Journal of cannabis research最新文献

Objective: Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use.

Design: Cross-sectional SUBJECTS: Eligible patients (n=1,037), who had a new period of prescription opioid use lasting 30-90 days, were recruited from two midwestern health care systems to a study of long-term prescription opioid use and mental health outcomes. The present cross-sectional analyses uses baseline data from this on-going cohort study.

Methods: Primary exposures were participant reported lifetime recreational and medical marijuana use versus no lifetime marijuana use. Prescription opioid characteristics included daily versus non-daily opioid use and ≥50 morphine milligram equivalent (MME) dose per day vs. <50 MME. Multivariate, logistic regression models estimated the association between lifetime recreational and medical marijuana use vs. no use and odds of daily and higher dose prescription opioid use, before and after adjusting for confounding.

Results: The sample was an average of 54.9 (SD±11.3) years of age, 57.3% identified as female gender, 75.2% identified as White, and 22.5% identified as Black race. Among all participants, 44.4% were never marijuana users, 21.3% were recreational only, 7.7% medical only and 26.6% were both recreational and medical marijuana users. After controlling for all confounders, lifetime recreational marijuana use, as compared to no use, was significantly associated with increased odds of daily prescription opioid use (OR=1.61; 95%CI:1.02-2.54). There was no association between lifetime recreational or medical marijuana use and daily opioid dose.

Conclusion: Lifetime medical marijuana use is not linked to current opioid dose, but lifetime recreational use is associated with more than a 60% odds of being a daily prescription opioid user. Screening for lifetime recreational marijuana use may identify patients with chronic pain who are vulnerable to daily opioid use which increases risk for adverse opioid outcomes. Prospective data is needed to determine how marijuana use influences the course of LTOT and vice versa.

Objective: Our primary objective was to understand breastfeeding individuals' decisions to use cannabis. Specifically, we investigated reasons for cannabis use, experiences with healthcare providers regarding use, and potential concerns about cannabis use.

Methods: We collected survey data from twenty breastfeeding participants from Washington and Oregon who used cannabis at least once weekly. We documented individuals' cannabis use and analyzed factors associated with their decisions to use cannabis during lactation. Qualitative description was used to assess responses to an open-ended question about potential concerns.

Results: Fifty-five percent of participants (n = 11) reported using cannabis to treat or manage health conditions, mostly related to mental health. Eighty percent of participants (n = 16) reported very few or no concerns about using cannabis while breastfeeding, although participants who used cannabis for medical purposes had significantly more concerns. Most participants (n = 18, 90%) reported receiving either no or unhelpful advice from healthcare providers. Four themes arose through qualitative analysis, indicating that breastfeeding individuals are: 1) identifying research gaps and collecting evidence; 2) monitoring their child's health and development; 3) monitoring and titrating their cannabis use; and 4) comparing risks between cannabis and other controlled substances.

Conclusions: Breastfeeding individuals reported cannabis for medical and non-medical reasons and few had concerns about cannabis use during breastfeeding. Breastfeeding individuals reported using a variety of strategies and resources in their assessment of risk or lack thereof when deciding to use cannabis. Most participants reported receiving no helpful guidance from healthcare providers.

Objectives: In legal cannabis markets, the distribution of retail stores has the potential to influence transitions from illegal to legal sources as well as consumer patterns of use. The current study examined the distribution of legal cannabis stores in Canada according to level of neighbourhood deprivation.

Methods: Postal code data for all legal cannabis stores in Canada were collected from government websites from October 2018 to September 2021. This data was linked to the Institut National de Santé Publique du Québec measures for material and social neighbourhood deprivation. Descriptive data are reported, including differences across provinces with different retail systems.

Results: At the national level, there were approximately 8.0 retail cannabis stores per 100,000 individuals age 15+ in September 2021. The distribution of stores was closely aligned with the expected distribution across levels of material deprivation: for example, 19.5% of stores were located in neighbourhoods with the lowest level of material deprivation versus 19.1% in the highest level. More cannabis stores were located in the 'most socially deprived' or 'socially deprived' neighbourhoods (37.2% and 22.1%, respectively), characterized by a higher proportion of residents who live alone, are unmarried, or in single-parent families. The distribution of stores in provinces and territories were generally consistent with national patterns with a few exceptions.

Conclusion: In the first 3 years following cannabis legalization in Canada, retail cannabis stores were evenly distributed across materially deprived neighbourhoods but were more common in socially deprived neighbourhoods. Future monitoring of retail store locations is required as the legal retail market evolves in Canada.

Background: With the legalization of cannabis in Canada, consumers are presented with numerous purchase options. Licensed retailers are limited by the Cannabis Act and provincial regulations with respect to offering sales, advertising, location, maximum quantities, and information sharing in an effort to protect public health and safety. The degree these policies influence consumer purchase behavior will help inform regulatory refinement.

