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The genotoxicity of Cannabis has long been suspected, even acknowledged, be it only in part. Research over the last 5 to 10 years has confirmed the case. Much of this important research has been ‘buried’ in the deluge of ‘hopeful’ and even spectacular claims of the potential therapeutic capacity of cannabis.

Claims and promises that have persisted for well over 20 years, yet with little to nothing to show for it.

However, the harms associated with the use of this now heavily engineered plant/product are mounting, and the research is not only monitoring, but discovering these harms.

If science and health matter, then all research must be thorough and properly vetted to ensure that health is advanced, not mere ‘symptom abated’ whilst disease, disorder or other harms grow.

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Boredom, self-medication for increased depression and/or isolation, along with the various mental health issues that ramp up with a toxic combination of managing a legitimate mental health concern with a psychotropic toxin that only aids and abets mental health decline – not fix it.

The vicious cycle of very short term ‘alleviation’ with self-medication, to only exacerbate symptoms and disorder accelerating even greater ‘need’ for further alleviation. The addiction for profit industry has hit a gold-mine with their fallacious medicinal marketing and wanton misrepresentation of this far from ‘natural’ drug.

Recent research from the Australian Institute of Criminology (Statistical Bulletin 33, July 2021) uncovered what anecdotal and observation had already assumed. Demand for Cannabis went up during the pandemic

The Report

This study uses data from the Drug Use Monitoring in Australia program to examine the impact of the COVID-19 pandemic on cannabis demand and supply in Australia. It found past-month cannabis users reported using cannabis on a median of 25 days per month, significantly more often than before the pandemic. Those experiencing changes in their employment, financial or living situation or mental health or who used drugs to cope with negative emotions were more likely to increase cannabis use. Most users reported no changes in cannabis supply, but there were increasing prices and decreasing numbers of dealers in Brisbane.

Quick Points from Discussion

  • This study suggests patterns of cannabis use may have been altered by COVID-19 restrictions, but that cannabis supply appears to have been resistant to the impacts of the pandemic.
  • Not so much more users, but the frequency of cannabis use was significantly greater than before the pandemic. This is consistent with other research suggesting an overall increase in frequency of cannabis use during the pandemic in Australia (Peacock et al. 2020; Sutherland et al. 2020) and internationally (EMCDDA 2020).
  • The National Wastewater Drug Monitoring Program also found an increase in cannabis consumption, reaching a record high in capital cities in June 2020 (ACIC 2020).
  • Increases in the frequency and quantity of cannabis use were significantly more likely to occur among detainees who had experienced changes in their employment, financial or living situation; who experienced changes in their mental health; or who used drugs to cope with negative emotions.
  • These results are consistent with Peacock et al.’s (2020) findings that cannabis users were likely to attribute increases in drug use to feelings of boredom (74%), an increase in available time to use the drug (38%) and greater anxiety or depression associated with COVID-19 (11%). These findings suggest it may be important to ensure support services for cannabis use are available to those who have experienced changes in their life associated with the pandemic.
  • Other factors may also explain the increase in cannabis use during the pandemic. Economic changes such as increases to income support and policies such as early access to superannuation may have provided some respondents with greater income and increased demand for cannabis. Detainees may also have bought more cannabis as a substitute for methamphetamine following a rise in the price of methamphetamine (Voce, Sullivan & Doherty 2021)
  • Cannabis supply appeared to remain stable during the pandemic. Most cannabis users reported no change in availability or quality compared with before the pandemic. Four out of five cannabis users also reported no change in the price of cannabis, and three out of five cannabis users reported no change in the number of dealers selling cannabis.
  • 90 percent of those interviewed between June and September 2020 for the Adapting to Pandemic Threats study reported that cannabis was easy or very easy to obtain (Sutherland et al. 2020). The cannabis market may have been less disrupted during the COVID-19 pandemic than other drug markets because cannabis cultivation occurs domestically, rather than relying on drugs being produced internationally and trafficked into the country (ACIC 2020). Despite this stability, two in five detainees purchased larger quantities of cannabis than usual because they anticipated a possible decrease in supply due to the pandemic. Seventeen percent of cannabis users also reported using other drugs as a substitute for cannabis, with benzodiazepines and methamphetamine common substitutes for cannabis. These results are concerning, as the risk of drug overdose may be increased when an individual has access to a large personal supply of a drug (Dietze & Peacock 2020), uses a new substance for the first time, or uses multiple drugs simultaneously or concurrently within a brief period (Lalica et al. 2018)

