Oral health status among recreational cannabis (marijuana and hashish) users in the USA: A NHANES-based cross-sectional study.

Background: As of November 2023, twenty-four states, two territories, and DC have legalized marijuana for non-medical use, leading to concerns about its potential oral health effects. This study investigated the association between marijuana use and clinical dental outcomes among adults in the US. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 using a cross-sectional survey of non-institutionalized US civilians. Marijuana use was assessed among 18-59-year-old adults and categorized as never, former, or current frequent use. The dental outcomes included the prevalence of untreated coronal caries, root caries, and missing teeth. We employed logistic and negative binomial regressions to assess the crude and adjusted associations between marijuana use, dental caries, and tooth loss. Results: Of the 6,424 participants, 13.85% of US adults aged 18-59 years were current frequent marijuana users (21.67 million), with the highest prevalence among 18-29-year-olds (21.31%), males (17.54%), and non-Hispanic Black individuals (21.31%). Frequent marijuana users showed the highest prevalence of untreated coronal caries (33.4%). Before adjusting for socioeconomic confounders, current frequent marijuana users had 1.76 times higher odds of having teeth with coronal caries, whereas former frequent users had 1.47 times higher odds. However, the associations between marijuana use and all dental outcomes were attenuated after adjusting for socioeconomic confounders, tobacco use, and access to dental care. Conclusion: Although marijuana use was associated with worse dental health, socioeconomic factors, tobacco use, and access to dental care were more significant contributors to the prevalence of untreated dental caries and missing teeth than marijuana use alone.

The Puzzle of Marijuana Use and Forced Vital Capacity.

In study after study, marijuana use has been found to be associated with increased forced vital capacity (FVC). This is puzzling, because marijuana is commonly consumed by inhalation of its smoke, and smoke exposure of any kind is not generally considered a cause of increased FVC. Although this observation was first made decades ago, a satisfactory explanation remains elusive. In this review we survey the evidence supporting the relationship between marijuana use and increased FVC, discuss potential threats to validity when inferring causation, and, presupposing a possible causal relationship, pose two key questions. First, what are possible physiologic or pathophysiologic mechanisms by which marijuana use might increase FVC? Second, why might this effect be consistently observed with marijuana use but not with tobacco use? Explanations for the first question include lung and chest growth and remodeling from strenuous marijuana smoke inhalation and reductions in lung elastic recoil from marijuana smoke exposure. Explanations for the second include differences between marijuana and tobacco in smoke composition and patterns of consumption, such as smoking topography. Finally, the possibility that smoke, whether from marijuana or tobacco, might have nonmonotonic effects on FVC depending on the degree of exposure is explored. In synthesizing a curated breadth of epidemiologic and physiologic science, we leverage a perplexing observation to generate potential insights and avenues for further research into the biological effects of smoke, from marijuana or otherwise, on the respiratory system.

Classification of patterns of tobacco and cannabis co-use based on temporal proximity: A qualitative study among young adults.

PURPOSE: Co-use of tobacco and cannabis is a common and complex behavior. The lack of harmonized measures of co-use yields confusion and inconsistencies in synthesizing evidence about the health effects of co-use. We aimed to classify co-use patterns based on temporal proximity and describe preferred products and motives for each pattern in order to improve co-use surveillance. METHODS: We conducted semi-structured interviews in a sample of 34 young adults (Mage = 22.8 years, 32.4 % female) during 2017-2019 in California, USA. We employed a qualitative thematic analysis to identify timing, reasons, and contexts for tobacco and cannabis co-use and classify co-use patterns. RESULTS: Four emergent patterns of co-use with increasing temporal proximity between tobacco use and cannabis use were: Same-month different-day co-use (Pattern 1); Same-day different-occasion co-use (Pattern 2); Same-occasion sequential co-use (Pattern 3); and Same-occasion simultaneous co-use (Pattern 4). Participants used various product combinations within each pattern. Similar motives for all patterns were socialization, product availability, and coping with stress/anxiety. Unique motive for temporally distant patterns (Patterns 1 and 2) was seeking substance-specific effects (e.g., stimulant effect from nicotine, relaxation effects from cannabis), while unique motives for temporally close patterns (Patterns 3 and 4) were seeking combined effects from both substances (e.g., more intense psychoactive effects, mitigating cannabis adverse effects) and behavioral trigger (e.g., cannabis use triggers tobacco use). CONCLUSIONS: Our classification of co-use patterns can facilitate consistency for measuring co-use and assessing its health impacts. Future research should also measure product types and motives for different patterns to inform intervention efforts.

