Legalization Of Recreational Use Research Articles

Cannabis sativa: A therapeutic medicinal plant-global marketing updates

Cannabis has been used for thousands of years for recreational, medicinal, or religious purposes and the therapeutic potential of medicinal Cannabis was demonstrated in various medical conditions. The legalization of Cannabis is an important source of economic growth as it contributes to the growing revenue tax, and the creation of new workplaces. The maturity of the Cannabis market varies across the globe mainly due to differing legal environments and public attitudes towards Cannabis. Some countries such as Canada and the United States have adopted fully regulated frameworks that allow the cultivation, consumption, and retail distribution of various Cannabis products. Uruguay became the first country in the world to legalize the production, distribution and consumption of cannabis in 2013. The Cannabis market in Canada and the USA is experiencing rapid growth due to the country's legalization of recreational use. Regulations can also differ regarding how cannabis is used. However, the use, cultivation, and marketing of Medical Cannabis sativa (drug or Marijuana type ) is banned and prohibited in India due to the presence of high levels of psychoactive principle THC (Narcotic drug). On the other hand, Industrial Cannabis sativa (seed or fiber type) Hemp was legalized in 2021 by The Food Safety and Standards Authority of India (FSSAI), Government of India, New Delhi. In Azerbaijan, Cannabis is not available for medical or recreational use. Recreational Cannabis and medical marijuana are illegal in Azerbaijan. Marijuana is illegal for medical and recreational purposes in China. There is still a huge prejudice in society about medical Cannabis due to its recreational use. However, this scenario is changing, and the social resistance is decreasing for the medicinal use of Cannabis. The Cannabis (Hemp) market in India is predicted to experience a substantial revenue growth, with projections indicating that it will reach ₹US$100.80m by 2024. The Cannabis market worldwide is projected to reach a revenue of US$60.79bn in 2024. The global legal marijuana market size is expected to reach USD 73.6 billion by 2027 and is anticipated to expand at a CAGR of 18.1% during the forecast period.

Cannabis reduction among adolescents as spillover from successful tobacco control

BackgroundNational programs that reduce adolescent cannabis use warrant renewed attention in light of current discussions to reform cannabis legislation, including the possibility of legalization for recreational use. This study measures the size of a decrease in a country's prevalence of adolescent cannabis use that accompanies a decrease in its prevalence of adolescents who had ever smoked a cigarette. MethodsData are from the European School Survey Project on Alcohol and Other Drugs (ESPAD), which is a collaborative effort of more than 40 European countries to surveil adolescent substance use. This study uses data from the seven survey administrations in 1995, 1999, 2003, 2007, 2011, 2015, and 2019. The main analysis is a fixed-effect regression analysis of country-level, four-year changes in adolescent lifetime cannabis use prevalence on country-level, four-year changes in adolescent lifetime cigarette use prevalence. ResultsDecreases in the national prevalence of adolescents who had ever smoked a cigarette were accompanied by decreases half as large in national prevalence of adolescent lifetime cannabis use. ConclusionFor European countries considering the legalization of adult recreational cannabis use, tobacco control can offer a tool to help counter potential increases in cannabis use among adolescents.

Prevalence of Cannabis Use Disorder and Reasons for Use Among Adults in a US State Where Recreational Cannabis Use Is Legal.

