The recent legalisation of cannabis for recreational use in several Australian states, alongside similar global trends, has heightened interest in its potential vascular health implications. While the psychoactive and neurological effects of cannabis are well characterised, its role in the pathogenesis of peripheral arterial disease (PAD) remains poorly defined. Emerging evidence suggests that cannabis may contribute to acute limb ischaemia (ALI) and chronic limb threatening ischaemia (CLTI) through distinct vascular mechanisms. A narrative review of the literature was undertaken, incorporating epidemiological data, clinical studies and mechanistic investigations. Particular emphasis was placed on pathophysiological processes relevant to arterial compromise and their association with cannabis use disorder (CUD). Evidence was synthesised to highlight epidemiological trends and surgical management considerations. Several mechanisms have been proposed to explain cannabis-associated vascular risk, including cannabinoid-induced vasospasm, endothelial dysfunction, platelet aggregation and oxidative stress. Lifestyle factors and comorbidities frequently observed among cannabis users may further potentiate these processes. Epidemiological studies demonstrate associations between CUD and increased incidence of PAD-related complications, particularly ALI and CLTI. Limited clinical data also suggest potential adverse perioperative outcomes, though findings are inconsistent and often confounded by concurrent substance use. Cannabis use may represent an under-recognised risk factor for PAD and related vascular complications. With legalisation expanding in Australia and internationally, clinicians should maintain vigilance, particularly in younger patients presenting with lower limb ischaemia. Further prospective research is required to delineate causal mechanisms, quantify risk and inform evidence-based management strategies.

Household cannabis use is a risk factor for adolescents' mental health problems. However, little is known about the association of the cessation and psychological impairments in affected adolescents. This study examined the associations of household cannabis cessation and adolescents' mental health outcomes and potential pathways. This cohort study used data from the Adolescent Brain Cognitive Development study and included adolescents aged 10-13years with household cannabis use within 12months at wave 2. Household cannabis cessation was defined as the absence of cannabis use by household members (excluding the adolescent participant) at wave 3 among households that reported use at wave 2. Internalizing and externalizing problems were assessed using the Child Behavior Checklist, and psychotic-like experiences (PLEs) were evaluated using the Prodromal Questionnaire-Brief Child Version. Family conflict and sleep problems were assessed using the Family Environment subscale and the Sleep Disturbance Scale for Children, respectively. Demographic and psychometric confounders were balanced with propensity score matching (PSM). Linear regression was applied to investigate the associations between cessation and mental health outcomes. Mediation analyses of family conflict and adolescent sleep problems were performed. We further considered the influence of genetic predisposition to cannabis use disorder (CUD) and examined whether brain connectivity patterns, measured by resting-state fMRI, modified the relationships. Of the 1426 adolescents exposed to household cannabis within 12months, 438 (30.7%) were no longer exposed by wave 3. After PSM, cessation was associated with lower levels of internalizing and externalizing problems, and PLEs (mean ratios, 0.84-0.86, all P < 0.02), adjusting for baseline scores. The associations persisted after additionally adjusting for the adolescents' polygenic risk for CUD among White participants. Family conflict and sleep problems mediated the associations of cessation with internalizing (proportion mediated, 6.8% and 25.8%, respectively) and externalizing symptoms (14.3% and 24.8%, respectively). Adolescents with weaker connections between cingulo-parietal and dorsal attention networks showed stronger associations between cessation and PLEs. Household cannabis cessation was linked to a lower level of adolescent mental health problems at follow-up. These findings suggest that interventions aimed at reducing or eliminating household cannabis exposure may be beneficial for youth well-being.

The relationship between maternal cannabis use disorder diagnosis and the development of retinopathy of prematurity.

Blowing Minds: A cross-cultural, longitudinal investigation to unravel the highs and lows of recreational and medicinal cannabis users.

