Recreational Cannabis Users Research Articles

Emerging trends in cannabis administration for women with chronic pain

AbstractCannabis use among women who experience chronic pain is on the rise in the United States. However, little is known about women's motives and preferences for cannabis administration. The purpose of this study was to characterize cannabis use among women with chronic pain. This study examined self‐reported forms of cannabis administration and preferred source of cannabis, frequency and quantity of use, and self‐reported side effects, and type, level, and intensity of chronic pain among adult women in the United States. This study also compared women who use cannabis for chronic pain and those who do not across the level of chronic pain, length of chronic pain, and the number of types of chronic pain experienced. Participants showed a significant preference (60%) for using recreational cannabis to treat chronic pain but reported that medical cannabis was more effective. For participants who preferred medical cannabis 24.3% reported daily use, as compared to only 7.8% of recreational cannabis users. Smoking was the most common form of administration (62.1%), followed by edibles (25.3%), vaporizing in any form (7.4%), tinctures and concentrates (3.2%), and topicals (2.1%). Participants reported using 1–6 different forms of cannabis administration. Those who preferred smoking were significantly likely to use all other forms of administration. However, those who preferred alternatives to smoking were significantly likely to use all forms of administration except for smoking. Medical cannabis users preferred to obtain cannabis from a dispensary, while recreational users preferred to obtain cannabis from unlicensed sources. Additionally, participants who used cannabis for chronic pain reported a 74% reduction in past 30‐day opioid use. Future research is needed to investigate the health effects associated with single and combined forms of cannabis administration for women with chronic pain. Results can inform educational and intervention programs, treatment development, content regulation of products, policy formation, women's health research, and public health guidelines.

Oral health status among recreational cannabis (marijuana and hashish) users in the USA: A NHANES-based cross-sectional study

BackgroundAs of November 2023, twenty-four states, two territories, and DC have legalized marijuana for non-medical use, leading to concerns about its potential oral health effects. This study investigated the association between marijuana use and clinical dental outcomes among adults in the US. MethodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 using a cross-sectional survey of non-institutionalized US civilians. Marijuana use was assessed among 18–59-year-old adults and categorized as never, former, or current frequent use. The dental outcomes included the prevalence of untreated coronal caries, root caries, and missing teeth. We employed logistic and negative binomial regressions to assess the crude and adjusted associations between marijuana use, dental caries, and tooth loss. ResultsOf the 6,424 participants, 13.85% of US adults aged 18–59 years were current frequent marijuana users (21.67 million), with the highest prevalence among 18–29-year-olds (21.31%), males (17.54%), and non-Hispanic Black individuals (21.31%). Frequent marijuana users showed the highest prevalence of untreated coronal caries (33.4%). Before adjusting for socioeconomic confounders, current frequent marijuana users had 1.76 times higher odds of having teeth with coronal caries, whereas former frequent users had 1.47 times higher odds. However, the associations between marijuana use and all dental outcomes were attenuated after adjusting for socioeconomic confounders, tobacco use, and access to dental care. ConclusionAlthough marijuana use was associated with worse dental health, socioeconomic factors, tobacco use, and access to dental care were more significant contributors to the prevalence of untreated dental caries and missing teeth than marijuana use alone.

Cannabis use in the UK: a quantitative comparison of individual differences in medical and recreational cannabis users.