Effects of cannabis legalisation on patterns of cannabis consumption among adolescents in Ontario, Canada (2001-2019).

INTRODUCTION: Cannabis legalisation was enacted on 17 October 2018 in Canada. Accordingly, the effects of cannabis legalisation on patterns of cannabis consumption were examined among adolescents, including on cannabis initiation, any cannabis use, daily cannabis use and cannabis dependence. METHODS: Data from a biennial population-based, cross-sectional survey of students in Ontario were pooled in a pre-post design (2001-2019; N = 89,238). Participants provided self-reports of cannabis initiation, any cannabis use, daily cannabis use and cannabis dependence. Long-term trends in these patterns of cannabis consumption over two decades of observation were characterised to provide a broader context of usage. The effects of cannabis legalisation on patterns of cannabis consumption were quantified using logistic regression analyses. RESULTS: Long-term trends over the two decades of observation indicated that cannabis initiation decreased and then increased (p = 0.0220), any cannabis use decreased and daily cannabis use decreased (p < 0.0001 and p = 0.0001, respectively) and cannabis dependence remained unchanged (p = 0.1187). However, in comparisons between the pre-cannabis legalisation period (2001-2017) and the post-cannabis legalisation period (2019), cannabis legalisation was not associated with cannabis initiation (odds ratio; 95% confidence interval 1.00; 0.79-1.27), but it was associated with an increased likelihood of any cannabis use (1.31; 1.12-1.53), daily cannabis use (1.40; 1.09-1.80) and cannabis dependence (1.98; 1.29-3.04). DISCUSSION AND CONCLUSIONS: Cannabis legalisation was not associated with cannabis initiation, but it was associated with an increased likelihood of any cannabis use, daily cannabis use and cannabis dependence.

Understanding Cannabis-Related Information Needs: An Analysis of Inquiries to the National Cancer Institute's Cancer Information Service.

Purpose: Given increased cannabis use for medical and nonmedical purposes alike, there is growing public interest related to the potential risks and benefits of cannabis use, particularly related to cancer. The purpose of this descriptive study was to analyze cannabis inquiries to the National Cancer Institute's Cancer Information Service (CIS). Materials and Methods: From September 2018 to June 2023, 190,070 noncannabis and 425 cannabis inquiries were documented by the CIS. Cannabis inquiries were delineated into two categories: nonmedical cannabis (NMC, n=240) or medical cannabis (MC, n=185). Chi-square tests were performed to determine differences between noncannabis and cannabis inquiries and descriptive analyses were used to identify patterns within cannabis-specific inquiries. Results: Statistically significant differences between noncannabis and cannabis inquiries were observed. In addition, there were variations in MC and NMC inquiries. For example, 73% of MC inquiries originated from cancer survivors and caregivers, whereas almost half of NMC inquiries (48%) were from individuals identifying as tobacco users. MC and NMC inquiries also differed by CIS access channel (e.g., instant chat, telephone), language used (English vs. Spanish), discussions of cancer continuum phases and cancer sites, and referrals provided to individuals for additional information and resources. Conclusion: Cannabis-related information needs of the public-as documented by the CIS-varied by several factors. Health information sources such as the CIS can help address cannabis-related questions and concerns, while noting differences in who is inquiring, how, and why.

Association between cannabis use and risk of diabetes mellitus type 2: A systematic review and meta-analysis.

