Risk factors for cannabis use disorders and cannabis psychosis in Japan: Second report of a survey on cannabis-related health problems among community cannabis users using social networking services.

AIM: To determine the risk factors for cannabis use disorders and cannabis psychosis in Japan based on a 2021 online survey among Japanese users of social network services. METHODS: The 3142 respondents who had used cannabis within the preceding year were categorized into two groups based on the development of cannabis use disorder and/or cannabis psychosis. Analyses were performed to determine these conditions' risk factors. RESULTS: Multivariate analysis revealed that factors significantly associated with cannabis use disorders were "cannabis-use initiation at a young age" (p = 0.004, OR: 0.951, 95% CI [0.920-0.984]), "family history of mental health problems" (p < 0.001, OR: 1.988, 95% CI [1.545-2.556]), "psychiatric disorders preceding cannabis use" (p = 0.039, OR: 1.672, 95% CI [1.026-2.722]), and "use of cannabis products other than dry flower" (p < 0.001, OR: 2.725, 95% CI [1.844-4.026]). Factors significantly associated with cannabis psychosis were "cannabis-use initiation at a young age" (p = 0.011, OR: 0.888, 95% CI [0.811-0.973]) and "family history of mental health problems" (p = 0.002, OR: 2.531, 95% CI [1.400-4. 576]). CONCLUSION: Risk factors for problematic cannabis use were cannabis initiation at a young age, pre-cannabis psychiatric disorders, family history of mental health problems, and the use of cannabis products other than dry flower. However, the causal relationship among these factors remains ambivalent.

Report of a 6-month-old Asian infant with early infantile epileptic encephalopathy whose seizures were eliminated by cannabidiol.

We observed that cannabidiol supplements were highly effective in treating an infant boy with drug-resistant early infantile epileptic encephalopathy, eliminating his intractable tonic seizures. The infant began suffering clusters of brief tonic seizures from birth at 39 weeks gestation. EEG showed burst-suppression and seizures could not be controlled by trials of phenobarbital, zonisamide, vitamin B6, clobazam, levetiracetam, topiramate, phenytoin, valproate, high-dose phenobarbital, and ACTH therapy. The boy was discharged from hospital at 130 days of age still averaging tonic seizures 20-30 times per day. We started him on a cannabidiol supplement on day 207, increasing the dosage to 18 mg/kg/d on day 219. His seizures reduced in frequency and completely disappeared by day 234. These effects were maintained, with improved EEG background, even after his other medications were discontinued. Cannabidiol's effectiveness in treating drug-resistant epilepsy has been confirmed in large-scale clinical trials in Europe and the United States; however, no such trials have been run in Asia. In addition, no reports to date have documented its efficacy in an infant as young as six months of age. This important case suggests that high-dose artisanal cannabidiol may effectively treat drug-resistant epilepsy in patients without access to pharmaceutical-grade CBD.

[Survey of neurologists regarding their attitudes toward medicinal cannabis and the effects of evidence-based cannabis education].

A survey was conducted with neurologists regarding their attitudes toward cannabis. Comparison was made between respondents who had previously been exposed to information about cannabis (31 neurologists), hereafter referred to as the "informed group," and those who had not (81 neurologists), hereafter referred to as the "non-informed group." While more than half of the respondents in both groups showed some acceptance toward the usage of cannabis for research purposes, there was a stronger tendency to accept the use of cannabis for medical purposes in the informed group. Since this acceptance was more often displayed by respondents who had adequate knowledge of the medical use of cannabis, this suggests that providing information on cannabis is useful in promoting acceptance. The result of the survey indicated that a portion of neurologists acknowledges the usefulness of cannabis, and that one's receptivity toward cannabis can be improved if adequate information is provided about cannabis.