Impact Of Marijuana Research Articles

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.

Marijuana's Impact On Implant-based Breast Reconstruction: A Retrospective Cohort Study.

Studies have shown that chronic marijuana use is associated with increased vascular inflammation, endothelial damage, myocardial infarctions, strokes, arteritis, and cardiomyopathies; however, cannabis's effect on wound healing in immediate direct-to-implant (DTI) breast reconstruction is unknown. With the increasing prevalence of marijuana use, it is imperative to understand its effects on surgical outcomes. We performed a retrospective cohort study of consecutive patients in a quaternary-care breast cancer center undergoing immediate DTI reconstruction. Patient demographics, operative details, and surgical complications were extracted through chart review. Active cannabis use was defined as use within 12 weeks of operation. Univariate and multivariable analyses were performed. In total, 243 consecutive patients underwent immediate DTI reconstruction, and 12 reported active cannabis use. There were no significant differences in patient demographics, cancer treatment, or operative details. Active marijuana users demonstrated higher rates of cellulitis treated with IV antibiotics (P = 0.004), explantation for infection (P = 0.004), emergency department visits (P = 0.028), readmission (P = 0.037), takeback to the operating room in 90 days (P < 0.001), and overall major complications (P < 0.001). Multivariable analysis demonstrated that active marijuana users were more likely to experience cellulitis treated with IV antibiotics [odds ratio (OR) = 3.55, P = 0.024], takeback to the OR within 90 days of operation (OR = 4.75, P = 0.001), and major complications (OR = 2.26, P = 0.048). The consumption of cannabis in the perioperative setting is associated with increased rates of complications in patients undergoing immediate DTI reconstruction; however, an analysis with a larger patient population is needed to conclude that abstinence from its use should be highly encouraged.

Impact of marijuana on masculinization top surgery postoperative complications: Single-surgeon single-institutional experience

Impact of marijuana on masculinization top surgery postoperative complications: Single-surgeon single-institutional experience

Effects of Marijuana Use in Patients Undergoing Abdominal Free Flap Breast Reconstruction.

Marijuana use has been associated with vascular inflammation and clotting, resulting in endothelial damage and arteritis. As marijuana use rises in the United States, few studies have evaluated its impact on surgical outcomes and wound healing in free flap breast reconstruction. A retrospective cohort study of patients undergoing abdominal free flap breast reconstruction between 2016 and 2022 at a large metropolitan healthcare system was performed. Patient demographics, comorbidities, procedural details, and complications were analyzed. Minor complications were defined as skin or fat necrosis not requiring intervention, nipple loss, any wound requiring management in the clinic, hematoma, and seroma. Major complications were defined as reoperation, flap loss, cardiac or thromboembolic events, and hospital readmission. Active marijuana users were those with marijuana use within 12 weeks of surgery. In total, 168 patients underwent 276 deep inferior epigastric artery-based flaps for breast reconstruction. There were 21 active marijuana users. There were no significant differences in patient demographics, cancer treatment, or minor and major complications. However, there were higher rates of active nicotine use (P = 0.001) and anxiety/depression amongst active marijuana users (P = 0.002). Active users had higher rates of bilateral breast reconstruction (P = 0.029), but no significant differences in other operative details. Active marijuana use of unknown frequency may be safe in patients undergoing breast free flap reconstruction. Advising marijuana abstinence preoperatively may not alter patient outcomes. Further studies of greater sample size are needed to evaluate marijuana's impact on outcomes associated with breast reconstruction using free flap.

Should Marijuana Be Legalized: A Scoping Review of Associations of Marijuana and Depression.

People with addiction to marijuana and those who have ever consumed marijuana at any time during their life suffer from depression at some point in their life. Depression has been associated with substance use as both a trigger and repercussion. A total of 3663 articles were analyzed, and 26 articles were collectively selected for this study. Consuming marijuana was linked to the development of depression in the majority of individuals. Marijuana consumption and its repercussions have both been connected to negative effects on the body, such as respiratory disorders and even psychological disorders, including stress and depressive disorders. Studies potentially point to a complicated causal relationship between marijuana consumption and depressive disorder, stating that early depressive symptoms enable marijuana usage, which then reduces depression. A research article clearly states that consuming marijuana can be helpful in elevating mood and anxiolytic initially, but it is subsequently followed by a rise in depressive symptoms, which manifest as mental distress and frustration. Discussions with patients about the extent of their marijuana consumption, techniques for reducing the use, and the impact of marijuana on depression may be beneficial in medical facilities where depressive disorder is treated. This research paper highlights the importance of understanding depression and the use of marijuana for temporary relief from depressive symptoms and its long-term consequences on mental health.

