Legalization Of Recreational Cannabis Use Research Articles

Legalization of Recreational Cannabis: Is India Ready for it?

Cannabis is one of the oldest psychoactive substances in India and worldwide. Many developed countries like Canada, Netherlands and few states of the USA have legalized the use of recreational cannabis. However, In India, the recreational use of cannabis and its various forms such as ganja, charas, hashish, and its combination is legally prohibited. There have been several discussions and public interest litigations in India regarding the legalization of recreational cannabis use and its benefits. With this background, this article addresses the various implications of legalizing recreational use of cannabis, a multibillion dollar market and its impact on mental health, physical health, social, cultural, economic, and legal aspects with the lessons learnt from other countries that have already legalized recreational cannabis use. It also discusses whether India is prepared for the legalization of recreational cannabis, given the current criminal justice and healthcare systems. The authors conclude that, India is perhaps not enough prepared to legalize cannabis for recreational use. India's existing criminal justice and healthcare systems are overburdened, finding it challenging to control medicinal use, which is often the first contact point for cannabis-related concerns.

P24. Effects of Cannabis Legalization in Canada on Daily Cannabis Use in Mental Health Disorders

Since the legalization of recreational cannabis use in Canada in 2018, one public health concern emerging is whether cannabis use will increase in people with mental illness. Relative to the general population, problematic cannabis use is elevated in psychiatric patients, including schizophrenia, mood and anxiety disorders, and PTSD. Moreover, problematic cannabis use is associated with more severe psychopathology and poorer functional outcomes. Thus, there is a need to evaluate whether legalization has led to changes in cannabis use patterns among psychiatric populations.

Qualitative Research Informing a Preference Study on Selecting Cannabis for Cancer Survivor Symptom Management: Design of a Discrete Choice Experiment.

IntroductionThe legalization of recreational cannabis use can enable cancer survivors to manage aspects of their care with cannabinoids without medical authorization or stigmatization. However, the absence of medical guidance—from the scientific literature or the healthcare system—makes it difficult for survivors to reach informed decisions about their care.ObjectiveThis article outlines the qualitative research undertaken to design a discrete choice experiment (DCE) aimed at understanding Canadian cancer survivors’ preferences for managing their cancer symptoms with cannabis in this complex socio-medical context.MethodsIn this study, we drew on previously published qualitative research (a literature review and interviews with cancer survivors) and the theory of planned behavior, holding weekly team meetings to review the qualitative data and identify initial attributes associated with medicinal cannabis consumption to inform the DCE design. The initial attributes were further assessed to determine whether they were sensitive to the Canadian context, modifiable to produce levels and trade-offs, and amenable to policy intervention, in order to form the DCE choice sets. The choice sets were tested via think-aloud exercises with members of the general population and included debriefing interviews. Think-aloud participants were recruited from patient groups and previous studies.ResultsBased on our review of the interview study, we identified the following attributes associated with selecting medicinal cannabis: effectiveness; chance of side effects; support from family, friends, and/or physicians; cost; and availability. Ability to perform everyday activities was added and monthly out-of-pocket cost was refined to render the DCE realistic to cancer survivors in the Canadian context. Revisions to the DCE instructions, terminology, and cost levels were made based on results from the think-aloud exercises (n = 10).ConclusionsThis qualitative study outlines the preference evidence collected regarding Canadian cancer survivors’ decisions to manage their symptoms with cannabis to inform a DCE quantitative survey. It contributes to transparent reporting of qualitative work in DCE development and to understanding cancer survivors’ preferences regarding medicinal cannabis consumption under legalization.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40271-021-00567-3.

Predictors of voter support for the legalization of recreational cannabis use and supply via a national referendum.