BACKGROUND Bacterial purulent pericarditis is rare and can be fatal if not treated appropriately. Streptococcus anginosus can cause invasive and cryptogenic infections, and purulent pericarditis is an uncommon presentation. Alcohol abuse can be a risk factor for abscesses caused by this agent. Cell-free DNA testing is a noninvasive method that has great potential in cases of serious infections in which pathogens are not easily identifiable by traditional microbiological techniques. CASE REPORT A 27-year-old man reported alcohol abuse and was hospitalized for acute pericarditis without signs of severity. He developed cardiac tamponade on the fifth day of hospitalization, requiring emergency pericardiocentesis. A significant persistent pericardial effusion was observed. Videopericardiectomy revealed a large amount of fibrin and purulent secretion in the pericardial sac. Additional tests and cultures did not identify systemic disease or an etiological agent. A cell-free DNA assay identified S. anginosus. He was discharged after 4 weeks of broad-spectrum antimicrobial therapy. There was no progression to constrictive pericarditis. CONCLUSIONS We present a case of purulent bacterial pericarditis with a cryptogenic focus in a young adult patient with a history of alcohol, marijuana, and e-cigarette abuse. He developed cardiac tamponade but received rapid and appropriate in-hospital therapeutic support, with clinical recovery within a few weeks. Alcohol and smoking may have facilitated bacterial translocation from the oropharynx to the bloodstream and then to the pericardium. S. anginosus was identified only by molecular research.

Objective: Cannabis use disorder (CUD) is increasingly prevalent and often co-occurs with psychiatric and legal complications. While cross-sectional associations between CUD and mental illness are well-documented, longitudinal data on the clinical and forensic trajectories of affected individuals remain limited, particularly in real-world settings. Methods: This naturalistic follow-up study tracked 51 male patients diagnosed with CUD over a five-year period. Data were collected via structured telephone interviews and hospital records, assessing substance use patterns, psychiatric diagnoses, Alcohol and Substance Addiction Treatment Center (AMATEM) admissions, and legal outcomes. Psychiatric comorbidities were evaluated using medical records, and substance use severity was assessed using the Addiction Profile Index (API). Results: Over five years, 82.4% of participants continued substance use, with synthetic cannabinoids being the most frequently used substance (76.5%). More than half (64.7%) developed a psychiatric diagnosis, most commonly depression and anxiety. Synthetic cannabinoid use was significantly different in individuals with psychiatric comorbidity (p = .033). AMATEM admissions declined over time but remained higher in patients with psychiatric diagnoses (Year × Diagnosis interaction: F = 2.600, p = .037). Nearly half experienced judicial psychiatric evaluations, and 23.5% had a history of incarceration. Conclusion: CUD is associated with persistent substance use, high rates of psychiatric comorbidity, and substantial legal-system involvement. Synthetic cannabinoids appear to exacerbate psychiatric outcomes. Long-term, integrated interventions are needed to address dual-diagnosis and reduce forensic burden.

Objective: To know the association between marijuana use and nutritional status in young Mexicans aged 18 to 34, according to sex. Materials and methods: Analytical cross-sectional study, in which 32 women and 35 men who used marijuana, recruited on social networks with the snowball technique, participated. The instrument used was a nutritional clinical history that included self-report of anthropometric measurements and dietary practices; the ASSIST questionnaire on the consumption of alcohol, tobacco and other drugs; as well as the International Physical Activity and Lifestyle Questionnaire, known as IPAQ (International Physical Activity Questionnaire). Results: The average age of the participants was 24 years for women and 25 for men. Regarding anthropometric measurements, the statistically significant results were lower body mass index and waist circumference in women than in men. The dietary indicator also showed lower caloric intake in women; however, both groups were classified as having hypercaloric diets. Conclusions: Despite the limitations of the study due to SARS-CoV-2 which prevented the implementation of the biochemical and clinical indicators, significant body and eating changes were found in marijuana users of both sexes. Keywords: Nutrition; Adults; Marijuana Abuse.

