DOCSLIB.ORG

Cannabis Use Disorder: Implications and Best Practices by Cameron Duncan, DNP, MS, APRN, FNP-C, PMHNP-BC; Kendra Butler, BSN, RN; and Laurielyn Loa, BSN, RN

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cannabis Use Disorder: Implications and Best Practices by Cameron Duncan, DNP, MS, APRN, FNP-C, PMHNP-BC; Kendra Butler, BSN, RN; and Laurielyn Loa, BSN, RN Mental Health Matters Cannabis use disorder: Implications and best practices By Cameron Duncan, DNP, MS, APRN, FNP-C, PMHNP-BC; Kendra Butler, BSN, RN; and Laurielyn Loa, BSN, RN Cannabis is the most commonly specifi c factors, such as age of fi rst receptors, such as c annabinoid misused illicit substance in the use as well as amount and fre- receptor type 1 (CB1). C B1 exists US.1,2 The National Survey on quency of use, are associated with a throughout the brain, although it Drug Use and Health found that person developing CUD.6 is mainly found in the frontal cor- cannabis use disorder (CUD) is a Pregnant women are also sig- tex, basal ganglia, and cerebellum; prevalent problem in the country, nifi cantly affected by cannabis use: these receptors are also found in requiring accurate and timely roughly 111,000 (4.7%) had used other parts of the body, from the diagnosis as well as effective cannabis in the previous month spinal cord and gastrointestinal therapeutic management.2 Accord- in 2018, with an estimated 35,000 tract to the reproductive organs.9 ing to the National Academies of (1.5%) admitting to its use every A second receptor, cannabinoid Sciences, Engineering, and Medi- day or nearly every day.7 Accord- receptor type 2 (CB2), is con- cine, this condition is associated ing to a retrospective cohort study sidered the peripheral cannabi- with a higher risk for other of more than 12 million births noid receptor, and is principally substance use and mental health conducted from 1999 through 2013, expressed in the body’s immune disorders.3 incidence of cannabis abuse or cells.9 THC works primarily as a dependence rose from 3.22 in 1,000 partial agonist of CB1, infl uencing ■ Prevalence and epidemiology births in 1999 to 8.55 in 1,000 births pain, digestion, appetite enhance- Recent research indicates the in 2013.8 Pregnant women report- ment, emotions, and processes prevalence of CUD is increasing. ing cannabis use were also more that are mediated through the In 2015, nearly 4% of the global likely to experience adverse peri- endocannabinoid system. Con- population used cannabis, with natal conditions, such as preterm versely, CBD is the major non- 8% of teenagers in the US report- rupture of membranes and intra- psychoactive phytocannabinoid ing having engaged in cannabis uterine fetal demise.8 The Substance component in cannabis.9 use; 9% of users become addicted, Abuse and Mental Health Services THC. Among the major can- with nearly 20% beginning Administration (SAMHSA) lists nabinoids, THC is regarded as the marijuana use in adolescence.1,4 other negative outcomes, including most psychoactive component According to the National Institute fetal growth restriction, preterm when considering behavioral on Alcohol Abuse and Alcoholism, birth, and neurologic development effects.9 It is proposed that the nearly 6 million adults experience concerns that may result in cogni- interaction of THC with the endo- CUD within any given year. In tive abnormalities.7 cannabinoid system is responsible addition, 6.3% meet the diagnostic for the way in which the physiologic criteria for the disorder at some ■ Pharmacokinetics effects of cannabis are primarily point in their lives.5 Cannabis is derived from a can- mediated.10 THC is the main mol- Cannabis is often used as a nabis plant (Cannabis sativa). ecule behind the reinforcing prop- form of self-medication for mental Although more than 100 dif- erties of marijuana (for example, health conditions, such as depres- ferent cannabinoids can be dependence), although the specifi c sion, anxiety, and posttraumatic isolated from this plant, the pathophysiologic mechanisms of stress disorder and is among the primary psychoactive compound cannabis are yet unclear.1 top four psychoactive substances is delta9-tetrahydrocannabinol CBD. CBD produces pharma- used in the US.1,6 The risk for (THC).9 The physiologic effects of cologic effects without any signifi - developing dependence among cannabinoids are due to interac- cant activity on CB1 and CB2 cannabis users is roughly 1 in 10; tions with specifi c cannabinoid receptors, meaning it does