Cannabis and Cannabinoid Research最新文献

Background: The literature supports the benefits of medical cannabis for core and comorbid symptoms in autistic individuals and anxiety-related symptoms in individuals without autism. However, no study has specifically investigated how cannabidiol (CBD)-rich cannabis affects anxiety subtypes in autistic children or its relationship with restricted and repetitive behaviors and interests (RRBI). Understanding the effects of CBD-rich cannabis treatment on anxiety subtypes and RRBI could offer more precise treatment approaches to managing anxiety symptoms and reducing RRBI frequency in autistic children. Objectives: To examine (1) the impact of CBD-rich cannabis treatment on autistic children's (1a) anxiety levels and subtypes and (1 b) RRBI and subtypes and (2) whether changes in anxiety explain changes in RRBI following cannabis treatment. Method: In this open-label study, we analyzed data from 65 autistic children (5-12 years) who had participated in research on the effects of CBD-rich cannabis on children with autism. Their parents completed the Repetitive Behavior Scale-revised to assess the frequency and severity of six subgroups of their children's recurrent behaviors and the Screen for Child Anxiety-Related Emotional Disorders for symptoms related to five types of anxiety disorders. They completed these assessments at three time points: (T1) before treatment, (T2) after 3 months, and (T3) after 6 months of treatment. Results: The results indicated reduced RRBI and symptoms related to various anxiety subtypes in autistic children following 6 months of CBD-rich cannabis treatment. Specifically, we observed significant differences in the autistic children's overall anxiety and in some anxiety subtypes (i.e., general, social, panic, and separation anxieties). Significant improvements were observed in RRBI, including the total score, and specifically in compulsive, ritualistic, and sameness behaviors. Our findings revealed that reduced anxiety, particularly within the panic- and separation-related subtypes, predicted a subsequent decrease in RRBI, specifically sameness behaviors, following cannabis treatment. Conclusions: The findings of the cannabis treatment's potential benefits for alleviating anxiety symptoms, leading to reduced RRBI, may provide evidence for the meaningful relationship between these variables and for the potential benefits of cannabis treatment for autistic children. We strongly recommend further double-blind, placebo-controlled studies using standardized assessments to validate these findings.

Background: Cannabis use is becoming increasingly prevalent worldwide, yet the full spectrum of its effects largely remain unknown. Although cannabis have immunomodulatory properties, there remains a significant gap in our understanding of the potential impact of marijuana use on COVID-19 outcomes. The purpose of this study is to evaluate the effect of chronic cannabis use on severe COVID-19. Materials and Methods: National Inpatient Sample Database was used to sample individuals admitted with the diagnosis of COVID-19. Patients were divided into two groups based on cannabis use. Baseline demographics and comorbidities were collected using ICD-10 codes. Patients with missing data or age under 18 were excluded. Propensity matching using R was performed to match cannabis users to non-cannabis users 1:1 on age, race, gender, and 17 other comorbidities. The primary outcome was severe COVID-19 infection, defined as a composite of acute respiratory failure, intubation, acute respiratory distress syndrome (ARDS), or severe sepsis with multiorgan failure. Results: Out of 322,214 patients included in the study, 2,603 were cannabis users. Cannabis users were younger and had higher prevalence of tobacco use. On initial analysis, cannabis users had significantly lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. After 1:1 matching, cannabis use was associated with lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. Conclusion: Cannabis users had better outcomes and mortality compared with non-users. The beneficial effect of cannabis use may be attributed to its immunomodulatory effects.