BACKGROUND: Cannabis consumption exerts multiple effects on metabolism via various pathways, including glucose regulation and insulin secretion. Studies concerning the association between cannabis use and diabetes mellitus type 2 are discrepant. OBJECTIVE: This study was conducted to evaluate the association between cannabis use and type 2 diabetes mellitus (T2DM). SEARCH METHODS: We searched PubMed, Scopus, Embase, Proquest, Web of Science, and Cochrane Library with no time, language or study types restriction until July 1, 2022, using various forms of "cannabis" and "diabetes mellitus" search terms. SELECTION CRITERIA: Randomized control trials, cohort, and case-control studies investigating the relationship between cannabis consumption and diabetes mellitus type 2 were included. DATA COLLECTION AND ANALYSIS: The Newcastle-Ottawa scale was used to assess the quality of studies. We pooled odds ratio (OR) with 95% confidence interval (CI) using the random-effects model, generic inverse variance method, DerSimonian and Laird approach. MAIN RESULTS: A meta-analysis of seven studies, containing 11 surveys and 4 cohorts, revealed that the odds of developing T2DM in individuals exposed to cannabis was 0.48 times (95% CI: 0.39 to 0.59) lower than in those without cannabis exposure. CONCLUSIONS: A protective effect of cannabis consumption on the odds of diabetes mellitus type 2 development has been suggested. Yet given the considerable interstudy heterogeneity, the upward trend of cannabis consumption and cannabis legalization is recommended to conduct studies with higher levels of evidence.

Spontaneous secondary pneumothorax due to cannabis-induced bullous lung disease: a case report.

Marijuana use has grown rapidly in the last decade with a prevalence greater than that of cocaine and opioids. With its increasing recreational and medical use, potential adverse outcomes from heavy use may be associated with bullous lung disease and spontaneous pneumothorax. This case report has been reported in line with the SCARE Criteria. Case presentation: The authors describe a case of an adult male with a past medical history of spontaneous pneumothorax and long-standing marijuana use presenting with dyspnoea who was found to have a secondary spontaneous pneumothorax requiring invasive treatment. Clinical discussion: The aetiology of lung injury due to heavy marijuana smoke may be from direct tissue injury from inhaled irritants and the method of which marijuana smoke is inhaled compared with tobacco smoke. Conclusion: Chronic marijuana use should be considered when evaluating structural lung disease and pneumothorax in the setting of minimal tobacco use.

Cannabis legalization and cannabis use, daily cannabis use and cannabis-related problems among adults in Ontario, Canada (2001-2019).

BACKGROUND: In the context of cannabis legalization in Canada, we examined the effects on cannabis patterns of consumption, including cannabis use, daily cannabis use and cannabis-related problems. In addition, we examined differential effects of cannabis legalization by age and sex. METHODS: A pre-post design was operationalized by combining 19 iterations of the Centre for Addiction and Mental Health (CAMH) Monitor Surveys (N = 52,260; 2001-2019): repeated, population-based, cross-sectional surveys of adults in Ontario. Participants provided self-reports of cannabis use (past 12 months), daily cannabis use (past 12 months) and cannabis-related problems though telephone interviews. The effects of cannabis legalization on cannabis patterns of consumption were examined using logistic regression analyses, with testing of two-way interactions to determine differential effects by age and sex. RESULTS: Cannabis use prevalence increased from 11 % to 26 % (p < 0.0001), daily cannabis use prevalence increased from 1 % to 6 % (p < 0.0001) and cannabis-related problems prevalence increased from 6 % to 14 % (p < 0.0001) between 2001 and 2019. Cannabis legalization was associated with an increased likelihood of cannabis use (OR, 95 % CI: 1.62, 1.40-1.86), daily cannabis use (1.59, 1.21-2.07) and cannabis-related problems (1.53, 1.20-1.95). For cannabis-related problems, a significant two-way interaction was observed between cannabis legalization and age (p = 0.0001), suggesting differential effects among adults ≥55 years. CONCLUSIONS: Cannabis legalization was associated with an increased likelihood of cannabis use, daily cannabis use and cannabis-related problems. Given increases in these cannabis patterns of consumption, broader dissemination and uptake of targeted prevention tools is indicated.

The association between public health engagement in school-based substance use prevention programs and student alcohol, cannabis, e-cigarette and cigarette use.