not 12 The Nurse Practitioner • Vol. 46, No. 3 www.tnpj.com Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. Mental Health Matters produce euphoria or intoxication.11 not limited to: larger amounts or psychological changes; these Therapeutic potential for CBD is of cannabis use than intended; may include impaired motor tied to its antiepileptic, anxiolytic, continual desire to reduce/control coordination, euphoria, anxiety, antipsychotic, anti-infl ammatory, use; cravings; continued substance sensation of slowed time, impaired and neuroprotective effects.11 As it use despite persistent social prob- judgment, and social withdrawal, is generally tolerated, recent lems; compromised engagement which develop during, or soon research indicates that CBD may be in activities (social, occupational, after, cannabis use.15 The patient a promising candidate for pharma- or recreational); tolerance; and may also experience cannabis with- cotherapy of psychostimulant withdrawal.14 drawal especially when undergoing substance use disorders.12 More When assessing a patient pre- detoxifi cation. This occurs if the research is needed into CBD’s senting with symptoms of CUD, patient has a history of prolonged potential health benefi ts. the advanced practice registered cannabis use but has recently nurse (APRN) must take a thor- stopped.15 Some symptoms associ- ■ Complications ough medical and mental health ated with cannabis withdrawal Heavy or chronic cannabis users history; this includes any history include irritability or aggression, are more likely to report a reduced of substance use or family history nervousness or anxiety, sleeping quality of life, including decreased of abuse. All physical and psycho- diffi culties, decreased appetite, satisfaction and achievement logical symptoms should be iden- restlessness, depressed mood, and/ compared with nonusers.13 Long- tifi ed. It is important to monitor or symptoms of physical discom- term use can cause disruptions in psychological symptoms, identify- fort.15 These usually present 1 week not only neurologic and mental, ing whether they are associated after cannabis cessation. A person but also physiologic and social with withdrawal or an undiag- undergoing detoxifi cation may health.13 Cannabis use has been nosed primary mental health ill- experience withdrawal, and APRNs associated with altered brain ness. The patient should be asked need to recommend or coordinate development and cognitive how long these symptoms have medical supervision to effectively impairment, which may lead to been occurring, if they have wors- manage presenting symptoms. lower IQ and poor educational ened over time, as well as if any outcomes; in adolescent users, this actions alleviate them. Cannabis- ■ Comorbidities increases the likelihood of drop- focused questions should also Associations have been found ping out of school.13 be asked, such as when they fi rst between CUDs and other sub- started using cannabis, its amount stance and mental health disor- ■ Assessment and diagnosis and frequency, the route (that is, ders, including alcohol use The American Psychiatric Asso- inhalation through smoking, oral disorders, nicotine disorders, ciation’s Diagnostic and Statistical ingestion through edible products, mood disorders, anxiety disorders, Manual of Mental Disorders and the like), as well as when they personality disorders, and post- (DSM-5) explains that CUD is last used the substance. The APRN traumatic stress disorder; canna- the continued use of cannabis must determine if the patient will bis use and psychosis have also regardless of impairment in need to undergo detoxifi cation been linked, as cannabis users are psychological, physical, or social and whether medical supervision found to have higher rates of posi- functioning.14 CUD includes is necessary. tive psychotic symptoms than pathologic patterns classifi ed nonusers.13 According to the under impaired control, social ■ Cannabis intoxication and SAMHSA, individuals with CUD impairment, risky behavior, or cannabis withdrawal are more likely to have alcohol physiologic adaptation.1 Phases within CUD include canna- and/or tobacco use disorders These patterns of impairment bis intoxication and cannabis with- (over 50%), with nearly 75% of or distress must be manifested drawal. In cannabis intoxication, individuals reporting problematic by specifi c symptoms within a the patient must have recently used use of a secondary or tertiary 12-month time frame for diag- cannabis, resulting