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Annual Review of Medicine Jan 2024Cannabis, the most commonly used recreational drug, is illicit in many areas of the world. With increasing decriminalization and legalization, cannabis use is increasing... (Review)
Review
Cannabis, the most commonly used recreational drug, is illicit in many areas of the world. With increasing decriminalization and legalization, cannabis use is increasing in the United States and other countries. The adverse effects of cannabis are unclear because its status as a Schedule 1 drug in the United States restricts research. Despite a paucity of data, cannabis is commonly perceived as a benign or even beneficial drug. However, recent studies show that cannabis has adverse cardiovascular and pulmonary effects and is linked with malignancy. Moreover, case reports have shown an association between cannabis use and neuropsychiatric disorders. With growing availability, cannabis misuse by minors has led to increasing incidences of overdose and toxicity. Though difficult to detect, cannabis intoxication may be linked to impaired driving and motor vehicle accidents. Overall, cannabis use is on the rise, and adverse effects are becoming apparent in clinical data sets.
Topics: Humans; Cannabis; Drug Overdose
PubMed: 37582489
DOI: 10.1146/annurev-med-052422-020627 -
The Psychiatric Clinics of North America Dec 2023This review summarizes treatments for cannabis use disorder (CUD) in adolescents. The best supported CUD treatments are cognitive behavioral psychotherapies, including... (Review)
Review
This review summarizes treatments for cannabis use disorder (CUD) in adolescents. The best supported CUD treatments are cognitive behavioral psychotherapies, including family-based models that facilitate environmental changes and youth-focused models that incorporate skills training, motivational interviewing, and contingency management to promote reductions in cannabis use. Some medications show promise in reducing cannabis craving and withdrawal symptoms. Further research is needed on the efficacy and implementation of existing treatments given the changes in cannabis use trends over time and on emerging technologies that may expand access to evidence-based CUD treatments.
Topics: Humans; Adolescent; Cannabis; Marijuana Abuse; Substance-Related Disorders; Cognitive Behavioral Therapy; Craving
PubMed: 37879838
DOI: 10.1016/j.psc.2023.03.004 -
Addictive Behaviors Jun 2024This study investigated whether adult use marijuana sales were associated with changes in lifetime and past 30-day (P30D) marijuana use among middle school students in...
PURPOSE
This study investigated whether adult use marijuana sales were associated with changes in lifetime and past 30-day (P30D) marijuana use among middle school students in Nevada (NV), which had adult-use marijuana sales during the study period, compared to New Mexico (NM), which did not have adult-use marijuana sales during the study period.
METHODS
Data were drawn from the middle school 2017 and 2019 NV Youth Risk Behavior and NM Youth Risk and Resiliency Surveys. Difference-in-difference analyses compare changes in lifetime and P30D marijuana use in NV (adult-use sales implemented July 2017) vs. NM (no adult-use sales during the study period).
RESULTS
There was no difference in lifetime (aOR 1.11; 95% CI 0.91,1.36) and P30D (aOR 1.17; 95% CI 0.91,1.51) marijuana use by adult-use sales status. The odds of lifetime and P30D marijuana use increased in both states, particularly among students who were female, older, non-White, or attending a Title 1 school.
DISCUSSION
Adult-use sales were not associated with an increase in lifetime or P30D marijuana use. State-level prevention efforts should focus on sub-populations with increasing lifetime and P30D use regardless of adult-use sales status.
Topics: Adolescent; Adult; Humans; Female; Male; Marijuana Use; Cannabis; Marijuana Smoking; Surveys and Questionnaires; Students
PubMed: 38452424
DOI: 10.1016/j.addbeh.2024.107999 -
MMW Fortschritte Der Medizin Jun 2024
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The Psychiatric Clinics of North America Dec 2023
Topics: Humans; Adolescent; Cannabis; Marijuana Smoking; Risk Factors; Longitudinal Studies
PubMed: 37879841
DOI: 10.1016/j.psc.2023.06.018 -
Cancer Research Communications Sep 2023Symptoms such as pain, nausea, and anxiety are common in individuals with cancer. Treatment of these issues is often challenging. Cannabis products may be helpful in...
