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Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016

Please use this link to access this publication. Key Points Question  How did marijuana use and cannabis use disorder change during 2008 to 2016 after the legalization of recreational marijuana in the United States? Findings  In this multilevel, difference-in-difference survey study with 505 796 respondents comparing marijuana use before and after the legalization of recreational marijuana in the United States, the proportion of respondents aged 12 to 17 years reporting cannabis use disorder increased from 2.18% to 2.72%, while the proportion of respondents 26 years or older reporting frequent marijuana use increased from 2.13% to 2.62% and those with cannabis use disorder, from 0.90% to 1.23%....
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Pharmacodynamic effects of vaporized and oral cannabidiol (CBD) and vaporized CBD-dominant cannabis in infrequent cannabis users

Please use this link to access this publication. Abstract Introduction The use and availability of oral and inhalable products containing cannabidiol (CBD) as the principal constituent has increased with expanded cannabis/hemp legalization. However, few controlled clinical laboratory studies have evaluated the pharmacodynamic effects of oral or vaporized CBD or CBD-dominant cannabis. Methods Eighteen healthy adults (9 men; 9 women) completed four, double-blind, double-dummy, drug administration sessions. Sessions were separated by ≥1 week and included self-administration of 100 mg oral CBD, 100 mg vaporized CBD, vaporized CBD-dominant cannabis (100 mg CBD; 3.7 mg THC), and placebo. Study outcomes included: subjective drug effects, vital signs, cognitive/psychomotor performance, and whole...
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Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Abstract Objective To determine the benefit of a tetrahydrocannabinol (THC)-rich cannabis oil on symptoms and quality of life of fibromyalgia patients. Methods A double-blind, randomized, placebo-controlled clinical trial was conducted for eight weeks to determine the benefit of a THC-rich cannabis oil (24.44 mg/mL of THC and 0.51 mg/mL of cannabidiol [CBD]) on symptoms and quality of life of 17 women with fibromyalgia, residents of a neighborhood with a low socioeconomic profile and a high incidence of violence in the city of Florianopolis, Brazil. The initial dose was one drop (∼1.22 mg of THC and 0.02 mg of CBD) a day with subsequent increases according to symptoms. The...
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Potential Adverse Drug Events with Tetrahydrocannabinol (THC) Due to Drug–Drug Interactions

Abstract Tetrahydrocannabinol (THC) is the primary psychoactive ingredient in cannabis. While the safety of THC and cannabis has been extrapolated from millennia of recreational use, medical marijuana programs have increased exposure among medically complex individuals with comorbid conditions and many co-prescribed medications. Thus, THC should be recognized as a pharmacologically complex compound with potential for drug–drug interactions and adverse drug events. This review summarizes potential adverse drug events related to THC when combined with other medications. Metabolic drug–drug interactions are primarily due to THC conversion by CYP3A4 and CYP2C9, which can be impacted by several common medications. Further, CYP2C9 polymorphisms are highly prevalent in...
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The The Effect of Delta-9-Tetrahydrocannabinol and Cannabidiol on Blood Flow

Abstract   Background: This study is based on the premise that while consumption of cannabis has increased for medicinal and recreational purposes there has also been an increase in adverse events seemingly associated with cannabis usage.   Objective: This study was designed to investigate the effect of different concentrations of Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD) separately and in combination on blood flow.   Method: Forty male Sprague-Dawley rats were randomly divided into eight groups consisting of five rats each. Six of the test groups received different concentrations of THC and CBD (1 and 2 mg/kg body weight) respectively, while the seventh group received an extract with a...
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Medical Cannabis to Treat Symptoms From Head and Neck Radiation Therapy

Please use this link to access this publication. Abstract I am a head and neck radiation oncologist in a tertiary care practice in Minnesota. I am credentialed in the state of Minnesota to certify patients for medical cannabis. Over the last 6 years, I have certified select patients for medical cannabis as part of management of their cancer-related symptoms and effects of treatment. In this paper, I review my approach to incorporating medical cannabis into the management of patients with head and neck cancer.
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A descriptive study of older medical cannabis users in medical cannabis clinics

Please use this link to access this publication. Abstract Introduction There is a dearth of information on older users (65+ years) of medical cannabis, who may face unique challenges due to altered metabolism with aging, concurrent medication use, and risk of adverse effects. This observational study aimed to describe a large cohort of older medical cannabis users in Canada. Methods From Oct 2014 to Oct 2020, a commercial medical cannabis provider based in Canada collected anonymized data for research purposes from patient volunteers. Data included demographic, social, and health details (at intake) and cannabis products, self-perceived changes in symptoms and change in medications (at...
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Cannabis Extracts and Their Cytotoxic Effects on Human Erythrocytes, Fibroblasts, and Murine Melanoma

Please use this link to access this publication. Abstract Most of the pharmacological effects of Cannabis species have been attributed to their cannabinoid constituents, primarily Δ9-tetrahydrocannabinol and cannabidiol. Efficient methods of extraction, purification, and characterization of these compounds are necessary to obtain both enriched preparations and isolated compounds for therapeutic applications. In this study, forensic samples of Cannabis sativa L., Cannabaceae, were subjected to extraction, using maceration in two different solvents, methanol, and diethyl ether. These extracts were subjected to thermal decarboxylation and purification by liquid–liquid fractionation. Δ9-Tetrahydrocannabinol and cannabidiol concentrations from various extracts were quantified by high-performance liquid chromatography with UV detection. Extract cytotoxicity was assayed in...
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Reduced responsiveness of the reward system is associated with tolerance to cannabis impairment in chronic users

Abstract Cannabis is the most commonly used illicit drug in the world. However, because of a changing legal landscape and rising interest in therapeutic utility, there is an increasing trend in (long-term) use and possibly cannabis impairment. Importantly, a growing body of evidence suggests that regular cannabis users develop tolerance to the impairing, as well as the rewarding, effects of the drug. However, the neuroadaptations that may underlie cannabis tolerance remain unclear. Therefore, this double-blind, randomized, placebo-controlled, cross-over study assessed the acute influence of cannabis on the brain and behavioral outcomes in two distinct cannabis user groups. Twelve occasional and 12 chronic cannabis users...
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The effects of marijuana use prior to traumatic brain injury on survival

  Abstract Background Legalization of recreational marijuana throughout the United States has been associated with increased emergency department visits involving marijuana and its metabolites, tetrahydrocannabinol (THC) and cannabinoids. We investigated the relationship between marijuana use and outcomes after all levels of traumatic brain injury (TBI) from a large multi-center regional dataset. Methods A retrospective review of de-identified patient data from twenty-six regional hospitals, was performed to identify adult patients with mild, moderate, and severe TBI between January 2012 and December 2018, a toxicology screen, and drug screen results. Included patients were divided into four subgroups: 1) No Drugs, 2) THC, 3) Other drugs (one or more drugs not including THC), and...
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