in clinically substance (for example, alcohol, nosis of CUD, including but signifi cant problematic behavioral cocaine, methamphetamine, or www.tnpj.com The Nurse Practitioner • March 2021 13 Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. Mental Health Matters opiates).15 According to a recent ■ Management and treatment may also be considered for the study on the association between The aim of CUD management treatment of anxious and depres- CUD and those with alcohol use should be to improve the indi- sive symptoms. Sedative hypnotics disorder (AUD), cannabis users vidual’s overall function.1 Patel such as zolpidem may be effective who meet criteria for AUD and and Marwaha recommend to help treat sleep disturbances.23 CUD diagnoses are at a greater increased access to mental health Off-label use of other medications, risk for problem drinking on days services, such as psychological including
Load more

Recommended publications
  • Clearing the Smoke on Cannabis: Regular Use and Cognitive Functioning
    6 Clearing the Smoke on Cannabis Regular Use and Cognitive Functioning Robert Gabrys, Ph.D., Research and Policy Analyst, CCSA Amy Porath, Ph.D., Director, Research, CCSA Key Points • Regular use refers to weekly or more frequent cannabis use over a period of months to years. Regular cannabis use is associated with mild cognitive difficulties, which are typically not apparent following about one month of abstinence. Heavy (daily) and long-term cannabis use is related to more This is the first in a series of reports noticeable cognitive impairment. that reviews the effects of cannabis • Cannabis use beginning prior to the age of 16 or 17 is one of the strongest use on various aspects of human predictors of cognitive impairment. However, it is unclear which comes functioning and development. This first — whether cognitive impairment leads to early onset cannabis use or report on the effects of chronic whether beginning cannabis use early in life causes a progressive decline in cannabis use on cognitive functioning cognitive abilities. provides an update of a previous report • Regular cannabis use is associated with altered brain structure and function. with new research findings that validate Once again, it is currently unclear whether chronic cannabis exposure and extend our current understanding directly leads to brain changes or whether differences in brain structure of this issue. Other reports in this precede the onset of chronic cannabis use. series address the link between chronic • Individuals with reduced executive function and maladaptive (risky and cannabis use and mental health, the impulsive) decision making are more likely to develop problematic cannabis use and cannabis use disorder.
    [Show full text]
  • Is Cannabis Addictive?
    Is cannabis addictive? CANNABIS EVIDENCE BRIEF BRIEFS AVAILABLE IN THIS SERIES: ` Is cannabis safe to use? Facts for youth aged 13–17 years. ` Is cannabis safe to use? Facts for young adults aged 18–25 years. ` Does cannabis use increase the risk of developing psychosis or schizophrenia? ` Is cannabis safe during preconception, pregnancy and breastfeeding? ` Is cannabis addictive? PURPOSE: This document provides key messages and information about addiction to cannabis in adults as well as youth between 16 and 18 years old. It is intended to provide source material for public education and awareness activities undertaken by medical and public health professionals, parents, educators and other adult influencers. Information and key messages can be re-purposed as appropriate into materials, including videos, brochures, etc. © Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2018 Publication date: August 2018 This document may be reproduced in whole or in part for non-commercial purposes, without charge or further permission, provided that it is reproduced for public education purposes and that due diligence is exercised to ensure accuracy of the materials reproduced. Cat.: H14-264/3-2018E-PDF ISBN: 978-0-660-27409-6 Pub.: 180232 Key messages ` Cannabis is addictive, though not everyone who uses it will develop an addiction.1, 2 ` If you use cannabis regularly (daily or almost daily) and over a long time (several months or years), you may find that you want to use it all the time (craving) and become unable to stop on your own.3, 4 ` Stopping cannabis use after prolonged use can produce cannabis withdrawal symptoms.5 ` Know that there are ways to change this and people who can help you.
