Effects Of Cannabis Research Articles

Evidence of altered monoamine oxidase B, an astroglia marker, in early psychosis and high-risk state.

A novel radiotracer, [11C]SL25.1188, targets monoamine oxidase-B (MAO-B) enzyme, found primarily in astrocytes, which metabolizes monoamines (including dopamine), particularly in subcortical regions. Altered astrocyte function in schizophrenia is supported by convergent evidence from post-mortem, genetic, transcriptomic, peripheral and preclinical findings. We aimed to test whether levels of MAO-B, an index of astrocyte function are low in the living brains of early psychosis and their high-risk states. Thirty-eight participants including antipsychotic-free/minimally exposed clinical participants with first-episode psychosis (FEP), clinical high-risk (CHR) individuals and healthy volunteers (HVs) underwent a 90-min positron emission tomography (PET) scan with [11C]SL25.1188, to measure MAO-B VT, an index of MAO-B concentration. Participants were excluded if tested positive on urine drug screen (except for cannabis). This study of 14 FEP (mean[SD] age, 25.7[5.7] years; 6 F), 7 CHR (mean[SD] age, 20.9[3.7] years; 4 F) and 17 HV (mean[SD] age, 31.2[13.9] years; 9 F) demonstrated significant group differences in regional MAO-B VT (F(2,37.42) = 4.56, p = 0.02, Cohen's f = 0.49), controlling for tobacco (F (1,37.42) = 5.37, p = 0.03) and cannabis use (F(1,37.42) = 5.11, p = 0.03) with significantly lower MAO-B VT in CHR compared to HV (Cohen's d = 0.99). We report a significant cannabis effect on MAO-B VT (F(1,39.19) = 12.57, p = 0.001, Cohen's f = 0.57), with a significant group-by-cannabis interaction (F(2,37.30) = 3.82, p = 0.03, Cohen's f = 0.45), indicating lower MAO-B VT in cannabis-using clinical groups. Lower MAO-B VT levels were more robust in striatal than cortical regions, in both clinical groups (F(12,46.84) = 2.08, p = 0.04, Cohen's f = 0.73) and in cannabis users (F(6,46.84) = 6.42, p < 0.001, Cohen's f = 0.91). Lower MAO-B concentration supports astrocyte dysfunction in cannabis-using CHR and FEP clinical populations. Lower MAO-B is consistent with replicated striatal dopamine elevation in psychosis, as well as astrocyte dysfunction in schizophrenia.

Multimodal examination of daily stress rhythms in chronic Cannabis users.

Chronic cannabis users frequently report stress relief as their primary reason for use. The endocannabinoid system is involved in the neuroendocrine stress response, and diurnal cortisol rhythms may be disrupted in chronic cannabis users. The objectives were to determine whether cannabis users demonstrate disruptions in diurnal stress rhythms and examine the acute effects of cannabis on stress-related outcomes in cannabis users' natural environments. Eighty-two participants (39 cannabis users, 43 non-users) collected saliva samples to quantify cortisol concentrations and provided subjective stress ratings at 8 time points throughout the day. They wore a medical-grade wearable device for 24h that recorded physiological indicators of stress (heart rate variability, electrodermal activity). Cannabis users collected additional saliva samples before and after cannabis use to examine acute effects of cannabis use. Cannabis users exhibited significant dysregulations in diurnal cortisol rhythms, including a blunted cortisol awakening response, flattened diurnal cortisol slope, and elevated afternoon cortisol concentrations. There were no differences in diurnal heart rate variability or electrodermal activity except for elevated evening heart rate in cannabis users. Finally, there were significant decreases in cortisol, subjective stress, and electrodermal activity following acute cannabis use in cannabis users' natural environment. These results provide evidence of dysregulated diurnal cortisol rhythms in cannabis users that were related to later waking times and acute stress-relieving properties of cannabis use in naturalistic environments. Future research should examine the direction of the relationship between cannabis use and diurnal cortisol rhythms and potential implications for other psychological disorders.

Effects of cannabis use on the heart.