Medical and nonmedical cannabis use and cannabis use disorders (CUD) have increased with increasing cannabis legalization. However, the prevalence of CUD among primary care patients who use cannabis for medical or nonmedical reasons is unknown for patients in states with legal recreational use. To estimate the prevalence and severity of CUD among patients who report medical use only, nonmedical use only, and both reasons for cannabis use in a state with legal recreational use. This cross-sectional survey study took place at an integrated health system in Washington State. Among 108 950 adult patients who completed routine cannabis screening from March 2019 to September 2019, 5000 were selected for a confidential cannabis survey using stratified random sampling for frequency of past-year cannabis use and race and ethnicity. Among 1688 respondents, 1463 reporting past 30-day cannabis use were included in the study. Patient survey-reported reason for cannabis use in the past 30 days: medical use only, nonmedical use only, and both reasons. Patient responses to the Composite International Diagnostic Interview-Substance Abuse Module for CUD, corresponding to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition CUD severity (0-11 symptoms) were categorized as any CUD (≥2 symptoms) and moderate to severe CUD (≥4 symptoms). Adjusted analyses were weighted for survey stratification and nonresponse for primary care population estimates and compared prevalence of CUD across reasons for cannabis use. Of 1463 included primary care patients (weighted mean [SD] age, 47.4 [16.8] years; 748 [weighted proportion, 61.9%] female) who used cannabis, 42.4% (95% CI, 31.2%-54.3%) reported medical use only, 25.1% (95% CI, 17.8%-34.2%) nonmedical use only, and 32.5% (95% CI, 25.3%-40.8%) both reasons for use. The prevalence of CUD was 21.3% (95% CI, 15.4%-28.6%) and did not vary across groups. The prevalence of moderate to severe CUD was 6.5% (95% CI, 5.0%-8.6%) and differed across groups: 1.3% (95% CI, 0.0%-2.8%) for medical use, 7.2% (95% CI, 3.9%-10.4%) for nonmedical use, and 7.5% (95% CI, 5.7%-9.4%) for both reasons for use (P = .01). In this cross-sectional study of primary care patients in a state with legal recreational cannabis use, CUD was common among patients who used cannabis. Moderate to severe CUD was more prevalent among patients who reported any nonmedical use. These results underscore the importance of assessing patient cannabis use and CUD symptoms in medical settings.

Is Twelve Hours Really the Optimum Photoperiod for Promoting Flowering in Indoor-Grown Cultivars of Cannabis sativa?

Cannabis sativa ("cannabis" hereafter) is a valuable recent addition to Canada's economy with the legalization for recreational use in 2018. The vast majority of indoor cannabis cultivators use a 12-h light/12-h dark photoperiod to promote flowering. To test the hypothesis that robust flowering initiation responses can be promoted in indoor-grown cannabis cultivars under longer photoperiods, clones of ten drug-type cannabis cultivars were grown under six photoperiod treatments. All treatments were based on a standard 24-h day and included 12 h, 12.5 h, 13 h, 13.5 h, 14 h, and 15 h of light. The plants were grown in a growth chamber for 3 to 4 weeks, receiving an approximate light intensity of 360 µmol·m-2·s-1 from white LEDs. Flowering initiation, defined as the appearance of ≥3 pairs of stigmas at the apex of the primary shoot, occurred in all cultivars under all photoperiod treatments up to 14 h. Delays in flowering initiation time under 14 h vs. 12 h ranged from no delay to approximately 4 days, depending on the cultivar. Some cultivars also initiated flowering under 15 h, but floral tissues did not further develop beyond the initiation phase. Harvest metrics of some cultivars responded quadratically with increasing photoperiod, with ideal levels of key flowering parameters varying between 12 h and 13 h. These results suggest there is potential to increase yield in some indoor-grown cannabis cultivars by using longer than 12-h photoperiods during the flowering stage of production. This is attributed to the inherently higher daily light integrals. Indoor cannabis growers should investigate the photoperiod responses of their individual cultivars to determine the optimal photoperiod for producing floral biomass.

Mental health adverse events with cannabis use diagnosed in the Emergency Department: what are we finding now and are our findings accurate?

