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Barrett FS, Schlienz NJ, Lembeck N, Waqas M, Vandrey R. "Hallucinations" Following Acute Cannabis Dosing: A Case Report and Comparison to Other Hallucinogenic Drugs. Cannabis Cannabinoid Res 2018; 3:85-93. [PMID: 29682608 PMCID: PMC5908416 DOI: 10.1089/can.2017.0052] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction: Cannabis has been historically classified as a hallucinogen. However, subjective cannabis effects do not typically include hallucinogen-like effects. Empirical reports of hallucinogen-like effects produced by cannabis in controlled settings, particularly among healthy research volunteers, are rare and have mostly occurred after administration of purified Δ-9 tetrahydrocannabinol (THC) rather than whole plant cannabis. Methods: The case of a healthy 30-year-old male who experienced auditory and visual hallucinations in a controlled laboratory study after inhaling vaporized cannabis that contained 25 mg THC (case dose) is presented. Ratings on the Hallucinogen Rating Scale (HRS) following the case dose are compared with HRS ratings obtained from the participant after other doses of cannabis and with archival HRS data from laboratory studies involving acute doses of cannabis, psilocybin, dextromethorphan (DXM), and salvinorin A. Results: Scores on the Volition subscale of the HRS were greater for the case dose than for the maximum dose administered in any other comparison study. Scores on the Intensity and Perception subscales were greater for the case dose than for the maximum dose of cannabis, psilocybin, or salvinorin A. Scores on the Somaesthesia subscale were greater for the case dose than for the maximum dose of DXM, salvinorin A, or cannabis. Scores on the Affect and Cognition subscales for the case dose were significantly lower than for the maximum doses of psilocybin and DXM. Conclusion: Acute cannabis exposure in a healthy adult male resulted in self-reported hallucinations that rated high in magnitude on several subscales of the HRS. However, the hallucinatory experience in this case was qualitatively different than that typically experienced by participants receiving classic and atypical hallucinogens, suggesting that the hallucinatory effects of cannabis may have a unique pharmacological mechanism of action. This type of adverse event needs to be considered in the clinical use of cannabis.
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Affiliation(s)
- Frederick S Barrett
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nicolas J Schlienz
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Natalie Lembeck
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Muhammad Waqas
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ryan Vandrey
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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202
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Haijen E, Farre M, de la Torre R, Pastor A, Olesti E, Pizarro N, Ramaekers JG, Kuypers KPC. Peripheral endocannabinoid concentrations are not associated with verbal memory impairment during MDMA intoxication. Psychopharmacology (Berl) 2018; 235:709-717. [PMID: 29143869 PMCID: PMC5847074 DOI: 10.1007/s00213-017-4787-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/07/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Preclinical data have suggested involvement of the endocannabinoid (eCB) system in MDMA-induced memory impairment. Clinical research has shown that blockade of the 5-HT2 receptor nulls memory impairment during MDMA intoxication. Interestingly, studies have demonstrated that the eCB and the 5-HT system interact. It was hypothesized that MDMA would cause an increase in eCB concentrations together with a decrease in memory performance, and that combining MDMA with a 5-HT2 receptor blocker ketanserin would lead to a counteraction of the MDMA effects on eCB concentrations and memory. METHODS Twenty healthy recreational polydrug users entered a double-blind placebo-controlled within-subject study. Participants received a pre-treatment (ketanserin 40 mg, placebo) followed 30 min later by a treatment (MDMA 75 mg, placebo). Verbal memory was tested by means of a 30-word learning test. Endocannabinoid concentrations (anandamide (2-AG); N-arachidonylethanolamine (AEA)) were assessed in blood at baseline, before (90 min post-treatment) and after cognitive tests (150 min post-treatment). RESULTS Findings showed that MDMA impaired memory 90 min post-treatment in the word learning task. This effect was a replication of previous studies using the same dose of MDMA (75 mg) and the same learning paradigm. Contrary to our hypothesis, MDMA did not affect eCB concentrations, nor did ketanserin block MDMA-induced memory impairment. Ketanserin caused an increase in AEA concentrations, 180 min after administration. CONCLUSION Current findings suggest that peripherally measured endocannabinoids are not associated with the verbal memory deficit during MDMA intoxication. TRIAL REGISTRATION NUMBER NTR3691.
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Affiliation(s)
- E Haijen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - M Farre
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - R de la Torre
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Santiago de Compostela, Spain
- Universitat Pompeu Fabra, CEXS-UPF, Barcelona, Spain
| | - A Pastor
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Santiago de Compostela, Spain
| | - E Olesti
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Universitat Pompeu Fabra, CEXS-UPF, Barcelona, Spain
| | - N Pizarro
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - K P C Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
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203
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Cohen K, Weinstein A. The Effects of Cannabinoids on Executive Functions: Evidence from Cannabis and Synthetic Cannabinoids-A Systematic Review. Brain Sci 2018; 8:brainsci8030040. [PMID: 29495540 PMCID: PMC5870358 DOI: 10.3390/brainsci8030040] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/08/2018] [Accepted: 02/24/2018] [Indexed: 12/21/2022] Open
Abstract
Background—Cannabis is the most popular illicit drug in the Western world. Repeated cannabis use has been associated with short and long-term range of adverse effects. Recently, new types of designer-drugs containing synthetic cannabinoids have been widespread. These synthetic cannabinoid drugs are associated with undesired adverse effects similar to those seen with cannabis use, yet, in more severe and long-lasting forms. Method—A literature search was conducted using electronic bibliographic databases up to 31 December 2017. Specific search strategies were employed using multiple keywords (e.g., “synthetic cannabinoids AND cognition,” “cannabis AND cognition” and “cannabinoids AND cognition”). Results—The search has yielded 160 eligible studies including 37 preclinical studies (5 attention, 25 short-term memory, 7 cognitive flexibility) and 44 human studies (16 attention, 15 working memory, 13 cognitive flexibility). Both pre-clinical and clinical studies demonstrated an association between synthetic cannabinoids and executive-function impairment either after acute or repeated consumptions. These deficits differ in severity depending on several factors including the type of drug, dose of use, quantity, age of onset and duration of use. Conclusions—Understanding the nature of the impaired executive function following consumption of synthetic cannabinoids is crucial in view of the increasing use of these drugs.
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Affiliation(s)
- Koby Cohen
- Department of Behavioral Science, Ariel University, Ariel 40700, Israel.
| | - Aviv Weinstein
- Department of Behavioral Science, Ariel University, Ariel 40700, Israel.
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204
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Meier MH, Caspi A, Danese A, Fisher HL, Houts R, Arseneault L, Moffitt TE. Associations between adolescent cannabis use and neuropsychological decline: a longitudinal co-twin control study. Addiction 2018; 113:257-265. [PMID: 28734078 PMCID: PMC5760333 DOI: 10.1111/add.13946] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/21/2017] [Accepted: 07/18/2017] [Indexed: 01/17/2023]
Abstract
AIMS This study tested whether adolescents who used cannabis or met criteria for cannabis dependence showed neuropsychological impairment prior to cannabis initiation and neuropsychological decline from before to after cannabis initiation. DESIGN A longitudinal co-twin control study. SETTING AND PARTICIPANTS Participants were 1989 twins from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of twins born in England and Wales from 1994 to 1995. MEASUREMENTS Frequency of cannabis use and cannabis dependence were assessed at age 18. Intelligence quotient (IQ) was obtained at ages 5, 12 and 18. Executive functions were assessed at age 18. FINDINGS Compared with adolescents who did not use cannabis, adolescents who used cannabis had lower IQ in childhood prior to cannabis initiation and lower IQ at age 18, but there was little evidence that cannabis use was associated with IQ decline from ages 12-18. For example, adolescents with cannabis dependence had age 12 and age 18 IQ scores that were 5.61 (t = -3.11, P = 0.002) and 7.34 IQ points (t = -5.27, P < 0.001) lower than adolescents without cannabis dependence, but adolescents with cannabis dependence did not show greater IQ decline from age 12-18 (t = -1.27, P = 0.20). Moreover, adolescents who used cannabis had poorer executive functions at age 18 than adolescents who did not use cannabis, but these associations were generally not apparent within twin pairs. For example, twins who used cannabis more frequently than their co-twin performed similarly to their co-twin on five of six executive function tests (Ps > 0.10). The one exception was that twins who used cannabis more frequently than their co-twin performed worse on one working memory test (Spatial Span reversed; β = -0.07, P = 0.036). CONCLUSIONS Short-term cannabis use in adolescence does not appear to cause IQ decline or impair executive functions, even when cannabis use reaches the level of dependence. Family background factors explain why adolescent cannabis users perform worse on IQ and executive function tests.
