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Alharbi FF, Alqahtani TM, Alzamil AM, Alharbi NH, Masud N. Knowledge, perception, and beliefs of Saudi physicians at King Abdulaziz Medical City, Riyadh related to medical cannabis: Literature review and a cross-sectional survey. J Family Med Prim Care 2023; 12:536-544. [PMID: 37122648 PMCID: PMC10131962 DOI: 10.4103/jfmpc.jfmpc_1856_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/03/2022] [Accepted: 12/12/2022] [Indexed: 05/02/2023] Open
Abstract
Cannabis is an herbaceous flowering plant, originally an indigenous plant in Eastern Asia, which later spread globally due to widespread agricultural practices. Cannabis was used medicinally until the early twentieth century, but subsequently prohibited due to the psychoactive effects. Aims To explore the medical cannabis-related level of knowledge of physicians at King Abdulaziz Medical City, including patient needs, perceptions of therapeutic effects, potential harm, and the willingness to prescribe if legalized in future. Methodology The study was a cross-sectional questionnaire-based survey. It was conducted at King Abdulaziz Medical City in Riyadh from February 2020 to February 2021. All physicians from the different specialties, who consented to participate, were included in this study. Statistical Analysis Descriptive statistics are presented as mean and standard deviation and proportions. An ANOVA test was applied to measure the association of the beliefs regarding the right to prescribe with overall knowledge. All tests were considered significant at P < 0.05. Results A total of 249 physicians participated with the majority (70%) male. The sample was similar regardless of the physician's position in the medical hierarchy, with a mean work experience of 8 years. Almost half of the participants indicated that they do not have good knowledge regarding the effects of MC products and more than half that they are unaware of the different MC products and formulations currently available. Conclusion The majority of the sample lacked knowledge about the medicinal use of cannabis for specific indications and felt uncomfortable to discuss the medicinal use of cannabis with their patients.
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Affiliation(s)
- Fares F Alharbi
- Department of Mental Health, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Taif M Alqahtani
- Department of Family Medicine, Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
- Bachelor of Medicine and Bachelor of Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Address for correspondence: Dr. Taif M Alqahtani, Department of Family Medicine, Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia. E-mail:
| | - Alaa M Alzamil
- Bachelor of Medicine and Bachelor of Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nouf H Alharbi
- Bachelor of Medicine and Bachelor of Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nazish Masud
- Member of Research Unit, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Interventions Addressing Cannabis Use During Pregnancy: A Systematic Review. J Addict Med 2023; 17:47-53. [PMID: 36731108 DOI: 10.1097/adm.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The prevalence of cannabis use among pregnant women is increasing in the United States and places mothers and infants at risk of multiple adverse health outcomes. Given the uncertainty expressed by providers regarding how to approach cannabis use during pregnancy and the growing need for a systematic endeavor to curb use in this population, the aim of this study is to conduct a systematic review of interventions focused on reduction in cannabis use during pregnancy. METHODS We conducted a systematic search of MEDLINE, PsycINFO, CINAHL, Web of Science, SCOPUS, and Cochrane Library to identify studies of interventions that target individuals that engaged in cannabis use during pregnancy. We included studies if they were randomized controlled trials, controlled studies, feasibility studies, pilot studies, as well as observational studies. The primary diagnostic outcome of interest is reduction in cannabis use. RESULTS We identified 9 studies for inclusion with sample sizes ranging from 15 to 658 pregnant people. Interventions involved brief counseling, cognitive behavioral therapy (CBT), motivational interviewing (MI), motivational enhancement therapy + cognitive behavioral therapy (MET-CBT), computer-delivered psychotherapy, and psychoeducation. The interventions that were effective primarily used MI, CBT, and/or MET. There was just 1 study that implemented a home intervention and one that explored computer-based psychotherapy. CONCLUSIONS The studies uncovered through this systematic review suggest that interventions involving CBT and/or MI demonstrate promise for decreasing cannabis use during pregnancy. There is a tremendous need for high-quality studies focused on this population, and the potential for remote and computer-based interventions should be explored more fully.