OBJECTIVE: This study examined the associations between public health engagement (PHE) in school-based substance use prevention programs and student substance use. For the purposes of this study, PHE refers to any form of collaboration between the local government public health agency and the school to promote the physical and mental health of students. METHODS: Data for this study were collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study during the 2018/2019 data collection year. Multilevel logistic regression was used to analyze the associations between PHE and student substance use. RESULTS: Data from 84 schools and 42,149 students were included; 70% of schools had PHE in substance use prevention programs. PHE in substance use prevention appears to have had no significant impact on student substance use in our models. When PHE was divided into five methods of engagement, it was found that when public health solved problems jointly with schools, the odds of a student using alcohol or cannabis significantly increased. When schools were split into low- and high-use schools for each substance measured, some methods of PHE significantly decreased the odds of cannabis and cigarette use in high-use schools and significantly increased the odds of alcohol and cannabis use in low-use schools. CONCLUSION: This study highlights the need to develop better partnerships and collaborations between public health and schools, and the importance of ensuring that school-based substance use prevention programs are evidence-based and tailored to the specific needs of schools and students.

RéSUMé: OBJECTIF: L'étude porte sur les associations entre la participation de la santé publique (PSP) aux programmes de prévention de l'usage de substances en milieu scolaire et l'usage de substances par les élèves. Pour les besoins de l'étude, la PSP désigne toute forme de collaboration entre un organisme de santé publique local et une école visant à promouvoir la santé physique et mentale des élèves. MéTHODE: Nos données sont tirées de l'étude COMPASS (étude de cohorte sur l'obésité, la consommation de marijuana, l'activité physique, la consommation d'alcool, le tabagisme et le comportement sédentaire) durant l'année de collecte de données 2018-2019. Les associations entre la PSP et l'usage de substances par les élèves ont été analysées au moyen de régressions logistiques multiniveaux. RéSULTATS: Nous avons inclus les données de 84 écoles et de 42 149 élèves; dans 70 % des écoles, la santé publique participait aux programmes de prévention de l'usage de substances. La PSP à la prévention de l'usage de substances semble n'avoir eu aucun effet significatif sur l'usage de substances par les élèves dans nos modèles. Quand nous avons divisé la PSP en cinq méthodes de participation, nous avons constaté que lorsque la santé publique résolvait les problèmes conjointement avec les écoles, la probabilité qu'une ou un élève consomme de l'alcool ou du cannabis augmentait de façon significative. Quand nous avons divisé les écoles en écoles à faible et à forte consommation pour chaque substance mesurée, certaines méthodes de PSP réduisaient de façon significative les probabilités d'usage de cannabis et de cigarettes dans les écoles à forte consommation et faisaient augmenter de façon significative les probabilités d'usage d'alcool et de cannabis dans les écoles à faible consommation. CONCLUSION: Notre étude fait ressortir le besoin de créer de meilleurs partenariats et collaborations entre la santé publique et les écoles, ainsi que l'importance de s'assurer que les programmes de prévention de l'usage de substances en milieu scolaire reposent sur des données probantes et qu'ils sont adaptés aux besoins particuliers des écoles et des élèves.

Guideline No. 425a: Cannabis Use Throughout Women's Lifespans - Part 1: Fertility, Contraception, Menopause, and Pelvic Pain.