Methods: A discrete choice experiment within a cross-sectional online survey was used to explore trade-offs consumers make when deciding where to purchase cannabis. Attributes included availability of sales/discounts, proximity, product information, customer service, product variety, and provincial regulation. Participants ≥ 19 years old who lived in Canada and purchased cannabis in the previous 12 months were recruited through an online market research survey panel. A multinomial logit (MNL) model was used for the base model, and latent class analysis was used to assess preference sub-groups. Key limitations included ordering effect, hypothetical bias, and framing effect.

Results: The survey was completed by 1626 people, and the base model showed that customer service carried the most weight in purchase decisions, followed by proximity and availability of sales and discounts. There was considerable heterogeneity in preference patterns, with a five-group latent class model demonstrating best fit. Only one group (15% of sample) placed a high value on the store being provincially regulated, while three groups were willing to make a trade-off with regulation to access better customer service, product information, or closer proximity. One group preferred non-regulated sources (24% of sample); this group was also primarily driven by the availability of sales and discounts. Three groups (60.5% of sample) preferred online stores.

Conclusion: This study highlighted that there exists significant diversity with respect to the influence of consumer experiences on cannabis purchase behaviors. Modifications to cannabis retail regulations that focus on improving access to product information as well as reviewing limitations on sales and discounts could have the most impact for shifting customers to licensed retailers.

Background: Acute cannabis use has been demonstrated to slow reaction time and affect decision-making and short-term memory. These effects may have utility in identifying impairment associated with recent use. However, these effects have not been widely investigated among individuals with a pattern of daily use, who may have acquired tolerance. The purpose of this study was to examine the impact of tolerance to cannabis on the acute effects as measured by reaction time, decision-making (gap acceptance), and short-term memory.

Methods: Participants (ages 25-45) completed a tablet-based (iPad) test battery before and approximately 60 min after smoking cannabis flower. The change in performance from before to after cannabis use was compared across three groups of cannabis users: (1) occasional use (n = 23); (2) daily use (n = 31); or (3) no current use (n = 32). Participants in the occasional and daily use group self-administered ad libitum, by smoking or vaping, self-supplied cannabis flower with a high concentration of total THC (15-30%).

Results: The occasional use group exhibited decrements in reaction time (slowed) and short-term memory (replicated fewer shapes) from before to after cannabis use, as compared to the no-use group. In the gap acceptance task, daily use participants took more time to complete the task post-smoking cannabis as compared to those with no use or occasional use; however, the level of accuracy did not significantly change.

Conclusions: The findings are consistent with acquired tolerance to certain acute psychomotor effects with daily cannabis use. The finding from the gap acceptance task which showed a decline in speed but not accuracy may indicate a prioritization of accuracy over response time. Cognitive and psychomotor assessments may have utility for identifying impairment associated with recent cannabis use.

Background: Canada took a national approach to recreational cannabis that resulted in official legalization on October 17, 2018. In the United States (US), the approach has been more piecemeal, with individual states passing their own laws regulating adult use. The objective of this study was to compare the two jurisdictions.

Methods: Two exploratory, quantitative surveys were administered in May of 2021 in both Canada and the US. One thousand forty-seven Canadian and 1037 US residents (age 19 and older) were surveyed on approaches to and attendant regulations of consumer cannabis. Tests of significance were performed to analyze differences between two groups.

Results: No statistically significant differences exist between the two countries in terms of cannabis legalization acceptance. Usage rates among adults was similar with 45% of Canadians and 42% of Americans confirming they consume cannabis. Respondents maintain that they intend to increase their usage, with edibles attracting a rising level of interest from consumers.

Conclusions: Results suggest that public policy in both Canada and the USA needs to change to reflect rapidly evolving acceptance of cannabis products in North America to realize potential economic returns.

Background: In the USA, an increasing number of states have legalized commercial recreational cannabis markets, allowing a private industry to sell cannabis to those 21 and older at retail locations known as dispensaries. Research on tobacco and alcohol suggests this new industry will use aggressive marketing tactics to attract new users and promote greater intensity of use. Of concern is that cannabis company advertising campaigns may be appealing to youth, promote false or misleading health claims, and disproportionately target low-income and minority communities. In this study, we evaluated recreational cannabis dispensary compliance with advertising regulations on social media in the state of Illinois.