Background and Aims:Substance use disorders (SUDs) are heritable and share genetic variance with externalizing and internalizing psychopathology. Although recent gene identification efforts have demonstrated the value of modeling the shared genetic architecture among SUDs and externalizing, most research has thus far failed to account for overlap with internalizing. In this study, we aim to characterize the genetic relationships of both externalizing and internalizing with SUDs.Design and setting:We used genome-wide association study (GWAS) summary statistics derived from previously published studies of externalizing, internalizing, and SUD outcomes to quantify the genetic overlap between these phenotypes. We characterize this overlap using omnibus, partial, and local genetic correlations, estimates of their shared polygenic effects, genetic causality models, polygenic score (PGS) analyses, and estimates of each SUDs residual variance derived from models in Genomic SEM.Participants:We used GWAS summary statistics from individuals whose genomes were most similar to those from reference panels sampled from Europe (Ns ranged from 45,395 to 1,565,618) and Africa (Ns ranged from 30,000 to 122,571). For polygenic scores analyses, we used data from individuals of European and African ancestry groups available in the Collaborative Study on the Genetics of Alcoholism (COGA) sample (NMaximum = 7,394 for European-like genomes and 3,238 for African-like genomes)Measurements:Measurements in this study include GWAS summary statistics for externalizing, internalizing, and four substance use disorders: problematic alcohol use (PAU), cannabis use disorder (CUD), opioid use disorder (OUD), and tobacco use disorder (TUD). SUD outcomes in COGA were DSM-IV symptom counts of AUD, CUD, and OUD and scores on the Fagerstrom Test for Nicotine Dependence.Findings:We found strong genetic relationships of externalizing and, to a lesser extent, internalizing with all SUDs across methods. Despite their more modest associations, internalizing emerged as an important genetic correlate of SUDs. After accounting for variance shared with externalizing, partial genetic correlations between internalizing and SUDs were attenuated but, with the exception of TUD, still significant. Similarly, the PGSINT accounted for a statistically significant increase in variance over and above PGSEXT. Two SUD specific patterns emerged such that TUD was least associated with both psychopathology spectra and OUD was most strongly related to internalizing relative to other SUDs.Conclusions:From these findings we conclude that shared genetic influences may explain comorbidity observed between SUDs and internalizing disorders and suggest that genetic risk for internalizing should be incorporated into SUD identification and prevention efforts. Future gene identification efforts should study SUDs in the context of both externalizing and internalizing psychopathology.

Opioid use disorder (OUD) often arises after prescription opioid exposure and follows transitions among onset, remission, and relapse. Linked EHR-survey resources such as the All of Us Research Program enable stage-specific risk modeling and connection to intervention options. We built a multi-stage framework to model time-to-onset, time-to-remission, and time-to-relapse after remission using All of Us EHR and survey data. For each participant we derived longitudinal predictors from clinical conditions and survey concepts, including recent (1/3/12-month) event counts, cumulative exposures, and time since last event. We fit regularized Cox models for each transition and aggregated selection frequencies and hazard ratios to identify a compact set of high-confidence predictors. Pain, mental health, and polysubstance use contributed across stages: chronic pain syndromes, tobacco/nicotine dependence, anxiety and depressive disorders, and cannabis dependence prominently predicted onset and relapse, whereas tobacco dependence during remission and other remission-coded conditions were strongly associated with transition to remission. To support therapeutic prioritization, we constructed a therapy knowledge graph integrating genetic targets, biological pathways, and published evidence to map identified risk factors to candidate treatments in recent OUD studies and clinical guidelines.

Cannabis is one of the most common intoxicants used worldwide. Cannabis is widely consumed worldwide and can lead to visual alterations. However, most of the available information on its effects comes from studies conducted in developed countries, while data remain limited in developing regions such as Morocco, despite its significant role in cannabis cultivation. The aim of this study was to explore multiple visual parameters and self-perceived eyesight in cannabis users in Morocco. A cross-sectional study was conducted between March 2022 and April 2023 in Marrakesh, Morocco, in cannabis consumers. Data collection was performed in two phases. First a hetero-administrated questionnaire was used to collect socio-demographics, intoxicant consumption habit information, and eye health information. Then, several visual acuity tests were performed, including a preliminary examination, a visual function assessment, and an eye health assessment. Ninety-five cannabis users participated in this study. The majority were single (62.1%) males (87.4%). All lived in the Marrakesh-Safi region (100%), and most had daily activities such as having a job or being a student (77.9%). Most had vision conditions like astigmatism or myopia (83.4%). The majority had multiple addictions (66.5%), mainly to tobacco (43.7%). Hashish was the main cannabis type used (57.9%), and smoked cannabis was the principal mode of consumption (94.7%). Many had a family history of cannabis addiction (58.9%). Day light sensitivity (66.3%) and appearance of eye symptoms after cannabis use (90.5%) were declared by the majority. In most cases, no impact on far or near vision or vision impairment due to cannabis use were declared. Our results showed that using cannabis could have significant adverse effects on visual functions.