UNLABELLED
Symptoms such as pain, nausea, and anxiety are common in individuals with cancer. Treatment of these issues is often challenging. Cannabis products may be helpful in reducing the severity of these symptoms. While some studies include data on the prevalence of cannabis use among patients with cancer, detailed data remain limited, and none have reported the prevalence of cannabidiol (CBD) use in this population. Adult patients with cancer attending eight clinics at a large, NCI-designated Comprehensive Cancer Center completed a detailed, cannabis-focused questionnaire between 2021 and 2022. Eligible participants were diagnosed with invasive cancer and treated in the past 12 months. Summary statistics were calculated to describe the sample regarding cannabis use. Approximately 15% (n = 142) of consented patients (n = 934) reported current cannabis use (defined as use within the past 12 months). Among which, 75% reported cannabis use in the past week. Among current cannabis users, 39% (n = 56; 6% overall) used CBD products. Current users reported using cannabis a median of 4.5 (interquartile range: 0.6–7.0) days/week, 2.0 (1.0–3.0) times per use/day, and for 3 years (0.8–30.0). Use patterns varied by route of administration. Patients reported moderate to high relief of symptoms with cannabis use. This study is the most detailed to date in terms of cannabis measurement and provides information about the current state of cannabis use in active cancer. Future studies should include complete assessments of cannabis product use, multiple recruitment sites, and diverse patient populations.
SIGNIFICANCE
Clinicians should be aware that patients are using cannabis products and perceive symptom relief with its use.
Topics: Adult; Humans; Cannabis; Cannabidiol; Medical Marijuana; Prevalence; Pain; Hallucinogens; Cannabinoid Receptor Agonists; Neoplasms
PubMed: 37772996
DOI: 10.1158/2767-9764.CRC-23-0233 -
Epigenetics Dec 2023Tobacco, alcohol, and marijuana consumption is an important public health problem because of their high use worldwide and their association with the risk of mortality...
Tobacco, alcohol, and marijuana consumption is an important public health problem because of their high use worldwide and their association with the risk of mortality and many health conditions, such as hypertension, which is the commonest risk factor for death throughout the world. A likely pathway of action of substance consumption leading to persistent hypertension is DNA methylation. Here, we evaluated the effects of tobacco, alcohol, and marijuana on DNA methylation in the same cohort ( = 3,424). Three epigenome-wide association studies (EWAS) were assessed in whole blood using the InfiniumHumanMethylationEPIC BeadChip. We also evaluated the mediation of the top CpG sites in the association between substance consumption and hypertension. Our analyses showed 2,569 CpG sites differentially methylated by alcohol drinking and 528 by tobacco smoking. We did not find significant associations with marijuana consumption after correcting for multiple comparisons. We found 61 genes overlapping between alcohol and tobacco that were enriched in biological processes involved in the nervous and cardiovascular systems. In the mediation analysis, we found 66 CpG sites that significantly mediated the effect of alcohol consumption on hypertension. The top alcohol-related CpG site (cg06690548, P-value = 5.9·10) mapped to SLC7A11 strongly mediated 70.5% of the effect of alcohol consumption on hypertension (P-value = 0.006). Our findings suggest that DNA methylation should be considered for new targets in hypertension prevention and management, particularly concerning alcohol consumption. Our data also encourage further research into the use of methylation in blood to study the neurological and cardiovascular effects of substance consumption.
Topics: Humans; DNA Methylation; Cannabis; Epigenesis, Genetic; Genome-Wide Association Study; Hypertension; DNA; Ethanol; CpG Islands
PubMed: 37216580
DOI: 10.1080/15592294.2023.2214392 -
JAMA Sep 2023
Topics: Female; Humans; Pregnancy; Cannabis; Hallucinogens; Marijuana Use; Biomedical Research
PubMed: 37589991
DOI: 10.1001/jama.2023.14697 -
Environmental Health Perspectives Aug 2023Marijuana is the third most used drug in the world.