Marijuana use is inversely associated with liver steatosis detected by transient elastography in the general United States population in NHANES 2017-2018: A cross-sectional study.

The impact of marijuana on the general population is largely unknown. The present study aimed to assess the association between marijuana use and liver steatosis and fibrosis in the general United States population utilizing data from the National Health and Nutrition Examination Survey (NHANES). This cross-sectional study was performed with data from the 2017-2018 cycle of NHANES. The target population comprised adults in the NHANES database with reliable vibration controlled transient elastography (VCTE) results. The median values of the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were used to evaluate liver steatosis and fibrosis, respectively. After adjusting for relevant confounders, a logistic regression analysis was used to assess the association between marijuana use and liver steatosis and fibrosis. A total of 2622 participants were included in this study. The proportions of never marijuana users, past users, and current users were 45.9%, 35.0%, and 19.1%, respectively. Compared to never marijuana users, past and current users had a lower prevalence of liver steatosis (P = 0.184 and P = 0.048, respectively). In the alcohol intake-adjusted model, current marijuana use was an independent predictor of a low prevalence of liver steatosis in people with non-heavy alcohol intake. The association between marijuana use and liver fibrosis was not significant in univariate and multivariate regression. In this nationally representative sample, current marijuana use is inversely associated with steatosis. The pathophysiology is unclear and needs further study. No significant association was established between marijuana use and liver fibrosis, irrespective of past or current use.

Correlation of symptoms registered during blood collection from drivers who tested positive for Δ9-tetrahydrocannabinol (THC)

The impact of marijuana on road safety has been the subject of many debates over the years. These debates have intensified in recent years due to initiatives carried out in several jurisdictions aimed at marketing medical cannabis. According to Polish forensic toxicologists, road safety is a key issue, especially following the conferences in November 2012 in Kraków and in 2013 in Augustów (Gieroń et al., 2013), Poland, on the determination of appropriate concentration thresholds. These thresholds, defining the limit for the ‘after use’ and ‘under the influence’ conditions, are still not unambiguous or easy to determine for the Polish government. An unambiguous assessment of the impact of a given concentration of blood Thc on psychomotor performance is very difficult, and will remain so in the foreseeable future. This study used 107 randomly selected blood collection protocols, with 10 protocols for each THC concentration ranging from 1 to 10 ng/ml, on the basis of which thirteen features related to the external appearance and behaviour of the tested individuals were analysed. These features were: facial skin (pale, normal or red), slurred speech, mood and behaviour (cheerful, talkative, rowdy or reticent), heart rate, pupils (normal, dilated or contracted), reaction of pupils to light, the romberg test, the finger-to-nose test, picking up objects from the ground and awareness of time and place. Five of the thirteen features related to the appearance and behaviour of the respondents showed no abnormalities (gait, the romberg test, the finger-to-nose test, picking up objects from the ground, and awareness of time and place). The study found that the symptoms observed and recorded in the protocols are insufficient to make a decision about the impact of Thc on psychomotor performance. The characteristic symptoms (cheerfulness and talkativeness) occurred no more frequently than in 3 out of 10 of the concentrations tested.

Pediatric Subspecialist Alcohol Screening Rates and Concerns About Alcohol and Cannabis Use Among Their Adolescent Patients

PurposePediatric specialty care provides an opportunity to screen for and address patient substance use; however, little is known about providers’ screening rates, their opinions regarding substance use harms, or the potential marijuana to be used as a medication. MethodsWe surveyed national convenience samples of pediatric endocrinologists (N = 142) and rheumatologists (N = 83) and used descriptive statistics and multivariate logistic regression to examine alcohol screening rates, barriers, and for medical use of marijuana, differences between subspecialist concerns. ResultsIn all, 36.4% of providers reported screening adolescent patients annually or more, and a majority expressed concerns about impacts on disease management (80.0%/80.0%) and symptom management (69.3%/53.3%) from alcohol and marijuana, respectively. Nearly equal proportions disagreed (30.2%), were neutral (34.7%), or agreed (35.1%) that some patients would benefit from medical marijuana, although majorities were not comfortable recommending marijuana (62.7%) and did not believe marijuana is standardized enough to be used as medication (57.8%). DiscussionFewer than half of the subspecialists in our study routinely screen their adolescent patients for substance use, although many have concerns regarding the impacts of alcohol and marijuana use on their patients. Education and training on best practice could help to increase screening rates. There is agreement that marijuana is not standardized enough to be used as a medication. There is also a broad range of opinions regarding the pharmaceutical potential of marijuana and concerns about the impact of marijuana on underlying chronic medical conditions, which should be considered as marijuana policy continues to evolve.

