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Cannabinoids in the management of behavioral, psychological, and motor symptoms of neurocognitive disorders: a mixed studies systematic review 大麻素治疗神经认知障碍的行为、心理和运动症状:一项混合研究系统综述
Pub Date : 2022-03-14 DOI: 10.1186/s42238-022-00119-y
A. Bahji, Natasha Breward, W. Duff, N. Absher, S. Patten, Janet K. Alcorn, D. Mousseau
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引用次数: 6
Growing ganja permission: a real gate-way for Thailand’s promising industrial crop? 种植大麻许可:通往泰国前途无量的工业作物的真正大门?
Pub Date : 2022-03-06 DOI: 10.1186/s42238-022-00121-4
S. Sommano, T. Tangpao, T. Pankasemsuk, Voranate Ponpanumas, Y. Phimolsiripol, P. Rachtanapun, Shashanka K. Prasad
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引用次数: 9
Characteristics that influence purchase choice for cannabis products: a systematic review. 影响大麻产品购买选择的特征:系统审查。
Pub Date : 2022-02-01 DOI: 10.1186/s42238-022-00117-0
Jennifer Donnan, Omar Shogan, Lisa Bishop, Michelle Swab, Maisam Najafizada

Introduction: When non-medical cannabis use became legal, government regulators implemented policies to encourage safer consumption through access to a regulated market. While this market is growing, sales still occur through unregulated channels. This systematic review identifies factors influencing cannabis purchasing to help policymakers understand why consumers still purchase illicit market cannabis (registered with PROSPERO CRD42020176079).

Methods: A comprehensive search strategy included databases in health, business, and social science fields (inception to June 2020). Studies were eligible for inclusion if they were conducted with persons who purchase cannabis and examine at least one attribute that would influence purchase choice and were published in the English language. Studies could be of any methodological design. Two independent reviewers completed two levels of screening, and all extraction was verified by a second reviewer. A qualitative synthesis of the findings was completed. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

Results: Of the 4839 citations screened, 96 were eligible for full-text review and 35 were included in the final synthesis. Aspects of price were the most common factors (27 studies). Twenty studies measured price elasticity; most studies found that demand was price inelastic. Many other attributes were identified (e.g., product quality, route of administration, product recommendations, packaging), but none were explored in depth. Eleven studies addressed aspects of product quality including demand elasticity based on quality, potency, and aroma. Studies also explored consumer-perceived "quality" but provided no definition; differences in quality appeared to impact consumer choice. Smoking cannabis appeared to be the preferred route of administration but was only examined in three studies. There was insufficient data to understand in the impact of other attributes on choice. There appeared to be preference heterogeneity for different attributes based on the consumer's experience, reason for use, and gender.

Conclusion: While price influences choices, demand is relatively inelastic. This suggests that consumers may be seeking lowest-cost, unregulated cannabis to avoid reducing consumption. Beyond price, there is a significant gap in our understanding of consumer choices. Perceived quality does appear to impact choice; however, more research is needed due to the lack of a recognized definition for cannabis quality.

导言:当非医用大麻使用合法化后,政府监管机构实施了政策,鼓励通过进入受管制的市场进行更安全的消费。虽然这个市场正在增长,但销售仍然是通过不受监管的渠道进行的。这项系统审查确定了影响大麻购买的因素,以帮助政策制定者了解为什么消费者仍在购买非法市场大麻(在PROSPERO CRD42020176079注册)。方法:综合检索策略包括健康、商业和社会科学领域的数据库(创建至2020年6月)。如果研究对象是购买大麻的人,调查了至少一个会影响购买选择的因素,并且以英文发表,就有资格纳入研究。研究可以采用任何方法设计。两名独立的审稿人完成了两级筛选,所有提取都由第二名审稿人验证。完成了对调查结果的定性综合。采用混合方法评价工具对纳入研究的质量进行评价。结果:在筛选的4839篇引文中,96篇符合全文综述的条件,35篇被纳入最终综合。价格方面是最常见的因素(27项研究)。20项研究测量了价格弹性;大多数研究发现,需求是价格无弹性的。确定了许多其他属性(例如,产品质量、管理途径、产品推荐、包装),但都没有深入探讨。11项研究涉及产品质量的各个方面,包括基于质量、效力和香气的需求弹性。研究还探讨了消费者感知的“质量”,但没有给出定义;质量的差异似乎影响了消费者的选择。吸食大麻似乎是给药的首选途径,但只在三项研究中进行了检验。没有足够的数据来理解其他属性对选择的影响。根据消费者的经验、使用原因和性别,对不同属性的偏好存在异质性。结论:虽然价格影响选择,但需求相对缺乏弹性。这表明,消费者可能正在寻求成本最低、不受管制的大麻,以避免减少消费。除了价格,我们对消费者选择的理解也有很大的差距。感知质量确实会影响选择;然而,由于大麻质量缺乏公认的定义,需要进行更多的研究。
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引用次数: 9
Ethical perspectives of certified public accountants and the cannabis industry. 注册会计师和大麻行业的道德观点。
Pub Date : 2022-01-26 DOI: 10.1186/s42238-022-00118-z
G Suzanne Owens-Ott, Johnny Snyder, Richard Ott