Cannabis and the marijuana derived from it, which mainly contains the psychoactive ingredient tetrahydrocannabinol (THC), is increasingly being used both for medicinal purposes and as anarcotic. While many emphasize the positive aspects and uses of cannabis, it is equally important to examine the potential negative effects on health. Here, we pay special attention to undesired cardiovascular effects, as the cardiovascular system is known to react strongly to psychoactive substances. This article highlights the current scientific findings on the effects of cannabis and marijuana on the heart and cardiovascular system. Since many patients conceal their marijuana consumption, we expect ahigh number of unreported cases. Therefore, the need to disclose any drug consumption is crucial for further therapeutic decisions when taking the medical history.

The Effect of Medical Cannabis on Anxiety and Depression

In December 2020, the United Nations removed medical cannabis (MC) from Schedule 4 of the 1961 UN Convention on Narcotic Drugs following a recommendation by the World Health Organization (WHO) on its medical potential to pave the way for the reduction of regulatory barriers for research (United Nations, 2020). Some of the medical indications for MC include but are not limited to rare seizure disorders, symptomatic treatment of nausea and vomiting, insomnia, pain, loss of appetite, anxiety, and post-traumatic stress disorder (PTSD), as well as glaucoma, Huntington’s Disease, dystonia, and Parkinson’s Disease (Klumpers &amp; Thacker, 2019). In countries like the United States, MC prescriptions are on the rise for various medical indications, especially in symptomatic treatment of nausea and vomiting, loss of appetite, and pain among oncology patients (Corroon et al., 2019; Vinette et al., 2022).

Cross-Sectional Associations Between Expectancies for Cannabis use and Pain in an Emerging Adult Sample.

Pain and cannabis use are highly prevalent among emerging adults but research regarding how pain is associated with cannabis-related expectancies is limited. Emerging adults who reported past three-month cannabis use (N = 173) were recruited through an online sampling platform. Participants completed the Graded Chronic Pain Scale, Cannabis Use Disorders Identification Test - Revised, and Marijuana Effect Expectancy Questionnaire. Multiple linear regressions indicated that pain intensity and disability were associated with hazardous cannabis use and expectancies for global negative effects (ps < .001). Sex did not moderate any of these relationships (ps > .14). Findings suggest that emerging adults who experience pain report greater hazardous cannabis use and may expect more negative effects of cannabis use. Researchers and clinicians should consider assessing pain in the context of cannabis studies and interventions.

Marijuana and Its Implications in Breast Reduction Surgery Outcomes and Quality of Life: A Matched Analysis.

With marijuana use on the rise, its influence on surgical outcomes, particularly for breast reduction, warrants investigation. This study aims to clarify marijuana's effects on breast reduction surgery outcomes, given its limited research focus despite potential perioperative implications. A retrospective review was conducted from 2016 to 2022 of patients with/without marijuana use undergoing breast reduction. Propensity score-matching considered age, body mass index, ptosis, and breast tissue mass. Patient demographics, clinical attributes, and postoperative details were analyzed. Quality-of-life (QoL) changes were gauged using pre- and postoperative BREAST-Q. Of 415 patients who underwent breast reduction, 140 patients documented marijuana use. After propensity matching, a total of 108 patients (54 marijuana users versus 54 nonusers) were analyzed. The average age was 39 years ± 12 and body mass index 30.1 kg/m2 ± 5.3. There were no differences between the 2 groups in comorbidities, breast symmetry, excision patterns, pedicle use, or drain count (P > 0.05). Furthermore, surgical outcomes including surgical site occurrences, scarring, pain levels, hypersensitivity, or sensation loss were comparable between the groups (P > 0.05). There were also no differences in number of readmissions, reoperations, or emergency department visits (P > 0.05). Both groups showed enhanced postoperative QoL, regardless of marijuana usage. This study indicates that marijuana use does not significantly impact breast reduction surgery outcomes. Comparable surgical results and postoperative QoL improvements were observed in both marijuana users and nonusers. This study provides surgeons with the knowledge to offer more informed patient counseling regarding the implications of marijuana use in relation to breast reduction procedures.

Regulatory Landscape of Cannabis Warning Labels in US States with Legal Retail Nonmedical Cannabis, 2024.

