Cannabis and Cannabinoid Research最新文献

Objective: Cannabis use disorder (CUD) is one of the most common substance use disorders (SUDs) worldwide and is frequently associated with high rates of polysubstance use; however, despite rising rates of polysubstance use disorders (PUD), the characteristics of individuals with both CUD and PUD remain unclear. This study, therefore, aims to examine social and clinical characteristics of adults diagnosed with CUD and comorbid PUD. It also aims to assess whether psychiatric disorders are linked to higher odds of PUD among individuals with CUD. Methods: Using a nationally representative U.S. dataset, we assessed 972 individuals with past-year DSM-5 CUD, grouped as CUD only, CUD individuals with one additional SUD (CUD + 1), and CUD individuals with two or more SUDs (CUD + 2). Descriptive statistics summarized social and clinical presentations; multivariate logistic regression examined factors contributing to PUD, controlling for clinical diagnoses and childhood maltreatment. Results: Among CUD individuals, 89.3% (n = 868) used at least one other substance in the past year, with 34.2% (n = 332) using two or more. Both the CUD + 1 and CUD + 2 groups experienced significantly more severe childhood maltreatment than CUD only. After adjusting for controls, personality disorders were associated with membership in the CUD + 1 group (odds ratio [OR]: 1.88, p = 0.01); mood disorders were associated with a higher likelihood of being in the CUD + 1 group (OR: 1.50, p = 0.049) and CUD + 2 group (OR: 2.58, p = 0.005). Conclusion: Mood and personality disorders were highly prevalent and linked with PUD in CUD cases. We recommend screening for these disorders in complex CUD cases.

Introduction: More adults can legally purchase cannabis in the United States than ever before. However, there is limited understanding as to how cannabis consumers make decisions about what products to purchase. Further insight is needed to guide policies that balance public health with profitable business strategies. Methods: Respondents were cannabis consumers participating in the legal adult-use market in Washington State. They were recruited through flyers posted in cannabis retail stores. Both the online survey and flyer were created by the Washington State Liquor and Cannabis Board and the Department of Health. Respondents answered questions on demographics, cannabis use patterns, and cannabis retail store employment status. Respondents also rated the importance of 10 different attributes when making a cannabis purchase: company/brand name, strain/cultivar name, production method, cost, tetrahydrocannabinol (THC), cannabidiol or terpene profile, perceived positive effects, perceived negative effects, flavor, and appearance/look. Linear regressions were conducted to predict the importance of each attribute by gender, age, cannabis use patterns, and cannabis retail employee status. Results: There were 437 survey respondents. All respondents were legal adult cannabis users and 137 reported they were employed at a cannabis retail store. Several group differences emerged. For example, cannabis retail employees rated THC concentration as less important (β = -1.67, p < 0.001) but brand name (β = 1.30, p < 0.001) and product appearance (β = 0.81, p = 0.001) as more important than nonretail employees. More frequent users rated cultivar/strain name (β = 0.50, p < 0.001), production method (β = 0.43, p < 0.001), price (β = 0.26 p = 0.01), and product appearance (β = 0.49, p < 0.001) as more important than less frequent users. Conclusions: Differences in purchasing decisions by subgroups have important public health, economic, and policy implications. For example, results showed that retail employees place less emphasis on THC relative to their nonemployee counterparts. If retail employees were to emphasize to customers about the attributes they focus on when purchasing cannabis (e.g., product appearance), this could help redirect market demand away from higher-THC products.

Introduction: Cannabis use has risen disproportionately among middle-aged and older U.S. adults, groups particularly vulnerable to adverse effects, including cannabis use disorder (CUD). Consumption patterns have diversified in recent years. The quantity of cannabis use, historically measured in limited ways (e.g., number of joints), is now considered a key risk factor for CUD. However, age-related differences in consumption patterns and their relationships with CUD remain understudied. This study investigated age-related differences in consumption patterns and examined the relationship between quantity of use-measured by milligrams of THC (mgTHC)-and self-reported CUD in individuals with regular cannabis use. Materials and Methods: A total of 4134 U.S. adults (ages 18+; 45.9% male, 54.1% female) who reported daily cannabis use completed an online survey assessing cannabis consumption patterns and self-reported Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition's CUD criteria. Pearson's chi-square tests and one-way analysis of variance examined differences in sex, reasons for use, methods of consumption, CUD severity, criteria count, and mgTHC with comparisons across three age-groups (18-49, 50-64, 65+). Regression models, adjusted for sex and reasons for use, analyzed age-specific associations between mgTHC and CUD. Results: Overall, over 70% reported using cannabis for both medical and recreational purposes. Middle-aged adults were more likely to report medical use than younger ones (18.1% vs. 13.7%; p < 0.001) and older adults (14.1%; p = 0.027). Older adults were more likely to report recreational-only use compared with middle-aged adults (15.8% vs. 10.5%; p = 0.002). Smoking buds was the most common consumption method across age-groups, while high-potency concentrate use declined with age. In the overall sample, daily mgTHC was associated with CUD severity, and middle-aged and older adults endorsed fewer CUD criteria than younger adults at all levels of mgTHC; however, age effects were not statistically significant. Discussion: Among daily cannabis consumers, middle-aged and older adults differed from younger consumers in methods of consumption and reasons for use. While both groups consumed lower quantities than their younger counterparts, no age-related differences were observed in the relationship between mgTHC consumption and CUD, contrasting with evidence suggesting that older cannabis consumers may be more vulnerable to cannabis-related negative outcomes.

