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Dogra R, Dogra V, Badyal H, Avasthi S. Hot Dab Associated Pneumonitis - a case report. BMC Pulm Med 2024; 24:449. [PMID: 39272060 PMCID: PMC11401242 DOI: 10.1186/s12890-024-03255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 08/29/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Dabbing is recently getting popular among young adults. It is a new method of using the most active form of marijuana where large amounts of concentrated tetrahydrocannabinol are inhaled. Tetrahydrocannabinol is associated with a feeling of 'High' which makes the user feel joyous and relaxed. With increasing use of such techniques, dabbing becomes an important differential for evaluation of acute respiratory failure with pneumonitis especially in the adult population. CASE PRESENTATION A Fifty-one years old Caucasian man presented to the hospital with chest pressure and shortness of breath. The patient was noted to be hypoxic, desaturating down to 82-83% on nasal cannula oxygen. Imaging revealed bilateral lung infiltrates. Patient was started on high flow oxygen, broad spectrum antibiotics and intravenous corticosteroids. The patient gradually improved and was able to come off oxygen completely. He was discharged home on prednisone taper. CONCLUSIONS Dabbing is a newer technique which has been gaining popularity for marijuana usage. With the legalization of marijuana, newer techniques are getting popular. Our case report emphasizes the importance of keeping dabbing as a differential when a patient presents with respiratory failure and has concerns for pneumonitis. Patients might not reveal until specifically asked about their practices.
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Affiliation(s)
- Ratika Dogra
- Hospitalist, Internal Medicine, Mercy St Vincent Medical Center, Toledo, Ohio, USA.
- , 2848 Orchard Tree Ln, Toledo, Ohio, USA.
| | - Vallabh Dogra
- Resident, Internal Medicine, Mercy St Vincent Medical Center, Toledo, Ohio, USA
| | - Himani Badyal
- Intern, Internal Medicine, Mercy St Vincent Medical Center, Toledo, Ohio, USA
| | - Salil Avasthi
- Critical Care Medicine, Pulmonology, Mercy St Vincent Medical Center, Toledo, Ohio, USA
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2
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Lamy FR, Meemon N. Exploring Twitter chatter to assess the type and availability of cannabis-related products in Thailand. J Ethn Subst Abuse 2024:1-21. [PMID: 38949657 DOI: 10.1080/15332640.2024.2367253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Cannabis-related tweets were collected between January and April 2022 to estimate the availability and characteristics of cannabis products advertised on Twitter amid the legalization of recreational cannabis in Thailand. The Twitter API was called using the tweepy Python library to collect cannabis-related tweets in the Thai language. A total of 185,558 unique tweets were collected over the duration of the data collection period based on 83 search terms. Twenty thousand random tweets were manually coded by four Thai native speakers to assess the volume and characteristics of tweets proposing cannabis. 72.6% of collected tweets from the 20,000 random samples were coded as relevant to the study. 54.6% of relevant tweets were advertising cannabis products, 29.8% were personal communications, and 15.6% were related to news or media content. Among the tweets that advertised cannabis products, 94.4% proposed cannabis flower, 2.4% cannabis edibles and 1.8% cannabis concentrates. Consumption of potent forms of cannabis such as cannabis edibles and concentrates increase the risk of harmful side-effects, especially in a population with limited knowledge about these products. Our findings call for additional monitoring efforts and for increasing the public awareness on potent cannabis products emerging in Thailand.
