Effects of cannabis

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A dried cannabis flower Marijuana-Cannabis-Weed-Bud-Gram.jpg
A dried cannabis flower

The short-termeffects of cannabis are caused by many chemical compounds in the cannabis plant, including 113[ clarification needed ] different cannabinoids, such as tetrahydrocannabinol (THC), and 120 terpenes, [1] which allow its drug to have various psychological and physiological effects on the human body. Different plants of the genus Cannabis contain different and often unpredictable concentrations of THC and other cannabinoids and hundreds of other molecules that have a pharmacological effect, [2] [3] so the final net effect cannot reliably be foreseen. Acute effects while under the influence can sometimes include euphoria or anxiety. [4] [5] Although some assert that cannabidiol (CBD), another cannabinoid found in cannabis in varying amounts, may alleviate the adverse effects of THC that some users experience, [6] little is known about CBD's effects on humans. [7] [8] Cannabinoid receptor antagonists have previously been tested as antidotes for cannabis intoxication with success, reducing or eliminating the physiological and psychological effects of intoxication. [9] Some of these products are currently in development as cannabis antidotes.

Contents

Background and chronic use

In the United States, medical cannabis research is limited by federal restrictions. [10]

Cannabis use disorder is defined as a medical diagnosis in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). [11]

Chemistry

The structural formula of tetrahydrocannabinol THC-skeletal.png
The structural formula of tetrahydrocannabinol
Tetrahydrocannabivarin THV structure.png
Tetrahydrocannabivarin
Cannabidiol Cannabidiol.png
Cannabidiol
Cannabinol CBN structure.png
Cannabinol
Cannabivarin Cannabivarin.png
Cannabivarin
Cannabidivarin Cannabidivarin.png
Cannabidivarin

Cannabinoids and cannabinoid receptors

The most prevalent psychoactive substances in cannabis are cannabinoids, particularly THC. Some varieties, having undergone careful selection and growing techniques, can yield as much as 34% THC. [12] Another psychoactive cannabinoid present in Cannabis sativa is tetrahydrocannabivarin (THCV), but it is only found in small amounts and is a cannabinoid antagonist. [13]

There are similar compounds in cannabis that do not exhibit psychoactive response but are obligatory for functionality: cannabidiol (CBD), an isomer of THC; cannabivarin (CBV), an analog of cannabinol (CBN) with a different side chain, cannabidivarin (CBDV), an analog of CBD with a different side chain, and cannabinolic acid. CBD is believed to regulate the metabolism of THC by inactivating cytochrome P450 enzymes that metabolize drugs; one such mechanism is via generation of carbon monoxide (a pharmacologically active neurotransmitter) by upon metabolism of CBD. [14] THC is converted rapidly to 11-hydroxy-THC, which is also pharmacologically active, so the euphoria outlasts measurable THC levels in blood. [15]

Biochemical mechanisms in the brain

Cannabinoids usually contain a 1,1'-di-methyl-pyran ring, a variedly derivatized aromatic ring and a variedly unsaturated cyclohexyl ring and their immediate chemical precursors, constituting a family of about 60 bi-cyclic and tri-cyclic compounds. Like most other neurological processes, the effects of cannabis on the brain follow the standard protocol of signal transduction, the electrochemical system of sending signals through neurons for a biological response. It is now understood that cannabinoid receptors appear in similar forms in most vertebrates and invertebrates and have a long evolutionary history of 500 million years. The binding of cannabinoids to cannabinoid receptors decrease adenylyl cyclase activity, inhibit calcium N channels, and disinhibit K+A channels. There are at least two types of cannabinoid receptors (CB1 and CB2). [16]

Sustainability in the body

Most cannabinoids are lipophilic (fat soluble) compounds that are easily stored in fat, thus yielding a long elimination half-life relative to other recreational drugs. The THC molecule, and related compounds, are usually detectable in drug tests from 3 days up to 10 days.[ citation needed ] Long-term users can produce positive tests for two to three months after ceasing cannabis use (see drug test). [17]

Toxicities

When cannabis is smoked, blood levels of THC peak rapidly after a few minutes and then decline, although the psychotropic effects persist for longer. Edible forms of cannabis often contain several hundred milligrams of THC, much more than the 32 mg of a typical cannabis cigarette.[ citation needed ] The rise of edible cannabis products has been responsible for a large increase of poisoning of children and young people.[ citation needed ] Symptoms in children can include lethargy, sedation and seizure. [18]

Synthetic cannabis is suspected of being a potential contributory factor or direct cause of sudden death, due to the strain it can place on the cardiovascular system, or because of cannabinoid hyperemesis syndrome. [19]

THC, the principal psychoactive constituent of the cannabis plant, has an extremely low toxicity and the amount that can enter the body through the consumption of cannabis plants poses no threat of death. In dogs, the minimum lethal dose of THC is over 3000 mg/kg. [20] According to The Merck Index , [21] the LD50 of THC (the dose which causes the death of 50% of individuals) is 1270 mg/kg for male rats and 730 mg/kg for female rats from oral consumption in sesame oil, and 42 mg/kg for rats from inhalation. [22]

Cannabinoids and other molecules present in cannabis can alter the metabolism of other drugs, especially due to competition for clearing metabolic pathways such as cytochromes CYP450, thus leading to drug toxicities by medications that the person consuming cannabis may be taking. [23]

A man smoking cannabis in Kolkata, India Ganja Smoking - Gangasagar Fair Transit Camp - Kolkata 2013-01-12 2646.JPG
A man smoking cannabis in Kolkata, India

A 2007 study found that while tobacco and cannabis smoke are quite similar, cannabis smoke contained higher amounts of ammonia, hydrogen cyanide, and nitrogen oxides, but lower levels of carcinogenic polycyclic aromatic hydrocarbons (PAHs). [24] This study found that directly inhaled cannabis smoke contained as much as 20 times as much ammonia and 5 times as much hydrogen cyanide as tobacco smoke and compared the properties of both mainstream and sidestream (smoke emitted from a smouldering 'joint' or 'cone') smoke. [24] Mainstream cannabis smoke was found to contain higher concentrations of selected polycyclic aromatic hydrocarbons (PAHs) than sidestream tobacco smoke. [24] However, other studies have found much lower disparities in ammonia and hydrogen cyanide between cannabis and tobacco, and that some other constituents (such as polonium-210, lead, arsenic, nicotine, and tobacco-specific nitrosamines) are either lower or non-existent in cannabis smoke. [25] [26] A 2021 longitudinal study conducted among populations of HIV-positive and HIV-negative adults found that smoke-related carcinogenic toxicants and biomarkers detected in tobacco smokers were also detected in exclusive cannabis smokers, including carbon monoxide (CO), polycyclic aromatic hydrocarbons (PAHs), aldehydes (such as acrolein), acrylonitrile and acrylamide metabolites, but exposures are lower compared with tobacco or dual smokers. [27] Increased levels of acrolein exposure by tobacco smoking but not exclusive cannabis smoking were detected both in HIV-positive and HIV-negative adults, and contribute to increased diagnoses of cardiovascular diseases and respiratory diseases among tobacco smokers. [27]

Cannabis smoke contains thousands of organic and inorganic chemical compounds. This tar is chemically similar to that found in tobacco smoke or cigars. [28] Over fifty known carcinogens have been identified in cannabis smoke. [29] These include nitrosamines, reactive aldehydes, and polycylic hydrocarbons, including benz[a]pyrene. [30] Cannabis smoke was listed as a cancer agent in California in 2009. [31] A study by the British Lung Foundation published in 2012 identifies cannabis smoke as a carcinogen and also finds awareness of the danger is low compared with the high awareness of the dangers of smoking tobacco particularly among younger users. Other observations include possible increased risk from each cigarette; lack of research on the effect of cannabis smoke alone; low rate of addiction compared to tobacco; and episodic nature of cannabis use compared to steady frequent smoking of tobacco. [32] [ unreliable medical source? ] Professor David Nutt, a UK drug expert, points out that the study cited by the British Lung Foundation has been accused of both "false reasoning" and "incorrect methodology". Further, he notes that other studies have failed to connect cannabis with lung cancer, and accuses the BLF of "scaremongering over cannabis". [33]

