Search Results (279)

Objective: To scope the available literature on antipsychotic treatment in substance-induced psychotic disorders, summarize evidence across substance categories, and highlight priorities for future research. Methods: This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, Embase, PsycINFO, and Cochrane Library (January 1985–August 2025) identified studies examining antipsychotic treatment in cannabis-, stimulant-, and hallucinogen-induced psychoses. Two reviewers independently screened studies and extracted data using a standardized form. Given marked heterogeneity, findings were synthesized descriptively. Results: Seventeen studies met inclusion criteria: 3 randomized controlled trials (17.6%), 10 observational studies (58.8%), and 4 case series (23.5%). Most evidence involved cannabis-induced (n = 7) and methamphetamine-induced (n = 6) psychosis. Randomized trials showed comparable efficacy between risperidone and haloperidol for cannabis-induced psychosis, and between quetiapine and haloperidol for methamphetamine-induced psychosis. Case series suggested potential benefits of third-generation antipsychotics such as lurasidone and cariprazine. No controlled studies were identified for cocaine- or hallucinogen-induced psychoses. Conclusions: Evidence for antipsychotic treatment in substance-induced psychoses remains scarce and uneven. While conventional antipsychotics appear effective for cannabis- and methamphetamine-related presentations, other substances remain virtually unstudied. Substantial evidence gaps and limited methodological quality highlight urgent research needs. Full article

Medical students are at elevated risk for psychoactive substance use and mental health challenges due to academic pressures and environmental stressors. This study aimed to determine the prevalence and trends of psychoactive substance use among medical students at Riga Stradins University (RSU) and to examine associations with symptoms of anxiety, depression, and resilience to stress. A bilingual, anonymous cross-sectional study was conducted using a SurveyMonkey-hosted questionnaire. The survey included a socio-demographic questionnaire, the Generalized Anxiety Disorder Questionnaire-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Brief Resilience Scale (BRS), and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (WHO ASSIST V3.1). A total of 559 RSU medical students participated (response rate: 31.8%). Lifetime substance use prevalence was highest for caffeine 98.7%, alcohol 93.9%, tobacco 68.4%, and cannabis 50.9%. High-risk use was noted for tobacco 6.8%, inhalants 4.2%, cocaine 3.6%, and alcohol 1.4%. Significant differences in total substance use were observed by gender (p = 0.006) and depression symptom severity by PHQ-9 (p < 0.001), which were predictors of the total involvement score. The findings suggest that further attention to mental health and substance use patterns among medical students may be beneficial for student well-being and professional development. Full article

Objectives: This study aims to assess differences in analgesia prescribing in UK primary care between individuals with osteoarthritis who have a recorded exposure to cannabis use and those who do not. Methods: This population-based retrospective cohort study included opioid-naïve patients with osteoarthritis (aged 25–85 years) who were active in Clinical Practice Research Datalink Aurum between 1 January 1995 and 15 December 2023. Patients with osteoarthritis who had current or historic cannabis use recorded were matched to two unexposed individuals by age, sex, smoking status, and health authority. Patients were followed up to assess prescriptions of analgesia. Cox regression was performed adjusted for age, sex, and ethnicity. Results: 662 exposed patients were matched to 1319 unexposed patients. Cannabis-exposed individuals were more likely to be prescribed opioids (adjusted hazard ratio (HR): 2.06; 95% confidence interval (CI): 1.74–2.43; p < 0.001), gabapentinoids (HR: 3.31; 95% CI: 2.34–4.67; p < 0.001), non-steroidal anti-inflammatory drugs (HR: 1.99; 95% CI: 1.72–2.31; p < 0.001), tricyclic antidepressants (HR: 2.64; 95% CI: 2.03–3.44; p < 0.001), other antidepressants (HR: 7.22; 95% CI: 5.24–9.94; p < 0.001), and paracetamol (HR: 3.30; 95% CI: 2.43–4.48; p < 0.001). Conclusions: This study suggests there is an association between coded exposure to cannabis in UK primary care records and increased prescribing of analgesia. Given the relative scarcity of recorded cannabis use relative to its prevalence in the general population, these findings must be interpreted cautiously. The increased hazard of using analgesia and mortality within the cannabis-exposed cohort may be confounded by socioeconomic status and a higher likelihood of coding cannabis use in those experiencing adverse effects after consumption or cannabis misuse disorder. Full article

