for prescription drugs were more likely to report difficulty affording sufficient quantities of cannabis, and patients under 40 years of age were more likely to substitute cannabis for all three classes of substance than older patients. The finding that cannabis was substituted for all three classes of substances suggests that the medical use of cannabis may play a harm reduction role in the context of use of these substances, and may have implications for abstinence-based substance use treatment approaches. Further research should seek to differentiate between biomedical substitution for prescription pharmaceuticals and psychoactive drug substitution, and to elucidate the mechanisms behind both. [Lucas P, Walsh Z, Crosby K, Callaway R, Belle-Isle L, Kay B, Capler R, Holtzman S. Substituting cannabis for prescription drugs, alcohol, and other substances among medical cannabis patients: The impact of contextual factors. Drug Alcohol Rev 2016;35:326-333]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Verbal learning and memory in adolescent cannabis users, alcohol users and non-users.

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Solowij, Nadia; Jones, Katy A; Rozman, Megan E; Davis, Sasha M; Ciarrochi, Joseph; Heaven, Patrick C L; Lubman, Dan I; Yücel, Murat

2011-07-01

Long-term heavy cannabis use can result in memory impairment. Adolescent users may be especially vulnerable to the adverse neurocognitive effects of cannabis. In a cross-sectional and prospective neuropsychological study of 181 adolescents aged 16-20 (mean 18.3 years), we compared performance indices from one of the most widely used measures of learning and memory--the Rey Auditory Verbal Learning Test--between cannabis users (n=52; mean 2.4 years of use, 14 days/month, median abstinence 20.3 h), alcohol users (n=67) and non-user controls (n=62) matched for age, education and premorbid intellectual ability (assessed prospectively), and alcohol consumption for cannabis and alcohol users. Cannabis users performed significantly worse than alcohol users and non-users on all performance indices. They recalled significantly fewer words overall (pmemory performance after controlling for extent of exposure to cannabis. Despite relatively brief exposure, adolescent cannabis users relative to their age-matched counterparts demonstrated similar memory deficits to those reported in adult long-term heavy users. The results indicate that cannabis adversely affects the developing brain and reinforce concerns regarding the impact of early exposure.

Evaluation of cannabinoids concentration and stability in standardized preparations of cannabis tea and cannabis oil by ultra-high performance liquid chromatography tandem mass spectrometry.

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Pacifici, Roberta; Marchei, Emilia; Salvatore, Francesco; Guandalini, Luca; Busardò, Francesco Paolo; Pichini, Simona

2017-08-28

Cannabis has been used since ancient times to relieve neuropathic pain, to lower intraocular pressure, to increase appetite and finally to decrease nausea and vomiting. The combination of the psychoactive cannabis alkaloid Δ9-tetrahydrocannabinol (THC) with the non-psychotropic alkaloids cannabidiol (CBD) and cannabinol (CBN) demonstrated a higher activity than THC alone. The Italian National Institute of Health sought to establish conditions and indications on how to correctly use nationally produced cannabis to guarantee therapeutic continuity in individuals treated with medical cannabis. The evaluation of cannabinoids concentration and stability in standardized preparations of cannabis tea and cannabis oil was conducted using an easy and fast ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) assay. Extraction efficiency of oil was significantly higher than that of water with respect to the different cannabinoids. This was especially observed in the case of the pharmacologically active THC, CBD and their acidic precursors. Fifteen minutes boiling was sufficient to achieve the highest concentrations of cannabinoids in the cannabis tea solutions. At ambient temperature, a significant THC and CBD decrease to 50% or less of the initial concentration was observed over 3 and 7 days, respectively. When refrigerated at 4 °C, similar decreasing profiles were observed for the two compounds. The cannabinoids profile in cannabis oil obtained after pre-heating the flowering tops at 145 °C for 30 min in a static oven resulted in a complete decarboxylation of cannabinoid acids CBDA and THCA-A. Nevertheless, it was apparent that heat not only decarboxylated acidic compounds, but also significantly increased the final concentrations of cannabinoids in oil. The stability of cannabinoids in oil samples was higher than that in tea samples since the maximum decrease (72% of initial concentration) was observed in THC coming from unheated flowering

Substitution and complementarity of alcohol and cannabis: A review of the literature

Science.gov (United States)

2016-01-01

Background Whether alcohol and cannabis are used as substitutes or complements remains debated, and findings across various disciplines have not been synthesized to date. Objective This paper is a first step towards organizing the interdisciplinary literature on alcohol and cannabis substitution and complementarity. Method Electronic searches were performed using PubMed and ISI Web of Knowledge. Behavioral studies of humans with ‘alcohol’ (or ‘ethanol’) and ‘cannabis’ (or ‘marijuana”) and ‘complement*’ (or ‘substitut*’) in the title or as a keyword were considered. Studies were organized according to sample characteristics (youth, general population, clinical and community-based). These groups were not set a priori, but were informed by the literature review process. Results Of the 39 studies reviewed, 16 support substitution, ten support complementarity, 12 support neither and one supports both. Results from studies of youth suggest that youth may reduce alcohol in more liberal cannabis environments (substitute), but reduce cannabis in more stringent alcohol environments (complement). Results from the general population suggest that substitution of cannabis for alcohol may occur under more lenient cannabis policies, though cannabis-related laws may affect alcohol use differently across genders and racial groups. Conclusions Alcohol and cannabis act as both substitutes and complements. Policies aimed at one substance may inadvertently affect consumption of other substances. Future studies should collect fine-grained longitudinal, prospective data from the general population and subgroups of interest, especially in locations likely to legalize cannabis. PMID:27249324

Cannabis and psychosis: have we found the missing links?

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Parakh, Preeti; Basu, Debasish

2013-08-01

The association between cannabis and psychosis has long been a matter of debate, with cannabis widely perceived as a harmless recreational drug. Electronic bibliographic databases like PubMed and Google Scholar were searched using the format "(psychosis or schizophrenia or synonyms) and (cannabis or synonyms)". Cross-linked searches were made taking the lead from key articles. Recent articles and those exploring the genetic factors or gene-environment interaction between cannabis use and psychosis were focussed upon. Heavy cannabis use at a n young age, in association with genetic liability to psychosis and exposure to environmental stressors like childhood trauma and urban upbringing increases the risk of psychotic outcome in later life. Cannabis acts as a component cause of psychosis, that is, it increases the risk of psychosis in people with certain genetic or environmental vulnerabilities, though by itself, it is neither a sufficient nor a necessary cause of psychosis. Although significant progress has been made over the last few years, we are yet to find all the missing links. Further work is necessary to identify all the factors that underlie individual vulnerability to cannabis-related psychosis and to elucidate the biological mechanisms underlying this risk. Copyright © 2013 Elsevier B.V. All rights reserved.

Cannabis use and first manic episode.

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Bally, Nathalie; Zullino, Daniele; Aubry, Jean-Michel

2014-08-01

Cannabis is the most commonly abused drug among patients with bipolar disorder. Available data has shown that the risk of psychotic disorders increases with the frequency and intensity of cannabis abuse. The present purpose was to review relevant studies to investigate whether cannabis use can be linked to the onset of mania in bipolar disorder. Articles published between 1972 and December 2013 were searched on Medline and PsychInfo using the following keywords: first manic episode, or onset mania, or bipolar disorder and cannabis. Relevant papers cited in the references of selected articles were further considered for inclusion into the review. Lifetime use of cannabis among bipolar patients appears to be around 70% and approximately 30% of patients with a bipolar disorder present a comorbidity of cannabis abuse or dependence. Cannabis use is associated with younger age at onset of first mania and with more frequent depressive or manic episodes, although the evidence is somewhat inconsistent. Likewise cannabis consumption is related to poorer outcome and an increased risk of rapid cycling or mixed episodes. In contrast, neuro-cognitive functioning seems to be positively affected in patients with psychiatric comorbidity. While cannabis use often precedes first manic episodes, the causal direction remains to be determined. Variations in definition of cannabis use/dependence. Lack of controlled studies limiting definite conclusions about a putative causal relationship between cannabis and onset of mania. Further investigations are needed to clarify the relationships between cannabis use and first manic episode. Copyright © 2014 Elsevier B.V. All rights reserved.

Cannabis Mobile Apps: A Content Analysis

Science.gov (United States)

Popova, Lucy; Grana, Rachel; Zhao, Shirley; Chavez, Kathryn

2015-01-01

Background Mobile technology is pervasive and widely used to obtain information about drugs such as cannabis, especially in a climate of rapidly changing cannabis policy; yet the content of available cannabis apps is largely unknown. Understanding the resources available to those searching for cannabis apps will clarify how this technology is being used to reflect and influence cannabis use behavior. Objective We investigated the content of 59 cannabis-related mobile apps for Apple and Android devices as of November 26, 2014. Methods The Apple and Google Play app stores were searched using the terms “cannabis” and “marijuana.” Three trained coders classified the top 20 apps for each term and each store, using a coding guide. Apps were examined for the presence of 20 content codes derived by the researchers. Results Total apps available for each search term were 124 for cannabis and 218 for marijuana in the Apple App Store, and 250 each for cannabis and marijuana on Google Play. The top 20 apps in each category in each store were coded for 59 independent apps (30 Apple, 29 Google Play). The three most common content areas were cannabis strain classification (33.9%), facts about cannabis (20.3%), and games (20.3%). In the Apple App Store, most apps were free (77%), all were rated “17+” years, and the average user rating was 3.9/5 stars. The most popular apps provided cannabis strain classifications (50%), dispensary information (27%), or general facts about cannabis (27%). Only one app (3%) provided information or resources related to cannabis abuse, addiction, or treatment. On Google Play, most apps were free (93%), rated “high maturity” (79%), and the average user rating was 4.1/5. The most popular app types offered games (28%), phone utilities (eg, wallpaper, clock; 21%) and cannabis food recipes (21%); no apps addressed abuse, addiction, or treatment. Conclusions Cannabis apps are generally free and highly rated. Apps were most often informational

Passive inhalation of cannabis smoke

Energy Technology Data Exchange (ETDEWEB)

Law, B; Mason, P A; Moffat, A C; King, L J; Marks, V

1984-09-01

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.