Background: Certified public accountants must follow very high standards of ethical conduct as set forth by the AICPA Code of Professional Conduct and individual state licensing requirements. A 2019 grounded theory qualitative study posed that CPAs remain largely hesitant to serve the cannabis industry primarily because they fear federal prosecution as long as cannabis remains on the DEA's Schedule I Drug List. The purpose of this research was to determine the perceptions of CPAs regarding providing accounting services to the cannabis industry in states that have legalized cannabis usage. This study investigated whether CPAs would serve the industry, why they might decline to serve the industry, what risks they believe serving the industry posed, and whether they believe serving the cannabis industry would create a moral or ethical issue.

Methods: This follow-up quantitative study investigated a small convenience sample of approximately one hundred CPAs in Colorado and Washington to learn more about their perceptions of serving the cannabis industry. Data was analyzed using chi-square and Mann-Whitney U tests to determine if there were any differences in perceptions between groups such as states, gender, and age categories.

Results: Of the participants, 77% responded that neither they nor their firm provided services to a cannabis-related business client compared to 23% that did serve cannabis clients. More Colorado CPAs were willing to turn down CRB work than were expected and fewer Colorado CPAs would be willing to take on CRB clients than were expected. While in Washington, fewer CPAs would turn down RB clients than expected, and more are willing to accept CRB clients than were expected. The risk due to potential liability coverage issues due to serving the cannabis industry was rated the highest while the risk of losing the CPA license was rated lowest. Data indicated that there was not a statistically significant difference between Colorado and Washington participants related to whether they were morally or religiously opposed to working in the industry or if they viewed serving the industry as an ethical violation.

Conclusion: CPAs remain largely unwilling to serve the cannabis industry primarily because CPAs fear federal prosecution as long as cannabis remains on the DEA's Schedule I Drug Listing. The results of this study indicate that while most CPAs are not morally or religiously opposed to serving the industry, about half still believe doing so may constitute an ethical violation for a CPA.

背景:注册会计师必须遵循美国注册会计师协会职业行为准则和各州许可要求所规定的非常高的道德行为标准。2019年的一项基于理论的定性研究表明,注册会计师在很大程度上仍然不愿为大麻行业服务,主要是因为他们担心只要大麻仍在DEA的附表1药物清单上,联邦就会起诉。本研究的目的是确定在大麻使用合法化的州,注册会计师对大麻行业提供会计服务的看法。本研究调查了注册会计师是否会为该行业服务,为什么他们可能会拒绝为该行业服务,他们认为服务该行业会带来什么风险,以及他们是否认为服务大麻行业会产生道德或伦理问题。方法:本后续定量研究调查了科罗拉多州和华盛顿州约100名注册会计师的小样本,以了解他们对服务大麻产业的看法。使用卡方检验和曼-惠特尼U检验来分析数据,以确定不同群体(如州、性别和年龄类别)之间的认知是否存在差异。结果:在参与者中,77%的人回答说他们或他们的公司都没有向大麻相关的商业客户提供服务,相比之下,23%的人确实为大麻客户提供服务。更多的科罗拉多州注册会计师愿意拒绝CRB工作,而更少的科罗拉多州注册会计师愿意接受CRB客户。而在华盛顿,拒绝RB客户的注册会计师比预期的少,而愿意接受CRB客户的注册会计师比预期的多。由于为大麻产业服务而产生的潜在责任保险问题的风险被评为最高,而失去注册会计师执照的风险被评为最低。数据显示,科罗拉多州和华盛顿州的参与者在道德上或宗教上是否反对在该行业工作,或者是否认为为该行业服务是违反道德的方面,没有统计学上的显著差异。结论:注册会计师仍然很大程度上不愿意为大麻行业服务,主要是因为注册会计师担心联邦起诉,只要大麻仍然在DEA的附表1药物清单上。这项研究的结果表明,虽然大多数注册会计师在道德上或宗教上并不反对为行业服务,但大约一半的注册会计师仍然认为这样做可能构成违反道德的行为。
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引用次数: 1
A mixed methods analysis of cannabis use routines for chronic pain management. 大麻使用常规治疗慢性疼痛的混合方法分析。
Pub Date : 2022-01-11 DOI: 10.1186/s42238-021-00116-7
Kevin F Boehnke, Laura Yakas, J Ryan Scott, Melissa DeJonckheere, Evangelos Litinas, Suzanne Sisley, Daniel J Clauw, David A Williams, Jenna McAfee

Background: The wide heterogeneity of available cannabis products makes it difficult for physicians to appropriately guide patients. In the current study, our objective was to characterize naturalistic cannabis use routines and explore associations between routines and reported benefits from consuming cannabis.

