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Journal articles on the topic 'Chronic cannabis use'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

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1

Hami, H., F. Z. Azzaoui, A. Mokhtari, A. Soulaymani, S. Skalli, and R. Soulaymani. "Chronic cannabis use in morocco." European Psychiatry 26, S2 (March 2011): 46. http://dx.doi.org/10.1016/s0924-9338(11)71757-6.

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IntroductionIn Morocco, as in other countries, the cannabis consumption by a great number of the population remains worrisome, in terms of its effects on “mental and physical” health and its social repercussions.Objectives and aimsTo determine the profile of the people poisoned by cannabis in Morocco in order to identify individuals and groups at high risk.MethodsA retrospective study was conducted on chronic cannabis poisoning cases notified between 2000 and 2008 in the Morocco Poison Control Center.ResultsDuring the study period, three hundred and one regular users of cannabis (28 women and 273 men) were poisoned, constituting 34 cases on average per year. The clinical symptoms presented by victims are different, depending on the quantity of inhaled and absorbed psychoactive substances (especially THC) and the frequency and method of use. The average age of victims is 22 years. Among the 225 patients for whom the evolution is known, a 23-year-old man died. The rest of the patients’ condition has improved under gut decontamination.ConclusionsThe influence of consumption of the increasingly high doses of cannabis on the quality of life of young people justifies a public information, particularly young people for better prevention of using of this psychoactive product.
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Lorenzetti, Valentina, Nadia Solowij, Sarah Whittle, Alex Fornito, Dan I. Lubman, Christos Pantelis, and Murat Yücel. "Gross morphological brain changes with chronic, heavy cannabis use." British Journal of Psychiatry 206, no. 1 (January 2015): 77–78. http://dx.doi.org/10.1192/bjp.bp.114.151407.

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SummaryWe investigated the morphology of multiple brain regions in a rare sample of 15 very heavy cannabis users with minimal psychiatric comorbidity or significant exposure to other substances (compared with 15 age- and IQ-matched non-cannabis-using controls) using manual techniques. Heavy cannabis users demonstrated smaller hippocampus and amygdala volumes, but no alterations of the orbitofrontal and anterior- and paracingulate cortices, or the pituitary gland. These findings indicate that chronic cannabis use has a selective and detrimental impact on the morphology of the mediotemporal lobe.
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Fontes, Maria Alice, Karen I. Bolla, Paulo Jannuzzi Cunha, Priscila Previato Almeida, Flávia Jungerman, Ronaldo Ramos Laranjeira, Rodrigo A. Bressan, and Acioly L. T. Lacerda. "Cannabis use before age 15 and subsequent executive functioning." British Journal of Psychiatry 198, no. 6 (June 2011): 442–47. http://dx.doi.org/10.1192/bjp.bp.110.077479.

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BackgroundMany studies have suggested that adolescence is a period of particular vulnerability to neurocognitive effects associated with substance misuse. However, few large studies have measured differences in cognitive performance between chronic cannabis users who started in early adolescence (before age 15) with those who started later.AimsTo examine the executive functioning of individuals who started chronic cannabis use before age 15 compared with those who started chronic cannabis use after 15 and controls.MethodWe evaluated the performance of 104 chronic cannabis users (49 early-onset users and 55 late-onset users) and 44 controls who undertook neuropsychological tasks, with a focus on executive functioning. Comparisons involving neuropsychological measures were performed using generalised linear model analysis of variance (ANOVA).ResultsThe early-onset group showed significantly poorer performance compared with the controls and the late-onset group on tasks assessing sustained attention, impulse control and executive functioning.ConclusionsEarly-onset chronic cannabis users exhibited poorer cognitive performance than controls and late-onset users in executive functioning. Chronic cannabis use, when started before age 15, may have more deleterious effects on neurocognitive functioning.
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Tse, Caroline, Alicia Stewart, Omar Ordaz-Johnson, Maya Herzig, Jacqueline Gagnon, Jonathan Emens, Steven Shea, and Nicole Bowles. "223 Sleep Duration and Sleep Quality in Chronic Cannabis Users and Non-Users." Sleep 44, Supplement_2 (May 1, 2021): A89. http://dx.doi.org/10.1093/sleep/zsab072.222.

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Abstract Introduction Cannabis use is on the rise in the United States, with 10% of adults reporting cannabis use in the past 30 days. Users commonly report consuming cannabis to improve sleep despite the lack of research that supports an association between cannabis use and sleep. In this pilot study we sought to examine objective measures of sleep duration and sleep quality among non- and chronic-cannabis users, and any patterns in relation to the time since consumption of cannabis. Methods Chronic cannabis users (cannabis used 2 or more times/week) and non-users provided up to 2-weeks of actigraphy (ActiGraph wGT3X-BT), worn on the wrist and verified by sleep diary. Chronic cannabis users also reported the date, time, amount, and route of their cannabis use. Mixed-effects models with participant as a random factor were used to examine: 1) the relationship between daily sleep parameters in cannabis non-users vs. users; and 2) the elapsed time between cannabis use and time in bed in chronic cannabis users. Results Chronic cannabis users (n=6) and non-users (n=7) collectively provided 151 nights of sleep. Participant characteristics (38.5% female; age, 25.8 years ± 4 years; BMI, 23.4 kg/m2 ± 3.4 kg/m2) did not significantly differ between groups. Cannabis use was associated with decreased total sleep time (measured in hours, ß=-0.58, p<0.001) and increased wake after sleep onset (WASO, ß=32.79, p=0.005), but not with the number of awakenings (ß=6.02, p=0.068). Among chronic cannabis users, cannabis use within two hours of bed was associated with increased sleep latency compared to use greater than two hours (ß=6.66, p=0.026). There was no association between time of cannabis use and WASO (p=0.621) or the number of awakenings (p=0.617). Conclusion In this pilot study of objectively measured sleep, we found that chronic cannabis use compared to non-use is associated with decreased sleep duration of otherwise healthy adults. Cannabis used closer to bedtime is associated with increased sleep latency. Additional studies that are able to assess the mode and dosage of use are needed to further understand the effects of cannabis and its components on sleep. Support (if any) KL2TR002370, AASM, Oregon Institute of Occupational Health Sciences
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5

Fatima, Hudaisa, Allyn C. Howlett, and Christopher T. Whitlow. "Reward, Control & Decision-Making in Cannabis Use Disorder: Insights from Functional MRI." British Journal of Radiology 92, no. 1101 (September 2019): 20190165. http://dx.doi.org/10.1259/bjr.20190165.

