Consumption Of Cannabinoids Research Articles

Cannabinoid receptor type 1 activation causes a water diuresis by inducing an acute central diabetes insipidus in mice.

Cannabis and synthetic cannabinoid consumption are increasing worldwide. Cannabis contains numerous phytocannabinoids that act on the G protein-coupled cannabinoid receptor type 1 (CB1R) and cannabinoid receptor type 2 expressed throughout the body, including the kidney. Essentially every organ, including the kidney, produces endocannabinoids, which are endogenous ligands to these receptors. Cannabinoids acutely increase urine output in rodents and humans, thus potentially influencing total body water and electrolyte homeostasis. As the kidney collecting duct (CD) regulates total body water, acid/base, and electrolyte balance through specific functions of principal cells (PCs) and intercalated cells (ICs), we examined the cell-specific immunolocalization of CB1R in the mouse CD. Antibodies against either the C-terminus or N-terminus of CB1R consistently labeled aquaporin 2 (AQP2)-negative cells in the cortical and medullary CD and thus presumably ICs. Given the well-established role of ICs in urinary acidification, we used a clearance approach in mice that were acid loaded with 280 mM NH4Cl for 7 days and nonacid-loaded mice treated with the cannabinoid receptor agonist WIN55,212-2 (WIN) or a vehicle control. Although WIN had no effect on urinary acidification, these WIN-treated mice had less apical + subapical AQP2 expression in PCs compared with controls and developed acute diabetes insipidus associated with the excretion of large volumes of dilute urine. Mice maximally concentrated their urine when WIN and 1-desamino-8-d-arginine vasopressin [desmopressin (DDAVP)] were coadministered, consistent with central rather than nephrogenic diabetes insipidus. Although ICs express CB1R, the physiological role of CB1R in this cell type remains to be determined.NEW & NOTEWORTHY The CB1R agonist WIN55,212-2 induces central diabetes insipidus in mice. This research integrates existing knowledge regarding the diuretic effects of cannabinoids and the influence of CB1R on vasopressin secretion while adding new mechanistic insights about total body water homeostasis. Our findings provide a deeper understanding about the potential clinical impact of cannabinoids on human physiology and may help identify targets for novel therapeutics to treat water and electrolyte disorders such as hyponatremia and volume overload.

Cannabis Use and Its Interaction with Anxiety Disorders

Introduction Cannabis use has been reported to cause a myriad of acute adverse reactions, including those linked to anxiety disorders, such as panic attacks and derealization. Notably, in the emergency department, anxiety makes up a significant proportion of the complaints related to cannabinoid consumption. Several reports show these symptoms can persist after the cessation of cannabis consumption. Consequently, some questions have arisen regarding the role of cannabinoids as precipitators for anxiety disorders in vulnerable individuals. Alternatively, it has been hypothesized that patients with anxiety disorders are more prone to using cannabis.Objectives We aim to understand whether there is an established relationship between anxiety disorders and cannabis use. Moreover, we intend to identify what are the factors which make an individual more likely to experience anxiety following cannabis consumption.MethodsA search was conducted in the PubMed database using the MeSH terms “cannabis”, “panic disorder”, “anxiety”, “panic” and “generalized anxiety disorder”. Articles published in the last ten years were considered. Publications were selected after careful reading of their abstract. A non-systematic review of the selected articles was performed.ResultsEight articles were included in this review. While a majority of these publications did not find a significant association between cannabis use and anxiety disorders, a small subset of analyzed articles found that cannabis use may increase anxiety severity in general, devoid of specific diagnostic association. Individuals who presented to the emergency department with anxiety complaints after cannabis use were likely to be young and to have ingested edible cannabis. History of psychiatric disease, especially substance use disorder, was common in this population.Conclusions Most available data suggest cannabis use is not clearly linked to anxiety disorders. However, information around this topic is scarce and heterogenous. Further research is needed focusing on the natural evolution of acute anxiety after cannabis use. Factors such as young age, presence of psychiatric comorbidities and consumption of edible cannabis appear to contribute to a significantly increased risk of experiencing acute anxiety after cannabis use.Disclosure of InterestNone Declared