The relationship between cannabis use and measures of anxiety and depression in a sample of college campus cannabis users and non-users post state legalization in Colorado

Directory of Open Access Journals (Sweden)

Lucy J. Troup

2016-12-01

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.

[Consumption of cannabis in adolescents].

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Phan, O; Obradovic, I; Har, A

2017-01-01

Over the past 10 years, the consumption of cannabis among adolescents has dramatically increased. Today, adolescent cannabis use is a major public health problem. Two forms of cannabis are commonly smoked: herb (marijuana) and resin. These forms have a high concentration of tetrahydrocannabinol, the active molecule of cannabis. Recent research has helped understand how the cannabinoid system works. This system combines specific receptors and specific molecules: the endocannabinoids. The effects of cannabis use are now well documented. Some adolescents report subjective positive effects. They use it not only on a recreational basis, but also to deal with their emotions. Over the long term, cannabis increases the risk of depression and schizophrenia for those adolescents who are at risk. Use, misuse, and dependence are frequently associated with heavy psychopathologic problems such as vulnerability and depression. Many cannabis dependence psychotherapies have shown their efficacy and efficiency. Motivational interviews, cognitive behavioral therapy, multidimensional family therapy (MDFT), and residential treatment have proved highly effective. MDFT seems very effective, especially in cases of heavy use. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Terpene synthases from Cannabis sativa.

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Judith K Booth

Full Text Available Cannabis (Cannabis sativa plants produce and accumulate a terpene-rich resin in glandular trichomes, which are abundant on the surface of the female inflorescence. Bouquets of different monoterpenes and sesquiterpenes are important components of cannabis resin as they define some of the unique organoleptic properties and may also influence medicinal qualities of different cannabis strains and varieties. Transcriptome analysis of trichomes of the cannabis hemp variety 'Finola' revealed sequences of all stages of terpene biosynthesis. Nine cannabis terpene synthases (CsTPS were identified in subfamilies TPS-a and TPS-b. Functional characterization identified mono- and sesqui-TPS, whose products collectively comprise most of the terpenes of 'Finola' resin, including major compounds such as β-myrcene, (E-β-ocimene, (--limonene, (+-α-pinene, β-caryophyllene, and α-humulene. Transcripts associated with terpene biosynthesis are highly expressed in trichomes compared to non-resin producing tissues. Knowledge of the CsTPS gene family may offer opportunities for selection and improvement of terpene profiles of interest in different cannabis strains and varieties.

Cannabis in the Treatment of Dystonia, Dyskinesias, and Tics.

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Koppel, Barbara S

2015-10-01

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.

Cannabis-induced impairment of learning and memory: effect of different nootropic drugs

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Abdel-Salam, Omar M.E.; Salem, Neveen A.; El-Sayed El-Shamarka, Marwa; Al-Said Ahmed, Noha; Seid Hussein, Jihan; El-Khyat, Zakaria A.

2013-01-01

Cannabis sativa preparations are the most commonly used illicit drugs worldwide. The present study aimed to investigate the effect of Cannabis sativa extract in the working memory version of the Morris water maze (MWM; Morris, 1984[43]) test and determine the effect of standard memory enhancing drugs. Cannabis sativa was given at doses of 5, 10 or 20 mg/kg (expressed as Δ9-tetrahydrocannabinol) alone or co-administered with donepezil (1 mg/kg), piracetam (150 mg/ kg), vinpocetine (1.5 mg/kg) or ginkgo biloba (25 mg/kg) once daily subcutaneously (s.c.) for one month. Mice were examined three times weekly for their ability to locate a submerged platform. Mice were euthanized 30 days after starting cannabis injection when biochemical assays were carried out. Malondialdehyde (MDA), reduced glutathione (GSH), nitric oxide, glucose and brain monoamines were determined. Cannabis resulted in a significant increase in the time taken to locate the platform and enhanced the memory impairment produced by scopolamine. This effect of cannabis decreased by memory enhancing drugs with piracetam resulting in the most-shorter latency compared with the cannabis. Biochemically, cannabis altered the oxidative status of the brain with decreased MDA, increased GSH, but decreased nitric oxide and glucose. In cannabis-treated rats, the level of GSH in brain was increased after vinpocetine and donepezil and was markedly elevated after Ginkgo biloba. Piracetam restored the decrease in glucose and nitric oxide by cannabis. Cannabis caused dose-dependent increases of brain serotonin, noradrenaline and dopamine. After cannabis treatment, noradrenaline is restored to its normal value by donepezil, vinpocetine or Ginkgo biloba, but increased by piracetam. The level of dopamine was significantly reduced by piracetam, vinpocetine or Ginkgo biloba. These data indicate that cannabis administration is associated with impaired memory performance which is likely to involve decreased brain glucose

Cannabis induced asystole.

Science.gov (United States)

Brancheau, Daniel; Blanco, Jessica; Gholkar, Gunjan; Patel, Brijesh; Machado, Christian

2016-01-01

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis

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Dragt, S.; Nieman, D. H.; Schultze-Lutter, F.; van der Meer, F.; Becker, H.; de Haan, L.; Dingemans, P. M.; Birchwood, M.; Patterson, P.; Salokangas, R. K. R.; Heinimaa, M.; Heinz, A.; Juckel, G.; Graf von Reventlow, H.; French, P.; Stevens, H.; Ruhrmann, S.; Klosterkötter, J.; Linszen, D. H.; McGorry, Patrick D.; McGlashan, Thomas H.; Knapp, Martin; van de Fliert, Reinaud; Klaassen, Rianne; Picker, Heinz; Neumann, Meike; Brockhaus-Dumke, Anke; Pukrop, Ralf; Svirskis, Tanja; Huttunen, Jukka; Laine, Tiina; Ilonen, Tuula; Ristkari, Terja; Hietala, Jarmo; Skeate, Amanda; Gudlowski, Yehonala; Ozgürdal, Seza; Witthaus, Henning; Lewis, Shôn; Morrisson, Antony

2012-01-01

Objective: Numerous studies have found a robust association between cannabis use and the onset of psychosis. Nevertheless, the relationship between cannabis use and the onset of early ( or, in retrospect, prodromal) symptoms of psychosis remains unclear. The study focused on investigating the

"I Use Weed for My ADHD": A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD.

Directory of Open Access Journals (Sweden)

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.

"I Use Weed for My ADHD": A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD.

Science.gov (United States)

Mitchell, John T; Sweitzer, Maggie M; Tunno, Angela M; Kollins, Scott H; McClernon, F Joseph

2016-01-01

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.

Concurrent cannabis use during treatment for comorbid ADHD and cocaine dependence: effects on outcome.

Science.gov (United States)

Aharonovich, Efrat; Garawi, Fatima; Bisaga, Adam; Brooks, Daniel; Raby, Wilfrid N; Rubin, Eric; Nunes, Edward V; Levin, Frances R

2006-01-01

Cannabis is the most widely used illicit substance in the United States with especially high prevalence of use among those with psychiatric disorders. Few studies have examined the relationship between concurrent cannabis use and treatment outcome among patients receiving treatment for comorbid substance abuse and psychiatric disorders. This study investigated the effects of cannabis use on treatment retention and abstinence from cocaine among cocaine dependent patients with Attention Deficit Hyperactivity Disorder (ADHD). Cocaine dependent patients diagnosed with current ADHD (DSM-IV, N = 92) aged 25 to 51 participated in a randomized clinical trial of methylphenidate for treatment of ADHD and cocaine dependence in an outpatient setting. The majority of patients (69%) used cannabis during treatment. Results suggest that moderate/intermittent cannabis users had greater retention rates compared to abstainers and consistent users (p = .02). This study is the first to examine concurrent cannabis use in cocaine dependent patients diagnosed with ADHD.

Marijuana (Cannabis) and Multiple Sclerosis

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... progression of MS: Effect of oral dronabinol (a synthetic Cannabis/marijuana derivative) on progression in progressive MS: Previous ... the evidence regarding marijuana and its derivatives: Oral cannabis extract and synthetic THC (tetrahydrocannabinol — a major active component of cannabis) ...

Successful and unsuccessful cannabis quitters: Comparing group characteristics and quitting strategies

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Rooke Sally E

2011-11-01

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.

Cannabis Use and Mental Health Problems

NARCIS (Netherlands)

van Ours, J.C.; Williams, J.

