The impact of education on attitudes toward medical cannabis

Abstract The intrinsic signatures of Cannabis species to bioaccumulate non-essential harmful heavy metals (HMs) are substantially determined by their high tolerance, weedy propensities, phenotypic plasticity attributes, and pedoclimatic stress adaptation in an ecological niche. The detection trends of HMs contaminants in cannabis products have reshaped the 2027 forecast and beyond for global cannabis trade valued at $57 billion. Consumer base awareness for the cohort of HMs contaminants viz., lead (Pb), mercury (Hg), arsenic (As), chromium (Cr), cadmium (Cd), and radioactive elements, and the associative dissuading effects significantly impact cannabis bioeconomy. On the premise that fiber hemp (Cannabis sativa L.) could be repurposed to diverse non-consumable products, concerns over HMs contamination would not significantly decrease fiber trade, a trend that could impact globally by 2025. The economic trend will depend on acceptable consumer risk, regulatory instruments, and grower's due diligence to implement agronomic best practices to mitigate HMs contamination in marketable cannabis-related products. In this unstructured meta-analysis study based on published literature, the application of Cannabis species in HMs phytoremediation, new insights into transportation, distribution, homeostasis of HMs, the impact of HMs on medical cannabis, and cannabis bioeconomic are discussed. Furthermore, a blueprint of agronomic strategies to alleviate HMs uptake by plant is proposed. Considering that one-third of the global arable lands are contaminated with HMs, revamping global production of domesticated cannabis requires a rethinking of agronomic best practices and post-harvest technologies to remove HMs contaminants.

Download Full-text

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

10.21203/rs.3.rs-15703/v4 ◽

2020 ◽

Author(s):

Philippa Helen Hawley ◽

Monica Gobbo ◽

Narsis Afghari

Keyword(s):

Cancer Patients ◽

Cannabis Use ◽

P Value ◽

Medical Cannabis ◽

Eligibility Criteria ◽

Cross Sectional ◽

Access System ◽

Patterns Of Use ◽

Barriers To Access ◽

The Impact

Abstract Background Canada legalized cannabis use for medical purposes in 1999. Legalization of cannabis for recreational purposes in October 2018 offered the opportunity to assess the impact of recreational legalization on cancer patients’ patterns of use to identify learning points that could be helpful to other countries considering similar legislation.Method Two identical anonymous cross-sectional surveys were administered to cancer patients in British Columbia (2 months before and 3 months following legalization), with the same eligibility criteria. The prevalence of medical cannabis use, the distribution of symptoms leading to use, the most common types of cannabis products and sources, reasons for stopping using cannabis, and barriers to access were assessed.Results The overall response rate was 27%. Both cohorts were similar regarding age (median= 66yrs), gender (53% female), and education (approximately 85% of participants had an education level of high school graduation and higher). Respondents had multiple motives for taking cannabis, including to manage multiple symptoms, to treat cancer, and for recreational reasons. The majority of patients in both surveys did not use the legal medical access system. Comparison of the two cohorts showed that after legalization the prevalence of current cannabis use increased by 26% (23·1% to 29·1%, p-value 0·01), including an increased disclosure of recreational motive for use, from 32% to 40%. However, in the post-legalization cohort more Current Users reported problems getting cannabis (18%) than the pre-legalization cohort (8%), (p-value <0·01). The most common barrier cited was lack of available preferred products, including edibles, as these were only available from illegal dispensaries. Conclusions Results showed that legalization of cannabis for recreational purposes may have an impact on those who use medical cannabis. Impacts include an increase in prevalence of use; problems accessing preferred products legally; higher cost, and difficulties using a legal access system. The desired goal of regulation in reducing harms from use of illegal cannabis products are unlikely to be achieved if the legal process is less attractive to patients than use of illegal sources.

Download Full-text

The Impact of Medical Cannabis on Intermittent and Chronic Opioid Users with Back Pain: How Cannabis Diminished Prescription Opioid Usage

Cannabis and Cannabinoid Research ◽

10.1089/can.2019.0039 ◽

2020 ◽

Vol 5 (3) ◽

pp. 263-270 ◽

Cited By ~ 1

Author(s):

Kevin M. Takakuwa ◽

Jeffrey Y. Hergenrather ◽

Frances S. Shofer ◽

Raquel M. Schears

Keyword(s):

Back Pain ◽

Prescription Opioid ◽

Medical Cannabis ◽

Opioid Users ◽

The Impact

Download Full-text

No pain, all gain? Interim analyses from a longitudinal, observational study examining the impact of medical cannabis treatment on chronic pain and related symptoms.

