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Abstract
Objective: To investigate changes in emergency nursing workload related to cannabis ingestion or inhalation by adult and pediatric patients in states and bordering states where recreational cannabis is legal.
Results: The legalization of recreational cannabis in some US states is reported as resulting in an increase in patients presenting with cyclic vomiting syndromes, and increased difficulty in managing both associated behaviors and repetitive ED presentations. New presentations also include unintentional intoxication in both pediatric and geriatric populations. An unexpected finding was the displacement of local homeless populations by younger, indigent “cannabis tourists”; social services agencies might consider this while planning for cannabis legalization in their state or territory.
Conclusions:To protect public health and safety, regulatory efforts to standardize the formulation, dosing and labeling of cannabis products would be beneficial along with educational initiatives for both consumers and health care providers.
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Highlights:
- Veterans with cannabis use and disorder had higher odds of psychiatric morbidities
- These veterans were also more likely to report suicidal ideation and attempt
- In line with these findings, they endorsed greater mental health service utilization
- Even so, <40% of veterans with cannabis use disorder reported mental health care
- Outreach and education about treatment are needed to mitigate cannabis-related harm
Abstract
Background: Cannabis use is associated with psychiatric illness and suicidality, which are prevalent among U.S. military veterans. However, the psychiatric burden of cannabis use and cannabis use disorder (CUD) among veterans is unclear. Using data from a nationally representative sample of veterans, we evaluated associations of lifetime cannabis use and CUD with psychiatric problems, suicidality, and treatment utilization.
Conclusions: Cannabis use and CUD are associated with substantial psychiatric and suicide-related burden among veterans, highlighting the need for screening, education, and treatment to mitigate potential cannabis-related harm.
September 2020 https://www.sciencedirect.com/science/article/abs/pii/S0165032720327956
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Marijuana & Pregnancy (American College of Obstetricians & Gynaecologists)
“Medical marijuana is not safer than recreational marijuana.”
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Nature Medicine volume 26, pages1536–1540 (2020)
Abstract: Cannabis use in pregnancy has increased1,2, and many women continue to use it throughout pregnancy3. With the legalization of recreational cannabis in many jurisdictions, there is concern about potentially adverse childhood outcomes related to prenatal exposure4. Using the provincial birth registry containing information on cannabis use during pregnancy, we perform a retrospective analysis of all live births in Ontario, Canada, between 1 April 2007 and 31 March 2012. We link pregnancy and birth data to provincial health administrative databases to ascertain child neurodevelopmental outcomes. We use matching techniques to control for confounding and Cox proportional hazards regression models to examine associations between prenatal cannabis use and child neurodevelopment. We find an association between maternal cannabis use in pregnancy and the incidence of autism spectrum disorder in the offspring. The incidence of autism spectrum disorder diagnosis was 4.00 per 1,000 person-years among children with exposure compared to 2.42 among unexposed children, and the fully adjusted hazard ratio was 1.51 (95% confidence interval: 1.17–1.96) in the matched cohort. The incidence of intellectual disability and learning disorders was higher among offspring of mothers who use cannabis in pregnancy, although less statistically robust. We emphasize a cautious interpretation of these findings given the likelihood of residual confounding.
Further…
Associations Between Prenatal Cannabis Exposure and Childhood Outcomes
Findings: This cross-sectional analysis of 11 489 children (655 exposed to cannabis prenatally) found that prenatal cannabis exposure after maternal knowledge of pregnancy was associated with greater psychopathology during middle childhood, even after accounting for potentially confounding variables.
Meaning: Prenatal cannabis exposure may increase risk for psychopathology; consistent with recent recommendations by the Surgeon General of the United States, these data suggest that cannabis use during pregnancy should be discouraged by clinicians and dispensaries.
Conclusions and Relevance: This study suggests that prenatal cannabis exposure and its correlated factors are associated with greater risk for psychopathology during middle childhood. Cannabis use during pregnancy should be discouraged.
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2770964
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