Search Results (325)

Marijuana use in the United States (U.S.) has diversified alongside expanding legalization, yet little is known about the psychosocial factors that distinguish medical from recreational use. This study examined whether psychological distress mediates the association between perceived social isolation (i.e., loneliness) and marijuana use type among U.S. adults. We analyzed cross-sectional, nationally representative data from the 2024 Health Information National Trends Survey (HINTS, cycle 7). Marijuana use was categorized as medical (including medical and both medical/recreational) versus recreational. Perceived social isolation was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation t-score, and psychological distress was assessed with the Personal Health Questionnaire (PHQ)-4. Survey-weighted descriptive analyses and a weighted structural equation mediation model accounting for the complex sampling design were conducted. Medical marijuana users reported significantly higher levels of psychological distress and perceived social isolation than recreational users. Greater social isolation was strongly associated with higher psychological distress, and higher distress was associated with a greater likelihood of medical (vs. recreational) marijuana use. The indirect effect of social isolation on marijuana use type through psychological distress was statistically significant, while the direct effect of social isolation was not significant after accounting for distress. Overall, greater perceived social isolation predicted medical marijuana use primarily through elevated psychological distress. These findings suggest that medical marijuana use among U.S. adults may reflect coping with psychological distress linked to social disconnection, underscoring the importance of integrating mental health and social context into clinical and public health approaches to cannabis use. Full article

Cannabis is the most-used psychoactive drug in Aotearoa—New Zealand (NZ); recreational use remains illegal, while medicinal use was legalized in 2020. Cannabis use is associated with increased risk of injury; however, there is little known on the causes and circumstances of cannabis-related fatal injuries. This retrospective population study utilized coronial case files to describe the contribution and circumstances of cannabis-related fatal injuries in NZ. Between 2012 and 2016, cannabis was reported in 273 of 3599 unintentional/assault injury deaths (1.32 deaths per 100,000 person-years, 95% CI 1.17, 1.49). High-risk groups included males aged 15–44 years, Indigenous Māori, and those in deprived areas, for whom higher rates of post mortem testing were conducted. Cannabis-related fatalities mainly resulted from road crashes and multi-drug poisonings with concomitant alcohol use common, especially in traffic crashes on public roads (49% of concomitant use). Cannabis use was mainly observed in the decedent (n = 256, 94%). One in five deaths involved a worker, either as a user or as a bystander to another’s use. Coronial files identified important opportunities for safety countermeasures targeting cannabis use among drivers and its concomitant use with alcohol. Improved coverage of post mortem testing could address data limitations, including biased testing patterns and missing medical use. Full article

This study assessed the correlates of cannabis and psychedelic use and legalization support among young adults in the United States (US). Using 2025 data among adults ages 18–34 (n = 3227), we assessed cannabis and psychedelic message exposure and perceptions, mental health symptoms (Patient Health Questionnaire-4 [PHQ-4]), and adverse childhood experiences (ACEs) in relation to past-6-month cannabis use (40.5%), past-year psychedelic use (11.9%), and legalization support. Relative to cannabis, psychedelics showed less legalization support, promotional and risk-message exposure, and social acceptability and higher perceived addictiveness and harm (p’s < 0.001). Factors associated with cannabis use and greater legalization support included: lower perceived addictiveness (aOR = 0.88, CI = 0.83–0.93; B = −0.04, SE = 0.01) and harm (aOR = 0.75, CI = 0.71–0.80; B = −0.16, SE = 0.01), higher social acceptability (aOR = 1.25, CI = 1.19–1.33; B = 0.19, SE = 0.01), and higher PHQ-4 (aOR = 1.04, CI = 1.01–1.07); more ACEs (aOR = 1.10, CI = 1.06–1.14) and more promotional (aOR = 1.08, CI = 1.01–1.17) and risk-message exposure (aOR = 1.27, CI = 1.17–1.39) were associated with use. Factors associated with psychedelic use and greater legalization support included: more promotional-message exposure (aOR = 1.61, CI = 1.36–1.91; B = 0.09, SE = 0.04), lower addictiveness (aOR = 0.87, CI = 0.78–0.97; B = −0.03, SE = 0.02) and harm (aOR = 0.74, CI = 0.66–0.82; B = −0.19, SE = 0.02), higher acceptability (aOR = 1.59, CI = 1.47–1.73; B = 0.15, SE = 0.01), and higher PHQ-4 (aOR = 1.06, CI = 1.02–1.11; B = 0.02, SE = 0.01); more risk-message exposure (aOR = 1.29, CI = 1.08–1.54) and ACEs (aOR = 1.15, CI = 1.09–1.21) were associated with use. Perceptions and mental health may influence cannabis and psychedelic use and legalization support, and message exposure may be particularly relevant in shaping psychedelic use and legalization support. Thus, information is crucial to ensure population understanding of the risks, benefits, and overall population impacts of cannabis and psychedelic use and legalization. Full article