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Affiliation(s)
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA,Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Andrea Danese
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK,National and Specialist Service Foundation Trust, London, UK
| | - Helen L. Fisher
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Renate Houts
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Louise Arseneault
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA,Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK
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205
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Szutorisz H, Hurd YL. High times for cannabis: Epigenetic imprint and its legacy on brain and behavior. Neurosci Biobehav Rev 2018; 85:93-101. [PMID: 28506926 PMCID: PMC5682234 DOI: 10.1016/j.neubiorev.2017.05.011] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 12/22/2022]
Abstract
Extensive debates continue regarding marijuana (Cannabis spp), the most commonly used illicit substance in many countries worldwide. There has been an exponential increase of cannabis studies over the past two decades but the drug's long-term effects still lack in-depth scientific data. The epigenome is a critical molecular machinery with the capacity to maintain persistent alterations of gene expression and behaviors induced by cannabinoids that have been observed across the individual's lifespan and even into the subsequent generation. Though mechanistic investigations regarding the consequences of developmental cannabis exposure remain sparse, human and animal studies have begun to reveal specific epigenetic disruptions in the brain and the periphery. In this article, we focus attention on long-term disturbances in epigenetic regulation in relation to prenatal, adolescent and parental germline cannabinoid exposure. Expanding knowledge about the protracted molecular memory could help to identify novel targets to develop preventive strategies and treatments for behaviors relevant to neuropsychiatric risks associated with developmental cannabis exposure.
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Affiliation(s)
- Henrietta Szutorisz
- Friedman Brain Institute, Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yasmin L Hurd
- Friedman Brain Institute, Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Addiction Institute at Mount Sinai, New York, NY, USA.
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206
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Ivan Ezquerra-Romano I, Lawn W, Krupitsky E, Morgan CJA. Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology 2018; 142:72-82. [PMID: 29339294 DOI: 10.1016/j.neuropharm.2018.01.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 12/14/2022]
Abstract
Ketamine is a dissociative anaesthetic drug which acts on the central nervous system chiefly through antagonism of the n-methyl-d-aspartate (NMDA) receptor. Recently, ketamine has attracted attention as a rapid-acting anti-depressant but other studies have also reported its efficacy in reducing problematic alcohol and drug use. This review explores the preclinical and clinical research into ketamine's ability to treat addiction. Despite methodological limitations and the relative infancy of the field, results thus far are promising. Ketamine has been shown to effectively prolong abstinence from alcohol and heroin in detoxified alcoholics and heroin dependent individuals, respectively. Moreover, ketamine reduced craving for and self-administration of cocaine in non-treatment seeking cocaine users. However, further randomised controlled trials are urgently needed to confirm ketamine's efficacy. Possible mechanisms by which ketamine may work within addiction include: enhancement of neuroplasticity and neurogenesis, disruption of relevant functional neural networks, treating depressive symptoms, blocking reconsolidation of drug-related memories, provoking mystical experiences and enhancing psychological therapy efficacy. Identifying the mechanisms by which ketamine exerts its therapeutic effects in addiction, from the many possible candidates, is crucial for advancing this treatment and may have broader implications understanding other psychedelic therapies. In conclusion, ketamine shows great promise as a treatment for various addictions, but well-controlled research is urgently needed. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- I Ivan Ezquerra-Romano
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London, UK
| | - W Lawn
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| | - E Krupitsky
- St.-Petersburg Pavlov State Medical University and Bekhterev Research Psychoneurological Institute, St. Petersburg, Russia
| | - C J A Morgan
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK; Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK.
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207
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Braidwood R, Mansell S, Waldron J, Rendell PG, Kamboj SK, Curran HV. Non-Dependent and Dependent Daily Cannabis Users Differ in Mental Health but Not Prospective Memory Ability. Front Psychiatry 2018; 9:97. [PMID: 29636705 PMCID: PMC5880932 DOI: 10.3389/fpsyt.2018.00097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/09/2018] [Indexed: 11/13/2022] Open
Abstract
Research suggests that daily cannabis users have impaired memory for past events, but it is not clear whether they are also impaired in prospective memory (PM) for future events. The present study examined PM in daily cannabis users who were either dependent (n = 18) or non-dependent (n = 18), and compared them with non-using controls (n = 18). The effect of future event simulation (FES) on PM performance was also examined. Participants were matched across groups on age, gender, and highest level of education. The virtual week (VW) was used to objectively assess PM abilities, both at baseline and following FES. Other measures used were: cannabis use variables, immediate and delayed prose recall, phonemic and category fluency, spot-the-word test (premorbid intelligence), Beck Depression Inventory, Beck Anxiety Inventory, and a measure of schizotypy (Oxford-Liverpool Inventory of Feelings and Experiences: unusual experiences subscale). No group differences were found in PM performance on the VW, and FES did not improve PM performance in any group. Dependent cannabis users scored higher on depression, anxiety, and schizotypy than both other groups with non-dependent cannabis users scoring at a similar level to controls. There were no group differences in alcohol use. Findings suggest that when carefully matched on baseline variables, and not differing in premorbid IQ or alcohol use, young, near-daily cannabis users do not differ from non-using controls in PM performance.
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Affiliation(s)
- Ruth Braidwood
- Clinical Psychopharmacology Unit (CPU), University College London, London, United Kingdom
| | - Samantha Mansell
- Clinical Psychopharmacology Unit (CPU), University College London, London, United Kingdom
| | - Jon Waldron
- Clinical Psychopharmacology Unit (CPU), University College London, London, United Kingdom
| | - Peter G Rendell
- Cognition and Emotion Research Centre, Australian Catholic University, Melbourne, VIC, Australia
| | - Sunjeev K Kamboj
- Clinical Psychopharmacology Unit (CPU), University College London, London, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit (CPU), University College London, London, United Kingdom
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208
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Cortical thickness, cortical surface area and subcortical volumes in schizophrenia and bipolar disorder patients with cannabis use. Eur Neuropsychopharmacol 2018; 28:37-47. [PMID: 29254657 DOI: 10.1016/j.euroneuro.2017.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/03/2017] [Accepted: 11/22/2017] [Indexed: 11/20/2022]
Abstract
Cannabis is associated with increased risk for severe mental illness and is commonly used among individuals with schizophrenia or bipolar disorder. In this study we investigated associations between cannabis use and brain structures among patients with schizophrenia or bipolar disorders. Magnetic resonance imaging scans were obtained for 77 schizophrenia and 55 bipolar patients with a history of cannabis use (defined as lifetime use >10 times during one month or abuse/dependence), and 97 schizophrenia, 85 bipolar disorder patients and 277 healthy controls without any previous cannabis use. Cortical thickness, cortical surface area and subcortical volumes were compared between groups. Both hypothesis-driven region-of-interest analyses from 11 preselected brain regions in each hemisphere and exploratory point-by-point analyses were performed. We tested for diagnostic interactions and controlled for potential confounders. After controlling for confounders such as tobacco use and alcohol use disorders we found reduced cortical thickness in the caudal middle frontal gyrus compared to non-user patients and healthy controls. The findings were not significant when patients with co-morbid alcohol and illicit drug use were excluded from the analyses, but onset of cannabis use before illness onset was associated with cortical thinning in the caudal middle frontal gyrus. To conclude, we found no structural brain changes associated with cannabis use among patients with severe mental illness, but the findings indicate excess cortical thinning among those who use cannabis before illness onset. The present findings support the understanding that cannabis use is associated with limited brain effects in schizophrenia as well as bipolar disorder.