A national referendum to legalise recreational cannabis use and supply in New Zealand via the Cannabis Legalisation and Control Bill (CLCB) was recently narrowly defeated. Understanding the underlying factors for this result can inform the cannabis legalisation debate in other countries. To investigate predictors of voter support for and opposition to the CLCB. A representative population panel of 1,022 people completed an online survey of intended voting on the CLCB referendum, which included questions on demographics, drug use history, medicinal cannabis, perceptions of the health risk and moral views of cannabis use, political affiliation, religiosity, community size and reading of the CLCB. Regression models were developed to predict support for the CLCB, with additional predictor variables added over successive iterations. The most robust predictors of support for the CLCB were use of and policy support for medicinal cannabis use, voting for a left-wing political party, having a positive moral view of cannabis use, living in a small town and having read the CLCB. Predictors of opposing the CLCB were voting for right-wing parties, considering "frequent" cannabis use to be a high health risk, and lifetime use of other drugs. Age, ethnicity, education, employment status, religiosity and lifetime cannabis use were not significant predictors after controlling for other variables. Support for cannabis legalization was not based on broad demographics, but rather specific views concerning the medicinal benefit, morality of cannabis use, health risk of frequent cannabis use, political party affiliation, and knowledge of the proposed regulatory controls of the CLCB. The influence of moral views of cannabis use on voting behaviour suggest the need to debate the right to use cannabis. The importance of knowledge of the proposed regulatory controls of the CLCB on voting underlines the need to raise awareness of proposed regulatory controls during debate.

Changes in California cannabis exposures following recreational legalization and the COVID-19 pandemic

Introduction Since 2012, eighteen states and the District of Columbia have legalized recreational cannabis. Past research suggests this policy change is associated with increased cannabis exposures however this has not yet been studied in California, despite its status as the world’s largest legal cannabis market. Methods This observational, retrospective study analyzed trends in cannabis exposures reported to the California Poison Control System (CPCS) from 2010 to 2020. We assessed shifts in exposures before and after the legalization of recreational cannabis in November 2016, the establishment of recreational retail sales in January 2018, and the institution of a statewide shelter-in-place order due to the COVID-19 pandemic in March 2020 using interrupted time-series analysis and reviewed all records to identify specific products associated with exposures. Results Between 2010 and 2020 edible exposures increased from near zero to 79% of exposures in 2020. Cannabis exposures significantly increased following recreational legalization in 2016 (by an estimated 2.07 exposures per month [CI: 0.60, 3.55]; p < 0.01) and initiation of retail sales in 2018 (0.85 [CI: 0.12, 1.58]; p < 0.05). There was no significant change in cannabis exposures following the first shelter-in-place order of the COVID-19 pandemic (1.59 [CI: −1.61, 3.68]; p = 0.43). Cannabis exposures for those thirteen and under increased significantly both after recreational legalization (1.04 [CI: 0.38, 1.70]) and after the opening of the retail sales market (0.73 [CI: 0.34, 1.12]), but not following the shelter-in-place order (1.59 [CI: −1.61, 3.68]), nor was there a significant change for those older than thirteen. Conclusions Our findings suggest that cannabis legalization is linked to increased exposures, particularly for products such as gummies and candy edibles among children under the age of thirteen. Clinicians should be aware of these risks and communicate them to patients, and policymakers should consider stronger regulations on packaging to reduce these exposures. Key points Question: How have cannabis exposures changed following legalization of recreational use, the opening of the recreational retail sales market, and the institution of shelter-in-place orders during the COVID-19 pandemic? Findings: In this retrospective review of 10,757 cases reported to the California Poison Control System (CPCS) between 2010 and 2020, exposures increased significantly after the legalization of recreational cannabis use and the opening of the recreational retail sales market, particularly among children, who primarily consumed candies and gummies. Meaning: Stronger regulation of cannabis edibles that mimic other products is warranted to decrease exposures among children.

