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Elliott C, Ventresca M, Truman E. The “risk object” of cannabis edibles: perspectives from young adults in Canada. HEALTH, RISK & SOCIETY 2023. [DOI: 10.1080/13698575.2023.2198558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Affiliation(s)
- Charlene Elliott
- Department of Communication, Media & Film, University of Calgary, Calgary, Canada
| | - Matt Ventresca
- Department of Communication, Media & Film, University of Calgary, Calgary, Canada
| | - Emily Truman
- Department of Communication, Media & Film, University of Calgary, Calgary, Canada
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Fischer B, Hall W, Fidalgo TM, Hoch E, Foll BL, Medina-Mora ME, Reimer J, Tibbo PG, Jutras-Aswad D. Recommendations for Reducing the Risk of Cannabis Use-Related Adverse Psychosis Outcomes: A Public Mental Health-Oriented Evidence Review. J Dual Diagn 2023; 19:71-96. [PMID: 37450645 DOI: 10.1080/15504263.2023.2226588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Objective: Cannabis use is increasingly normalized; psychosis is a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for psychosis outcomes at different stages toward recommendations for risk reduction by individuals involved in cannabis use. Methods: We searched primary databases for pertinent literature/data 2016 onward, principally relying on reviews and high-quality studies which were narratively summarized and quality-graded; recommendations were developed by international expert consensus. Results: Genetic risks, and mental health/substance use problem histories elevate the risks for cannabis-related psychosis. Early age-of-use-onset, frequency-of-use, product composition (i.e., THC potency), use mode and other substance co-use all influence psychosis risks; the protective effects of CBD are uncertain. Continuous cannabis use may adversely affect psychosis-related treatment and medication effects. Risk factor combinations further amplify the odds of adverse psychosis outcomes. Conclusions: Reductions in the identified cannabis-related risks factors-short of abstinence-may decrease risks of related adverse psychosis outcomes, and thereby protect cannabis users' health.
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Affiliation(s)
- Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Research and Graduate Studies Division, University of the Fraser Valley, Abbotsford, Canada
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Wayne Hall
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Australia
| | - Thiago M Fidalgo
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Eva Hoch
- Department of Psychiatry, Ludwig-Maximilian-University, Munich, Germany
- Institut für Therapieforschung (IFT), Munich, Germany
| | - Bernard Le Foll
- Translational Addiction Research Laboratory and Campbell Family Mental Health Research Institute and Acute Care Program, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology and Dalla Lana School of Public Health and Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Canada
| | - Maria-Elena Medina-Mora
- Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
- Department of Psychiatry and Mental Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Jens Reimer
- Departments of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
- Center for Psychosocial Medicine, Academic Teaching Hospital Itzehoe, Itzehoe, Germany
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Nova Scotia Health, Halifax, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Édouard Montpetit Boulevard, Montreal, Canada
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Myran DT, Tanuseputro P, Auger N, Konikoff L, Talarico R, Finkelstein Y. Pediatric Hospitalizations for Unintentional Cannabis Poisonings and All-Cause Poisonings Associated With Edible Cannabis Product Legalization and Sales in Canada. JAMA HEALTH FORUM 2023; 4:e225041. [PMID: 36637814 PMCID: PMC9857209 DOI: 10.1001/jamahealthforum.2022.5041] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Importance Canada legalized cannabis in October 2018 but initially prohibited the sale of edibles (eg, prepackaged candies). Starting in January 2020, some provinces permitted the sale of commercial cannabis edibles. The association of legalizing cannabis edibles with unintentional pediatric poisonings is uncertain. Objective To evaluate changes in proportions of all-cause hospitalizations for poisoning due to cannabis in children during 3 legalization policy periods in Canada's 4 most populous provinces (including 3.4 million children aged 0-9 years). Design, Setting, and Participants This repeated cross-sectional study included all hospitalizations in children aged 0 to 9 years in Ontario, Alberta, British Columbia, and Quebec