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JAMA Network Open Aug 2023Medical and nonmedical cannabis use and cannabis use disorders (CUD) have increased with increasing cannabis legalization. However, the prevalence of CUD among primary...
IMPORTANCE
Medical and nonmedical cannabis use and cannabis use disorders (CUD) have increased with increasing cannabis legalization. However, the prevalence of CUD among primary care patients who use cannabis for medical or nonmedical reasons is unknown for patients in states with legal recreational use.
OBJECTIVE
To estimate the prevalence and severity of CUD among patients who report medical use only, nonmedical use only, and both reasons for cannabis use in a state with legal recreational use.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional survey study took place at an integrated health system in Washington State. Among 108 950 adult patients who completed routine cannabis screening from March 2019 to September 2019, 5000 were selected for a confidential cannabis survey using stratified random sampling for frequency of past-year cannabis use and race and ethnicity. Among 1688 respondents, 1463 reporting past 30-day cannabis use were included in the study.
EXPOSURE
Patient survey-reported reason for cannabis use in the past 30 days: medical use only, nonmedical use only, and both reasons.
MAIN OUTCOMES AND MEASURES
Patient responses to the Composite International Diagnostic Interview-Substance Abuse Module for CUD, corresponding to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition CUD severity (0-11 symptoms) were categorized as any CUD (≥2 symptoms) and moderate to severe CUD (≥4 symptoms). Adjusted analyses were weighted for survey stratification and nonresponse for primary care population estimates and compared prevalence of CUD across reasons for cannabis use.
RESULTS
Of 1463 included primary care patients (weighted mean [SD] age, 47.4 [16.8] years; 748 [weighted proportion, 61.9%] female) who used cannabis, 42.4% (95% CI, 31.2%-54.3%) reported medical use only, 25.1% (95% CI, 17.8%-34.2%) nonmedical use only, and 32.5% (95% CI, 25.3%-40.8%) both reasons for use. The prevalence of CUD was 21.3% (95% CI, 15.4%-28.6%) and did not vary across groups. The prevalence of moderate to severe CUD was 6.5% (95% CI, 5.0%-8.6%) and differed across groups: 1.3% (95% CI, 0.0%-2.8%) for medical use, 7.2% (95% CI, 3.9%-10.4%) for nonmedical use, and 7.5% (95% CI, 5.7%-9.4%) for both reasons for use (P = .01).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of primary care patients in a state with legal recreational cannabis use, CUD was common among patients who used cannabis. Moderate to severe CUD was more prevalent among patients who reported any nonmedical use. These results underscore the importance of assessing patient cannabis use and CUD symptoms in medical settings.
Topics: Humans; Adult; Female; Middle Aged; Male; Cannabis; Cross-Sectional Studies; Marijuana Abuse; Prevalence; Hallucinogens; Cannabinoid Receptor Agonists; Substance-Related Disorders
PubMed: 37642968
DOI: 10.1001/jamanetworkopen.2023.28934 -
Nature Genetics Dec 2023As recreational use of cannabis is being decriminalized in many places and medical use widely sanctioned, there are growing concerns about increases in cannabis use... (Meta-Analysis)
Meta-Analysis
As recreational use of cannabis is being decriminalized in many places and medical use widely sanctioned, there are growing concerns about increases in cannabis use disorder (CanUD), which is associated with numerous medical comorbidities. Here we performed a genome-wide association study of CanUD in the Million Veteran Program (MVP), followed by meta-analysis in 1,054,365 individuals (n = 64,314) from four broad ancestries designated by the reference panel used for assignment (European n = 886,025, African n = 123,208, admixed American n = 38,289 and East Asian n = 6,843). Population-specific methods were applied to calculate single nucleotide polymorphism-based heritability within each ancestry. Statistically significant single nucleotide polymorphism-based heritability for CanUD was observed in all but the smallest population (East Asian). We discovered genome-wide significant loci unique to each ancestry: 22 in European, 2 each in African and East Asian, and 1 in admixed American ancestries. A genetically informed causal relationship analysis indicated a possible effect of genetic liability for CanUD on lung cancer risk, suggesting potential unanticipated future medical and psychiatric public health consequences that require further study to disentangle from other known risk factors such as cigarette smoking.
Topics: Humans; Genetic Predisposition to Disease; Genome-Wide Association Study; Marijuana Abuse; Polymorphism, Single Nucleotide; Public Health; Veterans; Racial Groups
PubMed: 37985822
DOI: 10.1038/s41588-023-01563-z -
Cureus Jan 2024Primary spontaneous pneumothorax occurs in patients without apparent clinical lung disease, with a higher incidence in tall, thin males between the ages of 10 and 30....