Introduction: Following the introduction of metabolic dysfunction-associated steatotic liver disease (MASLD) as a replacement term for nonalcoholic fatty liver disease, the relationship between MASLD and cannabis use has yet to be established. With the global rise in cannabis consumption, understanding its impact on MASLD is critical for clinical guidance. Our study investigated the association between cannabis use, MASLD, and clinically significant fibrosis (CSF) among U.S. adults. Methods: Data were collected from the National Health and Nutrition Examination Survey for the period 2017 to 2018 to conduct a cross-sectional analysis. The diagnosis of hepatic steatosis and CSF was based on median values of the controlled attenuation parameter and liver stiffness measurement, with thresholds of 285 dB/m and 8.6 kPa, respectively. Information on cannabis use was obtained through self-report questionnaires. Multinomial logistic regression models and subgroup analyses were used to investigate the association between cannabis use and MASLD with CSF. Results: Our study assessed data from 2,756 U.S. adults (51.1% female; 32.2% white; mean age 39.41 ± 11.83 years), who had complete information on liver stiffness measurements through transient elastography alongside reported cannabis use. Results indicated that cannabis use overall was not associated with liver stiffness in patients with MASLD. However, among females, cannabis use was associated with MASLD accompanied by CSF, with an adjusted odds ratio (OR) of 0.47 (95% confidence interval [CI]: 0.24-0.91). Heavy cannabis use (9 to 30 times per month) was associated with MASLD accompanied by CSF among female participants, with an adjusted OR of 0.12 (95% CI: 0.02-0.88). Conclusion: In our study, cannabis use did not show a significant association with liver stiffness in patients diagnosed with MASLD. However, heavy cannabis consumption in women was associated with MASLD accompanied by CSF. These findings suggest that the effects of cannabis on liver health may differ based on gender and frequency of cannabis use, emphasizing the need for further research in this area.

Introduction: More adults can legally purchase cannabis in the United States than ever before. However, there is limited understanding as to how cannabis consumers make decisions about what products to purchase. Further insight is needed to guide policies that balance public health with profitable business strategies.

Methods: Respondents were cannabis consumers participating in the legal adult-use market in Washington State. They were recruited through flyers posted in cannabis retail stores. Both the online survey and flyer were created by the Washington State Liquor and Cannabis Board and the Department of Health. Respondents answered questions on demographics, cannabis use patterns, and cannabis retail store employment status. Respondents also rated the importance of 10 different attributes when making a cannabis purchase: company/brand name, strain/cultivar name, production method, cost, tetrahydrocannabinol (THC), cannabidiol or terpene profile, perceived positive effects, perceived negative effects, flavor, and appearance/look. Linear regressions were conducted to predict the importance of each attribute by gender, age, cannabis use patterns, and cannabis retail employee status.

Results: There were 437 survey respondents. All respondents were legal adult cannabis users and 137 reported they were employed at a cannabis retail store. Several group differences emerged. For example, cannabis retail employees rated THC concentration as less important (β = -1.67, p < 0.001) but brand name (β = 1.30, p < 0.001) and product appearance (β = 0.81, p = 0.001) as more important than nonretail employees. More frequent users rated cultivar/strain name (β = 0.50, p < 0.001), production method (β = 0.43, p < 0.001), price (β = 0.26 p = 0.01), and product appearance (β = 0.49, p < 0.001) as more important than less frequent users.

Conclusions: Differences in purchasing decisions by subgroups have important public health, economic, and policy implications. For example, results showed that retail employees place less emphasis on THC relative to their nonemployee counterparts. If retail employees were to emphasize to customers about the attributes they focus on when purchasing cannabis (e.g., product appearance), this could help redirect market demand away from higher-THC products.

Introduction: Cannabis use has risen disproportionately among middle-aged and older U.S. adults, groups particularly vulnerable to adverse effects, including cannabis use disorder (CUD). Consumption patterns have diversified in recent years. The quantity of cannabis use, historically measured in limited ways (e.g., number of joints), is now considered a key risk factor for CUD. However, age-related differences in consumption patterns and their relationships with CUD remain understudied. This study investigated age-related differences in consumption patterns and examined the relationship between quantity of use-measured by milligrams of THC (mgTHC)-and self-reported CUD in individuals with regular cannabis use.

Materials and methods: A total of 4134 U.S. adults (ages 18+; 45.9% male, 54.1% female) who reported daily cannabis use completed an online survey assessing cannabis consumption patterns and self-reported Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition's CUD criteria. Pearson's chi-square tests and one-way analysis of variance examined differences in sex, reasons for use, methods of consumption, CUD severity, criteria count, and mgTHC with comparisons across three age-groups (18-49, 50-64, 65+). Regression models, adjusted for sex and reasons for use, analyzed age-specific associations between mgTHC and CUD.

