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Hillman C, Kearn J, Parker MO. A unified approach to investigating 4 dpf zebrafish larval behaviour through a standardised light/dark assay. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111084. [PMID: 39002928 DOI: 10.1016/j.pnpbp.2024.111084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 06/28/2024] [Accepted: 07/08/2024] [Indexed: 07/15/2024]
Abstract
Zebrafish are a dynamic research model in the domains of neuropsychopharmacology, biological psychiatry and behaviour. Working with larvae ≤4 days post-fertilisation (dpf) offers an avenue for high-throughput investigation whilst aligning with the 3Rs principles of animal research. The light/dark assay, which is the most widely used behavioural assay for larval neuropharmacology research, lacks experimental reliability and standardisation. This study aimed to formulate a robust, reproducible and standardised light/dark behavioural assay using 4 dpf zebrafish larvae. Considerable between-batch and inter-individual variability was found, which we rectified with a normalisation approach to ensure a reliable foundation for analysis. We then identified that 5-min light/dark transition periods are optimal for locomotor activity. We also found that a 30-min acclimation in the light was found to produce significantly increased dark phase larval locomotion. Next, we confirmed the pharmacological predictivity of the standardised assay using ethanol which, as predicted, caused hyperlocomotion at low concentrations and hypolocomotion at high concentrations. Finally, the assay was validated by assessing the behavioural phenotype of hyperactive transgenic (adgrl3.1-/-) larvae, which was rescued with psychostimulant medications. Our standardised assay not only provides a clear experimental and analytical framework to work with 4 dpf larvae, but also facilitates between-laboratory collaboration using our normalisation approach.
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Affiliation(s)
- Courtney Hillman
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK.
| | - James Kearn
- Defence Science and Technology Laboratory (DSTL), UK.
| | - Matthew O Parker
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK; School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK.
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2
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Banerjee S, Saha D, Sharma R, Jaidee W, Puttarak P, Chaiyakunapruk N, Chaoroensup R. Phytocannabinoids in neuromodulation: From omics to epigenetics. JOURNAL OF ETHNOPHARMACOLOGY 2024; 330:118201. [PMID: 38677573 DOI: 10.1016/j.jep.2024.118201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/27/2024] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Recent developments in metabolomics, transcriptomic and epigenetics open up new horizons regarding the pharmacological understanding of phytocannabinoids as neuromodulators in treating anxiety, depression, epilepsy, Alzheimer's, Parkinson's disease and autism. METHODS The present review is an extensive search in public databases, such as Google Scholar, Scopus, the Web of Science, and PubMed, to collect all the literature about the neurobiological roles of cannabis extract, cannabidiol, 9-tetrahydrocannabinol specially focused on metabolomics, transcriptomic, epigenetic, mechanism of action, in different cell lines, induced animal models and clinical trials. We used bioinformatics, network pharmacology and enrichment analysis to understand the effect of phytocannabinoids in neuromodulation. RESULTS Cannabidomics studies show wide variability of metabolites across different strains and varieties, which determine their medicinal and abusive usage, which is very important for its quality control and regulation. CB receptors interact with other compounds besides cannabidiol and Δ9-tetrahydrocannabinol, like cannabinol and Δ8-tetrahydrocannabinol. Phytocannabinoids interact with cannabinoid and non-cannabinoid receptors (GPCR, ion channels, and PPAR) to improve various neurodegenerative diseases. However, its abuse because of THC is also a problem found across different epigenetic and transcriptomic studies. Network enrichment analysis shows CNR1 expression in the brain and its interacting genes involve different pathways such as Rap1 signalling, dopaminergic synapse, and relaxin signalling. CBD protects against diseases like epilepsy, depression, and Parkinson's by modifying DNA and mitochondrial DNA in the hippocampus. Network pharmacology analysis of 8 phytocannabinoids revealed an interaction with 10 (out of 60) targets related to neurodegenerative diseases, with enrichment of ErbB and PI3K-Akt signalling pathways which helps in ameliorating neuro-inflammation in various neurodegenerative diseases. The effects of phytocannabinoids vary across sex, disease state, and age which suggests the importance of a personalized medicine approach for better success. CONCLUSIONS Phytocannabinoids present a range of promising neuromodulatory effects. It holds promise if utilized in a strategic way towards personalized neuropsychiatric treatment. However, just like any drug irrational usage may lead to unforeseen negative effects. Exploring neuro-epigenetics and systems pharmacology of major and minor phytocannabinoid combinations can lead to success.
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Affiliation(s)
- Subhadip Banerjee
- Medicinal Plant Innovation Center of Mae Fah Luang University, Mae Fah Luang University, ChiangRai, 57100, Thailand
| | - Debolina Saha
- School of Bioscience and Engineering, Jadavpur University, Kolkata, 700032, India
| | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India
| | - Wuttichai Jaidee
- Medicinal Plant Innovation Center of Mae Fah Luang University, Mae Fah Luang University, ChiangRai, 57100, Thailand
| | - Panupong Puttarak
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, 90112, Thailand; Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat-Yai, Songkhla 90110, Thailand
| | | | - Rawiwan Chaoroensup
- Medicinal Plant Innovation Center of Mae Fah Luang University, Mae Fah Luang University, ChiangRai, 57100, Thailand; School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, 57100, Thailand.
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3
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Swaminathan M, Tarifa A, DeCaprio AP. Development and validation of a method for analysis of 25 cannabinoids in oral fluid and exhaled breath condensate. Anal Bioanal Chem 2024; 416:4325-4340. [PMID: 38864915 DOI: 10.1007/s00216-024-05369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/13/2024]
Abstract
Currently, there is a significant demand in forensic toxicology for biomarkers of cannabis exposure that, unlike ∆9-tetrahydrocannabinol, can reliably indicate time and frequency of use, be sampled with relative ease, and correlate with impairment. Oral fluid (OF) and exhaled breath condensate (EBC) are alternative, non-invasive sample matrices that hold promise for identifying cannabis exposure biomarkers. OF, produced by salivary glands, is increasingly utilized in drug screening due to its non-invasive collection and is being explored as an alternative matrix for cannabinoid analysis. EBC is an aqueous specimen consisting of condensed water vapor containing water-soluble volatile and non-volatile components present in exhaled breath. Despite potential advantages, there are no reports on the use of EBC for cannabinoid detection. This study developed a supported liquid extraction approach and LC-QqQ-MS dMRM analytical method for quantification of 25 major and minor cannabinoids and metabolites in OF and EBC. The method was validated according to the ANSI/ASB 036 standard and other published guidelines. LOQ ranged from 0.5 to 6.0 ng/mL for all cannabinoids in both matrices. Recoveries for most analytes were 60-90%, with generally higher values for EBC compared to OF. Matrix effects were observed with some cannabinoids, with effects mitigated by use of matrix-matched calibration. Bias and precision were within ± 25%. Method applicability was demonstrated by analyzing ten authentic OF and EBC samples, with positive detections of multiple analytes in both matrices. The method will facilitate comprehensive analysis of cannabinoids in non-invasive sample matrices for the development of reliable cannabis exposure biomarkers.
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Affiliation(s)
- Meena Swaminathan
- Department of Chemistry & Biochemistry, Florida International University, 11200 SW 8th St., Miami, FL, 33199, USA
| | - Anamary Tarifa
- Department of Chemistry & Biochemistry and Global & Forensic Justice Center, Florida International University, Miami, FL, 33199, USA
| | - Anthony P DeCaprio
- Department of Chemistry & Biochemistry, Florida International University, 11200 SW 8th St., Miami, FL, 33199, USA.
- Department of Chemistry & Biochemistry and Global & Forensic Justice Center, Florida International University, Miami, FL, 33199, USA.
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4
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O'Donnell S, Scott-Storey K, Malcolm J, Vincent CD, Wuest J. Cumulative lifetime violence, social determinants of health, and cannabis use disorder post-cannabis legalization in a community sample of men: An intersectional perspective. Res Nurs Health 2024; 47:460-474. [PMID: 38722053 DOI: 10.1002/nur.22389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/30/2024] [Accepted: 04/27/2024] [Indexed: 07/11/2024]
Abstract
Despite Canada having the highest disease burden globally for cannabis use disorder (CUD) and violence being ubiquitous in men's lives, little is known about how intersections among social determinants of health (SDOH) and cumulative lifetime violence severity (CLVS) influence CUD in men post-cannabis legalization. Using data collected in a survey with a national community sample of 597 men who self-identified as having experienced violence, we conducted a latent profile analysis using 11 subscales of the CLVS-44 scale and explored differential associations between CLVS profiles and CUD considering SDOH covariates. Four profiles were distinguished by intersections among CLVS-44 subscale severity and roles as target and perpetrator. CLVS profiles were significantly associated with CUD in the unadjusted model and in the adjusted model where age, adverse housing, and education were significant covariate controls. In the adjusted model, CUD was differentially associated with CLVS profiles and significantly higher in Profile 4 (highest severity target and perpetrator) than in Profile 1 (lowest severity target, no perpetration). Chi-square tests showed significant intersection between adverse housing, younger age, Profile 4 CLVS, and moderate to severe CUD among cannabis users. These results reveal the importance of understanding simultaneous intersections among indicators of CLVS in determining profiles of lifetime violence. Also critical are intersections among CLVS profiles and significant covariates as a basis for trauma- and violence-informed care for CUD that prioritizes men most disadvantaged by this convergence and attends to individual and structural health disparities at practice and policy levels.
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Affiliation(s)
- Sue O'Donnell
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Kelly Scott-Storey
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Jeannie Malcolm
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Charlene D Vincent
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Judith Wuest
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
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5
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Chen S, Li X, Wu Q, Li Y, Puig M, Moulin F, Choudhuri S, Gingrich J, Guo L. Investigation of cannabidiol-induced cytotoxicity in human hepatic cells. Toxicology 2024; 506:153884. [PMID: 39004336 DOI: 10.1016/j.tox.2024.153884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/23/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
Cannabidiol (CBD) is one of the primary cannabinoids present in extracts of the plant Cannabis sativa L. A CBD-based drug, Epidiolex, has been approved by the U.S. FDA for the treatment of seizures in childhood-onset epileptic disorders. Although CBD-associated liver toxicity has been reported in clinical studies, the underlying mechanisms remain unclear. In this study, we demonstrated that CBD causes cytotoxicity in primary human hepatocytes and hepatic HepG2 cells. A 24-h CBD treatment induced cell cycle disturbances, cellular apoptosis, and endoplasmic reticulum (ER) stress in HepG2 cells. A potent ER stress inhibitor, 4-phenylbutyrate, markedly attenuated CBD-induced apoptosis and cell death. Additionally, we investigated the role of cytochrome P450 (CYP)-mediated metabolism in CBD-induced cytotoxicity using HepG2 cell lines engineered to express 14 individual CYPs. We identified CYP2C9, 2C19, 2D6, 2C18, and 3A5 as participants in CBD metabolism. Notably, cells overexpressing CYP2C9, 2C19, and 2C18 produced 7-hydroxy-CBD, while cells overexpressing CYP2C9, 2C19, 2D6, and 2C18 generated 7-carboxy-CBD. Furthermore, CBD-induced cytotoxicity was significantly attenuated in the cells expressing CYP2D6. Taken together, these data suggest that cell cycle disturbances, apoptosis, and ER stress are associated with CBD-induced cytotoxicity, and CYP2D6-mediated metabolism plays a critical role in decreasing the cytotoxicity of CBD.
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Affiliation(s)
- Si Chen
- Division of Biochemical Toxicology, National Center for Toxicological Research (NCTR), U.S. Food and Drug Administration (FDA), Jefferson, AR 72079, USA.
| | - Xilin Li
- Division of Genetic and Molecular Toxicology, NCTR, U.S. FDA, Jefferson, AR 72079, USA
| | - Qiangen Wu
- Division of Biochemical Toxicology, National Center for Toxicological Research (NCTR), U.S. Food and Drug Administration (FDA), Jefferson, AR 72079, USA
| | - Yuxi Li
- Division of Biochemical Toxicology, National Center for Toxicological Research (NCTR), U.S. Food and Drug Administration (FDA), Jefferson, AR 72079, USA
| | - Montserrat Puig
- Division of Biotechnology Review and Research III, Office of Biotechnology Products, Center for Drug Evaluation and Research, U.S. FDA, Silver Spring, MD 20993, USA
| | - Frederic Moulin
- Division of Hepatology and Nutrition, Office of New Drugs, Center for Drug Evaluation and Research, U.S. FDA, Silver Spring, MD 20993, USA
| | - Supratim Choudhuri
- Division of Food Ingredients, Office of Food Additive Safety, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD 20740, USA
| | - Jeremy Gingrich
- Division of Food Ingredients, Office of Food Additive Safety, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD 20740, USA
| | - Lei Guo
- Division of Biochemical Toxicology, National Center for Toxicological Research (NCTR), U.S. Food and Drug Administration (FDA), Jefferson, AR 72079, USA.
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6
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Hancock J, Livingston SJ, Samuels L. Building a biofactory: Constructing glandular trichomes in Cannabis sativa. CURRENT OPINION IN PLANT BIOLOGY 2024; 80:102549. [PMID: 38761520 DOI: 10.1016/j.pbi.2024.102549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 05/20/2024]
Abstract
Flowers of Cannabis sativa L. are densely covered with glandular trichomes containing cannabis resin that is used for medicinal and recreational purposes. The highly productive glandular trichomes have been described as 'biofactories.' In this review, we use this analogy to highlight recent advances in cannabis cell biology, metabolomics, and transcriptomics. The biofactory is built by epidermal outgrowths that differentiate into peltate-like glandular trichome heads, consisting of a disc of interconnected secretory cells with unique cellular structures. Cannabinoid and terpenoid products are warehoused in the extracellular storage cavity. Finally, multicellular stalks raise the glandular heads above the epidermis, giving cannabis flower their frosty appearance.
