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1.
Psychiatr Danub ; 33(3): 280-282, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795161

RESUMO

Western democracies continue to 'legalize recreational cannabis use' after its 'medicinal approval', while India continues to debate whether to 'decriminalize' cannabis or not. One of the strongest arguments against cannabis decriminalization is cannabis dependence and the risk of psychosis, at-least in the vulnerable groups. Endocannabinoids are involved in neuronal proliferation and differentiation during 'patterning of the central nervous system'. Aberrant neurostimulation caused by repeated heavy exo-cannabinoid exposure may increase the probability of pro-psychotic experiences. Various animal and human studies have demonstrated increased but abnormal activation of cortical and subcortical areas due to chronic cannabis use. Some of these areas are involved in the pathogenesis of psychosis or schizophrenia. A review of the literature was done to hypothesize the possible role of cannabis to cause (or precipitate) psychosis through repeated "aberrant neurostimulation". The 'aberrant neurostimulation model of cannabis psychosis' may explain pathogenesis, individual vulnerabilities and developing therapeutic strategies for this debated entity. In future, well designed placebo-controlled studies may find the answer with more confidence.


Assuntos
Canabinoides , Cannabis , Abuso de Maconha , Transtornos Psicóticos , Esquizofrenia , Animais , Cannabis/efeitos adversos , Humanos
2.
Am J Case Rep ; 22: e934187, 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34840324

RESUMO

BACKGROUND Tetrahydrocannabinol has been implicated in gastroparesis development, a disorder characterized by delayed gastric emptying in the absence of mechanical obstruction. While most patients with gastroparesis present with upper gastrointestinal symptoms, patients with significantly delayed emptying can be asymptomatic, creating a dangerous aspiration risk. CASE REPORT A 24-year-old man with a body mass index of 22 presented for right lower extremity open reduction and internal fixation. He endorsed daily marijuana use. His last meal was at 10 PM the prior night. After induction of general anesthesia and laryngeal mask airway (LMA) placement, 150 cc of gastric contents filled the LMA. The LMA was immediately removed and 25 to 50 cc of gastric contents was suctioned from the oropharynx. The airway was immediately secured with an endotracheal tube, after which 500 cc of clear gastric contents was suctioned from the stomach. Bronchoscopy revealed no obvious gastric contents in the tracheobronchial tree. The patient maintained adequate ventilation and oxygenation. He was safely extubated and brought to the post-anesthesia care unit, where recovery was uneventful. CONCLUSIONS Our case raises important questions and considerations for management of THC- dependent patients with potential for impacting NPO guidelines. It is unclear whether the quantity and chronicity of THC use effects gastroparesis development. The patient endorsed no signs of hyperemesis syndrome or gastric fullness; therefore, we cannot reliably deem patients risk-free based on their lack of symptomology alone. Until the true incidence of THC-induced gastroparesis is elicited in further studies, it is prudent to take aspiration precautions in all patients who endorse THC use.


Assuntos
Cannabis , Gastroparesia , Adulto , Anestesia Geral , Cannabis/efeitos adversos , Jejum , Gastroparesia/etiologia , Humanos , Intubação Intratraqueal , Adulto Jovem
3.
Curr Opin Endocrinol Diabetes Obes ; 28(6): 558-565, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34709212

RESUMO

PURPOSE OF REVIEW: Recent widespread legalization changes have promoted the availability of marijuana and its increased potency and perceived safety. The limited evidence on reproductive and perinatal outcomes from marijuana exposure is enough to warrant concern and action. The objective of this review is to provide a current and relevant summary of the recent literature surrounding this topic. RECENT FINDINGS: The available published studies on the effect of marijuana exposure on reproductive health and pregnancy outcomes are conflicting. Human studies are often observational or retrospective and confounded by self-report and polysubstance use. However, the current, limited evidence suggests that marijuana use adversely affects male and female reproductive health. Additionally, prenatal marijuana exposure has been reported to be associated with an increased risk of preterm birth and small for gestational age infants. SUMMARY: With the increasing prevalence of marijuana use, there is an urgent need for evidence-driven recommendations and guidelines for couples interested in conception, affected by infertility or who are expecting. At this time, no amount of marijuana use during conception or pregnancy is known to be well tolerated and the limited available evidence suggests that the safest choice is to abstain.