Introduction: In recent years, the production and consumption of cannabinoids have increased significantly. Researchers are particularly interested in cannabidiol (CBD), Δ⁸-tetrahydrocannabinol (Δ⁸-THC), and Δ⁹-tetrahydrocannabinol (Δ⁹-THC). Despite the growing prevalence of these molecules in everyday life, research shows that cannabinoid products are often mislabeled. In this study, we quantified and compared the label accuracy of CBD in full- and broad-spectrum tinctures to evaluate whether there is a public health concern related to CBD, Δ⁸-THC, and Δ⁹-THC. Materials and Methods: A total of 18 samples from different brands sold online in the United States were obtained for the study. Reverse-phase high-performance liquid chromatography with ultraviolet/visible light detection (RP-HPLC-UV) was employed to detect and quantify the concentration of CBD and THC isomers within the samples. Labels were deemed inaccurate if the actual concentration of CBD deviated by more than 10% from the labeled amount. Results: Our findings showed that 12 out of 18 samples had inaccurately labeled CBD concentrations. Notably, a significant difference in CBD label accuracy was observed between broad- and full-spectrum tinctures (p = 0.0282). No significant correlation was found between the cost of the tinctures and the label accuracy for CBD (p = 0.2117). While none of the broad-spectrum tinctures contained Δ⁸-THC, two contained Δ⁹-THC. All full-spectrum tinctures contained both Δ⁸-THC and Δ⁹-THC at levels below the federal limit for hemp of 0.3% on a dry weight basis. Discussion: Accurate labeling of CBD and THC in tincture products is a crucial public health concern, both locally in Texas and across the United States. There is a need for the U.S. Food and Drug Administration to promulgate regulations for labeling products that contain CBD and THC.

Introduction: Cannabis was legalized in California for recreational use through the passage of Proposition 64: The Adult Use Marijuana Act of 2016. This analysis from the Impact 64 study describes the cannabis use patterns of adults 21 years and older in California since the passage of Proposition 64. Methods: An online questionnaire addressing use of tetrahydrocannabinol-containing cannabis (including frequency, product(s), length, source, and purpose) was administered from December 2022 to February 2023. Of the initial 15,309 census-weighted participants, a subset of participants completed a detailed cannabis use questionnaire, including 4,020 people who currently use cannabis. Cannabis users were grouped by use frequency, and chi-squared analysis was utilized for descriptive analysis. Multinomial logistic regression was applied to assess significant variables associated with specific use patterns. Results: Of the initial sample of 15,208, 37% reported current cannabis use (with use in the past 3 months), 30% formerly used cannabis, and 33% were nonusers. Among current users, 38% reported very frequent use (multiple times a day), 33% frequent use (four times per week to daily), and 30% occasional use (three times per week or less). Compared with occasional users, very frequent users were more likely to be male (65%, odds ratio [OR] = 1.8, p < 0.001), less educated (OR = 1.7, p < 0.001), and have lower incomes (under 50K vs 100K, OR = 2.3, p < 0.001). Most users reported multiple cannabis products, mainly flower inhalation (80%), vaping (66%), and edibles (61%), primarily sourced from dispensaries (77%), which the majority (94%) perceived as licensed. Of all current users, most used cannabis at home (93%) or for entertainment (75%), with many reporting use during creative activities (45%), with alcohol (36%) and/or with cigarettes (24%). Positive impacts were reported in mental (82%), emotional (81%), and physical (62%) health. The internet (51%) and friends/family (50%) were the main sources of information. Most current users felt comfortable discussing cannabis with their primary doctor (78%), although only 66% of primary doctors knew about recreational use. Discussion: There is a high prevalence of daily cannabis use among adult Californians, with most users obtaining products from perceived licensed dispensaries or delivery services. While most users feel comfortable discussing cannabis use with physicians, they primarily obtain information from other sources, highlighting the need to bridge this information gap.

Background: In 2023, Japan's Cannabis Control Act underwent its first major revision since its establishment in 1948. The legal framework surrounding cannabis had long remained rigid, with limited scope for medical or industrial applications. Methods: This review examines the content and implications of the 2023 legal amendments based on governmental documents, legislative records, and secondary analyses of regulatory shifts. The assessment focuses on three key domains: medical application, industrial use, and drug control. Results: Under the revised law, cannabis-derived products intended for medical use were brought under the same regulatory framework as opioid analgesics, theoretically enabling physicians to prescribe them. Simultaneously, the longstanding restriction limiting industrial use to mature stalks and seeds was lifted. However, this liberalization was counterbalanced by the introduction of a stringent THC threshold. On the criminal side, cannabis continues to be regulated as an illicit substance, and new penalties for use have been introduced. The revised law came into effect on December 12, 2024. Conclusion: The 2023 amendment represents a significant shift in Japan's cannabis policy, aiming to balance expanded medical and industrial opportunities with continued drug control. Its practical implications remain to be seen and warrant close monitoring in the coming years.