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Affiliation(s)
- Jessica Hancock
- Department of Botany, University of British Columbia, 6270 University Boulevard, Vancouver, BC V6T 1Z4, Canada
| | - Samuel J Livingston
- Department of Botany, University of British Columbia, 6270 University Boulevard, Vancouver, BC V6T 1Z4, Canada
| | - Lacey Samuels
- Department of Botany, University of British Columbia, 6270 University Boulevard, Vancouver, BC V6T 1Z4, Canada.
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7
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Trunnell ER, Baines J, Farghali S, Jackson T, Jayne K, Smith R, Stibbe T. The need for guidance in antidepressant drug development: Revisiting the role of the forced swim test and tail suspension test. Regul Toxicol Pharmacol 2024; 151:105666. [PMID: 38942190 DOI: 10.1016/j.yrtph.2024.105666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/21/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024]
Abstract
Depressive disorders are one of the most common mental disorders globally and progress in treating these disorders has been hampered, in part, by a lack of suitable nonclinical efficacy tests. Two common tests used in nonclinical efficacy studies of antidepressants-the forced swim test (FST) and tail suspension test (TST)-have come under criticism in recent years for their inconsistency and lack of validity, yet they continue to be used in the pharmaceutical industry. In this review, we provide a rationale for why international pharmaceutical regulatory and guidance agencies should begin issuing direction on methods for non-clinical efficacy testing that traditionally use the FST and TST, particularly considering that some regulators, such as those in the U.S. and E.U., allow the authorization of clinical trials to proceed without requiring tests in animals. The area of antidepressant drug discovery represents an important opportunity for reducing the attrition of psychiatric drugs, harmonizing regulatory requirements, and reducing animal use. Specific recommendations for the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) have been provided.
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Affiliation(s)
- Emily R Trunnell
- People for the Ethical Treatment of Animals (PETA) U.S., 1536 16th St. N.W., Washington, DC, 20036, USA.
| | - Julia Baines
- PETA U.K., Society Building, 8 All Saints Street, London, N1 9RL, UK
| | - Stephen Farghali
- Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave # 400, Washington, DC, 20016, USA.
| | - Tara Jackson
- New Zealand Anti-Vivisection Society, PO BOX 9387, Tower Junction, Christchurch, 8149, New Zealand.
| | - Kimberley Jayne
- PETA U.K., Society Building, 8 All Saints Street, London, N1 9RL, UK.
| | - Rachel Smith
- Animal-Free Science Advocacy, PO Box 15, Fitzroy Vic, 3065, Australia.
| | - Tina Stibbe
- PETA Deutschland e.V., Friolzheimer Strasse 3, 70499, Stuttgart, Germany.
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8
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Gao X, Campasino K, Yourick MR, Zhao Y, Sepehr E, Vaught C, Sprando RL, Yourick JJ. Comparison on the mechanism and potency of hepatotoxicity among hemp extract and its four major constituent cannabinoids. Toxicology 2024; 506:153885. [PMID: 39004335 DOI: 10.1016/j.tox.2024.153885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
Cannabidiol (CBD) has been reported to induce hepatotoxicity in clinical trials and research studies; however, little is known about the safety of other nonintoxicating cannabinoids. New approach methodologies (NAMs) based on bioinformatic analysis of high-throughput transcriptomic data are gaining increasing importance in risk assessment and regulatory decision-making of data-poor chemicals. In the current study, we conducted a concentration response transcriptomic analysis of hemp extract and its four major constituent cannabinoids [CBD, cannabichromene (CBC), cannabigerol (CBG), and cannabinol (CBN)] in hepatocytes derived from human induced pluripotent stem cells (iPSCs). Each compound impacted a distinctive combination of biological functions and pathways. However, all the cannabinoids impaired liver metabolism and caused oxidative stress in the cells. Benchmark concentration (BMC) analysis showed potencies in transcriptional activity of the cannabinoids were in the order of CBN > CBD > CBC > CBG, consistent with the order of their cytotoxicity IC50 values. Patterns of transcriptomic changes induced by hemp extract and its median overall BMC were very similar to CBD but differed significantly from other cannabinoids, suggesting that potential adverse effects of hemp extract were largely due to its major constituent CBD. Lastly, transcriptomic point-of-departure (tPoD) values were determined for each of the compounds, with the value for CBD (0.106 µM) being concordant with a previously reported one derived from apical endpoints of clinical and animal studies. Taken together, the current study demonstrates the potential utility of transcriptomic BMC analysis as a NAM for hazard assessment of data-poor chemicals, improves our understanding of the possible health effects of hemp extract and its constituent cannabinoids, and provides important tPoD data that could contribute to inform human safety assessment of these cannabinoid compounds.
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Affiliation(s)
- Xiugong Gao
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA.
| | - Kayla Campasino
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
| | - Miranda R Yourick
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
| | - Yang Zhao
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
| | - Estatira Sepehr
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
| | - Cory Vaught
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
| | - Robert L Sprando
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
| | - Jeffrey J Yourick
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Laurel, MD 20708, USA
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9
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Benes F, Binova Z, Zlechovcova M, Maly M, Stranska M, Hajslova J. Thermally induced changes in the profiles of phytocannabinoids and other bioactive compounds in Cannabis sativa L. inflorescences. Food Res Int 2024; 190:114487. [PMID: 38945557 DOI: 10.1016/j.foodres.2024.114487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 07/02/2024]
Abstract
Phytocannabinoids occurring in Cannabis Sativa L. are unique secondary metabolites possessing interesting pharmacological activities. In this study, the dynamics of thermally induced (60 and 120 °C) phytocannabinoid reactions in four cannabis varieties were investigated. Using UHPLC-HRMS/MS, 40 phytocannabinoids were involved in target analysis, and an additional 281 compounds with cannabinoid-like structures and 258 non-cannabinoid bioactive compounds were subjected to suspect screening. As expected, the key reaction was the decarboxylation of acidic phytocannabinoids. Nevertheless, the rate constants differed among cannabis varieties, documenting the matrix-dependence of this process. Besides neutral counterparts of acidic species, ́neẃ bioactive compounds such as hydroxyquinones were found in heated samples. In addition, changes in other bioactive compounds with both cannabinoid-like and non-cannabinoid structures were documented during cannabis heating at 120 °C. The data document the complexity of heat-induced processes and provide a further understanding of changes in bioactivities occurring under such conditions.
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Affiliation(s)
- Frantisek Benes
- Department of Food Analysis and Nutrition, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Zuzana Binova
- Department of Food Analysis and Nutrition, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Marie Zlechovcova
- Department of Food Analysis and Nutrition, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Matej Maly
- Department of Food Analysis and Nutrition, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Milena Stranska
- Department of Food Analysis and Nutrition, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Jana Hajslova
- Department of Food Analysis and Nutrition, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic.
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10
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Bettstetter H, Schäfer A. [Tetrahydrocannabinol (THC) in patients with fibromyalgia syndrome (FMS) : A retrospective study of changes in pain, psychometric variables, and analgesic consumption during inpatient interdisciplinary multimodal pain therapy (IMPT)]. Schmerz 2024; 38:259-266. [PMID: 37289246 DOI: 10.1007/s00482-023-00727-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/09/2023] [Accepted: 04/13/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Since March 1, 2017, medical cannabis (MC) can be prescribed nationwide in Germany. To date, there have been a number of qualitatively different studies on the effectiveness of MC in fibromyalgia syndrome (FMS). OBJECTIVE The aim of the study was to investigate the effectiveness of THC in the course of interdisciplinary multimodal pain therapy (IMPT) on pain and several psychometric variables. MATERIALS AND METHODS For the study, in the period 2017-2018, all patients in the pain ward of a clinic who were suffering from FMS and were treated in a multimodal interdisciplinary setting were selected based on inclusion criteria. The patients were examined separately according to groups with and without THC about pain intensity, various psychometric parameters and analgesic consumption during the stay. RESULTS Of the 120 FMS patients included in the study, 62 patients (51.7%) were treated with THC. In the parameters of pain intensity, depression, and quality of life, there was a significant improvement in the entire group during the stay (p < 0.001), which was significantly greater through the use of THC. In five of the seven analgesic groups examined, the dose was reduced or the drug discontinued significantly more often in the patients treated with THC. CONCLUSION The results provide indications that THC can be considered as a medical alternative in addition to the substances previously recommended in various guidelines.
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Affiliation(s)
- Horst Bettstetter
- Schmerzzentrum Inn-Salzach, Wackerstr. 7, 84489, Burghausen, Deutschland.
| | - Arne Schäfer
- Fachbereich Psychodiabetologie, Diabetes-Klinik Bad Mergentheim, Theodor-Klotzbücher-Str. 12, 97980, Bad Mergentheim, Deutschland
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Oberdürrbacherstr. 6, Haus A3, 97080, Würzburg, Deutschland
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11
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LoParco CR, Tillett KK, Berg CJ, Rossheim ME. Online Retail of Derived Psychoactive Cannabis Products: Age and Shipping Restrictions. J Adolesc Health 2024; 75:249-253. [PMID: 38864789 PMCID: PMC11257780 DOI: 10.1016/j.jadohealth.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE The 2018 US Farm Bill's definition of hemp resulted in the proliferation of derived psychoactive cannabis products (DPCPs), which appeal to some youth. Despite the importance of restricting youth access, few studies have systematically examined the DPCP retail environment, particularly their online accessibility. METHODS In May 2023, Google incognito mode was used to search "buy delta thc." Among the first 100 results, data were collected from the 20 most trafficked websites that sold and delivered DPCPs. For each site, we documented the following policy-relevant information: 1) age verification measures for site entry and purchase attempts, 2) adult signature reportedly required upon delivery, and 3) shipping restrictions. RESULTS Overall, 14 websites (70%) required individuals to indicate their age. Most websites (n = 13, 65%) did not verify age at attempted purchase, nor indicated that an adult signature was required upon delivery (n = 15, 75%). Only three websites (15%) had rigorous age verification procedures during checkout that included contact information as well as an image of their photo ID, which would then be validated through a third-party software. None required age verification upon both purchase and delivery. Thirteen websites (65%) mentioned state shipping restrictions; four of these provided conflicting information across different sections of the website. DISCUSSION As the e-commerce landscape continues to evolve, clearer regulations regarding DPCP online retail sales and related enforcement are needed. In particular, measures are needed to enforce shipping restrictions and prevent youth access, including increasing the rigor of age verification.
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Affiliation(s)
- Cassidy R LoParco
- Department of Prevention & Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C..
| | - Kayla K Tillett
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
| | - Carla J Berg
- Department of Prevention & Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C
| | - Matthew E Rossheim
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
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12
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Xiao ATY, Turk T, Deol K, Zhang S, Aref HAT, Campbell A, Jones A, Yamamoto SS, Dennett L, Kolewaski L, Sadowski CA, Yacyshyn EA. Evidence for the use of cannabis-based medicines in osteoarthritis: a scoping review. Clin Rheumatol 2024; 43:2375-2390. [PMID: 38853226 DOI: 10.1007/s10067-024-07001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 06/11/2024]
Abstract
The purpose of this study was to conduct a scoping review to describe the evidence on the efficacy and safety of using cannabis-based medicines for osteoarthritis. The review was conducted following the framework proposed by Arksey and O'Malley and reported following PRISMA extension for scoping reviews guidelines. We conducted a comprehensive search across various databases including MEDLINE, Embase, Cochrane Library, CINAHL, Scopus, and Proquest, spanning from inception of each database to March 2023. We retrieved 2533 citations, and after deduplication, title and abstract screening, and full-text screening, 10 articles were included for analysis. These studies were composed of randomized-controlled trials (n = 4/10), cross-sectional surveys (n = 3/10), case studies (n = 2/10), and a cohort study (n = 1/10). Evidence for using cannabis-based medicines was mixed, with just 60% (n = 6/10) of included studies reporting statistically significant improvements in pain. Studies with larger samples sizes and longer durations of exposure did not find significant benefits for pain. The few adverse effects reported were generally mild and affected a minority of participants. Several studies also discovered that cannabis-based medicines were associated with a reduction in opioid use. Currently available data on the use of cannabis-based medicines in osteoarthritis is insufficient to make recommendations. Future research should address concerns regarding small sample sizes and short treatment durations to provide a more robust evidence base. Key Points • Current evidence remains mixed; studies that found a positive benefit with using cannabis-based medicines had limitations with small sample sizes and short durations of exposure • The use of cannabis-based medicines in osteoarthritis appears to be generally well tolerated, adverse effects are mild and experienced by a minority of participants • Cannabis-based medicines may decrease the use of opioids in patients with osteoarthritis • Future research should address the gaps in long-term efficacy and safety data.
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Affiliation(s)
- Andrew T Y Xiao
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, 8-130 Clinical Science Building, 11350-83rd Ave, Edmonton, AB, T6G 2G3, Canada
| | - Tarek Turk
- University of Alberta, Edmonton, AB, Canada
| | | | - Susan Zhang
- , Edmonton, AB, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-229 Edmonton Clinic Health Academy, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Heba A T Aref
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-229 Edmonton Clinic Health Academy, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Alexandra Campbell
- , Edmonton, AB, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-229 Edmonton Clinic Health Academy, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Allyson Jones
- Faculty of Rehabilitation Medicine - Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Liz Dennett
- Sperber Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | | | - Cheryl A Sadowski
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-229 Edmonton Clinic Health Academy, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Elaine A Yacyshyn
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, 8-130 Clinical Science Building, 11350-83rd Ave, Edmonton, AB, T6G 2G3, Canada.