Canada’s cannabis legalization and drivers’ traffic-injury presentations to emergency departments in Ontario and Alberta, 2015-2019

BackgroundWorldwide momentum toward legalization of recreational cannabis use has raised a common concern that such policies might increase cannabis-impaired driving and consequent traffic-related harms, especially among youth. The current study evaluated this issue in Canada. MethodsUtilizing provincial emergency department (ED) records (April 1, 2015-December 31, 2019) from Alberta and Ontario, Canada, we employed Seasonal Autoregressive Integrated Moving Average (SARIMA) models to assess associations between Canada’s cannabis legalization (via the Cannabis Act implemented on October 17, 2018) and weekly provincial counts of ICD-10-CA-defined traffic-injury ED presentations. For each province (Alberta/Ontario), SARIMA models were developed on two driver groups: all drivers, and youth drivers (aged 14–17 years in Alberta; 16–18 years, Ontario). ResultsThere was no evidence of significant changes associated with cannabis legalization on post-legalization weekly counts of drivers’ traffic-injury ED visits in: (1) Alberta, all drivers (n = 52,752 traffic-injury presentations), an increase of 9.17 visits (95 % CI -18.85; 37.20; p = 0.52); (2) Alberta, youth drivers (n = 3265 presentations), a decrease of 0.66 visits (95 % CI -2.26; 0.94; p = 0.42); (3) Ontario, all drivers (n = 186,921 presentations), an increase of 28.93 visits (95 % CI -26.32; 84.19; p = 0.30); and (4) Ontario, youth drivers (n = 4565), an increase of 0.09 visits (95 % CI -6.25; 6.42; p = 0.98). ConclusionsImplementation of the Cannabis Act was not associated with evidence of significant post-legalization changes in traffic-injury ED visits in Ontario or Alberta among all drivers or youth drivers, in particular.

Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study

IntroductionCanadian youth consume cannabis in multiple ways, including by smoking, vaping, and eating or drinking. Existing evidence suggests that these behaviours may change after law liberalization, though data regarding youth are scarce. We investigated changes in cannabis modes of use and associated factors across the federal legalization of recreational cannabis use for adults in Canada, among a large sample of underage youth before alternative products were made legally available. MethodsData were available from 2953 longitudinally linked Canadian high school students who reported on their cannabis use during the 2017/2018 and 2018/2019 school years. We explored whether students maintained a single or multiple cannabis use mode(s), contracted, or expanded the number of modes used. We then used generalized estimating equations to analyse associations of baseline characteristics with use mode trajectory. ResultsExpansion of cannabis use modes (42.3%) was more common than maintenance of a single mode (31.3%), maintenance of multiple modes (14.3%), or reduction (12.1%). Students who maintained multiple modes were significantly more likely to have high amounts of weekly spending money (AOR 1.68), to binge drink (AOR 2.25) or vape (AOR 1.99), to use cannabis regularly (AOR 2.67), and to endorse more symptoms of depression (AOR 1.06). School support for quitting tobacco, drug, or alcohol use appeared to have no effect. ConclusionsMulti-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.

Personal Correlates of Support for Medical and Recreational Cannabis Legalization in Australia.

Introduction and Aims: Increasingly more Australians are in favor of legalizing medical and recreational cannabis use. This paper explored the personal characteristics of those who supported each of these policies in Australia.Design: Cross-sectional national survey.Methods: This study included 21,729 participants aged 18 years and above who responded to the 2016 National Drug Strategy Household Survey. Participants were provided the assurance of confidentiality for their participations. Logistic regression models were used to examine the relationships between personal characteristics and support for the legalization of medical and recreational cannabis.Results: Overall, 77 and 40% of participants supported the legalization of medical and recreational cannabis respectively. People of older age were more likely to support medical cannabis legalization while those who supported legalization of recreational cannabis use were more likely to be younger. Medical cannabis supporters were more likely to report chronic pain (OR = 1.44, 95% CI: 1.04, 2.00) while recreational cannabis supporters were more likely to suffer high level of psychological distress (OR = 1.28, 95% CI: 1.14, 1.43). Experience with cannabis use was strongly associated with supportive attitudes, with recent cannabis users almost 14 times (OR = 14.13, 95% CI: 5.37, 37.20) and 34 times (OR = 33.74, 95% CI: 24.22, 47.01) more likely to support the legalization of medical and recreational cannabis use, respectively.Discussion and Conclusions: The majority of Australians approve the legalization of cannabis for medicinal purposes but most remain cautious about legalizing recreational cannabis use. The sociodemographic and clinical profile of supporters of medical and recreational legalization suggests a potential interaction of self-interests and beliefs about the harms of cannabis use.

