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The International Journal on Drug Policy Apr 2017Social attitudes and cultural norms around the issue of substance abuse are shifting rapidly around the world, leading to complex and unpredictable consequences. On the... (Review)
Review
Social attitudes and cultural norms around the issue of substance abuse are shifting rapidly around the world, leading to complex and unpredictable consequences. On the positive side, efforts to more intensely disseminate the scientific evidence for the many connections between chronic substance use and the emergence of measurable and discrete brain dysfunctions, has ushered in an evolving climate of acceptance and a new era of improved access to more effective interventions, at least in the United States. On the negative side, there has been a steady erosion in the public perception of the harms associated with the use of popular drugs, especially cannabis. This worrisome trend has sprouted at the convergence of several forces that have combined, more or less fortuitously, to effectively change long-standing policies away from prohibition and toward decriminalization or legalization. These forces include the outsized popularity of the cannabis plant among recreational users, the unflagging campaign by corporate lobbyists and patient advocates to mainstream its medicinal use, and the honest realization in some quarters of the deleterious impact of the drug war and its draconian cannabis laws, in particular, on society's most vulnerable populations. Updating drug policies is a desirable goal, and significant changes may indeed be warranted. However, there is a real concern when policy changes are hurriedly implemented without the required input from the medical, scientific, or policy research communities. Regardless of how well intentioned, such initiatives are bound to magnify the potential for unintended adverse consequences in the form of far ranging health and social costs. To minimize this risk, science must be front and center in this important policy debate. Here, we review the state of the science on cannabis and cannabinoid health effects, both adverse and therapeutic. We focus on the prevalence of use in different populations, the mechanisms by which cannabis exerts its effects (i.e., via the endocannabinoid system), and the double-edged potential of this system to inspire new medications, on one hand, and to cause short and long term harmful effects on the other. By providing knowledge of cannabis' broad ranging effects, we hope to enable better decision making regarding cannabis legislation and policy implementation.
Topics: Endocannabinoids; Humans; Legislation, Drug; Marijuana Abuse; Medical Marijuana; Plant Extracts; Public Policy; Science
PubMed: 28189459
DOI: 10.1016/j.drugpo.2017.01.007 -
Revista Chilena de Pediatria Apr 2014There are already several countries that have accepted marijuana as a soft drug, separating it from more dangerous ones. Yarious therapeutic properties have even been... (Review)
Review
There are already several countries that have accepted marijuana as a soft drug, separating it from more dangerous ones. Yarious therapeutic properties have even been attributed to its use. Others, however, think that its use should be prohibited due to the mental interference and behavioral changes produced either by its occasional use as well as the permanent mental damage linked to chronic marijuana use. In order to clarify this divergence of opinions, the scientific literature is reviewed. It is concluded that there is a serious risk, especially for teenagers, associated to chronic marijuana use due to the presence of more frequent psychotic and schizophrenic episodes, which can be permanent, while consumption during pregnancy results in brain damage to the fetus, similar to fetal alcohol syndrome. Scientific research also indicated that smoking marijuana produces an even more severe bronchial damage than tobacco, with risk of lung cancer. In conclusion, the notion that marijuana is a risk-free soft drug is a serious mistake, based on the available conclusive scientific research that shows the opposite.
