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Intravenous Haloperidol Versus Ondansetron for Cannabis Hyperemesis Syndrome (HaVOC): A Randomized, Controlled Trial

Please use this link to access this publication. Abstract Study objective Little is known about the cause or optimal treatment of hyperemesis in habitual cannabis users. Anecdotal evidence supports the use of haloperidol over traditional antiemetics for this newly recognized disorder. We compare haloperidol with ondansetron for cannabis hyperemesis syndrome. Methods We randomized cannabis users with active emesis to either haloperidol (with a nested randomization to either 0.05 or 0.1 mg/kg) or ondansetron 8 mg intravenously in a triple-blind fashion. The primary outcome was the reduction from baseline in abdominal pain and nausea (each measured on a 10-cm visual analog scale) at 2 hours after treatment. Although the trial allowed for crossover, the primary...
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Cannabis Glandular Trichomes: A Cellular Metabolite Factory

Abstract Cannabis has been legalized for recreational use in several countries and medical use is authorized in an expanding list of countries; markets are growing internationally, causing an increase in demand for high quality products with well-defined properties. The key compounds of Cannabis plants are cannabinoids, which are produced by stalked glandular trichomes located on female flowers. These trichomes produce resin that contains cannabinoids, such as tetrahydrocannabinolic acid and cannabidiolic acid, and an array of other secondary metabolites of varying degrees of commercial interest. While growers tend to focus on improving whole flower yields, our understanding of the “goldmines” of the plant – the...
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The Effects of Cannabis on Female Reproductive Health Across the Life Course

Abstract Introduction: Cannabis is commonly used for its medicinal and therapeutic benefits and is also widely used as a recreational drug. Cannabis use has been increasing in Canada, including among Canadian women of reproductive age. Post-legalization, further increases in cannabis use are expected due to increased availability and lowered perceptions of harm. Although cannabinoids are well known for their effects on the central and peripheral nervous systems, endocannabinoid receptors have also been characterized throughout the female reproductive tract. Cannabinoids may affect many aspects of female reproductive health, including fertility, pregnancy outcomes with neonatal implications, and menopause. Purpose: To provide a comprehensive review of trends...
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Safety and Efficacy of Medicinal Cannabis in the Treatment of Fibromyalgia: A Systematic Review

Please use this link to access this publication. Abstract Background: Fibromyalgia (FMS) is a complex condition that is characterized by various pain syndromes and fatigue, among other symptoms experienced. Current medical treatment of FMS involves both pharmacological and nonpharmacological approaches, but often with ineffective outcomes. Medicinal cannabis has the potential to be a therapeutic option for patients with FMS due to the positive research in chronic pain management. In addition, it has been found to have fewer adverse effects compared with currently available pain medications. This literature review aims at answering whether medicinal cannabis is reported to be safe and effective for the treatment of...
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Older Cannabis Users Are Not All Alike: Lifespan Cannabis Use Patterns

Please use this link to access this publication. Abstract Although several studies have examined individual-level correlates of cannabis use in later life, there is scant evidence identifying heterogeneity among older users. Using data from Colorado, this study examines variability in lifespan patterns of cannabis use among individuals aged 60 years and older. Sample respondents reported cannabis use in the past year and frequency of use in four periods of adulthood. Analyses used a multi-way contingency table to identify mutually exclusive subgroups of cannabis users based on lifetime reports of use and linear probability models to identify predictors of group identity. Three subgroups of older...
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Cannabis Abuse and Perioperative Complications Following Inpatient Spine Surgery in the United States

Please use this link to access this publication. Abstract Mini Due to its complicated legal status, the effects of cannabis on elective spine surgery patients have not been well studied. In this nationwide analysis, we find that cannabis abuse is associated with higher perioperative thromboembolism and neurologic complications, respiratory complications, sepsis, length of stay, hospital charges, and rates of unfavorable discharge disposition. Study Design. Retrospective cohort analysis of a nationwide administrative database. Objective. The aim of this study was to analyze the association between cannabis abuse and serious adverse events following elective spine surgery. Summary of Background Data. Cannabis is the most popular illicit...
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Neuropsychological performance in young adults with cannabis use disorder

Abstract Background and Aims: Cannabis is a commonly used recreational drug in young adults. The worldwide prevalence in 18- to 25-year-olds is approximately 35%. Significant differences in cognitive performance have been reported previously for groups of cannabis users. However, the groups are often heterogeneous in terms of cannabis use. Here, we study daily cannabis users with a confirmed diagnosis of cannabis use disorder (CUD) to examine cognitive performance on measures of memory, executive function and risky decision-making. Methods: Forty young adult daily cannabis users with diagnosed CUD and 20 healthy controls matched for sex and premorbid intelligence quotient (IQ) were included. The neuropsychological battery...
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Effect of preoperative cannabis use on perioperative outcomes: a retrospective cohort study

Please use this link to access this publication. Abstract Introduction The reported use of cannabis within surgical population is increasing. Cannabis use is potentially associated with increased harms and varied effects on pain control. These have important implications to perioperative care. Methods We conducted a retrospective cohort study comparing surgical patients reporting cannabis use preoperatively to control patients with no cannabis exposure, in a 1:2 ratio. To control for confounding, we used a propensity score-matched analysis to assess the adjusted association between cannabis use and study outcomes. Our primary outcome was a composite of (1) respiratory arrest or cardiac arrest, (2) intensive care admission, (3) stroke,...
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Cannabis use and psychosocial functioning: evidence from prospective longitudinal studies

Please use this link to access this publication. Abstract Cannabis legalization is expected to result in more frequent and compulsive use, potentially contributing to worsening psychosocial functioning among some cannabis users. This review evaluates associations between cannabis use and psychosocial functioning in recently published reports from prospective longitudinal studies and considers evidence for and against causation. Unlike previous reviews, studies of adolescents/emerging adults are considered separately from studies that followed adolescents well into adulthood, in part because of vast differences in cumulative cannabis exposure. Infrequent adolescent cannabis use is associated with poorer psychosocial functioning in some domains in emerging adulthood, whereas chronic, frequent adult use, regardless of adolescent-onset versus adult-onset, is associated...
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Cannabis Affects Cerebellar Volume and Sleep Differently in Men and Women

Abstract Background: There are known sex differences in behavioral and clinical outcomes associated with drugs of abuse, including cannabis. However, little is known about how chronic cannabis use and sex interact to affect brain structure, particularly in regions with high cannabinoid receptor expression, such as the cerebellum, amygdala, and hippocampus. Based on behavioral data suggesting that females may be particularly vulnerable to the effects of chronic cannabis use, we hypothesized lower volumes in these regions in female cannabis users. We also hypothesized poorer sleep quality among female cannabis users, given recent findings highlighting the importance of sleep for many outcomes related to cannabis use disorder....
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