Get a Clue - Weed

Details: Published: 27 January 2025; Hits: 467

Publication: Psychiatric News Volume 60, Number 1

With researchers continuing to find that cannabis in all its forms is helping fuel the youth depression and suicide epidemic, psychiatrists have a role to play in assessing and treating cannabis use—and countering disinformation.

There is mounting evidence that young people’s use of cannabis is fuelling depression and suicide in this population, according to experts who recently spoke during a session at the American Academy of Child and Adolescent Psychiatry’s annual meeting.

“Expanded cannabis product offerings, increasing potency, and an increase in state and local legalization laws are posing unprecedented exposure to young people during a critical period of brain development,” said esse D. Hinckley, M.D., Ph.D.J, associate clinical professor of psychiatry and co-founder of the addiction biology laboratory at the University of Colorado School of Medicine.

When it comes to youth, “cannabis prevention and early intervention are suicide prevention,” Jesse D. Hinckley, M.D., Ph.D., said. “There’s an even greater need for these programs in states that have passed recreational or medical cannabis laws, where youth cannabis use is more prevalent.”

Research has found a strong correlation between cannabis use and depression and suicidality in adults, and although the association is not as definitive in youth, Hinckley said that emerging data suggests that adolescents are similarly impacted.

Suicide is the second-leading cause of death among U.S. youth, accounting for one in five deaths in young people. Nearly one-third (30%) of female youth “seriously considered” suicide, while 13% attempted to die by suicide, according to the 2023 Youth Risk Behavior Survey, as did 14% and 7% of male youth, respectively. According to the National Institute of Mental Health, 20% of U.S. youth ages 12 to 17 experienced past-year major depressive disorder (MDD) in 2021.

“Cannabis has changed as legalization has progressed,” Hinckley said. “The biggest impact has been in the concentration or percentage of THC [tetrahydrocannabinol] within products, the types of products available, and the frequency of use of concentrates rather than [less-potent] flower-based products.”

Tests performed on confiscated cannabis have found it contains 10 times greater THC, the psychoactive compound that makes users feel high, than in the late 1970s. Back then, flower products were around 1% to 3% THC; as of 2023, they were 16% to 25% in most states, with one grower reportedly producing a plant that was 40% TCH. Concentrated products, such as vapes, edibles, and wax/dabs, are far more popular, and now routinely contain 60-90% THC, up from 20-30% a few decades prior.

“In other words, even products marketed as ‘concentrates’ 15 years ago weren’t as potent as many flower-based products are today,” Hinckley said.

Dose-Response Relationship: A study by Hinckley and colleagues issued by the Journal of the American Academy of Child and Adolescent Psychiatry in 2023 examined the results of a survey of 10,123 U.S. adolescents who provided data on their demographics, substance use, depression, suicidality, and mental health. They compared adolescents based on their cannabis use and found that cannabis users were:

2.35 times more likely to have MDD, 3.32 times more likely to have a past-12-month major depressive episode, and more likely to have greater depression severity.
3.7 times more likely to report suicide attempt—and those increased odds remained even after researchers controlled for whether the youth had depression.
More likely to report feelings of guilt, appetite problems, and suicidal ideation. (However, researchers found no difference between adolescent cannabis users and never-users on other common mental health symptoms, such as anhedonia, sleep problems, and fatigue.)

Hinckley and colleagues found a dose-response relationship, meaning that the greater the youth’s exposure to cannabis, the higher the odds of MDD, suicidality, and more severe depression. “For example, youth who used cannabis occasionally—once a month or less—in the past year were five times more likely to have attempted suicide than youth who did not use cannabis at all,” Hinckley said. “Meanwhile, youth who used cannabis one to two days a week or three to four days a week were seven and nine times more likely to have attempted suicide, respectively.”

Hinckley also reviewed several published meta-analyses and longitudinal studies on the topic that came to similar conclusions about the association. One study issued in Lancet Psychiatry by Edmund Silins and colleagues in 2014 found that daily users of cannabis before age 17 were nearly seven times more likely to have attempted suicide as an adult.

