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1.
Molecules ; 29(11)2024 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-38893387

RESUMO

The extraction of cannabinoids from the inflorescence and leaves of Cannabis sativa L. is gaining interest from researchers, in addition to addressing the under-utilization of the by-products in the stems and roots of the trees. The present study investigated the recovery of pectin from the left-over parts of hemp tress using an eco-friendly method with the aid of organic acids. Different cannabis cultivars-Chalotte's Angels (CHA) and Hang-Krarog (HKR)-were used as plant materials. The stems of both cannabis cultivars contained more pectin than the roots, and tartaric acid-aided extraction provided higher yields than from citric acid. Extracting the acid solution affected some characteristics, thereby differentiating the functional properties of the derived pectin. Extraction using tartaric acid provided pectin with a higher galacturonic acid content, whereas pectin with a higher methylation degree could be prepared using citric acid. The pectin samples extracted from the stems of CHA (P-CHA) and HKR (P-HKR) had low methoxyl pectin. P-CHA had better free radical scavenging capability, whereas P-HKR showed more potent reducibility. Considering the functional properties, P-CHA showed greater emulsion formability and foaming activity, whereas P-HKR possessed a better thickening effect. The present work suggests the feasible utilization of P-CHA and P-HKR as food additives with bioactivity.


Assuntos
Cannabis , Pectinas , Extratos Vegetais , Pectinas/química , Pectinas/isolamento & purificação , Cannabis/química , Extratos Vegetais/química , Ácido Cítrico/química , Folhas de Planta/química , Caules de Planta/química , Tartaratos/química , Raízes de Plantas/química , Ácidos Hexurônicos/química , Ácidos Hexurônicos/análise
2.
Artigo em Inglês | MEDLINE | ID: mdl-38885938

RESUMO

Introduction: In Colorado, both cannabis and psilocybin are legal and becoming more commonly used. However, there is almost no research detailing the public health concerns regarding negative outcomes (e.g., dependence) of cannabis and psilocybin co-use and motives that may perpetuate these negative outcomes (e.g., coping, boredom). Methods: Using data from a larger observational study on cannabis and metabolic processes, regular cannabis users (use ≥7 times/month; n = 97, 35.1% female, 89.7% WHITE) who used psilocybin in the past 3 months (n = 34) were compared with those who had not used psilocybin in the past 3 months (n = 63) on cannabis dependence as measured by the Marijuana Dependence Scale and endorsement of 12 cannabis motives from the Comprehensive Marijuana Motives Questionnaire. Correlations between motives and dependence were also examined and compared across groups. Results: Findings revealed that individuals who had recently used psilocybin had greater cannabis dependence scores than those who had not used recently [F (1, 95) = 5.53, p = 0.02], and more strongly endorsed that their cannabis use was motivated by enjoyment [F (1, 91) = 4.31, p = 0.04], boredom [F (1, 91) = 9.10, p < 0.01], and availability [F (1, 91) = 9.46, p < 0.01]. Correlations between dependence scores and coping and boredom motives were also significantly positive for both groups (all p values <0.05) whereas positive correlations with experimentation, celebration, and availability motives were only significant for recent psilocybin users (all p values <0.05). Discussion: These results suggest there are motivational differences for cannabis use among those who co-use cannabis and psilocybin, and there may be a greater risk for harm for these individuals.

