A prospective observational study of problematic oral cannabinoid use

Ware, Mark A.; Martel, Marc O.; Jovey, Roman D; Lynch, Mary; Singer, Joel

doi:10.1007/s00213-017-4811-6

Cited by 11 publications

(12 citation statements)

References 53 publications

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“…Similar trends are emerging in Canada (Lucas & Walsh, 2017; Lucas et al, 2016; Walsh et al, 2013). This is occurring despite little to no controlled clinical evidence supporting the therapeutic efficacy of cannabis for mental disorders (Belendiuk, Baldini, & Bonn-Miller, 2015), and despite data indicating that medical cannabis patients with a history of psychiatric problems have more problematic cannabis use than medical cannabis patients without a history of psychiatric problems (Ware, Martel, Jovey, Lynch, & Singer, 2018).…”

Section: Introductionmentioning

confidence: 99%

Cannabis regulatory science: risk–benefit considerations for mental disorders

Borodovsky

Budney²

2018

International Review of Psychiatry

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The evolving legal cannabis landscape in the US continues to present novel regulatory challenges that necessitate the development of a Cannabis Regulatory Science. Two specific issues of concern within Cannabis Regulatory Science are (1) the impact that cannabis use has on the incidence, prevalence, and severity of mental disorders, and (2) how cannabis laws and regulations modify this impact. This paper first provides several conceptual points that are useful for evaluating the relationship between cannabis use and mental disorders. Second, it selectively reviews and comments on data relevant to the relationship between cannabis use and depression, several forms of anxiety, post-traumatic stress disorder, schizophrenia, and bipolar disorder. Next, regulatory and public health parallels between the nascent cannabis industry and the pharmaceutical, tobacco, and alcohol industries are discussed. The focus is on specific types of industry practices that may harm those with or at risk for mental disorders. Recommendations are then offered for legal cannabis regulations that could mitigate this harm. Last, future research goals are discussed for building the field of Cannabis Regulatory Science and addressing the potential negative impact of cannabis on those with mental disorders.

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Section: Introductionmentioning

confidence: 99%

Cannabis regulatory science: risk–benefit considerations for mental disorders

Borodovsky

Budney²

2018

International Review of Psychiatry

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“…However, potential misuse and problematic use of oral cannabinoids have been found in a prospective observational study of 265 patients initiating oral cannabinoid therapy. Ware et al (2018) compared three measures (Current Opioid Misuse Measure (COMM); Addiction Behaviour Checklist, Chabal Prescription Opioid Abuse Checklist) modified by replacing the word ’opioid’ with ’cannabinoid’. At follow-up, up to a quarter of patients reported problematic prescription oral cannabinoid use on the COMM ( Ware et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

“… Ware et al (2018) compared three measures (Current Opioid Misuse Measure (COMM); Addiction Behaviour Checklist, Chabal Prescription Opioid Abuse Checklist) modified by replacing the word ’opioid’ with ’cannabinoid’. At follow-up, up to a quarter of patients reported problematic prescription oral cannabinoid use on the COMM ( Ware et al, 2018 ). This is important because the COMM is a self-reported and relatively detailed measure of dependence whilst the other measures are short, clinician-rated measures.…”

Section: Introductionmentioning

confidence: 99%

“…Although set and setting are most often discussed in relation to psychedelic research and recreational drug use, its importance for CBMPs should also be investigated. For example, in three studies investigating problematic medical cannabis use, those with a history of psychiatric problems or other drug-use problems (including alcohol), tobacco smokers and recreational cannabis users were more likely to experience medical cannabis dependence ( Feingold et al, 2017 ; Ware et al, 2018 ). Moreover, in regards to recreational cannabis dependence, van der Pol et al (2013) found strong evidence pointing to increased risk for CUD among individuals who use cannabis in order to cope with mental distress.…”