To characterize in-hospital morbidity and mortality in patients undergoing cardiovascular surgery with and without cannabis use disorder (CUD) using a national database. Between 2016 and 2018, 846,837 patients who underwent cardiovascular surgery were identified from the Nationwide Readmissions Database. Of these, 11,724 (1.4%) with CUD were identified. A 1:1 balancing-score matching was performed to compare outcomes while controlling baseline characteristics and comorbidities. Concomitant substance abuse, including smoking/nicotine, opioid abuse, cocaine/stimulants abuse, and alcohol abuse, was also significantly higher (P < .001 for all). Patients with CUD had a higher prevalence of deficiency anemia, congestive heart failure, chronic lung disease, depression, drug abuse, liver disease, neurological disorder, peripheral vascular disease, psychoses, pulmonary circulatory disorders and weight loss. Prior to matching, stroke (3.4% vs. 2.8%, P = .008), pneumonia (13% vs. 9.4%, P < .001), sepsis (5.5% vs. 3.2%, P < .001), and pulmonary embolism (3.6% vs. 1.8%, P < .001) were more common among patients with CUD. However, after matching, there were no differences in overall or individual complications. Mortality among patients with CUD was lower in both unmatched (1.8% vs. 3.0%, P < .001) and matched comparisons (1.8% vs. 2.7%, P < .001). Cannabis abuse was not associated with additional in-hospital morbidity or mortality and may not preclude cardiovascular surgery. However, CUD is a marker for polysubstance abuse, which deserves management. Patients with CUD are a vulnerable population with concomitant smoking, opioid abuse, cocaine abuse, and alcohol abuse that deserves treatment while undergoing cardiovascular surgery.

ABSTRACT Background Substance use is a growing public health concern in the Garhwal Himalayan region of Uttarakhand, India. Method This study aims to analyze the trends of substance use and the treatment provided over the past year (2024–2025) at the Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar (Garhwal). Finding A review of 858 outpatient records found alcohol dependence most common (67.1%), followed by opioid (16.4%), cannabis (8.62%), and nicotine dependence (7.81%). A positive correlation of 0.535 indicates a rise in patients with substance use as time progresses. Conclusion The findings underscore the immediate need for targeted public health strategies, increased community awareness, and the expansion of accessible de-addiction services in this rural Himalayan region.

Residents of rural areas face significant barriers to substance use disorder (SUD) treatment, including poor access, stigma, lack of confidentiality, and distrust of mental health services, which may inhibit treatment engagement. Mobile health (mHealth) approaches offer personalized, private, and easily accessible SUD treatment for rural residents, but differences in treatment mechanisms and efficacy across rural and urban regions are unknown. The present study investigates rural versus urban differences in the efficacy an mHealth SUD treatment via the theorized treatment mechanisms: protective behavioral strategies, readiness to change, and peer network health. The study leverages the results of a randomized clinical trial of an mHealth SUD treatment called Peer Network Counseling-txt (PNC-txt) conducted among a sample of young adults (age 18-25) with cannabis use disorder (CUD). We hypothesize that the impact of PNC-txt treatment on the treatment mechanisms will be stronger in rural, as compared to urban, regions, consequently leading to significantly greater reductions in cannabis use among rural residents. Results indicate that while PNC-txt reduces past 30-day cannabis use at 6 months via 1-month increases in both protective behavioral strategies and readiness to change, these indirect effects of treatment do not differ significantly between rural and urban residents. Our findings suggest that readiness to change and protective behavioral strategies are effective treatment targets for reducing the frequency of young adult cannabis use and support mHealth as an important SUD treatment approach for addressing treatment barriers in rural regions.

