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Published online: 17 Jun 2021 https://doi.org/10.1080/15563650.2021.1939881
Abstract
Introduction
On April 13, 2017, a bill to legalize cannabis was introduced to the Canadian Parliament and presented to the public. On October 17, 2018, Canada legalized recreational cannabis use. We assessed intoxication severity, reflected by ICU admission rates, risk factors and other characteristics in children who presented to the emergency department (ED) with cannabis intoxication, before and after legalization.
Methods
A retrospective cohort study of children 0–18 years who presented to a pediatric ED between January 1, 2008 and December 31, 2019 with cannabis intoxication. The pre-legalization period was defined from January 1, 2008 to April 12, 2017 and the peri-post legalization period from April 13, 2017 to December 31, 2019.
Results
We identified 298 patients; 232 (77.8%) presented in the pre legalization period and 66 (22.1%) in the peri-post legalization period; median age: 15.9 years (range: 11 months–17.99 years). A higher proportion of children were admitted to the ICU in the peri–post legalization period (13.6% vs. 4.7%, respectively; p = .02). While the median monthly number of cannabis-related presentations did not differ between the time periods (2.1 [IQR:1.9–2.5] in the pre legalization period vs. 1.7 [IQR:1.0–3.0] in the peri-post legalization period; p = .69), the clinical severity did. The proportions of children with respiratory involvement (65.9% vs. 50.9%; p = .05) and altered mental status (28.8% vs. 14.2%; p < .01) were higher in the peri-post legalization period. The peri-post legalization period was characterized by more children younger than 12 years (12.1% vs. 3.0%; p = .04), unintentional exposures (14.4% vs, 2.8%; p = .002) and edibles ingestion (19.7% vs. 7.8%; p = .01). Edible ingestion was an independent predictor of ICU admission (adjusted OR: 4.1, 95%CI: 1.2–13.7, p = .02).
Conclusions
The recreational cannabis legalization in Canada is associated with increased rates of severe intoxications in children. Edible ingestion is a strong predictor of ICU admission in the pediatric population.
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JAMA Netw Open. 2021;4(6):e2113025. doi:10.1001/jamanetworkopen.2021.13025
Key Points
- Question Are there associations between cannabis use and suicidality trends in young adults, and do they vary as a function of sex and depression?
- Findings This survey study examined 281 650 adult participants in the 2008-2019 National Surveys of Drug Use and Health data and found associations of past-year cannabis use disorder, daily cannabis use, and nondaily cannabis use with higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes, but significantly more in women.
- Meaning In this study, cannabis use was associated with higher prevalence of suicidal ideation, plan, and attempt among US young adults with or without depression, and the risks were greater for women than men.
Abstract
Importance During the past decade, cannabis use among US adults has increased markedly, with a parallel increase in suicidality (ideation, plan, attempt, and death). However, associations between cannabis use and suicidality among young adults are poorly understood.
Objective To determine whether cannabis use and cannabis use disorder (CUD) are associated with a higher prevalence of suicidality among young adults with or without depression and to assess whether these associations vary by sex.
Design, Setting, and Participants This survey study examined data from 281 650 adults aged 18 to 34 years who participated in the National Surveys on Drug Use and Health. Data were collected from January 1, 2008, to December 31, 2019.
Exposures Prevalence of past-year daily or near-daily cannabis use (≥300 days in the past year), CUD, and major depressive episode (MDE). Past-year CUD and MDE were based on DSM-IV diagnostic criteria.
Main Outcomes and Measures Past-year suicidal ideation, plan, and attempt.
Conclusions and Relevance From 2008 to 2019, suicidal ideation, plan, and attempt increased 40% to 60% over increases ascribed to cannabis use and MDE. Future research is needed to examine this increase in suicidality and to determine whether it is due to cannabis use or overlapping risk factors.
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Conclusions and Relevance Results suggest that cannabis use during adolescence is associated with altered neurodevelopment, particularly in cortices rich in cannabinoid 1 receptors and undergoing the greatest age-related thickness change in middle to late adolescence…accelerated thinning in the right dorsomedial prefrontal cortex was associated with the transition to cannabis use as well as greater attentional impulsiveness.
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Every kilo of weed grown in UK illegal cannabis farms produces the same carbon emissions as a return flight from London to New York. (Note, making the grow ‘legal’, doesn’t change the emissions! True environmentalists don’t use Weed. Apparently, when push comes to shove, Pot is more important than Planet!) https://www.vice.com/en/article/3aqak8/illegal-cannabis-farms-are-making-the-climate-crisis-worse
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A new study shows that in the time after first trying cannabis or first misusing prescription drugs, the percentages of young people who develop the corresponding substance use disorder are higher among adolescents (ages 12-17) than young adults (ages 18-25). In addition, 30% of young adults develop a heroin use disorder and 25% develop a methamphetamine use disorder a year after first using heroin or methamphetamine. These findings, published in JAMA Pediatrics, emphasize the vulnerability of young people to developing substance use disorders.
The researchers found that the prevalence of past-year cannabis use disorder was higher for adolescents than young adults at all examined time frames since first use of the drug. For example, within 12 months since first cannabis use, 10.7% of adolescents had cannabis use disorder versus 6.4% of young adults.
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