Assuntos
Cannabis , Nascimento Prematuro , Cannabis/efeitos adversos , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia , Saúde Reprodutiva , Estudos Retrospectivos
4.
Medicina (Kaunas) ; 57(10)2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34684144

RESUMO

Cannabis products that contain the tetrahydrocannabinol (THC) cannabinoid are emerging as promising therapeutic agents for the treatment of medical conditions such as chronic pain. THC elicits psychoactive effects through modulation of dopaminergic neurons, thereby altering levels of dopamine in the brain. This case report highlights the complexity associated with medicinal cannabis and the health risks associated with its use. A 57-year-old male with Parkinson's disease was experiencing worsening tremors and vivid hallucinations despite therapy optimization attempts. It was discovered that the patient took cannabis for chronic back pain, and a pharmacogenomics (PGx) test indicated the presence of variants for the COMT and HTR2A genes. These variants could increase dopamine levels and predispose patients to visual hallucinations. Once the cannabis was discontinued, the patient's hallucinations began to slowly dissipate. Cannabis use continues to expand as it gains more acceptance legally and medicinally, but cannabis can affect the response to drugs. This patient case suggests that cannabis use in combination with dopamine-promoting drugs, especially in a patient with genetic variants, can increase the risk for vivid hallucinations. These conditions support the importance of considering herb-drug interactions and PGx data when performing a medication safety review.


Assuntos
Cannabis , Doença de Parkinson , Cannabis/efeitos adversos , Dopaminérgicos , Dronabinol/efeitos adversos , Alucinações/induzido quimicamente , Humanos , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/tratamento farmacológico
6.
Alcohol Res ; 41(1): 11, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34567915

RESUMO

PURPOSE: Alcohol and cannabis are the most commonly used substances during adolescence and are typically initiated during this sensitive neurodevelopmental period. The aim of this review is to provide a comprehensive overview of the most recent literature focused on understanding how these substances affect the developing brain. SEARCH METHODS: Articles included in this review were identified by entering 30 search terms focused on substance use, adolescence, and neurodevelopment into MEDLINE, Embase, PsycINFO, ProQuest Central, and Web of Science. Studies were eligible for inclusion if they longitudinally examined the effect of adolescent alcohol and/or cannabis use on structural or functional outcomes in 50 or more participants. SEARCH RESULTS: More than 700 articles were captured by the search, and 43 longitudinal studies met inclusion criteria, including 18 studies focused on alcohol use, 13 on cannabis use, and 12 on alcohol and cannabis co-use. DISCUSSION AND CONCLUSIONS: Existing studies suggest heavy alcohol and cannabis use during adolescence are related to small to moderate disruptions in brain structure and function, as well as neurocognitive impairment. The effects of alcohol use include widespread decreases in gray matter volume and cortical thickness across time; slowed white matter growth and poorer integrity; disrupted network efficiency; and poorer impulse and attentional control, learning, memory, visuospatial processing, and psychomotor speed. The severity of some effects is dependent on dose. Heavy to very heavy cannabis use is associated with decreased subcortical volume and increased frontoparietal cortical thickness, disrupted functional development, and decreased executive functioning and IQ compared to non-using controls. Overall, co-use findings suggest more pronounced effects related to alcohol use than to cannabis use. Several limitations exist in the literature. Sample sizes are relatively small and demographically homogenous, with significant heterogeneity in substance use patterns and methodologies across studies. More research is needed to clarify how substance dosing and interactions between substances, as well as sociodemographic and environmental factors, affect outcomes. Larger longitudinal studies, already underway, will help clarify the relationship between brain development and substance use.


Assuntos
Consumo de Bebidas Alcoólicas , Encéfalo , Cannabis , Adolescente , Cannabis/efeitos adversos , Etanol , Substância Cinzenta , Humanos
8.
Psychopharmacology (Berl) ; 238(10): 2709-2728, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34505940