2009-01-01

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

Correlates of cannabis vape-pen use and knowledge among U.S. college students

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Tessa Frohe

2018-06-01

Full Text Available Introduction: The proliferation of electronic devices, such as vape-pens, has provided alternative means for cannabis use. Research has found cannabis-vaping (i.e., vape-pen use is associated with lower perceived risks and higher cannabis use. Knowledge of these products may increase likelihood of subsequent use. As policies for cannabis shift, beliefs that peers and family approve of this substance use (injunctive norms increase and there has been an increase in vape-pen use among young adults (18–35year olds; however, correlates thereof remain unknown. Young adults often engage in cross-substance use with cannabis and alcohol, making alcohol a potential correlate of cannabis vape-pen use and knowledge. Therefore, we examined alcohol use and other potential correlates of vape-pen use and knowledge among a sample of university students. Methods: This secondary data analysis utilized surveys at multiple colleges in the U.S. (N=270. Alcohol use, social anxiety, cannabis expectancies, injunctive and descriptive norms and facets of impulsivity were examined as correlates of vape-pen use and knowledge using bivariate correlations and logistic regressions. Results: Alcohol use was correlated with cannabis vape-pen use and knowledge. Frequency of cannabis use, peer injunctive norms, and positive expectancies were associated with increased likelihood of vape-pen use. Lack of premeditation, a facet of impulsivity, was associated with cannabis vape-pen knowledge. Conclusions: Given the unknown nature and consequences of cannabis vape-pens, the present findings offer valuable information on correlates of this behavior. Further, correlates of knowledge of vape-pens may point to areas for education and clinical intervention to prevent heavy cannabis vape-pen use. Keywords: Marijuana, Vaporizer, College students, Substance use, Attitudes, Cannabis

Neurobiologia da Cannabis: do sistema endocanabinoide aos transtornos por uso de Cannabis

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José Luis G. Pinho Costa

2011-01-01

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.

Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly.

Science.gov (United States)

Abuhasira, Ran; Schleider, Lihi Bar-Lev; Mechoulam, Raphael; Novack, Victor

2018-03-01

There is a substantial growth in the use of medical cannabis in recent years and with the aging of the population, medical cannabis is increasingly used by the elderly. We aimed to assess the characteristics of elderly people using medical cannabis and to evaluate the safety and efficacy of the treatment. A prospective study that included all patients above 65 years of age who received medical cannabis from January 2015 to October 2017 in a specialized medical cannabis clinic and were willing to answer the initial questionnaire. Outcomes were pain intensity, quality of life and adverse events at six months. During the study period, 2736 patients above 65 years of age began cannabis treatment and answered the initial questionnaire. The mean age was 74.5 ± 7.5 years. The most common indications for cannabis treatment were pain (66.6%) and cancer (60.8%). After six months of treatment, 93.7% of the respondents reported improvement in their condition and the reported pain level was reduced from a median of 8 on a scale of 0-10 to a median of 4. Most common adverse events were: dizziness (9.7%) and dry mouth (7.1%). After six months, 18.1% stopped using opioid analgesics or reduced their dose. Our study finds that the therapeutic use of cannabis is safe and efficacious in the elderly population. Cannabis use may decrease the use of other prescription medicines, including opioids. Gathering more evidence-based data, including data from double-blind randomized-controlled trials, in this special population is imperative. Copyright © 2018. Published by Elsevier B.V.

Predicting later problematic cannabis use from psychopathological symptoms during childhood and adolescence: Results of a 25-year longitudinal study.

Science.gov (United States)

Zohsel, Katrin; Baldus, Christiane; Schmidt, Martin H; Esser, Günter; Banaschewski, Tobias; Thomasius, Rainer; Laucht, Manfred

2016-06-01

Cannabis is the most commonly used illegal substance among adolescents and young adults. Problematic cannabis use is often associated with comorbid psychopathological problems. The purpose of the current study was to elucidate the underlying developmental processes connecting externalizing and internalizing psychopathology in childhood and adolescence with problematic cannabis use in young adulthood. Data were drawn from the Mannheim Study of Children at Risk, an ongoing epidemiological cohort study from birth to adulthood. For n=307 participants, symptom scores of conduct/oppositional defiant disorder, attention problems, hyperactivity/impulsivity, and internalizing disorders were available for the periods of childhood (4.5-11 years) and adolescence (15 years). At age 25 years, problematic cannabis use was assessed via clinical interview and a self-rating questionnaire. At age 25 years, problematic cannabis use was identified in n=28 participants (9.1%). Childhood conduct/oppositional behavior problems were predictive of problematic cannabis use during young adulthood when comorbid symptoms were controlled for. No such effect was found for childhood attention, hyperactivity/impulsivity or internalizing problems. With respect to psychopathological symptoms during adolescence, only attention problems were significantly related to later problematic cannabis use when controlling for comorbidity. The current study highlights the role of conduct/oppositional behavior problems during childhood and attention problems during adolescence in later problematic cannabis use. It sheds more light on the developmental sequence of childhood and adolescence psychopathology and young adult cannabis use, which is a prerequisite for effective prevention approaches. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Screening and Evaluation of Medications for Treating Cannabis Use Disorder

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Panlilio, Leigh V.; Justinova, Zuzana; Trigo, Jose M.; Le Foll, Bernard

2016-01-01

Cannabis use has been increasingly accepted legally and in public opinion. However, cannabis has the potential to produce adverse physical and mental health effects and can result in cannabis use disorder (CUD) in a substantial percentage of both occasional and daily cannabis users. Many people have difficulty discontinuing use. Therefore, it would be beneficial to develop safe and effective medications for treating CUD. To achieve this, methods have been developed for screening and evaluating potential medications using animal models and controlled experimental protocols in human volunteers. In this chapter we describe: 1) animal models available for assessing the effect of potential medications on specific aspects of CUD; 2) the main findings obtained so far with these animal models; 3) the approaches used to assess potential medications in humans in laboratory experiments and clinical trials; and 4) the effectiveness of several potential pharmacotherapies on the particular aspects of CUD modeled in these human studies. PMID:27055612

Daily Use, Especially of High-Potency Cannabis, Drives the Earlier Onset of Psychosis in Cannabis Users

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Di Forti, Marta; Sallis, Hannah; Allegri, Fabio; Trotta, Antonella; Ferraro, Laura; Stilo, Simona A.; Marconi, Arianna; La Cascia, Caterina; Reis Marques, Tiago; Pariante, Carmine; Dazzan, Paola; Mondelli, Valeria; Paparelli, Alessandra; Kolliakou, Anna; Prata, Diana; Gaughran, Fiona; David, Anthony S.; Morgan, Craig; Stahl, Daniel; Khondoker, Mizanur; MacCabe, James H.; Murray, Robin M.

2014-01-01

Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated. Methods: We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP. Results: Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16–1.74; P cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06–1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P cannabis had an onset an average of 6 years earlier than that of non-cannabis users. Conclusions: Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. PMID:24345517

Neurocognitive Correlates in Driving Under the Influence of Cannabis.

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Busardò, Francesco P; Pellegrini, Manuela; Klein, Julia; di Luca, Natale M

2017-01-01

Delta (9)-tetrahydrocannabinol (THC) is the main psychoactive compound in cannabis and is frequently identified in blood samples from apprehended drivers suspected for driving under the influence of drugs. Changing social norms towards cannabis and higher acceptability towards the drug emphasize the need for in-depth understanding of the acute neurocognitive and psychomotor effects caused by cannabis and how these effects are correlated to driving skills and performance. In this review, PubMed, Cochrane Central, Scopus, Web of Science, Science Direct, EMBASE and Google Scholar databases were used to identify and select publications up to January 2017 dealing with acute and chronic neurocognitive effects induced by cannabis and ability to drive. Thirty-six publications were selected for this review. The studies conducted were experimental, using simulators or on-road studies and brain imaging (structural and functional) to better understand the acute and chronic effects on cognitive functions comprised in the short and long-term fitness to drive after cannabis consumption. In a case-crossover self-report study a significant odds ratio increase was found for driving- related injury after combined exposure to cannabis and alcohol compared to cannabis alone (OR of 10.9 and 5.8 respectively). Both, experimental and epidemiological studies have revealed that THC affects negatively both, psychomotor skills and cognitive functions. Studies of the acute effects of cannabis on driving have shown that drivers under the influence of this substance are impaired. Indeed, driving under the influence of cannabis doubles or triples the risk of a crash. Specifically, cannabis use impairs critical-tracking tasks, increases lane weaving, decreases reaction time, and divided attention. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Pericyazine in the treatment of cannabis dependence in general practice: a naturalistic pilot trial

Directory of Open Access Journals (Sweden)

Morley KC

2012-05-01

Full Text Available Kirsten C Morley,1 Paul S Haber,1,2 Madeleine L Morgan,3 Fares Samara3,41Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, NSW, Australia; 2Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; 3Drug and Alcohol Services, North Coast Area Health Service, Kempsey and Port Macquarie, NSW, Australia; 4Durri Aboriginal Medical Service, Kempsey, NSW, AustraliaAbstract: Cannabis is one of the most widely used illicit drugs worldwide. However, while the rates of cannabis dependence and treatment increase, there remains no medications approved for this use. Due to its sedative effects and low abuse liability, the typical antipsychotic pericyazine has been utilized in some parts of Australia for the treatment of cannabis dependence. We aimed to provide documentation of preliminary outcomes and acceptability of pericyazine treatment in a small sample. A naturalistic case series study was conducted in which 21 patients were enrolled for a 4-week course of pericyazine (up to 8 × 2.5 mg tablets daily and weekly medical review. Levels of cannabis use were reported and side effects with electrocardiography and blood tests were monitored. Measures of dependence severity, depression, anxiety, and insomnia were taken at baseline and follow-up utilizing validated psychometric tools. Significant reductions in cannabis use, depression, anxiety, and insomnia severity occurred across time. Pericyazine appeared to be well tolerated and easily administered in the community clinics. The results provide some preliminary evidence that low-dose short-term pericyazine may be an acceptable mode of treatment in this population. Given the open-label nature of the design, we cannot conclude that pharmacotherapy was uniquely responsible for the treatment effect. Nonetheless, low-dose pericyazine may be a potentially effective approach to the treatment of cannabis dependence, and further evaluation via a randomized placebo

Subjective aggression during alcohol and cannabis intoxication before and after aggression exposure.