The Impact of Marijuana on Antidepressant Treatment in Adolescents: Clinical and Pharmacologic Considerations.

The neuropharmacology of marijuana, including its effects on selective serotonin reuptake inhibitor (SSRI)/antidepressant metabolism and the subsequent response and tolerability in youth, has received limited attention. We sought to (1) review clinically relevant pharmacokinetic (PK) and pharmacodynamic (PD) interactions between cannabinoids and selected SSRIs, (2) use PK models to examine the impact of cannabinoids on SSRI exposure (area under curve (AUC)) and maximum concentration (CMAX) in adolescents, and (3) examine the frequency of adverse events reported when SSRIs and cannabinoids are used concomitantly. Cannabinoid metabolism, interactions with SSRIs, impact on relevant PK/PD pathways and known drug–drug interactions were reviewed. Then, the impact of tetrahydrocannabinol (THC) and cannabidiol (CBD) on exposure (AUC24) and CMAX for escitalopram and sertraline was modeled using pediatric PK data. Using data from the Food and Drug Administration Adverse Events Reporting System (FAERS), the relationship between CBD and CYP2C19-metabolized SSRIs and side effects was examined. Cannabis and CBD inhibit cytochrome activity, alter serotonergic transmission, and modulate SSRI response. In PK models, CBD and/or THC increases sertraline and es/citalopram concentrations in adolescents, and coadministration of CBD and CYP2C19-metabolized SSRIs increases the risk of cough, diarrhea, dizziness, and fatigue. Given the significant SSRI–cannabinoid interactions, clinicians should discuss THC and CBD use in youth prescribed SSRIs and be aware of the impact of initiating, stopping, or decreasing cannabinoid use as this may significantly affect es/citalopram and sertraline exposure.

Marijuana, Alcohol, and ED: Correlations with LUTS/BPH.

Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH. LUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well studied but recent results support short-term benefit and long-term caution. Depression, a form of central nervous dysfunction, and ED, which is likely mediated via endothelial dysfunction, are independently associated with LUTS/BPH. The presence of cannabinoid receptors in urologic organs, coupled with recent population studies, supports a modulatory effect of marijuana on voiding although an enormous knowledge gap remains.

Decriminalized, Not Legalized: A Pilot Study of South African University Students’ Views on the Use, Impact, Legalization and Decriminalization of Marijuana

Given the 2018 decriminalization of marijuana in South Africa for personal use and medicinal consumption, the aim of this research was to explore the perceptions of university students regarding the use, impact, legalization, and decriminalization of marijuana. Key findings revealed that a fair number of participants acknowledged using marijuana. When asked about the potential impact of marijuana on users, their families and significant others, they seemed to have a good understanding of the effects of the drug. However, while some participants were aware of the addictive nature of marijuana, others were not aware of the risk of addiction from smoking or ingesting this substance. However, they were able to weigh up the risks as well as the benefits of legalization/decriminalization of marijuana. This study has implications for health care professionals working with youth who use illicit substances such as marijuana, and in developing prevention and intervention programs aimed at the youth.

Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients.

