ArticleLiterature Review

The adverse health effects of cannabis use: What are they, and what are their implications for policy?

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Abstract

The adverse health effects of cannabis are a source of contention in debates about policies towards the drug. This paper provides a review of epidemiological evidence on the major adverse health effects of cannabis use and considers its implications for policy. The evidence strongly suggests that cannabis can adversely affect some users, especially adolescents who initiate use early and young adults who become regular users. These adverse effects probably include increased risks of: motor vehicle crashes, the development of cannabis dependence, impaired respiratory function, cardiovascular disease, psychotic symptoms, and adverse outcomes of adolescent development, namely, poorer educational outcomes and an increased likelihood of using other illicit drugs. Politically, evidence of adverse health effects favours the status quo in developed countries like Australia where cannabis policy has been framed by the media as a choice between two views: (1) either cannabis use is largely harmless to most users and so we should legalize, or at the very least decriminalize its use; or (2) it harms some of its users so we should continue to prohibit its use.

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... A number of reviews have identified a range of negative health effects associated with cannabis use (Campeny et al., 2020;Hall, 2009Hall, , 2014Hall & Degenhardt, 2006;Hall et al., 2019;Zahra et al., 2020). These include effects on the respiratory system, cardiovascular system, cognitive function, psychomotor impairment, risk of cancer, inutero effects from maternal use and sleep. ...
... Memory, executive functioning and learning are all impacted by cannabis use (Campeny et al., 2020). Longitudinal research has identified that sustained cannabis use over several decades can produce substantial differences in cognitive performance that may not be wholly reversible which is strongest for those whose onset of use is in adolescence (Hall, 2009). Hall surmised that cannabis users have lower attention and memory than non-cannabis users (Hall, 2014). ...
... Cannabis use can result in acute psychomotor impairment (Hall, 2009(Hall, , 2014, in conjunction with cognitive impairment this can lead to an increase in risk for accidental injury and motor vehicle accidents (Leikin & Paloucek, 2007), indeed acute cannabis intoxication is associated with a two-fold increase in the risk of road traffic accidents (Asbridge et al., 2016;Els et al., 2019;Li et al., 2012). ...
Article
The health effects of cannabis use may not always be seen as a high priority for Aboriginal and Torres Strait Islander communities. However, the impact of cannabis use on physical and mental health can have significant consequences. It is known that the use of high potency cannabis has increased over the last two decades, with a corresponding increased risk to health. In particular, young people are at increased risk of experiencing harms to mental health. Physical harms to health include effects on the respiratory system, cardiovascular system, an increased risk of cancer, and in-utero effects from maternal use. The review notes concern that in countries where there has been commercialisation of cannabis use, there has been an increase in the rate and use of high potency products. While generalising findings about cannabis use for Aboriginal and Torres Strait Islander people is problematic due to limited data, high rates of cannabis use have been found in some remote communities. The review highlights the protective factors that reduce harms from cannabis use and suggests future directions for a collaborative approach to addressing cannabis related harms in communities. This review is part of a suite of knowledge exchange products that includes a summary, a video, and a fact sheet.
... 22 But limited plant compounds have been investigated for therapeutic purposes. Saffaron (Crocus sativus) is among the plants that has experimental autoimmune encephalomyelitis symptoms (experimental model of MS) in mice by inhibiting oxidative stress and leukocyte penetration into the central nervous system and thus has the potential for use in the treatment of MS. 23 Another drug for MS treatment on which many clinical trials have been done so far is Cannnabis that has a positive effect on detrusor over activity, spasticity, trembling and neuropathic pain in patients with MS. [24][25][26] However, it is not a good drug due to the side effects of cannabis, such as addiction, drowsiness, depression, anxiety, and decreased immune function. 26 The grape seed is a natural drug with strong anti-inflammatory and antioxidant effects and also prevents peroxidation in the central nervous system and inhibits harmful free radicals such as hydroxyl and superoxide. ...
... Saffaron (Crocus sativus) is among the plants that has experimental autoimmune encephalomyelitis symptoms (experimental model of MS) in mice by inhibiting oxidative stress and leukocyte penetration into the central nervous system and thus has the potential for use in the treatment of MS. 23 Another drug for MS treatment on which many clinical trials have been done so far is Cannnabis that has a positive effect on detrusor over activity, spasticity, trembling and neuropathic pain in patients with MS. [24][25][26] However, it is not a good drug due to the side effects of cannabis, such as addiction, drowsiness, depression, anxiety, and decreased immune function. 26 The grape seed is a natural drug with strong anti-inflammatory and antioxidant effects and also prevents peroxidation in the central nervous system and inhibits harmful free radicals such as hydroxyl and superoxide. The grape seed has regulatory effects on the catalase, superoxide reductase and peroxidase enzymes. ...
... Within the scope of this new approach, while some of the society benefits from the use of cannabis for recreational use, another part is concerned about the potential increases within the adolescent population, other negative consequences and addiction (13,14). Although the perception of cannabis as a harmless natural product is increasingly becoming more and more visible, the existence of concerns such as the legal spread of cannabis use and the effects of cannabis-related negative consequences on social structuring should not be ignored (15)(16)(17)(18)). ...
... The problems experienced by the person during the withdrawal period are listed as physical symptoms such as irritability, agitation / anxiety, sleep disorders, decreased appetite or weight loss, depressive symptoms, abdominal pain, chills, sweating, fever, cold or headaches (4). In general, cannabis use has been associated with a variety of short-term and long-term undesirable consequences such as addiction, short-term memory, motor coordination, judgment, brain development loss, impairment in brain development, acute paranoia, psychosis, and chronic psychotic disorder (16,17,40). These findings provide data, contrary to the opinion suggesting that cannabis use is not addictive. ...
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Yakın tarihe baktığımızda kannabis gibi psikoaktif etkili maddelerin kullanımı ile ilgili düzenlemelerin belirli dönemlerde sadece bir asayiş sorunu olarak değerlendirilerek, yasal tedbirlerle kontrol edilmek istendiği görülmüştür. Ancak, madde kullanımı ve bağımlılığı sorununun, zamanla sadece bir asayiş sorunu olmadığının farkına varılmasıyla, tedavi ve önleme faaliyetlerine de önem verilmeye başlanmıştır. Son yıllarda ise, tıbbi tedaviyi düzenleyen, yasal çerçeve konusunda çalışan ve olayın psikososyal boyutu ile ilgili kişilerin yasal düzenlemeler ve yeni gelişmeler konusunda hassasiyet ile birlikte çalıştığı görülmektedir. Madde kullanımının artık “halk sağlığı ve toplum güvenliği sorunu” olarak beraber değerlendirilmesi ile birlikte, son dönemlerde özellikle kannabise ilişkin düzenlemeler hızla değiştirilmekte, konu birçok ülkede hala tartışılmaktadır. Bu uygulamaların birey ve toplum bazında halk sağlığı ve toplum güvenliği açısından uzun vadede ortaya çıkacak sonuçlarının öngörülmesinin zor olacağı düşünülmektedir. Bu makale, konuya ilişkin yapılan çalışmaların derlenerek özellikle eğlence amaçlı (rekreasyonel) kannabis kullanımına izin verilmesi durumunda doğabilecek bireysel ve toplumsal sonuçları özetlemek amacıyla yazılmıştır.
... Si bien estos daños son inferiores a los derivados del consumo del alcohol y del tabaco (Seddon y Floodgate, 2020, p. 6;Caulkins et al., 2015, pp. 31-38), su cuantía es significativa: se trata de un producto cuyo consumo, especialmente si se inicia a edad temprana, genera adicción, episodios de ansiedad, aumenta los riesgos de sufrir bronquitis crónica y cáncer; reduce la capacidad inmunológica del sistema respiratorio, y se correlaciona con menores resultados académicos, abuso de otras drogas y diversas enfermedades siquiátricas (Hall, 2009;Hall y Lynskey, 2020). ...
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El artículo examina la estrategia de regulación comercial del cannabis recreativo y su posible aplicación en Chile. Propone que los tributos regulativos constituyen un elemento central para que la estrategia sea efectiva y que, para su adecuado diseño, la dogmática tributaria debe considerar los presupuestos económicos de este tipo de tributación, los conocimientos empíricos que proporcionan diversas disciplinas relacionadas con la materia y, en especial, su incidencia en el mercado ilegal de cannabis.
... It is also used in the relief of non-life-threatening, disabling chronic pain unresolved by conventional analgesics (Burns & !neck, 2006). However, marijuana does not always need to be used for symptomatic relief; with the need for it arising only when legally available medications fail to arrest the individual's pain and suffering, or do not work as effectively in providing symptomatic relief for the individual (Hall, 2009). On the other hand there are those who argue against the legalization of marijuana, even if it is for medical uses. ...
Article
In recent times, marijuana has enjoyed a momentous rise in consumption despite the various campaigns for the abolition or complete eradication of the consumption of illicit drugs in Nigeria. In the bid to restrain or exterminate the consumption, there has been a rise in the application of penal sanctions on the farmers, the sellers and the consumers of marijuana in Nigeria. Employing a discursive analysis of secondary data, this paper, therefore, raises the question of whether the trend in the level of punishment has developed in harmony with popular opinion, something which both antagonists and supporters of penalties of greater severity seem to take for granted.
... It is commonly believed that adolescents are more vulnerable to the adverse health effects of cannabis use than adults (Lorenzetti et al., 2020). Indeed, there is substantial evidence suggesting that cannabis use is correlated with a range of behavioral and physiological problems in adolescents, including impaired cognitive functions, memory deficits, impaired respiratory functions, cardiovascular disease, and poor educational outcomes (Hall, 2009;Lorenzetti et al., 2020;Meier et al., 2012). Although there is debate over whether adolescent cannabis use is a direct cause of negative health outcomes, this available evidence is sufficient to justify concerns surrounding the potential negative consequences of cannabis legalization for the health, safety, and well-being of adolescents. ...
Article
An important public concern about the impact of recreational cannabis legalization is how it may affect adolescent cannabis use. Prior research on this issue has primarily focused on the implications of medical cannabis legalization for adolescents and used data that cover a relatively short post-legalization period. This study extends this line of research by examining the relationship between recreational cannabis legalization and adolescent cannabis use in Washington State, using the National Survey of Drug Use and Health (NSDUH) data from 2005 to 2019. Based on a quasi-experimental research design, this study found some evidence suggesting a positive effect of recreational legalization on the prevalence of adolescent cannabis use and cannabis initiation. Findings suggest the need to create a cannabis regulatory environment that minimizes adolescent access to this drug.
