Cannabis Dependence Research Articles

The impact of schizophrenia genetic load and heavy cannabis use on the risk of psychotic disorder in the EU-GEI case-control and UK Biobank studies.

The association between cannabis and psychosis is established, but the role of underlying genetics is unclear. We used data from the EU-GEI case-control study and UK Biobank to examine the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS) on risk for psychosis. Genome-wide association study summary statistics from the Psychiatric Genomics Consortium and the Genomic Psychiatry Cohort were used to calculate schizophrenia and cannabis use disorder (CUD) PRS for 1098 participants from the EU-GEI study and 143600 from the UK Biobank. Both datasets had information on cannabis use. In both samples, schizophrenia PRS and cannabis use independently increased risk of psychosis. Schizophrenia PRS was not associated with patterns of cannabis use in the EU-GEI cases or controls or UK Biobank cases. It was associated with lifetime and daily cannabis use among UK Biobank participants without psychosis, but the effect was substantially reduced when CUD PRS was included in the model. In the EU-GEI sample, regular users of high-potency cannabis had the highest odds of being a case independently of schizophrenia PRS (OR daily use high-potency cannabis adjusted for PRS = 5.09, 95% CI 3.08-8.43, p = 3.21 × 10-10). We found no evidence of interaction between schizophrenia PRS and patterns of cannabis use. Regular use of high-potency cannabis remains a strong predictor of psychotic disorder independently of schizophrenia PRS, which does not seem to be associated with heavy cannabis use. These are important findings at a time of increasing use and potency of cannabis worldwide.

HLA Allele's Role in Cannabis Addiction

<p dir="ltr"><span>Background and objectives. It can be argued that there is a genetic component that has a determining or promoting role in this direction. In the present pilot study, we aimed to identify an element of the HLA profile that is involved in the development of addiction.</span></p><p dir="ltr"><span>Methods. The 60 study participants were divided into two groups - the control group - 40 people without cannabis use and the case group - 20 people with cannabis addiction.</span></p><p dir="ltr"><span>Results. We identified both an allele and a haplotype with a potential protective role and a haplotype with a risk factor role in the development of cannabis addiction.</span></p><p dir="ltr"><span>Conclusions. The results of the present study indicate several potential alleles that may act as a protective or risk factor for the development of cannabis addiction. The determination of these genes may have an important role in identifying possible mechanisms of developing addiction.</span></p><div><span><br /></span></div>

Avatar Intervention in Virtual Reality for Cannabis Use Disorder in Individuals With Severe Mental Disorders: Results From a 1-Year, Single-Arm Clinical Trial.

The dual diagnosis of cannabis use disorder (CUD) and severe mental disorder (SMD) results in clinically complex individuals. Cannabis use is known to have negative consequences on psychiatric symptoms, medication compliance, and disease prognosis. Moreover, the effectiveness of currently available psychotherapeutic treatments is limited in this population. In this context, our research team developed avatar intervention, an approach using virtual reality as a therapeutic tool to treat CUD in individuals with SMD. This pilot clinical trial aimed to evaluate, until the 1-year follow-up, the efficacy of avatar intervention for CUD among 32 participants with a dual diagnosis of SMD and CUD. Over the course of the 8 intervention sessions, participants were given the opportunity to enter a dialogue in virtual reality with an avatar representing a person with a significant role in their consumption, who was animated in real time by a therapist. The primary outcomes were the quantity of cannabis consumed and the frequency of use. Secondary outcomes included severity of problematic cannabis use, motivation for change, protective strategies for cannabis use, consequences of cannabis use, psychiatric symptoms, and quality of life. Changes in reported outcomes during the assessment periods before the intervention; postintervention; and 3, 6, and 12 months after the end of the intervention were assessed using a linear mixed-effects model. Significant reductions were observed in the quantity of cannabis consumed, and these were maintained until the 12-month follow-up visit (d=0.804; P<.001; confirmed by urine quantification). Frequency of cannabis use showed a small significant reduction at the 3-month follow-up (d=0.384; P=.03). Moreover, improvements were observed in the severity of CUD, cannabis-related negative consequences, the motivation to change cannabis use, and the strategies used to mitigate harms related to cannabis use. Finally, moderate benefits were observed for quality of life and psychiatric symptoms. Overall, this unique intervention shows promising results that seem to be maintained up to 12 months after the end of the intervention. With the aim of overcoming the methodological limitations of a pilot study, a single-blind randomized controlled trial is currently underway to compare the avatar intervention for CUD with a conventional addiction intervention.