Primary spontaneous pneumothorax occurs in patients without apparent clinical lung disease, with a higher incidence in tall, thin males between the ages of 10 and 30. Tension pneumothorax is a life-threatening condition that can develop within minutes due to progressive air accumulation in the pleural space; mechanical pressure can lead to significant cardiorespiratory compromise. Tobacco association with a higher incidence of spontaneous pneumothorax has been well documented, but marijuana and spontaneous pneumothorax connection has not been well studied. However, it has been observed that patients who use marijuana and tobacco simultaneously have a higher incidence of spontaneous tension and larger pneumothoraces, as well as longer postoperative stay and higher recurrence than cigarette-only users. We present a case of a 26-year-old young male with a history only significant for excessive tobacco and marijuana smoking who developed multiple recurrent spontaneous pneumothorax and had to undergo right-sided video-assisted thoracoscopic surgery (VATS) with minimally invasive thoracotomy and had a prolonged hospital stay. With our case report, we hope to add to the evidence the effects of combined marijuana and tobacco smoking on bullous lung disease and pneumothorax while emphasizing the importance of conducting a detailed substance use history in patients with spontaneous pneumothorax.
PubMed: 38361711
DOI: 10.7759/cureus.52391 -
Annals of Medicine and Surgery (2012) Jul 2023Marijuana use has grown rapidly in the last decade with a prevalence greater than that of cocaine and opioids. With its increasing recreational and medical use,...
UNLABELLED
Marijuana use has grown rapidly in the last decade with a prevalence greater than that of cocaine and opioids. With its increasing recreational and medical use, potential adverse outcomes from heavy use may be associated with bullous lung disease and spontaneous pneumothorax. This case report has been reported in line with the SCARE Criteria.
CASE PRESENTATION
The authors describe a case of an adult male with a past medical history of spontaneous pneumothorax and long-standing marijuana use presenting with dyspnoea who was found to have a secondary spontaneous pneumothorax requiring invasive treatment.
CLINICAL DISCUSSION
The aetiology of lung injury due to heavy marijuana smoke may be from direct tissue injury from inhaled irritants and the method of which marijuana smoke is inhaled compared with tobacco smoke.
CONCLUSION
Chronic marijuana use should be considered when evaluating structural lung disease and pneumothorax in the setting of minimal tobacco use.
PubMed: 37427209
DOI: 10.1097/MS9.0000000000000968 -
Foods (Basel, Switzerland) Sep 2023Recently, there has been a renewed interest in and its uses. The recreational use of inflorescences as a source of THC has led to the legal restriction of cultivation... (Review)
Review
Recently, there has been a renewed interest in and its uses. The recreational use of inflorescences as a source of THC has led to the legal restriction of cultivation to limit the detrimental effects of psychotropic substance abuse on health. However, this has also limited the cultivation of textile/industrial varieties with a low content of THC used for textile and nutritional purposes. While previously the bans had significantly penalized the cultivation of , today many countries discriminate between recreational use (marijuana) and industrial and food use (hemp). The stalks of industrial hemp (low in psychotropic substances) have been used extensively for textile purposes while the seeds are nutritionally versatile. From hemp seeds, it is possible to obtain flours applicable in the bakery sector, oils rich in essential fatty acids, proteins with a high biological value and derivatives for fortification, supplementation and nutraceutical purposes. Hemp seed properties seem relevant for vegetarian diets, due to their high nutritional value and underestimated employment in the food sector. Hemp seed and their derivatives are a valuable source of protein, essential fatty acids and minerals that could provide additional benefit to vegetarian nutrition. This document aims to explore the information available in the literature about hemp seeds from a nutritional point of view, highlighting possible beneficial effects for humans with particular attention to vegetarian nutrition as a supplemental option for a well-planned diet.
PubMed: 37761214
DOI: 10.3390/foods12183505 -
Military Medicine Nov 2023Use rates of cannabis, a substance associated with a host of comorbid physical and mental health concerns, continue to rise for military veterans. Despite this...
INTRODUCTION
Use rates of cannabis, a substance associated with a host of comorbid physical and mental health concerns, continue to rise for military veterans. Despite this prevalence, descriptive patterns of use among veterans and research on treatment factors that predict cannabis outcomes are lacking. This study aimed to conduct a descriptive profile of veterans who endorse cannabis use, compare veterans endorsing cannabis use to those who do not endorse use, and investigate what factors (other substance use, psychiatric symptoms, and treatment outcomes) predicted return to cannabis use following residential treatment.