There is a paucity of research, especially in the UK, that investigates individual differences in both medical and recreational cannabis users. A cross-sectional survey study design was used to assess recreational cannabis users and medical cannabis users currently living in the UK. Recreational cannabis users were invited to take part via social media. Medical cannabis users were recruited from Sapphire Medical Clinics, London, UK, which provides treatment with prescribed cannabis-based medicinal products. Demographic data and cannabis use frequency, as well as post-traumatic stress disorder symptoms (PCL-5), depression symptoms (Centre for Epidemiological Studies Depression Scale), trait and state anxiety (State-Trait Anxiety Inventory), and cannabis use motives [Comprehensive Marijuana Motives Questionnaire (CMMQ)] were collected. The Chi-square and independent-sample t-tests were used for the comparison of categorical variables and normally distributed continuous variables. Data were analyzed using analyses of variance (ANOVAs) and t-tests. Statistical significance was considered where the value of p was <0.05. The survey was completed by 161 participants. Medical cannabis users were older, consumed cannabis more often, had a higher "Sleep" motive on the CMMQ, and had a higher prevalence in self-reporting current diagnoses of neurological problems, mood disorders, and anxiety disorders (p < 0.05). Recreational cannabis users had higher scores on several motives for use (e.g., "Enjoyment," "Coping," "Experimentation," "Boredom," and "Celebration") and higher state anxiety scores (p < 0.05). The most common motives for cannabis use in both groups were "Enjoyment," "Low Risk," and "Sleep." There were no differences between groups in gender, "Low-Risk" motive, post-traumatic stress disorder symptoms, depression scores, trait anxiety scores, self-reported prevalence of substance use-related disorders, and past consumption of alcohol, tobacco, or caffeine (p > 0.05). The current study not only demonstrates a difference in age and motivations for cannabis consumption between recreational and medical cannabis users but also shows areas of potential overlap, including mental health outcomes, past substance use, and gender. These UK-specific findings indicate that recreational cannabis users experience higher state anxiety, highlighting the need for further evaluation of potential anxiogenic/anxiolytic properties of cannabis. These findings demonstrate the importance of researching individual differences in cannabis users and hold significant implications for future research, clinical practice, and legislation.

Sleep quality of adult recreational cannabis users: a systematic review of literature.

Human sleep is fundamental for the proper occurrence of organic functions. Hence, the lack of sleep can impair cognitive function, resulting in emotional problems, memory changes and disease onset. However, it is worth noting that sleep is influenced by outside factors, such as drug use. In this sense, the aim of this work is to analyze studies that had as their research object the influence of recreational marijuana on the sleep quality of adults. A high-sensitivity research was conducted in databases (Biblioteca Virtual em Saúde, Medline via Pubmed, Cochrane, Embase, Web of Science and Scopus) using descriptors linked to marijuana and sleep habits. Eighteen studies from four countries were included with a total sample size of 29,858 participants. It was identified that marijuana affects sleep characteristics-such as latency and duration-with these changes being more evident in users who make greater use of marijuana and in those who started premature use. It was observed that most articles demonstrated a detrimental effect of recreational cannabis use on the quality of sleep in adults.

The Synergistic Benefit Mechanism of Medical and Recreational Marijuana: Economic Gains of Cannabis Taxation based on US Federal Law for Corporate Governance and Sustainability

Purpose: Marijuana legalization is brought about by the demands of people as social utility either for medical or recreation consumption. It is essential that the control of cannabis fulfills the goals of corporate governance and sustainability. This paper aims to measure the profitability of marijuana taxation over a time period as trend analysis of economic gains.&#x0D; Methodology: The socio-legal taxation of marijuana in the United States follows a descriptive research design. The beneficial gains of marijuana as medical use created this substance to be controlled under contract law transactions. The removal of cannabis in US Pharmacopeia modified the tort law restriction for legalization of marijuana as recreational consumption. The recreational cannabis taxation together with medical marijuana state taxes are essential to fulfill the 4 pillars of corporate governance and sustainability for strengthening constitutional rights. The legalization of marijuana through votes of the people repeals the criminal punishments imposed by federal law to advocate the synergistic concepts of economic theory.&#x0D; Findings: State tax theory creates voluntary principles in transactions together with trend analysis in prices and demands of people resulting to efficiency in mutual gains through lessening the value of participation under a harmful environment. Hence, Pigouvian tax follows the public welfare of medical marijuana and common revenue of recreational cannabis diminishes the overall costs of social consumption. Federal laws control marijuana usage through Pigouvian taxes of medical use with lessened participation in externalities and common revenue in cannabis consumption, as a legalization process of other states in reinstating tort law for business purposes, while still enforcing criminal penalties to remaining states, in compliance with US federal laws, not in favor of medical and recreational marijuana use. The economic theory supports the legalization of medical and recreational cannabis use through taxation as profitable gains by allowing voluntary market transactions of marijuana as fulfillment to corporate governance and sustainability for more allocation of public funds. From 2002 to 2018, medical and recreational cannabis users increased to 70% of social utility through lessening the value of participation, a win-win in efficiency of economic design. In 2010, marijuana taxation generated $8.7 billion as federal public funds, with accompanied criminal penalties to other states.&#x0D; Recommendations: Economic theory is a conceptual design supporting the beneficial gains of legalizing marijuana via taxation. This economic design promotes fair responsibility of market gains while still in strict compliance of enforcing criminal punishments to violators. The people’s votes for legalization of marijuana taxation indicates that this economic policy has come by choice in a particular state as constitutional right of either a medical opinion or business ethics. However, cannabis is deemed to be a substance subject for criminal liabilities, similar to other patent drugs under taxation as well. Hence, it is suggested to create artificial intelligence using authorless works for clinical trials and other relevant studies subject to patent law of marijuana use, as advocacy of public welfare and safety since voluntary transactions are apparent harmful environment.