Objectives. To characterize regulatory practices related to nonmedical cannabis warning labels in states across the United States that have legalized retail nonmedical cannabis. Methods. In March 2024, we conducted a content analysis of regulations for nonmedical cannabis warning labels required on product packages in 20 states where, as of March 2024, adults could legally purchase nonmedical cannabis in retail environments. For each state, we examined requirements related to warning label content and characteristics. Results. Required warning label content and characteristics varied widely across states. Only 2 states required a warning about mental health risks (10%) and 2 states required a warning for high potency products on risk of psychosis (10%). No states required front-of-package warning placement, only 2 states required rotating warnings (10%), and 4 states required contrasting colors (20%). Warnings were often verbose (mean = 57 words), vague, and had small or no minimum font size. Conclusions. Opportunities exist for states to improve the alignment of their nonmedical cannabis warning label regulations with evidence that has been generated so far in cannabis effects, cannabis warning efficacy, and warning label design. (Am J Public Health. 2024;114(S8):S681-S684. https://doi.org/10.2105/AJPH.2024.307722).

Maternal Cannabis Use During Pregnancy and Maternal and Neonatal Adverse Outcomes.

Cannabis is a psychoactive substance the availability and use of which, in various forms, has been liberalized in many countries across the world. Cannabis use, including by women of reproductive age, has become increasingly common, with (in some studies) >5% of women using the substance even during pregnancy to self treat nausea, vomiting, stress, anxiety, depression, insomnia, chronic pain, and other conditions. Women who use cannabis during pregnancy are more likely to have a medical or mental health condition; they are commonly unaware that cannabis is associated with pregnancy related risks. These risks arise from effects of cannabis on cannabinoid receptors in the placenta as well as from cannabis constituents that cross the placenta and act on receptors in the developing fetal brain; other mechanisms may also operate. This article examines recent cohort studies and meta-analyses on specific maternal and neonatal adverse outcomes associated with gestational exposure to cannabis. Maternal cannabis use during pregnancy is associated with small to moderately increased risks of gestational hypertension, gestational weight gain less than as well as greater than guidelines, and placental abruption. Maternal cannabis use during pregnancy is also associated with small to moderately increased risks of preterm birth (<36 weeks, <34 weeks, and <32 weeks), small for gestational age, low birth weight, neonatal intensive care unit admission, and fetal death. The risk of some of these adverse outcomes is greater with greater frequency of cannabis use. These adverse outcomes have been identified even in women who do not use other substances during pregnancy. Other adverse outcomes, such as major congenital malformations and neurodevelopmental disorders, are also reported (but are not discussed in this article). For these and other reasons, many professional bodies across the world are already discouraging women from using cannabis during pregnancy. It is important for pregnant women to be educated about cannabis and pregnancy related risks in a shared decision-making process.

Cannabis-Related Disorders Are Associated with Increased Early Postoperative Opioid Prescriptions and Delayed Emergency Department Visits Following Open Carpal Tunnel Release.

The effect of cannabis on pain management following open carpal tunnel release (CTR) surgery is unknown. The purpose of this study is to compare outcomes for patients with cannabis-related disorder (CRD) undergoing open CTR to a propensity-matched cohort of patients without CRD (no cannabis-related disorder [NCRD]). The TriNetX Research Network was queried to identify patients undergoing primary open CTR between January 2010 and December 2022. Patients with CRD were propensity matched to a NCRD cohort in a 1:1 ratio based on 7 characteristics. Rates of postoperative opioid prescriptions, emergency department (ED) services, and outpatient appointments were reported at 0-2, 2-6, and 6-12 weeks postoperatively. A total of 925 CRD patients were propensity matched to 925 NCRD patients undergoing open CTR. Within 0-2 weeks postoperatively, CRD patients received significantly greater rates of opioid prescriptions compared to NCRD patients (30.9% and 25.6%, P = .011). No cannabis-related disorder (NCRD) patients presented for outpatient follow-up at significantly higher rates than CRD patients within 6 weeks postoperatively. CRD patients presented to the ED at significantly higher rates between 6 and 12 weeks postoperatively (11.0% vs. 8.0%, respectively, P = .027). Cannabis-related disorder (CRD) is associated with lower rates of outpatient follow-up but higher rates of postoperative opioid prescriptions and ED presentations following open CTR compared to a propensity-matched cohort of NCRD patients. Cohort Study; Level III.

Cannabis and Cannabinoid Signaling: Research Gaps and Opportunities.