Tetrahydrocannabinoids (THC) can modulate the coagulation cascade resulting in hypercoagulability. However, the clinical relevance of these findings has not been investigated. The aim of our study was to evaluate the impact of preinjury marijuana exposure on thromboembolic complications (TEC) in trauma patients. We performed a 2-year (2015-2016) analysis of American College of Surgeons Trauma Quality and Improvement Program database and included all adult (≥18 year) trauma patients. Patients were stratified based on preinjury exposure to Marijuana: THC + ve and THC -ve groups. We performed propensity score matching to control for confounding variables: demographics, comorbidities, injury parameters, hospital course, and thromboprophylaxis use. Outcomes were TEC (deep venous thrombosis, pulmonary embolism, stroke, myocardial infarction) and mortality. Of 593,818 trauma patients, 678 patients were matched (THC + ve: 226 vs. THC -ve: 452). Mean age was 34 ± 15 years, Injury Severity Score was 14 (10-21). There was no difference between the two groups regarding age (p = 0.75), sex (p = 0.99), Injury Severity Score (p = 0.54), spine Abbreviated Injury Scale (AIS) (p = 0.61), head AIS (p = 0.32), extremities AIS (p = 0.38), use of unfractionated heparin (p = 0.54), use of low molecular weight heparin (p = 0.54), and hospital length of stay (p = 0.87). Overall, the rate of TEC was 4.3% and mortality was 4%. Patients in THC + ve group had higher rates of TEC compared with those in THC -ve group (3.5% vs. 1.1%, p = 0.03). The rate of deep venous thrombosis (6.6% vs. 1.8%, p = 0.02) and PE (2.2% vs. 0.2%, p = 0.04) was higher in THC + ve group. However, there was no difference regarding the rate of stroke (p = 0.24), myocardial infarction (p = 0.35) and mortality (p = 0.28). THC exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients. Prognostic study, level III.

Blood Pressure and Marijuana Use: Results from a Decade of NHANES Data.

Objectives: After 14 years of no change, new blood pressure (BP) guidelines were released; yet, the impact of marijuana on BP remains unclear. Our objective was to examine the association between marijuana use and BP. Methods: We analyzed data for adults (N = 10,709; mean age 44.8 years; 50.3% men) who completed 2005-2014 National Health and Nutrition Examination Surveys. Marijuana use was defined as never (no lifetime use), past (lifetime, not in past 30 days), and current (≥ 1 in past 30 days). Frequency of use was categorized based past 30-day use. BP was categorized as elevated BP, Stage 1 hypertension (HTN-I), or Stage 2 hypertension (HTN-II) based on updated guidelines. Results: Current users had a higher prevalence of elevated BP (19.4%), HTN-I (22.7%), HTN-II (12.9%) than never users (16.1%, 21.4%, and 11.99%) respectively; p = .03). After covariate adjustment, heavy users had 1.80 higher odds of elevated BP than never users (95% CI: 1.13-2.88). There were no statistically significant differences in BP in any other marijuana use category. Conclusions: Driven by heavy use, current users had a higher prevalence of elevated BP than never users. Patients at risk for abnormal BP should use caution when engaging in heavy marijuana use.

Marijuana Use in Pregnancy: An Updated Look at Marijuana Use and Its Impact on Pregnancy.

This article aims to provide an updated look at the use of marijuana in the United States and its impact on pregnancy. First, the prevalence of marijuana use is examined, including use both in and outside of pregnancy. The literature surrounding attitudes and beliefs with regard to use in pregnancy is reviewed. The impact on pregnancy outcomes is reviewed along with the evidence of marijuana's impact on neural development of the fetus. Finally, clinical considerations for providers are discussed.

Association and Clinical Outcomes of Marijuana in Patients with Intracerebral Hemorrhage

ObjectiveAn epidemiological relationship between intracerebral hemorrhage (ICH) and marijuana use is not known. Data about the impact of marijuana on ICH patient's outcomes remain scarce. MethodsThe Nationwide Inpatient Sample was investigated from 2004 to 2011 to identify cohorts with marijuana (N = 2,496,165) and nonmarijuana (N = 116,163,454) usage. Patients with a primary diagnosis of ICH were identified using International Classification of Diseases, Ninth Edition, Clinical Modification codes. Univariable analysis was used to compare demographics and risk factors for ICH, and to study patient outcomes in ICH patients with or without marijuana use. Binary logistic regression analyses were used to study marijuana as independent predictor of ICH and to assess its effect on patient outcomes. ResultsThe prevalence of ICH was greater in the marijuana cohort (relative risk: 1.11, confidence interval [CI]: 1.07-1.16). However, marijuana use (odds ratio [OR]: 1.063; CI: .963-1.173) was not an independent predictor of ICH after adjusting for other illicit drug use and ICH risk factors. For in-hospital outcomes, marijuana users had fewer adverse discharge dispositions (OR .78; CI: .72-.86), reduced length of hospitalization (OR .54; CI: .48-.61), and lower hospitalization cost (OR .72; CI: .64-.81) but higher in-hospital mortality (OR 1.26; CI: 1.12-1.41). ConclusionsMarijuana users are more likely to be admitted with ICH, however, marijuana is not an independent risk factor for ICH. Although marijuana has paradoxical effect on ICH related outcomes, higher mortality rates in marijuana users offset any potential protective effect among ICH patients.