Use of Medical Cannabis by Patients With Cancer: Attitudes, Knowledge, and Practice.

Demand for medical cannabis (MC) is growing among Israeli patients with cancer. The study sought to assess factors contributing to the demand for MC among patients with cancer. Patients applying for a permit to receive MC at a pain and palliative clinic of a university-affiliated cancer center in Israel in 2020-2021 were asked to complete self-report questionnaires assessing attitudes, knowledge, and expectations regarding MC use. Findings were compared between first-time and repeat applicants. Repeat applicants were asked to report their indications for requesting MC, patterns of use, and treatment effect. The cohort included 146 patients: 63 first-time applicants and 83 repeat applicants. First-time applicants were more likely to consult sources other than their oncologist for MC-related information (P < 0.01) and expressed more concern about addiction (P < 0.001) and side effects (P < 0.05). They often erroneously assumed the treatment was subsidized (P < 0.001). Repeat applicants were younger (P < 0.05) and included more smokers (P < 0.05) and recreational cannabis users (P < 0.05); 56.6% were cancer survivors and 78% used high-potency MC. Most patients believed to some degree that MC is more effective than conventional medications for symptom control, and over half thought that MC helps to cure cancer. Misconceptions regarding the effectiveness of MC for symptom management and treatment may explain the motivation of patients with cancer to apply for a permit. There seems to be an association of young age, cigarette smoking, and recreational cannabis use with ongoing use of MC among cancer survivors.

Investigating predictors of driving immediately after consuming cannabis: A study of medical and recreational cannabis users in Australia

This study aimed to explore the length of time cannabis users typically wait between drug consumption and driving a vehicle, and what factors influence such decisions. A total of 839 Australian cannabis users participated in an online survey (26.3% had a prescription for cannabis). Participants ranged in age between 18 years and 75 years (M = 43.3) and 38.2% were female. Driving immediately after consuming cannabis was reported by 41.6% of the sample and waiting 1 h was the next most common response (17%). About one-quarter of participants reported that they waited at least 4 h, thus driving at a time they may no longer be impaired (26.8%). Factors that predicted waiting less time included: a greater frequency of drug consumption (times per day and per month), earlier age of cannabis use onset, using cannabis without a prescription, reporting past-year driving within four hours of consuming cannabis with an illegal drug, and lower perceptions of risk related to driving after consuming cannabis. Participants were asked to report how many days in the next year they would drive within four hours of cannabis consumption, with the most common response being 365 days (37.9% of sample). Given cannabis use is likely to increase through impending decriminalisation and expansion of prescription access, identifying ways to educate cannabis users and extend the length of time they wait between consumption and driving is critical for road safety.