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De Sousa Fernandes Perna, E B; Theunissen, E L; Kuypers, K P C; Toennes, S W; Ramaekers, J G

2016-09-01

Alcohol and cannabis use have been implicated in aggression. Alcohol consumption is known to facilitate aggression, whereas a causal link between cannabis and aggression has not been clearly demonstrated. This study investigated the acute effects of alcohol and cannabis on subjective aggression in alcohol and cannabis users, respectively, following aggression exposure. Drug-free controls served as a reference. It was hypothesized that aggression exposure would increase subjective aggression in alcohol users during alcohol intoxication, whereas it was expected to decrease subjective aggression in cannabis users during cannabis intoxication. Heavy alcohol (n = 20) and regular cannabis users (n = 21), and controls (n = 20) were included in a mixed factorial study. Alcohol and cannabis users received single doses of alcohol and placebo or cannabis and placebo, respectively. Subjective aggression was assessed before and after aggression exposure consisting of administrations of the point-subtraction aggression paradigm (PSAP) and the single category implicit association test (SC-IAT). Testosterone and cortisol levels in response to alcohol/cannabis treatment and aggression exposure were recorded as secondary outcome measures. Subjective aggression significantly increased following aggression exposure in all groups while being sober. Alcohol intoxication increased subjective aggression whereas cannabis decreased the subjective aggression following aggression exposure. Aggressive responses during the PSAP increased following alcohol and decreased following cannabis relative to placebo. Changes in aggressive feeling or response were not correlated to the neuroendocrine response to treatments. It is concluded that alcohol facilitates feelings of aggression whereas cannabis diminishes aggressive feelings in heavy alcohol and regular cannabis users, respectively.

Cannabis Use and Outcomes in Patients With Aneurysmal Subarachnoid Hemorrhage.

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Behrouz, Réza; Birnbaum, Lee; Grandhi, Ramesh; Johnson, Jeremiah; Misra, Vivek; Palacio, Santiago; Seifi, Ali; Topel, Christopher; Garvin, Rachel; Caron, Jean-Louis

2016-05-01

The incidence of cannabis use in patients with aneurysmal subarachnoid hemorrhage (aSAH) and its impact on morbidity, mortality, and outcomes are unknown. Our objective was to evaluate the relationship between cannabis use and outcomes in patients with aSAH. Records of consecutive patients admitted with aSAH between 2010 and 2015 were reviewed. Clinical features and outcomes of aSAH patients with negative urine drug screen and cannabinoids-positive (CB+) were compared. Regression analyses were used to assess for associations. The study group consisted of 108 patients; 25.9% with CB+. Delayed cerebral ischemia was diagnosed in 50% of CB+ and 23.8% of urine drug screen negative patients (P=0.01). CB+ was independently associated with development of delayed cerebral ischemia (odds ratio, 2.68; 95% confidence interval, 1.03-6.99; P=0.01). A significantly higher number of CB+ than urine drug screen negative patients had poor outcome (35.7% versus 13.8%; P=0.01). In univariate analysis, CB+ was associated with the composite end point of hospital mortality/severe disability (odds ratio, 2.93; 95% confidence interval, 1.07-8.01; P=0.04). However, after adjusting for other predictors, this effect was no longer significant. We offer preliminary data that CB+ is independently associated with delayed cerebral ischemia and possibly poor outcome in patients with aSAH. Our findings add to the growing evidence on the association of cannabis with cerebrovascular risk. © 2016 American Heart Association, Inc.

Distress intolerance moderation of motivated attention to cannabis and negative stimuli after induced stress among cannabis users: an ERP study.

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Macatee, Richard J; Okey, Sarah A; Albanese, Brian J; Schmidt, Norman B; Cougle, Jesse R

2018-05-07

Prevalence of cannabis use is increasing, but many regular users do not develop cannabis use disorder (CUD); thus, CUD risk identification among current users is vital for targeted intervention development. Existing data suggest that high distress intolerance (DI), an individual difference reflective of the ability to tolerate negative affect, may be linked to CUD, but no studies have tested possible neurophysiological mechanisms. Increased motivated attentional processing of cannabis and negative emotional stimuli as indexed by neurophysiology [i.e. the late positive potential (LPP)], particularly during acute stress, may contribute to CUD among high DI users. Frequent cannabis users with high (n = 61) and low DI (n = 44) viewed cannabis, negative, and matched neutral images during electroencephalography (EEG) recording before and after a laboratory stressor. Cannabis cue-elicited modulation of the 1000- to 3000-milliseconds LPP was larger in high DI users at post-stressor only, although the effect was only robust in the 1000- to 2000-milliseconds window. Further, modulation magnitude in the high DI group covaried with stress-relief craving and some CUD indices in the 400- to 1000-milliseconds and 1000- to 3000-milliseconds windows, respectively. No significant effects of DI on negative stimuli-elicited LPP modulation were found, although inverse associations with some CUD indices were observed. Finally, exploratory analyses revealed some evidence for DI moderation of the relation between subjective stressor reactivity and negative stimuli-elicited LPP modulation such that greater stressor reactivity was associated with blunted versus enhanced modulation in the high and low DI groups, respectively. Negative and cannabis stimuli-elicited LPP modulation appear to index distinct, CUD-relevant neural processes in high DI cannabis users. © 2018 Society for the Study of Addiction.

Dutch coffee shops and trends in cannabis use.

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Korf, Dirk J

2002-01-01

Conflicting predictions have been made to the influence of decriminalization on cannabis use. Prohibitionists forecast that decriminalization will lead to an increase in consumption of cannabis, while their opponents hypothesise that cannabis use will decline after decriminalization. Most probably cannabis use in the Netherlands so far evolved in two waves, with a first peak around 1970, a low during the late 1970s and early 1980s, and a second peak in the mid-1990s. It is striking that this trend in cannabis use among youth in the Netherlands rather parallels four identified stages in the availability of cannabis. The number of cannabis users peaked when the cannabis was distributed through an underground market (late 1960s and early 1970s). Then the number decreased as house dealers were superseeding the underground market (1970s), and went up again after coffee shops took over the sale of cannabis (1980s), and stabilised or slightly decreased by the end of the 1990s when the number of coffee shops was reduced. Although changes in cannabis policy went along with changes in availability of cannabis and prevalence of cannabis use, it is questionable whether changes in cannabis policy were causally related to trends in cannabis use. Cannabis use also developed in waves in other European countries that did not decriminalize cannabis, as well as in the US. Consequently, trends in cannabis use seem to develop rather independently of cannabis policy.

Cannabis - from cultivar to chemovar.

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Hazekamp, A; Fischedick, J T

2012-01-01

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. Copyright © 2012 John Wiley & Sons, Ltd.

Cannabis Decriminalization and the Age of Onset of Cannabis Use

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Cervený, J.; van Ours, J.C.; Chomynova, Pavla; Mravcik, Viktor

2015-01-01

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

Smoked cannabis' psychomotor and neurocognitive effects in occasional and frequent smokers.

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Desrosiers, Nathalie A; Ramaekers, Johannes G; Chauchard, Emeline; Gorelick, David A; Huestis, Marilyn A

2015-05-01

Δ9-Tetrahydrocannabinol (THC), the primary psychoactive constituent in cannabis, impairs psychomotor performance, cognition and driving ability; thus, driving under the influence of cannabis is a public safety concern. We documented cannabis' psychomotor, neurocognitive, subjective and physiological effects in occasional and frequent smokers to investigate potential differences between these smokers. Fourteen frequent (≥4x/week) and 11 occasional (cannabis smokers entered a secure research unit ∼19 h prior to smoking one 6.8% THC cigarette. Cognitive and psychomotor performance was evaluated with the critical tracking (CTT), divided attention (DAT), n-back (working memory) and Balloon Analog Risk (BART) (risk-taking) tasks at -1.75, 1.5, 3.5, 5.5 and 22.5 h after starting smoking. GLM (General Linear Model) repeated measures ANOVA was utilized to compare scores. Occasional smokers had significantly more difficulty compensating for CTT tracking error compared with frequent smokers 1.5 h after smoking. Divided attention performance declined significantly especially in occasional smokers, with session × group effects for tracking error, hits, false alarms and reaction time. Cannabis smoking did not elicit session × group effects on the n-back or BART. Controlled cannabis smoking impaired psychomotor function, more so in occasional smokers, suggesting some tolerance to psychomotor impairment in frequent users. These data have implications for cannabis-associated impairment in driving under the influence of cannabis cases. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Reasons for cannabis use among youths at ultra high risk for psychosis.