Topics: Adolescent; Female; Humans; Legislation, Drug; Marijuana Abuse; Marijuana Smoking; Pregnancy
PubMed: 25697213
DOI: 10.4067/S0370-41062014000200014 -
Journal of the American Heart... Apr 2014
Topics: Cardiovascular Diseases; Female; Humans; Male; Marijuana Abuse; Marijuana Smoking
PubMed: 24760963
DOI: 10.1161/JAHA.114.000904 -
Medical Science Monitor : International... May 2023Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adults. In the substance use disorders (SUDs) population, ADHD... (Review)
Review
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adults. In the substance use disorders (SUDs) population, ADHD prevalence reaches 23.1%, leading to more severe substance abuse progression and reduced treatment effectiveness. Cannabis is the most common illicit drug used among the ADHD population. The increasing popularity of medical marijuana (MM) has raised concerns about its potential impact on neurocognitive functions, particularly in adolescents. Persistent cannabis use can cause permanent changes in brain structures and circuits. This review aims to overview the comorbidity of ADHD and SUDs, focusing on cannabis use disorders. Theoretical models of the etiologies of ADHD and SUDs were investigated to establish a framework for analyzing their underlying neurocognitive mechanisms. The reward and motivational brain circuitries involving the default-mode network and the endocannabinoid system were emphasized. The high prevalence of SUDs in the ADHD population has ramifications, including earlier age of onset, self-medication, and reduced performance in various domains. Cannabis use disorders are particularly significant due to the increasingly widespread use of cannabis and its perceived safety. The review highlights the lack of theoretical background on the therapeutic properties of medicinal cannabis, criticizing its speculated applications in the ADHD population. This article reviews the current understanding of the association between ADHD and cannabis use, emphasizing the need for further research and a cautious approach to MM's potential therapeutic applications.
Topics: Adult; Adolescent; Child; Humans; Attention Deficit Disorder with Hyperactivity; Marijuana Abuse; Substance-Related Disorders; Brain; Comorbidity
PubMed: 37147797
DOI: 10.12659/MSM.939749 -
Viruses Jun 2021Cannabis continues to be the most used drug in the world today. Research shows that cannabis use is associated with a wide range of adverse health consequences that may... (Review)
Review
Cannabis continues to be the most used drug in the world today. Research shows that cannabis use is associated with a wide range of adverse health consequences that may involve almost every physiological and biochemical system including respiratory/pulmonary complications such as chronic cough and emphysema, impairment of immune function, and increased risk of acquiring or transmitting viral infections such as HIV, HCV, and others. The review of published research shows that cannabis use may impair immune function in many instances and thereby exerts an impact on viral infections including human immune deficiency virus (HIV), hepatitis C infection (HCV), and human T-cell lymphotropic type I and II virus (HTLV-I/II). The need for more research is also highlighted in the areas of long-term effects of cannabis use on pulmonary/respiratory diseases, immune dysfunction and the risk of infection transmission, and the molecular/genetic basis of immune dysfunction in chronic cannabis users.
Topics: HIV Infections; HTLV-II Infections; Hepatitis C; Humans; Immune System; Marijuana Abuse; Virus Diseases
PubMed: 34207524
DOI: 10.3390/v13061099 -
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 -
American Family Physician Dec 2021Cannabis use in the United States is increasing annually in people of all ages. This increase is fueled by state-level legalization, decreased risk perception, and...
Cannabis use in the United States is increasing annually in people of all ages. This increase is fueled by state-level legalization, decreased risk perception, and increased social acceptability. Cannabis and its active components, cannabinoids, have been studied for medical uses and marketed in many commercial forms. Cannabis can impair short-term memory, judgment, and coordination, and there is substantial evidence that it can adversely affect multiple organ systems. Cannabinoids have potential adverse drug interactions with commonly prescribed analgesic, psychotropic, and cardiovascular medications. Current evidence supports cannabinoid use only for a limited number of conditions (chemotherapy-induced nausea and vomiting, specific pain and spasticity syndromes, and certain forms of childhood epilepsy); thus, physicians recommending cannabinoids need to weigh the potential harms vs. perceived benefits. The U.S. Preventive Services Task Force recommends universal screening for unhealthy drug use, including cannabis, in adults 18 years and older. However, the American Academy of Family Physicians does not support this recommendation because of the lack of evidence of benefit in screening patients for unhealthy drug use, except for opioid use disorder. Treatment of cannabis use disorder is largely behavioral and requires a patient-centered, multifaceted approach with a focus on patient education. Pharmacotherapy for cannabis use disorder is limited and experimental. Harm reduction strategies and education about cannabis withdrawal syndrome should be provided to patients. Interpretation of urine drug testing for cannabis is challenging because of the persistence of metabolites for four to five days after a single use and for one month after chronic daily use.