Expressive Writing About One's Trauma Increases Accessibility of Cannabis Information in Memory Among Trauma-Exposed Individuals

Objective: Trauma survivors are more likely than others to use cannabis, and post-traumatic stress disorder (PTSD) commonly co-occurs with cannabis use disorder (CUD). Automatic memory associations between trauma reminders and cannabis use have been suggested as contributing mechanisms. These associations can be studied experimentally by manipulating trauma cue exposure in a cue-reactivity paradigm (CRP) and examining effects on the accessibility of cannabis information in memory in trauma survivors with and without PTSD. Method: Cannabis users with trauma histories (N = 202) completed a PTSD measure (PTSD Checklist-5) and were randomized to a trauma or neutral expressive writing task as an online CRP. Next, participants completed a cue-behavior word association task, which involved presentation of a series of ambiguous cue words to which participants provided the first word that came to mind. Some of these ambiguous cues pertained to cannabis (e.g., weed, pot) and some to other substances (e.g., blow, shot). This task was scored by two independent raters. Linear regression models tested the hypothesized main and interactive effects of CRP condition (trauma, neutral) and PTSD group (probable PTSD, no PTSD) on the number of cannabis and other substance responses generated. Results: Main effects of CRP condition were found for cannabis responses (b = 0.41, p = 0.048; trauma &gt; neutral) but not other substance responses. Unexpectedly, no main effects or interactions of PTSD group were observed for either outcome. Conclusions: In cannabis users with trauma histories, writing about one’s trauma specifically activates greater accessibility of cannabis-related information in memory, regardless of PTSD.

Changing Pattern of Substance Abuse in Patients Attending a Regional Psychiatric Rehabilitation Center at Al-Qassim, Saudi Arabia

Background and Purpose The aim of this study was to record the prevalence and the characteristics of substance abusers from the year 2007 to 2017 and also to find the most prevalent form of substance abuse and association, if any, between the abusers and their demographic characteristics. Materials and Methods Descriptive and retrospective medical record review included patients of substance abuse attending a rehabilitation center in Buraidah from January 2007 to December 2017. A majority of 5,639 patients (63.6%) belonged to the age group of 31–50 years. Twenty-five and thirty-nine percent patients had secondary and higher education, respectively. Notably, more than half of them were unemployed. The commonly abused single drugs were amphetamine (40%), cannabis (11%), and alcohol (7%). High school goers’ cases have continuously spiked over the years. Substance abuse over the years from 2007 to 2017 was above 11% in 2007 and 2015. From 2009 to 2014, it was between 8 and 10%. However, the number of cases reported dropped to below 9% from 2016 onward. Amphetamine saw a downfall except peaking in 2010 and 2015. On the other hand, there was no substantial jump in the abuse of alcohol and cannabis over the years, but an increasing use from 2015 onward was visible. There was also a gradual rise over the years in the abuse of polysubstance (more than three drugs). Conclusion There is a growing trend in the use of polysubstance and the combination of two substances. There is a high incidence of drug abuse in high schoolers and also in patients in the age groups of 10–30 years.

Maternal Cannabis Use Disorder and Neonatal Health Outcomes: A Data Linkage Study.