Experimental and Clinical Psychopharmacology ◽

10.1037/pha0000435 ◽

2021 ◽

Author(s):

Staci A. Gruber ◽

Rosemary T. Smith ◽

M. Kathryn Dahlgren ◽

Ashley M. Lambros ◽

Kelly A. Sagar

Keyword(s):

Chronic Pain ◽

Observational Study ◽

Medical Cannabis ◽

Interim Analyses ◽

Longitudinal Observational Study ◽

The Impact

Download Full-text

Cannabis, Impaired Driving, and Road Safety: An Overview of Key Questions and Issues

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.641549 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bruna Brands ◽

Patricia Di Ciano ◽

Robert E. Mann

Keyword(s):

Road Safety ◽

Relevant Literature ◽

Cannabis Use ◽

Central Question ◽

Medical Cannabis ◽

The Road ◽

Routes Of Administration ◽

Key Issues ◽

The Impact ◽

Key Questions

The road safety impact of cannabis has been a topic of much discussion and debate over the years. These discussions have been revitalized in recent years by initiatives in several jurisdictions to legalize non-medical cannabis. Canada became the second country to legalize non-medical cannabis use in October, 2018, preceded by Uruguay in December 2013. Road safety concerns were key issues in the Canadian government's deliberations on the issue. In this paper, we identify several key questions related to the impact of cannabis on road safety, and provide a consideration of the relevant literature on these questions. These questions cover several perspectives. From an epidemiological perspective, perhaps the central question is whether cannabis use contributes to the chances of being involved in a collision. The answer to this question has evolved in recent years as the ability to conduct the relevant studies has evolved. A related question is the extent to which cannabis plays an important role in road safety, and recent research has made progress in estimating the collisions, injuries, and deaths that may be attributed to cannabis use. Several questions relate to the behavioral and pharmacological effects of cannabis. One central question is whether cannabis affects driving skills in ways that can increase the chances of being involved in a collision. Another important question is whether the effects of the drug on the driving behavior of medical users is similar to, or different from, the effects on non-medical users and whether there are sex differences in the pharmacological and behavioral effects of cannabis. Other important questions are the impact of tolerance to the effects of cannabis on road safety as well as different routes of administration (e.g., edibles, vaped). It remains unclear if there is a dose-response relationship of cannabis to changes in driving. These and other key questions and issues are identified and discussed in this paper.

Download Full-text

Cannabis in the Emergency Department: The impact of cannabis legalization on cannabis and opioid-related presentations

Alberta Academic Review ◽

10.29173/aar93 ◽

2019 ◽

Vol 2 (3) ◽

pp. 6

Author(s):

Matthew Yeung ◽

Kevin Janz ◽

Colin Weaver ◽

Rebecca Saah-Haines ◽

Eddy Lang

Keyword(s):

Information Service ◽

State Level ◽

Interrupted Time Series ◽

The United States ◽

Poison Control ◽

Medical Cannabis ◽

Interrupted Time Series Analysis ◽

Developed Country ◽

Short Period ◽

The Impact

Background: On October 17th, 2018, non-medical cannabis became legal to adults for the first time in Canada. This has created a previously unseen opportunity to investigate the effects of recreational cannabis legalization in a developed country, particularly on strained Emergency Departments (EDs). Secondly, reports within the United States have suggested state-level legalization of cannabis, both recreationally and medically, has resulted in a decrease of opiate-related presentations. Given the pressure of the opiate crisis on healthcare resources, we sought to examine if this trend was present in Alberta. Objectives: The current study aims to identify if presentation patterns in adult and pediatric populations have changed when comparing pre- and post-legalization periods, and if rural-urban disparities exist. We also aim to identify if the legalization of cannabis is correlated with a reduction in opiate-related ED presentations. Lastly, we aimed to address the aforementioned objectives in the context of telehealth by examining calls to poison control and HealthLink within Alberta. Methods: Retrospective data was collected from the National Ambulatory Care Reporting System, HealthLink, and Poison and Drug Information Service. Extraction is currently in progress, and we expect to include 20 000 records and 12 000 calls. An interrupted time-series analysis will be completed, allowing for a comparison of trends pre- and post-legalization. Participants have been identified based on International Disease Classifications for cannabis and opiate-related injury. Commonly reported injuries will be clustered to identify changes in injury patterns. Data was collected from October 1st 2013 up to May 31st, 2019 for all EDs within Alberta. Results: Preliminary results suggest the legalization of cannabis initially led to a dramatic increase in ED presentations, followed by a return to pre-legalization volume. HealthLink data suggests a different trend, with steadily increasing calls in the months prior to legalization, followed by stabilization. Cannabis legalization is also correlated with a decrease in post-legalization opiate-related calls (r=-0.51, p=0.01). Conclusion: Overall, national legalization of cannabis appears to be responsible for a short period of increased ED usage, but does not appear to have long-lasting effects on healthcare resource utilization. Differences are apparent between telehealth service and ED use.