Dramatic shifts in state-level cannabis laws (CLs) and federal hemp regulations have resulted in increased availability and use of cannabis and cannabidiol (CBD) products throughout the US, with unknown implications for the youth. Youth with mood disorders represent a vulnerable population that is more likely to use cannabis and CBD and is at elevated risk for experiencing cannabis-related adverse health outcomes. This multisite study characterized attitudes, health perceptions, and behaviors related to cannabis and CBD use among US youth receiving mood disorder treatment and their parents, and assessed whether attitudinal differences varied as a function of respondent group and state-level CL status. Anonymous surveys were completed by 84 youths and 66 parents recruited from six child mood clinics providing care to patients living in eleven US states with variable CLs. Covariate-adjusted regressions were run using respondent group and state-level CL status as between-subject factors. Most youths (76% and 74%) and parents (65% and 68%) endorsed believing that cannabis and CBD, respectively, are safe and effective treatments for mental health conditions, and that regular use of these products reduces depression, anxiety, and suicidal behaviors. Intergenerational differences in cannabis-related attitudes and health perceptions were observed, with some associations varying as a function of state-level CL. Among the youth, male sex and positive cannabis expectancies and attitudes were associated with higher cannabis use intentions. Findings can inform prevention and public health messaging efforts. Full article

Background: A large number of substance use disorders are increasingly associated with complex clinical presentations and unknown mental and medical risks, presenting a growing challenge for mental health worldwide. Research exploring the interplay between substance use and psychiatric disorders remains limited in Eastern Europe. Objectives: We investigated the demographic and clinical features of 203 patients admitted to a major Romanian psychiatric hospital, aiming to clarify the patterns of dual diagnosis and symptomatology within this vulnerable population. Results: Cannabis, novel psychoactive substances and unknown substances were the most commonly used drugs. Psychiatric comorbidity was rather the rule than the exception within our group. Cluster analysis revealed three distinct symptom profiles: manic/psychotic, negative affective and disorganized. While individual drug type did not independently predict symptom severity or readmission risk, a significant interaction effect between drug use and psychiatric comorbidity influenced symptom cluster membership. Conclusions: These findings highlight the complexity and heterogeneity of dual diagnoses and underline the importance of an integrated, multidisciplinary approach in addiction medicine. Full article

Cannabis use (CU) motives among older adults (OA) could be an important indicator of broader mental health. OA ages 60+ (N = 78) reported on CU, alcohol consumption, and mood and anxiety. Coping, enhancement, social, conformity, expansion, and routine motives were assessed. Relationships among CU, alcohol consumption, and screenings for Cannabis Use Disorder (CUD), Alcohol Use Disorder (AUD), depression, and anxiety were examined. OA who screened positive for CUD were not different in CU frequency or alcohol consumption, but did endorse higher routine, social, coping, and conformity motives than OA endorsing non-harmful CU (d = 1.01 to 1.70). Participants who screened positive for depression or anxiety endorsed higher coping (d = 1.87, 2.18) and routine (d = 0.83, 0.85) motives in the absence of higher alcohol or CU. Higher routine motives were particularly associated with positive CUD screening, beyond other motives and CU frequency. Healthcare providers serving OA with CU should ask about motives to help determine if further mental health evaluation is warranted. Full article