... The plant contains a highly variable mixture of approximately 400 or more chemical constituents (De Aquino et al. 2018). Malaysia has ratified United Nations (UN) drug conventions and banned cannabis as cannabis use can be extremely harmful to users and causes adverse health effects (Hall 2009). ...
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The usage and values of cannabis, or cannabis for medicinal purposes, have been historically recognised since ancient times. Evidence from clinical research demonstrated the therapeutic advantages of cannabis in an extensively wide area of medicinal aspects. Resultantly, many nations have decided to legalise the medicinal use of cannabis. Despite the international recognition of medical cannabis, Malaysia maintains the status quo of cannabis prohibition as a highly addictive drug with no medicinal value. The Malaysian government argues that the harmful effects of medical cannabis legalisation outweigh the benefits. No review paper has discussed the current research patterns on the impact of medical cannabis legalisation, while thematic review studies on this issue are limited. Therefore, this article synthesised literature from 2017 to 2021 to identify research patterns and recent academic discussions on the impact of medical cannabis legalisation. A keyword search and screening process utilising Scopus and Web of Science (WoS) databases inclusion criteria yielded 718 peer-reviewed academic journal articles. Nonetheless, only 72 articles were selected for final evaluation following the exclusion and inclusion process. The thematic review of the 72 publications identified 19 preliminary codes on the impact of medical cannabis legalisation. The ATLAS.ti 9 software was utilised to conduct the theme analysis review of the selected articles. The quantitative results presented the research patterns of the impact of medical cannabis legalisation. Additionally, the qualitative analysis generated five main themes developed in the literature on the impact of medical cannabis legalisation, namely (1) impact on health, (2) impact on policy, (3) impact on society, (4) impact on health system, and (5) impact on criminal activities. The findings will benefit future studies on implementing medical cannabis law (MCL) in Malaysia. Unfortunately, this study is limited to Scopus and WoS databases, and the impact of recreational cannabis legalisation is not included. The findings may benefit future research on medical cannabis legalisation and the suitable regulatory framework of medical cannabis policy for Malaysia. ABSTRAK Penggunaan dan nilai ganja atau ganja bagi tujuan perubatan telah diiktiraf dalam sejarah sejak zaman dahulu. Kajian klinikal membuktikan kelebihan dan manfaat ganja yang luas dalam pelbagai aspek perubatan. Oleh itu, banyak negara telah meluluskan penggunaan ganja dalam perubatan. Walaupun ganja perubatan telah diktiraf di peringkat antarabangsa, Malaysia masih mengekalkan status larangan sebagai ubat dan ganja dianggap sebagai dadah yang menyebabkan ketagihan serta tidak mempunyai nilai perubatan. Kerajaan Malaysia berhujah bahawa kesan bahaya mensahkan ganja perubatan melebihi manfaatnya. Walaupun begitu, berdasarkan pemerhatian masih ada kekurangan kajian yang meninjau secara tematik mengenai impak mensahkan/legalisasi ganja perubatan. Oleh itu, tujuan tinjauan tematik ini mengunakan ATLAS.ti 9 adalah untuk mensintesis literatur daripada tahun 2017 to 2021 untuk mengenal pasti perbincangan akademik terkini tentang kesan menghalalkan/mensahkan ganja perubatan. Pencarian kata kunci, diikuti oleh saringan menggunakan kriteria kemasukan dari pangkalan data Scopus dan Web of Science (Wos), mengenal pasti 718 artikel jurnal. Namun, setelah proses penyaringan, hanya 72 artikel yang digunakan sebagai artikel terakhir yang akan dikaji. Kajian tematik terhadap 72 artikel ini mengenal pasti 19 kod awal yang membincangkan kesan meluluskan/legalisasi ganja perubatan. Penerbitan tersebut dikelompokkan kepada lima tema : (1) impak kepada kesihatan, (2) impact kepada polisi, (3) impak kepada masyarakat, (4) impak kepada sistem kesihatan, dan (5) impak kepada aktiviti jenayah. Hasil kajian ini akan memberi manfaat kepada kajian akan datang mengenai pelaksanaan undang-undang ganja perubatan (MCL) di Malaysia. Walau bagaimanapun, kajian ini terhad kepada pangkalan data Scopus dan WoS. Tambahan pula, kesan pengesahan ganja rekreasi tidak termasuk dalam kajian ini. Penemuan ini mungkin memberi manfaat kepada penyelidikan masa depan mengenai legalisasi ganja perubatan dan rangka kerja kawal selia yang sesuai bagi dasar ganja perubatan untuk Malaysia.
... Beyond changes in cannabis and other substance use and attitudes, health-related impacts of RCL are important to consider as there are links between cannabis use and adverse physical and mental health consequences (eg, respiratory and cardiovascular diseases, psychosis). 23 Additionally, emergency service utilization associated with cannabis consumption is a frequent concern associated with RCL, particularly due to the spikes in admissions following RCL in Colorado. 24 However, the rates of cannabis-related emergency service admissions more globally (eg, in legal countries like Canada and Uruguay) have not been fully integrated into summaries of the current literature. ...
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Background Recreational cannabis legalization has become more prevalent over the past decade, increasing the need to understand its impact on downstream health-related outcomes. Although prior reviews have broadly summarized research on cannabis liberalization policies (including decriminalization and medical legalization), directed efforts are needed to synthesize the more recent research that focuses on recreational cannabis legalization specifically. Thus, the current review summarizes existing studies using longitudinal designs to evaluate impacts of recreational cannabis legalization on cannabis use and related outcomes. Method A comprehensive bibliographic search strategy revealed 61 studies published from 2016 to 2022 that met criteria for inclusion. The studies were predominantly from the United States (66.2%) and primarily utilized self-report data (for cannabis use and attitudes) or administrative data (for health-related, driving, and crime outcomes). Results Five main categories of outcomes were identified through the review: cannabis and other substance use, attitudes toward cannabis, health-care utilization, driving-related outcomes, and crime-related outcomes. The extant literature revealed mixed findings, including some evidence of negative consequences of legalization (such as increased young adult use, cannabis-related healthcare visits, and impaired driving) and some evidence for minimal impacts (such as little change in adolescent cannabis use rates, substance use rates, and mixed evidence for changes in cannabis-related attitudes). Conclusions Overall, the existing literature reveals a number of negative consequences of legalization, although the findings are mixed and generally do not suggest large magnitude short-term impacts. The review highlights the need for more systematic investigation, particularly across a greater diversity of geographic regions.
... Studies show that the incidence of driving under the influence of cannabis (DUIC) has surpassed the incidence of driving under the influence of alcohol (DUIA) in Canada (University of Victoria, 2014). Making matters worse, cannabis crashes were more likely to involve multiple vehicles than crashes involving only alcohol (Hall, 2009). ...
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This paper investigates best theories and practices in the context of youth drug driving and describes initiatives aiming to decrease the incidence of youth driving high. Secondary data searches and content analysis of existent campaigns is conducted. Findings show that most initiatives properly use fear tactics and attempt to make youth feel that the issue is severe and that they are vulnerable to the negative consequences of driving high. Initiatives can become more effective if they provide specific and easy-to-follow recommendations of how to abstain from driving high, help young people abstain from driving high, make them feel that they can abstain from driving high, and showing how following the recommendations would succeed in preventing accidents. Implications and suggestions are discussed.
... Users disagree with non-users on the nature of cannabis addiction-that they presume it is more psychological than physical-and do not consider cannabis a gateway drug. This perception of risks is in line with pharmacological, biomedical, and psychological studies that have established a relationship between the use of cannabis and health problems (Hall, 2009;Thake & Davis, 2011;Volkow et al., 2014;WHO, 2016). Participants omit other adverse outcomes that cannabis can cause, such as academic failure, conflict with family and friends, and impaired driving. ...
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The social perception of cannabis use in Spain is getting more tolerant among young people. This study aims to uncover the attitudes of university students toward cannabis and examine the differences in their attitudes according to their use status. We applied concept mapping, a mixed-methods approach. Participants were recruited from 12 universities. During the first stage, 5 focus groups were conducted with 56 participants to determine the ideas in the concept map. In the second stage, ideas were pile-sorted and rated by 140 participants (77% females; average age = 21.6). Hierarchical cluster analysis of the pile-sort data generated the cluster map. We used t-tests to explore differences in ratings by past-year users and non-users (abstainers and ex-users). Participants generated 70 ideas associated with cannabis during the brainstorming sessions and categorized them into six groups: risks and harms, information, legalization, motives, tobacco and cannabis, and normalization. Users and non-users agree that cannabis has health risks and that smoking it mixed with tobacco is the main route of administration, although they do not perceive that this mode increases the hazards. Both users and non-users demand more information. However, they strongly disagree regarding the rest of the clusters. Users distinguish between sensible and problem use. They associate frequent use and coping motives with difficulties, whereas they perceive that moderate use yields pleasures and benefits. They blame the lack of legalization for the social stigma they still suffer. Non-users reject these considerations. Spanish university students believe that cannabis use is normal among young people. Non-users are tolerant of peers who use cannabis, but users feel stigmatized. There is a divide between the two groups regarding the convenience of implementing legal reforms.
... Por otra parte, se ha reportado que los estudiantes universitarios que consumen marihuana tienen un mayor riesgo de experimentar consecuencias negativas académicas, psicológicas y físicas de diferente severidad Buckner et al., 2010;Hall, 2009;Napper et al., 2016;Simons et al., 2012); vulnerabilidad que es mayor entre quienes presentan un patrón de uso de alta intensidad o frecuencia (Fischer et al., 2011;Hall & Degenhardt, 2009;Manning et al., 2019;Pearson, Bravo et al., 2017;Richter et al., 2017;Volkow et al., 2014). ...
