Abstract 1122‐000209: Cannabis and Cerebrovascular Outcomes: A National Registry Analysis

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Amol Mehta ◽  
Neha Siddiqui ◽  
Johanna T Fifi ◽  
Reade DeLeacy
Keyword(s):  
Legal Status ◽  
The United States ◽  
National Registry ◽  
Cannabis Use ◽  
Cannabis Use Disorder ◽  
Medical Cannabis ◽  
Perioperative Morbidity ◽  
Discharge Disposition ◽  
Significant Difference ◽  
Hospitalization Costs

Introduction : Recreational and medical cannabis use in the United States has been increasing in recent years in light of state and federal efforts to decriminalize and legalize its use. Its legal status has long precluded extensive research into its adverse effects, especially as it pertains to the realm of vascular and cerebrovascular outcomes. To date, minimal research has been completed on the sequelae of cannabis in inpatient admissions for stroke. Methods : A query of the 2012–2015 Nationwide Inpatient Sample searched for patients admitted with stroke ICD‐9 diagnoses. These patients were then grouped by the presence of concurrent diagnosis of cannabis use disorder, and compared with respect to various peri‐ and postoperative complications, all‐cause mortality, discharge disposition, length of stay, and hospitalization costs. Propensity score matching was utilized to control for potential baseline confounders. Results : A total of 414,340 patients met inclusion/exclusion criteria, 6794 (1.64%) of whom had cannabis use disorder. After controlling for baseline characteristics, these patients had higher rates of inpatient mortality (odds ratio [OR] 1.43; p = 0.01263), and non‐routine discharge, as well as increased lengths of stay (6.5 vs 5.7 days, p<0.001) and no significant difference in hospitalization charges ($67507 vs. $ 63328 10, p = 0.3918). Conclusions : Based on a national trends analysis, chronic cannabis use appears to be associated with increased perioperative morbidity and mortality among patients admitted for stroke diagnoses. Physicians should ensure affected patients be adequately informed of associated risks. Further research should include matching of risk factors not captured in databases.

scholarly journals Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries

2020 ◽  
Vol 132 (4) ◽  
pp. 625-635 ◽  
Author(s):  
Akash Goel ◽  
Brandon McGuinness ◽  
Naheed K. Jivraj ◽  
Duminda N. Wijeysundera ◽  
Murray A. Mittleman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Odds Ratio ◽  
Composite Endpoint ◽  
The United States ◽  
Cannabis Use ◽  
Perioperative Outcomes ◽  
Cannabis Use Disorder ◽  
Unadjusted Odds Ratio ◽  
Postoperative Myocardial Infarction ◽  
Significant Difference

Abstract Background Although cannabis is known to have cardiovascular and psychoactive effects, the implications of its use before surgery are currently unknown. The objective of the present study was to determine whether patients with an active cannabis use disorder have an elevated risk of postoperative complications. Methods The authors conducted a retrospective population-based cohort study of patients undergoing elective surgery in the United States using the Nationwide Inpatient Sample from 2006 to 2015. A sample of 4,186,622 inpatients 18 to 65 yr of age presenting for 1 of 11 elective surgeries including total knee replacement, total hip replacement, coronary artery bypass graft, caesarian section, cholecystectomy, colectomy, hysterectomy, breast surgery, hernia repair, laminectomy, and other spine surgeries was selected. The principal exposure was an active cannabis use disorder, as defined by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) diagnostic codes for cannabis dependence and cannabis abuse. The primary outcome was a composite endpoint of in-hospital postoperative myocardial infarction, stroke, sepsis, deep vein thrombosis, pulmonary embolus, acute kidney injury requiring dialysis, respiratory failure, and in-hospital mortality. Secondary outcomes included hospital length of stay, total hospital costs, and the individual components of the composite endpoint. Results The propensity-score matched-pairs cohort consisted of 27,206 patients. There was no statistically significant difference between patients with (400 of 13,603; 2.9%) and without (415 of 13,603; 3.1%) a reported active cannabis use disorder with regard to the composite perioperative outcome (unadjusted odds ratio = 1.29; 95% CI, 1.17 to 1.42; P &lt; 0.001; Adjusted odds ratio = 0.97; 95% CI, 0.84 to 1.11; P = 0.63). However, the adjusted odds of postoperative myocardial infarction was 1.88 (95% CI, 1.31 to 2.69; P &lt; 0.001) times higher for patients with a reported active cannabis use disorder (89 of 13,603; 0.7%) compared with those without (46 of 13,603; 0.3%) an active cannabis use disorder (unadjusted odds ratio = 2.88; 95% CI, 2.34 to 3.55; P &lt; 0.001). Conclusions An active cannabis use disorder is associated with an increased perioperative risk of myocardial infarction. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Time since first cannabis use and 12‐month prevalence of cannabis use disorder among youth and emerging adults in the United States