Media constructions of an illegal drug: the link between cannabis and organized crime in Swedish newspapers

Background Lately, there has been massive media coverage of gang-related criminality in ‘exposed areas’ in Sweden. Politicians have blamed the illegal drugs trade without questioning the country’s prohibitionist drug policy. This study analyzes how cannabis is constructed in Swedish newspaper articles that mention both organized crime and cannabis. We ask how the drug and its buyers and sellers are described, what discourses are drawn upon, and discuss the relationship between media coverage and drug policy. Methods We analyzed recent (2021) articles from four newspapers (n = 71) through Critical Discourse Analysis. Results Cannabis was constructed as a commodity linked to violence and deviance. Agency was attributed to people with power and status (e.g. gang leaders), and recreational cannabis users were described as guilty of feeding organized crime. A combination of economic and moral discourses was used to make the reported events meaningful, and to motivate both prohibition and decriminalization/legalization. Conclusion The study shows that assumedly neutral journalistic voices emphasized the link between cannabis and violence and problematized cannabis buyers and sellers. This homogenous media coverage will probably contribute to keep the question of cannabis law reform discursively lifeless in Sweden.

Are Younger Medical Cannabis Users at Risk? Comparing Patterns of Use and Mental Health in Younger and Older Medical Cannabis Dispensary Users

While there has been a considerable amount of research on recreational cannabis use in youth to date, much less is known about patterns of medical cannabis use in youth. Adult medical versus recreational cannabis users may differ in how they use the product on important factors such as dose, frequency and route of ingestion, and so it is important to understand whether adolescents and young adults differ in how they use medical cannabis compared to adults, and if this increases risk of impaired mental health. In the present study, one hundred members of a community cannabis dispensary who endorsed cannabis use for medical purposes were assessed for major psychiatric disorders, and completed questionnaires related to stress, depression, sleep and somatic symptoms. Detailed information about cannabis use was collected. In the sample, 35% were aged 19-24 years old, and 24% were aged 25-30 (categorized as youth/young adults). In comparison to the older medical cannabis users, there were unexpectedly few differences, both in mental health status as well as pattern of medical cannabis use. These findings contrast with those of recreational cannabis users, and indicate that medical cannabis in youth may be as effective and well-tolerated as in older adults.

"You Almost Feel Out of Touch [For Saying] … 'Oh, and by the way, Stop Smoking.'" A Qualitative Exploration of Provider Perspectives About Discussing Tobacco and Cannabis Use With 18-24-Year-Old Young Adults With HIV.

Background: Youth with HIV (YWH) aged 18-24 are overburdened by tobacco, with half also using cannabis recreationally. Increasing tobacco cessation necessitates exploring providers' approaches to cessation. Methods: Grounded in social cognitive theory, we explored cognitive, socioenvironmental, and behavioral factors impacting providers' approaches to tobacco use among recreational cannabis users. Virtual interviews were conducted among healthcare providers caring for YWH in Washington (legalized cannabis), Massachusetts (legalized cannabis), and Alabama (cannabis not legal). Interviews were transcribed and analyzed via deductive and exploratory, thematic approaches using NVivo 12 Plus. Results: Twelve providers participated; 80% were subspecialist physicians. All providers (N = 12) reported discussing tobacco use; none reported discussing tobacco use in conjunction with cannabis use. Identified themes included competing demands including cannabis co-use, prioritization of social determinants of health, and need for youth-tailored tools. Conclusions: YWH disproportionately use tobacco and recreational cannabis. Optimizing clinical visits to identify opportunities to address tobacco is crucial.

Cannabis containing equivalent concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) induces less state anxiety than THC-dominant cannabis