Legalization of cannabis use in Canada: Impacts on the cannabis use profiles of youth seeking services for substance use

BackgroundCannabis is a highly used substance among youth, but has the potential to negatively impact the developing brain. Recreational cannabis use was legalized in Canada in October 2018. This exploratory study examines cannabis use profiles of high-risk youth before and after the national legalization of recreational cannabis use. MethodThis cross-sectional cohort study examines the cannabis use profiles of two cohorts of youth, one recruited prior to legalization (N = 101) and one recruited after legalization (N = 168). ResultsThis study found few changes in cannabis use patterns after legalization. The rate of high-frequency cannabis use, polysubstance use, social circles of use, and mental health and substance use challenges showed no change, and the study found no associations with age. Exceptions were that youth were more likely to report purchasing cannabis from a legal source after legalization. Concealment of cannabis use from legal authorities declined after legalization among youth over the age of majority (19+ years), but not among younger youth (<19 years). ConclusionsMinimal changes have occurred in the cannabis use patterns of service-seeking youth in the short term following legalization. This holds true both for youth who have reached the age of majority and those who have not. Nevertheless, this population has overlapping substantial mental health and substance use challenges. Integrated services should address cannabis use and other concurrent challenges and be sensitive to the postlegalization social climate.

Changes in cannabis use, exposure, and health perceptions following legalization of adult recreational cannabis use in California: a prospective observational study

BackgroundMost U.S. states have legalized cannabis for medical and/or recreational use. In a 6-month prospective observational study, we examined changes in adult cannabis use patterns and health perceptions following broadened legalization of cannabis use from medical to recreational purposes in California.MethodsRespondents were part of Stanford University’s WELL for Life registry, an online adult cohort concentrated in Northern California. Surveys were administered online in the 10 days prior to state legalization of recreational use (1/1/18) and 1-month (2/1/18–2/15/18) and 6-months (7/1/2018–7/15/18) following the change in state policy. Online surveys assessed self-reported past 30-day cannabis use, exposure to others’ cannabis use, and health perceptions of cannabis use. Logistic regression models and generalized estimating equations (GEE) examined associations between participant characteristics and cannabis use pre- to 1-month and 6-months post-legalization.ResultsThe sample (N = 429, 51% female, 55% non-Hispanic White, age mean = 56 ± 14.6) voted 58% in favor of state legalization of recreational cannabis use, with 26% opposed, and 16% abstained. Cannabis use in the past 30-days significantly increased from pre-legalization (17%) to 1-month post-legalization (21%; odds ratio (OR) = 1.28, p-value (p) = .01) and stayed elevated over pre-legalization levels at 6-months post-legalization (20%; OR = 1.28, p = .01). Exposure to others’ cannabis use in the past 30 days did not change significantly over time: 41% pre-legalization, 44% 1-month post-legalization (OR = 1.18, p = .11), and 42% 6-months post-legalization (OR = 1.08, p = .61). Perceptions of health benefits of cannabis use increased from pre-legalization to 6-months post-legalization (OR = 1.19, p = .02). Younger adults, those with fewer years of education, and those reporting histories of depression were more likely to report recent cannabis use pre- and post-legalization. Other mental illness was associated with cannabis use at post-legalization only. In a multivariate GEE adjusted for sociodemographic characteristics and diagnoses, favoring legalization and the interaction of time and positive health perceptions were associated with a greater likelihood of using cannabis.ConclusionsLegalized recreational cannabis use was associated with greater self-reported past 30-day use post-legalization, and with more-positive health perceptions of cannabis use. Future research is needed to examine longer-term perceptions and behavioral patterns following legalization of recreational cannabis use, especially among those with mental illness.