Cannabis and its products have been used for centuries for both medicinal and recreational purposes. The recent widespread legalization of cannabis has vastly expanded its use in the United States across all demographics except for adolescents. Meanwhile, decades of research have advanced our knowledge of cannabis pharmacology and particularly of the endocannabinoid system with which the components of cannabis interact. This research has revealed multiple targets and approaches for manipulating the system for therapeutic use and to ameliorate cannabis toxicity or cannabis use disorder. Research has also led to new questions that underscore the potential risks of its widespread use, particularly the enduring consequences of exposure during critical windows of brain development or for consumption of large daily doses of cannabis with high content Δ 9-tetrahydrocannabinol. This article highlights current neuroscience research on cannabis that has shed light on therapeutic opportunities and potential adverse consequences of misuse and points to gaps in knowledge that can guide future research. SIGNIFICANCE STATEMENT: Cannabis use has escalated with its increased availability. Here, the authors highlight the challenges of cannabis research and the gaps in our knowledge of cannabis pharmacology and of the endocannabinoid system that it targets. Future research that addresses these gaps is needed so that the endocannabinoid system can be leveraged for safe and effective use.

Insecticidal effect of Cannabis

Currently, there is a need for the development of vector insect control products that are ecologically viable, utilizing active principles available in nature. Natural compounds with insecticidal potential already identified in Cannabis are promising prospects for the control and management of vector arthropods of diseases. In this context, the work aims to investigate possible disparities in the toxicity effects of Cannabis in different formulations and at different stages of the vectors' life. This is a systematic review. Experimental studies describing the toxic effects of Cannabis on eggs, larvae, pupae, and adult vector insects were included. Articles in which the insect was characterized as a mechanical vector, literature review research, and ethnobotanical studies were excluded. The study revealed the potential insecticidal effect of Cannabis when applied in different formulations on Ctenocephalides felis felis, Aedes albopictus, Anopheles stephensi, Anopheles gambiae, and Culex quinquefasciatus at different stages of development. Cannabis proved to be a promising plant in terms of mortality and evidenced effects on insect fertility, birth rates, and adult emergence. The study revealed a potential insecticidal effect of Cannabis. However, further investigations are crucial to elucidate the role of this plant in vector insect control strategies.

Exploring cannabis information and perceptions of cannabis harms among patients with cancer.

361 Background: Cannabis use is rising among both the general and cancer populations. While the impact of cannabis on cancer care remains unclear, many patients who use cannabis report improvement in their cancer-related symptoms. However, little is known about the potential impact of cannabis on cancer development and treatment outcomes. Understanding patient beliefs about cannabis risks and their awareness of information about cannabis use may be important for future patient education. Here, we explored patient perceptions of harms and information-seeking habits on cannabis. Methods: Patients with cancer were recruited across outpatient ambulatory clinics at the Princess Margaret Cancer Centre (Toronto, Canada) through convenience sampling from July to August 2023. A one-time, paper-based, self-administered questionnaire was used to assess sociodemographic characteristics, perceptions of cannabis harms, and awareness of cannabis information. Multivariable regression analysis was used to identify factors associated with perceptions of cannabis use. Results: Among 243 participants, median age was 65 years, 45% reported lifetime cannabis use (12% were using cannabis at the time of survey), 50% were cigarette smokers, 62% were not employed full-time, and 77% spoke English as a primary language at home. Half (51%) of the participants reported being worried about the potential impacts of cannabis on their health. Current tobacco users (aOR=0.46 [0.19-1.07], p=0.07), primary English speakers at home (aOR=0.53 [0.28-1.01], p=0.06) and those not currently employed (aOR=0.57 [0.33-0.99], p=0.04) were less worried about the effect of cannabis on their health. Despite the perceived harms of cannabis, 84% of participants never sought cannabis-related information, while 40% wanted to know more about the influence of cannabis on cancer risk and treatment. Furthermore, Most (90%) participants reported never having discussed cannabis with their oncologists, but 93% felt it was important for healthcare providers to ask patients about cannabis use. Conclusions: Many patients with cancer are worried about the impact of cannabis on their health and want to know more about cannabis use in cancer care. Most patients report it is important for healthcare providers to have discussions about cannabis use. With the rising prevalence of cannabis use among patients with cancer, validated tools to assess cannabis use and cannabis-related educational resources specific to cancer risk and treatment outcomes should be explored to help address informational needs.