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209
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Freeman TP, Pope RA, Wall MB, Bisby JA, Luijten M, Hindocha C, Mokrysz C, Lawn W, Moss A, Bloomfield MAP, Morgan CJA, Nutt DJ, Curran HV. Cannabis Dampens the Effects of Music in Brain Regions Sensitive to Reward and Emotion. Int J Neuropsychopharmacol 2018; 21:21-32. [PMID: 29025134 PMCID: PMC5795345 DOI: 10.1093/ijnp/pyx082] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Despite the current shift towards permissive cannabis policies, few studies have investigated the pleasurable effects users seek. Here, we investigate the effects of cannabis on listening to music, a rewarding activity that frequently occurs in the context of recreational cannabis use. We additionally tested how these effects are influenced by cannabidiol, which may offset cannabis-related harms. METHODS Across 3 sessions, 16 cannabis users inhaled cannabis with cannabidiol, cannabis without cannabidiol, and placebo. We compared their response to music relative to control excerpts of scrambled sound during functional Magnetic Resonance Imaging within regions identified in a meta-analysis of music-evoked reward and emotion. All results were False Discovery Rate corrected (P<.05). RESULTS Compared with placebo, cannabis without cannabidiol dampened response to music in bilateral auditory cortex (right: P=.005, left: P=.008), right hippocampus/parahippocampal gyrus (P=.025), right amygdala (P=.025), and right ventral striatum (P=.033). Across all sessions, the effects of music in this ventral striatal region correlated with pleasure ratings (P=.002) and increased functional connectivity with auditory cortex (right: P< .001, left: P< .001), supporting its involvement in music reward. Functional connectivity between right ventral striatum and auditory cortex was increased by cannabidiol (right: P=.003, left: P=.030), and cannabis with cannabidiol did not differ from placebo on any functional Magnetic Resonance Imaging measures. Both types of cannabis increased ratings of wanting to listen to music (P<.002) and enhanced sound perception (P<.001). CONCLUSIONS Cannabis dampens the effects of music in brain regions sensitive to reward and emotion. These effects were offset by a key cannabis constituent, cannabidol.
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Affiliation(s)
- Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, United Kingdom.,National Addiction Centre, King's College London, United Kingdom
| | - Rebecca A Pope
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, University College London, United Kingdom.,Imanova Centre for Imaging Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom.,Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - James A Bisby
- Institute of Cognitive Neuroscience, University College London, United Kingdom
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Abigail Moss
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Michael A P Bloomfield
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, United Kingdom.,Division of Psychiatry, University College London, United Kingdom
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, United Kingdom.,Department of Psychology, University of Exeter, United Kingdom
| | - David J Nutt
- Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, United Kingdom
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210
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Plourde G. Case Report #10—Euthanasia (Assisted Suicide) or Palliative Sedation. Prostate Cancer 2018. [DOI: 10.1016/b978-0-12-815966-8.00010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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211
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Cannabinoid Modulation of Object Recognition and Location Memory—A Preclinical Assessment. HANDBOOK OF OBJECT NOVELTY RECOGNITION 2018. [DOI: 10.1016/b978-0-12-812012-5.00031-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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212
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Why did cannabis treatment presentations rise in England from 2004-2005 to 2013-2014? DRUGS AND ALCOHOL TODAY 2017. [DOI: 10.1108/dat-08-2017-0033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Cannabis treatment entries rose significantly from 2004/2005 to 2013/2014, but there has been limited investigation into why this increase has occurred. The purpose of this paper is to evaluate the plausibility of different explanations within the English context and identifies gaps in the literature.
Design/methodology/approach
Explanations have been categorised under: misreporting, increased probability of entering treatment and increased incidence of cannabis use disorder (CUD). The explanations are evaluated through published literature, data in the public domain and interview data. Interview participants included four practitioners, one senior manager, one commissioner, one journalist, one academic and one clinician.
Findings
Plausible and influential explanations are that an expanding treatment offer occurred alongside an expanding cohort of people needing support for CUD. The evidence suggests increased prevalence in the 1990s to early 2000s, and an increase in high-potency cannabis, led to a significant rise in need for cannabis treatment. Minor explanations relating to funding formulas, criminal justice referrals and the emergence of synthetic cannabinoids could also cumulatively have a substantial effect on the data.
Research limitations/implications
Due to the dearth of research in use and attitudes towards cannabis, there are some explanations which cannot be ruled out.
Practical implications
More research is needed on user perceptions of cannabis harms and how intensively people are using cannabis.
Social implications
Wider implications are that a genuine and increasing need for support relating to cannabis within the English population requires an appropriate response from national bodies, commissioners and service providers.
Originality/value
A more comprehensive understanding of why this new cohort is emerging can inform better service provision and commissioning.
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213
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Lalanne L, Ferrand-Devouge E, Kirchherr S, Rauch L, Koning E, Speeg C, Laprevote V, Giersch A. Impaired contrast sensitivity at low spatial frequency in cannabis users with early onset. Eur Neuropsychopharmacol 2017; 27:1289-1297. [PMID: 29031837 DOI: 10.1016/j.euroneuro.2017.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 09/08/2017] [Accepted: 09/25/2017] [Indexed: 11/15/2022]
Abstract
The regular use of cannabis generates pronounced cognitive disorders, especially in users who begin before the age of 15-16. However, less is known about the impact of regular cannabis on visual function, especially in the case of early onset. Cannabinoid receptors (CB1) are expressed in areas of the visual system, like the thalamus and primary cortex, which might originate sensory disorders. Hence, we measured contrast sensitivity (CS) in three groups, i.e. cannabis users with late onset of cannabis use (after 16 years old), cannabis users with early onset". We used a constant method which allowed us to control for biased responses. Stimuli were presented at high and low spatial frequencies and in both static and dynamic conditions (8Hz). As contrast sensitivity is measured behaviorally based on an explicit response and could thus be impacted by attentional or vigilance disorders, participants' attention and vigilance were carefully monitored by means of the D2 test, CPT-AX for attention and pupillography for vigilance. Cannabis users with early onset were significantly impaired only at low spatial frequency. This effect was independent of response bias, vigilance and attention. These results show for the first time that early cannabis use impacts contrast sensitivity at low spatial frequency.
