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Peace-Tuskey K. What Do We Know About Cannabis Consumption and the Effect of Legalization: A Critical Appraisal of the Latest Systematic Review. J Adolesc Health 2024; 74:1266-1267. [PMID: 38762250 DOI: 10.1016/j.jadohealth.2022.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 05/20/2024]
Affiliation(s)
- Kimberly Peace-Tuskey
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
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2
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Lachance A, Bélanger RE, Riva M, Ross NA. A Response to "What Do We Know About Cannabis Consumption and the Effect of Legalization: A Critical Appraisal of the Latest Systematic Review". J Adolesc Health 2024; 74:1267-1268. [PMID: 38762251 DOI: 10.1016/j.jadohealth.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Antoine Lachance
- Department of Geography, McGill University, Montreal, Quebec, Canada; Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Richard E Bélanger
- Department of Pediatrics, Université Laval, Quebec City, Quebec, Canada; CHU de Quebec Research Center - Université Laval, Quebec City, Quebec, Canada
| | - Mylène Riva
- Department of Geography, McGill University, Montreal, Quebec, Canada; Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Nancy A Ross
- Department of Geography, McGill University, Montreal, Quebec, Canada; Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
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3
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Murta JCD, Easpaig BNG, Hazell-Raine K, Byrne MK, Lertwatthanawilat W, Kritkitrat P, Bressington D. Recreational cannabis policy reform-What mental health nurses need to know about minimising harm and contributing to the reform debate. J Psychiatr Ment Health Nurs 2024; 31:270-282. [PMID: 37767750 DOI: 10.1111/jpm.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
The recently rapidly evolving legal status of recreational cannabis in various countries has triggered international debate, particularly around measures required to minimise resulting harms. The present article argues that mental health nurses should have a key role in promoting safe and appropriate use of recreational cannabis, and minimising harm based on the extant evidence. The article summarises the factors driving legalisation, outlines the evident medicinal benefits of cannabis, and appraises the evidence on the negative mental health impacts associated with use. We go on to discuss research findings on the potentially deleterious mental health effects resulting from legalising recreational cannabis and strategies to minimise these harms, including directions for future research and evaluation. Further, we consider the importance of the implementation of harm minimisation measures that are context-specific, using Thailand as an example. Finally, we present the key health promotion messages that mental health nurses should aim to convey to people who use or consider using recreational cannabis. Ultimately, we aim to provide a summary of the existing evidence that mental health nurses can draw upon to promote mental health and engage with the policy reform debate.
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Affiliation(s)
| | | | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Mitchell K Byrne
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | | | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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Harrison ME, Kanbur N, Canton K, Desai TS, Lim-Reinders S, Groulx C, Norris ML. Adolescents' Cannabis Knowledge and Risk Perception: A Systematic Review. J Adolesc Health 2024; 74:402-440. [PMID: 37966406 DOI: 10.1016/j.jadohealth.2023.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/31/2023] [Accepted: 09/08/2023] [Indexed: 11/16/2023]
Abstract
To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10-18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.
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Affiliation(s)
- Megan E Harrison
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Division of Adolescent Health, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada.
| | - Nuray Kanbur
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Division of Adolescent Health, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada
| | - Kyle Canton
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Tejas S Desai
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Chase Groulx
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Mark L Norris
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Division of Adolescent Health, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada
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5
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Denton EE, Jung SS, Ventura CAI. Clinical Diagnosis and Management of Gradual Onset Cannabis-Induced Psychosis Following the Consumption of Delta-8-Tetrahydrocannabinol. Cureus 2024; 16:e55464. [PMID: 38571826 PMCID: PMC10988276 DOI: 10.7759/cureus.55464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
Cannabis-induced psychosis (CIP) is an increasingly acknowledged psychiatric phenomenon observed in vulnerable patients exposed to cannabis. This brief case report details a male patient in his 20s, who presents to the ED with derealization two days after ingesting a gummy worm containing delta-8-tetrahydrocannabinol (Δ8-THC). Two days post-ED discharge, the patient gradually developed symptoms of religious-themed psychosis and was prescribed 10 mg of aripiprazole daily. The patient seemingly recovered within four days of starting treatment. This paper contributes to the limited literature pertaining to CIP and discusses implications for diagnostics and treatment in the ED setting.