Results: Overall, over 70% reported using cannabis for both medical and recreational purposes. Middle-aged adults were more likely to report medical use than younger ones (18.1% vs. 13.7%; p < 0.001) and older adults (14.1%; p = 0.027). Older adults were more likely to report recreational-only use compared with middle-aged adults (15.8% vs. 10.5%; p = 0.002). Smoking buds was the most common consumption method across age-groups, while high-potency concentrate use declined with age. In the overall sample, daily mgTHC was associated with CUD severity, and middle-aged and older adults endorsed fewer CUD criteria than younger adults at all levels of mgTHC; however, age effects were not statistically significant.

Discussion: Among daily cannabis consumers, middle-aged and older adults differed from younger consumers in methods of consumption and reasons for use. While both groups consumed lower quantities than their younger counterparts, no age-related differences were observed in the relationship between mgTHC consumption and CUD, contrasting with evidence suggesting that older cannabis consumers may be more vulnerable to cannabis-related negative outcomes.

Introduction: In recent years, the production and consumption of cannabinoids have increased significantly. Researchers are particularly interested in cannabidiol (CBD), Δ⁸-tetrahydrocannabinol (Δ⁸-THC), and Δ⁹-tetrahydrocannabinol (Δ⁹-THC). Despite the growing prevalence of these molecules in everyday life, research shows that cannabinoid products are often mislabeled. In this study, we quantified and compared the label accuracy of CBD in full- and broad-spectrum tinctures to evaluate whether there is a public health concern related to CBD, Δ⁸-THC, and Δ⁹-THC.

Materials and methods: A total of 18 samples from different brands sold online in the United States were obtained for the study. Reverse-phase high-performance liquid chromatography with ultraviolet/visible light detection (RP-HPLC-UV) was employed to detect and quantify the concentration of CBD and THC isomers within the samples. Labels were deemed inaccurate if the actual concentration of CBD deviated by more than 10% from the labeled amount.

Results: Our findings showed that 12 out of 18 samples had inaccurately labeled CBD concentrations. Notably, a significant difference in CBD label accuracy was observed between broad- and full-spectrum tinctures (p = 0.0282). No significant correlation was found between the cost of the tinctures and the label accuracy for CBD (p = 0.2117). While none of the broad-spectrum tinctures contained Δ⁸-THC, two contained Δ⁹-THC. All full-spectrum tinctures contained both Δ⁸-THC and Δ⁹-THC at levels below the federal limit for hemp of 0.3% on a dry weight basis.

Discussion: Accurate labeling of CBD and THC in tincture products is a crucial public health concern, both locally in Texas and across the United States. There is a need for the U.S. Food and Drug Administration to promulgate regulations for labeling products that contain CBD and THC.

Introduction: Despite prohibitions against youth-appealing packages, deceptive "copycat" cannabis edible packages have been commonly seen in U.S. states that legalized recreational cannabis. Copycat packages mimic the branding features of popular food products, posing a high risk for accidental ingestion, particularly for the younger population. Materials and Methods: An online experiment was conducted among a representative sample of young adults aged 18-29 (N = 2,523). Participants were asked in timed trials to identify whether each package in a series of images contained cannabis content. Regression analysis was conducted to analyze the association between package type and correct identification and the association between correct identification and appeal ratings. Results: Copycat cannabis packages were associated with lower odds of correct identification of cannabis content (odds ratio = 0.35, 95% CI = [0.31, 0.40]) compared with the non-copycat branded cannabis package. Correct identification of cannabis content was associated with lower appeal ratings (odds ratio = 0.75, 95% CI = [0.69, 0.81]). Discussion: Copycat cannabis packages were associated with elevated risk of misidentification of cannabis content, making them a public health risk for accidental ingestion. Package features that make a package easily identifiable were less appealing, underscoring the need of requiring salient features to indicate cannabis content on cannabis packages.