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Affiliation(s)
- Francois R Lamy
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
- Health Solutions Research Unit, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
| | - Natthani Meemon
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
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3
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Berberian S, Broussard ML, Tully C, Methuku V, Pardini DA, Meier MH. Young adults' familiarity with different cannabis product terms: the need for standardized cannabis surveys. J Cannabis Res 2022; 4:14. [PMID: 35365236 PMCID: PMC8974070 DOI: 10.1186/s42238-022-00125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cannabis legalization has resulted in the proliferation of cannabis products. Participants’ familiarity with terms for these products may have implications for assessment, as unfamiliarity with particular terms may result in under-reports of use. Methods A convenience sample of 861 college students from one U.S. university completed a survey in the spring of 2020 about their familiarity with a variety of cannabis product terms and use of a variety of cannabis products. Results Participants varied in their familiarity with cannabis product terms. For example, with regard to terms for cannabis concentrates with very high concentrations of THC, 85% of participants reported being familiar with the term “wax pen or THC oil,” but only 27% reported being familiar with the term “butane hash oil (BHO)” (i.e., the oil that composes most concentrates). Moreover, of participants who reported use of concentrates based on selecting pictures of the products they had used (n = 324, 40%), 99% (n = 322) reported having seen a “wax pen or THC oil” based on a written list of product terms, whereas only 20% (n = 65) reported having seen “butane hash oil (BHO).” This suggests that asking about use of “butane hash oil” use may result in lower rates of cannabis concentrate use than asking about use of “wax pen/THC oil.” With regard to terms for marijuana flower, 29% of participants (n = 248) reported being unfamiliar with the term marijuana “buds or flowers.” Of participants who reported use of marijuana flower based on selecting pictures of the products they had used (38% of the sample, n = 329), only 86% (n = 282) reported having seen marijuana “buds or flowers” based on a written list of product terms. This suggests that asking about use of marijuana “buds or flowers” use could result in under-reporting due to lack of familiarity with that term. Finally, when asked to select pictures of the cannabis product(s) that participants thought constituted “marijuana,” participants most commonly selected pictures of marijuana flower (93%), followed by wax pen/THC oil (57%) and edibles (49%). Conclusions Young adults vary in their familiarity with cannabis product terms, and some may under-report cannabis use in surveys that rely on written cannabis product terms. Young adults also differ in terms of which cannabis products they think constitute “marijuana.” Although participants’ familiarity with specific cannabis product terms in this sample may not generalize to other populations, results highlight the need for standardized surveys of cannabis use that incorporate pictures of cannabis products to overcome issues related to variability in familiarity with cannabis product terms. Supplementary Information The online version contains supplementary material available at 10.1186/s42238-022-00125-0.
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Affiliation(s)
- S Berberian
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ, 85287-1104, USA
| | - M L Broussard
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - C Tully
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ, 85287-1104, USA
| | - V Methuku
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ, 85287-1104, USA
| | - D A Pardini
- Department of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ, USA
| | - M H Meier
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ, 85287-1104, USA.
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4
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Beiersdorf J, Hevesi Z, Calvigioni D, Pyszkowski J, Romanov R, Szodorai E, Lubec G, Shirran S, Botting CH, Kasper S, Guy GW, Gray R, Di Marzo V, Harkany T, Keimpema E. Adverse effects of Δ9-tetrahydrocannabinol on neuronal bioenergetics during postnatal development. JCI Insight 2020; 5:135418. [PMID: 33141759 PMCID: PMC7714410 DOI: 10.1172/jci.insight.135418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 10/28/2020] [Indexed: 11/22/2022] Open
Abstract
Ongoing societal changes in views on the medical and recreational roles of cannabis increased the use of concentrated plant extracts with a Δ9-tetrahydrocannabinol (THC) content of more than 90%. Even though prenatal THC exposure is widely considered adverse for neuronal development, equivalent experimental data for young age cohorts are largely lacking. Here, we administered plant-derived THC (1 or 5 mg/kg) to mice daily during P5–P16 and P5–P35 and monitored its effects on hippocampal neuronal survival and specification by high-resolution imaging and iTRAQ proteomics, respectively. We found that THC indiscriminately affects pyramidal cells and both cannabinoid receptor 1+ (CB1R)+ and CB1R– interneurons by P16. THC particularly disrupted the expression of mitochondrial proteins (complexes I–IV), a change that had persisted even 4 months after the end of drug exposure. This was reflected by a THC-induced loss of membrane integrity occluding mitochondrial respiration and could be partially or completely rescued by pH stabilization, antioxidants, bypassed glycolysis, and targeting either mitochondrial soluble adenylyl cyclase or the mitochondrial voltage-dependent anion channel. Overall, THC exposure during infancy induces significant and long-lasting reorganization of neuronal circuits through mechanisms that, in large part, render cellular bioenergetics insufficient to sustain key developmental processes in otherwise healthy neurons. Repeated THC exposure in juvenile mice compromises the limbic circuitry, with life-long impairment to the respiration of neurons.