    [Show full text]
  • Cannabinoid Hyperemesis Syndrome: a Case Report in Mexico
    CASE REPORT Cannabinoid hyperemesis syndrome: a case report in Mexico Luis Fernando García-Frade Ruiz,1 Rodrigo Marín-Navarrete,3 Emmanuel Solís Ayala,1 Ana de la Fuente-Martín2 1 Medicina Interna, Hospital Ánge- ABSTRACT les Pedregal. 2 Escuela de Medicina, Universi- Background. The first case report on the Cannabinoid hyperemesis syndrome (CHS) was registered in 2004. dad la Salle. Years later, other research groups complemented the description of CHS, adding that it was associated with 3 Unidad de Ensayos Clínicos, Instituto Nacional de Psiquiatría such behaviors as chronic cannabis abuse, acute episodes of nausea, intractable vomiting, abdominal pain Ramón de la Fuente Muñiz. and compulsive hot baths, which ceased when cannabis use was stopped. Objective. To provide a brief re- view of CHS and report the first documented case of CHS in Mexico. Method. Through a systematic search Correspondence: Luis Fernando García-Frade Ruiz. in PUBMED from 2004 to 2016, a brief review of CHS was integrated. For the second objective, CARE clinical Medicina Interna, Hospital Ángeles case reporting guidelines were used to register and manage a patient with CHS at a high specialty general del Pedregal. hospital. Results. Until December 2016, a total of 89 cases had been reported worldwide, although none from Av. Periférico Sur 7700, Int. 681, Latin American countries. Discussion and conclusion. Despite the cases reported in the scientific literature, Col. Héroes de Padierna, Del. Magdalena Contreras, C.P. 10700 experts have yet to achieve a comprehensive consensus on CHS etiology, diagnosis and treatment. The lack Ciudad de México. of a comprehensive, standardized CHS algorithm increases the likelihood of malpractice, in addition to con- Phone: +52 (55) 2098-5988.
    [Show full text]
  • DIAGNOSIS REFERENCE GUIDE A. Diagnostic Criteria for Substance
    ALCOHOL & OTHER DRUG SERVICES DIAGNOSIS REFERENCE GUIDE A. Diagnostic Criteria for Substance Use Disorder See DSM-5 for criteria specific to the drugs identified as primary, secondary or tertiary. P S T (P=Primary, S=Secondary, T=Tertiary) 1. Substance is often taken in larger amounts and/or over a longer period than the patient intended. 2. Persistent attempts or one or more unsuccessful efforts made to cut down or control substance use. 3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from effects. 4. Craving or strong desire or urge to use the substance 5. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home. 6. Continued substance use despite having persistent or recurrent social or interpersonal problem caused or exacerbated by the effects of the substance. 7. Important social, occupational or recreational activities given up or reduced because of substance use. 8. Recurrent substance use in situations in which it is physically hazardous. 9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance. 10. Tolerance, as defined by either of the following: a. Markedly increased amounts of the substance in order to achieve intoxication or desired effect; Which:__________________________________________ b. Markedly diminished effect with continued use of the same amount; Which:___________________________________________ 11. Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for the substance; Which:___________________________________________ b.
    [Show full text]
  • Clearing the Smoke on Cannabis: Regular Use and Mental Health
    1 Clearing the Smoke on Cannabis Regular Use and Mental Health Sarah Konefal, Ph.D., Research and Policy Analyst, CCSA Robert Gabrys, Ph.D., Research and Policy Analyst, CCSA Amy Porath, Ph.D., Director, Research, CCSA Key Points • Regular cannabis use refers to weekly or more frequent cannabis use over a period of months to years. • Regular cannabis use is at least twice as common among individuals with This is the first in a series of reports mental disorders, including schizophrenia, bipolar disorders, depressive and that reviews the effects of cannabis anxiety disorders, and post-traumatic stress disorder (PTSD). use on various aspects of human • There is strong evidence linking chronic cannabis use to increased risk of developing psychosis and schizophrenia among individuals with a family functioning and development. This history of these conditions. report on the effects of regular • Although smaller, there is still a risk of developing psychosis and cannabis use on mental health provides schizophrenia with regular cannabis use among individuals without a family an update of a previous report with history of these disorders. Other factors contributing to increased risk of new research findings that validate and developing psychosis and schizophrenia are early initiation of use, heavy or extend our current understanding of daily use and the use of products high in THC content. this issue. Other reports in this series • The risk of developing a first depressive episode among individuals who use address the link between regular cannabis regularly is small after accounting for the use of other substances cannabis use and cognitive functioning, and common sociodemographic factors.
