Impact of cannabis knowledge and attitudes on real-world practice

Unveiling the Complexities of Medications, Substance Abuse, and Plants for Recreational and Narcotic Purposes: An In-Depth Analysis

The complexities surrounding the use of medications, substance abuse, and the recreational use of plants are multifaceted and warrant a comprehensive examination. This review highlights the complexities surrounding the consumption of chemical substances in excess or for non-medical purposes, obtained through legal prescriptions, over-the-counter purchases, or illicit means, with an emphasis on the predictive role of stressors and individual-level variables in the development of substance use disorders, as well as the influence of the regulatory environment on patterns of consumption. Additionally, the alarming escalation in the mortality rate associated with illicit drug and opioid overdoses is also underscored. The recreational use of prescription medications can lead to significant health risks, particularly when combined with other substances; therefore, the need for interventions and preventive measures to address substance abuse among various populations is imperative. Furthermore, novel insights on substance abuse addiction, exploring the neurobiological mechanisms underlying addiction, and discussing treatment approaches and interventions are elucidated. Advancements in technology for detecting substance abuse are also highlighted, displaying innovative tools for more effective identification and monitoring. In conclusion, the complexities of medications, substance abuse, and the recreational use of plants reveal a landscape marked by overlapping motivations and health implications. The distinction between medical and recreational use is critical for understanding user behavior and addressing public health concerns.

IgE-Mediated Allergy and Asymptomatic Sensitization to Cannabis Allergens-Review of Current Knowledge and Presentation of Six Cases

Cannabis allergy is a relatively new phenomenon described in the 1970s. Its increased frequency has been observed over the last years due to the increasing therapeutic and recreational use of cannabis-based products. Sensitization possibly leading to allergy symptoms can occur not only through the smoking of cannabis, but also through ingestion, the inhalation of pollen, or direct contact. The severity of symptoms varies from benign pruritus to anaphylaxis. There is scant information available to support clinicians throughout the entire therapeutic process, starting from diagnosis and ending in treatment. In this review, we present six cases of patients in whom molecular in vitro testing revealed sensitization to cannabis extract and/or cannabis-derived nsLTP molecules (Can s 3). Based on these cases, we raise important questions regarding this topic. The article discusses current proposals and highlights the importance of further research not only on cannabis allergy but also on asymptomatic sensitization to cannabis allergens, which may be ascertained in some percentage of the population.

Therapeutic cannabis use by patients with cancer in Canada: A national survey of the experiences, opinions and information needs of Radiation Therapists

PURPOSE

To understand the experiences, opinions and information needs of Canadian Radiation Therapists when caring for cancer patients who are taking cannabis for therapeutic purposes (CTP).

METHODS

The study employed prospective data collection, via a single cross-sectional web-based questionnaire. After REB approval, the questionnaire was distributed electronically to all Radiation Therapists across Canada. The questionnaire was open for a one month accrual, with reminders sent at two and four weeks. The raw data was aggregated using standard descriptive statistics. The response differences between naturally occurring demographic cohorts was determined using inferential statistics.

RESULTS

Two hundred and eighty two Therapists completed the questionnaire (25.6%), of which 19.1% reported being approached by patients to talk about cannabis more than once per month and 4.4% reported initiating a conversation with patients about cannabis. There were no differences between the provinces or catchment areas regarding how common or socially acceptable cannabis use by patients was. Confidence in discussing cannabis was strongly positively correlated with ratings of current knowledge (r² 0.77). Of the respondents, 99.9% believed that their radiation therapy training did not prepare them to support patients using cannabis.

CONCLUSIONS

The data revealed that patients more frequently seek out guidance for CTP than Therapists initiate those discussions. This lack of Therapist willingness to begin cannabis conversations was associated with the low levels of knowledge. Almost all Therapists recognized the limitations of their knowledge and expressed interest in receiving further information about cannabis. The findings of this study strongly advocate for the development of educational tools to meet Therapists clinical needs.

A review of cannabis allergy in the early days of legalization

Cannabis allergy is a burgeoning field; consequently, research is still in its infancy and allergists' knowledge surrounding this topic is limited. As cannabis legalization expands across the world, it is anticipated that there will be an increase in cannabis use. Thus, we hypothesize that a concomitant rise in the incidence of allergy to this plant can be expected. Initiatives aimed at properly educating health care professionals are therefore necessary. This review presents the most up-to-date information on a broad range of topics related to cannabis allergy. Although the clinical features of cannabis allergy are becoming more well described and recognized, the tools available to make a correct diagnosis are meager and often poorly accessible. In addition, research on cannabis allergy is still taking its first steps, and new and potentially groundbreaking findings in this field are expected to occur in the next few years. Finally, although therapeutic approaches are being developed, patient and physician education regarding cannabis allergy is certainly needed.

Immunomodulatory Actions of Cannabinoids: Clinical Correlates and Therapeutic Opportunities for Allergic Inflammation

Endogenously produced cannabinoids as well as phytocannabinoids broadly exhibit anti-inflammatory actions. Recent emergence of cannabis for multiple medical issues combined with reports on potent immunomodulatory actions of distinct components has underscored the therapeutic potential of cannabis. Although synthetic cannabinoids that are based on structural similarities to the existing class of cannabinoids have been on the rise, their application in therapeutics have been limited owing to toxicity concerns. Herein, we review the current literature that details the immunomodulatory actions of cannabinoids. Further, we highlight the complexities of cannabinoid biology and examine the potential inflammatory risks associated with the use of cannabis including potential for toxic interactions between distinct constituents of cannabis.

Establishing diagnostic strategies for cannabis allergy

INTRODUCTION

Cannabis is the most widely consumed illicit drug in the world and carries a risk of severe IgE-mediated allergic reactions, requiring appropriate diagnostic management. Currently available diagnostics are still relatively limited and require careful interpretation of results to avoid harmful over- and underdiagnosis.

AREAS COVERED

This review focuses on the most up-to-date understandings of cannabis allergy diagnosis, starting with the main clinical features of the disease and the allergenic characteristics of Cannabis sativa, and then providing insights into in vivo, in vitro, and ex vivo diagnostic tests.

EXPERT OPINION

At present, the diagnosis of IgE-mediated cannabis allergy is based on a three-step approach that starts with accurate history taking and ends with a confirmation of sensitization to the whole extract and, finally, molecular components. Although much has been discovered since its first description in 1971, the diagnosis of cannabis allergy still has many unmet needs. The lack of commercial standardized and validated extracts and in vitro assays makes a harmonized workup of cannabis allergy difficult. Furthermore, the epidemiological characteristics, and clinical implications of sensitization to different molecular components are not yet fully known. Future research will complete the picture and likely result in an individualized and standardized approach.