Short-term effects

Difference between natural cannabinoids and THC: THC CB-1 receptor Neurotransmitters Postsynaptic Receptors Cannabinoid Cannabinoid Receptors With THC-2.svg
Difference between natural cannabinoids and THC:
  1. THC
  2. CB-1 receptor
  3. Neurotransmitters
  4. Postsynaptic Receptors
  5. Cannabinoid

Onset and duration

When smoked, the short-term effects of cannabis manifest within seconds and are fully apparent within a few minutes, [34] typically lasting 1–3 hours, varying by the person and the strain of cannabis. [35] With oral ingestion, however, the onset of effect is delayed, taking 30 minutes to 2 hours, but the duration is prolonged due to continued slow absorption. [34] The duration of noticeable effects has been observed to diminish after prolonged, repeated use leading to the development of increased tolerance to cannabinoids. [36]

Psychological effects

The psychoactive effects of cannabis, known as a "high", are subjective and vary among persons and the method of use.

When THC enters the blood stream and reaches the brain, it binds to cannabinoid receptors. The endogenous ligand of these receptors is anandamide, the effects of which THC emulates. This agonism of the cannabinoid receptors results in changes in the levels of various neurotransmitters, especially dopamine and norepinephrine, which are closely associated with the acute effects of cannabis ingestion, such as euphoria and anxiety. Some effects may include a general altered state of consciousness, euphoria, relaxation or stress reduction, increased appreciation of the arts, including humor and music, joviality, metacognition and introspection, enhanced recollection (episodic memory), and increased sensuality, sensory awareness, libido, and creativity. [37] Abstract or philosophical thinking, disruption of linear memory and paranoia or anxiety are also typical. Anxiety is cannabis's most commonly reported adverse side effect. Up to 30 percent of recreational users experience intense anxiety and/or panic attacks after smoking cannabis. Some report anxiety only after not smoking cannabis for a prolonged period of time. [38] Inexperience and use in an unfamiliar environment are major contributing factors to this anxiety. Cannabidiol (CBD), another cannabinoid found in cannabis, has been shown to mitigate THC's adverse effects, including anxiety. [39]

Cannabis produces many other subjective effects, including increased enjoyment of food taste and aroma, and marked distortions in the perception of time. At higher doses, effects can include altered body image, auditory or visual illusions, pseudohallucinations, and ataxia from selective impairment of polysynaptic reflexes.[ citation needed ] In some cases, cannabis can lead to acute psychosis and dissociative states such as depersonalization [40] [41] and derealization. [42]

Furthermore, even in those with no family history of psychosis, the administration of pure THC in clinical settings has been demonstrated to elicit transient psychotic symptoms. [43] [44] [45] [46] Any episode of acute psychosis that accompanies cannabis use usually abates after six hours, but in rare instances, users may find the symptoms continuing for many days. [47]

While psychoactive drugs are typically categorized as stimulants, depressants, or hallucinogens, cannabis exhibits a mix of all of these effects. Scientific studies have suggested that other cannabinoids like CBD may also play a significant role in its psychoactive effects. [48] [49] [50]

Somatic effects

Cannabis use can decrease blood pressure, which increases the risk of fainting. [51] Combining alcohol with cannabis greatly increases the level of impairment and the risk of injury or death from accidents. [52]

Bloodshot eye Bloodshot EyeBall.jpg
Bloodshot eye

Some of the short-term physical effects of cannabis use include increased heart rate, dry mouth, reddening of the eyes (congestion of the conjunctival blood vessels), a reduction in intra-ocular pressure, muscle relaxation, and a sensation of cold or hot hands and feet. [53]

Electroencephalography (EEG) shows somewhat more persistent alpha waves of slightly lower frequency than usual. [54] Cannabinoids produce a marked depression of motor activity via activation of receptors of cannabinoid receptor type 1. [55]

Duration

Peak levels of cannabis-associated intoxication occur about 20 minutes after smoking it and last several hours. [56] The total short-term duration of cannabis use when smoked depends on the potency, method of smoking – e.g. whether pure or in conjunction with tobacco – and quantity. Peak levels of intoxication typically last an average of three to four hours. [56] When taken orally (in the form of capsules, food, or drink), the psychoactive effects take longer to manifest and generally last longer, typically an average of four to six hours after consumption. [57] [ unreliable medical source? ] Oral ingestion use eliminates the need to inhale toxic combustion products created by smoking and therefore negates the risk of respiratory harm associated with cannabis smoking.

Appetite

Increased appetite after cannabis use has been documented for hundreds of years [58] and is known colloquially as the "munchies". Clinical studies and survey data have found that cannabis increases food enjoyment and interest in food. [59] [60] A 2015 study suggests that cannabis triggers uncharacteristic behaviour in proopiomelanocortin (POMC) neurons, which are usually associated with decreasing hunger. [61] [62]

Endogenous cannabinoids, more commonly known as endocannabinoids, exist in cow and human milk. [63] [64] [65] [66] [67] [68] [69] It is widely accepted that the neonatal survival of many species is largely dependent upon their suckling behavior, and research has identified the endogenous cannabinoid system as the first neural system to display complete control over milk ingestion and neonatal survival. [70] [69]

Cardiovascular effects

Short-term (one to two hours) effects on the cardiovascular system can include increased heart rate, dilation of blood vessels, and fluctuations in blood pressure. [71] [72] [73] There are medical reports of occasional heart attacks or myocardial infarction, stroke, and other cardiovascular side effects. [74] Cannabis's cardiovascular effects are not associated with serious health problems for most young, healthy users. [74] Researchers reported in the International Journal of Cardiology , "Marijuana use by older people, particularly those with some degree of coronary artery or cerebrovascular disease, poses greater risks due to the resulting increase in catecholamines, cardiac workload, and carboxyhemoglobin levels, and concurrent episodes of profound postural hypotension. Indeed, marijuana may be a much more common cause of myocardial infarction than is generally recognized. In day-to-day practice, a history of marijuana use is often not sought by many practitioners, and even when sought, the patient's response is not always truthful". [75]

A 2013 analysis of 3,886 myocardial infarction survivors over an 18-year period showed "no statistically significant association between marijuana use and mortality". [76]

A 2008 study by the National Institutes of Health Biomedical Research Centre in Baltimore found that heavy, chronic smoking of marijuana (138 joints per week) changed blood proteins associated with heart disease and stroke. [77]

A 2000 study by researchers at Boston's Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Harvard School of Public Health found that a middle-aged person's risk of heart attack rises nearly fivefold in the first hour after smoking cannabis, "roughly the same risk seen within an hour of sexual activity". [78] [79]

Cannabis arteritis is a very rare peripheral vascular disease similar to Buerger's disease. There were about 50 confirmed cases from 1960 to 2008, all in Europe. [80]

Memory and learning

Studies on cannabis and memory are hindered by small sample sizes, confounding drug use, and other factors. [81] The strongest evidence regarding cannabis and memory focuses on its temporary negative effects on short-term and working memory. [81]