Methods: We performed a mixed methods analysis of n=1087 cross-sectional survey responses from adults with self-reported chronic pain using cannabis for symptom management in the USA and Canada. First, we qualitatively analyzed responses to an open-ended question that assessed typical cannabis use routines, including administration routes, cannabinoid content, and timing. We then sub-grouped responses into categories based on inhalation (smoking, vaporizing) vs. non-inhalation (e.g., edibles). Finally, we investigated subgroups perceptions of how cannabis affected pain, overall health, and use of medications (e.g., substituting for opioids, benzodiazepines). Substitutions were treated as a count of medication classes, while responses for both pain and health were analyzed continuously, with - 2 indicating health declining a lot or pain increasing a lot and 2 indicating that health improved a lot or pain decreased a lot.

Results: Routines varied widely in terms of administration routes, cannabinoid content, and use timing. Overall, 18.8%, 36.2%, and 45% used non-inhalation, inhalation, and non-inhalation + inhalation routes, respectively. Those who used inhalation routes were younger (mean age 46.5 [inhalation] and 49.2 [non-inhalation + inhalation] vs. 56.3 [inhalation], F=36.1, p<0.001), while a higher proportion of those who used non-inhalation routes were female (72.5% non-inhalation vs. 48.3% inhalation and 65.3% non-inhalation + inhalation, X2=59.6, p<0.001). THC-rich products were typically used at night, while CBD-rich products were more often used during the day. While all participants reported similarly decreased pain, participants using non-inhalation + inhalation administration routes reported larger improvements in health than the non-inhalation (mean difference = 0.32, 95% CI: 0.07-0.37, p<0.001) and inhalation subgroups (mean difference = 0.22, 95% CI: 0.07-0.37, p=0.001). Similarly, the non-inhalation + inhalation group had significantly more medication substitutions than those using non-inhalation (mean difference = 0.62, 95% CI: 0.33-0.90, p<0.001) and inhalation administration routes (mean difference = 0.45, 95% CI: 0.22-0.69, p<0.001), respectively.

Conclusions: Subgrouping medical cannabis patients based on administration route profile may provide useful categories for future studies examining the risks and benefits of medical cannabis.

背景:现有大麻产品的广泛异质性使得医生很难对患者进行适当的指导。在目前的研究中,我们的目标是描述自然的大麻使用习惯,并探索习惯与报告的吸食大麻益处之间的联系。方法:我们对美国和加拿大使用大麻进行症状管理的自我报告慢性疼痛成年人的n=1087份横断面调查结果进行了混合方法分析。首先,我们对一个开放式问题的回答进行了定性分析,该问题评估了典型的大麻使用习惯,包括给药途径、大麻素含量和时间。然后,我们根据吸入(吸烟、蒸发)和非吸入(如食物)将反应分为几类。最后,我们调查了亚组对大麻如何影响疼痛、整体健康和药物使用(例如,替代阿片类药物、苯二氮卓类药物)的看法。替代品被视为药物类别的计数,同时对疼痛和健康的反应进行持续分析,-2表示健康状况下降或疼痛增加,2表示健康状况改善或疼痛减少。结果:在给药途径、大麻素含量和使用时间方面,常规药物差异很大。总体而言,18.8%、36.2%和45%分别使用非吸入、吸入和非吸入+吸入途径。使用吸入途径的患者更年轻(平均年龄46.5[吸入]和49.2[非吸入+吸入]vs.56.3[吸入],F=36.1,p2=59.6,P结论:根据给药途径对医用大麻患者进行分组可能为未来检查医用大麻风险和益处的研究提供有用的类别。
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引用次数: 0
Case report: Medical cannabis-warfarin drug-drug interaction. 病例报告:医用大麻与华法林的药物相互作用。
Pub Date : 2022-01-10 DOI: 10.1186/s42238-021-00112-x
Tyan F Thomas, Evdokia S Metaxas, Thu Nguyen, Whitni Bennett, Kathryn V Skiendzielewski, Diane H Quinn, Alice L Scaletta

Aim: A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoagulant agents. It is well known that warfarin has numerous drug interactions; however, much remains unknown about its interaction with THC and CBD. A literature review was conducted to identify documented cases of possible interactions between cannabis and warfarin. The case reports we identified noted that cannabis may potentially increase warfarin's effect. Therefore, we aimed to determine why an effect was not seen on our patient's warfarin dose despite daily use of medical cannabis.