OBJECTIVE: To provide health care providers with the best evidence on cannabis use with respect to women's health. Areas of focus include general patterns of cannabis use as well as safety of use; care for women who use cannabis; stigma; screening, brief intervention, and referral to treatment; impact on hormonal regulation; reproductive health, including contraception and fertility; sexual function; effects on perimenopausal and menopausal symptoms; and use in chronic pelvic pain syndromes. TARGET POPULATION: The target population includes all women currently using or contemplating using cannabis. OUTCOMES: Open, evidence-informed dialogue about cannabis use, which will lead to improvement in patient care. BENEFITS, HARMS, AND COSTS: Exploring cannabis use through a trauma-informed approach provides the health care provider and patient with an opportunity to build a strong, collaborative, therapeutic alliance. This alliance empowers women to make informed choices about their own care. It also allows for the diagnosis and possible treatment of cannabis use disorders. Use should not be stigmatized, as stigma leads to poor "partnered care" (i.e., the partnership between the patient and care provider). Multiple side effects of cannabis use may be mistaken for other disorders. Currently, use of cannabis to treat women's health issues is not covered by public funding; as a result, individual users must pay the direct cost. The indirect costs of cannabis use are unknown. Thus, health care providers and patients must understand the role of cannabis in women's health issues, so that women can make knowledgeable decisions. EVIDENCE: PubMed, EMBASE, and grey literature were searched to identify studies of "cannabis use and effect on infertility, contraception, perimenopause and menopausal symptoms, and pelvic pain" published between January 1, 2018 and February 18, 2021. All clinical trials, observational studies, reviews (including systematic reviews and meta-analyses), guidelines, and conference consensus statements were included. Publications were screened for relevance. The search terms were developed using the Medical Subject Headings (MeSH) terms and keywords (and variants), including cannabis, cannabinoids, marijuana, dexanabinol, dronabinol, tetrahydrocannabinol; the specific terms to capture women's health were estrogen, estradiol, medroxyprogesterone acetate, vaginal contraception, oral contraceptives, fertilization, amenorrhea, oligomenorrhea, pelvic pain, dysmenorrhea, endometriosis, interstitial cystitis, vulvodynia, and menopause. VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE: All heath care providers who care for women. SUMMARY STATEMENTS: RECOMMENDATIONS.

Spontaneous Pneumorachis - A Case-Based Review.

Pneumorachis is characterized by the presence of free air in the spinal canal. It is referred by different names in literature such as epidural emphysema, intraspinal air, intraspinal pneumoc(o)ele, spinal epidural and subarachnoid pneumatosis, spinal and epidural emphysema, aerorachia, pneumosaccus, air myelogram, etc. Pneumorachis can be broadly classified as traumatic, iatrogenic, or spontaneous. In this case-based review, we present a case of spontaneous pneumorachis secondary to asthma exacerbation. This is followed by a systematic review of all cases of spontaneous pneumorachis identified in PubMed. The aim of this review is to understand the pathophysiology, common causes and the management of spontaneous pneumorachis.

Prenatal cannabis use disorder and future risk of road traffic injuries in Canadian children.

The extent to which child traffic injuries may be attributed to parents who use cannabis before driving is unknown. We investigated whether prenatal cannabis use disorders may predict future road traffic injuries in children. We conducted a cohort study of 792,082 children in Quebec, Canada with 6,280,663 years of follow-up between 2006 and 2019. The main exposure measure was maternal cannabis use disorder before or during pregnancy. The main outcome measure was future hospitalizations for transport-related injuries in children after birth. Using Cox proportional hazards regression models adjusted for potential confounders, we estimated hazard ratios and 95% confidence intervals (CI) for the association of prenatal cannabis use disorders with transport-related injuries in children. Maternal cannabis use disorders before birth were associated with 5.64 times the risk of hospitalization for future motor vehicle crash injuries in children (95% CI 2.61-12.21). The risk increased with the child's age. Prenatal cocaine, opioid, and other drug use disorders were not associated with pediatric transport-related injuries. Maternal cannabis use disorders before birth may be an early predictor of childhood injuries from motor vehicle crashes.

Marijuana use and suicidal behaviours among school-going adolescents in Africa: assessments of prevalence and risk factors from the Global School-Based Student Health Survey.