Marijuana (Cannabis sativa L.) has a great economic potential due to its phytotherapeutic properties. Its propagation, however, faces numerous challenges due to the limited availability of standardized technical protocols for the crop. Vegetative propagation represents a, or even the, viable method for multiplying the genetically identical individuals while preserving their phytochemical profile, at lower costs and with shorter production times. This study investigated the morphological and colorimetric attributes associated with vegetative propagation success, aiming to develop sustainable cultivation strategies. Four cutting lengths (5, 10, 15 and 20 cm) were evaluated after 21 days of rooting, considering fresh mass, basal diameter, presence of apical meristem, number of root primordia, root length, and foliar and stem color parameters. Logistic regressions indicated that longer cuttings (p = 0.0101), greater fresh mass (p = 0.073) and the presence of apical meristem (p = 0.065), as well as greener leaves (p = 0.089), were positively associated with rooting probability (p < 0.10). Positive correlations between morphological and colorimetric variables were confirmed by Principal Component Analysis, with the first two principal components explaining 31.2% of the total variance in the dataset. The results provide support for the development of more efficient and low-cost vegetative propagation protocols, promoting uniformity and autonomy in local cutting production of marijuana. Full article

Cannabis is one of the most common intoxicants used worldwide. Cannabis is widely consumed worldwide and can lead to visual alterations. However, most of the available information on its effects comes from studies conducted in developed countries, while data remain limited in developing regions such as Morocco, despite its significant role in cannabis cultivation. The aim of this study was to explore multiple visual parameters and self-perceived eyesight in cannabis users in Morocco. A cross-sectional study was conducted between March 2022 and April 2023 in Marrakesh, Morocco, in cannabis consumers. Data collection was performed in two phases. First a hetero-administrated questionnaire was used to collect socio-demographics, intoxicant consumption habit information, and eye health information. Then, several visual acuity tests were performed, including a preliminary examination, a visual function assessment, and an eye health assessment. Ninety-five cannabis users participated in this study. The majority were single (62.1%) males (87.4%). All lived in the Marrakesh-Safi region (100%), and most had daily activities such as having a job or being a student (77.9%). Most had vision conditions like astigmatism or myopia (83.4%). The majority had multiple addictions (66.5%), mainly to tobacco (43.7%). Hashish was the main cannabis type used (57.9%), and smoked cannabis was the principal mode of consumption (94.7%). Many had a family history of cannabis addiction (58.9%). Day light sensitivity (66.3%) and appearance of eye symptoms after cannabis use (90.5%) were declared by the majority. In most cases, no impact on far or near vision or vision impairment due to cannabis use were declared. Our results showed that using cannabis could have significant adverse effects on visual functions. Full article

Cannabis and its derivatives are increasingly popular. The public perception of “cannabis” is commonly related to abuse potential with no sharp distinction to “marijuana”, “cannabinoids”, “hemp”, and cannabis derivatives. Delta 9-tetrahydrocannabinol (THC)—rich cannabis (“marijuana”), needs to be distinguished from hemp and cannabidiol (CBD)—rich; the former is psychotomimetic, while the latter is not, and it is increasingly used as a “health product”; the phytochemical composition makes the difference. However, this is still inadequately addressed. Without a detailed characterization of the components and effects conclusions cannot be generalized and are only applicable to the product used. Cannabis varieties have a highly variable phytochemical composition; the effects cannot always be attributed solely to the “main cannabinoids.” Growth conditions and processing methods also have a significant influence on the properties of the final product, even when the same cannabis variety is used. Therefore, the few comparative studies between extracts and the corresponding pure cannabinoids often produce conflicting results, as numerous preclinical and clinical examples demonstrate. They also show how little attention is paid to the phytochemical profile, even in scientific publications. Both in scientific research and consumer products, the phytochemical profile beyond the main cannabinoids should be disclosed in detail, especially since new cannabis products containing semi-synthetic CBD derivatives have recently entered the market. Full article