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The recreational consumption of cannabis has increased significantly across the world with an estimated 180 million people currently using. In the United States, 4.1 million are currently diagnosed with cannabis use disorder. Cannabis dependence and abuse was combined into a single entity as a behavioral disorder with a problematic pattern of cannabis use and termed cannabis use disorder by the Diagnostic and Statistical Manual of Mental Disorders. Chronic use of cannabis has been linked with region-specific effects across the brain mediating reward processing, cognitive control and decision-making that are central to understanding addictive behaviors. This review presents a snapshot of the current literature assessing the effects of chronic cannabis use on human brain function via functional MRI. Studies employing various paradigms and contrasting cognitive activation amongst cannabis users and non-users were incorporated. The effects of trans-del-ta-9-tetrahydrocannabinol (Δ9-THC) in marijuana and other preparations of cannabis are mediated by the endocannabinoid system, which is also briefly introduced. Much variation exists in the current literature regarding the functional changes associated with chronic cannabis use. One possible explanation for this variation is the heterogeneity in study designs, with little implementation of standardized diagnostic criteria when selecting chronic users, distinct time points of participant assessment, differing cognitive paradigms and imaging protocols. As such, there is an urgent requirement for future investigations that further characterize functional changes associated with chronic cannabis use.
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Tripp, Dean A., J. Curtis Nickel, Laura Katz, Adrijana Krsmanovic, Mark A. Ware, and Darcy Santor. "A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome." Canadian Urological Association Journal 8, no. 11-12 (December 15, 2014): 901. http://dx.doi.org/10.5489/cuaj.2268.

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Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic pelvic pain condition largely refractory to treatment. Cannabis (marijuana) use has been reported for a wide variety of chronic pain conditions, but no study has examined prevalence of cannabis use, symptom benefit or side effects, or frequency in CP/CPPS.Methods: Participants were recruited from an outpatient CP/CPPS urology clinic (n = 98) and online through the Prostatitis Foundation website (n = 244). Participants completed questionnaires (demographics, CP/CPPS, depression, cannabis).Results: The clinic sample included Canadian patients and the online sample included primarily American patients. Due to differences, groups were examined separately. Almost 50% of respondents reported using cannabis (clinic n = 49; online n = 89). Of the cannabis users, 36.8% of clinic and 75% of online respondents reported that it improved their symptoms. Most of the respondents (from the clinic and online groups) reported that cannabis improved their mood, pain, muscle spasms, and sleep. However, they did not note any improvements for weakness, fatigue, numbness, ambulation, and urination. Overall, the effectiveness of cannabis for CP/CPPS was “somewhat/very effective” (57% clinic; 63% online). There were no differences between side effects or choice of consumptionand most reported using cannabis rarely.Conclusions: These are the first estimates in men suffering from CP/CPPS and suggest that while cannabis use is prevalent, its medical use and benefit are unknown. This is an understudied area and the benefit or hazard for cannabis use awaits further study.
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7

Bekker, Alex. "Cannabis use and non-cancer chronic pain." Lancet Public Health 3, no. 10 (October 2018): e468. http://dx.doi.org/10.1016/s2468-2667(18)30178-6.

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McGregor, Iain. "Cannabis use and non-cancer chronic pain." Lancet Public Health 3, no. 10 (October 2018): e467. http://dx.doi.org/10.1016/s2468-2667(18)30180-4.

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9

Fajardo, Noel R., Filippo Cremonini, and Nicholas J. Talley. "Cyclic Vomiting Syndrome and Chronic Cannabis Use." American Journal of Gastroenterology 100 (September 2005): S342—S343. http://dx.doi.org/10.14309/00000434-200509001-00936.

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10

Sturgeon, John A., James Khan, Jennifer M. Hah, Heather Hilmoe, Juliette Hong, Mark A. Ware, and Sean C. Mackey. "Clinical Profiles of Concurrent Cannabis Use in Chronic Pain: A CHOIR Study." Pain Medicine 21, no. 11 (March 31, 2020): 3172–79. http://dx.doi.org/10.1093/pm/pnaa060.

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Abstract Objective Despite evidence of the analgesic benefits of cannabis, there remains a relative scarcity of research on the short- and long-term effects of cannabis use in individuals with chronic pain. Design The current study is a secondary analysis of clinical data from the Collaborative Health Outcomes Information Registry (CHOIR). Setting Data were drawn from a cohort of patients of a multidisciplinary tertiary care pain clinic. Subjects The study sample consisted of data from 7,026 new patient visits from CHOIR; of these, 1,668 patients with a follow-up time point within 180 days were included in a longitudinal analysis. Methods Clinical data were analyzed to characterize cross-sectional differences in pain and indicators of psychological and physical function according to self-reported, concurrent cannabis use. Additionally, a propensity score–weighted longitudinal analysis was conducted, examining cannabis use as a predictor of changes in clinical variables across time. Results Cross-sectional analyses suggested significantly poorer sleep and significantly higher intensities of pain, emotional distress, and physical and social dysfunction in patients reporting ongoing cannabis use; however, these differences were relatively small in magnitude. However, no differences between cannabis users and nonusers in terms of longitudinal changes in clinical variables were noted. Discussion Our results are among the first to examine concurrent cannabis use as a prognostic variable regarding trajectories of pain-related variables in tertiary care. Future studies may benefit from examining the effect of cannabis initiation, concurrent medication use, and specific aspects of cannabis use (dose, duration of use, or cannabis type) on clinical outcomes.
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Watson, C. Wei-Ming, Laura M. Campbell, Ni Sun-Suslow, Suzi Hong, Anya Umlauf, Ronald J. Ellis, Jennifer E. Iudicello, et al. "Daily Cannabis Use is Associated With Lower CNS Inflammation in People With HIV." Journal of the International Neuropsychological Society 27, no. 6 (July 2021): 661–72. http://dx.doi.org/10.1017/s1355617720001447.

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AbstractObjective:Recent cannabis exposure has been associated with lower rates of neurocognitive impairment in people with HIV (PWH). Cannabis’s anti-inflammatory properties may underlie this relationship by reducing chronic neuroinflammation in PWH. This study examined relations between cannabis use and inflammatory biomarkers in cerebrospinal fluid (CSF) and plasma, and cognitive correlates of these biomarkers within a community-based sample of PWH.Methods:263 individuals were categorized into four groups: HIV− non-cannabis users (n = 65), HIV+ non-cannabis users (n = 105), HIV+ moderate cannabis users (n = 62), and HIV+ daily cannabis users (n = 31). Differences in pro-inflammatory biomarkers (IL-6, MCP-1/CCL2, IP-10/CXCL10, sCD14, sTNFR-II, TNF-α) by study group were determined by Kruskal–Wallis tests. Multivariable linear regressions examined relationships between biomarkers and seven cognitive domains, adjusting for age, sex/gender, race, education, and current CD4 count.Results:HIV+ daily cannabis users showed lower MCP-1 and IP-10 levels in CSF compared to HIV+ non-cannabis users (p = .015; p = .039) and were similar to HIV− non-cannabis users. Plasma biomarkers showed no differences by cannabis use. Among PWH, lower CSF MCP-1 and lower CSF IP-10 were associated with better learning performance (all ps < .05).Conclusions:Current daily cannabis use was associated with lower levels of pro-inflammatory chemokines implicated in HIV pathogenesis and these chemokines were linked to the cognitive domain of learning which is commonly impaired in PWH. Cannabinoid-related reductions of MCP-1 and IP-10, if confirmed, suggest a role for medicinal cannabis in the mitigation of persistent inflammation and cognitive impacts of HIV.
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Manuballa, Vinayata, Maria Co, and Mitchell Cappell. "Cannabis Hyperemesis Syndrome: A Clinical Diagnosis in Patients with Chronic Cannabis Use." American Journal of Gastroenterology 106 (October 2011): S369. http://dx.doi.org/10.14309/00000434-201110002-00988.