We tested for the potential associations between maternal antenatal cannabis use disorders (CUD) and neonatal health outcomes using large linked administrative data. Population-based retrospective cohort study. The study was conducted in New South Wales, Australia. A total of 215 879 singleton live births. Generalised linear models (GLMs) fitted using log-binomial regression to estimate risk ratios (RRs) with the corresponding 95% confidence intervals (95% CI). Additionally, we conducted a propensity score matching (PSM) analysis. The outcomes include preterm births (PTB), low birth weight (LBW), small for gestational age (SGA), 5-min lower Apgar scores and admission to the neonatal intensive care unit (NICU). In unmatched analyses, antenatal CUD was associated with increased risks for all adverse neonatal outcomes (adjusted risk ratio [RR] ranging from 1.47 [95% CI: 1.01, 2.14] for 5-min lower APGAR scores to 2.58 [95% CI 2.28, 2.91] for PTB). In PSM analyses, we observed slightly attenuated risks of PTB (RR = 1.98 [1.70, 2.31]), LBW (RR = 2.46 [2.13, 2.84]), SGA (RR = 1.84 [1.44, 2.35]) and admission to NICU (RR = 1.91 [1.49, 2.45]) after matching by covariates. However, we found no significant association between antenatal CUD and 5-min low APGAR scores (RR = 1.47 [0.94, 2.30]). We found that maternal antenatal exposure to CUD is associated with a range of adverse neonatal outcomes. This study highlights that targeted interventions focusing on antenatal counselling are recommended to mitigate risks associated with maternal cannabis use.

Associations between big five personality dimensions and lifetime use of cannabis.

With the rise in cannabis use over the last couple of decades and shifting social views around drug use, the characterization of potential predictors for the development of cannabis use disorder (CUD) may be of high relevance for the implementation of preventive measures toward this condition. We conducted a study with the aim of analyzing possible associations between personality traits and CUD. Our sample consisted of 1335 inpatients admitted to The Menninger Clinic between September 2016 and December 2021. All participants completed the Big Five Inventory for the characterization of their personalities. The presence of a diagnosis of CUD and other substance use disorders was established through the administration of the Structured Clinical Interview for DSM-5 (SCID-5). Patients with and without a lifetime diagnosis of CUD were compared with regard to their scores in the five personality dimensions. We utilized analysis of covariance for the statistical inference, with age, sex, and use of other substances as covariates. Our findings revealed that low conscientiousness, low agreeableness, and high open-mindedness were associated with the presence of CUD. The relationships between CUD and the remaining personality dimensions explored (extraversion and neuroticism) were not statistically significant. This study indicates that certain personality dimensions are potential predictors for the risk for developing CUD. An inpatient population was sampled for this study, allowing for the comparison with other community-based studies. These findings have important preventative and treatment implications from a clinical and research standpoint.

Prevalence and correlates of severe problematic cannabis use: analysis of a population-based survey in Jamaica.

There is an increasing demand for the treatment of problematic cannabis use (PCU) in low-income and middle-income countries. Jamaica's historical inclination towards cannabis use underscores the need for research in addressing this issue. To determine the prevalence and patterns of cannabis use and assess the sociodemographic factors, psychosocial correlates, knowledge and perceptions associated with severe PCU among Jamaicans using nationally representative data. This study involved a secondary data analysis of the last Jamaica National Drug Prevalence Survey. It included 786 participants who used cannabis in the past year and completed the Cannabis Abuse Screening Test (CAST). The CAST has been validated against the Diagnostic and Statistical Manual of Mental Disorders (DSM), with a score ≥ 7 meeting the criteria for severe PCU. CAST scores were dichotomized utilizing these thresholds, and data generated were analyzed with SPSS version 25 using Pearson's χ2 test and logistic regression. In the past year, 53.3% of Jamaicans who smoked cannabis had a score of 7 or higher on the CAST and smoked an average of 62.21 joints per month. Male respondents were twice as likely to have severe PCU as females. Additionally, young, middle, and older adults were respectively 3, 5 and 3 times more likely to report severe PCU compared to adolescent respondents. Participants who started cannabis use at 11 years and under, 12-17 years, and 18-25 years were respectively 5, 7 and 7 times more likely to report severe PCU than those at 26 years and older. Moreover, easy access to cannabis, a high perceived need for treatment, belief in increased national drug use prevalence, and awareness of the National Drug Control and Prevention Agency were associated with increased odds of reporting severe PCU. One out of every two Jamaicans who used cannabis in the past year reported severe PCU and smoked an average of two cannabis joints per day. Early initiation increases the risk of severe PCU. Accordingly, a public health approach involving multiple sectors is needed to provide treatment options.