Hinckley said that overall, the data points to an increased need to screen all youth for suicidality as well as for cannabis use. When it comes to youth, “cannabis prevention and early intervention are suicide prevention,” Hinckley said. “There’s an even greater need for these programs in states that have passed recreational or medical cannabis laws, where youth cannabis use is more prevalent.”

With Legalization, Increasing Use: According to the 2024 Monitoring the Future (MTF) survey, cannabis use in recent decades by youth ages 12 to 17 has remained mostly flat yet substantial: 29% of 12th graders reported past-year cannabis use. However, this tells only part of the story. Expanding legalization has resulted in 43% of young adults 19 to 30 years old reporting past-year cannabis use in the 2024 MTF, amounting to a 40-year record.

“At age 18, our brains do not magically flip a switch and finish developing,” Hinckley said. “This is a population at risk, and [cannabis] use rates are still going up.”

Furthermore, in May 2024, the U.S. Department of Justice proposed reclassifying marijuana as a Schedule III drug, citing its “accepted medical use” and less potential for abuse-related harms than other Schedule I and II drugs. (APA opposes this rescheduling because of the potential to increase public acceptance and use, as well as lead to psychiatric harms.)

In 1995, just one state—California—had legalized cannabis, and only for medical use, noted Cristopher Joseph Hammond, M.D., Ph.D., an assistant professor of psychiatry at Johns Hopkins University. Now, the majority of U.S. states have legalized cannabis for medical and/or recreational purposes.

“Along with that has come a dramatic explosion of commercialization,” Hammons said, “including novel products, formulations, and methods of administration of cannabinoids … such as concentrates, solid concentrates, edibles, beverages, and topical forms.”

For example, a newer psychoactive hemp derivative known as Delta-8-TCH was used by 12% of twelfth graders in 2024, according to the MTF, which assessed the product’s uptake for the first time that year. Altogether, the U.S. cannabis industry is expected to take in about $42 billion in revenue in 2024.

Hammond reviewed a study for which he and colleagues examined the impact of state cannabis laws on the 113,512 U.S. youth suicides (among 12- to 25-year-olds) reported from 2000 to 2019. He and colleagues found an overall suicide rate of 10.9 per 100,000 youth during that timeframe, but a rate of 12.8 deaths in states allowing medical use of cannabis. The rate climbed to 16.7 deaths per 100,000 in states allowing recreational cannabis. That translates to 5,000 youth suicide deaths that can be attributed to cannabis legalization laws, even after controlling for confounding variables, according to their study issued by the Journal of the American Academy of Child and Adolescent Psychiatry in 2023.

Hammond said that there is a wide gulf between public perception and reality when it comes to cannabis’ impact on adolescent mental health. One recent study suggests psychiatrists have a role to play in educating young patients and their families on the subject, he said. Researchers recruited 150 parents and their children who were receiving treatment at mood disorders clinics in one of 11 states. They found that more than 75% of youth and 65% of their parents perceived cannabis and CBD to be safe and effective mental health treatments, with half of respondents believing that clinicians should be prescribing or recommending cannabis for their patients. (Source: https://psychiatryonline.org/doi/10.1176/appi.pn.2025.01.1.15)

Details: Published: 27 January 2025; Hits: 1103

canhealth A study published in JAMA Network Open has uncovered disturbing trends in mental health treatment following cannabis legalisation, raising serious concerns about the broader psychological impact of liberalised cannabis policies. While advocates have celebrated decreased benzodiazepine prescriptions, a careful analysis of the data reveals a more complex and potentially alarming picture of deteriorating mental health outcomes in states with legalised cannabis.

The Study: Scope and Methodology

The research, unprecedented in its scale, examined 9,438,716 commercially insured patients across multiple states, tracking prescription patterns for five major classes of psychotropic medications between 2007 and 2020. Using sophisticated synthetic control methods, researchers analysed how both medical and recreational cannabis laws affected prescription patterns for benzodiazepines, antidepressants, antipsychotics, barbiturates, and sleep medications.

