-
Current Opinion in Psychiatry Jul 2023As more jurisdictions legalize cannabis for non-medical use, the evidence on how legalization policies affect cannabis use and the use of other substances remains... (Review)
Review
PURPOSE OF REVIEW
As more jurisdictions legalize cannabis for non-medical use, the evidence on how legalization policies affect cannabis use and the use of other substances remains inconclusive and contradictory. This review aims to summarize recent research findings on the impact of recreational cannabis legalization (RCL) on cannabis and other substance use among different population groups, such as youth and adults.
RECENT FINDINGS
Recent literature reports mixed findings regarding changes in the prevalence of cannabis use after the adoption of RCL. Most studies found no significant association between RCL and changes in cannabis use among youth in European countries, Uruguay, the US, and Canada. However, some studies have reported increases in cannabis use among youth and adults in the US and Canada, although these increases seem to predate RCL. Additionally, there has been a marked increase in unintentional pediatric ingestion of cannabis edibles postlegalization, and an association between RCL and increased alcohol, vaping, and e-cigarette use among adolescents and young adults.
SUMMARY
Overall, the effects of cannabis legalization on cannabis use appear to be mixed. Further monitoring and evaluation research is needed to provide longer-term evidence and a more comprehensive understanding of the effects of RCL.
Topics: Adolescent; Young Adult; Humans; Child; Cannabis; Electronic Nicotine Delivery Systems; Legislation, Drug; Marijuana Use; Canada
PubMed: 37185310
DOI: 10.1097/YCO.0000000000000868 -
Supportive Care in Cancer : Official... Oct 2023Inflammation is thought to play a key role in malignant disease and may play a significant part in the expression of cancer-related symptoms. Cannabidiol (CBD) is a... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Inflammation is thought to play a key role in malignant disease and may play a significant part in the expression of cancer-related symptoms. Cannabidiol (CBD) is a bioactive compound in cannabis and is reported to have significant anti-inflammatory properties.
METHOD
Serial C-reactive protein (CRP) levels were measured in all participants recruited to a randomised controlled trial of CBD versus placebo in patients with symptoms related to advanced cancer. A panel of inflammatory cytokines was measured over time in a subset of these patients.
RESULTS
There was no difference between the two arms in the trajectory of CRP or cytokine levels from baseline to day 28.
CONCLUSION
We were unable to demonstrate an anti-inflammatory effect of CBD in cancer patients.
TRIAL REGISTRATION
ANZCTR 26180001220257, registered 20/07/2018.
Topics: Humans; Medical Marijuana; Cannabidiol; Cannabis; Anti-Inflammatory Agents; Neoplasms
PubMed: 37837446
DOI: 10.1007/s00520-023-08069-8 -
Current Pain and Headache Reports Sep 2023There is increasing interest in the use of cannabis and cannabinoid therapies (CCT) by the general population and among people with headache disorders, which results in... (Review)
Review
PURPOSE OF REVIEW
There is increasing interest in the use of cannabis and cannabinoid therapies (CCT) by the general population and among people with headache disorders, which results in a need for healthcare professionals to be well versed with the efficacy and safety data. In this manuscript, we review cannabis and cannabinoid terminology, the endocannabinoid system and its role in the central nervous system (CNS), the data on efficacy, safety, tolerability, and potential pitfalls associated with use in people with migraine and headache disorders. We also propose possible mechanisms of action in headache disorders and debunk commonly held myths about its use.
RECENT FINDINGS
Preliminary studies show that CCT have evidence for the management of migraine. While this evidence exists, further randomized, controlled studies are needed to better support its clinical use. CCT can be considered an integrative treatment added to mainstream medicine for people with migraine who are refractory to treatment and/or exhibit disability and/or interest in trying these therapies. Further studies are warranted to specify appropriate formulation, dosage, and indication(s). Although not included in guidelines or the AHS 2021 Consensus Statement on migraine therapies, with the legalization of CCT for medical or unrestricted use across the USA, recent systematic reviews highlighting the preliminary evidence for its use in migraine, it is vital for clinicians to be well versed in the efficacy, safety, and clinical considerations for their use. This review provides information which can help people with migraine and clinicians who care for them make mutual, well-informed decisions on the use of cannabis and cannabinoid therapies for migraine based on the existing data.