Quantity of delta-9-tetrahydrocannabinol consumption and cannabis use disorder among daily cannabis consumers.

Amid escalating cannabis legalization and daily consumption in the United States (US), determining the risk of cannabis use disorder (CUD) and relevant consequences among daily consumers has become a public health priority. Understanding these risks requires valid assessment of the daily quantity of delta-9-tetrahydrocannabinol (THC) consumed and its relation to consequences. This study characterized daily cannabis consumption using a new method for estimating milligrams of THC (mgTHC), and examined the relationship between daily mgTHC and CUD severity in a large national sample of daily consumers. US adult (aged 18+ years) daily cannabis consumers (n = 4134) completed a comprehensive online survey of cannabis consumption patterns (e.g. frequency, quantity, product types, potencies, administration methods) and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) CUD criteria. The primary exposure was past-week daily mgTHC consumption, calculated from survey responses to queries about product type, amount and potency consumed and including adjustments for puff size and loss of THC from specific methods of administration. The primary outcomes were (1) number of CUD criteria (range = 0-11) and (2) CUD severity categories: none, mild, moderate, severe. Median daily consumption was ~130 mgTHC, with substantial variability (25% ≤ 50 mg and 25% ≥ 290 mg). On average, participants endorsed 2.5 CUD criteria, and 65% met criteria for CUD (39% mild, 18% moderate, 8% severe). Greater daily mgTHC predicted higher CUD criteria count [betalog(mgTHC) = 0.50, 95% confidence interval (CI) = 0.267-0.734] and higher odds of mild [log odds ratio (logOR) = 0.238, 95% CI = 0.184-0.292], moderate (logOR = 0.303, 95% CI = 0.232-0.374) or severe (logOR = 0.335, 95% CI = 0.236-0.435) CUD. Among daily consumers of cannabis, there appears to be a positive relationship between the daily quantity of cannabis consumed (measured in milligrams of delta-9-tetrahydrocannabinol) and both the risk and severity of cannabis use disorder.

Occupational Stress, Psychological Distress, and Psychoactive Substance Use: A Clinical Case Study

Occupational stress has become a major global issue, affecting workers' mental health and well-being. Increasing pressures in the professional environment have led to a significant rise in psychological distress among many individuals. To cope with this growing pressure, individuals resort to coping strategies and defense mechanisms, including the use of psychoactive substances. Objective: This study aims to highlight the complex interactions between occupational stress, psychological distress, and the use of psychoactive substances, with a focus on the underlying psychological processes of this comorbidity in a clinical case. Method: A clinical study was conducted on a Moroccan worker who presented both chronic occupational stress and cannabis dependence, with a thorough psychodynamic analysis. Results: The psychodynamic analysis of clinical cases revealed that personal factors, such as low self-esteem, lack of self-confidence, poor self-management, alexithymia, introversion, and narcissistic gaps, can be precipitating factors for stress. They can also lead to psychoactive substance use, which is used as a defensive and adjustment mechanism to restore psychological balance. Conclusion: Occupational stress weakens an individual's psychological resources, leading them to seek psychoactive substances as a means of defense, anesthesia, and avoidance of psychological suffering, in a form of self-medication.

