Cannabis legalization: Did we make a mistake? Update 2019

Leyton, Marco

doi:10.1503/jpn.190136

Cited by 32 publications

(23 citation statements)

References 25 publications

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“…The UK also legalized medical cannabis in 2019, in addition to other countries worldwide. Changes in legalization laws and the liberalization of cannabis increase the need for more research to understand the cannabis plant and its effects, which may be available in the future [ 260 , 261 , 262 , 263 ].…”

Section: Legalization Of Cannabismentioning

confidence: 99%

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Breijyeh

Jubeh

Bufo

et al. 2021

Toxins

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For thousands of years, Cannabis sativa has been utilized as a medicine and for recreational and spiritual purposes. Phytocannabinoids are a family of compounds that are found in the cannabis plant, which is known for its psychotogenic and euphoric effects; the main psychotropic constituent of cannabis is Δ9-tetrahydrocannabinol (Δ9-THC). The pharmacological effects of cannabinoids are a result of interactions between those compounds and cannabinoid receptors, CB1 and CB2, located in many parts of the human body. Cannabis is used as a therapeutic agent for treating pain and emesis. Some cannabinoids are clinically applied for treating chronic pain, particularly cancer and multiple sclerosis-associated pain, for appetite stimulation and anti-emesis in HIV/AIDS and cancer patients, and for spasticity treatment in multiple sclerosis and epilepsy patients. Medical cannabis varies from recreational cannabis in the chemical content of THC and cannabidiol (CBD), modes of administration, and safety. Despite the therapeutic effects of cannabis, exposure to high concentrations of THC, the main compound that is responsible for most of the intoxicating effects experienced by users, could lead to psychological events and adverse effects that affect almost all body systems, such as neurological (dizziness, drowsiness, seizures, coma, and others), ophthalmological (mydriasis and conjunctival hyperemia), cardiovascular (tachycardia and arterial hypertension), and gastrointestinal (nausea, vomiting, and thirst), mainly associated with recreational use. Cannabis toxicity in children is more concerning and can cause serious adverse effects such as acute neurological symptoms (stupor), lethargy, seizures, and even coma. More countries are legalizing the commercial production and sale of cannabis for medicinal use, and some for recreational use as well. Liberalization of cannabis laws has led to increased incidence of toxicity, hyperemesis syndrome, lung disease cardiovascular disease, reduced fertility, tolerance, and dependence with chronic prolonged use. This review focuses on the potential therapeutic effects of cannabis and cannabinoids, as well as the acute and chronic toxic effects of cannabis use on various body systems.

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Section: Legalization Of Cannabismentioning

confidence: 99%

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Breijyeh

Jubeh

Bufo

et al. 2021

Toxins

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“…However, prior use was higher in states with legalized recreational cannabis, although the proportions varied between these states. This finding is contrary to findings that legalizing cannabis does not necessarily increase use, although the evidence surrounding this is inconsistent (Cerdá et al 2020 ; Cerdá et al 2017 ; Cerdá et al 2011 ; Gorman and Huber 2007 ; Leyton 2019 ; Marijuana Decriminalization and Its Impact on Use - NORML - Working to Reform Marijuana Laws 2020 ). The process by which patients choose to seek treatment with medical cannabis merits further investigation, as an understanding of this may help encourage patients who would like to use cannabis medically to seek guidance and oversight by a medical team as their first option.…”