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Affiliation(s)
- Edward E Denton
- Department of Emergency Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Sophia S Jung
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Christian Angelo I Ventura
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Guttmannova K, Fleming CB, Rhew IC, Delawalla MLM, Fairlie AM, Larimer ME, Kilmer JR. Changes in Cannabis Use From 2014 to 2019 Among Young Adults in Washington State. Am J Prev Med 2024; 66:252-259. [PMID: 37793557 PMCID: PMC10842380 DOI: 10.1016/j.amepre.2023.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Understanding changes in cannabis use in the legalized nonmedical cannabis context is critical. Washington State, one the earliest states to implement legalization, presents a unique opportunity to examine how cannabis use and its consequences changed after the implementation of legalization for adults. With a focus on Washington State young adults, this study conducted in 2022-2023 examined changes in (1) cannabis use by sex and age, (2) preferred mode of use, and (3) cannabis use disorder symptoms. METHODS Using repeated cross-sectional data on young adults aged 18-25 years in Washington State from 2014 (premarket opening) to 2019 (N=12,945), logistic regression models assessed trends over time in the prevalence of any and frequent (20+ days) past-month cannabis use. Among individuals reporting use, multinomial logistic regressions estimated trends over time in the preferred mode of use and negative binomial regressions examined trends in the count of cannabis use disorder symptoms. RESULTS From 2014 to 2019, the prevalence of cannabis use converged by sex, with females being equally likely as males to report both any and frequent use by 2019. Among young adults reporting past-month use, smoking as the preferred mode of use decreased relative to other modes. Number of cannabis use disorder symptoms reported increased, which was not accounted for by changes in preferred mode of use. CONCLUSIONS During the 5-year period following the implementation of legalization, patterns of young adult cannabis use shifted, including particularly sharp increases among females and increases in cannabis use disorder symptoms. Future studies should investigate underlying causes for these important changes.
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Affiliation(s)
- Katarina Guttmannova
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
| | - Charles B Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Miranda L M Delawalla
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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7
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Mennis J, Stahler GJ, Coffman DL. Why Are Adolescent Cannabis Use Disorder Treatment Admissions Declining in the US? The Mediated Pathway of State Treatment Admissions Rates before and after Recreational Cannabis Legalization. Subst Use Misuse 2024; 59:962-970. [PMID: 38297820 DOI: 10.1080/10826084.2024.2310500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Purpose: State-level prevalence data are used to investigate whether recreational cannabis legalization moderates the mediated pathway from the perception of low risk of harm, to cannabis use, to cannabis use disorder (CUD) treatment admissions, among adolescents (age 12-17) in the US. Methods: Annual state prevalence measures of perception of low risk, cannabis use, and CUD treatment admissions between 2008 and 2019 (N = 542 state-year observations) were collected from the National Survey on Drug Use and Health (NSDUH) and the Treatment Episode Dataset - Admissions (TEDS-A). A two-way fixed effects (state and year) moderated mediation model was used to test whether recreational legalization moderated the indirect effect of perception of low risk on treatment admissions via cannabis use. Results: A positive indirect effect of perceiving cannabis as low risk on CUD treatment admissions via cannabis use was observed prior to legalization but not afterwards. After legalization, the positive association of perceiving cannabis as low risk with cannabis use was strengthened, and the positive association of cannabis use with treatment admissions was suppressed, as compared to before legalization. Discussion: Recreational legalization may alter the social acceptability and medical self-administration of cannabis, potentially leading to CUD treatment utilization decline among adolescents even as risk factors for CUD increase. Linking recreational cannabis legalization to advancing awareness of the health risks associated with adolescent cannabis use and promoting adolescent CUD treatment engagement through mHealth approaches and primary care providers are key to addressing potential adolescent health challenges brought about by expanding cannabis legalization.
