Lower-Risk Cannabis Use Guidelines (LRCUG) for reducing health harms from non-medical cannabis use: A comprehensive evidence and recommendations update

International Journal of Drug Policy, Journal Year: 2021, Volume and Issue: 99, P. 103381 - 103381

Published: Aug. 28, 2021

Cannabis use is common, especially among young people, and associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public goals. Evidence-based 'Lower Risk Use Guidelines' (LRCUG) recommendations were previously developed reduce modifiable risk factors of cannabis-related adverse outcomes; related evidence has evolved substantially since. We aimed review new scientific develop comprehensively up-to-date LRCUG, including their recommendations, on this basis. Targeted searches literature (since 2016) main outcomes by the user-individual conducted. Topical areas informed previous LRCUG content expanded upon current evidence. Searches preferentially focused systematic reviews, supplemented key individual studies. The results evidence-graded, topically organized narratively summarized; through an iterative expert consensus development process. A substantial body cannabis use-related harms identified varying quality. Twelve substantive recommendation clusters three precautionary statements developed. In general, suggests that individuals can if they delay onset until after adolescence, avoid high-potency (THC) products high-frequency/-intensity use, refrain from smoking-routes administration. While people are particularly vulnerable harms, other sub-groups (e.g., pregnant women, drivers, older adults, those co-morbidities) advised exercise particular caution risks. Legal/regulated should be used where possible. result in outcomes, mostly higher-risk use. Reducing help offer one targeted intervention component within a comprehensive approach They require effective audience-tailoring dissemination, regular updating as become available, evaluated impact.

Language: Английский

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Driving Performance and Cannabis Users’ Perception of Safety

JAMA Psychiatry, Journal Year: 2022, Volume and Issue: 79(3), P. 201 - 201

Published: Jan. 26, 2022

Expanding cannabis medicalization and legalization increases the urgency to understand factors associated with acute driving impairment.To determine, in a large sample of regular users, magnitude time course impairment produced by smoked different Δ9-tetrahydrocannabinol (THC) content, effects use history, concordance between perceived observed performance.This double-blind, placebo-controlled parallel randomized clinical trial took place from February 2017 June 2019 at Center for Medicinal Cannabis Research, University California San Diego. users were recruited this study, analysis April 2020 September 2021.Placebo or 5.9% 13.4% THC ad libitum.The primary end point was Composite Drive Score (CDS), which comprised key simulator variables, assessed prior smoking multiple points postsmoking. Additional measures included self-perceptions history.Of 191 118 (61.8%) male, mean (SD) age 29.9 (8.3) years, days past month 16.7 (9.8). Participants placebo group (63 [33.0%]), (66 [34.6%]), (62 [32.5%]). Compared placebo, significantly declined on 30 minutes (Cohen d = 0.59 [95% CI, 0.28-0.90]; P < .001) 1 hour 0.55 0.24-0.86]; .001), borderline differences 3 hours 0.29 -0.02 0.60]; .07) no 4 -0.03 -0.33 0.28]; .87). The did not differ based content (likelihood ratio χ24 3.83; .43) intensity (quantity × frequency) 6 months 1.41; .49), despite postsmoking blood concentrations being higher those highest intensity. Although there hesitancy drive immediately postsmoking, increasing numbers (81 [68.6%]) participants reported readiness performance improving initial levels.Smoking libitum resulted simulated decrements. However, when experienced control their own intake, cannot be inferred cigarette, behavioral tolerance, concentrations. Participants' willingness may indicate false sense safety. Worse is evident several many but appears resolve most individuals. Further research needed impact individual biologic differences, administration methods performance.ClinicalTrials.gov Identifier: NCT02849587.