Addiction ◽  
2018 ◽  
Vol 114 (4) ◽  
pp. 698-707 ◽  
Author(s):  
Beth Han ◽  
Wilson M. Compton ◽  
Carlos Blanco ◽  
Christopher M. Jones
Keyword(s):  
United States ◽  
Emerging Adults ◽  
The United States ◽  
Cannabis Use ◽  
Cannabis Use Disorder

scholarly journals The Prevalence of Vaping and Smoking as Modes of Delivery for Nicotine and Cannabis among Youth in Canada, England and the United States

2019 ◽  
Vol 16 (21) ◽  
pp. 4111 ◽  
Author(s):  
Fathima Fataar ◽  
David Hammond
Keyword(s):  
Regression Models ◽  
Online Survey ◽  
The United States ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Logistic Regression Models ◽  
Canadian Youth ◽  
Patterns Of Use ◽  
Country Differences ◽  
The U.S

Background: Vaping has become an increasingly common mode of administration for both nicotine and cannabis, with overlap among users, devices, as well as nicotine and cannabis companies. There is a need to understand patterns of use among youth, including the way nicotine and cannabis are administered. Methods: Data are from Wave 2 of the ITC Youth Tobacco and Vaping survey, an online survey conducted in 2018 among 16–19 year-olds recruited from commercial panels in Canada (n = 3757), England (n = 3819), and the U.S. (n = 3961). The prevalence of past 30-day vaping nicotine, non-nicotine and cannabis substances, as well as cannabis modes of use was examined. Logistic regression models examined between country differences in prevalence. Results: Past 30-day cannabis use was highest among Canadian youth (16.6%), followed by youth in the U.S. (13.8%) and England (9.0%). Vaping e-cigarettes was substantially more prevalent than vaping cannabis in all three countries. All forms of cannabis use were higher among Canadian and U.S. youth compared to England (p < 0.001 for all). Past 30-day cannabis users in the U.S. were more likely to report vaping cannabis oil (30.1%), and consuming solid concentrates such as wax and shatter (30.2%), compared to cannabis users in Canada (18.6% and 22.9%) and England (14.3% and 11.0%; p < 0.001 for all). Conclusions: Youth are administering cannabis and nicotine using a wide diversity of modes. Cannabis users in the U.S.—where an increasing number of states have legalized medical and non-medical cannabis—reported notably higher use of more potent cannabis products, including cannabis oils and extracts.

scholarly journals Cannabis use disorder and male sex predict medical cannabis card status in a sample of high risk adolescents

2018 ◽  
Vol 183 ◽  
pp. 25-33 ◽  
Author(s):  
Janet Kim ◽  
Marilyn E. Coors ◽  
Susan E. Young ◽  
Kristen M. Raymond ◽  
Christian J. Hopfer ◽  
...  
Keyword(s):  
High Risk ◽  
Cannabis Use ◽  
Cannabis Use Disorder ◽  
Medical Cannabis ◽  
Male Sex

scholarly journals Trends in cannabis use disorder by cigarette smoking status in the United States, 2002–2016