Topics: Humans; Cannabinoids; Cannabis; Midazolam; Medical Marijuana; Migraine Disorders; Cannabinoid Receptor Agonists
PubMed: 37515745
DOI: 10.1007/s11916-023-01144-z -
WIREs Mechanisms of Disease 2023Cannabis sativa (cannabis) has been used as a therapeutic treatment for centuries treating various diseases and disorders. However, racial propaganda led to the... (Review)
Review
Cannabis sativa (cannabis) has been used as a therapeutic treatment for centuries treating various diseases and disorders. However, racial propaganda led to the criminalization of cannabis in the 1930s preventing opportunities to explore marijuana in therapeutic development. The increase in recreational use of cannabis further grew concern about abuse, and lead to further restrictions and distribution of cannabis in the 1970s when it was declared to be a Schedule I drug in the USA. In the late 1990s in some states, legislation assisted in legalizing the use of cannabis for medical purposes under physician supervision. As it has been proven that cannabinoids and their receptors play an essential role in the regulation of the physiological and biological processes in our bodies. The endocannabinoid system (ECS) is the complex that regulates the cell-signaling system consisting of endogenous cannabinoids (endocannabinoids), cannabinoid receptors, and the enzymes responsible for the synthesis and degradation of the endocannabinoids. The ECS along with phytocannabinoids and synthetic cannabinoids serves to be a beneficial therapeutic target in treating diseases as they play roles in cell homeostasis, cell motility, inflammation, pain-sensation, mood, and memory. Cannabinoids have been shown to inhibit proliferation, metastasis, and angiogenesis and even restore homeostasis in a variety of models of cancer in vitro and in vivo. Cannabis and its receptors have evolved into a therapeutic treatment for cancers. This article is categorized under: Cancer > Molecular and Cellular Physiology.
Topics: Humans; Receptors, Cannabinoid; Endocannabinoids; Cannabinoids; Cannabis; Cannabinoid Receptor Agonists; Neoplasms; Hallucinogens
PubMed: 36750231
DOI: 10.1002/wsbm.1602 -
MMW Fortschritte Der Medizin Oct 2023
Topics: Humans; Cannabis; Psychotic Disorders; Medication Adherence; Marijuana Abuse
PubMed: 37857969
DOI: 10.1007/s15006-023-2980-2 -
Annals of Agricultural and... Sep 2023Low back pain (LBP) is a major cause of disability and the main reason why individual patients need medical attention. Pharmacological treatment options for LBP are... (Review)
Review
INTRODUCTION AND OBJECTIVE
Low back pain (LBP) is a major cause of disability and the main reason why individual patients need medical attention. Pharmacological treatment options for LBP are limited and are often associated with serious side-effects. This makes it necessary to search for new painkillers. One potential therapeutic agent is cannabidiol (CDB). Cannabidiol and tetrahydrocannabinol are the most researched components of cannabis, the plant more commonly known as marijuana or hemp. To the best of our knowledge, this is the first narrative review of the effects of CBD alone on acute and chronic back pain.
REVIEW METHODS
Based on the guidelines provided by the Primary Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), the PubMed/ MEDLINE database was used to identify articles for analysis from the last 30 years. Due to the limited number of studies on this topic, all types of studies that met the inclusion criteria were included. After analysis, 10 studies were included in this review.
BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE
Currently, the use of medical marijuana continues to increase and the Food and Drug Administration (FDA) has already approved four cannabis-based drugs. Cannabidiol (CBD) is a relatively safe substance for humans and generally well tolerated. It is a substance that is easily available and often taken by patients with LBP.
SUMMARY
Evidence for the effectiveness of CBD in the treatment of acute low back pain is lacking. There was only one clinical trial conducted in the Emergency Department that showed no superiority of CBD over placebo in acute LBP. The majority of studies concern chronic rather than acute LBP. Although most of the results suggest a beneficial effect of cannabinoids in relieving chronic LBP, hard evidence is lacking. Rigorous randomized controlled trials are needed.
Topics: Humans; Cannabidiol; Low Back Pain; Cannabinoids; Cannabis; Medical Marijuana
PubMed: 37772533
DOI: 10.26444/aaem/168674 -
European Journal of Trauma and... Aug 2023Substance misuse has long been recognized as a major predisposing risk factor for traumatic injury. However, there still exists no clear scientific consensus regarding...
PURPOSE
Substance misuse has long been recognized as a major predisposing risk factor for traumatic injury. However, there still exists no clear scientific consensus regarding the impact of drug use on patient outcomes. Therefore, this study aims to evaluate the demographic profile, hospital-course factors, and outcomes of trauma patients based on their toxicology.