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Aunque el consumo de marihuana es altamente prevalente entre universitarios de Argentina, poco se sabe respecto a los factores que permiten distinguir a los consumidores frecuentes de marihuana de quienes consumen esporádicamente. Por esta razón, en el presente trabajo se indagó sobre las posibles variaciones en los contextos de consumo, motivos de consumo, normas percibidas y estrategias conductuales de protección entre universitarios con consumo frecuente o esporádico de marihuana, y se analizó la utilidad de este conjunto de variables para distinguir entre estos los tipos de consumidores mencionados. Para ello, se contó con una muestra de 1083 estudiantes universitarios argentinos que completó una encuesta en línea sobre el consumo de sustancias. En particular, este trabajo se realizó con la submuestra que reportó consumir marihuana en los últimos 30 días (n = 158; 51.3 % mujeres). Dicha encuesta interrogaba sobre el consumo de marihuana y las consecuencias negativas asociadas, así como por motivos de consumo, normas sociales percibidas y estrategias conductuales de protección. Como resultado, los consumidores frecuentes presentaron mayor cantidad de consecuencias negativas (M = 4.92) que los consumidores esporádicos (M = 1.82; p ≤ .05), y se halló un perfil distintivo en un conjunto de variables. A nivel multivariado, los motivos de animación (or = 1.230; p ≤ .05), las estrategias conductuales de protección (or = .941; p ≤ .05), el consumo en solitario (or = 2.024; p ≤ .05) y el consumo en fiestas universitarias (or = 2.669; p ≤ .05) discriminaron significativamente entre ambas clases de consumidores. En general, los hallazgos revelaron subpoblaciones heterogéneas de consumidores de marihuana que difieren no solo en el consumo y sus consecuencias, sino también en los contextos de consumo y en un conjunto de variables relevantes. Estas subpoblaciones distintivas requieren de intervenciones diferentes y específicas.
... Anaphase lag is a precursor lesion to micronucleus formation which is the primary engine for chromothripsis and chromoanagensis and micronuclei have long been associated with cannabinoid exposure [65]. Cannabis has been known to be positive in the micronucleus assay which is one of the primary genotoxicity assays for over fifty years [65,66]. Micronuclei have been shown to form when a chromosome becomes derailed and disconnected from the main mitotic spindle during the anaphase separation of the chromatids [67]. ...
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Background Acute lymphoid leukaemia (ALL) is the commonest childhood cancer whose incidence is rising in many nations. In the USA, between 1975 and 2016, ALL rates (ALLRs) rose 93.51% from 1.91 to 3.70/100,000 < 20 years. ALL is more common in Caucasian-Americans than amongst minorities. The cause of both the rise and the ethnic differential is unclear, however, prenatal cannabis exposure was previously linked with elevated childhood leukaemia rates. We investigated epidemiologically if cannabis use impacted nationally on ALLRs, its ethnic effects, and if the relationship was causal. Methods State data on overall, and ethnic ALLR from the Surveillance Epidemiology and End Results databank of the Centre for Disease Control (CDC) and National Cancer Institute (NCI) were combined with drug (cigarettes, alcoholism, cannabis, analgesics, cocaine) use data from the National Survey of Drug Use and Health; 74.1% response rate. Income and ethnicity data was from the US Census bureau. Cannabinoid concentration was from the Drug Enforcement Agency Data. Data was analyzed in R by robust and spatiotemporal regression. Results In bivariate analyses a dose-response relationship was demonstrated between ALLR and Alcohol Use Disorder (AUD), cocaine and cannabis exposure, with the effect of cannabis being strongest (β-estimate = 3.33(95%C.I. 1.97, 4.68), P = 1.92 × 10 − 6 ). A strong effect of cannabis use quintile on ALLR was noted (Chi.Sq. = 613.79, P = 3.04 × 10 − 70 ). In inverse probability weighted robust regression adjusted for other substances, income and ethnicity, cannabis was independently significant (β-estimate = 4.75(0.48, 9.02), P = 0.0389). In a spatiotemporal model adjusted for all drugs, income, and ethnicity, cannabigerol exposure was significant (β-estimate = 0.26(0.01, 0.52), P = 0.0444), an effect increased by spatial lagging (THC: β-estimate = 0.47(0.12, 0.82), P = 0.0083). After missing data imputation ethnic cannabis exposure was significant (β-estimate = 0.64(0.55, 0.72), P = 3.1 × 10 − 40 ). 33/35 minimum e-Values ranged from 1.25 to 3.94 × 10 ³⁶ indicative of a causal relationship. Relaxation of cannabis legal paradigms had higher ALLR (Chi.Squ.Trend = 775.12, P = 2.14 × 10 − 112 ). Cannabis legal states had higher ALLR (2.395 ± 0.039 v. 2.127 ± 0.008 / 100,000, P = 5.05 × 10 − 10 ). Conclusions Data show that ALLR is associated with cannabis consumption across space-time, is associated with the cannabinoids, THC, cannabigerol, cannabinol, cannabichromene, and cannabidiol, contributes to ethnic differentials, demonstrates prominent quintile effects, satisfies criteria for causality and is exacerbated by cannabis legalization.
... It is unclear as yetw hether young adult cannabis use is increasing postlegalization (Cerda et al., 2020;Kerr et al., 2017;Miller et al., 2017); however, cannabis and alcohol use in young adulthood are stronglycorrelated and often co-occur (Agrawalet al., 2012;Baileyetal., 2014;Patrick et al., 2018). Cannabis use also has been linked to manyo ft he harms examined here (Dutra et al., 2018;Epstein et al., 2015;Fergusson & Boden, 2008;Guttmannova et al., 2017;Hall, 2009). Thus, it is possible that cannabis legalization mayh avee ither increased rates of alcohol consumption and harms or changed the association between alcohol consumption and harms in the Washington sample, butnot the Victorian sample, as cannabis use remains illegali nVictoria. ...
Article
Objective: To test the premise that youth alcohol harm minimization policies (compared with abstinence policies) reduce later drinking and harmful consequences of alcohol use in young adulthood, we compared associations among adolescent alcohol use, young adult alcohol consumption, and alcohol-related harms in Victoria, Australia and Washington State, United States. Method: Data came from the International Youth Development Study, a longitudinal, cross-national study of the development of substance use. State-representative samples of seventh-grade (age 13) students in Victoria (n = 984, 53% female, 90% White) and Washington (n = 961, 54% female, 73% White) were surveyed in 2002, 2003, 2004, and 2014 (age 25). Participants self-reported alcohol initiation by age 15 and age 25 alcohol consumption (per the Alcohol Use Disorders Identification Test). Path modeling tested associations among age 15 alcohol use, age 25 consumption, and alcohol-related harms at age 25; multiple group modeling tested the equivalence of parameter estimates across states. Results: Age 25 alcohol consumption was lower in Washington versus Victoria and was associated with poor physical and mental health, partner conflict, substance use, criminal behavior, and violence exposure in both states equally. Living in Washington predicted lower levels of multiple alcohol-related harms at age 25 indirectly via lower age 25 alcohol consumption. Conclusions: Young adults growing up in Victoria reported greater alcohol consumption in young adulthood, which was associated to the same degree with the harms measured regardless of alcohol policy context. Findings support state-level policies that promote alcohol abstinence in adolescence and reduced consumption in young adulthood.
... Cannabis is commonly used by HIV-positive individuals [27,28], and its use is being decriminalized in many areas of the Global North [29]. Cannabis use is associated with adverse health consequences [30,31,32,33,34,35], but its associated harm is reportedly less extensive than that of alcohol and other drugs [36,37,38]. ...
Article
Aims To analyze the association between any past month cannabis use and advanced liver fibrosis. Background Cannabinoid receptors play a role in acute and chronic liver injury, but human studies addressing the impact of cannabis use on liver fibrosis have shown mixed results. Objectives To explore and estimate the association between past month cannabis use and advanced liver fibrosis (ALF) in a cohort of Russian HIV-positive individuals with heavy alcohol use and high prevalence of hepatitis C virus (HCV) coinfection. Methods Baseline data were analyzed from participants of the ZINC study, a trial that enrolled HIV-positive Russian patients without prior antiretroviral therapy. Cannabis use during the prior month was assessed at study entry. ALF was defined as FIB-4>3.25 and/or APRI>1.5, transient elastography was used to detect advanced liver fibrosis among participants with FIB-4 values in the intermediate range (between 1.45 and 3.25). Results Participants (n=248) were mostly male (72.6%), young (median age of 33.9 years), infected with HCV (87.9%) and not with advanced immunosuppression (median CD4 count 462). Cannabis use was uncommon (12.4%) and the prevalence of advanced liver disease was 21.7%. The prevalence of ALF was similar among those who used cannabis compared to those who did not (25.8% vs. 21.7%). We were unable to detect an association between cannabis use and ALF (adjusted odds ratio: 1.28, 95% confidence interval: 0.53-3.12, p=0.59) in logistic regression models adjusting for age, sex, heavy drinking, BMI and CD4 cell count. Conclusion In this exploratory study among HIV-positive heavy drinking Russians we did not detect an association between recent cannabis use and ALF. Larger scale studies including more participants with cannabis use are needed to further examine this relationship.
... Plusieurs revues générales ont rapporté les effets de la fumée de cannabis sur les symptômes et la fonction respiratoire [3][4][5][6]. Tashkin et al. [7] ont noté une augmentation significative de la prévalence de la toux chronique, de l'expectoration chronique, des sifflements thoraciques et des épisodes de bronchite aiguë chez les fumeurs réguliers de cannabis avec ou sans tabac, comparativement aux non-fumeurs. De même, Bloom et al. [8] ont retrouvé une augmentation significative de la prévalence de la toux, de l'expectoration et des sifflements thoraciques chez les fumeurs exclusifs de cannabis ainsi que chez les fumeurs de cannabis et de tabac, comparativement aux non-fumeurs. ...