Troubling Trends in Mental Health Treatment

Rising Antidepressant Use

The data reveals a striking pattern of increased antidepressant use following cannabis legalisation:

Medical cannabis law implementation was associated with a 3.8% increase in antidepressant fills per 10,000 enrollees
Medical dispensary openings corresponded with an even more dramatic 8.8% increase
These increases showed minimal state-to-state variation, suggesting a consistent pattern rather than isolated incidents

Concerning Spike in Antipsychotic Medications

Perhaps most alarming are the findings regarding antipsychotic medication use:

Both medical cannabis law implementation and dispensary openings were associated with a 2.5% increase in the mean number of antipsychotic prescription fills per patient
Medical dispensary openings correlated with a 2.6% increase in the mean days’ supply per prescription fill
No states with significant results showed decreases in antipsychotic medication use

The Benzodiazepine Narrative: A Closer Look

While cannabis advocates often highlight the study’s finding of reduced benzodiazepine prescriptions (12.4% reduction after medical cannabis laws and 15.2% after recreational laws), several crucial caveats must be considered:

Methodological Limitations

The study’s cross-sectional design cannot establish direct causation
There is no evidence that individuals actually substituted cannabis for benzodiazepines
The research cannot account for potential concurrent use of cannabis and benzodiazepines
The study only examined commercially insured patients, potentially missing crucial demographic segments

Population Health Implications

The decreased benzodiazepine prescriptions, while potentially positive in isolation, must be weighed against:

Increased use of other psychiatric medications
Potential undertreatment of anxiety disorders
Unknown long-term effects of cannabis as an anxiety treatment
Possible delay in seeking proper medical intervention

Mental Health and Cannabis: A Growing Body of Concern

Psychosis Risk

The study’s findings align with mounting evidence linking cannabis use to serious mental health concerns:

Early onset of psychosis
Increased risk of acute psychotic episodes
Exacerbation of existing psychotic disorders
Potential triggering of underlying psychiatric conditions

Depression and Anxiety

The increased antidepressant prescriptions suggest potential negative effects on mood disorders:

Possible cannabis-induced depression
Anxiety disorders potentially masked by cannabis use
Complications in treating co-occurring mental health conditions
Delayed recognition of underlying mental health issues

Public Health and Policy Implications

Healthcare System Impact

The study suggests significant shifts in mental health treatment patterns:

Increased burden on mental health services
Higher costs associated with antipsychotic and antidepressant medications
Potential complications in treatment planning
Need for enhanced mental health monitoring in states with legal cannabis

Policy Considerations

These findings raise important questions for policymakers:

Need for more robust mental health monitoring in states with legal cannabis
Importance of integrating mental health screening into cannabis dispensary regulations
Potential necessity for mental health warnings on cannabis products
Requirements for mental health education in cannabis dispensaries

Research Limitations and Future Directions

Study Constraints

Several important limitations must be considered:

Inability to track individual patient behaviours
Limited to commercially insured population
Potential influence of concurrent policy changes
Variable implementation of cannabis laws across states
Lack of data on cannabis consumption patterns

Areas for Further Research

The findings highlight crucial areas requiring additional investigation:

Long-term mental health outcomes in cannabis-legal states
Impact on specific demographic groups and vulnerable populations
Relationship between cannabis potency and mental health effects
Role of different cannabis consumption methods in mental health outcomes
Effectiveness of various policy interventions in mitigating mental health risks

This comprehensive study suggests that cannabis legalisation may be associated with broader negative mental health impacts than previously recognised. While decreased benzodiazepine use might offer certain benefits, the concurrent increases in antidepressant and antipsychotic medication use paint a concerning picture of population-level mental health effects.