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13
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David A, Stolar O, Berkovitch M, Kohn E, Hazan A, Waissengreen D, Gal E. Effects of Medical Cannabis Treatment for Autistic Children on Anxiety and Restricted and Repetitive Behaviors and Interests: An Open-Label Study. Cannabis Cannabinoid Res 2024. [PMID: 39047052 DOI: 10.1089/can.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Background: The literature supports the benefits of medical cannabis for core and comorbid symptoms in autistic individuals and anxiety-related symptoms in individuals without autism. However, no study has specifically investigated how cannabidiol (CBD)-rich cannabis affects anxiety subtypes in autistic children or its relationship with restricted and repetitive behaviors and interests (RRBI). Understanding the effects of CBD-rich cannabis treatment on anxiety subtypes and RRBI could offer more precise treatment approaches to managing anxiety symptoms and reducing RRBI frequency in autistic children. Objectives: To examine (1) the impact of CBD-rich cannabis treatment on autistic children's (1a) anxiety levels and subtypes and (1 b) RRBI and subtypes and (2) whether changes in anxiety explain changes in RRBI following cannabis treatment. Method: In this open-label study, we analyzed data from 65 autistic children (5-12 years) who had participated in research on the effects of CBD-rich cannabis on children with autism. Their parents completed the Repetitive Behavior Scale-revised to assess the frequency and severity of six subgroups of their children's recurrent behaviors and the Screen for Child Anxiety-Related Emotional Disorders for symptoms related to five types of anxiety disorders. They completed these assessments at three time points: (T1) before treatment, (T2) after 3 months, and (T3) after 6 months of treatment. Results: The results indicated reduced RRBI and symptoms related to various anxiety subtypes in autistic children following 6 months of CBD-rich cannabis treatment. Specifically, we observed significant differences in the autistic children's overall anxiety and in some anxiety subtypes (i.e., general, social, panic, and separation anxieties). Significant improvements were observed in RRBI, including the total score, and specifically in compulsive, ritualistic, and sameness behaviors. Our findings revealed that reduced anxiety, particularly within the panic- and separation-related subtypes, predicted a subsequent decrease in RRBI, specifically sameness behaviors, following cannabis treatment. Conclusions: The findings of the cannabis treatment's potential benefits for alleviating anxiety symptoms, leading to reduced RRBI, may provide evidence for the meaningful relationship between these variables and for the potential benefits of cannabis treatment for autistic children. We strongly recommend further double-blind, placebo-controlled studies using standardized assessments to validate these findings.
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Affiliation(s)
- Ayelet David
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Orit Stolar
- Child Development Division, Sharon District-Maccabi Healthcare Services, Tel Aviv, Israel
- Clinical Pharmacology and Toxicology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Matitiahu Berkovitch
- Clinical Pharmacology and Toxicology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
- The Andy Lebach Chair of Clinical Pharmacology and Toxicology, Tel-Aviv University, Tel-Aviv, Israel
| | - Elkana Kohn
- Clinical Pharmacology and Toxicology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Ariela Hazan
- Clinical Pharmacology and Toxicology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | | | - Eynat Gal
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
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14
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Russo E, Agredano PM, Flachenecker P, Lawthom C, Munro D, Hindocha C, Bagul M, Trinka E. The attitudes, knowledge and confidence of healthcare professionals about cannabis-based products. J Cannabis Res 2024; 6:32. [PMID: 39049083 DOI: 10.1186/s42238-024-00242-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 07/07/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Use of cannabis-based products is becoming more frequent, and it is important that healthcare professionals are informed and confident about them when making evidence-based decisions about their use. This study aimed to gain an international perspective on the attitudes, knowledge, and confidence of healthcare professionals about cannabis-based products. METHODS An online questionnaire regarding these products was completed by 1580 healthcare professionals (neurologists, psychiatrists, general practitioners, pharmacists and nurses) from 16 countries across Asia, Europe, Oceania, South America, and the Middle East. RESULTS Respondents expressed a high level of interest in cannabis-based products (median score 9 out of 10) and reported that they felt knowledgeable about them (median score 6 out of 7). They reported a high level of confidence when providing patients with information on cannabis-based products, returning median scores of 6 and 5 out of 7 for their legality and regulations, and their benefits and risks, respectively. Despite this, healthcare professionals sought further information on cannabis-based products across areas including legality, neurobiology, and scientific evidence. Finally, 59% (n = 930) of respondents considered robust clinical trial evidence as the most important factor to ensure patient safety in the context of these products. Few nominally significant differences emerged between healthcare professionals from different specialities or regions. CONCLUSION In conclusion, this large survey of attitudes held by healthcare professionals towards cannabis-based products revealed a high level of interest and a demand for more information. Limitations of this study include potential sample bias and limited external validity.
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Affiliation(s)
- Emilio Russo
- Science of Health Department, Magna Grecia University, Catanzaro, Italy.
| | | | | | | | | | - Chandni Hindocha
- GW Pharmaceuticals (Part of Jazz Pharmaceuticals), Cambridge, UK
| | - Makarand Bagul
- GW Pharmaceuticals (Part of Jazz Pharmaceuticals), Cambridge, UK
| | - Eugen Trinka
- Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, Centre for Cognitive Neuroscience Salzburg, Member of the European Reference Network, EpiCARE, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Centre for Cognitive Neuroscience Salzburg, Salzburg, Austria
- Karl Landsteiner Institute of Neurorehabilitation and Space Neurology, Salzburg, Austria
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15
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Crowley R, Cline K, Hilden D, Beachy M. Regulatory Framework for Cannabis: A Position Paper From the American College of Physicians. Ann Intern Med 2024. [PMID: 39038289 DOI: 10.7326/m24-0638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024] Open
Abstract
Cannabis, also known as marijuana, is the dried flowers, stems, seeds, and leaves of the Cannabis sativa plant. It contains more than 100 compounds, including tetrahydrocannabinol, which has psychoactive effects. Federal law prohibits the possession, distribution, and use of cannabis outside limited research activities, but most states have legalized cannabis for medical or recreational use. However, research into the potential therapeutic and adverse health effects of cannabis has been limited, in part because of the drug's federal legal status. In this position paper, the American College of Physicians (ACP) calls for the decriminalization of possession of small amounts of cannabis for personal use and outlines a public health approach to controlling cannabis in jurisdictions where it is legal. ACP recommends the rigorous evaluation of the health effects and potential therapeutic uses of cannabis and cannabinoids as well as research into the effects of legalization on cannabis use. It also calls for evidence-based medical education related to cannabis and increased resources for treatment of cannabis use disorder.
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Affiliation(s)
- Ryan Crowley
- American College of Physicians, Washington, DC (R.C., K.C.)
| | - Katelan Cline
- American College of Physicians, Washington, DC (R.C., K.C.)
| | - David Hilden
- Hennepin Healthcare, Minneapolis, Minnesota (D.H.)
| | - Micah Beachy
- University of Nebraska Medical Center, Omaha, Nebraska (M.B.)
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16
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Egan KL, Cox MJ. Cannabinoid home storage practices among a national Qualtrics panel of adult users of cannabinoid products in the USA. Inj Prev 2024; 30:328-333. [PMID: 38124000 DOI: 10.1136/ip-2023-044968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION The presence of cannabinoid products in the home may increase the likelihood of unintended adverse consequences for children and adolescents. Secure storage of these products is one prevention method to decrease the risk of diversion and use of cannabinoid products among youth. We sought to examine cannabis, delta-8 tetrahydrocannabinol (THC), and cannabidiol (CBD) storage practices among a sample of adults 18-64 years old residing in the USA. METHODS In December 2021, we conducted an online cross-sectional survey of 1042 current (past 30 day) users of cannabinoid products (88.3% cannabis, 49.0% delta-8 THC, and 67.2% CBD). Participants were asked about where they typically keep products in their home (ie, in a locked container, unlocked container, or out in the open). We conducted multinomial regression analyses to examine the relationship between sociodemographic characteristics and cannabinoid use behaviours with home storage practices. RESULTS For all products, participants more frequently reported locking, followed by storing the product in an unlocked but not visible location. Storing the product in an unlocked and visible location was endorsed the least across all three products. Participants reported more frequent endorsement of locking cannabis products as compared with delta-8-THC and CBD. Storage practices varied by biological sex, sexual orientation, ethnicity, educational attainment, having a child who lives in the home, frequency of use, possession of a medical cannabis card and exposure to advertising. CONCLUSIONS Increasing the prevalence of secure storage practices of cannabinoid products may facilitate prevention of unanticipated consequences associated with diversion of these products.
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Affiliation(s)
- Kathleen Louise Egan
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Melissa J Cox
- Department of Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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17
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McQuoid J, Regan T, Devkota J, Cheney MK, Kumar V, Oehlers J, Lopez-Paguyo K, Nguyen N, Meacham MC, Ling PM, Thrul J. Situations and roles of cannabis versus cigarette use: Integrating ecological momentary assessment with qualitative mapping interviews. Health Place 2024; 89:103314. [PMID: 39032204 DOI: 10.1016/j.healthplace.2024.103314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/24/2024] [Accepted: 07/04/2024] [Indexed: 07/22/2024]
Abstract
Use of both cannabis and tobacco has surpassed use of tobacco alone among young adults in California. To better understand why, we collected data with 32 young adults ages 18-30 in Northern California who regularly used cigarettes and cannabis and had diverse sexual, gender, racial, and ethnic identities. Geographically-explicit ecological momentary assessment (EMA; 30 days) was integrated with qualitative mapping interviews. We found contrasting situations of use for cannabis (e.g., around other people) versus cigarettes (e.g., recent discrimination) and different reasons for why participants chose one substance over the other (e.g., enhancing experiences vs. stepping away). Understanding when and why diverse young adults choose cannabis versus cigarettes as they navigate everyday environments helps explain how cannabis and tobacco retail markets shape substance use disparities over time.
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Affiliation(s)
- Julia McQuoid
- TSET Health Promotion Research Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Timothy Regan
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janardan Devkota
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Vaishnavi Kumar
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Julia Oehlers
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA; John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA
| | - Kekoa Lopez-Paguyo
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
| | - Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Meredith C Meacham
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
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18
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Wang F, Zang Z, Zhao Q, Xiaoyang C, Lei X, Wang Y, Ma Y, Cao R, Song X, Tang L, Deyholos MK, Zhang J. Advancement of Research Progress on Synthesis Mechanism of Cannabidiol (CBD). ACS Synth Biol 2024; 13:2008-2018. [PMID: 38900848 PMCID: PMC11264327 DOI: 10.1021/acssynbio.4c00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
Cannabis sativa L. is a multipurpose crop with high value for food, textiles, and other industries. Its secondary metabolites, including cannabidiol (CBD), have potential for broad application in medicine. With the CBD market expanding, traditional production may not be sufficient. Here we review the potential for the production of CBD using biotechnology. We describe the chemical and biological synthesis of cannabinoids, the associated enzymes, and the application of metabolic engineering, synthetic biology, and heterologous expression to increasing production of CBD.
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Affiliation(s)
- Fu Wang
- Faculty
of Agronomy, Jilin Agricultural University, Changchun 130118, China
| | - Zhenyuan Zang
- Faculty
of Agronomy, Jilin Agricultural University, Changchun 130118, China
| | - Qian Zhao
- Faculty
of Agronomy, Jilin Agricultural University, Changchun 130118, China
| | - Chunxiao Xiaoyang
- Faculty
of Agronomy, Jilin Agricultural University, Changchun 130118, China
| | - Xiujuan Lei
- College
of Chinese Medicinal Materials, Jilin Agricultural
University, Changchun 130118, China
| | - Yingping Wang
- College
of Chinese Medicinal Materials, Jilin Agricultural
University, Changchun 130118, China
| | - Yiqiao Ma
- Faculty
of Agronomy, Jilin Agricultural University, Changchun 130118, China
| | - Rongan Cao
- College
of Food Science, Heilongjiang Bayi Agricultural
University, Daqing 163319, China
| | - Xixia Song
- Institute
of Industrial Crops of Heilongjiang Academy of Agricultural Sciences, Haerbin 150000, China
| | - Lili Tang
- Institute
of Industrial Crops of Heilongjiang Academy of Agricultural Sciences, Haerbin 150000, China
| | - Michael K. Deyholos
- Department
of Biology, University of British Columbia,
Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Jian Zhang
- Faculty
of Agronomy, Jilin Agricultural University, Changchun 130118, China
- Department
of Biology, University of British Columbia,
Okanagan, Kelowna, BC V1V 1V7, Canada
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19
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Wang RQ, Bonomo YA, Hallinan CM. Overview of global monitoring systems for the side effects and adverse events associated with medicinal cannabis use: a scoping review using a systematic approach. BMJ Open 2024; 14:e085166. [PMID: 39025811 DOI: 10.1136/bmjopen-2024-085166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES The use of cannabis-based medicine (CBM) as a therapeutic has surged in Australia over the past 5 years. Historically, the United Nations Single Convention on Narcotic Drugs (1961) prohibited cannabis use in Europe, the USA, the UK and Australia, leading to legislative resistance and limited preclinical data on CBM. Existing safety monitoring systems for CBM are poorly structured and do not integrate well into the workflows of busy health professionals. As a result, postmarketing surveillance is inconsistent. This review aims to evaluate international systems for monitoring CBM side effects and adverse events. DESIGN To undertake a scoping review with a systematic approach, we used the Population, Intervention, Comparison, Outcome (PICO) framework to develop keyword elements, and two search queries to maximise search sensitivity and specificity. DATA SOURCES Search queries were entered into Embase and Scopus for peer-reviewed literature, and additional searches for grey literature were conducted on 23 June 2023. ELIGIBILITY CRITERIA We included 54 full-text articles in the review: 39 from peer-reviewed searches, 8 from grey literature and 7 from citations of relevant texts. DATA EXTRACTION AND SYNTHESIS Our search yielded two main forms of monitoring systems: databases and registries. Out of the 24 monitoring systems identified, there were 10 databases and 14 registries, with databases often created by regulatory authorities. Systems differed in methods of causality assessment, level of detail collected, terminology and affiliations. RESULTS Within the monitoring systems with enough published data for analysis, all except one remain active at the time of this review. VigiBase is the largest centralised monitoring system, receiving international case reports, however data heterogeneity persists. CONCLUSIONS Our study emphasises the need for a centralised, consistent and accessible system for the postmarketing surveillance of side effects and adverse events associated with medicinal cannabis use.