In a 2001 study of neuropsychological performance in long-term cannabis users, researchers found "some cognitive deficits appear detectable at least 7 days after heavy cannabis use but appear reversible and related to recent cannabis exposure rather than irreversible and related to cumulative lifetime use". [82] Of his studies on cannabis use, lead researcher and Harvard professor Harrison Pope said he found it is not dangerous over the long term, but there are short-term effects. From neuropsychological tests, Pope found that chronic cannabis users showed difficulty with verbal memory in particular for "at least a week or two" after they stopped smoking. Within 28 days, memory problems vanished and the subjects "were no longer distinguishable from the comparison group". [83] Researchers at the University of California, San Diego School of Medicine failed to show substantial, systemic neurological effects from long-term cannabis use. Their findings were published in the July 2003 issue of the Journal of the International Neuropsychological Society. [84] The research team, headed by Igor Grant, found that cannabis use affects perception but does not cause permanent brain damage. Researchers looked at data from 15 previously published controlled studies involving 704 long-term cannabis users and 484 nonusers. The results showed long-term cannabis use was only marginally harmful on memory and learning. Other functions such as reaction time, attention, language, reasoning ability, and perceptual and motor skills were unaffected. The observed effects on memory and learning, they said, showed long-term cannabis use caused "selective memory defects", but "of a very small magnitude". [85] A study by Johns Hopkins University School of Medicine found that heavy cannabis use is associated with decrements in neurocognitive performance even after 28 days of abstinence. [86]

Effects on driving

Several studies have shown increased risk associated with cannabis use by drivers, but others have found no increased risk. [87] Cannabis usage has been shown in some studies to have an adverse effect on driving ability. [88] The British Medical Journal indicated that "drivers who consume cannabis within three hours of driving are nearly twice as likely to cause a vehicle collision as those who are not under the influence of drugs or alcohol". [89]

In Cannabis and driving: a review of the literature and commentary, the United Kingdom's Department for Transport reviewed data on cannabis and driving, finding that, although impaired, "subjects under cannabis treatment appear to perceive that they are indeed impaired. Where they can compensate, they do". [90] In a review of driving simulator studies, researchers found that "even in those who learn to compensate for a drug's impairing effects, substantial impairment in performance can still be observed under conditions of general task performance (i.e. when no contingencies are present to maintain compensated performance)." [91]

A 2012 meta-analysis found that acute cannabis use increased the risk of an automobile crash. [92] An extensive 2013 review of 66 studies of crash risk and drug use found that cannabis is associated with slightly but not statistically significantly increased odds of injury or fatal accident. [93]

In the largest and most precisely controlled study of its kind, carried out by the U.S. Department of Transportation's National Highway Traffic Safety Administration, it was found that other "studies that measure the presence of THC in the drivers' blood or oral fluid, rather than relying on self-report tend to have much lower (or no) elevated crash risk estimates. Likewise better controlled studies have found lower (or no) elevated crash risk estimates". [87] The study found that "after adjusting for age, gender, race and alcohol use, drivers who tested positive for marijuana were no more likely to crash than those who had not used any drugs or alcohol prior to driving". [94] A 2018 study found that fatal crashes involving cannabis increased in Colorado, Washington, and Massachusetts after recreational cannabis legalization or decriminalization. [95]

Combination with other drugs

A confounding factor in cannabis research is the prevalent usage of other recreational drugs, especially alcohol and nicotine. [96] Such complications demonstrate the need for studies with stronger controls, and investigations into alleged symptoms of cannabis use that may also be caused by tobacco. Some critics question whether agencies doing the research make an honest effort to present an unbiased summary of the evidence without "cherry-picking" data to please funding sources such as the tobacco industry or governments dependent on cigarette tax revenue; others caution that the raw data, and not the final conclusions, are what should be examined. [97]

The Australian National Household Survey of 2001 [98] found that cannabis is rarely used in Australia without other drugs. 95% of cannabis users also drank alcohol; 26% took amphetamines; 19% took ecstasy and only 2.7% reported not having used any other drug with cannabis. [99] While there has been research on the combined effects of alcohol and cannabis on performing certain tasks, little has been done on the reasons this combination is so popular. Evidence from a controlled experimental study by Lukas and Orozco [100] suggests that alcohol causes THC to be absorbed more rapidly into the user's blood plasma. Data from the Australian National Survey of Mental Health and Wellbeing [101] found that three-quarters of recent cannabis users reported using alcohol when cannabis was not available, suggesting that the two have similar effects. [102]

Pathogens and microtoxins

Most microorganisms found in cannabis affect only plants, not humans, but some, especially those that proliferate when the herb is not correctly dried and stored, can be harmful to humans. Some users store cannabis in an airtight bag or jar in a refrigerator to prevent fungal and bacterial growth. [103]

Aspergillus fumigatus Aspergillus.jpg
Aspergillus fumigatus

The fungi Aspergillus flavus , [104] Aspergillus fumigatus , [104] Aspergillus niger , [104] Aspergillus parasiticus , Aspergillus tamarii , Aspergillus sulphureus , Aspergillus repens , Mucor hiemalis (not a human pathogen), Penicillium chrysogenum , Penicillium italicum , and Rhizopus nigricans have been found in moldy cannabis. [103] Aspergillus mold species can infect the lungs via smoking or handling of infected cannabis and cause opportunistic and sometimes deadly aspergillosis. [105] Some of the microorganisms found create aflatoxins, which are toxic and carcinogenic. Mold is also found in smoke from mold-infected cannabis, [103] [104] and the lungs and nasal passages are a major means of contracting fungal infections. Levitz and Diamond (1991) suggest baking cannabis in home ovens at 150 °C [302 °F], for five minutes before smoking. Oven treatment killed conidia of A. fumigatus, A. flavus and A. niger, and did not lower THC levels. [103] Cannabis contaminated with Salmonella muenchen was correlated with dozens of cases of salmonellosis in 1981. [106] Thermophilic actinomycetes were also found in cannabis. [104]

Long-term effects

Exposure to cannabis may have biologically based physical, mental, behavioral, and social health consequences and is "associated with diseases of the liver (particularly with co-existing hepatitis C), lungs, heart, eyesight, and vasculature" according to a 2013 literature review by Gordon and colleagues. The association with these diseases has only been reported in cases where people have smoked cannabis. The authors cautioned that "evidence is needed, and further research should be considered, to prove causal associations of cannabis with many physical health conditions". [107]

Cannabis use disorder is defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition requiring treatment. [107] Several drugs have been investigated in an attempt to ameliorate the symptoms of stopping cannabis use. Such drugs include bupropion, divalproex, nefazodone, lofexidine, and dronabinol. Of these, dronabinol (a trade name for THC) has proven the most effective. [108] The drugs buspirone and rimonabant have shown some success in helping maintain cannabis abstinence. [109]

There is evidence that long-term use of cannabis increases the risk of psychosis, regardless of confounding factors, and particularly for people who have genetic risk factors. [110] A 2019 meta-analysis found that 34% of people with cannabis-induced psychosis transitioned to schizophrenia. This was found to be comparatively higher than hallucinogens (26%) and amphetamines (22%). [111]

Long-term cannabis users are at risk for developing cannabinoid hyperemesis syndrome (CHS), characterized by recurrent bouts of intense vomiting and abdominal cramping during or within 48 hours of heavy cannabis use. [112] The mechanism behind CHS is poorly understood and is contrary to the antiemetic properties of cannabis and cannabinoids. Of those who went to the emergency department (ED) with recurrent vomiting in one institution in the United States from 2005 to 2010, about 6% had the condition. [113] [114] The condition is usually not responsive to traditionally used antiemetics and the primary treatment is cessation from cannabis use. [112]

Smoking cannabis can potentially cause cancer, due to carcinogens present in smoke. [115] [116] [117]

Effects in pregnancy

Cannabis consumption in pregnancy might be associated with restrictions in growth of the fetus, miscarriage, and cognitive deficits in offspring based on animal studies, although there is limited evidence for this in humans at this time. [118] A 2012 systematic review found although it was difficult to draw firm conclusions, there was some evidence that prenatal exposure to cannabis was associated with "deficits in language, attention, areas of cognitive performance, and delinquent behavior in adolescence". [119] A report prepared for the Australian National Council on Drugs concluded cannabis and other cannabinoids are contraindicated in pregnancy as it may interact with the endocannabinoid system. [120]

Effects in pediatrics

Children can become exposed to cannabis, typically through accidental exposure which can lead to very high doses, especially in the case of edibles. Unlike in adults, these levels of exposure can lead to major complications in children. [121] These complications include encephalopathy, hypotension, respiratory depression severe enough to require ventilation, somnolence, coma, and in extreme cases, reports of death. [121] [122] [123] Pediatric exposure to edibles is of increasing concern because these products are typically sweets (gummies, cookies, etc.), and their prevalence is increasing as cannabis is legalized or decriminalized in many territories. [124]

See also

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Synthetic cannabinoids are a class of designer drug molecules that bind to the same receptors to which cannabinoids in cannabis plants attach. These novel psychoactive substances should not be confused with synthetic phytocannabinoids or synthetic endocannabinoids from which they are in many aspects distinct.