Methods: Primary data were collected from a census of recreational dispensary Facebook and Twitter business pages during the first year of recreational sales in 2020. A quantitative content analysis was conducted to systematically analyze the data; a codebook that detailed a protocol for classifying posts was developed prior to the analysis using advertising regulations outlined in the Illinois Cannabis Regulation and Tax Act. Violations of advertising regulations were organized into three categories: advertisements that may be appealing to youth (< 21 years old), advertisements that make health claims, and other advertising violations. The data were analyzed cross-sectionally and longitudinally. Additionally, differences in compliance were assessed by dispensary and neighborhood characteristics.

Results: The results of the analysis revealed substantial and persistent non-compliance throughout the entire study period. Overall, nearly one third of posts had at least one violation and approximately one in ten posts met the criteria for appealing to youth or contained health claims. The majority of posts with health claims included health claims that were not qualifying conditions for medical cannabis access in the state of Illinois. No differences in compliance by neighborhood and dispensary characteristics were found.

Conclusions: The findings from this study suggest that systematic monitoring and enforcement is needed to ensure compliance with advertising regulations.

Background: Changes in regulation for cannabis for nonmedical use (CNMU) are underway worldwide. Switzerland amended the law in 2021 allowing pilot trials evaluating regulative models for cannabis production and distribution. Simultaneously, cannabis for medical use (CMU) in psychiatry is a growing issue, asked for by patients and being discussed by medical professionals.

Methods: From December 2021 to February 2022, we conducted an online survey of psychiatrists in Switzerland. The survey comprised questions on attitudes towards regulative models for CNMU and towards prescribing CMU for mental disorders.

Results: We contacted 2010 psychiatrists in Switzerland. A total of 274 (14%) participated in the survey. Sixty-four percent agreed to a regulated legalization of CNMU, and 89% would welcome pilot trials in Switzerland assessing models for regulating CNMU with those from a French-speaking region being more skeptical. Forty-nine percent of psychiatrists agree that CMU might have a therapeutic effect in mental disorders, but 50% agree that there is not enough scientific evidence yet. Participants working in an inpatient setting or in a French-speaking region as well as those with a longer duration of practice were more skeptical on CMU for mental health.

Conclusions: Most surveyed Swiss psychiatrists favor the regulation of CNMU and the conduct of pilot trials. Despite little evidence and potential negative consequences, many participating Swiss psychiatrists agreed that cannabis could be efficacious in the treatment of some mental disorders advocating for more research in this topic.

Background: In animals, the endocannabinoid system regulates multiple physiological functions. Like humans, animals respond to preparations containing phytocannabinoids for treating several conditions. In Argentina, laws 27350 and 27669 have expanded the possibility of studying beneficial and adverse effects.

Materials and methods: We conducted a web-based survey of Argentinian Cannabis Veterinarians to make a situational diagnosis on the number of veterinary medicine professionals currently developing treatments with cannabinoids focusing on dogs and cats.  RESULTS: Among the species treated, 77% corresponded to dogs, while 21% were cats. Pain, seizures, and behavior disorders are the most prevalent conditions in dogs. Seven conditions and combinations were treated in cats. Full-spectrum cannabis extract derived from three different chemotypes was administered alone or with standard medication. Response to cannabis treatment was characterized based on improvement categorized according to clinical assessment. Both dogs and cats showed different improvement grades in clinical signs.

Conclusion: This analysis provides promising results regarding the medicinal use of cannabis in dogs and cats. Based on this analysis, we propose to expand the training of professionals, obtain quality preparations, and initiate controlled trials to reinforce knowledge of the use of cannabinoids in veterinary medicine.

Background: Medical cannabis (MC) is increasingly used for chronic pain, but it is unclear how it aids in pain management. Previous literature suggests that MC could holistically alter the pain experience instead of only targeting pain intensity. However, this hypothesis has not been previously systematically tested.

Method: A retrospective internet survey was used in a sample of Finnish chronic pain patients (40 MC users and 161 opioid users). The patients evaluated statements describing positive and negative phenomenological effects of the medicine. The two groups were propensity score matched to control for possible confounding factors.

Results: Exploratory factor analysis revealed three experience factors: Negative Side Effects, Positive Holistic Effects, and Positive Emotional Effects. The MC group (matched n = 39) received higher scores than the opioid group (matched n = 39) in Positive Emotional Effects with large effect size (Rank-Biserial Correlation RBC = .71, p < .001), and in Holistic Positive Effects with medium effect size (RBC = .47, p < .001), with no difference in Negative Side Effects (p = .13). MC and opioids were perceived as equally efficacious in reducing pain intensity. Ratings of individual statements were exploratively examined in a post hoc analysis.

Conclusion: MC and opioids were perceived to be equally efficacious in reducing pain intensity, but MC additionally positively affected broader pain-related factors such as emotion, functionality, and overall sense of wellbeing. This supports the hypothesis that MC alleviates pain through holistically altering the pain experience.