Alcohol Use Disorder (AUD) is a prevalent and debilitating neuropsychiatric condition characterized by compulsive alcohol consumption, impaired control, and negative emotional states, affecting about 28 million adults in the United States. Despite its significant public health burden, there are few objective biomarkers and no reliable neurophysiological tools to assist in its clinical diagnosis. In this study, we investigated the potential of deep learning to classify individuals with AUD using raw resting-state electroencephalogram (EEG) data. EEG recordings were obtained from the Collaborative Study on the Genetics of Alcoholism (COGA), a large, longitudinal, multi-site dataset. The initial cohort included a total of 5,402 recordings from 2,710 participants (aged 12–83, mean age 24; 1,338 males and 1,372 females). To reduce confounding factors, we applied demographic matching, and to address class imbalance, we applied undersampling. Minimal preprocessing was applied to preserve the raw EEG features. We utilized EEGViT, a hybrid deep learning architecture that combines convolutional patch embedding with a Vision Transformer (ViT) pretrained on ImageNet, thereby enabling end-to-end learning directly from raw EEG input. The analysis was stratified by sex and age, and all groups were age-matched. To validate the generalization of the model, models were also trained for Cannabis Use Disorder (CUD) and Opioid Use Disorder (OUD). Results for the AUD model showed a classification accuracy of approximately 56% in the overall dataset, 54% for males, and 58% for females. The CUD model showed an accuracy of about 63% with 59% for females and 69% for males. The OUD model showed an accuracy of about 63% with 61% for females and 65% for males. Temporal analysis indicated that the model’s performance varied across time intervals, with higher accuracy observed in later minutes compared to earlier ones. While modest, these findings underscore the potential of transformer-based models in psychiatric classification using raw EEG data and provide a foundation for future development of EEG-based diagnostic tools for AUD.

Abstract Background and aims Although cannabis use is widespread and prevalence of cannabis use disorder (CUD) is increasing, limited advancements have been made in CUD medication development. The objective of this study was to test the efficacy of varenicline with medical management for reducing cannabis use in treatment‐seeking individuals with CUD. Design A phase 2, randomized, double‐blind, parallel group, placebo‐controlled trial was conducted. Setting Two outpatient research clinics in South Carolina, USA, from February 2020 to February 2023. Participants Eligible participants met Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition (DSM‐5) criteria for CUD and used cannabis a minimum of 3 days per week. One hundred and seventy‐four participants were randomized to either varenicline ( n = 90) or placebo ( n = 84) stratified by smoking status and sex. Interventions Varenicline (titrated to goal dose of 1 mg twice daily) or matching placebo for 12 weeks. Medical management was provided weekly. Measurements Primary outcome measure was reduction in total number of cannabis use sessions at each weekly visit (weeks 6–12). Findings There was no main effect of treatment on reduction of total number of cannabis use sessions per week during weeks 6 through 12 [between group difference (Δ) = 1.7; 95% confidence interval (CI) = −1.0 to 4.7; P = 0.41]; however, a statistically significant treatment by sex interaction was found (F 1,132 = 5.1; P = 0.026), with a statistically significant effect of varenicline on reduction of cannabis use sessions per week observed in men (Δ = 4.2; 95% CI = 0.6–7.8; P = 0.04) but not women (Δ = −1.4; 95% CI = −5.7 to 3.0; P = 0.18). Conclusions Varenicline with medical management resulted in decreased cannabis use among men with cannabis use disorder seeking treatment, but not women (no effect was observed on the overall sample of treatment‐seeking individuals with cannabis use disorder).

