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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 -
Drug and Alcohol Dependence Apr 2024The prevalence of cannabis use disorders (CUDs) in people who use cannabis recreationally has been estimated at 22%, yet there is a dearth of literature exploring CUDs... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The prevalence of cannabis use disorders (CUDs) in people who use cannabis recreationally has been estimated at 22%, yet there is a dearth of literature exploring CUDs among people who use medicinal cannabis. We aimed to systematically review the prevalence of CUDs in people who use medicinal cannabis.
METHODS
In our systematic review and meta-analysis, we followed PRISMA guidelines and searched three databases (PsychInfo, Embase and PubMed) to identify studies examining the prevalence of CUDs in people who use medicinal cannabis. Meta-analyses were calculated on the prevalence of CUDs. Prevalence estimates were pooled across different prevalence periods using the DSM-IV and DSM-5.
RESULTS
We conducted a systematic review of 14 eligible publications, assessing the prevalence of CUDs, providing data for 3681 participants from five different countries. The systematic review demonstrated that demographic factors, mental health disorders and the management of chronic pain with medicinal cannabis were associated with an elevated risk of CUDs. Meta-analyses were conducted on the prevalence of CUDs. For individuals using medicinal cannabis in the past 6-12 months, the prevalence of CUDs was 29% (95% CI: 21-38%) as per DSM-5 criteria. Similar prevalence was observed using DSM-IV (24%, CI: 14-38%) for the same period. When including all prevalence periods and using the DSM-5, the prevalence of CUDs in people who use medicinal cannabis was estimated at 25% (CI: 18-33%).
CONCLUSIONS
The prevalence of CUDs in people who use medicinal cannabis is substantial and comparable to people who use cannabis for recreational reasons, emphasizing the need for ongoing research to monitor the prevalence of CUDs in people who use medicinal cannabis.
Topics: Humans; Cannabis; Marijuana Abuse; Medical Marijuana; Prevalence; Substance-Related Disorders
PubMed: 38493566
DOI: 10.1016/j.drugalcdep.2024.111263 -
Frontiers in Psychiatry 2024Catatonia presents itself as a complex neuropsychiatric syndrome, giving rise to various motor, speech, and behavioral challenges. It is noteworthy that approximately...
BACKGROUND
Catatonia presents itself as a complex neuropsychiatric syndrome, giving rise to various motor, speech, and behavioral challenges. It is noteworthy that approximately 10% of psychiatric hospital admissions can be attributed to this condition. It is imperative to note that cannabis-induced catatonia, while infrequent, has been linked to the use of marijuana. This connection has the potential to disrupt neurotransmitter systems, necessitating further research for a comprehensive understanding and effective treatment, particularly given the evolving trends in cannabis use. In this context, we shall delve into a unique case of recurrent cannabis-induced catatonia.
CASE PRESENTATION
A 23-year-old gentleman, who has previously struggled with substance use disorder, experienced the emergence of mutism, social isolation, and a fixed gaze subsequent to his use of cannabis. Remarkably, despite the absence of hallucinations, he exhibited recurrent episodes of catatonia. These episodes were effectively addressed through a combination of electroconvulsive therapy (ECT) and lorazepam administration. Notably, when the lorazepam dosage was gradually reduced to below 2 mg per day, the catatonic symptoms resurfaced; however, they promptly abated upon reinstating the medication. The diagnosis of cannabis-induced catatonia was established, and its management primarily involved a therapeutic approach encompassing ECT and lorazepam. It is pertinent to underscore that this catatonic condition can be directly linked to the individual's cannabis usage.
CONCLUSION
The connection between cannabis and catatonia is intricate and not entirely comprehended. Although cannabis possesses therapeutic advantages, it can paradoxically trigger catatonia in certain individuals. Multiple factors, such as genetics, cannabinoids, and neurotransmitter systems, contribute to this intricacy, underscoring the necessity for additional research.
PubMed: 38313688
DOI: 10.3389/fpsyt.2024.1332310 -
Cureus Sep 2023The prevalence of cannabis use disorders has become a noteworthy global public health issue. Understanding the neurobiological factors associated with cannabis use... (Review)
Review
The prevalence of cannabis use disorders has become a noteworthy global public health issue. Understanding the neurobiological factors associated with cannabis use disorder (CUD) is crucial for creating effective interventions. One such factor, the brain-derived neurotrophic factor (BDNF), has been linked to the onset and persistence of addictive behaviors. This systematic review aims to summarize the existing literature on BDNF levels in individuals with CUD to provide a comprehensive overview of the current evidence. A systematic search was conducted using electronic databases (PubMed, Scopus) for relevant studies. The search approach yielded a total of 785 articles, with 559 located in the PubMed database and 226 in Scopus. Studies reporting BDNF levels in individuals with CUD compared to healthy controls were included in this study. Ultimately, eight articles were included in this systematic review. The primary emphasis of these studies was on individuals who were cannabis users or had a dependency on cannabis. There is considerable variation in the estimated effect size among included studies due to heterogeneity; hence, a random effect model was used for meta-analysis. The findings of our study suggest that the effect size of BDNF levels was 0.25 with 95% CI (-0.55; 1.05) in cannabis users, which was not statistically significant (p-value=0.54). Therefore, it is important to interpret the results with caution, and additional research is warranted to investigate the potential factors contributing to this heterogeneity.