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13

Campbell, Darren W., Sandra Stewart, Camille E. P. Gray, Courtney L. Ryan, Peter Fettes, Adam J. McLandress, and Ralph Dell'Aquila. "Chronic cannabis use and attentional bias: Extended attentional capture to cannabis cues." Addictive Behaviors 81 (June 2018): 17–21. http://dx.doi.org/10.1016/j.addbeh.2018.01.008.

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14

Griffin, Hailee, and Danielle Fixen. "Cannabis for Chronic Osteoarthritis Pain: A Case of an Older Person." Senior Care Pharmacist 36, no. 7 (July 1, 2021): 337–42. http://dx.doi.org/10.4140/tcp.n.2021.337.

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Objective: To review the safety and efficacy of cannabis use for chronic pain in older people. Setting: The case took place in a geriatric primary-care clinic in Colorado. Practice Description: The clinic serves adults 75 years of age and older where clinical pharmacists are used for medication consults and follow-up. Practice Innovation: Older people are using cannabis to treat a variety of conditions, with use increasing as more states legalize cannabis medically and recreationally. The primary reason for use is pain. Pharmacists in Colorado can assist with education regarding cannabis use and evaluate if cannabis may be safe for older people. Main Outcome Measurement: This case evaluates the use of a combination CBD:THC cannabis product in a 78-year-old female patient who was previously using opioids for degenerative disc disease and osteoarthritis. Results: The patient found improvement in her pain when using the combination cannabis product without any adverse effects. Conclusion: Further safety and efficacy evidence is needed for using combination cannabis products for pain management in older people.
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Manning, Lydia K., and Lauren M. Bouchard. "MEDICAL CANNABIS USE: EXPLORING THE PERCEPTIONS AND EXPERIENCES OF OLDER ADULTS WITH CHRONIC CONDITIONS." Innovation in Aging 3, Supplement_1 (November 2019): S258. http://dx.doi.org/10.1093/geroni/igz038.963.

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Abstract The past decade has witnessed an increased interest in the therapeutic properties of cannabis, and a growing body of research illustrates the varied uses of cannabis-based medicines for diverse symptoms, syndromes, disorder and both acute and chronic conditions, many of which are associated with advanced age (Lucas et. al, 2016). While the use of medical cannabis is on the rise in the older adult population (Kaskie et. al, 2017), more research is needed to advance the discourse on medical cannabis. With this study, we investigate older adult’s perceptions and experiences of medical cannabis use to treat and/or manage chronic conditions, specifically as a substitute for prescription drugs. Our findings suggest that older adults are open to medical cannabis as an alternative to pharmaceutical. Additionally, narratives revealed that users are hopeful that medical cannabis will provide relief with regard to the management of symptoms and relief of pain. Participants discussed their awareness and ability to manage issues related to stigma both from their primary care providers as well as family and friends. Furthermore, older adults described the frustrations with a lack of education, awareness, and support with dosing. Findings are presented as an interpretation of the participants’ perceptions of their medical cannabis use. Implications for putting medical cannabis use into everyday practice as well as policy implications are considered.
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Ware, Mark A., Ann Gamsa, Jan Persson, and Mary-Ann Fitzcharles. "Cannabis for Chronic Pain: Case Series and Implications for Clinicians." Pain Research and Management 7, no. 2 (2002): 95–99. http://dx.doi.org/10.1155/2002/380509.

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BACKGROUND:Chronic pain is one of the most common reasons for therapeutic cannabis use.OBJECTIVES:To describe therapeutic cannabis use among patients with chronic pain.METHODS:Patients with chronic pain who voluntarily indicated that they used cannabis therapeutically completed a questionnaire about the type of cannabis used, the mode of administration, the amount used and the frequency of use, and their perception of the effectiveness of cannabis on a set of pain-associated symptoms and side effects. The study was approved by the McGill University Health Centre Research Ethics Board.RESULTS:Fifteen patients (10 male) were interviewed (median age 49.5 years, range 24 to 68 years). All patients smoked herbal cannabis for therapeutic reasons (median duration of use six years, range two weeks to 37 years). Seven patients only smoked at night-time (median dose eight puffs, range two to eight puffs), and eight patients used cannabis mainly during the day (median dose three puffs, range two to eight puffs); the median frequency of use was four times per day (range one to 16 times per day). Twelve patients reported improvement in pain and mood, while 11 reported improvement in sleep. Eight patients reported a 'high'; six denied a 'high'. Tolerance to cannabis was not reported.CONCLUSIONS:The results of this self-selected case series must be interpreted with caution. Small doses of smoked cannabis may improve pain, mood and sleep in some patients with chronic pain. Clinical trials are warranted to test these effects. Further prospective studies should examine the patterns and prevalence of cannabis use among chronic pain populations.
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Griffin, Hailee, and Danielle Fixen. "Cannabis for Chronic Osteoarthritis Pain: A Case of an Older Person." Senior Care Pharmacist 36, no. 7 (July 1, 2021): 337–42. http://dx.doi.org/10.4140/tcp.n.2021.337.

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OBJECTIVE: To review the safety and efficacy of cannabis use for chronic pain in older people.<br/> SETTING: The case took place in a geriatric primarycare clinic in Colorado.<br/> PRACTICE DESCRIPTION: The clinic serves adults 75 years of age and older where clinical pharmacists are used for medication consults and follow-up.<br/> PRACTICE INNOVATION: Older people are using cannabis to treat a variety of conditions, with use increasing as more states legalize cannabis medically and recreationally. The primary reason for use is pain. Pharmacists in Colorado can assist with education regarding cannabis use and evaluate if cannabis may be safe for older people.<br/> MAIN OUTCOME MEASUREMENT: This case evaluates the use of a combination CBD:THC cannabis product in a 78-year-old female patient who was previously using opioids for degenerative disc disease and osteoarthritis.<br/> RESULTS: The patient found improvement in her pain when using the combination cannabis product without any adverse effects.<br/> CONCLUSION: Further safety and efficacy evidence is needed for using combination cannabis products for pain management in older people.
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18

Kar, Sujita Kumar, Suyash Dwivedi, Abhijeet Shrivastava, and Adarsh Tripathi. "Chronic mania—A sequel of cannabis use disorder!" Australian & New Zealand Journal of Psychiatry 51, no. 8 (December 5, 2016): 847–48. http://dx.doi.org/10.1177/0004867416682834.

