Adverse effects of heavy cannabis use: even plants can harm the brain

Sideli, Lucia; Trotta, Giulia; Spinazzola, Edoardo; Cascia, Caterina La; Forti, Marta Di

doi:10.1097/j.pain.0000000000001963

Cited by 15 publications

(12 citation statements)

References 115 publications

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“…Among patients with chronic pain, the factors associated with an increased risk of cannabis use problems have remained largely unexplored. Certain medical cannabis treatment characteristics such as use of THC‐dominant formulations via inhalation could increase risk of cannabis use problems (20,42), but optimal medical cannabis directives, including dosing, remain unclear. Recommendations are that amounts should not exceed 3 grams per day, with studies mostly reporting use of 1 to 2 grams per day (45−47).…”

Section: Discussionmentioning

confidence: 99%

“…Medical cannabis may present a useful treatment strategy for patients with FM in light of an effect on the triad of symptoms of pain, negative affect, and sleep disturbances. Long-term adverse effects of medical cannabis use are mostly unknown, but there is potential for worsening of depressive symptoms (31,40), emergence of psychotic illness especially in younger adults, and possible progression to a cannabis use disorder (41,42). Monitoring patients who are using medical cannabis has thus been emphasized, not only to track improvements in pain but also to mitigate the development of mental disorders, adverse effects, or other cannabis-related problems (9,43,44).…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Pain Reduction Among Fibromyalgia Patients Using Medical Cannabis: A Long‐Term Prospective Cohort Study

Sotoodeh

Waldman

Viganò

et al. 2023

Arthritis Care & Research

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Objective Many patients with fibromyalgia (FM) report using cannabis as a strategy to improve pain. Given that pain often co‐occurs with symptoms of anxiety and depression (i.e., negative affect) and sleep problems among patients with FM, improvements in these symptoms might indirectly contribute to reductions in pain intensity following cannabis use. The main objective of the study was to examine whether changes in pain intensity following initiation of medical cannabis among patients with FM could be attributed to concurrent changes (i.e., reductions) in negative affect and sleep problems. Methods This was a 12‐month prospective cohort study among patients with FM (n = 323) initiating medical cannabis under the care of physicians. Patients were assessed at baseline, and follow‐up assessment visits occurred every 3 months after initiation of medical cannabis. Patients’ levels of pain intensity, negative affect, and sleep problems were assessed across all visits. Results Multilevel mediation analyses indicated that reductions in patients’ levels of pain intensity were partly explained by concurrent reductions in sleep problems and negative affect (both P < 0.001). This remained significant even when accounting for patients’ baseline characteristics or changes in medical cannabis directives over time (all P > 0.05). Conclusion Our findings provide preliminary insight into the potential mechanisms of action underlying pain reductions among patients with FM who are using medical cannabis. Given the high attrition rate (i.e., 75%) observed in the present study at 12 months, our findings cannot be generalized to all patients with FM who are using medical cannabis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of Pain Reduction Among Fibromyalgia Patients Using Medical Cannabis: A Long‐Term Prospective Cohort Study

Sotoodeh

Waldman

Viganò

et al. 2023

Arthritis Care & Research

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“…Controversial data have also been observed in animal models of long-lasting consequences of adolescent THC exposure due to discrepancies in doses, routes of administration, and periods of exposure; however, the majority of preclinical data confirm the neuropsychiatric side effects of cannabis (see reviews [ 166 , 167 ]). Importantly, clinical evidence suggests that the magnitude of disorders is positively correlated with the frequency, dose, age at onset of consumption, and THC content [ 168 ]. Focusing on this latter aspect, it has been demonstrated that cannabis strains and extracts containing high THC and low CBD concentrations are linked to increased neuropsychiatric risk, highlighting the role of CBD in mitigating THC-related neuropsychiatric side effects [ 169 , 170 , 171 , 172 ].…”

Section: Divergent Central Effects Of Thc and Cbdmentioning

confidence: 99%

THC and CBD: Villain versus Hero? Insights into Adolescent Exposure

Pintori

Caria

Luca

et al. 2023

IJMS

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Cannabis is the most used drug of abuse worldwide. It is well established that the most abundant phytocannabinoids in this plant are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These two compounds have remarkably similar chemical structures yet vastly different effects in the brain. By binding to the same receptors, THC is psychoactive, while CBD has anxiolytic and antipsychotic properties. Lately, a variety of hemp-based products, including CBD and THC, have become widely available in the food and health industry, and medical and recreational use of cannabis has been legalized in many states/countries. As a result, people, including youths, are consuming CBD because it is considered “safe”. An extensive literature exists evaluating the harmful effects of THC in both adults and adolescents, but little is known about the long-term effects of CBD exposure, especially in adolescence. The aim of this review is to collect preclinical and clinical evidence about the effects of cannabidiol.

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“…Cannabis and cannabinoids are increasingly discussed for pain despite evidence that cannabis use is associated with an increased risk of psychosis and increased risk of relapse and rehospitalization among people with psychosis. 43,72,99 Guidelines advise against antipsychotics, gabapentinoids, benzodiazepines, and ketamine for chronic primary pain, 78 but when used for psychiatric comorbidities, 8,98,100 they may help comorbid pain. Recent advances in drugs targeting sleep disturbance 53,56 and transcranial magnetic stimulation 62 may prove fruitful for comorbid pain and SMI.…”

Section: Understanding Pain and Its Treatment In People With Severe M...mentioning

confidence: 99%