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Affiliation(s)
- Laurence Lalanne
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France.
| | - Eglantine Ferrand-Devouge
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - Sebastien Kirchherr
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - Lucie Rauch
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - Estelle Koning
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - Claude Speeg
- IRCAD-EITS, Strasbourg, France; Department of Ophthalmology, Strasbourg University Hospital, FMTS, University of Strasbourg, Strasbourg, France
| | - Vincent Laprevote
- Centre Psychothérapique de Nancy, Laxou F-54520, France; EA 7298, INGRES, Université de Lorraine, Vandoeuvre-lès-Nancy F-54000, France; CHU Nancy, Maison des Addictions, Nancy F-54000, France
| | - Anne Giersch
- Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
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214
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Waterreus A, Badcock JC, Di Prinzio P, Martin-Iverson M, Morgan VA. The impact of current cannabis use on general cognitive function in people with psychotic illness. Schizophr Res 2017; 190:164-171. [PMID: 28381332 DOI: 10.1016/j.schres.2017.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite growing research, it remains unclear if cannabis use is associated with additive cognitive impairment in people with psychotic illness and whether exposure in early adolescence is associated with poorer cognitive performance in adulthood. METHODS This cross-sectional study of a nationally representative sample of 1199 adults with psychotic illness compared current cognition (digit symbol coding) of 297 current users of cannabis (used in the past year), 460 past users (used previously but not in the past year) and 442 non-users (never used). Multiple logistic regression was used to examine whether cognitive performance of cannabis-user groups varied by exposure age and diagnosis (non-affective/affective psychoses). RESULTS Unadjusted analysis showed current cannabis users had significantly higher odds of impaired cognitive function compared to non-users (odds ratio=1.52, 95%CI=1.04-2.22). After adjusting for potential confounders, differences between the three groups were not significant. Exposure age was not significant in adjusted analysis. In participants with nonaffective psychoses, cognitive ability of current cannabis users did not differ from non-users. However, in participants with affective psychoses, using cannabis in the last year was a significant predictor of impaired cognitive function (odds ratio=2.25, 95%CI=1.05-4.84). CONCLUSION Among people with psychotic illness, there was no significant difference in cognitive function between current, past and non-users of cannabis. However, when we compared cognitive performance of the three cannabis groups by diagnostic grouping, current cannabis use had a significant negative relationship with cognitive function in people with affective psychoses, but not in those with non-affective psychoses. This finding requires replication and further investigation.
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Affiliation(s)
- Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia.
| | - Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Mathew Martin-Iverson
- Pharmacology, M510, School of Biomedical Sciences, University of Western Australia, Stirling Highway, Crawley, 6009, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
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215
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Hindocha C, Freeman TP, Xia JX, Shaban NDC, Curran HV. Acute memory and psychotomimetic effects of cannabis and tobacco both 'joint' and individually: a placebo-controlled trial. Psychol Med 2017; 47:2708-2719. [PMID: 28558859 PMCID: PMC5647681 DOI: 10.1017/s0033291717001222] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/07/2017] [Accepted: 04/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research. METHOD The individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions. RESULTS Cannabis alone impaired verbal memory. A priori contrasts indicated that tobacco offset the effects of cannabis on delayed recall. However, this was not supported by linear mixed model analysis. Cannabis load-dependently impaired WM. By contrast, tobacco improved WM across all load levels. The acute psychotomimetic effects and ratings of 'stoned' and 'dizzy' induced by cannabis were not altered by tobacco. Cannabis and tobacco had independent effects on increasing heart rate and interacting effects on increasing diastolic blood pressure. CONCLUSIONS Relative to placebo, acute cannabis impaired verbal memory and WM. Tobacco enhanced performance on WM, independently of cannabis. Moreover, we found some preliminary evidence that tobacco may offset the effects of cannabis on delayed, but not immediate, verbal recall. In contrast, the psychotomimetic and subjective effects of cannabis were unaffected by tobacco co-administration. By reducing the cognitive impairment from cannabis, tobacco co-administration may perpetuate use despite adverse health consequences.
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Affiliation(s)
- C. Hindocha
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - T. P. Freeman
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - J. X. Xia
- The Sophie Davis School of Biomedical Education,
The City College of New York, NY,
USA
| | - N. D. C. Shaban
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
| | - H. V. Curran
- Clincial Psychopharmacology Unit,
University College London, Gower St,
London, UK
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216
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Meier MH. Associations between butane hash oil use and cannabis-related problems. Drug Alcohol Depend 2017; 179:25-31. [PMID: 28750253 DOI: 10.1016/j.drugalcdep.2017.06.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/11/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND High-potency cannabis concentrates are increasingly popular in the United States, and there is concern that use of high-potency cannabis might increase risk for cannabis-related problems. However, little is known about the potential negative consequences of concentrate use. This study reports on associations between past-year use of a high-potency cannabis concentrate, known as butane hash oil (BHO), and cannabis-related problems. METHODS A sample of 821 college students were recruited to complete a survey about their health and behavior. Participants who had used cannabis in the past year (33%, n=273) completed questions about their cannabis use, including their use of BHO and cannabis-related problems in eight domains: physical dependence, impaired control, academic-occupational problems, social-interpersonal problems, self-care problems, self-perception, risk behavior, and blackouts. RESULTS Approximately 44% (n=121) of past-year cannabis users had used BHO in the past year. More frequent BHO use was associated with higher levels of physical dependence (RR=1.8, p<0.001), impaired control (RR=1.3, p<0.001), cannabis-related academic/occupational problems (RR=1.5, p=0.004), poor self-care (RR=1.3, p=0.002), and cannabis-related risk behavior (RR=1.2, p=0.001). After accounting for sociodemographic factors, age of onset of cannabis use, sensation seeking, overall frequency of cannabis use, and frequency of other substance use, BHO use was still associated with higher levels of physical dependence (RR=1.2, p=0.014). CONCLUSIONS BHO use is associated with greater physiological dependence on cannabis, even after accounting for potential confounders. Longitudinal research is needed to determine if cannabis users with higher levels of physiological dependence seek out BHO and/or if BHO use increases risk for physiological dependence.
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Affiliation(s)
- Madeline H Meier
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ 85287-1104, United States.
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217
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Chan GCK, Hall W, Freeman TP, Ferris J, Kelly AB, Winstock A. User characteristics and effect profile of Butane Hash Oil: An extremely high-potency cannabis concentrate. Drug Alcohol Depend 2017. [PMID: 28624604 DOI: 10.1016/j.drugalcdep.2017.04.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent reports suggest an increase in use of extremely potent cannabis concentrates such as Butane Hash Oil (BHO) in some developed countries. The aims of this study were to examine the characteristics of BHO users and the effect profiles of BHO. DESIGN Anonymous online survey in over 20 countries in 2014 and 2015. Participants aged 18 years or older were recruited through onward promotion and online social networks. The overall sample size was 181,870. In this sample, 46% (N=83,867) reported using some form of cannabis in the past year, and 3% reported BHO use (n=5922). MEASUREMENTS Participants reported their use of 7 types of cannabis in the past 12 months, the source of their cannabis, reasons for use, use of other illegal substances, and lifetime diagnosis for depression, anxiety and psychosis. Participants were asked to rate subjective effects of BHO and high potency herbal cannabis. FINDINGS Participants who reported a lifetime diagnosis of depression (OR=1.15, p=0.003), anxiety (OR=1.72, p<0.001), and a larger number of substance use (OR=1.29, p<0.001) were more likely to use BHO than only using high potency herbal cannabis. BHO users also reported stronger negative effects and less positive effects when using BHO than high potency herbal cannabis (p<0.001) CONCLUSION: Mental health problems and other illicit drug use were associated with use of BHO. BHO was reported to have stronger negative and weaker positive effects than high potency herbal cannabis.
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Affiliation(s)
- Gary C K Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia.
