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How has non-medical cannabis legalization served the health and welfare of under-age (adolescent) youth in Canada?
- prevalence of cannabis use (in the past 12-months) among ages 16–19 years increased from 36% in 2018 to 43% in 2023.
- implementation of cannabis legalization (2018–2019), compared with pre-legalization (2001–2017) was associated with a 31% increased likelihood of any cannabis use, a 40% increased likelihood of daily cannabis use and a 98% increased likelihood of cannabis dependence among Ontario secondary students
- under-age youth in Alberta (<18 years) and Ontario (<19 years), legalization was associated with a 20% increase-equivalent (2015–2019) for emergency department visits involving cannabis-related disorder/poisoning, and there were (moderate) increases in cannabis-related (e.g., for psychosis, poisoning, withdrawal, harmful use) hospitalizations among young individuals (ages 15–24) in Canada's four largest provinces
- remained as the respective relative majorities of enforced cannabis offenses in the post-legalization period. Despite a supposed general ‘ban’ on cannabis-related advertisement especially for youth protection, almost two-thirds (63%) of Canadian adolescents reported exposure to cannabis-related advertisements or promotions in 2023.3
- Half-a-decade into legalization and its consequential ‘normalization’ environment for cannabis, we observe a mixed picture of developments for main outcome indicators among underage/adolescent youth in Canada. While cannabis use rates have remained steady at best at comparably high levels, selected adverse cannabis-related health outcomes (e.g., hospitalizations), and some risk-behaviors have increased.
- With exposure to cannabis commercialization common, adolescents' cannabis sourcing practices have shifted from predominantly ‘illegal’ to ‘legal’ (albeit so only for adults) and ‘grey’ (e.g., ‘social’) sources. [remember it is illegal for children/youth under the age of 18, (some provinces 19 and 21) to buy or use cannabis] Cannabis-related enforcement has been markedly reduced; however, cannabis (possession) offenses remain disproportionately enforced against underage individuals… [because it is illegal for them to have and use] The—widely promoted—objective of effective cannabis access and use reduction for this particular age group has not been achieved through legalization.
(Source: The Lancet Regional Health – Americas)
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Incident psychotic experiences following self-reported use of high-potency cannabis
Findings: Use of high-potency cannabis at age 16 or 18 was associated with twice the likelihood of experiencing incident psychotic experiences from age 19–24
Conclusions: Use of high-potency cannabis appears to be associated with increased likelihood of psychotic experiences.
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Psychosis is an increasing risk of today's strong marijuana.
KEY POINTS
- Young adults and teens can develop an addiction to weed and become psychotic.
- Many people don’t know that regular marijuana use may carry serious health risks, especially for the young.
- No medication is FDA-approved for treating cannabis use disorder.
- One cannabis-induced psychotic episode ups the risk of developing bipolar disorder or schizophrenia by 50%.
- Cannabis use disorder (CUD) is also increasing; in 2022, 5.7 million people met diagnostic criteria for this disorder.
(Source: Psychology Today April 2024)
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Marijuana-induced Coronary Vasospasm with Persistent Inter-coronary Connection: A Case Report and Review of Literature
Coronary vasospasm is a well-known entity causing acute chest syndrome and can lead to myocardial infarction, ventricular arrhythmias, and even sudden cardiac death. While there are extensive case series showing the association of coronary vasospasm with cocaine, studies reporting marijuana-induced coronary vasospasm are limited in number. We herein present a case of coronary vasospasm in a middle-aged African-American male who presented to the emergency department after an episode of syncope. His urine drug screen was positive only for marijuana. He had a transient elevation of ST segments on his EKG with concomitant wall motion abnormalities on echocardiogram and was later found to have vasospasm of coronary arteries on coronary angiogram without any evidence of focal atherosclerotic disease. Another interesting finding was the persistent inter-coronary communication or coronary arcade connecting the left circumflex artery to the right coronary artery. There was bi-directional flow through the inter-coronary communication and hence, we believe this communication prevented our patient from experiencing acute chest symptoms or myocardial infarction. It is important for the clinicians to recognize the association of marijuana with coronary vasospasm. At the same time, these patients should be treated as acute coronary syndromes until proven otherwise by ischemia evaluation.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726350/
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Chronic Pain Associated With Increased Cannabis Use and Adverse Effects Among Young Adults
Nonmedical cannabis use is on this rise in adults suffering from pain, despite evidence demonstrating negative clinical outcomes. Researchers investigated the relationship between cannabis use, adverse consequences, and chronic pain in a US-based cohort of young adults aged 18–25 years.
- The sample of 403 young adults reported a mean cannabis use of 47 days in the prior 90 days; of this sample, 20 percent reported chronic pain.
- Participants with chronic pain used cannabis at significantly greater frequency (incident rate ratio [IRR], 1.35), intensity (IRR, 1.61), and reported more negative consequences (IRR, 1.23), compared with those without chronic pain.
Comments: This study contributes to a growing body of evidence that young people with chronic pain have increased cannabis use compared with their peers and experience more adverse effects. Youth are neuro-developmentally vulnerable to cannabis’s effects, with brain maturation occurring through the mid-twenties. Cultural messages that promote cannabis as a “medication” appear to be drowning out accurate information about the risks of use for this age group. Given the implications, young adults should be advised of non-cannabis alternatives to mitigate chronic pain.
(Source: Boston Medical Centre, Emily Nields, DO)