Language: Английский

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Cannabis-Related Disorders and Toxic Effects

New England Journal of Medicine, Journal Year: 2023, Volume and Issue: 389(24), P. 2267 - 2275

Published: Dec. 13, 2023

Language: Английский

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Recommendations for Reducing the Risk of Cannabis Use-Related Adverse Psychosis Outcomes: A Public Mental Health-Oriented Evidence Review

Journal of Dual Diagnosis, Journal Year: 2023, Volume and Issue: 19(2-3), P. 71 - 96

Published: July 3, 2023

Objective: Cannabis use is increasingly normalized; psychosis a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for outcomes at different stages toward recommendations reduction by individuals involved in use. Methods: searched primary databases pertinent literature/data 2016 onward, principally relying reviews and high-quality studies which were narratively summarized quality-graded; developed international expert consensus. Results: Genetic risks, mental health/substance problem histories elevate the risks cannabis-related psychosis. Early age-of-use-onset, frequency-of-use, product composition (i.e., THC potency), mode other substance co-use all influence risks; protective effects of CBD are uncertain. Continuous may adversely affect psychosis-related treatment medication effects. Risk factor combinations further amplify odds outcomes. Conclusions: Reductions identified factors—short abstinence—may decrease related outcomes, thereby protect users' health.

Language: Английский

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A semi-naturalistic open-label study examining the effect of prescribed medical cannabis use on simulated driving performance

Journal of Psychopharmacology, Journal Year: 2024, Volume and Issue: 38(3), P. 247 - 257

Published: Feb. 8, 2024

Background: Despite increasing medical cannabis use, research has yet to establish whether and what extent products containing delta-9-tetrahydrocannabinol (THC) impact driving performance among patients. Stable doses of prescribed cannabinoid during long-term treatment may alleviate clinical symptoms affecting cognitive psychomotor performance. Aim: To examine the effects open-label use on simulated Methods: In a semi-naturalistic laboratory study, 40 adults (55% male) aged between 23 80 years, consumed their own product. Driving outcomes including standard deviation lateral position (SDLP), speed (SDS), mean steering variability were evaluated using Forum8 simulator at baseline (pre-dosing), 2.5 h 5 -h (post-dosing). Perceived effort (PDE) was self-reported after each drive. Oral fluid whole blood samples collected multiple timepoints analysed for THC via liquid chromatography-mass spectrometry. Results: A significant main effect time observed (p = 0.014) PDE 0.020), with patients displaying modest stabilisation vehicle control, increased adherence limits reductions in post-dosing, relative baseline. SDLP 0.015) 0.043) elevated those who oil flower-based products. Detectable concentrations oral 6-h post-dosing (range 0–24 ng/mL). Conclusions: This study suggests that consumption (1.13–39.18 mg/dose) negligible when used as prescribed.

Language: Английский

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A randomised, placebo-controlled, double blind, crossover trial on the effect of a 20:1 cannabidiol: Δ9-tetrahydrocannabinol medical cannabis product on neurocognition, attention, and mood

European Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 82, P. 35 - 43

Published: March 14, 2024

As cannabinoid-based medications gain popularity in the treatment of refractory medical conditions, it is crucial to examine neurocognitive effects commonly prescribed products ensure associated safety profiles. The present study aims investigate acute a standard 1 mL sublingual dose CannEpil®, medicinal cannabis oil containing 100 mg cannabidiol (CBD) and 5 Δ9-tetrahydrocannabinol (THC) on neurocognition, attention, mood. A randomised, double-blind, placebo-controlled, within-subjects design assessed 31 healthy participants (16 female, 15 male), aged between 21 58 years, over two-week experimental protocol. Neurocognitive performance outcomes were using Cambridge Neuropsychological Test Automated Battery, with Profile Mood States questionnaire, Bond-Lader Visual Analogue Scale used assess subjective state CannEpil increased Total Errors Spatial Span Correct Latency (median) Pattern Recognition Memory, while also increasing Efficiency Score (lower score indicates greater efficiency) relative placebo (all p < .05). Subjective Contentedness (p .01) Amicability .05) at around 2.5 h post dosing, placebo. Drowsiness or sedative effect was reported by 23 % three six hours administration. Plasma concentrations CBD, THC, their metabolites not significantly correlated any observed alterations state, adverse event occurrence. An impairs select aspects visuospatial working memory delayed pattern recognition, largely preserving mood states among individuals. Intermittent reports drowsiness sedation underscore inter-individual variability state. (ANZCTR; ACTRN12619000932167; https://www.anzctr.org.au)