BACKGROUND: Marijuana use among adolescents, including high school students, has been consistently reported to be associated with a high incidence of suicidal behaviours. Little empirical research has been conducted on the propensity impact of marijuana use on suicidal behaviours in Africa. AIMS: To assess factors associated with marijuana use and further quantify marijuana use as an associated factor of suicidal behaviours, including repeated attempted suicide, suicidal ideation and suicide planning, among high school students in Africa. METHODS: A cross-sectional study was conducted among 32 802 school-going adolescents using the Global School-Based Student Health Survey data from 10 African countries grouped into West Africa, North Africa, South-East Africa, South Africa and East Africa subregions. Marijuana use and repeated attempted suicide were the main outcome variables. We employed double selection least absolute shrinkage and selection operator poisson regression model to assess risk factors associated with marijuana use and dominance analysis to establish ranked important and common risk factors. Inverse probability weighting poisson regression adjustment was applied to assess impact. RESULTS: The prevalence of marijuana use and repeated attempted suicide were 3.7% (95% CI: 3.1 to 4.3) and 6.6% (95% CI: 5.9 to 7.4), respectively. The most important risk factor for marijuana use generally across the countries and specifically in three subregions was alcohol consumption, which constituted approximately 40% of the impact. The average treatment effect on the treated (ATT) indicated that marijuana use significantly increased the risk of suicidal ideation, suicide planning and repeated attempted suicide by 12% (ATT=0.12 (95% CI: 0.02 to 0.22)), 18% (ATT=0.18 (95% CI: 0.13 to 0.22)) and 31% (ATT=0.31 (95% CI: 0.20 to 0.41)), respectively. CONCLUSIONS: Marijuana use was significantly associated with suicidal behaviours (suicidal ideation, planning and repeated attempted suicide) among the students. To achieve Sustainable Development Goal 3.5 (to strengthen prevention and treatment of substance abuse), school-based psychosocial interventions should be streamlined to adequately assess and manage marijuana use. Targeting the most dominant risk factors in this population could translate into the reduction of suicidal behaviours in countries within Africa.

The longitudinal relationship between cannabis use and hypertension.

INTRODUCTION: The relationship between cannabis use and hypertension is not clear based on prior epidemiological studies. Thus, we examined this relationship over a 3-year follow-up period using a large population-based sample from the USA. METHODS: Self-reported longitudinal data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 1 (2001/2002) and Wave 2 (2004/2005). The sample was restricted to participants who did not report hypertension at baseline (n = 26 844; 51% 40 years and older, 51% female, 71% white). χ2 -tests were used to examine the distributions of confounders stratified by the incidence of hypertension. Thereafter, multiple logistic regression analyses were conducted to quantify the relationships between lifetime cannabis use, 12-month cannabis use and 12-month cannabis use frequency and incidence of hypertension while adjusting for confounders. RESULTS: Cannabis use was associated with a decreased incidence of hypertension in the unadjusted analyses. However, the relationships were confounded by age. After adjustment for all confounders, neither lifetime cannabis use (odds ratio, 95% confidence interval 0.89, 0.77 to 1.02), 12-month cannabis use (0.78, 0.56 to 1.09) nor 12-month cannabis use frequency [at least monthly use (0.85, 0.57 to 1.28) and less than monthly use (0.67, 0.40 to 1.11)] were associated above chance with the incidence of hypertension. DISCUSSION AND CONCLUSIONS: Lifetime cannabis use, 12-month cannabis use and 12-month cannabis use frequency were not associated with the incidence of hypertension.

Association between the use of Cannabis and elevated suicide risk in high school adolescents from Santa Marta, Colombia / Asociación entre el consumo de Cannabis y el riesgo de suicidio en adolescentes escolarizados de Santa Marta, Colombia.

Introduction: The use of Cannabis continues to increase worldwide, especially among adolescents. This use overlaps with cigarette smoking and other illicit and licit drugs and s associated with depressive symptoms and suicide risk. In our national context, little is known about the relationship between Cannabis use and suicide risk. Objective: To evaluate the association between Cannabis use and elevated suicide risk in high school adolescents in Santa Marta, Colombia. Materials and methods: We conducted a cross-sectional study with a probabilistic sample of high school students between 13 and 17 years of age from official and private schools. We analyzed the use of Cannabis some time in life and suicide risk was quantified using the suicide ideation scale designed by the Center for Epidemiological Studies on Depression. Scores greater than eight were categorized as a high suicide risk. The crude and adjusted opportunity ratio (OR) was estimated. Results: A total of 1,462 students participated. Their mean age was 14.4 years (SD=0.8) and 60.3% were women. The lifetime prevalence of Cannabis use was 11.6% (95%CI: 10.0-13.2) and 13.3% of the students reported high suicide risk (95%CI: 11.6-15.0). Cannabis consumption was associated with high suicide risk adjusted by other variables (OR=1.88; 95%CI: 1.23-2.88). Conclusions: Cannabis use was associated with high suicide risk in high school adolescents in Santa Marta, Colombia. Other variables should be studied in order to further examine this association.