3.
Subst Abuse Treat Prev Policy ; 19(1): 30, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886804

RESUMO

BACKGROUND: Canada legalized recreational cannabis in 2018, and one of the primary objectives of the Cannabis Act was to protect youth by reducing their access to cannabis and providing public education. Canada has the highest prevalence of cannabis use worldwide, particularly among youth and young adults under the age of 25. Cannabis use is linked with many adverse effects for youth and young adults including psychosis, anxiety, depression, respiratory distress, cannabinoid hyperemesis syndrome, and impaired cognitive performance. Despite the high prevalence of cannabis use and the evolution of policies in Canada and globally, significant knowledge and research gaps remain regarding youth and young adult cannabis use. The aim of this scoping review is to map the extent, nature, and range of evidence available on youth and young adult cannabis use in Canada since its legalization, in order to strengthen policies, services, treatments, training, and public education strategies. METHODS: Using a scoping review framework developed by Arksey and O'Malley, along with the PRISMA-ScR guidelines, we conducted a rigorous search in five academic databases: MEDLINE, Embase, APA PsycINFO, CINAHL and Web of Science Core Collection. We included empirical studies that collected data in Canada after the legalization of recreational cannabis (October 2018) and focused on youth or young adults < 30. Two reviewers independently screened articles in two stages and extracted relevant information from articles meeting the inclusion criteria. RESULTS: Of the 47 articles meeting our inclusion criteria, 92% used quantitative methods, 6% were qualitative, and 2% used a mixed-methods approach. Over two-thirds (68%) used secondary data. These studies were categorized into six focus areas: (1) prevalence, patterns, and trends, (2) cannabis-related injuries and emergency department (ED) visits, (3) rates and patterns during the pandemic, (4) perceptions of cannabis use, (5) prevention tools, and (6) cannabis-related offenses. Key findings from the studies reviewed include an increase in cannabis use among 18-24-year-olds post-legalization, with mixed results for youth under 18. ED visits for intentional and unintentional cannabis-related injuries have increased in young children and teens. Perception studies show a mix of concern and normalization of cannabis use. Though limited, prevention studies are promising in raising awareness. A decline in cannabis-related offenses was noted by one study. The review highlights several research gaps, including the need for more qualitative data, disaggregation of demographic data, intervention research, and comprehensive studies on the physical and mental health impacts of cannabis use among youth and young adults. CONCLUSION: Maintaining a public health approach is critical, with a focus on reducing the high prevalence of cannabis use among youth and young adults. This involves implementing prevention strategies to minimize harms, enhancing public education, minimizing commercialization, reducing youth access to cannabis, promoting guidelines for lower-risk cannabis use and harm reduction strategies, and increasing training for healthcare providers.


Assuntos
Uso da Maconha , Humanos , Adolescente , Adulto Jovem , Canadá/epidemiologia , Uso da Maconha/epidemiologia , Uso da Maconha/legislação & jurisprudência , Saúde Pública , Legislação de Medicamentos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Adulto
5.
Int J Public Health ; 69: 1606911, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38887722

RESUMO

Objectives: This study assessed potential differences between girls and boys in the prevalence rates of cannabis use, sociodemographic factors, and beliefs about cannabis use. Methods: 1,896 Andalusian adolescents aged 14-18 participated in an online survey based on the I-Change model. The survey assessed their beliefs about cannabis use, including attitudes, social influences, self-efficacy, action planning, and intention to use. Multivariate analyses of variance were then conducted to examine potential gender differences in these beliefs, while controlling for last month's cannabis use. Results: Significantly more boys used cannabis in the last month, had boyfriends/girlfriends, and had more pocket money compared to girls. Additionally, girls - in comparison to boys - were more convinced of the disadvantages of cannabis use, but were also more convinced of some of the advantages (such as freedom from boredom, and medicinal use), reported having less favorable social norms for cannabis use, had more female best friends using cannabis, and felt pressure to use cannabis from their female peers. Conclusion: These findings highlight the need for cannabis prevention programs to consider gender differences in beliefs about cannabis use. Programs should not only address general risk factors for cannabis use but also evaluate if their interventions effectively target beliefs that are particularly important for girls and boys.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Humanos , Adolescente , Masculino , Feminino , Fatores Sexuais , Espanha , Inquéritos e Questionários , Comportamento do Adolescente/psicologia , Autoeficácia , Uso da Maconha/epidemiologia , Uso da Maconha/psicologia , Fatores Sociodemográficos , Fatores Socioeconômicos , Prevalência , Normas Sociais
6.
Vet Q ; 44(1): 1-10, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38889341