Driving under the influence of cannabis: A 5-year retrospective Italian study

IntroductionCannabis consumption is associated with driving impairment and increased crash risk, endangering road safety. Toxicological analyses play a fundamental role in detecting a recent consumption of psychoactive substances. The aim of this study was to examine the concentration of cannabinoids in blood samples of driving-under-the-influence (DUI) offenders in order to investigate whether delayed sample collection affects the toxicological assessment of the offenders. Materials and MethodsAn observational retrospective study was performed using anonymized toxicological data referring to cannabis-related DUI offenders involved in road traffic accidents (RTA) or apprehended by the police from 1 January 2017–31 December 2021 archived at Legal Medicine and Toxicology Department of the University Hospital of Padova, Italy. ResultsIn a total sample of 318 drivers, 143 blood samples tested positive for tetrahydrocannabinol (THC) and metabolites 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC) and 11-nor-Δ9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH), and 173 blood samples were positive for THC-COOH with THC negative. In the first group, the mean concentrations of THC and THC-COOH were 4.05 ng/mL and 28.29 ng/mL, respectively. In THC-negative cases, the mean THC-COOH concentration was 7.3 ng/mL. The time elapsed between the event and sample collection varied from 15 min to 7 h (mean 2 h 29 min). The average estimated time elapsed after consumption of cannabinoids was 3 h 7 min (Model I) and 2 h 36 min (Model II). ConclusionsThe present research discussed the main difficulties in the toxicological evaluation of drivers under the influence of Cannabis. Issues related to the time between RTA and sample collection, the laws and legal limits in force in various Countries were presented

Adolescent exposure to the Spice/K2 cannabinoid JWH-018 impairs sensorimotor gating and alters cortical perineuronal nets in a sex-dependent manner

The consumption of synthetic cannabinoids during adolescence is reported to be a risk factor for the appearance of psychiatric disorders later in life. JWH-018 was identified as one of the primary psychoactive components present in Spice/K2 preparations. This study evaluated the short- and long-term consequences of exposure to JWH-018 during the adolescence in anxiety-like behavior, fear extinction, and sensorimotor gating in male and female mice. Alterations in anxiety varied depending on the time interval between treatment and behavioral analysis along with sex, while no changes were observed in the extinction of fear memory. A decrease in prepulse inhibition of the startle reflex was revealed in male, but not female, mice at short- and long-term. This behavioral disturbance was associated with a reduction in the number of perineuronal nets in the prelimbic and infralimbic regions of the prefrontal cortex in the short-term. Furthermore, adolescent exposure to JWH-018 induced an activation of microglia and astrocytes in the prefrontal cortex of male mice at both time intervals. A transitory decrease in the expression of GAD67 and CB2 cannabinoid receptors in the prefrontal cortex was also found in male mice exposed to JWH-018. These data reveal that the treatment with JWH-018 during the adolescence leads to long-lasting neurobiological changes related to psychotic-like symptoms, which were sex-dependent.

Cannabis and Driving: Developing Guidelines for Safety Policies.

The dynamism in the regulatory frameworks concerning the consumption of cannabinoids has placed their effects on cognitive and psychomotor skills at the center of the scientific debate. In consideration of the potential repercussions on public safety, particular attention has been focused on the impairment of driving skills, opening up the need to specifically regulate driving under the effects of cannabinoids. Both native cannabinoids and metabolites show a long positivity at low concentrations in the biological fluids, especially in the case of chronic consumption. Qualitative positivity to cannabinoids does not itself prove the presence of detrimental effects, which require the presence of active substances at relevant concentrations. Driving Skill Impairment: Multiple studies highlight a tetrahydrocannabinol (THC) concentration- based alteration of driving skills mainly affecting automatisms, whereas skills subjected to cognitive control are preserved up to higher dosages. The evidence relating to associations with other substances, chronic consumption and other cannabinoids, on the other hand, is still burdened by a high degree of uncertainty. Regulation Policies: Different models can be adopted in the regulation of driving under the effects of cannabinoids: sanctions can be applied in case of qualitative positivity, cannabinoids concentration above a defined threshold, or in presence of a demonstrated state of cognitive alteration. "Per se limit" with a quantitative THC cut-off between 3.5 and 5 ng/ml can currently be considered the most balanced choice. Finally, the analysis carried out allowed to identify pitfalls in both scientific and legislative fields for the improvement of safety policies.

Human Astrocyte Spheroids as Suitable In Vitro Screening Model to Evaluate Synthetic Cannabinoid MAM2201-Induced Effects on CNS.