Introducción. La prevalencia del consumo de Cannabis sigue en aumento en el mundo, especialmente, entre adolescentes. Dicho consumo se sobrepone al de cigarrillos y otras sustancias lícitas e ilícitas, y se ha asociado con síntomas depresivos e incremento del riesgo suicida. En el contexto colombiano poco se conoce sobre la relación entre el consumo de Cannabis y el riesgo de suicidio. Objetivo. Evaluar la asociación entre el consumo de Cannabis y el riesgo suicida en adolescentes escolarizados de Santa Marta, Colombia. Materiales y métodos. Se hizo un estudio transversal con una muestra probabilística de estudiantes de media vocacional entre los 13 y los 17 años de edad en colegios oficiales y privados. Se indagó sobre el consumo de Cannabis alguna vez en la vida y se cuantificó el riesgo suicida con la Center for Epidemiologic Studies on Depression Scale. Las puntuaciones superiores a ocho se categorizaron como riesgo suicida elevado. Se estimó la razón de oportunidad (OR) cruda y la ajustada. Resultados. Participaron 1.462 estudiantes. La media para la edad fue de 14,4 años (desviación estándar, DE=0,8) y el 60,3 % correspondía a mujeres. La prevalencia del consumo de Cannabis alguna vez en la vida fue del 11,6 % (IC95% 10,0-13,2) y el 13,3 % (IC95% 11,6-15,0) de los estudiantes presentó riesgo suicida elevado. El consumo de Cannabis se asoció con dicho riesgo ajustado por otras variables (OR=1,88; IC95% 1,23-2,88). Conclusiones. El consumo de Cannabis se asoció con el riesgo suicida elevado en adolescentes escolarizados de Santa Marta, Colombia.

Mental Health and Cognition in Older Cannabis Users: a Review.

BACKGROUND: The impact of cannabis use on mental health and cognition in older adults remains unclear. With the recent legalization of cannabis in Canada, physicians will need up-to-date information about the mental and cognitive effects of cannabis use in this specific population. METHOD: A narrative review was conducted to summarize the literature on mental health and cognitive effects of cannabis use in older adults using Medline (OvidSP). RESULTS: A total of 16 studies were identified, including nine cross-sectional studies on mental health comorbidities reported by older cannabis users. The self-reported prevalence of mental and substance use disorders is approximately two to three times higher in older adults who report past-year cannabis use, compared to older adults who report using more than one year ago or never using. The remaining seven clinical trials found that short-term, low-dose medical cannabis was generally well-tolerated in older adults without prior serious mental illness. However, mental/cognitive adverse effects were not systematically assessed. CONCLUSION: Although preliminary findings suggests that low-dose, short-term medical cannabis does not carry significant risk of serious mental health and cognitive adverse effects in older adults without prior psychiatric history, epidemiological studies find a correlation between past-year cannabis use and poor mental health outcomes in community-dwelling older adults. These findings may indicate that longer term cannabis use in this population is detrimental to their mental health, although a direct causal link has not been established. Larger, longitudinal studies on the safety of medical cannabis in older adults are needed.

Asociación entre el consumo de Cannabis y el riesgo de suicidio en adolescentes escolarizados de Santa Marta, Colombia / Association between the use of Cannabis and elevated suicide risk in high school adolescents from Santa Marta, Colombia

