Abstract Although cannabinoids have proven therapeutic benefits, they are increasingly known for their capacity to disturb cardiac electrophysiology, particularly in individuals with hidden genetic issues such as channelopathies. This review consolidates molecular, clinical, epidemiological, and forensic findings linking cannabinoid exposure to arrhythmias and sudden cardiac death. It examines how phytocannabinoids, synthetic analogs, and endocannabinoids influence calcium and potassium currents through cannabinoid receptor-dependent and -independent pathways, affect autonomic regulation, and contribute to adverse conditions such as oxidative stress and inflammation in heart tissue. Genetic variants in key genes linked to SCD (SCN5A, KCNH2, KCNQ1, RYR2, and NOS1AP) can reduce repolarization reserve, transforming otherwise subclinical mutations into lethal substrates when...

Please use this link to access this publication. Abstract Momentum towards legalization of medical and recreational cannabis drives a convergence between natural cannabinoids and their synthetic counterparts, creating new clinical challenges in a second wave of exposures. This review critically examines the emerging challenges posed by synthetic cannabinoid receptor agonists (SCRAs) and semi-synthetic cannabinoids, emphasizing their clinical implications. SCRAs are potent full agonist activity that have been identified as adulterants in several recreational substances, including cannabis and opioids. Adulteration often leads to unpredictable clinical outcomes and exacerbates the potential for drug interactions. Drawing parallels with other drug epidemics, this paper highlights the urgent need for clinical preparedness to address the nuanced...

Please use this link to access this publication. Abstract Objective This study aimed to assess the impact of cannabis legalization on both qualitative and quantitative umbilical cord tissue tetrahydrocannabinol (THC) rates and concentrations as a proxy for fetal exposure. Study Design This is a retrospective, observational study of umbilical cord tissue THC levels in a single center, comparing THC exposure rates and concentration levels before and after cannabis legalization in the state of Illinois, Epoch 1 (October 1, 2018–June 30, 2019, pre-legalization) and Epoch 2 (July 1, 2019–August 31, 2021, post-legalization). Results A total of 811 umbilical cords were analyzed during epoch 1 and...

ABSTRACT Background: Germany experienced a steady rise in the prevalence of past-12-months cannabis use from 2012 to 2021. In 2024, cannabis was partially legalized for recreational use. Against this background, it is important to systematically examine consumption patterns in the early phase after legalization. Methods: Data are from the 2012 (n2012 = 9084), 2015 (n2015 = 9204), 2018 (n2018 = 9267), 2021 (n2021 = 9046), and 2024 (n2024 = 7534) waves of the Epidemiological Survey of Substance Abuse (ESA), a repeated cross-sectional survey of German-speaking adults in private households. Results: The prevalence of past 12-month cannabis use rose steadily from 4.6% in 2012 to 8.8% in 2021. The prevalence in 2024 was 9.8%, an additional increase compared...

ABSTRACT Background Cannabis-based medicinal products (CBMPs) are a potential treatment for post-traumatic stress disorder (PTSD), but their long-term efficacy and safety need further investigation. This study assessed the changes in health-related quality of life (HRQoL) and adverse events in PTSD patients prescribed CBMPs. Research design and methods This observational cohort study included PTSD patients enrolled on the UK Medical Cannabis Registry for 18 months or longer. Changes in PTSD-specific symptoms (IES-R), anxiety (GAD-7), sleep quality (SQS), and general HRQoL (EQ-5D-5 L) were assessed at 1, 3, 6, 12, and 18 months. Results In 269 patients, significant improvements in PTSD symptoms, anxiety, sleep quality, and HRQoL were observed...

Please use this link to access this publication. Objective: Epidemiologic surveys aim to estimate the population prevalence of cannabis use and cannabis use disorder. Prevalence estimates are important for understanding trends, such as the impact of policy change. Existing epidemiologic surveys have produced discrepant and potentially unreliable estimates. The current meta-analysis (PROSPERO CRD42022364818) aims to identify potential sources of unreliability in prevalence estimates of cannabis use and use disorder among the general population (age 12 and older). There was no specific hypothesis about overall prevalence estimate, but we expected significant variability (i.e., heterogeneity) in estimates based on factors such as country, year of data...

Abstract OBJECTIVES: Fibromyalgia (FM) is frequently associated with gastrointestinal (GI) disorders such as disorders of gut-brain interaction (DGBIs). Current treatments for FM offer limited relief, leading to the exploration of alternative therapies such as medical cannabis. This study evaluates in the impact of Bedrocan® medical cannabis in FM patients and GI symptoms over six months. METHODS: Sixty FM patients were enrolled, receiving a Bedrocan® cannabis treatment for 6 months. A standardised questionnaire evaluating upper and lower GI symptoms and the Revised Fibromyalgia Impact Questionnaire (FIQR) evaluating FM severity were administered at enrolment and 3 and 6-month follow-up evaluations. DGBIs, in particular, irritable bowel syndrome...

Abstract BACKGROUND: Tetrahydrocannabinol (THC), the psychoactive compound in cannabis, is increasingly used recreationally, especially among young adults. Although often perceived as harmless, emerging evidence links THC to serious cardiovascular complications, including QTc prolongation, ventricular arrhythmias, and sudden cardiac arrest, even in individuals without underlying heart disease. CASE REPORT: A 26-year-old woman with a history of chronic cannabis use was brought to the Emergency Department (ED) after having a sudden cardiac arrest. Her initial rhythm was ventricular fibrillation, and return of spontaneous circulation was achieved following advanced cardiac life support. An initial electrocardiogram revealed sinus tachycardia with a QTc interval of 483 ms, and a urine drug...

Abstract We report the case of a 34-year-old female who presented with acute respiratory failure and hemoptysis, requiring intubation and mechanical ventilation. Fiberoptic bronchoscopy revealed progressively bloodier returns during lavage, consistent with diffuse alveolar hemorrhage (DAH). This case highlights DAH as a rare but severe complication associated with cannabis use. DAH involves bleeding into the alveolar spaces, impairing gas exchange and causing respiratory distress. While cannabis use is not a well-established cause, this case underscores its potential to trigger serious respiratory complications. Recurrent DAH episodes can lead to long-term complications, such as interstitial fibrosis and emphysema, resulting in obstructive spirometry patterns. Acute complications, including...