Electronic Nicotine Delivery Systems (ENDSs) expose users to nicotine, volatile organic chemicals, and ultrafine particles that pose emerging toxicological concerns for youth. The prevalence of vaping among college students quadrupled between 2017 and 2019. The Vaping Initiation, Continuation, Termination, or Resumption in Youth (VICTORY) study explored a random sample of 543 undergraduate students at a Midwestern university, using an anonymous online survey, for factors associated with initiation and regular inhalation of vape-derived aerosols. Results showed that 50% of participants had ever used a vape, and 67% had used tobacco, vape, or marijuana. The mean age of first use of tobacco was 15.16 years, significantly younger than the mean ages for vaping (16.33) and marijuana (16.60). There were no significant gender differences in ENDS use, although more males reported tobacco as their first substance (18% difference). Notably, 40% reported non-alcoholic substance or alcohol use in the past 30 days. Decision-tree analysis revealed complex relationships between vaping aerosols, tobacco, alcohol use, marijuana use, and living arrangements. Logistic regression identified key predictors of regular vaping, including higher school year, lower household income, employment status, and younger age at first use. These findings highlight the need for tailored public health interventions and continued monitoring to address the growing trend of youth vaping. Full article

Personalizing therapy using medical marijuana (MM) is based on understanding the pharmacogenomics (PGx) and drug–drug interactions (DDIs) involved, as well as identifying potential epigenetic risk markers. In this work, the evidence regarding the role of variants in phase I (CYP2C9, CYP2C19, CYP3A4/5) and II (UGT1A9/UGT2B7) genes, transporters (ABCB1), and selected neurobiological factors (AKT1/COMT) in differentiating responses to Δ⁹-tetrahydrocannabinol (THC) and cannabidiol (CBD) has been reviewed. Data indicating enzyme inhibition by CBD and the possibility of phenoconversion were also considered, which highlights the importance of a dynamic interpretation of PGx in the context of current pharmacotherapy. Simultaneously, the results of epigenetic studies (DNA methylation, histone modifications, and ncRNA) in various tissues and developmental windows were summarized, including the reversibility of some signatures in sperm after a period of abstinence and the persistence of imprints in blood. Based on this, practical frameworks for personalization are proposed: the integration of PGx testing, DDI monitoring, and phenotype correction into clinical decision support systems (CDS), supplemented by cautious dose titration and safety monitoring. The culmination is a proposal of tables and diagrams that organize the most important PGx–DDI–epigenetics relationships and facilitate the elimination of content repetition in the text. The paper identifies areas of implementation maturity (e.g., CYP2C9/THC, CBD-CYP2C19/clobazam, AKT1, and acute psychotomimetic effects) and those requiring replication (e.g., multigenic analgesic signals), indicating directions for future research. Full article

Background: Law 1787 of 2016 established Colombia’s medical cannabis framework, intended as a public policy to improve health equity by guaranteeing access and promoting inclusive development. This scoping review analyzes this policy’s implementation as a social determinant of health, mapping the literature on the gap between its legislative promise and its real-world impact. Methods: A scoping review was conducted following PRISMA-ScR guidelines across six electronic databases, selecting peer-reviewed articles (2016–2025) that analyzed the regulatory, socioeconomic, and healthcare factors acting as structural determinants in Colombia. Results: From 122 initial records, 10 studies were included. The analysis reveals a systemic paradox: the policy’s implementation created structural barriers that undermine its equity goals. Findings highlight three gaps: (1) Inequitable Access: High costs and lack of medical knowledge create socioeconomic, rather than clinical, barriers for patients. (2) Socioeconomic Marginalization: The market model favors corporate capture, systematically excluding small-scale rural producers. (3) Policy-Driven Inequity: The regulatory framework’s complexity reinforces these inequities. Conclusions: Colombia’s medical cannabis policy implementation functions as a social determinant that produces health inequity. To align with public health objectives, policy reform must dismantle these identified structural barriers. Full article

Background/Objectives: Hyposalivation is a prevalent yet underrecognized factor contributing to oral health deterioration, often influenced by systemic disease, medication use, and recreational drug exposure. With rising use of mental health and cardiovascular medications, as well as increasing marijuana use among younger populations, there is a need to assess real-world data on xerostomia and hyposalivation prevalence and associated risk factors. This study aimed to evaluate the prevalence of hyposalivation and xerostomia, and its etiological associations among adult patients at the University of Nevada, Las Vegas (UNLV) School of Dental Medicine Clinics. Methods: A retrospective cohort study was conducted using electronic health record (EHR) data from 1600 randomly selected patients aged 30 years and older, treated between 1 January 2014, and 31 May 2023. Data on demographics, medical and social history, medication use, and oral health status were extracted. Hyposalivation was identified via chart review, and multivariate logistic regression was used to analyze associated risk factors. Results: Hyposalivation and xerostomia were identified in 705 patients (44.06%). Marijuana use was the strongest independent predictor across all age groups (RR = 3.10, p < 0.05). Among patients aged 30–35, use of antihypertensive (OR = 3.05, p < 0.05) and mental health medications (OR = 1.81, p < 0.05) were significantly associated with hyposalivation. A strong correlation was also found between hyposalivation and elevated caries risk (χ² = 205.99, p < 0.001). Conclusions: Hyposalivation and xerostomia are increasingly observed in younger adults, linked to pharmacological and behavioral factors. Full article

