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“Cannabis use poses a global disease burden, albeit substantially less than that posed by other psychoactive substances such as alcohol, tobacco (nicotine), opioids, and stimulants. The Global Burden of Disease project calculated that cannabis use in 2016 was responsible for an estimated 646,000 years of healthy life lost to disability, an age-standardized rate of 8.5 years per 100,000 persons. Cannabis use is most strongly associated with an increased risk of motor vehicle crashes, suicidality, and cardiovascular and pulmonary disease…Cannabis use was associated with an estimated 10% of drug-related emergency department visits in the United States in 2021.
Adults who use cannabis over the long term have downregulation of brain CB1 receptors.18 receptors are also found outside the central nervous system in the myocardium, the vascular endothelium, adipose tissue, the liver, and reproductive organs. CB2 receptors are found primarily on immune cells, although some are found in the central nervous system. THC is a agonist at both types of cannabinoid receptor.
Cannabis use induces a variety of acute psychological and physiological effects that vary in intensity and duration according to the dose (chiefly of THC), the route of administration, and the degree of tolerance in the user.
Acute psychological effects include euphoria(“high), relaxation, and sedation (usually desired by persons who use cannabis recreationally), increased appetite (“munchies”) and impaired short-term memory, concentration, and psychomotor coordination. Some people experience increased anxiety, panic attacks, or paranoia, especially at higher doses. Psychotic symptoms, such as perceptual alterations, hallucinations, and delusions, are less common. Acute physical effects include impaired motor coordination, slurred speech, dry mouth, conjunctival injection (“red eye), tachycardia, orthostatic hypotension, and horizontal nystagmus. Smoked cannabis induces cough, wheezing, and dyspnea; increases sputum production; and exacerbates asthma. Cannabis use, regardless of the route of administration, may be associated with acute transient cardiac arrhythmias, including atrial fibrillation, supraventricular tachycardia, premature ventricular contractions, and nonsustained ventricular tachycardia.
Cannabis use is also associated with acute impairment of driving ability, as assessed by driving simulators and on-road tests. Cross-sectional surveys suggest that recent cannabis use increases the risk of motor vehicle crashes by 30 to 40%.26 By comparison, a blood alcohol concentration of 0.08% increases the risk of crashes by 250 to 300%.
(Source: New England Journal of Medicine 14th December 2023 David A. Gorelick, M.D., Ph.D.)
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- Researchers say they looked at 9,000 pregnancies and concluded cannabis is associated with a number of unhealthy pregnancy outcomes.
- They noted that they used testing rather than self-reporting, as in other studies, because of the amount of contradictory information about cannabis’ effect on pregnancies.
- The researchers concluded that exposure to cannabis was associated with a 1.5-fold increase in risk for people who are pregnant.
A study published today in the Journal of the American Medical Association (JAMA) may not clear the air entirely, but researchers say their findings do determine that pregnant people can be at greater health risk if they are using cannabis.
The University of Utah researchers looked at more than 9,000 pregnant women from eight medical centers across the United States.
They concluded that cannabis is associated with “a composite measure of unhealthy pregnancy outcomes, especially low birth weight, and that higher exposure is associated with higher risks.”
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So, What’s Wrong With Marijuana? Dr Drew Pinsky – Physician & Addiction Medicine Specialist, unpacks the reality, not the hype, of cannabis use. “Two of my family members are among these statistics, one developed an addition, the other psychosis.”
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A critique by Neil O’Connell of Brunel University London found that 10 studies led by Marco Monticone of Italy’s University of Cagliari in Italy had inconsistencies including data that diverged from almost all similar studies, impossible statistical significance values, and duplicate or very similar data.
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Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial.
Background: Painful knee osteoarthritis (KOA) is common, pharmacological treatment, however, is often hampered by limited tolerability. Cannabidiol, which preclinically showed anti-inflammatory, analgesic activity, could supplement established analgesics, but robust clinical trials are lacking. The aim of our study was to investigate the effects of oral high-dose CBD administered over 8 weeks on pain, function and patient global assessment as an add-on to continued paracetamol in chronic symptomatic KOA.
Methods: Prospective, randomized, placebo-controlled, double-blind, parallel-group study. Single center, Outpatient Clinic, Department of Special Anaesthesia and Pain Therapy at Medical University of Vienna, Austria. Eligibility criteria included: age: 18–98 years; painful KOA; score ≥5 on the pain subscale of the Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index; KOA confirmed by imaging. Participants were on continued dosage of paracetamol 3 g/d and randomly assigned by web-based software 1:1 to oral cannabidiol 600 mg/d (n = 43) or placebo (n = 43). Study period: 8 weeks. Primary outcome: Change in WOMAC pain subscale scores (0 = no pain, 10 = worst possible pain) from baseline to week 8 of treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT04607603. Trial is completed.
Interpretation: In KOA patients, oral high-dose add-on cannabidiol had no additional analgesic effect compared to adding placebo to continued paracetamol. Our results do not support the use of cannabidiol as an analgesic supplement in KOA
(Source: https://www.sciencedirect.com/science/article/pii/S2666776223001965 )
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