RESUMO

The aim of the present study was to assess the effects of different levels of hempseed (HS) on growth performance, immunity and gut health in broiler chickens. A total of 192 Hubbard broiler chicks were divided into four groups and fed HS as follow: control (HS0), HS 10% (HS-10), HS 15% (HS-15) and HS 20% (HS-20). The study on HS supplementation in broilers revealed no significant impacts on feed intake during the starter (p = .2294) and finisher phases (p = .2294), or overall (p = .0944), though numerical increases were noted with higher HS levels. Body weight gain showed no significant influence in the starter and finisher phases, with overall weight gain also not significantly different (p = .0944), but numerically higher with increased HS. Feed conversion ratio was unaffected in the starter (p = .6986) and finisher phases (p = .6425), and overall (p = .2218). Dressing percentage (p = .1062) and mortality (p = .1631) were not significantly altered, but HS-20 had the highest dressing percentage and lowest mortality numerically. White blood cell counts increased significantly (p = .0377), especially in HS-15 and HS-20 groups. IgM and IgG production was higher in HS-20 on day 28 (p = .021). Gut pH (p > .05) and intestinal histomorphology (p > .05) were not significantly affected, although villus height increased numerically with higher HS levels. These results suggest potential benefits of HS, especially at higher inclusion levels. In conclusion, the obtained results indicated that HS incorporation into the diet of broilers did not affect the growth performance and gut health; however, the immune responses were significantly higher at 15 and 20% levels.


Assuntos
Ração Animal , Cannabis , Galinhas , Dieta , Suplementos Nutricionais , Animais , Galinhas/imunologia , Galinhas/crescimento & desenvolvimento , Galinhas/fisiologia , Ração Animal/análise , Cannabis/química , Dieta/veterinária , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Masculino , Aumento de Peso/efeitos dos fármacos , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/imunologia
7.
Child Abuse Negl ; 154: 106889, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38889556

RESUMO

BACKGROUND: Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use. OBJECTIVE: The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood. METHODS: Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase. RESULTS: Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use. CONCLUSIONS: This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.

8.
Front Plant Sci ; 15: 1381154, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38872884

RESUMO

The primary focus of medicinal cannabis research is to ensure the stability of cannabis lines for consistent administration of chemically uniform products to patients. In recent years, tissue culture has emerged as a valuable technique for genetic preservation and rapid multiplication of cannabis clones. However, there is concern that the physical and chemical conditions of the growing media can induce somaclonal variation, potentially impacting the viability and uniformity of clones. To address this concern, we developed Comparative Restriction Enzyme Analysis of Methylation (CREAM), a novel method to assess DNA methylation patterns and used it to study a population of 78 cannabis clones maintained in tissue culture. Through bioinformatics analysis of the methylome, we successfully detected 2,272 polymorphic methylated regions among the clones. Remarkably, our results demonstrated that DNA methylation patterns were preserved across subcultures within the clonal population, allowing us to distinguish between two subsets of clonal lines used in this study. These findings significantly contribute to our understanding of the epigenetic variability within clonal lines in medicinal cannabis produced through tissue culture techniques. This knowledge is crucial for understanding the effects of tissue culture on DNA methylation and ensuring the consistency and reliability of medicinal cannabis products with therapeutic properties. Additionally, the CREAM method is a fast and affordable technology to get a first glimpse at methylation in a biological system. It offers a valuable tool for studying epigenetic variation in other plant species, thereby facilitating broader applications in plant biotechnology and crop improvement.