Comparative Efficacy of Lorazepam and Risperidone in Hospitalized Cannabis-induced Psychotic Disorder

Abstract Background: There is a lack of a standardized treatment protocol for cannabis-induced psychotic disorder (CIPD). Current practice involves using antipsychotics and benzodiazepines concurrently for treating CIPD. Aim: The index study aimed to assess and compare the efficacy of lorazepam against risperidone in patients with CIPD. Methods: Hospitalized patients with a diagnosis of CIPD according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition were randomized to receive either lorazepam or risperidone orally. Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), Cannabis Withdrawal Scale, and the Marijuana Craving Questionnaire were administered at baseline and daily to assess the improvement in psychopathology, withdrawal, and craving over a period of 10 days. Monitoring was also done for any adverse effects associated with treatment. Results: A total of 40 patients with a diagnosis of CIPD were included; 20 each in lorazepam and risperidone group. Both groups were comparable with respect to baseline PANSS (P = 0.13) and YMRS (P = 0.92) scores. The baseline withdrawal score was higher in the risperidone group (P = 0.03). There was a significant reduction in PANSS and YMRS scores in both groups by day 5 and day 10 (values of &lt;0.001). However, there was no significant difference between the two groups. The degree of improvement during the initial 5 days was significantly more (P ≤ 0.001) than that observed from day 5 to day 10 in both groups. Conclusion: There was no statistically significant difference between lorazepam and risperidone groups in terms of improvement in PANSS and YMRS scores. The use of antipsychotic did not have any additional benefit in CIPD and was rather associated with more adverse effects.

Cannabis and Pregnancy.

We review recent evidence describing the effects of prenatal exposure to cannabis in pregnant individuals. In the context of changing cannabis policy, more pregnant individuals are using cannabis, despite profound risks. Recent studies show possible perinatal and longitudinal neurodevelopment risks associated with cannabis use during pregnancy and lactation. Healthcare providers are reluctant to discuss this topic with patients for a variety of reasons. With increased access to cannabis comes the possibility of increased adverse effects of cannabis upon pregnant individuals and their children. A concerted effort to educate pregnant individuals about the potential risks of cannabis might mitigate those potential effects.

Associations of Cannabis Use, Metabolic Dysfunction-Associated Steatotic Liver Disease, and Liver Fibrosis in U.S. Adults.

Introduction: Following the introduction of metabolic dysfunction-associated steatotic liver disease (MASLD) as a replacement term for nonalcoholic fatty liver disease, the relationship between MASLD and cannabis use has yet to be established. With the global rise in cannabis consumption, understanding its impact on MASLD is critical for clinical guidance. Our study investigated the association between cannabis use, MASLD, and clinically significant fibrosis (CSF) among U.S. adults. Methods: Data were collected from the National Health and Nutrition Examination Survey for the period 2017 to 2018 to conduct a cross-sectional analysis. The diagnosis of hepatic steatosis and CSF was based on median values of the controlled attenuation parameter and liver stiffness measurement, with thresholds of 285 dB/m and 8.6 kPa, respectively. Information on cannabis use was obtained through self-report questionnaires. Multinomial logistic regression models and subgroup analyses were used to investigate the association between cannabis use and MASLD with CSF. Results: Our study assessed data from 2,756 U.S. adults (51.1% female; 32.2% white; mean age 39.41 ± 11.83 years), who had complete information on liver stiffness measurements through transient elastography alongside reported cannabis use. Results indicated that cannabis use overall was not associated with liver stiffness in patients with MASLD. However, among females, cannabis use was associated with MASLD accompanied by CSF, with an adjusted odds ratio (OR) of 0.47 (95% confidence interval [CI]: 0.24-0.91). Heavy cannabis use (9 to 30 times per month) was associated with MASLD accompanied by CSF among female participants, with an adjusted OR of 0.12 (95% CI: 0.02-0.88). Conclusion: In our study, cannabis use did not show a significant association with liver stiffness in patients diagnosed with MASLD. However, heavy cannabis consumption in women was associated with MASLD accompanied by CSF. These findings suggest that the effects of cannabis on liver health may differ based on gender and frequency of cannabis use, emphasizing the need for further research in this area.

