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Changes in cannabis attitudes and perceptions in the five years following recreational legalization in Canada: Findings from an observational cohort study of community adults

Abstract Background Social acceptability and perceived risks/benefits are key attitudinal factors that influence substance use, and a major concern about cannabis legalization is an increase in more favourable attitudes ultimately leading to greater cannabis misuse. This study investigated perceptions of cannabis acceptability and risks/benefits over the 5 years following legalization in Canada, the first G7 nation to have legalized cannabis nationally, in a longitudinal observational cohort of community adults. Methods Participants (60 % female, median age = 29, 48% reporting cannabis use pre-legalization) were non-clinical adults from the general community who were assessed up to 11 times from September 2018 to October 2023 (mean...
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Quality of life and cannabis use among patients with drug-resistant epilepsy—An observational study from a Canadian tertiary care referral center

Abstract Objective Very few publications have reported the impact of artisanal cannabis use on overall quality of life among people with drug-resistant epilepsy. This study aimed to evaluate the association of artisanal cannabis use among adults with drug-resistant epilepsy with quality of life, and to determine if an association exists between Quality-of-Life in Epilepsy Inventory-31 (QOLIE-31) ‘T scores’ and different clinical variables. Methods This study included patients admitted to a Canadian tertiary care epilepsy center as part of a larger study. These patients were confirmed to have drug-resistant epilepsy by an epileptologist at the Ambulatory Epilepsy Clinic. Patients were categorized into cannabis users (CAN...
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Acute and chronic effects of medicinal cannabis use on anxiety and depression in a prospective cohort of patients new to cannabis

Abstract Introduction Medicinal cannabis has mixed evidence for treating anxiety and depression, yet patients frequently use it as a treatment. This observational study evaluated the effects of medicinal cannabis initiation in adults with clinically significant anxiety and/or depression over a 6-month period. Methods Adults with clinically significant anxiety and/or depression initiating medicinal cannabis use in Maryland, USA completed ecological momentary assessment (EMA) and longitudinal follow-up evaluations. Hospital Anxiety and Depression Scale (HADS) assessments were completed at baseline and 1, 3, and 6 months after medicinal cannabis initiation. EMA measures were completed at baseline and daily for 8 weeks after cannabis initiation with measures collected before each cannabis use and...
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VA Providers’ Perceptions of Cannabis Use Policies in a Legalized and Nonlegalized State

Abstract Background: Providers in the Department of Veterans Affairs (VA) system are caught between two opposing sets of laws regarding cannabis and cannabidiol (CBD) use by their patients. As VA is a federal agency, it must abide by federal regulations, including that the Food and Drug Administration classifies cannabis as a Schedule 1 drug and therefore cannot recommend or help Veterans obtain it. Meanwhile, 38 states have passed legislation, legalizing medical use of cannabis. Objective: The goal of this project is to examine how VA providers understand state and federal laws, and VA policies about cannabis and CBD use, and to learn more about...
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The effects of cannabis use disorder on cognitive functions: A meta-analysis

Abstract Background and aims Impairments in cognition are frequently associated with acute cannabis consumption; on the other hand, controversies persist regarding the residual cognitive impairments of cannabis, with some estimates highlighting significant or mild cognitive impairment. One of the main limitations of the available research syntheses is that little attention has been paid to individuals with cannabis use disorder. Thus, our main objectives are to determine the amplitude of the cognitive deficits associated with cannabis use disorder, and to identify the cognitive domains the most and least impaired. Methods Studies with a patient group with a cannabis use disorder diagnosis and data from at...
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Conceptualizing problematic use of medicinal Cannabis: Development and preliminary validation of a brief screening questionnaire

Please use this link to access this publication. Abstract The use of Medicinal Cannabis (MC) for treating chronic pain is increasing, globally, yet the definition of problematic MC use remains unclear. Defining problematic use of cannabis in medical and non-medical contexts may be fundamentally different since individuals prescribed MC often experience physical dependence, which do not necessarily imply pathology. We aimed to conceptualize problematic use of MC and develop a brief questionnaire for identifying and quantifying problematic MC use. Content validation used a broad definition of problematic substance use, adapting and compiling an initial list of 36 items from various sources: (a) screening tools...
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Effects of randomization to buprenorphine or naltrexone for OUD on cannabis use outcomes: A secondary analysis of the X:BOT trial

Please use this link to access this publication. Abstract Aims Cannabis use is highly prevalent in patients seeking treatment for opioid use disorder. Studies have shown mixed results on the association between cannabis use and opioid use as well as the impact of MOUD on cannabis use. The current study aims to investigate the effects of buprenorphine versus naltrexone on cannabis use outcomes in treatment seeking individuals with Opioid Use Disorder (OUD). Methods The current study was based on data from the CTN-0051 X:BOT trial, which compared the time to return to significant opioid use survival outcomes of two treatment seeking groups, one receiving Extended-Release Naltrexone (XR-naltrexone) (N = 283) versus...
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Cost-Effectiveness of Medical Cannabis Versus Opioids for Chronic Noncancer Pain

Abstract Background: Chronic noncancer pain (CNCP) affects one in five adults and is commonly managed with long-term opioid therapy. Concerns regarding rare but catastrophic harms associated with opioids, including overdose and death, have generated interest in alternatives including cannabis; however, the comparative cost-effectiveness of these management options is uncertain. Methods: We used findings from a network meta-analysis of 90 randomized trials to develop a 1-year microsimulation model to compare costs and quality-adjusted life years (QALY) between oral medical cannabis and opioids for CNCP. We used a publicly funded health care payer perspective for our analyses and obtained cost and utility data from publicly available...
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Development and validation of the Comprehensive Cannabis Motives Questionnaire (CCMQ)

Abstract Background: Existing scales that measure cannabis use motives have failed to incorporate the full range of motives that underpin cannabis consumption, especially with the increased use of medical cannabis. The current research aimed to develop a novel, psychometrically robust scale that comprehensively measures cannabis use motives. Here, we report the development and validation of the Comprehensive Cannabis Motives Questionnaire (CCMQ). Method: Cannabis users completed a 45-item questionnaire measuring a range of cannabis use motives. A UK English-speaking sample (n = 450) provided data for exploratory factor analysis. A second UK English-speaking sample (n = 200) was used for confirmatory factor analysis. Test–retest reliability was based on a...
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Does cannabidiol reduce the adverse effects of cannabis in schizophrenia? A randomised, double-blind, cross-over trial

Abstract In patients with schizophrenia, cannabis use exacerbates symptoms and can lead to a relapse of psychosis. Some experimental studies in healthy volunteers suggest that pre-treatment with cannabidiol (CBD) may reduce these effects, but others do not. Here, we investigated whether pre-treatment with CBD ameliorates the acute adverse effects of cannabis in patients with schizophrenia. Participants (n = 30) had schizophrenia or schizoaffective disorder plus a comorbid cannabis use disorder. In a double-blind, randomised, placebo-controlled, crossover trial, participants received oral CBD 1000 mg or placebo three hours before inhaling vaporised cannabis (containing Δ9-tetrahydrocannabinol (THC) 20–60 mg). The primary outcome was delayed verbal recall measured with the Hopkins Verbal...
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