Routes of administration for cannabis use – basic prevalence and related health outcomes: A scoping review and synthesis

Russell, Cayley; Rueda, Sergio; Room, Robin; Tyndall, Mark W.; Fischer, Benedikt

doi:10.1016/j.drugpo.2017.11.008

Cited by 234 publications

(200 citation statements)

References 149 publications

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“…This is possibly due to the route of administration since there was a tendency for the younger ages in this sample to smoke, vaporize, and consume edibles, while older age groups reported mostly using topicals, tinctures, and oils. Additionally, route of administration has been associated with subjective effects to cannabis use (Russell et al 2018) and the preferred cannabinoids could also play a role in the reporting of adverse (and positive) effects (Niesink and van Laar 2013).…”

Section: Discussionmentioning

confidence: 99%

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Zeiger¹,

Silvers

Fleegler³

et al. 2019

J Cannabis Res

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Background: There is a paucity of information regarding cannabis use behaviors in adult community-based athletes as most research in athletes has focused on misuse of cannabis in elite, adolescent, university-based athletes. We aimed to determine whether age related differences exist in patterns of cannabis use and subjective effects to cannabis in adult athletes. Methods:The Athlete PEACE Survey used mainly social media and email blasts to recruit and SurveyGizmo to collect data. Cannabis patterns of use (duration of use, frequency of use, routes of administration, cannabinoid used, concurrent use with exercise), benefits, and adverse effects were reported. Age was reported by decade from 21 to ≥60. Age trends in cannabis use patterns and subjective effects were assessed using linear trend analysis.Results: Of the 1161 participants, 301 (26%) athletes currently used cannabis. Younger athletes compared to older athletes reported significantly more positive and adverse subjective effects to cannabis, used cannabis longer, and used both tetrahydrocannabinol and cannabidiol for medical and recreational purposes. Younger athletes used cannabis concurrently with exercise more often than older athletes and consumed edibles, vaporized, and smoked more than older athletes. Conclusions:We found age-related cannabis patterns of use and subjective effects to cannabis. Concerns about cannabis mis-use and abuse in athletes maybe overstated with the potential benefits (improved sleep, decreased anxiety, less pain) outweighing the adverse effects (increased anxiety, increased appetite, difficulty concentrating).

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Section: Discussionmentioning

confidence: 99%

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Zeiger¹,

Silvers

Fleegler³

et al. 2019

J Cannabis Res

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“…Vaporization of cannabis is an increasingly common route of administration among both medicinal and recreational cannabis users; [21][22][23] however, only a small number of studies have described oral fluid concentrations 24,25 and POCT device performance 20 following vaporized cannabis. Moreover, these studies have been limited to THC-dominant cannabis.…”

Section: Introductionmentioning

confidence: 99%

Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Arkell

Kevin

Stuart

et al. 2019

Drug Testing and Analysis

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Point‐of‐collection testing (POCT) for Δ9‐tetrahydrocannabinol (THC) in oral fluid is increasingly used to detect driving under the influence of cannabis (DUIC). However, previous studies have questioned the reliability and accuracy of two commonly used POCT devices, the Securetec DrugWipe® 5 s (DW5s) and Dräger DrugTest® 5000 (DT5000). In the current placebo controlled, double‐blind, crossover study we used liquid chromatography‐tandem mass spectrometry (LC–MS/MS) to accurately quantify cannabinoid concentrations in the oral fluid of 14 participants at various timepoints (10, 60, 120, and 180 minutes) following vaporization of 125 mg of THC‐dominant (11% THC; <1% CBD), THC/CBD equivalent (11% THC; 11% CBD) and placebo (<1% THC; <1% CBD) cannabis. At each timepoint, oral fluid was also screened using the DW5s (10 ng/mL THC cut‐off) and DT5000 (10 ng/mL THC cut‐off). LC–MS/MS analysis showed peak oral fluid THC concentrations at the 10 minute timepoint with a rapid decline thereafter. This trajectory did not differ with THC dominant and THC/CBD equivalent cannabis. With a 10 ng/mL confirmatory cut‐off, 5% of DW5s test results were false positives and 16% false negatives. For the DT5000, 10% of test results were false positives and 9% false negatives. Neither the DW5s nor the DT5000 demonstrated the recommended >80% sensitivity, specificity and accuracy. Accuracy was lowest at 60 minutes, when THC concentrations were often close to the screening cut‐off (10 ng/mL). POCT devices can be useful tools in detecting recent cannabis use; however, limitations should be noted, and confirmatory LC–MS/MS quantification of results is strongly advisable.