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia
| | - Tom P Freeman
- National Addiction Centre, King's College London, 4 Windsor Walk, London SE5 8BB, UK; Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Jason Ferris
- Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Brisbane 4068, Australia
| | - Adrian B Kelly
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia
| | - Adam Winstock
- Global Drug Survey, Fergusson House,124/128 City Road, London EC1 V2NJ, UK; University College London,Gower Street, London WC1E 6BT, UK
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218
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Hindocha C, Freeman TP, Curran HV. Anatomy of a Joint: Comparing Self-Reported and Actual Dose of Cannabis and Tobacco in a Joint, and How These Are Influenced by Controlled Acute Administration. Cannabis Cannabinoid Res 2017; 2:217-223. [PMID: 29082319 PMCID: PMC5628568 DOI: 10.1089/can.2017.0024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Introduction: Major gaps exist in the measurement of cannabis exposure. The accuracy of self-reported cannabis and tobacco dose per joint is poorly characterized and has never been investigated following acute cannabis/tobacco exposure. Using an innovative "Roll a Joint" paradigm, this study aims to (1) compare estimated and actual dose of cannabis and tobacco per joint at baseline and (2) examine the acute effects of cannabis and/or tobacco on estimated and actual dose. Materials and Methods: We investigated this by using a randomized, double-blind, placebo-controlled crossover 2 (active cannabis, placebo cannabis)×2 (active tobacco, placebo tobacco) design in a laboratory setting. Participants were 24 recreational cousers of cannabis and tobacco. At baseline, they were asked to measure out the amount of cannabis and tobacco they would put in an average joint for themselves (dose per joint). Then, on each of four drug administration sessions, participants were again asked to do this for a joint they would want to smoke "right now." Self-reported and actual amount was recorded (g). Results: At baseline, the estimated amount of cannabis per joint (0.28±0.23 g) was double the actual amount (0.14±0.12 g) (p=0.003, d=0.723). No difference emerged between estimated (0.43±0.25 g) and actual (0.35±0.15 g) (p=0.125) amount of tobacco per joint. Compared to placebo, active cannabis reduced the actual dose of both cannabis (p=0.035) and tobacco (p<0.001) they put in a joint. Participants accurately estimated this reduction for tobacco (p=0.014), but not for cannabis (p=0.680). Conclusions: Self-reported dose per joint is accurate for tobacco but dramatically overestimates cannabis exposure and therefore should be viewed with caution. Cannabis administration reduced the amount of cannabis and tobacco added to joints, suggesting a reduction in dose during a smoking session. The "Roll A Joint" paradigm should be implemented for better accuracy in assessing dose per joint.
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Affiliation(s)
- Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom
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219
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Englund A, Freeman TP, Murray RM, McGuire P. Can we make cannabis safer? Lancet Psychiatry 2017; 4:643-648. [PMID: 28259650 DOI: 10.1016/s2215-0366(17)30075-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/10/2016] [Accepted: 11/09/2016] [Indexed: 12/15/2022]
Abstract
Cannabis use and related problems are on the rise globally alongside an increase in the potency of cannabis sold on both black and legal markets. Additionally, there has been a shift towards abandoning prohibition for a less punitive and more permissive legal stance on cannabis, such as decriminalisation and legalisation. It is therefore crucial that we explore new and innovative ways to reduce harm. Research has found cannabis with high concentrations of its main active ingredient, δ-9-tetrahydrocannabinol (THC), to be more harmful (in terms of causing the main risks associated with cannabis use, such as addiction, psychosis, and cognitive impairment) than cannabis with lower concentrations of THC. By contrast, cannabidiol, which is a non-intoxicating and potentially therapeutic component of cannabis, has been found to reduce the negative effects of cannabis use. Here, we briefly review findings from studies investigating various types of cannabis and discuss how future research can help to better understand and reduce the risks of cannabis use.
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Affiliation(s)
- Amir Englund
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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220
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Abstract
Due to their efficacy, cannabis based therapies are currently being prescribed for the treatment of many different medical conditions. Interestingly, treatments based on the use of cannabis flowers or their derivatives have been shown to be very effective, while therapies based on drugs containing THC alone lack therapeutic value and lead to increased side effects, likely resulting from the absence of other pivotal entourage compounds found in the Phyto-complex. Among these compounds are terpenoids, which are not produced exclusively by cannabis plants, so other plant species must share many of the enzymes involved in their metabolism. In the present work, 23,630 transcripts from the canSat3 reference transcriptome were scanned for evolutionarily conserved protein domains and annotated in accordance with their predicted molecular functions. A total of 215 evolutionarily conserved genes encoding enzymes presumably involved in terpenoid metabolism are described, together with their expression profiles in different cannabis plant tissues at different developmental stages. The resource presented here will aid future investigations on terpenoid metabolism in
Cannabis sativa.
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Affiliation(s)
- Luca Massimino
- Molecular Oncology Unit, San Gerardo Hospital, Monza, Italy
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221
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Chye Y, Solowij N, Suo C, Batalla A, Cousijn J, Goudriaan AE, Martin-Santos R, Whittle S, Lorenzetti V, Yücel M. Orbitofrontal and caudate volumes in cannabis users: a multi-site mega-analysis comparing dependent versus non-dependent users. Psychopharmacology (Berl) 2017; 234:1985-1995. [PMID: 28364340 DOI: 10.1007/s00213-017-4606-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 03/13/2017] [Indexed: 11/25/2022]
Abstract
RATIONALE Cannabis (CB) use and dependence are associated with regionally specific alterations to brain circuitry and substantial psychosocial impairment. OBJECTIVES The objective of this study was to investigate the association between CB use and dependence, and the volumes of brain regions critically involved in goal-directed learning and behaviour-the orbitofrontal cortex (OFC) and caudate. METHODS In the largest multi-site structural imaging study of CB users vs healthy controls (HC), 140 CB users and 121 HC were recruited from four research sites. Group differences in OFC and caudate volumes were investigated between HC and CB users and between 70 dependent (CB-dep) and 50 non-dependent (CB-nondep) users. The relationship between quantity of CB use and age of onset of use and caudate and OFC volumes was explored. RESULTS CB users (consisting of CB-dep and CB-nondep) did not significantly differ from HC in OFC or caudate volume. CB-dep compared to CB-nondep users exhibited significantly smaller volume in the medial and the lateral OFC. Lateral OFC volume was particularly smaller in CB-dep females, and reduced volume in the CB-dep group was associated with higher monthly cannabis dosage. CONCLUSIONS Smaller medial OFC volume may be driven by CB dependence-related mechanisms, while smaller lateral OFC volume may be due to ongoing exposure to cannabinoid compounds. The results highlight a distinction between cannabis use and dependence and warrant examination of gender-specific effects in studies of CB dependence.
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Affiliation(s)
- Yann Chye
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Chao Suo
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Albert Batalla
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Janna Cousijn
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM and Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Valentina Lorenzetti
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia.
- School of Psychological Sciences, Institute of Psychology, Health and Society, The University of Liverpool, Liverpool, UK.
| | - Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.
