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, Год журнала: 2021, Номер 99, С. 103381 - 103381

Опубликована: Авг. 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.

Язык: Английский

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Impact of cannabinoids on pregnancy, reproductive health, and offspring outcomes

American Journal of Obstetrics and Gynecology, Год журнала: 2022, Номер 227(4), С. 571 - 581

Опубликована: Май 31, 2022

Язык: Английский

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Risk of Adverse Neonatal Outcomes After Combined Prenatal Cannabis and Nicotine Exposure

JAMA Network Open, Год журнала: 2024, Номер 7(5), С. e2410151 - e2410151

Опубликована: Май 7, 2024

Importance The prevalence of cannabis use in pregnancy is rising and associated with adverse perinatal outcomes. In parallel, combined prenatal nicotine also increasing, but little known about the impact both substances on offspring outcomes compared each substance alone. Objective To assess exposure alone during pregnancy. Design, Setting, Participants This retrospective population-based cohort study included linked hospital discharge data (obtained from California Department Health Care Access Information) vital statistics Public Health) January 1, 2012, through December 31, 2019. Pregnant individuals singleton gestations gestational ages 23 to 42 weeks were included. Data analyzed October 14, 2023, March 4, 2024. Exposures Cannabis-related diagnosis product captured using codes International Classification Diseases, Ninth Revision, Clinical Modification , Statistical Tenth . Main Outcome Measures main infant neonatal death, infants small for age, preterm delivery. Results by multivariable Poisson regression models. A total 3 129 259 pregnant (mean [SD] maternal age 29.3 [6.0] years), whom 007 (0.7%) had a cannabis-related diagnosis, 56 811 (1.8%) nicotine-use 10 312 (0.3%) Compared nonusers, those or diagnoses increased rates (0.7% both) (0.3% (14.3% 13.7%, respectively), delivery (<37 weeks) (12.2% 12.0%, respectively). Moreover, risks higher death (1.2%; adjusted risk ratio [ARR], 2.18 [95% CI, 1.82-2.62]), (0.6%; ARR, 1.76 1.36-2.28]), (18.0%; 1.94 1.86-2.02]), (17.5%; 1.83 1.75-1.91]). Conclusions Relevance These findings suggest that co-occurring products an morbidity either Given increasing pregnancy, these can help guide health care practitioners preconception counseling, especially regarding benefits cessation.

Язык: Английский

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The Effects of Cannabis Use during Pregnancy on Low Birth Weight and Preterm Birth: A Systematic Review and Meta-analysis

American Journal of Perinatology, Год журнала: 2022, Номер 41(01), С. 017 - 030

Опубликована: Июль 28, 2022

Objective Our objective was to summarize the literature regarding effects of cannabis use during pregnancy on low birth weight (LBW), preterm (PTB), and small for gestational age (SGA). Study Design This is a systematic review meta-analysis. A search conducted in PubMed, Scopus, EBSCO, Web Science May 2021 updated November 2021. Only studies that assessed isolated pregnancy, controlling cigarette smoking, other illicit drug were included. Data synthesized using narrative summary pooled adjusted estimates, 95% confidence intervals (CIs) calculated each outcome. analyzed Stata 13.0 with METAN software package, random effects. Statistical heterogeneity Cochran's Q Higgins I2 tests. Results In total, 32 included data from approximately 5.5 million women LBW outcome 23 PTB SGA outcomes. Pregnant are at increased risk (adjusted odds ratio [aOR] = 1.52; CI [1.18; 1.96]), (aOR 1.39; [1.28; 1.51]), 1.47; [1.38; 1.58]). Studies type indicate higher risks spontaneous early or very-early PTBs associated pregnancy. The few timing frequency consumption suggest dose–response effect, negative outcomes among who reported heavy continued second third trimesters gestation. Conclusion There an effect irrespective drugs tobacco despite high quality evidence. need discuss public policies cannabis' regulation how it influences its consumption. Future should focus cannabis's (medicinal recreational), timing, dosage perinatal Key Points

Язык: Английский

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Long-term effects of prenatal cannabis exposure: Pathways to adolescent and adult outcomes

Pharmacology Biochemistry and Behavior, Год журнала: 2022, Номер 214, С. 173358 - 173358

Опубликована: Фев. 22, 2022

Язык: Английский

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Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians

Obstetrics and Gynecology, Год журнала: 2023, Номер unknown

Опубликована: Авг. 10, 2023

OBJECTIVE: To understand pregnant patients' reasons for prenatal cannabis use and perceptions of safety, desired undesirable health care experiences, information about secondarily to racial differences in these preferences. METHODS: We conducted a qualitative study including 18 semi-structured, race-concordant virtual focus groups with individuals who self-reported at entry large integrated system Northern California from November 2021 December 2021. The included semi-structured questions that were recorded, transcribed, coded by the research team. Thematic analysis was used analyze data. RESULTS: Overall, 53 participants included; 30 self-identified, as White 23 self-identified Black. Participants averaged 30.3 years age (SD 5.2 years) on average 20.9 weeks gestation enrollment; 69.8% reported daily use, 24.5% weekly 5.7% monthly or less entrance care. Although some quit early pregnancy because concerns potential risks, many perceived lack scientific evidence believed safe. Many preferred over-the-counter prescription medications treating mood, morning sickness, pain, sleep. valued open interactions obstetricians acknowledged their motivations they risks through conversations educational materials. Black participants' perspectives generally similar, but few uniquely described bias related use. CONCLUSION: Pregnant patients manage mood medical symptoms, safer than medications. Obstetrician-initiated, patient-centered around advice discontinue during pregnancy, exploration willingness switch medically recommended interventions pregnancy-related symptoms may benefit patients.

Язык: 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, Год журнала: 2023, Номер 19(2-3), С. 71 - 96

Опубликована: Июль 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.

Язык: Английский

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Social disadvantage during pregnancy: effects on gestational age and birthweight

Journal of Perinatology, Год журнала: 2023, Номер 43(4), С. 477 - 483

Опубликована: Март 13, 2023

Abstract Objective Whether psychosocial adversity during pregnancy impacts fetal health outcomes at birth remains underexplored. This is a critical issue given significant social disadvantage and stress faced by pregnant women worldwide. Study design Measures of psychological factors, medical/reproductive nutritional status in were obtained each trimester. Using Structural Equation Modeling (SEM), we investigated the relationship forms to other infant gestational age, birthweight. Results Among 399 singletons, Social Disadvantage significantly predicted age ( p = 0.003), residual birthweight 0.006). There was 0.4 week decrease 3% for standard deviation increase Disadvantage. Conclusion Significant negative effects on developing fetus found. Notably, these emerged despite good prenatal care after accounting maternal medical reproductive risk factors.

Язык: Английский

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Cannabis and Pregnancy: A Review

Obstetrical & Gynecological Survey, Год журнала: 2023, Номер 78(7), С. 411 - 428

Опубликована: Июль 1, 2023

Importance Prenatal cannabis use is rising and a major public health issue. Cannabis in pregnancy during lactation has been associated with increased maternal offspring morbidity mortality. Objective This review aims to summarize the existing literature current recommendations for or lactation. Evidence Acquisition A PubMed, Cochrane Library, Google Scholar search using following terms was performed gather relevant data: “cannabis,” “cannabinoid,” “delta-9-tetrahydrocannabinol,” “THC,” “cannabidiol,” “fetal outcomes,” “perinatal “pregnancy,” “lactation.” Results Available studies on were reviewed support an association risk of preterm birth, neonatal intensive care unit admission, low birth weight, small-for-gestational-age infants. Conclusion Relevance There critical need research effects necessary first step before furthering patient education, developing interventions, targeting antenatal surveillance ameliorate adverse impacts fetal health. Target Audience Obstetricians gynecologists, family physicians, pediatricians Learning Objectives After participating this activity, learner should be better able describe options treatment disorder; explain common forms cannabinoids available use; discuss screening pregnancy.

Язык: Английский

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Prenatal Exposure to Cannabis: Effects on Childhood Obesity and Cardiometabolic Health

Current Obesity Reports, Год журнала: 2024, Номер 13(1), С. 154 - 166

Опубликована: Янв. 3, 2024

Abstract Purpose of Review To consolidate information on the obesogenic and cardiometabolic effects prenatal exposure to cannabis. Recent Findings A PubMed search strategy updated from January 1, 2014, through 14 June 2023, produced a total 47 epidemiologic studies 12 animal studies. Prenatal cannabis is consistently associated with small for gestational age low birth weight. After birth, these offspring gain weight rapidly have increased adiposity higher glucose (fat mass percentage) in childhood. More preclinical prospective are needed deepen our understanding whether associations vary by sex, dose, timing, composition (e.g., ratio delta-Δ9-tetrahydrocannabinol [Δ9-THC] cannabidiol [CBD]). Addressing gaps may help solidify causality identify intervention strategies. Summary Based available data, clinicians public health officials should continue caution against use during pregnancy limit its potential adverse offspring.

Язык: Английский

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