Characteristics of secondhand cannabis smoke from common smoking methods: Calibration factor, emission rate, and particle removal rate

Abstract The widespread legalization of recreational cannabis use raises growing concerns about exposure to secondhand cannabis smoke (SCS). However, few studies are characterizing fine particulate matter (PM2.5) exposure from SCS. Here, we determined PM2.5 calibration factors (CFs) for SCS from four common cannabis consuming methods—glass pipe smoking, joint smoking, bong smoking, and cannabis pen vaping—for widely used optical monitors (SidePak™ AM510, TSI Inc., Shoreview, MN) by comparing the monitors with gravimetric mass measurements. We furthermore investigated the emission rate, particle size distribution, and particle removal rate of SCS. The CFs of SidePak PM2.5 monitors measuring the four types of SCS were 0.31 (SE = 0.02), 0.39 (SE = 0.02), 0.40 (SE = 0.01), and 0.44 (SE = 0.03), respectively. The arithmetic mean emission rates of the four SCS sources were ~2–6 times that of secondhand tobacco smoke (STS) on a per-puff basis. The fresh SCS (1-min after smoking) showed a bimodal size distribution—one mode located at ~380–420 nm and another at ~800–840 nm. Under low-ventilation conditions, the indoor removal rates of SCS from cannabis vaping were slightly higher (i.e., 0.61–0.77/h) than those for the other three sources (i.e., 0.35–0.53/h).

Assessing the public health impacts of legalizing recreational cannabis use: the US experience.

The sale of cannabis for adult recreational use has been made legal in nine US states since 2012, and nationally in Uruguay in 2013 and Canada in 2018. We review US research on the effects of legalization on cannabis use among adults and adolescents and on cannabis-related harms; the impact of legalizing adult recreational use on cannabis price, availability, potency and use; and regulatory policies that may increase or limit adverse effects of legalization. The legalization of recreational cannabis use in the US has substantially reduced the price of cannabis, increased its potency, and made cannabis more available to adult users. It appears to have increased the frequency of cannabis use among adults, but not so far among youth. It has also increased emergency department attendances and hospitalizations for some cannabis-related harms. The relatively modest effects on cannabis use to date probably reflect restrictions on the number and locations of retail cannabis outlets and the constraints on commercialization under a continued federal prohibition of cannabis. Future evaluations of legalization should monitor: cannabis sales volumes, prices and content of tetrahydrocannabinol; prevalence and frequency of cannabis use among adolescents and adults in household and high school surveys; car crash fatalities and injuries involving drivers who are cannabis-impaired; emergency department presentations related to cannabis; the demand for treatment of cannabis use disorders; and the prevalence of regular cannabis use among vulnerable young people in mental health services, schools and the criminal justice system. Governments that propose to legalize and regulate cannabis use need to fund research to monitor the impacts of these policy changes on public health, and take advantage of this research to develop ways of regulating can-nabis use that minimize adverse effects on public health.

The Impact of Cannabis Legalization in Canada on Adolescents’ Perceptions

Since the legalization of cannabis in Canada in October 2018, research has not reached a clear conclusion on how legalization impacts adolescents’ perceptions of the substance. This study sought to examine how the nationwide legalization of recreational cannabis in Canada impacted youth opinions of legalization. Surveys were administered to 398 Grade 8 students in May 2017 (pre-legalization) and 377 Grade 8 students in December 2018 (post-legalization). Participants completed an open-ended question regarding their opinion on cannabis legalization and a ranking of whether legalization of cannabis was very good (1), good (2), bad (3), or very bad (4). Analyses revealed that young adolescents primarily hold negative views toward cannabis legalization. No significant difference existed between theme frequencies or ratings when comparing responses prior to and following legalization. These results suggest that legalization of recreational cannabis use in Canada had little effect on youth perceptions of cannabis legalization.

Gender Norms, Roles and Relations and Cannabis-Use Patterns: A Scoping Review.

Currently, boys and men use cannabis at higher rates than girls and women, but the gender gap is narrowing. With the legalization of recreational cannabis use in Canada and in multiple US states, these trends call for urgent attention to the need to consider how gender norms, roles and relations influence patterns of cannabis use to inform health promotion and prevention responses. Based on a scoping review on sex, gender and cannabis use, this article consolidates existing evidence from the academic literature on how gender norms, roles and relations impact cannabis-use patterns. Evidence is reviewed on: adherence to dominant masculine and feminine norms and cannabis-use patterns among adolescents and young adults, and how prevailing norms can be both reinstated or reimagined through cannabis use; gendered social dynamics in cannabis-use settings; and the impact of gender roles and relations on cannabis use among young adults of diverse sexual orientations and gender identities. Findings from the review are compared and contrasted with evidence on gender norms, roles and relations in the context of alcohol and tobacco use. Recommendations for integrating gender transformative principles in health promotion and prevention responses to cannabis use are provided.