Topics: Humans; Marijuana Abuse; Medical Marijuana; Primary Health Care; United States
PubMed: 34913644
DOI: No ID Found -
The British Journal of Radiology Sep 2019The recreational consumption of cannabis has increased significantly across the world with an estimated 180 million people currently using. In the United States,... (Review)
Review
The recreational consumption of cannabis has increased significantly across the world with an estimated 180 million people currently using. In the United States, 4.1 million are currently diagnosed with cannabis use disorder. Cannabis dependence and abuse was combined into a single entity as a behavioral disorder with a problematic pattern of cannabis use and termed cannabis use disorder by the Diagnostic and Statistical Manual of Mental Disorders. Chronic use of cannabis has been linked with region-specific effects across the brain mediating reward processing, cognitive control and decision-making that are central to understanding addictive behaviors. This review presents a snapshot of the current literature assessing the effects of chronic cannabis use on human brain function via functional MRI. Studies employing various paradigms and contrasting cognitive activation amongst cannabis users and non-users were incorporated. The effects of trans-del-ta-9-tetrahydrocannabinol (Δ9-THC) in marijuana and other preparations of cannabis are mediated by the endocannabinoid system, which is also briefly introduced.Much variation exists in the current literature regarding the functional changes associated with chronic cannabis use. One possible explanation for this variation is the heterogeneity in study designs, with little implementation of standardized diagnostic criteria when selecting chronic users, distinct time points of participant assessment, differing cognitive paradigms and imaging protocols. As such, there is an urgent requirement for future investigations that further characterize functional changes associated with chronic cannabis use.
Topics: Adolescent; Adult; Brain; Decision Making; Female; Humans; Magnetic Resonance Imaging; Male; Marijuana Abuse; Reward; Young Adult
PubMed: 31364398
DOI: 10.1259/bjr.20190165 -
The British Journal of General Practice... Mar 2009
Topics: Cannabis; Family Practice; Humans; Marijuana Abuse; Physician's Role; Risk Factors
PubMed: 19275831
DOI: 10.3399/bjgp09X419501 -
Addictive Behaviors Nov 2010This study examined associations between the endorsement of drug use expectancies and the frequency and severity of marijuana use in a community sample of 332 women aged...
This study examined associations between the endorsement of drug use expectancies and the frequency and severity of marijuana use in a community sample of 332 women aged 18-24years who were not explicitly seeking treatment for their marijuana use. Participants were enrolled in a larger intervention study of motivational interviewing for various health behaviors and provided self-reports of their current and past marijuana use, marijuana abuse/dependence symptoms, and marijuana use expectancies. Marijuana use expectancies were measured using the six subscales of the Marijuana Effects Expectancy Questionnaire (MEEQ). Use frequency was defined as the number of use days in the past month, severity as the total number of DSM-IV marijuana abuse or dependence symptom criteria met. Replicating and extending prior research, expectations regarding Relaxation and Tension Reduction emerged as a robust belief in this cohort, predicting not only frequency (p<.01) but also severity (p<.01) of marijuana use in multivariate analyses. Severity of marijuana use was further predicted by expectations regarding loss of control, affective changes following marijuana use, and other aspects of emotion dysregulation (Global Negative Effects, p<.01). These findings document meaningful associations between substance-related cognitions and use behavior and suggest that marijuana users who hold certain beliefs regarding marijuana use may be particularly susceptible to clinically significant problems associated with their substance use. As such, marijuana use expectancies may represent a clinical target that could be incorporated into future interventions.
Topics: Adolescent; Female; Humans; Marijuana Abuse; Self Report; Young Adult
PubMed: 20621423
DOI: 10.1016/j.addbeh.2010.06.017