We have previously reviewed the types and numbers of cannabis-associated adverse events that have mental health presentations that are encountered in the Emergency Department. A particular challenge in examining these events is disentangling cannabis use adverse events from adverse events associated with use of multiple recreational substances. Since that review was published, cannabis legalization for recreational use has greatly expanded world-wide and with these changes in the legal climate has come clearer information around the frequency of adverse events seen in the Emergency Department. However, as we examined the current state of the literature, we also examined some of research designs and the biases that may be impacting the validity of the data in this field. The biases both of clinicians and researchers as well as research approaches to studying these events may be impacting our ability to assess the interaction between cannabis and mental health. For example, many of the studies performed examining cannabis-related admissions to the Emergency Department were administrative studies that relied on front line clinicians to identify and attribute that cannabis use was associated with any particular admission. This narrative review provides an overview on what we currently know about mental health adverse events in the Emergency Department with a focus on the mental health impacts both for those with and without a history of mental illness. The evidence that cannabis use can adversely impact genders and sexes differently is also discussed. This review outlines what the most common adverse events related to mental health with cannabis use are; as well as noting the most concerning but much rarer events that have been reported. Additionally, this review suggests a framework for critical evaluation of this field of study going forward.

Lessons from 20 years of medical cannabis use in Canada.

Canada was one of the first countries to regulate the medical use of cannabis. However, literature on Canada's medical cannabis program is limited. We use administrative data from the medical cannabis program, and licensed cannabis vendor catalog data to describe a) the participation of patients, physicians, and cannabis vendors in the program from its inception in 1999 to 2021, and b) trends in medical cannabis consumption, prices and potency. We also use national surveys conducted over the last several decades to estimate trends in regular cannabis use (medical or otherwise) and how it changed during the medical cannabis access regimes. In 2001, the Canadian government granted access to those with physician-documented evidence of a severe health problem that could not be managed using conventional therapies. Most patients accessed cannabis grown under a personal production license. By 2013, authorized daily cannabis dosages were very high. In 2014, the government, concerned over illegal diversion, required that cannabis be purchased from a licensed commercial grower; personal production was banned. Physicians were given responsibility for authorizing patient access. To fill the regulatory void, the physician regulatory bodies in Canada imposed their own prescribing restrictions. After these changes, the number of physicians who were willing to support patient cannabis use markedly decline but the number of patients participating in the program sharply increased. Medical cannabis use varied by province-rates were generally lower in provinces with stricter regulations on physician cannabis prescribing. Most varieties of cannabis oil available for sale are now high in CBD and low in THC. Dry cannabis varieties, conversely, tend to be high in THC and low in CBD. Inflation adjusted prices of most varieties of medical cannabis have declined over time. We find that rates of daily cannabis use (medical or otherwise) increased markedly after the 2014 policy regime. The fraction of Canadians using cannabis daily increased again after the 2018 legalization of recreational cannabis; at the same time, participation in the medical access program declined. The implications for patient health outcomes of changes in the medical cannabis program and legalization of recreational use remains an important area for future research.

Psychedelics Legislation Gains Momentum

Psychedelics Legislation Gains Momentum

Impact of cannabis-infused edibles on public safety and regulation.

Popularity of cannabis-infused products has bloomed since legalization for recreational use of marijuana started. Consumption of cannabis edibles has steadily increased, as restrictions on recreational cannabis smoking have become tighter. This phenomenon enhanced the possibility of these products crossing the state line. The most psychoactive component of cannabis, ∆9-tetrahydrocannabinol (THC) is infused in "edibles" and linked to physiological and psychological effects. Consumers unfamiliar with these edibles may mistake them for non-THC containing products, causing unintended use or overconsumption. In addition, these cannabis-infused edibles are posing significant health risks. The FDA has recognized the potential dangers and recommended that cannabis remain as a Schedule I substance and illegal at the federal level. However, states maintain control of determining the legality of cannabis related products, and creating guidelines distinguishing cannabis edibles from the non-cannabis containing products. Recently, the State of Maine offers a blueprint for edible regulation that should be implemented in all states that are considering or have legalized marijuana.

The Cannabis Policy Scale: A New Research and Surveillance Tool for U.S. States.