Older Adults Driving Under the Influence: Associations With Marijuana Use, Marijuana Use Disorder, and Risk Perceptions.

Despite increasing marijuana use among the 50+ age group, little research has been done on marijuana's impact on older adults' driving under the influence (DUI). Using the 2013 to 2014 National Survey on Drug Use and Health data, this study examined the association of older adults' self-reported DUI with marijuana use, marijuana abuse/dependence, and marijuana risk perception. The findings show that one third of past-year marijuana users aged 50+ reported past-year DUI, two thirds of which involved drugs. Those with marijuana abuse/dependence were 2.6 times more likely than those without the disorder to report DUI, controlling for alcohol abuse/dependence, other illicit drug use, and sociodemographic and health/mental health statuses. As safe driving is key to prolonging independence in late life, clinicians need to educate older adults about the risk of marijuana use, alone and with other substances, on their driving capacity and provide age-appropriate treatment for marijuana use disorder.

Marijuana Use in the Elderly: Implications and Considerations.

This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology. Findings are based on data collected from older adults (65 years of age and older) through August 2016. Because of the lack of research and funding, reputable literature on the impact of marijuana on older adults is scarce. The available evidence suggests that elderly individuals should be cautious when consuming marijuana, especially those who have certain comorbid conditions. The geriatric population has a higher likelihood of having multiple comorbidities and is subject to polypharmacy. Marijuana use, medicinal or recreational, complicates the picture with additive central nervous system side effects. This article reviews the growing information on marijuana use and discusses issues to consider and cautions in usage that can apply to day-to-day clinical practice and geriatric care. The role of the pharmacist in educating patients, caregivers, and health care providers is expanding with the growing number of states that have legalized medical marijuana (26 states and the District of Columbia, as of 2017). Important education points including drug-drug interactions, drug-disease interactions, and signs and symptoms of acute overdose should be considered. With this review, pharmacists will be informed on recommendations on the use of marijuana in the older adult. Monitoring of therapy, as well as adverse effects, will be reviewed, including some legal issues and challenges.

Marijuana on the Mind? The Impact of Marijuana on Cognition, Brain Structure, and Brain Function, and Related Public Policy Implications

Although marijuana (MJ) has been used for thousands of years, the public’s opinion of MJ has shifted drastically over the past century, leaving many wondering about its potential risks and benefits. This article summarizes research detailing the impact of recreational MJ and related variables (frequency, magnitude, potency, and mode of MJ use) on cognition, brain structure, and brain function. MJ use, particularly at young ages, has been reported to undermine cognition, as well as alter brain structure and function. Furthermore, we discuss how data from recreational MJ studies, as well as more recent medical marijuana (MMJ) research findings, relate to legalization efforts. Considerations for policymakers, such as age limits, guidelines for safe use, and the therapeutic potential of certain constituents of MJ (i.e., cannabidiol), are also outlined. In recent years, policy has outpaced science; important areas in need of further research are noted.

A Review of the Impact of Marijuana's Legalization on Colorado's Industrial Warehouse Lease Rates: How High is High?

We review the evolution of the marijuana industry in Colorado and its implications for real estate. We investigate industrial space pricing and the history of price effects caused by the legalization of marijuana in Colorado. We are the first to investigate how the legalization of marijuana has created an excess demand for real estate space. We show that the lease pricing of industrial grow facilities is well above that of non-marijuana related industrial spaces by referring to examples and reasoning for the lease rate spread. We comment on what the next phase of the marijuana real estate market will be as the industry matures.

Medical marijuana laws and pregnancy: implications for public health policy

Although there is much to learn yet about the effects of prenatal marijuana use on pregnancy and child outcome, there is enough evidence to suggest that marijuana, contrary to popular perception, is not a harmless drug, especially when used during pregnancy. Consequently, the public health system has a responsibility to educate physicians and the public about the impact of marijuana on pregnancy and to discourage the use of medical marijuana by pregnant women or women considering pregnancy.