There is growing concern about the consumption of synthetic cannabinoids (SCs), one of the largest groups of new psychoactive substances, its consequence on human health (general population and workers), and the continuous placing of new SCs on the market. Although drug-induced alterations in neuronal function remain an essential component for theories of drug addiction, accumulating evidence indicates the important role of activated astrocytes, whose essential and pleiotropic role in brain physiology and pathology is well recognized. The study aims to clarify the mechanisms of neurotoxicity induced by one of the most potent SCs, named MAM-2201 (a naphthoyl-indole derivative), by applying a novel three-dimensional (3D) cell culture model, mimicking the physiological and biochemical properties of brain tissues better than traditional two-dimensional in vitro systems. Specifically, human astrocyte spheroids, generated from the D384 astrocyte cell line, were treated with different MAM-2201 concentrations (1-30 µM) and exposure times (24-48 h). MAM-2201 affected, in a concentration- and time-dependent manner, the cell growth and viability, size and morphological structure, E-cadherin and extracellular matrix, CB1-receptors, glial fibrillary acidic protein, and caspase-3/7 activity. The findings demonstrate MAM-2201-induced cytotoxicity to astrocyte spheroids, and support the use of this human 3D cell-based model as species-specific in vitro tool suitable for the evaluation of neurotoxicity induced by other SCs.

Thermodynamics and transport properties of CBD and [formula omitted]-THC: A first attempt using molecular dynamics

As the consumption of cannabinoids for therapeutical purposes rises, understanding and modelling the thermodynamics and transport properties of major cannabinoids such as Δ-9-tetrahidrocannabinol (Δ9-THC) and cannabidiol (CBD) as well as their behavior in supercritical solvents such as CO2 is a key challenge to provide insights for the development of the purification process. In the present work, we used density functional theory (DFT) and classical molecular dynamics (MD) to estimate for the first time several thermodynamic and transport properties. The densities, vapor pressures, vaporization enthalpies, and self-diffusion coefficients for the main cannabinoids, CBD and Δ9-THC, were estimated in the range of 383–453 K. Diffusion coefficients in supercritical CO2 (sCO2) were also estimated for both molecules at the reported experimental solubilities. For the studied temperatures. densities are in the range of 900–980 kg/m3 being larger for the Δ9-THC due to a better packing of the molecules. Self diffusion coefficients are in the range of 0.11–0.24 *10-5 cm2/s being larger for the CBD. Estimated normal boiling points are 759.3 K and 744.2 K for the CBD and Δ9-THC respectively, a difference caused by the presence of more hydrogen bonds for the CBD in the liquid phase.

Toxic Habits and Well-Being Measures in Spanish Healthcare University Students during the COVID-19 Pandemic.

Background: Unhealthy lifestyles are strongly entrenched in healthcare universities and have sometimes been linked to stress or lack of sleep. This study investigated the prevalence of toxic habits (smoking, patterns of harmful alcohol use, and illicit drug use), stress levels, perceived health status, and sleep duration and assessed the connections between toxic habits and said well-being measures, as well as healthcare students’ perception of the influence of the COVID-19 pandemic on these health-related behaviors. Methods: In a cross-sectional study, healthcare students from Alfonso X University (Spain) completed a health survey composed of Alcohol Use Disorders Identification Test (AUDIT-C), Perceived Stress Scale (PSS-10), self-perceived health status, and the number of hours of sleep. Results: A total of 997 healthcare students completed the survey, of which 982 were analyzed. Being a smoker (32.2%) was associated with worse health status and insufficient sleep. Risk drinkers (33.2%) were associated with being female, and the consumption of cannabinoids (6.7%), with being male. These three toxic habits were related to each other. High levels of stress (28.2%) were correlated with worse ratings in the perception of health status (29.2%) and with insufficient sleep (45.8%), and all of them were associated with the female sex. Respectively, 49.3% and 44.2% of students recognized a worsening in their perception of stress and their sleep habits during the pandemic. Conclusion: Healthcare universities must carry out health promotion programs for stress management, sleep habits, and unhealthy lifestyles.