MATERIALS AND METHODS
The study was a secondary data analysis of a longitudinal sample of U.S. military veterans (N = 200, 193 males, Mage = 50.14, SD = 9) participating in residential substance use disorder treatment through a Veterans Affairs medical center. Interview, survey, and electronic health data were collected over 12 months. Analyses included descriptive and frequency statistics to identify patterns in cannabis use behaviors and motives, independent t-tests to examine differences between the cannabis-using group and non-using group, and a series of univariate logistic regressions to examine potential predictors for cannabis use after treatment discharge.
RESULTS
Lifetime cannabis use was common among veterans (77.5%), and 29.5% reported use during the study. On average, veterans had made one quit attempt before treatment entry. Veterans who endorsed cannabis use consumed more alcohol in the past 30 days at baseline and reported less impulse control and less confidence in maintaining abstinence at discharge. Length of stay in the residential program and no diagnosis of Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV cannabis use disorder criteria predicted post-treatment cannabis use such that veterans who remained in the program longer were more likely to abstain from cannabis use following treatment, and those who did not meet DSM-IV cannabis use disorder criteria were more likely to use following treatment.
CONCLUSIONS
Identification of relevant risk factors and treatment processes, such as impulse control, confidence in treatment, and length of stay in treatment, provides practical recommendations for future intervention efforts. This study calls for further examination of cannabis use outcomes among veterans, particularly those participating in substance use treatment.
Topics: Male; Humans; Veterans; Cannabis; Marijuana Abuse; Substance-Related Disorders; Comorbidity; Residential Treatment
PubMed: 37294846
DOI: 10.1093/milmed/usad216 -
Scientific Reports Nov 2023Precise crop fertilization requires an in-depth understanding of plant uptake and utilisation to optimise sustainable production. This study investigated the influence...
Precise crop fertilization requires an in-depth understanding of plant uptake and utilisation to optimise sustainable production. This study investigated the influence of nitrogen (N) nutrition and pruning on the cannabinoid concentrations and biomass of a commercial cannabis cultivar; the rationale for this study is how N supply and pruning affect cannabinoid yields and concentration in a commercial setting. Clones of a Cannabis sativa L. (CBD-type) were grown in a controlled-environment glasshouse in pots with coarse sand. After five weeks of vegetative growth under 210 mg/L N and an 18 h light regime, rates of 30, 60, 210, and 500 mg/L N were applied to plants for twelve weeks and a light regime set at 12 h. Double stem pruning was applied as an additional treatment to investigate efficacy on biomass increase. Biomass, N concentrations, and cannabinoid concentrations were measured after the final harvest. Pruning treatment did not increase cannabinoid concentrations or affect biomass. It was coincidentally found that plants on the glasshouse edge with higher exposure to sunlight developed more biomass and higher cannabinoid concentrations. Only biomass in leaves was increased significantly via higher nitrogen nutrition. Cannabinoid concentration, as well as cannabinoid yield per plant were decreased with the increase in N supply. High rates of fertilizer are not recommended because of reduced cannabinoid concentration and biomass yield: the ideal N supply is likely to be between 60 and 210 mg/L. This research will benefit growers and advisors in understanding the complexity of effects of nitrogen fertiliser and pruning practices on plant biomass and secondary metabolite production in medicinal cannabis.
Topics: Cannabis; Nitrogen; Biomass; Cannabinoids; Marijuana Abuse; Fertilizers
PubMed: 37945596
DOI: 10.1038/s41598-023-46369-5 -
Social Psychiatry and Psychiatric... Jan 2024Various forms of interpersonal abuse (e.g., physical, emotional, sexual) and cannabis use across the lifespan have both been known to increase odds of psychotic...
BACKGROUND
Various forms of interpersonal abuse (e.g., physical, emotional, sexual) and cannabis use across the lifespan have both been known to increase odds of psychotic experiences; however, there have been few studies examining their separate and joint effects in the United States.
METHODS
We analyzed data from the Healthy Minds Study (2020-2021) and used multivariable logistic regression and interaction contrast ratios to assess separate and joint effects of interpersonal abuse (past 12 months) and cannabis use (past 30 days) on psychotic experiences (past 12 months).
RESULTS
Students who only used cannabis had significantly greater odds of psychotic experiences (aOR: 1.70; 95% CI 1.58-1.82), as well as those who only experienced interpersonal abuse (aOR: 2.40; 95% CI 2.25-2.56). However, those who reported both cannabis use and interpersonal abuse had the greatest odds, exceeding the sum of these individual effects (the combined effect aOR: 3.46; 95% CI 3.19-3.76).
CONCLUSIONS
Recent interpersonal abuse and recent cannabis use both separately and jointly increase odds of having recent psychotic experiences. Future research should continue to examine the potential interactive and additive impact of multiple known exposures to better inform primary and secondary prevention efforts.