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ABSTRACT

Background and Aims The idea that cannabis is a ‘gateway drug’ to more harmful substances such as opioids is highly controversial, yet has substantially impacted policy, education and how we conceptualize substance use. Given a rise in access to cannabis products and opioid-related harm, the current study aimed to conduct the first systematic review and meta-analysis on the likelihood of transitioning from cannabis use to subsequent first-time opioid use, opioid use disorders (OUD), dependence or abuse.

Conclusion A systematic review and meta-analysis found that while people who use cannabis are disproportionately more likely to initiate opioid use and engage in problematic patterns of use than people who do not use cannabis, the low quality of the evidence must be considered when interpreting these findings.

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July 11, 2021,

BOULDER, Colo. — One day in fall 2018, Bo Gribbon began to vomit and couldn’t stop. He threw up multiple times an hour from morning to night before his mother drove him to the hospital near their home here.

“It felt like Edwards Scissorhands was trying to grab my intestines and pull them out,” said Gribbon, then 17.

Over the next nine months, Gribbon went to the emergency room 11 times for the same problem: severe vomiting and screaming at the same time that lasted for hours. When a physician’s assistant told him the likely cause, Gribbon didn’t believe it at first. He had never heard of marijuana producing a side effect like that.

Bo Gribbon, 20, went to the ER 11 times in 9 months for a condition that caused bouts of nonstop vomiting and screaming. Medical professionals told him it was from chronic cannabis use but he didn't believe it until stopping cannabis finally made the vomiting stop.Robin Noble

“The only thing that convinced me was that it stopped when I stopped smoking,” said Gribbon, now 20.

Colorado and Washington became the first states to legalize recreational marijuana in 2012. Several years later, doctors in Colorado and other states are expressing alarm over the increasing potency of cannabis and the health risks it may pose for young users — from psychiatric issues, including violent psychotic episodes, to the mysterious condition that plagued Gribbon.

The condition — officially called "cannabinoid hyperemesis syndrome" but now known to health care workers as "scromiting," a mashup of "screaming" and "vomiting" — has popped up with increasing frequency at hospitals in Colorado, doctors say.

The ER at Parkview Medical Center in Pueblo saw only five scromiting cases in 2009. By 2018, the number had risen to more than 120, according to data compiled by Dr. Brad Roberts, an emergency room physician at the hospital.

Reports of the syndrome doubled in two different ERs in the state shortly after legalization, according to one study.

Roberts said the presence of these patients strains hospital resources. When faced with people suffering from bouts of nonstop vomiting, doctors often order up an array of diagnostic tests to rule out other underlying causes.

“We use up a lot of medical resources to see if there is anything more seriously wrong with them,” Roberts said.

A 2018 national research review called the syndrome “an increasingly prevalent and complicated problem for health care providers and patients.”

A 2017 review of studies found that 97 percent of people who developed the condition reported using marijuana at least once a week. About 75 percent said they consumed cannabis regularly for over a year.

“These patients often undergo expensive medical testing, may require hospital admission for symptom management, and often experience significant delays in diagnosis,” the authors wrote.

Scromiting cases have increased as pot has become far more powerful, according to doctors. Experts say the marijuana consumed 20 years ago had levels of THC, the main psychoactive ingredient, of 2 percent to 3 percent, but cannabis products now sold in markets like Colorado can have THC levels as high as 90 percent.

Dr. Timothy Meyers, the chair of the emergency department at Boulder Community Health, said when he first arrived at the hospital 18 years ago, it was a condition he never saw.

“Now I see it practically every day,” he said.

Psychiatric issues

Four Colorado doctors interviewed by NBC News said they’ve also seen an increase in the number of patients with psychiatric issues after consuming powerful marijuana. A 2019 study found that consuming cannabis with THC levels exceeding 10 percent increased the odds of a psychotic episode.

“Almost every day I see a patient in the ER who is having a psychotic break after taking high-potency THC,” Roberts said.