RationaleDelta-9-tetrahydrocannabinol (THC), an active component of cannabis, can cause anxiety in some users during intoxication. Cannabidiol (CBD), another constituent of cannabis, has anxiolytic properties suggesting that cannabis products containing CBD in addition to THC may produce less anxiety than THC-only products. Findings to date around this issue have been inconclusive and could conceivably depend on moderating factors such as baseline anxiety levels in users.ObjectiveThe present study examined whether anxiety following single doses of vaporised THC, CBD and THC/CBD might be explained by state and trait anxiety levels at baseline.MethodsA placebo-controlled, randomised, within-subjects study including 26 healthy recreational cannabis users tested the effects of vaporised THC-dominant cannabis (13.75 mg THC), CBD-dominant cannabis (13.75 mg CBD), THC/CBD-equivalent cannabis (13.75 mg THC/13.75 mg CBD) and placebo cannabis on anxiety. Self-rated trait anxiety was assessed with the State-Trait Anxiety Inventory (STAI). State levels of anxiety were objectively assessed with a computer-based emotional Stroop task (EST) and subjectively rated with the STAI-state questionnaire and a visual analogue scale.ResultsBoth THC and THC/CBD significantly increased self-rated state anxiety compared to placebo. State anxiety after THC/CBD was significantly lower than after THC alone. THC-induced anxiety was independent of anxiety at baseline. When baseline anxiety was low, CBD completely counteracted THC-induced anxiety; however, when baseline anxiety was high, CBD did not counteract THC-induced anxiety. There were no effects of any treatment condition on the EST.ConclusionOverall, the study demonstrated that the THC/CBD-equivalent cannabis induces less state anxiety than THC-dominant cannabis.

Preparedness for healthy ageing and polysubstance use in long-term cannabis users: a population-representative longitudinal study

SummaryBackgroundCannabis is often characterised as a young person’s drug. However, people who began consuming cannabis in the 1970s and 1980s are no longer young and some have consumed it for many years. This study tested the preregistered hypothesis that long-term cannabis users show accelerated biological ageing in midlife and poorer health preparedness, financial preparedness, and social preparedness for old age.MethodsIn this longitudinal study, participants comprised a population-representative cohort of 1037 individuals born in Dunedin, New Zealand, between April, 1972, and March, 1973, and followed to age 45 years. Cannabis, tobacco, and alcohol use and dependence were assessed at ages 18 years, 21 years, 26 years, 32 years, 38 years, and 45 years. Biological ageing and health, financial, and social preparedness for old age were assessed at age 45 years. Long-term cannabis users were compared using independent samples t tests with five groups: lifelong cannabis non-users, long-term tobacco users, long-term alcohol users, midlife recreational cannabis users, and cannabis quitters. In addition, regression analyses tested dose–response associations for continuously measured persistence of cannabis dependence from age 18 years to 45 years, with associations adjusted for sex, childhood socioeconomic status, childhood IQ, low childhood self-control, family substance dependence history, and persistence of alcohol, tobacco, and other illicit drug dependence.FindingsOf 997 cohort members still alive at age 45 years, 938 (94%) were assessed at age 45 years. Long-term cannabis users showed statistically significant accelerated biological ageing and were less equipped to manage a range of later-life health, financial, and social demands than non-users. Standardised mean differences between long-term cannabis users and non-users were large: 0·70 (95% CI 0·46 to 0·94; p<0·0001) for biological ageing, −0·72 (−0·96 to −0·49, p<0·0001) for health preparedness, −1·08 (−1·31 to −0·85; p<0·0001) for financial preparedness, and −0·59 (−0·84 to −0·34, p<0·0001) for social preparedness. Long-term cannabis users did not fare better than long-term tobacco or alcohol users. Tests of dose–response associations suggested that cannabis associations could not be explained by the socioeconomic origins, childhood IQ, childhood self-control, and family substance-dependence history of long-term cannabis users. Statistical adjustment for long-term tobacco, alcohol, and other illicit drug dependence suggested that long-term cannabis users’ tendency toward polysubstance dependence accounted for their accelerated biological ageing and poor financial and health preparedness, although not for their poor social preparedness (β −0·10, 95% CI −0·18 to −0·02; p=0·017).InterpretationLong-term cannabis users are underprepared for the demands of old age. Although long-term cannabis use appears detrimental, the greatest challenge to healthy ageing is not use of any specific substance, but rather the long-term polysubstance use that characterises many long-term cannabis users. Substance-use interventions should include practical strategies for improving health and building financial and social capital for healthy longevity.

Use of psychedelics in the Czech Republic: results of recent population surveys.