Case: This case report describes an 85-year-old patient who despite starting an oromucosal medical cannabis regimen of THC and CBD (which provided 0.3 mg of THC and 5.3 mg CBD once daily and an additional 0.625 mg of THC and 0.625 mg CBD once daily as needed) had minimal INR fluctuations from October 2018 to September 2019.

Conclusion: Despite the introduction and use of medical cannabis therapy, with both THC and CBD components, an elderly patient with concurrent warfarin use did not see major INR fluctuations, in contrast to published literature. The potential for warfarin and THC/CBD interactions may be dependent on route of administration and dose of the cannabis product.

目的:本文描述了一例 85 岁患者同时服用华法林和含有δ-9-四氢大麻酚(THC)和大麻二酚(CBD)的医用大麻的病例。尽管美国食品及药物管理局(FDA)最近又批准了一些抗凝剂,但华法林仍然是抗凝治疗的基石。众所周知,华法林与许多药物存在相互作用,但它与四氢大麻酚和大麻二酚的相互作用仍有许多未知之处。我们进行了文献综述,以确定大麻与华法林之间可能发生相互作用的记录案例。我们发现的病例报告指出,大麻可能会增加华法林的药效。因此,我们旨在确定为什么尽管每天使用医用大麻,但对我们患者的华法林剂量未见影响。病例:本病例报告描述了一名 85 岁的患者,从 2018 年 10 月到 2019 年 9 月,尽管开始口服 THC 和 CBD 医用大麻疗法(每天一次提供 0.3 毫克 THC 和 5.3 毫克 CBD,并根据需要每天一次额外提供 0.625 毫克 THC 和 0.625 毫克 CBD),但 INR 波动很小:尽管引入并使用了含有 THC 和 CBD 成分的医用大麻疗法,但一名同时使用华法林的老年患者并未出现严重的 INR 波动,这与已发表的文献形成了鲜明对比。华法林和四氢大麻酚/CBD相互作用的可能性可能取决于给药途径和大麻产品的剂量。
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引用次数: 0
Identifying archetypal cannabis consumers to inform drug policy design: a Q-sort assessment of young adults' attitudes in Mexico City's metropolitan area. 识别典型的大麻消费者,为毒品政策设计提供信息:对墨西哥城大都市区年轻人态度的q分类评估。
Pub Date : 2022-01-08 DOI: 10.1186/s42238-021-00107-8
Salvador Espinosa, Charles Marks, Gustavo Fondevila

Background: As the legalization of cannabis moves forward in many countries, it is important to highlight the potential harm that excessive use can cause on young consumers. Crafting effective policy interventions to reduce the harm stemming from excessive use requires an understanding of the attitudes and motivations of young consumers.

Methods: This article uses Q methodology to study four aspects of cannabis use among young adults from Mexico City's metropolitan area: motivations for use, perceived consequences of use, reasons that would increase willingness to reduce consumption, and attitudes towards government regulation. A total of 110 cannabis users between 18 and 21 years old were recruited using chain-referral sampling. Using a Q methodology, we captured the relative importance that participants assigned to a series of statements and identified archetypal profiles of young adults who use cannabis for each of the four aspects mentioned above.

Results: The sample for this research study included 76 men and 34 women. The average age of participants was 20 years old, and the average age when cannabis consumption started was 15 years old. For each of the four Q-sort factor analyses, we identified 4 distinct factors based on explained variance and interpretability. The Q factor analysis indicated that attenuation of a negative affect (i.e., anxiety, stress) and relaxation were primary motivations for cannabis use. Understood consequences of cannabis use ranged across aspect-archetype, reflecting legal (i.e., interacting with law enforcement), financial, familial (i.e., disappointing family members), and educational performance concerns. Participants indicated that finding alternative relaxation strategies, receiving credible evidence of the health harms of cannabis use, increased financial burden of purchasing, and increased inaccessibility of cannabis products would motivate reductions in use. Across archetypes, participants indicated a willingness to comply with cannabis policies which are simple and easy to understand, which do not lead to discrimination or law enforcement involvement, and which provide for legal places to purchase and use safe (i.e., free of adulterants) cannabis products.