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Affiliation(s)
- Rebecca Qi Wang
- Department of General Practice and Primary Care, The University of Melbourne, Parkville, Victoria, Australia
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - Yvonne Ann Bonomo
- Addiction Medicine, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Parkville, Victoria, Australia
| | - Christine Mary Hallinan
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
- HaBIC R2, Department of General Practice and Primary Care, The University of Melbourne, Parkville, Victoria, Australia
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20
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Marini P, Maccarrone M, Saso L, Tucci P. The Effect of Phytocannabinoids and Endocannabinoids on Nrf2 Activity in the Central Nervous System and Periphery. Neurol Int 2024; 16:776-789. [PMID: 39051218 DOI: 10.3390/neurolint16040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
The relationship between nuclear factor erythroid 2-related factor 2 (Nrf2) and phytocannabinoids/endocannabinoids (pCBs/eCBs) has been investigated in a variety of models of peripheral illnesses, with little clarification on their interaction within the central nervous system (CNS). In this context, evidence suggests that the Nrf2-pCBs/eCBS interaction is relevant in modulating peroxidation processes and the antioxidant system. Nrf2, one of the regulators of cellular redox homeostasis, appears to have a protective role toward damaging insults to neurons and glia by enhancing those genes involved in the regulation of homeostatic processes. Specifically in microglia and macroglia cells, Nrf2 can be activated, and its signaling pathway modulated, by both pCBs and eCBs. However, the precise effects of pCBs and eCBs on the Nrf2 signaling pathway are not completely elucidated yet, making their potential clinical employment still not fully understood.
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Affiliation(s)
- Pietro Marini
- Institute of Education in Healthcare and Medical Sciences, Foresterhill Campus, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Mauro Maccarrone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio snc, Coppito, 67100 L'Aquila, Italy
- European Center for Brain Research (CERC), Santa Lucia Foundation IRCCS, Via del Fosso di Fiorano 64, 00143 Rome, Italy
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Tucci
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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21
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Pawson M, Kelly BC. Hemp-based psychoactive use and risk among young adults: Trend theory, policy, and regulation beyond legality. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 130:104523. [PMID: 39024688 DOI: 10.1016/j.drugpo.2024.104523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Hemp-based psychoactives comprise a burgeoning legal substance market with rising trends in use across the U.S. and Canada as well as parts of Europe. Currently, scant empirical research on the use of these Novel Psychoactive Substances (NPS) exists. By examining policy, market conditions, consumer uptake, and related risks, this research extends theory on drug trends by describing the regulatory environments that shape the emergence and popularity of psychoactive hemp-based products among young adults. METHODS Relying on ethnographic fieldwork of hemp-based markets across 3 U.S. state hemp and cannabis policy contexts as well as in-depth interviews with 40 young adult cannabis consumers recruited across 10 U.S. states, we examined how regulatory conditions shape hemp-based psychoactive markets, trends in their use, and associated risks. RESULTS Young adults are motivated to consume hemp-based psychoactives due to the regulatory and market environments that facilitate the production of highly potent products that are inexpensive and easily accessible. States that regulate hemp-based psychoactives as cannabis, do not provide hemp markets with a competitive advantage and as such see minimal uptake. In the absence of hemp specific policies, substantial variations in product potencies, insufficient dosing information, and unscrupulous product packaging practices may increase related risks. CONCLUSION Trend theory provides insight into the complex relationships that exist between drug policy, markets, and the proliferation of legal highs. Understanding the contextual significance that both market and regulatory conditions have on legal drug production, distribution, and consumption may better inform approaches to reduce the risks commonly associated with novel psychoactive substances like hemp-based psychoactives.
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Affiliation(s)
- Mark Pawson
- Department of Sociology, Purdue University 700 W State St, West Lafayette, IN 47907, United States.
| | - Brian C Kelly
- Department of Sociology, Purdue University 700 W State St, West Lafayette, IN 47907, United States
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22
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Spampinato G, Candeliere F, Amaretti A, Paris R, Montanari M, Virzì N, Strani L, Citti C, Cannazza G, Rossi M, Raimondi S. A three-years survey of microbial contaminants in industrial hemp inflorescences from two Italian cultivation sites. J Cannabis Res 2024; 6:31. [PMID: 39020444 PMCID: PMC11253326 DOI: 10.1186/s42238-024-00241-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/07/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND The use of industrial Cannabis sativa L. for recreational, cosmeceutical, nutraceutical, and medicinal purposes has gained momentum due to its rich content of valuable phytochemicals, such as cannabidiol (CBD) and cannabigerol (CBG). However, there are concerns regarding the risk of microbial contamination in plants grown outside controlled environments. Microbes associated with hemp can be either epiphytes or endophytes and may pose a risk of infectious illness for humans. METHODS Seven Italian hemp genotypes, including Bernabeo, Carmagnola, Carmaleonte, Codimono, CS, Eletta Campana, and Fibranova, were cultivated in two distinct geographic locations, Catania and Rovigo, for three consecutive years from 2019 to 2021. Total aerobic microbes (TAMC), total combined yeasts/moulds (TYMC), the presence of bile-tolerant Gram-negative bacteria, and the absence of Escherichia coli and Salmonella spp. were evaluated and compared. The main phytocannabinoid content was measured and correlated with microbial contamination. RESULTS Most samples analyzed in this study did not meet the European Pharmacopoeia microbiological limits. The detection of potential pathogens, such as E. coli and Salmonella spp., in the samples indicates that the use of inflorescences may represent a possible source of infection. Microbial contamination varied among harvesting seasons and production sites, with agroclimatic conditions influencing microbial load and composition. The presence of potentially pathogenic bacteria was less associated with seasonal climate variability and more likely affected by sporadic contamination from external sources. CBD concentration exhibited a negative correlation with bile-tolerant Gram-negative bacteria and total yeasts/moulds levels. Samples with lower CBD content were more contaminated than those with higher CBD levels, suggesting a potential protective effect of this phytochemical on the plant. CONCLUSIONS The threshing residues (inflorescences, floral bracts, and leaves) of industrial hemp varieties represent a valuable product and a source of beneficial phytochemicals that warrants further exploration. While post-harvest sterilization methods may reduce microbiological risks, they may also degrade heat- and light-sensitive bioactive phytochemicals. The most promising strategy involves implementing best agronomic practices to maintain healthy and uncontaminated cultures. Rigorous monitoring and quality certification protocols are essential to mitigate the microbiological risk associated with the consumption of hemp-derived products.
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Affiliation(s)
- Gloria Spampinato
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
| | - Francesco Candeliere
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
| | - Alberto Amaretti
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
- Biogest-Siteia, University of Modena and Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Roberta Paris
- CREA Research Centre for Cereal and Industrial Crops, Via Di Corticella 133, 40128, Bologna, Italy
| | - Massimo Montanari
- CREA Research Centre for Cereal and Industrial Crops, Via Di Corticella 133, 40128, Bologna, Italy
| | - Nino Virzì
- CREA Research Centre for Cereal and Industrial Crops, C.So Savoia 190, 95024, Acireale, CT, Italy
| | - Lorenzo Strani
- Department of Chemical and Geological Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
| | - Cinzia Citti
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
| | - Giuseppe Cannazza
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
| | - Maddalena Rossi
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy
- Biogest-Siteia, University of Modena and Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefano Raimondi
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 103, 41125, Modena, Italy.
- Biogest-Siteia, University of Modena and Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.
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Kudrich C, Chen R, Meng Y, Bachi K, Hurd YL. Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder. Harm Reduct J 2024; 21:135. [PMID: 39020418 PMCID: PMC11253449 DOI: 10.1186/s12954-024-01051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/30/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Cannabidiol (CBD) is a widely available cannabis product with many claims as to potential health benefits including alleviating symptoms related to opioid use disorder (OUD). However, little is known as to how individuals with OUD perceive CBD, to what extent they may already be using CBD, and for what purposes. METHODS A survey was conducted among individuals receiving treatment for OUD at the Addiction Institute of Mount Sinai in New York City from July 2021 to August 2023. The survey consisted of demographic questions, questions about opioid use, CBD use, and perceptions regarding CBD. Statistical analysis using ordinal logistic regression was employed to compare perceptions between CBD users and non-users while adjusting for age and race. RESULTS Among 587 respondents, 550 completed the survey. Among all survey completers, 129 (23%) reported a history of using CBD for a variety of reasons including: anxiety (81, 62.8%), pain (65, 50.4%), sleep (63, 48.8%), depression (62, 48.1%), recreational purposes (32, 24.8%), or for other reasons (8, 6.2%). Of note, 22 (17.1%) respondents reported using CBD to control their addiction and 54 (41.9%) reported using CBD to ease opioid withdrawal symptoms. CBD users demonstrated more positive perceptions regarding its legality (β = 0.673, OR = 1.960, 95% CI [1.211, 3.176], p = .006), social acceptance (β = 0.718, OR = 2.051, 95% CI [1.257, 3.341], p = .004), and therapeutic potential compared to non-users. CBD users also had a more positive view of its potential future role in managing addiction (β = 0.613, OR = 1.846, 95% CI [1.181, 2.887], p = .007). CONCLUSIONS This study highlights a significant association between CBD usage and progressive views regarding CBD among individuals with OUD, suggesting a growing interest in CBD as a potential adjunctive therapy for individuals in substance use treatment. Some patients are already using CBD for anxiety, pain, sleep, depression, or as a harm reduction intervention to control their addiction or for opioid withdrawal symptoms. These findings underscore the importance of integrating patient perspectives into future research and treatment strategies involving CBD in the context of OUD.
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Affiliation(s)
- Christopher Kudrich
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Addiction Institute of Mount Sinai, 1399 Park Ave, Room 3-330, New York, NY, 10029, USA.
| | - Rebecca Chen
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yuan Meng
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Addiction Institute of Mount Sinai, 1399 Park Ave, Room 3-330, New York, NY, 10029, USA
| | - Keren Bachi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Addiction Institute of Mount Sinai, 1399 Park Ave, Room 3-330, New York, NY, 10029, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yasmin L Hurd
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Addiction Institute of Mount Sinai, 1399 Park Ave, Room 3-330, New York, NY, 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, Addiction Institute of Mount Sinai, New York, NY, USA
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24
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Kim ES, Park SH, Kinney CA, Olejar KJ, Corredor-Perilla IC. Comparison of decarboxylation rates of acidic cannabinoids between secretory cavity contents and air-dried inflorescence extracts in Cannabis sativa cv. 'Cherry Wine'. Sci Rep 2024; 14:16411. [PMID: 39013926 PMCID: PMC11252385 DOI: 10.1038/s41598-024-66420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024] Open
Abstract
Studies with secretory cavity contents and air-dried inflorescence extracts of the CBD-rich hemp strain, Cannabis sativa cv. 'Cherry Wine', were conducted to compare the decarboxylation rates of acidic cannabinoids between two groups. The secretory cavity contents acquired from the capitate-stalked glandular trichomes by glass microcapillaries, and inflorescence samples air-dried for 15 days of storage in darkness at room temperature were analysed by high-pressure liquid chromatography. The ratio of acidic cannabinoids to the total cannabinoids was ranging from 0.5% to 2.4% lower in the air-dried inflorescence samples compared to the secretory cavity samples as follows. In the secretory cavity content, the percentage of acidic cannabinoids to the total cannabinoids was measured as 86.4% cannabidiolic acid (CBDA), 6.5% tetrahydrocannabinolic acid (THCA), 4.3% cannabichromenic acid (CBCA), 1.4% cannabigerolic acid (CBGA), and 0.6% cannabidivarinic acid (CBDVA), respectively. In the air-dried inflorescence, however, the acidic cannabinoids were detected with 84% CBDA, 4.8% THCA, 3.3% CBCA, 0.8% CBGA, and 0.3% Δ9-tetrahydrocannabivarinic acid (Δ9-THCVA), respectively. The ratio of cannabidiol (CBD) to cannabidiolic acid (CBDA) was close to 1:99 (w/w) in secretory cavity contents, however, it was roughly 1:20 (w/w) in the air-dried inflorescence. In addition, Δ9-tetrahydrocannabivarin (Δ9-THCV) and Δ9-tetrahydrocannabivarinic acid (Δ9-THCVA) were only detected in the air-dried inflorescence sample, and the ratio of Δ9-THCV to Δ9-THCVA was about 1:20 (w/w). Besides, cannabidivarinic acid (CBDVA) was only observed in the secretory cavity content.