PubMed: 37900486
DOI: 10.7759/cureus.45960 -
International Journal of Environmental... Jul 2023Regular cannabis use during adolescence can lead to cognitive, psychological, and social consequences, causing significant distress. Although psychological interventions... (Review)
Review
Regular cannabis use during adolescence can lead to cognitive, psychological, and social consequences, causing significant distress. Although psychological interventions are the mainstay type of treatment for cannabis use disorder, the results remain mixed among youths. The objective of this review is twofold: to identify the existing psychological interventions for cannabis use among youths, and to assess the evidence regarding the effectiveness of those interventions. Randomized controlled trials focused exclusively on cannabis use among adolescents and young adults were included. Three databases-Embase, PsycInfo, and PubMed-were searched to identify relevant peer-reviewed manuscripts published before February 2022 in English and French. The risk of bias was assessed using the Cochrane Collaboration's tool. Twenty-five randomized controlled trials were included. Fourteen studies reported a significant outcome related to cannabis use. These were mainly non-intensive, online interventions that aimed to improve the patients' relationships and emotion regulation. This review highlights the need to conduct additional randomized control trials that target cannabis use disorder specifically among adolescents. These randomized control trials should also aim to reduce the risk of bias related to psychiatric comorbidities as well as detection and attrition problems.
Topics: Humans; Adolescent; Young Adult; Cannabis; Psychosocial Intervention; Marijuana Abuse; Randomized Controlled Trials as Topic
PubMed: 37510578
DOI: 10.3390/ijerph20146346 -
Brain Sciences Jun 2023(1) Background: Synthetic cannabinoids (SCs) are emerging drugs of abuse sold as 'K2', 'K9' or 'Spice'. Evidence shows that using SCs products leads to greater health... (Review)
Review
(1) Background: Synthetic cannabinoids (SCs) are emerging drugs of abuse sold as 'K2', 'K9' or 'Spice'. Evidence shows that using SCs products leads to greater health risks than cannabis. They have been associated with greater toxicity and higher addiction potential unrelated to the primary psychoactive component of marijuana, Δ9-tetrahydrocannabinol (Δ9-THC). Moreover, early cases of intoxication and death related to SCs highlight the inherent danger that may accompany the use of these substances. However, there is limited knowledge of the toxicology of Spice ingredients. This systematic review intends to analyze the toxicity of SCs compounds in Spice/K2 drugs. (2) Methods: Studies analyzing synthetic cannabinoid toxicity and dependence were included in the present review. We searched the PubMed database of the US National Library of Medicine, Google Scholar, CompTox Chemicals, and Web of Science up to May 2022. (3) Results: Sixty-four articles reporting the effects of synthetic cannabinoids in humans were included in our review. Ten original papers and fifty-four case studies were also included. Fourteen studies reported death associated with synthetic cannabinoid use, with AB-CHMINACA and MDMB-CHMICA being the main reported SCs. Tachycardia and seizures were the most common toxicity symptoms. The prevalence of neuropsychiatric symptoms was higher in third-generation SCs. (4) Conclusion: SCs may exhibit higher toxicity than THC and longer-lasting effects. Their use may be harmful, especially in people with epilepsy and schizophrenia, because of the increased risk of the precipitation of psychiatric and neurologic disorders. Compared to other drugs, SCs have a higher potential to trigger a convulsive crisis, a decline in consciousness, and hemodynamic changes. Therefore, it is crucial to clarify their potential harms and increase the availability of toxicology data in both clinical and research settings.
PubMed: 37508922
DOI: 10.3390/brainsci13070990 -
Substance Abuse : Research and Treatment 2023Recreational cannabis legalization has become more prevalent over the past decade, increasing the need to understand its impact on downstream health-related outcomes.... (Review)
Review
BACKGROUND
Recreational cannabis legalization has become more prevalent over the past decade, increasing the need to understand its impact on downstream health-related outcomes. Although prior reviews have broadly summarized research on cannabis liberalization policies (including decriminalization and medical legalization), directed efforts are needed to synthesize the more recent research that focuses on recreational cannabis legalization specifically. Thus, the current review summarizes existing studies using longitudinal designs to evaluate impacts of recreational cannabis legalization on cannabis use and related outcomes.
