The impact of state legalization on rates of marijuana use in pregnancy in a universal drug screening population

Lee, Emily; Pluym, Ilina D.; Wong, Deanna H.; Kwan, Lorna; Varma, Vanita; Rao, Rashmi

doi:10.1080/14767058.2020.1765157

Cited by 28 publications

(18 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The implementation of a new medical marijuana law in Oklahoma provided an opportunity to examine whether the availability of a legal, less addictive drug might result in lower rates of neonatal exposure to opiates. Similar to studies comparing rates before and after recreational marijuana legalization [28,29], we found evidence of significantly higher prenatal marijuana exposure after Oklahoma legalized medical marijuana. But, contrary to our hypothesis, babies tested for amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, opiates, phencyclidine, or THC/cannabinoids after the law took effect showed no other significant changes when compared with the pre-law period.…”

Section: Discussionsupporting

confidence: 82%

Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates

et al. 2022

View full text Add to dashboard Cite

Background: The US opioid epidemic has been characterized by increases in opioid misuse, overdose deaths, and neonatal opioid withdrawal syndrome. Research suggests that marijuana legalization has contributed to decreased use of opiates, although many studies had methodological weaknesses and failed to address the pregnant population. Implementation of medical cannabis laws has the potential to reduce maternal opioid use and, therefore, neonatal exposure to the drugs. Objective: To examine the association between Oklahoma’s implementation of state medical marijuana laws and the neonatal exposure to opioids. Methods: Electronic medical records at two sites (Oklahoma City and Lawton) were searched for results of cord, urine and meconium screens to detect amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, opiates, phencyclidine, and tetrahydrocannabinol (THC). Two study periods were compared: 19 months before Oklahoma’s medical marijuana law took effect and 19 months after legalization began. Results: A total of 16,804 babies were born alive at the two sites during the study period. The rate of positive THC tests per 1000 liveborn infants significantly increased from 16.2 per 1000 during the pre-law period to 22.2 per 1000 during the post-law period, p = 0.004. Neonatal opioid exposure incidence showed a non-significant decrease from 7.6 positive tests per 1000 liveborn infants to 6.8 per 1000 from pre-law to post-law period, p = 0.542. The number of positive tests for THC and concomitant use of opioids doubled from the pre-law period (n = 4) to post-law (n = 9), but there were too few cases for statistical significance. Infants at the more rural site had significantly higher rates for amphetamines, benzodiazepines, and THC, with a trend toward higher rates for opiates. Conclusion: Marijuana legalization was related to significant increases in positive test rates for THC, but no significant change/association was noted for neonatal exposure to opioids.

show abstract

Section: Discussionsupporting

confidence: 82%

Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Since 2012, 15 states and DC further legalized recreational cannabis use among adults, but only California, Colorado, and Michigan require warning labels to disclose pregnancy-related risks [9][10][11]. Studies suggested that the increase in cannabis use among pregnant women may be associated with medical and recreational cannabis legalization [12][13][14]. Across the United States, pregnant women receive insufficient cannabis-related screening and counseling from health professionals [15,16].…”

