Abstract Introduction As legalization of cannabis products continues, cannabis use becomes more prevalent, and concerns regarding cannabis use disorder (CUD) rise, improving CUD treatment has become increasingly important. Techniques used to regulate emotions, such as cognitive reappraisal, may help manage cravings for cannabis in individuals with CUD. Transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, may improve regulation of emotions and reduce substance use. This study aims to determine whether the addition of tDCS to training in cognitive reappraisal leads to greater reductions in cravings and cannabis use than cognitive reappraisal without active stimulation. Methods and analysis This longitudinal between-subjects study will...

Abstract Introduction Chronic pain remains a challenge, with standard therapies often providing inadequate pain relief and causing undesirable side effects. Medicinal cannabis has emerged as promising alternative. This study assessed the impact of a cannabis hybrid extract on pain intensity and quality of life in daily clinical use. Methods ESCAPE was an observational study and included patients aged ≥ 18 years with chronic pain in Germany. The primary objective was to evaluate the effectiveness of the Cannamedical® Hybrid Cannabis Extract THC25:CBD25 on pain during four visits (V1–V4) in clinical practice, and key secondary objectives were pain interference and quality of life. Pain intensity was measured using the Numeric...

Abstract Introduction Cannabis use disorder (CUD) affects ∼33 million people globally and can be underscored by intense cravings to use cannabis, which can trigger compulsive use and relapse. Functional MRI (fMRI) evidence demonstrates hyperactivity of addiction brain pathways during cannabis cue-reactivity, consistent with prominent neuroscientific theories of addiction, particularly within the anterior cingulate cortex (ACC). The ACC also emerges as a key region of real-time fMRI-based neurofeedback (fMRI-neurofeedback) studies demonstrating voluntary changes during cravings in persons who use substances. However, this notion is untested in CUD. Methods and analysis We aim to develop a protocol that tests the feasibility of fMRI-neurofeedback to enable persons with a moderate-to-severe...

Abstract Introduction: Studies show that acute cannabis use significantly increases heart rate (HR) and mildly raises blood pressure in the minutes following smoked or inhaled use of cannabis. However, less is known about how the THC concentration of the product or an individual’s frequency of use (i.e., tolerance) may affect the magnitude of the change in HR. It is also relatively unexamined how the physical effects of increased HR after acute cannabis use relate to self-reported drug effects or blood THC levels. Aims: To describe the relationship between THC concentration of product used, self-reported subjective intoxication, THC blood levels, and frequency of cannabis use...

Please use this link to access this publication. Abstract Background and aims Recreational cannabis legalization has made high-potency cannabis products more readily available, raising public health concerns. While price-based taxes are common, potency-based taxes have been adopted as a potentially more effective approach to mitigate the harms associated with high-potency cannabis consumption. This study aimed to estimate and compare the effects of price- and potency-based taxes on cannabis purchase patterns. Design In May 2024, we conducted an online Experimental Cannabis Marketplace experiment, where cannabis products varied in product categories, delta-9-tetrahydrocannabinol (THC) levels, and prices. Participants completed hypothetical purchase sessions with varying tax rates and...

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Please use this link to access this publication. Abstract Background Simultaneous use of alcohol and cannabis—or use of both substances so effects overlap—is common among college-attending young adults and can heighten one's likelihood of experiencing substance-related harms in daily life. Limited ecological momentary assessment and daily diary work have examined the role of subjective intoxication and subjective effects when engaging in simultaneous relative to alcohol- or cannabis-only use, and studies have yielded mixed results. As such, subjective experiences serve as important internal cues for decision making; this study aimed to examine the level of subjective intoxication and effects across simultaneous, alcohol-only, and cannabis-only occasions....

Please use this link to access this publication. Abstract Hypokalemia is a relatively common reason for admission from the Emergency Department, with cannabinoid utilization being a more rare, indirect cause, as excessive use can lead to vomiting and diarrhea. More recently, there has been growing interest in the possible association between cannabis use and hypokalemia, even in the absence of gastrointestinal (GI) losses. This case involves a 24-year-old female with a history of anxiety, depression, and heavy cannabis use, who presented to the Emergency Department with bilateral lower extremity weakness and medial leg pain for two days. She was found to have an initial...

Abstract Background: Clinical trials are underway of medicinal cannabis for cancer-related anorexia, using various formulations and modes of administration. Objectives: To explore the benefits and burdens of vaporized medicinal cannabis flower bud for anorexia from the perspectives of trial participants with advanced cancer and their carers. Design: People with advanced cancer enrolled as inpatients in a Phase I/IIb clinical trial, and their carers participated in face-to-face semi-structured interviews. Analysis used the framework method. Setting: Inpatient specialist palliative care. Results: Ten out of 12 trial participants and 6 carers were interviewed. All perceived benefits to eating but, in two cases, this arose from reduced nausea...

Please use this link to access this publication. Abstract Operant conditioning and social learning theories suggest that positive cannabis use–related outcomes are a primary contributor to maintained use and risk for dependence. However, currently there does not exist a reliable, validated measure of positive cannabis-related outcomes. This study sought to develop and psychometrically evaluate the Positive Outcomes of Cannabis Use Scale (POCUS). We collected three samples, college students (N = 883), community adults (N = 214), and college students (N = 615), of predominantly White adults in the United States who completed an online survey. Exploratory and confirmatory factor analyses evaluated scale structure and identified four factors:...