Attitudes and beliefs of medical students on cannabis in Hong Kong.

BACKGROUND: To assess Hong Kong medical students' knowledge, attitudes and beliefs on cannabis and its future legal reform. METHODS: A cross-sectional anonymous online survey were sent from 1st December 2018 to 31st August 2020 to all medical students from the Li Ka Shing Faculty of Medicine, the University of Hong Kong (HKU). RESULTS: 187 students (13.6 %) responded the survey. Overall, students perceived cannabis possessed significant physical and mental health risks, but they were more neutral to its physical and mental benefits. They also supported legalizing cannabis more so for medical use than recreational use. Females perceived higher risks than males. Those who used cannabis before were more acceptable to recommend cannabis as medical treatments, perceived cannabis use with greater benefits and less risks, and were more likely to support legal reform for cannabis in Hong Kong than their counterparts. Students were also more likely to recommend medical cannabis than non-licensed cannabis to patients if they were legally available. CONCLUSION: Medical students in Hong Kong supported legalization of cannabis for medical use despite perceiving significant risks from cannabis use. Future research should investigate public acceptance on medical cannabis in Hong Kong and other Asian countries.

Predictors of Discontinuation of Efavirenz as Treatment for HIV, Due to Neuropsychiatric Side Effects, in a Multi-Ethnic Sample in the United Kingdom.

Efavirenz (EFV) is one of the most commonly prescribed antiretroviral therapy (ART) medications for human immunodeficiency virus-infected adults because of its favorable pharmacokinetic profile and well-documented efficacy. Nonetheless, neuropsychiatric adverse events (AE) occur in almost half of the EFV users and it is the main reason for treatment discontinuation. To identify the sociodemographic characteristics and reported neuropsychiatric side effects that placed EFV users at an increased risk of discontinuation in a multi-ethnic sample in the United Kingdom. A retrospective medical records analysis of patients prescribed EFV-containing ART in an outpatient sexual health clinic between 2010 and 2016. One hundred forty-nine medical records were reviewed. Fifty-five patients discontinued EFV within the study period. About 55.7% of patients suffered from at least one neuropsychiatric AE, the most commonly recorded symptoms were depression, vivid dreams, dizziness, and sleep disturbance. There was an inverse relationship between number of AE and EFV continuation [adjust odds ratio (OR) = 0.12; confidence interval (95% CI) = 0.03-0.44, p < .05]. Furthermore, neuropsychiatric symptoms, including depression (adjust OR = 3.01; 95% CI = 1.30-6.96, p < .05), sleep disturbance (adjust OR = 3.00; 95% CI = 1.10-8.19, p < .05), and vivid dreams (adjust OR = 2.51; 95% CI = 1.05-6.00, p < .05), were independent predictors of EFV discontinuation. The findings revealed that patients who did not experience any neuropsychiatric side effects were eight times more likely to stay on an EFV-containing regimen than those who suffered from more than three symptoms. Additionally, patients who experienced depression or sleep disturbance were at threefold elevated risk of discontinuing an EFV-based regimen. The implications for clinical practice are discussed.