    [Show full text]
  • Long-Term Outcomes of Chronic, Recreational Marijuana Use
    The Corinthian Volume 20 Article 16 November 2020 Long-Term Outcomes of Chronic, Recreational Marijuana Use Celia G. Imhoff Georgia College and State University Follow this and additional works at: https://kb.gcsu.edu/thecorinthian Part of the Medicine and Health Sciences Commons, and the Psychology Commons Recommended Citation Imhoff, Celia G. (2020) "Long-Term Outcomes of Chronic, Recreational Marijuana Use," The Corinthian: Vol. 20 , Article 16. Available at: https://kb.gcsu.edu/thecorinthian/vol20/iss1/16 This Article is brought to you for free and open access by the Undergraduate Research at Knowledge Box. It has been accepted for inclusion in The Corinthian by an authorized editor of Knowledge Box. LONG-TERM OUTCOMES OF CHRONIC, RECREATIONAL MARIJUANA USE Amidst insistent, nationwide demand for the acceptance of recreational marijuana, many Americans champion the supposedly non-addictive, inconsequential, and creativity-inducing nature of this “casual” substance. However, these personal beliefs lack scientific evidence. In fact, research finds that chronic adolescent and young adult marijuana use predicts a wide range of adverse occupational, educational, social, and health outcomes. Cannabis use disorder is now recognized as a legitimate condition in the Diagnostic and Statistical Manual of Mental Disorders and cannabis dependence is gaining respect as an authentic drug disorder. Some research indicates that medical marijuana can be somewhat effective in treating assorted medical conditions such as appetite in HIV/AIDS patients, neuropathic pain, spasticity and multiple sclerosis, nausea, and seizures, and thus its value to medicine continues to evolve (Atkinson, 2016). However, many studies on medical marijuana produce mixed results, casting doubt on our understanding of marijuana's medicinal properties (Atkinson, 2016; Keehbauch, 2015).
    [Show full text]
  • Cannabis Hyperemesis Syndrome: an Update on the Pathophysiology and Management
    REVIEW ARTICLE Annals of Gastroenterology (2020) 33, 571-578 Cannabis hyperemesis syndrome: an update on the pathophysiology and management Abhilash Perisettia, Mahesh Gajendranb, Chandra Shekhar Dasaric, Pardeep Bansald, Muhammad Azize, Sumant Inamdarf, Benjamin Tharianf, Hemant Goyalg University of Arkansas for Medical Sciences, Little Rock, AR; Texas Tech University Health Sciences Center El Paso; Kansas City VA Medical Center; Moses Taylor Hospital and Reginal Hospital of Scranton, Scranton, PA; University of Toledo, HO; The Wright Center for Graduate Medical Education, Scranton, PA, USA Abstract Cannabis hyperemesis syndrome (CHS) is a form of functional gut-brain axis disorder characterized by bouts of episodic nausea and vomiting worsened by cannabis intake. It is considered as a variant of cyclical vomiting syndrome seen in cannabis users especially characterized by compulsive hot bathing/showers to relieve the symptoms. CHS was reported for the first time in 2004, and since then, an increasing number of cases have been reported. With cannabis use increasing throughout the world as the threshold for legalization becomes lower, its user numbers are expected to rise over time. Despite this trend, a strict criterion for the diagnosis of CHS is lacking. Early recognition of CHS is essential to prevent complications related to severe volume depletion. The recent body of research recognizes that patients with CHS impose a burden on the healthcare systems. Understanding the pathophysiology of the endocannabinoid system (ECS) remains central in explaining the clinical features and potential drug targets for the treatment of CHS. The frequency and prevalence of CHS change in accordance with the doses of tetrahydrocannabinol and other cannabinoids in various formulations of cannabis.