METHOD
A comprehensive bibliographic search strategy revealed 61 studies published from 2016 to 2022 that met criteria for inclusion. The studies were predominantly from the United States (66.2%) and primarily utilized self-report data (for cannabis use and attitudes) or administrative data (for health-related, driving, and crime outcomes).
RESULTS
Five main categories of outcomes were identified through the review: cannabis and other substance use, attitudes toward cannabis, health-care utilization, driving-related outcomes, and crime-related outcomes. The extant literature revealed mixed findings, including some evidence of negative consequences of legalization (such as increased young adult use, cannabis-related healthcare visits, and impaired driving) and some evidence for minimal impacts (such as little change in adolescent cannabis use rates, substance use rates, and mixed evidence for changes in cannabis-related attitudes).
CONCLUSIONS
Overall, the existing literature reveals a number of negative consequences of legalization, although the findings are mixed and generally do not suggest large magnitude short-term impacts. The review highlights the need for more systematic investigation, particularly across a greater diversity of geographic regions.
PubMed: 37187466
DOI: 10.1177/11782218231172054 -
Cureus Feb 2023There is a rising incidence of coronary artery diseases and myocardial infarction (MI). Mortality associated with acute MI (AMI) is directly linked to the time to... (Review)
Review
There is a rising incidence of coronary artery diseases and myocardial infarction (MI). Mortality associated with acute MI (AMI) is directly linked to the time to receive treatment and missed diagnoses. Although health professionals are aware of typical AMI presentation, atypical MI is difficult to diagnose, which on the other hand, is likely to have an impact on morbidity and mortality. Therefore, it is prudent to know such atypical presentations, especially for emergency and primary care physicians. We aimed to systematically evaluate the clinical presentations of atypical MI and analyze them to characterize the common clinical presentations of atypical MI. We researched the PubMed database, did citation tracking, and performed Google Scholar advanced search to find the cases reported on the atypical presentation of MI published from January 2000 to September 2022. Articles of all languages were included; Google Translate was used to translate articles published in languages other than English. A total of 496 (56 PubMed articles, 340 citations from included PubMed articles, and 100 articles from Google Scholar advanced search) were screened; 52 case reports were evaluated, and their data were analyzed. Atypical presentations of myocardial infarction are vast; patients may have chest pain without typical characteristics of angina pain or may not have chest pain. No typical characterization could be done. Most patients were in their fifth decade or above of their life and commonly presented with pain and discomfort in the abdomen, head, and neck regions. Prodromal symptoms were consistent findings, and many patients had two to three comorbidities out of four common comorbidities, i.e., diabetes, hypertension, dyslipidemia, and substance abuse. A patient who is 50 years old or more, having comorbidities such as diabetes, hypertension, dyslipidemia, history of tobacco or marijuana usage, presenting with prodromal symptoms like shortness of breath, dizziness, fatigue, syncope, gastrointestinal discomfort or head/neck pain should be suspected for atypical MI.
PubMed: 36999116
DOI: 10.7759/cureus.35492 -
Campbell Systematic Reviews Dec 2022At-risk youth may be defined as a diverse group of young people in unstable life circumstances, who are currently experiencing or are at risk of developing one or more... (Review)
Review
BACKGROUND
At-risk youth may be defined as a diverse group of young people in unstable life circumstances, who are currently experiencing or are at risk of developing one or more serious problems. At-risk youth are often very unlikely to seek out help for themselves within the established venues, as their adverse developmental trajectories have installed a lack of trust in authorities such as child protection agencies and social workers. To help this population, a number of outreach programmes have been established seeking to help the young people on an ad hoc basis, meaning that the interventions are designed to fit the individual needs of each young person rather than as a one-size-fits-all treatment model. The intervention in this review is targeted outreach work which may be (but does not have to be) multicomponent programmes in which outreach may be combined with other services.
OBJECTIVES
The main objective of this review was to answer the following research questions: What are the effects of outreach programmes on problem/high-risk behaviour of young people between 8 and 25 years of age living in OECD countries? Are they less likely to experience an adverse outcome such as school failure or drop-out, runaway and homelessness, substance and/or alcohol abuse, unemployment, long-term poverty, delinquency and more serious criminal behaviour?
SEARCH METHODS
We identified relevant studies through electronic searches of bibliographic databases, governmental and grey literature repositories, hand search in specific targeted journals, citation tracking, and Internet search engines. The database searches were carried out in September 2020 and other resources were searched in October and November 2021. We searched to identify both published and unpublished literature, and reference lists of included studies and relevant reviews were searched.