Key Takeaways

Cannabis legalisation correlates with increased use of serious psychiatric medications
Mental health impacts appear to be more negative than positive overall
Current policy frameworks may inadequately address mental health risks
More comprehensive monitoring and intervention strategies are needed

Moving Forward

The findings underscore the need for:

More rigorous mental health monitoring in cannabis-legal states
Enhanced screening for mental health conditions among cannabis users
Development of targeted interventions for at-risk populations
Careful reconsideration of cannabis policy frameworks
Additional research into long-term mental health impacts

As more states consider cannabis legalisation, these findings suggest the need for a more cautious, mental health-focused approach to policy development and implementation. The potential mental health consequences of cannabis legalisation may be more serious and far-reaching than previously understood, demanding careful consideration from policymakers, healthcare providers, and public health officials.

Source Health Policy | JAMA Network Open | JAMA Network

Details: Published: 27 January 2025; Hits: 757

sad Cannabis is one of the most widely used psychoactive substances globally, but its effects on mental health remain a topic of significant concern and misunderstanding. With changing cannabis compositions and increasing availability, many individuals wrongly believe it has therapeutic benefits for psychiatric conditions. However, mounting evidence reveals that cannabis use, particularly at high potency and early in life, is more likely to exacerbate mental health issues rather than alleviate them. This post highlights the risks and misconceptions surrounding cannabis and its relationship with psychiatric disorders.

Misconceptions About Cannabis and Mental Health

There is a persistent misbelief that cannabis can effectively treat mental health disorders such as anxiety, depression, PTSD, and even psychosis. Surveys show that nearly half of individuals have used cannabis believing it improves anxiety or depression symptoms, while many fail to recognise its risks. These assumptions can be harmful, as scientific evidence does not support cannabis as a treatment for mental health conditions.

Instead, studies reveal that cannabis can worsen symptoms of depression, anxiety, and other psychiatric disorders. For example, cannabis use may provide short-term euphoria or relief, but its long-term impact often complicates and intensifies underlying conditions. This problem is compounded by the use of cannabis in place of proven, evidence-based treatments such as cognitive behavioural therapy (CBT) and medications like SSRIs, leaving many patients without effective care.

Cannabis Use and Psychiatric Disorders

The relationship between cannabis use and psychiatric disorders is both complex and alarming. Research indicates that individuals with existing psychiatric conditions are more likely to use cannabis. Equally, regular cannabis users—especially those who start in adolescence—are more likely to develop mental health issues later in life. The interplay between both factors creates a vicious cycle of worsening symptoms and increased vulnerability.

Heightened risks are observed with high-potency cannabis products now available, some containing THC levels far exceeding those found in previous decades. Regular use of such products is linked to earlier onset of psychotic disorders like schizophrenia, particularly in individuals with additional risk factors such as a family history of mental illness. Furthermore, cannabis use in adolescence is associated with impaired cognitive development, increased aggression, truancy, and heightened suicidal ideation, which can lead to tragic outcomes.

Warning Signs of Cannabis-Induced Mental Health Symptoms

Understanding the symptoms of cannabis-related mental illness is crucial in recognising its adverse effects. Acute intoxication may present as euphoria, sensory perception changes, or relaxation, but high doses or misuse can lead to severe outcomes. Symptoms such as paranoia, panic, hallucinations, delirium, and full-blown psychosis can result, particularly with high-THC strains or overly frequent use.

Withdrawal from regular cannabis use also brings its own set of challenges, often causing irritability, poor concentration, mood swings, and sleep disturbances. These issues can further overlap with general mental health symptoms, making the impact of cannabis even more difficult to disentangle from existing mental illnesses.

The Long-Term Consequences of Early Cannabis Use

One of the most concerning aspects of cannabis use is its long-term impact on those who begin using it at a young age. Adolescents, in particular, are at a greater risk of suffering adverse mental health outcomes as they are in a critical period of brain development. Regular or high-potency cannabis use during this stage is linked to severe cognitive impairment, hindered educational performance, and persistent mental health challenges into adulthood.

Cannabis is also associated with increased rates of suicidality, from thoughts and attempts to completed suicides. For young people grappling with mental health struggles, cannabis often worsens the severity of their conditions, driving them further from help.