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Tashkin, D. P. "Does cannabis use predispose to chronic airflow obstruction?" European Respiratory Journal 35, no. 1 (December 31, 2009): 3–5. http://dx.doi.org/10.1183/09031936.00109309.

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Hall, Wayne, and Louisa Degenhardt. "The adverse health effects of chronic cannabis use." Drug Testing and Analysis 6, no. 1-2 (July 8, 2013): 39–45. http://dx.doi.org/10.1002/dta.1506.

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Orhurhu, Vwaire, Ivan Urits, Mayowa Olusunmade, Akinola Olayinka, Mariam Salisu Orhurhu, Chiedozie Uwandu, Musa Aner, et al. "Cannabis Use in Hospitalized Patients with Chronic Pain." Advances in Therapy 37, no. 8 (July 6, 2020): 3571–83. http://dx.doi.org/10.1007/s12325-020-01416-9.

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22

Lundqvist, Thomas. "Chronic cannabis use and the sense of coherence." Life Sciences 56, no. 23-24 (May 1995): 2145–50. http://dx.doi.org/10.1016/0024-3205(95)00201-g.

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Maggirwar, Sanjay B., and Jag H. Khalsa. "The Link between Cannabis Use, Immune System, and Viral Infections." Viruses 13, no. 6 (June 9, 2021): 1099. http://dx.doi.org/10.3390/v13061099.

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Cannabis continues to be the most used drug in the world today. Research shows that cannabis use is associated with a wide range of adverse health consequences that may involve almost every physiological and biochemical system including respiratory/pulmonary complications such as chronic cough and emphysema, impairment of immune function, and increased risk of acquiring or transmitting viral infections such as HIV, HCV, and others. The review of published research shows that cannabis use may impair immune function in many instances and thereby exerts an impact on viral infections including human immune deficiency virus (HIV), hepatitis C infection (HCV), and human T-cell lymphotropic type I and II virus (HTLV-I/II). The need for more research is also highlighted in the areas of long-term effects of cannabis use on pulmonary/respiratory diseases, immune dysfunction and the risk of infection transmission, and the molecular/genetic basis of immune dysfunction in chronic cannabis users.
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Cavalli, Jessica, and Anita Cservenka. "Chronic Marijuana Use, Inhibitory Control, and Processing Speed in Young Adult College Students." Cannabis 3, no. 1 (January 31, 2020): 19–30. http://dx.doi.org/10.26828/cannabis.2020.01.003.

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Zeng, Linan, Lyubov Lytvyn, Xiaoqin Wang, Natasha Kithulegoda, Silvana Agterberg, Yaad Shergill, Meisam Abdar Esfahani, et al. "Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review." BMJ Open 11, no. 9 (September 2021): e050831. http://dx.doi.org/10.1136/bmjopen-2021-050831.

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ObjectiveTo explore values and preferences towards medical cannabis among people living with chronic pain.DesignMixed-methods systematic review.Data sourcesWe searched MEDLINE, EMBASE and PsycINFO from inception to 17 March 2020.Study selectionPairs of reviewers independently screened search results and included quantitative, qualitative and mixed-methods studies reporting values and preferences towards medical cannabis among people living with chronic pain.Review methodsWe analysed data using meta-narrative synthesis (quantitative findings were qualitised) and tabulated review findings according to identified themes. We used the Grading of Recommendations Assessment, Development and Evaluation approach to assess certainty of evidence.ResultsOf 1838 initial records, 15 studies proved eligible for review. High to moderate certainty evidence showed that patient’s use of medical cannabis for chronic pain was influenced by both positive (eg, support from friends and family) and negative social factors (eg, stigma surrounding cannabis use). Most patients using medical cannabis favoured products with balanced ratios of tetrahydrocannabinol (THC) and cannabidiol (CBD), or high levels of CBD, but not high THC preparations. Many valued the effectiveness of medical cannabis for symptom management even when experiencing adverse events related to concentration, memory or fatigue. Reducing use of prescription medication was a motivating factor for use of medical cannabis, and concerns regarding addiction, losing control or acting strangely were disincentives. Out-of-pocket costs were a barrier, whereas legalisation of medical cannabis improved access and incentivised use.Low to very low certainty evidence suggested highly variable values towards medical cannabis among people living with chronic pain. Individuals with pain related to life-limiting disease were more willing to use medical cannabis, and preferred oral over inhaled administration.ConclusionsOur findings highlight factors that clinicians should consider when discussing medical cannabis. The variability of patients’ values and preferences emphasise the need for shared decision making when considering medical cannabis for chronic pain.
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Wijayendran, Surapi Bhairavi, Aisling O’Neill, and Sagnik Bhattacharyya. "The effects of cannabis use on salience attribution: a systematic review." Acta Neuropsychiatrica 30, no. 1 (November 21, 2016): 43–57. http://dx.doi.org/10.1017/neu.2016.58.

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ObjectiveThe relationship between cannabis use and the onset of psychosis is well established. Aberrant salience processing is widely thought to underpin many of these symptoms. Literature explicitly investigating the relationship between aberrant salience processing and cannabis use is scarce; with those few studies finding that acute tetrahydrocannabinol (THC) administration (the main psychoactive component of cannabis) can result in abnormal salience processing in healthy cohorts, mirroring that observed in psychosis. Nevertheless, the extent of and mechanisms through which cannabis has a modulatory effect on aberrant salience, following both acute and chronic use, remain unclear.MethodsHere, we systematically review recent findings on the effects of cannabis use – either through acute THC administration or in chronic users – on brain regions associated with salience processing (through functional MRI data); and performance in cognitive tasks that could be used as either direct or indirect measures of salience processing. We identified 13 studies either directly or indirectly exploring salience processing. Three types of salience were identified and discussed – incentive/motivational, emotional/affective, and attentional salience.ResultsThe results demonstrated an impairment of immediate salience processing, following acute THC administration. Amongst the long-term cannabis users, normal salience performance appeared to be underpinned by abnormal neural processes.ConclusionsOverall, the lack of research specifically exploring the effects of cannabis use on salience processing, weaken any conclusions drawn. Additional research explicitly focussed on salience processing and cannabis use is required to advance our understanding of the neurocognitive mechanisms underlying the association between cannabis use and development of psychosis.
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Johal, Herman, Christopher Vannabouathong, Yaping Chang, Meng Zhu, and Mohit Bhandari. "Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?" Therapeutic Advances in Musculoskeletal Disease 12 (January 2020): 1759720X2093796. http://dx.doi.org/10.1177/1759720x20937968.

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The treatment of chronic, non-cancer musculoskeletal pain has become a topic growing interest as it is believed to be one of the reasons for the current opioid epidemic. The medicinal use of cannabis has a long history as a number of active compounds in cannabis have been shown to interact with the body’s endocannabinoid system to reduce pain. This position paper provides a history on the evolution of cannabis, the science behind its therapeutic effects, and review of the evidence and current guideline recommendations on its use as a treatment for patients with chronic, non-cancer musculoskeletal pain. Results from systematic reviews have demonstrated a statistically significant reduction in chronic pain conditions with cannabinoids, compared with placebo, although the effects might be considered small and did not reach the minimally important difference. More adverse events were reported in the cannabinoid group than in the placebo group with longer than 2 weeks of treatment. There is a lack of evidence on dependence. With changes to policies, patients’ perception has changed to be more positive toward the use of medical cannabis. Current recommendations from North America, Latin America, Europe, Australia and Iran support the use of medical cannabis for chronic, non-cancer pain. Based on the current evidence, it is our position that cannabinoids may be considered as an adjunctive therapy after recommended first- and second-line therapies have failed to provide sufficient efficacy or tolerability. Patients should consider the balance between the desirable and undesirable effects of taking cannabis for chronic pain, and comprehensively consider their own values and preferences, as well as cost-effectiveness factors, based on the information provided by their physician.
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Hirst, Rayna, Dylan Vaughn, Sana Arastu, Aubrey Deneen, and Haig Pilavjian. "Female Sex as a Protective Factor in the Effects of Chronic Cannabis Use on Verbal Learning and Memory." Journal of the International Neuropsychological Society 27, no. 6 (July 2021): 581–91. http://dx.doi.org/10.1017/s1355617721000217.

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AbstractObjective:The variability of findings in studies examining the effects of chronic cannabis use on neuropsychological functioning highlights the importance of examining contributing factors. Few studies examine the role of sex in the relationship between cannabis and neuropsychological functioning, despite known neurobiological structural differences between males and females. This study examined whether males and females experience differential cognitive effects of chronic cannabis use.Method:Chronic cannabis users (3+ days per week for >12 months, n = 110, 72% male) and non-users (n = 71, 39% male) completed a neuropsychological test battery. Two multivariate analyses of covariance (MANCOVAs) examined for sex differences in performance within users and non-users on neuropsychological tests, controlling for potential confounding variables. Bonferroni corrections were applied to adjust for multiple comparisons.Results:Male and female cannabis users did not differ in cannabis use variables. Female cannabis users performed better than males on multiple subtests of the California Verbal Learning Test-II (CVLT-II), a verbal learning and memory test. Male cannabis users performed better than female users on Trial 1 of the CVLT-II (p = .002), and Trail Making Test B (p = .001), which measure attention and cognitive flexibility, respectively. Non-user males and females performed comparably, with the exception of Trail Making Test B (p = .001).Conclusions:Results suggest that chronic cannabis use differentially impacts males and females, with females exhibiting better verbal learning and memory despite males demonstrating better attention and cognitive flexibility. Further research is needed to understand the potential protective mechanism of female sex on learning and memory effects of cannabis use.
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Roser, Patrik, Eva-Maria Pichler, Benedikt Habermeyer, Wolfram Kawohl, and Georg Juckel. "Impact of Chronic Cannabis Use on Auditory Mismatch Negativity Generation in Schizophrenia Patients." Pharmacopsychiatry 52, no. 03 (March 5, 2018): 126–33. http://dx.doi.org/10.1055/a-0573-9866.

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Abstract Introduction Cannabis use disorders (CUD) are highly prevalent among patients with schizophrenia (SCZ). Deficient mismatch negativity (MMN) generation is a characteristic finding in SCZ patients and cannabis users. This study therefore examined the effects of CUD on MMN generation in SCZ patients. Methods Twenty SCZ − CUD patients, 21 SCZ+CUD patients, and 20 healthy controls (HC) were included in this study. MMN to frequency and duration deviants was elicited within an auditory oddball paradigm and recorded by 32 channel EEG. Results As expected, SCZ − CUD patients showed reduced frontocentral MMN amplitudes to duration deviants compared to HC. Interestingly, SCZ+CUD patients demonstrated greater MMN amplitudes to duration deviants compared to SCZ − CUD patients at central electrodes with no differences compared to HC. Discussion These results demonstrate that comorbid cannabis use in SCZ patients might be associated with superior cognitive functioning. It can be assumed that the association between cannabis use and better cognitive performance may be due to a subgroup of cognitively less impaired SCZ patients characterized by lower genetic vulnerability for psychosis.
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ÖZTÜRK, Mustafa, Rana AKKOYUN, Sunay YILDIRIM, and Selman YENİOCAK. "Wellens’ Syndrome in a Patient with Chronic Cannabis Use." Phoenix Medical Journal 2, no. 1 (March 1, 2020): 50–53. http://dx.doi.org/10.38175/phnx.689283.

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Crean, Rebecca D., Susan F. Tapert, Arpi Minassian, Kai MacDonald, Natania A. Crane, and Barbara J. Mason. "Effects of Chronic, Heavy Cannabis Use on Executive Functions." Journal of Addiction Medicine 5, no. 1 (March 2011): 9–15. http://dx.doi.org/10.1097/adm.0b013e31820cdd57.

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Campbell, Gabrielle, Wayne Hall, Louisa Degenhardt, Timothy Dobbins, and Michael Farrell. "Cannabis use and non-cancer chronic pain – Authors' reply." Lancet Public Health 3, no. 10 (October 2018): e469. http://dx.doi.org/10.1016/s2468-2667(18)30182-8.

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Bostwick, J. Michael. "The use of cannabis for management of chronic pain." General Hospital Psychiatry 36, no. 1 (January 2014): 2–3. http://dx.doi.org/10.1016/j.genhosppsych.2013.08.004.

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Schwilke, Eugene W., Rod G. Gullberg, William D. Darwin, C. Nora Chiang, Jean Lud Cadet, David A. Gorelick, Harrison G. Pope, and Marilyn A. Huestis. "Differentiating new cannabis use from residual urinary cannabinoid excretion in chronic, daily cannabis users." Addiction 106, no. 3 (December 6, 2010): 499–506. http://dx.doi.org/10.1111/j.1360-0443.2010.03228.x.

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Parikh, Meet, Shelini Sookal, and Asyia Ahmad. "Cannabis Use in Patients Presenting to a Gastroenterology Clinic: Associations with Symptoms, Endoscopy Findings, and Esophageal Manometry." Gastrointestinal Disorders 1, no. 3 (July 1, 2019): 301–7. http://dx.doi.org/10.3390/gidisord1030025.