<span class="mw-page-title-main">Dronabinol</span> Generic name of Δ9-THC in medicine

Dronabinol, sold under the brand names Marinol and Syndros, is the generic name for the molecule of (−)-trans-Δ9-tetrahydrocannabinol (THC) in the pharmaceutical context. It has indications as an appetite stimulant, antiemetic, and sleep apnea reliever and is approved by the U.S. Food and Drug Administration (FDA) as safe and effective for HIV/AIDS-induced anorexia and chemotherapy-induced nausea and vomiting.

<span class="mw-page-title-main">Long-term effects of cannabis</span>

The long-term effects of cannabis have been the subject of ongoing debate. Given that the use of cannabis is illegal in most countries, clinical research presents a challenge and there is limited evidence from which to draw conclusions. In 2017, the U.S. National Academies of Sciences, Engineering, and Medicine issued a report summarizing much of the published literature on health effects of cannabis, into categories regarded as conclusive, substantial, moderate, limited and of no or insufficient evidence to support an association with a particular outcome.

<span class="mw-page-title-main">Cannabis use disorder</span> Continued use of cannabis despite clinically significant impairment

Cannabis use disorder (CUD), also known as cannabis addiction or marijuana addiction, is a psychiatric disorder defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and ICD-10 as the continued use of cannabis despite clinically significant impairment.

<span class="mw-page-title-main">Tetrahydrocannabinolic acid</span> THC precursor

Tetrahydrocannabinolic acid is a precursor of tetrahydrocannabinol (THC), an active component of cannabis.

<span class="mw-page-title-main">Cannabis in pregnancy</span> Effects of cannabis consumption during pregnancy

Cannabis consumption in pregnancy is an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.

<span class="mw-page-title-main">Medical cannabis research</span> Medical research on using cannabis

Medical cannabis research includes any medical research on using cannabis. The earliest systematic studies of physiological effects of cannabis-derived chemical were conducted in the 1920's. The level or research activity in this area remained relatively low and constant until 1966, when a 10-fold increase in publication activity occurred within 10 years. After the adoption of the Convention on Psychotropic Substances in 1971 there was a drop in research publishing, which continued till ca. 1987. Since then, cannabis research has been continuously on the rise. There is no apparent inflection point is 2013, when Uruguay "became the first country in the world to fully regulate its marijuana market, from production to consumption and distribution." Since then a large number of countries enacted policies on medical cannabis research, and there are substantial differences between such policies in different countries.

<span class="mw-page-title-main">Δ-8-Tetrahydrocannabinol</span> Isomer of tetrahydrocannabinol

Δ-8-tetrahydrocannabinol is a psychoactive cannabinoid found in the cannabis plant. It is an isomer of delta-9-tetrahydrocannabinol, the compound commonly known as THC, with which it co-occurs in hemp; natural quantities of ∆8-THC found in hemp are low. Psychoactive effects are similar to that of Δ9-THC, with central effects occurring by binding to cannabinoid receptors found in various regions of the brain.

