Please use this link to access this publication. Abstract Momentum towards legalization of medical and recreational cannabis drives a convergence between natural cannabinoids and their synthetic counterparts, creating new clinical challenges in a second wave of exposures. This review critically examines the emerging challenges posed by synthetic cannabinoid receptor agonists (SCRAs) and semi-synthetic cannabinoids, emphasizing their clinical implications. SCRAs are potent full agonist activity that have been identified as adulterants in several recreational substances, including cannabis and opioids. Adulteration often leads to unpredictable clinical outcomes and exacerbates the potential for drug interactions. Drawing parallels with other drug epidemics, this paper highlights the urgent need for clinical preparedness to address the nuanced...

Please use this link to access this publication. Abstract The partial legalization of cannabis in Germany in 2024 will affect both medical and recreational use of cannabis. Tetrahydrocannabinol (THC), the main psychoactive component of the cannabis plant, influences heart rate and blood pressure through the endocannabinoid system. Acute and chronic use can pose cardiovascular risks. There is evidence of a link between cannabis use and cardiovascular events such as stroke and myocardial infarction, although studies show conflicting results. The non-psychoactive cannabidiol (CBD) could have anti-inflammatory and antioxidant effects. Smoking cannabis poses additional cardiovascular risks similar to tobacco. Given these risks, cardiologists should routinely ask their...

Please use this link to access this publication. Abstract Introduction: Aromatase inhibitors (AIs) are commonly used for postmenopausal women with hormone receptor-positive breast cancer. Nearly two-thirds of women on AIs have arthralgias, joint stiffness, and/or bone pains referred to as aromatase inhibitor-induced musculoskeletal syndrome (AIMSS), leading to poor adherence. Preclinical and clinical data suggest topical cannabinoids can reduce inflammation in arthritis. Materials and Methods: We conducted a randomized trial assessing feasibility, tolerability, and preliminary efficacy of topical cannabis for women with stage 1–3 breast cancer experiencing AIMSS. Women were randomized 1:1 to cannabidiol (CBD) vs. delta-9-tetrahydrocannabinol (THC) balms. The balm was applied three times daily to...

Abstract This systematic review examines the efficacy of medical cannabis in pain management within orthopaedic domains, including arthritis pain, postsurgical pain, back pain, and post-trauma pain. Given the challenges and risks associated with traditional pain medications, particularly opioids, this review aims to assess the efficacy and safety of medical cannabis for orthopaedic pain management. A literature search was conducted on databases such as PubMed and Cochrane to find primary research papers on the efficacy and safety of cannabis. A comprehensive analysis was conducted on available literature, focusing on studies that evaluated the efficacy and safety profile of medical cannabis in various orthopaedic pain conditions....

Abstract Cannabis sativa L. is cultivated nowadays for agricultural, industrial, and medicinal applications and also for recreational use. The latter is due to the presence of delta-9-tetrahydrocannabinol, a psychoactive substance. Recreational cannabis policies vary between different countries, which has led to the lack of a clearly defined legal context for cannabis and also a diversity of products derived from or containing cannabis on the (il)legal market. These cannabis-derived products have regained attention, notably because of their cannabinoid content. This review aims to assess and present analytical methods developed to analyze phytocannabinoids with spectroscopic and chromatographic techniques in specific cannabis matrices: herbs and oily products. Published...

Please use this link to access this publication. Abstract Background: The rise in global cannabis use has led anaesthetists to encounter an increasing number of patients on cannabis and cannabinoids. With cannabis influencing the perioperative period, anaesthetists will face associated challenges managing these patients. Objective: This review aims to summarise this literature on perioperative care for patients with long-term cannabis consumption or cannabis use disorder. Methods: This review was conducted based on the PRISMA 2020 statement. A literature search was performed using Medline and Cochrane library databases to identify relevant reports published from 2003 to 2023. This search yielded 209 records. After screening, 17...

Abstract: Cannabis is the most used drug worldwide with an estimated 219 million users. This narrative review aims to explore the adverse effects and therapeutic applications of cannabis and cannabinoids on the eye, given its growing clinical and non-clinical uses. The current literature reports several adverse ocular effects of cannabis and cannabinoids, including eyelid tremor, ptosis, reduced corneal endothelial cell density, dry eyes, red eyes, and neuro-retinal dysfunction. Cannabinoids may transiently impair night vision, depth perception, binocular and monocular contrast sensitivity, and dynamic visual acuity. Cannabinoids are not currently considered a first-line treatment option for any ocular conditions. Δ-9-tetrahydrocannabinol been shown to result in...

Please use this link to access this publication. Abstract Introduction: The effect of cannabis use on health is likely to depend on individual differences. In particular, there is a growing need to understand the impact of cannabis and delta-9-tetrahydrocannabinol (THC) on brain and behavioral health across the lifespan. Materials and Methods: We conducted a narrative review summarizing the effects of cannabis and THC across three stages of life: in utero, adolescence, and late adulthood. We also provide an up-to-date report on past 30-day cannabis use and risk perceptions from the National Survey on Drug Use and Health (NSDUH; 2002–2023) during pregnancy, adolescence, and late adulthood. We note...

Abstract Background: Awareness has recently risen about the potential associated risks to the cardiovascular health of cannabis users. The objective was to evaluate the possible association between major adverse cardiovascular events (MACE) and the use of cannabis or cannabinoids. Methods: Original pharmacoepidemiological studies providing risk estimates on cannabis-related MACE (ie, cardiovascular death, non-fatal acute coronary syndrome (ACS) including myocardial infarction (MI) or non-fatal stroke) published from 1 January 2016 to 31 January 2023 were included in the systematic review exploring PubMed, Web of Science and Scopus (last search: 20 September 2023). Design, duration, baseline characteristics, exposure, inclusion criteria, sample size, effect size and confusing factors, including...

Abstract The legalization of cannabis for medical and recreational purposes has progressed internationally. Cannabis and cannabinoids are advocated for a plethora of medical indications. An increasing number of medical and nonmedical users regularly consume large doses of delta-9-Tetrahydrocannabinol (THC), the main active component of cannabis. Aim: to summarize the evidence on (1) risks of recreational cannabis use and (2) effectiveness and safety of medicinal cannabis. Findings on recreational use: Cannabis is mostly used to experience its acute rewarding effects. Regular use of high THC products can produce addiction (cannabis use disorder or CUD). Acute consumption of high THC doses (including unintentionally) can cause time-limited...