Introduction: Despite prohibitions against youth-appealing packages, deceptive "copycat" cannabis edible packages have been commonly seen in U.S. states that legalized recreational cannabis. Copycat packages mimic the branding features of popular food products, posing a high risk for accidental ingestion, particularly for the younger population. Materials and Methods: An online experiment was conducted among a representative sample of young adults aged 18-29 (N = 2,523). Participants were asked in timed trials to identify whether each package in a series of images contained cannabis content. Regression analysis was conducted to analyze the association between package type and correct identification and the association between correct identification and appeal ratings. Results: Copycat cannabis packages were associated with lower odds of correct identification of cannabis content (odds ratio = 0.35, 95% CI = [0.31, 0.40]) compared with the non-copycat branded cannabis package. Correct identification of cannabis content was associated with lower appeal ratings (odds ratio = 0.75, 95% CI = [0.69, 0.81]). Discussion: Copycat cannabis packages were associated with elevated risk of misidentification of cannabis content, making them a public health risk for accidental ingestion. Package features that make a package easily identifiable were less appealing, underscoring the need of requiring salient features to indicate cannabis content on cannabis packages.

Introduction: Cannabis cultivars were usually categorized based on their genetic profile as sativa, indica, or hybrid types. However, these three criteria do not allow sufficient differentiation between the numerous varieties of cannabis strains. Furthermore, this classification is based on morphological and bio-geographical properties of the plants and does not represent the chemical composition of different cultivars. The concentration of cannabinoids and terpenes are crucial for the pharmacological effect, not only because of the known entourage effect, and therefore needs to be considered by categorization. Materials and Methods: A total of 140 medicinal cannabis flowers available on the German market were analyzed regarding their individual terpene profile using GC-MS analysis. Statistical evaluation was performed to investigate correlations and data relations as well as for clustering. Results: Multivariate analysis showed correlations between individual terpenes. However, there was no statistical correlation between terpene profiles and their respective genetic profile. Terpene profiles of sativa, indica, and hybrid strains are quite heterogenous and clearly showed that there is no relation between terpenes and the estimated pharmacological effect. As a result, we suggest a new classification system based on individual terpene profiles to faster a comprehensive understanding of the expected medical effect. Discussion: Considering main terpenes, we established a concept of six clusters with various terpene profiles being attributed to different medicinal applications. We excluded tetrahydrocannabinol (THC) and cannabidiol (CBD) content from clustering as most of the strains were THC dominant and therefore distort the results. Our pattern of strains with similar terpene profiles might refine the existing classes of chemotypes with different THC:CBD content. Conclusion: The categorization of cannabis strains based on their terpene profiles allows a clearer, finer and, above all, more meaningful classification than the existing sativa/indica classification. Due to the entourage effect and the interactions between cannabinoids and terpenes, this group of substances is also given the necessary consideration when selecting the right medicine for the individual. Within the next steps, further studies are needed with the aim of mapping clinical validated effects to our chemovars. If it is possible to correlate therapy of symptoms to specific chemical profiles personalized cannabinoid therapy will be possible.

Background: Chronic noncancer pain (CNCP) affects one in five adults and is commonly managed with long-term opioid therapy. Concerns regarding rare but catastrophic harms associated with opioids, including overdose and death, have generated interest in alternatives including cannabis; however, the comparative cost-effectiveness of these management options is uncertain. Methods: We used findings from a network meta-analysis of 90 randomized trials to develop a 1-year microsimulation model to compare costs and quality-adjusted life years (QALY) between oral medical cannabis and opioids for CNCP. We used a publicly funded health care payer perspective for our analyses and obtained cost and utility data from publicly available sources. All costs are reported in 2023 Canadian dollars. All analyses were probabilistic, and we conducted sensitivity and scenario analyses to assess robustness. Results: Total mean annual cost per patient was $1,980 for oral medical cannabis and $1,851 for opioids, a difference of $129 (95% confidence interval [CI]: -$723 to $525). Mean QALYs were 0.582 for both oral medical cannabis and opioids (95% CI: -0.007 to 0.015). Cost-effectiveness acceptability curves showed that oral medical cannabis was cost-effective in 31% of iterations at willingness-to-pay thresholds up to $50,000/QALY gained. Use of opioids is associated with nonfatal and fatal overdose, whereas medical cannabis is not. Discussion: Our findings suggest that medical cannabis as an alternative to opioids for chronic pain may confer similar, but modest, benefits to patients, and reduce the risk of opioid overdose without substantially increasing costs.