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Affiliation(s)
- Jeremy Mennis
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania, USA
| | - Gerald J Stahler
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania, USA
| | - Donna L Coffman
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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8
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Sevigny EL, Greathouse J, Medhin DN. Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1362. [PMID: 37915420 PMCID: PMC10616541 DOI: 10.1002/cl2.1362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Background Globally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy-relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms. Objectives This evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps. Search Methods We comprehensively searched for eligible English-language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020. Selection Criteria The conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population-level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer-term consequences (health, safety, and socioeconomic outcomes) of these laws. Data Collection and Analysis Both dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2. Main Results The EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws-including CBDLs, IHLs, and DCLs-are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid-related harms (3), and alcohol-related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality. Authors’ Conclusions More primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer-term-and arguably more salient-health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions.
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Affiliation(s)
- Eric L. Sevigny
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Jared Greathouse
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Danye N. Medhin
- Department of Criminal Justice and CriminologyGeorgia State UniversityAtlantaGeorgiaUSA
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9
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Florimbio AR, Walton MA, Coughlin LN, Lin LA, Bonar EE. Perceived risk of harm for different methods of cannabis consumption: A brief report. Drug Alcohol Depend 2023; 251:110915. [PMID: 37597308 DOI: 10.1016/j.drugalcdep.2023.110915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/18/2023] [Accepted: 07/29/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Emerging adults' (EAs; ages 18-25) perceived risk of cannabis-related harms has decreased in recent decades, potentially contributing to their high prevalence of cannabis consumption. With the changing cannabis policy and product landscape, it is critical to understand perceived risk related to different consumption methods (e.g., smoking, dabbing). We examined differences in cannabis risk perceptions by method and consumption patterns. METHODS EAs recruited from an emergency department (N=359, 71.3% female, 53.5% Black) completed assessments on individual characteristics, cannabis/other substance use, and perceived risk of cannabis-related harm for four different methods (smoking, vaping, dabbing, ingestion) and two use frequencies (occasional, regular). Analyses examined associations between variables of interest and three mutually exclusive groups: no cannabis use, smoking-only, and multiple/other methods. RESULTS Forty-two percent of EAs reported no past 3-month cannabis use, 22.8% reported smoking only, and 35.1% reported consumption via multiple/other methods. Among all participants, the methods and frequency with the largest number of EAs endorsing any perceived risk from cannabis were dabbing and vaping cannabis regularly; smoking occasionally had the smallest number of EAs endorsing perceived risk. A greater proportion of EAs in the no use group viewed vaping cannabis regularly as having the most risk (63.6%), whereas the largest proportion of EAs in the smoking-only (64.6%) and multiple/other methods (47.2%) groups perceived dabbing regularly as having the most risk. CONCLUSIONS This work shows that EAs vary in perceptions of risk across methods of cannabis use and can inform potential directions for public health and policy efforts.
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Affiliation(s)
- Autumn Rae Florimbio
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Maureen A Walton
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - Lewei Allison Lin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
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Ross JA, Levy S. The Impact of Cannabis Use on Adolescent Neurodevelopment and Clinical Outcomes Amidst Changing State Policies. Clin Ther 2023; 45:535-540. [PMID: 37414504 DOI: 10.1016/j.clinthera.2023.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 07/08/2023]
Abstract
Cannabis is the most common illicit substance used by adolescents and the third most common psychoactive substance after alcohol and nicotine. Cannabis use during adolescence interrupts a critical period of brain development and leads to inappropriate activation of the reward pathway. Because the prefrontal cortex, which is responsible for impulse control and other executive functions, is not fully mature until the mid-twenties, the adolescent brain is especially vulnerable to damage from substance use. Although cannabis remains illegal at the federal level, recent changes in state policies have been associated with increased availability of a wide variety of cannabis products. As new products, formulations, and delivery devices that can deliver higher and faster peak doses of tetrahydrocannabinol enter the market, there is an even greater potential for cannabis to have negative clinical impacts on adolescent health. This article reviews the current literature on the impact of cannabis on adolescent health, including the neurobiology of the adolescent brain, potential clinical outcomes in adolescents who use cannabis, and the effects of changing state policies regarding cannabis on the increased availability of unregulated products.