Conclusions: We posit that these archetypes could be useful to inform cannabis policy design. As the study reveals, participants' cannabis use was primarily motivated by perceived improvements to mental health. Furthermore, participant responses indicated that they viewed cannabis use as a health matter, not a criminal one. Policies which aim to promote alternative mental health wellness and relaxation mechanisms, which aim to improve communication of potential health harms of cannabis, and which allow for the safe and legal purchase and use of cannabis may be effective in reducing cannabis-associated harms. Though our findings shed light on important aspects of can

背景:随着大麻合法化在许多国家取得进展,必须强调过度使用可能对年轻消费者造成的潜在危害。制定有效的政策干预措施以减少过度使用造成的危害,需要了解年轻消费者的态度和动机。方法:本文使用Q方法研究来自墨西哥城大都市区的年轻人使用大麻的四个方面:使用动机、使用的感知后果、增加减少消费意愿的原因以及对政府监管的态度。采用连锁转诊抽样共招募了110名18至21岁的大麻使用者。使用Q方法,我们捕获了参与者分配给一系列陈述的相对重要性,并确定了上述四个方面使用大麻的年轻人的原型资料。结果:本研究的样本包括76名男性和34名女性。参与者的平均年龄为20岁,开始吸食大麻的平均年龄为15岁。对于四个q排序因子分析中的每一个,我们根据解释方差和可解释性确定了4个不同的因素。Q因子分析表明,减轻负面影响(即焦虑、压力)和放松是使用大麻的主要动机。人们所了解的大麻使用的后果涉及各个方面——原型,反映了法律(即与执法部门互动)、经济、家庭(即让家庭成员失望)和教育表现方面的问题。与会者指出,寻找替代性放松战略、获得大麻使用危害健康的可靠证据、增加购买的财政负担以及大麻产品越来越难以获得,将促使减少使用。在所有类型中,与会者都表示愿意遵守大麻政策,这些政策简单易懂,不会导致歧视或执法介入,并为购买和使用安全(即无掺假)大麻产品提供合法场所。结论:我们认为这些原型可能对大麻政策设计有用。正如研究显示的那样,参与者使用大麻主要是出于对心理健康的改善。此外,与会者的答复表明,他们认为使用大麻是一个健康问题,而不是犯罪问题。旨在促进替代性心理健康保健和放松机制的政策,旨在加强对大麻潜在健康危害的宣传,并允许安全合法地购买和使用大麻,可能有效地减少与大麻有关的危害。虽然我们的研究结果揭示了大麻使用者的态度和观点的重要方面,但样本量并不允许对研究结果进行概括,也不能得出关于受审查人群的结论。进一步的研究应考虑将本文中使用的Q方法应用于更大、更有代表性的大麻使用者样本。
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引用次数: 1
UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes. 英国医用大麻登记处姑息治疗患者队列:初步经验和结果。
Pub Date : 2022-01-04 DOI: 10.1186/s42238-021-00114-9
Devaki Nimalan, Michal Kawka, Simon Erridge, Mehmet Ergisi, Michael Harris, Oliver Salazar, Rayyan Ali, Katerina Loupasaki, Carl Holvey, Ross Coomber, Michael Platt, James J Rucker, Shaheen Khan, Mikael H Sodergren

Introduction: Palliative care aims to improve quality of life through optimal symptom control and pain management. Cannabis-based medicinal products (CBMPs) have a proven role in the treatment of chemotherapy-induced nausea and vomiting. However, there is a paucity of high-quality evidence with regards to the optimal therapeutic regimen, safety, and effectiveness of CBMPs in palliative care, as existing clinical trials are limited by methodological heterogeneity. The aim of this study is to summarise the outcomes of the initial subgroup of patients from the UK Medical Cannabis Registry who were prescribed CBMPs for a primary indication of palliative care, cancer pain and chemotherapy-induced nausea and vomiting, including effects on health-related quality of life and clinical safety.

Methods: A case series from the UK Medical Cannabis Registry of patients, who were receiving CBMPs for the indication of palliative care was undertaken. The primary outcome consisted of changes in patient-reported outcome measures including EQ-5D-5L, General Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), Pain Visual Analog Scale (VAS) and the Australia-Modified Karnofsky Performance Scale at 1 and 3 months compared to baseline. Secondary outcomes included the incidence and characteristics of adverse events. Statistical significance was defined by p-value< 0.050.

Results: Sixteen patients were included in the analysis, with a mean age of 63.25 years. Patients were predominantly prescribed CBMPs for cancer-related palliative care (n = 15, 94%). The median initial CBD and THC daily doses were 32.0 mg (Range: 20.0-384.0 mg) and 1.3 mg (Range: 1.0-16.0 mg) respectively. Improvements in patient reported health outcomes were observed according to SQS, EQ-5D-5L mobility, pain and discomfort, and anxiety and depression subdomains, EQ-5D-5L index, EQ-VAS and Pain VAS validated scales at both 1-month and 3-months, however, the changes were not statistically significant. Three adverse events (18.75%) were reported, all of which were either mild or moderate in severity.

Conclusion: This small study provides an exploratory analysis of the role of CBMPs in palliative care in the first cohort of patients since CBMPs legalisation in the UK. CBMPs were tolerated with few adverse events, all of which were mild or moderate and resolved spontaneously. Further long-term safety and efficacy studies involving larger cohorts are needed to establish CBMPs role in palliative care, including comparisons with standard treatments.