Language: Английский

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Evaluation of Field Sobriety Tests for Identifying Drivers Under the Influence of Cannabis

JAMA Psychiatry, Journal Year: 2023, Volume and Issue: 80(9), P. 914 - 914

Published: Aug. 2, 2023

With increasing medicinal and recreational cannabis legalization, there is a public health need for effective unbiased evaluations determining whether driver impaired due to Δ9-tetrahydrocannabinol (THC) exposure. Field sobriety tests (FSTs) are key component of the gold standard law enforcement officer-based evaluations, yet controlled studies inconclusive regarding their efficacy in detecting person under influence THC.

Language: Английский

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Sleep Health, Self-Medication, and Cannabis Risk: A Bidirectional Model and Research Agenda

Current Sleep Medicine Reports, Journal Year: 2025, Volume and Issue: 11(1)

Published: Jan. 3, 2025

Language: Английский

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Identifying EEG markers related to acute cannabis consumption: A systematic review

Neuroscience & Biobehavioral Reviews, Journal Year: 2025, Volume and Issue: unknown, P. 106092 - 106092

Published: March 1, 2025

Electroencephalography (EEG) has potential to provide a sensitive measure of the acute neurophysiological response cannabis administration. As delta-9-tetrahydrocannabinol (THC; psychoactive constituent cannabis) can induce transient neurocognitive impairments that differ as function tolerance and dose, understanding neural profile related intoxication would be great benefit in wake increasing recreational medicinal use. Accordingly, present systematic review examined current research literature administration EEG measures. Peer-reviewed articles published from 2000 were assessed accordance with Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) guidelines. Studies administered non-synthetic cannabis, containing THC (orally or inhaled) reported differences outcomes within time frame (<6hours post-administration) compared baseline placebo, eligible inclusion. A total 16 studies inclusion, which 11 amplitude/latency event-related potentials (ERPs) 9 changes frequency band power. Of ERPs, P3 was identified indicator recent consumption, demonstrated by decreased amplitude across various doses (generally exhibiting small-to-moderate magnitude effects where effect sizes reported). Oscillatory activity theta power range (typically 4-7Hz) impacted following administration, some support dose-dependent change The results highlight utility measures markers although heterogeneity participant characteristics data limits conclusions these results. It is also evident highly tolerant user groups (such those who use medicinally), require further exploration.

Language: Английский

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Metabolomic profiling of cannabis use and cannabis intoxication in humans

Neuropsychopharmacology, Journal Year: 2025, Volume and Issue: unknown

Published: March 12, 2025

Abstract Acute intoxication from Δ9-tetrahydrocannabinol (THC, the primary active ingredient of cannabis) can lead to neurocognitive impairment and interference with day-to-day operations, such as driving. Present evaluations THC-induced in legal settings rely on biological drug tests that solely establish cannabis use, rather than impairment. The current study evaluated metabolome blood collected occasional chronic users ( N = 35) at baseline following treatments (300 μg/kg THC) placebo, aim identify unique metabolic alterations are associated acute use frequency. Blood samples were repeatedly during 70 min after treatment. Sustained attention performance ratings subjective high taken twice within 40 Metabolomic fingerprints distinctly different baseline, when both groups not intoxicated. A total 14 metabolites, mainly related endocannabinoid amino acid metabolism, identified distinguished yielded a discriminant analysis model an 80% classification rate (95% CI: 61–91%). Distinct metabolomic found for who, contrast users, showed attentional elevated intoxication. These included increments organic acids, β-hydroxybutyrate second messenger ceramides. demonstrates feasibility metabolomics approach changes specific state history use.

Language: Английский

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