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Affiliation(s)
- Jennifer A Ross
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
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11
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Ren W, Fishbein D. Prospective, longitudinal study to isolate the impacts of marijuana use on neurocognitive functioning in adolescents. Front Psychiatry 2023; 14:1048791. [PMID: 37255687 PMCID: PMC10225520 DOI: 10.3389/fpsyt.2023.1048791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/19/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Policies to legalize possession and use of marijuana have been increasingly supported across the United States. Although there are restrictions on use in minors, many substance abuse scientists anticipate that these policy changes may alter use patterns among adolescents due to its wider availability and a softening of beliefs about its potentially harmful consequences. Despite the possibility that these policies may increase the prevalence of use among adolescents, the effects of marijuana on neurodevelopment remain unclear, clouding arguments in favor of or opposition to these policies. Methods The present prospective, longitudinal study was designed to isolate the neurodevelopmental consequences of marijuana use from its precursors during adolescence-a period of heightened vulnerability for both substance use and disrupted development due to environmental insults. Early adolescents who were substance-naïve at baseline (N = 529, aged 10-12) were recruited and tracked into adolescence when a subgroup initiated marijuana use during one of three subsequent waves of data collection, approximately 18 months apart. Results Results suggest that marijuana use may be specifically related to a decline in verbal learning ability in the short term and in emotion recognition, attention, and inhibition in the longer-term. Discussion These preliminary findings suggest that marijuana use has potential to adversely impact vulnerable neurodevelopmental processes during adolescence. Intensive additional investigation is recommended given that state-level policies regulating marijuana use and possession are rapidly shifting in the absence of good scientific information.
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Affiliation(s)
- Wen Ren
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Diana Fishbein
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
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12
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Gómez Velásquez S, Amaya Heredia ÁM, Bedoya Moncada S, Patiño González JE, Martínez Ramírez JA. Recreational cannabis: Profile of cannabinoids present in marijuana samples supplied by the consuming population. Salud Colect 2023; 19:e4385. [PMID: 37311141 DOI: 10.18294/sc.2023.4385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/16/2023] [Indexed: 06/15/2023] Open
Abstract
As cannabis/marijuana is one of the most consumed psychoactive substances in the world, knowing the composition and type of cannabis sold in urban environments is a necessary input for the design of public health policies based on scientific evidence. This study characterized the main phytocannabinoids of marijuana samples (cigarettes or buds) obtained in urban and rural areas of the city of Medellín in October 2021. Non-probabilistic convenience sampling was carried out in which 87 marijuana samples donated by consumers were collected at different collection points throughout the city, and gas chromatography-mass spectrometry and flame ionization techniques were employed for the characterization of phytocannabinoids. Tetrahydrocannabinol (THC) was found to be the main constituent of circulating marijuana in Medellín, where 67.8% of the samples had a high or higher toxicological range for THC; the foregoing in a context where the deregulated market in practice limits the possibility that consumers have to calibrate or decide the concentration of cannabinoids in their doses.
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Affiliation(s)
- Santiago Gómez Velásquez
- Magíster en Salud Pública. Secretaría de la Juventud de Medellín. Estudiante del Doctorado en Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia
| | | | | | | | - Jorge Ariel Martínez Ramírez
- PhD en Toxicología Forense. Profesor, Departamento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, Colombia
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13
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Matheson J, Le Foll B. Impacts of recreational cannabis legalization on use and harms: A narrative review of sex/gender differences. Front Psychiatry 2023; 14:1127660. [PMID: 36970279 PMCID: PMC10036775 DOI: 10.3389/fpsyt.2023.1127660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
Legalization of cannabis use for non-medical (recreational) purposes is changing the global cannabis landscape. As attitudes toward cannabis use become more positive and prevalence of use increases in complex ways, concerns emerge about the potential for increased cannabis-attributable harms. Understanding the who, why, and when of this likely increase in cannabis-attributable harms is thus an important public health priority. Both sex and gender contribute to variability in the use, effects, and harms of cannabis and thus sex/gender considerations are important when evaluating the impacts of cannabis legalization. The goal of this narrative review is to broadly discuss sex/gender differences in attitudes toward and prevalence of cannabis use, whether there are sex/gender differences in the impacts of cannabis legalization, and why these sex/gender differences might exist. One of our strongest conclusions is that men have always been more likely to use cannabis than women, yet the sex/gender gap in prevalence of cannabis use has narrowed over time, and this might be partly due to cannabis legalization. The existing evidence suggests that there have also been sex/gender differences in the impacts of legalization on cannabis-attributable harms such as cannabis-involved motor vehicle collisions and hospitalizations, though these results are more variable. The body of literature reviewed has focused almost exclusively on samples of cisgender research participants, and thus future research should encourage inclusion of transgender and gender-diverse participants. More consideration of sex- and gender-based analysis in research evaluating long-term impacts of cannabis legalization is a clear research priority.