Different psychoactive substances are widely used in today's society. So far limited data are available on the use of psychedelics in the general population. The main aim of this study is to estimate the numbers of users of substances with psychedelic properties (classical psychedelics, cannabis, ecstasy, and ketamine) in the Czech Republic. Data from two samples enrolled in representative cross-sectional questionnaire surveys in the Czech adult population in 2016 (n = 2,785) and 2018 (n = 1,665) were analysed. Prevalence rates were extrapolated to estimate numbers of current, i.e., last-year, users of psychedelics, and their socio-demographic profiles were compared with non-users and users of cannabis. An estimated 5-6% of the Czech adult population (350-430 thousand people) used classical psychedelics (LSD, psilocybin mushrooms, ayahuasca) in their lifetime, increasing up to 28-30% when cannabis is included (1.9-2.1 million users). Current use of classical psychedelics reached 0.7-1.9% (50-130 thousand people), and 9-11% (590-750 thousand users) when cannabis was included. Users of psychedelics were more often males, of younger age and single. No significant socio-demographic differences were found between users of classical psychedelics and recreational cannabis users, however, differences were significant when compared to non-users and users of other illicit drugs. Findings should further serve to inform drug policy and social and healthcare systems in respect to the use of psychedelics.

I Smoke Alone: Indirect Effects of Solitary Cannabis Use on Negative Consequences Through Coping Motives.

Using cannabis in solitary contexts is associated with greater cannabis use problems than using cannabis in social contexts. However, it remains unclear why solitary use predicts greater problems. Consistent with a social learning perspective, the current study examined whether cannabis use motives mediated the association between context of cannabis use and negative consequences. We also examined whether cannabis type (concentrates vs. flower) moderated the relation between context of use and motives. Recreational college cannabis users (n = 387) reported their frequency of using cannabis alone or with others, motives for cannabis use, negative cannabis consequences, and type of cannabis typically used. Solitary cannabis use was associated with greater global negative consequences through coping motives (β = 0.26, SE = 0.10, 95% CI [0.10, 0.43]). Cannabis type did not moderate relations between context and motives, despite concentrate users reporting more frequent cannabis use, more frequent solitary use, and greater consequences than flower users. Frequent cannabis use in solitary contexts was associated with greater negative cannabis consequences, both directly and indirectly via coping motives. Efforts to reduce frequent use of cannabis in solitary contexts, particularly for the purpose of coping, may be beneficial in reducing negative consequences.

Driving under the influence of cannabis among recreational and medical cannabis users: A population study

BackgroundComparisons of individuals using cannabis for medical versus recreational purposes have identified differences in health status, alcohol and drug use, and perceived risk of drug use. All of these factors are associated with aggressive and impaired driving and collision risk. Yet, few studies comparing medical and recreational cannabis users have considered differences in driver behaviour and road safety. AimThis study examined the association between type of cannabis use (medical versus recreational-only) and engaging in driving under the influence of cannabis (DUIC), controlling for suspected confounding variables. MethodData were derived from a regionally stratified cross-sectional general population telephone survey of adults (18+ years) in Ontario, Canada conducted from 2014 to 2019. Respondents reporting past-year operation of a vehicle and past-year use of cannabis were selected (N = 1392). A binary logistic regression was conducted to assess the association between type of cannabis user (medical versus recreational-only) and self-reported DUIC, controlling for cannabis use frequency, hazardous drinking, perceived general and mental health, demographic characteristics, driving exposure, and interview year. ResultsIn total, 9.7 percent of recreational-only users reported DUIC compared to 27.0 percent of medical users. Adjusting for covariates, medical cannabis users had almost two times greater odds of DUIC than recreational-only users (AdjOR = 1.78, p = .037, 95%CI = 1.03, 3.05). DiscussionA higher proportion of medical cannabis users, relative to recreational-only users, engaged in DUIC. This finding has important implications for improving the effectiveness of public health interventions designed to reduce DUIC. Further research examining the harms of medical versus recreational cannabis use for road safety is needed.

Potency and Therapeutic THC and CBD Ratios: U.S. Cannabis Markets Overshoot.

