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Efficacy and safety of therapeutic use of cannabis derivatives and their synthetic analogs: Overview of systematic reviews

Please use this link to access this publication. Abstract The debate on the use of cannabinoids for therapeutic purposes is constantly on the rise. This overview aimed to map the evidence on the therapeutic effects of cannabis derivatives and their synthetic analogs. Systematic reviews (SRs) of randomized trials were identified through a comprehensive search in several databases, and their methodological quality were evaluated with AMSTAR-2. The results for main outcomes are presented, prioritizing those from updated and better quality SRs. Finally, 68 SRs, addressing 37 different health conditions, were included. The methodological quality was high for eight SRs. The evidence certainty (GRADE) for the...
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Effects of regular cannabis and nicotine use on acute stress responses: chronic nicotine, but not cannabis use, is associated with blunted adrenocortical and cardiovascular responses to stress

Please use this link to access this publication. Abstract Rationale Cannabis is one of the most prevalent substances used by tobacco smokers and, in light of the growing list of states and territories legalizing cannabis, it is expected that co-use of cannabis and nicotine will escalate significantly and will lead to continuing challenges with tobacco use. Objectives This study was conducted to examine the interactive effects of chronic cannabis and nicotine use on adrenocortical, cardiovascular, and psychological responses to stress and to explore sex differences in these effects. Methods Participants (N = 231) included cannabis-only users, nicotine-only users, co-users of both substances, and a non/light-user comparison...
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Cannabis use is associated with prevalent coronary artery disease

Please use this link to access this publication. Abstract Background Cannabis is associated with risk of acute coronary syndrome in observational studies. However, its association with prevalent coronary artery disease (CAD) remains unclear. We hypothesized that cannabis use is associated with prevalent CAD. Methods This analysis included 12,543 participants (age 39.3 ± 11.6 years, 48.8% male, 35.3% Caucasians) from The National Health and Nutrition Examination Survey (NHANES). Cannabis use was self-reported. Prevalent CAD was defined by physician diagnosis. The association between cannabis use and CAD was tested for using multivariable logistic regression. Results About 53.1% (n = 6,650) of participants were ever cannabis users...
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The relation between cannabis use, dependence severity and white matter microstructure: A diffusion tensor imaging study

Abstract Despite the significant societal and personal burden of cannabis use, the impact of long-term use and Cannabis Use Disorder (CUD) on white matter microstructure is still unclear. Previous studies show inconsistent findings, in part due to heterogeneity in methodology, variable severity of cannabis use, and potential confounding effects of other mental health issues and substance use. The goal of this diffusion tensor imaging (DTI) study was to compare whole-brain white matter microstructure between 39 near daily cannabis users and 28 controls closely matched on age, sex, alcohol use, cigarette use and mental health. Within the group of cannabis users, associations between white matter...
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Indeterminacy of cannabis impairment and ∆9-tetrahydrocannabinol (∆9-THC) levels in blood and breath

Abstract Previous investigators have found no clear relationship between specific blood concentrations of ∆9-tetrahydrocannabinol (∆9-THC) and impairment, and thus no scientific justification for use of legal “per se” ∆9-THC blood concentration limits. Analyzing blood from 30 subjects showed ∆9-THC concentrations that exceeded 5 ng/mL in 16 of the 30 subjects following a 12-h period of abstinence in the absence of any impairment. In blood and exhaled breath samples collected from a group of 34 subjects at baseline prior to smoking, increasing breath ∆9-THC levels were correlated with increasing blood levels (P < 0.0001) in the absence of impairment, suggesting that single measurements of ∆9-THC in breath, as...
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Bayesian causal network modeling suggests adolescent cannabis use accelerates prefrontal cortical thinning

Abstract While there is substantial evidence that cannabis use is associated with differences in human brain development, most of this evidence is correlational in nature. Bayesian causal network (BCN) modeling attempts to identify probable causal relationships in correlational data using conditional probabilities to estimate directional associations between a set of interrelated variables. In this study, we employed BCN modeling in 637 adolescents from the IMAGEN study who were cannabis naïve at age 14 to provide evidence that the accelerated prefrontal cortical thinning found previously in adolescent cannabis users by Albaugh et al. [1] is a result of cannabis use causally affecting neurodevelopment. BCNs incorporated...
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Geotemporospatial and causal inference epidemiological analysis of US survey and overview of cannabis, cannabidiol and cannabinoid genotoxicity in relation to congenital anomalies 2001–2015

Abstract Background Cannabinoids including cannabidiol have recognized genotoxic activities but their significance has not been studied broadly epidemiologically across the teratological spectrum. We examined these issues including contextual space-time relationships and formal causal inferential analysis in USA. Methods State congenital anomaly (CA) rate (CAR) data was taken from the annual reports of the National Birth Defects Prevention Network 2001–2005 to 2011–2015. Substance abuse rates were from the National Survey of Drug Use and Health a nationally representative longitudinal survey of the non-institutionalized US population with 74.1% response rate. Drugs examined were cigarettes, monthly and binge alcohol, monthly cannabis and analgesic and cocaine abuse. Early...
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Tolerance for specific negative affective states and coping-oriented cannabis use motives among college student cannabis users

Please use this link to access this publication. Abstract Objective The current study examined the unique predictive ability of tolerance of specific negative affective states in relation to frequency of past-month cannabis use and coping-oriented cannabis use motives. Participants: 416 undergraduates who reported past 30 day cannabis use (65.1% female; Mage = 19.46, SD = 2.56). Methods: Participants completed self-report questionnaires for course credit. Results: After accounting for the effects of sex, negative affectivity, and tolerance of other specific negative affective states, lower levels of tolerance for sadness, but not any other negative affective states, significantly predicted more frequent cannabis use in the past 30 days (1.1% unique...
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Association between cannabis use and suicidal behavior: A systematic review of cohort studies

Please use this link to access this publication. Abstract The use of cannabis is highly prevalent worldwide, with known short and long-term adverse effects. However, the relationship between cannabis use and suicidal behavior remains relatively unexplored and this paper aims to unify existing literature on the topic. A systematic review was conducted using MEDLINE, Embase, PsycINFO and LILACS databases with a supplementary search to identify cohort articles published up to January 2020, with no age delimitation for the samples. This review aimed to address the relationship between cannabis use and suicidal behavior, defined as suicidal ideation, attempted suicide or completed suicide. Twenty-two articles were...
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Tolerability of High-Dose Oral Δ9-THC: Implications for Human Laboratory Study Design

Please use this link to access this publication. Abstract Background: Δ9-tetrahydrocannabinol (THC), the primary intoxicating compound in cannabis, has been tested extensively in controlled administration human studies. Some studies require a high THC dose that may induce adverse events (AEs), such as those testing novel treatments for cannabinoid overdose. Although there are ethical concerns related to administering high THC doses, there is no systematic analysis on studies utilizing these doses. In this review, we examine studies that administered oral THC doses ≥30 mg (“high-dose THC”), focusing on reported tolerability, subjective effects, and pharmacokinetics (PK), with the objective to inform the design of future studies. Methods: A comprehensive...
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