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Panday J, Taneja S, Popoola A, Pack R, Greyson D, McDonald SD, Black M, Murray-Davis B, Darling E, Vanstone M. Clinician responses to cannabis use during pregnancy and lactation: a systematic review and integrative mixed-methods research synthesis. Fam Pract 2022; 39:504-514. [PMID: 34791187 PMCID: PMC9155166 DOI: 10.1093/fampra/cmab146] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Perinatal cannabis use is increasing, and clinician counselling is an important aspect of reducing the potential harm of cannabis use during pregnancy and lactation. To understand current counselling practices, we conducted a systematic review and integrative mixed-methods synthesis to determine "how do perinatal clinicians respond to pregnant and lactating patients who use cannabis?" METHODS We searched 6 databases up until 2021-05-31. Eligible studies described the attitudes, perceptions, or beliefs of perinatal clinician about cannabis use during pregnancy or lactation. Eligible clinicians were those whose practice particularly focusses on pregnant and postpartum patients. The search was not limited by study design, geography, or year. We used a convergent integrative analysis method to extract relevant findings for inductive analysis. RESULTS Thirteen studies were included; describing perspectives of 1,366 clinicians in 4 countries. We found no unified approach to screening and counselling. Clinicians often cited insufficient evidence around the effects of perinatal cannabis use and lacked confidence in counselling about use. At times, this meant clinicians did not address cannabis use with patients. Most counselled for cessation and there was little recognition of the varied reasons that patients might use cannabis, and an over-reliance on counselling focussed on the legal implications of use. CONCLUSION Current approaches to responding to cannabis use might result in inadequate counselling. Counselling may be improved through increased education and training, which would facilitate conversations to mitigate the potential harm of perinatal cannabis use while recognizing the benefits patients perceive.
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Affiliation(s)
- Janelle Panday
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Shipra Taneja
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Anuoluwa Popoola
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Rachael Pack
- Center for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Devon Greyson
- Department of Communication, University of Massachusetts Amherst, Amherst, United States.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,Department of Radiology, McMaster University, Hamilton, Canada
| | - Morgan Black
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Beth Murray-Davis
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Canada
| | - Elizabeth Darling
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Canada
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Abstract
With the legalization of both medical and recreational use of marijuana in some U.S. states, nurses and other clinicians should be prepared to care for pregnant women who have used marijuana during pregnancy. This column describes the prevalence of cannabis use among women, the effect cannabis has on the body and the potential maternal, fetal and neonatal effects of marijuana use during pregnancy.
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Cannabis and Amphetamine-type Stimulant-induced Psychoses: A Systematic Overview. ADDICTIVE DISORDERS & THEIR TREATMENT 2016. [DOI: 10.1097/adt.0000000000000086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Benevenuto SG, Domenico MD, Martins MAG, Costa NS, de Souza ARL, Costa JL, Tavares MFM, Dolhnikoff M, Veras MM. Recreational use of marijuana during pregnancy and negative gestational and fetal outcomes: An experimental study in mice. Toxicology 2016; 376:94-101. [PMID: 27234314 DOI: 10.1016/j.tox.2016.05.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/01/2016] [Accepted: 05/24/2016] [Indexed: 01/16/2023]
Abstract
The prevalence of marijuana use among pregnant women is high. However, the effects on gestation and fetal development are not well known. Epidemiological and experimental studies present conflicting results because of the route of administration, dose, time of exposure, species used, and how Cannabis toxicity is tested (prepared extracts, specific components, or by pyrolysis). In this study, we experimentally investigated the effects of maternal inhalation of Cannabis sativa smoke representing as nearly as possible real world conditions of human marijuana use. Pregnant mice (n=20) were exposed (nose-only) daily for 5min to marijuana smoke (0.2g of Cannabis) from gestational day (GD) 5.5 to GD17.5 or filtered air. Food intake and maternal weight gain were recorded. Ultrasound biomicroscopy was performed on 10.5 and 16.5dpc.On GD18.5, half of the dams were euthanized for the evaluation of term fetus, placenta, and resorptions. Gestation length, parturition, and neonatal outcomes were evaluated in the other half. Five minutes of daily (low dose) exposure during pregnancy resulted in reduced birthweight, and litter size was not altered; however, the number of male pups per litter was higher. Besides, placental wet weight was increased and fetal to placental weight ratio was decreased in male fetuses, showing a sex-specific effect. At the end of gestation, females from the Cannabis group presented reduced maternal net body weight gain, despite a slight increase in their daily food intake compared to the control group. In conclusion, our results indicate that smoking marijuana during pregnancy even at low doses can be embryotoxic and fetotoxic.
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Affiliation(s)
- Sarah G Benevenuto
- Department of Surgery, Sector of Anatomy, Faculty of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, Brazil
| | - Marlise D Domenico
- Department of Pathology, Laboratory of Experimental Air Pollution, School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Marco Antônio G Martins
- Department of Pathology, Laboratory of Experimental Air Pollution, School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Natália S Costa
- Department of Pathology, Laboratory of Experimental Air Pollution, School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | | | - Jose L Costa
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | | | - Marisa Dolhnikoff
- Department of Pathology, Laboratory of Experimental Air Pollution, School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | - Mariana Matera Veras
- Department of Pathology, Laboratory of Experimental Air Pollution, School of Medicine, University of Sao Paulo, São Paulo, Brazil.
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