Section: Introductionmentioning

confidence: 99%

The associations between prenatal cannabis use disorder and neonatal outcomes

2021

View full text Add to dashboard Cite

Background and Aims Cannabis use disorder (CUD) during pregnancy has increased dramatically in the United States (US). This study examined the associations between prenatal CUD and adverse neonatal outcomes and heterogeneities in the associations by mothers’ tobacco use status and race/ethnicity. Design Population‐based, retrospective cohort study. Setting California, USA. Participants A total of 4.83 million mothers who delivered a live singleton birth during 2001 to 2012 and their paired infants. Data were obtained from mother–infant linked hospital discharge records and birth and death certificates. Identified by ICD‐9 codes recorded at delivery, 20 237 mothers had prenatal CUD. Measurements Neonatal outcomes included length of gestation, preterm birth, birth weight, admission into neonatal intensive care unit, hospitalization within 1 year of birth, and death within 1 year of birth. Propensity score matching was used to balance maternal, paternal, and infant characteristics in the comparisons between infants exposed and unexposed to prenatal CUD. Findings CUD increased from 2.8 to 6.9 per 1000 deliveries during 2001 to 2012. Multivariable regressions in matched samples estimated that prenatal CUD was associated with greater odds of being small for gestational age (OR = 1.13, 95% CI = 1.08, 1.18), preterm birth (OR = 1.06, 95% CI = 1.01, 1.12), low birth weight (OR = 1.13, 95% CI = 1.07, 1.20), and death within 1 year of birth (OR = 1.35, 95% CI = 1.12, 1.62). Compared with infants whose mothers were tobacco non‐users, infants whose mothers were tobacco users had greater odds of preterm birth, low birth weight, hospitalization, and death in association with prenatal CUD. Compared with infants whose mothers were non‐Hispanic White, infants whose mothers were Hispanic had greater odds of hospitalization and death and infants whose mothers were non‐Hispanic Black had greater odds of being small for gestational age in association with prenatal CUD. Conclusion Prenatal cannabis use disorder appears to be associated with escalated odds of major adverse neonatal outcomes, with heterogeneities in the associations by mothers’ tobacco use status and race/ethnicity.

show abstract

“…This is of particular concern among adolescents and young adults, including women of child-bearing age (Brown et al, 2017). For instance, 20% of U.S. women ages 18-25 use cannabis (SAMHSA, 2020), with higher rates in areas where cannabis is legal (Lee et al, 2020;Reimann et al, 2011). In particular, prevalence of cannabis use among pregnant women ranges from 3-10% (Coleman-Cowger et al, 2017;Ko et al, 2015;Obisesan et al, 2020;Oh et al, 2017;SAMHSA, 2020;Volkow et al, 2019;Young-Wolff et al, 2019), with even higher rates among pregnant teens (Gupta et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects

Breit

Rodriguez

Lei

et al. 2020

Neurotoxicology and Teratology

View full text Add to dashboard Cite

Cannabis is the most frequently used illicit drug among pregnant women, yet the potential consequences of prenatal cannabis exposure on development are not well understood. Electronic cigarettes have become an increasingly popular route of administration among pregnant women, in part to user's perception that e-cigarettes are a safer route for consuming cannabis products. Importantly, half of pregnant women who consume cannabis also report consuming alcohol, but research investigating co-consumption of these drugs is limited, particularly with current routes of administration.The purpose of this study was to establish a co-exposure vapor inhalation model of alcohol and THC in pregnant rats, to ultimately determine the effects on fetal development. Pregnant Sprague-Dawley rats were exposed to moderate doses of THC via e-cigarettes, alcohol, the combination, or vehicle daily from gestational days 5-20. Importantly, pharmacokinetic interactions of alcohol and THC were observed during pregnancy. Combined exposure consistently increased blood alcohol concentrations, indicating that THC alters alcohol metabolism. In addition, THC levels also increased over the course of pregnancy and THC metabolism was altered by alcohol. Alcohol, but not THC, exposure during pregnancy reduced maternal weight gain, despite no group differences in food intake. Neither prenatal alcohol nor THC exposure altered gestational length, litter size, sex ratio or birth weight. However, prenatal alcohol exposure delayed eye opening, and prenatal THC exposure decreased body weights during adolescence among offspring. These individual and synergistic effects suggest that this novel co-exposure vapor inhalation paradigm can effectively be used to expose pregnant dams, exerting some effects on fetal development, while avoiding nutritional confounds, birth complications, or changes in litter size. With this model, we have demonstrated that combining THC and alcohol alters drug metabolism, which could have important consequences on prenatal development.

show abstract

The impact of state legalization on rates of marijuana use in pregnancy in a universal drug screening population

Cited by 28 publications

References 30 publications

Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates

Medical Marijuana Legalization in Oklahoma: Effects on Neonatal Exposure to Opiates

The associations between prenatal cannabis use disorder and neonatal outcomes

Combined vapor exposure to THC and alcohol in pregnant rats: Maternal outcomes and pharmacokinetic effects

Contact Info

Product

Resources

About