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Recreational cannabis use is increasing with its legalization in many states. Animal studies suggest cannabis can reduce transient lower esophageal sphincter relaxations (TLESRS), reflux and vomiting, while human studies report conflicting findings. There are currently no large studies investigating gastrointestinal symptoms in patients with chronic cannabis use. This was a retrospective case-control study including patients who presented to an outpatient Gastroenterology office, with documented cannabis use. Their main presenting complaint, demographics, frequency and duration of cannabis use, endoscopic and high-resolution esophageal manometry (HREM) with impedance findings were recorded. Cannabis users were more likely to complain of abdominal pain (25% vs. 8%, p < 0.0001), heartburn (15% vs. 9%, p < 0.0001), and nausea & vomiting (7% vs. 1%, p < 0.0001). They were also more likely to have findings of esophagitis (8% vs. 3%, p = 0.0002), non-erosive gastritis (30% vs. 15%, p = 0.0001) and erosive gastritis (14% vs. 3%, p < 0.0001) on upper endoscopy. Cannabis users were more likely to have impaired esophageal bolus clearance (43% vs. 17%, p = 0.04) and a hypertensive lower esophageal sphincter (LES) (29% vs. 7%, p = 0.04). This study is the largest to date evaluating GI complaints of patients with chronic recreational cannabis use. Our results suggest that cannabis use may potentiate or fail to alleviate a variety of GI symptoms which goes against current knowledge.
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Cunningham, Chinazo O., Joanna L. Starrels, Chenshu Zhang, Marcus A. Bachhuber, Nancy L. Sohler, Frances R. Levin, Haruka Minami, Deepika E. Slawek, and Julia H. Arnsten. "Medical Marijuana and Opioids (MEMO) Study: protocol of a longitudinal cohort study to examine if medical cannabis reduces opioid use among adults with chronic pain." BMJ Open 10, no. 12 (December 2020): e043400. http://dx.doi.org/10.1136/bmjopen-2020-043400.

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IntroductionIn the USA, opioid analgesic use and overdoses have increased dramatically. One rapidly expanding strategy to manage chronic pain in the context of this epidemic is medical cannabis. Cannabis has analgesic effects, but it also has potential adverse effects. Further, its impact on opioid analgesic use is not well studied. Managing pain in people living with HIV is particularly challenging, given the high prevalence of opioid analgesic and cannabis use. This study’s overarching goal is to understand how medical cannabis use affects opioid analgesic use, with attention to Δ9-tetrahydrocannabinol and cannabidiol content, HIV outcomes and adverse events.Methods and analysesWe are conducting a cohort study of 250 adults with and without HIV infection with (a) severe or chronic pain, (b) current opioid use and (c) who are newly certified for medical cannabis in New York. Over 18 months, we collect data via in-person visits every 3 months and web-based questionnaires every 2 weeks. Data sources include: questionnaires; medical, pharmacy and Prescription Monitoring Program records; urine and blood samples; and physical function tests. Using marginal structural models and comparisons within participants’ 2-week time periods (unit of analysis), we will examine how medical cannabis use (primary exposure) affects (1) opioid analgesic use (primary outcome), (2) HIV outcomes (HIV viral load, CD4 count, antiretroviral adherence, HIV risk behaviours) and (3) adverse events (cannabis use disorder, illicit drug use, diversion, overdose/deaths, accidents/injuries, acute care utilisation).Ethics and disseminationThis study is approved by the Montefiore Medical Center/Albert Einstein College of Medicine institutional review board. Findings will be disseminated through conferences, peer-reviewed publications and meetings with medical cannabis stakeholders.Trial registration numberClinicalTrials.gov Registry (NCT03268551); Pre-results.
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BILALIS, Dimitrios, Stella KARIDOGIANNI, Ioannis ROUSSIS, Varvara KOUNELI, Ioanna KAKABOUKI, and Antigolena FOLINA. "Cannabis sativa L.: A New Promising Crop for Medical and Industrial Use." Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Horticulture 76, no. 2 (November 19, 2019): 145. http://dx.doi.org/10.15835/buasvmcn-hort:2019.0020.

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The cannabis plant was discovered 10,000 years ago without its exact use being known in China and Central Asia. Equally highly interested in this plant are the pharmaceutical and construction sectors. The cultivation of Cannabis sativa L. varieties containing more than 0.2% tetrahydrocannabinol (THC) has been legalized by the law 4523/2018 in Greece for the sole purpose of producing end-products of medicinal cannabis. The use of medicinal cannabis is important for dealing with chronic diseases. As far as cannabis cultivated for industrial use is concerned, there is a significant increase in the secondary services sector. The resulting fibers are used for the manufacture of ropes etc. Especially CBD is of great interest. Through surveys carried out by the Agronomy Laboratory of Agricultural University of Athens regarding the development of cannabis by applying geotextiles, radiation management, cannabidiol (CBD) content and tetrahydrocannabinol (THC), statistical data have been compiled for cannabis cultivation both pharmaceutical and textile. On the basis of the results, cannabis can be grown in Greece due to the weather conditions and, above all, sunshine, which is the main factor for the development of the plant.
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Andrews, Natasha J., and Adele J. Phillips. "Community nurses' support for patients with fibromyalgia who use cannabis to manage pain." British Journal of Community Nursing 26, no. 2 (February 2, 2021): 92–98. http://dx.doi.org/10.12968/bjcn.2021.26.2.92.

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Supporting patients to manage chronic pain conditions, such as fibromyalgia (FM), remains a challenge for community nurses. Research suggests that despite the absence of a licensed cannabis-based product for medicinal use (CBPM) available for people with FM in the UK, there is an appetite for FM patients to use cannabis for pain management. Nurses have expressed anxieties when balancing tensions between helping patients and working within medical guidelines, as well as a need for further education about patient cannabis use. This article provides community nurses with insight into how cannabis use affects the pain experience for people living with FM. Despite potential harms, cannabis is perceived by users to have a positive impact on the lived experience of pain, and it may be preferred to prescribed opioid medication. This understanding can help to inform empathic practice and recommendations are made for reducing the risks of cannabis use to patient health.
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D'Souza, Deepak Cyril, Suhas Ganesh, Jose Cortes-Briones, Michael H. Campbell, and Maisha K. Emmanuel. "Characterizing psychosis-relevant phenomena and cognitive function in a unique population with isolated, chronic and very heavy cannabis exposure." Psychological Medicine 50, no. 14 (October 16, 2019): 2452–59. http://dx.doi.org/10.1017/s0033291719002721.

