Abstract STUDY OBJECTIVE: Cannabis and its principal active constituent, Δ9-tetrahydrocannabinol (THC), are increasingly available as edibles resembling commercially available food products. In this case series, we describe a population of predominantly paediatric patients who were inadvertently exposed to a THC-containing product in San Francisco.
METHODS: Twelve children and 9 adults were identified, with 16 patients having detectable serum THC and THC metabolites. All patients presented to hospitals with a variety of constitutional symptoms and all were discharged home within 12 hours.
RESULTS: In general, pediatric patients had more severe symptoms and longer hospital length of stay, and, uniquely, a majority presented with leukocytosis and elevated lactic acid levels.
CONCLUSION: We recommend that efforts be made to increase general public awareness in regard to the potential hazards of THC-containing edibles resembling commercially available food products. PMID: 29103798 DOI: 10.1016/j.annemergmed.2017.09.008
Objective: The current study prospectively investigated the relationship between cannabis use and cigarette smoking initiation, persistence, and relapse during a 3-year period among adults in the United States.
Methods: Analyses included respondents who completed Waves 1 (2001–2002) and 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions and responded to questions about cannabis use and smoking status (n = 34,639). Multivariable logistic regression models were used to calculate the odds of cigarette use at Wave 2 among Wave 1 daily smokers, nondaily smokers, former smokers, and nonsmokers by Wave 1 cannabis use.
Results: In unadjusted analyses, Wave 1 cannabis use was associated with increased odds of Wave 2 daily and nondaily smoking for Wave 1 nonsmokers (daily OR = 2.90; 95% CI, 2.10–4.00; nondaily OR = 4.45; 95% CI, 3.97–5.00) and Wave 2 relapse to daily and nondaily smoking for Wave 1 former smokers (daily OR = 4.18, 95% CI, 3.01–5.81; nondaily OR = 5.24; 95% CI, 3.74–7.34). Wave 1 cannabis use was associated with decreased odds of Wave 2 smoking cessation for Wave 1 daily cigarette smokers (OR = 0.57; 95% CI, 0.51–0.64). The associations remained significant for daily smoking initiation (OR = 1.43; 95% CI, 1.06–1.93), daily smoking relapse (OR = 1.47; 95% CI, 1.00–2.16), and smoking cessation (OR = 0.77; 95% CI, 0.69–0.87) after adjusting for demographics and psychiatric disorders. Associations remained significant for nondaily smoking initiation (OR = 1.85; 95% CI, 1.59–2.16) and nondaily smoking relapse (OR = 1.63; 95% CI, 1.05–2.54) after adjusting for these covariates as well as for alcohol and substance use disorders.
Conclusions: Cannabis use was associated with increased initiation of, persistence of, and relapse to cigarette smoking. Additional attention to cannabis use in tobacco control efforts and in clinical settings aimed at reducing cigarette smoking and smoking-related negative consequences may be warranted.
A continued effort to legalize the unrestricted access and use of marijuana in the U.S., primarily through voter initiatives, continues in spite of clinical trial evidence of lack of efficacy, increasing teen use, and reports of serious consequences from accidents to mental illness.
As marijuana is currently viewed by the public as “safe until proven dangerous” rather than dangerous until proven safe and effective, by way of randomized double blind clinical trials for a specific medical problem, we cannot make any claims regarding its medical benefit.
Risk of Psychosis
Little is known about the long-term effects of marijuana use as concern rises regarding the impact on the developing brains of young initiates. The effect of the psychoactive ingredient in cannabis, Δ9- tetrahydrocannabinol (THC) on subcortical neuronal connectivity and function is the most recent concern as increased prevalence of psychiatric morbidity have been reported in the medical literature— including depression, suicidality, panic, paranoia, amotivation, increased risk for psychosis and now, a six-fold increase in the risk of schizophrenia among the youngest initiates.
Why Does This Matter?
Although there is much to learn regarding the role of marijuana use and concurrent psychopathology, these findings support the hypothesis that prevention and early intervention for children and adolescents, young adults, and pregnant females is essential and a highly worthy goal. Bottom line is clear. Early onset and persistent, long-term marijuana use is associated with changes in resting-state brain function in the same dopaminergic nuclei and regions associated with brain reward, habit formulation and psychiatric illness, including psychosis.
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