The legalization of cannabis in multiple U.S. states and several other countries, along with its increasing social acceptance across diverse demographic and socioeconomic groups, has led to a growing number of patients presenting for interventional procedures with a history of cannabis use. Although anesthetic and sedation-related implications may be less pronounced than in major surgery, they remain clinically relevant and warrant careful consideration. Key factors include acute intoxication, chronic use, and cannabis use disorder. Cannabis users often require higher—and sometimes unpredictable—doses of propofol and other sedatives. Inhalational use is associated with airway hyperreactivity, increasing the risk of bronchospasm and, in severe cases, life-threatening laryngospasm. Acute intoxication may also impair the patient’s ability to provide informed consent. Cardiovascular manifestations, including tachycardia, hypertension, and an elevated risk of myocardial infarction, may occur depending on the timing and extent of recent cannabis exposure. Although these effects are unlikely to cause major complications during routine screening colonoscopy or diagnostic esophagogastroduodenoscopy, advanced therapeutic procedures may pose significant challenges for sedation providers. This narrative review summarizes the chemistry, pharmacology, and sedation-related implications of cannabis use in patients undergoing sedation requiring interventional procedures, with a specific focus on GI endoscopy. Full article

Cannabidiol (CBD) is a chemical produced by the cannabis plant that acts as an allosteric modulator of cannabinoid receptors resulting in non-competitive receptor antagonism in the central nervous system. This mechanism of action leads to anti-convulsant, anti-anxiety, and analgesic properties with minimal psycho-activity, which has led to significant interest in the use of CBD as a medication. Legislation around cannabis has changed in recent years, with many states permitting the use of CBD-based products as “medication” without approval from the Federal Drug Administration. This has led to a proliferation of products with associated marketing claims that are often unsubstantiated. This review summarizes the evidence for cannabidiol as a medical treatment, focusing on epilepsy, mental health, behavioral and substance use disorders occurring in pediatric and adolescent populations for which information is available. CBD preparations have been approved by the FDA to treat epilepsy in childhood; no other indications currently exist, and the literature remains inconclusive. Few adverse effects related to CBD use have been reported. However, endogenous cannabinoids play an important role in guiding brain development, and the long-term impact of modulating the endocannabinoid system during periods of brain growth during childhood and adolescence is unknown. While there is excitement about the potential for the development of CBD medications, currently, there is very limited information about the long-term safety of CBD, especially in children and adolescents, and caution is recommended regarding the use of unregulated, unapproved CBD preparations that are currently available over the counter. Full article

Irritable Bowel Syndrome (IBS) is a complex and multifactorial gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits, impacting quality of life. Therapy is mainly based on relieving symptoms with specific drugs, whereas herbal and complementary remedies have gained attention in recent years. This review examines the current knowledge on herbal remedies in IBS management. Several herbal treatments, particularly peppermint oil and Iberogast, have demonstrated efficacy in randomized controlled trials. Preclinical studies have revealed promising anti-inflammatory and antispasmodic effects for herbs, e.g., curcumin, fennel oil, and cannabis derivatives. However, many studies suffer from some limitations, e.g., small sample sizes, short study durations, or methodological weaknesses. There is a lack of large-scale, long-term randomized controlled trials for most herbal remedies, and heterogeneity in study designs makes direct comparisons challenging. Moreover, limited evidence exists regarding herb–drug interactions and long-term safety profiles. Despite these limitations, certain herbal remedies may offer a valuable complementary approach for some IBS patients when used under medical supervision. Future research should focus on larger, well-designed clinical trials to establish efficacy, optimal dosing, and long-term safety, as well as elucidate specific mechanisms of action and identify patient subgroups that may benefit most from specific herbal treatments. Full article

