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The American Journal on Addictions Jan 2017Cannabis is now the most commonly used illicit drug in the United States and use is increasing. Frequent cannabis use has been associated with adverse social and health... (Review)
Review
INTRODUCTION
Cannabis is now the most commonly used illicit drug in the United States and use is increasing. Frequent cannabis use has been associated with adverse social and health effects. We sought to evaluate the relationship between recreational cannabis use and Quality of Life (QoL), a person-centered measure that characterizes the overall sense of health and wellbeing. We hypothesized that QoL would be unchanged or increased among recreational cannabis users, who did not meet criteria for a Cannabis Use Disorder (CUD) and that QoL would be lower among those who met criteria for a CUD.
METHODS
We conducted a systematic review, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The results were categorized into tables and identified trends.
RESULTS
Fourteen studies met our pre-defined selection criteria. The studies were heterogeneous and their quality was low. With one exception, we did not identify any population for whom cannabis use was associated with improved QoL. QoL was lower in persons who used cannabis heavily, or who met criteria for CUD. However, this association was inconsistent and the magnitude was weaker than the relationship between QoL and use of other addictive substances (including tobacco and illicit drugs).
CONCLUSION
In this systematic review, heavy cannabis use or CUD was associated with reduced QoL. It is unknown whether reduced QoL drives cannabis use, or whether cannabis use can lead to reduced QoL. Prospective studies are needed to evaluate the causal relationship between cannabis and QoL.
SCIENTIFIC SIGNIFICANCE
Furthering the understanding of the relationship between cannabis and QoL can inform public policy, prevention efforts, outcomes, and an objective understanding of the effects of cannabis users. (Am J Addict 2017;26:8-25).
Topics: Humans; Marijuana Abuse; Marijuana Smoking; Quality of Life
PubMed: 28000973
DOI: 10.1111/ajad.12486 -
European Journal of Gastroenterology &... Feb 2019An estimated 22 million adults use marijuana in the USA. The role of marijuana in the progression of hepatic fibrosis remains unclear. (Meta-Analysis)
Meta-Analysis
BACKGROUND
An estimated 22 million adults use marijuana in the USA. The role of marijuana in the progression of hepatic fibrosis remains unclear.
AIMS
We carried out a systematic review and meta-analysis to evaluate the impact of marijuana on prevalence and progression of hepatic fibrosis in chronic liver disease.
PATIENTS AND METHODS
We searched several databases from inception through 10 November 2017 to identify studies evaluating the role of marijuana in chronic liver disease. Our main outcome of interest was prevalence/progression of hepatic fibrosis. Adjusted odds ratios (ORs) and hazards ratios (HRs) were pooled and analyzed using random-effects model.
RESULTS
Nine studies with 5 976 026 patients were included in this meta-analysis. Prevalence of hepatic fibrosis was evaluated in nonalcoholic fatty liver disease (NAFLD), hepatitis C virus (HCV), and hepatitis C and HIV coinfection by two, four, and one studies. Progression of hepatic fibrosis was evaluated by two studies. Pooled OR for prevalence of fibrosis was 0.91 (0.72-1.15), I=75%. On subgroup analysis, pooled OR among NAFLD patients was 0.80 (0.75-0.86), I=0% and pooled OR among HCV patients was 1.96 (0.78-4.92), I=77%. Among studies evaluating HR, pooled HR for progression of fibrosis in HCV-HIV co-infected patients was 1.03 (0.96-1.11), I=0%.
CONCLUSION
Marijuana use did not increase the prevalence or progression of hepatic fibrosis in HCV and HCV-HIV-coinfected patients. On the contrary, we noted a reduction in the prevalence of NAFLD in marijuana users. Future studies are needed to further understand the therapeutic impact of cannabidiol-based formulations in the management of NAFLD.
Topics: Adult; Coinfection; Comorbidity; Disease Progression; Female; HIV Infections; Hepatitis C; Humans; Liver Cirrhosis; Male; Marijuana Abuse; Marijuana Smoking; Middle Aged; Non-alcoholic Fatty Liver Disease; Prevalence; Prognosis; Risk Assessment; Risk Factors; Time Factors
PubMed: 30234644
DOI: 10.1097/MEG.0000000000001263 -
European Archives of Psychiatry and... Feb 2013Substance abuse is the most prevalent comorbid psychiatric condition associated with schizophrenia, and cannabis is the illicit drug most often abused. Apart from... (Review)
Review
Substance abuse is the most prevalent comorbid psychiatric condition associated with schizophrenia, and cannabis is the illicit drug most often abused. Apart from worsening the course of schizophrenia, frequent cannabis use especially at an early age seems to be an important risk factor for developing schizophrenia. Although a large body of neuroimaging studies gives evidence for structural alterations in many different brain regions in schizophrenia patients, there is still limited knowledge of the impact of cannabis abuse on brain structure in schizophrenia. We performed a systematic review including structural magnetic resonance imaging studies comparing high-risk and schizophrenia patients with and without cannabis abuse and found inconclusive results. While there is some evidence that chronic cannabis abuse could alter brain morphology in schizophrenia in patients continuing their cannabis consumption, there is no convincing evidence that this alteration takes place before the onset of schizophrenia when looking at first-episode patients. There is some weak evidence that cannabis abuse could affect brain structures in high-risk subjects, but replication of these studies is needed.
Topics: Brain; Cross-Sectional Studies; Humans; Magnetic Resonance Imaging; Marijuana Abuse; PubMed; Risk Factors; Schizophrenia; Schizophrenic Psychology
PubMed: 22907121
DOI: 10.1007/s00406-012-0346-3 -
Child Maltreatment May 2022State and federal policies regarding substance use in pregnancy, specifically whether a notification to child protective services is required, continue to evolve. To...
State and federal policies regarding substance use in pregnancy, specifically whether a notification to child protective services is required, continue to evolve. To inform practice, policy, and future research, we sought to synthesize and critically evaluate the existing literature regarding the association of prenatal substance exposure with child maltreatment. We conducted a comprehensive electronic search of PubMed, Web of Science, PsycInfo, CHINAL, Social Work Abstracts, Sociological Abstracts, and Social Services Abstracts. We identified 30 studies that examined the association of exposure to any/multiple substances, cocaine, alcohol, opioids, marijuana, and amphetamine/methamphetamine with child maltreatment. Overall, results indicated that substance exposed infants have an increased likelihood of child protective services involvement, maternal self-reported risk of maltreatment behaviors, hospitalizations and clinic visits for suspected maltreatment, and adolescent retrospective self-report of maltreatment compared to unexposed infants. While study results suggest an association of prenatal substance exposure with child maltreatment, there are several methodological considerations that have implications for results and interpretation, including definitions of prenatal substance exposure and maltreatment, study populations used, and potential unmeasured confounding. As each may bias study results, careful interpretation and further research are warranted to appropriately inform programs and policy.
Topics: Adolescent; Child; Child Abuse; Child Protective Services; Family; Female; Humans; Infant; Pregnancy; Retrospective Studies; Substance-Related Disorders
PubMed: 33550839
DOI: 10.1177/1077559521990116 -
Substance Use & Misuse Nov 2016Although cannabis is widely used, it remains unclear which consumption patterns are more likely to produce future consequences (risky/hazardous use) or current damage... (Review)
Review
UNLABELLED
Although cannabis is widely used, it remains unclear which consumption patterns are more likely to produce future consequences (risky/hazardous use) or current damage (problematic/harmful use). This unresolved issue contributes to cannabis public health implications. In order to facilitate further consensus, this review analyzes previously used definitions in the literature.
METHODS
This systematic review was performed following the PRISMA guidelines. Articles published before October 2015 in the Medline, Scopus-Elsevier, ISI-Web of Knowledge and Cochrane databases and fulfilling a-priori decided criteria were retrieved. Definitions in preselected websites of national and international organizations addressing drug problems were also included.
RESULTS
Definitions identified in articles (n = 46) and official websites (n = 3) widely varied from each other. Weekly cannabis use was mostly considered risky. Problematic cannabis use was mostly described with the Cannabis Abuse and Screening Test. Evidence-based definitions as well as information on quantities consumed, time-frames and special considerations for risky groups were very limited.
CONCLUSIONS
Working on official definitions is highly necessary as criteria used remain incomplete, leading to increased confusion in the field. Recommendations to improve existing definitions are given.
Topics: Cannabis; Humans; Marijuana Abuse; Risk Factors; Substance-Related Disorders
PubMed: 27556867
DOI: 10.1080/10826084.2016.1197266 -
Frontiers in Public Health 2024Problematic cannabis use is highly prevalent among people with mood disorders. This underscores the need to understand the effects of cannabis and cannabinoids in this...
BACKGROUND
Problematic cannabis use is highly prevalent among people with mood disorders. This underscores the need to understand the effects of cannabis and cannabinoids in this population, especially considering legalization of recreational cannabis use.
OBJECTIVES
We aimed to (1) systematically evaluate cross-sectional and longitudinal studies investigating the interplay between cannabis use, cannabis use disorder (CUD), and the occurrence of mood disorders and symptoms, with a focus on major depressive disorder (MDD) and bipolar disorder (BD) and; (2) examine the effects of cannabis on the prognosis and treatment outcomes of MDD and BD.
METHODS
Following PRISMA guidelines, we conducted an extensive search for English-language studies investigating the potential impact of cannabis on the development and prognosis of mood disorders published from inception through November 2023, using EMBASE, PsycINFO, PubMed, and MEDLINE databases.
RESULTS
Our literature search identified 3,262 studies, with 78 meeting inclusion criteria. We found that cannabis use is associated with increased depressive and manic symptoms in the general population in addition to an elevated likelihood of developing MDD and BD. Furthermore, we observed that cannabis use is linked to an unfavorable prognosis in both MDD or BD.
DISCUSSION
Our findings suggest that cannabis use may negatively influence the development, course, and prognosis of MDD and BD. Future well-designed studies, considering type, amount, and frequency of cannabis use while addressing confounding factors, are imperative for a comprehensive understanding of this relationship.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023481634.
Topics: Humans; Depressive Disorder, Major; Mood Disorders; Bipolar Disorder; Marijuana Abuse; Cross-Sectional Studies; Marijuana Use; Longitudinal Studies; Prognosis
PubMed: 38655516
DOI: 10.3389/fpubh.2024.1346207 -
The Journal of Adolescent Health :... Mar 2024To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO,... (Review)
Review
To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10-18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.
Topics: Child; Adolescent; Humans; Cannabis; Marijuana Abuse; Medical Marijuana; Intention; Perception
PubMed: 37966406
DOI: 10.1016/j.jadohealth.2023.09.014 -
The American Journal of Drug and... Mar 2024The use of cannabis is highly prevalent during adolescence compared to the general adult population. In addition to the high comorbidity between cannabis use and... (Meta-Analysis)
Meta-Analysis Review
The use of cannabis is highly prevalent during adolescence compared to the general adult population. In addition to the high comorbidity between cannabis use and anxiety disorders, early evidence suggests that cannabis may precede the development of anxiety. Moreover, adolescence represents a major developmental period for both neurobiological and psychological processes, placing these individuals at a heightened vulnerability to the influence of cannabis. This systematic review and meta-analysis examined the prospective associations between adolescent cannabis use and subsequent anxiety outcomes (i.e. anxiety disorders and/or symptoms). Following PRISMA guidelines, a systematic review and meta-analysis were conducted encompassing data from articles published between database inception and September 2022. Six longitudinal studies were identified for quantitative analysis, while twelve non-overlapping longitudinal studies were identified for qualitative review (total = 18; 33380 subjects). Meta-analytical findings supported an association between adolescent cannabis use and the development of a subsequent anxiety disorder (Odds Ratio = 2.14, 95% CI: 1.37-3.36, < .01). These findings were consistent with our qualitative synthesis where nine of the twelve longitudinal studies observed a significant relationship between adolescent cannabis use and exacerbation of anxiety symptoms later in life, irrespective of an anxiety disorder diagnosis. In summary, the current evidence suggests a prospective association between adolescent cannabis use and later anxiety symptoms and disorders. These findings underscore the importance of refining research methodologies, considering sex-based differences and controlling for confounding factors, as well as implementing educational initiatives and developing clinical interventions to address the mental health risks associated with cannabis use among adolescents.
Topics: Humans; Adolescent; Anxiety Disorders; Marijuana Use; Anxiety; Longitudinal Studies
PubMed: 38285048
DOI: 10.1080/00952990.2023.2299922 -
Sports Health 2020Cannabis use has increased, in large part due to decriminalization. Despite this increase in usage, it remains unclear what proportion of athletes use cannabis and what...