Lower risk guidelines for safer levels of cannabis use could help to reduce the health burden posed by cannabis use disorder (CUD). We aimed to estimate risk thresholds for CUD based on delta-9-tetrahydrocannabinol (THC) consumption using standard THC units (1 unit = 5mg THC). Data from the CannTeen study, a longitudinal observational study consisting of five assessments over a 12-month period. London, UK. Participants were n = 65 adults aged 26-29 (46% female, 70.77% white ethnicity) and n = 85 adolescents aged 16-17 (56% female, 65.48% white ethnicity). All participants reported at least one use of cannabis during the 12-month study period. Mean weekly standard THC units were estimated using the Enhanced Cannabis Timeline Followback, a comprehensive and validated assessment of quantity, frequency and potency of cannabis consumed. This was administered at 3-month intervals and averaged over a 12-month period. Past 12-month diagnosis of CUD using The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was assessed at the final follow-up. Receiver operating characteristic curve models estimated the extent to which weekly standard THC unit consumption could discriminate no CUD from any CUD (mild, moderate or severe), and no CUD from moderate/severe CUD, in adults and adolescents separately. Risk thresholds were selected based on cut-offs that maximised sensitivity and specificity. Discrimination accuracy of weekly standard THC units on CUD was good, with area under the curve > 0.70 for all models. Optimal cut-offs for risk of any CUD (versus no CUD) were 8.26 units per week for adults and 6.04 units per week for adolescents. For risk of moderate/severe CUD (versus no CUD) optimal cut-offs were 13.44 units per week for adults and 6.45 units per week for adolescents. Weekly cannabis consumption based on standard delta-9-tetrahydrocannabinol (THC) units appears to show good discrimination accuracy of cannabis use disorder at different severities and in different age groups. Safer levels of cannabis use, defined by low weekly standard THC unit consumption, could be recommended in lower risk cannabis use guidelines.

IntroductionCannabis use and cannabis use disorder (CUD) are more prevalent among men and boys than among women and girls. However, this sex/gender gap has been narrowing in recent decades, likely due to an increase in cannabis use among women and girls, who have been historically under-represented in cannabis research. The lack of sex- and gender-based approaches within cannabis research has been highlighted in previous reviews, some of which have synthesized existing literature of associations between sex, gender, and cannabis use. What is missing is a clinically-relevant synthesis of evidence for sex and gender influences on problematic cannabis use, including treatment-related outcomes that could be used to influence care. The objective of this scoping review is to identify and synthesize published evidence about the influence of sex and gender on correlates and outcomes of treatment among people with problematic cannabis use (including CUD). Furthermore, we will examine to what extent this published literature has considered how sex and gender intersect with other social categories such as race and sexuality.Methods and analysisThis scoping review will follow the most commonly used methodology, the 2005 Arksey and O’Malley scoping study framework (including the optional consultation exercise to solicit feedback from relevant stakeholders) and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews reporting guidelines. The protocol has been registered on Open Science Framework (OSF) Registries (Registration DOI: https://doi.org/10.17605/OSF.IO/KC76M). We will search MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science for articles published between 2010 and the present (inclusive). Included studies must be conducted in human participants with problematic cannabis use (e.g., diagnosis or screening for CUD) and include an analysis of sex- and/or gender-related factors. Using Covidence software, two independent reviewers will screen each record at the title/abstract and full text phases. Two independent reviewers will then use a data charting form developed by the study team to extract data. Data charting and both phases of article screening will begin with a pilot process completed by all article reviewers to ensure consistency. Article data will be exported into a spreadsheet to facilitate summary and basic descriptive statistics. Studies will be grouped together first by content area (e.g., treatment correlates, treatment effectiveness), then by study design, and which sex- or gender-related factors are considered in the analysis.DisseminationWe will disseminate findings using two main strategies. First, we will engage in traditional knowledge translation, including publication in peer-reviewed journals and presentation at both medical and scientific conferences. Second, we will engage in knowledge translation strategies that will reach a wider audience (e.g., presentations to non-researcher audiences, dissemination of findings through social media networks, and development of brochures, infographics, and short videos to summarize our findings for a lay audience). We aim to ultimately engage relevant stakeholders (including clinicians) to determine how the identified evidence can best support care of problematic cannabis use.