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Pour citer cet article : Underner M, et al. Usage du cannabis et retentissement fonctionnel respiratoire. Revue des Maladies Respiratoires (2013), http://dx. Reçu le 6 août 2012 ; accepté le 26 janvier 2013 MOTS CLÉS Cannabis ; Marijuana ; Tabagisme ; Épidémiologie ; Fonction respiratoire ; BPCO Résumé Le cannabis est la substance psychoactive illicite la plus fumée dans de nombreux pays dont la France. S'il peut être consommé seul sous forme d'herbe (marijuana), dans notre pays il est pour l'essentiel fumé à l'état de résine mélangée à du tabac. La technique d'inhalation de la fumée de cannabis est différente de celle du tabac, favorisant son contact avec la muqueuse bronchique et son impact sur la fonction respiratoire. Une fumée composée de tabac et de cannabis sera d'autant plus nocive. Chez le fumeur de cannabis, les fréquences des signes d'irritation bronchique et des épisodes de bronchites aiguës sont augmentées. Le cannabis a un effet bronchodilatateur rapide ; sa consommation chronique provoque une dimi-nution de la conductance spécifique ; les études portant sur le déclin du VEMS sont discordantes. La fumée de cannabis et le tétrahydrocannabinol sont irritants pour l'arbre bronchique. Ils induisent des signes histologiques d'inflammation de la muqueuse bronchique, altèrent les capa-cités de défense antifungique et antibactérienne des macrophages alvéolaires. L'inhalation de fumée de cannabis est un facteur de risque de cancer bronchique. L'arrêt de la consommation induira des bénéfices importants pour l'appareil respiratoire. Cela doit encourager les praticiens à proposer aux consommateurs des prises en charge de sevrage. Summary Cannabis is the most commonly smoked illicit substance in many countries including France. It can be smoked alone in plant form (marijuana) but in our country it is mainly smoked in the form of cannabis resin mixed with tobacco. The technique of inhaling cannabis differs from that of tobacco, increasing the time that the smoke spends in contact with the bronchial mucosal and its impact on respiratory function. One cigarette composed of cannabis and tobacco is much more harmful than a cigarette containing only tobacco. In cannabis smokers there is an increased incidence of respiratory symptoms and episodes of acute bronchitis. Cannabis produces a rapid bronchodilator effect; chronic use provokes a reduction in specific conductance and increase in airways resistance. Studies on the decline of Forced Expiratory Volume are discordant. Cannabis smoke and tetrahydrocannabinol irritate the bronchial tree. They bring about histological signs of airways inflammation and alter the fungicidal and anti-bacterial activity of alveolar macrophages. Inhalation of cannabis smoke is a risk factor for lung cancer. Stopping smoking cannabis will bring about important benefits for lung function. This should encourage clinicians to offer patients support in quitting smoking.
... Regular marijuana use, defined as once a month or more, has been linked to mental health problems such as anxiety, depression, and both psychoses and greater symptomology in people with schizophrenia (Volkow et al., 2014). Marijuana users have also demonstrated lower educational attainment (Hall, 2009), decreased workforce productivity (Hara et al., 2013), and greater involvement in criminal activity (Brook et al., 2011) compared to non-users. ...
Article
Background The transition to adulthood may be especially difficult for those who use drugs and alcohol regularly. While research clearly links adverse childhood experiences (ACEs) with later substance use, many studies have explored only a limited range of ACEs, and have focused on the number instead of specific types of ACE. Objectives: The current study examined the role of ACEs on the likelihood of frequent marijuana and alcohol use among a community sample of emerging adults (N = 185). This research builds on and extends previous work by focusing on a low-income sample, examining specific types of ACEs, and expanding categories to include some less studied ACEs. Logistic regression models examined the relationships between ACEs and frequent alcohol or marijuana use. Results: The emerging adults in the current sample experienced many ACEs in childhood, and roughly a third reported frequent (defined as using once a week or more for the past 90 days) alcohol or marijuana use. ACEs associated with both frequent marijuana and alcohol use were time spent in foster care, childhood emotional abuse, and having a close family member or friend who died violently. Alcohol use was further predicted by childhood sexual abuse and witnessing a serious injury or death, while marijuana use was further predicted by childhood physical abuse. Conclusions: Findings highlight the importance of thoroughly assessing for ACEs when addressing substance use issues in young adults. The negative impact of being in foster care may be overlooked as a trauma beyond the experiences that contributed to entering care.
... The more risk factors an adolescent has, the greater their risk of a CUD diagnosis in young adulthood 165 . An individual's risk of CUD can in addition be influenced by cultural norms, values, rules and the price, availability and supply of drugs, and drug policy, legislation, prosecution, prevention and access to treatment 10,166,167 . Personality traits and temperament may also have a role in vulnerability to cannabis use and CUD, for example, antisocial behaviour 168 , novelty seeking 165 and impulsivity 169 . ...
Article
Cannabis use disorder (CUD) is an underappreciated risk of using cannabis that affects ~10% of the 193 million cannabis users worldwide. The individual and public health burdens are less than those of other forms of drug use, but CUD accounts for a substantial proportion of persons seeking treatment for drug use disorders owing to the high global prevalence of cannabis use. Cognitive behavioural therapy, motivational enhancement therapy and contingency management can substantially reduce cannabis use and cannabis-related problems, but enduring abstinence is not a common outcome. No pharmacotherapies have been approved for cannabis use or CUD, although a number of drug classes (such as cannabinoid agonists) have shown promise and require more rigorous evaluation. Treatment of cannabis use and CUD is often complicated by comorbid mental health and other substance use disorders. The legalization of non-medical cannabis use in some high-income countries may increase the prevalence of CUD by making more potent cannabis products more readily available at a lower price. States that legalize medical and non-medical cannabis use should inform users about the risks of CUD and provide information on how to obtain assistance if they develop cannabis-related mental and/or physical health problems.
... The change in norms and perceptions may impact the increase in marijuana use, abuse and dependence (Cerdá et al., 2012). On the individual level, marijuana use is associated with increased risks of adverse outcomes, including addiction and withdrawal syndrome (Hall, 2009;Volkow et al., 2014). At the state level, state legalization of medical marijuana was associated with illicit drug use and the combination of illicit drug use and prescription drug misuse among U.S. adults (Lee et al., 2020). ...
Article
Background: Medical marijuana legalization (MML) has become more prevalent in the United States. This study examined the association between medical marijuana legalization and sources of obtaining marijuana among adults in the United States. Methods: Adult participants (age ≥18) from the 2018 wave of the National Survey on Drug Use and Health (NSDUH) were analyzed (n = 42,669, weighted N = 247,247,786). We used two multinomial regression models to estimate the association. The first model controlled for sociodemographic variables, and the second model additionally included an interaction effect of participants’ race with MML. Results: In the first model, participants residing in states with MML were positively associated with reporting lifetime marijuana use (but did not use in the past 12 months), buying marijuana, receiving marijuana for free or sharing with others, and growing marijuana on their own (all p < .01). With the interaction of participants’ race, nonwhites residing in states with MML were negatively associated with reporting lifetime marijuana use and receiving marijuana for free or sharing marijuana with others (all p < .05). Conclusion: Policy makers should be aware of the sources of obtaining marijuana in the states with legalization of medical marijuana.
... Inflammation of respiratory, resistance of airway, impairment of lung tissue appear consequently. [31,32] In addition, both long-term and acute exposure on CBDs will cause cardiovascular risk, and even lead to death. [33,34] Drug users could cut loss in time by stopping exposing to CBDs. ...
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Cannabinoids (CBDs) have been traditionally used as a folk medicine. Recently, they have been found to exhibit a high pharmacological potential. However, they are addicted and are often abused by drug users, thereby, becoming a threat to public safety. CBDs and their metabolites are usually found in trace levels in plants or in biological matrices and, are therefore not easy to be detected. Advances have been made toward accurately analyzing CBDs in plants or in biological matrices. This review aims at elucidating on the consumption of CBDs as well as its adverse effects and to provide a comprehensive overview of CBD pretreatment and detection methods. Moreover, novel pretreatment methods such as microextraction, Quick Easy Cheap Effective Rugged Safe and online technology as well as novel analytic methods such as ion-mobility mass spectrometry, application of high resolution mass spectrometry in nontarget screening are summarized. In addition, we discuss and compare the strengths and weaknesses of different methods and suggest their future prospect.
... Regular marijuana use has been connected to an increased risk of anxiety and depression and linked to both psychoses and poorer outcomes in people diagnosed with schizophrenia (Volkow et al., 2014). Marijuana users have also been found to demonstrate lower educational attainment (Hall, 2009), decreased workforce productivity (Hara et al., 2013), and greater involvement in criminal activity (Brook et al., 2011) compared to non-users. National data show that marijuana use is more prevalent among people with the lowest incomes (Carliner et al., 2017). ...
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Transitioning to adulthood may be more challenging, and lead to greater negative outcomes, when a youth uses drugs. This study examined the unique effects of foster care experiences on marijuana use in young adults aged 18–25 (N = 185), controlling for mental health, trauma history, and child maltreatment type. Compared to a low-income control sample, foster care alumni were more likely to report trauma exposure, anxiety, and daily marijuana use. Hierarchical linear showed that trauma exposure and physical abuse both predicted marijuana use in foster care alumni, as did entering foster care at a younger age and spending more time in care.
... To be included as an adverse effect, side effects were gathered from published literature and listed side effects of dronabinol and nabilone. 3,4,11,17,18 The second domain, which measured student attitudes, contained a series of twenty-three 5-point Likert-scale questions (15strongly disagree to 55strongly agree). Students were asked about their attitudes regarding medical and recreational use of marijuana, and they were surveyed on their confidence levels in answering questions regarding efficacy, safety, and drug interactions of medical marijuana. ...
... De nombreuses études ont montré une augmentation significative de la prévalence de la toux et des sifflements thoraciques chez les fumeurs de cannabis et de tabac [35,36] et chez des fumeurs exclusifs de cannabis, comparativement aux sujets n'ayant jamais fumé ni tabac ni cannabis [36][37][38][39][40]. En Nouvelle-Zélande, Aldington et al. [39] notaient également une association positive entre consommation exclusive de cannabis et développement d'un asthme après l'âge de 16 ans (odds ratio (OR) = 1,7 ; intervalle de confiance à 95 % (IC95 % ) : 1,0-2,9). D'autre part, plusieurs revues générales ont rapporté les effets de la fumée de cannabis sur les symptômes respiratoires [9,[41][42][43]. Ces symptômes respiratoires peuvent se compliquer de pneumothorax [44][45][46]. ...
Article
Résumé Introduction L’usage de cannabis, de cocaïne ou d’héroïne peut être responsable de complications pulmonaires parmi lesquelles figure l’asthme. Objectifs L’objectif de cette revue systématique de la littérature est d’exposer les données concernant la relation entre la consommation de cannabis, de cocaïne ou d’héroïne et l’asthme. Résultats L’usage de cannabis, de cocaïne ou d’héroïne par voie inhalée peut être responsable de symptômes respiratoires (toux, sifflements thoraciques), favoriser le développement d’un asthme, augmenter le risque d’exacerbation aiguë d’asthme (pouvant nécessiter une intubation et une ventilation invasive), voire des décès par asthme et diminuer l’observance du traitement de l’asthme. Le cannabis a un effet bronchodilatateur rapide. En revanche, sa consommation chronique provoque une diminution de la conductance spécifique des voies aériennes. Les études portant sur la diminution ou le déclin du volume expiratoire maximal par seconde (VEMS) sont discordantes. Conclusion Une consommation de cannabis, de cocaïne ou d’héroïne doit être recherchée devant des symptômes respiratoires survenant chez des sujets jeunes et les praticiens doivent aider les usagers de ces substances illicites à arrêter leur consommation.