Effects of Cannabis sativa on the Neuromuscular System and Cognitive Behavior of Male Wistar Rats

This research investigates the influence of Cannabis sativa on the neuromuscular system and cognitive behavior of male Wistar rats. Twenty rats were randomly allocated into five groups, with Group 5 serving as the control and Groups 1 to 4 receiving oral doses of Cannabis sativa at concentrations of 100 mg/kg, 200 mg/kg, 400 mg/kg, and 800 mg/kg, respectively. The study employs various behavioral tests, including the Beam Walking Test, Morris Water Maze, Tail Suspension Test, Open-Field Test, and Hand Grip Test, to assess the effects of Cannabis on Wistar rats. Results from the Beam walking Test suggest that the control group (Group 5) demonstrated the best neuromuscular performance, with Group 3, (receiving 400 mg/kg), following closely. In the Morris Water Maze, Groups 1 and 5 exhibited superior results, while higher doses had a negative impact. Tail Suspension Test outcomes revealed that Group 5 displayed non-depressive behavior, while Group 4 exhibited signs of depression. The Hand Grip Test demonstrated longer duration for Groups 2 and 4, suggesting a positive impact on muscle strength compared to the control, on Open Field Test, Group 1 spent the most of the time at the center, indicating lower anxiety, whereas other groups displayed increased anxiety with higher Cannabis doses. The study highlights complex and dose-dependent effects of Cannabis on neuromuscular and cognitive parameters. Caution is advised in interpreting these findings, and further research is recommended to elucidate underlying mechanisms and explore a broader range of doses. Keywords: Cannabis sativa, cognitive function neuromuscular function

Clinical effectiveness of medical marijuana in patients with amyotrophic lateral sclerosis

Following legalization, Medical Marijuana (MM), has been used to treat the symptoms of Amyotrophic Lateral Sclerosis (ALS), yet data regarding Medical Marijuana's efficacy is lacking. Thus, we conducted a retrospective cohort study to assess Medical Marijuana's impact on ALS symptoms and progression. We reviewed the charts of all ALS patients treated in our clinic over a two-year period to collect data related to the primary outcome measures of symptoms of pain, poor appetite, anxiety, spasticity, insomnia, ALSFRS-R score, BMI, and MM use. Two groups were defined: a control group with target symptoms but no MM prescription, and a test group that filled a MM prescription, including a subgroup on MM for ≥3 visits. Outcomes were correlations between MM usage and symptom prevalence, and between MM usage and BMI and ALSFRS-R decline slope, analyzed using descriptive statistics and qualitative analysis via local regression. Data included 344 ALS patients. We found MM use correlated with alleviation of pain, poor appetite, and anxiety in the short term, but not with spasticity or insomnia. There was no correlation between MM use BMI maintenance. Notably, MM usage correlated with faster ALS progression, although patients using MM exhibited higher symptom burden and progressed faster than controls even pre-MM prescription. In conclusion, MM shows correlation with managing pain, poor appetite, and short-term anxiety in ALS, but is also correlated with faster disease progression based on ALSFRS-R scores. We suggest a multi-center, randomized controlled trial to evaluate both the clinical efficacy and safety of MM in the treatment of ALS.

Sexual experience under the influence of alcohol and cannabis consumption.

Substance use affects different areas of life, including the sexual sphere. Drugs and specifically the use of alcohol and cannabis, can influence sexual experience. However, there has been little research and to date none has been carried out in Spain that compares the effect of alcohol and cannabis consumption in the same people on their sexual experience. Therefore, the objective of the study was to analyze and compare the effect of alcohol and cannabis in the same people on their sexual experience. The sample consisted of 483 people who had ever consumed alcohol and cannabis. Participants answered an online questionnaire about alcohol and cannabis use and sexual experience. The results show that despite the fact that when people consume alcohol, they feel more attractive, they feel more attraction towards other people, they are more extroverted, their desire increases and they have longer sexual relations than when they consume cannabis, people who frequently consume when consume cannabis, they have more sensitivity and they are more sexually satisfied than when they consume alcohol. Regarding the sexual experience, although they prefer not to use drugs when they have sex, people who frequently consume prefer to consume more cannabis than alcohol. Therefore, it is concluded that, although alcohol facilitates the sexual encounter, with cannabis people feel more sexually satisfied.