Dr. Karen Randall worked in emergency rooms in Detroit for 19 years but she said she never saw anything like the acute violent psychotic reactions from high potency THC cannabis that she is seeing now in her emergency room in Pueblo, Colo.Dr. Karen Randall

Dr. Karen Randall, who works in the Parkview Medical Center emergency room with Roberts, said she spent 19 years working in a downtown Detroit emergency room, but that didn’t prepare her for what she characterized as the high volume of “acutely violent psychotic patients” in Colorado.

“I never saw anything like this,” Randall said.

Marijuana has long been considered a nonaddictive drug that causes few, if any, serious side effects. It’s still not clear if it causes more serious mental health problems, but a growing body of research suggests it can have damaging effects on adolescent brains.

An increasing share of Colorado’s $2 billion cannabis market is made up of concentrates or other products with high levels of THC, according to Tim Ruybal Jr., who founded Dyspense, a company that tracks inventory for the industry. Ruybal said concentrates made up 43 percent of the market share in 2020, up from 32 percent in 2019.

“Evidence for how cannabis, especially in higher concentrations, impacts mental health is growing and stronger, especially on how it relates to psychosis and schizophrenia-like symptoms,” said Dr. G. Sam Wang, an emergency room doctor and toxicologist at Children’s Hospital Colorado in Denver.

“These impacts are seen more with higher-concentrated products and with more frequent use,” Wang said.

Lawmakers take action

Randall and Roberts were among a group of Colorado doctors who threw their support behind a state bill designed to close a loophole that allowed young people between the ages of 18 and 20 to get their hands on large quantities of high-potency pot.

Cannabis is not legal in Colorado for people under 21, but prior to the bill’s passage in late May, 18-year-olds could get state medical cards after a brief call with a doctor, allowing them to buy up to 400 doses per day shopping from store to store.

The new legislation requires those under 21 to visit two separate doctors in person to get a medical marijuana card and limits the amount they can buy from an individual store. It also restricts the amount of marijuana concentrates that people over 21 can purchase at medical dispensaries and mandates the creation of a tracking system to prevent people from going shop to shop to amass large quantities of pot.

People stand in freshly painted circles, six-feet-apart, as they wait in a two-hour line to buy marijuana products from Good Chemistry on March 23, 2020 in Denver.Michael Ciaglo / Getty Images file

Rep. Judy Amabile, a state lawmaker who represents Boulder, supported the bill and gave an impassioned speech on the House floor linking her own son’s experience with schizophrenia to cannabis.

“Everywhere he went, this product was available and in greater and greater concentrations and potency,” she said.

“It’s too late for him,” she added. “Let’s talk instead about your children.”

In an interview with NBC News, Amabile said she was surprised the bill passed with such wide margins.

“To me that is a sea change, and I credit this group of activist moms who testified, who really put in the work to educate legislators,” she said.

'My life was falling apart'

The bill is directed at young people like Will Brown, 17.

Brown told NBC News his mother would sometimes find him on his bedroom floor unable to speak after he inhaled concentrated cannabis oil vapors in a process called dabbing.

“I knew I couldn't stop,” Brown said. “My life was falling apart around me.”

Jasmine Block, 18, said she got high-potency cannabis from dealers who obtained medical cards fraudulently.

“They wanted to profit off of these younger kids, who don't have access to this,” she said.

“I am an advocate for stricter marijuana policies and stricter doctor-to-patient relationships and the qualifications you need to meet in order to get a medical marijuana card,” Block said. “Because [from] experience, it is so easy to get your hands on.”

Both Block and Brown are now sober and attend 5280 High School, a Denver charter school for teens with substance issues. They said they’re alarmed to meet kids in their recovery groups who dabbed in middle school.

“It's kind of terrifying to just watch,” Brown said.

Colorado’s cannabis industry supported the new legislation. Truman Bradley, executive director of the Marijuana Industry Group, said the trade association believes young people “should never use cannabis unless under the strict supervision of a medical professional."

Bo Gribbon is now sober and headed to college this fall to study electronic music.

He said he’s clear-eyed that what happened to him was a result of his own decisions, but he said the industry should also be held accountable.

“I don’t know if anyone needs to go to jail, but I think they need to be sued,” he said.

Gribbon’s mother, Robin Noble, said pot may work for some people, but “for my son, it stole his curiosity and interest in life.”

Now that he has stopped, she said, “his general joy is back.”

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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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