Section: Introductionmentioning

confidence: 99%

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Cannabis based medicines and cannabis dependence: A critical review of issues and evidence

et al. 2021

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Cannabis has been legalised for medical use in an ever-increasing number of countries. A growing body of scientific evidence supports the use of medical cannabis for a range of therapeutic indications. In parallel with these developments, concerns have been expressed by many prescribers that increased use will lead to patients developing cannabis use disorder. Cannabis use disorder has been widely studied in recreational users, and these findings have often been projected onto patients using medical cannabis. However, studies exploring medical cannabis dependence are scarce and the appropriate methodology to measure this construct is uncertain. This article provides a narrative review of the current research to discern if, how and to what extent, concerns about problems of dependence in recreational cannabis users apply to prescribed medical users. We focus on the main issues related to medical cannabis and dependence, including the importance of dose, potency, cannabinoid content, pharmacokinetics and route of administration, frequency of use, as well as set and setting. Medical and recreational cannabis use differs in significant ways, highlighting the challenges of extrapolating findings from the recreational cannabis literature. There are many questions about the potential for medical cannabis use to lead to dependence. It is therefore imperative to address these questions in order to be able to minimise harms of medical cannabis use. We draw out seven recommendations for increasing the safety of medical cannabis prescribing. We hope that the present review contributes to answering some of the key questions surrounding medical cannabis dependence.

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“…Abuse liability is defined as the potential of a drug to illicit positive subjective effects that contribute to nonmedical use, which over time, could lead to chronic use despite negative consequences [14] and in this case, Cannabis Use Disorder (CUD). Over 80% of people who use cannabis for medical purposes also use it for recreational reasons [15] and approximately 25% of patients prescribed oral cannabinoid therapy demonstrated problematic medical cannabis use [16]. As such, understanding the abuse liability of cannabis and CDPs is critical to optimizing therapeutic benefit and preventing increases in rates of CUD among this population.…”

Section: Introductionmentioning

confidence: 99%

Considering abuse liability and neurocognitive effects of cannabis and cannabis-derived products when assessing analgesic efficacy: a comprehensive review of randomized-controlled studies

Cooper

Abrams

2019

The American Journal of Drug and Alcohol Abuse

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Background-Pain is the most frequent indication for which medical cannabis treatment is sought. Objectives-The clinical potential of cannabis and cannabis-derived products (CDPs) relies on their efficacy to treat an indication and potential adverse effects that impact outcomes, including abuse liability and neurocognitive effects. To ascertain the extent to which these effects impact therapeutic utility, studies investigating cannabis and CDPs for pain were reviewed for analgesic efficacy and assessments of abuse liability and neurocognitive effects. Methods-A comprehensive review of placebo-controlled studies investigating cannabis and CDP analgesia was performed. Methods and findings related to adverse effects, abuse liability, and neurocognitive effects were extracted. Results-Thirty-eight studies were reviewed; 29 assessed cannabis and CDPs for chronic pain, 1 for acute pain, and 8 used experimental pain tests. Most studies ascertained adverse effects through self-report (N = 27). Fewer studies specifically probed abuse liability (N = 7) and cognitive and psychomotor effects (N = 12). Many studies related to chronic and experimental pain (N = 18 and N = 5 respectively) found cannabis and CDPs to reduce pain. Overall, adverse effects were mild to moderate, and dose-related. Studies investigating the impact of cannabis and CDPs of abuse liability and neurocognitive endpoints were mostly limited to inhaled administration and confirmed dose-related effects. Conclusion-Few studies investigating cannabis and CDP analgesia assess abuse liability and cognitive endpoints, adverse effects that impact long-term clinical utility of these drugs. Future

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A prospective observational study of problematic oral cannabinoid use

Cited by 11 publications

References 53 publications

Cannabis regulatory science: risk–benefit considerations for mental disorders

Cannabis regulatory science: risk–benefit considerations for mental disorders

Cannabis based medicines and cannabis dependence: A critical review of issues and evidence

Considering abuse liability and neurocognitive effects of cannabis and cannabis-derived products when assessing analgesic efficacy: a comprehensive review of randomized-controlled studies

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