Divergence in Cannabis and Alcohol Use Disorder Prevalence Trends from 2002-2019

IntroductionDespite increases in availability, potency, and consumption of cannabis, epidemiological data suggest decreases in prevalence of cannabis use disorder (CUD) in some groups. Understanding mechanisms for these changes may help improve diagnostic tools for identifying disordered use. This analysis evaluates changes in CUD compared to a substance with comparably stable social and environmental context (alcohol use disorder [AUD]) as well as treatment engagement and need from 2002 to 2019. MethodsData were from the National Survey on Drug Use and Health. Outcomes included CUD and AUD symptoms, treatment engagement, and perceived need. Temporal trends and average annual rate of change [AARC] were computed. ResultsBetween 2002 and 2019, daily cannabis use prevalence increased by 94% (AARC=11.68%), whereas CUD prevalence among those using cannabis daily reduced by 47.9% (AARC=-10.30%). Daily alcohol use prevalence decreased by 10.86% (AARC=-1.90%), and AUD prevalence among those using alcohol daily reduced by 3.9% (AARC=-0.67%). Prevalence of individual 12-month CUD criteria among those using cannabis daily decreased (-13.4 to -59.6% change; AARC = -2.4% to -14%). Among those using cannabis daily, trends in prevalence of individual AUD criteria varied, with some criteria increasing in prevalence and others decreasing (-30.2% to 24.6% change; AARC = -5.82% to 3.7%). Treatment engagement and perceived need reduced for cannabis, whereas treatment engagement increased and perceived need decreased for alcohol. ConclusionThese results suggest that CUD and AUD criteria may be determined within the cultural context dictating the definition of harm which has changed for cannabis, but not alcohol, from 2002-2019.

Zur Diskussion / Up for Discussion. Gefährdet die Cannabislegalisierung Kinder und Jugendliche? / Does Cannabis Legalization Endanger Children and Adolescents?

Does Cannabis Legalization Endanger Children and Adolescents? The Cannabis Act (CanG) came into force on April 1, 2024. It regulates the "controlled supply of cannabis to adults for recreational purposes". In the USA, legalization has contributed to a decrease in the risk perception of the health hazards of consumption and an increase in risky consumption patterns, including among adolescents. The use of cannabis-related emergency and addiction treatment has risen sharply. Similar developments are now to be feared for Germany. For children and adolescents with cannabis-related disorders, a high standard of quality is maintained in the addiction departments of child and adolescent psychiatric and psychotherapeutic clinics with qualified withdrawal treatment and the subsequent treatment of comorbid mental disorders. However, the number of hospital beds is not sufficient to meet demand. This also applies to the medical rehabilitation measures for children and adolescents with the indications of cannabis abuse and addiction, which are too limited. There is a risk that children and young people will suffer in two ways as a result of the change in drug policy. Conclusion: The CanG sends the wrong signal for addiction prevention. Just a few months after the CanG came into force, the cannabis industry is already expanding. International evidence indicates that legalization endangers the health of the younger generation. Instead of a CanG, the better path for young people would have been to strengthen cannabis-related education and prevention in Germany.

Cannabis Use and Cannabis Use Disorder Among U.S. Adults with Psychiatric Disorders: 2001-2002 and 2012-2013

Background Rates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S. adults, so results on disproportionate increases in CUD prevalence could have been biased. To address this concern, we investigated whether disproportionate increases in the prevalence of cannabis outcomes among those with psychiatric disorders would replicate in nationally representative samples of U.S. adults. Methods Data came from two national surveys conducted in 2001-2002 (n = 43,093) and 2012-2013 (n = 36,309). Outcomes were any past-year non-medical cannabis use, frequent non-medical use (≥3 times weekly), and DSM-IV CUD. Psychiatric disorders included mood, anxiety and antisocial personality disorders. Logistic regression was used to generate predicted prevalences of the outcomes, prevalence differences calculated and additive interactions compared differences between those with and without psychiatric disorders. Results Cannabis outcomes increased more among those with psychiatric disorders. The difference in prevalence differences included any past-year non-medical cannabis use, 2.45% (95%CI = 1.29-3.62); frequent non-medical cannabis use, 1.58% (95%CI = 0.83-2.33); CUD, 1.40% (95%CI = 0.58-2.21). For most specific disorders, prevalences increased more among those with the disorder. Conclusions In the U.S. general population, rates of cannabis use and CUD increased more among adults with psychiatric disorders than other adults, similar to findings from VA patient samples. Results suggest that although VA patients are not representative of all U.S. adults, findings from this important patient group can be informative. Greater clinical and policy attention to CUD is warranted for adults with psychiatric disorders.