3110 A Case of Reflux Esophagitis Mimicking Globus Sensation in a Patient With Cannabis Abuse

INTRODUCTION: Cannabis is a widely used drug of abuse in the United States (US). It is mostly commonly abused by young individuals and is known for it's psychedelic effects. Cannabis is also utilized by the medical field for a number of medicinal purposes. We present a case of a young male who presented with sudden onset dysphagia and had a significant history of marijuana abuse for several years. CASE DESCRIPTION/METHODS: 28 year old Caucasian male with a past medical history of ADHD presented with dysphagia. The symptoms started 2 days ago. He felt like the food was stuck in his throat. Every time he attempted to drink water or liquids it regurgitated. He also reported several episodes of nausea and vomiting since the onset of his symptoms. Review of systems was negative for odynophagia, fever, drooling, weight loss, chest pain, diarrhea, constipation or acid reflux. Denied any allergies, surgical history or family history. He denied alcohol or cigarette smoking. He agreed to smoking marijunana 2-3 times per day for over 4 years. Physical examination revealed a healthy non obese male with blood pressure and pulse of 120/80 mmhg and 86 per minute respectively. Rest of his examination was unremarkable. Upper endoscopy was performed on the day of admission which revealed LA Grade D esophagitis with multiple superficial ulcers extending 5 cm from GE junction. Patient was started on proton pump inhibitors twice daily. His symptoms improved and was eventually discharged. Biopsies were suggestive of changes consistent with chronic reflux esophagitis. DISCUSSION: Tetrahydrocannabinol (THC) is the active ingredient derived from Cannabis Sativum. THC works by stimulating the G protein-coupled cannabinoid receptors (CBR) receptors. The presence of CBRs in the esophagus, specifically those affecting transient lower esophageal sphincter relaxations (TLESRs), offers a potential therapeutic target for treating GERD. Using Delta (9)-THC, Beaumont et al. demonstrated decreased rate of TLESRs in healthy volunteers who received 10 and 20 mg of Δ9-THC on three occasions a week apart. However, in the high dose of ΔDelta (9)-THC (20 mg) group, central activity led to increased nausea, vomiting and reflux symptoms. With ongoing discussions for the legalization of recreational cannabis use in US, we may encounter an increase in the number of reflux esophagitis cases. With this in mind, additional studies would be beneficial to determine potential risk factors for developing severe reflux esophagitis with extensive marijuana use.

The Risk of Cardiovascular Events on Cannabis’ Highest Day

Knowledge of the acute cardiovascular effects of cannabis consumption remains largely unknown and is important given the changing landscape of legalization of recreational cannabis use. “4/20” is an annual event where many individuals gather to consume cannabis. An increased risk of adverse health events such as motor vehicle accidents has previously been reported to occur on “4/20.” In this study, population-based administrative databases in Ontario, Canada, were used to evaluate the association between “4/20” and cardiovascular events. An increased risk of cardiovascular events on a population level was not observed on “4/20.” Additional research into the changes in the prevalence of the use of cannabis with recreational legalization and acute and chronic risk with cannabis use is suggested.