Diagnostic stability in substance-induced psychosis

IntroductionSubstance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse but persists for days and weeks with no substance use. There is as yet little knowledge about the longitudinal course of this psychosis, which suggests that significant numbers go on to be diagnosed with a severe mental disorder (SMD). The objective of this study was to analyse the progression of SIP to SMD in our environment and the possible factors that may be involved in that conversion. Material and MethodsWe used a retrospective cohort follow-up design. We reviewed all diagnoses of patients discharged from the psychiatric hospitalisation unit of the University Hospital of Basurto from January 2002 to December 2015 inclusively. In addition to sociodemographic and clinical data, information was collected on the consumption of cannabinoids, opioids, amphetamines, cocaine and alcohol. The data were analysed using descriptive analysis, Kaplan-Meier survival curves and Cox regression. ResultsOf the 116 patients, 78.4% were male, had an average age of 33.0 (SD = 8.9) years and 44.0% were single; 31.0% had a psychiatric family history; the most commonly used substance was cannabis (60.3%), followed by cocaine (40.5%). The cumulative risk of diagnostic conversion to an SMD in 16 years was 41.6% (95%CI: 32.2–52.2) over a mean 36.43 months. ConclusionsIn interventions in episodes of SIP we must bear in mind that a significant proportion will progress to an SMD in the first three years.

Adverse Effects of Cannabinoids and Tobacco Consumption on the Cardiovascular System: A Systematic Review.

With the recent legalization of marijuana in several countries for recreational use, a controversial belief is spreading about it being "safe". In this systematic review, we decided to investigate this belief and present the adverse effects of marijuana and tobacco smoking on the cardiovascular system.We carried out an electronic search on databases including PubMed, PubMed Central, and Medline. Medical Subject Headings (MeSH) terms and different keywords were used for data collection. We included studies published in the last 10 years that were in English. All types of study subjects were accepted. Grey literature, books, case reports and case series, overlapping and duplicate studies, and studies older than 10 years were excluded.In this review, we included 18 studies, which we then separated into the "tobacco and cardiovascular disease" arm and the "cannabinoids and cardiovascular disease" arm. We had 11 and seven studies for each of the arms, respectively. The types of articles included in this review were traditional and systematic reviews and meta-analyses.After reviewing all the data included in this article, we found out that cannabinoid consumption has a more devastating effect on the cardiovascular system when compared to tobacco. The shocking fact was that in several cases, deadly adverse effects were observed in patients within a few hours after consumption or even during their first time using cannabinoids.

Acute effects of cannabinoid consumption on endocannabinoid levels

Investigating the acute effects of cannabinoids consumption on circulating levels of endocannabinoids. Cannabis remains the most commonly used drug of abuse worldwide and the legalization in several states caused a drastic change in the variety of products available on the market. Over the past few years, several studies reported that the average concentration of Δ9-tetrahydrocannabinol (THC) drastically increased as well as the availability of products containing different combinations of THC and other cannabinoids, mainly cannabidiol (CBD). However, little is known about the acute effects of THC and/or CBD on the lipidome and more specifically the endocannabinoid system. The aim of the present study was to examine the acute effects of three cannabis flower chemovars with different THC to CBD ratios, in order to test whether chemovars with a higher CBD content produce different subjective effects and analyze their influence on the circulating levels of endocannabinoids. Participants were randomly assigned to ad libitum administration of one of three chemovars (THC-dominant: 24% THC, 1% CBD; THC + CBD: 9% THC, 10% CBD; CBD-dominant: 1% THC, 23% CBD); plasma samples were collected in a mobile pharmacology laboratory before, immediately after and 1 hour after ad libitum administration of their assigned chemovar. Twelve cannabinoids and 14 endocannabinoids were quantified using liquid chromatography tandem mass spectrometry assays previously published and validated by our group. Statistical analysis was performed using SPSS and MetaboAnalyst. One hundred and six participants were included in the study; 29 were assigned to the THC-dominant chemovar, 37 to the CBD-dominant chemovar and 40 to the THC + CBD chemovar. A total of 318 plasma samples were analyzed for both cannabinoids and endocannabinoids concentrations. Results were divided in 9 sub-groups based on the chemovar used and the time after consumption. Across the different time points, significant changes were noted for docosatetraenoyl ethanolamide (DEA), palmitoyl ethanolamide (PEA), stearoyl ethanolamide (SEA), linoleoyl ethanolamide (LEA) and oleoyl ethanolamine (OEA). Interestingly, anandamide (AEA) concentrations were significantly decreased only after consumption of the CBD-dominant chemovar and the THC + CBD chemovar. The mean AEA concentrations in the CBD-dominant group dropped from 0.74 ± 0.24 ng/mL before consumption to 0.54 ± 0.17 ng/mL one hour after use ( P < 0.001) and from 0.70 ± 0.18 ng/mL to 0.53 ± 0.17 ng/mL in the THC + CBD chemovar group ( P < 0.001). Chronic cannabis abuse can lead to damaging effects in humans and some authors examined whether components of the endocannabinoid system will undergo alterations and have shown decreased anandamide levels in CSF and an alteration of serum anandamide was not observed in the same study. Others reported increased levels of anandamide upon CBD treatment, mostly in Schizophrenia patients. These studies focused on long-term effects (14, 28 days). To our knowledge, this is the first study to assess the acute effects of different cannabis chemovars (THC-dominant, CBD-dominant and THC + CBD chemovar) on the circulating levels of endocannabinoids in healthy frequent user volunteers. It is very interesting that upon CBD consumption a decrease in AEA was observed. This decrease might alter the effect of THC, since AEA and THC both bind to CB1 receptors. Further studies are needed to better understand the acute effects of cannabis consumption on the circulating levels of endocannabinoids and potentially explain the differences in endocannabinoid patterns after acute versus chronic consumption as well as the potential indirect effect of CBD on THC's mechanism of action.