High Potency Cannabis—A Growing Threat to Mental Health

Today’s cannabis is vastly different from the substances available decades ago. While cannabis in the 1990s rarely exceeded 20% THC potency, current products can contain up to 80% THC, making them exponentially stronger. This increase in potency amplifies the drug’s psychoactive effects and poses a greater threat to overall mental health. Studies in Europe have already recorded a troubling correlation between exposure to high-potency cannabis and the onset of psychotic disorders.

Additionally, one-time use of strong cannabis products can trigger temporary psychotic episodes in some individuals, further increasing the likelihood of developing chronic psychotic disorders.

Evidence-Based Treatments Are a Better Approach

Despite widespread misconceptions, cannabis use lacks evidence as a treatment for mental health disorders. This false narrative encourages vulnerable individuals to self-medicate with cannabis, diverting them from evidence-based treatments that are effective, safe, and well-researched. Established therapies like CBT and SSRI medications have been proven to significantly improve serious mental health issues, yet they remain underused due to misinformation surrounding alternative options like cannabis.

Choosing cannabis over tested treatment approaches means exposing oneself to a host of psychological risks with little to no benefit. For individuals battling mental illness, prioritising scientifically-backed treatments is essential in achieving long-term stability and recovery.

A Call for Caution

The link between cannabis and mental health cannot be ignored. High-potency cannabis and early exposure significantly increase the risks of developing or worsening psychiatric conditions. This drug is not benign nor an alternative to proper healthcare—it is a substance capable of derailing the mental well-being of those already struggling or vulnerable.

Education and awareness are critical in confronting these myths. While society shifts towards greater cannabis accessibility, it is vital to approach its use with an understanding of the very real risks.

By re-focusing on evidence-based treatments and creating greater awareness around cannabis-related mental health challenges, we can help individuals make informed decisions that prioritise their safety and long-term health.

Source: AMA

Details: Published: 27 January 2025; Hits: 396

Remember when they said weed was harmless? Tell that to the nearly 900,000 Americans who ended up in emergency rooms last year due to cannabis. That’s right – while pot advocates preach peace and love, emergency departments across the nation are drowning in cannabis-related crises.

The Numbers Don’t Lie

In 2023, U.S. emergency departments logged an estimated 896,418 cannabis-related visits – a 4.6% increase from the previous year. This isn’t just a statistical blip; it represents nearly 12% of all drug-related emergency department visits nationwide. That’s one in eight drug-related ER visits attributed to a substance that proponents insist is “completely safe.”

The data paints a particularly troubling picture for young adults. Those aged 18-25 face the highest risk, with a staggering 676 visits per 100,000 individuals – more than double the national average of 268 per 100,000. So much for the argument that cannabis helps young people “mellow out.”

While individuals aged 26-44 account for 41.6% of all cannabis-related ED visits, it’s the concentration among young adults that should set off alarm bells. These aren’t just numbers; they represent thousands of young lives disrupted by what many consider a “harmless plant.”

The Demographic Divide

ambo The racial and ethnic disparities in cannabis-related ED visits reveal a troubling pattern:

Black individuals face a rate of 717 visits per 100,000 – more than four times higher than White individuals (167 per 100,000)
Non-Hispanic or Latino individuals show significantly higher rates (281 per 100,000) compared to Hispanic or Latino individuals (148 per 100,000)

These disparities raise serious questions about targeted marketing, access to healthcare resources, and the social determinants driving these stark differences. The cannabis industry’s rapid expansion into urban areas and communities of color isn’t just coincidental – it’s strategic.

Consistent Crisis Throughout the Year

The Northeast region leads with 389 visits per 100,000 individuals, nearly double the rate seen in the West (198 per 100,000). This regional disparity becomes even more interesting when you consider that the South, despite its generally stricter cannabis laws, accounts for 41.1% of all cannabis-related ED visits.

Unlike seasonal substances, cannabis-related ED visits maintain a disturbing consistency across all quarters, ranging from 247 to 278 visits per 100,000. This steady stream of emergencies contradicts the notion that cannabis use is primarily recreational or occasional. The data suggests a pattern of regular use leading to regular problems.