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Gill, Kelly E; Poe, Lucy; Azimov, Neyra; Ben-David, Shelly; Vadhan, Nehal P; Girgis, Ragy; Moore, Holly; Cressman, Victoria; Corcoran, Cheryl M

2015-06-01

Cannabis use is prevalent in schizophrenia and its risk states, despite its association with anxiety and positive symptoms. While schizophrenia patients report using cannabis for mood enhancement and social motives, it is not known what motivates clinical high risk (CHR) patients to use cannabis. Among 102 CHR patients, 24 (23%) endorsed cannabis use, and were queried as to reasons for use, using a scale previously administered in schizophrenia patients. We hypothesized a primary motivation for mood enhancement related to anhedonia. We evaluated the 'self-medication' hypothesis by examining if motivation for symptom relief was associated with concurrent severity of symptoms. The rank order of reasons for use in CHR patients was similar to that previously reported by schizophrenia patients, with mood enhancement and social motives as primary reasons for use, and the motivation to use cannabis for symptom relief comparatively less common. Motivation for mood enhancement had a trend association with anhedonia. Motivation for symptom relief was entirely unrelated to concurrent severity of positive and anxiety symptoms. As in schizophrenia, CHR patients primarily use cannabis for mood enhancement, especially in the context of decreased motivation to seek pleasure otherwise. Negative symptoms may drive cannabis use in schizophrenia and its risk states, which may exacerbate positive symptoms. By contrast, CHR patients do not report using cannabis to 'self-medicate' emergent positive symptoms. The understanding of motives for cannabis use among CHR patients may be informative for treatments aimed at reducing use, such as motivational interviewing. © 2013 Wiley Publishing Asia Pty Ltd.

Kwaliteitsnormen Medicinale Cannabis

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Slijkhuis C; Hoving R; Blok-Tip L; Kaste D de; KCF

2004-01-01

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

Cannabis can augment thrombolytic properties of rtPA: Intracranial hemorrhage in a heavy cannabis user.

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Shere, Amar; Goyal, Hemant

2017-12-01

Cannabis is one of the most commonly used illicit drugs in the United States and is considered to have several adverse health effects. There is evidence suggesting that its recreational use is associated with both increased cardio- and cerebrovascular events. Recently, multiple cases of ischemic and hemorrhagic strokes associated with cannabis use were reported in the literature (Goyal et al., 2017). It has been suggested that cannabis can affect cerebral auto-regulation and vascular tone leading to vasoconstriction and acute ischemic stroke. However, hemorrhagic strokes, which are often seen with sympathomimetic illicit drugs (e.g. cocaine and amphetamines), have rarely been reported due to cannabis. Many cellular mechanisms within non-ischemic tissue post stroke may be augmented by heavy cannabis use. Here, we describe a rapid development of hemorrhage following thrombolytic therapy in a patient with heavy cannabis use with an ischemic stroke. Copyright © 2017 Elsevier Inc. All rights reserved.

Cannabis-Related Problems and Social Anxiety: The Mediational Role of Post-Event Processing.

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Ecker, Anthony H; Buckner, Julia D

2018-01-02

Cannabis is the most commonly used illicit drug in the US, and is associated with a range of psychological, social, and physical health-related problems. Individuals who endorse elevated levels of social anxiety are especially at risk for experiencing cannabis-related problems, including cannabis use disorder, despite not using cannabis more often than those with more normative social anxiety. Identification of mechanisms that underlie the relationship between social anxiety and cannabis-related problems may inform treatment and prevention efforts. Post-event processing (PEP, i.e., cognitively reviewing past social interactions/performances) is a social anxiety-related phenomenon that may be one such mechanism. The current study sought to test PEP as a mediator of the relationship between social anxiety and cannabis-related problems, adjusting for cannabis use frequency. Cannabis-using (past 3-month) undergraduate students recruited in 2015 (N = 244; 76.2% female; 74.2% Non-Hispanic Caucasian) completed an online survey of cannabis use, cannabis-related problems, social anxiety, and PEP. Bootstrap estimate of the indirect effect of social anxiety through PEP was significant, suggesting PEP is a mediator of the social anxiety-cannabis-related problems relationship. Conclusions/Importance: Treatment and prevention efforts may benefit from targeting PEP among individuals with elevated social anxiety and cannabis-related problems.

Cannabis use and mental health

NARCIS (Netherlands)

van Gastel, W.A.

2013-01-01

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

Smoking, vaping, eating: Is legalization impacting the way people use cannabis?

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Borodovsky, Jacob T; Crosier, Benjamin S; Lee, Dustin C; Sargent, James D; Budney, Alan J

2016-10-01

In the context of the shifting legal landscape of medical cannabis, different methods of cannabis administration have important public health implications. How medical marijuana laws (MML) may influence patterns of use of alternative methods of cannabis administration (vaping and edibles) compared to traditional methods (smoking) is unclear. The purpose of this study was to determine if the prevalence of use of alternative methods of cannabis administration varied in relation to the presence of and variation in MMLs among states in the United States. Using Qualtrics and Facebook, we collected survey data from a convenience sample of n=2838 individuals who had used cannabis at least once in their lifetime. Using multiple sources, U.S. states were coded by MML status, duration of MML status, and cannabis dispensary density. Adjusted logistic and linear regression analyses were used to analyze outcomes of ever use, preference for, and age of initiation of smoking, vaping, and edibles in relation to MML status, duration of MML status, and cannabis dispensary density. Individuals in MML states had a significantly higher likelihood of ever use of vaping (OR: 2.04, 99% CI: 1.62-2.58) and edibles (OR: 1.78, 99% CI: 1.39-2.26) than those in states without MMLs. Longer duration of MML status and higher dispensary density were also significantly associated with ever use of vaping and edibles. MMLs are related to state-level patterns of utilization of alternative methods of cannabis administration. Whether discrepancies in MML legislation are causally related to these findings will require further study. If MMLs do impact methods of use, regulatory bodies considering medical or recreational legalization should be aware of the potential impact this may have on cannabis users. Copyright © 2016 Elsevier B.V. All rights reserved.

Quantification of Cannabinoid Content in Cannabis

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Tian, Y.; Zhang, F.; Jia, K.; Wen, M.; Yuan, Ch.

2015-09-01

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.

Cannabis use and cognition in schizophrenia

Directory of Open Access Journals (Sweden)

Else-Marie Løberg

2009-11-01

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.

“I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD

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Mitchell, John T.; Sweitzer, Maggie M.; Tunno, Angela M.; Kollins, Scott H.; McClernon, F. Joseph

2016-01-01

Background 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. Methods 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. Results 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). Conclusions 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

Cannabis use in persons with traumatic spinal cord injury in Denmark.

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Andresen, Sven R; Biering-Sørensen, Fin; Hagen, Ellen Merete; Nielsen, Jørgen F; Bach, Flemming W; Finnerup, Nanna B

2017-01-31

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. Cross-sectional survey in Denmark. 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. 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/larger cities, tobacco-smoking, high alcohol intake and higher muscle stiffness were significantly associated with cannabis use. Those who had never tried cannabis reported that they would mainly use cannabis to alleviate pain and spasticity if it were legalized. Cannabis use is more frequent among individuals with spinal cord injury in Denmark than among the general population. High muscle stiffness and various demographic characteristics (lower age, living in rural areas/larger cities, tobacco-smoking and high alcohol intake) were associated with cannabis use. Most participants had started using cannabis before their spinal cord injury. There was considerable overlap between recreational and disability-related use.

Effects of quitting cannabis on respiratory symptoms

Science.gov (United States)

Hancox, Robert J.; Shin, Hayden H.; Gray, Andrew R.; Poulton, Richie; Sears, Malcolm R.

2016-01-01

Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults. Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as ≥52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age. Frequent cannabis use was associated with morning cough (OR 1.97, pcannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers. Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms. PMID:25837035

Cannabis Use When it's Legal

NARCIS (Netherlands)

van Ours, J.C.

2005-01-01

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

Cannabis use and first-episode psychosis: relationship with manic and psychotic symptoms, and with age at presentation.

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Stone, J M; Fisher, H L; Major, B; Chisholm, B; Woolley, J; Lawrence, J; Rahaman, N; Joyce, J; Hinton, M; Johnson, S; Young, A H

2014-02-01

Cannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we investigated the relationship between cannabis use, age of presentation to services, daily functioning, and positive, negative and manic symptoms. Clinical data on 502 patients with first-episode psychosis were collected using the MiData audit database from seven London-based Early Intervention in psychosis teams. Individuals were assessed at two time points--at entry to the service and after 1 year. On each occasion, the Positive and Negative Syndrome Scale, Young Mania Rating Scale and Global Assessment of Functioning Scale disability subscale were rated. At both time points, the use of cannabis and other drugs of abuse in the 6 months preceding each assessment was recorded. Level of cannabis use was associated with a younger age at presentation, and manic symptoms and conceptual disorganization, but not with delusions, hallucinations, negative symptoms or daily functioning. Cannabis users who reduced or stopped their use following contact with services had the greatest improvement in symptoms at 1 year compared with continued users and non-users. Continued users remained more symptomatic than non-users at follow-up. Effective interventions for reducing cannabis use may yield significant health benefits for patients with first-episode psychosis.

Cannabis-Induced Acute Pancreatitis: A Systematic Review.

