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Clinical Evaluation of the Cannabis-Using Patient: A Moving Target

Abstract The prevalence of cannabis use has been increasing among both adolescents and adults worldwide. New trends in cannabis legalization and enhanced social media marketing have led to the availability of multiple high-potency cannabis products with hundreds of new and powerful delivery systems. Over the last decade, there have been drastic changes in cannabis formulations, potency, routes of consumption, and device technology, with increased complexity and sophistication among growers, suppliers, and consumers. Patterns of cannabis use among patients can have important clinical implications, including acute neurocognitive effects, chronic multiorgan toxicity, psychiatric, behavioral, social, and economic impact. However, assessment of medical or surgical patients who...
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Cannabis derivatives and their synthetic analogs for treatment-resistant epilepsy: A systematic review and meta-analysis

Please use this link to access this publication. Abstract Background: Cannabidiol and other synthetic analogs from the Cannabis sativa plant have been investigated as alternative for the treatment of refractory epilepsy. Objective: to assess the effects of cannabis derivatives for the treatment of refractory epilepsy. Search methods: a search of the literature was carried out in the several databases, as well as a manual search of the reference lists of relevant studies, gray literature and clinical trial registries. Selection criteria and analysis: randomized controlled trials were included, and the risk of bias was assessed using the Cochrane risk of bias tool. The certainty of the evidence was assessed using the GRADE approach. Main results: Seven randomized clinical...
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Cannabis Use in HIV: Impact on Inflammation, Immunity and the Microbiome

Please use this link to access this publication. Abstract Purpose of Review This review explores how cannabis impacts the gut microbiome, immune system, and ART outcomes in people with HIV (PWH). Given the increasing prevalence of cannabis use among PWH, we investigated its potential to reduce chronic inflammation and enhance gut health, both of which can influence HIV pathogenesis. Recent Findings Cannabis has immunomodulatory and anti-inflammatory effects, including reducing systemic inflammatory biomarkers (such as MCP-1 and IP-10) and improving gut barrier integrity through increased short-chain fatty acid (SCFA) production. Studies have shown that cannabis use is associated with increased gut mucosal immunity, decreased immune...
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The differential effects of medicinal cannabis on mental health: A systematic review

Abstract The use of medicinal cannabis to improve mental health is increasing globally, both in clinical settings and through self-medication. This involves a variety of products containing ∆9-tetrahydrocannabinol (THC), cannabidiol (CBD), THC + CBD combinations, or derivatives. This review provides an up-to-date overview of the positive and negative effects of medicinal cannabis on mental health diagnoses and related symptoms of the Diagnostic and Statistical Manual of Mental Disorders 5th Edition. Searches in PubMed, PsycInfo, Embase, and the Cochrane Library (October 2023 and July 2024) identified 18,341 studies, of which 49 controlled studies from 15 different countries were included. All studies focused on treatment-seeking participants using medicinal cannabis for (symptoms of) their mental health diagnosis....
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Cannabis Uses in Dentistry: A Bibliometric Analysis

Please use this link to access this publication. Abstract Background: This bibliometric review seeks to understand metrics of papers, authors, journals, and universities, about the benefits of the therapeutic application of Cannabis sativa (CS), as well as the most harmful effects associated to its use. Methods: The main search strategy applied to the topic was conducted in Web Of Science Core Collection on February 2024. A crossmatch of the number of citations was performed in Scopus and Google Scholar. The analyses were carried out in VOSviewer and Altmetric for PubMed and Google Scholar. Results: Of a total of 196 records, 53 articles were included for analysis. There were 25 publications on either...
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Acute cannabis intoxication among the paediatric population

Abstract This narrative review synthesizes the toxicological, clinical and medico-legal aspects of paediatric cannabis intoxication. By providing a comprehensive overview, it aims to inform future research, guide policymaking, and enhance clinical and toxicological practice in addressing this growing public health concern. The pharmacokinetics of cannabinoid ingestion in children are significantly influenced by the immaturity of their gastrointestinal tract and metabolic enzyme systems, resulting in altered oral bioavailability. Clinical data indicate that Δ9-tetrahydrocannabinol (THC)-related effects in paediatricpaediatric patients typically emerge within 2 hours of ingestion, with more severe symptoms developing within 4 hours. The endocannabinoid system (ECS) undergoes significant developmental changes, with marked differences in cannabinoid receptor...
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Genotoxicity study of Cannabis sativa L. extract

Abstract Cannabis sativa L., a member of the Cannabaceae family, has been thoroughly investigated for its diverse therapeutic properties, primarily attributed to cannabinoids such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Secondary, metabolites like terpenes also exhibit pharmacological effects. This study examined the genotoxicity of a whole Cannabis sativa flower extract 160.32 mg/mL using three OECD-recommended protocols: the Ames test, micronucleus test, and comet assay. Five groups of six Wistar rats were used. Three doses of the extract (500, 1000, and 2000 mg/kgbw) or negative control (placebo) were administered orally, while cyclophosphamide monohydrate (20 mg/kgbw) was used as a positive control via intraperitoneal injection. Blood was collected for the comet test, and the animals were euthanized for bone marrow collection for the micronucleus...
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A Comprehensive Review and Update on Cannabis Hyperemesis Syndrome

Abstract Cannabis, derived from Cannabis sativa plants, is a prevalent illicit substance in the United States, containing over 400 chemicals, including 100 cannabinoids, each affecting the body’s organs differently upon ingestion. Cannabis hyperemesis syndrome (CHS) is a gut–brain axis disorder characterized by recurring nausea and vomiting intensified by excessive cannabis consumption. CHS often goes undiagnosed due to inconsistent criteria, subjective symptoms, and similarity to cyclical vomiting syndrome (CVS). Understanding the endocannabinoid system (ECS) and its dual response (pro-emetic at higher doses and anti-emetic at lower doses) is crucial in the pathophysiology of CHS. Recent research noted that type 1 cannabinoid receptors in the intestinal nerve plexus...
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Cannabis-based products for medicinal use in dogs and cats: a systematic review

Please use this link to access this publication. Abstract Objectives Cannabis-based products for medicinal use, also referred to as cannabinoid-containing products, particularly those containing cannabidiol as the primary active constituent, have shown to be a possible alternative in treating various health conditions in companion animals. Thus, this systematic review aims to synthesise and analyse the available data on the efficacy/effectiveness and safety of cannabis-based products for medicinal use in dogs and cats to assist in clinical decision-making. Materials and Methods A systematic review was conducted across PubMed, LILACS, Scopus, and Google Scholar from February 2014 to February 2024. The search strategy included both MeSH...
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Cannabis and psychopathology: 2024 Snapshot of a meandering journey

Abstract Background: Cannabis has been associated with psychopathology since ancient times, but controversies continue despite important advances in the field. This article is the fourth one in our decadal series of review articles that have been providing an update snapshot of the meandering journey of the research findings in this area. Aims: This narrative review of a comprehensive literature search over the past 10 years aims to provide an update and current understanding, while raising unanswered questions for the future, focusing on the following areas: (a) nosological changes in cannabis-related psychiatric syndromes; (b) psychopathology associated with the newer category of synthetic cannabinoids; (c) cannabis...
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