Cannabinoid consumption among cancer patients receiving systemic anti-cancer treatment in the Netherlands

PurposeDespite the inconclusiveness regarding health effects of cannabinoids among cancer patients, studies from non-European countries suggest that the medical-intended consumption of such products by this patient group is significant. The current study analyses cannabinoid usage among oncology patients receiving systemic treatment in the Netherlands. MethodsThe current study included adult patients receiving intravenous systemic therapy at Maastricht Comprehensive Cancer Centre, for a solid malignancy. Participants were asked to complete an anonymous questionnaire including questions on demographic variables, clinical variables and cannabinoid consumption.ResultsA total of 153 patients with solid cancer were included in this study. Almost 25% reported usage of cannabinoids for medical purposes, with 15% of the patients currently using the substance. Additionally, 18% of non-users considered future medical usage. In 48% of the cases, consumption was reported by the oncologist. The proposed anti-cancer effect was reported by 46% of the users as motivation for consumption. Current users were mainly palliative patients and 54% of the users were undergoing immunotherapy. Intention of treatment and type of therapy were predictive factors for consumption. Cannabinoid-oil was the most frequently used way of consumption.ConclusionThis study underlines the high number of cannabinoid users among oncology patients in the Netherlands in presumed absence of clinical guidance. It highlights the essence of a pro-active role of the clinician, assessing cannabinoid usage and educating the patients on the most recent evidence regarding its potential benefits and risks. Further studies on clinical decision making and efficacy of cannabinoids are recommended, to improve clinical guidance.

Oral fluid analysis to monitor recent exposure to synthetic cannabinoids in a high‐risk subpopulation

Among novel psychoactive substances, synthetic cannabinoid receptor agonists (SCRA) seem to have the widest diffusion in the population with no limitation to any particular demographic group. Information on drug consumption relies mostly on anonymized surveys and less on clinical or analytical data; notwithstanding, the huge efforts constantly made to enroll subjects to gather epidemiological data. In the present study, we collected 66 oral fluid samples from volunteers in a drug rehabilitation center in 2019 and early 2020. A liquid chromatography-mass spectrometry method previously developed and validated by our Unit was applied to detect SCRA (n= 10) in oral fluid. Results proved the presence of synthetic cannabinoids at a positivity rate of almost 20%, with detection frequency HU211(5/13) > UR144/JWH122 (3/13) > JWH019/JWH081/AM2201 (1/13). Concentrations were in the range < LOQ -0.36 ng/ml. Synthetic cannabinoids consumption had not been declared by any volunteer. This study enabled for the unprecedent detection of synthetic cannabinoids use in the territory of Parma (Italy) in a high-risk subpopulation. The identified SCRA proved the persistence into the market of the "first-generation" JWH family into the Italian territory and the marketing of relatively new ones (AM-2201). Public health consequences represented by NPS consumption are still scarce; therefore, further studies are needed to understand the real diffusion in the population.