References

  1. ↑ Aizpurua-Olaizola O, Soydaner U, Öztürk E, Schibano D, Simsir Y, Navarro P, Etxebarria N, Usobiaga A (February 2016). "Evolution of the Cannabinoid and Terpene Content during the Growth of Cannabis sativa Plants from Different Chemotypes". Journal of Natural Products. 79 (2): 324–31. doi:10.1021/acs.jnatprod.5b00949. PMID   26836472. Archived from the original on 5 January 2023. Retrieved 24 November 2022.
  2. ↑ Rudolf Brenneisen. "Chemistry and Analysis of Phytocannabinoids and Other Cannabis Constituents" (PDF). Medicinalgenomics.com. Archived (PDF) from the original on 7 April 2018. Retrieved 9 April 2018.
  3. ↑ Atakan Z (December 2012). "Cannabis, a complex plant: different compounds and different effects on individuals". Therapeutic Advances in Psychopharmacology. 2 (6): 241–54. doi:10.1177/2045125312457586. PMC   3736954 . PMID   23983983.
  4. ↑ Osborne GB, Fogel C (2008). "Understanding the motivations for recreational marijuana use among adult Canadians". Substance Use & Misuse. 43 (3–4): 539–72, discussion 573–9, 585–7. doi:10.1080/10826080701884911. PMID   18365950. S2CID   31053594.
  5. ↑ Ranganathan M, D'Souza DC (November 2006). "The acute effects of cannabinoids on memory in humans: a review". Psychopharmacology. 188 (4): 425–44. doi:10.1007/s00213-006-0508-y. PMID   17019571. S2CID   10328820.
  6. ↑ Grotenhermen F (2003). "Pharmacokinetics and pharmacodynamics of cannabinoids". Clinical Pharmacokinetics. 42 (4): 327–60. doi:10.2165/00003088-200342040-00003. PMID   12648025. S2CID   25623600.
  7. ↑ White CM (July 2019). "A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential". Journal of Clinical Pharmacology. 59 (7): 923–934. doi:10.1002/jcph.1387. PMID   30730563. S2CID   73452711.
  8. ↑ Haney M, Malcolm RJ, Babalonis S, Nuzzo PA, Cooper ZD, Bedi G, et al. (July 2016). "Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis". Neuropsychopharmacology. 41 (8): 1974–82. doi:10.1038/npp.2015.367. PMC   4908634 . PMID   26708108.
  9. ↑ Sabioni, Pamela; Le Foll, Bernard (2018). "Psychosocial and pharmacological interventions for the treatment of cannabis use disorder". F1000Research. 7: 173. doi: 10.12688/f1000research.11191.1 . ISSN   2046-1402. PMC   5811668 . PMID   29497498.
  10. ↑ Borgelt LM, Franson KL, Nussbaum AM, Wang GS (February 2013). "The pharmacologic and clinical effects of medical cannabis". Pharmacotherapy (Review). 33 (2): 195–209. CiteSeerX   10.1.1.1017.1935 . doi:10.1002/phar.1187. PMID   23386598. S2CID   8503107.
  11. ↑ Grohol, John M. (21 May 2013) Psy.D:DSM-5 Changes: Addiction, Substance-Related Disorders & Alcoholism Archived 11 December 2017 at the Wayback Machine . Pro.psychcentral.com. Retrieved on 19 December 2016.
  12. ↑ Escondido N (26 April 2017). "The Strongest Strains on Earth 2017". High Times . Archived from the original on 1 July 2018. Retrieved 30 June 2018.
  13. ↑ Turner CE, Bouwsma OJ, Billets S, Elsohly MA (June 1980). "Constituents of Cannabis sativa L. XVIII--Electron voltage selected ion monitoring study of cannabinoids". Biomedical Mass Spectrometry. 7 (6): 247–56. doi:10.1002/bms.1200070605. PMID   7426688.
  14. ↑ Hopper, Christopher P.; Zambrana, Paige N.; Goebel, Ulrich; Wollborn, Jakob (June 2021). "A brief history of carbon monoxide and its therapeutic origins". Nitric Oxide. 111–112: 45–63. doi:10.1016/j.niox.2021.04.001. PMID   33838343. S2CID   233205099. Archived from the original on 25 May 2021. Retrieved 23 April 2021.
  15. ↑ H.K. Kalant; W.H.E. Roschlau (1998). Principles of Medical Pharmacology (6th ed.). pp. 373–375.
  16. ↑ Pertwee RG (January 1997). "Pharmacology of cannabinoid CB1 and CB2 receptors". Pharmacology & Therapeutics. 74 (2): 129–80. doi:10.1016/S0163-7258(97)82001-3. PMID   9336020.
  17. ↑ "How long does cannabis stay in the body after smoking?". NHS. Archived from the original on 16 July 2015. Retrieved 4 August 2015.[ failed verification ]
  18. ↑ Blohm E, Sell P, Neavyn M (April 2019). "Cannabinoid toxicity in pediatrics". Curr Opin Pediatr. 31 (2): 256–261. doi:10.1097/MOP.0000000000000739. PMID   30694824. S2CID   59410966.
  19. ↑ Drummer OH, Gerostamoulos D, Woodford NW (May 2019). "Cannabis as a cause of death: A review". Forensic Sci Int. 298: 298–306. doi:10.1016/j.forsciint.2019.03.007. PMID   30925348. S2CID   87511682.
  20. ↑ Fitzgerald KT, Bronstein AC, Newquist KL (February 2013). "Marijuana poisoning". Topics in Companion Animal Medicine. 28 (1): 8–12. doi:10.1053/j.tcam.2013.03.004. PMID   23796481.
  21. ↑ 1996. The Merck Index, 12th ed., Merck & Co., Rahway, New Jersey
  22. ↑ "Cannabis Chemistry". Erowid.org. Archived from the original on 14 March 2007. Retrieved 29 July 2007.
  23. ↑ Zendulka, Ondřej; Dovrtělová, Gabriela; Nosková, Kristýna; Turjap, Miroslav; Šulcová, Alexandra; Hanuš, Lumír; Juřica, Jan (2016). "Cannabinoids and Cytochrome P450 Interactions". Current Drug Metabolism. 17 (3): 206–226. doi:10.2174/1389200217666151210142051. PMID   26651971.
  24. 1 2 3 Moir D, Rickert WS, Levasseur G, Larose Y, Maertens R, White P, Desjardins S (February 2008). "A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions". Chemical Research in Toxicology. 21 (2): 494–502. doi: 10.1021/tx700275p . PMID   18062674.
  25. ↑ Institute of Medicine (1982). Marijuana and Health . Washington, D.C.: The National Academies Press. doi:10.17226/18942. ISBN   978-0-309-03236-0.
  26. ↑ Malmo-Levine, David (2 January 2002). "Radioactive Tobacco". acsa2000.net. Archived from the original on 12 January 2013.
  27. 1 2 Lorenz, David R.; Misra, Vika; Chettimada, Sukrutha; Uno, Hajime; Wang, Lanqing; Blount, Benjamin C.; De Jesus, Victor R.; Gelman, Benjamin B.; Morgello, Susan; Wolinsky, Steven M.; Gabuzda, Dana (January 2021). "Acrolein and other toxicant exposures in relation to cardiovascular disease among marijuana and tobacco smokers in a longitudinal cohort of HIV-positive and negative adults" (PDF). eClinicalMedicine. 31 (100697). Elsevier: 100697. doi: 10.1016/j.eclinm.2020.100697 . PMC   7846668 . PMID   33554087. S2CID   231802821. Archived from the original on 20 April 2023. Retrieved 7 September 2021.
  28. ↑ Hashibe M, Straif K, Tashkin DP, Morgenstern H, Greenland S, Zhang ZF (April 2005). "Epidemiologic review of marijuana use and cancer risk". Alcohol. 35 (3): 265–75. doi:10.1016/j.alcohol.2005.04.008. PMID   16054989.
  29. ↑ "Does smoking cannabis cause cancer?". Cancer Research UK. 20 September 2010. Archived from the original on 29 July 2012. Retrieved 23 June 2012.{{cite journal}}: Cite journal requires |journal= (help)
  30. ↑ Tashkin D (March 1997). "Effects of marijuana on the lung and its immune defenses". UCLA School of Medicine. Archived from the original on 23 June 2012. Retrieved 23 June 2012.{{cite journal}}: Cite journal requires |journal= (help)
  31. ↑ "Chemicals known to the state to cause cancer or reproductive toxicity" (PDF). ca.gov. 20 July 2012. Archived from the original (PDF) on 20 January 2013. Retrieved 8 January 2013.
  32. ↑ "The impact of cannabis on your lung". British Lung Association. June 2012. Archived from the original on 27 September 2013. Retrieved 8 January 2013.{{cite journal}}: Cite journal requires |journal= (help)
  33. ↑ Le B (8 June 2012). "Drug prof slams pot lung-danger claims". The Fix. Archived from the original on 30 December 2012. Retrieved 9 January 2013.{{cite journal}}: Cite journal requires |journal= (help)