RESUMO

RATIONALE: Regular cannabis use (i.e. ≥ monthly) is highly prevalent, with past year use being reported by ~ 200 million people globally.High reactivity to cannabis cues is a key feature of regular cannabis use and has been ascribed to greater cannabis exposure and craving, but the underlying neurobiology is yet to be systematically integrated. OBJECTIVES: We aim to systematically summarise the findings from fMRI studies which examined brain function in cannabis users while exposed to cannabis vs neutral stimuli during a cue-reactivity fMRI task. METHODS: A systematic search of PsycINFO, PubMed and Scopus databases was pre-registered in PROSPERO (CRD42020171750) and conducted following PRISMA guidelines. Eighteen studies met inclusion/exclusion criteria. Samples comprised 918 participants (340 female) aged 16-38 years. Of these, 603 were regular cannabis users, and 315 were controls. RESULTS: The literature consistently reported greater brain activity in cannabis users while exposed to cannabis vs neutral stimuli in three key brain areas: the striatum, the prefrontal (anterior cingulate, middle frontal) and the parietal cortex (posterior cingulate/precuneus) and additional brain regions (hippocampus, amygdala, thalamus, occipital cortex). Preliminary correlations emerged between cannabis craving and the function of partially overlapping regions (amygdala, striatum, orbitofrontal cortex ). CONCLUSIONS: Exposure to cannabis-cues may elicit greater brain function and thus trigger cravings in regular cannabis users and thus trigger cannabis craving. Standardised and longitudinal assessments of cannabis use and related problems are required to profile with greater precision the neurobiology of cannabis cue-reactivity, and its role in predicting  cravings and relapse.


Assuntos
Cannabis , Abuso de Maconha , Encéfalo/diagnóstico por imagem , Cannabis/efeitos adversos , Sinais (Psicologia) , Humanos , Imageamento por Ressonância Magnética , Abuso de Maconha/diagnóstico por imagem
9.
PLoS One ; 16(8): e0255745, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34370775

RESUMO

BACKGROUND AND OBJECTIVES: Epidemiological studies show that the use of cannabis is related to the use of other illicit drugs, including stimulants such as cocaine and ecstasy. However, few studies have examined how patterns of cannabis use relate to the use of stimulants. In this research we determined relationships between patterns of cannabis use and recent stimulant use, drawing on data from two large nationally representative surveys. We also explored how frequency of cannabis use relates to stimulant use and whether subjects with a cannabis use disorder (CUD)-defined as cannabis abuse or dependence-are more likely to be recent users of cocaine or ecstasy. MATERIALS AND METHODS: We analysed data from Ireland's 2010/11 and 2014/15 National Drug Prevalence Surveys,which recruited 5,134 and 7,005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported some past cannabis use. Multivariable logistic regression analysis was used to examine associations between patterns of cannabis use and recent stimulant use. RESULTS: Among survey participants who had used cannabis in the last month, 17.9% reported recent cocaine use, while almost one-quarter (23.6%) reported recent ecstasy use. There was a significant linear relationship between patterns of cannabis use and recent use of cocaine, ecstasy or any stimulant, with last month cannabis users displaying greater odds (OR = 12.03, 95% CI: 8.15-17.78) of having recent stimulant use compared to last year (OR = 4.48, 95% CI: 2.91-6.91) and former (reference) cannabis users. Greater frequency of cannabis use in the last 30 days was also significantly related to the use of stimulants. In addition, results demonstrated an association between CUD and recent use of cocaine or ecstasy (OR = 2.28, 95% CI: 1.55-3.35). CONCLUSIONS: Findings from this study suggest a relationship between patterns and frequency of cannabis use and recent use of stimulants and an association between CUD and stimulant use. As the use of cannabis with stimulants may increase the risk of negative health consequences, education in community and medical settings about polydrug use and its increased risks may be warranted.


Assuntos
Cannabis/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Abuso de Maconha/epidemiologia , Fumar Maconha/efeitos adversos , Adolescente , Adulto , Estimulantes do Sistema Nervoso Central/efeitos adversos , Cocaína/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/patologia , Feminino , Alucinógenos/efeitos adversos , Humanos , Irlanda/epidemiologia , Masculino , Abuso de Maconha/patologia , Adulto Jovem
10.
Sci Rep ; 11(1): 16826, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413325

RESUMO

There is increasing evidence that the life-course origins of health and development begin before conception. We examined associations between timing and frequency of preconception cannabis and tobacco use and next generation preterm birth (PTB), low birth weight (LBW) and small for gestational age. 665 participants in a general population cohort were repeatedly assessed on tobacco and cannabis use between ages 14-29 years, before pregnancy. Associations were estimated using logistic regression. Preconception parent (either maternal or paternal) daily cannabis use age 15-17 was associated with sixfold increases in the odds of offspring PTB (aOR 6.65, 95% CI 1.92, 23.09), and offspring LBW (aOR 5.84, 95% CI 1.70-20.08), after adjusting for baseline sociodemographic factors, parent sex, offspring sex, family socioeconomic status, parent mental health at baseline, and concurrent tobacco use. There was little evidence of associations with preconception parental cannabis use at other ages or preconception parental tobacco use. Findings support the hypothesis that the early life origins of growth begin before conception and provide a compelling rationale for prevention of frequent use during adolescence. This is pertinent given liberalisation of cannabis policy.