BACKGROUND
Marijuana is the third most used drug in the world.
OBJECTIVES
Because the cannabis plant is a known scavenger of metals, we hypothesized that individuals who use marijuana will have higher metal biomarker levels compared with those who do not use.
METHODS
We combined data from the National Health and Nutrition Examination Survey (2005-2018) for participants, classified by use: non-marijuana/non-tobacco, exclusive marijuana, exclusive tobacco, and dual marijuana and tobacco use. Five metals were measured in blood and 16 in urine using inductively coupled plasma mass spectrometry; urinary metals were adjusted for urinary creatinine.
RESULTS
Participants reporting exclusive marijuana use compared with non-marijuana/non-tobacco use had statistically significantly higher mean cadmium levels in blood [ (95% CI: 1.11, 1.34); ] and urine [ (95% CI: 1.0, 1.31); ] and statistically significantly higher mean lead levels in blood [ (95% CI: 1.07, 1.50); ] and urine [ (95% CI: , 1.50); ].
DISCUSSION
Our results suggest marijuana is a source of cadmium and lead exposure. Research regarding cannabis use and cannabis contaminants, particularly metals, should be conducted to address public health concerns related to the growing number of cannabis users. https://doi.org/10.1289/EHP12074.
Topics: Humans; Nutrition Surveys; Cadmium; Lead; Cannabis; Public Health
PubMed: 37646523
DOI: 10.1289/EHP12074 -
Journal of the American Heart... Dec 2023Marijuana leaf vaporizers, which heat plant material and sublimate Δ-9-tetrahydrocannabinol without combustion, are popular alternatives to smoking cannabis that are...
BACKGROUND
Marijuana leaf vaporizers, which heat plant material and sublimate Δ-9-tetrahydrocannabinol without combustion, are popular alternatives to smoking cannabis that are generally perceived to be less harmful. We have shown that smoke from tobacco and marijuana, as well as aerosol from e-cigarettes and heated tobacco products, impair vascular endothelial function in rats measured as arterial flow-mediated dilation (FMD).
METHODS AND RESULTS
We exposed 8 rats per group to aerosol generated by 2 vaporizer systems (Volcano and handheld Yocan) using marijuana with varying Δ-9-tetrahydrocannabinol levels, in a single pulsatile exposure session of 2 s/min over 5 minutes, and measured changes in FMD. To model secondhand exposure, we exposed rats for 1 minute to diluted aerosol approximating release of uninhaled Volcano aerosol into typical residential rooms. Exposure to aerosol from marijuana with and without cannabinoids impaired FMD by ≈50%. FMD was similarly impaired by aerosols from Yocan (237 °C), and from Volcano at both its standard temperature (185 °C) and the minimum sublimation temperature of Δ-9-tetrahydrocannabinol (157 °C), although the low-temperature aerosol condition did not effectively deliver Δ-9-tetrahydrocannabinol to the circulation. Modeled secondhand exposure based on diluted Volcano aerosol also impaired FMD. FMD was not affected in rats exposed to clean air or water vapor passed through the Volcano system.
CONCLUSIONS
Acute direct exposure and modeled secondhand exposure to marijuana leaf vaporizer aerosol, regardless of cannabinoid concentration or aerosol generation temperature, impair endothelial function in rats comparably to marijuana smoke. Our findings indicate that use of leaf vaporizers is unlikely to reduce the vascular risk burden of smoking marijuana.
Topics: Animals; Rats; Aerosols; Cannabinoids; Cannabis; Dilatation, Pathologic; Dronabinol; Electronic Nicotine Delivery Systems; Marijuana Smoking; Nebulizers and Vaporizers; Plant Leaves; Smoke
PubMed: 38014661
DOI: 10.1161/JAHA.123.032969