Abstract Warfarin, a commonly prescribed anticoagulant, is utilized to prevent thrombotic issues and requires careful dose adjustment due to its narrow therapeutic range. As warfarin is metabolized by essential drug-metabolizing enzymes (DMEs), it is prone to interactions with a wide range of therapeutic agents, including herbal medicines. In June 2022, Thailand became the first country in Asia to remove cannabis plants from its narcotics control list, allowing individuals to cultivate them for personal use. Consequently, this report aimed to examine the interaction between cannabis and warfarin in Thai patients following the legalization of cannabis from 2021 to 2023. These three case reports elucidated the potential for...

Abstract Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome that combines nonspecific neurological manifestations, sometimes severe (coma, status epilepticus), with typical brain imaging showing mostly bilateral, symmetrical abnormalities, predominantly affecting the white matter. Termed "reversible," the norm is a return to the previous neurological state. However, this recovery is not always guaranteed, with potential neurological sequelae or even progression to death. PRES has multiple etiologies. The primary etiology associated with PRES is substance consumption. However, cases of PRES following cannabis consumption are rare. Here, we present the case of a 27-year-old man admitted for the management of a feverless altered state of consciousness, whose investigations eventually revealed PRES due to...

Abstract Background and Objectives: The impact of gynaecological cancer and its treatments on sexual intimacy can be profound on female sexuality. However, very few registered clinical trials have addressed sexual intimacy among this cohort. Materials and Methods: This preliminary randomised control trial (RCT) and content analysis assessed the effectiveness of a brief online mindful compassion group intervention adjunct with cannabis suppositories. Eighty-three participants aged between 18 and 50+ years who were at least six months post-cancer treatment were randomly allocated to one of four groups, depending on whether they were already using cannabis suppositories. These included a cannabis-only group (CO), a mindful-compassion group (MC), a combined mindful-compassion...

Abstract Background Cholangiocarcinoma (CCA) incidence in Northeastern Thailand is very high and a major cause of mortality. CCA patients typically have a poor prognosis and short-term survival rate due to late-stage diagnosis. Thailand is the first Southeast Asian country to approve medicinal cannabis treatment, especially for palliative care with advanced cancer patients. Methods A retrospective cohort study compared survival among 491 newly diagnosed advanced CCA patients between September 2019 and June 2021. Of these, 404 received standard palliative pain management (ST), and 87 received medicinal cannabis treatment (CT). Patients were enrolled from four tertiary hospitals and two secondary hospitals in five provinces of Northeast...

Abstract Canada has established a strict set of testing requirements for pesticides that are unauthorized for use on cannabis, currently holding the most extensive list of analytes in North America to date, listing minimum method performance limits rather than maximum allowable concentration limits. These requirements establish the need for validated analytical methods capable of quantifying pesticides and growth regulators in highly variable cannabis inflorescence prior to distribution and sale. We have developed quantitative LC-MS/MS and GC-MS/MS methods capable of quantifying the 96 pesticides unauthorized in Canada for use on cannabis in dried cannabis flower and hemp. Herein, we report the validation results for linearity,...

Abstract This image visualizes the weighing of commercial incentives against research integrity, highlighting the challenge of maintaining transparency in CBD-related studies.

Please use this link to access this publication. Abstract Background There is substantial evidence that smokers present a less favorable response following regenerative periodontal surgery. However, there are no reports to date on the response to regenerative procedures in chronic cannabis smokers. In the present case study, we discuss the periodontal outcomes of reparative and regenerative surgical treatment in a cannabis consumer patient with generalized stage III grade C periodontitis. Methods and Results We report the case of a young adult cannabis consumer patient diagnosed with generalized stage III grade C periodontitis who had a probing depth (PD) of ≥ 4 at 18% of...

Please use this link to access this publication. Abstract Cannabis withdrawal syndrome (CWS) presents with irritability, anxiety and sleep disturbances within a week of stopping cannabis use. This case highlights a young woman with a medical history of recurrent hospitalisations due to intractable nausea and vomiting related to heavy, prolonged cannabis use and acute dystonic reactions secondary to haloperidol. The patient presented with intractable nausea, vomiting and frequent hot bathing five days after her last cannabis use. She developed an acute dystonic reaction to low-dose metoclopramide, a commonly used antiemetic, potentially exacerbated by cannabis’s inhibition of drug-metabolising enzymes. We also highlight key differences between...

Please use this link to access this publication. Abstract Background Two scientific and clinical challenges for treating cannabis use disorder (CUD) are developing efficacious treatments with high likelihood of uptake and scalability, and testing the clinical mechanisms by which treatments work. Because young adults experience more CUD than other age groups, a need exists to test the efficacy and hypothesized causal pathways of novel treatments for CUD. Text-delivered treatments have the potential to reach young adults by increasing access and perceived privacy. Methods We conducted a randomized clinical trial (n = 1078) of a 4-week CUD treatment with U.S. young adults from Colorado and Tennessee. Participants...

Abstract Background Recreational cannabis legalization marked a significant policy shift in Canada, but has been difficult to evaluate because of the absence of a control group. Although it is unfeasible to evaluate legalization using a randomized controlled trial design, sophisticated statistical techniques can employ quasi-experimental designs using natural experiments. This study evaluates the impact of cannabis legalization in a longitudinal cohort of Canadian emerging adults by comparing changes in cannabis use frequency and related consequences over time to changes in a similar cohort in a United States jurisdiction where no policy change took place. Methods Two samples of emerging adults from Hamilton, Ontario, and...