Assuntos
Cannabis/efeitos adversos , Resultado da Gravidez , Uso de Tabaco/efeitos adversos , Adolescente , Adulto , Criança , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Modelos Logísticos , Gravidez , Adulto Jovem
11.
Int Rev Psychiatry ; 33(6): 528-533, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34402713

RESUMO

Cannabis use in pregnancy is common, as are mental health disorders, but the association between the two is not well established. This study is a single-site retrospective cohort. Urine testing for cannabis was evaluated at two-time points to categorize women as having never used, quit or continued to use. Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder (GAD) screen results were compared across groups using multinomial logistic regression. In addition, EPDS and GAD change scores between initiation of care and delivery were analyzed. 604 women were included, 221 (36.3%) with positive toxicology testing for cannabis at the initiation of care. Women who continued cannabis use were significantly more likely to have elevated GAD and EPDS scores (2.55 [1.31, 4.99]) and EPDS score (2.75 [1.43, 5.28]), respectively as compared to those with no use. No significant differences were found between groups in GAD or EPDS change scores t women with higher depression scores on the EPDS had 2.70 times the odds of being in the continuous use group compared to the quit using group (aOR = 2.70, 95% CI = [1.30, 5.88]). Both anxiety and depression symptoms were found to be associated with cannabis use and continued use during pregnancy.


Assuntos
Ansiedade , Cannabis , Depressão , Uso da Maconha/psicologia , Adulto , Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/tratamento farmacológico , Cannabis/efeitos adversos , Depressão/tratamento farmacológico , Feminino , Humanos , Gravidez , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Abandono do Hábito de Fumar/psicologia
12.
Int J Mol Sci ; 22(15)2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34360626

RESUMO

Neurodevelopmental exposure to psychoactive compounds in cannabis, specifically THC, is associated with a variety of long-term psychopathological outcomes. This increased risk includes a higher prevalence of schizophrenia, mood and anxiety disorders, and cognitive impairments. Clinical and pre-clinical research continues to identify a wide array of underlying neuropathophysiological sequelae and mechanisms that may underlie THC-related psychiatric risk vulnerability, particularly following adolescent cannabis exposure. A common theme among these studies is the ability of developmental THC exposure to induce long-term adaptations in the mesocorticolimbic system which resemble pathological endophenotypes associated with these disorders. This narrative review will summarize recent clinical and pre-clinical evidence that has elucidated these THC-induced developmental risk factors and examine how specific pharmacotherapeutic interventions may serve to reverse or perhaps prevent these cannabis-related risk outcomes.


Assuntos
Cannabis/efeitos adversos , Dronabinol/efeitos adversos , GABAérgicos/uso terapêutico , Transtornos do Neurodesenvolvimento/induzido quimicamente , Psicologia do Adolescente , Animais , Humanos , Transtornos do Neurodesenvolvimento/tratamento farmacológico
13.
Leg Med (Tokyo) ; 53: 101955, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34438239

RESUMO

We report a case of sudden death due to acute coronary syndrome (ACS) in a young cannabis user. A man in his late thirties died at home, and marijuana was found. The autopsy revealed severe occlusion by an atherosclerotic plaque in the left anterior descending artery. The histopathological examination revealed ischemic changes, likely caused by cannabis-induced sympathetic ß-adrenergic stimulation. Both cannabinoid receptors (CB1 and CB2) were expressed in the atherosclerotic lesions. The CB2 expression was higher than CB1 expression in the atherosclerotic plaque, corresponding to macrophage infiltration. Since cannabis is regarded as a casual drug due to its lower levels of dependency, some individuals have supported legalized marijuana use. However, this case report will provide cautions on the casual use of cannabis.