Rapid shifts toward cannabis liberalization in the United States have created immense policy variability that is challenging to measure. We developed composite measures to characterize the restrictiveness of U.S. state cannabis policy environments. Nine panelists, consisting of four research team members and five expert policy consultants, nominated distinct cannabis policies pertaining to cannabis prohibition, medicalization, and legalization for recreational use. For each of the 17 nominated policies, panelists developed implementation ratings and rated each policy's relative efficacy for reducing excessive cannabis use by adults, youth use, and impaired driving. Cannabis Policy Scale scores were then calculated for each state-year for all 50 states from 1999 to 2019 by weighting policies by their efficacy and implementation ratings, and then summing over policies. Median Cannabis Policy Scale scores remained stable until 2008, when they started declining (representing policy liberalization), with steeper declines after 2012. In 2019, state Cannabis Policy Scale scores targeting excessive use among the general population ranged from 29.6 to 66.7 for recreational cannabis legalization states, and from 72.4 to 93.4 for medical cannabis legalization states. Cannabis Policy Scale scores using youth-specific and driving-specific efficacy ratings showed similar trends. The Cannabis Policy Scale reflects trends toward liberalization of cannabis policy in many U.S. states. Even within crude policy phenotypes (e.g., medical cannabis programs), Cannabis Policy Scale scores varied considerably between states and over time. The Cannabis Policy Scale is a new measure that can add nuance to cannabis policy research and help assess cannabis policy-outcome relationships.

Attitudes in 2020 Towards Medical and Recreational Marijuana in Prohibitionist Nebraska

Despite considerable change in the legal status of marijuana in the United States in the 21st century, the state of Nebraska has become an outlier in maintaining a complete prohibition on the substance. We estimate overall public support for medical and recreational marijuana in the state of Nebraska. Our data comes from the 2020 Nebraska Annual Social Indicators Survey, an address-based sample of Nebraskan adults. We asked a question from the Pew Research Center if participants support legal marijuana for medical AND recreational use, medical use only, or if they think it should not be legal. We estimate that 83.18% of Nebraskans support medical marijuana legalization. There is less consistent support for legal recreational use than medical use alone. There are also associations between support preferences and age, political party, gender, and the amount of stigma a participant reports in their community towards people that use various substances.

Cannabis presentations to the emergency department after MVC in the era of legalization for recreational use

Introduction: The objectives of this study were to examine cannabis and alcohol use among injured patients presenting to emergency departments (ED) in cannabis-legal states to capture an expanded profile of cannabis use and evaluate differences in motor-vehicle collision (MVC) characteristics among those using cannabis alone and in combination with alcohol. Methods: This was a cross-sectional study of ED visits by drivers in MVC who presented to one of three study sites. Event-related and usual drug and alcohol use information were obtained using a detailed interviewer-administered computerized questionnaire. We also obtained data from blood and breathalyzer tests and the electronic medical record. We examined frequency and types of acute and past-year cannabis and alcohol use and crash mechanisms and characteristics. Our primary method of determining substance use was self-report; we used biosamples secondarily. Results: Eight percent of drivers reported cannabis use in the 8 h prior to MVC, alone or in combination with alcohol; however, a higher proportion (18%) were positive by biosample. High-risk crash features were common in MVCs associated with cannabis, as they were for alcohol use and co-use of cannabis and alcohol; however, patients injured seriously enough to require admission were less likely to report cannabis use (7% vs. 9%) and more likely to report alcohol use (16% vs. 10%). Conclusions: Cannabis use was common among patients presenting after MVC in this sample of cannabis-legal states. Practical Applications: Differences between self-report and biosample data for cannabis and alcohol use were significant and supports the need to use both means of assessing acute use.

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.