Background: Chronic noncancer pain (CNCP) affects one in five adults and is commonly managed with long-term opioid therapy. Concerns regarding rare but catastrophic harms associated with opioids, including overdose and death, have generated interest in alternatives including cannabis; however, the comparative cost-effectiveness of these management options is uncertain. Methods: We used findings from a network meta-analysis of 90 randomized trials to develop a 1-year microsimulation model to compare costs and quality-adjusted life years (QALY) between oral medical cannabis and opioids for CNCP. We used a publicly funded health care payer perspective for our analyses and obtained cost and utility data from publicly available sources. All costs are reported in 2023 Canadian dollars. All analyses were probabilistic, and we conducted sensitivity and scenario analyses to assess robustness. Results: Total mean annual cost per patient was $1,980 for oral medical cannabis and $1,851 for opioids, a difference of $129 (95% confidence interval [CI]: -$723 to $525). Mean QALYs were 0.582 for both oral medical cannabis and opioids (95% CI: -0.007 to 0.015). Cost-effectiveness acceptability curves showed that oral medical cannabis was cost-effective in 31% of iterations at willingness-to-pay thresholds up to $50,000/QALY gained. Use of opioids is associated with nonfatal and fatal overdose, whereas medical cannabis is not. Discussion: Our findings suggest that medical cannabis as an alternative to opioids for chronic pain may confer similar, but modest, benefits to patients, and reduce the risk of opioid overdose without substantially increasing costs.

Introduction: Cannabis cultivars were usually categorized based on their genetic profile as sativa, indica, or hybrid types. However, these three criteria do not allow sufficient differentiation between the numerous varieties of cannabis strains. Furthermore, this classification is based on morphological and bio-geographical properties of the plants and does not represent the chemical composition of different cultivars. The concentration of cannabinoids and terpenes are crucial for the pharmacological effect, not only because of the known entourage effect, and therefore needs to be considered by categorization. Materials and Methods: A total of 140 medicinal cannabis flowers available on the German market were analyzed regarding their individual terpene profile using GC-MS analysis. Statistical evaluation was performed to investigate correlations and data relations as well as for clustering. Results: Multivariate analysis showed correlations between individual terpenes. However, there was no statistical correlation between terpene profiles and their respective genetic profile. Terpene profiles of sativa, indica, and hybrid strains are quite heterogenous and clearly showed that there is no relation between terpenes and the estimated pharmacological effect. As a result, we suggest a new classification system based on individual terpene profiles to faster a comprehensive understanding of the expected medical effect. Discussion: Considering main terpenes, we established a concept of six clusters with various terpene profiles being attributed to different medicinal applications. We excluded tetrahydrocannabinol (THC) and cannabidiol (CBD) content from clustering as most of the strains were THC dominant and therefore distort the results. Our pattern of strains with similar terpene profiles might refine the existing classes of chemotypes with different THC:CBD content. Conclusion: The categorization of cannabis strains based on their terpene profiles allows a clearer, finer and, above all, more meaningful classification than the existing sativa/indica classification. Due to the entourage effect and the interactions between cannabinoids and terpenes, this group of substances is also given the necessary consideration when selecting the right medicine for the individual. Within the next steps, further studies are needed with the aim of mapping clinical validated effects to our chemovars. If it is possible to correlate therapy of symptoms to specific chemical profiles personalized cannabinoid therapy will be possible.

Introduction: Following the spread of recreational cannabis legalization and commercialization, cannabis has become increasingly available at lower prices. As policies regulating prices are common tools to control the demand for commercialized drugs, it is crucial to understand how cannabis use responds to price changes. In this study, we assessed the association between wholesale prices for legal cannabis flower and adults' self-reported current cannabis use in ten states with recreational cannabis commercialization in the U.S. Materials and Methods: We conducted a secondary data analysis using individual-level data on cannabis use from the longitudinal Population Assessment of Tobacco and Health Study, during 2015 and 2021. Our analysis included 19,812 U.S. adults from ten states that legalized recreational cannabis sales during the study period. We first conducted logistic regressions to estimate the association between state-level cannabis prices and individual current cannabis use. To address potential endogeneity of cannabis prices, we then employed generalized method of moment (GMM) estimator, using cannabis taxes as an instrumental variable (IV). Results: IV-based GMM regressions suggested that cannabis taxes were a significant predictor of cannabis prices. However, the association between legal cannabis flower prices and adults' current cannabis use was negative but statistically insignificant (coefficient = -0.18, p = 0.086). Price elasticity estimates for current cannabis use ranged from -0.66 to -0.59 across different model specifications. Conclusion: In the initial years of recreational cannabis commercialization in the U.S., the price elasticity of cannabis use among adults was negative but statistically insignificant. Given the rapid progression of commercialization, further research utilizing longer-term data is needed.