Assuntos
Cannabis , Alucinógenos , Fumar Maconha , Cannabis/efeitos adversos , Vasos Coronários , Morte Súbita Cardíaca/etiologia , Humanos
16.
BMJ Case Rep ; 14(7)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34257123

RESUMO

A 27-year-old man presented to the emergency department of a tertiary care centre with complaints of acute onset breathing difficulty and retrosternal chest discomfort of 6 hours' duration. On primary survey, he was dyspnoeic with a room air saturation of 85% and a blood pressure of 80/50 mm Hg. A bedside ultrasound revealed an ejection fraction of around 40%, with hypokinesia of interventricular septum, left ventricular apex and anterior wall with bilateral multiple B lines in all lung zones. A 12 lead ECG showed ST segment elevation in leads V2-V6. He sustained a cardiac arrest. Return of spontaneous circulation was achieved following high-quality cardiopulmonary resuscitation. After successful resuscitation, the patient underwent primary percutaneous coronary intervention and recovered fully from the event. On further evaluation, an acute binge of marijuana smoking prior to the onset of symptoms was identified as the cause of the acute coronary syndrome.


Assuntos
Cannabis , Reanimação Cardiopulmonar , Infarto do Miocárdio , Intervenção Coronária Percutânea , Adulto , Cannabis/efeitos adversos , Angiografia Coronária , Eletrocardiografia , Humanos , Masculino , Infarto do Miocárdio/etiologia
17.
Drug Alcohol Depend ; 226: 108860, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34198130

RESUMO

BACKGROUND AND AIM: Evidence suggests a positive association between cannabis use and depression however whether preconception cannabis use is associated with postpartum depression (PPD) remains unknown. This study examined the association using a longitudinal design. METHODS: Participants were from the Australian Longitudinal Study on Women's Health (cohort born in 1989-95), a sample broadly representative of similarly aged Australian women. The association of past year cannabis use at 3-15 months prior to pregnancy with PPD at ages 19-24 to 22-27 was examined in 516 women with 570 singleton live births. The associations of chronicity, recency, and initiation of cannabis use before pregnancy with PPD at ages 21-26 to 24-29 were investigated in 538 women with 590 singleton live births. PPD was ascertained from self-report of doctor diagnosis for each birth. Relative risk (RR) and 95 % confidence interval (CI) were used to calculate the associations of interest. RESULTS: Compared with no cannabis use, any past-year cannabis use at 3-15 months before pregnancy may be associated with an increased risk of PPD (1.50, 0.99-2.28). Compared with no cannabis use in the first three annual surveys before pregnancy, chronic use (a past year user in ≥ 2 surveys) was associated with an 80 % higher risk of incident PPD for births in the following 1-4 years (1.80, 1.22-2.68). Compared to never users at ages 20-25, former users who had no use within the past year had no increased risk; past year users had 73 % higher risk (1.73, 1.07-2.81); and past year users who initiated cannabis use at or after age 18 had twice the risk of incident PPD for births in the following 1-4 years (2.02, 1.17-3.49). CONCLUSION: This study provides evidence that preconception cannabis use is associated with increased risk of PPD. More studies are warranted to confirm this finding before cannabis cessation policies can be reinforced on reducing the risk of PPD.


Assuntos
Cannabis , Depressão Pós-Parto , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Cannabis/efeitos adversos , Estudos de Coortes , Depressão Pós-Parto/epidemiologia , Humanos , Estudos Longitudinais , Gravidez , Fatores de Risco , Adulto Jovem
18.
Drug Alcohol Depend ; 226: 108834, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34216857

RESUMO

BACKGROUND: Persons with severe opioid or cocaine use disorders are particularly vulnerable to morbidity and mortality. Heaviest use of mu-opioid receptor agonists and cocaine typically commences in early adulthood and is preceded by substantial adolescent exposure to cannabis and/or alcohol. Little information exists on the age trajectories of exposure to cannabis or alcohol in persons diagnosed with severe opioid or cocaine use disorders, compared to persons diagnosed with other substance use disorders (unrelated to opioids or cocaine). METHOD: This observational study had n = 854 volunteers (male = 581, female = 273; ≥18 years of age at the time of interview) and examined the ages of onset of heaviest use of cannabis and alcohol in persons diagnosed by DSM-IV criteria with opioid dependence (OD), both opioid and cocaine dependence (OD + CD) and cocaine dependence (CD). These age trajectory measures were compared to persons with other substance use disorders (primarily cannabis and alcohol use disorders, termed "Any Other Diagnoses"). RESULTS: Unadjusted survival analyses showed persons diagnosed with either OD + CD or CD had earlier onset of heaviest use of cannabis (mean ages of 16.2 and 17.8, respectively) compared to the "Any Other Diagnoses" reference group (mean age = 19.5). A multivariate logistic regression showed that later onset of heaviest use of cannabis was associated with lower odds of being in the OD + CD or CD groups, when compared to the reference group. CONCLUSIONS: Persons diagnosed with severe cocaine use disorders or dual opioid and cocaine use disorders exhibit a pattern of heavy and especially early adolescent exposure to cannabis, compared to persons with other substance use disorders.