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Affiliation(s)
- Eun-Soo Kim
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, 81001, USA.
| | - Sang-Hyuck Park
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, 81001, USA
| | - Chad A Kinney
- Institute of Cannabis Research, Colorado State University-Pueblo, Pueblo, CO, 81001, USA
- Department of Chemistry, Colorado State University-Pueblo, Pueblo, CO, 81001, USA
| | - Kenneth J Olejar
- Department of Chemistry, Colorado State University-Pueblo, Pueblo, CO, 81001, USA
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25
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Bernstein N. Introduction to the special issue: the two sides of hemp: medical and industrial. J Cannabis Res 2024; 6:30. [PMID: 39010234 PMCID: PMC11251343 DOI: 10.1186/s42238-024-00237-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Affiliation(s)
- Nirit Bernstein
- Agricultural Research Organization - Volcani Institute, Rishon LeZion, Israel.
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26
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Desaulniers Brousseau V, Goldstein BP, Sedlock C, Lefsrud M. Environmental Impact of Outdoor Cannabis Production. ACS AGRICULTURAL SCIENCE & TECHNOLOGY 2024; 4:690-699. [PMID: 39027629 PMCID: PMC11253875 DOI: 10.1021/acsagscitech.4c00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 07/20/2024]
Abstract
Environmental impacts of cannabis production are of increasing concern because it is a newly legal and growing industry. Although a handful of studies have quantified the impacts of indoor production, very little is known about the impact of outdoor cannabis agriculture. Outdoor production typically uses little direct energy but can require significant fertilizer and other inputs due to dissipative losses via runoff and mineralization. Conversely, fertilizer high in nitrogen can be counterproductive, as it produces flowers with decreased cannabinoid content. This study has two aims: (1) To identify reduced-fertilizer regimes that provide optimal cannabis flower yields with reduced inputs and (2) to quantify how this shifts greenhouse gas emissions, resource depletion (fossil and metal), terrestrial acidification, and the eutrophication potential of outdoor cannabis production. Primary data from a fertilizer response trial are incorporated into a life-cycle assessment model. Results show that outdoor cannabis agriculture can be 50 times less carbon-emitting than indoor production. Dissemination of this knowledge is of utmost importance for producers, consumers, and government officials in nations that have either legalized or will legalize cannabis production.
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Affiliation(s)
- Vincent Desaulniers Brousseau
- Department
of Bioresource Engineering, McGill University, 21111 Lakeshore Road, Sainte-Anne-de-Bellevue H9X 3 V9, Canada
| | - Benjamin P. Goldstein
- Department
of Bioresource Engineering, McGill University, 21111 Lakeshore Road, Sainte-Anne-de-Bellevue H9X 3 V9, Canada
| | - Charlotte Sedlock
- School
for Environment and Sustainability, University
of Michigan, 440 Church Street, Ann Arbor, Michigan 48109, United States
| | - Mark Lefsrud
- Department
of Bioresource Engineering, McGill University, 21111 Lakeshore Road, Sainte-Anne-de-Bellevue H9X 3 V9, Canada
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27
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Berg CJ, Romm KF, LoParco CR, Rossheim ME, Cui Y, Platt E, Yang YT, Wang Y, Kasson E, Szlyk HS, McCready DM, Cavazos-Rehg PA. Young Adults' Experiences with Cannabis Retailer Marketing and Related Practices: Differences Among Sociodemographic Groups and Associations with Cannabis Use-related Outcomes. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02092-z. [PMID: 39009926 DOI: 10.1007/s40615-024-02092-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVES Limited cannabis retail surveillance has been conducted, particularly assessing retailer practices in relation to consumer sociodemographic factors or use-related outcomes. This study examined young adults': exposure to promotions, health claims, warnings, and age restrictions at cannabis retailers; demographic correlates of retail exposures; and retail exposures in relation to use-related outcomes. STUDY DESIGN This study used the cross-sectional quantitative analysis. METHODS We analyzed 2023 survey data among 876 young adults in states with legal non-medical cannabis, reporting past-month cannabis use and past-year retailer visits. RESULTS In this sample (Mage = 27.1, 44.1% male, 31.7% sexual minority, 17.7% Black, 11.2% Asian, 25.1% Hispanic), 46.7% "at least sometimes" noticed free samples, 76.5% price promotions, 37.4% subpopulation-targeted promotions; 72.5% health claims on products/ads, 63.1% signage, and 70.5% from budtenders; 72.5% warnings on labels, 65.5% signage, and 38.9% from budtenders; and > 80% age verifications. Multivariable analyses identified sociodemographic correlates of exposure outcomes: greater promotion exposure was associated with Black race; greater health claim exposure with being heterosexual, Black, and less educated; less warning exposure with less education; and less age restriction exposure with being younger, male, and Black. Retail exposures were associated with use-related outcomes: more frequent cannabis use was associated with less health claim exposure; greater perceived social acceptability with greater promotion and age restriction exposure; greater perceived risk with greater warning and less age restriction exposure; more problematic use and driving after use with greater promotion and less age restriction exposure. CONCLUSIONS Cannabis retail exposure disparities and their associations with use-related outcomes highlight the importance of regulatory and prevention efforts.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA.
- George Washington Cancer Center, George Washington University, Washington, DC, USA.
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
| | - Matthew E Rossheim
- Department of Health Administration and Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
| | - Elizabeth Platt
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA, USA
| | - Y Tony Yang
- George Washington Cancer Center, George Washington University, Washington, DC, USA
- School of Nursing, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Darcey M McCready
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
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28
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Patton AL, Pacheco IC, Seither JZ, Brown JT, Walterscheid JP, Karschner EL. Cross-reactivity of 24 cannabinoids and metabolites in blood using the Immunalysis Cannabinoids Direct enzyme-linked immunosorbent assay. J Anal Toxicol 2024; 48:439-446. [PMID: 38648393 DOI: 10.1093/jat/bkae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024] Open
Abstract
With wider availability of synthetic and semi-synthetic cannabinoids in the consumer space, there is a growing impact on public health and safety. Forensic toxicology laboratories should keep these compounds in mind as they attempt to remain effective in screening for potential sources of human performance impairment. Enzyme-linked immunosorbent assay (ELISA) is a commonly utilized tool in forensic toxicology, as its efficiency and sensitivity make it useful for rapid and easy screening for a large number of drugs. This screening technique has lower specificity, which allows for broad cross-reactivity among structurally similar compounds. In this study, the Cannabinoids Direct ELISA kit from Immunalysis was utilized to assess the cross-reactivities of 24 cannabinoids and metabolites in whole blood. The assay was calibrated with 5 ng/mL of 11-nor-9-carboxy-Δ9-tetrahydrocannabinol and the analytes of interest were evaluated at concentrations ranging from 5 to 500 ng/mL. Most parent compounds demonstrated cross-reactivity ≥20 ng/mL, with increasing alkyl side-chain length relative to Δ9-tetrahydrocannabinol resulting in decreased cross-reactivity. Of the 24 analytes, only the carboxylic acid metabolites, 11-nor-9-carboxy-Δ8-tetrahydrocannabinol, 11-nor-9(R)-carboxy-hexahydrocannabinol and 11-nor-9(S)-carboxy-hexahydrocannabinol, were cross-reactive at levels ≤10 ng/mL. Interestingly, 11-nor-9(R)-carboxy-hexahydrocannabinol demonstrated cross-reactivity at 5 ng/mL, where its stereoisomer 11-nor-9(S)-carboxy-hexahydrocannabinol, did not. As more information emerges about the prevalence of these analytes in blood specimens, it is important to understand and characterize their impact on current testing paradigms.
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Affiliation(s)
- Amy L Patton
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA
- SNA International, contractor supporting the Armed Forces Medical Examiner System, 500 Montgomery Street, Suite 500, Alexandria, VA 22314, USA
| | - Igor C Pacheco
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA
| | - Joshua Z Seither
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA
| | - Jordan T Brown
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA
| | - Jeffrey P Walterscheid
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA
| | - Erin L Karschner
- Division of Forensic Toxicology, Armed Forces Medical Examiner System, 115 Purple Heart Drive, Dover AFB, DE 19902, USA
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29
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Chesworth R, Yim HCH, Watt G, El-Omar E, Karl T. Cannabidiol (CBD) facilitates cocaine extinction and ameliorates cocaine-induced changes to the gut microbiome in male C57BL/6JArc mice. Prog Neuropsychopharmacol Biol Psychiatry 2024; 133:111014. [PMID: 38649130 DOI: 10.1016/j.pnpbp.2024.111014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
Cocaine use disorder (CUD) is a global health problem with no approved medications. One potential treatment target is the gut microbiome, but it is unknown if cocaine induces long-lasting effects on gut microbes. A novel therapeutic candidate for CUD, cannabidiol (CBD), can improve gut function in rodent models. It is possible that protective effects of CBD against cocaine use are mediated by improving gut health. We examined this question in this experiment. Cocaine conditioned place preference (CPP) was conducted in adult male C57BL/6JArc mice. Mice were treated with vehicle or 20 mg/kg CBD prior to all cocaine CPP sessions (N = 11-13/group). Mice were tested drug free 1, 14 and 28 days after cessation of cocaine and CBD treatment. Fecal samples were collected prior to drug treatment and after each test session. Gut microbiome analyses were conducted using 16 s rRNA sequencing and correlated with behavioural parameters. We found a persistent preference for a cocaine-environment in mice, and long-lasting changes to gut microbe alpha diversity. Cocaine caused persistent changes to beta diversity which lasted for 4 weeks. CBD treatment reduced cocaine-environment preference during abstinence from cocaine and returned gut beta diversity measures to control levels. CBD treatment increased the relative abundance of Firmicutes phyla and Oscillospira genus, but decreased Bacteroidetes phyla and Bacteroides acidifaciens species. Preference score in cocaine-treated mice was positively correlated with abundance of Actinobacteria, whereas in mice treated with CBD and cocaine, the preference score was negatively correlated with Tenericutes abundance. Here we show that CBD facilitates cocaine extinction memory and reverses persistent cocaine-induced changes to gut microbe diversity. Furthermore, CBD increases the abundance of gut microbes which have anti-inflammatory properties. This suggests that CBD may act via the gut to reduce the memory of cocaine reward. Our data suggest that improving gut health and using CBD could limit cocaine abuse.
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Affiliation(s)
- Rose Chesworth
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
| | - Howard Chi-Ho Yim
- St George and Sutherland Clinical Campus, School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Sydney, Australia; UNSW Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia; Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia
| | - Georgia Watt
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Emad El-Omar
- St George and Sutherland Clinical Campus, School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Sydney, Australia; UNSW Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia; Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia
| | - Tim Karl
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
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30
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Haghdoost M, Peters EN, Roberts M, Bonn-Miller MO. Tetrahydrocannabivarin is Not Tetrahydrocannabinol. Cannabis Cannabinoid Res 2024. [PMID: 38995871 DOI: 10.1089/can.2024.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024] Open
Abstract
Tetrahydrocannabivarin (THCV) is a phytocannabinoid that is becoming popular across the North American cannabis market. THCV has been reported to reduce blood sugar and act as an appetite suppressant in several independent pre-clinical studies, which has earned it the popular nickname of "diet weed," despite few human studies of these effects. Additionally, THCV is usually and incorrectly categorized as an intoxicating analogue of tetrahydrocannabinol (THC), which causes confusion among both consumers and regulators. In this article, we examine what is known pre-clinically and clinically about THCV, as well as highlight mechanisms of action, in order to clarify the scientific differences between THCV and THC. THCV, although structurally similar to THC, has distinct pharmacological activity and physiological effects at the doses currently reported in the literature. We highlight areas of opportunity for further THCV research in order to determine the full and appropriate potential for unique health, wellness, and therapeutic applications of this compound.
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Affiliation(s)
| | - Erica N Peters
- Emerald Mountain Consulting, LLC, Charlottesville, Virginia, USA
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31
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Piercey CJ, Hetelekides E, Karoly HC. Simultaneous cannabis and psychedelic use among festival and concert attendees in Colorado: characterizing enhancement and adverse reactions using mixed methods. J Cannabis Res 2024; 6:29. [PMID: 38992787 PMCID: PMC11238454 DOI: 10.1186/s42238-024-00235-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/01/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Most studies examining the simultaneous use of cannabis with other drugs have focused on cannabis and alcohol, with fewer studies examining simultaneous use of cannabis with other drugs. The United States is currently experiencing an upward trend in psychedelic use and there is an increasing need to characterize cannabis and psychedelic drug interactions to best inform public health recommendations. MATERIALS AND METHODS A mixed methods field study design was used to survey participants (N = 128) on their lifetime co-use of cannabis with other drugs. Participants who reported lifetime co-use of cannabis and psychedelics (N = 63) were then asked open-ended questions about their most recent simultaneous co-use experience (i.e., how cannabis enhanced their psychedelic experience and whether they experienced any adverse reactions). We conducted a thematic analysis of responses describing how cannabis enhanced the psychedelic experience (N = 54). However, due to low response rate for participants reporting an adverse reaction (N = 7, 11.1%), responses to this question were not analyzed thematically and are instead presented individually. RESULTS Themes included tension reduction and balancing of drug effects (N = 27, 50%), enhancement to psychological processes (N = 11, 20.4%), intensified psychedelic drug effects (N = 12, 22.2%), enhanced psychedelic come-down experience (N = 8, 14.8%), and overall ambiguous enhancement (N = 7, 13%). Among participants reporting an adverse reaction, individual responses included increased anxiety and intensity of the experience, decreased sociability, increased negative affect, sleepiness, disassociation, and confusion. CONCLUSION Additional research is warranted to better characterize cannabis and psychedelic drug interactions to best inform public health recommendations.