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Barkin, Jodie A; Nemeth, Zsuzsanna; Saluja, Ashok K; Barkin, Jamie S

2017-09-01

Cannabis is the most frequently consumed illicit drug in the world, with higher prevalence under the age of 35 years. Cannabis was first reported as a possible cause of acute pancreatitis (AP) in 2004. The aim of this systematic review is to examine cannabis use as an etiology of AP. A search using PubMed/Medline, Embase, Scopus, and Cochrane was performed without language or year limitations to May 1, 2016. Search terms were "Cannabis" and "Acute Pancreatitis" with all permutations. The search yielded 239 results. Acute pancreatitis was defined by meeting 2 of 3 Revised Atlanta Classification criteria. Cannabis-induced AP was defined by preceding use of cannabis and exclusion of common causes of AP when reported. Sixteen papers met inclusion criteria dating from 2004 to 2016. There were 26 cases of cannabis-induced AP (23/26 men; 24/26 under the age of 35 y). Acute pancreatitis correlated with increased cannabis use in 18 patients. Recurrent AP related temporally to cannabis use was reported in 15 of 26. There are 13 reports of no further AP episodes after cannabis cessation. Cannabis is a possible risk factor for AP and recurrent AP, occurring primarily in young patients under the age of 35 years. Toxicology screens should be considered in all patients with idiopathic AP.

Impaired functional connectivity of brain reward circuitry in patients with schizophrenia and cannabis use disorder: Effects of cannabis and THC.

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Fischer, Adina S; Whitfield-Gabrieli, Susan; Roth, Robert M; Brunette, Mary F; Green, Alan I

2014-09-01

Cannabis use disorder (CUD) occurs in up to 42% of patients with schizophrenia and substantially worsens disease progression. The basis of CUD in schizophrenia is unclear and available treatments are rarely successful at limiting cannabis use. We have proposed that a dysregulated brain reward circuit (BRC) may underpin cannabis use in these patients. In the present pilot study, we used whole-brain seed-to-voxel resting state functional connectivity (rs-fc) to examine the BRC of patients with schizophrenia and CUD, and to explore the effects of smoked cannabis and orally administered delta-9-tetrahydrocannabinol (THC) on the BRC. 12 patients with schizophrenia and CUD and 12 control subjects each completed two fMRI resting scans, with patients administered either a 3.6% THC cannabis cigarette (n=6) or a 15 mg THC capsule (n=6) prior to their second scan. Results revealed significantly reduced connectivity at baseline in patients relative to controls, with most pronounced hypoconnectivity found between the nucleus accumbens and prefrontal cortical BRC regions (i.e., anterior prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex). Both cannabis and THC administration increased connectivity between these regions, in direct correlation with increases in plasma THC levels. This study is the first to investigate interregional connectivity of the BRC and the effects of cannabis and THC on this circuit in patients with schizophrenia and CUD. The findings from this pilot study support the use of rs-fc as a means of measuring the integrity of the BRC and the effects of pharmacologic agents acting on this circuit in patients with schizophrenia and CUD. Copyright © 2014. Published by Elsevier B.V.

Predicting the transition from frequent cannabis use to cannabis dependence: a three-year prospective study

NARCIS (Netherlands)

van der Pol, Peggy; Liebregts, Nienke; de Graaf, Ron; Korf, Dirk J.; van den Brink, Wim; van Laar, Margriet

2013-01-01

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 cannabis users. A

An Event-Related Potential Study on the Effects of Cannabis on Emotion Processing

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Troup, Lucy J.; Bastidas, Stephanie; Nguyen, Maia T.; Andrzejewski, Jeremy A.; Bowers, Matthew; Nomi, Jason S.

2016-01-01

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. PMID:26926868

Schizophrenia and comorbid cannabis use disorders: Brain structure, function and the effect of antipsychotic medications

NARCIS (Netherlands)

Machielsen, M.W.J.

2014-01-01

The overall aim of the studies described in this thesis was to increase our understanding of schizophrenia, co-morbid cannabis use disorders and the effects of different antipsychotic medications in patients with schizophrenia and a comorbid cannabis use disorder. Therefore we studied the clinical

Neurofunctional changes in adolescent cannabis users with and without bipolar disorder.

Science.gov (United States)

Bitter, Samantha M; Adler, Caleb M; Eliassen, James C; Weber, Wade A; Welge, Jeffrey A; Burciaga, Joaquin; Shear, Paula K; Strakowski, Stephen M; DelBello, Melissa P

2014-11-01

To compare regional brain activation among adolescents with bipolar disorder and co-occurring cannabis use disorder. Cross-sectional study. Cincinnati, OH, USA. Adolescents with bipolar disorder (BP, n = 14), adolescents with cannabis use disorder (MJ, n = 13), adolescents with co-occurring cannabis use and bipolar disorders (BPMJ, n = 25) and healthy adolescents (HC, n = 15). Cannabis craving, substance use, Blood Oxygenation Level Dependent (BOLD) signal assessed by the Marijuana Craving Questionnaire (MCQ), Teen-Addiction Severity Index (T-ASI) and a cannabis cue-reactivity task during a functional magnetic resonance imaging (fMRI) session, respectively. The BP group exhibited significantly greater brain activation than the BPMJ group in the right amygdala (F = 4.14, P = 0.046), left nucleus accumbens (F = 3.8, P = 0.02), left thalamus (F = 3.8, P adolescents with comorbid cannabis use do not exhibit the same over-activation of the regions involved in emotional processing as seen in adolescents with bipolar disorder alone. The absence of these findings in patients with comorbid bipolar and cannabis use disorders suggests that these individuals may have a unique endophenotype of bipolar disorder or that cannabis use may alter brain activation uniquely in bipolar disorder patients who use cannabis. © 2014 Society for the Study of Addiction.

[Cognitive abnormalities and cannabis use].

Science.gov (United States)

Solowij, Nadia; Pesa, Nicole

2010-05-01

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. Literature searches were conducted using the Web of Science database up to February 2010. The terms searched were: "cannabi*" or "marijuana", and "cogniti*" or "memory" or "attention" or "executive function", and human studies were reviewed preferentially over the animal literature. Cannabis use impairs memory, attention, inhibitory control, executive functions and decision making, both during the period of acute intoxication and beyond, persisting for hours, days, weeks or more after the last use of cannabis. Pharmacological challenge studies in humans are elucidating the nature and neural substrates of cognitive changes associated with various cannabinoids. Long-term or heavy cannabis use appears to result in longer-lasting cognitive abnormalities and possibly structural brain alterations. Greater adverse cognitive effects are associated with cannabis use commencing in early adolescence. The endogenous cannabinoid system is involved in regulatory neural mechanisms that modulate processes underlying a range of cognitive functions that are impaired by cannabis. Deficits in human users most likely therefore reflect neuroadaptations and altered functioning of the endogenous cannabinoid system.

Cannabis and Cannabinoids for Chronic Pain.

Science.gov (United States)

Romero-Sandoval, E Alfonso; Kolano, Ashley L; Alvarado-Vázquez, P Abigail

2017-10-05

The purpose of this study was to provide the most up-to-date scientific evidence of the potential analgesic effects, or lack thereof, of the marijuana plant (cannabis) or cannabinoids, and of safety or tolerability of their long-term use. We found that inhaled (smoked or vaporized) cannabis is consistently effective in reducing chronic non-cancer pain. Oral cannabinoids seem to improve some aspects of chronic pain (sleep and general quality of life), or cancer chronic pain, but they do not seem effective in acute postoperative pain, abdominal chronic pain, or rheumatoid pain. The available literature shows that inhaled cannabis seems to be more tolerable and predictable than oral cannabinoids. Cannabis or cannabinoids are not universally effective for pain. Continued research on cannabis constituents and improving bioavailability for oral cannabinoids is needed. Other aspects of pain management in patients using cannabis require further open discussion: concomitant opioid use, medical vs. recreational cannabis, abuse potential, etc.

Cannabis; extracting the medicine

OpenAIRE

Hazekamp, Arno

2007-01-01

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...

Attitudes and perceived risk of cannabis use in Irish adolescents.

Science.gov (United States)

Barrett, P; Bradley, C

2016-08-01

Cannabis is the most widely used illicit drug in the developed world and its use is associated with several adverse physical and mental health effects and negative social outcomes. Earlier use of cannabis increases the risk of adverse effects. Attitudes and perceived risk towards drugs are regarded as strong influences in determining whether or not a person uses cannabis, but there is little existing research on Irish teenagers' attitudes to the risks of this drug. This was a descriptive, cross-sectional study using a structured, anonymous questionnaire. The study was undertaken in nine public and private secondary schools in Cork City and suburbs. Students aged 15-18 and in fourth, fifth or sixth year of school were included. Of the 507 participating students, 39.3 % (n = 199) reported previous cannabis use. There were significantly lower levels of perceived risk of cannabis among those who had used the drug compared with those who had not, for all categories of risk (p < 0.01). Attitudes towards cannabis were more liberal among males and those with previous use of the drug. A minority of students (n = 92; 18.2 %) support legalisation of cannabis. The majority of teenagers (n = 382; 75.8 %) believe that they are not given enough information about the drug. Cannabis use is very widespread among teenagers in Cork. There are relatively low levels of perceived risk of mental and physical health problems with use of the drug. Attitudes towards cannabis are associated with personal use of the drug and gender.

Medicinal cannabis (Bedrolite) substitution therapy in inpatients with a psychotic disorder and a comorbid cannabis use disorder: A case series.