Background and aims: The effects exuded by cannabis are a result of the cannabinoids trans-Δ⁹-tetrahydrocannabinol (THC) and cannabidiol (CBD), and is dependent upon their pharmacological interaction and linked to the two cannabinoids’ concentrations and ratios. Based on current literature and trends of increasing cannabis potency, we postulate that most medical cannabis products with THC and CBD have ratios capable of producing significant acute intoxication and are similar to recreational products. We will test this by organizing products into clinically distinct categories according to TCH:CBD ratios, evaluating the data in terms of therapeutic potential, and comparing the data obtained from medical and recreational programs and from states with differing market policies. Methods: We utilized data encompassing online herbal dispensary product offerings from nine U.S. states. The products were analyzed after being divided into four clinically significant THC:CBD ratio categories identified based on the literature: CBD can enhance THC effects (THC:CBD ratios ≥1:1), CBD has no significant effect on THC effects (ratios ∼ 1:2), CBD can either have no effect or can mitigate THC effects (ratios 1:>2 < 6), or CBD is protective against THC effects (ratios ≤1:6). Results: A significant number of products (58.5%) did not contain any information on CBD content. Across all states sampled, the majority (72–100%) of both medical and recreational products with CBD (>0%) fall into the most intoxicating ratio category (≥1:1 THC:CBD), with CBD likely enhancing THC’s acute effects. The least intoxicating categories (1:>2 < 6 and ≤1:6 THC:CBD) provided the smallest number of products. Similarly, the majority of products without CBD (0%) contained highly potent amounts of THC (>15%). These results were consistent, regardless of differing market policies in place. Conclusions: Despite the distinct goals of medical and recreational cannabis users, medical and recreational program product offerings are nearly identical. Patients seeking therapeutic benefits from herbal cannabis products are therefore at a substantial risk of unwanted side effects, regardless of whether they obtain products from medical or recreational programs. Efforts are needed to better inform patients of the risks associated with high potency cannabis and the interaction between THC and CBD, and to help shape policies that promote more therapeutic options.

Medical cannabis and stigma: A qualitative study with patients living with chronic pain.

To explore the ways in which stigma is experienced, and what strategies are used to manage stigma among patients using medical cannabis to ease suffering from chronic pain. Various jurisdictions have legalised medical cannabis in recent decades. Despite increasing prevalence and more liberal attitudes towards medical cannabis, it is possible that patients who use medical cannabis experience stigma. A phenomenological qualitative study. Fifteen patients living with chronic pain and licensed by the Israeli Ministry of Health to use medical cannabis to treat pain symptoms for at least 1year participated in semi-structured interviews. Transcribed data were analysed using thematic analysis to identify themes related to stigma. The manuscript is in correspondence to SRQR EQUATOR checklist. Expressions of stigma were more related to 'felt' than 'enacted' stigma. Stigma related to decisions to delay onset of medical cannabis treatment and the ways in which participants managed medical cannabis use during their everyday lives. Participants dissociated themselves from recreational cannabis users, by presenting themselves as responsible normative individuals and engaging in a form of normalisation known as 'normification', emphasising their own discrete and controlled medical cannabis use and cannabis' benefits. Patients experienced 'felt' stigma which had consequences for their self-presentations and medical cannabis use. This suggests that medical cannabis is not normalised in Israel and interventions may be needed to handle stigma related to medical cannabis. The findings emphasise the effects of 'felt' stigma on patients. Aiming to increase the effectiveness of medical cannabis treatment and reducing harms, we suggest that particular focus should be placed on managing stigma at the intrapersonal level. In addition, there may be a need to address stigma at the societal level including social interactions with friends, family and medical personnel.

The Potential Proconvulsant Effects of Cannabis: a Scoping Review.