简介:姑息治疗旨在通过最佳的症状控制和疼痛管理来改善生活质量。以大麻为基础的医药产品(CBMPs)在治疗化疗引起的恶心和呕吐方面已被证实具有作用。然而,由于现有的临床试验受到方法学异质性的限制,关于CBMPs在姑息治疗中的最佳治疗方案、安全性和有效性,缺乏高质量的证据。本研究的目的是总结来自英国医用大麻登记处的最初亚组患者的结果,这些患者因姑息治疗、癌症疼痛和化疗引起的恶心和呕吐的主要指征而开了CBMPs,包括对健康相关生活质量和临床安全的影响。方法:从英国医用大麻登记的患者,谁正在接受CBMPs的指征姑息治疗的病例系列进行。主要结果包括患者报告的结果测量值的变化,包括EQ-5D-5L、一般焦虑障碍-7 (GAD-7)、单项睡眠质量量表(SQS)、疼痛视觉模拟量表(VAS)和澳大利亚修正Karnofsky表现量表在1个月和3个月时与基线相比。次要结局包括不良事件的发生率和特征。结果:纳入16例患者,平均年龄63.25岁。患者主要使用CBMPs进行癌症相关姑息治疗(n = 15,94%)。中位初始CBD和THC每日剂量分别为32.0 mg(范围:20.0-384.0 mg)和1.3 mg(范围:1.0-16.0 mg)。根据SQS、EQ-5D-5L活动度、疼痛和不适、焦虑和抑郁子域、EQ-5D-5L指数、EQ-VAS和pain VAS验证量表,在1个月和3个月时观察患者报告的健康结果的改善,但变化无统计学意义。报告3例不良事件(18.75%),均为轻度或中度严重事件。结论:这项小型研究提供了自英国CBMPs合法化以来首个患者队列中CBMPs在姑息治疗中的作用的探索性分析。CBMPs具有耐受性,几乎没有不良事件,所有不良事件均为轻度或中度,并自发消退。进一步的长期安全性和有效性研究需要涉及更大的队列来确定CBMPs在姑息治疗中的作用,包括与标准治疗的比较。
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引用次数: 5
Delta-8-THC: Delta-9-THC's nicer younger sibling? 8-四氢大麻酚:9-四氢大麻酚的弟妹?
Pub Date : 2022-01-04 DOI: 10.1186/s42238-021-00115-8
Jessica S Kruger, Daniel J Kruger

Background: Products containing delta-8-THC became widely available in most of the USA following the 2018 Farm Bill and by late 2020 were core products of hemp processing companies, especially where delta-9-THC use remained illegal or required medical authorization. Research on experiences with delta-8-THC is scarce, some state governments have prohibited it because of this lack of knowledge.

Objective: We conducted an exploratory study addressing a broad range of issues regarding delta-8-THC to inform policy discussions and provide directions for future systematic research.

Methods: We developed an online survey for delta-8-THC consumers, including qualities of delta-8-THC experiences, comparisons with delta-9-THC, and open-ended feedback. The survey included quantitative and qualitative aspects to provide a rich description and content for future hypothesis testing. Invitations to participate were distributed by a manufacturer of delta-8-THC products via social media accounts, email contact list, and the Delta8 Reddit.com discussion board. Participants (N = 521) mostly identified as White/European American (90%) and male (57%). Pairwise t tests compared delta-8-THC effect rating items; one-sample t tests examined responses to delta-9-THC comparison items.

Results: Most delta-8-THC users experienced a lot or a great deal of relaxation (71%); euphoria (68%) and pain relief (55%); a moderate amount or a lot of cognitive distortions such as difficulty concentrating (81%), difficulties with short-term memory (80%), and alerted sense of time (74%); and did not experience anxiety (74%) or paranoia (83%). Participants generally compared delta-8-THC favorably with both delta-9-THC and pharmaceutical drugs, with most participants reporting substitution for delta-9-THC (57%) and pharmaceutical drugs (59%). Participant concerns regarding delta-8-THC were generally focused on continued legal access.

Conclusions: Delta-8-THC may provide much of the experiential benefits of delta-9-THC with lesser adverse effects. Future systematic research is needed to confirm participant reports, although these studies are hindered by the legal statuses of both delta-8-THC and delta-9-THC. Cross-sector collaborations among academics, government officials, and representatives from the cannabis industry may accelerate the generation of knowledge regarding delta-8-THC and other cannabinoids. A strength of this study is that it is the first large survey of delta-8 users, limitations include self-report data from a self-selected convenience sample.