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Affiliation(s)
- Cianna J Piercey
- Department of Psychology, Colorado State University, Fort Collins, CO, 80521, USA.
| | | | - Hollis C Karoly
- Department of Psychology, Colorado State University, Fort Collins, CO, 80521, USA
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32
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Guo Y, Wei X, Pei J, Yang H, Zheng XL. Dissecting the role of cannabinoids in vascular health and disease. J Cell Physiol 2024:e31373. [PMID: 38988064 DOI: 10.1002/jcp.31373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/04/2024] [Accepted: 06/27/2024] [Indexed: 07/12/2024]
Abstract
Cannabis, often recognized as the most widely used illegal psychoactive substance globally, has seen a shift in its legal status in several countries and regions for both recreational and medicinal uses. This change has brought to light new evidence linking cannabis consumption to various vascular conditions. Specifically, there is an association between cannabis use and atherosclerosis, along with conditions such as arteritis, reversible vasospasm, and incidents of aortic aneurysm or dissection. Recent research has started to reveal the mechanisms connecting cannabinoid compounds to atherosclerosis development. It is well known that the primary biological roles of cannabinoids operate through the activation of cannabinoid receptor types 1 and 2. Manipulation of the endocannabinoid system, either genetically or pharmacologically, is emerging as a promising approach to address metabolic dysfunctions related to obesity. Additionally, numerous studies have demonstrated the vasorelaxant properties and potential atheroprotective benefits of cannabinoids. In preclinical trials, cannabidiol is being explored as a treatment option for monocrotaline-induced pulmonary arterial hypertension. Although existing literature suggests a direct role of cannabinoids in the pathogenesis of atherosclerosis, the correlation between cannabinoids and other vascular diseases was only reported in some case series or observational studies, and its role and precise mechanisms remain unclear. Therefore, it is necessary to summarize and update previously published studies. This review article aims to summarize the latest clinical and experimental research findings on the relationship between cannabis use and vascular diseases. It also seeks to shed light on the potential mechanisms underlying these associations, offering a comprehensive view of current knowledge in this evolving field of study.
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Affiliation(s)
- Yanan Guo
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Biochemistry and Molecular Biology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Xiaoyun Wei
- Department of Cardiology, The Fifth School of Clinical Medicine of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Junyu Pei
- Department of Biochemistry and Molecular Biology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Haibo Yang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xi-Long Zheng
- Department of Biochemistry and Molecular Biology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Pastina JT, Abel MG, Bollinger LM, Best SA. Topical Cannabidiol Application May Not Attenuate Muscle Soreness or Improve Performance: A Randomized, Double-Blinded, Placebo-Controlled Pilot Study. Cannabis Cannabinoid Res 2024. [PMID: 38980809 DOI: 10.1089/can.2024.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
Purpose: The purpose of this pilot study was to investigate cannabidiol (CBD) cream's effects on muscle soreness and performance after exercise. Materials and Methods: This double-blinded, placebo-controlled experiment included 15 men and 13 women (n = 28; mean ± standard deviation age: 23.29 ± 2.54 years) untrained in lower-body resistance training. Participants were randomized into control (NG, n = 9), CBD (CG, n = 9), or placebo (PG, n = 10) groups. Participants completed a lower-body fatigue protocol (FP) consisting of unilateral maximal concentric and eccentric isokinetic muscle actions of the quadriceps and hamstrings (5 sets, 10 repetitions, both legs). CG and PG participants applied ∼100 mg CBD or placebo cream, respectively, matched for weight and appearance to the quadriceps on three separate days. NG participants engaged in a sitting rest period matched in duration to cream application processes. Questionnaires, pressure-pain threshold (PPT), peak torque test (PTT), and countermovement jump (CMJ) were assessed. Mixed-model analysis of variance was conducted to assess main effects and interactions (group × muscle × time; group × time). Results: There were no significant interactions or main effects for group for PPT, CMJ, or PTT. There were main effects for time (p < 0.05) for all soreness questions, PPT, CMJ, and PTT. There was one significant interaction (group × time; p = 0.045) for cream/rest effect questions, in which PG participants perceived the effect of cream to be greater than the effect of rest for NG participants. There were main effects for group (p ≤ 0.031) for all soreness questions, in which PG participants perceived enhanced recovery. Conclusions: The present pilot study did not discover any significant impacts of CBD cream use for muscle recovery. For individuals seeking to attenuate muscle soreness and improve performance, the current dose of this topical CBD product may not be an effective treatment.
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Affiliation(s)
- Joseph T Pastina
- Department of Kinesiology & Health Promotion, The University of Kentucky, Lexington, Kentucky, USA
| | - Mark G Abel
- Department of Kinesiology & Health Promotion, The University of Kentucky, Lexington, Kentucky, USA
| | - Lance M Bollinger
- Department of Kinesiology & Health Promotion, The University of Kentucky, Lexington, Kentucky, USA
| | - Stuart A Best
- Department of Kinesiology & Health Promotion, The University of Kentucky, Lexington, Kentucky, USA
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Stellpflug SJ, Stolbach A, Ghorayeb J, Magraken E, Twohey E, Lapoint J, deWeber K. Cannabis in combat sports: position statement of the Association of Ringside Physicians. PHYSICIAN SPORTSMED 2024:1-12. [PMID: 38949963 DOI: 10.1080/00913847.2024.2375788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/30/2024] [Indexed: 07/03/2024]
Abstract
and ARP Position Statement: Based on the available body of scientific evidence and with the goals of promoting safety of combat sports athletes and striving for the advancement of clean sport, the Association of Ringside Physicians recommends the following regarding cannabis:• Use of marijuana or synthetic cannabinoids by combat sports athletes is discouraged due to unproven benefits and many known adverse effects. Acute use can impair cognition and complex motor function, which likely leads to reduced performance in combat sports. Chronic use can increase risk for heart and lung disease, several cancers, schizophrenia, and can reduce testosterone in men and impair fertility. Benefits from cannabis in most contexts, including athletic performance, have not been proven.• Use of topical purified CBD is neither encouraged nor discouraged.• Since acute cannabis intoxication can impair complex cognitive and motor function, any athlete suspected of acute intoxication at the time of competition - based on clinical judgment - should be banned from that competition.• Wide-scale regulation of cannabis based on quantitative testing has limited usefulness in combat sports, for the following reasons:∘ Cannabis is not ergogenic and is likely ergolytic.∘ Concentrations in body fluids correlate poorly with clinical effects and timing of use.∘ Access to testing resources varies widely across sporting organizations.
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Affiliation(s)
| | - Andrew Stolbach
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joe Ghorayeb
- University of Medicine and Health Sciences, New York, NY, USA
| | | | - Eric Twohey
- Mayo Clinic Department of Physical Medicine and Rehabilitation, Rochester, MN, USA
| | - Jeff Lapoint
- Southern California Permanente Medical Group, San Diego Medical Center, Department of Emergency Medicine, San Diego, CA, USA
| | - Kevin deWeber
- SW Washington Sports Medicine Fellowship, Vancouver, WA, USA
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Vernec A, Healy D, Banon T, Petroczi A. Prevalence of therapeutic use exemptions at the Olympic Games and Paralympic Games: an analysis of data from 2016 to 2022. Br J Sports Med 2024:bjsports-2024-108266. [PMID: 38981660 DOI: 10.1136/bjsports-2024-108266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES The objectives of this study are to describe the prevalence of therapeutic use exemptions (TUEs) among athletes competing in four Olympic and four Paralympic games. The secondary objective was to present the prohibited substance and methods classes associated with TUEs. METHODS Data from the Anti-Doping Administration and Management System were extracted for this cross-sectional observation study. Eight cohorts were created to include athletes with TUEs who competed in the Rio 2016, Pyeongchang 2018, Tokyo 2020 and Beijing 2022 Olympic and Paralympic games. Prevalence of TUEs and proportion of prohibited substance and methods classes were defined as percentages among all athletes competing at each games. RESULTS 28 583 athletes competed in four editions of the Olympic games. Total prevalence of athletes with TUEs was 0.90% among all competitors. At the four Paralympic games, a total of 9852 athletes competed and the total TUE prevalence was 2.76%. The most frequently observed substances associated with TUEs at the Summer Olympics were glucocorticoids (0.50% in Rio) and stimulants (0.39% in Tokyo). At the Summer Paralympics, diuretics (0.79% in Rio) and stimulants (0.75% in Tokyo) were the most common. Winter games had somewhat similar trends, although TUE numbers were very low. CONCLUSIONS The number of athletes competing with valid TUEs at the Olympic and Paralympic games was <1% and <3%, respectively. Variations in substances and methods associated with TUEs for different medical conditions were identified. Nevertheless, numbers were low, further reaffirming that TUEs are not widespread in elite sport.
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Affiliation(s)
- Alan Vernec
- Science and Medicine, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - David Healy
- Science and Medicine, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - Tamar Banon
- Science and Medicine, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - Andrea Petroczi
- School of Life Sciences, Pharmacy and Chemistery, Kingston University, Kingston, UK
- Institute of Health Promotion & Sport Sciences, Eötvös Loránd University, Budapest, Hungary
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Lissitsa D, Hovers M, Shamuilova M, Ezrapour T, Peled-Avron L. Update on cannabis in human sexuality. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06643-4. [PMID: 38977465 DOI: 10.1007/s00213-024-06643-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/21/2024] [Indexed: 07/10/2024]
Abstract
RATIONALE Sexuality is a central aspect of being human that encompasses many facets. Cannabis, a widely used psychoactive substance, has been associated with various effects on sexuality. The relationship between cannabis and sexuality is complex and multifaceted, involving physiological, psychological, and social factors. OBJECTIVES This review aims to provide an overview of the current literature on the effects of cannabis on several sexual functions, including sexual desire, arousal, orgasm, and sexual satisfaction. It also discusses the potential mechanisms underlying these effects, as well as the impact of dose and frequency of use. RESULTS This review has revealed a complex relationship between cannabis dosage and its influence on sexuality. It appears that the frequency of cannabis use in humans has been associated with the frequency of sexual activities. Individuals who use cannabis more frequently tend to report higher levels of sexual activity. Moreover, there is a notable gender difference in how cannabis affects sexuality. In addition, we found lower doses of cannabis to be linked to heightened sexual desire and enjoyment, whereas higher doses may lead to a decrease in sexual desire and performance. CONCLUSIONS Overall, the association between cannabis and sexuality is complex and warrants further research to better understand the psychological and neurological mechanisms that underlie the effect of cannabis on these sexuality functions and its implications for sexual health. To advance in this endeavor, a crucial step is establishing a precise measurement of dosage in human studies.
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Affiliation(s)
- Denis Lissitsa
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel.
- Department of Psychology, Bar-Ilan University, 5290002, Ramat Gan, Israel.
| | - May Hovers
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Michal Shamuilova
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Tal Ezrapour
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Leehe Peled-Avron
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
- Department of Psychology, Bar-Ilan University, 5290002, Ramat Gan, Israel
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Bando JM, Tashkin DP, Barjaktarevic IZ. Impact of Marijuana Use on Lung Health. Semin Respir Crit Care Med 2024. [PMID: 38968961 DOI: 10.1055/s-0044-1785679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
The widespread use of marijuana in the context of increasing legalization has both short- and long-term health implications. Although various modes of marijuana use-smoked, vaped, or ingested-may lead to a wide scope of potential systemic effects, we focus here on inhalational use of marijuana as the most common mode with the lung as the organ that is most directly exposed to its effects. Smoked marijuana has been associated with symptoms of chronic bronchitis and histopathologic changes in airway epithelium, but without consistent evidence of long-term decline in pulmonary function. Its role in immunomodulation, both for risk of infection and protection against a hyperinflammatory host response to infection, has been suggested in animal models and in vitro without conclusive extrapolation to humans. Marijuana smoke contains carcinogens like those found in tobacco, raising concern about its role in lung cancer, but evidence is mixed and made challenging by concurrent tobacco use. Vaping may offer a potential degree of harm reduction when compared with smoking marijuana with reduction of exposure to several toxins, including carbon monoxide, and reduction in chronic respiratory symptoms. However, these potential benefits are counterbalanced by risks including vaping-associated lung injury, potentially more intense drug exposure, and other yet not well-understood toxicities. As more states legalize marijuana and the federal government considers changing this from a Schedule I to a Schedule III controlled substance, we anticipate an increase in prospective medical studies concerning the risks related to marijuana use. This review is based on currently available data concerning the impact of inhaled marijuana on lung health.
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Affiliation(s)
- Joanne M Bando
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Igor Z Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Dang J, Tong Y, Wang Q, Li G, Abd El-Aty AM. Innovative orthogonal two-dimensional reversed-phase liquid chromatography × supercritical fluid chromatography with a phenyl/tetrazole stationary phase for the preparative isolation of diarylheptanoids. J Chromatogr A 2024; 1726:464950. [PMID: 38704964 DOI: 10.1016/j.chroma.2024.464950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 05/07/2024]
Abstract
In this investigation, we successfully isolated and purified natural diarylheptanoids using an orthogonal offline two-dimensional RPLC × SFC approach, employing only the phenyl/tetrazole stationary phase. First, a styrene-divinylbenzene matrix medium pretreatment liquid chromatography system effectively processed chlorophyll-containing plant extract solution with a recovery rate of 33.8 %, obviating the need for concentration steps. Subsequently, an offline two-dimensional RPLC × SFC employing only the phenyl/tetrazole stationary phase achieved a remarkable 96.38 % orthogonality and was established and utilized in the preparative separation and purification of natural products. Finally, the constructed single stationary phase highly orthogonal RPLC × SFC system was successfully applied in the preparative separation and purification of natural diarylheptanoids from the Saxifraga tangutica target fraction and yielded four diarylheptanoids with purities exceeding 95 %.