... Moreover, extant research demonstrates that marijuana use in adolescence is associated with negative psychosocial outcomes in adulthood, including poorer educational attainment, greater risk of intimate partner violence, lower work commitment, and increased involvement in crime (Chen, Storr, and Anthony 2009;Green et al. 2010;Hall 2009;Hall and Degenhardt 2009;Hyggen 2012;Reingle et al. 2012). Auer et al. (2016) found that people who began using marijuana in their teen years showed a decreased ability to learn and remember new words by the time they reached middle age than those who began later or used marijuana less often. ...
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This paper explores the intersections of emerging recreational marijuana policy and large-scale contemporary marketing practices. The authors examine the evolution of current policies and the overall regulatory environment related to the legalization and marketing of recreational marijuana in the United States, exploring current and possible effects of marijuana legalization on adolescent uptake. Although the federal government still classifies marijuana as a Schedule I drug and prohibits possession and sale of the drug for both medical and recreational purposes, states are moving toward legalization. Implications of legalization are explored from the perspectives of regulation, harm reduction, and risk perception. The authors make recommendations and develop propositions regarding future research needed to evaluate the marketing implications and regulatory efforts aimed at U.S. adolescents.
... With cannabis medicalization and legalization increasing, the prevalence of cannabis use, in various forms, is also predicted to increase 2,3 . Several studies indicate that recreational cannabis use can have detrimental effects on physical and mental health [4][5][6][7] . On the other hand, continued work on cannabinoids for medical use resulted in the Food and Drug Administration's (FDA) approval of cannabidiol (CBD), in the form of Epidiolex, for treating rare and severe forms of epilepsy, and of synthetic Δ9-9 tetrahydrocannabinol (THC), dronabinol, and nabilone, for preventing nausea and vomiting associated with chemotherapy. ...
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As perspectives on cannabis continue to shift, understanding the physiological and behavioral effects of cannabis use is of paramount importance. Previous data suggest that cannabis use influences food intake, appetite, and metabolism, yet human research in this regard remains scant. The present study investigated the effects of cannabis administration, via different routes, on peripheral concentrations of appetitive and metabolic hormones in a sample of cannabis users. This was a randomized, crossover, double-blind, placebo-controlled study. Twenty participants underwent four experimental sessions during which oral cannabis, smoked cannabis, vaporized cannabis, or placebo was administered. Active compounds contained 6.9 ± 0.95% (~50.6 mg) ∆9-tetrahydrocannabinol (THC). Repeated blood samples were obtained, and the following endocrine markers were measured: total ghrelin, acyl-ghrelin, leptin, glucagon-like peptide-1 (GLP-1), and insulin. Results showed a significant drug main effect (p = 0.001), as well as a significant drug × time-point interaction effect (p = 0.01) on insulin. The spike in blood insulin concentrations observed under the placebo condition (probably due to the intake of brownie) was blunted by cannabis administration. A significant drug main effect (p = 0.001), as well as a trend-level drug × time-point interaction effect (p = 0.08) was also detected for GLP-1, suggesting that GLP-1 concentrations were lower under cannabis, compared to the placebo condition. Finally, a significant drug main effect (p = 0.01) was found for total ghrelin, suggesting that total ghrelin concentrations during the oral cannabis session were higher than the smoked and vaporized cannabis sessions. In conclusion, cannabis administration in this study modulated blood concentrations of some appetitive and metabolic hormones, chiefly insulin, in cannabis users. Understanding the mechanisms underpinning these effects may provide additional information on the cross-talk between cannabinoids and physiological pathways related to appetite and metabolism.
... It is a common myth that cannabis is not addictive and the Canadian lifetime prevalence of cannabis use disorder (CUD), the formal psychiatric diagnosis for addiction to cannabis, is 7%. 3 In terms of its abuse liability, in a large epidemiological study, 9% of individuals who reported ever using cannabis developed CUD, a rate that was lower than the parallel one for cocaine, alcohol, and tobacco. 4 Importantly, however, misuse of cannabis at subclinical levels is still associated with risk for harm 5 and there is no established safe level of use. 6 Furthermore, cannabis use has been linked to greater risk for other psychiatric disorders also. ...
Chapter
The prohibition of cannabis in the Anglophone Caribbean arose in the 1930s. It consequently criminalised the use, possession, sale, and in some countries the cultivation of a substance that was known to be previously accessible in some shops and was a part of the cultural identity of some of the countries. At the root of drug policy at that time and any attendant offences would have been colonialism. In 2015, Jamaica became the first of these countries to pursue cannabis policy reform. Several countries in the region have since undergone cannabis policy reform to different degrees and with several implications. This chapter explores the potential criminal justice system and public health implications that accompany cannabis policy reform in the Caribbean.
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Questo studio, che riporta i risultati dell’analisi degli accessi al Pronto soccorso generale dell’Ospedale Maggiore di Bologna negli anni 2006 e 2007, vuole affrontare quattro punti: 1. Quale è la popolazione maggiormente a rischio di fare un uso di sostanze che lo porti a rivolgersi al Pronto Soccorso (P.S.); 2. Quanto l’uso di sostanze aumenta la possibilità di ammalarsi e di rivolgersi al P.S.; 3. Quale è l’impatto sul sistema sanitario in termini di costi e di ospedalizzazioni; 4. Quale è l’efficacia degli interventi preventivi e curativi messi in atto nel territorio.
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Introduction: Legal access to and attitudes toward cannabis are changing rapidly. Most of the United States and territories allow adults to use medical and/or recreational cannabis. Recent trends demonstrate increasing cannabis use among older U.S. adults. However, little research has examined cannabis use among older adults since 2019, when the COVID-19 pandemic caused major changes in patterns of substance use. Methods: The National Poll on Healthy Aging is a nationally cross-sectional survey that asked U.S. adults ages 50-80 in January 2021 about their cannabis use in the past year. Multivariable logistic regression was used to identify demographic and health characteristics associated with cannabis use. Results: Among 2023 participants aged 50-80 (52.7% female), 12.1% reported cannabis use in the past year. Among those who reported cannabis use, 34.2% reported using cannabis products 4 or more days per week. In multivariable logistic regression, cannabis use was less likely among people who identified as Hispanic ethnicity or as "other" races compared with non-Hispanic white respondents. Cannabis use was more likely among unmarried/unpartnered and unemployed respondents. Those who consumed alcohol were more likely to use cannabis. Conclusions: More than one in 10 U.S. adults aged 50-80 used cannabis in the 1st year of the COVID-19 pandemic, and many used cannabis frequently. As access to and use of cannabis continue to increase nationally, clinicians and policymakers should monitor and address the potential risks among older adults.
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Cannabis use and the prevalence of cannabis use disorder (CUD) among emerging adults are on the rise. Several indicators of cannabis use (e.g., quantity, frequency) as they relate to negative outcomes have been posited in the extant literature. Despite research examining links between indicators and cannabis outcomes, few assessments of cannabis use indicators exist. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU) was developed to assess cannabis use across a range of factors. However, the factor structure of the DFAQ-CU has not been replicated. Further, the DFAQ-CU was modeled using reflective strategies despite formative strategies being conceptually appropriate. The present study utilized principal components analyses (PCA) and principal axis factoring (PAF) to evaluate the structure of the DFAQ-CU. PCA yielded a four-component solution; PAF resulted in a five-factor solution. Linear regression found significant relations between PCA components and PAF factors with CUD symptoms and cannabis-related problems; however, effect sizes were larger for the PAF suggesting possible misdisattenuation. The PCA components demonstrated evidence of discriminant and convergent validity with measures of cannabis and alcohol behavior. The study informs research and clinical work through the refinement of cannabis use assessment and enhancing our understanding of the importance of model selection.
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Drug treatment courts are challenged by the ongoing trend of marijuana legalization. In states where it is legal for adult citizens to consume marijuana for medical and recreational purposes, treatment courts need to determine whether participants should be allowed to consume or possess marijuana. By analyzing the written policies of treatment courts in states that have legalized recreational and medical marijuana, this study explores how treatment courts address such challenges. The review shows a large percentage of drug treatment courts have yet to clearly communicate their marijuana policies with the participants in writing. However, among the drug treatment courts that have established marijuana-specific policies, the vast majority of courts continue to ban the use of marijuana while a few courts allow medical marijuana use on an individual basis.
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The possibilities of legalizing cannabis for commercial use in South Africa is investigated in this study using desktop research from documents, newsletters, and existing literature. Indigenous communities would gain immensely from the legalization of producing cannabis-infused products, as it would help to enhance the rural economy by producing jobs and create wealth. Cannabis is a significant component of African religion, culture, and beliefs, having been used by indigenous communities for generations and believed to have curative properties. Moreover, legalizing cannabis for industrial use makes sense not only for economic development but also for further medical research. According to the 2022 February speech of the Republic of South Africa's president, Mr. Cyril Ramaphosa, cannabis has the potential to be industrialized and commercialized in South Africa in the near future. The speech came after the Constitutional Court (ConCourt) in 2018 had already decriminalized and permitted cannabis use for both personal and medical purposes, which was previously illegal.
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This paper focuses on Amparo 237/2014 (A.R.237/2014) issued by the Mexican Supreme Court in 2015, which recognizes that recreational use of marijuana is lawful based on the plaintiff's human rights. Previous studies have analyzed how drug policies are justified or unjustified by States' goals of public order and health preservation. However, this article studies how prohibitionist policies can affect individual human rights and how human rights' protection can influence future policies. This research focuses on how the Mexican Supreme Court considered the use of recreational marijuana through the lens of the right to free development of personality, which is tied to human dignity. The Court found that human dignity encompasses the use of marijuana for recreational purposes and based its decision on the essential belief that each human being has the innate right to make his or her own decisions without trespassing or affecting the rights of third parties. Then, this study examines how a balance between human rights and the competing values of public health, order, and security can be found. The analysis in this paper contains a description of Mexican law-making, exploration of court cases and the application of the principle of proportionality to highlight the tensions between human rights and the opposing government policies. This paper does not pretend to advocate for the legalization of marijuana, but since prohibitionist acts from the government could infringe human rights, it is necessary to analyze how policies can be improved and what kinds of measures can be adopted under a framework of human rights protection. In the conclusion, the article suggests that the government should adopt less restrictive measures as an alternative.