Cannabis is one of the most studied psychoactive substances due to its increasing prevalence and evolving legal status. Of particular concern is the rising consumption among young individuals, where excessive use may disrupt reproductive processes and pose long-term health risks to offspring. This narrative review examines the effects of cannabis use on male and female reproductive health, including its impact on male fertility, the female reproductive system, placental function, and prenatal and postnatal outcomes, as well as fetal development. A nonsystematic review was conducted using PubMed, Scopus, Web of Science, and Google Scholar databases in November 2024. After screening titles and abstracts and the full-text analysis, 64 studies were included in this narrative review. In men, cannabinoids can interfere with spermatogenesis, reduce sperm motility and quality, and lower testosterone levels, as demonstrated in clinical and experimental studies. In women, cannabinoid-induced disorders include negative effects on ovarian follicle maturation, ovulation, placental function, and prenatal development. Prenatal exposure to cannabis is associated with the risk of reduced birth weight, birth defects, sudden infant death syndrome (SIDS) or lactation problems due to the penetration of cannabis metabolites into breast milk. The findings highlight the potential negative effects of cannabis on reproductive health and fetal development. Given these risks, individuals attempting to conceive, and pregnant women should be advised against cannabis use. Greater awareness is needed among healthcare professionals and the public regarding the reproductive risks associated with cannabis consumption. While the evidence on teratogenic effects is not always conclusive, caution should be exercised, and further research is essential to deepen the understanding of these effects. Full article

Background: Myocardial infarction (MI) in young adults, once a rarity, is increasingly recognized as a distinct clinical entity. Unlike traditional MI patients, younger individuals often present without established risk factors or advanced atherosclerosis, prompting a reevaluation of pathophysiologic paradigms and risk assessment strategies. Objective: This review synthesizes current evidence on the epidemiology, pathophysiology, and diagnostic challenges of MI in adults under 55 years, with emphasis on risk factor profiles. We distinguish between traditional cardiovascular risk factors—smoking, dyslipidemia, hypertension, diabetes, obesity, and family history—and emerging contributors, including elevated lipoprotein(a), recreational drug use (cocaine, cannabis, amphetamines), autoimmune and inflammatory conditions, psychosocial stress, sleep disorders, genetic predisposition, and non-atherosclerotic mechanisms such as myocardical infarction with non-obstructive coronary arteries, spontaneous coronary artery dissection, SCAD and Takotsubo syndrome. Methods: A narrative literature review was conducted, focusing on studies from the last five years addressing MI in young adults, including data from large registries, cohort studies, and recent experimental findings. Full article

Post-traumatic stress symptoms (PTSSs) are associated with an imbalanced time perspective (TP) as well as with unhealthy substance use. Although neurodevelopmental processes during adolescence may impact PTSS, most etiological models of post-traumatic stress disorder (PTSD) are derived from studies with adults and neglect possible distinctive characteristics in adolescent PTSD. This study examined possible direct and mediated relations between exposure to potentially traumatic experiences (EPTEs) and PTSS with TP as a potential mediator. In addition, the study investigated the direct and indirect effects of EPTE, TP, and PTSS on cannabis use. The aim of this study was to investigate whether findings from adult studies can be transferred to adolescent PTSD. One hundred and five patients between 14 and 20 years of age were recruited from child and adolescent psychiatric units. They answered questionnaires to assess EPTE, PTSS, TP, and cannabis use. Participants with clinically relevant PTSS showed imbalanced TP with a high orientation to negative past and a low orientation to positive past and future. Higher EPTE was associated with higher level of PTSS, but TP mediated the level of PTSS in this relation. PTSS predicted the frequency of cannabis use. It may therefore be beneficial to consider TP in PTSD therapy with the aim of reducing deviation from balanced TP and PTSS and preventing comorbid substance use. Full article

Background: Ulcerative colitis (UC) is an autoimmune disorder characterized by inflammation of the mucosa that gives rise to a disrupted epithelial morphology. Persistent or recurrent inflammation and the debilitating nature of the associated symptoms make treatment of UC challenging. Cannabinoids derived from Cannabis sativa L. have been used for treatment of gastrointestinal disorders due to the wide-ranging therapeutic benefits of these compounds. Methods: We evaluated a commercial hemp extract, high in cannabigerol (CBG) and cannabidiol (CBD), as a novel treatment for UC symptoms using the dextran sodium sulfate (DSS) model in mice. Hemp extract was administered via two different routes of administration, intraperitoneal (i.p) and oral (p.o). Results: Specifically, we observed that cannabinoid treatment reduced damage to the colonic epithelium. We also observed that CBG/CBD rich hemp extracts help reduce pain-related responses in these animals. Conclusions: Together, the data suggest that cannabinoid administration has the potential to be an effective alternate therapeutic option for UC management. Full article