    [Show full text]
  • MARIJUANA and SUBSTANCE USE DISORDER, Part 1: a Historical Perspective and DSM-5 Overview
    MARIJUANA AND SUBSTANCE USE DISORDER, Part 1: a historical perspective and DSM-5 overview Introduction Marijuana is the most widely used illicit drug in the Western world and the third most commonly used recreational drug after alcohol and tobacco. According to the World Health Organization, it also is the illicit substance most widely cultivated, trafficked, and used. Although the long-term clinical outcome of marijuana use disorder may be less severe than other commonly used substances, it is by no means a "safe" drug. Sustained marijuana use can have negative impacts on the brain as well as the body. Studies have indicated a link between regular marijuana use and schizophrenia as well as a demonstrated relationship between marijuana use and a higher incidence of lung cancer. Although there are no pharmacological treatments available with a proven impact on marijuana use disorder, there are several types of behavior therapy that may be effective in treating this disorder. Worldwide Use Of Marijuana For a number of years, the United Nations has been compiling annual surveys of worldwide drug use, including cannabis. Reflecting the difficulties and uncertainties associated with developing estimates of the number of people who use drugs (such as the quality of the data gathered and the methodologies used to sample populations), the latest United Nations estimates are presented in ranges, reflecting the lower and upper estimates indicated through the array of surveys ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com ce4less.com 1 available. In their 2012 report (covering 2010), the United Nations estimated that between 119.4 and 224.5 million people between the ages of 15 and 64 had used cannabis in the past year, representing between 2.6% and 5.0% of the world’s population.22 In 2014, approximately 22.2 million people ages 12 and up reported using marijuana during the past month.
    [Show full text]
  • 1 Public Policy Statement on Cannabis Background Cannabis Is a Plant That Has Been Used for Its Intoxicating Effects for at Leas
    Public Policy Statement on Cannabis Background Cannabis is a plant that has been used for its intoxicating effects for at least a century in the United States and for longer in other cultures. It also has a long history of use around the world for purported medical benefits. More than 100 different cannabinoids have been identified in cannabis. The primary intoxicating cannabinoid in cannabis is delta-9-tetrahydrocannabinol (THC). The cannabinoid cannabidiol (CBD) has received increasing public attention in recent years; preliminary findings suggest that CBD may be a useful treatment for several medical conditions and it is not reported to be associated with intoxication or addiction, unlike THC.1 In this document, the term “cannabis” is used to describe the plant-based products. When the document refers specifically to individual cannabinoids, they are identified as such. Between 2001-2002 and 2012-2013, the prevalence of past-year cannabis use by U.S. adults increased from 4.1% to 9.5%, respectively, and the prevalence of cannabis use disorder (CUD) nearly doubled.2 Adults and adolescents increasingly view cannabis use as harmless. A 2019 Pew Research Center survey revealed two-thirds of American adults support cannabis legalization, which reflects a steady increase over the past decade.3 However, between 9.3% and 30.6% of American adults who use cannabis have CUD as measured in the largest recent national surveys. Specifically, 9.3% of past-year adult cannabis users met DSM-IV criteria for CUD based on the 2017 National Survey on Drug Use and Health (NSDUH).4 2012-2013 data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) showed that 30.6% of past- year cannabis users had DSM-IV CUD.2 Among U.S.