CONTEXT
Cannabis use has increased, in large part due to decriminalization. Despite this increase in usage, it remains unclear what proportion of athletes use cannabis and what effect it has on athletic performance and recovery.
OBJECTIVE
To systematically review cannabis use among athletes, including epidemiology, effect on performance and recovery, and regulations for use in sport.
DATA SOURCES
PubMed, MEDLINE, and EMBASE databases were queried from database inception through November 15, 2018. A hand search of policies, official documents, and media reports was performed for relevant information.
STUDY SELECTION
All studies related to cannabis use in athletes, including impact on athletic performance or recovery, were included.
STUDY DESIGN
Systematic review.
LEVEL OF EVIDENCE
Level 4.
DATA EXTRACTION
Demographic and descriptive data of included studies relating to epidemiology of cannabis use in athletes were extracted and presented in weighted means or percentages where applicable.
RESULTS
Overall, 37 studies were included, of which the majority were cross-sectional studies of elite and university athletes. Among 11 studies reporting use among athletes (n = 46,202), approximately 23.4% of respondents reported using cannabis in the past 12 months. Two studies found a negative impact on performance, while another 2 studies found no impact. There was no literature on the influence of cannabis on athletic recovery. Across athletic organizations and leagues, there is considerable variability in acceptable thresholds for urine tetrahydrocannabinol levels (>15 to 150 ng/mL) and penalties for athletes found to be above these accepted thresholds.
CONCLUSION
Overall, these results suggest that approximately 1 in 4 athletes report using cannabis within the past year. Based on the available evidence, cannabis does not appear to positively affect performance, but the literature surrounding this is generally poor. Given the variability in regulation across different sport types and competition levels, as well as the growing number of states legalizing recreational cannabis use, there is a need to improve our understanding of the effects of cannabis use on the athlete and perhaps adopt a clearer and overarching policy for the use of cannabis by athletes in all sports and at all levels.
Topics: Athletic Performance; Dronabinol; Humans; Marijuana Abuse; Marijuana Smoking; Organizational Policy; Sports; Substance Abuse Detection
PubMed: 32023171
DOI: 10.1177/1941738120901670 -
Child Neuropsychology : a Journal on... 2012The impacts of maternal substance use have been observed in both research and clinical experience. Several studies have shown that preschool children are at heightened... (Review)
Review
BACKGROUND
The impacts of maternal substance use have been observed in both research and clinical experience. Several studies have shown that preschool children are at heightened risk of developing various cognitive, behavioral, and socioemotional difficulties. Most knowledge has been generated concerning alcohol consumption during pregnancy and the postnatal effects thereof. Less is known about substance use other than alcohol (for instance, opiates, marijuana, and cocaine) during pregnancy and the long-term developmental consequences.
OBJECTIVE
The aims of this review are to identify relevant published data on adolescents who have been exposed in utero to alcohol and/or other substances and to examine developmental consequences across functions and mental health at this point in life.
METHODS
PubMed, Embase, and PsychInfo were searched for publications during the period of 1980-2011 and titles and abstracts selected according to prespecified broad criteria.
RESULTS
Twenty-five studies fulfilled all of the specific requirements and were included in this review. Most research covered prenatal alcohol exposure. Other substances, however, included cocaine, marijuana, opiates, and poly-substances. Results showed that prenatal exposure to alcohol has long-term cognitive, behavioral, social, and emotional developmental consequences depending on amount and timing of exposure in utero. Less evidence exists for long-term consequences of exposure in utero to other substances than alcohol. However, recent brain-imaging studies have provided important evidence of serious effects of other substance exposure on the developing brain and recent follow-up studies have found an association with deficits in language, attention, areas of cognitive performance and delinquent behavior in adolescence.
Topics: Adolescent; Adolescent Development; Alcohol Drinking; Attention Deficit and Disruptive Behavior Disorders; Child; Cocaine-Related Disorders; Female; Humans; Male; Marijuana Abuse; Mental Health; Opioid-Related Disorders; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Substance-Related Disorders
PubMed: 22114955
DOI: 10.1080/09297049.2011.628309