Science.gov (United States)

Schipper, Regi; Dekker, Mathilde; de Haan, Lieuwe; van den Brink, Wim

2018-03-01

Cannabis use disorders are frequently comorbid in patients with a psychotic disorder and are associated with worse outcomes. To date there are no proven effective strategies to achieve cannabis abstinence in this population. An alternative for abstinence might be harm reduction, i.e. replacing the use of street cannabis with high tetrahydrocannabinol and low cannabidiol levels by medicinal cannabis variants with relatively low tetrahydrocannabinol and relatively high cannabidiol levels, thereby reducing the psychosis inducing effects of cannabis and enhancing the antipsychotic effects of cannabis. Here we present the data of a case series with seven inpatients diagnosed with a psychotic disorder and a treatment-resistant cannabis use disorder who received substitution therapy with a low tetrahydrocannabinol medicinal cannabis variant (Bedrolite). The results suggest that the low tetrahydrocannabinol medicinal cannabis variant Bedrolite is not effective in the treatment of inpatients with a psychotic disorder and comorbid cannabis use disorder. Bedrolite is thus not very likely to become an effective harm reduction strategy in these patients.

Cannabis use, cognitive functioning and behaviour problems

OpenAIRE

Griffith-Lendering, Merel Frederique Heleen

2013-01-01

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 an association between psychosis vulnerability and cannabis use, where cannabis use predicts psychosis vulnerability and vice versa, suggesting a bi-directional cascading association. Thirdly, durin...

Correlates of cannabis use among high school students in Shamva ...

African Journals Online (AJOL)

Results: Eight percent of the students in our sample reported current use of cannabis. Associations were found between cannabis use and alcohol consumption (P < 0.001), cigarette smoking (P < 0.001), and having had engaged in sexual intercourse (P < 0.001). Significant relationships were found between recreational ...

Cannabis Epidemiology: A Selective Review.

Science.gov (United States)

Anthony, James C; Lopez-Quintero, Catalina; Alshaarawy, Omayma

2017-01-04

Globally, the most widely used set of compounds among the internationally regulated drugs is cannabis. 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. 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. 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. 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 governmentsponsored research will be sufficient to meet consumer demand for balanced points of view and truly definitive evidence. Copyright© Bentham Science Publishers; For any queries

Cannabis Epidemiology: A Selective Review

Science.gov (United States)

Anthony, James C.; Lopez-Quintero, Catalina; Alshaarawy, Omayma

2017-01-01

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

Standardized Cannabis sativa extract attenuates tau and stathmin gene expression in the melanoma cell line

Directory of Open Access Journals (Sweden)

Golnaz Vaseghi

2017-10-01

Full Text Available Objective(s: Metastasis is the main cause of death in patients with melanoma. Cannabis-based medicines are effective adjunctive drugs in cancer patients. Tau and Stathmin proteins are the key proteins in cancer metastasis. Here we have investigated the effect of a standardized Cannabis sativa extract on cell migration and Tau and Stathmin gene expression in the melanoma cell line. Materials and Methods: In the treatment group, melanoma (B1617 was treated 48 hr with various concentrations of standardized C. sativa extract. Cells with no treatment were considered as the control group, then study was followed by Quantitative RT-Real Time PCR assay. Relative gene expression was calculated by the ΔΔct method. Migration assay was used to evaluate cancer metastasis. Results: Tau and stathmin gene expression was significantly decreased compared to the control group. Cell migration was also significantly reduced compared to controls.  Conclusion: C. sativa decreased tau and stathmin gene expression and cancer metastasis.  The results may have some clinical relevance for the use of cannabis-based medicines in patients with metastatic melanoma.

Medicinal cannabis: moving the debate forward.

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Newton-Howes, Giles; McBride, Sam

2016-11-18

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.

The impact of cannabis use on patients enrolled in opioid agonist therapy in Ontario, Canada.

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Franklyn, Alexandra M; Eibl, Joseph K; Gauthier, Graham J; Marsh, David C

2017-01-01

With the Canadian government legalizing cannabis in the year 2018, the potential harms to certain populations-including those with opioid use disorder-must be investigated. Cannabis is one of the most commonly used substances by patients who are engaged in medication-assisted treatment for opioid use disorder, the effects of which are largely unknown. In this study, we examine the impact of baseline and ongoing cannabis use, and whether these are impacted differentially by gender. We conducted a retrospective cohort study using anonymized electronic medical records from 58 clinics offering opioid agonist therapy in Ontario, Canada. One-year treatment retention was the primary outcome of interest and was measured for patients who did and did not have a cannabis positive urine sample in their first month of treatment, and as a function of the proportion of cannabis-positive urine samples throughout treatment. Our cohort consisted of 644 patients, 328 of which were considered baseline cannabis users and 256 considered heavy users. Patients with baseline cannabis use and heavy cannabis use were at increased risk of dropout (38.9% and 48.1%, respectively). When evaluating these trends by gender, only female baseline users and male heavy users are at increased risk of premature dropout. Both baseline and heavy cannabis use are predictive of decreased treatment retention, and differences do exist between genders. With cannabis being legalized in the near future, physicians should closely monitor cannabis-using patients and provide education surrounding the potential harms of using cannabis while receiving treatment for opioid use disorder.

Child maltreatment and cannabis use in young adulthood: a birth cohort study.

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Mills, Ryan; Kisely, Steve; Alati, Rosa; Strathearn, Lane; Najman, Jake M

2017-03-01

To investigate whether: (1) child maltreatment is associated with life-time cannabis use, early-onset cannabis use, daily cannabis use and DSM-IV cannabis abuse in young adulthood; and (2) behaviour problems, tobacco use and alcohol use at age 14 are associated with cannabis use. Birth cohort using linked government agency child protection data to define exposure to child maltreatment. The Mater-University of Queensland Study of Pregnancy in Brisbane, Australia. Of the original cohort of 7223 mother and child pairs, obtained from consecutive presentations for prenatal care at a hospital serving a cross-section of the community, 3778 (52.3%) of the young people participated at age 21 years. Exposure to child maltreatment was established by substantiated government agency reports. Cannabis outcomes were by self-report questionnaire and Composite International Diagnostic Interview (CIDI)-Auto at age 21. Associations were adjusted for a range of potential confounders. Additional adjustment was carried out for variables measured at age 14-youth behaviour problems [Achenbach Child Behavior Checklist (CBCL)], tobacco use and alcohol use. After adjustment, substantiated child maltreatment was associated with any life-time cannabis use [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.08-2.39], cannabis use prior to age 17 (OR = 2.47, 95 % CI = 1.67-3.65), daily cannabis use (OR = 2.68, 95% CI = 1.49-4.81) and DSM-IV cannabis abuse/dependence (OR = 1.72, 95% CI = 1.07-2.77). Externalizing behaviour and tobacco and alcohol use at age 14 were associated significantly with almost all cannabis outcomes (P maltreated are more likely to go on to use cannabis before the age of 17, use cannabis as an adult, use cannabis daily and meet DSM-IV criteria for cannabis dependence. Externalizing behaviour in adolescence appears partly to mediate the association with adult cannabis use. © 2016 Society for the Study of Addiction.

Limitations to the Dutch cannabis toleration policy: Assumptions underlying the reclassification of cannabis above 15% THC.

Science.gov (United States)

Van Laar, Margriet; Van Der Pol, Peggy; Niesink, Raymond

2016-08-01

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. Copyright © 2016 Springer. Published by Elsevier B.V. All rights reserved.

Correlates of Intentions to Use Cannabis among US High School Seniors in the Case of Cannabis Legalization

Science.gov (United States)

Palamar, Joseph J.; Ompad, Danielle C.; Petkova, Eva

2014-01-01

Background Support for cannabis (“marijuana”) legalization is increasing in the United States (US). Use was recently legalized in two states and in Uruguay, and other states and countries are expected to follow suit. This study examined intentions to use among US high school seniors if cannabis were to become legally available. Methods Data from the last five cohorts (2007–2011) of high school seniors in Monitoring the Future, an annual nationally representative survey of students in the US were utilized. Data were analyzed separately for the 6,116 seniors who reported no lifetime use of cannabis and the 3,828 seniors who reported lifetime use (weighted Ns). We examined whether demographic characteristics, substance use and perceived friend disapproval towards cannabis use were associated with 1) intention to try cannabis among non-lifetime users, and 2) intention to use cannabis as often or more often among lifetime users, if cannabis was legal to use. Results Ten percent of non-cannabis-using students reported intent to initiate use if legal and this would constitute a 5.6% absolute increase in lifetime prevalence of cannabis use in this age group from 45.6% (95% CI=46.6, 44.6) to 51.2% (95% CI=50.2, 52.2). Eighteen percent of lifetime users reported intent to use cannabis more often if it was legal. Odds for intention to use outcomes increased among groups already at high risk for use (e.g., males, whites, cigarette smokers) and odds were reduced when friends disapproved of use. However, large proportions of subgroups of students normally at low risk for use (e.g., non-cigarette-smokers, religious students, those with friends who disapprove of use) reported intention to use if legal. Recent use was also a risk factor for reporting intention to use as often or more often. Conclusion Prevalence of cannabis use is expected to increase if cannabis is legal to use and legally available. PMID:24589410

Correlates of intentions to use cannabis among US high school seniors in the case of cannabis legalization.