between January 1, 2015, and September 30, 2021. Exposures Prelegalization (January 2015 to September 2018); period 1, in which dried flower only was legalized in all provinces (October 2018 to December 2019); and period 2, in which edibles were legalized in 3 provinces (exposed provinces) and restricted in 1 province (control province) (January 2020 to September 2021). Main Outcomes and Measures The primary outcome was the proportion of hospitalizations due to cannabis poisoning out of all-cause poisoning hospitalizations. Data analysis was performed using descriptive statistics and Poisson regression models. Results During the 7-year study period, there were 581 pediatric hospitalizations for cannabis poisoning (313 [53.9%] boys; 268 [46.1%] girls; mean [SD] age, 3.6 [2.5] years) and 4406 hospitalizations for all-cause poisonings. Of all-cause poisoning hospitalizations, the rate per 1000 due to cannabis poisoning before legalization was 57.42 in the exposed provinces and 38.50 in the control province. During period 1, the rate per 1000 poisoning hospitalizations increased to 149.71 in the exposed provinces (incidence rate ratio [IRR], 2.55; 95% CI, 1.88-3.46) and to 117.52 in the control province (IRR, 3.05; 95% CI, 1.82-5.11). During period 2, the rate per 1000 poisoning hospitalizations due to cannabis more than doubled to 318.04 in the exposed provinces (IRR, 2.16; 95% CI, 1.68-2.80) but remained similar at 137.93 in the control province (IRR, 1.18; 95% CI, 0.71-1.97). Conclusions and Relevance This cross-sectional study found that following cannabis legalization, provinces that permitted edible cannabis sales experienced much larger increases in hospitalizations for unintentional pediatric poisonings than the province that prohibited cannabis edibles. In provinces with legal edibles, approximately one-third of pediatric hospitalizations for poisonings were due to cannabis. These findings suggest that restricting the sale of legal commercial edibles may be key to preventing pediatric poisonings after recreational cannabis legalization.
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Affiliation(s)
- Daniel T. Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada,ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada,ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada,Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Nathalie Auger
- University of Montreal Hospital Centre, Montreal, Quebec, Canada,Institut national de santé publique du Quebec, Montreal, Quebec, Canada,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Lauren Konikoff
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Robert Talarico
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada,ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Yaron Finkelstein
- Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, Ontario, Canada,Departments of Paediatrics and Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
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Hajjar ER, Lungen JM, Worster BK. Therapeutic Benefits of Medical Cannabis. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Krüger M, van Eeden T, Beswa D. Cannabis sativa Cannabinoids as Functional Ingredients in Snack Foods-Historical and Developmental Aspects. PLANTS (BASEL, SWITZERLAND) 2022; 11:plants11233330. [PMID: 36501366 PMCID: PMC9739163 DOI: 10.3390/plants11233330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 05/10/2023]
Abstract
The published health benefits of Cannabis sativa has caught the attention of health-conscious consumers and the food industry. Historically, seeds have long been utilized as a food source and currently there is an increasing number of edibles on the market that contain cannabis. Cannabinoids include the psychoactive constituent, delta-9-tetrahydrocannabinol (THC), and the non-psychoactive cannabidiol (CBD) that are both compounds of interest in Cannabis sativa. This paper looks at the distribution of nutrients and phytocannabinoids in low-THC Cannabis sativa, the historical uses of hemp, cannabis edibles, and the possible side-effects and concerns related to cannabis edibles. Several authors have pointed out that even though the use of cannabis edibles is considered safe, it is important to mention their possible side-effects and any concerns related to its consumption that negatively influence consumer acceptance of cannabis edibles. Such risks include unintentional overdose by adults and accidental ingestion by children and adolescents resulting in serious adverse effects. Therefore, cannabis edibles should be specifically packaged and labelled to differentiate them from known similar non-cannabis edibles so that, together with tamperproof packaging, these measures reduce the appeal of these products to children.