    [Show full text]
  • A Systematic Review and Bayesian Meta‐Analysis of Interventions
    City Research Online City, University of London Institutional Repository Citation: Walsh, H., McNeill, A., Purssell, E. ORCID: 0000-0003-3748-0864 and Duaso, M. (2020). A systematic review and Bayesian meta‐ analysis of interventions which target or assess co‐‐ use of tobacco and cannabis in single or multi substance interventions. Addiction, 115(10), pp. 1800-1814. doi: 10.1111/add.14993 This is the accepted version of the paper. This version of the publication may differ from the final published version. Permanent repository link: https://openaccess.city.ac.uk/id/eprint/23622/ Link to published version: http://dx.doi.org/10.1111/add.14993 Copyright: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. Reuse: Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. City Research Online: http://openaccess.city.ac.uk/ [email protected] Walsh Hannah (Orcid ID: 0000-0002-1638-1050) McNeill Ann (Orcid ID: 0000-0002-6223-4000) Duaso Maria (Orcid ID: 0000-0002-4801-2954) A systematic review and Bayesian meta-analysis of interventions which target or assess co-use of
    [Show full text]
  • Acute and Long-Term Effects of Cannabis Use: a Review
    Send Orders for Reprints to [email protected] Current Pharmaceutical Design, 2014, 20, 000-000 1 Acute and Long-Term Effects of Cannabis Use: A Review Laurent Karila1,*, Perrine Roux2, Benjamin Rolland3, Amine Benyamina4, Michel Reynaud4, Henri-Jean Aubin4 and Christophe Lançon5 1Addiction Research and Treatment Center, Paul Brousse Hospital, Paris Sud-11 University, AP-HP, INSERM-CEA U1000, Villejuif, France; 2INSERM U912 (SESSTIM), Université Aix Marseille, IRD, UMR-S912, ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France; 3Department of Addiction Medicine, CHU Lille; EA1046, Univ Lille Nord de France, Lille, France; 4Addiction Research and Treatment Center, Paul Brousse Hospital, Paris Sud-11 University, AP-HP, Villejuif, France; 5Psychiatry and Addictology Department, AP-HM, Marseille, France Abstract: Cannabis remains the most commonly used and trafficked illicit drug in the world. Its use is largely concentrated among young people (15- to 34-year-olds). There is a variety of cannabis use patterns, ranging from experimental use to dependent use. Men are more likely than women to report both early initiation and frequent use of cannabis. Due to the high prevalence of cannabis use, the impact of cannabis on public health may be significant. A range of acute and chronic health problems associated with cannabis use has been identi- fied. Cannabis can frequently have negative effects in its users, which may be amplified by certain demographic and/or psychosocial factors. Acute adverse effects include hyperemesis syndrome, impaired coordination and performance, anxiety, suicidal ideations/tendencies, and psychotic symptoms. Acute cannabis consumption is also associated with an increased risk of motor vehicle crashes, especially fatal col- lisions.
    [Show full text]
  • ASAM Issues New Public Policy Statement on Cannabis
    FOR IMMEDIATE RELEASE October 13, 2020 Media Contact Rebecca Reid 410-212-3843 [email protected] ASAM Issues New Public Policy Statement on Cannabis Nation’s leading association of addiction specialist physicians and other clinicians issues new policy recommendations to protect public health and mitigate the risks of cannabis use Rockville, MD – In a new public policy statement on cannabis, the American Society of Addiction Medicine (ASAM) reviews the medical and social science literature about cannabis use and recommends important, evidence-based policy changes that mitigate potential harm related to cannabis use in the United States. As the medical community continues to document evidence of the harms and potential benefits of cannabis use, ASAM calls for the decriminalization of cannabis use, alongside appropriate regulations and oversight that protect public health. “Today’s public policy statement recognizes that our country’s historically punitive approach to cannabis use has caused significant harms—especially to persons of color, who are disproportionately arrested and incarcerated for cannabis possession and use,” said Paul H. Earley, MD, DFASAM, president of ASAM. “We must safeguard against the potential harms of cannabis use such as cannabis use disorder, while also recognizing that criminalization is not a constructive way to promote public health.” The new statement makes several recommendations regarding cannabis used for medical purposes, including: Cannabis used for medical purposes should be rescheduled from Schedule 1 of the Controlled Substances Act to promote more clinical research and Food and Drug Administration (FDA) oversight. Cannabis and cannabis-derived products recommended for medical indications should be subject to FDA review and approval to ensure their safety and effectiveness.
    [Show full text]