The annual trend of suicide rates from 2010 to 2021 in patients with cannabis use disorder – a national registry study

Abstract Purpose The temporal trend of suicide in patients with cannabis use disorder (CUD) is important to investigate, considering the recent increases in THC concentration in cannabis products. This study describes the annual suicide rates in patients with CUD from 2010 to 2021. To investigate if any change in suicide rate was specific to CUD, we compared these suicide rates with corresponding data for patients with alcohol use disorders (AUD) and other substance use disorders (SUDs). Method The study used a time series design. We used a national registry linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry from 2010 to 2021, including patients with CUD (ICD-10 code F12), AUD (F10), or other SUDs (F11; F13-F16; F18-F19) who died by suicide, supplemented with the total number of patients treated with specific disorders to estimate the suicide rates. The trend was analyzed by comparing the annual suicide rate to 2010 and using Poisson regression, adjusting for gender, age, and mental disorders. Results We found increased annual incidence rate ratios for patients with CUD in 2018 (IRR = 2.14 (95% CI 1.14–3.99)) and onwards and an increasing time trend over the study period (IRR = 1.08 (1.05–1.12)). No increases in trends were found for AUD or other SUDs. The time trend for CUD was attenuated when adjusting for depressive or anxiety disorders (aIRR = 1.00 (0.92–1.08)) or other SUDs (aIRR = 0.96 (0.87–1.06)). Conclusions Increasing suicide rates were found in patients with CUD. Comorbid anxiety and depression or other SUDs, but not other mental disorders, could partly explain these results.

The trajectory of substance use disorder among people formerly in foster care: A survival analysis.

Substance use disorder (SUD) represents a significant public health challenge, especially among individuals who have faced early life adversities. Foster care aims to provide a supportive environment for children; however, the relationship between a history of foster care and SUD development remains unclear. This study aims to examine the likelihood of developing SUD among individuals with a history of foster care, who have used substances during their lifetime, compared to those raised by biological parents. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we analyzed the prevalence of social demographics and clinical variables among individuals who have used alcohol, nicotine, or cannabis. We calculated the probabilities of developing SUD for each factor, including exposure to foster care. Various covariates that could impact SUD occurrence were also assessed. The duration from initial substance use to SUD onset was calculated for both groups. Survival analysis curves were generated for each substance to depict the probability of SUD development over time. Our analysis revealed that foster care may act as a protective factor against Cannabis Use Disorder (CUD), with a hazard ratio of 0.25 (95% CI [0.07, 0.88]). No significant associations were found with Alcohol Use Disorder (AUD) or Nicotine Use Disorder (NUD). Both foster and non-foster care groups exhibited higher probabilities of developing NUD compared to the general population. For cannabis users, the probability of developing CUD stabilizes after approximately 10 years. Family history of SUD and clinical predictors such as mood disorders consistently showed significant associations across all substance groups, highlighting their importance in SUD development. Our findings suggest that foster care may offer some protective benefits, particularly against CUD, emphasizing the need for further research into its protective factors and the development of targeted interventions to reduce SUD prevalence in this population.

Prevalence of Cannabis Use Disorder Among Primary Care Patients with Varying Frequency of Past-Year Cannabis Use.