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Affiliation(s)
- Marlize Krüger
- Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, University of South Africa, 28 Pioneer Ave, Florida Park, Roodepoort 1709, South Africa
| | - Tertia van Eeden
- Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, University of South Africa, 28 Pioneer Ave, Florida Park, Roodepoort 1709, South Africa
| | - Daniso Beswa
- Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, University of South Africa, 28 Pioneer Ave, Florida Park, Roodepoort 1709, South Africa
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, 25 Louisa St, Doornfontein, Johannesburg 2028, South Africa
- Correspondence: ; Tel.: +27-11559-6000
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Myran DT, Tanuseputro P, Auger N, Konikoff L, Talarico R, Finkelstein Y. Edible Cannabis Legalization and Unintentional Poisonings in Children. N Engl J Med 2022; 387:757-759. [PMID: 36001718 DOI: 10.1056/nejmc2207661] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Nathalie Auger
- University of Montreal Hospital Centre, Montreal, QC, Canada
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Abstract
PURPOSE OF REVIEW In recent years, an increasing number of states have legalized marijuana, also known as cannabis, for recreational use. As marijuana becomes more accessible, adolescent use and accidental pediatric exposures are likely to become broad public health concerns. Edible marijuana products, which are consumable foods or beverages that contain cannabis extract, are particularly enticing to youth, as they come in appealing forms such as candies, cookies, and drinks. The purpose of this review is to provide pediatricians with an overview of the different types and potential dangers associated with edible marijuana products. RECENT FINDINGS Edible marijuana products are often indistinguishable in appearance from normal food items and lack the smell and visible smoke associated with inhaled marijuana. Because they are inconspicuous, palatable, and easily accessible, they are increasingly popular among adolescents. Additionally, the packaging of edible baked goods, candies, and drinks is often purposefully very similar to that of mainstream foods, increasing the risk of accidental ingestion by children. An edible marijuana product must be digested before Δ9-tetrahydrocannabinol can enter the bloodstream, so there is a delayed onset of effects when consuming edibles compared with inhaling marijuana. This also predisposes users to accidental overconsumption. SUMMARY Greater knowledge of edible marijuana product consumption by pediatric populations will allow pediatricians to more effectively help patients and advise caregivers in cases of overconsumption, dependence, or accidental ingestion. It is important for parents, guardians, and educators to be able to successfully identify edible marijuana products and recognize signs of cannabis use.
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Ventresca M, Elliott C. Cannabis edibles packaging: Communicative objects in a growing market. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103645. [PMID: 35276401 DOI: 10.1016/j.drugpo.2022.103645] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Cannabis edibles were legalized for recreational use across Canada in October 2019. The Canadian Cannabis Act requires legally produced edibles to be sold in plain single-color packages with limited branded elements and prominent health warning labels, serving size and nutritional information, and product ingredients including amounts of cannabis compounds. Little research, however, assesses what consumers think of standardized packaging, and how product packaging influences perceptions of cannabis edibles. METHODS Eight focus groups with young adults (ages 18-24; n = 57) were conducted in November 2018. Participants were recruited from a Canadian university, and asked to assess sample images of cannabis packaging approved by Health Canada. They then discussed the information they would like to see on packages. Focus group discussions were transcribed and analyzed using a descriptive, qualitative approach following methods of process evaluation and inductive coding. RESULTS Discussions generally pertained to four main themes: dosage and consumption recommendations; food and nutritional information; concerns for children; and health warning labels. Participants suggested improvements for cannabis packaging, including standardized THC units, non-numerical consumption instructions, and unit-dose packaging. Instead of recommending packaging that deters consumption, participants requested packaging features that promote safe consumption by adults while also protecting children. Findings reveal how packages function as communicative objects that convey meanings about safety and risk, yet these meanings may not resonate with Canadian young adults' perceptions of cannabis as relatively safe. CONCLUSIONS While the packaging regulated for use in Canada may be assumed, due to its plain, standardized format, to communicate "little", we highlight tensions in the meanings of such packaging to young adults-especially around competing ideas related to safety and risk.
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Affiliation(s)
- Matt Ventresca
- Department of Communication, Media, and Film, University of Calgary, Canada
| | - Charlene Elliott
- Department of Communication, Media, and Film, University of Calgary, Canada.
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Myran DT, Cantor N, Finkelstein Y, Pugliese M, Guttmann A, Jesseman R, Tanuseputro P. Unintentional Pediatric Cannabis Exposures After Legalization of Recreational Cannabis in Canada. JAMA Netw Open 2022; 5:e2142521. [PMID: 34994796 PMCID: PMC8742190 DOI: 10.1001/jamanetworkopen.2021.42521] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional study examines changes in emergency department visits and hospitalizations due to cannabis exposures among children after legalization of recreational cannabis in Canada.