SELECTION CRITERIA
The intervention was targeted outreach work which may have been combined with other services. Young people between 8 and 25 years of age living in OECD countries, who either have experienced or is at-risk of experiencing an adverse outcome were eligible. Our primary focus was on measures of problem/high-risk behaviour and a secondary focus was on social and emotional outcomes. All study designs that used a well-defined control group were eligible for inclusion. Studies that utilised qualitative approaches were not included.
DATA COLLECTION AND ANALYSIS
The total number of potentially relevant studies constituted 17,659 hits. A total of 16 studies (17 different interventions) met the inclusion criteria. Only five studies could be used in the data synthesis. Eight studies could not be used in the data synthesis as they were judged to have critical risk of bias and, in accordance with the protocol, were excluded from the meta-analysis on the basis that they would be more likely to mislead than inform. Two studies (three interventions) did not provide enough information enabling us to calculate an effect size and standard error, and one study did not provide enough information to assess risk of bias. Meta-analysis of all outcomes were conducted on each conceptual outcome separately. All analyses were inverse variance weighted using random effects statistical models incorporating both the sampling variance and between study variance components into the study level weights. Random effects weighted mean effect sizes were calculated using 95% confidence intervals. Too few studies were included to carry out any sensitivity analyses.
MAIN RESULTS
Four of the five studies used for meta analysis were from the USA and one was from Canada. The timespan in which included studies were carried out was 32 years, from 1985 to 2017; on average the intervention year was 2005. The average number of participants in the analysed interventions was 116, ranging from 30 to 346 and the average number of controls was 81, ranging from 32 to 321. At most, the results from two studies could be pooled in a single meta-analysis. It was only possible to pool the outcomes drug (other than marijuana) use, marijuana use and alcohol use each at two different time points (one and 3 months follow up). At 1 month follow up the weighted averages varied between zero and 0.05 and at 3 months follow up between -0.17 and 0.07. None of them were statistically significant. In addition, a number of other outcomes were reported in a single study only.
AUTHORS' CONCLUSIONS
Overall, there were too few studies included in any of the meta-analyses in order for us to draw any conclusion concerning the effectiveness of outreach. The vast majority of studies were undertaken in the USA. The dominance of the USA as the main country in which outreach interventions meeting our inclusion criteria have been evaluated using rigorous methods and within our specific parameters clearly limits the generalisability of the findings. None of the studies, however, was considered to be of overall high quality in our risk of bias assessment and the process of excluding studies with critical risk of bias from the meta-analysis applied in this review left us with only five of a total of 16 possible studies to synthesise. Further, because too few studies reported results on the same type of outcome at most two studies could be combined in a particular meta-analysis. Given the limited number of rigorous studies available from countries other than the USA, it would be natural to consider conducting a series of randomised controlled trials evaluating the effectiveness of outreach for at-risk youth in countries outside the USA. The trial(s) should be designed, conducted and reported according to methodological criteria for rigour in respect of internal and external validity to achieve robust results and preferably reporting a larger number of outcomes.
PubMed: 36908846
DOI: 10.1002/cl2.1282 -
Revista Espanola de Salud Publica Oct 2022Cannabis is an illegal drug whose use has increased in recent years, especially among adolescents. Despite its popularity, its use and abuse brings with it health... (Review)
Review
OBJECTIVE
Cannabis is an illegal drug whose use has increased in recent years, especially among adolescents. Despite its popularity, its use and abuse brings with it health consequences, being greater if consumption occurs in the adolescent stage, since the brain is in full development. The objective of this systematic review was to determine the effects of cannabis use on cognitive functions of attention and memory in adolescent population.
METHODS
A systematic review of the literature was carried out in the main search portals (Pubmed, Web of Science, SciELO, Cochrane) referring to the last 10 years, following the PRISMA criteria. The systematic search strategy was carried out in the period from March to May 2021, applying the PICO method and the PEDro scale to guarantee the methodological quality of the included studies.
RESULTS
Both attention and memory are affected by cannabis use; however, memory functions improve with abstinence, not being so for attention. Memory deficits are an indicator of therapeutic abandonment of addiction treatment. In relation to psychosocial interventions aimed at improving memory, the contingency management, educational interventions and motivational interviewing have not been shown to be effective on the effects of substances. Working memory training offers positive results, although not clinically significant. Finally, memory deficits are an indicator of therapeutic abandonment of pharmacological treatment for cannabis addiction. Therefore, research is needed aimed both at reducing the side effects of drugs on memory processes and at establishing to what extent memory deficits associated with cannabis use can facilitate therapeutic abandonment.
CONCLUSIONS
More research is necessary, considering the dual consumption of cannabis-tobacco and the effects that both substances may have jointly and separately on attention and memory processes.
Topics: Adolescent; Humans; Cannabis; Marijuana Abuse; Spain; Illicit Drugs; Memory Disorders
PubMed: 36300331
DOI: No ID Found