Trends of poly-substance use among Canadian youth

IntroductionPoly-substance use, increasingly understood as a behaviour with uniquely adverse consequences, is on the rise among Canadian youth. High levels of e-cigarette vaping and the recent legalization of recreational cannabis use may result in an acceleration of this trend. The aim of this work was to characterise changes in youth poly-substance use over time, generate baseline data for future investigations, and highlight areas of interest for policy action. MethodsDescriptive statistics and regression models explored patterns and trends in concurrent use of multiple substances (alcohol, cigarettes, cannabis, and e-cigarettes) among Canadian high school students taking part in the COMPASS prospective cohort study during Y2 (2013/2014; n = 45,298), Y3 (2014/2015, n = 42,355), Y4 (2015/2016; n = 40,436), Y5 (2016/2017; n = 37,060), and Y6 (2017/2018; n = 34,879). ResultsPoly-substance use increased significantly over time, with over 50% of students who used substance reporting past-year use of multiple substances by 2017/2018. Male and Indigenous students were significantly more likely to report poly-substance use than female and white students respectively. E-cigarette vaping doubled from Y5 to Y6 and was included in all increasingly prevalent substance use combinations. ConclusionsYouth poly-substance use, rising since 2012/2013, saw a particularly steep increase after 2016/2017. Differential effects were observed for distinct demographic subpopulations, indicating tailored interventions may be required. E-cigarette vaping surged in parallel with the observed increase, suggesting a key role for this behaviour in shaping youth poly-substance use.

Development of an ultra-sensitive electrochemical sensor for Δ9-tetrahydrocannabinol (THC) and its metabolites using carbon paper electrodes

With the legalization of recreational cannabis use, there is a need to develop a rapid and accurate roadside test that can be used to analyze human saliva samples for Δ9-tetrahydrocannabinol (THC), the main psychoactive ingredient in cannabis. Here we demonstrate a novel drug detection method where THC is infused into carbon paper electrodes followed by electrochemical detection in a pH 10 aqueous solution. This method produces a linear, sensitive (down to ∼1 pmol), dose-dependent change in the oxidation peak current that varies with THC surface densities. These results, as well as the peak charge per real carbon surface area and linear current/scan-rate dependence, support a model for the distribution of THC on the carbon surface in a thin-layer configuration, facilitating the oxidation of the deposited drug. We also demonstrate electro-oxidation of the two major metabolites of THC, the psychoactive 11-hydroxy-tetrahydrocannabinol (OH-THC), and the non-psychoactive 11-nor-9-carboxy-tetrahydrocannabinol (COOH-THC), that also produce linear, dose-dependent changes in peak charge. However, COOH-THC exhibits a much lower Faradaic efficiency than OH-THC and THC, suggesting that variations in the THC functional groups affect the electro-oxidation of the cannabinoids. Overall, this work illustrates a novel, reproducible, and sensitive method for the analysis of THC and oxidation properties of its common metabolites that could be adapted for use with human saliva samples in future work.

Potential harms from legalization of recreational cannabis use in Canada.

With the recent legalization of recreational cannabis use in Canada, questions remain concerning optimal regulation to minimize harms and ensure public health and safety. Patterns of use are subject to change following legalization, and it is important to consider the potential adverse effects that this may have on public health. Important areas of consideration are methods of consumption (e.g., vaping, edibles) and product proliferation; acute and long-term health and behavioural effects (including impaired driving); and use in vulnerable groups, such as children and youth, pregnant women, individuals with mental illness, individuals with low socio-economic status, and Indigenous populations. To support harm reduction measures and evidence-based policy, there is a need to anticipate the potential ramifications that legalization of recreational cannabis use may have on public health in Canada.

Recreational Cannabis Legalization and Opioid-Related Deaths in Colorado, 2000-2015.

To examine the association between Colorado's legalization of recreational cannabis use and opioid-related deaths. We used an interrupted time-series design (2000-2015) to compare changes in level and slope of monthly opioid-related deaths before and after Colorado stores began selling recreational cannabis. We also describe the percent change in opioid-related deaths by comparing the unadjusted model-smoothed number of deaths at the end of follow-up with the number of deaths just prior to legalization. Colorado's legalization of recreational cannabis sales and use resulted in a 0.7 deaths per month (b = -0.68; 95% confidence interval = -1.34, -0.03) reduction in opioid-related deaths. This reduction represents a reversal of the upward trend in opioid-related deaths in Colorado. Legalization of cannabis in Colorado was associated with short-term reductions in opioid-related deaths. As additional data become available, research should replicate these analyses in other states with legal recreational cannabis.