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Affiliation(s)
- Johannes Beiersdorf
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Zsofia Hevesi
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Daniela Calvigioni
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | | | - Roman Romanov
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Edit Szodorai
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Gert Lubec
- Paracelsus Private Medical University, Salzburg, Austria
| | - Sally Shirran
- School of Chemistry, University of St. Andrews, St. Andrews, United Kingdom
| | | | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Roy Gray
- GW Phamaceuticals, Salisbury, Wiltshire, United Kingdom
| | - Vincenzo Di Marzo
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy.,Canada Excellence Research Chair, Institut Universitaire de Cardiologie et de Pneumologie de Québec and Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, Québec, Canada
| | - Tibor Harkany
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria.,Department of Neuroscience, Biomedikum D7, Karolinska Institutet, Solna, Sweden
| | - Erik Keimpema
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
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5
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D'Amico EJ, Rodriguez A, Dunbar MS, Firth CL, Tucker JS, Seelam R, Pedersen ER, Davis JP. Sources of cannabis among young adults and associations with cannabis-related outcomes. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 86:102971. [PMID: 33038599 DOI: 10.1016/j.drugpo.2020.102971] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/13/2020] [Accepted: 09/12/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The ways in which young people learn about cannabis product availability and where they obtain cannabis products are important to understand for prevention and intervention efforts. METHODS Young adults who reported past month cannabis use (N = 758) completed an online survey in 2018-2019 on how they obtained cannabis and the products they used in a newly legalized market in Los Angeles (mean age 21.6; 44% Hispanic, 27% white, 15% Asian). RESULTS Overall, 59.1% obtained cannabis from recreational cannabis retailers (RCRs), 51.5% from family or friends, 39.1% from medical cannabis dispensaries (MCDs), and 5.5% from strangers or dealers in the past month. Compared to those getting cannabis from family or friends, those getting cannabis from MCDs or RCRs spent more money, used more cannabis products, were more likely to use alone, used greater quantities of bud/flower, and reported more consequences from use. Further, those obtaining cannabis from MCDs were more likely to screen positive for cannabis use disorder (CUD). For type of products, those obtaining cannabis from MCDs or RCRs were more likely to use joints, bongs, pipes, dabs, vape, and consume edibles relative to those obtaining from family or friends. Subgroup differences were found for both source patterns and cannabis-related outcomes. Males and those with a cannabis medical card reported spending more money on cannabis, using more types of products, and indicated more frequent use and greater CUD symptoms and consequences. Compared to Whites, Blacks spent more money on cannabis and used more products, and Hispanics reported using more products and greater quantities of cannabis bud/flower. CONCLUSIONS Findings highlight the different ways that young adults obtain cannabis, and how young adults with a medical cannabis card may be at greater risk for problems compared to young adults who use cannabis recreationally.
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Affiliation(s)
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, 9th Floor, Suite 920, Boston, MA 02116
| | - Michael S Dunbar
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | | | - Joan S Tucker
- RAND Corporation, 1776 Main St., Santa Monica, CA 90407
| | | | - Eric R Pedersen
- RAND Corporation, 1776 Main St., Santa Monica, CA 90407; University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA 90033
| | - Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles CA, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science
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6
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Baltz JW, Le LT. Serotonin Syndrome versus Cannabis Toxicity in the Emergency Department. Clin Pract Cases Emerg Med 2020; 4:171-173. [PMID: 32426664 PMCID: PMC7220016 DOI: 10.5811/cpcem.2020.1.45410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/13/2020] [Accepted: 01/23/2020] [Indexed: 11/21/2022] Open
Abstract
As more states legalize marijuana, the potential of marijuana abuse could lead to an increase in the number of emergency department (ED) visits. We describe two patients who presented to the ED with dilated pupils, rigidity in both lower extremities, and clonus in both feet after inhaling the vapor of a highly potent form of marijuana. Serotonin syndrome diagnosis was initially considered in the differential diagnosis. Ultimately, high-potency marijuana abuse was the final diagnosis. Therefore, marijuana toxicity should be considered in ED patients who present with signs and symptoms similar to that of serotonin syndrome.