Males represent 56% of cannabis-related ED visits, with a rate of 303 per 100,000 compared to females at 233 per 100,000. While this gap might seem modest, it represents thousands of additional male patients annually streaming into already overwhelmed emergency departments.

Wake Up and Smell the Truth

While politicians chase tax dollars and dispensaries multiply like weeds, emergency rooms tell the real story. Nearly 900,000 emergency visits in one year isn’t a statistic – it’s a scandal. The cannabis industry is smoking profits while hospitals deal with the fallout.

Here’s your reality check: that “harmless herb” is sending hundreds of thousands to the ER annually. But hey, at least it’s “natural,” right?

Maybe it’s time we all stopped pretending weed is consequence-free. Emergency rooms don’t lie – even if the cannabis industry does.

Source: National Estimates from Drug-Related Emergency Department Visits, 2023 – SAMHSA

Details: Published: 17 January 2025; Hits: 617

contbuds In a move that should concern parents and public health advocates alike, DoorDash has decided to join the troubling trend of normalising drug use by launching home delivery of cannabis products. The same app that brings you tacos and groceries will now deliver THC-laden gummies and beverages right to your doorstep. How convenient – and how utterly irresponsible.

Marketing Spin or Drug Delivery?

The company’s gleaming press statements talk about “helping eligible customers find new products to safely enjoy while they unwind.” Let’s call this what it really is: making drug consumption as casual as ordering a pizza. Their marketing spin about “evolving preferences” and “decompressing” cleverly masks the reality that they’re essentially becoming drug runners with a fancy app.

Sure, they’re technically staying within federal law by limiting products to less than 0.3% delta-9 THC on a dry weight basis. They’ve also implemented age verification systems, much like they do for alcohol delivery. But these safeguards hardly address the broader societal implications of making intoxicating substances available at the tap of a screen.

A Troubling Vision of Mainstream Cannabis Consumption Trends

Most concerning is the company’s cited Harris Poll survey, suggesting that 75% of adults aged 21-65 are considering incorporating THC/CBD products into their 2025 routine. Rather than raising alarm bells about this disturbing trend, DoorDash seems to be celebrating it as a business opportunity.

Some cannabis industry executives are, predictably, jumping for joy. Adam Terry, CEO of Cantrip, speaks enthusiastically about “breaking into the new ecosystem of direct delivery.” However, more sobering voices like Mike Khemmoro from Mango Cannabis raise valid concerns about the looser regulatory framework for hemp-derived products compared to state-regulated cannabis businesses.

States Struggle to Regulate Intoxicating Hemp Products Amid New Moves

The timing couldn’t be more problematic, with several states including Illinois grappling with regulations on intoxicating hemp products. New Jersey recently saw a ban put on hold, while California implemented emergency regulations last September. Instead of waiting for clearer regulatory frameworks, DoorDash has chosen to barrel ahead.

The company’s partnership with Cann, offering promotional discounts on THC drinks, feels particularly tone-deaf. Nothing says “responsible business practices” quite like discount drugs, right?

What’s next? Will we see “bundle deals” where you can add THC gummies to your burger order? Perhaps a “happy hour” for hemp-derived products? The slippery slope from here isn’t hard to imagine.

While DoorDash executives celebrate their expansion into this controversial market, communities across America continue to struggle with substance abuse issues. The normalisation of drug use through mainstream delivery platforms only serves to compound these challenges.

Profiting from Public Health Risks? Corporate America’s Priorities

The harsh reality is that this move represents everything wrong with corporate America’s rush to profit from substances that should remain strictly controlled. DoorDash may have found another revenue stream, but at what cost to public health and social responsibility?

Perhaps it’s time for regulators and lawmakers to take a harder look at whether delivery apps should be permitted to branch into controlled substances at all. Until then, we can only hope that consumers will think twice before treating drug delivery with the same casualness as ordering their daily coffee.

After all, just because something can be delivered to your door doesn’t mean it should be. (WRD News)