METHODS
This is a non-concurrent cohort study of 3709 patients treated at the Puerto Rico Trauma Hospital during 2002-2018. The sample was divided into four groups according to their toxicology status. Statistical techniques used included Pearson's chi-square test, Spearman correlation, and negative binomial and logistic regressions.
RESULTS
Admission rates for marijuana (rho = 0.87) and marijuana and cocaine positive (rho = 0.68) patients increased. Positive toxicology patients underwent surgery more often than negative testing patients (marijuana: 68.7%, cocaine: 65.6%, marijuana & cocaine: 69.8%, negative: 57.0%). Among patients with non-penetrating injuries, a positive toxicology for cocaine or marijuana was linked to a 48% and 42% increased adjusted risk of complications, 37% and 27% longer TICU LOS, and 32% and 18% longer hospital LOS, respectively.
CONCLUSION
Our results show an association between positive toxicology for either marijuana, cocaine, or both with higher need for surgery. Additionally, our results show an increase in complications, TICU LOS, and hospital LOS among non-penetrating trauma patients testing positive for marijuana or cocaine. Therefore, this study provides valuable information on the clinical profile of patients with positive toxicology, suggesting they might benefit from more aggressive management.
Topics: Humans; Cannabis; Cocaine; Cohort Studies; Risk Factors; Substance-Related Disorders; Wounds and Injuries
PubMed: 37000193
DOI: 10.1007/s00068-023-02261-5 -
Dialogues in Clinical Neuroscience Dec 2023The increasing prevalence and burden of suicide have led to numerous studies to identify its risk factors. Cannabis is the most common illicit substance detected in... (Review)
Review
The increasing prevalence and burden of suicide have led to numerous studies to identify its risk factors. Cannabis is the most common illicit substance detected in suicide victims' toxicology tests. This study aims to identify and appraise systematic reviews investigating suicidality after using cannabis and cannabinoids. Seven databases and two registries were searched without restrictions for systematic reviews investigating cannabis effects on suicidality. AMSTAR-2 was used for quality assessment and corrected covered area and citation matrix were used to determine overlap. Twenty-five studies were included, of which 24 were on recreational use and one was on therapeutic use. Only three of the studies on recreational use reported no effect or inconsistent results. Evidence generally showed a positive association between cannabis use and suicidal ideation and attempt among the general population, military veterans, and bipolar or major depression patients. A bidirectional causal association between cannabis and suicidal ideation was also mentioned. Moreover, a younger age of initiation, long-term use, and heavy consumption were reported to be associated with even worse suicidal outcomes. On the contrary, current evidence indicates that the therapeutic cannabis is safe. In conclusion, the literature supports the cannabis-suicidality association in recreational use but considers cannabidiol safe for treatment. Further studies with quantitative and interventional approaches are recommended.
Topics: Humans; Suicide; Cannabis; Suicide, Attempted; Cannabinoids; Systematic Reviews as Topic; Risk Factors; Depressive Disorder, Major
PubMed: 37427882
DOI: 10.1080/19585969.2023.2231466 -
Pediatric Annals Oct 2023Pediatric epilepsy is a debilitating disease cluster that is much less researched than adult epilepsy. With approximately 30% of patients with pediatric epilepsy...
Pediatric epilepsy is a debilitating disease cluster that is much less researched than adult epilepsy. With approximately 30% of patients with pediatric epilepsy experiencing refractory seizures, novel treatment modalities are sometimes necessary to provide benefit. The use of marijuana, and more specifically cannabidiol, in people with seizures is much more broadly researched in adults compared with pediatric patients, although several recent review articles have been published. This article seeks to provide a pathophysiological basis for cannabidiol in epilepsy, discuss commercially available products and nonpharmaceutical marijuana, and review recent evidence in pediatric epilepsy. .
Topics: Humans; Child; Cannabidiol; Anticonvulsants; Epilepsy; Seizures; Cannabis
PubMed: 37820705
DOI: 10.3928/19382359-20230829-04 -
International Journal of Molecular... Aug 2023Since ancient times, cannabis has been used for recreational and medical purposes [...].
Since ancient times, cannabis has been used for recreational and medical purposes [...].
Topics: Endocannabinoids; Cannabinoids; Hallucinogens; Cannabinoid Receptor Agonists; Cannabis
PubMed: 37628940
DOI: 10.3390/ijms241612760