The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

BackgroundMarijuana 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.AimsTo 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.MethodsA 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.ResultsThe 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.ConclusionsMarijuana 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.

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“…This significant finding affirms the observation that heavy cannabis users are more likely to report suicidal ideation than non-users. 45 …”

Section: Discussionmentioning

confidence: 99%

“… 52 Marijuana has mind-altering compounds (like dopamine) that affect the brain and can potentially worsen the symptoms of any mental disorders including schizophrenia and other forms of psychoses. 45 …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Cannabis is one of the most widely used psychoactive substances in the world 1 and has a well-documented but unclear relationship with sleep. Cannabis contains cannabinoids, which are the major contributors to psychoactive and medicinal effects 2 . The brain contains cannabinoid receptors, which are affected by exogenous cannabinoids and endogenous cannabinoids (i.e.…”

Section: Introductionmentioning

confidence: 99%

Sleep deficits and cannabis use behaviors: an analysis of shared genetics using linkage disequilibrium score regression and polygenic risk prediction

Winiger

Ellingson

Morrison

et al. 2020

Sleep

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Study Objectives Estimate the genetic relationship of cannabis use with sleep deficits and eveningness chronotype. Methods We used linkage disequilibrium score regression (LDSC) to analyze genetic correlations between sleep deficits and cannabis use behaviors. Secondly, we generated sleep deficit polygenic risk scores (PRS) and estimated their ability to predict cannabis use behaviors using linear and logistic regression. Summary statistics came from existing genome wide association studies (GWAS) of European ancestry that were focused on sleep duration, insomnia, chronotype, lifetime cannabis use, and cannabis use disorder (CUD). A target sample for PRS prediction consisted of high-risk participants and participants from twin/family community-based studies (European ancestry; n = 760, male = 64%; mean age = 26.78 years). Target data consisted of self-reported sleep (sleep duration, feeling tired, and taking naps) and cannabis use behaviors (lifetime ever use, number of lifetime uses, past 180-day use, age of first use, and lifetime CUD symptoms). Results Significant genetic correlation between lifetime cannabis use and eveningness chronotype (rG = 0.24, p < 0.001), as well as between CUD and both short sleep duration (<7 h) (rG = 0.23, p = 0.017) and insomnia (rG = 0.20, p = 0.020). Insomnia PRS predicted earlier age of first cannabis use (OR = 0.92, p = 0.036) and increased lifetime CUD symptom count (OR = 1.09, p = 0.012). Conclusion Cannabis use is genetically associated with both sleep deficits and an eveningness chronotype, suggesting that there are genes that predispose individuals to both cannabis use and sleep deficits.

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“…Unlike the established relationships between tobacco and alcohol use and fetal development, the outcomes related to cannabis use and embryo development have not been clearly defined [13] [18]. The studies published have shown associations between cannabis and fetal outcomes such as preterm deliveries, low birth weight, decreased cognitive function, poor attention, and academic performance [19] [20]. However, none have shown causality, while other findings seem to conflict and are limited to lower quality studies such as cohort or case-control.…”

Section: Cannabis and Fetal Outcomesmentioning

confidence: 99%

The Safety of Cannabis Use in Pregnancy

Senovaityte¹,

Nguyen²,

Han³

et al. 2021

OJOG

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The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

Cited by 54 publications

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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

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

Sleep deficits and cannabis use behaviors: an analysis of shared genetics using linkage disequilibrium score regression and polygenic risk prediction

The Safety of Cannabis Use in Pregnancy

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