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222
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Janik P, Kosticova M, Pecenak J, Turcek M. Categorization of psychoactive substances into “hard drugs” and “soft drugs”: a critical review of terminology used in current scientific literature. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017. [DOI: 10.1080/00952990.2017.1335736] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Peter Janik
- Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Michaela Kosticova
- Institute of Social Medicine and Medical Ethics, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Jan Pecenak
- Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Michal Turcek
- Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
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223
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Ruggiero RN, Rossignoli MT, De Ross JB, Hallak JEC, Leite JP, Bueno-Junior LS. Cannabinoids and Vanilloids in Schizophrenia: Neurophysiological Evidence and Directions for Basic Research. Front Pharmacol 2017; 8:399. [PMID: 28680405 PMCID: PMC5478733 DOI: 10.3389/fphar.2017.00399] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 01/14/2023] Open
Abstract
Much of our knowledge of the endocannabinoid system in schizophrenia comes from behavioral measures in rodents, like prepulse inhibition of the acoustic startle and open-field locomotion, which are commonly used along with neurochemical approaches or drug challenge designs. Such methods continue to map fundamental mechanisms of sensorimotor gating, hyperlocomotion, social interaction, and underlying monoaminergic, glutamatergic, and GABAergic disturbances. These strategies will require, however, a greater use of neurophysiological tools to better inform clinical research. In this sense, electrophysiology and viral vector-based circuit dissection, like optogenetics, can further elucidate how exogenous cannabinoids worsen (e.g., tetrahydrocannabinol, THC) or ameliorate (e.g., cannabidiol, CBD) schizophrenia symptoms, like hallucinations, delusions, and cognitive deficits. Also, recent studies point to a complex endocannabinoid-endovanilloid interplay, including the influence of anandamide (endogenous CB1 and TRPV1 agonist) on cognitive variables, such as aversive memory extinction. In fact, growing interest has been devoted to TRPV1 receptors as promising therapeutic targets. Here, these issues are reviewed with an emphasis on the neurophysiological evidence. First, we contextualize imaging and electrographic findings in humans. Then, we present a comprehensive review on rodent electrophysiology. Finally, we discuss how basic research will benefit from further combining psychopharmacological and neurophysiological tools.
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Affiliation(s)
- Rafael N Ruggiero
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Matheus T Rossignoli
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Jana B De Ross
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil.,National Institute for Science and Technology-Translational Medicine, National Council for Scientific and Technological Development (CNPq)Ribeirão Preto, Brazil
| | - Joao P Leite
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
| | - Lezio S Bueno-Junior
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São PauloRibeirão Preto, Brazil
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224
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Prashad S, Milligan AL, Cousijn J, Filbey FM. Cross-Cultural Effects of Cannabis Use Disorder: Evidence to Support a Cultural Neuroscience Approach. CURRENT ADDICTION REPORTS 2017; 4:100-109. [PMID: 29062679 PMCID: PMC5650117 DOI: 10.1007/s40429-017-0145-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Cannabis use disorders (CUDs) are prevalent worldwide. Current epidemiological studies underscore differences in behaviors that contribute to cannabis use across cultures that can be leveraged towards prevention and treatment of CUDs. This review proposes a framework for understanding the effects of cross-cultural differences on psychological, neural, and genomic processes underlying CUDs that has the potential to inform global policies and impact global public health. RECENT FINDINGS We found that cultural factors may influence (1) the willingness to acknowledge CUD-related symptoms among populations of different countries, and (2) neural responses related to the sense of self, perception, emotion, and attention. These findings leverage the potential effects of culture on neural mechanisms underlying CUDs. SUMMARY As the number of individuals seeking treatment for CUDs increases globally, it is imperative to incorporate cultural considerations to better understand and serve differing populations and develop more targeted treatment strategies and interventions.
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Affiliation(s)
- Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences The University of Texas at Dallas, Dallas, Texas, USA
| | - Amber L. Milligan
- Center for BrainHealth, School of Behavioral and Brain Sciences The University of Texas at Dallas, Dallas, Texas, USA
| | - Janna Cousijn
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Francesca M. Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences The University of Texas at Dallas, Dallas, Texas, USA
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225
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Recommendation to reconsider examining cannabis subtypes together due to opposing effects on brain, cognition and behavior. Neurosci Biobehav Rev 2017; 80:156-158. [PMID: 28579491 DOI: 10.1016/j.neubiorev.2017.05.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/15/2017] [Accepted: 05/29/2017] [Indexed: 11/22/2022]
Abstract
Cannabis use represents a major public health issue throughout the globe. Yet, we still lack the most fundamental knowledge on long-term effects of cannabis on neural, cognitive, and behavioral function. Part of this stems from how cannabis has been measured historically. To this end, most empirical examinations of cannabis have consolidated all types of cannabis collectively. However, this approach obscures differences in how cannabinoids operate. In this commentary, we address the contrasting properties of tetrahydrocannabinol (THC) and cannabidiol (CBD) and their opposing effects on cognitive function. In addition, we address the increase in cannabis potency throughout the past two decades and how that impacts generalizability of early data to evaluations of contemporary public health. We underscore the urgent need for future research to disaggregate examination of THC from CBD, along with the importance of measuring cannabis potency to more effectively unravel its influence on cognitive function and other health issues.
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226
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Maccarrone M. Metabolism of the Endocannabinoid Anandamide: Open Questions after 25 Years. Front Mol Neurosci 2017; 10:166. [PMID: 28611591 PMCID: PMC5447297 DOI: 10.3389/fnmol.2017.00166] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/12/2017] [Indexed: 02/06/2023] Open
Abstract
Cannabis extracts have been used for centuries, but its main active principle ∆9-tetrahydrocannabinol (THC) was identified about 50 years ago. Yet, it is only 25 years ago that the first endogenous ligand of the same receptors engaged by the cannabis agents was discovered. This “endocannabinoid (eCB)” was identified as N-arachidonoylethanolamine (or anandamide (AEA)), and was shown to have several receptors, metabolic enzymes and transporters that altogether drive its biological activity. Here I report on the latest advances about AEA metabolism, with the aim of focusing open questions still awaiting an answer for a deeper understanding of AEA activity, and for translating AEA-based drugs into novel therapeutics for human diseases.
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Affiliation(s)
- Mauro Maccarrone
- Department of Medicine, Campus Bio-Medico University of RomeRome, Italy.,European Center for Brain Research, IRCCS Santa Lucia FoundationRome, Italy
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227
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Campos AC, Fogaça MV, Scarante FF, Joca SRL, Sales AJ, Gomes FV, Sonego AB, Rodrigues NS, Galve-Roperh I, Guimarães FS. Plastic and Neuroprotective Mechanisms Involved in the Therapeutic Effects of Cannabidiol in Psychiatric Disorders. Front Pharmacol 2017; 8:269. [PMID: 28588483 PMCID: PMC5441138 DOI: 10.3389/fphar.2017.00269] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/01/2017] [Indexed: 12/25/2022] Open
Abstract
Beneficial effects of cannabidiol (CBD) have been described for a wide range of psychiatric disorders, including anxiety, psychosis, and depression. The mechanisms responsible for these effects, however, are still poorly understood. Similar to clinical antidepressant or atypical antipsychotic drugs, recent findings clearly indicate that CBD, either acutely or repeatedly administered, induces plastic changes. For example, CBD attenuates the decrease in hippocampal neurogenesis and dendrite spines density induced by chronic stress and prevents microglia activation and the decrease in the number of parvalbumin-positive GABA neurons in a pharmacological model of schizophrenia. More recently, it was found that CBD modulates cell fate regulatory pathways such as autophagy and others critical pathways for neuronal survival in neurodegenerative experimental models, suggesting the potential benefit of CBD treatment for psychiatric/cognitive symptoms associated with neurodegeneration. These changes and their possible association with CBD beneficial effects in psychiatric disorders are reviewed here.