9.
Tob Use Insights ; 17: 1179173X241261302, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38873657

RESUMO

Background: Tobacco cannabis co-use is common and becoming more prevalent. Frequent and heavy users of cannabis may struggle to quit smoking. Quitlines offer free cessation treatment in the United States and 25% of quitline callers may also be cannabis users. The present paper describes a randomized pilot study of a tailored intervention for cannabis and cigarette co-users. The intervention combines the quitline smoking cessation treatment with a motivational enhancement therapy-based cannabis intervention. Methods: The randomized pilot study was conducted within four state-funded quitlines with quitline coaches as interventionists. 102 quitline callers who were cannabis and cigarette co-users were randomized to receive treatment as usual (TAU) or the new Quitline Check-Up (QLCU) intervention. Outcomes were collected 90 days post-randomization. Primary outcomes included feasibility and acceptability of delivering the QLCU in the quitline setting. Secondary outcomes included 7-day point prevalence tobacco abstinence, past 30-day cannabis use, and Cannabis Use Disorder Identification Test scores. Results: Study participants were heavy cannabis users, averaging 25 days of use in the past 30; nearly 70% used at a level considered hazardous. Fidelity ratings indicated coaches were successful at delivering the intervention. Treatment engagement was high for both groups (TAU m = 3.4 calls; QLCU m = 3.6 calls) as was treatment satisfaction. Intent-to-treat quit rates (with survey non-responders classified as smokers) were 28.6% for the TAU control group and 24.5% for the QLCU group (P = .45). Discussion: Hazardous cannabis use rates were high in this sample of tobacco cannabis co-users calling quitlines to quit smoking. The intervention for co-users was acceptable and feasible to deliver. No improvements in tobacco cessation outcomes were observed. Pragmatic intervention development within a real-world clinical setting can streamline the intervention development process. More research is needed on tobacco cannabis co-users and who can benefit from a tailored intervention. Registered: ClinicalTrials.gov NCT04737772, February 4, 2021.

10.
Prev Med Rep ; 43: 102775, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38873660

RESUMO

Cannabis use is common in young adulthood, yet little is known about the prevalence and patterns of multi-modal (i.e., use of more than one mode) cannabis use. Objective: We aimed to (1) determine the past 30-day prevalence of five modes (smoke, vape, edible, dab, other) of cannabis use, (2) describe the prevalence of multi-modal cannabis use (single vs. dual vs. poly-modal), and (3) identify socio-demographic correlates of multi-modal use among young adults. Method: Participants were 764 22-30-year-olds who currently used cannabis from Wave 9 (Spring 2019) of the Marketing and Promotions Across Colleges in Texas Project. Participants were 25.11 years old on average (SD = 1.81), 63.6% female, 38.7% identified as non-Hispanic white, 30.6% as Hispanic/Latino, 13.0% as Asian and 9.4% as Black, and 8.2% identified with two or more races or another race/ethnicity. Bivariate analyses and a multinomial regression were used to examine study questions. Results: Smoking was the most common mode of cannabis use followed by vaping and then edibles. Nearly 43% of participants reported single-modal cannabis use, 33% reported dual-modal use, and 24% reported poly-modal use. Males and those identifying as non-heterosexual were at a greater risk than their counterparts for using multiple modes of cannabis. Participants identifying as Black were at a reduced risk for poly-modal compared to single-modal use. Conclusion: Multi-modal use is common among young adults who currently use cannabis, indicating a need for universal efforts aimed at all young adults. Tailored interventions aimed toward those at elevated risk for multi-modal use also are needed.