Substance use during pregnancy is an increasingly important yet under-recognized threat to maternal and child health. This narrative review synthesizes the current evidence available on the epidemiology, pathophysiology, clinical management, and policy landscape of prenatal exposure to alcohol, tobacco, opioids, benzodiazepines, cocaine, cannabis, methamphetamines, and other synthetic drugs. All major psychoactive substances readily cross the placenta and can remain detectable in breast milk, leading to a shared cascade of obstetric complications (hypertensive disorders, placental abruption, pre-term labor), fetal consequences (growth restriction, structural malformations), and neonatal morbidities such as neonatal abstinence syndrome and sudden infant death. Mechanistically, trans-placental diffusion, oxidative stress, inflammatory signaling, and placental vascular dysfunction converge to disrupt critical neuro- and cardiovascular developmental windows. Early identification hinges on the combined use of validated screening questionnaires (4 P’s Plus, CRAFFT, T-ACE, AUDIT-C, TWEAK) and matrix-specific biomarkers (PEth, EtG, FAEE, CDT), while effective treatment requires integrated obstetric, addiction, and mental health services. Medication for opioid use disorders, particularly buprenorphine, alone or with naloxone, confers superior neonatal outcomes compared to methadone and underscores the value of harm-reducing non-punitive care models. Public-health strategies, such as Mexico’s “first 1 000 days” framework, wrap-around clinics, and home-visiting programs, demonstrate the potential of multisectoral interventions, but are hampered by structural inequities and punitive legislation that deter care-seeking. Research gaps persist in polysubstance exposure, culturally tailored therapies, and long-term neurodevelopmental trajectories. Multigenerational, omics-enabled cohorts, and digital longitudinal-care platforms represent promising avenues for closing these gaps and informing truly preventive perinatal health policies. Full article

Background/Objectives: Gender-affirming surgery (GAS) is associated with improved mental health outcomes in transgender and gender-diverse (TGD) individuals. However, TGD populations experience disproportionately high rates of substance use disorders (SUDs), which are established risk factors for surgical complications. Despite this, the relationship between preoperative SUDs and postoperative outcomes following GAS has not been studied. Our objective was to evaluate how specific SUD subtypes, including tobacco, alcohol, and cannabis, impact short- and medium-term postoperative complications following GAS. Methods: A retrospective cohort study was conducted using the TriNetX Research Network, which includes de-identified electronic health records from over 100 million U.S. patients. Adults with documented gender dysphoria who underwent GAS between April 2015 and April 2025 were included. Patients were divided into four groups: no SUD, tobacco use, alcohol use, and cannabis use. Propensity score matching was used to control for demographic variables. Postoperative complications were assessed at 30 days and 6 months. Results: Alcohol use was significantly associated with increased rates of delayed wound healing, wound dehiscence, gastrointestinal symptoms, and postoperative pain at both 30 days and 6 months. Cannabis use was linked to higher rates of wound dehiscence, infections, GI symptoms, and pain. Tobacco use showed the broadest impact, significantly associated with nearly all complications measured except pain at 30 days. These associations persisted at six months. Conclusions: This is the first study to quantify the relationship between substance use and GAS outcomes. Preoperative use of tobacco, alcohol, and cannabis was independently associated with increased postoperative complications. These findings underscore the need for systematic preoperative screening and the development of SUD-specific perioperative care pathways to improve outcomes and advance equity in surgical care for TGD patients. Full article