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Affiliation(s)
- Alline C Campos
- Department of Pharmacology, Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), School of Medicine of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Manoela V Fogaça
- Department of Pharmacology, Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), School of Medicine of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Franciele F Scarante
- Department of Pharmacology, Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), School of Medicine of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Sâmia R L Joca
- Department of Physical and Chemical, School of Pharmaceutical Science of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Amanda J Sales
- Department of Physical and Chemical, School of Pharmaceutical Science of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Felipe V Gomes
- Department of Neuroscience, University of PittsburghPittsburgh, PA, United States
| | - Andreza B Sonego
- Department of Pharmacology, Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), School of Medicine of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Naielly S Rodrigues
- Department of Pharmacology, Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), School of Medicine of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
| | - Ismael Galve-Roperh
- Department of Biochemistry and Molecular Biology I, School of Biology, Complutense UniversityMadrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Universitario de Investigación en Neuroquímica and Instituto Ramón y Cajal de Investigación SanitariaMadrid, Spain
| | - Francisco S Guimarães
- Department of Pharmacology, Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), School of Medicine of Ribeirão Preto, University of São PauloRibeirão Preto, Brazil
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228
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d'Angelo LSC, Savulich G, Sahakian BJ. Lifestyle use of drugs by healthy people for enhancing cognition, creativity, motivation and pleasure. Br J Pharmacol 2017; 174:3257-3267. [PMID: 28427114 DOI: 10.1111/bph.13813] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/22/2017] [Accepted: 03/29/2017] [Indexed: 12/24/2022] Open
Abstract
Today, there is continued, and in some cases growing, availability of not only psychoactive substances, including treatments for mental health disorders such as cognitive enhancers, which can enhance or restore brain function, but also 'recreational' drugs such as novel psychoactive substances (NPS). The use of psychoactive drugs has both benefits and risks: whilst new drugs to treat cognitive symptoms in neuropsychiatric or neurodegenerative disorders could have great benefits for many patient groups, the increasing ease of accessibility to recreational NPS and the increasing lifestyle use of cognitive enhancers by healthy people means that the effective management of psychoactive substances will be an issue of increasing importance. Clearly, the potential benefits of cognitive enhancers are large and increasingly relevant, particularly as the population ages, and for this reason, we should continue to devote resources to the development of cognitive enhancers as treatments for neurodegenerative diseases and psychiatric disorders, including Alzheimer's disease, attention deficit hyperactivity disorder and schizophrenia. However, the increasing use of cognitive enhancers by healthy individuals raises safety, ethical and regulatory concerns, which should not be ignored. Similarly, understanding the short- and long-term consequences of the use of NPS, as well as better understanding the motivations and profiles of users could promote more effective prevention and harm reduction measures. Linked Articles This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc.
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Affiliation(s)
- L-S Camilla d'Angelo
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - George Savulich
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
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229
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Holman MJ, Greene DN, Gandhi JC, Soeprono TM. A Diagnostic Dilemma Involving Dabs in First-Episode Psychosis. J Appl Lab Med 2017; 2:113-117. [DOI: 10.1373/jalm.2016.022525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 12/14/2016] [Indexed: 11/06/2022]
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230
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Mizrahi R, Watts JJ, Tseng KY. Mechanisms contributing to cognitive deficits in cannabis users. Neuropharmacology 2017; 124:84-88. [PMID: 28414051 DOI: 10.1016/j.neuropharm.2017.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/13/2017] [Indexed: 12/19/2022]
Abstract
Studies from preclinical animal models indicate that sustained activation of CB1 receptor signaling is a major contributing factor for the onset of cognitive deficits associated to chronic cannabis use, in particular within the working memory and decision-making domains. Yet, very few studies have been designed to directly assess the role of CB1 receptors in mediating the effects of cannabis on human brain function. This perspective review article provides an overview of current state of knowledge on possible neurobiological mechanisms accounting for the detrimental effects of chronic cannabis use on cognition and related changes in brain structure and functional connectivity. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- Romina Mizrahi
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology & Toxicology, University of Toronto, ON, Canada; Research Imaging Center, CAMH, PET Centre, Toronto, ON, Canada
| | - Jeremy J Watts
- Department of Pharmacology & Toxicology, University of Toronto, ON, Canada; Research Imaging Center, CAMH, PET Centre, Toronto, ON, Canada
| | - Kuei Y Tseng
- Department of Cellular & Molecular Pharmacology, The Chicago Medical School at Rosalind Franklin University, North Chicago, IL, USA.
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231
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Setlow B, Bizon JL. Adolescent Cannabinoid Use and Cognition; Unexpected Results from a Rat Model of Cannabinoid Self-Administration. Neuropsychopharmacology 2017; 42:983-984. [PMID: 27654216 PMCID: PMC5506783 DOI: 10.1038/npp.2016.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 09/02/2016] [Accepted: 09/07/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Barry Setlow
- Department of Psychiatry; University of Florida College of Medicine, Gainesville, FL, USA,Department of Neuroscience; University of Florida College of Medicine, Gainesville, FL, USA,Department of Psychology; University of Florida, Gainesville, FL, USA,Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA,Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL 32610-0256, USA, Tel: +352 294 5203, Fax: 352 392 9887, E-mail:
| | - Jennifer L Bizon
- Department of Psychiatry; University of Florida College of Medicine, Gainesville, FL, USA,Department of Neuroscience; University of Florida College of Medicine, Gainesville, FL, USA,Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
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232
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Medical Marijuana: Just the Beginning of a Long, Strange Trip? Phys Ther 2017; 97:239-248. [PMID: 27660328 DOI: 10.2522/ptj.20160367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/16/2016] [Indexed: 12/12/2022]
Abstract
Medical marijuana continues to gain acceptance and become legalized in many states. Various species of the marijuana plant have been cultivated, and this plant can contain up to 100 active compounds known as cannabinoids. Two cannabinoids seem the most clinically relevant: Δ9-tetrahydrocannabinol (THC), which tends to produce the psychotropic effects commonly associated with marijuana, and cannabidiol (CBD), which may produce therapeutic effects without appreciable psychoactive properties. Smoking marijuana, or ingesting extracts from the whole plant orally (in baked goods, teas, and so forth), introduces variable amounts of THC, CBD, and other minor cannabinoids into the systemic circulation, where they ultimately reach the central and peripheral nervous systems. Alternatively, products containing THC, CBD, or a combination of both compounds, can be ingested as oral tablets or via sprays applied to the oral mucosal membranes. These products may provide a more predictable method for delivering a known amount of specific cannabinoids into the body. Although there is still a need for randomized controlled trials, preliminary studies have suggested that medical marijuana and related cannabinoids may be beneficial in treating people with chronic pain, inflammation, spasticity, and other conditions seen commonly in physical therapist practice. Physical therapists, therefore, should be aware of the options that are available for patients considering medical marijuana and should be ready to provide information for these patients. Clinicians also should be aware that marijuana can produce untoward effects on cognition, coordination, balance, and cardiovascular and pulmonary function and should be vigilant for any problems that may arise if patients are using cannabinoids during physical rehabilitation.
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233
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Abstract
Cannabis use affects cortico-striatal networks that are essential for producing movement. In this review, we summarize the literature on motor system dysfunction in cannabis users and provide a rationale for why motor learning should be considered an important area in cannabis research. A majority of studies have addressed cognitive impairments in cannabis users and some have focused on driving performance, motor impulsivity, and motor inhibition. Our review of the literature has found that cannabis use is associated with motor performance impairments; however, there is a gap in the literature regarding impairments in motor learning. The involvement of the cortico-striatal network in both cannabis addiction and movement also suggests potential avenues for treatment and rehabilitation via the motor system.
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Affiliation(s)
- Shikha Prashad
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA
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234
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Abstract
The cannabis plant and its active ingredients (i.e., cannabinoids and terpenoids) have been socially stigmatized for half a century. Luckily, with more than 430,000 published scientific papers and about 600 ongoing and completed clinical trials, nowadays cannabis is employed for the treatment of many different medical conditions. Nevertheless, even if a large amount of high-throughput functional genomic data exists, most researchers feature a strong background in molecular biology but lack advanced bioinformatics skills. In this work, publicly available gene expression datasets have been analyzed giving rise to a total of 40,224 gene expression profiles taken from cannabis plant tissue at different developmental stages. The resource presented here will provide researchers with a starting point for future investigations with Cannabis sativa.