Topics: Humans; United States; Cannabis; Psychotic Disorders; Marijuana Abuse; Students
PubMed: 37093229
DOI: 10.1007/s00127-023-02483-3 -
JAMA Psychiatry Aug 2023Modeling genetic nurture (ie, the effects of parental genotypes through influences on the environment experienced by their children) is essential to accurately...
IMPORTANCE
Modeling genetic nurture (ie, the effects of parental genotypes through influences on the environment experienced by their children) is essential to accurately disentangle genetic and environmental influences on phenotypic variance. However, these influences are often ignored in both epidemiologic and genetic studies of depression.
OBJECTIVE
To estimate the association of genetic nurture with depression and neuroticism.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study jointly modeled parental and offspring polygenic scores (PGSs) across 9 traits to test for the association of genetic nurture with lifetime broad depression and neuroticism using data from nuclear families in the UK Biobank, with data collected between 2006 and 2019. A broad depression phenotype was measured in 38 702 offspring from 20 905 independent nuclear families, with most of these participants also reporting neuroticism scores. Parental genotypes were imputed from sibships or parent-offspring duos and used to calculate parental PGSs. Data were analyzed between March 2021 and January 2023.
MAIN OUTCOMES AND MEASURES
Estimates of genetic nurture and direct genetic regression coefficients on broad depression and neuroticism.
RESULTS
This study of 38 702 offspring with data on broad depression (mean [SD] age, 55.5 [8.2] years at study entry; 58% female) found limited preliminary evidence for a statistically significant association of genetic nurture with lifetime depression and neuroticism in adults. The estimated regression coefficient of the parental depression PGS on offspring neuroticism (β = 0.04, SE = 0.02, P = 6.63 × 10-3) was estimated to be approximately two-thirds (66%) that of the offspring's depression PGS (β = 0.06, SE = 0.01, P = 6.13 × 10-11). Evidence for an association between parental cannabis use disorder PGS and offspring depression was also found (β = 0.08, SE = 0.03, P = .02), which was estimated to be 2 times greater than the association between the offspring's cannabis use disorder PGS and their own depression status (β = 0.04, SE = 0.02, P = .07).
CONCLUSIONS AND RELEVANCE
The results of this cross-sectional study highlight the potential for genetic nurture to bias results from epidemiologic and genetic studies on depression or neuroticism and, with further replication and larger samples, identify potential avenues for future prevention and intervention efforts.
Topics: Humans; Female; Male; Neuroticism; Depression; Cross-Sectional Studies; Marijuana Abuse; Genotype; Multifactorial Inheritance; Genome-Wide Association Study
PubMed: 37285136
DOI: 10.1001/jamapsychiatry.2023.1544 -
Annals of Emergency Medicine Aug 2023The objectives of this study were to characterize the detailed cannabis use patterns (eg, frequency, mode, and product) and determine the differences in the whole-blood... (Observational Study)
Observational Study
STUDY OBJECTIVES
The objectives of this study were to characterize the detailed cannabis use patterns (eg, frequency, mode, and product) and determine the differences in the whole-blood cannabinoid profiles during symptomatic versus asymptomatic periods of participants with suspected cannabinoid hyperemesis syndrome recruited from the emergency department (ED) during a symptomatic episode.
METHODS
This is a prospective observational cohort study of participants with symptomatic cyclic vomiting onset after chronic cannabis use. Standardized assessments were conducted to evaluate for lifetime and recent cannabis use, cannabis use disorder, and cannabis withdrawal symptoms. Quantitative whole-blood cannabinoid testing was performed at 2 times, first when symptomatic (ie, baseline) and at least 2 weeks after the ED visit when asymptomatic. The differences in cannabinoid concentrations were compared between symptomatic and asymptomatic testing. The study was conducted from September 2021 to August 2022.
RESULTS
There was a difference observed between delta-9-tetrahydrocannabinol metabolites, but not the parent compound during symptomatic episodes and asymptomatic periods. Most participants (84%) reported using cannabis > once per day (median 3 times per day on weekdays, 4 times per day on weekends). Hazardous cannabis use was universal among participants; the mean cannabis withdrawal discomfort score was 13, indicating clinically significant rates of cannabis withdrawal symptoms with cessation of use. Most participants (79%) previously tried to stop cannabis use, but a few (13%) of them had sought treatment.
CONCLUSION
Patients presenting to the ED with cannabinoid hyperemesis syndrome have high cannabis use disorder scores. Further studies are needed to better understand the influence of THC metabolism and concentrations on symptomatic cyclic vomiting.
Topics: Humans; Cannabinoids; Cannabis; Cohort Studies; Marijuana Abuse; Vomiting; Substance Withdrawal Syndrome; Emergency Service, Hospital
PubMed: 37479395
DOI: 10.1016/j.annemergmed.2023.03.005