  34. 1 2 Ashton CH (February 2001). "Pharmacology and effects of cannabis: a brief review". The British Journal of Psychiatry. 178 (2): 101–6. doi: 10.1192/bjp.178.2.101 . PMID   11157422.
  35. ↑ "Cannabis". Dasc.sa.gov.au. Archived from the original on 27 March 2011. Retrieved 20 April 2011.
  36. ↑ Colizzi, Marco; Bhattacharyya, Sagnik (October 2018). "Cannabis use and the development of tolerance: a systematic review of human evidence". Neuroscience and Biobehavioral Reviews. 93: 1–25. doi:10.1016/j.neubiorev.2018.07.014. ISSN   1873-7528. PMID   30056176. S2CID   51718458. Archived from the original on 20 December 2022. Retrieved 20 December 2022.
  37. ↑ Osborne GB, Fogel C (2009). "Understanding the motivations for recreational marijuana use among adult Canadians" (PDF). Substance Use & Misuse. 43 (3–4): 539–72, discussion 573–9, 585–7. doi:10.1080/10826080701884911. PMID   18365950. S2CID   31053594. Archived (PDF) from the original on 3 March 2016.
  38. ↑ "Medical Marijuana and the Mind". Harvard Mental Health Letter. April 2010. Archived from the original on 16 January 2015. Retrieved 25 April 2011.
  39. ↑ Niesink RJ, van Laar MW (October 2013). "Does Cannabidiol Protect Against Adverse Psychological Effects of THC?". Frontiers in Psychiatry (Review). 4: 130. doi: 10.3389/fpsyt.2013.00130 . PMC   3797438 . PMID   24137134.
  40. ↑ "Medication-Associated Depersonalization Symptoms". Medscape. Archived from the original on 14 February 2015. Retrieved 2 April 2009.
  41. ↑ Shufman E, Lerner A, Witztum E (April 2005). "[Depersonalization after withdrawal from cannabis usage]" (PDF). Harefuah (in Hebrew). 144 (4): 249–51, 303. PMID   15889607. Archived from the original (PDF) on 4 March 2011.
  42. ↑ Johnson BA (February 1990). "Psychopharmacological effects of cannabis". British Journal of Hospital Medicine. 43 (2): 114–6, 118–20, 122. PMID   2178712.
  43. ↑ D'Souza DC, Perry E, MacDougall L, Ammerman Y, Cooper T, Wu YT, et al. (August 2004). "The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis". Neuropsychopharmacology. 29 (8): 1558–72. doi: 10.1038/sj.npp.1300496 . PMID   15173844. S2CID   12508404.
  44. ↑ Morrison PD, Nottage J, Stone JM, Bhattacharyya S, Tunstall N, Brenneisen R, et al. (March 2011). "Disruption of frontal θ coherence by Δ9-tetrahydrocannabinol is associated with positive psychotic symptoms". Neuropsychopharmacology. 36 (4): 827–36. doi:10.1038/npp.2010.222. PMC   3055738 . PMID   21150914.
  45. ↑ Bhattacharyya S, Crippa JA, Allen P, Martin-Santos R, Borgwardt S, Fusar-Poli P, et al. (January 2012). "Induction of psychosis by Δ9-tetrahydrocannabinol reflects modulation of prefrontal and striatal function during attentional salience processing". Archives of General Psychiatry. 69 (1): 27–36. doi:10.1001/archgenpsychiatry.2011.161. PMID   22213786.
  46. ↑ Freeman D, Dunn G, Murray RM, Evans N, Lister R, Antley A, et al. (March 2015). "How cannabis causes paranoia: using the intravenous administration of ∆9-tetrahydrocannabinol (THC) to identify key cognitive mechanisms leading to paranoia". Schizophrenia Bulletin. 41 (2): 391–9. doi:10.1093/schbul/sbu098. PMC   4332941 . PMID   25031222.
  47. ↑ Barceloux DG (20 March 2012). "Chapter 60: Marijuana (Cannabis sativa L.) and synthetic cannabinoids". Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants. John Wiley & Sons. p. 915. ISBN   978-0-471-72760-6.
  48. ↑ Stafford, Peter (1992). Psychedelics Encyclopedia. Berkeley, California, United States: Ronin Publishing, Inc. ISBN   978-0-914171-51-5.
  49. ↑ McKim, William A (2002). Drugs and Behavior: An Introduction to Behavioral Pharmacology (5 ed.). Prentice Hall. p.  400. ISBN   978-0-13-048118-4.
  50. ↑ "Information on Drugs of Abuse". Commonly Abused Drug Chart. nih.gov. 2 July 2018. Archived from the original on 29 December 2011. Retrieved 2 December 2013.
  51. ↑ Canada, Health (2 March 2018). "Health effects of cannabis". www.canada.ca. Archived from the original on 17 November 2022. Retrieved 17 November 2022.
  52. ↑ "Health effects of cannabis" (PDF). Archived (PDF) from the original on 17 November 2022. Retrieved 17 November 2022.
  53. ↑ Moelker W (19 September 2008). "How does Marijuana Affect Your Body? What are the Marijuana Physical Effects?". Archived from the original on 7 February 2009. Retrieved 22 January 2009.
  54. ↑ Kalant, H.K.; Roschlau, W.H.E. (1998). Principles of Medical Pharmacology (6th ed.). pp. 373–375.
  55. ↑ Andersson M, Usiello A, Borgkvist A, Pozzi L, Dominguez C, Fienberg AA, Svenningsson P, Fredholm BB, Borrelli E, Greengard P, Fisone G (September 2005). "Cannabinoid action depends on phosphorylation of dopamine- and cAMP-regulated phosphoprotein of 32 kDa at the protein kinase A site in striatal projection neurons". The Journal of Neuroscience. 25 (37): 8432–8. doi:10.1523/JNEUROSCI.1289-05.2005. PMC   6725667 . PMID   16162925.
  56. 1 2 Crean RD, Crane NA, Mason BJ (March 2011). "An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions". Journal of Addiction Medicine. 5 (1): 1–8. doi:10.1097/ADM.0b013e31820c23fa. PMC   3037578 . PMID   21321675.
  57. ↑ "Erowid Cannabis (Marijuana) Vault : Effects". Erowid.org. Archived from the original on 19 August 2016. Retrieved 9 April 2018.
  58. ↑ Mechoulam R (1984). Cannabinoids as therapeutic agents. Boca Raton, FL: CRC Press. ISBN   978-0-8493-5772-5.[ page needed ]
  59. ↑ Ad Hoc Group of Experts. "Workshop on the Medical Utility of Marijuana". Report to the Director, Institute of Medicine . U.S. National Institutes of Health. Archived from the original on 3 November 2007.
  60. ↑ Bonsor, Kevin. "How Marijauan Works: Other Physiological Effects Archived 11 August 2007 at the Wayback Machine ". HowStuffWorks. Retrieved on 3 November 2007
  61. ↑ Devlin H (18 February 2015). "Cannabis 'munchies' explained by new research". The Guardian. Archived from the original on 18 October 2018. Retrieved 18 October 2018.
  62. ↑ Koch M, Varela L, Kim JG, Kim JD, Hernández-Nuño F, Simonds SE, Castorena CM, Vianna CR, Elmquist JK, Morozov YM, Rakic P, Bechmann I, Cowley MA, Szigeti-Buck K, Dietrich MO, Gao XB, Diano S, Horvath TL (March 2015). "Hypothalamic POMC neurons promote cannabinoid-induced feeding". Nature. 519 (7541): 45–50. Bibcode:2015Natur.519...45K. doi:10.1038/nature14260. PMC   4496586 . PMID   25707796.
  63. ↑ Di Marzo V, Sepe N, De Petrocellis L, Berger A, Crozier G, Fride E, Mechoulam R (December 1998). "Trick or treat from food endocannabinoids?". Nature. 396 (6712): 636–7. Bibcode:1998Natur.396..636D. doi: 10.1038/25267 . PMID   9872309. S2CID   4425760. Archived from the original on 20 April 2023. Retrieved 27 August 2020.
  64. ↑ di Tomaso E, Beltramo M, Piomelli D (August 1996). "Brain cannabinoids in chocolate". Nature (Submitted manuscript). 382 (6593): 677–8. Bibcode:1996Natur.382..677D. doi:10.1038/382677a0. PMID   8751435. S2CID   4325706. Archived from the original on 19 October 2018. Retrieved 28 August 2018.
  65. ↑ Fride E, Bregman T, Kirkham TC (April 2005). "Endocannabinoids and food intake: newborn suckling and appetite regulation in adulthood" (PDF). Experimental Biology and Medicine. 230 (4): 225–34. doi:10.1177/153537020523000401. PMID   15792943. S2CID   25430588. Archived (PDF) from the original on 2 August 2009. Retrieved 20 June 2017.