Health effects of cannabis

Health effects of cannabis

Characterizing the Cannabis Withdrawal Trajectory in Men With Cannabis and Tobacco Co-Use: A Preliminary Study

ABSTRACT Background: Cannabis and tobacco co-use is prevalent, and individuals who co-use have elevated cannabis relapse rates compared with those using cannabis alone. Research demonstrates that individuals who co-use experience greater cannabis withdrawal severity, a strong predictor of cannabis relapse, compared with those using cannabis alone. In this secondary analysis, we compared the trajectory of cannabis withdrawal severity during 28 days of cannabis abstinence in individuals with cannabis use disorder parsed according to tobacco co-use status. Methods: Men with cannabis use disorder (N=20) were parsed according to tobacco co-use: those with heavy (CT-H ≥10 cigarettes/day, n=11) and light tobacco co-use (CT-L ≤5 cigarettes/day, n=9). Participants completed 28 days of cannabis abstinence encouraged by contingency management and supportive therapy. Cannabis withdrawal severity was assessed weekly using the Marijuana Withdrawal Checklist. Abstinence was biochemically verified using urine analyzed by gas chromatography-mass spectrometry. Results: Fourteen participants achieved 28 days of biochemically verified cannabis abstinence and 4 participants significantly reduced their cannabis use (&gt;70%); 2 participants relapsed and were excluded from the analyses. In the included participants (CT-H, n=9; CT-L, n=9), there was a significant interaction (group x time) effect for Marijuana Withdrawal Checklist severity (P=0.03). Relative to CT-L, CT-H exhibited elevated cannabis withdrawal severity across multiple time points during cannabis abstinence. Conclusions: CT-H experiences elevated cannabis withdrawal severity that persists throughout 28 days of cannabis abstinence, relative to CT-L. Since withdrawal symptoms that remain elevated in severity over time prolong cannabis relapse risk, personalized approaches that target heavy tobacco co-use in CT-H may improve rates of cannabis cessation. Contexte: La consommation simultanée de cannabis et de tabac est répandue, et les personnes qui la pratiquent ont des taux de rechute élevés pour le cannabis par rapport à celles qui consomment seulement du cannabis. Les recherches démontrent que les personnes qui font un usage conjoint éprouvent une plus grande intensité de sevrage du cannabis, un facteur prédictif important de rechute, par rapport à celles qui ne consomment que du cannabis. Dans cette analyse complémentaire, nous avons comparé la courbe d’intensité du sevrage du cannabis pendant 28 jours d’abstinence chez des personnes souffrant de troubles liés à l’usage du cannabis et classées en fonction de leur statut de consommateur simultané de tabac. Méthodes: Les hommes souffrant de troubles liés à la consommation de cannabis (N=20) ont été répartis en fonction de leur consommation simultanée de tabac : ceux ayant une forte consommation de tabac (CT-H ≥10 cigarettes/jour, n=11) et ceux ayant une faible consommation de tabac (CT-L ≤5 cigarettes/jour, n=9). Les participants ont suivi 28 jours d’abstinence de cannabis, encouragés par une gestion des contingences et une thérapie de soutien. La sévérité du sevrage du cannabis a été évaluée chaque semaine à l’aide de la liste de contrôle du sevrage de la marijuana (Marijuana Withdrawal Checklist-MWC). L’abstinence a été vérifiée biochimiquement en analysant l’urine par chromatographie en phase gazeuse et spectrométrie de masse. Résultats: Quatorze participants ont atteint 28 jours d’abstinence de cannabis vérifiée biochimiquement et quatre participants ont réduit de manière significative leur consommation de cannabis (&gt;70%); deux participants ont rechuté et ont été exclus des analyses. Parmi les participants inclus (CT-H, n=9; CT-L, n=9), il y avait un effet d’interaction significatif (groupe x temps) pour la sévérité de la MWC (P=0,03). Par rapport à CT-L, CT-H a présenté une sévérité de sevrage du cannabis élevée sur plusieurs points temporels pendant l’abstinence de cannabis. Conclusions: Les CT-H présentent une sévérité de sevrage du cannabis élevée qui persiste pendant les 28 jours d’abstinence, par rapport aux CT-L. Étant donné que les symptômes de sevrage dont la gravité reste élevée au fil du temps prolongent le risque de rechute de consommation de cannabis, les approches personnalisées qui ciblent la forte consommation conjointe avec le tabac chez les CT-H peuvent améliorer les taux d’abandon du cannabis.