Introducción. La prevalencia del consumo de Cannabis sigue en aumento en el mundo, especialmente, entre adolescentes. Dicho consumo se sobrepone al de cigarrillos y otras sustancias lícitas e ilícitas, y se ha asociado con síntomas depresivos e incremento del riesgo suicida. En el contexto colombiano poco se conoce sobre la relación entre el consumo de Cannabis y el riesgo de suicidio. Objetivo. Evaluar la asociación entre el consumo de Cannabis y el riesgo suicida en adolescentes escolarizados de Santa Marta, Colombia. Materiales y métodos. Se hizo un estudio transversal con una muestra probabilística de estudiantes de media vocacional entre los 13 y los 17 años de edad en colegios oficiales y privados. Se indagó sobre el consumo de Cannabis alguna vez en la vida y se cuantificó el riesgo suicida con la Center for Epidemiologic Studies on Depression Scale. Las puntuaciones superiores a ocho se categorizaron como riesgo suicida elevado. Se estimó la razón de oportunidad (OR) cruda y la ajustada. Resultados. Participaron 1.462 estudiantes. La media para la edad fue de 14,4 años (desviación estándar, DE=0,8) y el 60,3 % correspondía a mujeres. La prevalencia del consumo de Cannabis alguna vez en la vida fue del 11,6 % (IC95% 10,0-13,2) y el 13,3 % (IC95% 11,6-15,0) de los estudiantes presentó riesgo suicida elevado. El consumo de Cannabis se asoció con dicho riesgo ajustado por otras variables (OR=1,88; IC95% 1,23-2,88). Conclusiones. El consumo de Cannabis se asoció con el riesgo suicida elevado en adolescentes escolarizados de Santa Marta, Colombia. Es necesario analizar otras variables que pueden mediar esta asociación.

Introduction: The use of Cannabis continues to increase worldwide, especially among adolescents. This use overlaps with cigarette smoking and other illicit and licit drugs and is associated with depressive symptoms and suicide risk. In our national context, little is known about the relationship between Cannabis use and suicide risk. Objective: To evaluate the association between Cannabis use and elevated suicide risk in high school adolescents in Santa Marta, Colombia. Materials and methods: We conducted a cross-sectional study with a probabilistic sample of high school students between 13 and 17 years of age from official and private schools. We analyzed the use of Cannabis some time in life and suicide risk was quantified using the suicide ideation scale designed by the Center for Epidemiological Studies on Depression. Scores greater than eight were categorized as a high suicide risk. The crude and adjusted opportunity ratio (OR) was estimated. Results: A total of 1,462 students participated. Their mean age was 14.4 years (SD=0.8) and 60.3% were women. The lifetime prevalence of Cannabis use was 11.6% (95%CI: 10.0 13.2) and 13.3% of the students reported high suicide risk (95%CI: 11.6-15.0). Cannabis consumption was associated with high suicide risk adjusted by other variables (OR=1.88; 95%CI: 1.23-2.88). Conclusions: Cannabis use was associated with high suicide risk in high school adolescents in Santa Marta, Colombia. Other variables should be studied in order to further examine this association.

Cannabis use is associated with a lower risk of diabetes in chronic hepatitis C-infected patients (ANRS CO22 Hepather cohort).

Chronic hepatitis C virus (HCV) infection is a risk factor of insulin resistance, and HCV-infected patients are at a high risk of developing diabetes. In the general population, research has shown the potential benefit of cannabis use for the prevention of diabetes and related metabolic disorders. We aimed to test whether cannabis use is associated with a lower risk of diabetes in chronic HCV-infected patients. Chronic HCV-infected patients (n = 10 445) were selected from the French national, multicenter, observational ANRS CO22 Hepather cohort. Cross-sectional data collected at cohort enrollment were used to assess the association between patients' clinical and behavioural characteristics and the risk of diabetes. Logistic regression model was performed with cannabis use as the main independent variable and a significance level set at 5%. A similar model stratified by the presence of advanced liver fibrosis (FIB-4 > 3.25) was also run. After multivariable adjustment, current (AOR [95%CI]: 0.49 [0.38-0.63]) and former (0.81 [0.67-0.98], P < .001) cannabis use were both associated with a reduced odds of diabetes. Conversely, male gender, tobacco use, elevated BMI, poverty, being a migrant and advanced fibrosis were associated with increased odds of diabetes. The association between cannabis use and diabetes was maintained in the stratified analysis. In this large cross-sectional study of chronic HCV-infected patients, cannabis use was associated with a lower risk of diabetes independently of clinical and socio-behavioural factors. Further studies are needed to elucidate a potential causal link and shed light on cannabis compounds and mechanisms involved in this relationship.