Abstract Purpose Patients with cancer commonly access cannabis hoping to relieve their symptoms. This study assessed whether a 1:1 10 mg/ml THC:CBD combination oil could improve total symptom burden in patients with advanced cancer over that provided by palliative care alone. Methods Participants were randomised to medicinal cannabis (MC) or placebo oil; dose escalated over 14 days according to tolerance and efficacy and continued to day 28. Symptoms assessed using the Edmonton Symptom Assessment Scale (ESAS) were summated to give a total symptom distress score (TSDS). The primary outcome measure was the change from baseline in TSDS at day 14. Secondary outcomes included individual symptom scores,...

Please use this link to access this publication. Abstract Aim: Few studies have directly compared the bioavailability of different cannabinoid formulations. Our goal was to assess the pharmacokinetic parameters and relative bioavailability of two Δ9-tetrahydrocannabinol:cannabidiol (THC:CBD) formulations: orally administered THC:CBD extract and oromucosally administered nabiximols. Methods: This pilot crossover study counterbalanced (1) 1 mL of orally administered THC:CBD extract (10 mg/mL each of THC and CBD in grapeseed oil) and (2) oromucosally administered nabiximols (four sprays of 2.7 mg THC and 2.5 mg CBD per spray, for a total dose of 10.8 mg THC and 10 mg CBD). Blood samples were obtained pre-dose and...

Abstract The 2018 Farm Bill legalized hemp and defined it as cannabis plant material having not more than 0.3% ∆9-tetrahydrocannabinol (∆9-THC) by dry weight. This has opened the door for the sale of hemp-derived ∆8-tetrahydrocannabinol (∆8-THC), a psychoactive isomer of ∆9-THC. Hemp has minimal amounts of naturally occurring ∆8-THC; however, the cannabidiol found in hemp can be chemically converted into ∆8-THC. Unfortunately, depending on the method of conversion, the amount of ∆8-THC, ∆9-THC, and other by-products can vary widely. For many laboratories, the emergence of ∆8-THC products resulted in analytical challenges because of the structural similarity of the isomers resulting in coelution. In response,...

Abstract Point-of-collection testing (POCT) devices are widely used in roadside and workplace drug testing to identify recent cannabis use by measuring the presence of Δ9-tetrahydrocannabinol (THC) in oral fluid (OF). However, the performance of POCT devices with oral medicinal cannabis products remains poorly described. In a randomised, double-blinded, crossover trial, adults with insomnia disorder (n = 20) received a single (2 mL) oral dose of oil containing 10 mg THC + 200 mg cannabidiol, or placebo, prior to sleep. Participants were tested with the Securetec DrugWipe® 5S (10 ng/mL THC cut-off) and Dräger DrugTest® 5000 (25 ng/mL THC cut-off) POCT devices at baseline (pre-treatment) and then at 0.5, 10, and 18 h post-treatment. An...

Please use this link to access this publication. Abstract Background Youth use of hemp-derived cannabis products containing psychoactive Δ8-tetrahydrocannabinol (delta-8-THC) is prevalent in the United States (US). Delta-8-THC is intoxicating, however delta-8-THC products are not subject to warning labeling requirements in many US states. This experiment determined effects of hypothetical cannabis warning labels on perception of delta-8-THC gummies and vape products. Methods A mixed within-between-subject experiment was embedded into a 2023 survey of 3,647 Southern California adolescents. Participants were randomized to view photos of delta-8-THC edible and vape products under one of three conditions (control [unmodified] vs. standard size warning label [universal cannabis warning...

Abstract In conducting a scoping review on the health effects of high-concentration cannabis products, we have uncovered pervasive methodological shortcomings within the cannabis literature. This review begins by defining the “causal effect” of interest for public health and delineating the desirable features of study design that can address crucial questions pertaining to public health and policy. We further delve into the methodological complexities inherent in studying the health effects of high-concentration cannabis products, describing challenges associated with the measurement of exposures and outcomes, confounding, selection bias, and the generalizability of findings. We introduce causal inference methods to mitigate potential biases in observational cannabis use...

Abstract Aim: To examine the acute pharmacokinetics (PK) and pharmacodynamics (PD) of a patented oral cannabinoid product containing a botanical hemp-derived “full-spectrum” extract with an approximate 1:1 ratio of cannabidiol (CBD) to cannabidiolic acid (CBDA) and delta-9-tetrahydrocannabinol (THC) to delta-9-tetrahydrocannabinolic acid (THCA). Methods: Healthy adults (n = 15) ingested soft gels containing 0 (placebo), and approximately 1, 2, and 4 mg/kg of total cannabinoids (combination of CBD, CBDA, THC, THCA, and other minor cannabinoids) in an ascending-dose order in four experimental sessions separated by ≥1 week (the placebo condition occurred randomly within the dose sequence). Mean doses (mg) of primary cannabinoids in the active drug...

Abstract Importance Driving under the influence of cannabis increases the risk of motor vehicle collisions. In some jurisdictions, deterrence rests on the ability to detect delta-9-tetrahydrocannabinol (THC) in blood. Recent evidence suggests that there may be a nuanced relationship of blood THC to driving. Objective The purpose of this systematic review was to summarize all published papers investigating the presence of a linear relationship between blood THC and driving, primarily measured by simulated driving in the lab. Outcomes The main outcomes assessed included “weaving”/lateral control (eg, standard deviation of lateral position), speed, car following (following distance; coherence), reaction time, and overall driving performance. Results...

Abstract Introduction: Studies show that acute cannabis use significantly increases heart rate (HR) and mildly raises blood pressure in the minutes following smoked or inhaled use of cannabis. However, less is known about how the THC concentration of the product or an individual’s frequency of use (i.e., tolerance) may affect the magnitude of the change in HR. It is also relatively unexamined how the physical effects of increased HR after acute cannabis use relate to self-reported drug effects or blood THC levels. Aims: To describe the relationship between THC concentration of product used, self-reported subjective intoxication, THC blood levels, and frequency of cannabis use...

Please use this link to access this publication. Abstract Purpose of Review There are disproportionately elevated rates of cannabis use and cannabis use disorder (CUD) among sexual and gender minoritized (SGM) individuals. Minority stressors (e.g., victimization, internalized stigma) are a robust predictor of SGM cannabis and related outcomes. The psychological mediation framework posits that changes in coping and emotion regulation, social/interpersonal, cognitive, and SGM group-specific functioning explain associations between minority stress and cannabis outcomes. This systematic review covers the extant literature evaluating the putative mechanisms that link minority stress to cannabis use and related outcomes. Recent Findings Searches were conducted on MEDLINE, Embase, PsycInfo,...