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Obesity in the US arguably constitutes the most significant health epidemic over the past century. Recent legislative changes allowing for recreational marijuana use further create a need to better understand the relationship between marijuana use and health choices, leading to obesity. We examine this relationship by using a synthetic control approach to examine the impact of legalized recreational marijuana access on obesity rates by comparing Washington State to a synthetically constructed counterfactual. We find that recreational marijuana's introduction did not lead to increased obesity rates and may have led to decreases in obesity.
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As cannabis use is being legalized in an increasing number of states, it is important to understand the changing dynamic of the risk in cannabis use disorder (CUD). Shape-based time-series clustering was used to identify ZIP Code Tabulation Areas (ZCTAs) with similar changing pattern in CUD over time. We conducted a cross-sectional logistic regression analysis to investigate the most recent ZCTA socio-demographic characteristics in relation to the changing CUD rates. The emergency discharge rates generally increased during 2010-2016. Increase during 2017-2019 was found in Sacramento and Santa Barbara County. Approximately 13% of ZCTAs showed an increasing trend of hospitalization discharge during 2017-2019. Males and non-Hispanic Black had larger increase than other groups during 2017-2019. The recent growing trend was found associated with greater racial diversity and rural ZCTAs. The findings from this study hold promise for local public health officials to adjust the cannabis intervention strategies in target districts and improve overall health outcomes.
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Background: The COVID-19 pandemic, and stringent lockdown measures implemented to curb transmission, might be related to increased cannabis use risk behaviors. This rapid response short-term longitudinal study investigated predictors of increased cannabis use risk behaviors and their association with severity of cannabis dependence during 2 separate COVID-19 lockdown periods. Methods: Analyses were based on data from 116 monthly cannabis users who responded to 2 survey waves, corresponding to the first and the second lockdown periods in Israel. Multinomial regressions predicted risk of increased cannabis use, solitary use, and morning use during 1 or both of the lockdown periods as a function of sociodemographic factors and coping motives. Robust regression analyses assessed whether changes in cannabis use risk behaviors predicted severity of cannabis dependence at wave 2. Results: A substantial proportion reported increased cannabis use, solitary use, and use before noon during both lockdown periods. Coping motives were related to reported increases in cannabis use and more frequent use before noon at 1 and both lockdown periods. Respondents who reported increases in cannabis use and use before noon at both lockdown periods, but not those who reported increases at only 1 lockdown period, had more severity of cannabis dependence at wave 2. Conclusions: The COVID-19 pandemic is likely to have ongoing and long-term effects on the health of the population, including those related to increased cannabis use risk behaviors. Continued monitoring of individual differences and long-term changes in cannabis use is needed to assess consequences of lockdown restrictions.
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During a health crisis like the COVID-19 pandemic, the public depends on the media for accurate and up-to-date information. However, frequent use of media for COVID-19-related information may be associated with maladaptive coping, and with increased prevalence of substance use. This study examined indirect associations between the frequency of media use for information about COVID-19 and increases in cannabis use behaviors through maladaptive coping strategies. We use data from an online survey of Israeli adult cannabis users (N = 440), conducted in May of 2020, to test associations between media use frequency for COVID-19 information and three problematic cannabis use behaviors: increased cannabis use, increased use alone, and increased use before midday. Among all respondents, 41% agreed that their cannabis use had increased since the onset of the pandemic. Analyses showed that higher frequency of media use was positively associated with all three indicators of problematic cannabis use, and that associations were partly mediated by maladaptive coping strategies. Higher frequency of media use for information about COVID-19 may be an indicator of difficulty with coping and of increased risk of escalation of cannabis use. These results have implications for assessing and mitigating the risk of coping-motivated cannabis use during a crisis.
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Background As diverse cannabis use patterns among recreational users continue to evolve, little is known about how modes of use may contribute to long-term risk. The current study examined the association between types and number of modes of cannabis used over a 21-day ecological momentary assessment (EMA) period with hazardous cannabis use and consequences both concurrently and six months later. Methods A sample of 155 young adult recreational cannabis users, aged 18-30 (M=21.1), reported on cannabis use patterns over 21-days, and completed baseline and six-month assessments of hazardous cannabis use and cannabis consequences. Results At baseline, more frequent bowl use was associated with hazardous cannabis use and cannabis consequences. More frequent use of hash-oil was associated with more consequences at six months, while a greater proportion of hash-oil use relative to total use was associated with increased risk for hazardous cannabis use at six months. Conclusion While bowl use is characteristic of concurrent problematic use and consequences, only hash-oil predicted increased risk for hazardous use and consequences later. It may be that more frequent use of high-potency cannabis products, such as hash-oil, present unique risks for cannabis problems and consequences.
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Purpose This paper aims to consider the nature of cannabis-related harms under the UK’s Misuse of Drugs Act (MDA). Written for the specific context of this four-paper special section on 50 years of the MDA, it argues that the MDA may cause more harm than it prevents. Design/methodology/approach An opinion piece offering a structured overview of cannabis-related harms under prohibition. It summarises existing evidence of the ways in which prohibition may exacerbate existing – and create new – harms related to the production, distribution, use and control of cannabis. Findings The paper argues that prohibition of cannabis under the MDA may cause more harm than it prevents. Originality/value It has long been argued that the MDA does not accurately or fairly reflect the harms of the substances it prohibits, and much existing research points to different ways in which drug prohibition can itself be harmful. The originality of this paper lies in bringing together these arguments and developing a framework for analysing the contribution of prohibition to drug-related harm.
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Background: Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have been the most studied and debated cannabinoids present in cannabis. The last decade has shown a notable increase in literature regarding CBD, recognizing its anti-inflammatory and neuroprotective effects. Although there is limited evidence regarding the use of CBD in psychiatric disorders' treatment, studies so far available have reported therapeutic potential in substance use disorders (SUDs), psychosis and anxiety. Methods: Literature review, performing a research in MedLine for articles on the subject, written in English and Portuguese, published until 2019, resulting in a total of 108 selected publications. Results: CBD appears to reduce psychotic symptoms and cognitive impairment associated with cannabis use and decrease the risk of developing psychosis in this context. Early clinical studies using CBD as treatment in patients with psychotic symptoms confirm its potential as an effective antipsychotic compound with negligible side effects, with excellent safety profile and tolerability. Cannabidiol is also capable of modulating the neuronal circuits involved in SUDs, presenting the potential to reduce dependence in these individuals. Discussion: CBD is currently an emerging therapeutic agent that has shown potential efficacy in the treatment of psychotic disorders and SUDs, and may represent a more easily accepted and tolerable therapeutic agent for this particularly vulnerable population.
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La marihuana es una planta del género Cannabis sativa de la que se extraen unos 400 compuestos, de los cuales se destacan el tetrahidrocannabinol (THC) y el cannabidiol (CBD); conocidos desde la década de 1960 y utilizados ampliamente en el tratamiento de enfermedades refractarias. Sin embargo, en Bolivia y Brasil esas sustancias todavía se consideran estupefacientes y su producción y uso, aunque medicinal, son sancionados penalmente. Este artículo se propone investigar la posibilidad de ampliación por el Estado del acceso a esos medicamentos, como una garantía del derecho fundamental a la salud.
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Prevalence of cannabis use in the United States continues to rise, and 30% of cannabis users eventually meet criteria for Cannabis Use Disorder (CUD). One response to this problem is to develop decision-making constructs that indicate vulnerability to CUD that might not be gleaned from diagnostic criteria. Unfortunately, there is limited evidence that decision-making constructs consistently relate to cannabis use. Interestingly, those who exhibit the sunk cost bias, an overgeneralized tendency to persist based on past investment, and those who use cannabis, both tend to focus on the past and perseverate more than their counterparts. Despite this overlap, no studies have assessed whether the sunk cost bias is positively associated with cannabis use. In 2 experiments with undergraduates, relations between cannabis use and the propensity to engage in the sunk cost bias were examined using negative binomial models. Experiment 1 (n = 46) evaluated the association between sunk cost bias propensity (using hypothetical costs and rewards) and frequency of cannabis use over the past 30 days. Greater sunk cost propensity was associated with more frequent cannabis use after controlling for demographics and alcohol use. In Experiment 2 (n = 103), more frequent cannabis use during a 6-week follow-up period was predicted by greater sunk cost propensity at baseline (using a real cost and reward-based task), independently and after controlling for mental health symptoms, alcohol use, and demographics. These findings provide preliminary evidence that a propensity to exhibit the sunk cost bias may be an important feature associated with cannabis use. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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This paper examines whether and how teen delinquency is consequential for a variety of educational and employment outcomes. From the National Longitudinal Survey of Youth we measure five forms of delinquency from 1979 when respondents were 14-17 years old, and investigate whether they predict five different outcomes when those individuals were aged twenty-five to thirty. We measure delinquency as the prevalence of skipping school, drug use, violent behavior, engaging in property crime, and contact with the criminal justice system. Using a variety of regression models, we explore whether delinquency has negative zero-order effects, and negative partial effects net of standard status attainment variables. We find that all types of delinquency have consistently significant and negative impacts on educational attainment among both males and females, net of status attainment variables. Delinquency also has a fairly consistent impact on male occupational outcomes, but has weaker effects on female occupational outcomes. Overall, the data suggest that delinquency has autonomous and negative effects on later life chances. We discuss these findings in light of links between status attainment models and theories of crime and delinquency.
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The function of the central cannabinoid receptor (CB1) was investigated by invalidating its gene. Mutant mice did not respond to cannabinoid drugs, demonstrating the exclusive role of the CB1 receptor in mediating analgesia, reinforcement, hypothermia, hypolocomotion, and hypotension. The acute effects of opiates were unaffected, but the reinforcing properties of morphine and the severity of the withdrawal syndrome were strongly reduced. These observations suggest that the CB1 receptor is involved in the motivational properties of opiates and in the development of physical dependence and extend the concept of an interconnected role of CB1 and opiate receptors in the brain areas mediating addictive behavior.