Valid, single-item cannabis screens for the frequency of past-year use (SIS-C) can identify patients at risk for cannabis use disorder (CUD); however, the prevalence of CUD for patients who report varying frequencies of use in the clinical setting remains unexplored. Compare clinical responses about the frequency of past-year cannabis use to typical use and CUD severity reported on a confidential survey. Among adult patients in an integrated health system who completed the SIS-C as part of routine care (3/28/2019-9/12/2019; n = 108,950), 5000 were selected for a confidential survey using stratified random sampling. Among 1688 respondents (34% response rate), 1589 who reported past-year cannabis use on the SIS-C were included. We compared patients with varying frequency of cannabis use on the SIS-C (< monthly, monthly, weekly, daily) to survey responses on the Composite International Diagnostic Interview Substance Abuse Module for CUD (any and moderate-severe CUD) and cannabis exposure measures (typical use per-week, per-day). Adjusted multinomial (categorical) and logistic regression (binary), weighted for population estimates, estimated the prevalence of outcomes across frequencies. Patients were predominantly middle-aged (mean = 43.3years [SD = 16.9]), male (51.8%), white (78.2%), non-Hispanic (94.0%), and commercially insured (68.9%). The prevalence of any and moderate-severe CUD increased with greater frequency of past-year cannabis use reported on the SIS-C (p-values < 0.001) and ranged from 12.7% (6.3-19.2%) and 0.9% (0.0-2.7%) for < monthly to 44.6% (41.4-47.7%) and 20.3% (17.8-22.9%) for daily use, respectively. Greater frequency of use on the SIS-C in the clinical setting corresponded with greater per-week and per-day use on the confidential survey. Among patients who reported past-year cannabis use as part of routine screening, the prevalence of CUD and other cannabis exposure measures increased with greater frequency of cannabis use, underscoring the utility of brief cannabis screens for identifying patients at risk for CUD.

Impact of cannabis abuse on the occurrence of stroke in young people: a systematic review and meta-analysis.

The occurrence of stroke in young people has risen significantly. This can easily lead to physical disabilities, swallowing difficulties, and cognitive impairment, among other issues, having a profound impact on families and society. Risk factors for stroke in young people differ from those for traditional stroke, with cannabis abuse emerging as a significant high-risk factor. However, the extent of the impact of cannabis abuse on the occurrence of stroke and the rate of disability in young people remains unclear. To clarify this issue and provide evidence supporting the primary prevention of stroke in young people, this systematic review and meta-analysis summarizes the latest findings from previous studies. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science databases was conducted until April 2023. The review included observational studies comparing stroke risk estimates between cannabis abusers and non-users. This review included six observational studies focusing on cannabis abuse, involving 119,284,152 participants. A significant association was found between cannabis abuse and an increased risk of stroke [OR = 1.14, 95% CI (1.08, 1.20)]. However, there was substantial heterogeneity among the studies (I 2 = 89%, p < 0.001). After adjusting for confounders such as smoking and alcohol abuse, we found a stronger association between cannabis abuse and stroke in young adults [OR = 1.21, 95% CI (1.12, 1.29)]. Subgroup analyses revealed no significant difference in stroke risk between ischemic and hemorrhagic strokes (p = 0.43). The results of our systematic review and meta-analysis showed that cannabis abuse has a more significant effect on the occurrence of stroke in young people; however, it was not possible to distinguish whether cannabis abuse is more likely to cause ischemic or hemorrhagic stroke. Further research is needed to explore the impact of different drug types, dosages, and behaviors on stroke risk. https://www.crd.york.ac.uk/prospero/, Identifier CRD42023443261.

Cannabis use disorder increases risk of large-artery atherosclerotic stroke and migraine with aura through mendelian randomization study