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AbstractBackgroundThe literature on psychosis-relevant outcomes in cannabis users does not adequately address the confounding effects of other substance use/misuse and psychiatric disorders.MethodsWe studied a unique population for whom cannabis use is central and necessary to their way of life. They are forbidden from using other substances, including tobacco and alcohol. Their use of cannabis is heavy, chronic, and begins early. The cases were compared with matched controls who did not use cannabis, alcohol, or drugs. The controls were from the same location and shared similar beliefs and lifestyle, except for cannabis use. Attenuated psychosis-relevant phenomena were assessed with the Schizotypal Personality Questionnaire (SPQ) and cognitive functioning with a culture-neutral computerized cognitive battery.ResultsFifteen cases and 12 matched controls were studied. The cases averaged >30 000 lifetime cannabis exposures. Relative to controls, the cases had significantly higher mean (s.d.) SPQ scores 24 (14.32) v. 13 (8.92), p = 0.031; and poorer cognitive performance, reflected by a lower mean (s.d.) composite cognitive score −0.23 (0.32) v. +0.28 (0.52), p = 0.03. Moderate to large effect sizes were noted for differences in tests of attention, psychomotor speed, working memory, cognitive flexibility, visuo-spatial processing, and verbal memory. A subsample of cases had higher SPQ scores and worse cognitive performance than their siblings not using cannabis.ConclusionHeavy, chronic, and early cannabis use that is not confounded by other drug use is associated with psychosis-relevant phenomena and cognitive deficits. The findings are relevant to the evolving attitudes and laws about cannabis.
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Breijyeh, Zeinab, Buthaina Jubeh, Sabino A. Bufo, Rafik Karaman, and Laura Scrano. "Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses." Toxins 13, no. 2 (February 5, 2021): 117. http://dx.doi.org/10.3390/toxins13020117.

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For thousands of years, Cannabis sativa has been utilized as a medicine and for recreational and spiritual purposes. Phytocannabinoids are a family of compounds that are found in the cannabis plant, which is known for its psychotogenic and euphoric effects; the main psychotropic constituent of cannabis is Δ9-tetrahydrocannabinol (Δ9-THC). The pharmacological effects of cannabinoids are a result of interactions between those compounds and cannabinoid receptors, CB1 and CB2, located in many parts of the human body. Cannabis is used as a therapeutic agent for treating pain and emesis. Some cannabinoids are clinically applied for treating chronic pain, particularly cancer and multiple sclerosis-associated pain, for appetite stimulation and anti-emesis in HIV/AIDS and cancer patients, and for spasticity treatment in multiple sclerosis and epilepsy patients. Medical cannabis varies from recreational cannabis in the chemical content of THC and cannabidiol (CBD), modes of administration, and safety. Despite the therapeutic effects of cannabis, exposure to high concentrations of THC, the main compound that is responsible for most of the intoxicating effects experienced by users, could lead to psychological events and adverse effects that affect almost all body systems, such as neurological (dizziness, drowsiness, seizures, coma, and others), ophthalmological (mydriasis and conjunctival hyperemia), cardiovascular (tachycardia and arterial hypertension), and gastrointestinal (nausea, vomiting, and thirst), mainly associated with recreational use. Cannabis toxicity in children is more concerning and can cause serious adverse effects such as acute neurological symptoms (stupor), lethargy, seizures, and even coma. More countries are legalizing the commercial production and sale of cannabis for medicinal use, and some for recreational use as well. Liberalization of cannabis laws has led to increased incidence of toxicity, hyperemesis syndrome, lung disease cardiovascular disease, reduced fertility, tolerance, and dependence with chronic prolonged use. This review focuses on the potential therapeutic effects of cannabis and cannabinoids, as well as the acute and chronic toxic effects of cannabis use on various body systems.
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Troup, Lucy J., Jeremy A. Andrzejewski, Jacob T. Braunwalder, and Robert D. Torrence. "The relationship between cannabis use and measures of anxiety and depression in a sample of college campus cannabis users and non-users post state legalization in Colorado." PeerJ 4 (December 8, 2016): e2782. http://dx.doi.org/10.7717/peerj.2782.

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As part of an ongoing research program into the relationship between cannabis use and emotion processing, participants were assessed on their level of cannabis exposure using the Recreational Cannabis Use Examination, a measure developed specifically to assess cannabis use in Colorado post state legalization. Three groups were created based on self-reported use: a control group who have never used, a casual user group and a chronic user group. Each participant also completed two measures of mood assessment, the Center for Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory. Relationships between cannabis use groups and scores on these measures were then analyzed using both correlations and multivariate analysis of variance. Results indicate a relationship between casual cannabis use and scoring highly for depressive symptomatology on the Center for Epidemiologic Studies Depression Scale. There were no significant relationships between cannabis use and scores on the State-Trait Anxiety Inventory.
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42

Wright, Patrick, Zach Walsh, Shari Margolese, Tatiana Sanchez, Stephanie Arlt, Lynne Belle-Isle, Michelle St.Pierre, et al. "Canadian clinical practice guidelines for the use of plant-based cannabis and cannabinoid-based products in the management of chronic non-cancer pain and co-occurring conditions: protocol for a systematic literature review." BMJ Open 10, no. 5 (May 2020): e036114. http://dx.doi.org/10.1136/bmjopen-2019-036114.

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IntroductionChronic pain and co-occurring disorders, such as sleep disorders, anxiety, depression, post-traumatic stress disorder and substance use disorders, are among the most common conditions for which cannabis and cannabinoid-based products derived from the cannabis plant (CBP) are used for therapeutic purposes. However, healthcare providers report that they lack sufficient information on the risks, benefits and appropriate use of cannabis and CBP derived from the cannabis plant for therapeutic purposes.Methods and analysisWe will conduct a systematic review of studies investigating the use of cannabis and CBP derived from the cannabis plant for the treatment of chronic pain and co-occurring conditions. Randomised controlled trials, meta-analyses and observational studies will be prioritised. We will exclude reviews of cannabinoid mechanisms of actions, commentary articles and narrative reviews. The primary outcome of interest will be efficacy in relieving chronic pain. Secondary outcomes will be efficacy in ameliorating conditions such as sleep disorders, anxiety, depression, post-traumatic stress disorder and substance use disorders. We will search electronic bibliographic databases including Academic Search Complete, Cochrane Database of Systematic Reviews, Evidence based Medicine Reviewes, OVID Medline, PsychINFO, PubMed, CINAHL and Web of Science. Two reviewers will conduct screening and data collection independently. Study level of bias will be assessed using the Cochrane Risk of Bias Assessment Tool for randomised controlled trials and non-randomised studies. Narrative analysis will be utilised to interpret the data.Ethics and disseminationThe results of this systematic review will inform guideline development for the use of cannabis and CBP derived from the cannabis plant in the management of chronic pain and co-occurring conditions. Areas requiring further study will also be highlighted.PROSPERO registration numberCRD42020135886.
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Argueta, Donovan A., Anupam Aich, Fjolla Muqolli, Hemanth Cherukury, Varun Sagi, Nicholas V. DiPatrizio, and Kalpna Gupta. "Considerations for Cannabis Use to Treat Pain in Sickle Cell Disease." Journal of Clinical Medicine 9, no. 12 (December 1, 2020): 3902. http://dx.doi.org/10.3390/jcm9123902.