背景:在2018年农业法案之后,含有delta-8-THC的产品在美国大部分地区广泛使用,到2020年底成为大麻加工公司的核心产品,特别是在delta-9-THC的使用仍然是非法的或需要医疗授权的地方。关于delta-8-THC的经验研究很少,由于缺乏知识,一些州政府已经禁止使用它。目的:我们对delta-8-THC的广泛问题进行了探索性研究,为政策讨论提供信息,并为未来的系统研究提供方向。方法:我们对delta-8-THC消费者进行了一项在线调查,包括delta-8-THC体验的质量、与delta-9-THC的比较以及开放式反馈。调查包括定量和定性两个方面,为以后的假设检验提供了丰富的描述和内容。参与邀请由delta-8-THC产品的制造商通过社交媒体帐户、电子邮件联系人列表和Delta8 Reddit.com讨论板分发。参与者(N = 521)主要是白人/欧洲裔美国人(90%)和男性(57%)。两两t检验比较δ -8- thc效应评定项目;单样本t检验检验了对delta-9-THC比较项目的反应。结果:大多数delta-8-THC使用者体验到大量或大量的放松(71%);欣快感(68%)和疼痛缓解(55%);中度或重度认知扭曲,如注意力难以集中(81%),短期记忆困难(80%),时间意识警觉(74%);没有焦虑(74%)或偏执(83%)。参与者普遍将δ -8- thc与δ -9- thc和药物进行比较,大多数参与者报告替代δ -9- thc(57%)和药物(59%)。与会者对δ -8-四氢大麻酚的关切一般集中在继续合法获取方面。结论:Delta-8-THC可能提供delta-9-THC的许多经验益处,而副作用较小。尽管delta-8-THC和delta-9-THC的法律地位阻碍了这些研究,但仍需要未来的系统研究来证实参与者的报告。学术界、政府官员和大麻行业代表之间的跨部门合作可能会加速有关δ -8-四氢大麻酚和其他大麻素的知识的产生。这项研究的优势在于它是对delta-8用户的第一次大规模调查,局限性包括来自自我选择的方便样本的自我报告数据。
{"title":"Delta-8-THC: Delta-9-THC's nicer younger sibling?","authors":"Jessica S Kruger,&nbsp;Daniel J Kruger","doi":"10.1186/s42238-021-00115-8","DOIUrl":"https://doi.org/10.1186/s42238-021-00115-8","url":null,"abstract":"<p><strong>Background: </strong>Products containing delta-8-THC became widely available in most of the USA following the 2018 Farm Bill and by late 2020 were core products of hemp processing companies, especially where delta-9-THC use remained illegal or required medical authorization. Research on experiences with delta-8-THC is scarce, some state governments have prohibited it because of this lack of knowledge.</p><p><strong>Objective: </strong>We conducted an exploratory study addressing a broad range of issues regarding delta-8-THC to inform policy discussions and provide directions for future systematic research.</p><p><strong>Methods: </strong>We developed an online survey for delta-8-THC consumers, including qualities of delta-8-THC experiences, comparisons with delta-9-THC, and open-ended feedback. The survey included quantitative and qualitative aspects to provide a rich description and content for future hypothesis testing. Invitations to participate were distributed by a manufacturer of delta-8-THC products via social media accounts, email contact list, and the Delta8 Reddit.com discussion board. Participants (N = 521) mostly identified as White/European American (90%) and male (57%). Pairwise t tests compared delta-8-THC effect rating items; one-sample t tests examined responses to delta-9-THC comparison items.</p><p><strong>Results: </strong>Most delta-8-THC users experienced a lot or a great deal of relaxation (71%); euphoria (68%) and pain relief (55%); a moderate amount or a lot of cognitive distortions such as difficulty concentrating (81%), difficulties with short-term memory (80%), and alerted sense of time (74%); and did not experience anxiety (74%) or paranoia (83%). Participants generally compared delta-8-THC favorably with both delta-9-THC and pharmaceutical drugs, with most participants reporting substitution for delta-9-THC (57%) and pharmaceutical drugs (59%). Participant concerns regarding delta-8-THC were generally focused on continued legal access.</p><p><strong>Conclusions: </strong>Delta-8-THC may provide much of the experiential benefits of delta-9-THC with lesser adverse effects. Future systematic research is needed to confirm participant reports, although these studies are hindered by the legal statuses of both delta-8-THC and delta-9-THC. Cross-sector collaborations among academics, government officials, and representatives from the cannabis industry may accelerate the generation of knowledge regarding delta-8-THC and other cannabinoids. A strength of this study is that it is the first large survey of delta-8 users, limitations include self-report data from a self-selected convenience sample.</p>","PeriodicalId":15172,"journal":{"name":"Journal of Cannabis Research","volume":" ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39643326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Olivetolic acid, a cannabinoid precursor in Cannabis sativa, but not CBGA methyl ester exhibits a modest anticonvulsant effect in a mouse model of Dravet syndrome. 橄榄酸是大麻素的前体,而不是CBGA甲酯,在Dravet综合征的小鼠模型中表现出适度的抗惊厥作用。
Pub Date : 2022-01-04 DOI: 10.1186/s42238-021-00113-w
Lyndsey L Anderson, Michael Udoh, Declan Everett-Morgan, Marika Heblinski, Iain S McGregor, Samuel D Banister, Jonathon C Arnold