11.
Int J Drug Policy ; 129: 104479, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38875878

RESUMO

BACKGROUND: In recent years, the cannabis industry has evolved from a world defined by the simplicity and ubiquity of illegality of recreational drug cannabis to a world marked by the legal and geographic complexity of ongoing depenalisation, decriminalisation, and legalisation processes. Within this landscape where drug Cannabis plants and their many derivatives see their legal status change, Cannabis cultigens and end products are increasingly likely to becoming subject to protection by intellectual property rights. This article delves into the implications of these changes for traditional Cannabis farmers, particularly in the Global South, as they face economic and legal threats amidst global legalisation efforts. It examines the potential role of appellations of origin in protecting local Cannabis cultigens and end products, focusing on Moroccan Cannabis and hashish as a case study. METHODS: The text resorts to the treaties and agreements regulating international property rights and plant variety protection, but also to the concepts of terroir and landrace and their definitions, in order to determine, by way of treaty interpretation and conceptual analysis, what type of legal and economic protections can apply to Cannabis landraces and terroir products. The analysis is also based on previous empirical research published by the author. RESULTS: The text argues that appellations of origin are the best intellectual property protections possible for landraces and terroir products because what needs to be protected is not innovation and individual ownership, but tradition and collective ownership, and because appellations of origin are suitable collective intellectual property rights. It shows that appellations of origin are best suited to protect terroir products and landraces because their originality and distinctiveness are place-based originality and distinctiveness. CONCLUSION: The text concludes that appellations or origin offer the only existing intellectual property protection for preserving the distinctiveness of terroir cannabis products, and for landrace conservation. It acknowledges that neither appellations of origin nor existing plant variety protection laws can be legal forms of control of third parties' uses of landraces but that appellations of origin can help protect terroir products and landraces by way of their associated agro-ecosystems.

12.
Front Neurol ; 15: 1378532, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38863511

RESUMO

Object: This cross-sectional study aims to investigate migraineurs' preferred complementary and alternative medicine (CAM) types and the factors influencing their usage. Materials and methods: An anonymous e-survey was distributed to Lithuanian Migraine Association members, and social media migraine support communities. The collected data consisted of demographic, migraine-related questions, personal qualities, CAM habits. Results: 470 respondents were analyzed. 95.96% were women with a median age of 37 (IQR 31, 44). The median duration of migraine was 17.5 years (IQR 10, 25) and the median headache severity was rated 8 (IQR 7, 10) out of 10. 68.90% of participants had one or more headache days per week. 71.49% of respondents were triptan users, 27.66% used medical prophylaxis, and 17.87% used monoclonal antibodies. 52.55% of respondents used CAM in the past 12 months. Physical activity (36.17%), dietary changes/fasting (27.02%), relaxation/meditation (26.60%) were the most used CAM types. Reasons for CAM use included dissatisfaction with conventional treatment effectiveness (42.51%), concerns about safety (48.18%) and adverse effects (37.25%). Factors associated with the decision to explore CAM included longer headache duration (p = 0.017, Mann-Whitney U test), frequent sick leaves (p < 0.001, Mann-Whitney U test), current preventive medication use (p = 0.016, chi-square test), positive views on CAM safety/naturality (p = 0.001/ p < 0.001, Mann-Whitney U test), belief of having a healthy diet (p < 0.001, chi-square test), food-related worries (p = 0.011, Mann-Whitney U test) and Big-five personality trait of openness to experience (p = 0.049, chi-square test). After logistic regression, the frequent need to take sick leaves, having a healthy diet, food-associated fears maintained statistical significance. CAM use was not associated with non-adherence to conventional medicine. 48.99% of CAM consumers disclosed CAM use to their doctors. Conclusion: CAM is explored by a significant proportion of migraineurs, less than half communicate this to their doctors. In our sample, physical activity, dietary changes, and relaxation techniques were the most common. Many patients opted for CAM due to previously experienced side effects/ineffectiveness of conventional migraine treatment or the fear of potential harm from standard medication. Individual factors, such as openness of personality can be an important contributing factor.