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Affiliation(s)
- Jacob W Baltz
- CoxHealth System, Department of Emergency Medicine, Springfield, Missouri
| | - Lamanh T Le
- CoxHealth System, Department of Pharmacy, Springfield, Missouri
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7
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Spindle TR, Bonn-Miller MO, Vandrey R. Changing landscape of cannabis: novel products, formulations, and methods of administration. Curr Opin Psychol 2019; 30:98-102. [PMID: 31071592 PMCID: PMC7041884 DOI: 10.1016/j.copsyc.2019.04.002] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Abstract
Laws regulating cannabis have changed radically in the U.S. and abroad. Historically, users smoked dried cannabis flowers that contained Δ9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis, as the principal product constituent. Coincident with cannabis legalization and increased interest in medicinal use of the plant, there is now an expansive retail cannabis marketplace with novel cannabis products, formulations, and methods of administration. In this review, we describe emergent cannabis product chemotypes (e.g. THC-dominant, CBD-dominant, balanced or 'hybrid' with high concentrations of THC and CBD), product formulations (e.g. edibles, concentrates), and methods of administration (e.g. smoked, vaporized, orally ingested). Psychologists can play a pivotal role in studying the health impact of cannabis legalization and conducting research to inform product regulation.
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Affiliation(s)
- Tory R Spindle
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Marcel O Bonn-Miller
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States
| | - Ryan Vandrey
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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8
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Who's Buying What and How Much? Correlates of Purchase Behaviors From Medical Marijuana Dispensaries in Los Angeles, California. J Prim Prev 2019; 39:571-589. [PMID: 30414021 DOI: 10.1007/s10935-018-0528-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Venue-based distribution of marijuana has become the normative model in the United States to obtain marijuana. This study examines one-time purchase behaviors at medical marijuana dispensaries (MMDs) to identify potential venue- and individual-level targets for prevention. We used a two-stage, venue-based sampling approach to randomly select patrons exiting 16 MMDs in Los Angeles, California during the spring of 2013. Patrons (N = 595) reported their discrete purchase behaviors during their most recent visit to the sampled MMD. We used hierarchical linear modeling to examine the amount spent on marijuana products, regressed on characteristics of the sampled dispensaries and their patrons. We used hierarchical generalized linear modeling to examine the likelihood of purchasing specific types of marijuana products and total grams of loose-leaf buds purchased. Patrons spent US$41.73 on average, with a range of $0-$330. We observed significant variation in purchase behaviors across MMDs and associations between venues located within high median income census tracts and a higher total amount spent and lower odds of purchasing only loose-leaf buds. The networked distance between a patron's home and the sampled MMD was positively associated with the total amount spent and total quantity of buds purchased. We also found significant relationships between medical conditions reported for use in three models: total amount spent, purchase of pre-rolled joints, and total grams of buds purchased. Policy makers may want to explore regulating the availability of specialty items that may be attractive to naïve users, such as pre-rolled joints or edibles, or high-concentration products that may be sought out by regular, heavy users.
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9
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Modeling drug exposure in rodents using e-cigarettes and other electronic nicotine delivery systems. J Neurosci Methods 2019; 330:108458. [PMID: 31614162 DOI: 10.1016/j.jneumeth.2019.108458] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/05/2019] [Accepted: 10/06/2019] [Indexed: 12/25/2022]
Abstract
Smoking tobacco products is the leading cause of preventable death worldwide. Coordinated efforts have successfully reduced tobacco cigarette smoking in the United States; however, electronic cigarettes (e-cigarette) and other electronic nicotine delivery systems (ENDS) recently have replaced traditional cigarettes for many users. While the clinical risks associated with long-term ENDS use remain unclear, advancements in preclinical rodent models will enhance our understanding of their overall health effects. This review examines the peripheral and central effects of ENDS-mediated exposure to nicotine and other drugs of abuse in rodents and evaluates current techniques for implementing ENDS in preclinical research.