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Affiliation(s)
- Luca Massimino
- Molecular Oncology Unit, San Gerardo Hospital, Monza, Italy
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235
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Suryadevara U, Bruijnzeel DM, Nuthi M, Jagnarine DA, Tandon R, Bruijnzeel AW. Pros and Cons of Medical Cannabis use by People with Chronic Brain Disorders. Curr Neuropharmacol 2017; 15:800-814. [PMID: 27804883 PMCID: PMC5652027 DOI: 10.2174/1570159x14666161101095325] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/26/2016] [Accepted: 10/28/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cannabis is the most widely used illicit drug in the world and there is growing concern about the mental health effects of cannabis use. These concerns are at least partly due to the strong increase in recreational and medical cannabis use and the rise in tetrahydrocannabinol (THC) levels. Cannabis is widely used to self-medicate by older people and people with brain disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer's disease (AD), Parkinson's disease (PD), bipolar disorder, and schizophrenia. OBJECTIVE This review provides an overview of the perceived benefits and adverse mental health effects of cannabis use in people with ALS, MS, AD, PD, bipolar disorder, and schizophrenia. RESULTS The reviewed studies indicate that cannabis use diminishes some symptoms associated with these disorders. Cannabis use decreases pain and spasticity in people with MS, decreases tremor, rigidity, and pain in people with PD, and improves the quality of life of ALS patients by improving appetite, and decreasing pain and spasticity. Cannabis use is more common among people with schizophrenia than healthy controls. Cannabis use is a risk factor for schizophrenia which increases positive symptoms in schizophrenia patients and diminishes negative symptoms. Cannabis use worsens bipolar disorder and there is no evidence that bipolar patients derive any benefit from cannabis. In late stage Alzheimer's patients, cannabis products may improve food intake, sleep quality, and diminish agitation. CONCLUSION Cannabis use diminishes some of the adverse effects of neurological and psychiatric disorders. However, chronic cannabis use may lead to cognitive impairments and dependence.
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Affiliation(s)
- Uma Suryadevara
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | | | - Meena Nuthi
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | | | - Rajiv Tandon
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Adriaan W. Bruijnzeel
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, University of Florida, Gainesville, Florida, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
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236
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Mokrysz C, Freeman TP, Korkki S, Griffiths K, Curran HV. Are adolescents more vulnerable to the harmful effects of cannabis than adults? A placebo-controlled study in human males. Transl Psychiatry 2016; 6:e961. [PMID: 27898071 PMCID: PMC5290352 DOI: 10.1038/tp.2016.225] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 12/18/2022] Open
Abstract
Preclinical research demonstrates that cannabinoids have differing effects in adolescent and adult animals. Whether these findings translate to humans has not yet been investigated. Here we believe we conducted the first study to compare the acute effects of cannabis in human adolescent (n=20; 16-17 years old) and adult (n=20; 24-28 years old) male cannabis users, in a placebo-controlled, double-blind cross-over design. After inhaling vaporized active or placebo cannabis, participants completed tasks assessing spatial working memory, episodic memory and response inhibition, alongside measures of blood pressure and heart rate, psychotomimetic symptoms and subjective drug effects (for example, 'stoned', 'want to have cannabis'). Results showed that on active cannabis, adolescents felt less stoned and reported fewer psychotomimetic symptoms than adults. Further, adults but not adolescents were more anxious and less alert during the active cannabis session (both pre- and post-drug administration). Following cannabis, cognitive impairment (reaction time on spatial working memory and prose recall following a delay) was greater in adults than adolescents. By contrast, cannabis impaired response inhibition accuracy in adolescents but not in adults. Moreover, following drug administration, the adolescents did not show satiety; instead they wanted more cannabis regardless of whether they had taken active or placebo cannabis, while the opposite was seen for adults. These contrasting profiles of adolescent resilience (blunted subjective, memory, physiological and psychotomimetic effects) and vulnerability (lack of satiety, impaired inhibitory processes) show some degree of translation from preclinical findings, and may contribute to escalated cannabis use by human adolescents.
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Affiliation(s)
- C Mokrysz
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
| | - S Korkki
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - K Griffiths
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, Clinical Educational and Health Psychology, University College London, London, UK
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237
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Perry CJ, Lawrence AJ. Addiction, cognitive decline and therapy: seeking ways to escape a vicious cycle. GENES BRAIN AND BEHAVIOR 2016; 16:205-218. [DOI: 10.1111/gbb.12325] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/14/2016] [Accepted: 08/25/2016] [Indexed: 12/31/2022]
Affiliation(s)
- C. J. Perry
- Behavioural Neuroscience Division; The Florey Institute of Neuroscience and Mental Health; Melbourne VIC Australia
- Florey Department of Neuroscience and Mental Health; University of Melbourne; Melbourne VIC Australia
| | - A. J. Lawrence
- Behavioural Neuroscience Division; The Florey Institute of Neuroscience and Mental Health; Melbourne VIC Australia
- Florey Department of Neuroscience and Mental Health; University of Melbourne; Melbourne VIC Australia
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238
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Russo EB. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues. Front Pharmacol 2016; 7:309. [PMID: 27683558 PMCID: PMC5022003 DOI: 10.3389/fphar.2016.00309] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/30/2016] [Indexed: 12/12/2022] Open
Abstract
This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration "Botanical Guidance." The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain.
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239
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Acute and chronic effects of cannabinoids on effort-related decision-making and reward learning: an evaluation of the cannabis 'amotivational' hypotheses. Psychopharmacology (Berl) 2016; 233:3537-52. [PMID: 27585792 PMCID: PMC5021728 DOI: 10.1007/s00213-016-4383-x] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 07/16/2016] [Indexed: 01/21/2023]
Abstract
RATIONALE Anecdotally, both acute and chronic cannabis use have been associated with apathy, amotivation, and other reward processing deficits. To date, empirical support for these effects is limited, and no previous studies have assessed both acute effects of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), as well as associations with cannabis dependence. OBJECTIVES The objectives of this study were (1) to examine acute effects of cannabis with CBD (Cann + CBD) and without CBD (Cann-CBD) on effort-related decision-making and (2) to examine associations between cannabis dependence, effort-related decision-making and reward learning. METHODS In study 1, 17 participants each received three acute vaporized treatments, namely Cann-CBD (8 mg THC), Cann + CBD (8 mg THC + 10 mg CBD) and matched placebo, followed by a 50 % dose top-up 1.5 h later, and completed the Effort Expenditure for Rewards Task (EEfRT). In study 2, 20 cannabis-dependent participants were compared with 20 non-dependent, drug-using control participants on the EEfRT and the Probabilistic Reward Task (PRT) in a non-intoxicated state. RESULTS Cann-CBD reduced the likelihood of high-effort choices relative to placebo (p = 0.042) and increased sensitivity to expected value compared to both placebo (p = 0.014) and Cann + CBD (p = 0.006). The cannabis-dependent and control groups did not differ on the EEfRT. However, the cannabis-dependent group exhibited a weaker response bias than the control group on the PRT (p = 0.007). CONCLUSIONS Cannabis acutely induced a transient amotivational state and CBD influenced the effects of THC on expected value. In contrast, cannabis dependence was associated with preserved motivation alongside impaired reward learning, although confounding factors, including depression, cannot be disregarded. This is the first well powered, fully controlled study to objectively demonstrate the acute amotivational effects of THC.
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