13.
Wiad Lek ; 77(4): 635-639, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865615

RESUMO

OBJECTIVE: Aim: To reveal traceability and control as levers to prevent leakage from legal circulation when legalizing medical cannabis. PATIENTS AND METHODS: Materials and Methods: The methodological basis of this research work is based on a systematic approach. Methods of structural and logical analysis, bibliosemantic, abstraction and generalization were used in this article. RESULTS: Results: The analysis of the regulatory framework and regulatory initiatives in the field of circulation of narcotic drugs, in particular, cannabis (in total 56 documents) demonstrated repeated attempts to reform it in Ukraine in order to increase the availability and efficiency of medical and pharmaceutical services. Recently adopted law on the legalization of medical cannabis pays special attention to the traceability of the circulation of medical cannabis and cannabis-based medicines (CbMs) by digitalization and creation of the appropriate electronic information system. CONCLUSION: Conclusions: With the adoption of the law on the legalization of medical cannabis Ukraine became the 57th country in the world to legalize such cannabis. The study and analysis of the regulatory framework of Ukraine, taking into account the best world practices, showed that the legalization of medical cannabis will allow for providing more effective care to many patients including wounded defenders.


Assuntos
Legislação de Medicamentos , Maconha Medicinal , Maconha Medicinal/uso terapêutico , Humanos , Ucrânia
14.
Prev Med ; : 108041, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38866211

RESUMO

OBJECTIVE: To examine associations between serious psychological distress (SPD) and tobacco and cannabis use among college students in the United States. METHODS: This cross-sectional study included 257,626 college students from the 2019-2022 National College Health Assessment survey. SPD was defined as having symptoms in the past month. Current tobacco (i.e., cigarettes, e-cigarettes) and cannabis use was defined as past month use. Multiple product use was categorized for single, dual, or triple products. Adjusted logistic regression models were used to examine associations between SPD, tobacco, cannabis, and multiple product use. RESULTS: SPD increased over time (18.4% to 23.8%) among students and nearly 30% of tobacco or cannabis users reported SPD. Cigarette, e-cigarette, or cannabis use was associated with about a 50-60% increased likelihood of reporting SPD than non-current use of each product, with the highest associations in Fall 2020. Triple product users had double the likelihood of reporting SPD, followed by dual users at 70% and single users at 47%, relative to non-current users. Daily users also had nearly twice the likelihood of reporting SPD, followed by non-daily users at 13-35%, relative to non-current users. CONCLUSIONS: College students have an increasing burden of SPD which is significantly associated with tobacco and cannabis use. There is a dose-response relationship between the number of tobacco and cannabis products used, as well as the frequency of use, and SPD among U.S. college students. Colleges addressing student mental health should prioritize the implementation of screening and treatment support for tobacco, cannabis, and multiple product use.

15.
Artigo em Inglês | MEDLINE | ID: mdl-38867084

RESUMO

Cannabis use and treatment demand has risen in the past decade. Previous analyses of treatment demand are limited by methodological constraints or are outdated. Cross-country differences and trends in cannabis treatment demand are described using data from the European Monitoring Centre for Drugs and Drug Addiction. Two novel indicators are employed: firstly, the cannabis-attributable treatment fraction (CATF) is obtained by dividing the number of treatment entrants for cannabis use problems by the number of treatment entrants for any substance use problem, accounting for possible changes in the reporting system. Secondly, comparing the number of treatment entrants for cannabis use problems to the number of people who use cannabis (near) daily yields the treated-user-ratio (TUR), which considers a proxy for treatment need (frequent use). Across 30 countries with available data, the importance of cannabis in European treatment facilities varies greatly (CATF: min = 3%; max = 65%), with lower estimates in Eastern European countries. Across 20 countries with complete data, the CATF has risen from 29.4% in 2013 to 37.1% in 2020. The TUR calculated on 26 countries suggests that about 3 in 100 frequent users have sought treatment for their cannabis use problems. Over time, treatment demand has increased at a slower pace than treatment need in most countries. One in three treatment entrants for substance use problems in Europe are due to cannabis, with large variations between countries. There are indications for a widening treatment gap for cannabis use problems. In countries liberalising cannabis laws, monitoring changes in treatment access and demand is warranted.