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10
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Young SD, Padwa H, Bonar EE. Social Big Data as a Tool for Understanding and Predicting the Impact of Cannabis Legalization. Front Public Health 2019; 7:274. [PMID: 31637226 PMCID: PMC6787761 DOI: 10.3389/fpubh.2019.00274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sean D. Young
- University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, Irvine, CA, United States
- Department of Emergency Medicine, University of California, Irvine, Irvine, CA, United States
| | - Howard Padwa
- Integrated Substance Abuse Program, University of California, Los Angeles, Los Angeles, CA, United States
| | - Erin E. Bonar
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
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11
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Meacham MC, Roh S, Chang JS, Ramo DE. Frequently asked questions about dabbing concentrates in online cannabis community discussion forums. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 74:11-17. [PMID: 31400582 DOI: 10.1016/j.drugpo.2019.07.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND "Dabbing" involves vaporizing a "dab" of cannabis concentrate on a heated "nail," passing the vapour through a water-pipe rig or portable pen device, and inhaling the vapour. While some cannabis industry media claims that this process is cleaner, safer, and more effective for getting high, medical and public health sources raise concerns about residual solvents and pesticides, unexpectedly intense effects, and rapid increases in tolerance. The aim of this study is to characterize the content of questions about dabbing posed in cannabis and dabbing-specific forums on the Reddit social media platform, as well as comment responses to these questions. METHODS We conducted a content analysis of one year (2017) of information-seeking user-generated posts to three Reddit online cannabis community discussion forums ("subreddits") that contained the terms "dab" and "question." We also examined post engagement and the types and sentiment of information exchanged in the comment responses. RESULTS Across 193 dabbing question posts, the most frequently asked question content was about types and logistical use of devices and related equipment (38%) and comparisons of cannabis products (32%), followed by questions about the step-by-step process of getting high (18%), legal issues (17%), and health concerns (13%). Nearly every post had a response (98%), with a median 5 comments per post and few negative (i.e. hostile, condescending, or trolling) comments (4%). Source of advice or information was stated in about a quarter (26%) of comment responses, with the overwhelming majority of this information (89%) coming from disclosures of personal experience vs. web or commercial sources. CONCLUSION People seeking advice online about dabbing inquired most often about logistics of use, but less often about health, tolerance, and legal risks. These findings may be used to inform public health efforts and health practitioner education as cannabis becomes increasingly legal and accessible.
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Affiliation(s)
- Meredith C Meacham
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
| | - Shim Roh
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Jamie Suki Chang
- Public Health Program, Santa Clara University, Santa Clara, CA, USA
| | - Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Hopelab, San Francisco, CA, USA
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12
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Kleckner AS, Kleckner IR, Kamen CS, Tejani MA, Janelsins MC, Morrow GR, Peppone LJ. Opportunities for cannabis in supportive care in cancer. Ther Adv Med Oncol 2019; 11:1758835919866362. [PMID: 31413731 PMCID: PMC6676264 DOI: 10.1177/1758835919866362] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/03/2019] [Indexed: 12/17/2022] Open
Abstract
Cannabis has the potential to modulate some of the most common and debilitating symptoms of cancer and its treatments, including nausea and vomiting, loss of appetite, and pain. However, the dearth of scientific evidence for the effectiveness of cannabis in treating these symptoms in patients with cancer poses a challenge to clinicians in discussing this option with their patients. A review was performed using keywords related to cannabis and important symptoms of cancer and its treatments. Literature was qualitatively reviewed from preclinical models to clinical trials in the fields of cancer, human immunodeficiency virus (HIV), multiple sclerosis, inflammatory bowel disease, post-traumatic stress disorder (PTSD), and others, to prudently inform the use of cannabis in supportive and palliative care in cancer. There is a reasonable amount of evidence to consider cannabis for nausea and vomiting, loss of appetite, and pain as a supplement to first-line treatments. There is promising evidence to treat chemotherapy-induced peripheral neuropathy, gastrointestinal distress, and sleep disorders, but the literature is thus far too limited to recommend cannabis for these symptoms. Scant, yet more controversial, evidence exists in regard to cannabis for cancer- and treatment-related cognitive impairment, anxiety, depression, and fatigue. Adverse effects of cannabis are documented but tend to be mild. Cannabis has multifaceted potential bioactive benefits that appear to outweigh its risks in many situations. Further research is required to elucidate its mechanisms of action and efficacy and to optimize cannabis preparations and doses for specific populations affected by cancer.
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Affiliation(s)
- Amber S Kleckner
- Cancer Control and Survivorship, University of Rochester Medical Center, CU 420658, 265 Crittenden Blvd., Rochester, NY 14642, USA
| | - Ian R Kleckner
- Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA
| | - Charles S Kamen
- Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA
| | - Mohamedtaki A Tejani
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA
| | - Gary R Morrow
- Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA
| | - Luke J Peppone
- Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA
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