Observational studies have shown some association between cannabis use disorder (CUD) and neurological disorders, but their causal relationship is unclear. In this study, we tested the potential causal relationship between CUD and three common neurological disorders using two-sample Mendelian randomization (TSMR) and multivariate MR (MVMR) methods. Thirty-two genetic loci were extracted as exposure factors from the largest genome-wide association study (GWAS) summary statistics for CUD to date. TSMR results showed that genetic prediction of CUD with all stroke, ischemic stroke, large-artery atherosclerotic stroke, migraine with aura, and Alzheimer’s disease (AD) had a positive causal relationship (P < 0.05), which was not found in several other diseases. The association between CUD and stroke, ischemic stroke, and AD in the MVMR study may have been influenced by confounding factors (P > 0.05). Subgroup analyses highlighted a causal relationship between genetically predicted CUD and large-artery atherosclerotic stroke (OR = 1.169; 95%CI 1.030–1.328; P = 0.016) and migraine with aura (OR = 1.142; 95% 1.021–1.278; P = 0.020). Our further functional mapping and annotation enrichment analyses using FUMA suggest that the brain-gut axis may serve as another layer of explanation for the existence of an association between CUD and neurological disorders.

Pandangan Masyarakat Aceh tentang Penggunaan Ganja

This study aims to explore the views of the Acehnese people regarding the use of marijuana, with a special focus on the perspectives of traditional leaders and clergy in the region. Aceh, known for its strict application of sharia law, has a distinctive view of prohibited substances, including marijuana. This research method uses a qualitative approach with in-depth interview techniques with traditional leaders and clergy as well as literature studies to strengthen their views on the legality, social impact, and moral implications of cannabis use. The results of this study show that medically, marijuana can overcome long-term pain, mental health problems, slow the development of cancer cells, and improve symptoms of epilepsy and multiple sclerosis. However, there are health risks such as mental health problems, testicular cancer, and respiratory diseases if used. In Indonesia law, marijuana is considered a drug with a high addictive effect and is prohibited from use. By teaching the community and working with law enforcement, Acehnese traditional and religious leaders play an important role in preventing marijuana abuse. In general, although marijuana has potential medical benefits, marijuana use in Indonesia must continue to be controlled and restricted to prevent abuse. If the legalization of medical marijuana is discussed, the benefits and risks should be carefully considered, with strict regulation to reduce its adverse effects.

Cannabis Use Disorder Associated With Increased Risk of Postoperative Complications After Hip or Knee Arthroplasties: A Meta-analysis of Observational Studies.

With the legalization of marijuana in the United States, the number of patients with cannabis use disorder (CUD) in the joint arthroplasty population has increased markedly. The primary purpose of this meta-analysis was to determine whether there were differences in clinical and economic outcomes after total joint arthroplasty (TJA) between patients with and without perioperative CUD. We searched PubMed, Embase, Scopus, and Web of Science databases up to July 2018 to identify all eligible studies investigating the association of CUD with postoperative outcomes in patients undergoing TJA. Postoperative outcomes assessed consisted of complications, readmission, length of stay (LOS), implant revision, and cost of care. For dichotomous outcomes, pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random effects model. We identified 10 retrospective cohort studies with a total of 17,981,628 study participants. Patients with CUD had significantly higher odds of medical complications (OR 1.33 [95% CI 1.07 to 1.66], P = 0.01) and implant-related complications (OR 1.75 [95% CI: 1.64 to 1.88], P < 0.00001) than noncannabis users. Specifically, CUD was associated with significantly increased odds of cardiac complications (OR 1.95 [95% CI 1.50 to 2.54], P < 0.00001), cerebrovascular accidents (OR 2.06 [95% CI 1.66 to 2.57], P < 0.00001), postoperative infections (OR 1.68 [95% CI 1.34 to 2.10], P < 0.00001), periprosthetic fracture (OR 1.42 [95% CI 1.19 to 1.70], P < 0.0001), mechanical loosening (OR 1.54 [95% CI 1.42 to 1.66], P < 0.00001), and dislocation/instability (OR 1.88 [95% CI 1.32 to 2.68], P = 0.0005). Longer LOS and higher cost of care were also found in patients with CUD. This study strengthens the body of evidence that patients with CUD face higher risk of postoperative complications and greater financial burden after knee and hip arthroplasties. Physicians should inform patients about adverse outcomes and undertake appropriate risk adjustments before elective orthopaedic surgery. Level III.