  66. ↑ The Endocannabinoid-CB Receptor System: Importance for development and in pediatric disease Archived 2 April 2016 at the Wayback Machine Neuroendocrinology Letters Nos.1/2, Feb-Apr Vol.25, 2004.
  67. ↑ Cannabinoids and Feeding: The Role of the Endogenous Cannabinoid System as a Trigger for Newborn Suckling Archived 1 October 2020 at the Wayback Machine Women and Cannabis: Medicine, Science, and Sociology, 2002 The Haworth Press, Inc.
  68. ↑ Wu J, Gouveia-Figueira S, Domellöf M, Zivkovic AM, Nording ML (January 2016). "Oxylipins, endocannabinoids, and related compounds in human milk: Levels and effects of storage conditions". Prostaglandins & Other Lipid Mediators. 122: 28–36. doi:10.1016/j.prostaglandins.2015.11.002. PMID   26656029.
  69. 1 2 Fride E (October 2004). "The endocannabinoid-CB(1) receptor system in pre- and postnatal life". European Journal of Pharmacology. 500 (1–3): 289–97. doi:10.1016/j.ejphar.2004.07.033. PMID   15464041.
  70. ↑ "NCPIC Research Briefs • NCPIC". Ncpic.org.au. 11 March 2011. Archived from the original on 6 July 2011. Retrieved 20 April 2011.{{cite web}}: CS1 maint: unfit URL (link)
  71. ↑ Falvo, D R (2005). Medical and psychosocial aspects of chronic illness and disability (Third ed.). Jones & Bartlett Learning. p. 217. ISBN   978-0-7637-3166-3.
  72. ↑ Ghodse, Hamid (2010). Ghodse's Drugs and Addictive Behaviour. Cambridge University Press. p. 97. ISBN   978-1-139-48567-8.
  73. ↑ Jones RT (November 2002). "Cardiovascular system effects of marijuana". Journal of Clinical Pharmacology. 42 (S1): 58S–63S. doi:10.1002/j.1552-4604.2002.tb06004.x. PMID   12412837. S2CID   12193532.
  74. 1 2 Jones RT (November 2002). "Cardiovascular system effects of marijuana". Journal of Clinical Pharmacology. 42 (S1): 58S–63S. doi:10.1002/j.1552-4604.2002.tb06004.x. PMID   12412837. S2CID   12193532.
  75. ↑ Aryana A, Williams MA (May 2007). "Marijuana as a trigger of cardiovascular events: speculation or scientific certainty?". International Journal of Cardiology. 118 (2): 141–4. doi:10.1016/j.ijcard.2006.08.001. PMID   17005273. Archived from the original on 17 April 2018. Retrieved 6 April 2013.
  76. ↑ Frost L, Mostofsky E, Rosenbloom JI, Mukamal KJ, Mittleman MA (February 2013). "Marijuana use and long-term mortality among survivors of acute myocardial infarction". American Heart Journal. 165 (2): 170–5. doi:10.1016/j.ahj.2012.11.007. PMC   3558923 . PMID   23351819.
  77. ↑ "Heavy pot smoking could raise risk of heart attack, stroke". CBC. 13 May 2008. Archived from the original on 10 November 2012. Retrieved 17 April 2009.
  78. ↑ "Marijuana Linked to Increased Stroke Risk". Time . 8 February 2013. Archived from the original on 20 April 2023. Retrieved 19 May 2013.
  79. ↑ Noble HB (3 March 2000). "Report Links Heart Attacks To Marijuana". The New York Times . Archived from the original on 7 August 2009. Retrieved 26 April 2009.
  80. ↑ Peyrot I, Garsaud AM, Saint-Cyr I, Quitman O, Sanchez B, Quist D (March 2007). "Cannabis arteritis: a new case report and a review of literature". Journal of the European Academy of Dermatology and Venereology. 21 (3): 388–91. doi:10.1111/j.1468-3083.2006.01947.x. PMID   17309465. S2CID   43529847. Amputation of the right second toe and of the left leg finally became necessary.
  81. 1 2 Riedel G, Davies SN (2005). "Cannabinoid function in learning, memory and plasticity". Cannabinoids. Handbook of Experimental Pharmacology. Vol. 168. pp. 445–77. doi:10.1007/3-540-26573-2_15. ISBN   978-3-540-22565-2. PMID   16596784.
  82. ↑ Pope HG, Gruber AJ, Hudson JI, Huestis MA, Yurgelun-Todd D (October 2001). "Neuropsychological performance in long-term cannabis users". Archives of General Psychiatry. 58 (10): 909–15. doi:10.1001/archpsyc.58.10.909. PMID   11576028.
  83. ↑ Lyons, Casey (October 2012) "Lost in the Weeds: Legalizing Medical Marijuana in Massachusetts" Archived 24 October 2014 at the Wayback Machine . Boston .
  84. ↑ Minimal Long-Term Effects of Marijuana Use Found. Journal of the International Neuropsychological Society (27 June 2003)
  85. ↑ Beasley, Deena (27 June 2003) Study – Pot doesn't cause permanent brain damage. Reuters Health E-Line
  86. ↑ Bolla KI, Brown K, Eldreth D, Tate K, Cadet JL (November 2002). "Dose-related neurocognitive effects of marijuana use". Neurology. 59 (9): 1337–43. doi:10.1212/01.WNL.0000031422.66442.49. PMID   12427880. S2CID   11525660.
  87. 1 2 Compton R, Berning A (February 2015). "Drug and Alcohol Crash Risk" (PDF). Traffic Safety Facts. Archived from the original (PDF) on 9 August 2018. Retrieved 13 February 2015.
  88. ↑ Li MC, Brady JE, DiMaggio CJ, Lusardi AR, Tzong KY, Li G (2012). "Marijuana use and motor vehicle crashes". Epidemiologic Reviews. 34 (1): 65–72. doi:10.1093/epirev/mxr017. PMC   3276316 . PMID   21976636.
  89. ↑ Asbridge M, Hayden JA, Cartwright JL (February 2012). "Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis". BMJ. 344: e536. doi:10.1136/bmj.e536. PMC   3277079 . PMID   22323502.
  90. ↑ Department For Transport, Great Minster House. "Cannabis and driving: a review of the literature and commentary (No.12)". Department of Transport. UK Government. Archived from the original on 9 February 2010. Retrieved 19 December 2016.
  91. ↑ European Monitoring Centre for Drugs Drug Addiction (June 2008). Sznitman SR, Olsson B, Room R (eds.). A cannabis reader: global issues and local experiences . Vol. 2. Lisbon: European Monitoring Centre for Drugs and Drug Addiction. doi:10.2810/13807. ISBN   978-92-9168-312-3.[ page needed ]
  92. ↑ Asbridge M, Hayden JA, Cartwright JL (February 2012). "Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis". BMJ. 344 (feb09 2): e536. doi:10.1136/bmj.e536. PMC   3277079 . PMID   22323502.
  93. ↑ Elvik R (November 2013). "Risk of road accident associated with the use of drugs: a systematic review and meta-analysis of evidence from epidemiological studies". Accident Analysis and Prevention. 60: 254–67. doi:10.1016/j.aap.2012.06.017. PMID   22785089.
  94. ↑ Ingraham, C (9 February 2015). "Stoned drivers are a lot safer than drunk ones, new federal data show". Washington Post. Archived from the original on 13 February 2015. Retrieved 13 February 2015.
  95. ↑ Lee J, Abdel-Aty A, Park J (May 2018). "Investigation of associations between marijuana law changes and marijuana-involved fatal traffic crashes: A state-level analysis". Journal of Transport & Health. 10: 194–202. Bibcode:2018JTHea..10..194L. doi:10.1016/j.jth.2018.05.017. S2CID   159774424.
  96. ↑ Zhang ZF, Morgenstern H, Spitz MR, Tashkin DP, Yu GP, Marshall JR, Hsu TC, Schantz SP (December 1999). "Marijuana use and increased risk of squamous cell carcinoma of the head and neck". Cancer Epidemiology, Biomarkers & Prevention. 8 (12): 1071–8. PMID   10613339. Archived from the original on 23 February 2013. Retrieved 27 January 2011.
  97. ↑ "Public opinion on drugs and drug policy". Fact Research Guide. Easton Business Centre, Felix Rd., Bristol, UK.: Transform Drug Policy Foundation. Archived from the original on 15 July 2014. Retrieved 24 March 2007. Data is notoriously easy to cherry pick or spin to support a particular agenda or position. Often the raw data will conceal all sorts of interesting facts that the headlines have missed.