Science.gov (United States)

Palamar, Joseph J; Ompad, Danielle C; Petkova, Eva

2014-05-01

Support for cannabis ("marijuana") legalization is increasing in the United States (US). Use was recently legalized in two states and in Uruguay, and other states and countries are expected to follow suit. This study examined intentions to use among US high school seniors if cannabis were to become legally available. Data from the last five cohorts (2007-2011) of high school seniors in Monitoring the Future, an annual nationally representative survey of students in the US were utilized. Data were analyzed separately for the 6116 seniors who reported no lifetime use of cannabis and the 3829 seniors who reported lifetime use (weighted Ns). We examined whether demographic characteristics, substance use and perceived friend disapproval towards cannabis use were associated with (1) intention to try cannabis among non-lifetime users, and (2) intention to use cannabis as often or more often among lifetime users, if cannabis was legal to use. Ten percent of non-cannabis-using students reported intent to initiate use if legal and this would be consistent with a 5.6% absolute increase in lifetime prevalence of cannabis use in this age group from 45.6% (95% CI=44.6, 46.6) to 51.2% (95% CI=50.2, 52.2). Eighteen percent of lifetime users reported intent to use cannabis more often if it was legal. Odds for intention to use outcomes increased among groups already at high risk for use (e.g., males, whites, cigarette smokers) and odds were reduced when friends disapproved of use. However, large proportions of subgroups of students normally at low risk for use (e.g., non-cigarette-smokers, religious students, those with friends who disapprove of use) reported intention to use if legal. Recent use was also a risk factor for reporting intention to use as often or more often. Prevalence of cannabis use is expected to increase if cannabis is legal to use and legally available. Copyright © 2014 Elsevier B.V. All rights reserved.

Cue-induced striatal activity in frequent cannabis users independently predicts cannabis problem severity three years later

NARCIS (Netherlands)

Vingerhoets, W.A.M.; Koenders, L.; van den Brink, W.P.; Wiers, R.W.; Goudriaan, A.E.; van Amelsvoort, T.; de Haan, L.; Cousijn, J.

2016-01-01

Cannabis is the most frequently used illicit drug worldwide, but little is known about the mechanisms underlying continued cannabis use. Cue-reactivity (the physical, psychological, behavioural and neural reaction to substance-related cues) might be related to continued cannabis use. In this 3-year

[Cannabis smoking and lung cancer].

Science.gov (United States)

Underner, M; Urban, T; Perriot, J; de Chazeron, I; Meurice, J-C

2014-06-01

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. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Demographic trends among older cannabis users in the United States, 2006–13

Science.gov (United States)

Han, Benjamin H.; Sherman, Scott; Mauro, Pia M.; Martins, Silvia S.; Rotenberg, James; Palamar, Joseph J.

2017-01-01

Background and Aims The ageing US population is providing an unprecedented population of older adults who use recreational drugs. We aimed to estimate the trends in the prevalence of past-year use of cannabis, describe the patterns and attitudes and determine correlates of cannabis use by adults age 50 years and older. Design Secondary analysis of the National Survey on Drug Use and Health survey from 2006 to 2013, a cross-sectional survey given to a nationally representative probability sample of populations living in US households. Setting USA. Participants A total of 47 140 survey respondents aged ≥ 50 years. Measures Estimates and trends of past-year use of cannabis. Findings The prevalence of past-year cannabis use among adults aged ≥ 50 increased significantly from 2006/07 to 2012/13, with a 57.8% relative increase for adults aged 50–64 (linear trend P aged ≥ 65 (linear trend P = 0.002). When combining data from 2006 to 2013, 6.9% of older cannabis users met criteria for cannabis abuse or dependence, and the majority of the sample reported perceiving no risk or slight risk associated with monthly cannabis use (85.3%) or weekly use (79%). Past-year users were more likely to be younger, male, non-Hispanic, not have multiple chronic conditions and use tobacco, alcohol or other drugs compared with non-past-year cannabis users. Conclusions The prevalence of cannabis use has increased significantly in recent years among US adults aged ≥ 50 years. PMID:27767235

Examining the relationship between medical cannabis laws and cardiovascular deaths in the US.

Science.gov (United States)

Abouk, Rahi; Adams, Scott

2018-03-01

Several countries and many U.S. states have allowed, for cannabis to be used as therapy to treat chronic conditions or pain., This has increased the use of cannabis, particularly among older people.Because cannabis has been linked to adverse cardiac events in the medical literature, there may be unintended consequences on increased use among older people. We analyze cardiac-related mortality data from the U.S. National Vital Statistics System for 1990-2014. We use difference-in-difference fixed-effects models to assess whether there are increased rates of cardiac-related mortality following passage of medical cannabis programs. We also analyze whether states with more liberal rules on dispensing cannabis show higher mortality rates. For men, there is a statistically significant 2.3% increase in the rate of cardiac death following passage. For women, there is a 1.3% increase that is also statistically significant. he effects increase or both men and women with age. The effects are also stronger in states with more a lax approach to cannabis dispensing. Policymakers should be aware of a potential unintended consequence of allowing broader use of cannabis, specifically for those more at risk of cardiovascular events. Copyright © 2017. Published by Elsevier B.V.

Cannabis in cancer care.

Science.gov (United States)

Abrams, D I; Guzman, M

2015-06-01

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-tetrahydrocannabinol, the main bioactive cannabinoid in the plant, has been available as a prescription medication approved for treatment of cancer chemotherapy-induced nausea and vomiting and anorexia associated with the AIDS wasting syndrome. Cannabinoids may be of benefit in the treatment of cancer-related pain, possibly synergistic with opioid analgesics. Cannabinoids have been shown to be of benefit in the treatment of HIV-related peripheral neuropathy, suggesting that they may be worthy of study in patients with other neuropathic symptoms. Cannabinoids have a favorable drug safety profile, but their medical use is predominantly limited by their psychoactive effects and their limited bioavailability. © 2015 American Society for Clinical Pharmacology and Therapeutics.

Cannabis users have higher premorbid IQ than other patients with first onset psychosis.

Science.gov (United States)

Ferraro, Laura; Russo, Manuela; O'Connor, Jennifer; Wiffen, Benjamin D R; Falcone, Maria Aurora; Sideli, Lucia; Gardner-Sood, Poonam; Stilo, Simona; Trotta, Antonella; Dazzan, Paola; Mondelli, Valeria; Taylor, Heather; Friedman, Bess; Sallis, Hannah; La Cascia, Caterina; La Barbera, Daniele; David, Anthony S; Reichenberg, Abraham; Murray, Robin M; Di Forti, Marta

2013-10-01

A number of studies have reported that patients with psychosis who use cannabis have better cognitive performance than those who do not. This is surprising as cannabis can impair cognition in healthy subjects. An obvious question is whether the better current performance of psychotic patients who have used cannabis is a reflection of their having a higher premorbid IQ than those psychotic patients who haven't used cannabis. In a sample of patients at their first episode of psychosis, we tested the hypothesis that patients who smoked cannabis would have a higher premorbid IQ than patients who did not. 279 participants (119 patients and 160 healthy controls) were assessed in order to obtain current and premorbid IQ measures and detailed information on cannabis use. We examined the association between cannabis use and both premorbid and current IQ in patients and controls. Patients who had ever smoked cannabis had significantly higher current (pIQ (p=.004) compared to patients who had never used cannabis. This difference was not found among controls. These findings suggest that the better cognitive performance of patients with their first episode of psychosis who have used cannabis compared with those who haven't is due to the better premorbid IQ of the former. © 2013.

US Epidemiology of Cannabis Use and Associated Problems

Science.gov (United States)

Hasin, Deborah S

2018-01-01

This review provides an overview of the changing US epidemiology of cannabis use and associated problems. Adults and adolescents increasingly view cannabis as harmless, and some can use cannabis without harm. However, potential problems include harms from prenatal exposure and unintentional childhood exposure; decline in educational or occupational functioning after early adolescent use, and in adulthood, impaired driving and vehicle crashes; cannabis use disorders (CUD), cannabis withdrawal, and psychiatric comorbidity. Evidence suggests national increases in cannabis potency, prenatal and unintentional childhood exposure; and in adults, increased use, CUD, cannabis-related emergency room visits, and fatal vehicle crashes. Twenty-nine states have medical marijuana laws (MMLs) and of these, 8 have recreational marijuana laws (RMLs). Many studies indicate that MMLs or their specific provisions did not increase adolescent cannabis use. However, the more limited literature suggests that MMLs have led to increased cannabis potency, unintentional childhood exposures, adult cannabis use, and adult CUD. Ecological-level studies suggest that MMLs have led to substitution of cannabis for opioids, and also possibly for psychiatric medications. Much remains to be determined about cannabis trends and the role of MMLs and RMLs in these trends. The public, health professionals, and policy makers would benefit from education about the risks of cannabis use, the increases in such risks, and the role of marijuana laws in these increases. PMID:28853439

Design paper: The CapOpus trial: A randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis

Directory of Open Access Journals (Sweden)

Gluud Christian

2008-07-01

Full Text Available Abstract Background A number of studies indicate a link between cannabis-use and psychosis as well as more severe psychosis in those with existing psychotic disorders. There is currently insufficient evidence to decide the optimal way to treat cannabis abuse among patients with psychosis. Objectives The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. Design The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are primarily recruited through early-psychosis detection teams, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months: 1 specialized addiction treatment plus treatment as usual or 2 treatment as usual. The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case manager of the patient. The primary outcome measure will be changes in amount of cannabis consumption over time. Other outcome measures will be psychosis symptoms, cognitive functioning, quality of life, social functioning, and cost-benefit analyses. Trial registration ClinicalTrials.gov NCT00484302.