Download Full-text

Mandatory pharmacist-led education session for patients seeking medical cannabis

Pharmacy Practice ◽

10.18549/pharmpract.2020.4.2088 ◽

2020 ◽

Vol 18 (4) ◽

pp. 2088

Author(s):

Vikas Parihar ◽

Laura Katz ◽

Mahmoud A. Siyam ◽

Anna Rogers ◽

Lisa Patterson ◽

...

Keyword(s):

Chronic Pain ◽

Perceived Benefits ◽

Medical Cannabis ◽

Education Session ◽

Chi Square ◽

Mandatory Education ◽

Chronic Pain Patients ◽

The Future ◽

The Impact ◽

Pain Patients

Objective: The primary objectives of this pre-post session study, was to evaluate the impact of a pharmacist-led education session on the perceived benefits and safety of cannabis among patients with chronic pain, as well as determine the influence of pharmacist education on the selection of safer cannabis products and dosage forms for medical use among patients. Methods: A retrospective analysis of completed pre-post session questionnaires was conducted among chronic pain patients attending a mandatory education session led by a pharmacist, prior to being authorized cannabis in clinic. All questionnaire data was analyzed using SPSS v. 25. Demographic and sample characteristics were reviewed using univariate analyses. Chi-Square tests were employed to determine if the group-based education significantly affected knowledge, perception of efficacy and safety of cannabis. Results: Of the 260 session participants, 203 completed pre-post session questionnaires. After the session, a majority of current cannabis users (33.8%) and cannabis naïve/past users (56.9%) reported they would use a low THC product in the future, and a majority of current users (54.5%) would use a high CBD product in the future. After education, participants were more likely to report cannabis as having the potential for addiction (chi-square =42.6, p <0.0001) and harm (chi-square =34.0, p <0.0001). Conclusions: Pharmacist counselling and education has the potential to influence patient selection and use of cannabis, from more harmful to safer products, as well as moderate the potential perceived benefits of use.

Download Full-text

Mental Health and Cognition in Older Cannabis Users: a Review

Canadian Geriatrics Journal ◽

10.5770/cgj.23.399 ◽

2020 ◽

Vol 23 (3) ◽

pp. 237-244

Author(s):

Blanca E. Vacaflor ◽

Olivier Beauchet ◽

G. Eric Jarvis ◽

Alessandra Schiavetto ◽

Soham Rej

Keyword(s):

Mental Health ◽

Older Adults ◽

Adverse Effects ◽

Low Dose ◽

Community Dwelling ◽

Cannabis Use ◽

Cognitive Effects ◽

Medical Cannabis ◽

Short Term ◽

The Impact

Background The impact of cannabis use on mental health and cognition in older adults remains unclear. With the recent legalization of cannabis in Canada, physicians will need up-to-date information about the mental and cognitive effects of cannabis use in this specific population. Method A narrative review was conducted to summarize the literature on mental health and cognitive effects of cannabis use in older adults using Medline (OvidSP). Results A total of 16 studies were identified, including nine cross-sectional studies on mental health comorbidities reported by older cannabis users. The self-reported prevalence of mental and substance use disorders is approximately two to three times higher in older adults who report past-year cannabis use, compared to older adults who report using more than one year ago or never using. The remaining seven clinical trials found that short-term, low-dose medical cannabis was generally well-tolerated in older adults without prior serious mental illness. However, mental/cognitive adverse effects were not systematically assessed. Conclusion Although preliminary findings suggests that low-dose, short-term medical cannabis does not carry significant risk of serious mental health and cognitive adverse effects in older adults without prior psychiatric history, epidemiological studies find a correlation between past-year cannabis use and poor mental health outcomes in community-dwelling older adults. These findings may indicate that longer term cannabis use in this population is detrimental to their mental health, although a direct causal link has not been established. Larger, longitudinal studies on the safety of medical cannabis in older adults are needed.