  98. ↑ "2001 National Drug Strategy Household Survey: detailed findings". Australian Institute of Health and Welfare. 19 December 2002. Archived from the original on 21 February 2011. Retrieved 1 February 2011. AIHW cat no. PHE 41.
  99. ↑ "2001 National Drug Steategy Household Survey: first results". Australian Institute of Health and Welfare. 20 May 2002. Archived from the original on 21 February 2011. Retrieved 1 February 2011. AIHW cat no. PHE 35.
  100. ↑ Lukas SE, Orozco S (October 2001). "Ethanol increases plasma Delta(9)-tetrahydrocannabinol (THC) levels and subjective effects after marihuana smoking in human volunteers". Drug and Alcohol Dependence. 64 (2): 143–9. doi:10.1016/S0376-8716(01)00118-1. PMID   11543984.
  101. ↑ Kee, Carol (August 1998). National Survey of Mental Health and Wellbeing of Adults 1997. ACT Department of Health and Community Care. Archived from the original on 14 March 2011. Retrieved 1 February 2011.
  102. ↑ Degenhardt L, Hall W (August 2001). "The relationship between tobacco use, substance-use disorders and mental health: results from the National Survey of Mental Health and Well-being". Nicotine & Tobacco Research. 3 (3): 225–34. doi:10.1080/14622200110050457. PMID   11506766.
  103. 1 2 3 4 "Microbiological contaminants of marijuana". www.hempfood.com. Archived from the original on 11 July 2011. Retrieved 22 June 2008.[ unreliable source? ]
  104. 1 2 3 4 5 Kagen SL, Kurup VP, Sohnle PG, Fink JN (April 1983). "Marijuana smoking and fungal sensitization". The Journal of Allergy and Clinical Immunology. 71 (4): 389–93. doi:10.1016/0091-6749(83)90067-2. PMID   6833678.
  105. ↑ Remington TL, Fuller J, Chiu I (November 2015). "Chronic necrotizing pulmonary aspergillosis in a patient with diabetes and marijuana use". CMAJ. 187 (17): 1305–8. doi:10.1503/cmaj.141412. PMC   4646751 . PMID   26100839.
  106. ↑ Taylor DN, Wachsmuth IK, Shangkuan YH, Schmidt EV, Barrett TJ, Schrader JS, Scherach CS, McGee HB, Feldman RA, Brenner DJ (May 1982). "Salmonellosis associated with marijuana: a multistate outbreak traced by plasmid fingerprinting". The New England Journal of Medicine. 306 (21): 1249–53. doi:10.1056/NEJM198205273062101. PMID   7070444.
  107. 1 2 Gordon AJ, Conley JW, Gordon JM (December 2013). "Medical consequences of marijuana use: a review of current literature". Current Psychiatry Reports (Submitted manuscript). 15 (12): 419. doi:10.1007/s11920-013-0419-7. PMID   24234874. S2CID   29063282. Archived from the original on 7 August 2019. Retrieved 28 August 2018.
  108. ↑ Vandrey R, Haney M (2009). "Pharmacotherapy for cannabis dependence: how close are we?". CNS Drugs (Review). 23 (7): 543–53. doi:10.2165/00023210-200923070-00001. PMC   2729499 . PMID   19552483.
  109. ↑ Benyamina, Amine; Lecacheux, Marie; Blecha, Lisa; Reynaud, Michel; Lukasiewcz, Michael (1 March 2008). "Pharmacotherapy and psychotherapy in cannabis withdrawal and dependence". Expert Review of Neurotherapeutics. 8 (3): 479–491. doi:10.1586/14737175.8.3.479. ISSN   1473-7175. PMID   18345976. S2CID   207194905.
  110. ↑ Steenkamp MM, Blessing EM, Galatzer-Levy IR, Hollahan LC, Anderson WT (March 2017). "Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review". Depression and Anxiety. 34 (3): 207–216. doi: 10.1002/da.22596 . PMID   28245077. S2CID   205737272.
  111. ↑ Murrie, Benjamin; Lappin, Julia; Large, Matthew; Sara, Grant (16 October 2019). "Transition of Substance-Induced, Brief, and Atypical Psychoses to Schizophrenia: A Systematic Review and Meta-analysis". Schizophrenia Bulletin. 46 (3): 505–516. doi: 10.1093/schbul/sbz102 . PMC   7147575 . PMID   31618428.
  112. 1 2 Gorelick, David A. (14 December 2023). "Cannabis-Related Disorders and Toxic Effects". New England Journal of Medicine. 389 (24): 2267–2275. doi:10.1056/NEJMra2212152. PMID   38091532.
  113. ↑ Simonetto, Douglas A.; Oxentenko, Amy S.; Herman, Margot L.; Szostek, Jason H. (2012). "Cannabinoid Hyperemesis: A Case Series of 98 Patients". Mayo Clinic Proceedings. 87 (2): 114–119. doi:10.1016/j.mayocp.2011.10.005. ISSN   0025-6196. PMC   3538402 . PMID   22305024.
  114. ↑ Chocron, Yaniv; Zuber, Jean-Philippe; Vaucher, Julien (2019). "Cannabinoid hyperemesis syndrome". BMJ. 366: l4336. doi:10.1136/bmj.l4336. ISSN   0959-8138. PMID   31324702. S2CID   198133206.
  115. ↑ Tomar, Rajpal C.; Beaumont and Hsieh (August 2009). "Evidence on the carcinogenicity of marijuana smoke" (PDF). Reproductive and Cancer Hazard Assessment Branch Office of Environmental Health Hazard Assessment, California Environmental Protection Agency. Archived (PDF) from the original on 24 July 2012. Retrieved 29 November 2018.
  116. ↑ Leweke FM, Koethe D (June 2008). "Cannabis and psychiatric disorders: it is not only addiction". Addiction Biology. 13 (2): 264–75. doi:10.1111/j.1369-1600.2008.00106.x. PMID   18482435. S2CID   205400285.
  117. ↑ Rubino T, Parolaro D (April 2008). "Long lasting consequences of cannabis exposure in adolescence". Molecular and Cellular Endocrinology (Submitted manuscript). 286 (1–2 Suppl 1): S108-13. doi:10.1016/j.mce.2008.02.003. PMID   18358595. S2CID   39245784. Archived from the original on 29 November 2018. Retrieved 28 August 2018.
  118. ↑ Fonseca BM, Correia-da-Silva G, Almada M, Costa MA, Teixeira NA (2013). "The Endocannabinoid System in the Postimplantation Period: A Role during Decidualization and Placentation". International Journal of Endocrinology (Review). 2013: 1–11. doi: 10.1155/2013/510540 . PMC   3818851 . PMID   24228028.
  119. ↑ Irner TB (2012). "Substance exposure in utero and developmental consequences in adolescence: a systematic review". Child Neuropsychology (Review). 18 (6): 521–49. doi:10.1080/09297049.2011.628309. PMID   22114955. S2CID   25014303.
  120. ↑ Copeland J, Gerber S, Swift W (2006). Evidence-based answers to cannabis questions: a review of the literature. Canberra: Australian National Council on Drugs. ISBN   978-1-877018-12-1.
  121. 1 2 Wong, Kei U.; Baum, Carl R. (November 2019). "Acute Cannabis Toxicity". Pediatric Emergency Care. 35 (11): 799–804. doi:10.1097/PEC.0000000000001970. ISSN   0749-5161. PMID   31688799. S2CID   207897219. Archived from the original on 20 April 2023. Retrieved 27 October 2021.
  122. ↑ Nappe, Thomas M.; Hoyte, Christopher O. (16 March 2017). "Pediatric Death Due to Myocarditis After Exposure to Cannabis". Clinical Practice and Cases in Emergency Medicine. 1 (3): 166–170. doi:10.5811/cpcem.2017.1.33240. ISSN   2474-252X. PMC   5965161 . PMID   29849306.
  123. ↑ Claudet, Isabelle; Le Breton, Mathilde; Bréhin, Camille; Franchitto, Nicolas (April 2017). "A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach?". European Journal of Pediatrics. 176 (4): 553–556. doi:10.1007/s00431-017-2872-5. ISSN   1432-1076. PMID   28210835. S2CID   11639790. Archived from the original on 29 July 2021. Retrieved 29 July 2021.
  124. ↑ Wang, George S.; Roosevelt, Genie; Le Lait, Marie-Claire; Martinez, Erin M.; Bucher-Bartelson, Becki; Bronstein, Alvin C.; Heard, Kennon (1 June 2014). "Association of Unintentional Pediatric Exposures With Decriminalization of Marijuana in the United States". Annals of Emergency Medicine. 63 (6): 684–689. doi:10.1016/j.annemergmed.2014.01.017. ISSN   0196-0644. PMID   24507243. Archived from the original on 29 July 2021. Retrieved 29 July 2021.

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