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Affiliation(s)
- Jun Dang
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research, Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining, Qinghai, China.
| | - Yingying Tong
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research, Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining, Qinghai, China; Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, PR China
| | - Qilan Wang
- Qinghai Provincial Key Laboratory of Tibetan Medicine Research, Key Laboratory of Tibetan Medicine Research, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining, Qinghai, China
| | - Gang Li
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, PR China
| | - A M Abd El-Aty
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt; Department of Medical Pharmacology, Faculty of Medicine, Atatürk University, Erzurum 25240, Turkey
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Cottrell K, Chong J. Impact of Medical Cannabis on Recovery from Playing-Related Musculoskeletal Disorders in Musicians: An Observational Cohort Study. Healthcare (Basel) 2024; 12:1335. [PMID: 38998869 PMCID: PMC11241574 DOI: 10.3390/healthcare12131335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Playing-related musculoskeletal disorders (PRMDs) are musculoskeletal symptoms that interfere with the ability to play at the level a musician is accustomed to. Musicians have an 84% lifetime prevalence of PRMD. Many types of analgesia are inappropriate for this population due to their risks, but cannabidiol (CBD) has been shown to have anti-inflammatory properties and can reduce the perception of pain. Medical cannabis has also been shown to be safer than other analgesia in terms of serious adverse events. This study explores the impact of medical cannabis for PRMD on perceptions of pain and mental health outcomes. METHODS Participants (n = 204) completed questionnaires at baseline and six months: the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) and Depression, Anxiety and Stress Scale (DASS-21). Participants self-selected their group: non-cannabis users (n = 42), new medical cannabis users (n = 61), and long-term medical cannabis users (n = 101). Data were analyzed using paired t-tests for within-group and ANOVA for between-group differences. RESULTS At six months, there was no difference (p = 0.579) in cannabidiol dose between new (24.87 ± 12.86 mg) and long-term users (21.48 ± 12.50 mg). There was a difference in tetrahydrocannabinol (THC) dose (p = 0.003) between new (3.74 ± 4.22 mg) and long-term users (4.41 ± 5.18 mg). At six months, new cannabis users had a significant reduction in pain intensity as measured by The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM40) (p = 0.002). Non-users (p = 0.035), new users (p = 0.002), and long-term cannabis users (p = 0.009) all had significant reductions in pain interference (MPIIQM50) at six months. At six months, non-cannabis (p = 0.022) and long-term cannabis users (p = 0.001) had an improvement in DASS-21. The change in pain intensity was the only difference between groups, F(2, 201) = 3.845, p = 0.023. This difference was between long-term (0.83 ± 0.79) and new users (-2.61 ± 7.15). No serious adverse events occurred, and a minority experienced tiredness, cough, and dry mouth. DISCUSSION/CONCLUSIONS This practice-based evidence demonstrated that the multidimensional approach to care provided by the Musicians' Clinics of Canada benefited all groups at six months. Medical cannabis significantly reduced pain intensity in new users of medical cannabis with PRMD, and all groups saw improvements in pain interference. In keeping with prior studies, medical cannabis seems to be effective at reducing perceptions of pain, including for PRMD. CBD/THC dosing was within guideline recommendations, and no patients experienced any serious adverse events. Limitations include multiple factors impacting patients' decisions to opt in or out of medical cannabis. These include cost, comorbidities, and disease chronicity. In conclusion, medical cannabis reduces pain intensity in new users, and when combined with a multidimensional approach to care, patients with PRMD can see improvements in pain as well as mental wellbeing.
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Affiliation(s)
| | - John Chong
- Musicians' Clinics of Canada, Hamilton, ON L9C 7N4, Canada
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40
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Couch AN, Lanza JM, Zall CM, Davidson JT. Differentiation of Δ 9-THC and CBD Using Silver-Ligand Ion Complexation and Electrospray Ionization Tandem Mass Spectrometry (ESI-MS/MS). JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2024; 35:1413-1421. [PMID: 38804709 DOI: 10.1021/jasms.3c00452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The 2018 Farm Bill defines marijuana as Cannabis sativa L. or any derivative thereof that contains greater than 0.3% Δ9-tetrahydrocannabinol (Δ9-THC) on a dry weight basis. The main cannabinoids present in Cannabis sativa L., Δ9-THC and cannabidiol (CBD), are structural isomers that cannot be differentiated using direct mass spectrometry with soft ionization techniques alone. Due to the classification of marijuana as a Schedule I controlled substance, the differentiation of Δ9-THC and CBD is crucial within the seized drug community. This study explores the use of Ag-ligand ion complexation and electrospray ionization tandem mass spectrometry (ESI-MS/MS) for the differentiation of Δ9-THC and CBD using six different Ag complexes. Differences between the binding affinities of Δ9-THC and CBD for [Ag(PPh3)(OTf)]2 lead to the formation of unique product ions at m/z 421/423, m/z 353/355, and m/z 231 for CBD, enabling the differentiation of CBD from Δ9-THC. When applied to the analysis of known Δ9-THC:CBD mixture ratios, the developed [Ag(PPh3)(OTf)]2 ion complexation method was able to differentiate Δ9-THC-rich and CBD-rich samples based on the average abundance of the product ions at m/z 421/423. The developed approach was then applied to methanolic extracts of 20 authentic cannabis samples with known Δ9-THC and CBD compositions, resulting in a 95% correct classification rate. Even though the developed Ag-ligand ion complexation method was only demonstrated for the qualitative differentiation of Δ9-THC-rich and CBD-rich cannabis, this study establishes a foundation for the use of Ag-ligand ion complexation that is essential for future quantitative approaches.
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Affiliation(s)
- Alleigh N Couch
- Department of Forensic Science, Sam Houston State University, Huntsville, Texas 77341-2116, United States
| | - Jayleigh M Lanza
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341-2116, United States
| | - Christopher M Zall
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341-2116, United States
| | - J Tyler Davidson
- Department of Forensic Science, Sam Houston State University, Huntsville, Texas 77341-2116, United States
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Leroux T, Ajrawat P, Sundararajan K, Maldonado-Rodriguez N, Ravi B, Gandhi R, Rampersaud R, Veillette C, Mahomed N, Clarke H. Understanding the epidemiology and perceived efficacy of cannabis use in patients with chronic musculoskeletal pain. J Cannabis Res 2024; 6:28. [PMID: 38961506 PMCID: PMC11220958 DOI: 10.1186/s42238-024-00231-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/11/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The belief that cannabis has analgesic and anti-inflammatory properties continues to attract patients with chronic musculoskeletal (MSK) pain towards its use. However, the role that cannabis will play in the management of chronic MSK pain remains to be determined. This study examined 1) the rate, patterns of use, and self-reported efficacy of cannabis use among patients with chronic MSK pain and 2) the interest and potential barriers to cannabis use among patients with chronic MSK pain not currently using cannabis. METHODS Self-reported cannabis use and perceived efficacy were prospectively collected from chronic MSK pain patients presenting to the Orthopaedic Clinic at the University Health Network, Toronto, Canada. The primary dependent variable was current or past use of cannabis to manage chronic MSK pain; bivariate and multivariable logistic regression were used to identify patient characteristics independently associated with this outcome. Secondary outcomes were summarized descriptively, including self-perceived efficacy among cannabis users, and interest as well as barriers to cannabis use among cannabis non-users. RESULTS The sample included 629 patients presenting with chronic MSK pain (mean age: 56±15.7 years; 56% female). Overall, 144 (23%) reported past or present cannabis use to manage their MSK pain, with 63.7% perceiving cannabis as very or somewhat effective and 26.6% considering it as slightly effective. The strongest predictor of cannabis use in this study population was a history of recreational cannabis use (OR 12.7, p<0.001). Among cannabis non-users (N=489), 65% expressed interest in using cannabis to manage their chronic MSK pain, but common barriers to use included lack of knowledge regarding access, use and evidence, and stigma. CONCLUSIONS One in five patients presenting to an orthopaedic surgeon with chronic MSK pain are using or have used cannabis with the specific intent to manage their pain, and most report it to be effective. Among non-users, two-thirds reported an interest in using cannabis to manage their MSK pain, but common barriers to use existed. Future double-blind placebo-controlled trials are required to understand if this reported efficacy is accurate, and what role, if any, cannabis may play in the management of chronic MSK pain.
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Affiliation(s)
- Timothy Leroux
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada.
| | - Prabjit Ajrawat
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Kala Sundararajan
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Naomi Maldonado-Rodriguez
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Bheeshma Ravi
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajiv Gandhi
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Raja Rampersaud
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Christian Veillette
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Nizar Mahomed
- The Arthritis Program, University Health Network, 399 Bathurst St, East Wing, 1st Floor, Room 1-436, Toronto, Ontario, M5T 2S8, Canada
| | - Hance Clarke
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
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Nascimento GC, Escobar-Espinal D, Bálico GG, Silva NR, Del-Bel E. Cannabidiol and pain. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 177:29-63. [PMID: 39029988 DOI: 10.1016/bs.irn.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Chronic pain presents significant personal, psychological, and socioeconomic hurdles, impacting over 30% of adults worldwide and substantially contributing to disability. Unfortunately, current pharmacotherapy often proves inadequate, leaving fewer than 70% of patients with relief. This shortfall has sparked a drive to seek alternative treatments offering superior safety and efficacy profiles. Cannabinoid-based pharmaceuticals, notably cannabidiol (CBD), hold promise in pain management, driven by their natural origins, versatility, and reduced risk of addiction. As we navigate the opioid crisis, ongoing research plunges into CBD's therapeutic potential, buoyed by animal studies revealing its pain-relieving prowess through various system tweaks. However, the efficacy of cannabis in chronic pain management remains a contentious and stigmatized issue. The International Association for the Study of Pain (IASP) presently refrains from endorsing cannabinoid use for pain relief. Nevertheless, evidence indicates their potential in alleviating cancer-related, neuropathic, arthritis, and musculoskeletal pain, necessitating further investigation. Crucially, our comprehension of CBD's role in pain management is a journey still unfolding, with animal studies illustrating its analgesic effects through interactions with the endocannabinoid, inflammatory, and nociceptive systems. As the plot thickens, it's clear: the saga of chronic pain and CBD's potential offers a compelling narrative ripe for further exploration and understanding.
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Affiliation(s)
- Glauce Crivelaro Nascimento
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | - Daniela Escobar-Espinal
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Gabriela Gonçalves Bálico
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | | | - Elaine Del-Bel
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil; National Institute for Science and Technology, Translational Medicine, University of Sao Paulo, Ribeirao Preto, SP, Brazil; Center for Cannabinoid Research, Mental Health Building, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Lisboa SF, Stern CAJ, Gazarini L, Bertoglio LJ. Cannabidiol effects on fear processing and implications for PTSD: Evidence from rodent and human studies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 177:235-250. [PMID: 39029986 DOI: 10.1016/bs.irn.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Cannabidiol (CBD) modulates aversive memory and its extinction, with potential implications for treating anxiety- and stress-related disorders. Here, we summarize and discuss scientific evidence showing that CBD administered after the acquisition (consolidation) and retrieval (reconsolidation) of fear memory attenuates it persistently in rats and mice. CBD also reduces fear expression and enhances fear extinction. These effects involve the activation of cannabinoid type-1 (CB1) receptors in the dorsal hippocampus, bed nucleus of stria terminalis, and medial prefrontal cortex, comprising the anterior cingulate, prelimbic, and infralimbic subregions. Serotonin type-1A (5-HT1A) receptors also mediate some CBD effects on fear memory. CBD effects on fear memory acquisition vary, depending on the aversiveness of the conditioning procedure. While rodent findings are relatively consistent and encouraging, human studies investigating CBD's efficacy in modulating aversive/traumatic memories are still limited. More studies are needed to investigate CBD's effects on maladaptive, traumatic memories, particularly in post-traumatic stress disorder patients.
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Affiliation(s)
- Sabrina Francesca Lisboa
- Department of BioMolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto (FCFRP), University of Sao Paulo, Brazil.
| | | | - Lucas Gazarini
- Federal University of Mato Grosso do Sul, Campus Três Lagoas, Três Lagoas, MS, Brazil
| | - Leandro José Bertoglio
- Pharmacology Department, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Vardanega R, Lüdtke FL, Loureiro L, Toledo Hijo AAC, Martins JT, Pinheiro AC, Vicente AA. Enhancing cannabidiol bioaccessibility using ionic liquid as emulsifier to produce nanosystems: Characterization of structures, cytotoxicity assessment, and in vitro digestion. Food Res Int 2024; 188:114498. [PMID: 38823878 DOI: 10.1016/j.foodres.2024.114498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 06/03/2024]
Abstract
The emulsifying potential of a biocompatible ionic liquid (IL) to produce lipid-based nanosystems developed to enhance the bioaccessibility of cannabidiol (CBD) was investigated. The IL (cholinium oleate) was evaluated at concentrations of 1 % and 2 % to produce nanoemulsions (NE-IL) and nanostructured lipid carriers (NLC-IL) loaded with CBD. The IL concentration of 1 % demonstrated to be sufficient to produce both NE-IL and NLC-IL with excellent stability properties, entrapment efficiency superior to 99 %, and CBD retention rate of 100 % during the storage period evaluated (i.e. 28 days at 25 °C). The in vitro digestion evaluation demonstrated that the NLC-IL provided a higher stability to the CBD, while the NE-IL improved the CBD bioaccessibility, which was mainly related to the composition of the lipid matrices used to obtain each nanosystem. Finally, it was observed that the CBD cytotoxicity was reduced when the compound was entrapped into both nanosystems.