16.
Oxf Med Case Reports ; 2024(6): omae055, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38860017

RESUMO

The increasing prevalence of cannabis worldwide requires awareness of a potential, less recognized, paradoxical entity, the cannabinoid hyperemesis syndrome (CHS). This includes cyclic episodes of nausea, vomiting, and compulsive hot water bathing for alleviation in individuals with chronic cannabis use. An 18-year-old male with daily and prolonged cannabis use has excessive nausea and vomiting, is diagnosed with CHS, and is further complicated by severe and rapidly fluctuating hypophosphatemia. He was successfully managed with intravenous (IV) antiemetic (metoclopramide) and IV normal saline in the emergency department. Hypophosphatemia was treated with IV phosphorous. Although hypophosphatemia in CHS is a rare encounter, the authors share their experience to promote broader recognition and insight into successful management.

17.
J Adolesc Health ; 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38864789

RESUMO

PURPOSE: The 2018 US Farm Bill's definition of hemp resulted in the proliferation of derived psychoactive cannabis products (DPCPs), which appeal to some youth. Despite the importance of restricting youth access, few studies have systematically examined the DPCP retail environment, particularly their online accessibility. METHODS: In May 2023, Google incognito mode was used to search "buy delta thc." Among the first 100 results, data were collected from the 20 most trafficked websites that sold and delivered DPCPs. For each site, we documented the following policy-relevant information: 1) age verification measures for site entry and purchase attempts, 2) adult signature reportedly required upon delivery, and 3) shipping restrictions. RESULTS: Overall, 14 websites (70%) required individuals to indicate their age. Most websites (n = 13, 65%) did not verify age at attempted purchase, nor indicated that an adult signature was required upon delivery (n = 15, 75%). Only three websites (15%) had rigorous age verification procedures during checkout that included contact information as well as an image of their photo ID, which would then be validated through a third-party software. None required age verification upon both purchase and delivery. Thirteen websites (65%) mentioned state shipping restrictions; four of these provided conflicting information across different sections of the website. DISCUSSION: As the e-commerce landscape continues to evolve, clearer regulations regarding DPCP online retail sales and related enforcement are needed. In particular, measures are needed to enforce shipping restrictions and prevent youth access, including increasing the rigor of age verification.

18.
Anal Bioanal Chem ; 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38864915

RESUMO

Currently, there is a significant demand in forensic toxicology for biomarkers of cannabis exposure that, unlike ∆9-tetrahydrocannabinol, can reliably indicate time and frequency of use, be sampled with relative ease, and correlate with impairment. Oral fluid (OF) and exhaled breath condensate (EBC) are alternative, non-invasive sample matrices that hold promise for identifying cannabis exposure biomarkers. OF, produced by salivary glands, is increasingly utilized in drug screening due to its non-invasive collection and is being explored as an alternative matrix for cannabinoid analysis. EBC is an aqueous specimen consisting of condensed water vapor containing water-soluble volatile and non-volatile components present in exhaled breath. Despite potential advantages, there are no reports on the use of EBC for cannabinoid detection. This study developed a supported liquid extraction approach and LC-QqQ-MS dMRM analytical method for quantification of 25 major and minor cannabinoids and metabolites in OF and EBC. The method was validated according to the ANSI/ASB 036 standard and other published guidelines. LOQ ranged from 0.5 to 6.0 ng/mL for all cannabinoids in both matrices. Recoveries for most analytes were 60-90%, with generally higher values for EBC compared to OF. Matrix effects were observed with some cannabinoids, with effects mitigated by use of matrix-matched calibration. Bias and precision were within ± 25%. Method applicability was demonstrated by analyzing ten authentic OF and EBC samples, with positive detections of multiple analytes in both matrices. The method will facilitate comprehensive analysis of cannabinoids in non-invasive sample matrices for the development of reliable cannabis exposure biomarkers.