2018 ◽  
Vol 191 ◽  
pp. 45-51 ◽  
Author(s):  
Andrea H. Weinberger ◽  
Lauren R. Pacek ◽  
Melanie M. Wall ◽  
Michael J. Zvolensky ◽  
Jan Copeland ◽  
...  
Keyword(s):  
United States ◽  
Cigarette Smoking ◽  
Smoking Status ◽  
The United States ◽  
Cannabis Use ◽  
Cannabis Use Disorder

scholarly journals Genome-wide association study implicates CHRNA2 in cannabis use disorder

2017 ◽  
Author(s):  
Ditte Demontis ◽  
Veera Manikandan Rajagopal ◽  
Thomas D. Als ◽  
Jakob Grove ◽  
Jonatan Pallesen ◽  
...  
Keyword(s):  
Association Study ◽  
Genome Wide Association Study ◽  
Significant Risk ◽  
The United States ◽  
Cannabis Use ◽  
Genome Wide Association ◽  
Cannabis Use Disorder ◽  
Genome Wide ◽  
Independent Population ◽  
A Genome

Introductory paragraphCannabis is the most frequently used illicit psychoactive substance worldwide1. Life time use has been reported among 35-40% of adults in Denmark2 and the United States3. Cannabis use is increasing in the population4–6 and among users around 9% become dependent7. The genetic risk component is high with heritability estimates of 518–70%9. Here we report the first genome-wide significant risk locus for cannabis use disorder (CUD, P=9.31×10−12) that replicates in an independent population (Preplication=3.27×10−3, Pmetaanalysis=9.09×10−12). The finding is based on a genome-wide association study (GWAS) of 2,387 cases and 48,985 controls followed by replication in 5,501 cases and 301,041 controls. The index SNP (rs56372821) is a strong eQTL for CHRNA2 and analyses of the genetic regulated gene expressions identified significant association of CHRNA2 expression in cerebellum with CUD. This indicates a potential therapeutic use in CUD of compounds with agonistic effect on the neuronal acetylcholine receptor alpha-2 subunit encoded by CHRNA2. At the polygenic level analyses revealed a significant decrease in the risk of CUD with increased load of variants associated with cognitive performance.

scholarly journals CANreduce 2.0 – the effects of adherence-focused guidance for Internet self-help among cannabis misusers: results of a three-arm randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Christian Baumgartner ◽  
Michael Patrick Schaub ◽  
Andreas Wenger ◽  
Doris Malischnig ◽  
Mareike Augsburger ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Anxiety Symptoms ◽  
Cannabis Use ◽  
Cannabis Use Disorder ◽  
General Anxiety ◽  
Cannabis Dependence ◽  
Randomized Controlled ◽  
Self Help ◽  
Significant Difference

BACKGROUND Despite increasing demand for treatment among cannabis misusers in many countries, most misusers are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low-effectiveness and adherence issues often arise. Through adherence-focused guidance enhancement (AFGE), we aimed to increase adherence to, and the effectiveness of Internet-based self-help among cannabis misusers. OBJECTIVE A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an AFGE Internet-based self-help intervention with social presence (AFGE-SP), (2) a similar intervention with an impersonal service team (AFGE-ST), and (3) Internet access as usual (IAU, controls). METHODS From July 2016—May 2019, 575 cannabis misusers (70.6% males, mean age=28.3) not otherwise in treatment were recruited from the general population. The primary outcome was cannabis-use days over the preceding 30 days. Secondary outcomes included cannabis-dependence severity, changes in cannabis misuse disorder (CMD) symptoms, and intervention adherence. RESULTS All groups exhibited reduced cannabis-use days after 3 months (AFGE-SP: -8.2; AFGE-ST: -9.8; IAU: -4.2). AFGE-ST participants reported significantly fewer cannabis-use days than IAU controls (P = .01, d = .60); a similar reduction in the AFGE-SP (d=.40) group failed to achieve significance (P =.07). There was no significant difference between the two intervention groups. AFGE-ST patients also exhibited superior improvements in cannabis-use disorder, cannabis-dependence severity, and general anxiety symptoms after three months. CONCLUSIONS Adding an impersonal service team to the AFGE Internet-based self-help intervention significantly reduced cannabis use, cannabis use disorder, dependence severity, and general anxiety symptoms. CLINICALTRIAL http://www.isrctn.com/ISRCTN11086185

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