Download Full-text

Cohort study of medical cannabis authorization and motor vehicle crash-related healthcare visits in 2014–2017 in Ontario, Canada

Injury Epidemiology ◽

10.1186/s40621-021-00321-1 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Cerina Lee ◽

Don Voaklander ◽

Jasjeet K. Minhas-Sandhu ◽

John G. Hanlon ◽

Elaine Hyshka ◽

...

Keyword(s):

Public Health ◽

Emergency Department ◽

Motor Vehicle ◽

Emergency Department Visits ◽

Motor Vehicle Crash ◽

Cannabis Use ◽

Medical Cannabis ◽

The Impact

Abstract Background With increasing numbers of countries/jurisdictions legalizing cannabis, cannabis impaired driving has become a serious public health concern. Despite substantive research linking cannabis use with higher rates of motor vehicle crashes (MVC), there is an absence of conclusive evidence linking MVC risk with medical cannabis use. In fact, there is no clear understanding of the impact of medical cannabis use on short- and long-term motor vehicle-related healthcare visits. This study assesses the impact of medical cannabis authorization on motor vehicle-related health utilization visits (hospitalizations, ambulatory care, emergency department visits, etc) between 2014 and 2017 in Ontario, Canada. Methods A matched cohort study was conducted on patients authorized to use medical cannabis and controls who did not receive authorization for medical cannabis – in Ontario, Canada. Overall, 29,153 adult patients were identified and subsequently linked to the administrative databases of the Ontario Ministry of Health, providing up to at least 6 months of longitudinal follow-up data following the initial medical cannabis consultation. Interrupted time series analyses was conducted to evaluate the change in rates of healthcare utilization as a result of MVC 6 months before and 6 months after medical cannabis authorization. Results Over the 6-month follow-up period, MVC-related visits in medical cannabis patients were 0.50 visits/10000 patients (p = 0.61) and − 0.31 visits/10000 patients (p = 0.64) for MVC-related visits in controls. Overall, authorization for medical cannabis was associated with an immediate decrease in MVC-related visits of − 2.42 visits/10000 patients (p = 0.014) followed by a statistically significant increased rate of MVC-related visits (+ 0.89 events/10,000 in those authorized medical cannabis) relative to controls in the period following their authorization(p = 0.0019). Overall, after accounting for both the immediate and trend effects, authorization for medical cannabis was associated with an increase of 2.92 events/10,000 (95%CI 0.64 to 5.19) over the entire follow-up period. This effect was largely driven by MVC-related emergency department visits (+ 0.80 events/10,000, p < 0.001). Conclusions Overall, there was an association between medical cannabis authorization and healthcare utilization, at the population level, in Ontario, Canada. These findings have public health importance and patients and clinicians should be fully educated on the potential risks. Continued follow-up of medically authorized cannabis patients is warranted to fully comprehend long-term impact on motor vehicle crash risk.

Download Full-text

Impact of Harvest Time and Pruning Technique on Total CBD Concentration and Yield of Medicinal Cannabis

Plants ◽

10.3390/plants11010140 ◽

2022 ◽

Vol 11 (1) ◽

pp. 140

Author(s):

Danilo Crispim Massuela ◽

Jens Hartung ◽

Sebastian Munz ◽

Federico Erpenbach ◽

Simone Graeff-Hönninger

Keyword(s):

Plant Biomass ◽

Biomass Accumulation ◽

Dry Weight ◽

Control Group ◽

Harvest Time ◽

Medical Cannabis ◽

Medicinal Cannabis ◽

Definition Of ◽

And Control ◽

The Impact

The definition of optimum harvest and pruning interventions are important factors varying inflorescence yield and cannabinoid composition. This study investigated the impact of (i) harvest time (HT) and (ii) pruning techniques (PT) on plant biomass accumulation, CBD and CBDA-concentrations and total CBD yield of a chemotype III medical cannabis genotype under indoor cultivation. The experiment consisted of four HTs between 5 and 11 weeks of flowering and three PTs-apical cut (T); removal of side shoots (L) and control (C), not pruned plants. Results showed that inflorescence dry weight increased continuously, while the total CBD concentration did not differ significantly over time. For the studied genotype, optimum harvest time defined by highest total CBD yield was found at 9 weeks of flowering. Total CBD-concentration of inflorescences in different fractions of the plant’s height was significantly higher in the top (9.9%) in comparison with mid (8.2%) and low (7.7%) fractions. The T plants produced significantly higher dry weight of inflorescences and leaves than L and C. Total CBD yield of inflorescences for PTs were significantly different among pruned groups, but do not differ from the control group. However, a trend for higher yields was observed (T > C > L).

Download Full-text