19.
Front Pharmacol ; 15: 1282831, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38868665

RESUMO

Background: The recent exponential increase in legalized medical and recreational cannabis, development of medical cannabis programs, and production of unregulated over-the-counter products (e.g., cannabidiol (CBD) oil, and delta-8-tetrahydrocannabinol (delta-8-THC)), has the potential to create unintended health consequences. The major cannabinoids (delta-9-tetrahydrocannabinol and cannabidiol) are metabolized by the same cytochrome P450 (CYP) enzymes that metabolize most prescription medications and xenobiotics (CYP3A4, CYP2C9, CYP2C19). As a result, we predict that there will be instances of drug-drug interactions and the potential for adverse outcomes, especially for prescription medications with a narrow therapeutic index. Methods: We conducted a systematic review of all years to 2023 to identify real world reports of documented cannabinoid interactions with prescription medications. We limited our search to a set list of medications with predicted narrow therapeutic indices that may produce unintended adverse drug reactions (ADRs). Our team screened 4,600 reports and selected 151 full-text articles to assess for inclusion and exclusion criteria. Results: Our investigation revealed 31 reports for which cannabinoids altered pharmacokinetics and/or produced adverse events. These reports involved 16 different Narrow Therapeutic Index (NTI) medications, under six drug classes, 889 individual subjects and 603 cannabis/cannabinoid users. Interactions between cannabis/cannabinoids and warfarin, valproate, tacrolimus, and sirolimus were the most widely reported and may pose the greatest risk to patients. Common ADRs included bleeding risk, altered mental status, difficulty inducing anesthesia, and gastrointestinal distress. Additionally, we identified 18 instances (58%) in which clinicians uncovered an unexpected serum level of the prescribed drug. The quality of pharmacokinetic evidence for each report was assessed using an internally developed ten-point scale. Conclusion: Drug-drug interactions with cannabinoids are likely amongst prescription medications that use common CYP450 systems. Our findings highlight the need for healthcare providers and patients/care-givers to openly communicate about cannabis/cannabinoid use to prevent unintended adverse events. To that end, we have developed a free online tool (www.CANN-DIR.psu.edu) to help identify potential cannabinoid drug-drug interactions with prescription medications.

20.
Int J Drug Policy ; 129: 104484, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38870546

RESUMO

BACKGROUND: The Canadian Cannabis Act (CCA, implemented in October 2018) and the COVID-19 pandemic (April 2020) might have contributed to cannabis-related harms in Québec, known for its stringent cannabis legal framework. We explored changes in incidence rates of cannabis-related disorders (CRD) diagnoses associated with these events in Québec. METHODS: We utilized linked administrative health data to identify individuals aged 15 year+ newly diagnosed with CRD during hospitalizations, emergency, and outpatients clinics across Québec, from January 2010 and March 2022 (147 months). Interrupted time-series analyses (ITSA) assessed differences (as percentage changes) in sex- and age-standardized, and sex-stratified, monthly incidence rates (per 100,000 population) attributed to the CCA and the COVID-19 pandemic, compared to counterfactual scenarios where pre-events trends would continue unchanged. RESULTS: The overall monthly mean rates of incident diagnoses nearly doubled from the pre-CCA period (1.56 per 100,000 population) to the COVID-19 pandemic period (3.02 per 100,000 population). ITSA revealed no statistically significant level or slope changes between adjacent study periods, except for a decrease in the slope of incidence rates among males by 1.84 % (95 % CI -3.41 to -0.24) during the COVID-19 pandemic compared to the post-CCA period. During the post-CCA period, the trends of incidence rates in the general and male populations grew significantly by 1.22 % (95 % CI 0.08 to 2.35) and 1.44 % (0.04 to 2.84) per month, respectively. Similarly significant increases were observed for the general and female populations during the COVID-19 pandemic, with monthly rates rising by 1.43 % (95 % CI 0.75 to 2.12) and 1.75 % (95 % CI 0.13 to 3.37), respectively. These increases more than doubled pre-CCA rates. CONCLUSIONS: The incidence rates of CRD diagnoses across Québec appears to have increased following the implementation of the CCA and during the COVID-19 pandemic. Our findings echo public health concerns regarding potential cannabis-related harms and are consistent with previous Canadian studies.

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