Localization and Functional Characterization of the Cannabinoid Receptor Type 1 (CB1R) in the Kidney

IntroductionCannabis and synthetic cannabinoid consumption is increasing worldwide. The impact of their consumption on human health including the risk of kidney disease and its associated complications is uncertain. The kidney, among other organs, produces endogenous cannabinoids (endocannabinoids, ECs) that act on the G‐protein‐coupled cannabinoid receptors type 1 (CB1R) and type 2 (CB2R). ECs and CB1R agonists acutely act as diuretics with variable effects on Na+, K+, and HCO3– excretion. As the aldosterone sensitive distal nephron (ASDN) is responsible for the final renal regulation of total body electrolyte, acid/base, and water balance that is mediated by principal cells (PCs) and intercalated cells (ICs), we sought to examine the cell specific expression of components of the EC system in the mouse collecting duct and the acute changes in urine composition after administration of the cannabinoid receptor agonist WIN55,212‐2 (WIN).MethodsCB1R and AQP2 localization were examined by immunofluorescence microscopy in cryosections of kidneys harvested from non‐manipulated male C57BL/6 mice (7‐12 weeks of age) using protein‐specific Abs. A subset of whole animal metabolic studies were performed in mice that were acid‐loaded by provision of 20 mM NH4Cl and 1% sucrose added to the drinking water x 7d. On the day of experimentation, mice were allowed to spontaneously void, then injected SC with either 1.5 mg/kg WIN or vehicle control (10% Tween‐80 and 10% DMSO in 1x PBS) in a volume &lt;1% BW. Urine was collected for up to 4hr for measurement of volume, pH, osmolality, Na+ and K+.ResultsIn the ASDN, CB1R was localized to AQP2(‐) cells, and thus presumably ICs. Acid‐loaded mice treated with WIN (n=5) had similar UpH, UNaV, and UKV to untreated mice (n= 4) but had a higher urine output (UOP) (24.1 ± 6.5 vs. 13.6 ±1.2 µL/gBW/4hr; (P=0.02) and a lower UOsm (822 ± 335 vs. 1912 ± 293 mmol/kg H2O; P=0.001). WIN‐treated non‐acid loaded mice (n=7) urinated more frequently (3.6 ± 2.2 vs. 0.4 ± 0.5 micturitions/2 hr; P=0.05), had a lower UOsm (315 ± 82 vs. 1449 ± 553 mmol/kg H2O; P&lt;0.0001), and lower UKV (0.4 ± 0.2 vs. 0.9 ± 0.3 µmol/gBW/2hrs; P=0.002) compared to controls (n=8), whereas UNaV and UpH were similar. Furthermore, WIN reduced the apical/cytoplasmic ratio of AQP2 expression in PCs of the inner medulla by 43% (n=209 cells in 4 mice) compared to controls (n=183 cells in 4 mice) (P&lt;0.0001).ConclusionICs express CB1R. Although UpH and Na+ excretion were unaffected in either acid‐loaded or non‐acid loaded mice by WIN, the cannabinoid receptor agonist induced diabetes insipidus, a disorder characterized by the excretion of large volumes of dilute urine, and reduced K+ excretion in non‐acid loaded mice. Efforts are underway to determine whether this effect is central or nephrogenic. These results promise to reveal how cannabis affects kidney function and to identify potential targets for novel therapeutics to treat water and electrolyte disorders.

Trends in the Pharmaceutical Design of New Psychoactive Substances Detected in Oral Fluid OF Drivers Around a Music Festival in South-West France: Comparison 2019/2017.

New psychoactive substance use (NPS) is a reality in France, including among drivers. This work aims (i) to report the pharmaceutical design of NPS detected in oral fluid (OF) from drivers initially screened for drugs around a music festival in 2019 and (ii) to compare obtained results with those of a previous similar study carried out in 2017 in the same situation (and the same music festival) and according to the same methodology. OF specimens were recovered from the user devices of the salivary immunochemical tests used by the police during the controls carried out at the entering and leaving the festival. These OF were analyzed using liquid chromatography coupled with tandem mass spectrometry and high-resolution mass spectrometry methods using mass spectra libraries of approximately 1700 substances, including (in 2020) more than 650 NPS and metabolites. NPS was detected in 14 out of the 265 collected OF specimens. Ten NPS were identified (number of identification): APINACA (1), AB-Chminaca (1), 5F-AMB (1), 5F-PB-22 (5), 2C-D (1), methoxetamine (2), ketamine (1), x-CMC (1), 4-MEC (2), ethylone (2). The prevalence of NPS detection in OF (5.2%) is in the same order as the observed one in 2017 (6.8%), but these results are marked by the majority and increasing proportion of synthetic cannabinoids (47% of identified NPS in 2019 vs. 25% in 2017), an increase also in the proportion of cathinone derivatives (29% in 2019 vs. 6% in 2017), and a decrease in cyclohexanones (17% in 2019 vs. 43% in 2017). These pharmaceutical design trends (2019 vs. 2017) observed in a population of drivers around a music festival seem to reflect those that can be seen in more general populations in France, with probably a rise in the consumption of synthetic cannabinoids.