BackgroundCannabis use is increasing globally, with a parallel rise in Cannabis Use Disorder (CUD). Chronic pancreatitis (CP), a progressive inflammatory condition, is associated with acute pancreatitis (AP) flares and an elevated risk of pancreatic cancer (PC). Although cannabis is often used for pain management in CP, its impact on PC risk and AP flare frequency is unclear.MethodsWe conducted a retrospective cohort study using TriNetX to identify adults with CP, stratified by CUD status. Patients with pre-existing PC were excluded. Propensity score matching (1:1) was applied for demographics, behavioral factors, and comorbidities. The primary outcome was PC incidence; the secondary was AP flare frequency. Hazard ratios (HR) were calculated using Cox proportional hazards regression. Sensitivity analysis adjusted for opioid use disorder.ResultsBefore matching, the CUD cohort (n = 10,864) had higher rates of alcohol and nicotine use than controls (n = 42,160). After matching, 6,858 patients per group remained with balanced covariates (SMD < 0.1). Mean follow-up was shorter in the CUD cohort (736 ± 422 vs. 896 ± 368 days). CUD was associated with a significantly reduced risk of PC (67 vs. 274 cases; HR: 0.263, 95% CI: 0.202–0.344; p < 0.001) but a modest increase in AP flare risk (HR: 1.102, 95% CI: 1.043–1.166; p = 0.001). Results were consistent in the sensitivity analysis.ConclusionsAmong patients with CP, CUD was associated with lower rates of PC detection during available follow-up, but a slightly increased risk of AP flares. These findings warrant further prospective and mechanistic studies to clarify cannabis’s role in pancreatic disease.

As cannabis use continues to rise globally, its impact on surgical outcomes remains poorly characterized. Cannabinoids modulate immune, nociceptive, and vascular pathways, with implications for postoperative healing. This study aimed to evaluate whether cannabis use disorder (CUD) is independently associated with increased complications following infraumbilical panniculectomy. A retrospective cohort study was conducted using the TriNetX Research Network, a globally federated database of de-identified electronic health records from over 100 healthcare organizations. Adult patients (≥ 18 years old) who underwent infraumbilical panniculectomy between 2010 and 2025 were identified. Patients with CUD documented 6 months preoperatively were propensity score-matched 1:1 to non-users by age, sex, BMI, race or ethnicity, and comorbidities. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for postoperative complications within 90 days. The mean age of the cohort was 43.2 ± 12.3 years, with 80.3% of participants identifying as female. Among 1,596 matched patients (798 CUD, 798 controls), the CUD cohort exhibited significantly higher rates of postprocedural pain (RR 1.82, 95% CI [1.32, 2.46]; p < 0.001) and postprocedural skin complications (RR 1.48, 95% CI [1.05, 2.09]; p = 0.019). No statistically significant differences were observed in rates of sepsis, hematoma or seroma, venous embolism or thrombosis, pulmonary embolism, and hospital readmission. Cannabis use disorder is independently associated with increased postoperative pain and wound-related complications following panniculectomy. Surgeons should incorporate cannabis use screening into preoperative risk assessments, particularly in procedures with high soft tissue demand. Limitations include reliance on ICD coding, lack of data on cannabis route or dose, and potential confounding from concurrent nicotine use. The online version contains supplementary material available at 10.1186/s44452-026-00013-z.

Objective: To determine the prevalence and associated factors related to cannabis abuse among school children in Kohat. Methods: This cross-sectional study was conducted among schoolchildren aged 13-20 years in Kohat City from May 2025 to June 2025. A systematic sampling technique was used in this study with a sample size of 281 children, taken from different public and private schools. Data were collected through a well-structured questionnaire that contained 10 questions with their Urdu translation. Statistical analysis was done through SPSS version 22. Results: A total of 281 students were given a questionnaire, out of which 270 (96%) filled and back and 11 (4%) did not give a response. All the students were male, and their mean ages were 17±3 years. 155 (56%) students were from the public schools, and the remaining 122 (42%) were from the private schools. Overall, 78% children were aware of cannabis addiction, of which 14 (5.2%) children had used cannabis. Most of the children referred to this abuse as peer pressure (friends) and their society. Conclusion: The prevalence of cannabis abuse among school children exceeds rates within the country. This has been accompanied by significant changes in the prevalence and strength of associated factors related to cannabis abuse. Furthermore, cannabis abuse among school children is a serious public health problem that requires special attention from the concerned education and health departments to overcome and control this issue.