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Pain in Sickle Cell Disease (SCD) is a major comorbidity and unique with acute pain due to recurrent and episodic vaso-occlusive crises as well as chronic pain, which can span an individual’s entire life. Opioids are the mainstay treatment for pain in SCD. Due to recent health crises raised by adverse effects including deaths from opioid use, pain management in SCD is adversely affected. Cannabis and its products are most widely used for pain in multiple conditions and also by patients with SCD on their own. With the availability of “Medical Cannabis” and approval to use cannabis as medicine across majority of States in the United States as well as over-the-counter preparations, cannabis products are being used increasingly for SCD. The reliability of many of these products remains questionable, which poses a major health risk to the vulnerable individuals seeking pain relief. Therefore, this review provides up to date insights into available categories of cannabis-based treatment strategies, their mechanism of action and pre-clinical and clinical outcomes in SCD. It provides evidence for the benefits and risks of cannabis use in SCD and cautions about the unreliable and unvalidated products that may be adulterated with life-threatening non-cannabis compounds.
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Chan, Tommy L. H., and Niushen Zhang. "Chronic Cannabis Use and Treatment Failure of Onabotulinum Toxin A for Chronic Migraine." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, no. 6 (August 30, 2019): 785–86. http://dx.doi.org/10.1017/cjn.2019.291.

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Utomo, Wesley K., Kaushal Parikh, Marjan de Vries, Harry Van Goor, Marco J. Bruno, Henri Braat, and Maikel P. Peppelenbosch. "Sa1801 Potential Mechanisms of Therapeutic Cannabis Use in Chronic Pancreatitis." Gastroenterology 146, no. 5 (May 2014): S—298. http://dx.doi.org/10.1016/s0016-5085(14)61070-2.

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46

Rogers, Andrew H., Jafar Bakhshaie, Julia D. Buckner, Michael F. Orr, Daniel J. Paulus, Joseph W. Ditre, and Michael J. Zvolensky. "Opioid and Cannabis Co-Use among Adults With Chronic Pain." Journal of Addiction Medicine 13, no. 4 (2019): 287–94. http://dx.doi.org/10.1097/adm.0000000000000493.

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Russo, Ethan, Mary Lynn Mathre, Al Byrne, Robert Velin, Paul J. Bach, Juan Sanchez-Ramos, and Kristin A. Kirlin. "Chronic Cannabis Use in the Compassionate Investigational New Drug Program." Journal of Cannabis Therapeutics 2, no. 1 (February 13, 2002): 3–57. http://dx.doi.org/10.1300/j175v02n01_02.

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48

Greenwood, Lisa-marie, Samantha J. Broyd, Rodney Croft, Juanita Todd, Patricia T. Michie, Stuart Johnstone, Robin Murray, and Nadia Solowij. "Chronic Effects of Cannabis Use on the Auditory Mismatch Negativity." Biological Psychiatry 75, no. 6 (March 2014): 449–58. http://dx.doi.org/10.1016/j.biopsych.2013.05.035.

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49

Martín-Santos, R., A. B. Fagundo, J. A. Crippa, Z. Atakan, S. Bhattacharyya, P. Allen, P. Fusar-Poli, et al. "Neuroimaging in cannabis use: a systematic review of the literature." Psychological Medicine 40, no. 3 (July 23, 2009): 383–98. http://dx.doi.org/10.1017/s0033291709990729.

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BackgroundWe conducted a systematic review to assess the evidence for specific effects of cannabis on brain structure and function. The review focuses on the cognitive changes associated with acute and chronic use of the drug.MethodWe reviewed literature reporting neuroimaging studies of chronic or acute cannabis use published up until January 2009. The search was conducted using Medline, EMBASE, LILACS and PsycLIT indexing services using the following key words: cannabis, marijuana, delta-9-tetrahydrocannabinol, THC, cannabidiol, CBD, neuroimaging, brain imaging, computerized tomography, CT, magnetic resonance, MRI, single photon emission tomography, SPECT, functional magnetic resonance, fMRI, positron emission tomography, PET, diffusion tensor MRI, DTI-MRI, MRS and spectroscopy.ResultsSixty-six studies were identified, of which 41 met the inclusion criteria. Thirty-three were functional (SPECT/PET/fMRI) and eight structural (volumetric/DTI) imaging studies. The high degree of heterogeneity across studies precluded a meta-analysis. The functional studies suggest that resting global and prefrontal blood flow are lower in cannabis users than in controls. The results from the activation studies using a cognitive task are inconsistent because of the heterogeneity of the methods used. Studies of acute administration of THC or marijuana report increased resting activity and activation of the frontal and anterior cingulate cortex during cognitive tasks. Only three of the structural imaging studies found differences between users and controls.ConclusionsFunctional neuroimaging studies suggest a modulation of global and prefrontal metabolism both during the resting state and after the administration of THC/marijuana cigarettes. Minimal evidence of major effects of cannabis on brain structure has been reported.
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Ribeiro, Luis, and Philip W. Ind. "Marijuana and the lung: hysteria or cause for concern?" Breathe 14, no. 3 (August 31, 2018): 196–205. http://dx.doi.org/10.1183/20734735.020418.

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Increasing cannabis use and legalisation highlights the paucity of data we have on the safety of cannabis smoking for respiratory health. Unfortunately, concurrent use of tobacco among marijuana smokers makes it difficult to untangle individual effect of marijuana smoking. Chronic cannabis only smoking has been shown in large cohort studies to reduce forced expiratory volume in 1 s/forced vital capacity via increasing forced vital capacity in chronic use contrary to the picture seen in tobacco smoking. The cause of this is unclear and there are various proposed mechanisms including respiratory muscle training secondary to method of inhalation and acute anti-inflammatory effect and bronchodilation of cannabis on the airways. While cannabis smoke has been shown to increase symptoms of chronic bronchitis, it has not been definitively shown to be associated with shortness of breath or irreversible airway changes. The evidence surrounding the development of lung cancer is less clear; however, preliminary evidence does not suggest association. Bullous lung disease associated with marijuana use has long been observed in clinical practice but published evidence is limited to a total of 57 published cases and only one cross-sectional study looking at radiological changes among chronic users which did not report any increase in macroscopic emphysema. More studies are required to elucidate these missing points to further guide risk stratification, clinical diagnosis and management.Key pointsCannabis smoking has increased and is likely to increase further with relaxation of legalisation and medicinal use of cannabinoids.Chronic marijuana smoking often produces symptoms similar to those of chronic tobacco smoking such as cough, sputum production, shortness of breath and wheeze.Cessation of marijuana smoking is associated with a reduction in respiratory symptoms and no increased risk of chronic bronchitis.Spirometry changes seen in chronic marijuana smokers appear to differ from those in chronic tobacco smokers. In chronic marijuana smokers there is an increase in FVC as opposed to a definite decrease in FEV1.Multiple case series have demonstrated peripheral bullae in marijuana smokers, but no observational studies have elucidated the risk.There is currently no clear association between cannabis smoking and lung cancer, although the research is currently limited.Educational aimsTo update readers on legalisation of recreational and medicinal cannabis.To summarise the evidence base surrounding the respiratory effects of inhaled marijuana use.To provide clinicians with an understanding of the main differences between cannabis and tobacco to be able to apply this to patient education.To highlight common respiratory problems among cannabis users and the need for recreational drug history taking.
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