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Affiliation(s)
- Justin Matheson
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
- *Correspondence: Justin Matheson,
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Acute Care Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Waypoint Centre for Mental Health Care, Waypoint Research Institute, Penetanguishene, ON, Canada
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Brown T, Banz B, Schmitt R, Gaffney G, Milavetz G, Camenga D, Li K, Brooks-Russell A, Vaca F. A study of self-reported personal cannabis use and state legal status and associations with engagement in and perceptions of cannabis-impaired driving. TRAFFIC INJURY PREVENTION 2022; 23:S183-S186. [PMID: 37014194 PMCID: PMC10618935 DOI: 10.1080/15389588.2022.2124803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Objective: The objectives of the current study were to (1) characterize predictors of perceived risk of driving within 2 h of cannabis use and driving after cannabis use in a sample of adults who have used cannabis in the past year and (2) determine whether the influence of these predictors vary by state legalizations status.Methods: Data for this study were from online surveys. Study participants from Colorado, Iowa, and Illinois were included if they reported being between 25 and 40 years old and had a history of cannabis use. Outcome variables included (1) days of cannabis use per month, (2) reported driving within 2 h of cannabis use (vs. not driving within 2 h as reference), (3) proportion of driving after cannabis use days per month (days of driving a car within 2 h of cannabis use per month/days of cannabis use per month), and (4) perception of safety of driving after cannabis use. Potential predictors included age of first use of cannabis, gender, education status, and state of residence. The SAS GLMSELECT Procedure was used for the analysis.Results: Increased age of first use of cannabis was associated with decreased days of cannabis use per month (B = -0.51 days/month per year), a reduction in the proportion of driving after cannabis use days per month (B = -0.02 per month), and decreased perception of safety of driving after cannabis use (B = -0.06 per year). Female gender was also associated with less use (B = -2.3 days per month), a lower proportion of driving following use (B = -0.06 days driving/days used), and decreased perception of safety (B = -0.29). In addition, residents of Colorado reported using the most days, had the highest likelihood of driving within 2 h of use, and had the most positive perceptions of being able to safely drive after cannabis use.Conclusions: The delay in onset of cannabis use may mitigate its use among adults and driving after cannabis use. This has important implications for driver safety. Intervention programs for reducing cannabis's effects on driving should focus on individuals with early onset of use, male drivers, and drivers in states where cannabis for adult recreational use is legalized.
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Affiliation(s)
- Timothy Brown
- National Advanced Driving Simulator, University of Iowa, Iowa City, IA
| | - Barbara Banz
- Yale DrivSim Lab, Yale University School of Medicine, New Haven, CT
| | - Rose Schmitt
- National Advanced Driving Simulator, University of Iowa, Iowa City, IA
| | - Gary Gaffney
- Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Gary Milavetz
- College of Pharmacy, University of Iowa, Iowa City, IA
| | - Deepa Camenga
- Department of Emergency Medicine, Yale University, New Haven, CT
| | - Kaigang Li
- College of Health and Human Sciences, Colorado State University, Fort Collins, CO
| | | | - Federico Vaca
- UCI School of Medicine, University of California Irvine (UCI), Irvine, CA
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Richter L. The Prevention of Nonmedical Marijuana Use Must Extend Past Adolescence. J Adolesc Health 2022; 71:6-7. [PMID: 35718391 DOI: 10.1016/j.jadohealth.2022.04.002] [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: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
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