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Affiliation(s)
- Renata Vardanega
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal.
| | - Fernanda L Lüdtke
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal
| | - Luís Loureiro
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal
| | - Ariel A C Toledo Hijo
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal; School of Food Engineering, University of Campinas, R. Monteiro Lobato, 80, 13083-862 Campinas, Brazil
| | - Joana T Martins
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal
| | - Ana C Pinheiro
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal
| | - António A Vicente
- Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Guimarães, Portugal
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Romm KF, Berg CJ, Wang Y, Cohn AM. Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:397-407. [PMID: 38281150 DOI: 10.1177/29767342231222245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Although sexual minority (SM; vs heterosexual) individuals display higher rates of tobacco and cannabis use, limited research has examined sociodemographic and psychosocial correlates of single and co-use among this population. METHODS Participants were SM-identifying female (N = 2419; Mage = 27.80; 50.0% racial/ethnic minority) and male (N = 1142; Mage = 30.34; 46.1% racial/ethnic minority) adults from Wave 5 of the Population Assessment of Tobacco and Health study. Multinomial logistic regressions examined sociodemographic (ie, sexual identity, age, race/ethnicity, education, income) and psychosocial (ie, alcohol use, mental health, substance use) correlates of single and co-use (ie, no use [referent], tobacco-only, cannabis-only, co-use), controlling for state cannabis legalization, among SM females and males, separately. RESULTS The proportions of SM females reporting no use, tobacco-only, cannabis-only, and co-use were 37.9%, 24.0%, 10.5%, and 27.6%, respectively. Among males, 40.6%, 27.8%, 10.1%, and 21.5% reported no use, tobacco-only, cannabis-only, and co-use, respectively. Among females and males, substance use problems were associated with all 3 use groups (vs no use); past-month alcohol use was associated with cannabis-only and co-use; and mental health symptoms were associated with co-use (and cannabis-only in males). Sociodemographic correlates among females were: tobacco-only-identifying as bisexual (vs lesbian), White (vs Black), older, lower education, and lower income; cannabis-only-bisexual, other race (vs White); and co-use-White (vs Hispanic), lower education, and lower income. Among males, sociodemographic correlates were: tobacco-only-older, lower education, and lower income; cannabis-only-Black (vs White) and higher income. CONCLUSIONS Public health efforts to reduce tobacco and cannabis use among SM adults should target single versus co-use patterns and their corresponding sociodemographic, mental health, and substance use profiles.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Dobson O, Barber M, Graham M, Carter A, Savic M. 'The wild west of medicine': A qualitative investigation of the factors influencing Australian health-care practitioners' delivery of medicinal cannabis. Drug Alcohol Rev 2024; 43:1280-1293. [PMID: 38630896 DOI: 10.1111/dar.13847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Strong patient interest in the use of medicinal cannabis to treat various clinical indications has sparked global legislative changes. Practitioners are vital in implementing regulatory changes and facilitating patient access to medicinal cannabis, however, little is currently known about the factors influencing practitioners' uptake. Recent rapid increases in practitioner applications to prescribe medicinal cannabis in Australia provides a unique backdrop to examine the current factors influencing prescribing behaviours. This qualitative study examined Australian practitioners' perspectives on prescribing medicinal cannabis to provide a comprehensive exploration of the potential factors influencing uptake in clinical practice. METHODS Seventeen semi-structured interviews were conducted with Australian health-care practitioners. Transcripts were analysed using the Framework approach to thematic analysis and cross-mapped to appropriate domains of the Theoretical Domains Framework. RESULTS We identified four themes related to the barriers and facilitators to prescribing medicinal cannabis: (i) clinical capabilities needed to prescribe; (ii) prescribing an unapproved therapeutic good; (iii) negative attitudes towards prescribers in the medical community; and (iv) divergent beliefs about clinical utility. DISCUSSION AND CONCLUSIONS Practitioners face multiple pervasive barriers to prescribing medicinal cannabis. Beliefs about clinical utility appear to be highly influential in shaping prescribing behaviours. Moreover, our findings suggest that a medicinal cannabis 'specialisation' has emerged within the Australian medical community. Findings demonstrate that a range of complex and multifaceted factors influence practitioners' medicinal cannabis prescribing behaviours. We highlight several considerations for policy and practice to support safe and appropriate patient access to medicinal cannabis in this emerging area of clinical practice.
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Affiliation(s)
- Olivia Dobson
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Michaela Barber
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Myfanwy Graham
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University and Turning Point, Melbourne, Australia
| | - Adrian Carter
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash Bioethics Centre, School of Philosophy, History and International Studies, Monash University, Melbourne, Australia
| | - Michael Savic
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University and Turning Point, Melbourne, Australia
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Balant M, Garnatje T, Vitales D, Hidalgo O, Chitwood DH. Intra-leaf modeling of Cannabis leaflet shape produces leaf models that predict genetic and developmental identities. THE NEW PHYTOLOGIST 2024; 243:781-796. [PMID: 38757746 DOI: 10.1111/nph.19817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
The iconic, palmately compound leaves of Cannabis have attracted significant attention in the past. However, investigations into the genetic basis of leaf shape or its connections to phytochemical composition have yielded inconclusive results. This is partly due to prominent changes in leaflet number within a single plant during development, which has so far prevented the proper use of common morphometric techniques. Here, we present a new method that overcomes the challenge of nonhomologous landmarks in palmate, pinnate, and lobed leaves, using Cannabis as an example. We model corresponding pseudo-landmarks for each leaflet as angle-radius coordinates and model them as a function of leaflet to create continuous polynomial models, bypassing the problems associated with variable number of leaflets between leaves. We analyze 341 leaves from 24 individuals from nine Cannabis accessions. Using 3591 pseudo-landmarks in modeled leaves, we accurately predict accession identity, leaflet number, and relative node number. Intra-leaf modeling offers a rapid, cost-effective means of identifying Cannabis accessions, making it a valuable tool for future taxonomic studies, cultivar recognition, and possibly chemical content analysis and sex identification, in addition to permitting the morphometric analysis of leaves in any species with variable numbers of leaflets or lobes.
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Affiliation(s)
- Manica Balant
- Institut Botànic de Barcelona, IBB (CSIC-CMCNB), Passeig del Migdia s.n., 08038, Barcelona, Spain
- Laboratori de Botànica, Unitat Associada al CSIC, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona (UB), Av. Joan XXIII 27-31, 08028, Barcelona, Spain
- Department of Horticulture, Michigan State University, East Lansing, MI, 48824, USA
| | - Teresa Garnatje
- Institut Botànic de Barcelona, IBB (CSIC-CMCNB), Passeig del Migdia s.n., 08038, Barcelona, Spain
- Jardí Botànic Marimurtra - Fundació Carl Faust, pg. Carles Faust, 9, 17300, Blanes, Spain
| | - Daniel Vitales
- Institut Botànic de Barcelona, IBB (CSIC-CMCNB), Passeig del Migdia s.n., 08038, Barcelona, Spain
| | - Oriane Hidalgo
- Institut Botànic de Barcelona, IBB (CSIC-CMCNB), Passeig del Migdia s.n., 08038, Barcelona, Spain
- Royal Botanic Gardens, Kew, Richmond, TW9 3AE, UK
| | - Daniel H Chitwood
- Department of Horticulture, Michigan State University, East Lansing, MI, 48824, USA
- Department of Computational Mathematics, Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA
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Holdsworth EA, Berim A, Gang DR, Williams JE, Smith CB, Caffé B, Brooks O, Barbosa-Leiker C, McGuire MA, McGuire MK, Meehan CL. Human Milk Cannabinoid Concentrations and Associations with Maternal Factors: The Lactation and Cannabis (LAC) Study. Breastfeed Med 2024; 19:515-524. [PMID: 38695182 DOI: 10.1089/bfm.2024.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Background and Objectives: As cannabis use increases among reproductive-aged women, there is a growing need to better understand the presence of cannabinoids in milk produced by women using cannabis. It is unclear how concentrations of cannabinoids such as delta-9-tetrahydrocannabinol (Δ9-THC) persist in milk after cannabis use and what factors contribute to variation in milk Δ9-THC concentrations. Our objectives were to measure cannabinoids in human milk following cannabis abstention, after single and repeated instances of cannabis use, and identify factors contributing to concentration variation. Methods: The Lactation and Cannabis (LAC) Study prospectively observed 20 breastfeeding participants who frequently used cannabis (≥1/week), had enrolled <6 months postpartum, were feeding their infant their milk ≥5 times/day, and were not using any illicit drugs. Participants collected a baseline milk sample after ≥12 hours of abstaining from cannabis and five milk samples at set intervals over 8-12 hours after initial cannabis use. Participants completed surveys and recorded self-directed cannabis use during the study period. Results: Δ9-THC peaked 120 minutes after a single instance of cannabis use (median, n = 9). More instances of cannabis use during the study period were associated with greater Δ9-THC area-under-the-curve concentrations (ρ = 0.65, p = 0.002), indicating Δ9-THC bioaccumulation in most participants. Baseline Δ9-THC logged concentration was positively associated with self-reported frequency of cannabis use (b = 0.57, p = 0.01). Conclusions: Cannabinoids are measurable in human milk following cannabis use, and concentrations remain elevated with repeated cannabis use over a day. Substantial variation in Δ9-THC milk concentrations reflects individual differences in characteristics and behavior, including average postpartum frequency of cannabis use.
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Affiliation(s)
| | - Anna Berim
- Institute of Biological Chemistry, Washington State University, Pullman, Washington, USA
| | - David R Gang
- Institute of Biological Chemistry, Washington State University, Pullman, Washington, USA
| | - Janet E Williams
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, Idaho, USA
| | - Caroline B Smith
- Department of Anthropology, Washington State University, Pullman, Washington, USA
| | - Beatrice Caffé
- Department of Anthropology, Washington State University, Pullman, Washington, USA
| | - Olivia Brooks
- College of Nursing, Washington State University, Spokane, Washington, USA
| | | | - Mark A McGuire
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, Idaho, USA
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Courtney L Meehan
- Department of Anthropology, Washington State University, Pullman, Washington, USA
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Businelle MS, Perski O, Hébert ET, Kendzor DE. Mobile Health Interventions for Substance Use Disorders. Annu Rev Clin Psychol 2024; 20:49-76. [PMID: 38346293 DOI: 10.1146/annurev-clinpsy-080822-042337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Substance use disorders (SUDs) have an enormous negative impact on individuals, families, and society as a whole. Most individuals with SUDs do not receive treatment because of the limited availability of treatment providers, costs, inflexible work schedules, required treatment-related time commitments, and other hurdles. A paradigm shift in the provision of SUD treatments is currently underway. Indeed, with rapid technological advances, novel mobile health (mHealth) interventions can now be downloaded and accessed by those that need them anytime and anywhere. Nevertheless, the development and evaluation process for mHealth interventions for SUDs is still in its infancy. This review provides a critical appraisal of the significant literature in the field of mHealth interventions for SUDs with a particular emphasis on interventions for understudied and underserved populations. We also discuss the mHealth intervention development process, intervention optimization, and important remaining questions.
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Affiliation(s)
- Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA;
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Olga Perski
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Emily T Hébert
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA;
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Mirzayov S, Peleg R, Freud T. Attitudes and Knowledge of Medical Students in South of Israel Toward Medical Cannabis. Am J Ther 2024; 31:e372-e381. [PMID: 38976525 DOI: 10.1097/mjt.0000000000001749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Public and medical interest in the use of cannabis has increased in Israel and the world over recent years. STUDY QUESTION The aim of the study was to assess the attitudes of medical students from the Faculty of Health Sciences of Ben-Gurion University of the Negev on the use of medical cannabis. STUDY DESIGN This is a cross-sectional study using a self-administered questionnaire completed by medical students from Ben-Gurion University of the Negev, Beer-Sheva, Israel. MEASURES AND OUTCOMES Attitudes and knowledge toward the use of medical cannabis were evaluated. RESULTS A total of 243 medical students participated in the study. Of these, 111 (46.1%) were from preclinical years. The mean age was 27.31 ± 3.07, and 138 (57.3%) were female students. Most students (N = 193, 79.4%) agreed to a great degree or to a very great degree that there was a role for cannabis for medical purposes. Most students thought that medical cannabis should be recommended for use by pain specialists (N = 231, 95.1%), by oncologists (N = 208, 85.6%), and by psychiatrists (N = 192, 79%). A little more than half of the participants (N = 127, 52.5%) would agree to be licensed, as future physicians, to prescribe medical cannabis. A logistic regression analysis found that the students strongly agreed with legalization of medical cannabis and students who strongly agreed that medical cannabis should be in the health basket predicted a very strong agreement about its use (OR = 2.623, P ≤ 0.002, and OR = 3.285, P ≤ 0.001, respectively). CONCLUSIONS Most medical students support the use of medical cannabis for medical purposes and are in favor of its legalization. As physicians of the future, it is important to assess the attitudes of medical students on medical cannabis.
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Affiliation(s)
- Shira Mirzayov
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Roni Peleg
- Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; and
- Clalit Health Services, Southern District, Israel
| | - Tamar Freud
- Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; and
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