Assuntos
Alcoolismo , Cannabis , Cocaína , Abuso de Maconha , Transtornos Relacionados ao Uso de Opioides , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Idade de Início , Alcoolismo/epidemiologia , Analgésicos Opioides , Cannabis/efeitos adversos , Humanos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Adulto Jovem
19.
J Int Neuropsychol Soc ; 27(6): 648-660, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34261553

RESUMO

OBJECTIVE: Cannabis use has increased dramatically across the country; however, few studies have assessed the long-term impact of medical cannabis (MC) use on cognition. Studies examining recreational cannabis users generally report cognitive decrements, particularly in those with adolescent onset. As MC patients differ from recreational consumers in motives for use, product selection, and age of onset, we assessed cognitive and clinical measures in well-characterized MC patients over 1 year. Based on previous findings, we hypothesized MC patients would not show decrements and might instead demonstrate improvements in executive function over time. METHOD: As part of an ongoing study, MC patients completed a baseline visit prior to initiating MC and evaluations following 3, 6, and 12 months of treatment. At each visit, patients completed a neurocognitive battery assessing executive function, verbal learning/memory, and clinical scales assessing mood, anxiety, and sleep. Exposure to delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) was also quantified. RESULTS: Relative to baseline, MC patients demonstrated significant improvements on measures of executive function and clinical state over the course of 12 months; verbal learning/memory performance generally remained stable. Improved cognitive performance was not correlated with MC use; however, clinical improvement was associated with higher CBD use. Analyses suggest cognitive improvements were associated with clinical improvement. CONCLUSIONS: Study results extend previous pilot findings, indicating that MC patients may exhibit enhanced rather than impaired executive function over time. Future studies should examine distinctions between recreational and MC use to identify potential mechanisms related to cognitive changes and the role of clinical improvement.


Assuntos
Canabidiol , Cannabis , Maconha Medicinal , Adolescente , Cannabis/efeitos adversos , Cognição , Humanos , Estudos Longitudinais
20.
J Int Neuropsychol Soc ; 27(6): 546-558, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34261558

RESUMO

OBJECTIVE: Verbal memory deficits are linked to cannabis use. However, self-reported episodic use does not allow for assessment of variance from other factors (e.g., cannabis potency, route of consumption) that are important for assessing brain-behavior relationships. Further, co-occurring nicotine use may moderate the influence of cannabis on cognition. Here we utilized objective urinary measurements to assess the relationship between metabolites of cannabis, 11-nor-9-carboxy-∆9-tetrahydrocannabinol (THCCOOH), and nicotine (cotinine) on verbal memory in young adults. METHOD: Adolescents and young adults (n = 103) aged 16-22 completed urinary drug testing and verbal memory assessment (RAVLT). Linear regressions examined the influence of THCCOOH and cotinine quantitative concentrations, and their interaction, on RAVLT scores, controlling for demographics and alcohol. Cannabis intake frequency was also investigated. Secondary analyses examined whether past month or recency of use related to performance, while controlling for THCCOOH and cotinine concentrations. RESULTS: THCCOOH concentration related to both poorer total learning and long delay recall. Cotinine concentration related to poorer short delay recall. Higher frequency cannabis use status was associated with poorer initial learning and poorer short delay. When comparing to self-report, THCCOOH and cotinine concentrations were negatively related to learning and memory performance, while self-report was not. CONCLUSIONS: Results confirm the negative relationship between verbal memory and cannabis use, extending findings with objective urinary THCCOOH, and cotinine concentration measurements. No moderating relationship with nicotine was found, though cotinine concentration independently associated with negative short delay performance. Findings support the use of both urinary and self-report metrics as complementary methods in substance use research.


Assuntos
Cannabis , Adolescente , Cannabis/efeitos adversos , Cognição , Dronabinol , Humanos , Nicotina , Detecção do Abuso de Substâncias , Adulto Jovem
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