Objective: Cannabigerolic acid (CBGA), a precursor cannabinoid in Cannabis sativa, has recently been found to have anticonvulsant properties in the Scn1a+/- mouse model of Dravet syndrome. Poor brain penetration and chemical instability of CBGA limits its potential as an anticonvulsant therapy. Here, we examined whether CBGA methyl ester, a more stable analogue of CBGA, might have superior pharmacokinetic and anticonvulsant properties. In addition, we examined whether olivetolic acid, the biosynthetic precursor to CBGA with a truncated (des-geranyl) form, might possess minimum structural requirements for anticonvulsant activity. We also examined whether olivetolic acid and CBGA methyl ester retain activity at the epilepsy-relevant drug targets of CBGA: G-protein-coupled receptor 55 (GPR55) and T-type calcium channels.

Methods: The brain and plasma pharmacokinetic profiles of CBGA methyl ester and olivetolic acid were examined following 10 mg/kg intraperitoneal (i.p.) administration in mice (n = 4). The anticonvulsant potential of each was examined in male and female Scn1a+/- mice (n = 17-19) against hyperthermia-induced seizures (10-100 mg/kg, i.p.). CBGA methyl ester and olivetolic acid were also screened in vitro against T-type calcium channels and GPR55 using intracellular calcium and ERK phosphorylation assays, respectively.

Results: CBGA methyl ester exhibited relatively limited brain penetration (13%), although somewhat superior to that of 2% for CBGA. No anticonvulsant effects were observed against thermally induced seizures in Scn1a+/- mice. Olivetolic acid also showed poor brain penetration (1%) but had a modest anticonvulsant effect in Scn1a+/- mice increasing the thermally induced seizure temperature threshold by approximately 0.4°C at a dose of 100 mg/kg. Neither CBGA methyl ester nor olivetolic acid displayed pharmacological activity at GPR55 or T-type calcium channels.

Conclusions: Olivetolic acid displayed modest anticonvulsant activity against hyperthermia-induced seizures in the Scn1a+/- mouse model of Dravet syndrome despite poor brain penetration. The effect was, however, comparable to the known anticonvulsant cannabinoid cannabidiol in this model. Future studies could explore the anticonvulsant mechanism(s) of action of olivetolic acid and examine whether its anticonvulsant effect extends to other seizure types.

目的:大麻酚酸(Cannabigerolic acid, CBGA)是大麻中的一种前体大麻素,最近在Dravet综合征的Scn1a+/-小鼠模型中被发现具有抗惊厥特性。CBGA的脑穿透性差和化学不稳定性限制了其作为抗惊厥治疗的潜力。在这里,我们研究了CBGA甲酯,一种更稳定的CBGA类似物,是否具有更好的药代动力学和抗惊厥特性。此外,我们研究了橄榄酸,CBGA的生物合成前体,截断(去香叶基)形式,是否可能具有抗惊厥活性的最低结构要求。我们还研究了橄榄酸和CBGA甲酯是否在CBGA: g蛋白偶联受体55 (GPR55)和t型钙通道的癫痫相关药物靶点上保持活性。方法:在小鼠(n = 4)腹腔给药10 mg/kg后,检测CBGA甲酯和橄榄酸的脑和血浆药代动力学特征,并在雄性和雌性Scn1a+/-小鼠(n = 17-19)中检测它们对高热诱发癫痫(10-100 mg/kg, i.p)的抗惊厥电位。通过细胞内钙和ERK磷酸化实验,分别筛选CBGA甲酯和橄榄酸对t型钙通道和GPR55的体外抑制作用。结果:CBGA甲酯表现出相对有限的脑穿透性(13%),尽管略优于CBGA的2%。在Scn1a+/-小鼠中未观察到抗惊厥作用。橄榄酸也表现出较差的脑穿透性(1%),但在Scn1a+/-小鼠中具有适度的抗惊厥作用,当剂量为100 mg/kg时,热诱导的癫痫发作温度阈值增加约0.4°C。CBGA甲酯和橄榄酸对GPR55和t型钙通道均无药理活性。结论:在Dravet综合征的Scn1a+/-小鼠模型中,橄榄酸显示出适度的抗惊厥活性,尽管脑穿透性差。然而,在这个模型中,这种效果与已知的抗惊厥大麻素大麻二酚相当。未来的研究将进一步探讨橄榄酸的抗惊厥作用机制,并检验其抗惊厥作用是否延伸到其他癫痫发作类型。
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引用次数: 5
期刊
Journal of Cannabis Research
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