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Studying prevalence of Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) drug dependence among Americans 15–54 yrs old, the authors found about 1 in 4 (24%) had a history of tobacco dependence; about 1 in 7 (14%) had a history of alcohol dependence, and about 1 in 13 (7.5%) had a history of dependence on an inhalant or controlled drug. About one third of tobacco smokers had developed tobacco dependence and about 15% of drinkers had become alcohol dependent. Among users of the other drugs, about 15% had become dependent. Many more Americans age 15–54 have been affected by dependence on psychoactive substances than by other psychiatric disturbances now accorded a higher priority in mental health service delivery systems, prevention, and sponsored research programs. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Objective: To estimate the prevalence of illicit drug use among Australian secondary school students. Method: Data was collected as part of the Australian School Student's Alcohol and Drugs Survey, a national survey of 29,447 secondary school students. Results: Of all students aged 12–17 years, 39.9% (44.1% of males and 35.9% of females) reported having used at least one illicit drug in their lifetime. Cannabis was the most widely used illicit drug with 36.4% of all students reporting having used cannabis. Substantially fewer students reported using other drugs: hallucinogens (8.6%), amphetamines (6.1%), cocaine (3.6%), ecstasy (3.6%), opiates (3.7%) and steroids (1.8%). There were clear gender and age differences in the prevalence of illicit drug use: more males than females reported illicit drug use and the lifetime prevalence of illicit drug use increased with age. Most of those who reported illicit drug use had used drugs on relatively few occasions although there was a small minority of the sample who reported more frequent use. Finally, there were strong association between regular cannabis use and the use of other illicit drugs in the past year, and moderate associations between illicit drug use and the extent of both tobacco and alcohol use. Conclusions: The findings of this, the first national survey of illicit drug use among Australian school students, indicate a high prevalence of illicit drug use. Comparisons with previous regionally based surveys suggest there may have been a recent increase in the prevalence of cannabis use and highlight the need for further monitoring of and prevention efforts aimed at reducing illicit drug use among students.
Chapter
This book provides a comprehensive overview of the psychiatry and neuroscience of Cannabis sativa (marijuana), with particular emphasis on psychotic disorders. It outlines developments in our understanding of the human cannabinoid system, and links this knowledge to clinical and epidemiological facts about the impact of cannabis on mental health. Clinically focused chapters review not only the direct psychomimetic properties of cannabis, but also the impact consumption has on the courses of evolving or established mental illness such as schizophrenia. A number of controversial issues are critically explored, including whether a discrete 'cannabis psychosis' exists, and whether cannabis can actually cause schizophrenia. Effects of cannabis on mood, notably depression, are reviewed, as are its effects on cognition. This book will be of interest to all members of the mental health team, as well as to neuroscientists and those involved in drug and alcohol research.
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Although tolerance to cannabinoids has been well established, the question of cannabinoid dependence had been very controversial until the discovery of a cannabinoid antagonist, SR141716A. The objective of this study was to develop and characterize a mouse model of precipitated withdrawal indicative of cannabinoid dependence. Using a dosing regimen known to produce pharmacological and behavioral tolerance, mice were treated with Delta(9)-tetrahydrocannabinol (Delta(9)-THC) twice a day for 1 wk. SR141716A administration after the last Delta(9)-THC injection promptly precipitated a profound withdrawal syndrome. Typical withdrawal behavior was an increase in paw tremors and head shakes that was accompanied with a decrease in normal behavior such as grooming and scratching. Of the three Delta(9)-THC regimens tested, daily Delta(9)-THG injections of 10 and 30 mg/kg produced the greatest number of paw tremors and head shakes and the least number of grooms after challenge with SR141716A. Precipitated withdrawal was apparent after 2, 3, 7 and 14 days of treatment based on an increase in paw tremors in Delta(9)-THC-treated mice as compared with vehicle-treated mice. These findings are consistent with SR141716A-precipitated withdrawal in rats. Moreover, these results suggest that mice are a viable model for investigating dependence to cannabinoids.
Chapter
What used to be called applied social research and is now commonly called policy research is a large, multiform, and complex enterprise. In essence, it is the application of social science concepts and methods to the study of issues on the practical agenda, these days commonly on the agenda of government decision makers. Over the years, it has been the object of grandiose hopes and doleful disappointments.
Chapter
With few exceptions, addicting drugs enhance electrical brain-stimulation reward and act as direct or indirect dopamine agonists in the reward-relevant dopaminergic projections of the medial forebrain bundle. These dopaminergic projections constitute a crucial drug-sensitive link in the brain’s reward circuitry, and addictive drugs derive significant abuse liability from enhancing these circuits. Furthermore, basal aberrations in dopaminergic function within these circuits appear to constitute a major neurobiological vulnerability factor for drug addiction. Marihuana was long considered an “anomalous” addictive drug, lacking pharmacological interaction with these brain reward substrates. However, it is now clear—from more than 10 years of consistent research findings—that ∆9-tetrahydrocannabinol (THC), marihuana’s principal psychoactive constituent, acts on these brain reward substrates in strikingly similar fashion to noncannabinoid addictive drugs. Specifically, THC enhances MFB electrical brain-stimulation reward, and enhances both basal and stimulated dopamine release in reward-relevant MFB projection loci. THC’s actions on these mechanisms is tetrodotoxin-sensitive, calcium-dependent, and naloxone-blockable. Furthermore, THC modulates brain t and S opioid receptors. Also, withdrawal from THC produces neurophysiological and neurochemical sequelae that are strikingly similar to those seen in withdrawal from other addictive drugs. Mechanistically, THC appears to act on brain reward substrates by inhibiting the reuptake of dopamine from the synaptic cleft in reward-relevant synapses of the nucleus accumbens. Behaviorally, THC enhances reward-related behaviors and incentive motivation. This paper reviews these data, and suggests that marihuana’s interaction with brain reward systems is fundamentally similar to that of other addictive drugs. This paper concludes that persistent claims that cannabinoids do not interact with brain reward mechanisms must be dismissed—on the basis of more than 10 years of consistent published findings—as either uninformed or biased pleadings.
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In this work, the author explains the remarkable advances that have been made in scientific research on cannabis with the discovery of specific receptors and the existence of naturally occurring cannabis-like substances in the brain. He provides an objective and up-to-date assessment of the scientific basis for the medical use of cannabis and what risks this may entail. The recreational use of the drug and how it affects users is described along with some predictions about how attitudes to cannabis may change in the future.
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Studying prevalence of Diagnostic and Statistical Manual (3rd ed., rev., American Psychiatric Association, 1987) drug dependence among Americans 15-54 years old, we found about 1 in 4 (24%) had a history of tobacco dependence; about 1 in 7 (14%) had a history of alcohol dependence; and about 1 in 13 (7.5%) had a history of dependence on an inhalant or controlled drug. About one third of tobacco smokers had developed tobacco dependence and about 15% of drinkers had become alcohol dependent. Among users of the other drugs, about 15% had become dependent. Many more Americans age 15-54 have been affected by dependence on psychoactive substances than by other psychiatric disturbances now accorded a higher priority in mental health service delivery systems, prevention, and sponsored research programs.
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This chapter describes selected features of cannabis epidemiology, with a focus upon recent evidence from field studies of cannabis dependence. An epidemiologist's interest in cannabis can be motivated by an appreciation that cannabis smoking represents the most common illegal drug use behavior in the world, with a roughly estimated 140–150 million cannabis users, as compared to rough estimates of 14–15 million for cocaine and 13–14 million for opium, heroin, and other opioid drugs (United Nations, 2002). Based upon recent estimates, projections, and averages for the USA, an estimated 7000–8000 individuals start using cannabis every day and there are 95 million US community residents who have tried cannabis on at least one occasion (Substance Abuse and Mental Health Services Administration, Office of Applied Studies (SAMHSA), 2002c, d). As will be documented later in this chapter, our rough averaged estimate is that some 50–80 recent-onset cannabis users develop a cannabis dependence syndrome each day during the year; some substantial fraction of these cases appear to require clinical intervention services. It is generally possible to dissect epidemiological research in relation to five general rubrics or sub-headings. The first rubric concerns quantification of disease burden, including the burdens associated with mental and behavioral disturbances that do not qualify as formal diseases, as well as the population-averaged “incidence” and individual-level risk of becoming a cannabis user, and the separately estimated population-averaged “prevalence” and individual-level likelihood of being an active or former cannabis user (e.g., see Anthony & Van Etten, 1998, Wu, et al ., 2003, for detailed discussions of the distinctions between incidence and prevalence).
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Although marijuana is the most commonly used illicit drug in the United States, it is not established whether withdrawal from chronic use results in a clinically significant abstinence syndrome. The present study was conducted to characterize symptoms associated with marijuana withdrawal following chronic use during a supervised 28-day abstinence period. Three groups of participants were studied: (a) current chronic marijuana users, (b) former chronic marijuana users who had not used marijuana for at least 6 months prior to the study, and (c) marijuana nonusers. Current users experienced significant increases in anxiety, irritability, physical tension, and physical symptoms and decreases in mood and appetite during marijuana withdrawal. These symptoms were most pronounced during the initial 10 days of abstinence, but some were present for the entire 28-day withdrawal period. These findings support the notion of a marijuana withdrawal syndrome in humans.
Conference Paper
Objective: To review the evidence on the mental health and psychosocial consequences of rising rates of cannabis use among young people in developed countries. Method: This paper critically reviews epidemiological evidence on the following psychosocial consequences of adolescent cannabis use: cannabis dependence; the use of heroin and cocaine; educational underachievement; and psychosis. Leading electronic databases such as PubMed have been searched to identify large-scale longitudinal studies of representative samples of adolescents and young adults conducted in developed societies over the past 20 years. Results: Cannabis is a drug of dependence, the risk of which increases with decreasing age of initiation. Cannabis dependence in young people predicts increased risks of using other illicit drugs, underperforming in school, and reporting psychotic symptoms. Uncertainty remains about which of these relationships are causal although the evidence is growing that cannabis is a contributory cause of psychotic symptoms. Conclusions: We face major challenges in communicating with young people about the most probable risks of cannabis use (dependence, educational underachievement and psychosis) given uncertainties about these risks and polarized community views about the policies that should be adopted to reduce them.
Article
• To examine the consequences of adolescent drug use on the psychosocial and health functioning of young adults, we followed up 1004 young men and women from age 15 or 16 years to age 25 years. The use of four different classes of drugs was examined: cigarettes, alcohol, marijuana, and other illicit drugs. Twenty outcomes were examined, including continuity of participation in work and in family roles, level of education, delinquent activities, self-reported health and psychological symptoms, and use of five drug classes in early adulthood (including prescribed psychoactive medications). The effects of marijuana and of other illicit drugs could not be disentangled, so these drugs were treated as a single class. Controlling for initial individual differences in adolescence, use of the three major drug classes between adolescence and early adulthood affected most of the outcomes examined; most strongly continued use of the same substance. Unique drug effects included those of illicit drugs on increased delinquency, unemployment, divorce, and abortions, and of cigarettes on lowered psychological mood. Illicit drugs predicted drug-related health problems, whereas cigarette use predicted increased breathing difficulties.