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“…A cannabis pode ser administrada por via oral, na forma de infusões, gotas sublinguais, por via transdérmica, em vaporizações, etc. [30][31][32] Existem muitos outros chás com muito menos evidências científicas que suportem a sua recomendação, e que mesmo assim são passíveis de aquisição (e.g., em farmácias) e amplamente consumidos.…”

Section: Propostas De Resoluçãounclassified

A Perspetiva da Toxicologia Clínica Sobre a Utilização Terapêutica da Cannabis e dos Canabinoides

Dinis-Oliveira¹

2019

Acta Med Port

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INTRODUÇÃOOs derivados da planta cannabis sativa são as substâncias psicoativas recreativas ilícitas de maior consumo mundial. 1,2 Dos mais de 100 canabinoides já descritos, os fitocanabinoides delta-9-tetrahidrocanabinol (Δ 9 -THC; principal constituinte psicoativo), Δ 8 -THC (quase tão ativo como o anterior, mas em menores concentrações), canabinol (pouco ativo, mas em elevadas concentrações) e o canabidiol (não psicoativo mas presente em elevadas concentrações na planta), são aqueles que melhor se conhecem do ponto de vista científico. 3,4 Destes, o Δ 9 -THC e o canabidiol têm eficácia farmacológica comprovada e as suas concentrações na planta são diferentes entre o caule, folhas ou flores e altamente dependentes do teor de humidade, luz e da tipologia do solo. 3,4 O conhecimento sobre o funcionamento do sistema dos endocanabinoides endógenos em vários processos fisiológicos (e.g., memória, ansiedade, imunidade, dor, regulação do apetite, etc.) mostra como estes podem ter um efeito terapêutico em algumas patologias e também que a sua ausência endógena poderá explicar a patofisiologia de algumas doenças prevalentes. 5 A natureza ensina-nos, pois, se não fossem importantes, não teríamos recetores -muito provavelmente endógenos -para os canabinoides nomeadamente em neurónios (recetores CB 1 ) e em várias células do sistema imunológico (recetores CB 2 ). 6 Numa pesquisa em bases de dados científicas na área da medicina (credíveis e alvo de processo de revisão pelos parceiros científicos) utilizando as palavras-chave cannabinoids, therapeutic use e clinical trials, fica claro que os fitocanabinoides estão já licenciados em vários países para a terapêutica de várias patologias, algumas com forte evidência científica, e outras em que a evidência não é tão óbvia, mas mesmo assim promissora. 7-9 O tratamento das náuseas e vómitos associados à quimioterapia, como analgésicos na dor crónica, na anorexia associada à síndrome de imunodeficiência adquirida humana, dor neuropática e da espasticidade em algumas doenças neurológicas como a esclerose múltipla, ansiedade, insónia e epilepsia na idade pediátrica, doença de Parkinson, sobretudo nas formas refratárias à terapêutica convencional, são algumas das indicações terapêuticas mais documentadas e que justificam alterações do enquadramento legal para uma regulação da sua aplicação terapêutica. 10,11 Estão descritos ainda vários outros estudos que mostram potencial na utilização destes fármacos como antiespasmódicos, neuroprotetores, imunomoduladores, na doença de Alzheimer, na fibromialgia, na apneia obstrutiva do sono e também em algumas doenças oncológicas como anticancerígenos. [12][13][14] Neste artigo pretende-se discutir a perspetiva do toxicologista e da toxicologia clínica e forense da utilização terapêutica da Cannabis medicinal e dos fitocanabinoides puros. Questões em aberto: o que é mito?A inquietude da toxicologia não é pois se os fitocanabinoides têm ou não atividade terapêutica, porque essa está mais que demonstrada. A questão também não é se o seu poder psico...

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Routes of administration for cannabis use – basic prevalence and related health outcomes: A scoping review and synthesis

Cited by 234 publications

References 149 publications

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

A Perspetiva da Toxicologia Clínica Sobre a Utilização Terapêutica da Cannabis e dos Canabinoides

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Routes of administration for cannabis use – basic prevalence and related health outcomes: A scoping review and synthesis

Cited by 234 publications

References 149 publications

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Detection of Δ9 THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

A Perspetiva da Toxicologia Clínica Sobre a Utilização Terapêutica da Cannabis e dos Canabinoides

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Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices