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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Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline

BMJ, Journal Year: 2021, Volume and Issue: unknown, P. n2040 - n2040

Published: Sept. 8, 2021

Abstract Clinical question What is the role of medical cannabis or cannabinoids for people living with chronic pain due to cancer non-cancer causes? Current practice Chronic common and distressing associated considerable socioeconomic burden globally. Medical increasingly used manage pain, particularly in jurisdictions that have enacted policies reduce use opioids; however, existing guideline recommendations are inconsistent, remains illegal therapeutic many countries. Recommendation The expert panel issued a weak recommendation offer trial non-inhaled cannabinoids, addition standard care management (if not sufficient), pain. How this was created An international development including patients, clinicians content expertise, methodologists produced adherence standards trustworthy guidelines using GRADE approach. MAGIC Evidence Ecosystem Foundation (MAGIC) provided methodological support. applied an individual patient perspective. evidence This informed by linked series four systematic reviews summarising current body benefits harms, as well values preferences, regarding Understanding because close balance between harms It reflects high value placed on small very improvements self reported intensity, physical functioning, sleep quality, willingness accept modest risk mostly limited transient harms. Shared decision making required ensure patients make choices reflect their personal context. Further research warranted may alter recommendation.

Language: Английский

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THC and CBD: Similarities and differences between siblings

Neuron, Journal Year: 2023, Volume and Issue: 111(3), P. 302 - 327

Published: Jan. 12, 2023

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Cannabis use in Adolescence and Risk of Psychosis: Are there Factors that Moderate this Relationship? A Systematic Review and Meta-Analysis

Substance Abuse, Journal Year: 2021, Volume and Issue: 42(4), P. 527 - 542

Published: Feb. 22, 2021

Background: Previous research has reported increased risk for psychosis among individuals who use cannabis during adolescence. We conducted a systematic review and meta-analysis to investigate the interaction between adolescent other factors in moderating later life. Method: searched four electronic databases June 2020 articles that assessed use, had as an outcome analyzed association psychosis. Analysis was done using random-effects narrative synthesis. Results: A total of 63 studies were included 18 meta-analysis. Adolescent found increase (RR = 1.71 (95%CI, 1.47-2.00, p < 0.00001) predict earlier onset The following moderate relationship psychosis: age frequent exposure childhood trauma, concurrent substances genetic factors. Conclusion: is associated with In addition, there are this relationship; therefore need assess these factors, risk.

Language: Английский

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Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis

Psychological Medicine, Journal Year: 2022, Volume and Issue: 53(9), P. 3858 - 3868

Published: March 24, 2022

Abstract Background Epidemiological studies show a dose–response association between cannabis use and the risk of psychosis. This review aimed to determine whether there are identifiable risk-thresholds frequency psychosis development. Methods Systematic search Embase, MEDLINE, PsycINFO, CINAHL, Web Science for relevant (1 January 2010–26 April 2021). Case–control or cohort that investigated relationship development reported effect estimates [odds ratios (OR), hazard (HR), (RR)] raw data calculate them, with information on consumption were included. Effect extracted from individual converted RR. Two-stage multivariable meta-analytic models utilized sensitivity analyses conducted. The Newcastle Ottawa Scale was used assess bias included studies. Results Ten original (three cohorts, seven case–control) included, including 7390 participants an age range 12–65 years. Random-effect model meta-analyses showed significant log-linear A restricted cubic-splines provided best fit data, significantly increasing weekly more frequent [RR = 1.01, 95% confidence interval (CI) 0.93–1.11 yearly; RR 1.10, CI 0.97–1.25 monthly; 1.35, 1.19–1.52 weekly; 1.76, 1.47–2.12 daily] Conclusion Individuals using frequently at increased psychosis, no associated less use. Public health prevention messages should convey these risk-thresholds, which be refined through further work.

Language: Английский

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Evaluating the Exposome Score for Schizophrenia in a Transdiagnostic Psychosis Cohort: Associations With Psychosis Risk, Symptom Severity, and Personality Traits

Schizophrenia Bulletin, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 8, 2025

Abstract Background Investigations of causal pathways for psychosis can be guided by the identification environmental risk factors. A recently developed composite tool, exposome score schizophrenia (ES-SCZ), which controls intercorrelations between factors, has shown fair to good performance. We tested transdiagnostic classifier performance ES-SCZ with Bipolar-Schizophrenia Network Intermedial Phenotypes data and examined its relationship clinical-level outcomes. Study Design computed case-control from cross-sectional on 1055 volunteers psychotic diagnoses (schizophrenia, schizoaffective, bipolar psychosis) 510 controls. Multivariate regression models were used control correlations outcomes correct effects age, sex, family socioeconomic status across estimated association mood symptom severity, 5-factor model personality, function biologically defined biotypes, traditional diagnostic categories, Results was good. associations personality factor scores qualitatively similar groups decreased conscientiousness agreeableness increased neuroticism. The patterns symptoms differed biotypes diagnoses. Biotype 3 disorder had consistent within-group where greater predicted more severe worse function. Conclusions previous reports in this sample (adjusted odds ratio: 3.331 [2.834, 3.915], P &lt; .001; area under curve: 0.762 [0.735, 0.789]). Individual differences magnitude may useful investigating developmentally relevant exposures symptomatic expression psychosis.

Language: Английский

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The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review

Journal of Clinical Medicine, Journal Year: 2019, Volume and Issue: 8(7), P. 1058 - 1058

Published: July 19, 2019

The endogenous cannabinoid (eCB) system plays an important role in the pathophysiology of both psychotic disorders and substance use (SUDs). non-psychoactive compound, cannabidiol (CBD) is a highly promising tool treatment disorders. Here we review human clinical studies that investigated efficacy CBD for schizophrenia, disorders, their comorbidity. In particular, examined possible profiles patients who may benefit most from treatment. CBD, either as monotherapy or added to regular antipsychotic medication, improved symptoms with particularly effects early stages illness. A potential biomarker level anandamide blood. THC mixtures showed positive reducing short-term withdrawal craving cannabis Studies on schizophrenia comorbid are lacking. Future should focus different illness, together use. These standardized measures assess addition, future efforts be taken study relationship between eCB system, GABA/glutamate, immune reveal underlying neurobiology CBD.

Language: Английский

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The Impact of Cannabidiol on Human Brain Function: A Systematic Review

Frontiers in Pharmacology, Journal Year: 2021, Volume and Issue: 11

Published: Jan. 21, 2021

Background: Accumulating evidence suggests that the non-intoxicating cannabinoid compound cannabidiol (CBD) may have antipsychotic and anxiolytic properties, thus be a promising new agent in treatment of psychotic anxiety disorders. However, neurobiological substrates underlying potential therapeutic effects CBD are still unclear. The aim this systematic review is to provide detailed up-to-date literature overview neuroimaging studies investigated acute impact on human brain function. Methods: Papers published until May 2020 were included from PubMed following comprehensive search strategy pre-determined set criteria for article selection. We examined function healthy volunteers individuals diagnosed with psychiatric disorder, comprising both alone as well direct comparison those induced by ∆9-tetrahydrocannabinol (THC), main psychoactive component Cannabis . Results: One-ninety four identified, which 17 met inclusion criteria. All during resting state or context cognitive tasks. In volunteers, enhanced fronto-striatal connectivity, compared placebo THC. Furthermore, modulated activity had opposite when THC task-specific patterns various paradigms, such emotional processing (fronto-temporal), verbal memory (fronto-striatal), response inhibition (fronto-limbic-striatal), auditory/visual (temporo-occipital). at clinical high risk psychosis patients established psychosis, showed intermediate controls task performance. limbic subjects metabolite levels autism spectrum Conclusion: Neuroimaging shown induces significant alterations connectivity performance tasks disorder. This modulation functional networks relevant disorders, possibly reflecting CBD’s effects. Future should consider replication findings enlarge patients, combining longer-term assessments.

Language: Английский

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Cognitive Behavioral Therapy Program for Cannabis Use Cessation in First-Episode Psychosis Patients: A 1-Year Randomized Controlled Trial

International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(12), P. 7325 - 7325

Published: June 15, 2022

Despite the negative influence of cannabis use on development and prognosis first-episode psychosis (FEP), there is little evidence effective specific interventions for cessation in FEP. The aim this study was to compare efficacy a cognitive behavioral therapy (CBT) (CBT-CC) with treatment as usual (TAU) FEP users. In single-blind, 1-year randomized controlled trial, 65 participants were randomly assigned CBT-CC or TAU. primary outcome reduction severity. group had greater decrease severity positive psychotic symptoms over time, improvement functioning at post-treatment than response also faster group, reducing use, anxiety, general symptoms, improving earlier TAU follow-up. Moreover, patients who stopped and/or reduced during follow-up, decreased increased awareness disease compared those continued using cannabis. Early intervention based CBT cessation, may be severity, addition clinical functional outcomes

Language: Английский

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Associations Between Canada's Cannabis Legalization and Emergency Department Presentations for Transient Cannabis-Induced Psychosis and Schizophrenia Conditions: Ontario and Alberta, 2015–2019

The Canadian Journal of Psychiatry, Journal Year: 2022, Volume and Issue: 67(8), P. 616 - 625

Published: Jan. 12, 2022

Objective Cannabis legalization in many jurisdictions worldwide has raised concerns that such legislation might increase the burden of transient and persistent psychotic illnesses society. Our study aimed to address this issue. Methods Drawing upon emergency department (ED) presentations aggregated across Alberta Ontario, Canada records (April 1, 2015–December 31, 2019), we employed Seasonal Autoregressive Integrated Moving Average (SARIMA) models assess associations between Canada's cannabis (via Act implemented on October 17, 2018) weekly ED presentation counts following ICD-10-CA-defined target series cannabis-induced psychosis (F12.5; n = 5832) schizophrenia related conditions (“schizophrenia”; F20-F29; 211,661), as well two comparison amphetamine-induced (F15.5; 10,829) alcohol-induced (F10.5; 1,884). Results for doubled April 2015 December 2019. However, all four SARIMA models, there was no evidence significant step-function effects associated with post-legalization of: (1) [0.34 (95% CI −4.1; 4.8; P 0.88)]; (2) [24.34 −18.3; 67.0; 0.26)]; (3) [0.61 −0.6; 1.8; 0.31); or (4) [1.93 −2.8; 6.7; 0.43)]. Conclusion Implementation framework not changes presentations. Given potentially idiosyncratic rollout legalization, further research will be required establish whether results generalize other settings.

Language: Английский

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