Medical cannabis use in Thailand after its legalization: a respondent-driven sample survey.

BackgroundMany countries now allow the consumption of cannabis or cannabinoids for medical purposes with varying approaches concerning products allowed and the regulatory frameworks prevailing their endowment. On 18 February 2019 Thailand passed legislation allowing the use of cannabis for medical purposes. This study aimed to examine patterns and purposes for consumption of medical cannabis, and consumers’ perceptions and opinions towards benefits and harms of cannabis and related policies in 2019–2020.MethodsA cross-sectional study using a respondent-driven sampling (RDS) method was conducted in four sites across Thailand. Participants were 485 adults aged 18 years and over, living in the study region, who had used cannabis for medical purposes within the past 12 months. Face-to-face interviews using a structured questionnaire were used to collect data on (1) demographic characteristics, (2) pattern of consumption, (3) source of information and perception of benefits and harms of medical cannabis, and (4) opinion towards cannabis policies. Data were analyzed using RDS Analyst and presented as percentage and mean with 95% confidence interval (CI).ResultsMost participants (84.7%, 95% CI [78.9–90.5]) used an oral form of crude oil extract while 9.2% (95% CI [4.1–14.2]) used the raw form. The most common uses were for treatment of cancers (23.3%, 95% CI [16.1–30.4]), neuropsychiatric symptoms (22.8%, 95% CI [17.5–28.0]), and musculoskeletal pains (21.6%, 95% CI [16.7–26.6]). Illegal sources such as underground traders (54.5%, 95% CI [40.8–68.3]), friends and relatives (12.2%, 95% CI [6.2–18.3]), not-for-profit provider groups (5.2%, 95% CI [0.5–10.9]), and clandestine growers or producers (2.9%, 95% CI [0.6–5.3]) were the main suppliers. Most (>80%) perceived cannabis could treat cancers, chronic pains, insomnia, Parkinson’s disease and generalized anxiety disorder. Less than half perceived that cannabis could cause adverse conditions e.g., palpitation, panic, memory impairment and schizophrenic-like psychosis. Most respondents agreed or strongly agreed with the policies regarding permission to use cannabis for medical purposes (95.1%, 95% CI [92.0–98.2]), for the legal sale of medical cannabis products (95.9%, 95% CI [93.7–98.2]), and for people to grow cannabis for medical use (94.2%, 95% CI [91.8–96.5]). However, only two-thirds agreed with policies concerning the sales of cannabis (65.3%, 95% CI [56.9–73.7]) and home-grown cannabis for recreational purposes (61.3%, 95% CI [52.7–69.9]).ConclusionOur study reports the experiences of consumers of medical cannabis in the first year after its legalization in Thailand. Consumers reported various patterns and indications of consumption that were not supported by scientific evidence, but had positive perception of the results of consumption. These findings highlight ongoing policy challenges for Thailand and can be a lesson to be learned for other countries in the region.

Faktori uticaja na znanje o sintetskim kanabinoidima - studija sprovedena među budućim zdravstvenim radnicima