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Affiliation(s)
- Daniel T. Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Nathan Cantor
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Yaron Finkelstein
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Michael Pugliese
- ICES (formerly the Institute for Clinical Evaluative Sciences), Ontario, Canada
| | - Astrid Guttmann
- ICES (formerly the Institute for Clinical Evaluative Sciences), Ontario, Canada
| | - Rebecca Jesseman
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Zuckermann AM, Gohari MR, Romano I, Leatherdale ST. Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study. Addict Behav 2021; 122:107025. [PMID: 34175660 DOI: 10.1016/j.addbeh.2021.107025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 05/24/2021] [Accepted: 06/18/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and eating or drinking. Existing evidence suggests that these behaviours may change after law liberalization, though data regarding youth are scarce. We investigated changes in cannabis modes of use and associated factors across the federal legalization of recreational cannabis use for adults in Canada, among a large sample of underage youth before alternative products were made legally available. METHODS Data were available from 2953 longitudinally linked Canadian high school students who reported on their cannabis use during the 2017/2018 and 2018/2019 school years. We explored whether students maintained a single or multiple cannabis use mode(s), contracted, or expanded the number of modes used. We then used generalized estimating equations to analyse associations of baseline characteristics with use mode trajectory. RESULTS Expansion of cannabis use modes (42.3%) was more common than maintenance of a single mode (31.3%), maintenance of multiple modes (14.3%), or reduction (12.1%). Students who maintained multiple modes were significantly more likely to have high amounts of weekly spending money (AOR 1.68), to binge drink (AOR 2.25) or vape (AOR 1.99), to use cannabis regularly (AOR 2.67), and to endorse more symptoms of depression (AOR 1.06). School support for quitting tobacco, drug, or alcohol use appeared to have no effect. CONCLUSIONS Multi-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.
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Ladha KS, Mistry N, Wijeysundera DN, Clarke H, Verma S, Hare GMT, Mazer CD. Recent cannabis use and myocardial infarction in young adults: a cross-sectional study. CMAJ 2021; 193:E1377-E1384. [PMID: 34493564 PMCID: PMC8443297 DOI: 10.1503/cmaj.202392] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cannabis use is increasing among young adults, but its effects on cardiovascular health are poorly understood. We aimed to assess the association between recent cannabis use and history of myocardial infarction (MI) in young adults (aged 18-44 yr). METHODS We performed a cross-sectional study using pooled data from the 2017 and 2018 cohorts of the American Behavioral Risk Factor Surveillance System survey of US adults. We analyzed the association between any recent cannabis use and history of MI using a weighted logistic regression model that adjusted for demographic factors, socioeconomic factors, health-related behaviours, concomitant substance use and other comorbidities. We also assessed this association after stratifying by frequency of use and by primary method of consumption. RESULTS Among 33 173 young adults (18.5 million weighted), 4610 respondents (3.2 million weighted) reported recent cannabis use (17.5%, 95% confidence interval [CI] 16.8%-18.2%). A history of MI was more frequent among recent cannabis users (n = 61 of 4610, 1.3%) relative to nonusers (n = 240 of 28 563 [0.8%], adjusted odds ratio [OR] 2.07, 95% CI 1.12-3.82). A history of MI was associated with cannabis use of more than 4 times per month (adjusted OR 2.31, 95% CI 1.18-4.50), and with smoking as a primary method of consumption (adjusted OR 2.01, 95% CI 1.02-3.98). INTERPRETATION Our study provides evidence supporting an association between recent cannabis use and history of MI in young adults. Increasing cannabis use in an at-risk population could have negative implications for cardiovascular health.
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Affiliation(s)
- Karim S Ladha
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Nikhil Mistry
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Duminda N Wijeysundera
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Hance Clarke
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Subodh Verma
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Gregory M T Hare
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - C David Mazer
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont.
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Windle SB, Sequeira C, Filion KB, Thombs BD, Reynier P, Grad R, Ells C, Eisenberg MJ. Conduite avec facultés affaiblies après la légalisation du cannabis à usage récréatif. CMAJ 2021; 193:E1071-E1075. [PMID: 34253556 PMCID: PMC8342014 DOI: 10.1503/cmaj.191032-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sarah B Windle
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Crystal Sequeira
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Kristian B Filion
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Brett D Thombs
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Pauline Reynier
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Roland Grad
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Carolyn Ells
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc
| | - Mark J Eisenberg
- Institut Lady Davis (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Hôpital général juif; Département d'épidémiologie, de biostatistique et de santé du travail (Windle, Filion, Thombs, Eisenberg), Université McGill; Faculté de médecine (Filion, Thombs, Eisenberg), Université McGill; Départements de psychiatrie, de psychologie et de psychologie de l'enseignement et du counseling (Thombs), Université McGill; Département de médecine familiale (Grad, Ells), Université McGill; Unité d'éthique biomédicale, Division de médecine expérimentale et Département des sciences sociales en médecine (Ells), Université McGill; Département de cardiologie (Eisenberg), Hôpital général juif, Montréal, Qc.