Cannabis' effect on seizure activity is an emerging topic that remains without consensus and merits further investigation. We therefore performed a scoping review to identify the available evidence and knowledge gaps within the existing literature on cannabis product exposures as a potential cause of seizures in humans. A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews guidelines. The PubMed and Scopus databases were searched over a 20-year period from the date of the database query (12/21/2020). Inclusion criteria were (1) English language original research articles, (2) inclusion of human subjects, and (3) either investigation of seizures as a part of recreational cannabinoid use OR of exogenous cannabinoids as a cause of seizures. A total of 3104 unique articles were screened, of which 68 underwent full-text review, and 13 met inclusion/exclusion criteria. Ten of 11 studies evaluating acute cannabis exposures reported a higher seizure incidence than would be expected based on the prevalence of epilepsy in the general and pediatric populations (range 0.7-1.2% and 0.3-0.5% respectively). The remaining two studies demonstrated increased seizure frequency and/or seizure-related hospitalization in recreational cannabis users and those with cannabis use disorder. This scoping review demonstrates that a body of literature describing seizures in the setting of cannabis exposure exists, but it has several limitations. Ten identified studies showed a higher than expected incidence of seizures in populations exposed to cannabis products. Based on the Bradford Hill criteria, delta-9 tetrahydrocannabinol (THC) may be the causative xenobiotic for this phenomenon.

Long-Term Cannabis Use and Cognitive Reserves and Hippocampal Volume in Midlife.

Cannabis use is increasing among midlife and older adults. This study tested the hypotheses that long-term cannabis use is associated with cognitive deficits and smaller hippocampal volume in midlife, which is important because midlife cognitive deficits and smaller hippocampal volume are risk factors for dementia. Participants are members of a representative cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972-1973 and followed to age 45, with 94% retention. Cannabis use and dependence were assessed at ages 18, 21, 26, 32, 38, and 45. IQ was assessed at ages 7, 9, 11, and 45. Specific neuropsychological functions and hippocampal volume were assessed at age 45. Long-term cannabis users showed IQ decline from childhood to midlife (mean=-5.5 IQ points), poorer learning and processing speed relative to their childhood IQ, and informant-reported memory and attention problems. These deficits were specific to long-term cannabis users because they were either not present or were smaller among long-term tobacco users, long-term alcohol users, midlife recreational cannabis users, and cannabis quitters. Cognitive deficits among long-term cannabis users could not be explained by persistent tobacco, alcohol, or other illicit drug use, childhood socioeconomic status, low childhood self-control, or family history of substance dependence. Long-term cannabis users showed smaller hippocampal volume, but smaller hippocampal volume did not statistically mediate cannabis-related cognitive deficits. Long-term cannabis users showed cognitive deficits and smaller hippocampal volume in midlife. Research is needed to ascertain whether long-term cannabis users show elevated rates of dementia in later life.

The Effects of a Single Transcranial Direct Current Stimulation Session on Impulsivity and Risk Among a Sample of Adult Recreational Cannabis Users.

Individuals with substance use disorders exhibit risk-taking behaviors, potentially leading to negative consequences and difficulty maintaining recovery. Non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have yielded mixed effects on risk-taking among healthy controls. Given the importance of risk-taking behaviors among substance-using samples, this study aimed to examine the effects of tDCS on risk-taking among a sample of adults using cannabis. Using a double-blind design, 27 cannabis users [M(SD) age = 32.48 (1.99), 41% female] were randomized, receiving one session of active or sham tDCS over the bilateral dorsolateral prefrontal cortex (dlPFC). Stimulation parameters closely followed prior studies with anodal right dlPFC and cathodal left dlPFC stimulation. Risk-taking—assessed via a modified Cambridge Gambling Task—was measured before and during tDCS. Delay and probability discounting tasks were assessed before and after stimulation. No significant effects of stimulation on risk-taking behavior were found. However, participants chose the less risky option ∼86% of the trials before stimulation which potentially contributed to ceiling effects. These results contradict one prior study showing increased risk-taking among cannabis users following tDCS. There was a significant increase in delay discounting of a $1000 delayed reward during stimulation for the sham group only, but no significant effects for probability discounting. The current study adds to conflicting and inconclusive literature on tDCS and cognition among substance-using samples. In conclusion, results suggest the ineffectiveness of single session dlPFC tDCS using an established stimulation protocol on risk-taking, although ceiling effects at baseline may have also prevented behavior change following tDCS.