Book
This book provides the first multidisciplinary and nonpartisan analysis of how the United States should decide on the legal status of cocaine, heroin and marijuana. It draws on data about the experiences of Western European nations with less punitive drug policies as well as new analyses of America’s experience with legal cocaine and heroin a century ago, and of America’s efforts to regulate gambling, prostitution, alcohol and cigarettes. It offers projections on the likely consequences of a number of different legalization regimes and shows that the choice about how to regulate drugs involves complicated tradeoffs among goals and conflict among social groups. The book presents a sophisticated discussion of how society should deal with the uncertainty about the consequences of legal change. Finally, it explains, in terms of individual attitudes toward risk, why it is so difficult to accomplish substantial reform of drug policy in America.
Article
OBJECTIVE To assess the feasibility of reducing tobacco-caused disease by gradually removing nicotine from cigarettes until they would not be effective causes of nicotine addiction.DATA SOURCESIssues posed by such an approach, and potential solutions, were identified from analysis of literature published by the US Food and Drug Administration (FDA) in its 1996 Tobacco Rule, comments of the tobacco industry and other institutions and individuals on the rule, review of the reference lists of relevant journal articles, other government publications, and presentations made at scientific conferences.DATA SYNTHESISThe role of nicotine in causing and sustaining tobacco use was evaluated to project the impact of a nicotine reduction strategy on initiation and maintenance of, and relapse to, tobacco use. A range of potential concerns and barriers was addressed, including the technical feasibility of reducing cigarette nicotine content to non-addictive levels, the possibility that compensatory smoking would reduce potential health benefits, and whether such an approach would foster illicit (“black market”) tobacco sales. Education, treatment, and research needs to enable a nicotine reduction strategy were also addressed. The Council on Scientific Affairs came to the following conclusions: (a) gradually eliminating nicotine from cigarettes is technically feasible; (b) a nicotine reduction strategy holds great promise in preventing adolescent tobacco addiction and assisting the millions of current cigarette smokers in their efforts to quit using tobacco products; (c) potential problems such as compensatory over-smoking of denicotinised cigarettes and black market sales could be minimised by providing alternate forms of nicotine delivery with less or little risk to health, as part of expanded access to treatment; and (d) such a strategy would need to be accompanied by relevant research and increased efforts to educate consumers and health professionals about tobacco and health.CONCLUSIONS The council recommends the following: (a) that cessation of tobacco use should be the goal for all tobacco users; (b) that the American Medical Association continue to support FDA authority over tobacco products, and FDA classification of nicotine as a drug and tobacco products as drug-delivery devices; (c) that research be encouraged on cigarette modifications that may result in less addicting cigarettes; (d) that the FDA require that the addictiveness of cigarettes be reduced within 5–10 years; (e) expanded surveillance to monitor trends in the use of tobacco products and other nicotine-containing products; (f) expanded access to smoking cessation treatment, and strengthening of the treatment infrastructure; and (g) more accurate labelling of tobacco products, including a more meaningful and understandable indication of nicotine content.
Article
Because a wide variety of deviant behaviors are positively correlated with one another, some researchers conclude that all are manifestations of a single general tendency. The present analysis incorporated three waves of self-reports about heavy alcohol use, marijuana use, use of other illicit drugs, dangerous driving, and other criminal behavior for a nationally representative sample of high school seniors. A relatively stable general involvement in deviance accounted for virtually all association between different types of deviance, but the stability of each behavior could only be explained by equally important and stable specific influences. Thus, theories that treat different deviant behaviors as alternative manifestations of a single general tendency can account for some, but far from all, of the meaningful variance in these behaviors. The only significant influence of one type of deviance on another was that of marijuana use on later use of other illicit drugs. The causal model also revealed interpretable shifts in the associations among these behaviors over the four years following high school.
Article
Examined the impact of early adolescent drug use on subsequent dropping out of high school in a sample of 4,390 adolescents from California and Oregon. Participants were initially surveyed in 7th grade in 1985 and again in 1990 when they should have completed 12th grade. Logistic regression analyses showed that frequency of cigarette use during 7th grade predicted dropping out of high school, controlling for demographics, family structure, academic orientation, early deviance, and school environment. Separate analyses by race/ethnicity replicated this finding for Asians, Blacks, and Whites, but not for Latinos. For Latinos, early marijuana use predicted dropping out. Results suggest that preventing or reducing the incidence of early smoking and marijuana use may help reduce the probability of dropping out of high school. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Administered anonymous questionnaires about drug use, accidents, violations, drug-related accidents and violations, and numbers of drug-driving occasions to 1,538 Canadian high school students. Of the 1,538 students, 710 had driven in the past year. About 15% reported an accident and 20% a driving offense. Users of all drugs more often reported accidents than nonusers, but results are statistically significant only for tobacco, marihuana, opiates, speed, LSD, and other hallucinogens. Only 2.7% had an alcohol-influenced accident and 2.0% a drug-influenced accident. Exposure to drinking and driving was far more common than drug use and driving (56% of students compared to 1-6%). When exposure to drug-related driving occasions are considered, LSD, tranquilizers, and stimulants are the most dangerous drugs, and they are more dangerous than alcohol. The infrequent use of drugs makes their total effect on accidents small compared to alcohol. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Data from the Vietnam Era Twin (VET) Registry were analyzed to explore the degree to which the same genetic and environmental factors contribute to childhood conduct disorder symptoms and to alcohol and marijuana dependence symptoms. Data on conduct disorder and alcohol and marijuana dependence were obtained from administration of the Diagnostic Interview Schedule to 1,856 monozygotic and 1,479 dizygotic male-male twin pair members of the VET Registry. Multivariate genetic models were compared to determine the genetic and environmental influences common and or specific to all three phenotypes. A full model that allowed for common genetic and environmental influences to all three phenotypes gave a good fit to the data, but the best fitting reduced model did not allow for a genetic influence on conduct disorder symptoms. Under the best fitting reduced model, genes explained 44.7% of the variance in risk for alcohol dependence symptoms. The genetic liability for symptoms of marijuana dependence was due to a 36.3% specific contribution and a 7.6% contribution from genes common with alcohol dependence symptoms. Family environmental contributions common to all three phenotypes explained 46.7%, 11.9%, and 21.3% of variance in risk for symptoms of conduct disorder, alcohol dependence, and marijuana dependence, respectively. Common family environmental factors contribute to risk of conduct disorder symptoms and alcohol and marijuana dependence symptoms. Common genetic influences contribute to risk of symptoms of alcohol dependence and marijuana dependence. While our findings suggest genes do not contribute to co-morbid conduct disorder symptoms, comparisons with other twin studies suggest that the role of genes in risk for conduct disorder remains uncertain. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:391–397, 1999. © 1999 Wiley-Liss, Inc.
Article
Anonymous random digit dialing telephone surveys of nearly 6000 16–19 year old respondents were conducted in Massachusetts and Upstate New York in 1979–1981. These surveys explored frequency of driving after using marijuana, driving after drinking, respondent accident involvement in the year prior to the interview, and a variety of other respondent characteristics. Frequency of driving after using marijuana and after drinking were each associated with greater accident involvement. To isolate the accident risk of driving after marijuana use, respondents who drove after drinking were excluded from a logistic regression analysis. This analysis also controlled for the distance respondents drove and several respondent demographic characteristics. Compared to respondents who did not drive after marijuana use, teenageers who drove after smoking marijuana on at least 6 occasions per month were 2.4 times more likely to be involved in traffic accidents. Those who drove after marijuana use on at least 15 occasions per month were 2.9 times more likely to have an accident.
Article
A fair appraisal of the public health significance of cannabis use has been hampered by the polarised opinions about its health effects expressed by partisans on both sides of the debate on its legal status. The findings of a recent review of the literature on the adverse health and psychological effects of cannabis are used to estimate the major probable public health risks of cannabis use in Australia. These appear to be, in order of approximate public health importance: adverse psychological effects; motor vehicle accidents; cannabis dependence; respiratory disease; precipitation and exacerbation of schizophrenia in vulnerable individuals; low-birthweight babies; and perhaps subtle cognitive impairment. On current patterns of use, cannabis use is a modest public health concern by comparison with alcohol and tobacco, although given the scale of public health damage caused by the latter drugs, and the currently low prevalence of regular cannabis use, this is not cause for complacency. (Aust J Public Health 1995; 19: 235–42)
Article
This paper outlines the ethical arguments used in the Australian debate about whether or not to relax the prohibition on cannabis use by adults. Over the past two decades a rising prevalence of cannabis use in the Australian population has led to proposals for the decriminalization of the personal use of cannabis. Three states and territories have removed criminal penalties for personal use while criminal penalties are rarely imposed in the remaining states. Libertarian arguments for legalization of cannabis use have attracted a great deal of media interest but very little public and political support. Other arguments in favour of decriminalization have attracted more support. One has been the utilitarian argument that prohibition has failed to deter cannabis use and the social costs of its continuation outweigh any benefits that it produces. Another has been the argument from hypocrisy that cannabis is less harmful than alcohol and so, on the grounds of consistency, if alcohol is legally available then so should cannabis. To date public opinion has not favoured legalization, although support for the decriminalization of personal cannabis use has increased. In the long term, the outcome of the debate may depend more upon trends in cannabis use and social attitudes among young adults than upon the persuasiveness of the arguments for a relaxation of the prohibition of cannabis.
Article
The relationships between early onset (prior to 16 years) cannabis use and later psychosocial adjustment was examined in a birth cohort of New Zealand children studied to age 18 years. Early onset users had significantly higher rates of later substance use, juvenile offending, mental health problems, unemployment and school dropout. The linkages between early onset cannabis use and later outcomes were largely explained by two routes that linked cannabis use to later adjustment. First, those electing to use cannabis were a high risk population characterized by social disadvantage, childhood adversity, early onset behavioural difficulties and adverse peer affiliations. Secondly, early onset cannabis use was associated with subsequent affiliations with delinquent and substance using peers, moving away from home and dropping out of education with these factors in turn, being associated with increased psychosocial risk. The implications of these results are examined.