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13
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Aleixandre-Benavent R, Agulló-Calatayud V, Alonso-Arroyo A, Bueno-Cañigral FJ, Castelló-Cogollos L, Lucas-Domínguez R, Melero-Fuentes D, Sixto-Costoya A, Vidal-Infer A, Valderrama-Zurián JC. Investigación española en las áreas de adicciones y de trastornos de la alimentación: análisis de la producción, colaboración e impacto científico (1962-2017). REVISTA ESPANOLA DE DOCUMENTACION CIENTIFICA 2021. [DOI: 10.3989/redc.2021.3.1766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Las adicciones y los trastornos de la alimentación constituyen uno de los principales problemas de salud en la sociedad contemporánea al que se destinan gran cantidad de recursos destinados a la investigación para su prevención y tratamiento. Objetivos. Analizar la investigación española en el área de adicciones y trastornos de la alimentación desde que se publicó el primer trabajo recogido en bases de datos bibliográficas y desde una perspectiva bibliométrica. Metodología. Para obtener la información necesaria se consultaron las bases de datos Web of Science, Scopus y bases de datos del CSIC. Se elaboró un perfil de búsqueda específico. Se obtuvieron indicadores bibliométricos de producción, colaboración e impacto científico. Se utilizó el análisis de redes sociales para identificar las redes de investigadores y sus relaciones de colaboración, así como la red de co-palabras clave. Resultados. La producción científica aumentó progresivamente durante los casi 50 años analizados. Los trabajos se publicaron en una gran variedad de revistas nacionales y extranjeras, entre las que destacaron Adicciones, Revista Española de Drogodependencias, Trastornos Adictivos y Salud y Drogas. Conclusiones. La producción, colaboración e impacto de la investigación ha sido creciente y las adicciones más estudiadas fueron el tabaquismo, alcoholismo, consumo de cocaína y consumo de anfetaminas.
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14
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Ventresca M, Truman E, Elliott C. Assessing public health messaging about cannabis edibles: perspectives from canadian young adults. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1937943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Matt Ventresca
- Department of Communication, Media, and Film, University of Calgary, Calgary, Canada
| | - Emily Truman
- Department of Communication, Media, and Film, University of Calgary, Calgary, Canada
| | - Charlene Elliott
- Department of Communication, Media, and Film, University of Calgary, Calgary, Canada
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15
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Windle SB, Sequeira C, Filion KB, Thombs BD, Reynier P, Grad R, Ells C, Eisenberg MJ. Impaired driving and legalization of recreational cannabis. CMAJ 2021; 193:E481-E485. [PMID: 33824147 PMCID: PMC8049641 DOI: 10.1503/cmaj.191032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sarah B Windle
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Crystal Sequeira
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Kristian B Filion
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Brett D Thombs
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Pauline Reynier
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Roland Grad
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Carolyn Ells
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que
| | - Mark J Eisenberg
- Lady Davis Institute (Windle, Sequeira, Filion, Thombs, Reynier, Grad, Ells, Eisenberg), Jewish General Hospital; Department of Epidemiology, Biostatistics and Occupational Health (Windle, Filion, Thombs, Eisenberg), McGill University; Department of Medicine (Filion, Thombs, Eisenberg), McGill University; Departments of Psychiatry, of Psychology, and of Educational and Counselling Psychology (Thombs), McGill University; Department of Family Medicine (Grad, Ells), McGill University; Biomedical Ethics Unit, Division of Experimental Medicine, and Department of Social Sciences of Medicine (Ells), McGill University; Division of Cardiology (Eisenberg), Jewish General Hospital, Montréal, Que.