Study objective: Electronic vapor product (EVP) use remains prevalent among adolescents in the United States. EVP use may be associated with high-risk substance use behaviors. This study investigates the association between current EVP use and current opioid misuse in high school students. Methods: We conducted a secondary analysis of the 2021 Youth Risk Behavior Survey (YRBS) (n = 7471). We first examined the prevalence rates of current prescription opioid misuse between participants ages 14 to 19 who reported any EVP use compared to those who did not report any EVP use. We conducted an adjusted Poisson regression analysis to determine whether EVP use was associated with prescription opioid misuse after controlling for multiple variables, including age, biological sex, race, ethnicity, alcohol use, other tobacco use, marijuana use, and depressive symptoms. Results: Among participants, 17.2% (95% confidence interval (CI): 15.4–19.1%) reported current EVP use. The prevalence of current opioid misuse was higher in the group of students who use EVPs (13.3%) as compared to students who do not use EVPs (3.2%) (p < 0.0001). Compared to participants who did not use EVPs, those with EVP use had an 80% greater prevalence of opioid misuse, after adjusting in regression analyses (adjusted prevalence rate ratio: 1.8, 95% CI: 1.4–2.3, p < 0.0001). Conclusions: Our findings highlight the significantly increased prevalence of opioid misuse among this population and the need to educate adolescents about the additional risks associated with nicotine and EVP use. Longitudinal studies are needed to test causal relationships and better understand the biobehavioral mechanisms that connect EVP use and opioid misuse. Full article

Adverse childhood experiences (ACEs) are recognized risk factors for later substance use. Yet, data remain scarce—particularly regarding the differentiated effects of specific types of ACEs and their distinct associations with various psychoactive substances. The current study is one of the first in Lithuania to explore the associations between specific ACEs and psychoactive substance use in young adulthood (ages 18–29). This cross-sectional study included a total of 709 participants who completed an online survey. ACEs were measured using a combination of adapted ACEs items and the MACE questionnaire. Substance use was assessed using self-reported instruments: CUDIT-R (cannabis), AUDIT (alcohol), ASSIST (heavy psychoactive substances), and nicotine use. Structural equation modeling (SEM) was chosen to examine predictive relationships. Results revealed that experiences of sexual abuse and physical maltreatment in childhood predicted higher levels of alcohol use in young adulthood. Sexual abuse was positively associated with nicotine, cannabis, and heavy psychoactive substance use, while witnessing interpersonal violence was only associated with higher nicotine use. However, verbal abuse showed significant negative associations across several substance categories. No significant associations were found between family addiction history and substance use. The absence of an important relationship between family history of addiction and substance use indicates that genetic factors may be less decisive than environmental or psychosocial conditions. The main findings of this study are that ACEs are not qualitatively equivalent to one another, so it is worth examining them separately, rather than summing them. Furthermore, based on the negative associations with verbal abuse and the generally statistically negative associations, we can assume that ACEs may not be the most important factors increasing substance use. Further studies should look for other factors that influence substance use. Full article

Introduction: The global use of medical cannabis is steadily increasing. In Poland, medical cannabis was legalised in 2017; however, its use remains limited and not widely integrated into clinical practice. This study aimed to explore the attitudes, concerns, and beliefs of pharmacists and pharmacy students regarding the medical use of cannabis. Methods: A study was conducted in 2021 among 422 pharmacists and pharmacy students in Poland, primarily working in community pharmacies. Data were collected using a custom-designed questionnaire addressing beliefs, concerns, and professional experiences related to medical cannabis. Results: Nearly half of the respondents (48.9%) believe that cannabis should be used exclusively for medical purposes, while 47.6% support its use for both medical and recreational purposes following legalisation. A substantial majority (over 90%) consider cannabis effective for treating adults, with nearly 70% acknowledging its potential for treating children. Over 66% of respondents feel comfortable discussing medical cannabis with patients; however, fewer are confident in providing detailed advice about its use. The findings also highlight concerns about the long-term effects and potential legal implications of dispensing medical cannabis. Conclusions: Pharmacists and pharmacy students in Poland demonstrate openness to the medical use of cannabis and recognise its therapeutic potential. However, to enhance their ability to advise patients effectively, targeted educational initiatives are needed. These should focus on the clinical applications, safety, and long-term effects of cannabis, alongside strategies for addressing patient concerns and ensuring responsible usage. 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