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A Retrospective Cohort Study That Examined the Impact of Cannabis Consumption on Long-Term Kidney Outcomes

Abstract Background: Cannabis consumption for recreational and medical use is increasing worldwide. However, the long-term effects on kidney health and disease are largely unknown. Materials and Methods: Post hoc analysis of cannabis use as a risk factor for kidney disease was performed using data from the Assessment, Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury (ASSESS-AKI) study that enrolled hospitalized adults with and without acute kidney injury from four U.S. centers during 2009–2015. Associations between self-reported cannabis consumption and the categorical and continuous outcomes were determined using multivariable Cox regression and linear mixed models, respectively. Results: Over a mean follow-up of 4.5±1.8 years, 94 participants without chronic...
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A national study of clinical discussions about cannabis use among Veteran patients prescribed opioids

Abstract Background The Veterans Health Administration tracks urine drug tests (UDTs) among patients on long-term opioid therapy (LTOT) and recommends discussing the health effects of cannabis use. Objective To determine the occurrence of cannabis-related discussions between providers and patients on LTOT during six months following UDT positive for cannabis, and examine factors associated with documenting cannabis use. Design We identified patients prescribed LTOT with a UDT positive for cannabis in 2019. We developed a text-processing tool to extract discussions around cannabis use from their charts. Subjects Twelve thousand seventy patients were included. Chart review was conducted on a random sample of 1,946 patients. Main...
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Patient–provider interactions about cannabis for therapeutic purposes vary as a function of provider type: A pilot study

Please use this link to access this publication. Abstract Background and Objectives Limited evidence guides the efficacy and safety of cannabis for therapeutic purposes (CTP). Healthcare providers lack requisite knowledge to advise and support patients. This study aimed to describe and compare several aspects of initial CTP interactions across different provider types. Methods Adult cannabis consumers (N = 507) from the United States completed an anonymous online survey about their initial CTP interaction with their healthcare provider. Providers were categorized into four groups (Mental Health [MH], Family Medicine [FM], Medical Clinics [MC], and Other Specialty [OS]). Analyses compared several aspects of the interaction (e.g., risk mitigation,...
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Limited psychological and social effects of lifetime cannabis use frequency: Evidence from a 30-year community study of 4,078 twins

Please use this link to access this publication. Abstract Background: Cannabis use is associated with outcomes like income, legal problems, and psychopathology. This finding rests largely on correlational research designs, which rely at best on statistical controls for confounding. Here, we control for unmeasured confounders using a longitudinal study of twins. Method: In a sample of 4,078 American adult twins first assessed decades ago, we used cotwin control mixed effects models to evaluate the effect of lifetime average frequency of cannabis consumption measured on substance use, psychiatric, and psychosocial outcomes. Results: On average, participants had a lifetime cannabis frequency of about one to two...
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Daily associations with cannabis use and sleep quality in anxious cannabis users

Please use this link to access this publication. ABSTRACT Introduction Cannabis is increasingly used to self-treat anxiety and related sleep problems, without clear evidence of either supporting or refuting its anxiolytic or sleep aid effects. In addition, different forms of cannabis and primary cannabinoids ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have differing pharmacological effects. Methods Thirty days of daily data on sleep quality and cannabis use were collected in individuals who use cannabis for mild-to-moderate anxiety (n = 347; 36% male, 64% female; mean age = 33 years). Participants self-reported both the form (flower or edible) and the ratio of THC to CBD in the cannabis used during the observation...
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Edible cannabis for chronic low back pain: associations with pain, mood, and intoxication

Abstract Introduction: Cannabis, commonly known for both therapeutic and intoxicating effects, is gaining accessibility on legal markets and traction as a potential alternative therapy for pain mediation, particularly in those suffering from chronic low back pain. However, the effectiveness in this population of legal market forms of cannabis, particularly commonly used edibles, is unknown. Methods: Therefore, this study utilized a naturalistic prospective design where participants with chronic low back pain with intentions to initiate cannabis use for treatment were recruited and self-selected edible cannabis products containing varying amounts of delta- 9 tetrahydrocannabinol (THC) and cannabidiol (CBD). Products were categorized as CBD-dominant, THC-dominant, or combined THC and...
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Comparing Cannabis Use for Pain to Use for Other Reasons in Primary Care Patients

Abstract Background: Medical cannabis is commonly used for chronic pain, but little is known about differences in characteristics, cannabis use patterns, and perceived helpfulness among primary care patients who use cannabis for pain versus nonpain reasons. Methods: Among 1688 patients who completed a 2019 cannabis survey administered in a health system in Washington state, where recreational use is legal, participants who used cannabis for pain (n = 375) were compared with those who used cannabis for other reasons (n = 558) using survey and electronic health record data. We described group differences in participant characteristics, use patterns, and perceptions and applied adjusted multinomial logistic and modified...
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Cannabis for medical use versus opioids for chronic non-cancer pain: a systematic review and network meta-analysis of randomised clinical trials

Abstract Objective The objective of this study is to evaluate the comparative benefits and harms of opioids and cannabis for medical use for chronic non-cancer pain. Design Systematic review and network meta-analysis. Data sources EMBASE, MEDLINE, CINAHL, AMED, PsycINFO, PubMed, Web of Science, Cannabis-Med, Epistemonikos and the Cochrane Library (CENTRAL) from inception to March 2021. Study selection Randomised trials comparing any type of cannabis for medical use or opioids, against each other or placebo, with patient follow-up ≥4 weeks. Data extraction and synthesis Paired reviewers independently extracted data. We used Bayesian random-effects network meta-analyses to summarise the evidence and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach...
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Daily diary study of associations between alcohol, cannabis, co-use and sleep quality in individuals with intentions to use cannabis to cope with anxiety

Abstract Introduction Sleep problems and anxiety conditions are common comorbidities and may be influenced by cannabis and alcohol use. This study examined daily within-person variation in subjective sleep quality among individuals with anxiety symptoms after cannabis or alcohol were used alone, and after co-use. Methods A total of 347 individuals with intentions to use cannabis to cope with anxiety reported their cannabis and alcohol use in the previous 24 h and their previous nights' sleep quality for 30 consecutive days. Mixed-effects models examined whether the within-person daily variation in use of cannabis and alcohol (alone and co-use) was associated with subjective sleep quality. Models also...
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Use of cannabis for mental health in the Canadian territories: a cross-sectional study

Please use this link to access this publication. Abstract Background Population prevalence and patterns of cannabis use for mental health (CUMH) are underexplored. This is important to understand in the Canadian territories which has the highest prevalence of cannabis use in Canada. This study aimed to examine socio-demographic factors associated with CUMH in the territories and associations between CUMH and cannabis use outcomes. Methods This study is a cross-sectional analysis of survey data from the 2022 Cannabis Policy Study in the Territories, including 2431 respondents aged 16+. Multivariable logistic regression models were used to examine socio-demographic characteristics associated with CUMH. Among past 12-month cannabis...
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