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Choi NG, DiNitto DM, Marti CN, Baker SD. Sex differences in cannabis forms and exposure reasons in cannabis-related poison control center cases aged 50. Clin Toxicol (Phila) 2021; 59:822-831. [PMID: 33475427 DOI: 10.1080/15563650.2020.1869756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONTEXT/OBJECTIVES A significant proportion of individuals aged 50+ in the U.S. use cannabis for medical or recreational purposes, sometimes with adverse effects. Given differences in cannabis use among men and women, we examined sex differences in (1) cannabis forms used, (2) exposure reasons, and (3) medical outcomes in older-adult poison control center (PCC) cases. METHODS Data came from the American Association of Poison Control Centers' National Poison Data System, 2009-2019. We focused on the 3633 cases aged 50+ in which plant and other non-synthetic cannabinoid cannabis forms were the only or primary substance. Logistic regression was used to examine associations of sex with cannabis forms. Multinomial logistic regression models were fit to examine associations of sex with exposure reasons (therapeutic errors/adverse reactions, intentional misuse/abuse, other) and medical outcomes (no-to-minimal, moderate, or major effects). RESULTS Females constituted 57.4% of cases. In multivariable analyses, female cases had 1.20 (95% CI = 1.01-1.43) greater odds of involving cannabis forms other than plant forms and 1.93 greater odds (95% CI = 1.66-2.24) of therapeutic errors/adverse effects compared to intentional misuse/abuse. Older age and occurrence in recreational-cannabis-legal states were positively associated with other cannabis forms. Older age, recreational and/or medical cannabis-legal states, CBD, pharmaceuticals, concentrated extracts, and chronic exposure were associated with higher odds of therapeutic errors/adverse effects. Sex was not significantly associated with medical outcomes. CONCLUSIONS Female cases compose a large share of PCC cases aged 50+ and are associated with higher odds of involving cannabis forms other than plants and therapeutic errors/adverse reactions compared to intentional misuse/abuse.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Diana M DiNitto
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - C Nathan Marti
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Parihar V, Katz L, Siyam MA, Rogers A, Patterson L, Zacharias R. Mandatory pharmacist-led education session for patients seeking medical cannabis. Pharm Pract (Granada) 2020; 18:2088. [PMID: 33343771 PMCID: PMC7732211 DOI: 10.18549/pharmpract.2020.4.2088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/15/2020] [Indexed: 11/21/2022] Open
Abstract
Objective: The primary objectives of this pre-post session study, was to evaluate the impact of a pharmacist-led education session on the perceived benefits and safety of cannabis among patients with chronic pain, as well as determine the influence of pharmacist education on the selection of safer cannabis products and dosage forms for medical use among patients. Methods: A retrospective analysis of completed pre-post session questionnaires was conducted among chronic pain patients attending a mandatory education session led by a pharmacist, prior to being authorized cannabis in clinic. All questionnaire data was analyzed using SPSS v. 25. Demographic and sample characteristics were reviewed using univariate analyses. Chi-Square tests were employed to determine if the group-based education significantly affected knowledge, perception of efficacy and safety of cannabis. Results: Of the 260 session participants, 203 completed pre-post session questionnaires. After the session, a majority of current cannabis users (33.8%) and cannabis naïve/past users (56.9%) reported they would use a low THC product in the future, and a majority of current users (54.5%) would use a high CBD product in the future. After education, participants were more likely to report cannabis as having the potential for addiction (chi-square =42.6, p <0.0001) and harm (chi-square =34.0, p <0.0001). Conclusions: Pharmacist counselling and education has the potential to influence patient selection and use of cannabis, from more harmful to safer products, as well as moderate the potential perceived benefits of use.
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Affiliation(s)
- Vikas Parihar
- BSc(Pharm), PharmD. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & Department of Anesthesia, McMaster University. Hamilton, ON (Canada).
| | - Laura Katz
- PhD, CPsych. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & Department of Psychology, Neuroscience and Behavior, McMaster University. Hamilton, ON (Canada).
| | - Mahmoud A Siyam
- BSc. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & School of Pharmacy, University of Waterloo. Waterloo, ON (Canada).
| | - Anna Rogers
- BSc(Pharm). Michael G. DeGroote Pain Clinic, Hamilton Health Sciences. Hamilton, ON (Canada).
| | - Lisa Patterson
- BA. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences. Hamilton, ON (Canada).
| | - Ramesh Zacharias
- MD, FRSC, DAAPM, CMD. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & Department of Anesthesia, McMaster University. Hamilton, ON (Canada).
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