Cannabis presentations to the emergency department after MVC in the era of legalization for recreational use

Cannabis presentations to the emergency department after MVC in the era of legalization for recreational use

The relationship between cannabis use and IVF outcome\u2014a cohort study

BackgroundThe effects of cannabis use on male and female reproduction have been the focus of scientific research for decades. Although initial studies raised concerns, more recent studies were reassuring. Considering the recent legalization of recreational use of cannabis in Canada, we sought to analyze IVF outcomes among users and non-users in a single IVF center.MethodsThis is a retrospective cohort study from a single IVF center assessing IVF outcomes among male-female, non-donor IVF patients that are either cannabis users or non-users. We analyzed the ongoing pregnancy rate as well as oocyte yield, fertilization rate, peak serum estradiol, sperm, and embryo quality. We used the Mann-Whitney test, chi-square test, and Kruskal-Wallis tests where appropriate.ResultsOverall, the study included 722 patients of which 68 (9.4%) were cannabis users, most defined as light users. The results of the study show similar implantation rate (40.74% vs. 41.13%) and ongoing pregnancy rate (35.2% vs. 29.1%) between the users and non-users, respectively. No significant difference between users and non-users in any of the other analyzed outcomes could be detected.ConclusionsThe results may provide some reassurance for the lack of any demonstrable detrimental effects of cannabis consumption on IVF outcomes. This study was limited by its retrospective nature, self-reporting of cannabis use, and a small user sample size. A larger prospective study is needed to validate its findings.

The Use of Marijuana Derivatives in Primary Care: An Evidence-Based Approach to Cannabidiol

Changes in the legality of marijuana for medicinal use and the further legalization for recreational use have brought about renewed interest in the properties of the cannabis plant. Cannabidiol (CBD), a derivative of the cannabis plant, has emerged as a widely available panacea. The purpose of this review is to discuss the differences in the active ingredients of the cannabis plant as well as the mechanisms by which CBD may provide benefit. In addition, the evidence for pain management and anxiety are evaluated. Finally, safety, tolerability, and legal issues surrounding CBD are examined.

Cannabis Consumption in Dispensaries: Public Health Implications of an Emerging Practice.

Cannabis Consumption in Dispensaries: Public Health Implications of an Emerging Practice.

Modelling opinion on legalization of recreational use of marijuana with a survey of Rio de Janeiro residents.

Modelling opinion on legalization of recreational use of marijuana with a survey of Rio de Janeiro residents.

Sourcing Cannabis sativa L. by thermogravimetric analysis

Marijuana, dried and ground Cannabis, is the most consumed illicit drug in the world. Many undesirable and risky effects to human health are caused by its use. The medicinal use or legal recreational use of Cannabis has also been rising in many countries. These facts make traceability methodologies increasingly important whether for forensic use, such as drug trafficking eradication, or for quality control purposes of legal medicinal Cannabis. Consequently, the objective of this study was to analyze Cannabis by means of thermogravimetric analysis (TGA) in order to assess the capability of this technique to trace the geographical origin of Cannabis cultivated in Colorado, United States of America. TGA appears to be sensitive enough to detect the degradation/decarboxylation of cannabinoids and terpenes, at least to some extent; also, the degradation of cellulose, hemicellulose and lignin was indicated. Overall, the temperature ranges we analyzed using linear discriminant analysis showed high accuracies, with the 200 to 300 °C and 600 to 700 °C ranges achieving 100% accuracy.

Call to Action for Enhanced Equity and Inclusion in Cannabis Research.

Introduction: Policies regarding cannabis use are rapidly evolving in the United States as exemplified by the legalization of recreational use in 11 states and the District of Columbia. Previous cannabis-related laws, however, disproportionately targeted communities of color before legalization, and many argue new policies are not being developed with the input of minority stakeholders postlegalization. Given that biomedical research has also historically underrepresented communities of color, there is an obligation on the part of researchers now to actively work toward improving equity in cannabis research at a time when the field is rapidly expanding. This is particularly important for research concerning therapeutic uses of cannabis and risk liabilities.Objective: This article is a call to action to improve equity and inclusion in cannabis research design and practice. Specifically, it includes three recommendations focusing on (1) inclusiveness of recruitment, (2) improve demographic reporting in articles, and (3) strengthening publication requirements.Conclusion: These efforts will enhance the shared values and ethics of our field and improve the quality and validity of our research findings moving forward.

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.