Introduction: Although the consumption of synthetic cannabinoids (SC) has become more and more widespread recently, future healthcare professionals, according to the currently available curriculum, receive minimal information about diagnosis and treatment thereof. Aim: The main goal is to assess the level of knowledge of students of health professions about SC and examine the factors that influence that knowledge. Material and methods: A cross-section academic study was conducted among 510 students of medicine, dentistry and pharmacy at the Faculty of Medicine, University of Novi Sad, Serbia, during 2017 using a structured questionnaire. Results: Forty-nine percent of students answered positively to the question if they knew what SCs were, whereas when they were offered three definitions regarding SCs-92.2% gave the correct answer, with male students demonstrating a better knowledge than female ones (p=0.014). There was no correlation between previous knowledge about SCs and professional qualifications of the student's parents (p=0.953 mother, p=0.500 father) or the student's social media profile existence (p=0.057). Pharmacy students showed better previous knowledge about SCs in comparison with students of other courses (p=0.000) as well as the final year students when compared to those from the 1 st and 2 nd year of study (p=0.000). The repetition of a year level did not affect student's knowledge (p=0.616). Students with experience in alcohol usage showed better previous knowledge of SCs in comparison with alcohol non-users (p=0.008). However, most of the respondents answered "do not know" on the majority of statements about SCs offered. Conclusion: Superficiality in students' knowledge and insufficiency of formal education contributes to the necessity for revising curriculum regarding SCs for future health care professionals.

The Impact of Cannabinoid Consumption on Outcomes of Geriatric Rib Fracture Patients: A Nationwide Propensity-Matched Analysis

The Impact of Cannabinoid Consumption on Outcomes of Geriatric Rib Fracture Patients: A Nationwide Propensity-Matched Analysis

Alcohol, Cannabis and Crossfading: Concerns for COVID-19 Disease Severity.

Simple SummaryHeavy alcohol and cannabinoid consumption prior to pneumonia infection resulted in an increased severity of disease in mice. Analysis of hospital discharge data showed an increased length of stay among alcohol-consuming pneumonia patients. Increased alcohol and cannabis sales during the early months of 2020 suggest that consumption of both substances has increased significantly during the pandemic, potentially representing an increased risk of severe COVID-19 mediated by lung inflammation.Risk factors for severe COVID-19 pathology are currently being investigated worldwide. The emergence of this highly infectious respiratory disease has plagued the world, with varying severity across populations of different age, race, and socio-economic level. These data suggest that other environmental or social factors may contribute to this disease’s severity. Using a mouse model, we identify heavy alcohol and cannabinoid consumption as risk factors for increased pulmonary pathology in the setting of exposure to a microbial pulmonary pathogen (K. pneumoniae). We present observational evidence that pneumonia patients admitted to North Carolina hospitals have longer lengths of stay when they endorse alcohol use or have conditions considered alcohol attributable. We are concerned that the observed increase in alcohol and legal cannabinoid sales during lockdown and quarantine may contribute to increased pulmonary pathology among patients who become infected with COVID-19.

Prevalence and associated risk factors of cannabinoid abuse among Egyptian university students: a cross-sectional study.

Global surveys have highlighted rise in consumption of cannabinoids among residents of both developed and developing countries. Cannabinoids cause severe damage to the cardiovascular, nervous, respiratory, and renal systems, and have been linked with several deaths. Despite these adverse health effects, the use of cannabinoids has rapidly increased. This work seeks to estimate the prevalence of cannabinoid abuse among Egyptian university students and explore the associated risk factors. A cross-sectional study was carried out over 3 months (1st of July–1st of October 2020) and included 2380 students. Participants were subjected to a pre-designed self-administered questionnaire that included demographic data, Addiction Severity Index, and Depression Anxiety Stress Scale. Among the participating students, 4.9% of them reported cannabinoid abuse and 41% reported smoking cigarettes. The most used substances were hashish (96.5%), Strox (41.3%), Bhang (34.4%), voodoo (34.4%), and Tramadol (31.1%). Gender and social status were also significantly related to rates of substances abuse; most illicit drug users were males (93.1%), and the majority was of low (41.3%) or moderate (50.8%) socioeconomic status. The most significant risk factors associated with substance use were positive history of family conflict (OR=6.48; CI95%: 5.08–8.64, p<0.001), encouragement by peers (OR=2.95; CI95%: 1.73–5.05, p<0.001), male gender (OR=5.46; CI95%: 2.40–12.44, p=0.001), positive history of child abuse (OR=2.85; CI95%: 1.96–3.04, p=0.001), having a stay-at-home mother (OR= 1.56, CI95%: 1.19–2.04, p=0.001), living in an urban area (OR=2.22; CI95%: 1.53–5.0, p=0.002), and positive family history of substance use (OR=1.98; CI95%: 1.48–2.08, p=0.045). This study emphasizes the possible significant rise in substance use among university students. Awareness campaigns should target both students and student families.