Section: Discussionmentioning

confidence: 71%

Comparing medical cannabis use in 5 US states: a retrospective database study

Mahabir¹,

Smith²,

Vannabouathong³

et al. 2021

J Cannabis Res

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Background US states have been adopting their own medical cannabis laws since 1996. There is substantial variability in the medical cannabis programs between states, and these differences have not been thoroughly investigated in the literature. The objective of the study was to compare medical cannabis patient characteristics across five states to identify differences potentially caused by differing policies surrounding condition eligibility. Methods We conducted secondary analyses following a retrospective study of a registry database with data from 33 medical cannabis evaluation clinics in the US, owned and operated by CB2 Insights. This study narrowed the dataset to include patients from five states with the largest samples: Massachusetts (n = 27,892), Colorado (n = 16,434), Maine (n = 4591), Connecticut (n = 2643), and Maryland (n = 2403) to conduct an in-depth study of the characteristics of patients accessing medical cannabis in these states, including analysis of variance to compare average ages and number of conditions and chi-squared tests to compare proportions of patient characteristics between states. Results Average ages varied between the states, with the youngest average in Connecticut (42.2) and the oldest in Massachusetts (47.0). Males represented approximately 60% of the patients with data on gender in each state. The majority of patients in each state had cannabis experience prior to seeking medical certification. Primary medical conditions varied for each state, with chronic pain, anxiety, and back and neck problems topping the list in varying orders for Massachusetts, Maine, and Maryland. Colorado had 78.7% of patients report chronic pain as their primary condition, and 70.4% of patients in Connecticut reported post-traumatic stress disorder as their primary medical condition. Conclusion This study demonstrated the significant impact that policy has on patients’ access to medical cannabis in Massachusetts, Colorado, Maine, Connecticut, and Maryland utilizing real-world data. It highlights how qualifications differ between the five states and brings into question the routes through which patients in states with stricter regulations surrounding eligible conditions choose to seek treatment with cannabis. These patients may turn to alternative treatments, or to the illicit or recreational cannabis markets, where permitted.

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“…The United States Center for Disease Control (CDC) declares that cigarette smoking is the leading preventable cause of death in the United States (CDCTobaccoFree, 2019). Adding to the pressing concern is the relatively new increase in global legalization and practice of smoking cannabis (Cerdá et al, 2017;Leyton, 2019;Volkow et al, 2014). Notably, evidence suggests that cannabis smoke consists of differential components relative to tobacco smoke, which may function as immunomodulatory agents (Ashton & Hancox, 2018;Kaplan et al, 2008;Klein, 2005).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of an open-source, disposable, 3D-printed in vitro environmental exposure system for Transwell culture inserts

et al. 2020

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Accessible in vitro models recapitulating the human airway that are amenable to study whole cannabis smoke exposure are needed for immunological and toxicological studies that inform public health policy and recreational cannabis use. In the present study, we developed and validated a novel 3D printed In Vitro Exposure System (IVES) that can be directly applied to study the effect of cannabis smoke exposure on primary human bronchial epithelial cells.Using commercially available design software and a 3D printer, we designed a four-chamber Transwell® insert holder for exposures to whole smoke. COMSOL® Multiphysics software was used to model gas distribution, concentration gradients, velocity profile and shear stress within IVES. Following simulations, primary human bronchial epithelial cells cultured at air-liquid interface on Transwell® inserts were exposed to whole cannabis smoke using a modified version of the Foltin Puff procedure. Following 24 h, outcome measurements included cell morphology, epithelial barrier function, lactate dehydrogenase (LDH) levels, cytokine and gene expression.Whole smoke delivered through IVES possesses velocity profiles consistent with uniform gas distribution across the four chambers and complete mixing. Airflow velocity ranged between 1.0–1.5 µm s−1 and generated low shear stresses (≪ 1 Pa). Human airway epithelial cells exposed to cannabis smoke using IVES showed changes in cell morphology and disruption of barrier function without significant cytotoxicity. Cannabis smoke elevated IL-1 family cytokines and elevated CYP1A1 and CYP1B1 expression relative to control, validating IVES smoke exposure impacts in human airway epithelial cells at a molecular level.The growing legalisation of cannabis on a global scale must be paired with research related to potential health impacts of lung exposures. IVES represents an accessible, open-source, exposure system that can be used to model varying types of cannabis smoke exposures with human airway epithelial cells grown under air-liquid interface culture conditions.

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Cannabis legalization: Did we make a mistake? Update 2019

Cited by 32 publications

References 25 publications

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Comparing medical cannabis use in 5 US states: a retrospective database study

Development and validation of an open-source, disposable, 3D-printed in vitro environmental exposure system for Transwell culture inserts

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